Client,Section,HospitalDescription,ChargeCode,Code,CPTModifier,CPTDescription,StandardChargeQuantity,NDCCode,ServiceType,Place,PayorName,BundleRange,BundleBasis,BundleRate,GrossChargeRate,ChargeRateType,PaymentRatePercent,PaymentRate,PayorLower,PayorMedian,PayorHigher,DeIdentifiedLower,DeIdentifiedHigher,FootnoteReference
unity,CDM,ROOM & NURSING,1210000,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,200.00",% of charge rate,95.00%,"1,140.00",,,,"1,140.00","1,200.00",0
unity,CDM,Um Esophagogastorduodeno,UM3250003,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,857.60",% of charge rate,95.00%,"1,764.72",,,,"1,764.72","1,857.60",0
unity,CDM,Um Esophagogastorduodeno,UM3250003,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,857.60",% of charge rate,95.00%,"1,764.72",,,,"1,764.72","1,857.60",0
unity,CDM,Um Surgery 4 Hours,UM3250004,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"6,500.00",% of charge rate,95.00%,"6,175.00",,,,"6,175.00","6,500.00",0
unity,CDM,Um Surgery 4 Hours,UM3250004,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"6,500.00",% of charge rate,95.00%,"6,175.00",,,,"6,175.00","6,500.00",0
unity,CDM,Um Surgery 3.5 Hours,UM3250005,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,800.00",% of charge rate,95.00%,"5,510.00",,,,"5,510.00","5,800.00",0
unity,CDM,Um Surgery 3.5 Hours,UM3250005,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,800.00",% of charge rate,95.00%,"5,510.00",,,,"5,510.00","5,800.00",0
unity,CDM,Um Surgery 2.5 Hours,UM3250006,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,500.00",% of charge rate,95.00%,"4,275.00",,,,"4,275.00","4,500.00",0
unity,CDM,Um Surgery 2.5 Hours,UM3250006,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,500.00",% of charge rate,95.00%,"4,275.00",,,,"4,275.00","4,500.00",0
unity,CDM,Um Cataract Surgery - Simple,UM3250007,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,415.01",% of charge rate,95.00%,"2,294.26",,,,"2,294.26","2,415.01",0
unity,CDM,Um Cataract Surgery - Simple,UM3250007,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,415.01",% of charge rate,95.00%,"2,294.26",,,,"2,294.26","2,415.01",0
unity,CDM,Um Surgery 3 Hours,UM3250008,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,200.00",% of charge rate,95.00%,"4,940.00",,,,"4,940.00","5,200.00",0
unity,CDM,Um Surgery 3 Hours,UM3250008,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,200.00",% of charge rate,95.00%,"4,940.00",,,,"4,940.00","5,200.00",0
unity,CDM,Um Surgery 1 Hour,UM3250009,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,500.00",% of charge rate,95.00%,"2,375.00",,,,"2,375.00","2,500.00",0
unity,CDM,Um Surgery 1 Hour,UM3250009,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,500.00",% of charge rate,95.00%,"2,375.00",,,,"2,375.00","2,500.00",0
unity,CDM,Um Surgery .5 Hour,UM3250010,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,900.00",% of charge rate,95.00%,"1,805.00",,,,"1,805.00","1,900.00",0
unity,CDM,Um Surgery .5 Hour,UM3250010,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,900.00",% of charge rate,95.00%,"1,805.00",,,,"1,805.00","1,900.00",0
unity,CDM,Um Surgery 1.5 Hr,UM3250011,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,200.00",% of charge rate,95.00%,"3,040.00",,,,"3,040.00","3,200.00",0
unity,CDM,Um Surgery 1.5 Hr,UM3250011,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,200.00",% of charge rate,95.00%,"3,040.00",,,,"3,040.00","3,200.00",0
unity,CDM,Um Colonscopy Flex/sig,UM3250012,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,508.04",% of charge rate,95.00%,"1,432.64",,,,"1,432.64","1,508.04",0
unity,CDM,Um Colonscopy Flex/sig,UM3250012,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,508.04",% of charge rate,95.00%,"1,432.64",,,,"1,432.64","1,508.04",0
unity,CDM,Um Surgery 2 Hours,UM3250013,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,900.00",% of charge rate,95.00%,"3,705.00",,,,"3,705.00","3,900.00",0
unity,CDM,Um Surgery 2 Hours,UM3250013,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,900.00",% of charge rate,95.00%,"3,705.00",,,,"3,705.00","3,900.00",0
unity,CDM,Um Ortho Surg.5 Hour,UM3250015,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,700.00",% of charge rate,95.00%,"2,565.00",,,,"2,565.00","2,700.00",0
unity,CDM,Um Ortho Surg.5 Hour,UM3250015,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,700.00",% of charge rate,95.00%,"2,565.00",,,,"2,565.00","2,700.00",0
unity,CDM,Um Surgicel 2x3in,UM325001505,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.99,% of charge rate,95.00%,62.69,,,,62.69,65.99,0
unity,CDM,Um Surgicel 2x3in,UM325001505,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.99,% of charge rate,95.00%,62.69,,,,62.69,65.99,0
unity,CDM,Um Surgicel 4x8in,UM325001513,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.63,% of charge rate,95.00%,116.5,,,,116.5,122.63,0
unity,CDM,Um Surgicel 4x8in,UM325001513,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.63,% of charge rate,95.00%,116.5,,,,116.5,122.63,0
unity,CDM,Um Ortho Surg 1 Hour,UM3250016,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,500.00",% of charge rate,95.00%,"4,275.00",,,,"4,275.00","4,500.00",0
unity,CDM,Um Ortho Surg 1 Hour,UM3250016,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,500.00",% of charge rate,95.00%,"4,275.00",,,,"4,275.00","4,500.00",0
unity,CDM,Um Ortho Surg 1.5 Hour,UM3250017,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,760.00",% of charge rate,95.00%,"5,472.00",,,,"5,472.00","5,760.00",0
unity,CDM,Um Ortho Surg 1.5 Hour,UM3250017,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,760.00",% of charge rate,95.00%,"5,472.00",,,,"5,472.00","5,760.00",0
unity,CDM,Um Ortho Surg 2 Hours,UM3250018,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"7,020.00",% of charge rate,95.00%,"6,669.00",,,,"6,669.00","7,020.00",0
unity,CDM,Um Ortho Surg 2 Hours,UM3250018,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"7,020.00",% of charge rate,95.00%,"6,669.00",,,,"6,669.00","7,020.00",0
unity,CDM,Um Ortho Surg 2 .5 Hour,UM3250019,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"8,100.00",% of charge rate,95.00%,"7,695.00",,,,"7,695.00","8,100.00",0
unity,CDM,Um Ortho Surg 2 .5 Hour,UM3250019,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"8,100.00",% of charge rate,95.00%,"7,695.00",,,,"7,695.00","8,100.00",0
unity,CDM,Um Ortho Surg 3 Hour,UM3250020,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,360.00",% of charge rate,95.00%,"8,892.00",,,,"8,892.00","9,360.00",0
unity,CDM,Um Ortho Surg 3 Hour,UM3250020,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,360.00",% of charge rate,95.00%,"8,892.00",,,,"8,892.00","9,360.00",0
unity,CDM,Um Ortho Surg 3.5 Hour,UM3250021,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"10,440.00",% of charge rate,95.00%,"9,918.00",,,,"9,918.00","10,440.00",0
unity,CDM,Um Ortho Surg 3.5 Hour,UM3250021,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"10,440.00",% of charge rate,95.00%,"9,918.00",,,,"9,918.00","10,440.00",0
unity,CDM,Um Ortho Surg 4 Hour,UM3250022,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"11,700.00",% of charge rate,95.00%,"11,115.00",,,,"11,115.00","11,700.00",0
unity,CDM,Um Ortho Surg 4 Hour,UM3250022,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"11,700.00",% of charge rate,95.00%,"11,115.00",,,,"11,115.00","11,700.00",0
unity,CDM,Um Cataract Surgery - Complex,UM3250023,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,000.00",% of charge rate,95.00%,"2,850.00",,,,"2,850.00","3,000.00",0
unity,CDM,Um Cataract Surgery - Complex,UM3250023,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,000.00",% of charge rate,95.00%,"2,850.00",,,,"2,850.00","3,000.00",0
unity,CDM,Um Par-recovery Rm 3 Hrs,UM3300001,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,686.17,% of charge rate,95.00%,651.86,,,,651.86,686.17,0
unity,CDM,Um Par-recovery Rm 3 Hrs,UM3300001,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,686.17,% of charge rate,95.00%,651.86,,,,651.86,686.17,0
unity,CDM,Um Par-recovery Rm 1 1/2 Hr,UM3300002,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,537.85,% of charge rate,95.00%,510.96,,,,510.96,537.85,0
unity,CDM,Um Par-recovery Rm 1 1/2 Hr,UM3300002,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,537.85,% of charge rate,95.00%,510.96,,,,510.96,537.85,0
unity,CDM,Um Par-recovery Rm 1 Hr,UM3300003,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,400.54,% of charge rate,95.00%,380.51,,,,380.51,400.54,0
unity,CDM,Um Par-recovery Rm 1 Hr,UM3300003,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,400.54,% of charge rate,95.00%,380.51,,,,380.51,400.54,0
unity,CDM,Um Recovery First 2 Hours,UM3300004,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,498.16,% of charge rate,95.00%,473.25,,,,473.25,498.16,0
unity,CDM,Um Recovery First 2 Hours,UM3300004,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,498.16,% of charge rate,95.00%,473.25,,,,473.25,498.16,0
unity,CDM,Um Par-recovery Room-40 Mins,UM3300005,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,337.2,% of charge rate,95.00%,320.34,,,,320.34,337.2,0
unity,CDM,Um Par-recovery Room-40 Mins,UM3300005,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,337.2,% of charge rate,95.00%,320.34,,,,320.34,337.2,0
unity,CDM,Um Par-recovery Rm 1/2 Hr,UM3300006,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,253.02,% of charge rate,95.00%,240.37,,,,240.37,253.02,0
unity,CDM,Um Par-recovery Rm 1/2 Hr,UM3300006,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,253.02,% of charge rate,95.00%,240.37,,,,240.37,253.02,0
unity,CDM,Um Par-recovery Rm 2.5 Hr,UM3300007,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,558.63,% of charge rate,95.00%,530.7,,,,530.7,558.63,0
unity,CDM,Um Par-recovery Rm 2.5 Hr,UM3300007,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,558.63,% of charge rate,95.00%,530.7,,,,530.7,558.63,0
unity,CDM,Um Par-recovery Rm 2 Hrs,UM3300008,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,677.36,% of charge rate,95.00%,643.49,,,,643.49,677.36,0
unity,CDM,Um Par-recovery Rm 2 Hrs,UM3300008,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,677.36,% of charge rate,95.00%,643.49,,,,643.49,677.36,0
unity,CDM,UM 1/2 HOUR (AFTER 3 HOUR),UM3300009,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.8,% of charge rate,95.00%,24.51,,,,24.51,25.8,0
unity,CDM,UM 1/2 HOUR (AFTER 3 HOUR),UM3300009,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.8,% of charge rate,95.00%,24.51,,,,24.51,25.8,0
unity,CDM,Um Par-recovery First 2 Hours,UM3350004,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,498.16,% of charge rate,95.00%,473.25,,,,473.25,498.16,0
unity,CDM,Um Par-recovery First 2 Hours,UM3350004,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,498.16,% of charge rate,95.00%,473.25,,,,473.25,498.16,0
unity,CDM,Um Par-recovery Rm Addl 1/2 Hr,UM3350006,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,238.7,% of charge rate,95.00%,226.77,,,,226.77,238.7,0
unity,CDM,Um Par-recovery Rm Addl 1/2 Hr,UM3350006,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,238.7,% of charge rate,95.00%,226.77,,,,226.77,238.7,0
unity,CDM,Um 02 Concentr Sp Rental/day,UM3470023,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.39,% of charge rate,95.00%,11.77,,,,11.77,12.39,0
unity,CDM,Um 02 Concentr Sp Rental/day,UM3470023,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.39,% of charge rate,95.00%,11.77,,,,11.77,12.39,0
unity,CDM,Um Cpap Repair,UM3470042,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,242.52,% of charge rate,95.00%,230.39,,,,230.39,242.52,0
unity,CDM,Um Cpap Repair,UM3470042,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,242.52,% of charge rate,95.00%,230.39,,,,230.39,242.52,0
unity,CDM,Um O2 Concentrator-station>4l,UM3470105,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.32,% of charge rate,95.00%,80.1,,,,80.1,84.32,0
unity,CDM,Um O2 Concentrator-station>4l,UM3470105,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.32,% of charge rate,95.00%,80.1,,,,80.1,84.32,0
unity,CDM,Um Occup Pulmonary Screening,UM3480019,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Occup Pulmonary Screening,UM3480019,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Drug Screen Collection,UM3480022,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20,% of charge rate,95.00%,19,,,,19,20,0
unity,CDM,Um Drug Screen Collection,UM3480022,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20,% of charge rate,95.00%,19,,,,19,20,0
unity,CDM,Um Er Drug Screen Collection,UM3480024,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.63,% of charge rate,95.00%,52.85,,,,52.85,55.63,0
unity,CDM,Um Er Drug Screen Collection,UM3480024,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.63,% of charge rate,95.00%,52.85,,,,52.85,55.63,0
unity,CDM,Um Drug Screen After Hours,UM3480025,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75,% of charge rate,95.00%,71.25,,,,71.25,75,0
unity,CDM,Um Drug Screen After Hours,UM3480025,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75,% of charge rate,95.00%,71.25,,,,71.25,75,0
unity,CDM,Um Sequential Boots One Size,UM3500003,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.15,% of charge rate,95.00%,76.14,,,,76.14,80.15,0
unity,CDM,Um Sequential Boots One Size,UM3500003,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.15,% of charge rate,95.00%,76.14,,,,76.14,80.15,0
unity,CDM,Um K-wire 6 X .054,UM3500006,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.41,% of charge rate,95.00%,91.59,,,,91.59,96.41,0
unity,CDM,Um K-wire 6 X .054,UM3500006,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.41,% of charge rate,95.00%,91.59,,,,91.59,96.41,0
unity,CDM,Um Variabl Mask Nonrebrthing,UM3500011,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.61,% of charge rate,95.00%,7.23,,,,7.23,7.61,0
unity,CDM,Um Variabl Mask Nonrebrthing,UM3500011,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.61,% of charge rate,95.00%,7.23,,,,7.23,7.61,0
unity,CDM,Um Blade Fanous All Sizes,UM3500012,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,161.56,% of charge rate,95.00%,153.48,,,,153.48,161.56,0
unity,CDM,Um Blade Fanous All Sizes,UM3500012,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,161.56,% of charge rate,95.00%,153.48,,,,153.48,161.56,0
unity,CDM,Um Supp Por/cen Lin Infu/fsh,UM3500018,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Supp Por/cen Lin Infu/fsh,UM3500018,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Dispos Incentive Spiromet,UM3500021,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.39,% of charge rate,95.00%,62.12,,,,62.12,65.39,0
unity,CDM,Um Dispos Incentive Spiromet,UM3500021,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.39,% of charge rate,95.00%,62.12,,,,62.12,65.39,0
unity,CDM,Um Suture Set/large,UM3500024,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.96,% of charge rate,95.00%,116.81,,,,116.81,122.96,0
unity,CDM,Um Suture Set/large,UM3500024,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.96,% of charge rate,95.00%,116.81,,,,116.81,122.96,0
unity,CDM,Um Supp - Push / Centrl Line,UM3500031,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,77.62,% of charge rate,95.00%,73.74,,,,73.74,77.62,0
unity,CDM,Um Supp - Push / Centrl Line,UM3500031,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,77.62,% of charge rate,95.00%,73.74,,,,73.74,77.62,0
unity,CDM,Um Oxygen Er/outpatient,UM3500036,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.67,% of charge rate,95.00%,45.29,,,,45.29,47.67,0
unity,CDM,Um Oxygen Er/outpatient,UM3500036,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.67,% of charge rate,95.00%,45.29,,,,45.29,47.67,0
unity,CDM,Um Intubation Supplies,UM3500050,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.5,% of charge rate,95.00%,69.83,,,,69.83,73.5,0
unity,CDM,Um Intubation Supplies,UM3500050,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.5,% of charge rate,95.00%,69.83,,,,69.83,73.5,0
unity,CDM,Um Elastic Stock Knee Per Pr,UM3500060,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.13,% of charge rate,95.00%,41.92,,,,41.92,44.13,0
unity,CDM,Um Elastic Stock Knee Per Pr,UM3500060,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.13,% of charge rate,95.00%,41.92,,,,41.92,44.13,0
unity,CDM,Um Corregated Tubing -10 Ft.,UM3500073,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.49,% of charge rate,95.00%,39.42,,,,39.42,41.49,0
unity,CDM,Um Corregated Tubing -10 Ft.,UM3500073,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.49,% of charge rate,95.00%,39.42,,,,39.42,41.49,0
unity,CDM,Um Airway-nasopharyngeal,UM3500084,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.14,% of charge rate,95.00%,38.13,,,,38.13,40.14,0
unity,CDM,Um Airway-nasopharyngeal,UM3500084,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.14,% of charge rate,95.00%,38.13,,,,38.13,40.14,0
unity,CDM,Um Spinal Tray,UM3500093,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,205.49,% of charge rate,95.00%,195.22,,,,195.22,205.49,0
unity,CDM,Um Spinal Tray,UM3500093,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,205.49,% of charge rate,95.00%,195.22,,,,195.22,205.49,0
unity,CDM,Um Bone Screw 2.3,UM3500108,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143,% of charge rate,95.00%,135.85,,,,135.85,143,0
unity,CDM,Um Bone Screw 2.3,UM3500108,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143,% of charge rate,95.00%,135.85,,,,135.85,143,0
unity,CDM,Um Morgan Medi-flow Lens,UM3500110,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.1,% of charge rate,95.00%,62.8,,,,62.8,66.1,0
unity,CDM,Um Morgan Medi-flow Lens,UM3500110,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.1,% of charge rate,95.00%,62.8,,,,62.8,66.1,0
unity,CDM,Um 2.7 Cortical Screw(20mm),UM3500112,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.94,% of charge rate,95.00%,66.44,,,,66.44,69.94,0
unity,CDM,Um 2.7 Cortical Screw(20mm),UM3500112,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.94,% of charge rate,95.00%,66.44,,,,66.44,69.94,0
unity,CDM,Um Dress Sponges (tray),UM3500113,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.34,% of charge rate,95.00%,10.77,,,,10.77,11.34,0
unity,CDM,Um Dress Sponges (tray),UM3500113,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.34,% of charge rate,95.00%,10.77,,,,10.77,11.34,0
unity,CDM,Um Bone Wax,UM3500114,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.08,% of charge rate,95.00%,46.63,,,,46.63,49.08,0
unity,CDM,Um Bone Wax,UM3500114,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.08,% of charge rate,95.00%,46.63,,,,46.63,49.08,0
unity,CDM,Um Nasal Pack 7.5,UM3500123,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.62,% of charge rate,95.00%,105.09,,,,105.09,110.62,0
unity,CDM,Um Nasal Pack 7.5,UM3500123,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.62,% of charge rate,95.00%,105.09,,,,105.09,110.62,0
unity,CDM,Um Supp Port/centrl Line Fsh,UM3500129,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.21,% of charge rate,95.00%,68.6,,,,68.6,72.21,0
unity,CDM,Um Supp Port/centrl Line Fsh,UM3500129,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.21,% of charge rate,95.00%,68.6,,,,68.6,72.21,0
unity,CDM,Um Supplies Iv Push,UM3500156,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.02,% of charge rate,95.00%,32.32,,,,32.32,34.02,0
unity,CDM,Um Supplies Iv Push,UM3500156,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.02,% of charge rate,95.00%,32.32,,,,32.32,34.02,0
unity,CDM,Um Fluidair Bed,UM3500160,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.52,% of charge rate,95.00%,100.24,,,,100.24,105.52,0
unity,CDM,Um Fluidair Bed,UM3500160,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.52,% of charge rate,95.00%,100.24,,,,100.24,105.52,0
unity,CDM,Um Self Tap Cordial Scr 2.7,UM3500162,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.14,% of charge rate,95.00%,79.93,,,,79.93,84.14,0
unity,CDM,Um Self Tap Cordial Scr 2.7,UM3500162,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.14,% of charge rate,95.00%,79.93,,,,79.93,84.14,0
unity,CDM,Um Intubation Tray,UM3500170,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.5,% of charge rate,95.00%,69.83,,,,69.83,73.5,0
unity,CDM,Um Intubation Tray,UM3500170,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.5,% of charge rate,95.00%,69.83,,,,69.83,73.5,0
unity,CDM,Um K-wire 6 X .045,UM3500174,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.41,% of charge rate,95.00%,91.59,,,,91.59,96.41,0
unity,CDM,Um K-wire 6 X .045,UM3500174,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.41,% of charge rate,95.00%,91.59,,,,91.59,96.41,0
unity,CDM,Um Oxygen Contents Per Day,UM3500175,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,253.69,% of charge rate,95.00%,241.01,,,,241.01,253.69,0
unity,CDM,Um Oxygen Contents Per Day,UM3500175,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,253.69,% of charge rate,95.00%,241.01,,,,241.01,253.69,0
unity,CDM,Um Variable Mask Oxygen,UM3500189,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.61,% of charge rate,95.00%,7.23,,,,7.23,7.61,0
unity,CDM,Um Variable Mask Oxygen,UM3500189,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.61,% of charge rate,95.00%,7.23,,,,7.23,7.61,0
unity,CDM,Um Supp Iv Infusion/ Ctrl Li,UM3500199,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,128.98,% of charge rate,95.00%,122.53,,,,122.53,128.98,0
unity,CDM,Um Supp Iv Infusion/ Ctrl Li,UM3500199,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,128.98,% of charge rate,95.00%,122.53,,,,122.53,128.98,0
unity,CDM,Um Supplies  Iv Infusion,UM3500206,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.56,% of charge rate,95.00%,115.48,,,,115.48,121.56,0
unity,CDM,Um Supplies  Iv Infusion,UM3500206,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.56,% of charge rate,95.00%,115.48,,,,115.48,121.56,0
unity,CDM,Um Bur Medium 4mm,UM3500212,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246.74,% of charge rate,95.00%,234.4,,,,234.4,246.74,0
unity,CDM,Um Bur Medium 4mm,UM3500212,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246.74,% of charge rate,95.00%,234.4,,,,234.4,246.74,0
unity,CDM,Um Ensure-8 Oz-all Flavors,UM3500213,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.34,% of charge rate,95.00%,8.87,,,,8.87,9.34,0
unity,CDM,Um Ensure-8 Oz-all Flavors,UM3500213,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.34,% of charge rate,95.00%,8.87,,,,8.87,9.34,0
unity,CDM,Um Perfix Plug Universal,UM3500216,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,406.14,% of charge rate,95.00%,385.83,,,,385.83,406.14,0
unity,CDM,Um Perfix Plug Universal,UM3500216,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,406.14,% of charge rate,95.00%,385.83,,,,385.83,406.14,0
unity,CDM,Um Mask Aerosol,UM3500227,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.43,% of charge rate,95.00%,3.26,,,,3.26,3.43,0
unity,CDM,Um Mask Aerosol,UM3500227,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.43,% of charge rate,95.00%,3.26,,,,3.26,3.43,0
unity,CDM,Um Sterile Water Neb,UM3500231,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.59,% of charge rate,95.00%,4.36,,,,4.36,4.59,0
unity,CDM,Um Sterile Water Neb,UM3500231,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.59,% of charge rate,95.00%,4.36,,,,4.36,4.59,0
unity,CDM,Um Trach Mask,UM3500245,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.6,% of charge rate,95.00%,2.47,,,,2.47,2.6,0
unity,CDM,Um Trach Mask,UM3500245,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.6,% of charge rate,95.00%,2.47,,,,2.47,2.6,0
unity,CDM,Um Tray Picc Line Dressing,UM3500246,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.04,% of charge rate,95.00%,50.39,,,,50.39,53.04,0
unity,CDM,Um Tray Picc Line Dressing,UM3500246,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.04,% of charge rate,95.00%,50.39,,,,50.39,53.04,0
unity,CDM,Um Tray C Cath/meter Bag,UM3500247,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.04,% of charge rate,95.00%,38.04,,,,38.04,40.04,0
unity,CDM,Um Tray C Cath/meter Bag,UM3500247,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.04,% of charge rate,95.00%,38.04,,,,38.04,40.04,0
unity,CDM,Um Mesh Prolene 12x12,UM3500252,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,482.24,% of charge rate,95.00%,458.13,,,,458.13,482.24,0
unity,CDM,Um Mesh Prolene 12x12,UM3500252,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,482.24,% of charge rate,95.00%,458.13,,,,458.13,482.24,0
unity,CDM,Um Quicktrach,UM3500254,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.05,% of charge rate,95.00%,150.15,,,,150.15,158.05,0
unity,CDM,Um Quicktrach,UM3500254,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.05,% of charge rate,95.00%,150.15,,,,150.15,158.05,0
unity,CDM,Um Open Pack 1,UM3500265,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,102.40",% of charge rate,95.00%,"1,047.28",,,,"1,047.28","1,102.40",0
unity,CDM,Um Open Pack 1,UM3500265,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,102.40",% of charge rate,95.00%,"1,047.28",,,,"1,047.28","1,102.40",0
unity,CDM,Um Open Pack 2,UM3500266,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,378.00",% of charge rate,95.00%,"1,309.10",,,,"1,309.10","1,378.00",0
unity,CDM,Um Open Pack 2,UM3500266,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,378.00",% of charge rate,95.00%,"1,309.10",,,,"1,309.10","1,378.00",0
unity,CDM,Um Open Pack 3,UM3500267,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,653.60",% of charge rate,95.00%,"1,570.92",,,,"1,570.92","1,653.60",0
unity,CDM,Um Open Pack 3,UM3500267,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,653.60",% of charge rate,95.00%,"1,570.92",,,,"1,570.92","1,653.60",0
unity,CDM,Um Lap Pack 1,UM3500268,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,822.56",% of charge rate,95.00%,"2,681.43",,,,"2,681.43","2,822.56",0
unity,CDM,Um Lap Pack 1,UM3500268,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,822.56",% of charge rate,95.00%,"2,681.43",,,,"2,681.43","2,822.56",0
unity,CDM,Um Lap Pack Ii,UM3500269,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,949.92",% of charge rate,95.00%,"3,752.42",,,,"3,752.42","3,949.92",0
unity,CDM,Um Lap Pack Ii,UM3500269,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,949.92",% of charge rate,95.00%,"3,752.42",,,,"3,752.42","3,949.92",0
unity,CDM,Um Lap Pack I I I,UM3500270,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"7,257.12",% of charge rate,95.00%,"6,894.26",,,,"6,894.26","7,257.12",0
unity,CDM,Um Lap Pack I I I,UM3500270,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"7,257.12",% of charge rate,95.00%,"6,894.26",,,,"6,894.26","7,257.12",0
unity,CDM,Um Lap Pack Iv,UM3500271,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,834.08,% of charge rate,95.00%,792.38,,,,792.38,834.08,0
unity,CDM,Um Lap Pack Iv,UM3500271,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,834.08,% of charge rate,95.00%,792.38,,,,792.38,834.08,0
unity,CDM,Um On Q Pump,UM3500272,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,532.22,% of charge rate,95.00%,505.61,,,,505.61,532.22,0
unity,CDM,Um On Q Pump,UM3500272,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,532.22,% of charge rate,95.00%,505.61,,,,505.61,532.22,0
unity,CDM,Um Solution Clinimix 5/15,UM3500273,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.67,% of charge rate,95.00%,55.74,,,,55.74,58.67,0
unity,CDM,Um Solution Clinimix 5/15,UM3500273,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.67,% of charge rate,95.00%,55.74,,,,55.74,58.67,0
unity,CDM,Um Solution Clinimix 4/25,UM3500274,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.75,% of charge rate,95.00%,48.21,,,,48.21,50.75,0
unity,CDM,Um Solution Clinimix 4/25,UM3500274,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.75,% of charge rate,95.00%,48.21,,,,48.21,50.75,0
unity,CDM,Um Intra Lipids,UM3500275,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.5,% of charge rate,95.00%,38.48,,,,38.48,40.5,0
unity,CDM,Um Intra Lipids,UM3500275,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.5,% of charge rate,95.00%,38.48,,,,38.48,40.5,0
unity,CDM,Um Mesh Prolene 6x6,UM3500276,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,212.82,% of charge rate,95.00%,202.18,,,,202.18,212.82,0
unity,CDM,Um Mesh Prolene 6x6,UM3500276,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,212.82,% of charge rate,95.00%,202.18,,,,202.18,212.82,0
unity,CDM,Um Hinged Knee Splint,UM3500277,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.7,% of charge rate,95.00%,28.22,,,,28.22,29.7,0
unity,CDM,Um Hinged Knee Splint,UM3500277,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.7,% of charge rate,95.00%,28.22,,,,28.22,29.7,0
unity,CDM,Um Thumb Wrist Orthosis,UM3500278,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.01,% of charge rate,95.00%,58.91,,,,58.91,62.01,0
unity,CDM,Um Thumb Wrist Orthosis,UM3500278,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.01,% of charge rate,95.00%,58.91,,,,58.91,62.01,0
unity,CDM,Um 10x30 Bio Flat Sheet Mesh,UM3500279,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,837.2,% of charge rate,95.00%,795.34,,,,795.34,837.2,0
unity,CDM,Um 10x30 Bio Flat Sheet Mesh,UM3500279,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,837.2,% of charge rate,95.00%,795.34,,,,795.34,837.2,0
unity,CDM,Um 9x15 Bio Flat Sheet Mesh,UM3500280,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,451.80",% of charge rate,95.00%,"2,329.21",,,,"2,329.21","2,451.80",0
unity,CDM,Um 9x15 Bio Flat Sheet Mesh,UM3500280,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,451.80",% of charge rate,95.00%,"2,329.21",,,,"2,329.21","2,451.80",0
unity,CDM,Um Derabond,UM3500281,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.56,% of charge rate,95.00%,46.13,,,,46.13,48.56,0
unity,CDM,Um Derabond,UM3500281,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.56,% of charge rate,95.00%,46.13,,,,46.13,48.56,0
unity,CDM,Um Splint Fib/tib,UM3500283,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.45,% of charge rate,95.00%,45.08,,,,45.08,47.45,0
unity,CDM,Um Splint Fib/tib,UM3500283,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.45,% of charge rate,95.00%,45.08,,,,45.08,47.45,0
unity,CDM,Um Medihoney Unv,UM3500284,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.25,% of charge rate,95.00%,5.94,,,,5.94,6.25,0
unity,CDM,Um Medihoney Unv,UM3500284,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.25,% of charge rate,95.00%,5.94,,,,5.94,6.25,0
unity,CDM,Um Xtrasorb Unv,UM3500285,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.99,% of charge rate,95.00%,2.84,,,,2.84,2.99,0
unity,CDM,Um Xtrasorb Unv,UM3500285,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.99,% of charge rate,95.00%,2.84,,,,2.84,2.99,0
unity,CDM,CHEST DRAINAGE KIT,UM3500286,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.28,% of charge rate,95.00%,105.72,,,,105.72,111.28,0
unity,CDM,CHEST DRAINAGE KIT,UM3500286,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.28,% of charge rate,95.00%,105.72,,,,105.72,111.28,0
unity,CDM,PARACENTIS TRAY,UM3500287,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.79,% of charge rate,95.00%,50.15,,,,50.15,52.79,0
unity,CDM,PARACENTIS TRAY,UM3500287,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.79,% of charge rate,95.00%,50.15,,,,50.15,52.79,0
unity,CDM,Um Pleurx Procedure Pack,UM3500288,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.51,% of charge rate,95.00%,95.48,,,,95.48,100.51,0
unity,CDM,Um Pleurx Procedure Pack,UM3500288,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.51,% of charge rate,95.00%,95.48,,,,95.48,100.51,0
unity,CDM,Um Forcep Blue,UM3500292,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.51,% of charge rate,95.00%,9.03,,,,9.03,9.51,0
unity,CDM,Um Forcep Blue,UM3500292,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.51,% of charge rate,95.00%,9.03,,,,9.03,9.51,0
unity,CDM,Um Clip Applier,UM3500293,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,151.58,% of charge rate,95.00%,144,,,,144,151.58,0
unity,CDM,Um Clip Applier,UM3500293,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,151.58,% of charge rate,95.00%,144,,,,144,151.58,0
unity,CDM,Um Clip Applier 5mm,UM3500294,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,749.23,% of charge rate,95.00%,711.77,,,,711.77,749.23,0
unity,CDM,Um Clip Applier 5mm,UM3500294,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,749.23,% of charge rate,95.00%,711.77,,,,711.77,749.23,0
unity,CDM,Um Protack,UM3500295,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,711.2,% of charge rate,95.00%,675.64,,,,675.64,711.2,0
unity,CDM,Um Protack,UM3500295,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,711.2,% of charge rate,95.00%,675.64,,,,675.64,711.2,0
unity,CDM,Um Linear Cutter,UM3500296,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,576.6,% of charge rate,95.00%,547.77,,,,547.77,576.6,0
unity,CDM,Um Linear Cutter,UM3500296,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,576.6,% of charge rate,95.00%,547.77,,,,547.77,576.6,0
unity,CDM,Um Retriever Pouch,UM3500297,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.74,% of charge rate,95.00%,76.7,,,,76.7,80.74,0
unity,CDM,Um Retriever Pouch,UM3500297,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.74,% of charge rate,95.00%,76.7,,,,76.7,80.74,0
unity,CDM,Um Dissector Tip 5mm,UM3500298,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.01,% of charge rate,95.00%,25.66,,,,25.66,27.01,0
unity,CDM,Um Dissector Tip 5mm,UM3500298,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.01,% of charge rate,95.00%,25.66,,,,25.66,27.01,0
unity,CDM,Um Secure Strap 12,UM3500299,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,528.16,% of charge rate,95.00%,501.75,,,,501.75,528.16,0
unity,CDM,Um Secure Strap 12,UM3500299,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,528.16,% of charge rate,95.00%,501.75,,,,501.75,528.16,0
unity,CDM,Um Secure Strap 25,UM3500300,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,766.92,% of charge rate,95.00%,728.57,,,,728.57,766.92,0
unity,CDM,Um Secure Strap 25,UM3500300,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,766.92,% of charge rate,95.00%,728.57,,,,728.57,766.92,0
unity,CDM,Um Curved Scissors,UM3500301,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,492.3,% of charge rate,95.00%,467.69,,,,467.69,492.3,0
unity,CDM,Um Curved Scissors,UM3500301,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,492.3,% of charge rate,95.00%,467.69,,,,467.69,492.3,0
unity,CDM,Um Paddle Endo,UM3500303,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,485.9,% of charge rate,95.00%,461.61,,,,461.61,485.9,0
unity,CDM,Um Paddle Endo,UM3500303,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,485.9,% of charge rate,95.00%,461.61,,,,461.61,485.9,0
unity,CDM,Um Endo Stitch,UM3500304,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,388.21,% of charge rate,95.00%,368.8,,,,368.8,388.21,0
unity,CDM,Um Endo Stitch,UM3500304,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,388.21,% of charge rate,95.00%,368.8,,,,368.8,388.21,0
unity,CDM,Um Purestring,UM3500305,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,243.79,% of charge rate,95.00%,231.6,,,,231.6,243.79,0
unity,CDM,Um Purestring,UM3500305,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,243.79,% of charge rate,95.00%,231.6,,,,231.6,243.79,0
unity,CDM,Um Ligasure,UM3500306,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,849.09,% of charge rate,95.00%,806.64,,,,806.64,849.09,0
unity,CDM,Um Ligasure,UM3500306,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,849.09,% of charge rate,95.00%,806.64,,,,806.64,849.09,0
unity,CDM,Um Linear Cutter,UM3500307,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.21,% of charge rate,95.00%,67.65,,,,67.65,71.21,0
unity,CDM,Um Linear Cutter,UM3500307,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.21,% of charge rate,95.00%,67.65,,,,67.65,71.21,0
unity,CDM,Um Linear Cutter,UM3500314,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.78,% of charge rate,95.00%,84.34,,,,84.34,88.78,0
unity,CDM,Um Linear Cutter,UM3500314,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.78,% of charge rate,95.00%,84.34,,,,84.34,88.78,0
unity,CDM,Um Blue Reload 45,UM3500315,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,278.89,% of charge rate,95.00%,264.95,,,,264.95,278.89,0
unity,CDM,Um Blue Reload 45,UM3500315,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,278.89,% of charge rate,95.00%,264.95,,,,264.95,278.89,0
unity,CDM,Um Grey Reload 45,UM3500316,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,278.89,% of charge rate,95.00%,264.95,,,,264.95,278.89,0
unity,CDM,Um Grey Reload 45,UM3500316,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,278.89,% of charge rate,95.00%,264.95,,,,264.95,278.89,0
unity,CDM,Um Surgidac Single,UM3500317,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.77,% of charge rate,95.00%,76.73,,,,76.73,80.77,0
unity,CDM,Um Surgidac Single,UM3500317,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.77,% of charge rate,95.00%,76.73,,,,76.73,80.77,0
unity,CDM,Um Surgidac Triple,UM3500318,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,215.72,% of charge rate,95.00%,204.93,,,,204.93,215.72,0
unity,CDM,Um Surgidac Triple,UM3500318,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,215.72,% of charge rate,95.00%,204.93,,,,204.93,215.72,0
unity,CDM,Um Polysorb Single,UM3500319,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.77,% of charge rate,95.00%,76.73,,,,76.73,80.77,0
unity,CDM,Um Polysorb Single,UM3500319,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.77,% of charge rate,95.00%,76.73,,,,76.73,80.77,0
unity,CDM,Um Insorb Absorable Stapler,UM3500325,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.08,% of charge rate,95.00%,88.43,,,,88.43,93.08,0
unity,CDM,Um Insorb Absorable Stapler,UM3500325,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.08,% of charge rate,95.00%,88.43,,,,88.43,93.08,0
unity,CDM,Um Endoscopic Hemoclip,UM3500326,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,433.37,% of charge rate,95.00%,411.7,,,,411.7,433.37,0
unity,CDM,Um Endoscopic Hemoclip,UM3500326,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,433.37,% of charge rate,95.00%,411.7,,,,411.7,433.37,0
unity,CDM,Um Drsg Aquacel Ag Surgical,UM3500327,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.97,% of charge rate,95.00%,52.22,,,,52.22,54.97,0
unity,CDM,Um Drsg Aquacel Ag Surgical,UM3500327,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.97,% of charge rate,95.00%,52.22,,,,52.22,54.97,0
unity,CDM,Um Mesh Retrieval Polyp,UM3500329,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.77,% of charge rate,95.00%,87.18,,,,87.18,91.77,0
unity,CDM,Um Mesh Retrieval Polyp,UM3500329,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.77,% of charge rate,95.00%,87.18,,,,87.18,91.77,0
unity,CDM,Um Iv Pump Set,UM3600027,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.71,% of charge rate,95.00%,82.37,,,,82.37,86.71,0
unity,CDM,Um Iv Pump Set,UM3600027,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.71,% of charge rate,95.00%,82.37,,,,82.37,86.71,0
unity,CDM,Um Nitro Pump Set,UM3600028,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.41,% of charge rate,95.00%,112.49,,,,112.49,118.41,0
unity,CDM,Um Nitro Pump Set,UM3600028,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.41,% of charge rate,95.00%,112.49,,,,112.49,118.41,0
unity,CDM,Um Er Cast/splint Applicatio,UM3700001,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,249.97,% of charge rate,95.00%,237.47,,,,237.47,249.97,0
unity,CDM,Um Er Cast/splint Applicatio,UM3700001,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,249.97,% of charge rate,95.00%,237.47,,,,237.47,249.97,0
unity,CDM,Um Er Ear Irrigation,UM3700007,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,92.49,% of charge rate,95.00%,87.87,,,,87.87,92.49,0
unity,CDM,Um Er Ear Irrigation,UM3700007,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,92.49,% of charge rate,95.00%,87.87,,,,87.87,92.49,0
unity,CDM,Um Er Removal Foreign Body,UM3700009,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,545.27,% of charge rate,95.00%,518.01,,,,518.01,545.27,0
unity,CDM,Um Er Removal Foreign Body,UM3700009,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,545.27,% of charge rate,95.00%,518.01,,,,518.01,545.27,0
unity,CDM,Um Er Remov Foreign Body Eye,UM3700010,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,139.56,% of charge rate,95.00%,132.58,,,,132.58,139.56,0
unity,CDM,Um Er Remov Foreign Body Eye,UM3700010,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,139.56,% of charge rate,95.00%,132.58,,,,132.58,139.56,0
unity,CDM,Um Er Suture Level I,UM3700015,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,306,% of charge rate,95.00%,290.7,,,,290.7,306,0
unity,CDM,Um Er Suture Level I,UM3700015,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,306,% of charge rate,95.00%,290.7,,,,290.7,306,0
unity,CDM,Um Er Control Nasal Hemorrha,UM3700019,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,176.83,% of charge rate,95.00%,167.99,,,,167.99,176.83,0
unity,CDM,Um Er Control Nasal Hemorrha,UM3700019,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,176.83,% of charge rate,95.00%,167.99,,,,167.99,176.83,0
unity,CDM,"Um Er Burn Care, Medium",UM3700021,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,201.82,% of charge rate,95.00%,191.73,,,,191.73,201.82,0
unity,CDM,"Um Er Burn Care, Medium",UM3700021,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,201.82,% of charge rate,95.00%,191.73,,,,191.73,201.82,0
unity,CDM,"Um Er Burn Care, Small",UM3700026,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,306.34,% of charge rate,95.00%,291.02,,,,291.02,306.34,0
unity,CDM,"Um Er Burn Care, Small",UM3700026,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,306.34,% of charge rate,95.00%,291.02,,,,291.02,306.34,0
unity,CDM,Um Er Suture Level Ii,UM3700027,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,545.27,% of charge rate,95.00%,518.01,,,,518.01,545.27,0
unity,CDM,Um Er Suture Level Ii,UM3700027,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,545.27,% of charge rate,95.00%,518.01,,,,518.01,545.27,0
unity,CDM,Um Er Drainage Abscess,UM3700029,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,306.34,% of charge rate,95.00%,291.02,,,,291.02,306.34,0
unity,CDM,Um Er Drainage Abscess,UM3700029,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,306.34,% of charge rate,95.00%,291.02,,,,291.02,306.34,0
unity,CDM,"Um Er Burn Care, Large",UM3700030,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,201.82,% of charge rate,95.00%,191.73,,,,191.73,201.82,0
unity,CDM,"Um Er Burn Care, Large",UM3700030,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,201.82,% of charge rate,95.00%,191.73,,,,191.73,201.82,0
unity,CDM,Um Er Fract Care/disloca L I,UM3700041,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,251.29,% of charge rate,95.00%,238.73,,,,238.73,251.29,0
unity,CDM,Um Er Fract Care/disloca L I,UM3700041,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,251.29,% of charge rate,95.00%,238.73,,,,238.73,251.29,0
unity,CDM,Um Er Suture Level Iii,UM3700043,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,112.28",% of charge rate,95.00%,"2,006.67",,,,"2,006.67","2,112.28",0
unity,CDM,Um Er Suture Level Iii,UM3700043,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,112.28",% of charge rate,95.00%,"2,006.67",,,,"2,006.67","2,112.28",0
unity,CDM,Um Drain/inject Joint/bursa,UM3700052,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,357.8,% of charge rate,95.00%,339.91,,,,339.91,357.8,0
unity,CDM,Um Drain/inject Joint/bursa,UM3700052,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,357.8,% of charge rate,95.00%,339.91,,,,339.91,357.8,0
unity,CDM,Um Postage (sheriff's Dept),UM4000747,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.83,% of charge rate,95.00%,3.64,,,,3.64,3.83,0
unity,CDM,Um Postage (sheriff's Dept),UM4000747,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.83,% of charge rate,95.00%,3.64,,,,3.64,3.83,0
unity,CDM,Um Specimen Collection/processing,UM4000769,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Specimen Collection/processing,UM4000769,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Autopsy,UM4010004,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,732.68,% of charge rate,95.00%,696.05,,,,696.05,732.68,0
unity,CDM,Um Autopsy,UM4010004,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,732.68,% of charge rate,95.00%,696.05,,,,696.05,732.68,0
unity,CDM,Um Iv Starts Non Surg,UM4270001,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.11,% of charge rate,95.00%,81.8,,,,81.8,86.11,0
unity,CDM,Um Iv Starts Non Surg,UM4270001,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.11,% of charge rate,95.00%,81.8,,,,81.8,86.11,0
unity,CDM,Um Minor,UM4270004,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,177.88,% of charge rate,95.00%,168.99,,,,168.99,177.88,0
unity,CDM,Um Minor,UM4270004,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,177.88,% of charge rate,95.00%,168.99,,,,168.99,177.88,0
unity,CDM,Um Mask-vital Signs-anest,UM4270005,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.08,% of charge rate,95.00%,19.08,,,,19.08,20.08,0
unity,CDM,Um Mask-vital Signs-anest,UM4270005,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.08,% of charge rate,95.00%,19.08,,,,19.08,20.08,0
unity,CDM,Um Major,UM4270006,,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,233.87,% of charge rate,95.00%,222.18,,,,222.18,233.87,0
unity,CDM,Um Major,UM4270006,,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,233.87,% of charge rate,95.00%,222.18,,,,222.18,233.87,0
unity,CDM,Hc Swing Bed,1200000,1200000,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,500,% of charge rate,95.00%,475,,,,475,500,0
unity,CDM,Hc Respite Care,1200002,1200002,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,325,% of charge rate,95.00%,308.75,,,,308.75,325,0
unity,CDM,HC ROOM & NURSING W/TELEMETRY,1211000,1211000,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,621.13",% of charge rate,95.00%,"1,540.07",,,,"1,540.07","1,621.13",0
unity,CDM,"Hc Mastectomy,smpl,complete",4900284,19303,,Mast simple complete,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,302.84",% of charge rate,95.00%,"1,237.70",,,,"1,237.70","1,302.84",0
unity,CDM,"Hc Mastectomy,smpl,complete",4900284,19303,,Mast simple complete,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,302.84",% of charge rate,95.00%,"1,237.70",,,,"1,237.70","1,302.84",0
unity,CDM,Hc Needle Insert W/o Inj 1 Or 2 Musc,4903367,20560,,Ndl insj w/o njx 1 or 2 musc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40,% of charge rate,95.00%,38,,,,38,40,0
unity,CDM,Hc Needle Insert W/o Inj 1 Or 2 Musc,4903367,20560,,Ndl insj w/o njx 1 or 2 musc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40,% of charge rate,95.00%,38,,,,38,40,0
unity,CDM,Hc Needle Insert W/o Inj 3+ Musc,4903368,20561,,Ndl insj w/o njx 3+ musc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70,% of charge rate,95.00%,66.5,,,,66.5,70,0
unity,CDM,Hc Needle Insert W/o Inj 3+ Musc,4903368,20561,,Ndl insj w/o njx 3+ musc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70,% of charge rate,95.00%,66.5,,,,66.5,70,0
unity,CDM,Um Poct Us Injection Phalanges Joint,UM4022002,20604,,Drain/inj joint/bursa w/us,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,398,% of charge rate,95.00%,378.1,,,,378.1,398,0
unity,CDM,Um Poct Us Injection Phalanges Joint,UM4022002,20604,,Drain/inj joint/bursa w/us,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,398,% of charge rate,95.00%,378.1,,,,378.1,398,0
unity,CDM,Um Poct Us Injection Medium Joint,UM4022003,20606,,Drain/inj joint/bursa w/us,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,883.87,% of charge rate,95.00%,839.68,,,,839.68,883.87,0
unity,CDM,Um Poct Us Injection Medium Joint,UM4022003,20606,,Drain/inj joint/bursa w/us,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,883.87,% of charge rate,95.00%,839.68,,,,839.68,883.87,0
unity,CDM,Um Poct Us Injection Large Joint,UM4022004,20611,,Drain/inj joint/bursa w/us,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,425,% of charge rate,95.00%,403.75,,,,403.75,425,0
unity,CDM,Um Poct Us Injection Large Joint,UM4022004,20611,,Drain/inj joint/bursa w/us,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,425,% of charge rate,95.00%,403.75,,,,403.75,425,0
unity,CDM,Hc Insert Emergency Airway,4901106,31500,,Insert emergency airway,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,327,% of charge rate,95.00%,310.65,,,,310.65,327,0
unity,CDM,Hc Insert Emergency Airway,4901106,31500,,Insert emergency airway,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,327,% of charge rate,95.00%,310.65,,,,310.65,327,0
unity,CDM,Hc Suctioning,4901140,31720,,Clearance of airways,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,304.75,% of charge rate,95.00%,289.51,,,,289.51,304.75,0
unity,CDM,Hc Suctioning,4901140,31720,,Clearance of airways,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,304.75,% of charge rate,95.00%,289.51,,,,289.51,304.75,0
unity,CDM,Um Venipuncture,UM4000046,36415,,Routine venipuncture,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.28,% of charge rate,95.00%,11.67,,,,11.67,12.28,0
unity,CDM,Um Venipuncture,UM4000046,36415,,Routine venipuncture,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.28,% of charge rate,95.00%,11.67,,,,11.67,12.28,0
unity,CDM,Um Capillary Puncture,UM4000880,36416,,Capillary blood draw,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.12,% of charge rate,95.00%,5.81,,,,5.81,6.12,0
unity,CDM,Um Capillary Puncture,UM4000880,36416,,Capillary blood draw,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.12,% of charge rate,95.00%,5.81,,,,5.81,6.12,0
unity,CDM,Hc Blood Admin 2+ Hrs,3910000,36430,,Blood transfusion service,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,790,% of charge rate,95.00%,750.5,,,,750.5,790,0
unity,CDM,Hc Blood Admin 2+ Hrs,3910000,36430,,Blood transfusion service,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,790,% of charge rate,95.00%,750.5,,,,750.5,790,0
unity,CDM,Hc Collect Blood Venous Device,4901266,36591,,Draw blood off venous device,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,165,% of charge rate,95.00%,156.75,,,,156.75,165,0
unity,CDM,Hc Collect Blood Venous Device,4901266,36591,,Draw blood off venous device,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,165,% of charge rate,95.00%,156.75,,,,156.75,165,0
unity,CDM,Hc Collect Blood Picc,4901267,36592,,Collect blood from picc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,165,% of charge rate,95.00%,156.75,,,,156.75,165,0
unity,CDM,Hc Collect Blood Picc,4901267,36592,,Collect blood from picc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,165,% of charge rate,95.00%,156.75,,,,156.75,165,0
unity,CDM,Hc Declot Vascular Device,4901268,36593,,Declot vascular device,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,600,% of charge rate,95.00%,570,,,,570,600,0
unity,CDM,Hc Declot Vascular Device,4901268,36593,,Declot vascular device,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,600,% of charge rate,95.00%,570,,,,570,600,0
unity,CDM,Um Arterial Blood Draw,UM3480020,36600,,Withdrawal of arterial blood,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,184.2,% of charge rate,95.00%,174.99,,,,174.99,184.2,0
unity,CDM,Um Arterial Blood Draw,UM3480020,36600,,Withdrawal of arterial blood,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,184.2,% of charge rate,95.00%,174.99,,,,174.99,184.2,0
unity,CDM,Hc Plcmt Of Needle Intraosseo,4500067,36680,,Insert needle bone cavity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,705,% of charge rate,95.00%,669.75,,,,669.75,705,0
unity,CDM,Hc Plcmt Of Needle Intraosseo,4500067,36680,,Insert needle bone cavity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,705,% of charge rate,95.00%,669.75,,,,669.75,705,0
unity,CDM,Hc Abd Paracentesis W/imaging,4902347,49083,,Abd paracentesis w/imaging,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,450.00",% of charge rate,95.00%,"1,377.50",,,,"1,377.50","1,450.00",0
unity,CDM,Hc Abd Paracentesis W/imaging,4902347,49083,,Abd paracentesis w/imaging,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,450.00",% of charge rate,95.00%,"1,377.50",,,,"1,377.50","1,450.00",0
unity,CDM,Um Poct Us Guidance Abd Paracentesis,UM4022006,49083,,Abd paracentesis w/imaging,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,265.00",% of charge rate,95.00%,"1,201.75",,,,"1,201.75","1,265.00",0
unity,CDM,Um Poct Us Guidance Abd Paracentesis,UM4022006,49083,,Abd paracentesis w/imaging,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,265.00",% of charge rate,95.00%,"1,201.75",,,,"1,201.75","1,265.00",0
unity,CDM,Hc Image Cath Fluid Peri/retro,4902574,49406,,Image cath fluid peri/retro,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,625.00",% of charge rate,95.00%,"2,493.75",,,,"2,493.75","2,625.00",0
unity,CDM,Hc Image Cath Fluid Peri/retro,4902574,49406,,Image cath fluid peri/retro,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,625.00",% of charge rate,95.00%,"2,493.75",,,,"2,493.75","2,625.00",0
unity,CDM,Um Poct Us Guidance Retroperitoneal Paracentesis,UM4022005,49406,,Image cath fluid peri/retro,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,293.73",% of charge rate,95.00%,"2,179.04",,,,"2,179.04","2,293.73",0
unity,CDM,Um Poct Us Guidance Retroperitoneal Paracentesis,UM4022005,49406,,Image cath fluid peri/retro,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,293.73",% of charge rate,95.00%,"2,179.04",,,,"2,179.04","2,293.73",0
unity,CDM,Hc Insert Temp Bladder Catheter,4500078,51702,,Insert temp bladder cath,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,190,% of charge rate,95.00%,180.5,,,,180.5,190,0
unity,CDM,Hc Insert Temp Bladder Catheter,4500078,51702,,Insert temp bladder cath,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,190,% of charge rate,95.00%,180.5,,,,180.5,190,0
unity,CDM,Hc Us Urine Capacity Measure,4901360,51798,,Us urine capacity measure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100,% of charge rate,95.00%,95,,,,95,100,0
unity,CDM,Hc Us Urine Capacity Measure,4901360,51798,,Us urine capacity measure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100,% of charge rate,95.00%,95,,,,95,100,0
unity,CDM,YAG LASER,4901775,66821,,After cataract laser surgery,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,075.00",% of charge rate,95.00%,"1,021.25",,,,"1,021.25","1,075.00",0
unity,CDM,YAG LASER,4901775,66821,,After cataract laser surgery,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,075.00",% of charge rate,95.00%,"1,021.25",,,,"1,021.25","1,075.00",0
unity,CDM,XR-FB IN EYE,3200300,70030,,X-ray eye for foreign body,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.43,% of charge rate,95.00%,92.56,,,,92.56,97.43,0
unity,CDM,XR-FB IN EYE,3200300,70030,,X-ray eye for foreign body,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.43,% of charge rate,95.00%,92.56,,,,92.56,97.43,0
unity,CDM,XR-MANDIBLE <4 VIEWS,3200226,70100,,X-ray exam of jaw <4views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.63,% of charge rate,95.00%,110.8,,,,110.8,116.63,0
unity,CDM,XR-MANDIBLE <4 VIEWS,3200226,70100,,X-ray exam of jaw <4views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.63,% of charge rate,95.00%,110.8,,,,110.8,116.63,0
unity,CDM,XR-MANDIBLE 4+ VIEWS,3200228,70110,,X-ray exam of jaw 4/> views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,123.1,% of charge rate,95.00%,116.95,,,,116.95,123.1,0
unity,CDM,XR-MANDIBLE 4+ VIEWS,3200228,70110,,X-ray exam of jaw 4/> views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,123.1,% of charge rate,95.00%,116.95,,,,116.95,123.1,0
unity,CDM,Hc Mastoid 1-2 Vws,3200317,70120,,X-ray exam of mastoids,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.48,% of charge rate,95.00%,105.91,,,,105.91,111.48,0
unity,CDM,Hc Mastoid 1-2 Vws,3200317,70120,,X-ray exam of mastoids,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.48,% of charge rate,95.00%,105.91,,,,105.91,111.48,0
unity,CDM,XR-MASTOIDS 3+ VIEWS,3200003,70130,,X-ray exam of mastoids,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,168.04,% of charge rate,95.00%,159.64,,,,159.64,168.04,0
unity,CDM,XR-MASTOIDS 3+ VIEWS,3200003,70130,,X-ray exam of mastoids,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,168.04,% of charge rate,95.00%,159.64,,,,159.64,168.04,0
unity,CDM,Hc Facial Bones Part,3200316,70140,,X-ray exam of facial bones,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,Hc Facial Bones Part,3200316,70140,,X-ray exam of facial bones,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XRAY FACIAL BONES <3 VW,3200319,70140,,X-ray exam of facial bones,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XRAY FACIAL BONES <3 VW,3200319,70140,,X-ray exam of facial bones,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XR-FACIAL BONES 3+ VIEWS,3200004,70150,,X-ray exam of facial bones,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,136.02,% of charge rate,95.00%,129.22,,,,129.22,136.02,0
unity,CDM,XR-FACIAL BONES 3+ VIEWS,3200004,70150,,X-ray exam of facial bones,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,136.02,% of charge rate,95.00%,129.22,,,,129.22,136.02,0
unity,CDM,XR-NOSE BONES 3+ VIEWS,3200005,70160,,X-ray exam of nasal bones,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.63,% of charge rate,95.00%,120.3,,,,120.3,126.63,0
unity,CDM,XR-NOSE BONES 3+ VIEWS,3200005,70160,,X-ray exam of nasal bones,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.63,% of charge rate,95.00%,120.3,,,,120.3,126.63,0
unity,CDM,Hc Orbits Min 4 Views,3200006,70200,,X-ray exam of eye sockets,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.02,% of charge rate,95.00%,119.72,,,,119.72,126.02,0
unity,CDM,Hc Orbits Min 4 Views,3200006,70200,,X-ray exam of eye sockets,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.02,% of charge rate,95.00%,119.72,,,,119.72,126.02,0
unity,CDM,XR-SINUSES < 3 VIEWS,3200007,70210,,X-ray exam of sinuses,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.7,% of charge rate,95.00%,89.02,,,,89.02,93.7,0
unity,CDM,XR-SINUSES < 3 VIEWS,3200007,70210,,X-ray exam of sinuses,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.7,% of charge rate,95.00%,89.02,,,,89.02,93.7,0
unity,CDM,XR-SINUSES 3+ VIEWS,3200008,70220,,X-ray exam of sinuses,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.48,% of charge rate,95.00%,105.91,,,,105.91,111.48,0
unity,CDM,XR-SINUSES 3+ VIEWS,3200008,70220,,X-ray exam of sinuses,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.48,% of charge rate,95.00%,105.91,,,,105.91,111.48,0
unity,CDM,XR-SKULL <4 VIEWS,3200009,70250,,X-ray exam of skull,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.04,% of charge rate,95.00%,109.29,,,,109.29,115.04,0
unity,CDM,XR-SKULL <4 VIEWS,3200009,70250,,X-ray exam of skull,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.04,% of charge rate,95.00%,109.29,,,,109.29,115.04,0
unity,CDM,XR-SKULL 4+ VIEWS,3200010,70260,,X-ray exam of skull,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,136.02,% of charge rate,95.00%,129.22,,,,129.22,136.02,0
unity,CDM,XR-SKULL 4+ VIEWS,3200010,70260,,X-ray exam of skull,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,136.02,% of charge rate,95.00%,129.22,,,,129.22,136.02,0
unity,CDM,XR-TMJ,3200011,70330,,X-ray exam of jaw joints,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,155.08,% of charge rate,95.00%,147.33,,,,147.33,155.08,0
unity,CDM,XR-TMJ,3200011,70330,,X-ray exam of jaw joints,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,155.08,% of charge rate,95.00%,147.33,,,,147.33,155.08,0
unity,CDM,MRI-TMJ,6110000,70336,,Magnetic image jaw joint,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,888.12",% of charge rate,95.00%,"1,793.71",,,,"1,793.71","1,888.12",0
unity,CDM,MRI-TMJ,6110000,70336,,Magnetic image jaw joint,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,888.12",% of charge rate,95.00%,"1,793.71",,,,"1,793.71","1,888.12",0
unity,CDM,XR-SOFT TISSUE NECK,3200013,70360,,X-ray exam of neck,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.87,% of charge rate,95.00%,93.93,,,,93.93,98.87,0
unity,CDM,XR-SOFT TISSUE NECK,3200013,70360,,X-ray exam of neck,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.87,% of charge rate,95.00%,93.93,,,,93.93,98.87,0
unity,CDM,CT-BRAIN,3510000,70450,,Ct head/brain w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,590.1,% of charge rate,95.00%,560.6,,,,560.6,590.1,0
unity,CDM,CT-BRAIN,3510000,70450,,Ct head/brain w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,590.1,% of charge rate,95.00%,560.6,,,,560.6,590.1,0
unity,CDM,CT-BRAIN,3510001,70460,,Ct head/brain w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,859.63,% of charge rate,95.00%,816.65,,,,816.65,859.63,0
unity,CDM,CT-BRAIN,3510001,70460,,Ct head/brain w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,859.63,% of charge rate,95.00%,816.65,,,,816.65,859.63,0
unity,CDM,CT-BRAIN,3510002,70470,,Ct head/brain w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,029.25",% of charge rate,95.00%,977.79,,,,977.79,"1,029.25",0
unity,CDM,CT-BRAIN,3510002,70470,,Ct head/brain w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,029.25",% of charge rate,95.00%,977.79,,,,977.79,"1,029.25",0
unity,CDM,CT-EAR,3510003,70480,,Ct orbit/ear/fossa w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,359.88",% of charge rate,95.00%,"1,291.89",,,,"1,291.89","1,359.88",0
unity,CDM,CT-EAR,3510003,70480,,Ct orbit/ear/fossa w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,359.88",% of charge rate,95.00%,"1,291.89",,,,"1,291.89","1,359.88",0
unity,CDM,CT EAR,3510004,70481,,Ct orbit/ear/fossa w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,442.77",% of charge rate,95.00%,"1,370.63",,,,"1,370.63","1,442.77",0
unity,CDM,CT EAR,3510004,70481,,Ct orbit/ear/fossa w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,442.77",% of charge rate,95.00%,"1,370.63",,,,"1,370.63","1,442.77",0
unity,CDM,CT-EAR,3510005,70482,,Ct orbit/ear/fossa w/o&w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,837.13",% of charge rate,95.00%,"1,745.27",,,,"1,745.27","1,837.13",0
unity,CDM,CT-EAR,3510005,70482,,Ct orbit/ear/fossa w/o&w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,837.13",% of charge rate,95.00%,"1,745.27",,,,"1,745.27","1,837.13",0
unity,CDM,CT-FACIAL BONE,3510006,70486,,Ct maxillofacial w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,776.23,% of charge rate,95.00%,737.42,,,,737.42,776.23,0
unity,CDM,CT-FACIAL BONE,3510006,70486,,Ct maxillofacial w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,776.23,% of charge rate,95.00%,737.42,,,,737.42,776.23,0
unity,CDM,CT-FACIAL BONES,3510007,70487,,Ct maxillofacial w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,902.92,% of charge rate,95.00%,857.77,,,,857.77,902.92,0
unity,CDM,CT-FACIAL BONES,3510007,70487,,Ct maxillofacial w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,902.92,% of charge rate,95.00%,857.77,,,,857.77,902.92,0
unity,CDM,CT-FACIAL BONES,3510008,70488,,Ct maxillofacial w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,128.67",% of charge rate,95.00%,"1,072.24",,,,"1,072.24","1,128.67",0
unity,CDM,CT-FACIAL BONES,3510008,70488,,Ct maxillofacial w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,128.67",% of charge rate,95.00%,"1,072.24",,,,"1,072.24","1,128.67",0
unity,CDM,CT-NECK,3500000,70490,,Ct soft tissue neck w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,895.08,% of charge rate,95.00%,850.33,,,,850.33,895.08,0
unity,CDM,CT-NECK,3500000,70490,,Ct soft tissue neck w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,895.08,% of charge rate,95.00%,850.33,,,,850.33,895.08,0
unity,CDM,CT-NECK,3500001,70491,,Ct soft tissue neck w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,156.79",% of charge rate,95.00%,"1,098.95",,,,"1,098.95","1,156.79",0
unity,CDM,CT-NECK,3500001,70491,,Ct soft tissue neck w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,156.79",% of charge rate,95.00%,"1,098.95",,,,"1,098.95","1,156.79",0
unity,CDM,CT-NECK,3500002,70492,,Ct sft tsue nck w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,320.75",% of charge rate,95.00%,"1,254.71",,,,"1,254.71","1,320.75",0
unity,CDM,CT-NECK,3500002,70492,,Ct sft tsue nck w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,320.75",% of charge rate,95.00%,"1,254.71",,,,"1,254.71","1,320.75",0
unity,CDM,Hc Cta Head,3500003,70496,,Ct angiography head,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,701.90",% of charge rate,95.00%,"3,516.81",,,,"3,516.81","3,701.90",0
unity,CDM,Hc Cta Head,3500003,70496,,Ct angiography head,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,701.90",% of charge rate,95.00%,"3,516.81",,,,"3,516.81","3,701.90",0
unity,CDM,Hc Cta Neck,3500004,70498,,Ct angiography neck,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,701.90",% of charge rate,95.00%,"3,516.81",,,,"3,516.81","3,701.90",0
unity,CDM,Hc Cta Neck,3500004,70498,,Ct angiography neck,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,701.90",% of charge rate,95.00%,"3,516.81",,,,"3,516.81","3,701.90",0
unity,CDM,MRI-EYE/FACE/NECK,6100000,70540,,Mri orbit/face/neck w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,035.70",% of charge rate,95.00%,"1,933.92",,,,"1,933.92","2,035.70",0
unity,CDM,MRI-EYE/FACE/NECK,6100000,70540,,Mri orbit/face/neck w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,035.70",% of charge rate,95.00%,"1,933.92",,,,"1,933.92","2,035.70",0
unity,CDM,MRI ORBIT/FACE/NECK,6100001,70542,,Mri orbit/face/neck w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,236.05",% of charge rate,95.00%,"2,124.25",,,,"2,124.25","2,236.05",0
unity,CDM,MRI ORBIT/FACE/NECK,6100001,70542,,Mri orbit/face/neck w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,236.05",% of charge rate,95.00%,"2,124.25",,,,"2,124.25","2,236.05",0
unity,CDM,MRI EYE/FACE/NECK,6100002,70543,,Mri orbt/fac/nck w/o &w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,787.83",% of charge rate,95.00%,"2,648.44",,,,"2,648.44","2,787.83",0
unity,CDM,MRI EYE/FACE/NECK,6100002,70543,,Mri orbt/fac/nck w/o &w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,787.83",% of charge rate,95.00%,"2,648.44",,,,"2,648.44","2,787.83",0
unity,CDM,MRA-HEAD,6100003,70544,,Mr angiography head w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,313.60",% of charge rate,95.00%,"2,197.92",,,,"2,197.92","2,313.60",0
unity,CDM,MRA-HEAD,6100003,70544,,Mr angiography head w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,313.60",% of charge rate,95.00%,"2,197.92",,,,"2,197.92","2,313.60",0
unity,CDM,MRA-NECK,6100006,70547,,Mr angiography neck w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,320.00",% of charge rate,95.00%,"2,204.00",,,,"2,204.00","2,320.00",0
unity,CDM,MRA-NECK,6100006,70547,,Mr angiography neck w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,320.00",% of charge rate,95.00%,"2,204.00",,,,"2,204.00","2,320.00",0
unity,CDM,Hc Mra Neck W/dye,6100007,70548,,Mr angiography neck w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,460.63",% of charge rate,95.00%,"2,337.60",,,,"2,337.60","2,460.63",0
unity,CDM,Hc Mra Neck W/dye,6100007,70548,,Mr angiography neck w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,460.63",% of charge rate,95.00%,"2,337.60",,,,"2,337.60","2,460.63",0
unity,CDM,MRA-NECK,6100008,70549,,Mr angiograph neck w/o&w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,572.18",% of charge rate,95.00%,"3,393.57",,,,"3,393.57","3,572.18",0
unity,CDM,MRA-NECK,6100008,70549,,Mr angiograph neck w/o&w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,572.18",% of charge rate,95.00%,"3,393.57",,,,"3,393.57","3,572.18",0
unity,CDM,MRI-BRAIN/BRAIN STEM,6110001,70551,,Mri brain stem w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,705.24",% of charge rate,95.00%,"1,619.98",,,,"1,619.98","1,705.24",0
unity,CDM,MRI-BRAIN/BRAIN STEM,6110001,70551,,Mri brain stem w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,705.24",% of charge rate,95.00%,"1,619.98",,,,"1,619.98","1,705.24",0
unity,CDM,MRI-BRAIN,6110002,70552,,Mri brain stem w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,766.56",% of charge rate,95.00%,"1,678.23",,,,"1,678.23","1,766.56",0
unity,CDM,MRI-BRAIN,6110002,70552,,Mri brain stem w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,766.56",% of charge rate,95.00%,"1,678.23",,,,"1,678.23","1,766.56",0
unity,CDM,MRI-BRAIN,6110003,70553,,Mri brain stem w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,520.00",% of charge rate,95.00%,"2,394.00",,,,"2,394.00","2,520.00",0
unity,CDM,MRI-BRAIN,6110003,70553,,Mri brain stem w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,520.00",% of charge rate,95.00%,"2,394.00",,,,"2,394.00","2,520.00",0
unity,CDM,Hc Recovery Observation/hr,7100010,7100010,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,498.16,% of charge rate,95.00%,473.25,,,,473.25,498.16,0
unity,CDM,Hc Recovery Observation/hr,7100010,7100010,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,498.16,% of charge rate,95.00%,473.25,,,,473.25,498.16,0
unity,CDM,Hc Chest Multiple Views,3200314,71030,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.33,% of charge rate,95.00%,110.51,,,,110.51,116.33,0
unity,CDM,Hc Chest Multiple Views,3200314,71030,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.33,% of charge rate,95.00%,110.51,,,,110.51,116.33,0
unity,CDM,Hc Xray Chest 1 View,3240020,71045,,X-ray exam chest 1 view,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.78,% of charge rate,95.00%,56.79,,,,56.79,59.78,0
unity,CDM,Hc Xray Chest 1 View,3240020,71045,,X-ray exam chest 1 view,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.78,% of charge rate,95.00%,56.79,,,,56.79,59.78,0
unity,CDM,Hc Xray Chest 2 Views,3240021,71046,,X-ray exam chest 2 views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.63,% of charge rate,95.00%,101.3,,,,101.3,106.63,0
unity,CDM,Hc Xray Chest 2 Views,3240021,71046,,X-ray exam chest 2 views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.63,% of charge rate,95.00%,101.3,,,,101.3,106.63,0
unity,CDM,Hc Xray Chest 3 Views,3240022,71047,,X-ray exam chest 3 views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.47,% of charge rate,95.00%,85.95,,,,85.95,90.47,0
unity,CDM,Hc Xray Chest 3 Views,3240022,71047,,X-ray exam chest 3 views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.47,% of charge rate,95.00%,85.95,,,,85.95,90.47,0
unity,CDM,XR-RIBS 2 VIEWS,3240007,71100,,X-ray exam ribs uni 2 views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.93,% of charge rate,95.00%,92.08,,,,92.08,96.93,0
unity,CDM,XR-RIBS 2 VIEWS,3240007,71100,,X-ray exam ribs uni 2 views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.93,% of charge rate,95.00%,92.08,,,,92.08,96.93,0
unity,CDM,XR-RIBS 3+ VIEWS,3240008,71101,,X-ray exam unilat ribs/chest,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.57,% of charge rate,95.00%,107.89,,,,107.89,113.57,0
unity,CDM,XR-RIBS 3+ VIEWS,3240008,71101,,X-ray exam unilat ribs/chest,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.57,% of charge rate,95.00%,107.89,,,,107.89,113.57,0
unity,CDM,XR-RIBS 3 VIEWS,3240009,71110,,X-ray exam ribs bil 3 views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.63,% of charge rate,95.00%,110.8,,,,110.8,116.63,0
unity,CDM,XR-RIBS 3 VIEWS,3240009,71110,,X-ray exam ribs bil 3 views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.63,% of charge rate,95.00%,110.8,,,,110.8,116.63,0
unity,CDM,XR-RIBS 4 VIEWS,3240010,71111,,X-ray exam ribs/chest4/> vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.55,% of charge rate,95.00%,133.52,,,,133.52,140.55,0
unity,CDM,XR-RIBS 4 VIEWS,3240010,71111,,X-ray exam ribs/chest4/> vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.55,% of charge rate,95.00%,133.52,,,,133.52,140.55,0
unity,CDM,XR-STERNUM 2+ VIEWS,3240011,71120,,X-ray exam breastbone 2/>vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.26,% of charge rate,95.00%,92.4,,,,92.4,97.26,0
unity,CDM,XR-STERNUM 2+ VIEWS,3240011,71120,,X-ray exam breastbone 2/>vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.26,% of charge rate,95.00%,92.4,,,,92.4,97.26,0
unity,CDM,Hc Sterno-clav Jts Min 3 V,3200230,71130,,X-ray strenoclavic jt 3/>vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.68,% of charge rate,95.00%,108.95,,,,108.95,114.68,0
unity,CDM,Hc Sterno-clav Jts Min 3 V,3200230,71130,,X-ray strenoclavic jt 3/>vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.68,% of charge rate,95.00%,108.95,,,,108.95,114.68,0
unity,CDM,CT-THORAX,3520000,71250,,Ct thorax w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,899.91,% of charge rate,95.00%,854.91,,,,854.91,899.91,0
unity,CDM,CT-THORAX,3520000,71250,,Ct thorax w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,899.91,% of charge rate,95.00%,854.91,,,,854.91,899.91,0
unity,CDM,CT-THORAX,3520010,71260,,Ct thorax w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,161.65",% of charge rate,95.00%,"1,103.57",,,,"1,103.57","1,161.65",0
unity,CDM,CT-THORAX,3520010,71260,,Ct thorax w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,161.65",% of charge rate,95.00%,"1,103.57",,,,"1,103.57","1,161.65",0
unity,CDM,CT THORAX,3520002,71270,,Ct thorax w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,436.29",% of charge rate,95.00%,"1,364.48",,,,"1,364.48","1,436.29",0
unity,CDM,CT THORAX,3520002,71270,,Ct thorax w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,436.29",% of charge rate,95.00%,"1,364.48",,,,"1,364.48","1,436.29",0
unity,CDM,CT-CHEST,3500005,71275,,Ct angiography chest,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,699.13",% of charge rate,95.00%,"1,614.17",,,,"1,614.17","1,699.13",0
unity,CDM,CT-CHEST,3500005,71275,,Ct angiography chest,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,699.13",% of charge rate,95.00%,"1,614.17",,,,"1,614.17","1,699.13",0
unity,CDM,MRI-CHEST,6100009,71550,,Mri chest w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,135.25",% of charge rate,95.00%,"2,978.49",,,,"2,978.49","3,135.25",0
unity,CDM,MRI-CHEST,6100009,71550,,Mri chest w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,135.25",% of charge rate,95.00%,"2,978.49",,,,"2,978.49","3,135.25",0
unity,CDM,CHEST WO/W DYE,6100011,71552,,Mri chest w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,162.75",% of charge rate,95.00%,"3,954.61",,,,"3,954.61","4,162.75",0
unity,CDM,CHEST WO/W DYE,6100011,71552,,Mri chest w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,162.75",% of charge rate,95.00%,"3,954.61",,,,"3,954.61","4,162.75",0
unity,CDM,XR-SPINE SINGLE VIEW,3200232,72020,,X-ray exam of spine 1 view,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.63,% of charge rate,95.00%,61.4,,,,61.4,64.63,0
unity,CDM,XR-SPINE SINGLE VIEW,3200232,72020,,X-ray exam of spine 1 view,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.63,% of charge rate,95.00%,61.4,,,,61.4,64.63,0
unity,CDM,XR-SPINE 2/3 VIEWS,3200233,72040,,X-ray exam neck spine 2-3 vw,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.71,% of charge rate,95.00%,81.42,,,,81.42,85.71,0
unity,CDM,XR-SPINE 2/3 VIEWS,3200233,72040,,X-ray exam neck spine 2-3 vw,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.71,% of charge rate,95.00%,81.42,,,,81.42,85.71,0
unity,CDM,XR-SPINE 4/5 VIEWS,3200017,72050,,X-ray exam neck spine 4/5vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.59,% of charge rate,95.00%,119.31,,,,119.31,125.59,0
unity,CDM,XR-SPINE 4/5 VIEWS,3200017,72050,,X-ray exam neck spine 4/5vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.59,% of charge rate,95.00%,119.31,,,,119.31,125.59,0
unity,CDM,XR-SPINE 6+ VIEWS,3200018,72052,,X-ray exam neck spine 6/>vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,166.38,% of charge rate,95.00%,158.06,,,,158.06,166.38,0
unity,CDM,XR-SPINE 6+ VIEWS,3200018,72052,,X-ray exam neck spine 6/>vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,166.38,% of charge rate,95.00%,158.06,,,,158.06,166.38,0
unity,CDM,XR-THORACIC SPINE 2 VIEWS,3200301,72070,,X-ray exam thorac spine 2vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.8,% of charge rate,95.00%,96.71,,,,96.71,101.8,0
unity,CDM,XR-THORACIC SPINE 2 VIEWS,3200301,72070,,X-ray exam thorac spine 2vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.8,% of charge rate,95.00%,96.71,,,,96.71,101.8,0
unity,CDM,Hc Thoracic Ap/lateral Spine,3200312,72070,,X-ray exam thorac spine 2vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.8,% of charge rate,95.00%,96.71,,,,96.71,101.8,0
unity,CDM,Hc Thoracic Ap/lateral Spine,3200312,72070,,X-ray exam thorac spine 2vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.8,% of charge rate,95.00%,96.71,,,,96.71,101.8,0
unity,CDM,XR-THORACIC SPINE 3 VIEWS,3200020,72072,,X-ray exam thorac spine 3vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.63,% of charge rate,95.00%,110.8,,,,110.8,116.63,0
unity,CDM,XR-THORACIC SPINE 3 VIEWS,3200020,72072,,X-ray exam thorac spine 3vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.63,% of charge rate,95.00%,110.8,,,,110.8,116.63,0
unity,CDM,XR-TRUNK SPINE 2 VIEWS,3200022,72080,,X-ray exam thoracolmb 2/> vw,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.87,% of charge rate,95.00%,84.43,,,,84.43,88.87,0
unity,CDM,XR-TRUNK SPINE 2 VIEWS,3200022,72080,,X-ray exam thoracolmb 2/> vw,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.87,% of charge rate,95.00%,84.43,,,,84.43,88.87,0
unity,CDM,X-RAY EXAM ENTIRE SPINE 1 VW,3200339,72081,,X-ray exam entire spi 1 vw,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110,% of charge rate,95.00%,104.5,,,,104.5,110,0
unity,CDM,X-RAY EXAM ENTIRE SPINE 1 VW,3200339,72081,,X-ray exam entire spi 1 vw,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110,% of charge rate,95.00%,104.5,,,,104.5,110,0
unity,CDM,X-RAY EXAM ENTIRE SPINE 2/3 VW,3200340,72082,,X-ray exam entire spi 2/3 vw,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,230,% of charge rate,95.00%,218.5,,,,218.5,230,0
unity,CDM,X-RAY EXAM ENTIRE SPINE 2/3 VW,3200340,72082,,X-ray exam entire spi 2/3 vw,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,230,% of charge rate,95.00%,218.5,,,,218.5,230,0
unity,CDM,X-RAY EXAM ENITRE SPINE 4/5 VW,3200341,72083,,X-ray exam entire spi 4/5 vw,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,254.18,% of charge rate,95.00%,241.47,,,,241.47,254.18,0
unity,CDM,X-RAY EXAM ENITRE SPINE 4/5 VW,3200341,72083,,X-ray exam entire spi 4/5 vw,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,254.18,% of charge rate,95.00%,241.47,,,,241.47,254.18,0
unity,CDM,"Hc Xray Exam Of Spine,minimum Of 6 Views",3200370,72084,,X-ray exam entire spi 6/> vw,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,350,% of charge rate,95.00%,332.5,,,,332.5,350,0
unity,CDM,"Hc Xray Exam Of Spine,minimum Of 6 Views",3200370,72084,,X-ray exam entire spi 6/> vw,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,350,% of charge rate,95.00%,332.5,,,,332.5,350,0
unity,CDM,XR-LUMBAR SPINE 2 VIEWS,3200024,72100,,X-ray exam l-s spine 2/3 vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.63,% of charge rate,95.00%,110.8,,,,110.8,116.63,0
unity,CDM,XR-LUMBAR SPINE 2 VIEWS,3200024,72100,,X-ray exam l-s spine 2/3 vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.63,% of charge rate,95.00%,110.8,,,,110.8,116.63,0
unity,CDM,XR-LUMBAR SPINE,3200025,72110,,X-ray exam l-2 spine 4/>vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.65,% of charge rate,95.00%,150.72,,,,150.72,158.65,0
unity,CDM,XR-LUMBAR SPINE,3200025,72110,,X-ray exam l-2 spine 4/>vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.65,% of charge rate,95.00%,150.72,,,,150.72,158.65,0
unity,CDM,CT-CERVICAL SPINE,3520003,72125,,Ct neck spine w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,052.25",% of charge rate,95.00%,999.64,,,,999.64,"1,052.25",0
unity,CDM,CT-CERVICAL SPINE,3520003,72125,,Ct neck spine w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,052.25",% of charge rate,95.00%,999.64,,,,999.64,"1,052.25",0
unity,CDM,CT-CERVICAL SPINE,3500006,72126,,Ct neck spine w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,339.75",% of charge rate,95.00%,"1,272.76",,,,"1,272.76","1,339.75",0
unity,CDM,CT-CERVICAL SPINE,3500006,72126,,Ct neck spine w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,339.75",% of charge rate,95.00%,"1,272.76",,,,"1,272.76","1,339.75",0
unity,CDM,CT-THORACIC SPINE,3500008,72128,,Ct chest spine w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,049.38",% of charge rate,95.00%,996.91,,,,996.91,"1,049.38",0
unity,CDM,CT-THORACIC SPINE,3500008,72128,,Ct chest spine w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,049.38",% of charge rate,95.00%,996.91,,,,996.91,"1,049.38",0
unity,CDM,CT-THORACIC SPINE,3500009,72129,,Ct chest spine w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,451.00",% of charge rate,95.00%,"1,378.45",,,,"1,378.45","1,451.00",0
unity,CDM,CT-THORACIC SPINE,3500009,72129,,Ct chest spine w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,451.00",% of charge rate,95.00%,"1,378.45",,,,"1,378.45","1,451.00",0
unity,CDM,CT-LUMBAR SPINE,3500011,72131,,Ct lumbar spine w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,043.63",% of charge rate,95.00%,991.45,,,,991.45,"1,043.63",0
unity,CDM,CT-LUMBAR SPINE,3500011,72131,,Ct lumbar spine w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,043.63",% of charge rate,95.00%,991.45,,,,991.45,"1,043.63",0
unity,CDM,MRI-C-SPINE,6120000,72141,,Mri neck spine w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,628.75",% of charge rate,95.00%,"1,547.31",,,,"1,547.31","1,628.75",0
unity,CDM,MRI-C-SPINE,6120000,72141,,Mri neck spine w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,628.75",% of charge rate,95.00%,"1,547.31",,,,"1,547.31","1,628.75",0
unity,CDM,MRI-C-SPINE,6120001,72142,,Mri neck spine w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,313.00",% of charge rate,95.00%,"2,197.35",,,,"2,197.35","2,313.00",0
unity,CDM,MRI-C-SPINE,6120001,72142,,Mri neck spine w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,313.00",% of charge rate,95.00%,"2,197.35",,,,"2,197.35","2,313.00",0
unity,CDM,MRI-T-SPINE,6120002,72146,,Mri chest spine w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,631.63",% of charge rate,95.00%,"1,550.05",,,,"1,550.05","1,631.63",0
unity,CDM,MRI-T-SPINE,6120002,72146,,Mri chest spine w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,631.63",% of charge rate,95.00%,"1,550.05",,,,"1,550.05","1,631.63",0
unity,CDM,MRI-T-SPINE,6120003,72147,,Mri chest spine w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,301.50",% of charge rate,95.00%,"2,186.43",,,,"2,186.43","2,301.50",0
unity,CDM,MRI-T-SPINE,6120003,72147,,Mri chest spine w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,301.50",% of charge rate,95.00%,"2,186.43",,,,"2,186.43","2,301.50",0
unity,CDM,MRI-L-SPINE,6120004,72148,,Mri lumbar spine w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,631.63",% of charge rate,95.00%,"1,550.05",,,,"1,550.05","1,631.63",0
unity,CDM,MRI-L-SPINE,6120004,72148,,Mri lumbar spine w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,631.63",% of charge rate,95.00%,"1,550.05",,,,"1,550.05","1,631.63",0
unity,CDM,MRI-LUMBAR SPINE,6120005,72149,,Mri lumbar spine w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,281.38",% of charge rate,95.00%,"2,167.31",,,,"2,167.31","2,281.38",0
unity,CDM,MRI-LUMBAR SPINE,6120005,72149,,Mri lumbar spine w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,281.38",% of charge rate,95.00%,"2,167.31",,,,"2,167.31","2,281.38",0
unity,CDM,MRI-C-SPINE,6120006,72156,,Mri neck spine w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,540.13",% of charge rate,95.00%,"2,413.12",,,,"2,413.12","2,540.13",0
unity,CDM,MRI-C-SPINE,6120006,72156,,Mri neck spine w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,540.13",% of charge rate,95.00%,"2,413.12",,,,"2,413.12","2,540.13",0
unity,CDM,T-SPINE,6120007,72157,,Mri chest spine w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,548.75",% of charge rate,95.00%,"2,421.31",,,,"2,421.31","2,548.75",0
unity,CDM,T-SPINE,6120007,72157,,Mri chest spine w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,548.75",% of charge rate,95.00%,"2,421.31",,,,"2,421.31","2,548.75",0
unity,CDM,L-SPINE,6120008,72158,,Mri lumbar spine w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,534.38",% of charge rate,95.00%,"2,407.66",,,,"2,407.66","2,534.38",0
unity,CDM,L-SPINE,6120008,72158,,Mri lumbar spine w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,534.38",% of charge rate,95.00%,"2,407.66",,,,"2,407.66","2,534.38",0
unity,CDM,XRAY PELVIS,3200028,72170,,X-ray exam of pelvis,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.41,% of charge rate,95.00%,98.24,,,,98.24,103.41,0
unity,CDM,XRAY PELVIS,3200028,72170,,X-ray exam of pelvis,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.41,% of charge rate,95.00%,98.24,,,,98.24,103.41,0
unity,CDM,Hc Pelvis Minimum 3 Views,3200029,72190,,X-ray exam of pelvis,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.77,% of charge rate,95.00%,116.63,,,,116.63,122.77,0
unity,CDM,Hc Pelvis Minimum 3 Views,3200029,72190,,X-ray exam of pelvis,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.77,% of charge rate,95.00%,116.63,,,,116.63,122.77,0
unity,CDM,CT PELVIS,3520004,72192,,Ct pelvis w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,733.13,% of charge rate,95.00%,696.47,,,,696.47,733.13,0
unity,CDM,CT PELVIS,3520004,72192,,Ct pelvis w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,733.13,% of charge rate,95.00%,696.47,,,,696.47,733.13,0
unity,CDM,CT PELVIS,3520005,72193,,Ct pelvis w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,417.38",% of charge rate,95.00%,"1,346.51",,,,"1,346.51","1,417.38",0
unity,CDM,CT PELVIS,3520005,72193,,Ct pelvis w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,417.38",% of charge rate,95.00%,"1,346.51",,,,"1,346.51","1,417.38",0
unity,CDM,CT PELVIS,3520006,72194,,Ct pelvis w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,653.13",% of charge rate,95.00%,"1,570.47",,,,"1,570.47","1,653.13",0
unity,CDM,CT PELVIS,3520006,72194,,Ct pelvis w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,653.13",% of charge rate,95.00%,"1,570.47",,,,"1,570.47","1,653.13",0
unity,CDM,PELVIS,6100013,72195,,Mri pelvis w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,101.95",% of charge rate,95.00%,"1,996.85",,,,"1,996.85","2,101.95",0
unity,CDM,PELVIS,6100013,72195,,Mri pelvis w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,101.95",% of charge rate,95.00%,"1,996.85",,,,"1,996.85","2,101.95",0
unity,CDM,MRI-PELVIS,6100014,72196,,Mri pelvis w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,261.89",% of charge rate,95.00%,"2,148.80",,,,"2,148.80","2,261.89",0
unity,CDM,MRI-PELVIS,6100014,72196,,Mri pelvis w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,261.89",% of charge rate,95.00%,"2,148.80",,,,"2,148.80","2,261.89",0
unity,CDM,MRI PELVIS,6100015,72197,,Mri pelvis w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,733.67",% of charge rate,95.00%,"2,596.99",,,,"2,596.99","2,733.67",0
unity,CDM,MRI PELVIS,6100015,72197,,Mri pelvis w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,733.67",% of charge rate,95.00%,"2,596.99",,,,"2,596.99","2,733.67",0
unity,CDM,Hc Mra Pelvis W/wo Dye,6100016,72198,,Mr angio pelvis w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,911.00",% of charge rate,95.00%,"2,765.45",,,,"2,765.45","2,911.00",0
unity,CDM,Hc Mra Pelvis W/wo Dye,6100016,72198,,Mr angio pelvis w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,911.00",% of charge rate,95.00%,"2,765.45",,,,"2,765.45","2,911.00",0
unity,CDM,XRAY SACROILIAC JOINTS,3200030,72200,,X-ray exam si joints,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.08,% of charge rate,95.00%,91.28,,,,91.28,96.08,0
unity,CDM,XRAY SACROILIAC JOINTS,3200030,72200,,X-ray exam si joints,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.08,% of charge rate,95.00%,91.28,,,,91.28,96.08,0
unity,CDM,Hc Sacroiliac Joints,3200031,72202,,X-ray exam si joints 3/> vws,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.42,% of charge rate,95.00%,105.85,,,,105.85,111.42,0
unity,CDM,Hc Sacroiliac Joints,3200031,72202,,X-ray exam si joints 3/> vws,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.42,% of charge rate,95.00%,105.85,,,,105.85,111.42,0
unity,CDM,XRAY  SACRUM & COCCYX,3200032,72220,,X-ray exam sacrum tailbone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.26,% of charge rate,95.00%,92.4,,,,92.4,97.26,0
unity,CDM,XRAY  SACRUM & COCCYX,3200032,72220,,X-ray exam sacrum tailbone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.26,% of charge rate,95.00%,92.4,,,,92.4,97.26,0
unity,CDM,XRAY CLAVICLE,3200041,73000,,X-ray exam of collar bone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XRAY CLAVICLE,3200041,73000,,X-ray exam of collar bone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,HC SCAPULA,3200042,73010,,X-ray exam of shoulder blade,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.7,% of charge rate,95.00%,98.52,,,,98.52,103.7,0
unity,CDM,HC SCAPULA,3200042,73010,,X-ray exam of shoulder blade,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.7,% of charge rate,95.00%,98.52,,,,98.52,103.7,0
unity,CDM,XRAY SHOULDER,3200043,73020,,X-ray exam of shoulder,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.86,% of charge rate,95.00%,64.47,,,,64.47,67.86,0
unity,CDM,XRAY SHOULDER,3200043,73020,,X-ray exam of shoulder,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.86,% of charge rate,95.00%,64.47,,,,64.47,67.86,0
unity,CDM,XRAY SHOULDER,3200044,73030,,X-ray exam of shoulder,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.26,% of charge rate,95.00%,82.9,,,,82.9,87.26,0
unity,CDM,XRAY SHOULDER,3200044,73030,,X-ray exam of shoulder,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.26,% of charge rate,95.00%,82.9,,,,82.9,87.26,0
unity,CDM,XRAY AC JOINTS,3200046,73050,,X-ray exam of shoulders,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.48,% of charge rate,95.00%,115.41,,,,115.41,121.48,0
unity,CDM,XRAY AC JOINTS,3200046,73050,,X-ray exam of shoulders,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.48,% of charge rate,95.00%,115.41,,,,115.41,121.48,0
unity,CDM,XRAY HUMERUS,3200047,73060,,X-ray exam of humerus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,92.09,% of charge rate,95.00%,87.49,,,,87.49,92.09,0
unity,CDM,XRAY HUMERUS,3200047,73060,,X-ray exam of humerus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,92.09,% of charge rate,95.00%,87.49,,,,87.49,92.09,0
unity,CDM,XRAY ELBOW,3200048,73070,,X-ray exam of elbow,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XRAY ELBOW,3200048,73070,,X-ray exam of elbow,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XRAY ELBOW,3200049,73080,,X-ray exam of elbow,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.18,% of charge rate,95.00%,95.17,,,,95.17,100.18,0
unity,CDM,XRAY ELBOW,3200049,73080,,X-ray exam of elbow,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.18,% of charge rate,95.00%,95.17,,,,95.17,100.18,0
unity,CDM,XRAY FOREARM,3200051,73090,,X-ray exam of forearm,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.56,% of charge rate,95.00%,83.18,,,,83.18,87.56,0
unity,CDM,XRAY FOREARM,3200051,73090,,X-ray exam of forearm,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.56,% of charge rate,95.00%,83.18,,,,83.18,87.56,0
unity,CDM,Hc Child Upper Extremity,3200052,73092,,X-ray exam of arm infant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,Hc Child Upper Extremity,3200052,73092,,X-ray exam of arm infant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XRAY WRIST,3200053,73100,,X-ray exam of wrist,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.05,% of charge rate,95.00%,99.8,,,,99.8,105.05,0
unity,CDM,XRAY WRIST,3200053,73100,,X-ray exam of wrist,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.05,% of charge rate,95.00%,99.8,,,,99.8,105.05,0
unity,CDM,XRAY WRIST,3200054,73110,,X-ray exam of wrist,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,119.58,% of charge rate,95.00%,113.6,,,,113.6,119.58,0
unity,CDM,XRAY WRIST,3200054,73110,,X-ray exam of wrist,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,119.58,% of charge rate,95.00%,113.6,,,,113.6,119.58,0
unity,CDM,XRAY HAND,3200056,73120,,X-ray exam of hand,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,XRAY HAND,3200056,73120,,X-ray exam of hand,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,XRAY HAND,3200057,73130,,X-ray exam of hand,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,108.57,% of charge rate,95.00%,103.14,,,,103.14,108.57,0
unity,CDM,XRAY HAND,3200057,73130,,X-ray exam of hand,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,108.57,% of charge rate,95.00%,103.14,,,,103.14,108.57,0
unity,CDM,XRAY FINGER,3200058,73140,,X-ray exam of finger(s),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.48,% of charge rate,95.00%,98.31,,,,98.31,103.48,0
unity,CDM,XRAY FINGER,3200058,73140,,X-ray exam of finger(s),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.48,% of charge rate,95.00%,98.31,,,,98.31,103.48,0
unity,CDM,CT UPPER EXTREMITY,3500016,73200,,Ct upper extremity w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,040.75",% of charge rate,95.00%,988.71,,,,988.71,"1,040.75",0
unity,CDM,CT UPPER EXTREMITY,3500016,73200,,Ct upper extremity w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,040.75",% of charge rate,95.00%,988.71,,,,988.71,"1,040.75",0
unity,CDM,CT UPPER EXTREMITY,3500017,73201,,Ct upper extremity w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,328.25",% of charge rate,95.00%,"1,261.84",,,,"1,261.84","1,328.25",0
unity,CDM,CT UPPER EXTREMITY,3500017,73201,,Ct upper extremity w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,328.25",% of charge rate,95.00%,"1,261.84",,,,"1,261.84","1,328.25",0
unity,CDM,UPPER EXT W/O DYE,6100017,73218,,Mri upper extremity w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,804.63",% of charge rate,95.00%,"2,664.40",,,,"2,664.40","2,804.63",0
unity,CDM,UPPER EXT W/O DYE,6100017,73218,,Mri upper extremity w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,804.63",% of charge rate,95.00%,"2,664.40",,,,"2,664.40","2,804.63",0
unity,CDM,Hc Upper Ext Wdye,6100018,73219,,Mri upper extremity w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,980.00",% of charge rate,95.00%,"2,831.00",,,,"2,831.00","2,980.00",0
unity,CDM,Hc Upper Ext Wdye,6100018,73219,,Mri upper extremity w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,980.00",% of charge rate,95.00%,"2,831.00",,,,"2,831.00","2,980.00",0
unity,CDM,MRI-UPPER EXTREMITY,6100019,73220,,Mri uppr extremity w/o&w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,526.25",% of charge rate,95.00%,"3,349.94",,,,"3,349.94","3,526.25",0
unity,CDM,MRI-UPPER EXTREMITY,6100019,73220,,Mri uppr extremity w/o&w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,526.25",% of charge rate,95.00%,"3,349.94",,,,"3,349.94","3,526.25",0
unity,CDM,MRI-UPPER EXTREMITY,6100020,73221,,Mri joint upr extrem w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,781.13",% of charge rate,95.00%,"1,692.07",,,,"1,692.07","1,781.13",0
unity,CDM,MRI-UPPER EXTREMITY,6100020,73221,,Mri joint upr extrem w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,781.13",% of charge rate,95.00%,"1,692.07",,,,"1,692.07","1,781.13",0
unity,CDM,Hc Mra Upper Ext W/wo Dye,6100023,73225,,Mr angio upr extr w/o&w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,905.25",% of charge rate,95.00%,"2,759.99",,,,"2,759.99","2,905.25",0
unity,CDM,Hc Mra Upper Ext W/wo Dye,6100023,73225,,Mr angio upr extr w/o&w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,905.25",% of charge rate,95.00%,"2,759.99",,,,"2,759.99","2,905.25",0
unity,CDM,X-RAY EXAM HIP UNI 1 VW,3200342,73501,,X-ray exam hip uni 1 view,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.4,% of charge rate,95.00%,83.03,,,,83.03,87.4,0
unity,CDM,X-RAY EXAM HIP UNI 1 VW,3200342,73501,,X-ray exam hip uni 1 view,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.4,% of charge rate,95.00%,83.03,,,,83.03,87.4,0
unity,CDM,X-RAY EXAM HIP UNI 2-3 VW,3200343,73502,,X-ray exam hip uni 2-3 views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,135.72,% of charge rate,95.00%,128.93,,,,128.93,135.72,0
unity,CDM,X-RAY EXAM HIP UNI 2-3 VW,3200343,73502,,X-ray exam hip uni 2-3 views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,135.72,% of charge rate,95.00%,128.93,,,,128.93,135.72,0
unity,CDM,Hc X-ray Exam Hip Bil 2 Vw,3200344,73521,,X-ray exam hips bi 2 views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144.73,% of charge rate,95.00%,137.49,,,,137.49,144.73,0
unity,CDM,Hc X-ray Exam Hip Bil 2 Vw,3200344,73521,,X-ray exam hips bi 2 views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144.73,% of charge rate,95.00%,137.49,,,,137.49,144.73,0
unity,CDM,X-RAY EXAM FEMUR 1 VW,3200345,73551,,X-ray exam of femur 1,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.49,% of charge rate,95.00%,80.27,,,,80.27,84.49,0
unity,CDM,X-RAY EXAM FEMUR 1 VW,3200345,73551,,X-ray exam of femur 1,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.49,% of charge rate,95.00%,80.27,,,,80.27,84.49,0
unity,CDM,X-RAY EXAM FEMUR 2/>,3200346,73552,,X-ray exam of femur 2/>,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.4,% of charge rate,95.00%,98.23,,,,98.23,103.4,0
unity,CDM,X-RAY EXAM FEMUR 2/>,3200346,73552,,X-ray exam of femur 2/>,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.4,% of charge rate,95.00%,98.23,,,,98.23,103.4,0
unity,CDM,XRAY KNEE,3200067,73560,,X-ray exam of knee 1 or 2,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.8,% of charge rate,95.00%,96.71,,,,96.71,101.8,0
unity,CDM,XRAY KNEE,3200067,73560,,X-ray exam of knee 1 or 2,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.8,% of charge rate,95.00%,96.71,,,,96.71,101.8,0
unity,CDM,XRAY KNEE,3200068,73562,,X-ray exam of knee 3,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.94,% of charge rate,95.00%,112.04,,,,112.04,117.94,0
unity,CDM,XRAY KNEE,3200068,73562,,X-ray exam of knee 3,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.94,% of charge rate,95.00%,112.04,,,,112.04,117.94,0
unity,CDM,Hc Knee Min 3 Views Bilateral,3200234,73562,,X-ray exam of knee 3,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.94,% of charge rate,95.00%,112.04,,,,112.04,117.94,0
unity,CDM,Hc Knee Min 3 Views Bilateral,3200234,73562,,X-ray exam of knee 3,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.94,% of charge rate,95.00%,112.04,,,,112.04,117.94,0
unity,CDM,XRAY KNEE,3200069,73564,,X-ray exam knee 4 or more,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,131.72,% of charge rate,95.00%,125.13,,,,125.13,131.72,0
unity,CDM,XRAY KNEE,3200069,73564,,X-ray exam knee 4 or more,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,131.72,% of charge rate,95.00%,125.13,,,,125.13,131.72,0
unity,CDM,XRAY KNEES-STANDING,3200070,73565,,X-ray exam of knees,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.19,% of charge rate,95.00%,115.13,,,,115.13,121.19,0
unity,CDM,XRAY KNEES-STANDING,3200070,73565,,X-ray exam of knees,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.19,% of charge rate,95.00%,115.13,,,,115.13,121.19,0
unity,CDM,XRAY LOWER LEG,3200072,73590,,X-ray exam of lower leg,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.47,% of charge rate,95.00%,85.95,,,,85.95,90.47,0
unity,CDM,XRAY LOWER LEG,3200072,73590,,X-ray exam of lower leg,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.47,% of charge rate,95.00%,85.95,,,,85.95,90.47,0
unity,CDM,Hc Child Lower Ext Min 2 Views,3200074,73592,,X-ray exam of leg infant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.87,% of charge rate,95.00%,84.43,,,,84.43,88.87,0
unity,CDM,Hc Child Lower Ext Min 2 Views,3200074,73592,,X-ray exam of leg infant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.87,% of charge rate,95.00%,84.43,,,,84.43,88.87,0
unity,CDM,XRAY ANKLE,3200075,73600,,X-ray exam of ankle,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.93,% of charge rate,95.00%,92.08,,,,92.08,96.93,0
unity,CDM,XRAY ANKLE,3200075,73600,,X-ray exam of ankle,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.93,% of charge rate,95.00%,92.08,,,,92.08,96.93,0
unity,CDM,XRAY ANKLE,3200076,73610,,X-ray exam of ankle,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.18,% of charge rate,95.00%,95.17,,,,95.17,100.18,0
unity,CDM,XRAY ANKLE,3200076,73610,,X-ray exam of ankle,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.18,% of charge rate,95.00%,95.17,,,,95.17,100.18,0
unity,CDM,XRAY FOOT,3200078,73620,,X-ray exam of foot,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.4,% of charge rate,95.00%,78.28,,,,78.28,82.4,0
unity,CDM,XRAY FOOT,3200078,73620,,X-ray exam of foot,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.4,% of charge rate,95.00%,78.28,,,,78.28,82.4,0
unity,CDM,XRAY FOOT,3200079,73630,,X-ray exam of foot,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.18,% of charge rate,95.00%,94.22,,,,94.22,99.18,0
unity,CDM,XRAY FOOT,3200079,73630,,X-ray exam of foot,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.18,% of charge rate,95.00%,94.22,,,,94.22,99.18,0
unity,CDM,XRAY HEEL,3200080,73650,,X-ray exam of heel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XRAY HEEL,3200080,73650,,X-ray exam of heel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,XRAY TOE(S),3200081,73660,,X-ray exam of toe(s),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.08,% of charge rate,95.00%,91.28,,,,91.28,96.08,0
unity,CDM,XRAY TOE(S),3200081,73660,,X-ray exam of toe(s),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.08,% of charge rate,95.00%,91.28,,,,91.28,96.08,0
unity,CDM,CT LOWER EXTREMITY,3500020,73700,,Ct lower extremity w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,043.63",% of charge rate,95.00%,991.45,,,,991.45,"1,043.63",0
unity,CDM,CT LOWER EXTREMITY,3500020,73700,,Ct lower extremity w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,043.63",% of charge rate,95.00%,991.45,,,,991.45,"1,043.63",0
unity,CDM,CT LOWER EXTREMITY,3500021,73701,,Ct lower extremity w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,351.25",% of charge rate,95.00%,"1,283.69",,,,"1,283.69","1,351.25",0
unity,CDM,CT LOWER EXTREMITY,3500021,73701,,Ct lower extremity w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,351.25",% of charge rate,95.00%,"1,283.69",,,,"1,283.69","1,351.25",0
unity,CDM,MRI LOWER EXTREMITY,6100024,73718,,Mri lower extremity w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,069.64",% of charge rate,95.00%,"1,966.16",,,,"1,966.16","2,069.64",0
unity,CDM,MRI LOWER EXTREMITY,6100024,73718,,Mri lower extremity w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,069.64",% of charge rate,95.00%,"1,966.16",,,,"1,966.16","2,069.64",0
unity,CDM,MRI LOWER EXTREMITY,6100026,73720,,Mri lwr extremity w/o&w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,751.44",% of charge rate,95.00%,"2,613.87",,,,"2,613.87","2,751.44",0
unity,CDM,MRI LOWER EXTREMITY,6100026,73720,,Mri lwr extremity w/o&w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,751.44",% of charge rate,95.00%,"2,613.87",,,,"2,613.87","2,751.44",0
unity,CDM,MRI LOWER EXTREMITY,6100027,73721,,Mri jnt of lwr extre w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,781.13",% of charge rate,95.00%,"1,692.07",,,,"1,692.07","1,781.13",0
unity,CDM,MRI LOWER EXTREMITY,6100027,73721,,Mri jnt of lwr extre w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,781.13",% of charge rate,95.00%,"1,692.07",,,,"1,692.07","1,781.13",0
unity,CDM,LOWER EXT JOINT W/DYE,6100028,73722,,Mri joint of lwr extr w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,807.50",% of charge rate,95.00%,"2,667.13",,,,"2,667.13","2,807.50",0
unity,CDM,LOWER EXT JOINT W/DYE,6100028,73722,,Mri joint of lwr extr w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,807.50",% of charge rate,95.00%,"2,667.13",,,,"2,667.13","2,807.50",0
unity,CDM,LOWER EXT JOINT W/WO DYE,6100029,73723,,Mri joint lwr extr w/o&w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,299.13",% of charge rate,95.00%,"3,134.17",,,,"3,134.17","3,299.13",0
unity,CDM,LOWER EXT JOINT W/WO DYE,6100029,73723,,Mri joint lwr extr w/o&w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,299.13",% of charge rate,95.00%,"3,134.17",,,,"3,134.17","3,299.13",0
unity,CDM,Hc Mra Lower Ext W/wo Dye,6100030,73725,,Mr ang lwr ext w or w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,908.30",% of charge rate,95.00%,"2,762.89",,,,"2,762.89","2,908.30",0
unity,CDM,Hc Mra Lower Ext W/wo Dye,6100030,73725,,Mr ang lwr ext w or w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,908.30",% of charge rate,95.00%,"2,762.89",,,,"2,762.89","2,908.30",0
unity,CDM,Hc Abdomen Ap & Obique,3200313,74010,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.37,% of charge rate,95.00%,85.85,,,,85.85,90.37,0
unity,CDM,Hc Abdomen Ap & Obique,3200313,74010,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.37,% of charge rate,95.00%,85.85,,,,85.85,90.37,0
unity,CDM,Hc Xray Abdomen 1 View,3200360,74018,,X-ray exam abdomen 1 view,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.63,% of charge rate,95.00%,61.4,,,,61.4,64.63,0
unity,CDM,Hc Xray Abdomen 1 View,3200360,74018,,X-ray exam abdomen 1 view,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.63,% of charge rate,95.00%,61.4,,,,61.4,64.63,0
unity,CDM,Hc Xray Abdomen 2 Views,3200361,74019,,X-ray exam abdomen 2 views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.63,% of charge rate,95.00%,101.3,,,,101.3,106.63,0
unity,CDM,Hc Xray Abdomen 2 Views,3200361,74019,,X-ray exam abdomen 2 views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.63,% of charge rate,95.00%,101.3,,,,101.3,106.63,0
unity,CDM,Hc Xray Abdomen 3+ Views,3200362,74021,,X-ray exam abdomen 3+ views,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,127.64,% of charge rate,95.00%,121.26,,,,121.26,127.64,0
unity,CDM,Hc Xray Abdomen 3+ Views,3200362,74021,,X-ray exam abdomen 3+ views,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,127.64,% of charge rate,95.00%,121.26,,,,121.26,127.64,0
unity,CDM,XRAY ABDOMEN,3200084,74022,,X-ray exam complete abdomen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137.64,% of charge rate,95.00%,130.76,,,,130.76,137.64,0
unity,CDM,XRAY ABDOMEN,3200084,74022,,X-ray exam complete abdomen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137.64,% of charge rate,95.00%,130.76,,,,130.76,137.64,0
unity,CDM,CT ABDOMEN,3520007,74150,,Ct abdomen w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,724.5,% of charge rate,95.00%,688.28,,,,688.28,724.5,0
unity,CDM,CT ABDOMEN,3520007,74150,,Ct abdomen w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,724.5,% of charge rate,95.00%,688.28,,,,688.28,724.5,0
unity,CDM,CT ABDOMEN,3520008,74160,,Ct abdomen w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,411.63",% of charge rate,95.00%,"1,341.05",,,,"1,341.05","1,411.63",0
unity,CDM,CT ABDOMEN,3520008,74160,,Ct abdomen w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,411.63",% of charge rate,95.00%,"1,341.05",,,,"1,341.05","1,411.63",0
unity,CDM,CT ABDOMEN,3520009,74170,,Ct abdomen w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,618.83",% of charge rate,95.00%,"1,537.89",,,,"1,537.89","1,618.83",0
unity,CDM,CT ABDOMEN,3520009,74170,,Ct abdomen w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,618.83",% of charge rate,95.00%,"1,537.89",,,,"1,537.89","1,618.83",0
unity,CDM,Hc Cta Abdomen/pelvis W/contrast,3520038,74174,,Ct angio abd&pelv w/o&w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,317.25",% of charge rate,95.00%,"2,201.39",,,,"2,201.39","2,317.25",0
unity,CDM,Hc Cta Abdomen/pelvis W/contrast,3520038,74174,,Ct angio abd&pelv w/o&w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,317.25",% of charge rate,95.00%,"2,201.39",,,,"2,201.39","2,317.25",0
unity,CDM,CT ABDOMEN/PELVIS,3520035,74176,,Ct abd & pelvis w/o contrast,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,959.6,% of charge rate,95.00%,911.62,,,,911.62,959.6,0
unity,CDM,CT ABDOMEN/PELVIS,3520035,74176,,Ct abd & pelvis w/o contrast,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,959.6,% of charge rate,95.00%,911.62,,,,911.62,959.6,0
unity,CDM,CT ABDOMEN/PELVIS,3520036,74177,,Ct abd & pelv w/contrast,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,837.13",% of charge rate,95.00%,"1,745.27",,,,"1,745.27","1,837.13",0
unity,CDM,CT ABDOMEN/PELVIS,3520036,74177,,Ct abd & pelv w/contrast,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,837.13",% of charge rate,95.00%,"1,745.27",,,,"1,745.27","1,837.13",0
unity,CDM,CT ABDOMEN/PELVIS,3520037,74178,,Ct abd & pelv 1/> regns,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,098.75",% of charge rate,95.00%,"1,993.81",,,,"1,993.81","2,098.75",0
unity,CDM,CT ABDOMEN/PELVIS,3520037,74178,,Ct abd & pelv 1/> regns,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,098.75",% of charge rate,95.00%,"1,993.81",,,,"1,993.81","2,098.75",0
unity,CDM,MRI-ABDOMEN,6100031,74181,,Mri abdomen w/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,814.38",% of charge rate,95.00%,"1,723.66",,,,"1,723.66","1,814.38",0
unity,CDM,MRI-ABDOMEN,6100031,74181,,Mri abdomen w/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,814.38",% of charge rate,95.00%,"1,723.66",,,,"1,723.66","1,814.38",0
unity,CDM,MRI ABDOMEN,6100033,74183,,Mri abdomen w/o & w/dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,740.11",% of charge rate,95.00%,"2,603.10",,,,"2,603.10","2,740.11",0
unity,CDM,MRI ABDOMEN,6100033,74183,,Mri abdomen w/o & w/dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,740.11",% of charge rate,95.00%,"2,603.10",,,,"2,603.10","2,740.11",0
unity,CDM,MRA ABDOMEN,6100034,74185,,Mri angio abdom w orw/o dye,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,919.63",% of charge rate,95.00%,"2,773.65",,,,"2,773.65","2,919.63",0
unity,CDM,MRA ABDOMEN,6100034,74185,,Mri angio abdom w orw/o dye,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,919.63",% of charge rate,95.00%,"2,773.65",,,,"2,773.65","2,919.63",0
unity,CDM,Hc Chole Operative,3200100,74300,,X-ray bile ducts/pancreas,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.12,% of charge rate,95.00%,48.56,,,,48.56,51.12,0
unity,CDM,Hc Chole Operative,3200100,74300,,X-ray bile ducts/pancreas,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.12,% of charge rate,95.00%,48.56,,,,48.56,51.12,0
unity,CDM,Hc Cta Abdominal Arteries,3500031,75635,,Ct angio abdominal arteries,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,610.50",% of charge rate,95.00%,"2,479.98",,,,"2,479.98","2,610.50",0
unity,CDM,Hc Cta Abdominal Arteries,3500031,75635,,Ct angio abdominal arteries,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,610.50",% of charge rate,95.00%,"2,479.98",,,,"2,479.98","2,610.50",0
unity,CDM,Hc Ct Limited Or Localized Follow-up Study,3500027,76380,,Cat scan follow-up study,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,730.54,% of charge rate,95.00%,694.01,,,,694.01,730.54,0
unity,CDM,Hc Ct Limited Or Localized Follow-up Study,3500027,76380,,Cat scan follow-up study,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,730.54,% of charge rate,95.00%,694.01,,,,694.01,730.54,0
unity,CDM,US EXAM HEAD/NECK,4020004,76536,,Us exam of head and neck,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,402.29,% of charge rate,95.00%,382.18,,,,382.18,402.29,0
unity,CDM,US EXAM HEAD/NECK,4020004,76536,,Us exam of head and neck,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,402.29,% of charge rate,95.00%,382.18,,,,382.18,402.29,0
unity,CDM,Hc Us Exam Chest,4020005,76604,,Us exam chest,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,277.9,% of charge rate,95.00%,264.01,,,,264.01,277.9,0
unity,CDM,Hc Us Exam Chest,4020005,76604,,Us exam chest,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,277.9,% of charge rate,95.00%,264.01,,,,264.01,277.9,0
unity,CDM,US EXAM ABDOMEN COMPLETE,4020007,76700,,Us exam abdom complete,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,374.84,% of charge rate,95.00%,356.1,,,,356.1,374.84,0
unity,CDM,US EXAM ABDOMEN COMPLETE,4020007,76700,,Us exam abdom complete,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,374.84,% of charge rate,95.00%,356.1,,,,356.1,374.84,0
unity,CDM,US EXAM ABDOMEN LMTD,4020008,76705,,Echo exam of abdomen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.75,% of charge rate,95.00%,268.61,,,,268.61,282.75,0
unity,CDM,US EXAM ABDOMEN LMTD,4020008,76705,,Echo exam of abdomen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.75,% of charge rate,95.00%,268.61,,,,268.61,282.75,0
unity,CDM,Um Poct Us Fast,UM4022007,76705,,Echo exam of abdomen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.75,% of charge rate,95.00%,268.61,,,,268.61,282.75,0
unity,CDM,Um Poct Us Fast,UM4022007,76705,,Echo exam of abdomen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.75,% of charge rate,95.00%,268.61,,,,268.61,282.75,0
unity,CDM,Hc Ultrasound Exam Aaa Screen,4020080,76706,,Us abdl aorta screen aaa,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,375,% of charge rate,95.00%,356.25,,,,356.25,375,0
unity,CDM,Hc Ultrasound Exam Aaa Screen,4020080,76706,,Us abdl aorta screen aaa,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,375,% of charge rate,95.00%,356.25,,,,356.25,375,0
unity,CDM,US RENAL COMPLETE,4020009,76770,,Us exam abdo back wall comp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,348.97,% of charge rate,95.00%,331.52,,,,331.52,348.97,0
unity,CDM,US RENAL COMPLETE,4020009,76770,,Us exam abdo back wall comp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,348.97,% of charge rate,95.00%,331.52,,,,331.52,348.97,0
unity,CDM,US RENAL LMTD,4020010,76775,,Us exam abdo back wall lim,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,296.39,% of charge rate,95.00%,281.57,,,,281.57,296.39,0
unity,CDM,US RENAL LMTD,4020010,76775,,Us exam abdo back wall lim,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,296.39,% of charge rate,95.00%,281.57,,,,281.57,296.39,0
unity,CDM,Hc Us Exam Spinal Canal,4020012,76800,,Us exam spinal canal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,375,% of charge rate,95.00%,356.25,,,,356.25,375,0
unity,CDM,Hc Us Exam Spinal Canal,4020012,76800,,Us exam spinal canal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,375,% of charge rate,95.00%,356.25,,,,356.25,375,0
unity,CDM,US OB COMPLETE(<14 WKS),4020013,76801,,Ob us < 14 wks single fetus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,332.82,% of charge rate,95.00%,316.18,,,,316.18,332.82,0
unity,CDM,US OB COMPLETE(<14 WKS),4020013,76801,,Ob us < 14 wks single fetus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,332.82,% of charge rate,95.00%,316.18,,,,316.18,332.82,0
unity,CDM,US PREGNANCY COMPLETE,4020015,76805,,Ob us >= 14 wks sngl fetus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,418.45,% of charge rate,95.00%,397.53,,,,397.53,418.45,0
unity,CDM,US PREGNANCY COMPLETE,4020015,76805,,Ob us >= 14 wks sngl fetus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,418.45,% of charge rate,95.00%,397.53,,,,397.53,418.45,0
unity,CDM,US PREGNANCY CMPLT ADDL FETUS,4020016,76810,,Ob us >= 14 wks addl fetus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,196.52,% of charge rate,95.00%,186.69,,,,186.69,196.52,0
unity,CDM,US PREGNANCY CMPLT ADDL FETUS,4020016,76810,,Ob us >= 14 wks addl fetus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,196.52,% of charge rate,95.00%,186.69,,,,186.69,196.52,0
unity,CDM,US PREGNANCY LMTD,4020017,76815,,Ob us limited fetus(s),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,238.67,% of charge rate,95.00%,226.74,,,,226.74,238.67,0
unity,CDM,US PREGNANCY LMTD,4020017,76815,,Ob us limited fetus(s),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,238.67,% of charge rate,95.00%,226.74,,,,226.74,238.67,0
unity,CDM,Hc Follow Up/repeat Ob,4020018,76816,,Ob us follow-up per fetus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,326.36,% of charge rate,95.00%,310.04,,,,310.04,326.36,0
unity,CDM,Hc Follow Up/repeat Ob,4020018,76816,,Ob us follow-up per fetus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,326.36,% of charge rate,95.00%,310.04,,,,310.04,326.36,0
unity,CDM,US TRANSVAGINAL OB,4020019,76817,,Transvaginal us obstetric,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,269.8,% of charge rate,95.00%,256.31,,,,256.31,269.8,0
unity,CDM,US TRANSVAGINAL OB,4020019,76817,,Transvaginal us obstetric,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,269.8,% of charge rate,95.00%,256.31,,,,256.31,269.8,0
unity,CDM,US FETAL BIOPSY PROFILE,4020040,76818,,Fetal biophys profile w/nst,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,294.43,% of charge rate,95.00%,279.71,,,,279.71,294.43,0
unity,CDM,US FETAL BIOPSY PROFILE,4020040,76818,,Fetal biophys profile w/nst,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,294.43,% of charge rate,95.00%,279.71,,,,279.71,294.43,0
unity,CDM,Hc Bio Profile,4020020,76819,,Fetal biophys profil w/o nst,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235,% of charge rate,95.00%,223.25,,,,223.25,235,0
unity,CDM,Hc Bio Profile,4020020,76819,,Fetal biophys profil w/o nst,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235,% of charge rate,95.00%,223.25,,,,223.25,235,0
unity,CDM,US TRANSVAGINAL,4020022,76830,,Transvaginal us non-ob,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,399.05,% of charge rate,95.00%,379.1,,,,379.1,399.05,0
unity,CDM,US TRANSVAGINAL,4020022,76830,,Transvaginal us non-ob,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,399.05,% of charge rate,95.00%,379.1,,,,379.1,399.05,0
unity,CDM,US PELVIC COMPLETE,4020024,76856,,Us exam pelvic complete,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,344.14,% of charge rate,95.00%,326.93,,,,326.93,344.14,0
unity,CDM,US PELVIC COMPLETE,4020024,76856,,Us exam pelvic complete,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,344.14,% of charge rate,95.00%,326.93,,,,326.93,344.14,0
unity,CDM,US PELVIC LIMITED,4020025,76857,,Us exam pelvic limited,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,293.7,% of charge rate,95.00%,279.02,,,,279.02,293.7,0
unity,CDM,US PELVIC LIMITED,4020025,76857,,Us exam pelvic limited,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,293.7,% of charge rate,95.00%,279.02,,,,279.02,293.7,0
unity,CDM,US SCROTUM,4020026,76870,,Us exam scrotum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,326.23,% of charge rate,95.00%,309.92,,,,309.92,326.23,0
unity,CDM,US SCROTUM,4020026,76870,,Us exam scrotum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,326.23,% of charge rate,95.00%,309.92,,,,309.92,326.23,0
unity,CDM,US EXTREMITY,4020075,76882,,Us lmtd jt/nonvasc xtr strux,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,146.57,% of charge rate,95.00%,139.24,,,,139.24,146.57,0
unity,CDM,US EXTREMITY,4020075,76882,,Us lmtd jt/nonvasc xtr strux,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,146.57,% of charge rate,95.00%,139.24,,,,139.24,146.57,0
unity,CDM,Um Poct Us Guidance Iv,UM4022000,76937,,Us guide vascular access,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.94,% of charge rate,95.00%,66.44,,,,66.44,69.94,0
unity,CDM,Um Poct Us Guidance Iv,UM4022000,76937,,Us guide vascular access,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.94,% of charge rate,95.00%,66.44,,,,66.44,69.94,0
unity,CDM,Hc Us Guidance/ndl Placement,4020035,76942,,Echo guide for biopsy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.66,% of charge rate,95.00%,107.98,,,,107.98,113.66,0
unity,CDM,Hc Us Guidance/ndl Placement,4020035,76942,,Echo guide for biopsy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.66,% of charge rate,95.00%,107.98,,,,107.98,113.66,0
unity,CDM,Um Poct Us Biopsy,UM4022001,76942,,Echo guide for biopsy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.46,% of charge rate,95.00%,108.74,,,,108.74,114.46,0
unity,CDM,Um Poct Us Biopsy,UM4022001,76942,,Echo guide for biopsy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.46,% of charge rate,95.00%,108.74,,,,108.74,114.46,0
unity,CDM,Hc Us Study Follow Up Repeat,3200318,76970,,Ultrasound exam follow-up,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,336.05,% of charge rate,95.00%,319.25,,,,319.25,336.05,0
unity,CDM,Hc Us Study Follow Up Repeat,3200318,76970,,Ultrasound exam follow-up,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,336.05,% of charge rate,95.00%,319.25,,,,319.25,336.05,0
unity,CDM,Hc Diagnostic Mammo Tomo Unilateral,4010010,77061,,Breast tomosynthesis uni,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.78,% of charge rate,95.00%,82.44,,,,82.44,86.78,0
unity,CDM,Hc Diagnostic Mammo Tomo Unilateral,4010010,77061,,Breast tomosynthesis uni,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.78,% of charge rate,95.00%,82.44,,,,82.44,86.78,0
unity,CDM,Hc Diagnostic Mammo Tomo Bilat,4010011,77062,,Breast tomosynthesis bi,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,132.06,% of charge rate,95.00%,125.46,,,,125.46,132.06,0
unity,CDM,Hc Diagnostic Mammo Tomo Bilat,4010011,77062,,Breast tomosynthesis bi,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,132.06,% of charge rate,95.00%,125.46,,,,125.46,132.06,0
unity,CDM,Hc Tomo Screening Bilat Add-on,4030005,77063,,Breast tomosynthesis bi,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.48,% of charge rate,95.00%,107.81,,,,107.81,113.48,0
unity,CDM,Hc Tomo Screening Bilat Add-on,4030005,77063,,Breast tomosynthesis bi,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.48,% of charge rate,95.00%,107.81,,,,107.81,113.48,0
unity,CDM,HC MAMMO OF ONE BREAST,4010015,77065,,Dx mammo incl cad uni,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,404.46,% of charge rate,95.00%,384.24,,,,384.24,404.46,0
unity,CDM,HC MAMMO OF ONE BREAST,4010015,77065,,Dx mammo incl cad uni,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,404.46,% of charge rate,95.00%,384.24,,,,384.24,404.46,0
unity,CDM,HC MAMMO OF BOTH BREASTS,4010016,77066,,Dx mammo incl cad bi,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,517.58,% of charge rate,95.00%,491.7,,,,491.7,517.58,0
unity,CDM,HC MAMMO OF BOTH BREASTS,4010016,77066,,Dx mammo incl cad bi,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,517.58,% of charge rate,95.00%,491.7,,,,491.7,517.58,0
unity,CDM,HC MAMMO OF BOTH BREASTS,4030015,77067,,Scr mammo bi incl cad,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,427.7,% of charge rate,95.00%,406.32,,,,406.32,427.7,0
unity,CDM,HC MAMMO OF BOTH BREASTS,4030015,77067,,Scr mammo bi incl cad,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,427.7,% of charge rate,95.00%,406.32,,,,406.32,427.7,0
unity,CDM,Hc X-ray Bone Age Studies,3200212,77072,,X-rays for bone age,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.38,% of charge rate,95.00%,52.61,,,,52.61,55.38,0
unity,CDM,Hc X-ray Bone Age Studies,3200212,77072,,X-rays for bone age,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.38,% of charge rate,95.00%,52.61,,,,52.61,55.38,0
unity,CDM,Hc Scanogram,3200213,77073,,X-rays bone length studies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.08,% of charge rate,95.00%,109.33,,,,109.33,115.08,0
unity,CDM,Hc Scanogram,3200213,77073,,X-rays bone length studies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.08,% of charge rate,95.00%,109.33,,,,109.33,115.08,0
unity,CDM,Hc Bone Survey Lmtd,3200214,77074,,X-rays bone survey limited,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.26,% of charge rate,95.00%,185.5,,,,185.5,195.26,0
unity,CDM,Hc Bone Survey Lmtd,3200214,77074,,X-rays bone survey limited,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.26,% of charge rate,95.00%,185.5,,,,185.5,195.26,0
unity,CDM,Hc Bone Survey Complete,3200215,77075,,X-rays bone survey complete,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,283.58,% of charge rate,95.00%,269.4,,,,269.4,283.58,0
unity,CDM,Hc Bone Survey Complete,3200215,77075,,X-rays bone survey complete,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,283.58,% of charge rate,95.00%,269.4,,,,269.4,283.58,0
unity,CDM,"Hc Joint Survey,sngl V,2 Or M Joints",3200217,77077,,Joint survey single view,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.77,% of charge rate,95.00%,93.83,,,,93.83,98.77,0
unity,CDM,"Hc Joint Survey,sngl V,2 Or M Joints",3200217,77077,,Joint survey single view,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.77,% of charge rate,95.00%,93.83,,,,93.83,98.77,0
unity,CDM,DEXASCAN,3200218,77080,,Dxa bone density axial,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,264.47,% of charge rate,95.00%,251.25,,,,251.25,264.47,0
unity,CDM,DEXASCAN,3200218,77080,,Dxa bone density axial,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,264.47,% of charge rate,95.00%,251.25,,,,251.25,264.47,0
unity,CDM,"Hc Dexa 1 Or More Sties,axial Skeleton,w/vfa",3200277,77085,,Dxa bone density study,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,299.96,% of charge rate,95.00%,284.96,,,,284.96,299.96,0
unity,CDM,"Hc Dexa 1 Or More Sties,axial Skeleton,w/vfa",3200277,77085,,Dxa bone density study,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,299.96,% of charge rate,95.00%,284.96,,,,284.96,299.96,0
unity,CDM,NM LIVER SPLEEN SCAN,3410013,78215,,Liver and spleen imaging,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,804.59,% of charge rate,95.00%,764.36,,,,764.36,804.59,0
unity,CDM,NM LIVER SPLEEN SCAN,3410013,78215,,Liver and spleen imaging,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,804.59,% of charge rate,95.00%,764.36,,,,764.36,804.59,0
unity,CDM,HIDA IMAGE,3410075,78226,,Hepatobiliary system imaging,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,318.00",% of charge rate,95.00%,"1,252.10",,,,"1,252.10","1,318.00",0
unity,CDM,HIDA IMAGE,3410075,78226,,Hepatobiliary system imaging,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,318.00",% of charge rate,95.00%,"1,252.10",,,,"1,252.10","1,318.00",0
unity,CDM,HIDA IMAGE,3410076,78227,,Hepatobil syst image w/drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,914.54",% of charge rate,95.00%,"1,818.81",,,,"1,818.81","1,914.54",0
unity,CDM,HIDA IMAGE,3410076,78227,,Hepatobil syst image w/drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,914.54",% of charge rate,95.00%,"1,818.81",,,,"1,818.81","1,914.54",0
unity,CDM,NM MECKELS,3410024,78290,,Meckels divert exam,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,329.58",% of charge rate,95.00%,"1,263.10",,,,"1,263.10","1,329.58",0
unity,CDM,NM MECKELS,3410024,78290,,Meckels divert exam,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,329.58",% of charge rate,95.00%,"1,263.10",,,,"1,263.10","1,329.58",0
unity,CDM,BONE LIMITED,3410025,78300,,Bone imaging limited area,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,891.03,% of charge rate,95.00%,846.48,,,,846.48,891.03,0
unity,CDM,BONE LIMITED,3410025,78300,,Bone imaging limited area,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,891.03,% of charge rate,95.00%,846.48,,,,846.48,891.03,0
unity,CDM,NM BONE SCAN,3410026,78305,,Bone imaging multiple areas,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,070.91",% of charge rate,95.00%,"1,017.36",,,,"1,017.36","1,070.91",0
unity,CDM,NM BONE SCAN,3410026,78305,,Bone imaging multiple areas,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,070.91",% of charge rate,95.00%,"1,017.36",,,,"1,017.36","1,070.91",0
unity,CDM,BONE SCAN,3410027,78306,,Bone imaging whole body,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,163.77",% of charge rate,95.00%,"1,105.58",,,,"1,105.58","1,163.77",0
unity,CDM,BONE SCAN,3410027,78306,,Bone imaging whole body,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,163.77",% of charge rate,95.00%,"1,105.58",,,,"1,105.58","1,163.77",0
unity,CDM,BONE SCAN,3410028,78315,,Bone imaging 3 phase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,402.38",% of charge rate,95.00%,"1,332.26",,,,"1,332.26","1,402.38",0
unity,CDM,BONE SCAN,3410028,78315,,Bone imaging 3 phase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,402.38",% of charge rate,95.00%,"1,332.26",,,,"1,332.26","1,402.38",0
unity,CDM,NM MUSCLE IMAGE,3410036,78452,,Ht muscle image spect mult,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,760.37",% of charge rate,95.00%,"1,672.35",,,,"1,672.35","1,760.37",0
unity,CDM,NM MUSCLE IMAGE,3410036,78452,,Ht muscle image spect mult,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,760.37",% of charge rate,95.00%,"1,672.35",,,,"1,672.35","1,760.37",0
unity,CDM,CARDIAC BLOOD POOL (MUGA),3410039,78472,,Gated heart planar single,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,808.91,% of charge rate,95.00%,768.46,,,,768.46,808.91,0
unity,CDM,CARDIAC BLOOD POOL (MUGA),3410039,78472,,Gated heart planar single,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,808.91,% of charge rate,95.00%,768.46,,,,768.46,808.91,0
unity,CDM,NM MUGA SCAN,3410040,78473,,Gated heart multiple,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,965.95,% of charge rate,95.00%,917.65,,,,917.65,965.95,0
unity,CDM,NM MUGA SCAN,3410040,78473,,Gated heart multiple,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,965.95,% of charge rate,95.00%,917.65,,,,917.65,965.95,0
unity,CDM,NM MUGA SCAN,3410087,78494,,Heart image spect,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,751.08,% of charge rate,95.00%,713.53,,,,713.53,751.08,0
unity,CDM,NM MUGA SCAN,3410087,78494,,Heart image spect,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,751.08,% of charge rate,95.00%,713.53,,,,713.53,751.08,0
unity,CDM,NM PERFUSION LUNG,3410046,78580,,Lung perfusion imaging,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,868.6,% of charge rate,95.00%,825.17,,,,825.17,868.6,0
unity,CDM,NM PERFUSION LUNG,3410046,78580,,Lung perfusion imaging,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,868.6,% of charge rate,95.00%,825.17,,,,825.17,868.6,0
unity,CDM,NM RENAL SCAN,3410057,78700,,Kidney imaging morphol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,644.16,% of charge rate,95.00%,611.95,,,,611.95,644.16,0
unity,CDM,NM RENAL SCAN,3410057,78700,,Kidney imaging morphol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,644.16,% of charge rate,95.00%,611.95,,,,611.95,644.16,0
unity,CDM,NM KIDNEY IMAGING,3410088,78701,,Kidney imaging with flow,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,883.74,% of charge rate,95.00%,839.55,,,,839.55,883.74,0
unity,CDM,NM KIDNEY IMAGING,3410088,78701,,Kidney imaging with flow,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,883.74,% of charge rate,95.00%,839.55,,,,839.55,883.74,0
unity,CDM,NM RENOGRAM,3410058,78707,,K flow/funct image w/o drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,878.91,% of charge rate,95.00%,834.96,,,,834.96,878.91,0
unity,CDM,NM RENOGRAM,3410058,78707,,K flow/funct image w/o drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,878.91,% of charge rate,95.00%,834.96,,,,834.96,878.91,0
unity,CDM,Um Basic Metabolic Panel,UM4000132,80048,,Metabolic panel total ca,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.08,% of charge rate,95.00%,44.73,,,,44.73,47.08,0
unity,CDM,Um Basic Metabolic Panel,UM4000132,80048,,Metabolic panel total ca,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.08,% of charge rate,95.00%,44.73,,,,44.73,47.08,0
unity,CDM,Um General Health Panel,UM4000803,80050,,General health panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150,% of charge rate,95.00%,142.5,,,,142.5,150,0
unity,CDM,Um General Health Panel,UM4000803,80050,,General health panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150,% of charge rate,95.00%,142.5,,,,142.5,150,0
unity,CDM,Um Electrolyte Panel,UM4000335,80051,,Electrolyte panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.08,% of charge rate,95.00%,37.13,,,,37.13,39.08,0
unity,CDM,Um Electrolyte Panel,UM4000335,80051,,Electrolyte panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.08,% of charge rate,95.00%,37.13,,,,37.13,39.08,0
unity,CDM,Um Comp. Metabolic Panel,UM4000345,80053,,Comprehen metabolic panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.85,% of charge rate,95.00%,55.91,,,,55.91,58.85,0
unity,CDM,Um Comp. Metabolic Panel,UM4000345,80053,,Comprehen metabolic panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.85,% of charge rate,95.00%,55.91,,,,55.91,58.85,0
unity,CDM,Um Prenatal Profile,UM4000151,80055,,Obstetric panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,359.23,% of charge rate,95.00%,341.27,,,,341.27,359.23,0
unity,CDM,Um Prenatal Profile,UM4000151,80055,,Obstetric panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,359.23,% of charge rate,95.00%,341.27,,,,341.27,359.23,0
unity,CDM,Um Lipid Panel,UM4000249,80061,,Lipid panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.91,% of charge rate,95.00%,64.51,,,,64.51,67.91,0
unity,CDM,Um Lipid Panel,UM4000249,80061,,Lipid panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.91,% of charge rate,95.00%,64.51,,,,64.51,67.91,0
unity,CDM,Um Renal Panel,UM4000207,80069,,Renal function panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.37,% of charge rate,95.00%,45.95,,,,45.95,48.37,0
unity,CDM,Um Renal Panel,UM4000207,80069,,Renal function panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.37,% of charge rate,95.00%,45.95,,,,45.95,48.37,0
unity,CDM,Um Hepatitis (acute) Panel,UM4000133,80074,,Acute hepatitis panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,253.35,% of charge rate,95.00%,240.68,,,,240.68,253.35,0
unity,CDM,Um Hepatitis (acute) Panel,UM4000133,80074,,Acute hepatitis panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,253.35,% of charge rate,95.00%,240.68,,,,240.68,253.35,0
unity,CDM,Um Liver Function Panel,UM4000192,80076,,Hepatic function panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.49,% of charge rate,95.00%,43.22,,,,43.22,45.49,0
unity,CDM,Um Liver Function Panel,UM4000192,80076,,Hepatic function panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.49,% of charge rate,95.00%,43.22,,,,43.22,45.49,0
unity,CDM,Um Obstetric Panel With Hiv,UM4000773,80081,,Obstetric panel,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,417.4,% of charge rate,95.00%,396.53,,,,396.53,417.4,0
unity,CDM,Um Obstetric Panel With Hiv,UM4000773,80081,,Obstetric panel,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,417.4,% of charge rate,95.00%,396.53,,,,396.53,417.4,0
unity,CDM,Um Carbamazepine  (tegretol),UM4000206,80156,,Assay carbamazepine total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.05,% of charge rate,95.00%,77,,,,77,81.05,0
unity,CDM,Um Carbamazepine  (tegretol),UM4000206,80156,,Assay carbamazepine total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.05,% of charge rate,95.00%,77,,,,77,81.05,0
unity,CDM,"Um Carbamezipine, Free",UM4000404,80157,,Assay carbamazepine free,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.81,% of charge rate,95.00%,70.12,,,,70.12,73.81,0
unity,CDM,"Um Carbamezipine, Free",UM4000404,80157,,Assay carbamazepine free,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.81,% of charge rate,95.00%,70.12,,,,70.12,73.81,0
unity,CDM,Um Cyclosporins,UM4000445,80158,,Drug assay cyclosporine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,136.6,% of charge rate,95.00%,129.77,,,,129.77,136.6,0
unity,CDM,Um Cyclosporins,UM4000445,80158,,Drug assay cyclosporine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,136.6,% of charge rate,95.00%,129.77,,,,129.77,136.6,0
unity,CDM,Um Digoxin,UM4000031,80162,,Assay of digoxin total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.9,% of charge rate,95.00%,70.21,,,,70.21,73.9,0
unity,CDM,Um Digoxin,UM4000031,80162,,Assay of digoxin total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.9,% of charge rate,95.00%,70.21,,,,70.21,73.9,0
unity,CDM,Um Depakene (valproic Acid),UM4000272,80164,,Assay dipropylacetic acd tot,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.44,% of charge rate,95.00%,71.67,,,,71.67,75.44,0
unity,CDM,Um Depakene (valproic Acid),UM4000272,80164,,Assay dipropylacetic acd tot,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.44,% of charge rate,95.00%,71.67,,,,71.67,75.44,0
unity,CDM,Um Ethosuximide (zarontin),UM4000308,80168,,Assay of ethosuximide,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91,% of charge rate,95.00%,86.45,,,,86.45,91,0
unity,CDM,Um Ethosuximide (zarontin),UM4000308,80168,,Assay of ethosuximide,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91,% of charge rate,95.00%,86.45,,,,86.45,91,0
unity,CDM,Um Everolimus,UM4000792,80169,,Drug assay everolimus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.51,% of charge rate,95.00%,72.68,,,,72.68,76.51,0
unity,CDM,Um Everolimus,UM4000792,80169,,Drug assay everolimus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.51,% of charge rate,95.00%,72.68,,,,72.68,76.51,0
unity,CDM,Um Gentamicin,UM4000065,80170,,Assay of gentamicin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.24,% of charge rate,95.00%,86.68,,,,86.68,91.24,0
unity,CDM,Um Gentamicin,UM4000065,80170,,Assay of gentamicin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.24,% of charge rate,95.00%,86.68,,,,86.68,91.24,0
unity,CDM,Um Neurontin (gabapentin),UM4000060,80171,,Drug screen quant gabapentin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,0
unity,CDM,Um Neurontin (gabapentin),UM4000060,80171,,Drug screen quant gabapentin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,0
unity,CDM,Um Lamotrigine,UM4000243,80175,,Drug screen quan lamotrigine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,0
unity,CDM,Um Lamotrigine,UM4000243,80175,,Drug screen quan lamotrigine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,0
unity,CDM,Um Keppra Assay,UM4000205,80177,,Drug scrn quan levetiracetam,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,0
unity,CDM,Um Keppra Assay,UM4000205,80177,,Drug scrn quan levetiracetam,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,0
unity,CDM,Um Lithium,UM4000072,80178,,Assay of lithium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.79,% of charge rate,95.00%,34.95,,,,34.95,36.79,0
unity,CDM,Um Lithium,UM4000072,80178,,Assay of lithium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.79,% of charge rate,95.00%,34.95,,,,34.95,36.79,0
unity,CDM,Um Mycophenolic Acid,UM4000884,80180,,Drug scrn quan mycophenolate,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.64,% of charge rate,95.00%,99.41,,,,99.41,104.64,0
unity,CDM,Um Mycophenolic Acid,UM4000884,80180,,Drug scrn quan mycophenolate,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.64,% of charge rate,95.00%,99.41,,,,99.41,104.64,0
unity,CDM,"Um Carbamaepine 10,11 Epoxid",UM4000562,80183,,Drug scrn quant oxcarbazepin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,0
unity,CDM,"Um Carbamaepine 10,11 Epoxid",UM4000562,80183,,Drug scrn quant oxcarbazepin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,0
unity,CDM,Um Phenobarbital,UM4000167,80184,,Assay of phenobarbital,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.76,% of charge rate,95.00%,60.57,,,,60.57,63.76,0
unity,CDM,Um Phenobarbital,UM4000167,80184,,Assay of phenobarbital,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.76,% of charge rate,95.00%,60.57,,,,60.57,63.76,0
unity,CDM,Um Dilantin (phenytoin),UM4000319,80185,,Assay of phenytoin total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.81,% of charge rate,95.00%,70.12,,,,70.12,73.81,0
unity,CDM,Um Dilantin (phenytoin),UM4000319,80185,,Assay of phenytoin total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.81,% of charge rate,95.00%,70.12,,,,70.12,73.81,0
unity,CDM,Um Dilantin-unbound (free),UM4000022,80186,,Assay of phenytoin free,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.64,% of charge rate,95.00%,72.81,,,,72.81,76.64,0
unity,CDM,Um Dilantin-unbound (free),UM4000022,80186,,Assay of phenytoin free,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.64,% of charge rate,95.00%,72.81,,,,72.81,76.64,0
unity,CDM,Um Primadone (mysoline),UM4000015,80188,,Assay of primidone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,136.43,% of charge rate,95.00%,129.61,,,,129.61,136.43,0
unity,CDM,Um Primadone (mysoline),UM4000015,80188,,Assay of primidone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,136.43,% of charge rate,95.00%,129.61,,,,129.61,136.43,0
unity,CDM,Um Tacrolimus,UM4000808,80197,,Assay of tacrolimus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.51,% of charge rate,95.00%,72.68,,,,72.68,76.51,0
unity,CDM,Um Tacrolimus,UM4000808,80197,,Assay of tacrolimus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.51,% of charge rate,95.00%,72.68,,,,72.68,76.51,0
unity,CDM,Um Theophylline,UM4000182,80198,,Assay of theophylline,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.8,% of charge rate,95.00%,74.86,,,,74.86,78.8,0
unity,CDM,Um Theophylline,UM4000182,80198,,Assay of theophylline,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.8,% of charge rate,95.00%,74.86,,,,74.86,78.8,0
unity,CDM,Um Gabitril (tiagibine),UM4000074,80199,,Drug screen quant tiagabine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.61,% of charge rate,95.00%,95.58,,,,95.58,100.61,0
unity,CDM,Um Gabitril (tiagibine),UM4000074,80199,,Drug screen quant tiagabine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.61,% of charge rate,95.00%,95.58,,,,95.58,100.61,0
unity,CDM,Um Tobramycin,UM4000360,80200,,Assay of tobramycin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.21,% of charge rate,95.00%,118.95,,,,118.95,125.21,0
unity,CDM,Um Tobramycin,UM4000360,80200,,Assay of tobramycin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.21,% of charge rate,95.00%,118.95,,,,118.95,125.21,0
unity,CDM,Um Topiramate,UM4000187,80201,,Assay of topiramate,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.33,% of charge rate,95.00%,150.41,,,,150.41,158.33,0
unity,CDM,Um Topiramate,UM4000187,80201,,Assay of topiramate,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.33,% of charge rate,95.00%,150.41,,,,150.41,158.33,0
unity,CDM,Um Vancomycin,UM4000250,80202,,Assay of vancomycin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.44,% of charge rate,95.00%,71.67,,,,71.67,75.44,0
unity,CDM,Um Vancomycin,UM4000250,80202,,Assay of vancomycin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.44,% of charge rate,95.00%,71.67,,,,71.67,75.44,0
unity,CDM,Um Zonisamide,UM4000799,80203,,Drug screen quant zonisamide,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.85,% of charge rate,95.00%,70.16,,,,70.16,73.85,0
unity,CDM,Um Zonisamide,UM4000799,80203,,Drug screen quant zonisamide,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.85,% of charge rate,95.00%,70.16,,,,70.16,73.85,0
unity,CDM,UM ACETAMINOPHEN [TYLENOL],UM4000127,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.69,% of charge rate,95.00%,75.71,,,,75.71,79.69,0
unity,CDM,UM ACETAMINOPHEN [TYLENOL],UM4000127,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.69,% of charge rate,95.00%,75.71,,,,75.71,79.69,0
unity,CDM,Um Salicylate,UM4000144,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.69,% of charge rate,95.00%,75.71,,,,75.71,79.69,0
unity,CDM,Um Salicylate,UM4000144,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.69,% of charge rate,95.00%,75.71,,,,75.71,79.69,0
unity,CDM,Um Risperidone,UM4000197,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150.7,% of charge rate,95.00%,143.17,,,,143.17,150.7,0
unity,CDM,Um Risperidone,UM4000197,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150.7,% of charge rate,95.00%,143.17,,,,143.17,150.7,0
unity,CDM,Um Trileptal (oxcarbzepine),UM4000341,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.25,% of charge rate,95.00%,72.44,,,,72.44,76.25,0
unity,CDM,Um Trileptal (oxcarbzepine),UM4000341,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.25,% of charge rate,95.00%,72.44,,,,72.44,76.25,0
unity,CDM,Um Posaconazole,UM4000568,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,257.58,% of charge rate,95.00%,244.7,,,,244.7,257.58,0
unity,CDM,Um Posaconazole,UM4000568,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,257.58,% of charge rate,95.00%,244.7,,,,244.7,257.58,0
unity,CDM,"Um Methylphenidate Metabolite Quant,urine",UM4000718,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.38,% of charge rate,95.00%,155.21,,,,155.21,163.38,0
unity,CDM,"Um Methylphenidate Metabolite Quant,urine",UM4000718,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.38,% of charge rate,95.00%,155.21,,,,155.21,163.38,0
unity,CDM,"Um Clonidine,serum",UM4000719,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,355.56,% of charge rate,95.00%,337.78,,,,337.78,355.56,0
unity,CDM,"Um Clonidine,serum",UM4000719,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,355.56,% of charge rate,95.00%,337.78,,,,337.78,355.56,0
unity,CDM,Um Voriconazole,UM4000732,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,222.57,% of charge rate,95.00%,211.44,,,,211.44,222.57,0
unity,CDM,Um Voriconazole,UM4000732,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,222.57,% of charge rate,95.00%,211.44,,,,211.44,222.57,0
unity,CDM,Um Quetiapine (seroquel),UM4000746,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.38,% of charge rate,95.00%,159.01,,,,159.01,167.38,0
unity,CDM,Um Quetiapine (seroquel),UM4000746,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.38,% of charge rate,95.00%,159.01,,,,159.01,167.38,0
unity,CDM,Um Lacosamide,UM4000859,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.42,% of charge rate,95.00%,75.45,,,,75.45,79.42,0
unity,CDM,Um Lacosamide,UM4000859,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.42,% of charge rate,95.00%,75.45,,,,75.45,79.42,0
unity,CDM,Um Adalimumab Level,UM4000869,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.42,% of charge rate,95.00%,75.45,,,,75.45,79.42,0
unity,CDM,Um Adalimumab Level,UM4000869,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.42,% of charge rate,95.00%,75.45,,,,75.45,79.42,0
unity,CDM,Um Amiodarone,UM4000920,80299,,Quantitative assay drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.6,% of charge rate,95.00%,94.62,,,,94.62,99.6,0
unity,CDM,Um Amiodarone,UM4000920,80299,,Quantitative assay drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.6,% of charge rate,95.00%,94.62,,,,94.62,99.6,0
unity,CDM,Um Urine Drug Screen (uds),UM4000456,80306,,Drug test prsmv instrmnt,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.99,% of charge rate,95.00%,80.74,,,,80.74,84.99,0
unity,CDM,Um Urine Drug Screen (uds),UM4000456,80306,,Drug test prsmv instrmnt,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.99,% of charge rate,95.00%,80.74,,,,80.74,84.99,0
unity,CDM,Um Alcohol,UM4000146,80307,,Drug test prsmv chem anlyzr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235.61,% of charge rate,95.00%,223.83,,,,223.83,235.61,0
unity,CDM,Um Alcohol,UM4000146,80307,,Drug test prsmv chem anlyzr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235.61,% of charge rate,95.00%,223.83,,,,223.83,235.61,0
unity,CDM,Um Presumptive Drug Id,UM4000805,80307,,Drug test prsmv chem anlyzr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,Um Presumptive Drug Id,UM4000805,80307,,Drug test prsmv chem anlyzr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,"Um Nicotine, Cotinine",UM4000435,80323,,Alkaloids nos,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,131.33,% of charge rate,95.00%,124.76,,,,124.76,131.33,0
unity,CDM,"Um Nicotine, Cotinine",UM4000435,80323,,Alkaloids nos,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,131.33,% of charge rate,95.00%,124.76,,,,124.76,131.33,0
unity,CDM,"Um Amphetamines,quant,urine",UM4000713,80324,,Drug screen amphetamines 1/2,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,168.38,% of charge rate,95.00%,159.96,,,,159.96,168.38,0
unity,CDM,"Um Amphetamines,quant,urine",UM4000713,80324,,Drug screen amphetamines 1/2,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,168.38,% of charge rate,95.00%,159.96,,,,159.96,168.38,0
unity,CDM,"Um Methamphetamine And Metabolite, Quant, Urine",UM4000752,80324,,Drug screen amphetamines 1/2,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,108.67,% of charge rate,95.00%,103.24,,,,103.24,108.67,0
unity,CDM,"Um Methamphetamine And Metabolite, Quant, Urine",UM4000752,80324,,Drug screen amphetamines 1/2,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,108.67,% of charge rate,95.00%,103.24,,,,103.24,108.67,0
unity,CDM,Um Imipramine,UM4000004,80335,,Antidepressant tricyclic 1/2,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.46,% of charge rate,95.00%,116.34,,,,116.34,122.46,0
unity,CDM,Um Imipramine,UM4000004,80335,,Antidepressant tricyclic 1/2,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.46,% of charge rate,95.00%,116.34,,,,116.34,122.46,0
unity,CDM,Um Clomipramine,UM4000837,80335,,Antidepressant tricyclic 1/2,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.18,% of charge rate,95.00%,99.92,,,,99.92,105.18,0
unity,CDM,Um Clomipramine,UM4000837,80335,,Antidepressant tricyclic 1/2,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.18,% of charge rate,95.00%,99.92,,,,99.92,105.18,0
unity,CDM,Um Trazodone,UM4000891,80338,,Antidepressant not specified,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.18,% of charge rate,95.00%,99.92,,,,99.92,105.18,0
unity,CDM,Um Trazodone,UM4000891,80338,,Antidepressant not specified,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.18,% of charge rate,95.00%,99.92,,,,99.92,105.18,0
unity,CDM,Um Wellbuterin,UM4000892,80338,,Antidepressant not specified,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.18,% of charge rate,95.00%,99.92,,,,99.92,105.18,0
unity,CDM,Um Wellbuterin,UM4000892,80338,,Antidepressant not specified,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.18,% of charge rate,95.00%,99.92,,,,99.92,105.18,0
unity,CDM,Um Clozapine,UM4000765,80342,,Antipsychotics nos 1-3,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.48,% of charge rate,95.00%,99.26,,,,99.26,104.48,0
unity,CDM,Um Clozapine,UM4000765,80342,,Antipsychotics nos 1-3,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.48,% of charge rate,95.00%,99.26,,,,99.26,104.48,0
unity,CDM,Um Thioridazine,UM4000775,80342,,Antipsychotics nos 1-3,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.29,% of charge rate,95.00%,74.38,,,,74.38,78.29,0
unity,CDM,Um Thioridazine,UM4000775,80342,,Antipsychotics nos 1-3,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.29,% of charge rate,95.00%,74.38,,,,74.38,78.29,0
unity,CDM,Um Benzodiazepines,UM4000090,80346,,Benzodiazepines1-12,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.22,% of charge rate,95.00%,104.71,,,,104.71,110.22,0
unity,CDM,Um Benzodiazepines,UM4000090,80346,,Benzodiazepines1-12,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.22,% of charge rate,95.00%,104.71,,,,104.71,110.22,0
unity,CDM,Um Clonazepam,UM4000722,80346,,Benzodiazepines1-12,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.22,% of charge rate,95.00%,104.71,,,,104.71,110.22,0
unity,CDM,Um Clonazepam,UM4000722,80346,,Benzodiazepines1-12,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.22,% of charge rate,95.00%,104.71,,,,104.71,110.22,0
unity,CDM,Um Lorazepam,UM4000872,80346,,Benzodiazepines1-12,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.01,% of charge rate,95.00%,101.66,,,,101.66,107.01,0
unity,CDM,Um Lorazepam,UM4000872,80346,,Benzodiazepines1-12,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.01,% of charge rate,95.00%,101.66,,,,101.66,107.01,0
unity,CDM,"Um Cocaine, Urine",UM4000763,80353,,Drug screening cocaine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,128.16,% of charge rate,95.00%,121.75,,,,121.75,128.16,0
unity,CDM,"Um Cocaine, Urine",UM4000763,80353,,Drug screening cocaine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,128.16,% of charge rate,95.00%,121.75,,,,121.75,128.16,0
unity,CDM,"Um Fentanyl And Norfentanyl, Urine Confirm",UM4000791,80354,,Drug screening fentanyl,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.2,% of charge rate,95.00%,93.29,,,,93.29,98.2,0
unity,CDM,"Um Fentanyl And Norfentanyl, Urine Confirm",UM4000791,80354,,Drug screening fentanyl,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.2,% of charge rate,95.00%,93.29,,,,93.29,98.2,0
unity,CDM,METHADONE,UM4000761,80358,,Drug screening methadone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.03,% of charge rate,95.00%,118.78,,,,118.78,125.03,0
unity,CDM,METHADONE,UM4000761,80358,,Drug screening methadone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.03,% of charge rate,95.00%,118.78,,,,118.78,125.03,0
unity,CDM,Um Opiates Assay,UM4000432,80361,,Opiates 1 or more,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,168.38,% of charge rate,95.00%,159.96,,,,159.96,168.38,0
unity,CDM,Um Opiates Assay,UM4000432,80361,,Opiates 1 or more,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,168.38,% of charge rate,95.00%,159.96,,,,159.96,168.38,0
unity,CDM,Um Pain Mgmt/oxycodone Only,UM4000608,80365,,Drug screening oxycodone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.08,% of charge rate,95.00%,99.83,,,,99.83,105.08,0
unity,CDM,Um Pain Mgmt/oxycodone Only,UM4000608,80365,,Drug screening oxycodone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.08,% of charge rate,95.00%,99.83,,,,99.83,105.08,0
unity,CDM,Um Tramadol,UM4000774,80373,,Drug screening tramadol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.2,% of charge rate,95.00%,93.29,,,,93.29,98.2,0
unity,CDM,Um Tramadol,UM4000774,80373,,Drug screening tramadol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.2,% of charge rate,95.00%,93.29,,,,93.29,98.2,0
unity,CDM,Um Drug Screen Stereoisomer Analysis,UM4000893,80374,,Stereoisomer analysis,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,128.52,% of charge rate,95.00%,122.09,,,,122.09,128.52,0
unity,CDM,Um Drug Screen Stereoisomer Analysis,UM4000893,80374,,Stereoisomer analysis,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,128.52,% of charge rate,95.00%,122.09,,,,122.09,128.52,0
unity,CDM,Um Urine Dipstick And Micro,UM4000062,81001,,Urinalysis auto w/scope,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.62,% of charge rate,95.00%,16.74,,,,16.74,17.62,0
unity,CDM,Um Urine Dipstick And Micro,UM4000062,81001,,Urinalysis auto w/scope,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.62,% of charge rate,95.00%,16.74,,,,16.74,17.62,0
unity,CDM,"Um Urinalysis, Dipstick Only",UM4000100,81003,,Urinalysis auto w/o scope,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.51,% of charge rate,95.00%,11.88,,,,11.88,12.51,0
unity,CDM,"Um Urinalysis, Dipstick Only",UM4000100,81003,,Urinalysis auto w/o scope,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.51,% of charge rate,95.00%,11.88,,,,11.88,12.51,0
unity,CDM,"Um Urinalysis, Qual/semiqua",UM4000406,81005,,Urinalysis,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.08,% of charge rate,95.00%,11.48,,,,11.48,12.08,0
unity,CDM,"Um Urinalysis, Qual/semiqua",UM4000406,81005,,Urinalysis,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.08,% of charge rate,95.00%,11.48,,,,11.48,12.08,0
unity,CDM,"Um Urine, Microscopic Only",UM4000316,81015,,Microscopic exam of urine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.95,% of charge rate,95.00%,16.1,,,,16.1,16.95,0
unity,CDM,"Um Urine, Microscopic Only",UM4000316,81015,,Microscopic exam of urine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.95,% of charge rate,95.00%,16.1,,,,16.1,16.95,0
unity,CDM,"Um Preg, Hcg,qual,urine",UM4000457,81025,,Urine pregnancy test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.22,% of charge rate,95.00%,33.46,,,,33.46,35.22,0
unity,CDM,"Um Preg, Hcg,qual,urine",UM4000457,81025,,Urine pregnancy test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.22,% of charge rate,95.00%,33.46,,,,33.46,35.22,0
unity,CDM,Um Urine Volume Measurement,UM4000352,81050,,Urinalysis volume measure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.7,% of charge rate,95.00%,15.87,,,,15.87,16.7,0
unity,CDM,Um Urine Volume Measurement,UM4000352,81050,,Urinalysis volume measure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.7,% of charge rate,95.00%,15.87,,,,15.87,16.7,0
unity,CDM,Um Genomic Alterations,UM4000945,81229,,Cytogen m array copy no&snp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,942.21",% of charge rate,95.00%,"2,795.10",,,,"2,795.10","2,942.21",0
unity,CDM,Um Genomic Alterations,UM4000945,81229,,Cytogen m array copy no&snp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,942.21",% of charge rate,95.00%,"2,795.10",,,,"2,795.10","2,942.21",0
unity,CDM,Um Factor Ii G20210a Mutation,UM4000576,81240,,F2 gene,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,328.35,% of charge rate,95.00%,311.93,,,,311.93,328.35,0
unity,CDM,Um Factor Ii G20210a Mutation,UM4000576,81240,,F2 gene,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,328.35,% of charge rate,95.00%,311.93,,,,311.93,328.35,0
unity,CDM,Um Factor V (leiden) Mutation Analysis,UM81241,81241,,F5 gene,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,420.95,% of charge rate,95.00%,399.9,,,,399.9,420.95,0
unity,CDM,Um Factor V (leiden) Mutation Analysis,UM81241,81241,,F5 gene,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,420.95,% of charge rate,95.00%,399.9,,,,399.9,420.95,0
unity,CDM,Um Fragile X Syndrome,UM4000812,81243,,Fmr1 gene detection,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,311.47,% of charge rate,95.00%,295.9,,,,295.9,311.47,0
unity,CDM,Um Fragile X Syndrome,UM4000812,81243,,Fmr1 gene detection,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,311.47,% of charge rate,95.00%,295.9,,,,295.9,311.47,0
unity,CDM,Um Hereditary Hemochromotosis Dna Mutations,UM4000710,81256,,Hfe gene,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,661.73,% of charge rate,95.00%,628.64,,,,628.64,661.73,0
unity,CDM,Um Hereditary Hemochromotosis Dna Mutations,UM4000710,81256,,Hfe gene,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,661.73,% of charge rate,95.00%,628.64,,,,628.64,661.73,0
unity,CDM,Um Jak2 V617f,UM4000867,81270,,Jak2 gene,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,531.4,% of charge rate,95.00%,504.83,,,,504.83,531.4,0
unity,CDM,Um Jak2 V617f,UM4000867,81270,,Jak2 gene,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,531.4,% of charge rate,95.00%,504.83,,,,504.83,531.4,0
unity,CDM,"Um Mthfr,gene Analysis,dna",UM4000728,81291,,Mthfr gene,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,378.18,% of charge rate,95.00%,359.27,,,,359.27,378.18,0
unity,CDM,"Um Mthfr,gene Analysis,dna",UM4000728,81291,,Mthfr gene,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,378.18,% of charge rate,95.00%,359.27,,,,359.27,378.18,0
unity,CDM,"Um Hla Class I Typing Low Resolution, Complete",UM4000934,81372,,Hla i typing complete lr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,910,% of charge rate,95.00%,864.5,,,,864.5,910,0
unity,CDM,"Um Hla Class I Typing Low Resolution, Complete",UM4000934,81372,,Hla i typing complete lr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,910,% of charge rate,95.00%,864.5,,,,864.5,910,0
unity,CDM,Um Hla - Dq Typing,UM4000541,81377,,Hla ii type 1 ag equiv lr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,462.83,% of charge rate,95.00%,439.69,,,,439.69,462.83,0
unity,CDM,Um Hla - Dq Typing,UM4000541,81377,,Hla ii type 1 ag equiv lr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,462.83,% of charge rate,95.00%,439.69,,,,439.69,462.83,0
unity,CDM,Um Hla Class I Typing High Resolution One Allele/allele Group,UM4000854,81381,,Hla i typing 1 allele hr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,548.31,% of charge rate,95.00%,520.89,,,,520.89,548.31,0
unity,CDM,Um Hla Class I Typing High Resolution One Allele/allele Group,UM4000854,81381,,Hla i typing 1 allele hr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,548.31,% of charge rate,95.00%,520.89,,,,520.89,548.31,0
unity,CDM,Um Hereditary Colon Cancer Multi-gene Panel,UM4000781,81435,,Hereditary colon ca dsordrs,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,415.80",% of charge rate,95.00%,"3,245.01",,,,"3,245.01","3,415.80",0
unity,CDM,Um Hereditary Colon Cancer Multi-gene Panel,UM4000781,81435,,Hereditary colon ca dsordrs,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,415.80",% of charge rate,95.00%,"3,245.01",,,,"3,245.01","3,415.80",0
unity,CDM,Um Quad Screen Maternal,UM4000861,81511,,Ftl cgen abnor four anal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,374.54,% of charge rate,95.00%,355.81,,,,355.81,374.54,0
unity,CDM,Um Quad Screen Maternal,UM4000861,81511,,Ftl cgen abnor four anal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,374.54,% of charge rate,95.00%,355.81,,,,355.81,374.54,0
unity,CDM,"Um Acylcarnitines, Quant",UM4000396,82017,,Acylcarnitines quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,226.21,% of charge rate,95.00%,214.9,,,,214.9,226.21,0
unity,CDM,"Um Acylcarnitines, Quant",UM4000396,82017,,Acylcarnitines quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,226.21,% of charge rate,95.00%,214.9,,,,214.9,226.21,0
unity,CDM,Um Acth,UM4000159,82024,,Assay of acth,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,215.06,% of charge rate,95.00%,204.31,,,,204.31,215.06,0
unity,CDM,Um Acth,UM4000159,82024,,Assay of acth,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,215.06,% of charge rate,95.00%,204.31,,,,204.31,215.06,0
unity,CDM,Um Albumin,UM4000242,82040,,Assay of serum albumin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.54,% of charge rate,95.00%,26.16,,,,26.16,27.54,0
unity,CDM,Um Albumin,UM4000242,82040,,Assay of serum albumin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.54,% of charge rate,95.00%,26.16,,,,26.16,27.54,0
unity,CDM,"Um Albumin, Other Than Serum",UM4000346,82042,,Other source albumin quan ea,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,"Um Albumin, Other Than Serum",UM4000346,82042,,Other source albumin quan ea,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,"Um Microalbumin, Urine Quantification",UM4000907,82043,,Ur albumin quantitative,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.94,% of charge rate,95.00%,31.29,,,,31.29,32.94,0
unity,CDM,"Um Microalbumin, Urine Quantification",UM4000907,82043,,Ur albumin quantitative,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.94,% of charge rate,95.00%,31.29,,,,31.29,32.94,0
unity,CDM,"Um Micro Albumin, Urine",UM4000263,82044,,Ur albumin semiquantitative,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.48,% of charge rate,95.00%,24.21,,,,24.21,25.48,0
unity,CDM,"Um Micro Albumin, Urine",UM4000263,82044,,Ur albumin semiquantitative,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.48,% of charge rate,95.00%,24.21,,,,24.21,25.48,0
unity,CDM,Um Breathe Alcohol Confirm,UM3480021,82075,,Assay of breath ethanol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Breathe Alcohol Confirm,UM3480021,82075,,Assay of breath ethanol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,"Um Alcohol, Breath",UM3480023,82075,,Assay of breath ethanol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,"Um Alcohol, Breath",UM3480023,82075,,Assay of breath ethanol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Aldolase,UM4000363,82085,,Assay of aldolase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.05,% of charge rate,95.00%,51.35,,,,51.35,54.05,0
unity,CDM,Um Aldolase,UM4000363,82085,,Assay of aldolase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.05,% of charge rate,95.00%,51.35,,,,51.35,54.05,0
unity,CDM,Um Aldosterone,UM4000019,82088,,Assay of aldosterone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.54,% of charge rate,95.00%,268.41,,,,268.41,282.54,0
unity,CDM,Um Aldosterone,UM4000019,82088,,Assay of aldosterone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.54,% of charge rate,95.00%,268.41,,,,268.41,282.54,0
unity,CDM,Um Alpha-1-antitrypsin,UM4000158,82103,,Alpha-1-antitrypsin total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,74.82,% of charge rate,95.00%,71.08,,,,71.08,74.82,0
unity,CDM,Um Alpha-1-antitrypsin,UM4000158,82103,,Alpha-1-antitrypsin total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,74.82,% of charge rate,95.00%,71.08,,,,71.08,74.82,0
unity,CDM,"Um Alpha-1 Antigrypsin, Phen",UM4000431,82104,,Alpha-1-antitrypsin pheno,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.5,% of charge rate,95.00%,76.48,,,,76.48,80.5,0
unity,CDM,"Um Alpha-1 Antigrypsin, Phen",UM4000431,82104,,Alpha-1-antitrypsin pheno,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.5,% of charge rate,95.00%,76.48,,,,76.48,80.5,0
unity,CDM,Um Alpha-fetoprotein; Serum,UM4000362,82105,,Alpha-fetoprotein serum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.41,% of charge rate,95.00%,88.74,,,,88.74,93.41,0
unity,CDM,Um Alpha-fetoprotein; Serum,UM4000362,82105,,Alpha-fetoprotein serum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.41,% of charge rate,95.00%,88.74,,,,88.74,93.41,0
unity,CDM,"Um Aluminum, Whole Blood",UM4000776,82108,,Assay of aluminum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,141.92,% of charge rate,95.00%,134.82,,,,134.82,141.92,0
unity,CDM,"Um Aluminum, Whole Blood",UM4000776,82108,,Assay of aluminum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,141.92,% of charge rate,95.00%,134.82,,,,134.82,141.92,0
unity,CDM,"Um Amino Acids, Urine",UM4000933,82136,,Amino acids quant 2-5,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.8,% of charge rate,95.00%,92.91,,,,92.91,97.8,0
unity,CDM,"Um Amino Acids, Urine",UM4000933,82136,,Amino acids quant 2-5,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.8,% of charge rate,95.00%,92.91,,,,92.91,97.8,0
unity,CDM,"Um Amino Acid, 6 Or Mr, Plas",UM4000264,82139,,Amino acids quan 6 or more,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,287.67,% of charge rate,95.00%,273.29,,,,273.29,287.67,0
unity,CDM,"Um Amino Acid, 6 Or Mr, Plas",UM4000264,82139,,Amino acids quan 6 or more,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,287.67,% of charge rate,95.00%,273.29,,,,273.29,287.67,0
unity,CDM,Um Ammonia,UM4000188,82140,,Assay of ammonia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.14,% of charge rate,95.00%,77.08,,,,77.08,81.14,0
unity,CDM,Um Ammonia,UM4000188,82140,,Assay of ammonia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.14,% of charge rate,95.00%,77.08,,,,77.08,81.14,0
unity,CDM,Um Amylase,UM4000075,82150,,Assay of amylase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.08,% of charge rate,95.00%,34.28,,,,34.28,36.08,0
unity,CDM,Um Amylase,UM4000075,82150,,Assay of amylase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.08,% of charge rate,95.00%,34.28,,,,34.28,36.08,0
unity,CDM,Um Androstenedione,UM4000395,82157,,Assay of androstenedione,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,239.2,% of charge rate,95.00%,227.24,,,,227.24,239.2,0
unity,CDM,Um Androstenedione,UM4000395,82157,,Assay of androstenedione,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,239.2,% of charge rate,95.00%,227.24,,,,227.24,239.2,0
unity,CDM,Um Angiotensin 1 Assay,UM4000388,82164,,Angiotensin i enzyme test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.31,% of charge rate,95.00%,77.24,,,,77.24,81.31,0
unity,CDM,Um Angiotensin 1 Assay,UM4000388,82164,,Angiotensin i enzyme test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.31,% of charge rate,95.00%,77.24,,,,77.24,81.31,0
unity,CDM,"Um Apolipoprotein, Each",UM4000179,82172,,Assay of apolipoprotein,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,160.08,% of charge rate,95.00%,152.08,,,,152.08,160.08,0
unity,CDM,"Um Apolipoprotein, Each",UM4000179,82172,,Assay of apolipoprotein,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,160.08,% of charge rate,95.00%,152.08,,,,152.08,160.08,0
unity,CDM,Um Arsenic,UM4000058,82175,,Assay of arsenic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.78,% of charge rate,95.00%,120.44,,,,120.44,126.78,0
unity,CDM,Um Arsenic,UM4000058,82175,,Assay of arsenic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.78,% of charge rate,95.00%,120.44,,,,120.44,126.78,0
unity,CDM,Um Vitamin C,UM4000745,82180,,Assay of ascorbic acid,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.7,% of charge rate,95.00%,78.57,,,,78.57,82.7,0
unity,CDM,Um Vitamin C,UM4000745,82180,,Assay of ascorbic acid,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.7,% of charge rate,95.00%,78.57,,,,78.57,82.7,0
unity,CDM,Um Barbituates Gc/ms Urine,UM4000714,82205,,BARBITURATES- WHOLE BLOOD,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,168.38,% of charge rate,95.00%,159.96,,,,159.96,168.38,0
unity,CDM,Um Barbituates Gc/ms Urine,UM4000714,82205,,BARBITURATES- WHOLE BLOOD,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,168.38,% of charge rate,95.00%,159.96,,,,159.96,168.38,0
unity,CDM,Um Beta-2 Microglobulin,UM4000130,82232,,Assay of beta-2 protein,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.07,% of charge rate,95.00%,85.57,,,,85.57,90.07,0
unity,CDM,Um Beta-2 Microglobulin,UM4000130,82232,,Assay of beta-2 protein,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.07,% of charge rate,95.00%,85.57,,,,85.57,90.07,0
unity,CDM,"Um Bile Acids, Total Serum",UM4000795,82239,,Bile acids total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.98,% of charge rate,95.00%,39.88,,,,39.88,41.98,0
unity,CDM,"Um Bile Acids, Total Serum",UM4000795,82239,,Bile acids total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.98,% of charge rate,95.00%,39.88,,,,39.88,41.98,0
unity,CDM,Um Bilirubin Total,UM4000049,82247,,Bilirubin total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.92,% of charge rate,95.00%,26.52,,,,26.52,27.92,0
unity,CDM,Um Bilirubin Total,UM4000049,82247,,Bilirubin total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.92,% of charge rate,95.00%,26.52,,,,26.52,27.92,0
unity,CDM,Um Bilirubin Direct,UM4000312,82248,,Bilirubin direct,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.92,% of charge rate,95.00%,26.52,,,,26.52,27.92,0
unity,CDM,Um Bilirubin Direct,UM4000312,82248,,Bilirubin direct,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.92,% of charge rate,95.00%,26.52,,,,26.52,27.92,0
unity,CDM,"Um Occult Blood, Screening",UM4000203,82270,,Occult blood feces,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.57,% of charge rate,95.00%,14.79,,,,14.79,15.57,0
unity,CDM,"Um Occult Blood, Screening",UM4000203,82270,,Occult blood feces,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.57,% of charge rate,95.00%,14.79,,,,14.79,15.57,0
unity,CDM,Um Occult Blood- Gastric,UM4000150,82271,,Occult blood other sources,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.57,% of charge rate,95.00%,14.79,,,,14.79,15.57,0
unity,CDM,Um Occult Blood- Gastric,UM4000150,82271,,Occult blood other sources,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.57,% of charge rate,95.00%,14.79,,,,14.79,15.57,0
unity,CDM,Um Occult Blood (hemosure) Diagnostic,UM4000573,82274,,Assay test for blood fecal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.56,% of charge rate,95.00%,84.13,,,,84.13,88.56,0
unity,CDM,Um Occult Blood (hemosure) Diagnostic,UM4000573,82274,,Assay test for blood fecal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.56,% of charge rate,95.00%,84.13,,,,84.13,88.56,0
unity,CDM,Um Vitamin D 25-hydroxy,UM4000059,82306,,Vitamin d 25 hydroxy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,164.9,% of charge rate,95.00%,156.66,,,,156.66,164.9,0
unity,CDM,Um Vitamin D 25-hydroxy,UM4000059,82306,,Vitamin d 25 hydroxy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,164.9,% of charge rate,95.00%,156.66,,,,156.66,164.9,0
unity,CDM,Um Calcitonin,UM4000838,82308,,Assay of calcitonin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,155.32,% of charge rate,95.00%,147.55,,,,147.55,155.32,0
unity,CDM,Um Calcitonin,UM4000838,82308,,Assay of calcitonin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,155.32,% of charge rate,95.00%,147.55,,,,147.55,155.32,0
unity,CDM,"Um Calcium, Serum",UM4000013,82310,,Assay of calcium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.69,% of charge rate,95.00%,27.26,,,,27.26,28.69,0
unity,CDM,"Um Calcium, Serum",UM4000013,82310,,Assay of calcium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.69,% of charge rate,95.00%,27.26,,,,27.26,28.69,0
unity,CDM,"Um Calcium, Random Urine",UM4000902,82310,,Assay of calcium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.69,% of charge rate,95.00%,27.26,,,,27.26,28.69,0
unity,CDM,"Um Calcium, Random Urine",UM4000902,82310,,Assay of calcium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.69,% of charge rate,95.00%,27.26,,,,27.26,28.69,0
unity,CDM,"Um Calcium, Ionized",UM4000063,82330,,Assay of calcium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.08,% of charge rate,95.00%,72.28,,,,72.28,76.08,0
unity,CDM,"Um Calcium, Ionized",UM4000063,82330,,Assay of calcium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.08,% of charge rate,95.00%,72.28,,,,72.28,76.08,0
unity,CDM,"Um Calcium - Urine, Quant",UM4000045,82340,,Assay of calcium in urine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.58,% of charge rate,95.00%,31.9,,,,31.9,33.58,0
unity,CDM,"Um Calcium - Urine, Quant",UM4000045,82340,,Assay of calcium in urine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.58,% of charge rate,95.00%,31.9,,,,31.9,33.58,0
unity,CDM,Um Calculus(stone) Assay,UM4000194,82365,,Calculus spectroscopy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.81,% of charge rate,95.00%,68.22,,,,68.22,71.81,0
unity,CDM,Um Calculus(stone) Assay,UM4000194,82365,,Calculus spectroscopy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.81,% of charge rate,95.00%,68.22,,,,68.22,71.81,0
unity,CDM,Um Co2 Carbon Dioxide,UM4000117,82374,,Assay blood carbon dioxide,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150,% of charge rate,95.00%,142.5,,,,142.5,150,0
unity,CDM,Um Co2 Carbon Dioxide,UM4000117,82374,,Assay blood carbon dioxide,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150,% of charge rate,95.00%,142.5,,,,142.5,150,0
unity,CDM,Um Co (carboxyhemoglobin),UM4000126,82375,,Assay carboxyhb quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.54,% of charge rate,95.00%,40.41,,,,40.41,42.54,0
unity,CDM,Um Co (carboxyhemoglobin),UM4000126,82375,,Assay carboxyhb quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.54,% of charge rate,95.00%,40.41,,,,40.41,42.54,0
unity,CDM,Um Cea,UM4000089,82378,,Carcinoembryonic antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.63,% of charge rate,95.00%,100.35,,,,100.35,105.63,0
unity,CDM,Um Cea,UM4000089,82378,,Carcinoembryonic antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.63,% of charge rate,95.00%,100.35,,,,100.35,105.63,0
unity,CDM,Um Carnitine,UM4000155,82379,,Assay of carnitine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,265.08,% of charge rate,95.00%,251.83,,,,251.83,265.08,0
unity,CDM,Um Carnitine,UM4000155,82379,,Assay of carnitine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,265.08,% of charge rate,95.00%,251.83,,,,251.83,265.08,0
unity,CDM,Um Carotene,UM4000201,82380,,Assay of carotene,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,123.33,% of charge rate,95.00%,117.16,,,,117.16,123.33,0
unity,CDM,Um Carotene,UM4000201,82380,,Assay of carotene,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,123.33,% of charge rate,95.00%,117.16,,,,117.16,123.33,0
unity,CDM,"Um Catcholmns, Fract/tot Pla",UM4000044,82384,,Assay three catecholamines,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.56,% of charge rate,95.00%,133.53,,,,133.53,140.56,0
unity,CDM,"Um Catcholmns, Fract/tot Pla",UM4000044,82384,,Assay three catecholamines,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.56,% of charge rate,95.00%,133.53,,,,133.53,140.56,0
unity,CDM,Um Cathcholines Fract/total 24 Hr Uriine,UM4000813,82384,,Assay three catecholamines,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.56,% of charge rate,95.00%,133.53,,,,133.53,140.56,0
unity,CDM,Um Cathcholines Fract/total 24 Hr Uriine,UM4000813,82384,,Assay three catecholamines,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.56,% of charge rate,95.00%,133.53,,,,133.53,140.56,0
unity,CDM,"Um Catcholines Fractionated, Serum",UM4000814,82384,,Assay three catecholamines,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.56,% of charge rate,95.00%,133.53,,,,133.53,140.56,0
unity,CDM,"Um Catcholines Fractionated, Serum",UM4000814,82384,,Assay three catecholamines,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.56,% of charge rate,95.00%,133.53,,,,133.53,140.56,0
unity,CDM,Um Ceruloplasmin,UM4000184,82390,,Assay of ceruloplasmin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.8,% of charge rate,95.00%,56.81,,,,56.81,59.8,0
unity,CDM,Um Ceruloplasmin,UM4000184,82390,,Assay of ceruloplasmin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.8,% of charge rate,95.00%,56.81,,,,56.81,59.8,0
unity,CDM,Um Ttg(tissue Transglutamase),UM4000529,82397,,Chemiluminescent assay,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um Ttg(tissue Transglutamase),UM4000529,82397,,Chemiluminescent assay,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um Inhibin B,UM4000858,82397,,Chemiluminescent assay,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.87,% of charge rate,95.00%,77.78,,,,77.78,81.87,0
unity,CDM,Um Inhibin B,UM4000858,82397,,Chemiluminescent assay,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.87,% of charge rate,95.00%,77.78,,,,77.78,81.87,0
unity,CDM,Um Chloride,UM4000285,82435,,Assay of blood chloride,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.59,% of charge rate,95.00%,24.31,,,,24.31,25.59,0
unity,CDM,Um Chloride,UM4000285,82435,,Assay of blood chloride,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.59,% of charge rate,95.00%,24.31,,,,24.31,25.59,0
unity,CDM,Um Chloride Urine,UM4000005,82436,,Assay of urine chloride,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.98,% of charge rate,95.00%,26.58,,,,26.58,27.98,0
unity,CDM,Um Chloride Urine,UM4000005,82436,,Assay of urine chloride,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.98,% of charge rate,95.00%,26.58,,,,26.58,27.98,0
unity,CDM,Um Cholesterol,UM4000029,82465,,Assay bld/serum cholesterol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.2,% of charge rate,95.00%,22.99,,,,22.99,24.2,0
unity,CDM,Um Cholesterol,UM4000029,82465,,Assay bld/serum cholesterol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.2,% of charge rate,95.00%,22.99,,,,22.99,24.2,0
unity,CDM,"Um Cholinesterase, Serum",UM4000268,82480,,Assay serum cholinesterase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.88,% of charge rate,95.00%,41.69,,,,41.69,43.88,0
unity,CDM,"Um Cholinesterase, Serum",UM4000268,82480,,Assay serum cholinesterase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.88,% of charge rate,95.00%,41.69,,,,41.69,43.88,0
unity,CDM,Um Citrate,UM4000191,82507,,Assay of citrate,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,286.66,% of charge rate,95.00%,272.33,,,,272.33,286.66,0
unity,CDM,Um Citrate,UM4000191,82507,,Assay of citrate,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,286.66,% of charge rate,95.00%,272.33,,,,272.33,286.66,0
unity,CDM,Um Copper Serum,UM4000359,82525,,Assay of copper,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.7,% of charge rate,95.00%,64.32,,,,64.32,67.7,0
unity,CDM,Um Copper Serum,UM4000359,82525,,Assay of copper,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.7,% of charge rate,95.00%,64.32,,,,64.32,67.7,0
unity,CDM,"Um Copper, Urine",UM4000941,82525,,Assay of copper,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.7,% of charge rate,95.00%,64.32,,,,64.32,67.7,0
unity,CDM,"Um Copper, Urine",UM4000941,82525,,Assay of copper,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.7,% of charge rate,95.00%,64.32,,,,64.32,67.7,0
unity,CDM,"Um Cortisol, Free",UM4000008,82530,,Cortisol free,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,151.95,% of charge rate,95.00%,144.35,,,,144.35,151.95,0
unity,CDM,"Um Cortisol, Free",UM4000008,82530,,Cortisol free,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,151.95,% of charge rate,95.00%,144.35,,,,144.35,151.95,0
unity,CDM,"Um Cortisol, Total",UM4000326,82533,,Total cortisol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.8,% of charge rate,95.00%,86.26,,,,86.26,90.8,0
unity,CDM,"Um Cortisol, Total",UM4000326,82533,,Total cortisol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.8,% of charge rate,95.00%,86.26,,,,86.26,90.8,0
unity,CDM,"Um Gc/ms, Hplc/ms",UM4000330,82542,,Col chromotography qual/quan,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.51,% of charge rate,95.00%,95.48,,,,95.48,100.51,0
unity,CDM,"Um Gc/ms, Hplc/ms",UM4000330,82542,,Col chromotography qual/quan,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.51,% of charge rate,95.00%,95.48,,,,95.48,100.51,0
unity,CDM,Um Tpmt Column Chromatography,UM4000835,82542,,Col chromotography qual/quan,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.7,% of charge rate,95.00%,99.47,,,,99.47,104.7,0
unity,CDM,Um Tpmt Column Chromatography,UM4000835,82542,,Col chromotography qual/quan,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.7,% of charge rate,95.00%,99.47,,,,99.47,104.7,0
unity,CDM,"Um Iodine, Serum Or Plasma",UM4000919,82542,,Col chromotography qual/quan,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.7,% of charge rate,95.00%,99.47,,,,99.47,104.7,0
unity,CDM,"Um Iodine, Serum Or Plasma",UM4000919,82542,,Col chromotography qual/quan,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.7,% of charge rate,95.00%,99.47,,,,99.47,104.7,0
unity,CDM,"Um Organic Acid Component, Quant.",UM4000944,82542,,Col chromotography qual/quan,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,365.8,% of charge rate,95.00%,347.51,,,,347.51,365.8,0
unity,CDM,"Um Organic Acid Component, Quant.",UM4000944,82542,,Col chromotography qual/quan,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,365.8,% of charge rate,95.00%,347.51,,,,347.51,365.8,0
unity,CDM,"Um Ck, Total",UM4000314,82550,,Assay of ck (cpk),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.31,% of charge rate,95.00%,34.49,,,,34.49,36.31,0
unity,CDM,"Um Ck, Total",UM4000314,82550,,Assay of ck (cpk),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.31,% of charge rate,95.00%,34.49,,,,34.49,36.31,0
unity,CDM,Um Ck-mb,UM4000343,82553,,Creatine mb fraction,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.29,% of charge rate,95.00%,61.08,,,,61.08,64.29,0
unity,CDM,Um Ck-mb,UM4000343,82553,,Creatine mb fraction,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.29,% of charge rate,95.00%,61.08,,,,61.08,64.29,0
unity,CDM,Um Creatinine,UM4000294,82565,,Assay of creatinine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.53,% of charge rate,95.00%,27.1,,,,27.1,28.53,0
unity,CDM,Um Creatinine,UM4000294,82565,,Assay of creatinine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.53,% of charge rate,95.00%,27.1,,,,27.1,28.53,0
unity,CDM,"Um Creatinine, Urine",UM4000260,82570,,Assay of urine creatinine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,"Um Creatinine, Urine",UM4000260,82570,,Assay of urine creatinine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Creatinine-cl Urine,UM4000086,82575,,Creatinine clearance test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.64,% of charge rate,95.00%,50.01,,,,50.01,52.64,0
unity,CDM,Um Creatinine-cl Urine,UM4000086,82575,,Creatinine clearance test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.64,% of charge rate,95.00%,50.01,,,,50.01,52.64,0
unity,CDM,Um Cryoglobulin,UM4000237,82595,,Assay of cryoglobulin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.33,% of charge rate,95.00%,55.41,,,,55.41,58.33,0
unity,CDM,Um Cryoglobulin,UM4000237,82595,,Assay of cryoglobulin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.33,% of charge rate,95.00%,55.41,,,,55.41,58.33,0
unity,CDM,Um Vitamin B-12,UM4000039,82607,,Vitamin b-12,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.93,% of charge rate,95.00%,79.73,,,,79.73,83.93,0
unity,CDM,Um Vitamin B-12,UM4000039,82607,,Vitamin b-12,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.93,% of charge rate,95.00%,79.73,,,,79.73,83.93,0
unity,CDM,Um Vit B12 Binding Capacity,UM4000241,82608,,B-12 binding capacity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.97,% of charge rate,95.00%,93.07,,,,93.07,97.97,0
unity,CDM,Um Vit B12 Binding Capacity,UM4000241,82608,,B-12 binding capacity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.97,% of charge rate,95.00%,93.07,,,,93.07,97.97,0
unity,CDM,Um Dhea,UM4000211,82626,,Dehydroepiandrosterone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.68,% of charge rate,95.00%,133.65,,,,133.65,140.68,0
unity,CDM,Um Dhea,UM4000211,82626,,Dehydroepiandrosterone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.68,% of charge rate,95.00%,133.65,,,,133.65,140.68,0
unity,CDM,Um Dehydroepiandosterone,UM4000216,82627,,Dehydroepiandrosterone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,123.81,% of charge rate,95.00%,117.62,,,,117.62,123.81,0
unity,CDM,Um Dehydroepiandosterone,UM4000216,82627,,Dehydroepiandrosterone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,123.81,% of charge rate,95.00%,117.62,,,,117.62,123.81,0
unity,CDM,Um Dihydrotestosterone (dht),UM4000394,82651,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,172.05,% of charge rate,95.00%,163.45,,,,163.45,172.05,0
unity,CDM,Um Dihydrotestosterone (dht),UM4000394,82651,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,172.05,% of charge rate,95.00%,163.45,,,,163.45,172.05,0
unity,CDM,"Um Vit D, 1, 25 Oh",UM4000364,82652,,Vit d 1 25-dihydroxy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,216.3,% of charge rate,95.00%,205.49,,,,205.49,216.3,0
unity,CDM,"Um Vit D, 1, 25 Oh",UM4000364,82652,,Vit d 1 25-dihydroxy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,216.3,% of charge rate,95.00%,205.49,,,,205.49,216.3,0
unity,CDM,"Um Pancreatic Elastase, Fecal",UM4000866,82656,,Pancreatic elastase fecal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.86,% of charge rate,95.00%,63.52,,,,63.52,66.86,0
unity,CDM,"Um Pancreatic Elastase, Fecal",UM4000866,82656,,Pancreatic elastase fecal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.86,% of charge rate,95.00%,63.52,,,,63.52,66.86,0
unity,CDM,Um Tpmt Enzyme Activity,UM4000836,82657,,Enzyme cell activity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.7,% of charge rate,95.00%,99.47,,,,99.47,104.7,0
unity,CDM,Um Tpmt Enzyme Activity,UM4000836,82657,,Enzyme cell activity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.7,% of charge rate,95.00%,99.47,,,,99.47,104.7,0
unity,CDM,Um Erythropoietin,UM4000172,82668,,Assay of erythropoietin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.68,% of charge rate,95.00%,99.45,,,,99.45,104.68,0
unity,CDM,Um Erythropoietin,UM4000172,82668,,Assay of erythropoietin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.68,% of charge rate,95.00%,99.45,,,,99.45,104.68,0
unity,CDM,Um Estradiol,UM4000189,82670,,Assay of estradiol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,155.6,% of charge rate,95.00%,147.82,,,,147.82,155.6,0
unity,CDM,Um Estradiol,UM4000189,82670,,Assay of estradiol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,155.6,% of charge rate,95.00%,147.82,,,,147.82,155.6,0
unity,CDM,"Um Estrogens, Total",UM4000390,82672,,Assay of estrogen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.24,% of charge rate,95.00%,150.33,,,,150.33,158.24,0
unity,CDM,"Um Estrogens, Total",UM4000390,82672,,Assay of estrogen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.24,% of charge rate,95.00%,150.33,,,,150.33,158.24,0
unity,CDM,Um Estrodial,UM4000366,82677,,Assay of estriol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,151.73,% of charge rate,95.00%,144.14,,,,144.14,151.73,0
unity,CDM,Um Estrodial,UM4000366,82677,,Assay of estriol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,151.73,% of charge rate,95.00%,144.14,,,,144.14,151.73,0
unity,CDM,Um Fecal Fat (lipids),UM4000174,82705,,Fats/lipids feces qual,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.65,% of charge rate,95.00%,72.82,,,,72.82,76.65,0
unity,CDM,Um Fecal Fat (lipids),UM4000174,82705,,Fats/lipids feces qual,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.65,% of charge rate,95.00%,72.82,,,,72.82,76.65,0
unity,CDM,Um Ferritin,UM4000055,82728,,Assay of ferritin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.88,% of charge rate,95.00%,72.09,,,,72.09,75.88,0
unity,CDM,Um Ferritin,UM4000055,82728,,Assay of ferritin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.88,% of charge rate,95.00%,72.09,,,,72.09,75.88,0
unity,CDM,Um Folate (folic Acid),UM4000225,82746,,Assay of folic acid serum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.86,% of charge rate,95.00%,77.77,,,,77.77,81.86,0
unity,CDM,Um Folate (folic Acid),UM4000225,82746,,Assay of folic acid serum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.86,% of charge rate,95.00%,77.77,,,,77.77,81.86,0
unity,CDM,"Um Folate, Rbc",UM4000279,82747,,Assay of folic acid rbc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.89,% of charge rate,95.00%,91.1,,,,91.1,95.89,0
unity,CDM,"Um Folate, Rbc",UM4000279,82747,,Assay of folic acid rbc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.89,% of charge rate,95.00%,91.1,,,,91.1,95.89,0
unity,CDM,"Um Immunoglobins(iga,igm,igg",UM4000554,82784,,Assay iga/igd/igg/igm each,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.8,% of charge rate,95.00%,49.21,,,,49.21,51.8,0
unity,CDM,"Um Immunoglobins(iga,igm,igg",UM4000554,82784,,Assay iga/igd/igg/igm each,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.8,% of charge rate,95.00%,49.21,,,,49.21,51.8,0
unity,CDM,"Um Gammaglobin, (ige)",UM4000373,82785,,Assay of ige,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.66,% of charge rate,95.00%,87.08,,,,87.08,91.66,0
unity,CDM,"Um Gammaglobin, (ige)",UM4000373,82785,,Assay of ige,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.66,% of charge rate,95.00%,87.08,,,,87.08,91.66,0
unity,CDM,"Um Immunoglob G, Subclass 1",UM82787,82787,,Igg 1 2 3 or 4 each,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,259.07,% of charge rate,95.00%,246.12,,,,246.12,259.07,0
unity,CDM,"Um Immunoglob G, Subclass 1",UM82787,82787,,Igg 1 2 3 or 4 each,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,259.07,% of charge rate,95.00%,246.12,,,,246.12,259.07,0
unity,CDM,Um Blood Ph Only,UM4000580,82800,,Blood ph,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54,% of charge rate,95.00%,51.3,,,,51.3,54,0
unity,CDM,Um Blood Ph Only,UM4000580,82800,,Blood ph,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54,% of charge rate,95.00%,51.3,,,,51.3,54,0
unity,CDM,Um Blood Gases W/o2 Sat,UM3480013,82805,,Blood gases w/o2 saturation,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,386.2,% of charge rate,95.00%,366.89,,,,366.89,386.2,0
unity,CDM,Um Blood Gases W/o2 Sat,UM3480013,82805,,Blood gases w/o2 saturation,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,386.2,% of charge rate,95.00%,366.89,,,,366.89,386.2,0
unity,CDM,Um Gastrin,UM4000923,82941,,Assay of gastrin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.7,% of charge rate,95.00%,99.47,,,,99.47,104.7,0
unity,CDM,Um Gastrin,UM4000923,82941,,Assay of gastrin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,104.7,% of charge rate,95.00%,99.47,,,,99.47,104.7,0
unity,CDM,Um Glucose Other Fluid,UM4000073,82945,,Glucose other fluid,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.41,% of charge rate,95.00%,20.34,,,,20.34,21.41,0
unity,CDM,Um Glucose Other Fluid,UM4000073,82945,,Glucose other fluid,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.41,% of charge rate,95.00%,20.34,,,,20.34,21.41,0
unity,CDM,Um Glucose - Quantitative,UM4000375,82947,,Assay glucose blood quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.86,% of charge rate,95.00%,20.77,,,,20.77,21.86,0
unity,CDM,Um Glucose - Quantitative,UM4000375,82947,,Assay glucose blood quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.86,% of charge rate,95.00%,20.77,,,,20.77,21.86,0
unity,CDM,Um Glucose Post Dose,UM4000306,82950,,Glucose test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,Um Glucose Post Dose,UM4000306,82950,,Glucose test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,"Um Glucose Tol.,  3 Specs",UM4000300,82951,,Glucose tolerance test (gtt),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.65,% of charge rate,95.00%,68.07,,,,68.07,71.65,0
unity,CDM,"Um Glucose Tol.,  3 Specs",UM4000300,82951,,Glucose tolerance test (gtt),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.65,% of charge rate,95.00%,68.07,,,,68.07,71.65,0
unity,CDM,"Um Lactose Tol.,5 Specs",UM4000712,82951,,Glucose tolerance test (gtt),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.3,% of charge rate,95.00%,94.34,,,,94.34,99.3,0
unity,CDM,"Um Lactose Tol.,5 Specs",UM4000712,82951,,Glucose tolerance test (gtt),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.3,% of charge rate,95.00%,94.34,,,,94.34,99.3,0
unity,CDM,Um Glu.tol/add Spec. Each,UM4000270,82952,,Gtt-added samples,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.83,% of charge rate,95.00%,20.74,,,,20.74,21.83,0
unity,CDM,Um Glu.tol/add Spec. Each,UM4000270,82952,,Gtt-added samples,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.83,% of charge rate,95.00%,20.74,,,,20.74,21.83,0
unity,CDM,Um G (6) Pd-enzyme Quant,UM4000149,82955,,Assay of g6pd enzyme,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.97,% of charge rate,95.00%,51.27,,,,51.27,53.97,0
unity,CDM,Um G (6) Pd-enzyme Quant,UM4000149,82955,,Assay of g6pd enzyme,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.97,% of charge rate,95.00%,51.27,,,,51.27,53.97,0
unity,CDM,"Um Glucose, Reagent Strip",UM4000057,82962,,Glucose blood test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.07,% of charge rate,95.00%,9.57,,,,9.57,10.07,0
unity,CDM,"Um Glucose, Reagent Strip",UM4000057,82962,,Glucose blood test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.07,% of charge rate,95.00%,9.57,,,,9.57,10.07,0
unity,CDM,Um Ggt,UM4000040,82977,,Assay of ggt,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.09,% of charge rate,95.00%,38.09,,,,38.09,40.09,0
unity,CDM,Um Ggt,UM4000040,82977,,Assay of ggt,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.09,% of charge rate,95.00%,38.09,,,,38.09,40.09,0
unity,CDM,Um Glutathiome,UM4000905,82978,,Assay of glutathione,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.56,% of charge rate,95.00%,74.63,,,,74.63,78.56,0
unity,CDM,Um Glutathiome,UM4000905,82978,,Assay of glutathione,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.56,% of charge rate,95.00%,74.63,,,,74.63,78.56,0
unity,CDM,"Um Folicle Stim Hormone, Fsh",UM4000180,83001,,Assay of gonadotropin (fsh),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.45,% of charge rate,95.00%,98.28,,,,98.28,103.45,0
unity,CDM,"Um Folicle Stim Hormone, Fsh",UM4000180,83001,,Assay of gonadotropin (fsh),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.45,% of charge rate,95.00%,98.28,,,,98.28,103.45,0
unity,CDM,Um Luteinizing Hormone (lh),UM4000110,83002,,Assay of gonadotropin (lh),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.09,% of charge rate,95.00%,97.94,,,,97.94,103.09,0
unity,CDM,Um Luteinizing Hormone (lh),UM4000110,83002,,Assay of gonadotropin (lh),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.09,% of charge rate,95.00%,97.94,,,,97.94,103.09,0
unity,CDM,"Um Haptoglobin, Quantitative",UM4000283,83010,,Assay of haptoglobin quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.88,% of charge rate,95.00%,111.99,,,,111.99,117.88,0
unity,CDM,"Um Haptoglobin, Quantitative",UM4000283,83010,,Assay of haptoglobin quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.88,% of charge rate,95.00%,111.99,,,,111.99,117.88,0
unity,CDM,Um Hgb Electrophoresis Cascade,UM4000709,83020,,Hemoglobin electrophoresis,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,178.41,% of charge rate,95.00%,169.49,,,,169.49,178.41,0
unity,CDM,Um Hgb Electrophoresis Cascade,UM4000709,83020,,Hemoglobin electrophoresis,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,178.41,% of charge rate,95.00%,169.49,,,,169.49,178.41,0
unity,CDM,"Um Fractionated Hgb, Chrom",UM4000229,83021,,Hemoglobin chromotography,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,308.78,% of charge rate,95.00%,293.34,,,,293.34,308.78,0
unity,CDM,"Um Fractionated Hgb, Chrom",UM4000229,83021,,Hemoglobin chromotography,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,308.78,% of charge rate,95.00%,293.34,,,,293.34,308.78,0
unity,CDM,"Um Hgb,glycated (hgb A1c)",UM4000068,83036,,Glycosylated hemoglobin test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.05,% of charge rate,95.00%,51.35,,,,51.35,54.05,0
unity,CDM,"Um Hgb,glycated (hgb A1c)",UM4000068,83036,,Glycosylated hemoglobin test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.05,% of charge rate,95.00%,51.35,,,,51.35,54.05,0
unity,CDM,Um Histamine,UM4000906,83088,,Assay of histamine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,162.7,% of charge rate,95.00%,154.57,,,,154.57,162.7,0
unity,CDM,Um Histamine,UM4000906,83088,,Assay of histamine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,162.7,% of charge rate,95.00%,154.57,,,,154.57,162.7,0
unity,CDM,Um Homocysteine,UM4000177,83090,,Assay of homocystine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.91,% of charge rate,95.00%,89.21,,,,89.21,93.91,0
unity,CDM,Um Homocysteine,UM4000177,83090,,Assay of homocystine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.91,% of charge rate,95.00%,89.21,,,,89.21,93.91,0
unity,CDM,Um Hydrocortisteroid,UM4000215,83491,,Assay of corticosteroids 17,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.53,% of charge rate,95.00%,92.65,,,,92.65,97.53,0
unity,CDM,Um Hydrocortisteroid,UM4000215,83491,,Assay of corticosteroids 17,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.53,% of charge rate,95.00%,92.65,,,,92.65,97.53,0
unity,CDM,Um Hiaa 5,UM4000193,83497,,Assay of 5-hiaa,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.81,% of charge rate,95.00%,68.22,,,,68.22,71.81,0
unity,CDM,Um Hiaa 5,UM4000193,83497,,Assay of 5-hiaa,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.81,% of charge rate,95.00%,68.22,,,,68.22,71.81,0
unity,CDM,"Um Hydroxyprogesterone, 17-d",UM4000042,83498,,Assay of progesterone 17-d,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,151.26,% of charge rate,95.00%,143.7,,,,143.7,151.26,0
unity,CDM,"Um Hydroxyprogesterone, 17-d",UM4000042,83498,,Assay of progesterone 17-d,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,151.26,% of charge rate,95.00%,143.7,,,,143.7,151.26,0
unity,CDM,Um M2(mitochondvial Ab)(ama),UM4000486,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um M2(mitochondvial Ab)(ama),UM4000486,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um Mpo (myeloperoxidase),UM4000487,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.17,% of charge rate,95.00%,98.01,,,,98.01,103.17,0
unity,CDM,Um Mpo (myeloperoxidase),UM4000487,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.17,% of charge rate,95.00%,98.01,,,,98.01,103.17,0
unity,CDM,Um Pr3 (proteinase 3 Ab),UM4000491,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.63,% of charge rate,95.00%,90.85,,,,90.85,95.63,0
unity,CDM,Um Pr3 (proteinase 3 Ab),UM4000491,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.63,% of charge rate,95.00%,90.85,,,,90.85,95.63,0
unity,CDM,Um Srp(signal Recog Particle,UM4000495,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.04,% of charge rate,95.00%,104.54,,,,104.54,110.04,0
unity,CDM,Um Srp(signal Recog Particle,UM4000495,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.04,% of charge rate,95.00%,104.54,,,,104.54,110.04,0
unity,CDM,Um Ttg(tissue Transglutamase,UM4000496,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.86,% of charge rate,95.00%,63.52,,,,63.52,66.86,0
unity,CDM,Um Ttg(tissue Transglutamase,UM4000496,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.86,% of charge rate,95.00%,63.52,,,,63.52,66.86,0
unity,CDM,"Um Gliadin Ab, Iga",UM4000510,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,"Um Gliadin Ab, Iga",UM4000510,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um Histone Abs,UM4000516,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um Histone Abs,UM4000516,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um Ribosomal P Antibody,UM4000908,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.52,% of charge rate,95.00%,60.34,,,,60.34,63.52,0
unity,CDM,Um Ribosomal P Antibody,UM4000908,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.52,% of charge rate,95.00%,60.34,,,,60.34,63.52,0
unity,CDM,Um Bullous Pemphigoid Igg Antibody,UM4000930,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.86,% of charge rate,95.00%,63.52,,,,63.52,66.86,0
unity,CDM,Um Bullous Pemphigoid Igg Antibody,UM4000930,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.86,% of charge rate,95.00%,63.52,,,,63.52,66.86,0
unity,CDM,Um Pth Related Protein,UM4000103,83519,,Ria nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,214.74,% of charge rate,95.00%,204,,,,204,214.74,0
unity,CDM,Um Pth Related Protein,UM4000103,83519,,Ria nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,214.74,% of charge rate,95.00%,204,,,,204,214.74,0
unity,CDM,Um Acetylchol Rec Bind Ab,UM4000408,83519,,Ria nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,230.48,% of charge rate,95.00%,218.96,,,,218.96,230.48,0
unity,CDM,Um Acetylchol Rec Bind Ab,UM4000408,83519,,Ria nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,230.48,% of charge rate,95.00%,218.96,,,,218.96,230.48,0
unity,CDM,Um Gad 65 A6,UM4000555,83519,,Ria nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,243.33,% of charge rate,95.00%,231.16,,,,231.16,243.33,0
unity,CDM,Um Gad 65 A6,UM4000555,83519,,Ria nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,243.33,% of charge rate,95.00%,231.16,,,,231.16,243.33,0
unity,CDM,"Um Igf I,binding Protein",UM4000726,83519,,Ria nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,166.71,% of charge rate,95.00%,158.37,,,,158.37,166.71,0
unity,CDM,"Um Igf I,binding Protein",UM4000726,83519,,Ria nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,166.71,% of charge rate,95.00%,158.37,,,,158.37,166.71,0
unity,CDM,Um Ria Nonantibody,UM4000790,83519,,Ria nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.07,% of charge rate,95.00%,42.82,,,,42.82,45.07,0
unity,CDM,Um Ria Nonantibody,UM4000790,83519,,Ria nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.07,% of charge rate,95.00%,42.82,,,,42.82,45.07,0
unity,CDM,Um Tsh Receptor Binding Antibody,UM4000873,83519,,Ria nonantibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,46.92,% of charge rate,95.00%,44.57,,,,44.57,46.92,0
unity,CDM,Um Tsh Receptor Binding Antibody,UM4000873,83519,,Ria nonantibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,46.92,% of charge rate,95.00%,44.57,,,,44.57,46.92,0
unity,CDM,"Um Immunoassay, Unspec",UM4000296,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,"Um Immunoassay, Unspec",UM4000296,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Anti Gbm,UM4000449,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,173.31,% of charge rate,95.00%,164.64,,,,164.64,173.31,0
unity,CDM,Um Anti Gbm,UM4000449,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,173.31,% of charge rate,95.00%,164.64,,,,164.64,173.31,0
unity,CDM,Um Centromere Ab (cma),UM4000506,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um Centromere Ab (cma),UM4000506,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.23,% of charge rate,95.00%,61.02,,,,61.02,64.23,0
unity,CDM,Um Phosphatidylethanolamine,UM4000523,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.17,% of charge rate,95.00%,98.01,,,,98.01,103.17,0
unity,CDM,Um Phosphatidylethanolamine,UM4000523,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,103.17,% of charge rate,95.00%,98.01,,,,98.01,103.17,0
unity,CDM,"Um Ribosomal Ab,igg",UM4000700,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,108.6,% of charge rate,95.00%,103.17,,,,103.17,108.6,0
unity,CDM,"Um Ribosomal Ab,igg",UM4000700,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,108.6,% of charge rate,95.00%,103.17,,,,103.17,108.6,0
unity,CDM,Um Anti-mullerian Hormone,UM4000748,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Anti-mullerian Hormone,UM4000748,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Kappa/lambda Free Light Chain,UM4000914,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,Um Kappa/lambda Free Light Chain,UM4000914,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.64,% of charge rate,95.00%,81.36,,,,81.36,85.64,0
unity,CDM,"Um Insulin Assay, Total",UM4000328,83525,,Assay of insulin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.63,% of charge rate,95.00%,60.45,,,,60.45,63.63,0
unity,CDM,"Um Insulin Assay, Total",UM4000328,83525,,Assay of insulin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.63,% of charge rate,95.00%,60.45,,,,60.45,63.63,0
unity,CDM,Um Insulin Assay,UM4000175,83527,,Assay of insulin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Insulin Assay,UM4000175,83527,,Assay of insulin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Iron,UM4000147,83540,,Assay of iron,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.08,% of charge rate,95.00%,34.28,,,,34.28,36.08,0
unity,CDM,Um Iron,UM4000147,83540,,Assay of iron,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.08,% of charge rate,95.00%,34.28,,,,34.28,36.08,0
unity,CDM,Um Iron Binding (ibc),UM4000254,83550,,Iron binding test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.66,% of charge rate,95.00%,46.23,,,,46.23,48.66,0
unity,CDM,Um Iron Binding (ibc),UM4000254,83550,,Iron binding test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.66,% of charge rate,95.00%,46.23,,,,46.23,48.66,0
unity,CDM,Um Lactic Acid,UM4000433,83605,,Assay of lactic acid,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.28,% of charge rate,95.00%,55.37,,,,55.37,58.28,0
unity,CDM,Um Lactic Acid,UM4000433,83605,,Assay of lactic acid,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.28,% of charge rate,95.00%,55.37,,,,55.37,58.28,0
unity,CDM,Um Ldh,UM4000056,83615,,Lactate (ld) (ldh) enzyme,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.61,% of charge rate,95.00%,31.93,,,,31.93,33.61,0
unity,CDM,Um Ldh,UM4000056,83615,,Lactate (ld) (ldh) enzyme,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.61,% of charge rate,95.00%,31.93,,,,31.93,33.61,0
unity,CDM,Um Lactoferrin (stool Wbgs),UM4000571,83630,,Lactoferrin fecal (qual),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.28,% of charge rate,95.00%,103.82,,,,103.82,109.28,0
unity,CDM,Um Lactoferrin (stool Wbgs),UM4000571,83630,,Lactoferrin fecal (qual),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.28,% of charge rate,95.00%,103.82,,,,103.82,109.28,0
unity,CDM,Um Lead,UM4000099,83655,,Assay of lead,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.44,% of charge rate,95.00%,94.47,,,,94.47,99.44,0
unity,CDM,Um Lead,UM4000099,83655,,Assay of lead,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.44,% of charge rate,95.00%,94.47,,,,94.47,99.44,0
unity,CDM,Um Lipase,UM4000267,83690,,Assay of lipase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.36,% of charge rate,95.00%,36.44,,,,36.44,38.36,0
unity,CDM,Um Lipase,UM4000267,83690,,Assay of lipase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.36,% of charge rate,95.00%,36.44,,,,36.44,38.36,0
unity,CDM,Um Hdl Cholesteral,UM4000271,83718,,Assay of lipoprotein,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.92,% of charge rate,95.00%,36.97,,,,36.97,38.92,0
unity,CDM,Um Hdl Cholesteral,UM4000271,83718,,Assay of lipoprotein,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.92,% of charge rate,95.00%,36.97,,,,36.97,38.92,0
unity,CDM,Um Ldl Cholesterol Direct,UM4000340,83721,,Assay of blood lipoprotein,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.1,% of charge rate,95.00%,50.45,,,,50.45,53.1,0
unity,CDM,Um Ldl Cholesterol Direct,UM4000340,83721,,Assay of blood lipoprotein,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.1,% of charge rate,95.00%,50.45,,,,50.45,53.1,0
unity,CDM,Um Magnesium,UM4000181,83735,,Assay of magnesium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.31,% of charge rate,95.00%,35.44,,,,35.44,37.31,0
unity,CDM,Um Magnesium,UM4000181,83735,,Assay of magnesium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.31,% of charge rate,95.00%,35.44,,,,35.44,37.31,0
unity,CDM,"Um Magnesium,24 Hr Urine",UM4000729,83735,,Assay of magnesium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.31,% of charge rate,95.00%,35.44,,,,35.44,37.31,0
unity,CDM,"Um Magnesium,24 Hr Urine",UM4000729,83735,,Assay of magnesium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.31,% of charge rate,95.00%,35.44,,,,35.44,37.31,0
unity,CDM,"Um Magnesium, Random Urine",UM4000903,83735,,Assay of magnesium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.31,% of charge rate,95.00%,35.44,,,,35.44,37.31,0
unity,CDM,"Um Magnesium, Random Urine",UM4000903,83735,,Assay of magnesium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.31,% of charge rate,95.00%,35.44,,,,35.44,37.31,0
unity,CDM,Um Clomipramine/anafranil,UM4000450,83789,,Mass spectrometry qual/quan,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,157.88,% of charge rate,95.00%,149.99,,,,149.99,157.88,0
unity,CDM,Um Clomipramine/anafranil,UM4000450,83789,,Mass spectrometry qual/quan,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,157.88,% of charge rate,95.00%,149.99,,,,149.99,157.88,0
unity,CDM,Um Tpmt Activity,UM4000742,83789,,Mass spectrometry qual/quan,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,457.65,% of charge rate,95.00%,434.77,,,,434.77,457.65,0
unity,CDM,Um Tpmt Activity,UM4000742,83789,,Mass spectrometry qual/quan,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,457.65,% of charge rate,95.00%,434.77,,,,434.77,457.65,0
unity,CDM,"Um Mercury, Blood",UM4000310,83825,,Assay of mercury,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,141.98,% of charge rate,95.00%,134.88,,,,134.88,141.98,0
unity,CDM,"Um Mercury, Blood",UM4000310,83825,,Assay of mercury,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,141.98,% of charge rate,95.00%,134.88,,,,134.88,141.98,0
unity,CDM,"Um Metanephrines, Plasma",UM4000047,83835,,Assay of metanephrines,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.36,% of charge rate,95.00%,89.64,,,,89.64,94.36,0
unity,CDM,"Um Metanephrines, Plasma",UM4000047,83835,,Assay of metanephrines,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.36,% of charge rate,95.00%,89.64,,,,89.64,94.36,0
unity,CDM,"Um Metanephrines, 24hr Urine",UM4000425,83835,,Assay of metanephrines,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.24,% of charge rate,95.00%,90.48,,,,90.48,95.24,0
unity,CDM,"Um Metanephrines, 24hr Urine",UM4000425,83835,,Assay of metanephrines,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.24,% of charge rate,95.00%,90.48,,,,90.48,95.24,0
unity,CDM,"Um Metanephrines, Ua Random",UM4000426,83835,,Assay of metanephrines,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.24,% of charge rate,95.00%,90.48,,,,90.48,95.24,0
unity,CDM,"Um Metanephrines, Ua Random",UM4000426,83835,,Assay of metanephrines,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.24,% of charge rate,95.00%,90.48,,,,90.48,95.24,0
unity,CDM,Um Mucin Synovial Fluid,UM4000355,83872,,Assay synovial fluid mucin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.64,% of charge rate,95.00%,31.01,,,,31.01,32.64,0
unity,CDM,Um Mucin Synovial Fluid,UM4000355,83872,,Assay synovial fluid mucin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.64,% of charge rate,95.00%,31.01,,,,31.01,32.64,0
unity,CDM,"Um Myoglobin, Serum",UM4000170,83874,,Assay of myoglobin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,197.94,% of charge rate,95.00%,188.04,,,,188.04,197.94,0
unity,CDM,"Um Myoglobin, Serum",UM4000170,83874,,Assay of myoglobin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,197.94,% of charge rate,95.00%,188.04,,,,188.04,197.94,0
unity,CDM,"Um Myoglobin, Urine",UM4000422,83874,,Assay of myoglobin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.68,% of charge rate,95.00%,87.1,,,,87.1,91.68,0
unity,CDM,"Um Myoglobin, Urine",UM4000422,83874,,Assay of myoglobin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.68,% of charge rate,95.00%,87.1,,,,87.1,91.68,0
unity,CDM,Um Bnp(natriuretic Peptide),UM4000165,83880,,Assay of natriuretic peptide,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,189.01,% of charge rate,95.00%,179.56,,,,179.56,189.01,0
unity,CDM,Um Bnp(natriuretic Peptide),UM4000165,83880,,Assay of natriuretic peptide,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,189.01,% of charge rate,95.00%,179.56,,,,179.56,189.01,0
unity,CDM,Um Kappa/lamda-light Chains,UM4000556,83883,,Assay nephelometry not spec,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.59,% of charge rate,95.00%,58.51,,,,58.51,61.59,0
unity,CDM,Um Kappa/lamda-light Chains,UM4000556,83883,,Assay nephelometry not spec,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.59,% of charge rate,95.00%,58.51,,,,58.51,61.59,0
unity,CDM,Um C1 Esterase Inhibitor Antigen,UM4000809,83883,,Assay nephelometry not spec,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.66,% of charge rate,95.00%,58.58,,,,58.58,61.66,0
unity,CDM,Um C1 Esterase Inhibitor Antigen,UM4000809,83883,,Assay nephelometry not spec,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.66,% of charge rate,95.00%,58.58,,,,58.58,61.66,0
unity,CDM,"Um Nephelometry, Alpha-2 Macroglobulin",UM4000818,83883,,Assay nephelometry not spec,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,138.16,% of charge rate,95.00%,131.25,,,,131.25,138.16,0
unity,CDM,"Um Nephelometry, Alpha-2 Macroglobulin",UM4000818,83883,,Assay nephelometry not spec,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,138.16,% of charge rate,95.00%,131.25,,,,131.25,138.16,0
unity,CDM,"Um Mol Diag., Amplif, Target",UM4000392,83900,,LH MOLECULE NUCLEIC AMPLIFICATION 2 SEQUENC,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,176.66,% of charge rate,95.00%,167.83,,,,167.83,176.66,0
unity,CDM,"Um Mol Diag., Amplif, Target",UM4000392,83900,,LH MOLECULE NUCLEIC AMPLIFICATION 2 SEQUENC,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,176.66,% of charge rate,95.00%,167.83,,,,167.83,176.66,0
unity,CDM,Um Nucleotidase-5,UM4000208,83915,,Assay of nucleotidase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.11,% of charge rate,95.00%,59,,,,59,62.11,0
unity,CDM,Um Nucleotidase-5,UM4000208,83915,,Assay of nucleotidase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.11,% of charge rate,95.00%,59,,,,59,62.11,0
unity,CDM,Um 5 Nucleotidase,UM4000800,83915,,Assay of nucleotidase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.15,% of charge rate,95.00%,59.04,,,,59.04,62.15,0
unity,CDM,Um 5 Nucleotidase,UM4000800,83915,,Assay of nucleotidase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.15,% of charge rate,95.00%,59.04,,,,59.04,62.15,0
unity,CDM,"Um Organic Acids, Total, Ea",UM4000317,83918,,Organic acids total quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,499.66,% of charge rate,95.00%,474.68,,,,474.68,499.66,0
unity,CDM,"Um Organic Acids, Total, Ea",UM4000317,83918,,Organic acids total quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,499.66,% of charge rate,95.00%,474.68,,,,474.68,499.66,0
unity,CDM,"Um Organic Acids, Qualitativ",UM4000557,83919,,Organic acids qual each,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,492.06,% of charge rate,95.00%,467.46,,,,467.46,492.06,0
unity,CDM,"Um Organic Acids, Qualitativ",UM4000557,83919,,Organic acids qual each,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,492.06,% of charge rate,95.00%,467.46,,,,467.46,492.06,0
unity,CDM,Um Methylmalonic Acid,UM4000305,83921,,Organic acid single quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.62,% of charge rate,95.00%,87.04,,,,87.04,91.62,0
unity,CDM,Um Methylmalonic Acid,UM4000305,83921,,Organic acid single quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.62,% of charge rate,95.00%,87.04,,,,87.04,91.62,0
unity,CDM,Um Osmolality  Serum,UM4000134,83930,,Assay of blood osmolality,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.79,% of charge rate,95.00%,34.95,,,,34.95,36.79,0
unity,CDM,Um Osmolality  Serum,UM4000134,83930,,Assay of blood osmolality,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.79,% of charge rate,95.00%,34.95,,,,34.95,36.79,0
unity,CDM,Um Osmolality-urine,UM4000003,83935,,Assay of urine osmolality,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.93,% of charge rate,95.00%,36.03,,,,36.03,37.93,0
unity,CDM,Um Osmolality-urine,UM4000003,83935,,Assay of urine osmolality,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.93,% of charge rate,95.00%,36.03,,,,36.03,37.93,0
unity,CDM,Um Oxalate - Urine,UM4000076,83945,,Assay of oxalate,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.65,% of charge rate,95.00%,68.07,,,,68.07,71.65,0
unity,CDM,Um Oxalate - Urine,UM4000076,83945,,Assay of oxalate,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.65,% of charge rate,95.00%,68.07,,,,68.07,71.65,0
unity,CDM,Um Her 2,UM4000550,83950,,Oncoprotein her-2/neu,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,358.63,% of charge rate,95.00%,340.7,,,,340.7,358.63,0
unity,CDM,Um Her 2,UM4000550,83950,,Oncoprotein her-2/neu,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,358.63,% of charge rate,95.00%,340.7,,,,340.7,358.63,0
unity,CDM,Um Pth-intact,UM4000166,83970,,Assay of parathormone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,229.79,% of charge rate,95.00%,218.3,,,,218.3,229.79,0
unity,CDM,Um Pth-intact,UM4000166,83970,,Assay of parathormone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,229.79,% of charge rate,95.00%,218.3,,,,218.3,229.79,0
unity,CDM,Um Body Fluid Acid Assay,UM4000357,83986,,Assay ph body fluid nos,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.93,% of charge rate,95.00%,18.93,,,,18.93,19.93,0
unity,CDM,Um Body Fluid Acid Assay,UM4000357,83986,,Assay ph body fluid nos,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.93,% of charge rate,95.00%,18.93,,,,18.93,19.93,0
unity,CDM,"Um Phencyclide, Urine, Conf",UM4000921,83992,,Assay for phencyclidine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.55,% of charge rate,95.00%,76.52,,,,76.52,80.55,0
unity,CDM,"Um Phencyclide, Urine, Conf",UM4000921,83992,,Assay for phencyclidine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.55,% of charge rate,95.00%,76.52,,,,76.52,80.55,0
unity,CDM,"Um Calprotectin, Feces",UM4000797,83993,,Assay for calprotectin fecal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.33,% of charge rate,95.00%,103.86,,,,103.86,109.33,0
unity,CDM,"Um Calprotectin, Feces",UM4000797,83993,,Assay for calprotectin fecal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.33,% of charge rate,95.00%,103.86,,,,103.86,109.33,0
unity,CDM,Um Pku Neonatal,UM4000030,84030,,Assay of blood pku,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.52,% of charge rate,95.00%,85.99,,,,85.99,90.52,0
unity,CDM,Um Pku Neonatal,UM4000030,84030,,Assay of blood pku,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90.52,% of charge rate,95.00%,85.99,,,,85.99,90.52,0
unity,CDM,Um Alkaline Phosphatase,UM4000161,84075,,Assay alkaline phosphatase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Alkaline Phosphatase,UM4000161,84075,,Assay alkaline phosphatase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Alp Isoenzymes,UM4000258,84080,,Assay alkaline phosphatases,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.35,% of charge rate,95.00%,78.23,,,,78.23,82.35,0
unity,CDM,Um Alp Isoenzymes,UM4000258,84080,,Assay alkaline phosphatases,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.35,% of charge rate,95.00%,78.23,,,,78.23,82.35,0
unity,CDM,Um Bone Alkaline Phosphatase,UM4000834,84080,,Assay alkaline phosphatases,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.72,% of charge rate,95.00%,81.43,,,,81.43,85.72,0
unity,CDM,Um Bone Alkaline Phosphatase,UM4000834,84080,,Assay alkaline phosphatases,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.72,% of charge rate,95.00%,81.43,,,,81.43,85.72,0
unity,CDM,Um Phosphorus,UM4000233,84100,,Assay of phosphorus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.42,% of charge rate,95.00%,25.1,,,,25.1,26.42,0
unity,CDM,Um Phosphorus,UM4000233,84100,,Assay of phosphorus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.42,% of charge rate,95.00%,25.1,,,,25.1,26.42,0
unity,CDM,Um Phosphorus Urine,UM4000011,84105,,Assay of urine phosphorus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Phosphorus Urine,UM4000011,84105,,Assay of urine phosphorus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,"Um Porphrins Ua, Quant",UM4000218,84120,,Assay of urine porphyrins,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,149.5,% of charge rate,95.00%,142.03,,,,142.03,149.5,0
unity,CDM,"Um Porphrins Ua, Quant",UM4000218,84120,,Assay of urine porphyrins,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,149.5,% of charge rate,95.00%,142.03,,,,142.03,149.5,0
unity,CDM,Um Potassium,UM4000050,84132,,Assay of serum potassium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.59,% of charge rate,95.00%,24.31,,,,24.31,25.59,0
unity,CDM,Um Potassium,UM4000050,84132,,Assay of serum potassium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.59,% of charge rate,95.00%,24.31,,,,24.31,25.59,0
unity,CDM,"Um Potassium, Urine",UM4000131,84133,,Assay of urine potassium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.94,% of charge rate,95.00%,22.74,,,,22.74,23.94,0
unity,CDM,"Um Potassium, Urine",UM4000131,84133,,Assay of urine potassium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.94,% of charge rate,95.00%,22.74,,,,22.74,23.94,0
unity,CDM,Um Prealbumin,UM4000311,84134,,Assay of prealbumin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.57,% of charge rate,95.00%,104.09,,,,104.09,109.57,0
unity,CDM,Um Prealbumin,UM4000311,84134,,Assay of prealbumin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.57,% of charge rate,95.00%,104.09,,,,104.09,109.57,0
unity,CDM,Um Progesterone,UM4000313,84144,,Assay of progesterone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.15,% of charge rate,95.00%,110.34,,,,110.34,116.15,0
unity,CDM,Um Progesterone,UM4000313,84144,,Assay of progesterone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.15,% of charge rate,95.00%,110.34,,,,110.34,116.15,0
unity,CDM,Um Procalcitonin,UM4000943,84145,,Procalcitonin (pct),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150.18,% of charge rate,95.00%,142.67,,,,142.67,150.18,0
unity,CDM,Um Procalcitonin,UM4000943,84145,,Procalcitonin (pct),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150.18,% of charge rate,95.00%,142.67,,,,142.67,150.18,0
unity,CDM,Um Prolactin,UM4000224,84146,,Assay of prolactin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.9,% of charge rate,95.00%,102.51,,,,102.51,107.9,0
unity,CDM,Um Prolactin,UM4000224,84146,,Assay of prolactin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.9,% of charge rate,95.00%,102.51,,,,102.51,107.9,0
unity,CDM,Um Psa,UM4000023,84153,,Assay of psa total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.44,% of charge rate,95.00%,97.32,,,,97.32,102.44,0
unity,CDM,Um Psa,UM4000023,84153,,Assay of psa total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.44,% of charge rate,95.00%,97.32,,,,97.32,102.44,0
unity,CDM,"Um Psa,free",UM4000084,84154,,Assay of psa free,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.44,% of charge rate,95.00%,97.32,,,,97.32,102.44,0
unity,CDM,"Um Psa,free",UM4000084,84154,,Assay of psa free,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.44,% of charge rate,95.00%,97.32,,,,97.32,102.44,0
unity,CDM,Um Protein Total,UM4000385,84155,,Assay of protein serum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.41,% of charge rate,95.00%,19.39,,,,19.39,20.41,0
unity,CDM,Um Protein Total,UM4000385,84155,,Assay of protein serum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.41,% of charge rate,95.00%,19.39,,,,19.39,20.41,0
unity,CDM,"Um Protein, Total, Urine",UM4000321,84156,,Assay of protein urine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.01,% of charge rate,95.00%,19.01,,,,19.01,20.01,0
unity,CDM,"Um Protein, Total, Urine",UM4000321,84156,,Assay of protein urine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.01,% of charge rate,95.00%,19.01,,,,19.01,20.01,0
unity,CDM,"Um Protein,total; Other Fluid",UM4000890,84157,,Assay of protein other,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.25,% of charge rate,95.00%,20.19,,,,20.19,21.25,0
unity,CDM,"Um Protein,total; Other Fluid",UM4000890,84157,,Assay of protein other,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.25,% of charge rate,95.00%,20.19,,,,20.19,21.25,0
unity,CDM,Um Protein E-phoresis-serum,UM4000052,84165,,Protein e-phoresis serum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.8,% of charge rate,95.00%,56.81,,,,56.81,59.8,0
unity,CDM,Um Protein E-phoresis-serum,UM4000052,84165,,Protein e-phoresis serum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.8,% of charge rate,95.00%,56.81,,,,56.81,59.8,0
unity,CDM,"Um Protein E-phoresis, Urine",UM4000244,84166,,Protein e-phoresis/urine/csf,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.33,% of charge rate,95.00%,94.36,,,,94.36,99.33,0
unity,CDM,"Um Protein E-phoresis, Urine",UM4000244,84166,,Protein e-phoresis/urine/csf,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.33,% of charge rate,95.00%,94.36,,,,94.36,99.33,0
unity,CDM,Um Vitamin B6/pyridoxal Phos,UM4000454,84207,,Assay of vitamin b-6,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,289.47,% of charge rate,95.00%,275,,,,275,289.47,0
unity,CDM,Um Vitamin B6/pyridoxal Phos,UM4000454,84207,,Assay of vitamin b-6,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,289.47,% of charge rate,95.00%,275,,,,275,289.47,0
unity,CDM,Um Pyridocal 5-phosphate,UM4000820,84207,,Assay of vitamin b-6,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,156.54,% of charge rate,95.00%,148.71,,,,148.71,156.54,0
unity,CDM,Um Pyridocal 5-phosphate,UM4000820,84207,,Assay of vitamin b-6,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,156.54,% of charge rate,95.00%,148.71,,,,148.71,156.54,0
unity,CDM,Um Pyruvic Acid,UM4000937,84210,,Assay of pyruvate,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130.03,% of charge rate,95.00%,123.53,,,,123.53,130.03,0
unity,CDM,Um Pyruvic Acid,UM4000937,84210,,Assay of pyruvate,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130.03,% of charge rate,95.00%,123.53,,,,123.53,130.03,0
unity,CDM,Um Acetylcholine Receptor Ab,UM4000297,84238,,Assay nonendocrine receptor,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.58,% of charge rate,95.00%,193.4,,,,193.4,203.58,0
unity,CDM,Um Acetylcholine Receptor Ab,UM4000297,84238,,Assay nonendocrine receptor,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.58,% of charge rate,95.00%,193.4,,,,193.4,203.58,0
unity,CDM,"Um Receptor Assay,soluble Transferrin",UM4000730,84238,,Assay nonendocrine receptor,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.58,% of charge rate,95.00%,193.4,,,,193.4,203.58,0
unity,CDM,"Um Receptor Assay,soluble Transferrin",UM4000730,84238,,Assay nonendocrine receptor,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.58,% of charge rate,95.00%,193.4,,,,193.4,203.58,0
unity,CDM,Um Renin,UM4000098,84244,,Assay of renin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,166.67,% of charge rate,95.00%,158.34,,,,158.34,166.67,0
unity,CDM,Um Renin,UM4000098,84244,,Assay of renin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,166.67,% of charge rate,95.00%,158.34,,,,158.34,166.67,0
unity,CDM,Um Vitamin B2/riboflavin,UM4000453,84252,,Assay of vitamin b-2,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.27,% of charge rate,95.00%,220.66,,,,220.66,232.27,0
unity,CDM,Um Vitamin B2/riboflavin,UM4000453,84252,,Assay of vitamin b-2,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.27,% of charge rate,95.00%,220.66,,,,220.66,232.27,0
unity,CDM,Um Selenium Assay,UM4000324,84255,,Assay of selenium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.15,% of charge rate,95.00%,135.04,,,,135.04,142.15,0
unity,CDM,Um Selenium Assay,UM4000324,84255,,Assay of selenium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.15,% of charge rate,95.00%,135.04,,,,135.04,142.15,0
unity,CDM,Um Sex Hormone Binding Globulin,UM4000889,84270,,Assay of sex hormone globul,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.98,% of charge rate,95.00%,119.68,,,,119.68,125.98,0
unity,CDM,Um Sex Hormone Binding Globulin,UM4000889,84270,,Assay of sex hormone globul,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.98,% of charge rate,95.00%,119.68,,,,119.68,125.98,0
unity,CDM,Um Sodium; Serum,UM4000079,84295,,Assay of serum sodium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.82,% of charge rate,95.00%,25.48,,,,25.48,26.82,0
unity,CDM,Um Sodium; Serum,UM4000079,84295,,Assay of serum sodium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.82,% of charge rate,95.00%,25.48,,,,25.48,26.82,0
unity,CDM,"Um Sodium, Urine",UM4000154,84300,,Assay of urine sodium,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.06,% of charge rate,95.00%,25.71,,,,25.71,27.06,0
unity,CDM,"Um Sodium, Urine",UM4000154,84300,,Assay of urine sodium,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.06,% of charge rate,95.00%,25.71,,,,25.71,27.06,0
unity,CDM,"Um Pyrroles, Urine",UM4000762,84311,,Spectrophotometry,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.7,% of charge rate,95.00%,107.07,,,,107.07,112.7,0
unity,CDM,"Um Pyrroles, Urine",UM4000762,84311,,Spectrophotometry,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.7,% of charge rate,95.00%,107.07,,,,107.07,112.7,0
unity,CDM,Um Sp. Gravity Body Fluid,UM4000365,84315,,Body fluid specific gravity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.94,% of charge rate,95.00%,13.24,,,,13.24,13.94,0
unity,CDM,Um Sp. Gravity Body Fluid,UM4000365,84315,,Body fluid specific gravity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.94,% of charge rate,95.00%,13.24,,,,13.24,13.94,0
unity,CDM,"Um Reducing Substance, Stool",UM4000173,84377,,Sugars multiple qual,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.55,% of charge rate,95.00%,72.72,,,,72.72,76.55,0
unity,CDM,"Um Reducing Substance, Stool",UM4000173,84377,,Sugars multiple qual,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.55,% of charge rate,95.00%,72.72,,,,72.72,76.55,0
unity,CDM,Um Urine Sulfate,UM4000839,84392,,Assay of urine sulfate,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.52,% of charge rate,95.00%,26.14,,,,26.14,27.52,0
unity,CDM,Um Urine Sulfate,UM4000839,84392,,Assay of urine sulfate,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.52,% of charge rate,95.00%,26.14,,,,26.14,27.52,0
unity,CDM,"Um Testosterone, Free",UM4000199,84402,,Assay of free testosterone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,141.8,% of charge rate,95.00%,134.71,,,,134.71,141.8,0
unity,CDM,"Um Testosterone, Free",UM4000199,84402,,Assay of free testosterone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,141.8,% of charge rate,95.00%,134.71,,,,134.71,141.8,0
unity,CDM,"Um Testosterone, Total",UM4000164,84403,,Assay of total testosterone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.76,% of charge rate,95.00%,136.57,,,,136.57,143.76,0
unity,CDM,"Um Testosterone, Total",UM4000164,84403,,Assay of total testosterone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.76,% of charge rate,95.00%,136.57,,,,136.57,143.76,0
unity,CDM,"Um Vit B-1/thiamine,plasma",UM4000369,84425,,Assay of vitamin b-1,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,176.67,% of charge rate,95.00%,167.84,,,,167.84,176.67,0
unity,CDM,"Um Vit B-1/thiamine,plasma",UM4000369,84425,,Assay of vitamin b-1,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,176.67,% of charge rate,95.00%,167.84,,,,167.84,176.67,0
unity,CDM,Um Thyroglobulin,UM4000186,84432,,Assay of thyroglobulin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.48,% of charge rate,95.00%,85.01,,,,85.01,89.48,0
unity,CDM,Um Thyroglobulin,UM4000186,84432,,Assay of thyroglobulin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.48,% of charge rate,95.00%,85.01,,,,85.01,89.48,0
unity,CDM,Um T 4 Total/thyroxine,UM4000111,84436,,Assay of total thyroxine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.24,% of charge rate,95.00%,36.33,,,,36.33,38.24,0
unity,CDM,Um T 4 Total/thyroxine,UM4000111,84436,,Assay of total thyroxine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.24,% of charge rate,95.00%,36.33,,,,36.33,38.24,0
unity,CDM,Um T4 Neonatal,UM4000210,84437,,Assay of neonatal thyroxine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.35,% of charge rate,95.00%,29.78,,,,29.78,31.35,0
unity,CDM,Um T4 Neonatal,UM4000210,84437,,Assay of neonatal thyroxine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.35,% of charge rate,95.00%,29.78,,,,29.78,31.35,0
unity,CDM,"Um T4/throxin, Free",UM4000255,84439,,Assay of free thyroxine,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.08,% of charge rate,95.00%,42.83,,,,42.83,45.08,0
unity,CDM,"Um T4/throxin, Free",UM4000255,84439,,Assay of free thyroxine,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.08,% of charge rate,95.00%,42.83,,,,42.83,45.08,0
unity,CDM,Um Tsh,UM4000123,84443,,Assay thyroid stim hormone,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.55,% of charge rate,95.00%,88.87,,,,88.87,93.55,0
unity,CDM,Um Tsh,UM4000123,84443,,Assay thyroid stim hormone,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.55,% of charge rate,95.00%,88.87,,,,88.87,93.55,0
unity,CDM,Um Thyroid Stimulating Ig B,UM4000038,84445,,Assay of tsi globulin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,283.12,% of charge rate,95.00%,268.96,,,,268.96,283.12,0
unity,CDM,Um Thyroid Stimulating Ig B,UM4000038,84445,,Assay of tsi globulin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,283.12,% of charge rate,95.00%,268.96,,,,268.96,283.12,0
unity,CDM,Um Vitamin E,UM4000108,84446,,Assay of vitamin e,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.2,% of charge rate,95.00%,89.49,,,,89.49,94.2,0
unity,CDM,Um Vitamin E,UM4000108,84446,,Assay of vitamin e,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.2,% of charge rate,95.00%,89.49,,,,89.49,94.2,0
unity,CDM,Um Ast,UM4000014,84450,,Transferase (ast) (sgot),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Ast,UM4000014,84450,,Transferase (ast) (sgot),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Alt,UM4000026,84460,,Alanine amino (alt) (sgpt),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.5,% of charge rate,95.00%,28.03,,,,28.03,29.5,0
unity,CDM,Um Alt,UM4000026,84460,,Alanine amino (alt) (sgpt),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.5,% of charge rate,95.00%,28.03,,,,28.03,29.5,0
unity,CDM,Um Tranferrin,UM4000037,84466,,Assay of transferrin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.09,% of charge rate,95.00%,67.54,,,,67.54,71.09,0
unity,CDM,Um Tranferrin,UM4000037,84466,,Assay of transferrin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.09,% of charge rate,95.00%,67.54,,,,67.54,71.09,0
unity,CDM,Um Triglycerides,UM4000069,84478,,Assay of triglycerides,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.03,% of charge rate,95.00%,30.43,,,,30.43,32.03,0
unity,CDM,Um Triglycerides,UM4000069,84478,,Assay of triglycerides,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.03,% of charge rate,95.00%,30.43,,,,30.43,32.03,0
unity,CDM,Um T3  Or T4 Uptake,UM4000273,84479,,Assay of thyroid (t3 or t4),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,Um T3  Or T4 Uptake,UM4000273,84479,,Assay of thyroid (t3 or t4),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,"Um T3, Total",UM4000124,84480,,Assay triiodothyronine (t3),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.94,% of charge rate,95.00%,74.99,,,,74.99,78.94,0
unity,CDM,"Um T3, Total",UM4000124,84480,,Assay triiodothyronine (t3),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.94,% of charge rate,95.00%,74.99,,,,74.99,78.94,0
unity,CDM,Um T3 Free,UM4000282,84481,,Free assay (ft-3),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.36,% of charge rate,95.00%,89.64,,,,89.64,94.36,0
unity,CDM,Um T3 Free,UM4000282,84481,,Free assay (ft-3),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.36,% of charge rate,95.00%,89.64,,,,89.64,94.36,0
unity,CDM,Um T3-reverse Assay,UM4000214,84482,,T3 reverse,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,278.33,% of charge rate,95.00%,264.41,,,,264.41,278.33,0
unity,CDM,Um T3-reverse Assay,UM4000214,84482,,T3 reverse,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,278.33,% of charge rate,95.00%,264.41,,,,264.41,278.33,0
unity,CDM,"Um Troponin, Quant",UM4000033,84484,,Assay of troponin quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.23,% of charge rate,95.00%,35.37,,,,35.37,37.23,0
unity,CDM,"Um Troponin, Quant",UM4000033,84484,,Assay of troponin quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.23,% of charge rate,95.00%,35.37,,,,35.37,37.23,0
unity,CDM,Um Urea Nitrogen (bun),UM4000169,84520,,Assay of urea nitrogen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.98,% of charge rate,95.00%,20.88,,,,20.88,21.98,0
unity,CDM,Um Urea Nitrogen (bun),UM4000169,84520,,Assay of urea nitrogen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.98,% of charge rate,95.00%,20.88,,,,20.88,21.98,0
unity,CDM,"Um Urea Nitrogen, Urine",UM4000142,84540,,Assay of urine/urea-n,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,"Um Urea Nitrogen, Urine",UM4000142,84540,,Assay of urine/urea-n,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,"Um Uric Acid , Blood",UM4000219,84550,,Assay of blood/uric acid,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.15,% of charge rate,95.00%,23.89,,,,23.89,25.15,0
unity,CDM,"Um Uric Acid , Blood",UM4000219,84550,,Assay of blood/uric acid,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.15,% of charge rate,95.00%,23.89,,,,23.89,25.15,0
unity,CDM,"Um Uric Acid, Other Source",UM4000113,84560,,Assay of urine/uric acid,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.19,% of charge rate,95.00%,45.78,,,,45.78,48.19,0
unity,CDM,"Um Uric Acid, Other Source",UM4000113,84560,,Assay of urine/uric acid,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.19,% of charge rate,95.00%,45.78,,,,45.78,48.19,0
unity,CDM,"Um Uric Acid, Urine",UM4000407,84560,,Assay of urine/uric acid,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,"Um Uric Acid, Urine",UM4000407,84560,,Assay of urine/uric acid,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,Um Vma Urine,UM4000337,84585,,Assay of urine vma,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.33,% of charge rate,95.00%,82.01,,,,82.01,86.33,0
unity,CDM,Um Vma Urine,UM4000337,84585,,Assay of urine vma,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.33,% of charge rate,95.00%,82.01,,,,82.01,86.33,0
unity,CDM,Um Vasoactive Intestinal Poplypeptide,UM4000922,84586,,Assay of vip,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,209.8,% of charge rate,95.00%,199.31,,,,199.31,209.8,0
unity,CDM,Um Vasoactive Intestinal Poplypeptide,UM4000922,84586,,Assay of vip,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,209.8,% of charge rate,95.00%,199.31,,,,199.31,209.8,0
unity,CDM,Um Vitamin A (retinol),UM4000559,84590,,Assay of vitamin a,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.3,% of charge rate,95.00%,135.19,,,,135.19,142.3,0
unity,CDM,Um Vitamin A (retinol),UM4000559,84590,,Assay of vitamin a,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.3,% of charge rate,95.00%,135.19,,,,135.19,142.3,0
unity,CDM,Um Vitamin B3,UM4000546,84591,,Assay of nos vitamin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,205.72,% of charge rate,95.00%,195.43,,,,195.43,205.72,0
unity,CDM,Um Vitamin B3,UM4000546,84591,,Assay of nos vitamin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,205.72,% of charge rate,95.00%,195.43,,,,195.43,205.72,0
unity,CDM,"Um Zinc, Plasma",UM4000094,84630,,Assay of zinc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.37,% of charge rate,95.00%,60.2,,,,60.2,63.37,0
unity,CDM,"Um Zinc, Plasma",UM4000094,84630,,Assay of zinc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.37,% of charge rate,95.00%,60.2,,,,60.2,63.37,0
unity,CDM,"Um Zinc, 24-hr Urine",UM4000419,84630,,Assay of zinc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.37,% of charge rate,95.00%,60.2,,,,60.2,63.37,0
unity,CDM,"Um Zinc, 24-hr Urine",UM4000419,84630,,Assay of zinc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.37,% of charge rate,95.00%,60.2,,,,60.2,63.37,0
unity,CDM,"Um Zinc, Random Urine",UM4000420,84630,,Assay of zinc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,74.16,% of charge rate,95.00%,70.45,,,,70.45,74.16,0
unity,CDM,"Um Zinc, Random Urine",UM4000420,84630,,Assay of zinc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,74.16,% of charge rate,95.00%,70.45,,,,70.45,74.16,0
unity,CDM,Um C-peptide,UM4000153,84681,,Assay of c-peptide,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.85,% of charge rate,95.00%,110.06,,,,110.06,115.85,0
unity,CDM,Um C-peptide,UM4000153,84681,,Assay of c-peptide,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.85,% of charge rate,95.00%,110.06,,,,110.06,115.85,0
unity,CDM,"Um Hcg, Quantitative",UM4000135,84702,,Chorionic gonadotropin test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.85,% of charge rate,95.00%,79.66,,,,79.66,83.85,0
unity,CDM,"Um Hcg, Quantitative",UM4000135,84702,,Chorionic gonadotropin test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.85,% of charge rate,95.00%,79.66,,,,79.66,83.85,0
unity,CDM,"Um Pregnancy Test, Hcg Qual",UM4000006,84703,,Chorionic gonadotropin assay,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.83,% of charge rate,95.00%,39.74,,,,39.74,41.83,0
unity,CDM,"Um Pregnancy Test, Hcg Qual",UM4000006,84703,,Chorionic gonadotropin assay,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.83,% of charge rate,95.00%,39.74,,,,39.74,41.83,0
unity,CDM,Um Bleeding Time,UM4000235,85002,,Bleeding time test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.55,% of charge rate,95.00%,23.32,,,,23.32,24.55,0
unity,CDM,Um Bleeding Time,UM4000235,85002,,Bleeding time test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.55,% of charge rate,95.00%,23.32,,,,23.32,24.55,0
unity,CDM,"Um Differential, Automated",UM4000547,85004,,Automated diff wbc count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,"Um Differential, Automated",UM4000547,85004,,Automated diff wbc count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,"Um Differential, Wbc",UM4000092,85007,,Bl smear w/diff wbc count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.12,% of charge rate,95.00%,18.16,,,,18.16,19.12,0
unity,CDM,"Um Differential, Wbc",UM4000092,85007,,Bl smear w/diff wbc count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.12,% of charge rate,95.00%,18.16,,,,18.16,19.12,0
unity,CDM,Um Morphology Manual Exam,UM4000303,85008,,Bl smear w/o diff wbc count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.12,% of charge rate,95.00%,18.16,,,,18.16,19.12,0
unity,CDM,Um Morphology Manual Exam,UM4000303,85008,,Bl smear w/o diff wbc count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.12,% of charge rate,95.00%,18.16,,,,18.16,19.12,0
unity,CDM,"Um Differential, Buffy Coat",UM4000088,85009,,Manual diff wbc count b-coat,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.7,% of charge rate,95.00%,19.67,,,,19.67,20.7,0
unity,CDM,"Um Differential, Buffy Coat",UM4000088,85009,,Manual diff wbc count b-coat,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.7,% of charge rate,95.00%,19.67,,,,19.67,20.7,0
unity,CDM,Um Hematocrit,UM4000238,85014,,Hematocrit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.17,% of charge rate,95.00%,12.51,,,,12.51,13.17,0
unity,CDM,Um Hematocrit,UM4000238,85014,,Hematocrit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.17,% of charge rate,95.00%,12.51,,,,12.51,13.17,0
unity,CDM,Um Hemoglobin,UM4000347,85018,,Hemoglobin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.17,% of charge rate,95.00%,12.51,,,,12.51,13.17,0
unity,CDM,Um Hemoglobin,UM4000347,85018,,Hemoglobin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.17,% of charge rate,95.00%,12.51,,,,12.51,13.17,0
unity,CDM,Um Cbc With Diff Screen,UM4000325,85025,,Complete cbc w/auto diff wbc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.32,% of charge rate,95.00%,41.15,,,,41.15,43.32,0
unity,CDM,Um Cbc With Diff Screen,UM4000325,85025,,Complete cbc w/auto diff wbc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.32,% of charge rate,95.00%,41.15,,,,41.15,43.32,0
unity,CDM,Um Hemogram,UM4000077,85027,,Complete cbc automated,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,Um Hemogram,UM4000077,85027,,Complete cbc automated,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,Um Reticulocyte Count,UM4000227,85045,,Automated reticulocyte count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.3,% of charge rate,95.00%,21.19,,,,21.19,22.3,0
unity,CDM,Um Reticulocyte Count,UM4000227,85045,,Automated reticulocyte count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.3,% of charge rate,95.00%,21.19,,,,21.19,22.3,0
unity,CDM,Um Wbc,UM4000348,85048,,Automated leukocyte count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.16,% of charge rate,95.00%,13.45,,,,13.45,14.16,0
unity,CDM,Um Wbc,UM4000348,85048,,Automated leukocyte count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.16,% of charge rate,95.00%,13.45,,,,13.45,14.16,0
unity,CDM,Um Platelet Count,UM4000304,85049,,Automated platelet count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.89,% of charge rate,95.00%,23.65,,,,23.65,24.89,0
unity,CDM,Um Platelet Count,UM4000304,85049,,Automated platelet count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.89,% of charge rate,95.00%,23.65,,,,23.65,24.89,0
unity,CDM,Um Smears To Pathologist,UM4000318,85060,,Blood smear interpretation,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.37,% of charge rate,95.00%,48.8,,,,48.8,51.37,0
unity,CDM,Um Smears To Pathologist,UM4000318,85060,,Blood smear interpretation,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.37,% of charge rate,95.00%,48.8,,,,48.8,51.37,0
unity,CDM,"Um Factor V Test, Clotting",UM4000252,85220,,Blooc clot factor v test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.82,% of charge rate,95.00%,167.03,,,,167.03,175.82,0
unity,CDM,"Um Factor V Test, Clotting",UM4000252,85220,,Blooc clot factor v test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.82,% of charge rate,95.00%,167.03,,,,167.03,175.82,0
unity,CDM,Um Factor Vii Activity,UM4000771,85230,,Clot factor vii proconvertin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.77,% of charge rate,95.00%,94.78,,,,94.78,99.77,0
unity,CDM,Um Factor Vii Activity,UM4000771,85230,,Clot factor vii proconvertin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.77,% of charge rate,95.00%,94.78,,,,94.78,99.77,0
unity,CDM,Um Factor Viii Activity,UM4000265,85240,,Clot factor viii ahg 1 stage,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.32,% of charge rate,95.00%,63,,,,63,66.32,0
unity,CDM,Um Factor Viii Activity,UM4000265,85240,,Clot factor viii ahg 1 stage,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.32,% of charge rate,95.00%,63,,,,63,66.32,0
unity,CDM,Um Ristocetin Cofactor Activ,UM4000286,85245,,Clot factor viii vw ristoctn,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,223.33,% of charge rate,95.00%,212.16,,,,212.16,223.33,0
unity,CDM,Um Ristocetin Cofactor Activ,UM4000286,85245,,Clot factor viii vw ristoctn,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,223.33,% of charge rate,95.00%,212.16,,,,212.16,223.33,0
unity,CDM,Um Vwf Antigen,UM4000295,85246,,Clot factor viii vw antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,283.75,% of charge rate,95.00%,269.56,,,,269.56,283.75,0
unity,CDM,Um Vwf Antigen,UM4000295,85246,,Clot factor viii vw antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,283.75,% of charge rate,95.00%,269.56,,,,269.56,283.75,0
unity,CDM,Um Von Willebrand Factor Antigen,UM4000885,85246,,Clot factor viii vw antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,133,% of charge rate,95.00%,126.35,,,,126.35,133,0
unity,CDM,Um Von Willebrand Factor Antigen,UM4000885,85246,,Clot factor viii vw antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,133,% of charge rate,95.00%,126.35,,,,126.35,133,0
unity,CDM,"Um Vonwillebrand Ag, Multime",UM4000563,85247,,Clot factor viii multimetric,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,134.92",% of charge rate,95.00%,"1,078.17",,,,"1,078.17","1,134.92",0
unity,CDM,"Um Vonwillebrand Ag, Multime",UM4000563,85247,,Clot factor viii multimetric,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,134.92",% of charge rate,95.00%,"1,078.17",,,,"1,078.17","1,134.92",0
unity,CDM,Um Factor Ix,UM4000882,85250,,Clot factor ix ptc/chrstmas,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.39,% of charge rate,95.00%,104.87,,,,104.87,110.39,0
unity,CDM,Um Factor Ix,UM4000882,85250,,Clot factor ix ptc/chrstmas,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.39,% of charge rate,95.00%,104.87,,,,104.87,110.39,0
unity,CDM,Um Factor Xi,UM4000370,85270,,Clot factor xi pta,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.82,% of charge rate,95.00%,167.03,,,,167.03,175.82,0
unity,CDM,Um Factor Xi,UM4000370,85270,,Clot factor xi pta,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.82,% of charge rate,95.00%,167.03,,,,167.03,175.82,0
unity,CDM,Um Factor Xii,UM4000883,85280,,Clot factor xii hageman,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.16,% of charge rate,95.00%,106.55,,,,106.55,112.16,0
unity,CDM,Um Factor Xii,UM4000883,85280,,Clot factor xii hageman,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.16,% of charge rate,95.00%,106.55,,,,106.55,112.16,0
unity,CDM,Um Factor Viii Clot Solubili,UM4000565,85291,,Clot factor xiii fibrin scrn,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,Um Factor Viii Clot Solubili,UM4000565,85291,,Clot factor xiii fibrin scrn,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,Um Antithrombin Iii Activity,UM4000109,85300,,Antithrombin iii activity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.01,% of charge rate,95.00%,62.71,,,,62.71,66.01,0
unity,CDM,Um Antithrombin Iii Activity,UM4000109,85300,,Antithrombin iii activity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.01,% of charge rate,95.00%,62.71,,,,62.71,66.01,0
unity,CDM,Um Antithrombin Iii Ref Ag,UM4000427,85300,,Antithrombin iii activity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,178.21,% of charge rate,95.00%,169.3,,,,169.3,178.21,0
unity,CDM,Um Antithrombin Iii Ref Ag,UM4000427,85300,,Antithrombin iii activity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,178.21,% of charge rate,95.00%,169.3,,,,169.3,178.21,0
unity,CDM,Um Antithrombin Iii Antigen,UM4000351,85301,,Antithrombin iii antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,184.6,% of charge rate,95.00%,175.37,,,,175.37,184.6,0
unity,CDM,Um Antithrombin Iii Antigen,UM4000351,85301,,Antithrombin iii antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,184.6,% of charge rate,95.00%,175.37,,,,175.37,184.6,0
unity,CDM,Um Protein C Antigen,UM4000437,85302,,Clot inhibit prot c antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.94,% of charge rate,95.00%,63.59,,,,63.59,66.94,0
unity,CDM,Um Protein C Antigen,UM4000437,85302,,Clot inhibit prot c antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.94,% of charge rate,95.00%,63.59,,,,63.59,66.94,0
unity,CDM,Um Protein C Activity,UM4000438,85303,,Clot inhibit prot c activity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,257.72,% of charge rate,95.00%,244.83,,,,244.83,257.72,0
unity,CDM,Um Protein C Activity,UM4000438,85303,,Clot inhibit prot c activity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,257.72,% of charge rate,95.00%,244.83,,,,244.83,257.72,0
unity,CDM,Um Protein S Antigen-total,UM4000600,85305,,Clot inhibit prot s total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,228.96,% of charge rate,95.00%,217.51,,,,217.51,228.96,0
unity,CDM,Um Protein S Antigen-total,UM4000600,85305,,Clot inhibit prot s total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,228.96,% of charge rate,95.00%,217.51,,,,217.51,228.96,0
unity,CDM,Um Protein S Antigen-free,UM4000601,85306,,Clot inhibit prot s free,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,228.96,% of charge rate,95.00%,217.51,,,,217.51,228.96,0
unity,CDM,Um Protein S Antigen-free,UM4000601,85306,,Clot inhibit prot s free,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,228.96,% of charge rate,95.00%,217.51,,,,217.51,228.96,0
unity,CDM,Um Protein S Activity,UM4000868,85306,,Clot inhibit prot s free,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,68.3,% of charge rate,95.00%,64.89,,,,64.89,68.3,0
unity,CDM,Um Protein S Activity,UM4000868,85306,,Clot inhibit prot s free,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,68.3,% of charge rate,95.00%,64.89,,,,64.89,68.3,0
unity,CDM,Um Activated Protein C Resistence,UM4000604,85307,,Assay activated protein c,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.57,% of charge rate,95.00%,62.29,,,,62.29,65.57,0
unity,CDM,Um Activated Protein C Resistence,UM4000604,85307,,Assay activated protein c,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.57,% of charge rate,95.00%,62.29,,,,62.29,65.57,0
unity,CDM,Um Fibrin Monomer,UM4000772,85362,,Fibrin degradation products,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.4,% of charge rate,95.00%,36.48,,,,36.48,38.4,0
unity,CDM,Um Fibrin Monomer,UM4000772,85362,,Fibrin degradation products,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.4,% of charge rate,95.00%,36.48,,,,36.48,38.4,0
unity,CDM,Um Fibrum Degradation Products,UM4000605,85366,,Fibrinogen test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.65,% of charge rate,95.00%,61.42,,,,61.42,64.65,0
unity,CDM,Um Fibrum Degradation Products,UM4000605,85366,,Fibrinogen test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.65,% of charge rate,95.00%,61.42,,,,61.42,64.65,0
unity,CDM,Um Fibrin Degradat Prod Quan,UM4000105,85379,,Fibrin degradation quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.13,% of charge rate,95.00%,42.87,,,,42.87,45.13,0
unity,CDM,Um Fibrin Degradat Prod Quan,UM4000105,85379,,Fibrin degradation quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.13,% of charge rate,95.00%,42.87,,,,42.87,45.13,0
unity,CDM,"Um D-dimer, Quantitative",UM4000240,85379,,Fibrin degradation quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.13,% of charge rate,95.00%,42.87,,,,42.87,45.13,0
unity,CDM,"Um D-dimer, Quantitative",UM4000240,85379,,Fibrin degradation quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.13,% of charge rate,95.00%,42.87,,,,42.87,45.13,0
unity,CDM,Um Fibrinogen; Activity,UM4000320,85384,,Fibrinogen activity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.3,% of charge rate,95.00%,44.94,,,,44.94,47.3,0
unity,CDM,Um Fibrinogen; Activity,UM4000320,85384,,Fibrinogen activity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.3,% of charge rate,95.00%,44.94,,,,44.94,47.3,0
unity,CDM,Um Von Willebrand Disease Profile Tech Interp,UM4000912,85390,,Fibrinolysins screen i&r,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.77,% of charge rate,95.00%,72.93,,,,72.93,76.77,0
unity,CDM,Um Von Willebrand Disease Profile Tech Interp,UM4000912,85390,,Fibrinolysins screen i&r,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.77,% of charge rate,95.00%,72.93,,,,72.93,76.77,0
unity,CDM,Um Von Willebrand Factor Activity,UM4000886,85397,,Clotting funct activity,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,133,% of charge rate,95.00%,126.35,,,,126.35,133,0
unity,CDM,Um Von Willebrand Factor Activity,UM4000886,85397,,Clotting funct activity,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,133,% of charge rate,95.00%,126.35,,,,126.35,133,0
unity,CDM,Um Fetal Maternal Hemorr Scr,UM4050012,85460,,Hemoglobin fetal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.22,% of charge rate,95.00%,40.11,,,,40.11,42.22,0
unity,CDM,Um Fetal Maternal Hemorr Scr,UM4050012,85460,,Hemoglobin fetal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.22,% of charge rate,95.00%,40.11,,,,40.11,42.22,0
unity,CDM,Um Heparin Xa Assay,UM4000539,85520,,Heparin assay,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.9,% of charge rate,95.00%,69.26,,,,69.26,72.9,0
unity,CDM,Um Heparin Xa Assay,UM4000539,85520,,Heparin assay,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.9,% of charge rate,95.00%,69.26,,,,69.26,72.9,0
unity,CDM,Um Bm Iron Stain,UM4000247,85536,,Iron stain peripheral blood,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,Um Bm Iron Stain,UM4000247,85536,,Iron stain peripheral blood,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,"Um Iron Stain, Periph Blood",UM4000315,85536,,Iron stain peripheral blood,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,"Um Iron Stain, Periph Blood",UM4000315,85536,,Iron stain peripheral blood,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.05,% of charge rate,95.00%,34.25,,,,34.25,36.05,0
unity,CDM,Um Lysozyme (muramidase)seru,UM4000338,85549,,Muramidase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.52,% of charge rate,95.00%,104.99,,,,104.99,110.52,0
unity,CDM,Um Lysozyme (muramidase)seru,UM4000338,85549,,Muramidase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.52,% of charge rate,95.00%,104.99,,,,104.99,110.52,0
unity,CDM,Um Lysozyme (muramidase) Ua,UM4000430,85549,,Muramidase,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.52,% of charge rate,95.00%,104.99,,,,104.99,110.52,0
unity,CDM,Um Lysozyme (muramidase) Ua,UM4000430,85549,,Muramidase,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.52,% of charge rate,95.00%,104.99,,,,104.99,110.52,0
unity,CDM,Um Prothombin Time,UM4000012,85610,,Prothrombin time,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.86,% of charge rate,95.00%,20.77,,,,20.77,21.86,0
unity,CDM,Um Prothombin Time,UM4000012,85610,,Prothrombin time,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.86,% of charge rate,95.00%,20.77,,,,20.77,21.86,0
unity,CDM,Um Lupus Anticoagulant(rvvt),UM4000533,85613,,Russell viper venom diluted,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.43,% of charge rate,95.00%,67.86,,,,67.86,71.43,0
unity,CDM,Um Lupus Anticoagulant(rvvt),UM4000533,85613,,Russell viper venom diluted,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.43,% of charge rate,95.00%,67.86,,,,67.86,71.43,0
unity,CDM,Um Sed Rate Automated,UM4000331,85652,,Rbc sed rate automated,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.05,% of charge rate,95.00%,14.3,,,,14.3,15.05,0
unity,CDM,Um Sed Rate Automated,UM4000331,85652,,Rbc sed rate automated,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.05,% of charge rate,95.00%,14.3,,,,14.3,15.05,0
unity,CDM,Um Sickling Of Rbc,UM4000104,85660,,Rbc sickle cell test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.89,% of charge rate,95.00%,57.85,,,,57.85,60.89,0
unity,CDM,Um Sickling Of Rbc,UM4000104,85660,,Rbc sickle cell test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.89,% of charge rate,95.00%,57.85,,,,57.85,60.89,0
unity,CDM,Um Thrombin Time,UM4000564,85670,,Thrombin time plasma,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.02,% of charge rate,95.00%,89.32,,,,89.32,94.02,0
unity,CDM,Um Thrombin Time,UM4000564,85670,,Thrombin time plasma,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.02,% of charge rate,95.00%,89.32,,,,89.32,94.02,0
unity,CDM,Um Thromboplastin Inhibition,UM4000139,85705,,Thromboplastin inhibition,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.4,% of charge rate,95.00%,30.78,,,,30.78,32.4,0
unity,CDM,Um Thromboplastin Inhibition,UM4000139,85705,,Thromboplastin inhibition,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.4,% of charge rate,95.00%,30.78,,,,30.78,32.4,0
unity,CDM,Um Aptt,UM4000212,85730,,Thromboplastin time partial,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.41,% of charge rate,95.00%,31.74,,,,31.74,33.41,0
unity,CDM,Um Aptt,UM4000212,85730,,Thromboplastin time partial,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.41,% of charge rate,95.00%,31.74,,,,31.74,33.41,0
unity,CDM,Um Lupus Anticoagulant (ptt),UM4000534,85730,,Thromboplastin time partial,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.41,% of charge rate,95.00%,31.74,,,,31.74,33.41,0
unity,CDM,Um Lupus Anticoagulant (ptt),UM4000534,85730,,Thromboplastin time partial,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.41,% of charge rate,95.00%,31.74,,,,31.74,33.41,0
unity,CDM,"Um Ptt,substitution (plasmafraction)",UM4000603,85730,,Thromboplastin time partial,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.24,% of charge rate,95.00%,99.98,,,,99.98,105.24,0
unity,CDM,"Um Ptt,substitution (plasmafraction)",UM4000603,85730,,Thromboplastin time partial,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,105.24,% of charge rate,95.00%,99.98,,,,99.98,105.24,0
unity,CDM,"Um Viscosity, Serum",UM4000096,85810,,Blood viscosity examination,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,"Um Viscosity, Serum",UM4000096,85810,,Blood viscosity examination,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Urine Eosinophil,UM4000743,85999,,Hematology procedure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.14,% of charge rate,95.00%,48.58,,,,48.58,51.14,0
unity,CDM,Um Urine Eosinophil,UM4000743,85999,,Hematology procedure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.14,% of charge rate,95.00%,48.58,,,,48.58,51.14,0
unity,CDM,Um Allergen Specific Igg Quantitative/semi Quant Ea. Allergen,UM4000807,86001,,Allergen specific igg,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.65,% of charge rate,95.00%,25.32,,,,25.32,26.65,0
unity,CDM,Um Allergen Specific Igg Quantitative/semi Quant Ea. Allergen,UM4000807,86001,,Allergen specific igg,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.65,% of charge rate,95.00%,25.32,,,,25.32,26.65,0
unity,CDM,"Um Allergen Specific Ige, Ea",UM4000542,86003,,Allg spec ige crude xtrc ea,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.86,% of charge rate,95.00%,53.07,,,,53.07,55.86,0
unity,CDM,"Um Allergen Specific Ige, Ea",UM4000542,86003,,Allg spec ige crude xtrc ea,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.86,% of charge rate,95.00%,53.07,,,,53.07,55.86,0
unity,CDM,Um Antibody Id Leukocytes,UM4000257,86021,,Wbc antibody identification,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,208.5,% of charge rate,95.00%,198.08,,,,198.08,208.5,0
unity,CDM,Um Antibody Id Leukocytes,UM4000257,86021,,Wbc antibody identification,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,208.5,% of charge rate,95.00%,198.08,,,,198.08,208.5,0
unity,CDM,Um Platelet Antibody,UM4000436,86022,,Platelet antibodies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.3,% of charge rate,95.00%,97.19,,,,97.19,102.3,0
unity,CDM,Um Platelet Antibody,UM4000436,86022,,Platelet antibodies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.3,% of charge rate,95.00%,97.19,,,,97.19,102.3,0
unity,CDM,"Um Platelet Ag, Direct",UM4000066,86023,,Immunoglobulin assay,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,226,% of charge rate,95.00%,214.7,,,,214.7,226,0
unity,CDM,"Um Platelet Ag, Direct",UM4000066,86023,,Immunoglobulin assay,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,226,% of charge rate,95.00%,214.7,,,,214.7,226,0
unity,CDM,Um Ana (hep-2) Screen,UM4000466,86038,,Antinuclear antibodies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.3,% of charge rate,95.00%,63.94,,,,63.94,67.3,0
unity,CDM,Um Ana (hep-2) Screen,UM4000466,86038,,Antinuclear antibodies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.3,% of charge rate,95.00%,63.94,,,,63.94,67.3,0
unity,CDM,Um Ana (hep-) Titer,UM4000467,86039,,Antinuclear antibodies (ana),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.15,% of charge rate,95.00%,59.04,,,,59.04,62.15,0
unity,CDM,Um Ana (hep-) Titer,UM4000467,86039,,Antinuclear antibodies (ana),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.15,% of charge rate,95.00%,59.04,,,,59.04,62.15,0
unity,CDM,Um Aso Titer,UM4000036,86060,,Antistreptolysin o titer,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.64,% of charge rate,95.00%,38.61,,,,38.61,40.64,0
unity,CDM,Um Aso Titer,UM4000036,86060,,Antistreptolysin o titer,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.64,% of charge rate,95.00%,38.61,,,,38.61,40.64,0
unity,CDM,Um Crp/c Reactive Protein,UM4000349,86140,,C-reactive protein,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Crp/c Reactive Protein,UM4000349,86140,,C-reactive protein,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Crp (hs),UM4000085,86141,,C-reactive protein hs,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Crp (hs),UM4000085,86141,,C-reactive protein hs,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Beta-2 Glycoprotein 1,UM4000468,86146,,Beta-2 glycoprotein antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.45,% of charge rate,95.00%,112.53,,,,112.53,118.45,0
unity,CDM,Um Beta-2 Glycoprotein 1,UM4000468,86146,,Beta-2 glycoprotein antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.45,% of charge rate,95.00%,112.53,,,,112.53,118.45,0
unity,CDM,Um Cardiolipin Ab(phospholip,UM4000511,86147,,Cardiolipin antibody ea ig,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.45,% of charge rate,95.00%,112.53,,,,112.53,118.45,0
unity,CDM,Um Cardiolipin Ab(phospholip,UM4000511,86147,,Cardiolipin antibody ea ig,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.45,% of charge rate,95.00%,112.53,,,,112.53,118.45,0
unity,CDM,Um Anti-phosohatidylserine,UM4000860,86148,,Anti-phospholipid antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.15,% of charge rate,95.00%,88.49,,,,88.49,93.15,0
unity,CDM,Um Anti-phosohatidylserine,UM4000860,86148,,Anti-phospholipid antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.15,% of charge rate,95.00%,88.49,,,,88.49,93.15,0
unity,CDM,"Um Cold Agglutinin, Titer",UM4000383,86157,,Cold agglutinin titer,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.4,% of charge rate,95.00%,30.78,,,,30.78,32.4,0
unity,CDM,"Um Cold Agglutinin, Titer",UM4000383,86157,,Cold agglutinin titer,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.4,% of charge rate,95.00%,30.78,,,,30.78,32.4,0
unity,CDM,Um C3 (complement C3),UM4000503,86160,,Complement antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.88,% of charge rate,95.00%,63.54,,,,63.54,66.88,0
unity,CDM,Um C3 (complement C3),UM4000503,86160,,Complement antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.88,% of charge rate,95.00%,63.54,,,,63.54,66.88,0
unity,CDM,Um C4 (complement C4),UM4000504,86160,,Complement antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.88,% of charge rate,95.00%,63.54,,,,63.54,66.88,0
unity,CDM,Um C4 (complement C4),UM4000504,86160,,Complement antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.88,% of charge rate,95.00%,63.54,,,,63.54,66.88,0
unity,CDM,"Um Complement, Total (ch50)",UM4000051,86162,,Complement total (ch50),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.14,% of charge rate,95.00%,107.48,,,,107.48,113.14,0
unity,CDM,"Um Complement, Total (ch50)",UM4000051,86162,,Complement total (ch50),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.14,% of charge rate,95.00%,107.48,,,,107.48,113.14,0
unity,CDM,Um Ccp(cyclic Citrul Peptide,UM4000507,86200,,Ccp antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Ccp(cyclic Citrul Peptide,UM4000507,86200,,Ccp antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Dnase-b Ab,UM4000405,86215,,Deoxyribonuclease antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.16,% of charge rate,95.00%,84.7,,,,84.7,89.16,0
unity,CDM,Um Dnase-b Ab,UM4000405,86215,,Deoxyribonuclease antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.16,% of charge rate,95.00%,84.7,,,,84.7,89.16,0
unity,CDM,Um Ds-dna(dna Double Strand),UM4000508,86225,,Dna antibody native,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.46,% of charge rate,95.00%,72.64,,,,72.64,76.46,0
unity,CDM,Um Ds-dna(dna Double Strand),UM4000508,86225,,Dna antibody native,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.46,% of charge rate,95.00%,72.64,,,,72.64,76.46,0
unity,CDM,"Um Ssa(sjogrens,syndrome)may",UM4000463,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,"Um Ssa(sjogrens,syndrome)may",UM4000463,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,"Um Ssb(sjogrens,syndrome)may",UM4000464,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,"Um Ssb(sjogrens,syndrome)may",UM4000464,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,Um Pm-scl Ab (pm-1 Ab),UM4000490,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.96,% of charge rate,95.00%,79.76,,,,79.76,83.96,0
unity,CDM,Um Pm-scl Ab (pm-1 Ab),UM4000490,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.96,% of charge rate,95.00%,79.76,,,,79.76,83.96,0
unity,CDM,"Um Jo - I Ab, Igg",UM4000517,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,"Um Jo - I Ab, Igg",UM4000517,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,Um Rnp (ribonuclear Protein),UM4000526,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,Um Rnp (ribonuclear Protein),UM4000526,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,Um Scl-70 Ab(scleroderma),UM4000527,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,Um Scl-70 Ab(scleroderma),UM4000527,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,Um Sm Ab (anti-smith),UM4000528,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,Um Sm Ab (anti-smith),UM4000528,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.87,% of charge rate,95.00%,94.88,,,,94.88,99.87,0
unity,CDM,Um Chromatin (nuclcosomal) Ab,UM4000701,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.4,% of charge rate,95.00%,119.13,,,,119.13,125.4,0
unity,CDM,Um Chromatin (nuclcosomal) Ab,UM4000701,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.4,% of charge rate,95.00%,119.13,,,,119.13,125.4,0
unity,CDM,Um Centromere B Antibody,UM4000909,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.83,% of charge rate,95.00%,93.89,,,,93.89,98.83,0
unity,CDM,Um Centromere B Antibody,UM4000909,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.83,% of charge rate,95.00%,93.89,,,,93.89,98.83,0
unity,CDM,Um Sm/rnp Antibody,UM4000910,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.83,% of charge rate,95.00%,93.89,,,,93.89,98.83,0
unity,CDM,Um Sm/rnp Antibody,UM4000910,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.83,% of charge rate,95.00%,93.89,,,,93.89,98.83,0
unity,CDM,Um Anca(cytoplasm Neutscreen,UM4000478,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,265,% of charge rate,95.00%,251.75,,,,251.75,265,0
unity,CDM,Um Anca(cytoplasm Neutscreen,UM4000478,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,265,% of charge rate,95.00%,251.75,,,,251.75,265,0
unity,CDM,Um Smooth Muscle Ab,UM4000535,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,Um Smooth Muscle Ab,UM4000535,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,Um Striated Muscle Abs,UM4000552,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,Um Striated Muscle Abs,UM4000552,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,Um Parietal Cell Ab,UM4000560,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,Um Parietal Cell Ab,UM4000560,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,"Um Fluorescent Antibody Screen, Unspec",UM4000789,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.14,% of charge rate,95.00%,63.78,,,,63.78,67.14,0
unity,CDM,"Um Fluorescent Antibody Screen, Unspec",UM4000789,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.14,% of charge rate,95.00%,63.78,,,,63.78,67.14,0
unity,CDM,"Um Endomysial Antibody, Iga",UM4000871,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.86,% of charge rate,95.00%,66.37,,,,66.37,69.86,0
unity,CDM,"Um Endomysial Antibody, Iga",UM4000871,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.86,% of charge rate,95.00%,66.37,,,,66.37,69.86,0
unity,CDM,Um Nmda Receptor Antibody,UM4000928,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,530,% of charge rate,95.00%,503.5,,,,503.5,530,0
unity,CDM,Um Nmda Receptor Antibody,UM4000928,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,530,% of charge rate,95.00%,503.5,,,,503.5,530,0
unity,CDM,Um Fluorescent Ab Titer,UM4000115,86256,,Fluorescent antibody titer,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,Um Fluorescent Ab Titer,UM4000115,86256,,Fluorescent antibody titer,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,Um Endomysial Ab,UM4000475,86256,,Fluorescent antibody titer,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,178.57,% of charge rate,95.00%,169.64,,,,169.64,178.57,0
unity,CDM,Um Endomysial Ab,UM4000475,86256,,Fluorescent antibody titer,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,178.57,% of charge rate,95.00%,169.64,,,,169.64,178.57,0
unity,CDM,Um Anca Titer,UM4000479,86256,,Fluorescent antibody titer,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,178.57,% of charge rate,95.00%,169.64,,,,169.64,178.57,0
unity,CDM,Um Anca Titer,UM4000479,86256,,Fluorescent antibody titer,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,178.57,% of charge rate,95.00%,169.64,,,,169.64,178.57,0
unity,CDM,Um Hemagglutination Inhibit,UM4000157,86280,,Hemagglutination inhibition,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.08,% of charge rate,95.00%,42.83,,,,42.83,45.08,0
unity,CDM,Um Hemagglutination Inhibit,UM4000157,86280,,Hemagglutination inhibition,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.08,% of charge rate,95.00%,42.83,,,,42.83,45.08,0
unity,CDM,Um Breast Cancer Antigen 27.29,UM4000209,86300,,Immunoassay tumor ca 15-3,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.91,% of charge rate,95.00%,110.11,,,,110.11,115.91,0
unity,CDM,Um Breast Cancer Antigen 27.29,UM4000209,86300,,Immunoassay tumor ca 15-3,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.91,% of charge rate,95.00%,110.11,,,,110.11,115.91,0
unity,CDM,Um Cancer Antigen 15-3,UM4000863,86300,,Immunoassay tumor ca 15-3,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.91,% of charge rate,95.00%,110.11,,,,110.11,115.91,0
unity,CDM,Um Cancer Antigen 15-3,UM4000863,86300,,Immunoassay tumor ca 15-3,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.91,% of charge rate,95.00%,110.11,,,,110.11,115.91,0
unity,CDM,Um Immunoassay Tumor Ca 19-9,UM4000093,86301,,Immunoassay tumor ca 19-9,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.91,% of charge rate,95.00%,110.11,,,,110.11,115.91,0
unity,CDM,Um Immunoassay Tumor Ca 19-9,UM4000093,86301,,Immunoassay tumor ca 19-9,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.91,% of charge rate,95.00%,110.11,,,,110.11,115.91,0
unity,CDM,Um Ca-125,UM4000307,86304,,Immunoassay tumor ca 125,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.91,% of charge rate,95.00%,110.11,,,,110.11,115.91,0
unity,CDM,Um Ca-125,UM4000307,86304,,Immunoassay tumor ca 125,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,115.91,% of charge rate,95.00%,110.11,,,,110.11,115.91,0
unity,CDM,Um Mono Test,UM4000106,86308,,Heterophile antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Mono Test,UM4000106,86308,,Heterophile antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Chromogranin A Level,UM4000540,86316,,Immunoassay tumor other,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,209.66,% of charge rate,95.00%,199.18,,,,199.18,209.66,0
unity,CDM,Um Chromogranin A Level,UM4000540,86316,,Immunoassay tumor other,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,209.66,% of charge rate,95.00%,199.18,,,,199.18,209.66,0
unity,CDM,"Um Hep B Surface Ab, Quant.",UM4000543,86317,,Immunoassay infectious agent,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.49,% of charge rate,95.00%,79.32,,,,79.32,83.49,0
unity,CDM,"Um Hep B Surface Ab, Quant.",UM4000543,86317,,Immunoassay infectious agent,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.49,% of charge rate,95.00%,79.32,,,,79.32,83.49,0
unity,CDM,"Um Strep Pneumo Ab, Igg, 23 Serotypes",UM4000753,86317,,Immunoassay infectious agent,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.49,% of charge rate,95.00%,79.32,,,,79.32,83.49,0
unity,CDM,"Um Strep Pneumo Ab, Igg, 23 Serotypes",UM4000753,86317,,Immunoassay infectious agent,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.49,% of charge rate,95.00%,79.32,,,,79.32,83.49,0
unity,CDM,Um H.  Pylori,UM4000125,86318,,Immunoassay infectious agent,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um H.  Pylori,UM4000125,86318,,Immunoassay infectious agent,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.08,% of charge rate,95.00%,68.48,,,,68.48,72.08,0
unity,CDM,Um Rubella Igg,UM4000876,86318,,Immunoassay infectious agent,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43,% of charge rate,95.00%,40.85,,,,40.85,43,0
unity,CDM,Um Rubella Igg,UM4000876,86318,,Immunoassay infectious agent,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43,% of charge rate,95.00%,40.85,,,,40.85,43,0
unity,CDM,"Um Immundodiffus, Gel, Qual",UM4000162,86331,,Immunodiffusion ouchterlony,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.36,% of charge rate,95.00%,30.74,,,,30.74,32.36,0
unity,CDM,"Um Immundodiffus, Gel, Qual",UM4000162,86331,,Immunodiffusion ouchterlony,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.36,% of charge rate,95.00%,30.74,,,,30.74,32.36,0
unity,CDM,"Um Immunoe-phoresis, Serum",UM4000190,86334,,Immunofix e-phoresis serum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,124.38,% of charge rate,95.00%,118.16,,,,118.16,124.38,0
unity,CDM,"Um Immunoe-phoresis, Serum",UM4000190,86334,,Immunofix e-phoresis serum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,124.38,% of charge rate,95.00%,118.16,,,,118.16,124.38,0
unity,CDM,Um Immunofix E-phnesis/csf,UM4000198,86335,,Immunfix e-phorsis/urine/csf,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.43,% of charge rate,95.00%,155.26,,,,155.26,163.43,0
unity,CDM,Um Immunofix E-phnesis/csf,UM4000198,86335,,Immunfix e-phorsis/urine/csf,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.43,% of charge rate,95.00%,155.26,,,,155.26,163.43,0
unity,CDM,"Um Immunofixation, Urine",UM4000766,86335,,Immunfix e-phorsis/urine/csf,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.5,% of charge rate,95.00%,155.33,,,,155.33,163.5,0
unity,CDM,"Um Immunofixation, Urine",UM4000766,86335,,Immunfix e-phorsis/urine/csf,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.5,% of charge rate,95.00%,155.33,,,,155.33,163.5,0
unity,CDM,"Um Beta 2 Transferrin, Nasal Drainage",UM4000870,86335,,Immunfix e-phorsis/urine/csf,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,170.15,% of charge rate,95.00%,161.64,,,,161.64,170.15,0
unity,CDM,"Um Beta 2 Transferrin, Nasal Drainage",UM4000870,86335,,Immunfix e-phorsis/urine/csf,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,170.15,% of charge rate,95.00%,161.64,,,,161.64,170.15,0
unity,CDM,Um Inhibin A,UM4000163,86336,,Inhibin a,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,220.96,% of charge rate,95.00%,209.91,,,,209.91,220.96,0
unity,CDM,Um Inhibin A,UM4000163,86336,,Inhibin a,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,220.96,% of charge rate,95.00%,209.91,,,,209.91,220.96,0
unity,CDM,Um Insulin Autoantibodies,UM4000851,86337,,Insulin antibodies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,124.13,% of charge rate,95.00%,117.92,,,,117.92,124.13,0
unity,CDM,Um Insulin Autoantibodies,UM4000851,86337,,Insulin antibodies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,124.13,% of charge rate,95.00%,117.92,,,,117.92,124.13,0
unity,CDM,Um Interferon Ab,UM4000386,86340,,Intrinsic factor antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.23,% of charge rate,95.00%,93.32,,,,93.32,98.23,0
unity,CDM,Um Interferon Ab,UM4000386,86340,,Intrinsic factor antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.23,% of charge rate,95.00%,93.32,,,,93.32,98.23,0
unity,CDM,Um Intrinsic Factor Blkng Ab,UM4000561,86340,,Intrinsic factor antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,129.06,% of charge rate,95.00%,122.61,,,,122.61,129.06,0
unity,CDM,Um Intrinsic Factor Blkng Ab,UM4000561,86340,,Intrinsic factor antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,129.06,% of charge rate,95.00%,122.61,,,,122.61,129.06,0
unity,CDM,Um Glutamic Acid Autoantibody,UM4000852,86341,,Islet cell antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.7,% of charge rate,95.00%,108.97,,,,108.97,114.7,0
unity,CDM,Um Glutamic Acid Autoantibody,UM4000852,86341,,Islet cell antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.7,% of charge rate,95.00%,108.97,,,,108.97,114.7,0
unity,CDM,Um Islet Cell Antibody,UM4000853,86341,,Islet cell antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.7,% of charge rate,95.00%,108.97,,,,108.97,114.7,0
unity,CDM,Um Islet Cell Antibody,UM4000853,86341,,Islet cell antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.7,% of charge rate,95.00%,108.97,,,,108.97,114.7,0
unity,CDM,Um Gad 65 Neurological Syndrome Antibody,UM4000929,86341,,Islet cell antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,390,% of charge rate,95.00%,370.5,,,,370.5,390,0
unity,CDM,Um Gad 65 Neurological Syndrome Antibody,UM4000929,86341,,Islet cell antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,390,% of charge rate,95.00%,370.5,,,,370.5,390,0
unity,CDM,"Um B Cells, Total Count",UM4000399,86355,,B cells total count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.04,% of charge rate,95.00%,199.54,,,,199.54,210.04,0
unity,CDM,"Um B Cells, Total Count",UM4000399,86355,,B cells total count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.04,% of charge rate,95.00%,199.54,,,,199.54,210.04,0
unity,CDM,Um B Cells Total Count/flow Cytometry,UM4000754,86355,,B cells total count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.03,% of charge rate,95.00%,199.53,,,,199.53,210.03,0
unity,CDM,Um B Cells Total Count/flow Cytometry,UM4000754,86355,,B cells total count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.03,% of charge rate,95.00%,199.53,,,,199.53,210.03,0
unity,CDM,"Um Mononuclear Cell Antigen, Quant",UM4000927,86356,,Mononuclear cell antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175,% of charge rate,95.00%,166.25,,,,166.25,175,0
unity,CDM,"Um Mononuclear Cell Antigen, Quant",UM4000927,86356,,Mononuclear cell antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175,% of charge rate,95.00%,166.25,,,,166.25,175,0
unity,CDM,"Um Nk Cells, Total Count",UM4000400,86357,,Nk cells total count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.04,% of charge rate,95.00%,199.54,,,,199.54,210.04,0
unity,CDM,"Um Nk Cells, Total Count",UM4000400,86357,,Nk cells total count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.04,% of charge rate,95.00%,199.54,,,,199.54,210.04,0
unity,CDM,Um T Cells Total Count/flow Cytometry,UM4000755,86359,,T cells total count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.03,% of charge rate,95.00%,199.53,,,,199.53,210.03,0
unity,CDM,Um T Cells Total Count/flow Cytometry,UM4000755,86359,,T cells total count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.03,% of charge rate,95.00%,199.53,,,,199.53,210.03,0
unity,CDM,Um T Cells Absolute Ct/ratio,UM4000401,86360,,T cell absolute count/ratio,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,261.61,% of charge rate,95.00%,248.53,,,,248.53,261.61,0
unity,CDM,Um T Cells Absolute Ct/ratio,UM4000401,86360,,T cell absolute count/ratio,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,261.61,% of charge rate,95.00%,248.53,,,,248.53,261.61,0
unity,CDM,Um Cd4,UM4000911,86361,,T cell absolute count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,147.53,% of charge rate,95.00%,140.15,,,,140.15,147.53,0
unity,CDM,Um Cd4,UM4000911,86361,,T cell absolute count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,147.53,% of charge rate,95.00%,140.15,,,,140.15,147.53,0
unity,CDM,Um Microsomal Ab/same As Tpo,UM4000522,86376,,Microsomal antibody each,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.02,% of charge rate,95.00%,76.97,,,,76.97,81.02,0
unity,CDM,Um Microsomal Ab/same As Tpo,UM4000522,86376,,Microsomal antibody each,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.02,% of charge rate,95.00%,76.97,,,,76.97,81.02,0
unity,CDM,"Um Particle Agglutinatin, Ag",UM4000122,86403,,Particle agglut antbdy scrn,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56.75,% of charge rate,95.00%,53.91,,,,53.91,56.75,0
unity,CDM,"Um Particle Agglutinatin, Ag",UM4000122,86403,,Particle agglut antbdy scrn,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56.75,% of charge rate,95.00%,53.91,,,,53.91,56.75,0
unity,CDM,"Um Strep Pneumoniae Ag,urine",UM4000716,86403,,Particle agglut antbdy scrn,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99,% of charge rate,95.00%,94.05,,,,94.05,99,0
unity,CDM,"Um Strep Pneumoniae Ag,urine",UM4000716,86403,,Particle agglut antbdy scrn,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99,% of charge rate,95.00%,94.05,,,,94.05,99,0
unity,CDM,"Um Rheumatoid Factor, Quant",UM4000202,86431,,Rheumatoid factor quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.6,% of charge rate,95.00%,30.02,,,,30.02,31.6,0
unity,CDM,"Um Rheumatoid Factor, Quant",UM4000202,86431,,Rheumatoid factor quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.6,% of charge rate,95.00%,30.02,,,,30.02,31.6,0
unity,CDM,Um Quantiferon-tb Gold,UM4000498,86480,,Tb test cell immun measure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29,% of charge rate,95.00%,27.55,,,,27.55,29,0
unity,CDM,Um Quantiferon-tb Gold,UM4000498,86480,,Tb test cell immun measure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29,% of charge rate,95.00%,27.55,,,,27.55,29,0
unity,CDM,TB INTRADERMAL TEST,86580,86580,,Tb intradermal test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20,% of charge rate,95.00%,19,,,,19,20,0
unity,CDM,TB INTRADERMAL TEST,86580,86580,,Tb intradermal test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20,% of charge rate,95.00%,19,,,,19,20,0
unity,CDM,Um Tb Tine Test,UM4000380,86580,,Tb intradermal test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.28,% of charge rate,95.00%,20.22,,,,20.22,21.28,0
unity,CDM,Um Tb Tine Test,UM4000380,86580,,Tb intradermal test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.28,% of charge rate,95.00%,20.22,,,,20.22,21.28,0
unity,CDM,Um Serology (rpr),UM4000160,86592,,Syphilis test non-trep qual,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Serology (rpr),UM4000160,86592,,Syphilis test non-trep qual,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Vdrl,UM4000819,86592,,Syphilis test non-trep qual,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.78,% of charge rate,95.00%,22.59,,,,22.59,23.78,0
unity,CDM,Um Vdrl,UM4000819,86592,,Syphilis test non-trep qual,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.78,% of charge rate,95.00%,22.59,,,,22.59,23.78,0
unity,CDM,Um Adenovirus Antibody,UM4000021,86603,,Adenovirus antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.94,% of charge rate,95.00%,87.34,,,,87.34,91.94,0
unity,CDM,Um Adenovirus Antibody,UM4000021,86603,,Adenovirus antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.94,% of charge rate,95.00%,87.34,,,,87.34,91.94,0
unity,CDM,Um Aspergillus Antibody,UM4000299,86606,,Aspergillus antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.76,% of charge rate,95.00%,68.17,,,,68.17,71.76,0
unity,CDM,Um Aspergillus Antibody,UM4000299,86606,,Aspergillus antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.76,% of charge rate,95.00%,68.17,,,,68.17,71.76,0
unity,CDM,"Um Antibody, Listeria",UM4000544,86609,,Bacterium antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.86,% of charge rate,95.00%,155.67,,,,155.67,163.86,0
unity,CDM,"Um Antibody, Listeria",UM4000544,86609,,Bacterium antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.86,% of charge rate,95.00%,155.67,,,,155.67,163.86,0
unity,CDM,Um Bartonella Antibody,UM4000926,86611,,Bartonella antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.4,% of charge rate,95.00%,57.38,,,,57.38,60.4,0
unity,CDM,Um Bartonella Antibody,UM4000926,86611,,Bartonella antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.4,% of charge rate,95.00%,57.38,,,,57.38,60.4,0
unity,CDM,Um Blastomyces Antibody,UM4000097,86612,,Blastomyces antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.5,% of charge rate,95.00%,59.38,,,,59.38,62.5,0
unity,CDM,Um Blastomyces Antibody,UM4000097,86612,,Blastomyces antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.5,% of charge rate,95.00%,59.38,,,,59.38,62.5,0
unity,CDM,Um Bordatella Antibody,UM4000293,86615,,Bordetella antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.45,% of charge rate,95.00%,69.78,,,,69.78,73.45,0
unity,CDM,Um Bordatella Antibody,UM4000293,86615,,Bordetella antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.45,% of charge rate,95.00%,69.78,,,,69.78,73.45,0
unity,CDM,Um Lyme Disease Igg W Blot,UM4000376,86617,,Lyme disease antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,138.15,% of charge rate,95.00%,131.24,,,,131.24,138.15,0
unity,CDM,Um Lyme Disease Igg W Blot,UM4000376,86617,,Lyme disease antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,138.15,% of charge rate,95.00%,131.24,,,,131.24,138.15,0
unity,CDM,"Um Lyme Disease Ab, Wb Conf",UM4000061,86618,,Lyme disease antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.83,% of charge rate,95.00%,90.09,,,,90.09,94.83,0
unity,CDM,"Um Lyme Disease Ab, Wb Conf",UM4000061,86618,,Lyme disease antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.83,% of charge rate,95.00%,90.09,,,,90.09,94.83,0
unity,CDM,Um Chlamydia Antibody,UM4000339,86631,,Chlamydia antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.84,% of charge rate,95.00%,62.55,,,,62.55,65.84,0
unity,CDM,Um Chlamydia Antibody,UM4000339,86631,,Chlamydia antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.84,% of charge rate,95.00%,62.55,,,,62.55,65.84,0
unity,CDM,"Um Chlamydia , Igm",UM4000223,86632,,Chlamydia igm antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.64,% of charge rate,95.00%,67.11,,,,67.11,70.64,0
unity,CDM,"Um Chlamydia , Igm",UM4000223,86632,,Chlamydia igm antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.64,% of charge rate,95.00%,67.11,,,,67.11,70.64,0
unity,CDM,"Um Coccidoides, Ab(igg,igm)",UM4000302,86635,,Coccidioides antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.5,% of charge rate,95.00%,59.38,,,,59.38,62.5,0
unity,CDM,"Um Coccidoides, Ab(igg,igm)",UM4000302,86635,,Coccidioides antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.5,% of charge rate,95.00%,59.38,,,,59.38,62.5,0
unity,CDM,Um Cytomegalovirus (cmv),UM4000298,86644,,Cmv antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,Um Cytomegalovirus (cmv),UM4000298,86644,,Cmv antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,"Um Cytomegolvirus (cmv), Igm",UM4000128,86645,,Cmv antibody igm,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.55,% of charge rate,95.00%,75.57,,,,75.57,79.55,0
unity,CDM,"Um Cytomegolvirus (cmv), Igm",UM4000128,86645,,Cmv antibody igm,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.55,% of charge rate,95.00%,75.57,,,,75.57,79.55,0
unity,CDM,Um Diphtheria Toxoid Igg Ab,UM4000757,86648,,Diphtheria antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.67,% of charge rate,95.00%,80.44,,,,80.44,84.67,0
unity,CDM,Um Diphtheria Toxoid Igg Ab,UM4000757,86648,,Diphtheria antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.67,% of charge rate,95.00%,80.44,,,,80.44,84.67,0
unity,CDM,Um Coxsackie Antibody,UM4000925,86658,,Enterovirus antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.3,% of charge rate,95.00%,66.79,,,,66.79,70.3,0
unity,CDM,Um Coxsackie Antibody,UM4000925,86658,,Enterovirus antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.3,% of charge rate,95.00%,66.79,,,,66.79,70.3,0
unity,CDM,Um Epstein Barr Antibody,UM4000041,86664,,Epstein-barr nuclear antigen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,Um Epstein Barr Antibody,UM4000041,86664,,Epstein-barr nuclear antigen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,"Um Epstein-barr Virus, Viral",UM4000054,86665,,Epstein-barr capsid vca,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.55,% of charge rate,95.00%,75.57,,,,75.57,79.55,0
unity,CDM,"Um Epstein-barr Virus, Viral",UM4000054,86665,,Epstein-barr capsid vca,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.55,% of charge rate,95.00%,75.57,,,,75.57,79.55,0
unity,CDM,ANAPLASMA/ERLICHIA AB PANEL,UM4000759,86666,,Ehrlichia antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.86,% of charge rate,95.00%,96.77,,,,96.77,101.86,0
unity,CDM,ANAPLASMA/ERLICHIA AB PANEL,UM4000759,86666,,Ehrlichia antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.86,% of charge rate,95.00%,96.77,,,,96.77,101.86,0
unity,CDM,"Um Antibody, Fungus Nos",UM4000444,86671,,Fungus nes antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.5,% of charge rate,95.00%,59.38,,,,59.38,62.5,0
unity,CDM,"Um Antibody, Fungus Nos",UM4000444,86671,,Fungus nes antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.5,% of charge rate,95.00%,59.38,,,,59.38,62.5,0
unity,CDM,"Um H.pylori Igg, Igm, Iga",UM4000446,86677,,Helicobacter pylori antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.82,% of charge rate,95.00%,76.78,,,,76.78,80.82,0
unity,CDM,"Um H.pylori Igg, Igm, Iga",UM4000446,86677,,Helicobacter pylori antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.82,% of charge rate,95.00%,76.78,,,,76.78,80.82,0
unity,CDM,"Um Echinococcus Antibody, Serum",UM4000816,86682,,Helminth antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.64,% of charge rate,95.00%,54.76,,,,54.76,57.64,0
unity,CDM,"Um Echinococcus Antibody, Serum",UM4000816,86682,,Helminth antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.64,% of charge rate,95.00%,54.76,,,,54.76,57.64,0
unity,CDM,Um Cysticercus Antibody,UM4000942,86682,,Helminth antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.89,% of charge rate,95.00%,69.25,,,,69.25,72.89,0
unity,CDM,Um Cysticercus Antibody,UM4000942,86682,,Helminth antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.89,% of charge rate,95.00%,69.25,,,,69.25,72.89,0
unity,CDM,"Um Herpes Simplex,non-spec",UM4000071,86694,,Herpes simplex nes antbdy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,"Um Herpes Simplex,non-spec",UM4000071,86694,,Herpes simplex nes antbdy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,Um Herpes Simplex Test,UM4000141,86695,,Herpes simplex type 1 test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.45,% of charge rate,95.00%,69.78,,,,69.78,73.45,0
unity,CDM,Um Herpes Simplex Test,UM4000141,86695,,Herpes simplex type 1 test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.45,% of charge rate,95.00%,69.78,,,,69.78,73.45,0
unity,CDM,Um Herpes Simplex Test,UM4000141A,86695,,Herpes simplex type 1 test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.45,% of charge rate,95.00%,69.78,,,,69.78,73.45,0
unity,CDM,Um Herpes Simplex Test,UM4000141A,86695,,Herpes simplex type 1 test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.45,% of charge rate,95.00%,69.78,,,,69.78,73.45,0
unity,CDM,Um Herpes Simplex Type 2,UM4000289,86696,,Herpes simplex type 2 test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.76,% of charge rate,95.00%,102.37,,,,102.37,107.76,0
unity,CDM,Um Herpes Simplex Type 2,UM4000289,86696,,Herpes simplex type 2 test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.76,% of charge rate,95.00%,102.37,,,,102.37,107.76,0
unity,CDM,Um Herpes Simplex Type 2,UM4000289A,86696,,Herpes simplex type 2 test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.76,% of charge rate,95.00%,102.37,,,,102.37,107.76,0
unity,CDM,Um Herpes Simplex Type 2,UM4000289A,86696,,Herpes simplex type 2 test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.76,% of charge rate,95.00%,102.37,,,,102.37,107.76,0
unity,CDM,"Um Histoplasma Ab, Immuno",UM4000020,86698,,Histoplasma antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.5,% of charge rate,95.00%,59.38,,,,59.38,62.5,0
unity,CDM,"Um Histoplasma Ab, Immuno",UM4000020,86698,,Histoplasma antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.5,% of charge rate,95.00%,59.38,,,,59.38,62.5,0
unity,CDM,Um Hiv 1/2 Eia,UM86703,86703,,Hiv-1/hiv-2 1 result antbdy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56.82,% of charge rate,95.00%,53.98,,,,53.98,56.82,0
unity,CDM,Um Hiv 1/2 Eia,UM86703,86703,,Hiv-1/hiv-2 1 result antbdy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56.82,% of charge rate,95.00%,53.98,,,,53.98,56.82,0
unity,CDM,"Um Hep B Core Ab, Total",UM4000080,86704,,Hep b core antibody total,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,"Um Hep B Core Ab, Total",UM4000080,86704,,Hep b core antibody total,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.09,% of charge rate,95.00%,63.74,,,,63.74,67.09,0
unity,CDM,Um Hb Core Ab Igm,UM4000371,86705,,Hep b core antibody igm,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.54,% of charge rate,95.00%,62.26,,,,62.26,65.54,0
unity,CDM,Um Hb Core Ab Igm,UM4000371,86705,,Hep b core antibody igm,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65.54,% of charge rate,95.00%,62.26,,,,62.26,65.54,0
unity,CDM,Um Hepatitis B Surface Ab,UM4000137,86706,,Hep b surface antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.8,% of charge rate,95.00%,56.81,,,,56.81,59.8,0
unity,CDM,Um Hepatitis B Surface Ab,UM4000137,86706,,Hep b surface antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.8,% of charge rate,95.00%,56.81,,,,56.81,59.8,0
unity,CDM,Um Hepatitis Be Antibody,UM4000028,86707,,Hepatitis be antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.4,% of charge rate,95.00%,61.18,,,,61.18,64.4,0
unity,CDM,Um Hepatitis Be Antibody,UM4000028,86707,,Hepatitis be antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.4,% of charge rate,95.00%,61.18,,,,61.18,64.4,0
unity,CDM,"Um Hep A, Ab, Total",UM4000213,86708,,Hepatitis a antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69,% of charge rate,95.00%,65.55,,,,65.55,69,0
unity,CDM,"Um Hep A, Ab, Total",UM4000213,86708,,Hepatitis a antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69,% of charge rate,95.00%,65.55,,,,65.55,69,0
unity,CDM,"Um Hepatitis A Ab, Igm",UM4000548,86709,,Hepatitis a igm antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.89,% of charge rate,95.00%,51.2,,,,51.2,53.89,0
unity,CDM,"Um Hepatitis A Ab, Igm",UM4000548,86709,,Hepatitis a igm antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.89,% of charge rate,95.00%,51.2,,,,51.2,53.89,0
unity,CDM,Um Mumps Antibody,UM4000221,86735,,Mumps antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.68,% of charge rate,95.00%,69.05,,,,69.05,72.68,0
unity,CDM,Um Mumps Antibody,UM4000221,86735,,Mumps antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.68,% of charge rate,95.00%,69.05,,,,69.05,72.68,0
unity,CDM,Um Mycoplasma Antibody,UM4000251,86738,,Mycoplasma antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.74,% of charge rate,95.00%,70.05,,,,70.05,73.74,0
unity,CDM,Um Mycoplasma Antibody,UM4000251,86738,,Mycoplasma antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.74,% of charge rate,95.00%,70.05,,,,70.05,73.74,0
unity,CDM,Um Norcardia Antibody,UM4000381,86744,,Nocardia antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.45,% of charge rate,95.00%,69.78,,,,69.78,73.45,0
unity,CDM,Um Norcardia Antibody,UM4000381,86744,,Nocardia antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.45,% of charge rate,95.00%,69.78,,,,69.78,73.45,0
unity,CDM,Um Parvovirus(igg/igm),UM4000138,86747,,Parvovirus antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.5,% of charge rate,95.00%,83.13,,,,83.13,87.5,0
unity,CDM,Um Parvovirus(igg/igm),UM4000138,86747,,Parvovirus antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.5,% of charge rate,95.00%,83.13,,,,83.13,87.5,0
unity,CDM,BABESIA AB,UM4000760,86753,,Protozoa antibody nos,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.89,% of charge rate,95.00%,59.75,,,,59.75,62.89,0
unity,CDM,BABESIA AB,UM4000760,86753,,Protozoa antibody nos,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.89,% of charge rate,95.00%,59.75,,,,59.75,62.89,0
unity,CDM,"Um E. Histolytica Antibody, Serum",UM4000815,86753,,Protozoa antibody nos,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.64,% of charge rate,95.00%,54.76,,,,54.76,57.64,0
unity,CDM,"Um E. Histolytica Antibody, Serum",UM4000815,86753,,Protozoa antibody nos,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.64,% of charge rate,95.00%,54.76,,,,54.76,57.64,0
unity,CDM,Um Rsv Antibody,UM4000332,86756,,Respiratory virus antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.81,% of charge rate,95.00%,68.22,,,,68.22,71.81,0
unity,CDM,Um Rsv Antibody,UM4000332,86756,,Respiratory virus antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.81,% of charge rate,95.00%,68.22,,,,68.22,71.81,0
unity,CDM,Um Rickettsia Antibody,UM4000924,86757,,Rickettsia antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.95,% of charge rate,95.00%,105.4,,,,105.4,110.95,0
unity,CDM,Um Rickettsia Antibody,UM4000924,86757,,Rickettsia antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,110.95,% of charge rate,95.00%,105.4,,,,105.4,110.95,0
unity,CDM,"Um Rubella, Acute Phase, Igm",UM4000329,86762,,Rubella antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,"Um Rubella, Acute Phase, Igm",UM4000329,86762,,Rubella antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,Um Rubella Antibody Igg,UM4000551,86762,,Rubella antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,Um Rubella Antibody Igg,UM4000551,86762,,Rubella antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,"Um Rubeola, Acute Phase, Igm",UM4000016,86765,,Rubeola antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.74,% of charge rate,95.00%,68.15,,,,68.15,71.74,0
unity,CDM,"Um Rubeola, Acute Phase, Igm",UM4000016,86765,,Rubeola antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.74,% of charge rate,95.00%,68.15,,,,68.15,71.74,0
unity,CDM,"Um Rubeola(measles) Ab, Igg",UM4000553,86765,,Rubeola antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.74,% of charge rate,95.00%,68.15,,,,68.15,71.74,0
unity,CDM,"Um Rubeola(measles) Ab, Igg",UM4000553,86765,,Rubeola antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.74,% of charge rate,95.00%,68.15,,,,68.15,71.74,0
unity,CDM,Um Covid-19 Igg Antibody,UM4000938,86769,,Antibody Coronavirus,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80,% of charge rate,95.00%,76,,,,76,80,0
unity,CDM,Um Covid-19 Igg Antibody,UM4000938,86769,,Antibody Coronavirus,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80,% of charge rate,95.00%,76,,,,76,80,0
unity,CDM,Um Tetanus Toxoid Igg Ab,UM4000756,86774,,Tetanus antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.39,% of charge rate,95.00%,78.27,,,,78.27,82.39,0
unity,CDM,Um Tetanus Toxoid Igg Ab,UM4000756,86774,,Tetanus antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.39,% of charge rate,95.00%,78.27,,,,78.27,82.39,0
unity,CDM,Um Toxoplasma Antibody Igg,UM4000367,86777,,Toxoplasma antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,Um Toxoplasma Antibody Igg,UM4000367,86777,,Toxoplasma antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,Um Toxoplasma Antibody Igm,UM4000007,86778,,Toxoplasma antibody igm,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.55,% of charge rate,95.00%,75.57,,,,75.57,79.55,0
unity,CDM,Um Toxoplasma Antibody Igm,UM4000007,86778,,Toxoplasma antibody igm,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.55,% of charge rate,95.00%,75.57,,,,75.57,79.55,0
unity,CDM,Um Syphillis Ab Igg & Igm,UM4000451,86780,,Treponema pallidum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.69,% of charge rate,95.00%,70.01,,,,70.01,73.69,0
unity,CDM,Um Syphillis Ab Igg & Igm,UM4000451,86780,,Treponema pallidum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.69,% of charge rate,95.00%,70.01,,,,70.01,73.69,0
unity,CDM,Um Treponema Pallidum Antibody(fta-ab),UM4000780,86780,,Treponema pallidum,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.77,% of charge rate,95.00%,70.08,,,,70.08,73.77,0
unity,CDM,Um Treponema Pallidum Antibody(fta-ab),UM4000780,86780,,Treponema pallidum,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.77,% of charge rate,95.00%,70.08,,,,70.08,73.77,0
unity,CDM,Um Varicella-zoster Igg,UM4000185,86787,,Varicella-zoster antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.74,% of charge rate,95.00%,68.15,,,,68.15,71.74,0
unity,CDM,Um Varicella-zoster Igg,UM4000185,86787,,Varicella-zoster antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.74,% of charge rate,95.00%,68.15,,,,68.15,71.74,0
unity,CDM,"Um Varicella-zoster, Igm",UM4000413,86787,,Varicella-zoster antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.46,% of charge rate,95.00%,111.59,,,,111.59,117.46,0
unity,CDM,"Um Varicella-zoster, Igm",UM4000413,86787,,Varicella-zoster antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.46,% of charge rate,95.00%,111.59,,,,111.59,117.46,0
unity,CDM,"Um West Nile,igg/igm",UM4000725,86788,,West nile virus ab igm,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.55,% of charge rate,95.00%,75.57,,,,75.57,79.55,0
unity,CDM,"Um West Nile,igg/igm",UM4000725,86788,,West nile virus ab igm,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.55,% of charge rate,95.00%,75.57,,,,75.57,79.55,0
unity,CDM,Um West Nile Virus Antibody,UM4000358,86789,,West nile virus antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,Um West Nile Virus Antibody,UM4000358,86789,,West nile virus antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.14,% of charge rate,95.00%,76.13,,,,76.13,80.14,0
unity,CDM,Um Virus Ab (nos),UM4000398,86790,,Virus antibody nos,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.74,% of charge rate,95.00%,68.15,,,,68.15,71.74,0
unity,CDM,Um Virus Ab (nos),UM4000398,86790,,Virus antibody nos,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.74,% of charge rate,95.00%,68.15,,,,68.15,71.74,0
unity,CDM,Um Hantavirus Ab,UM4000545,86790,,Virus antibody nos,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.83,% of charge rate,95.00%,167.04,,,,167.04,175.83,0
unity,CDM,Um Hantavirus Ab,UM4000545,86790,,Virus antibody nos,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.83,% of charge rate,95.00%,167.04,,,,167.04,175.83,0
unity,CDM,Um Herpes Virus 6 Igg,UM4000778,86790,,Virus antibody nos,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.76,% of charge rate,95.00%,68.17,,,,68.17,71.76,0
unity,CDM,Um Herpes Virus 6 Igg,UM4000778,86790,,Virus antibody nos,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.76,% of charge rate,95.00%,68.17,,,,68.17,71.76,0
unity,CDM,Um Herpes Virus 6 Igm,UM4000779,86790,,Virus antibody nos,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.76,% of charge rate,95.00%,68.17,,,,68.17,71.76,0
unity,CDM,Um Herpes Virus 6 Igm,UM4000779,86790,,Virus antibody nos,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.76,% of charge rate,95.00%,68.17,,,,68.17,71.76,0
unity,CDM,Um Thyroglobulin Anitbody,UM4000354,86800,,Thyroglobulin antibody,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.56,% of charge rate,95.00%,84.13,,,,84.13,88.56,0
unity,CDM,Um Thyroglobulin Anitbody,UM4000354,86800,,Thyroglobulin antibody,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.56,% of charge rate,95.00%,84.13,,,,84.13,88.56,0
unity,CDM,Um Hep C Antibody,UM4000120,86803,,Hepatitis c ab test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.49,% of charge rate,95.00%,75.52,,,,75.52,79.49,0
unity,CDM,Um Hep C Antibody,UM4000120,86803,,Hepatitis c ab test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.49,% of charge rate,95.00%,75.52,,,,75.52,79.49,0
unity,CDM,"Um Anti Hcv, Riba",UM4000239,86804,,Hep c ab test confirm,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,356.11,% of charge rate,95.00%,338.3,,,,338.3,356.11,0
unity,CDM,"Um Anti Hcv, Riba",UM4000239,86804,,Hep c ab test confirm,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,356.11,% of charge rate,95.00%,338.3,,,,338.3,356.11,0
unity,CDM,Um Hla-b27 Antigen,UM4000342,86812,,Hla typing a b or c,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.7,% of charge rate,95.00%,136.52,,,,136.52,143.7,0
unity,CDM,Um Hla-b27 Antigen,UM4000342,86812,,Hla typing a b or c,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.7,% of charge rate,95.00%,136.52,,,,136.52,143.7,0
unity,CDM,Um Antibody Screening,UM4050002,86850,,Rbc antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.31,% of charge rate,95.00%,103.84,,,,103.84,109.31,0
unity,CDM,Um Antibody Screening,UM4050002,86850,,Rbc antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.31,% of charge rate,95.00%,103.84,,,,103.84,109.31,0
unity,CDM,Um Antibody Screen-ubs,UM4050024,86850,,Rbc antibody screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,134,% of charge rate,95.00%,127.3,,,,127.3,134,0
unity,CDM,Um Antibody Screen-ubs,UM4050024,86850,,Rbc antibody screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,134,% of charge rate,95.00%,127.3,,,,127.3,134,0
unity,CDM,Um Antibody Elution (rbc),UM4050016,86860,,Rbc antibody elution,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,179.79,% of charge rate,95.00%,170.8,,,,170.8,179.79,0
unity,CDM,Um Antibody Elution (rbc),UM4050016,86860,,Rbc antibody elution,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,179.79,% of charge rate,95.00%,170.8,,,,170.8,179.79,0
unity,CDM,Um Antibody Identifica Pan,UM4050006,86870,,Rbc antibody identification,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,287.51,% of charge rate,95.00%,273.13,,,,273.13,287.51,0
unity,CDM,Um Antibody Identifica Pan,UM4050006,86870,,Rbc antibody identification,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,287.51,% of charge rate,95.00%,273.13,,,,273.13,287.51,0
unity,CDM,Um Direct Coombs,UM4050001,86880,,Coombs test direct,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.66,% of charge rate,95.00%,50.98,,,,50.98,53.66,0
unity,CDM,Um Direct Coombs,UM4050001,86880,,Coombs test direct,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.66,% of charge rate,95.00%,50.98,,,,50.98,53.66,0
unity,CDM,"Um Antibody Titration, Per Antibody",UM4000810,86886,,Coombs test indirect titer,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,"Um Antibody Titration, Per Antibody",UM4000810,86886,,Coombs test indirect titer,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Abo Grouping,UM4050013,86900,,Blood typing serologic abo,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.63,% of charge rate,95.00%,15.8,,,,15.8,16.63,0
unity,CDM,Um Abo Grouping,UM4050013,86900,,Blood typing serologic abo,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.63,% of charge rate,95.00%,15.8,,,,15.8,16.63,0
unity,CDM,Um Rh Typing,UM4050018,86901,,Blood typing serologic rh(d),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.63,% of charge rate,95.00%,15.8,,,,15.8,16.63,0
unity,CDM,Um Rh Typing,UM4050018,86901,,Blood typing serologic rh(d),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.63,% of charge rate,95.00%,15.8,,,,15.8,16.63,0
unity,CDM,Um Antigen Typing,UM4050019,86902,,Blood type antigen donor ea,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42,% of charge rate,95.00%,39.9,,,,39.9,42,0
unity,CDM,Um Antigen Typing,UM4050019,86902,,Blood type antigen donor ea,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42,% of charge rate,95.00%,39.9,,,,39.9,42,0
unity,CDM,Um Antigen Tpg Dnr Class Ii,UM4050022,86902,,Blood type antigen donor ea,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85,% of charge rate,95.00%,80.75,,,,80.75,85,0
unity,CDM,Um Antigen Tpg Dnr Class Ii,UM4050022,86902,,Blood type antigen donor ea,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85,% of charge rate,95.00%,80.75,,,,80.75,85,0
unity,CDM,Um Antigen Tpg Dnr Class Iii,UM4050023,86902,,Blood type antigen donor ea,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144,% of charge rate,95.00%,136.8,,,,136.8,144,0
unity,CDM,Um Antigen Tpg Dnr Class Iii,UM4050023,86902,,Blood type antigen donor ea,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144,% of charge rate,95.00%,136.8,,,,136.8,144,0
unity,CDM,Um Crossmatch Immediate Spin,UM4050014,86920,,Compatibility test spin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,179.79,% of charge rate,95.00%,170.8,,,,170.8,179.79,0
unity,CDM,Um Crossmatch Immediate Spin,UM4050014,86920,,Compatibility test spin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,179.79,% of charge rate,95.00%,170.8,,,,170.8,179.79,0
unity,CDM,"Um Crossmatch, Antiglob Tech",UM4050007,86922,,Compatibility test antiglob,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,179.79,% of charge rate,95.00%,170.8,,,,170.8,179.79,0
unity,CDM,"Um Crossmatch, Antiglob Tech",UM4050007,86922,,Compatibility test antiglob,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,179.79,% of charge rate,95.00%,170.8,,,,170.8,179.79,0
unity,CDM,Um Irradiation/blood Product,UM4050011,86945,,Blood product/irradiation,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,120,% of charge rate,95.00%,114,,,,114,120,0
unity,CDM,Um Irradiation/blood Product,UM4050011,86945,,Blood product/irradiation,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,120,% of charge rate,95.00%,114,,,,114,120,0
unity,CDM,UM RBCs PRETREATM ANTIB DET,UM4050005,86970,,Rbc pretx incubatj w/chemicl,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.67,% of charge rate,95.00%,50.04,,,,50.04,52.67,0
unity,CDM,UM RBCs PRETREATM ANTIB DET,UM4050005,86970,,Rbc pretx incubatj w/chemicl,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.67,% of charge rate,95.00%,50.04,,,,50.04,52.67,0
unity,CDM,Um Concentration Inf Agents,UM4000336,87015,,Specimen infect agnt concntj,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.18,% of charge rate,95.00%,35.32,,,,35.32,37.18,0
unity,CDM,Um Concentration Inf Agents,UM4000336,87015,,Specimen infect agnt concntj,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.18,% of charge rate,95.00%,35.32,,,,35.32,37.18,0
unity,CDM,Um Culture-blood,UM4000274,87040,,Blood culture for bacteria,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.48,% of charge rate,95.00%,54.61,,,,54.61,57.48,0
unity,CDM,Um Culture-blood,UM4000274,87040,,Blood culture for bacteria,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.48,% of charge rate,95.00%,54.61,,,,54.61,57.48,0
unity,CDM,Um Culture Stool,UM4000322,87045,,Feces culture aerobic bact,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.52,% of charge rate,95.00%,49.89,,,,49.89,52.52,0
unity,CDM,Um Culture Stool,UM4000322,87045,,Feces culture aerobic bact,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.52,% of charge rate,95.00%,49.89,,,,49.89,52.52,0
unity,CDM,"Um Stool Culture, Ea Addl",UM4000168,87046,,Stool cultr aerobic bact ea,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.52,% of charge rate,95.00%,49.89,,,,49.89,52.52,0
unity,CDM,"Um Stool Culture, Ea Addl",UM4000168,87046,,Stool cultr aerobic bact ea,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.52,% of charge rate,95.00%,49.89,,,,49.89,52.52,0
unity,CDM,"Um Culture, Bacterial",UM4000095,87070,,Culture othr specimn aerobic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.97,% of charge rate,95.00%,45.57,,,,45.57,47.97,0
unity,CDM,"Um Culture, Bacterial",UM4000095,87070,,Culture othr specimn aerobic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.97,% of charge rate,95.00%,45.57,,,,45.57,47.97,0
unity,CDM,Um Strep Screen Grp B,UM4000262,87070,,Culture othr specimn aerobic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.97,% of charge rate,95.00%,45.57,,,,45.57,47.97,0
unity,CDM,Um Strep Screen Grp B,UM4000262,87070,,Culture othr specimn aerobic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.97,% of charge rate,95.00%,45.57,,,,45.57,47.97,0
unity,CDM,Um Culture-throat & Nose,UM4000275,87070,,Culture othr specimn aerobic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.97,% of charge rate,95.00%,45.57,,,,45.57,47.97,0
unity,CDM,Um Culture-throat & Nose,UM4000275,87070,,Culture othr specimn aerobic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.97,% of charge rate,95.00%,45.57,,,,45.57,47.97,0
unity,CDM,Um Culture Bacterial Other Referred,UM4000736,87070,,Culture othr specimn aerobic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.97,% of charge rate,95.00%,45.57,,,,45.57,47.97,0
unity,CDM,Um Culture Bacterial Other Referred,UM4000736,87070,,Culture othr specimn aerobic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.97,% of charge rate,95.00%,45.57,,,,45.57,47.97,0
unity,CDM,Um Culture-anaerobic Iso/id,UM4000278,87075,,Cultr bacteria except blood,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.68,% of charge rate,95.00%,50.05,,,,50.05,52.68,0
unity,CDM,Um Culture-anaerobic Iso/id,UM4000278,87075,,Cultr bacteria except blood,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.68,% of charge rate,95.00%,50.05,,,,50.05,52.68,0
unity,CDM,"Um Culture, Anaerobe, Def Id",UM4000048,87076,,Culture anaerobe ident each,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.01,% of charge rate,95.00%,42.76,,,,42.76,45.01,0
unity,CDM,"Um Culture, Anaerobe, Def Id",UM4000048,87076,,Culture anaerobe ident each,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.01,% of charge rate,95.00%,42.76,,,,42.76,45.01,0
unity,CDM,"Um Aerobic Isolate, Addl Id",UM4000107,87077,,Culture aerobic identify,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.01,% of charge rate,95.00%,42.76,,,,42.76,45.01,0
unity,CDM,"Um Aerobic Isolate, Addl Id",UM4000107,87077,,Culture aerobic identify,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.01,% of charge rate,95.00%,42.76,,,,42.76,45.01,0
unity,CDM,"Um Clo Test, Rapid Urease",UM4000434,87077,,Culture aerobic identify,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.01,% of charge rate,95.00%,42.76,,,,42.76,45.01,0
unity,CDM,"Um Clo Test, Rapid Urease",UM4000434,87077,,Culture aerobic identify,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.01,% of charge rate,95.00%,42.76,,,,42.76,45.01,0
unity,CDM,Um Culture Aerobic Id Referred,UM4000733,87077,,Culture aerobic identify,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.01,% of charge rate,95.00%,42.76,,,,42.76,45.01,0
unity,CDM,Um Culture Aerobic Id Referred,UM4000733,87077,,Culture aerobic identify,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.01,% of charge rate,95.00%,42.76,,,,42.76,45.01,0
unity,CDM,Um Mrsa Screen,UM4000067,87081,,Culture screen only,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.03,% of charge rate,95.00%,29.48,,,,29.48,31.03,0
unity,CDM,Um Mrsa Screen,UM4000067,87081,,Culture screen only,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.03,% of charge rate,95.00%,29.48,,,,29.48,31.03,0
unity,CDM,Um Grp B Strep,UM4000731,87081,,Culture screen only,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.64,% of charge rate,95.00%,30.06,,,,30.06,31.64,0
unity,CDM,Um Grp B Strep,UM4000731,87081,,Culture screen only,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.64,% of charge rate,95.00%,30.06,,,,30.06,31.64,0
unity,CDM,Um Culture Screen Only Referred,UM4000735,87081,,Culture screen only,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.64,% of charge rate,95.00%,30.06,,,,30.06,31.64,0
unity,CDM,Um Culture Screen Only Referred,UM4000735,87081,,Culture screen only,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.64,% of charge rate,95.00%,30.06,,,,30.06,31.64,0
unity,CDM,Um Vre Screen,UM4000811,87081,,Culture screen only,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.64,% of charge rate,95.00%,30.06,,,,30.06,31.64,0
unity,CDM,Um Vre Screen,UM4000811,87081,,Culture screen only,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.64,% of charge rate,95.00%,30.06,,,,30.06,31.64,0
unity,CDM,Um Urine Culture Colony Ct,UM4000291,87086,,Urine culture/colony count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.95,% of charge rate,95.00%,42.7,,,,42.7,44.95,0
unity,CDM,Um Urine Culture Colony Ct,UM4000291,87086,,Urine culture/colony count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.95,% of charge rate,95.00%,42.7,,,,42.7,44.95,0
unity,CDM,"Um Culture-urine, Pres Id",UM4000176,87088,,Urine bacteria culture,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.08,% of charge rate,95.00%,42.83,,,,42.83,45.08,0
unity,CDM,"Um Culture-urine, Pres Id",UM4000176,87088,,Urine bacteria culture,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.08,% of charge rate,95.00%,42.83,,,,42.83,45.08,0
unity,CDM,Um Culture Fungal Skin/nail,UM4000549,87101,,Skin fungi culture,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.98,% of charge rate,95.00%,40.83,,,,40.83,42.98,0
unity,CDM,Um Culture Fungal Skin/nail,UM4000549,87101,,Skin fungi culture,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.98,% of charge rate,95.00%,40.83,,,,40.83,42.98,0
unity,CDM,"Um Culture,fungal Isolation",UM4000119,87102,,Fungus isolation culture,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,46.81,% of charge rate,95.00%,44.47,,,,44.47,46.81,0
unity,CDM,"Um Culture,fungal Isolation",UM4000119,87102,,Fungus isolation culture,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,46.81,% of charge rate,95.00%,44.47,,,,44.47,46.81,0
unity,CDM,"Um Blood Culture, Fungal",UM4000879,87103,,Blood fungus culture,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.29,% of charge rate,95.00%,49.68,,,,49.68,52.29,0
unity,CDM,"Um Blood Culture, Fungal",UM4000879,87103,,Blood fungus culture,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.29,% of charge rate,95.00%,49.68,,,,49.68,52.29,0
unity,CDM,Um Fungus Culture Id (yeast),UM4000770,87106,,Fungi identification yeast,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.52,% of charge rate,95.00%,54.64,,,,54.64,57.52,0
unity,CDM,Um Fungus Culture Id (yeast),UM4000770,87106,,Fungi identification yeast,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.52,% of charge rate,95.00%,54.64,,,,54.64,57.52,0
unity,CDM,Um Culture Fungus Id,UM4000740,87107,,Fungi identification mold,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.48,% of charge rate,95.00%,54.61,,,,54.61,57.48,0
unity,CDM,Um Culture Fungus Id,UM4000740,87107,,Fungi identification mold,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.48,% of charge rate,95.00%,54.61,,,,54.61,57.48,0
unity,CDM,"Um Culture, Mycoplasma",UM4000377,87109,,Mycoplasma,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.65,% of charge rate,95.00%,81.37,,,,81.37,85.65,0
unity,CDM,"Um Culture, Mycoplasma",UM4000377,87109,,Mycoplasma,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.65,% of charge rate,95.00%,81.37,,,,81.37,85.65,0
unity,CDM,"Um Culture, Mycobacteria",UM4000276,87116,,Mycobacteria culture,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.59,% of charge rate,95.00%,28.11,,,,28.11,29.59,0
unity,CDM,"Um Culture, Mycobacteria",UM4000276,87116,,Mycobacteria culture,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.59,% of charge rate,95.00%,28.11,,,,28.11,29.59,0
unity,CDM,Um Culture Tb (mycobacteria),UM4000204,87118,,Mycobacteric identification,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.94,% of charge rate,95.00%,57.89,,,,57.89,60.94,0
unity,CDM,Um Culture Tb (mycobacteria),UM4000204,87118,,Mycobacteric identification,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.94,% of charge rate,95.00%,57.89,,,,57.89,60.94,0
unity,CDM,Um Culture Typing,UM4000356,87140,,Culture type immunofluoresc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.04,% of charge rate,95.00%,29.49,,,,29.49,31.04,0
unity,CDM,Um Culture Typing,UM4000356,87140,,Culture type immunofluoresc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.04,% of charge rate,95.00%,29.49,,,,29.49,31.04,0
unity,CDM,Um Culture Typing,UM4000532,87147,,Culture type immunologic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Culture Typing,UM4000532,87147,,Culture type immunologic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.82,% of charge rate,95.00%,27.38,,,,27.38,28.82,0
unity,CDM,Um Culture Typing Dna Probe,UM4000741,87149,,Dna/rna direct probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.64,% of charge rate,95.00%,106.06,,,,106.06,111.64,0
unity,CDM,Um Culture Typing Dna Probe,UM4000741,87149,,Dna/rna direct probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.64,% of charge rate,95.00%,106.06,,,,106.06,111.64,0
unity,CDM,"Um Culture, Typing, Id By Dna/rna Ampl Probe Per Organism",UM4000833,87150,,Dna/rna amplified probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,"Um Culture, Typing, Id By Dna/rna Ampl Probe Per Organism",UM4000833,87150,,Dna/rna amplified probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,Um Dna/rna Sequencing,UM4000850,87153,,Dna/rna sequencing,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,668.77,% of charge rate,95.00%,635.33,,,,635.33,668.77,0
unity,CDM,Um Dna/rna Sequencing,UM4000850,87153,,Dna/rna sequencing,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,668.77,% of charge rate,95.00%,635.33,,,,635.33,668.77,0
unity,CDM,"Um Macroscopic Examiniation, Arthropod",UM4000888,87168,,Macroscopic exam arthropod,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.77,% of charge rate,95.00%,23.53,,,,23.53,24.77,0
unity,CDM,"Um Macroscopic Examiniation, Arthropod",UM4000888,87168,,Macroscopic exam arthropod,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.77,% of charge rate,95.00%,23.53,,,,23.53,24.77,0
unity,CDM,Um O&p Macroscopic Exam,UM4000259,87169,,Macroscopic exam parasite,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um O&p Macroscopic Exam,UM4000259,87169,,Macroscopic exam parasite,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Pinworm Exam,UM4000384,87172,,Pinworm exam,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Pinworm Exam,UM4000384,87172,,Pinworm exam,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um O&p Concentrate/id (ph),UM4000724,87177,,Ova and parasites smears,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.54,% of charge rate,95.00%,47.06,,,,47.06,49.54,0
unity,CDM,Um O&p Concentrate/id (ph),UM4000724,87177,,Ova and parasites smears,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.54,% of charge rate,95.00%,47.06,,,,47.06,49.54,0
unity,CDM,Um E Test Sensitivity,UM4000234,87181,,Microbe susceptible diffuse,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,Um E Test Sensitivity,UM4000234,87181,,Microbe susceptible diffuse,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,"Um Sensitivity, K-b",UM4000232,87184,,Microbe susceptible disk,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.43,% of charge rate,95.00%,36.51,,,,36.51,38.43,0
unity,CDM,"Um Sensitivity, K-b",UM4000232,87184,,Microbe susceptible disk,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.43,% of charge rate,95.00%,36.51,,,,36.51,38.43,0
unity,CDM,Um Beta Lactamase Sens,UM4000236,87185,,Microbe susceptible enzyme,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,Um Beta Lactamase Sens,UM4000236,87185,,Microbe susceptible enzyme,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.45,% of charge rate,95.00%,25.13,,,,25.13,26.45,0
unity,CDM,"Um Sensitivity, Mic",UM4000350,87186,,Microbe susceptible mic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.92,% of charge rate,95.00%,36.97,,,,36.97,38.92,0
unity,CDM,"Um Sensitivity, Mic",UM4000350,87186,,Microbe susceptible mic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.92,% of charge rate,95.00%,36.97,,,,36.97,38.92,0
unity,CDM,"Um Sensitivity, Mycobacterium",UM4000793,87186,,Microbe susceptible mic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150,% of charge rate,95.00%,142.5,,,,142.5,150,0
unity,CDM,"Um Sensitivity, Mycobacterium",UM4000793,87186,,Microbe susceptible mic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150,% of charge rate,95.00%,142.5,,,,142.5,150,0
unity,CDM,Um Gram Stain,UM4000148,87205,,Smear gram stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Gram Stain,UM4000148,87205,,Smear gram stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Gram Stain Referred,UM4000737,87205,,Smear gram stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Gram Stain Referred,UM4000737,87205,,Smear gram stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Fluoro Acid Fast Stain,UM4000253,87206,,Smear fluorescent/acid stai,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.91,% of charge rate,95.00%,28.41,,,,28.41,29.91,0
unity,CDM,Um Fluoro Acid Fast Stain,UM4000253,87206,,Smear fluorescent/acid stai,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.91,% of charge rate,95.00%,28.41,,,,28.41,29.91,0
unity,CDM,Um Ova & Parasite Stain,UM4000246,87207,,Smear special stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.37,% of charge rate,95.00%,31.7,,,,31.7,33.37,0
unity,CDM,Um Ova & Parasite Stain,UM4000246,87207,,Smear special stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.37,% of charge rate,95.00%,31.7,,,,31.7,33.37,0
unity,CDM,"Um Parasites, Blood Giemsa Stain",UM4000798,87207,,Smear special stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.37,% of charge rate,95.00%,31.7,,,,31.7,33.37,0
unity,CDM,"Um Parasites, Blood Giemsa Stain",UM4000798,87207,,Smear special stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.37,% of charge rate,95.00%,31.7,,,,31.7,33.37,0
unity,CDM,Um O&p Trichrome Stain (ph),UM4000723,87209,,Smear complex stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.07,% of charge rate,95.00%,95.07,,,,95.07,100.07,0
unity,CDM,Um O&p Trichrome Stain (ph),UM4000723,87209,,Smear complex stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.07,% of charge rate,95.00%,95.07,,,,95.07,100.07,0
unity,CDM,Um Wet Prep,UM4000018,87210,,Smear wet mount saline/ink,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Wet Prep,UM4000018,87210,,Smear wet mount saline/ink,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Koh Slide,UM4000372,87220,,Tissue exam for fungi,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,Um Koh Slide,UM4000372,87220,,Tissue exam for fungi,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.79,% of charge rate,95.00%,22.6,,,,22.6,23.79,0
unity,CDM,"Um Virus Rapid Culture, Resp",UM4000027,87254,,Virus inoculation shell via,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,208.7,% of charge rate,95.00%,198.27,,,,198.27,208.7,0
unity,CDM,"Um Virus Rapid Culture, Resp",UM4000027,87254,,Virus inoculation shell via,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,208.7,% of charge rate,95.00%,198.27,,,,198.27,208.7,0
unity,CDM,Um Virus Isolation; Centrifuge Enhanced Technique,UM4000864,87254,,Virus inoculation shell via,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.39,% of charge rate,95.00%,107.72,,,,107.72,113.39,0
unity,CDM,Um Virus Isolation; Centrifuge Enhanced Technique,UM4000864,87254,,Virus inoculation shell via,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.39,% of charge rate,95.00%,107.72,,,,107.72,113.39,0
unity,CDM,"Um Virus Isolation, Enzymat",UM4000403,87255,,Genet virus isolate hsv,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,188.58,% of charge rate,95.00%,179.15,,,,179.15,188.58,0
unity,CDM,"Um Virus Isolation, Enzymat",UM4000403,87255,,Genet virus isolate hsv,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,188.58,% of charge rate,95.00%,179.15,,,,179.15,188.58,0
unity,CDM,"Um Pertussis Ag, If",UM4000269,87265,,Pertussis ag if,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,"Um Pertussis Ag, If",UM4000269,87265,,Pertussis ag if,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,"Um Crypto, Antigen, If",UM4000256,87272,,Cryptosporidium ag if,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,"Um Crypto, Antigen, If",UM4000256,87272,,Cryptosporidium ag if,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,"Um Parainfluenzae, Ag,if",UM4000017,87279,,Parainfluenza ag if,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,171.6,% of charge rate,95.00%,163.02,,,,163.02,171.6,0
unity,CDM,"Um Parainfluenzae, Ag,if",UM4000017,87279,,Parainfluenza ag if,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,171.6,% of charge rate,95.00%,163.02,,,,163.02,171.6,0
unity,CDM,Um Aspergillus Ag,UM4000537,87305,,Aspergillus ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,154.55,% of charge rate,95.00%,146.82,,,,146.82,154.55,0
unity,CDM,Um Aspergillus Ag,UM4000537,87305,,Aspergillus ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,154.55,% of charge rate,95.00%,146.82,,,,146.82,154.55,0
unity,CDM,Um C Diff Toxins Eia,UM4000569,87324,,Clostridium ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um C Diff Toxins Eia,UM4000569,87324,,Clostridium ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Ova & Parasites,UM4000379,87328,,Cryptosporidium ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Ova & Parasites,UM4000379,87328,,Cryptosporidium ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Giardia,UM4000195,87329,,Giardia ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Giardia,UM4000195,87329,,Giardia ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,"Um H Pylori Stool Ag,referred",UM4000217,87338,,Hpylori stool ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,224.36,% of charge rate,95.00%,213.14,,,,213.14,224.36,0
unity,CDM,"Um H Pylori Stool Ag,referred",UM4000217,87338,,Hpylori stool ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,224.36,% of charge rate,95.00%,213.14,,,,213.14,224.36,0
unity,CDM,Um H. Pylori Stool Ag,UM4000572,87338,,Hpylori stool ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um H. Pylori Stool Ag,UM4000572,87338,,Hpylori stool ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Hepatitis Bsag,UM4000200,87340,,Hepatitis b surface ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.43,% of charge rate,95.00%,51.71,,,,51.71,54.43,0
unity,CDM,Um Hepatitis Bsag,UM4000200,87340,,Hepatitis b surface ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.43,% of charge rate,95.00%,51.71,,,,51.71,54.43,0
unity,CDM,Um Hbsag Neutralization,UM4000382,87341,,Hepatitis b surface ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.43,% of charge rate,95.00%,51.71,,,,51.71,54.43,0
unity,CDM,Um Hbsag Neutralization,UM4000382,87341,,Hepatitis b surface ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.43,% of charge rate,95.00%,51.71,,,,51.71,54.43,0
unity,CDM,Um Hepatitis Be Antigen,UM4000301,87350,,Hepatitis be ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.15,% of charge rate,95.00%,60.94,,,,60.94,64.15,0
unity,CDM,Um Hepatitis Be Antigen,UM4000301,87350,,Hepatitis be ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.15,% of charge rate,95.00%,60.94,,,,60.94,64.15,0
unity,CDM,"Um Histplama Cps, At, Eia,ur",UM4000323,87385,,Histoplasma capsul ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,141.13,% of charge rate,95.00%,134.07,,,,134.07,141.13,0
unity,CDM,"Um Histplama Cps, At, Eia,ur",UM4000323,87385,,Histoplasma capsul ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,141.13,% of charge rate,95.00%,134.07,,,,134.07,141.13,0
unity,CDM,Um Hiv Screening,UM4000281,87389,,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.46,% of charge rate,95.00%,46.99,,,,46.99,49.46,0
unity,CDM,Um Hiv Screening,UM4000281,87389,,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.46,% of charge rate,95.00%,46.99,,,,46.99,49.46,0
unity,CDM,Um Hiv-1 Antigen W/ Hiv-1 & 2 Antibody,UM4000862,87389,,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.96,% of charge rate,95.00%,120.61,,,,120.61,126.96,0
unity,CDM,Um Hiv-1 Antigen W/ Hiv-1 & 2 Antibody,UM4000862,87389,,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.96,% of charge rate,95.00%,120.61,,,,120.61,126.96,0
unity,CDM,"Um Rsv, Eia-screening",UM4000231,87420,,Resp syncytial ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,"Um Rsv, Eia-screening",UM4000231,87420,,Resp syncytial ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Rotavirus,UM4000156,87425,,Rotavirus ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Rotavirus,UM4000156,87425,,Rotavirus ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Shiga-like Toxin,UM4000734,87427,,Shiga-like toxin ag ia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Shiga-like Toxin,UM4000734,87427,,Shiga-like toxin ag ia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Beta-d-glucans(fungitell),UM4000538,87449,,Ag detect nos ia mult,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150.77,% of charge rate,95.00%,143.23,,,,143.23,150.77,0
unity,CDM,Um Beta-d-glucans(fungitell),UM4000538,87449,,Ag detect nos ia mult,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150.77,% of charge rate,95.00%,143.23,,,,143.23,150.77,0
unity,CDM,Um C Diff Ag Eia,UM4000570,87449,,Ag detect nos ia mult,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um C Diff Ag Eia,UM4000570,87449,,Ag detect nos ia mult,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,"Um Legionella Ag,urine",UM4000717,87449,,Ag detect nos ia mult,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.59,% of charge rate,95.00%,102.21,,,,102.21,107.59,0
unity,CDM,"Um Legionella Ag,urine",UM4000717,87449,,Ag detect nos ia mult,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,107.59,% of charge rate,95.00%,102.21,,,,102.21,107.59,0
unity,CDM,Um Legionella Ag Urine,UM4000738,87450,,Ag detect nos ia single,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,0
unity,CDM,Um Legionella Ag Urine,UM4000738,87450,,Ag detect nos ia single,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,0
unity,CDM,Um Strep Pneumo Ag Urine,UM4000739,87450,,Ag detect nos ia single,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,0
unity,CDM,Um Strep Pneumo Ag Urine,UM4000739,87450,,Ag detect nos ia single,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,0
unity,CDM,"Um Lyme Disease,pcr",UM4000767,87476,,Lyme dis dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,"Um Lyme Disease,pcr",UM4000767,87476,,Lyme dis dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,Um Candida Sp Direct Probe,UM4000782,87480,,Candida dna dir probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.72,% of charge rate,95.00%,106.13,,,,106.13,111.72,0
unity,CDM,Um Candida Sp Direct Probe,UM4000782,87480,,Candida dna dir probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.72,% of charge rate,95.00%,106.13,,,,106.13,111.72,0
unity,CDM,"Um Chlamydia Pneumo, Amp Probe",UM4000847,87486,,Chylmd pneum dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,"Um Chlamydia Pneumo, Amp Probe",UM4000847,87486,,Chylmd pneum dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Chlamydia Dna Probe,UM4000183,87491,,Chylmd trach dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.5,% of charge rate,95.00%,46.08,,,,46.08,48.5,0
unity,CDM,Um Chlamydia Dna Probe,UM4000183,87491,,Chylmd trach dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.5,% of charge rate,95.00%,46.08,,,,46.08,48.5,0
unity,CDM,Um Clostridium Difficile,UM4000290,87493,,C diff amplified probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,Um Clostridium Difficile,UM4000290,87493,,C diff amplified probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,"Um Cmv / Pcr, Quant",UM4000536,87497,,Cytomeg dna quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,419.23,% of charge rate,95.00%,398.27,,,,398.27,419.23,0
unity,CDM,"Um Cmv / Pcr, Quant",UM4000536,87497,,Cytomeg dna quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,419.23,% of charge rate,95.00%,398.27,,,,398.27,419.23,0
unity,CDM,"Um Vre Screen,pcr",UM4000720,87500,,Vanomycin dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,"Um Vre Screen,pcr",UM4000720,87500,,Vanomycin dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,Um Influenzae Dna Amp Probe,UM4000758,87502,,Influenza dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167,% of charge rate,95.00%,158.65,,,,158.65,167,0
unity,CDM,Um Influenzae Dna Amp Probe,UM4000758,87502,,Influenza dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167,% of charge rate,95.00%,158.65,,,,158.65,167,0
unity,CDM,"Um Rsv, Amp Probe",UM4000844,87502,,Influenza dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,307,% of charge rate,95.00%,291.65,,,,291.65,307,0
unity,CDM,"Um Rsv, Amp Probe",UM4000844,87502,,Influenza dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,307,% of charge rate,95.00%,291.65,,,,291.65,307,0
unity,CDM,Um Enteric Pathogen Panel,UM4000764,87506,,Iadna-dna/rna probe tq 6-11,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,190,% of charge rate,95.00%,180.5,,,,180.5,190,0
unity,CDM,Um Enteric Pathogen Panel,UM4000764,87506,,Iadna-dna/rna probe tq 6-11,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,190,% of charge rate,95.00%,180.5,,,,180.5,190,0
unity,CDM,Um Gi Panel Pcr,UM4000939,87507,,Iadna-dna/rna probe tq 12-25,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,225,% of charge rate,95.00%,213.75,,,,213.75,225,0
unity,CDM,Um Gi Panel Pcr,UM4000939,87507,,Iadna-dna/rna probe tq 12-25,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,225,% of charge rate,95.00%,213.75,,,,213.75,225,0
unity,CDM,Um Gardnerella Vagininalis Direct Probe,UM4000783,87510,,Gardner vag dna dir probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.72,% of charge rate,95.00%,106.13,,,,106.13,111.72,0
unity,CDM,Um Gardnerella Vagininalis Direct Probe,UM4000783,87510,,Gardner vag dna dir probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.72,% of charge rate,95.00%,106.13,,,,106.13,111.72,0
unity,CDM,"Um Hepatitis B, Dna Pb,qual",UM4000032,87516,,Hepatitis b dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,276.28,% of charge rate,95.00%,262.47,,,,262.47,276.28,0
unity,CDM,"Um Hepatitis B, Dna Pb,qual",UM4000032,87516,,Hepatitis b dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,276.28,% of charge rate,95.00%,262.47,,,,262.47,276.28,0
unity,CDM,"Um Hep C Rna, Amp Probe",UM4000327,87521,,Hepatitis c probe&rvrs trnsc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,356.41,% of charge rate,95.00%,338.59,,,,338.59,356.41,0
unity,CDM,"Um Hep C Rna, Amp Probe",UM4000327,87521,,Hepatitis c probe&rvrs trnsc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,356.41,% of charge rate,95.00%,338.59,,,,338.59,356.41,0
unity,CDM,"Um Hepatitis C-rna,quant",UM4000222,87522,,Hepatitis c revrs trnscrpj,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,710.57,% of charge rate,95.00%,675.04,,,,675.04,710.57,0
unity,CDM,"Um Hepatitis C-rna,quant",UM4000222,87522,,Hepatitis c revrs trnscrpj,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,710.57,% of charge rate,95.00%,675.04,,,,675.04,710.57,0
unity,CDM,"Um Hcv-rna, Quant Pcr",UM4000424,87522,,Hepatitis c revrs trnscrpj,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,394.68,% of charge rate,95.00%,374.95,,,,374.95,394.68,0
unity,CDM,"Um Hcv-rna, Quant Pcr",UM4000424,87522,,Hepatitis c revrs trnscrpj,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,394.68,% of charge rate,95.00%,374.95,,,,374.95,394.68,0
unity,CDM,Um Hsv Dna Amplified Probe,UM4000043,87529,,Hsv dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,Um Hsv Dna Amplified Probe,UM4000043,87529,,Hsv dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,Um Hsv1/hsv2 By Pcr,UM4000116,87529,,Hsv dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,Um Hsv1/hsv2 By Pcr,UM4000116,87529,,Hsv dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,"UM RBC ANTIGENS, OTHER THAN ABO OR  RH, EACH",UM4000794,87536,,Hiv-1 quant&revrse trnscrpj,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,474.03,% of charge rate,95.00%,450.33,,,,450.33,474.03,0
unity,CDM,"UM RBC ANTIGENS, OTHER THAN ABO OR  RH, EACH",UM4000794,87536,,Hiv-1 quant&revrse trnscrpj,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,474.03,% of charge rate,95.00%,450.33,,,,450.33,474.03,0
unity,CDM,"Um Mycobacteria, Pcr-respira",UM4000143,87556,,M.tuberculo dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,229.81,% of charge rate,95.00%,218.32,,,,218.32,229.81,0
unity,CDM,"Um Mycobacteria, Pcr-respira",UM4000143,87556,,M.tuberculo dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,229.81,% of charge rate,95.00%,218.32,,,,218.32,229.81,0
unity,CDM,"Um Mycobact, Pcr Non Resp",UM4000421,87556,,M.tuberculo dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,218.53,% of charge rate,95.00%,207.6,,,,207.6,218.53,0
unity,CDM,"Um Mycobact, Pcr Non Resp",UM4000421,87556,,M.tuberculo dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,218.53,% of charge rate,95.00%,207.6,,,,207.6,218.53,0
unity,CDM,"Um Mycoplasma Pneumo, Amp Probe",UM4000848,87581,,M.pneumon dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,"Um Mycoplasma Pneumo, Amp Probe",UM4000848,87581,,M.pneumon dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,"Um N. Gonorrhoeae, Dna, Amb Probe",UM4000817,87591,,N.gonorrhoeae dna amp prob,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.5,% of charge rate,95.00%,46.08,,,,46.08,48.5,0
unity,CDM,"Um N. Gonorrhoeae, Dna, Amb Probe",UM4000817,87591,,N.gonorrhoeae dna amp prob,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.5,% of charge rate,95.00%,46.08,,,,46.08,48.5,0
unity,CDM,Um Hpv - High Risk Types,UM4000821,87624,,Hpv high-risk types,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,Um Hpv - High Risk Types,UM4000821,87624,,Hpv high-risk types,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,Um Hpv Types 16 & 18 Only,UM4000804,87625,,Hpv types 16 & 18 only,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,Um Hpv Types 16 & 18 Only,UM4000804,87625,,Hpv types 16 & 18 only,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,Um Rsv & Influenza 3-5 Targets,UM4000899,87631,,Resp virus 3-5 targets,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,458,% of charge rate,95.00%,435.1,,,,435.1,458,0
unity,CDM,Um Rsv & Influenza 3-5 Targets,UM4000899,87631,,Resp virus 3-5 targets,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,458,% of charge rate,95.00%,435.1,,,,435.1,458,0
unity,CDM,"Um Covid / Influenza, 3-5 Targets Pcr",UM4000940,87631,,Resp virus 3-5 targets,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,310,% of charge rate,95.00%,294.5,,,,294.5,310,0
unity,CDM,"Um Covid / Influenza, 3-5 Targets Pcr",UM4000940,87631,,Resp virus 3-5 targets,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,310,% of charge rate,95.00%,294.5,,,,294.5,310,0
unity,CDM,Um Respiratory Virus 12-25 Targets,UM4000845,87633,,Resp virus 12-25 targets,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Respiratory Virus 12-25 Targets,UM4000845,87633,,Resp virus 12-25 targets,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,"Um Infectious Agent Detection By Nucleic Acid, Sars-cov-2",UM4000935,87635,,Sars-Covid -19- PROBE,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140,% of charge rate,95.00%,133,,,,133,140,0
unity,CDM,"Um Infectious Agent Detection By Nucleic Acid, Sars-cov-2",UM4000935,87635,,Sars-Covid -19- PROBE,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140,% of charge rate,95.00%,133,,,,133,140,0
unity,CDM,"Um Mrsa Screen,pcr",UM4000715,87641,,Mr-staph dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,"Um Mrsa Screen,pcr",UM4000715,87641,,Mr-staph dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,Um Strep A Dna Amplified Probe,UM4000768,87651,,Strep a dna amp probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,Um Strep A Dna Amplified Probe,UM4000768,87651,,Strep a dna amp probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,Um Trichomonas Vaginalis Direct Probe,UM4000784,87660,,Trichomonas vagin dir probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.72,% of charge rate,95.00%,106.13,,,,106.13,111.72,0
unity,CDM,Um Trichomonas Vaginalis Direct Probe,UM4000784,87660,,Trichomonas vagin dir probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.72,% of charge rate,95.00%,106.13,,,,106.13,111.72,0
unity,CDM,"Um Trichomonas Vaginalis, Rna, Qual",UM4000796,87661,,Trichomonas vaginalis amplif,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,"Um Trichomonas Vaginalis, Rna, Qual",UM4000796,87661,,Trichomonas vaginalis amplif,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.5,% of charge rate,95.00%,185.73,,,,185.73,195.5,0
unity,CDM,"Um Amp Probe, Each Organism",UM4000374,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,191.49,% of charge rate,95.00%,181.92,,,,181.92,191.49,0
unity,CDM,"Um Amp Probe, Each Organism",UM4000374,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,191.49,% of charge rate,95.00%,181.92,,,,181.92,191.49,0
unity,CDM,"Um Varicella Zoster Pcr,qual",UM4000727,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,308.87,% of charge rate,95.00%,293.43,,,,293.43,308.87,0
unity,CDM,"Um Varicella Zoster Pcr,qual",UM4000727,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,308.87,% of charge rate,95.00%,293.43,,,,293.43,308.87,0
unity,CDM,Um Bordetella Pertussis Pcr,UM4000744,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Bordetella Pertussis Pcr,UM4000744,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,"Um Mycoplasma Genitalium, Mol Detect",UM4000840,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Mycoplasma Genitalium, Mol Detect",UM4000840,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Mycoplasma Hominis, Mol Detect",UM4000841,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Mycoplasma Hominis, Mol Detect",UM4000841,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Ureaplasma Urealyticum, Mol Detect",UM4000842,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Ureaplasma Urealyticum, Mol Detect",UM4000842,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Ureaplasma Parvum, Mol Detect",UM4000843,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Ureaplasma Parvum, Mol Detect",UM4000843,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Detect Agent Nos, Dna, Amplified",UM4000846,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Detect Agent Nos, Dna, Amplified",UM4000846,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,203.45,% of charge rate,95.00%,193.28,,,,193.28,203.45,0
unity,CDM,"Um Bk Virus, Pcr, Quant",UM4000558,87799,,Detect agent nos dna quant,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,639.31,% of charge rate,95.00%,607.34,,,,607.34,639.31,0
unity,CDM,"Um Bk Virus, Pcr, Quant",UM4000558,87799,,Detect agent nos dna quant,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,639.31,% of charge rate,95.00%,607.34,,,,607.34,639.31,0
unity,CDM,Um Bordetella Culture,UM4000877,87801,,Detect agnt mult dna ampli,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85,% of charge rate,95.00%,80.75,,,,80.75,85,0
unity,CDM,Um Bordetella Culture,UM4000877,87801,,Detect agnt mult dna ampli,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85,% of charge rate,95.00%,80.75,,,,80.75,85,0
unity,CDM,"Um Varicella Zoster, Amplified Probe Technique",UM4000878,87801,,Detect agnt mult dna ampli,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,"Um Varicella Zoster, Amplified Probe Technique",UM4000878,87801,,Detect agnt mult dna ampli,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,195.42,% of charge rate,95.00%,185.65,,,,185.65,195.42,0
unity,CDM,Um Influenza A,UM4000152,87804,,Influenza assay w/optic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Influenza A,UM4000152,87804,,Influenza assay w/optic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Influenzae B,UM4000458,87804,,Influenza assay w/optic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Influenzae B,UM4000458,87804,,Influenza assay w/optic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Rsv Antigen,UM4000226,87807,,Rsv assay w/optic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93,% of charge rate,95.00%,88.35,,,,88.35,93,0
unity,CDM,Um Rsv Antigen,UM4000226,87807,,Rsv assay w/optic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93,% of charge rate,95.00%,88.35,,,,88.35,93,0
unity,CDM,Um Strep A Screen,UM4000136,87880,,Strep a assay w/optic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Strep A Screen,UM4000136,87880,,Strep a assay w/optic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.8,% of charge rate,95.00%,63.46,,,,63.46,66.8,0
unity,CDM,Um Agent Nos Assay W/optic,UM4000849,87899,,Agent nos assay w/optic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.48,% of charge rate,95.00%,66.01,,,,66.01,69.48,0
unity,CDM,Um Agent Nos Assay W/optic,UM4000849,87899,,Agent nos assay w/optic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.48,% of charge rate,95.00%,66.01,,,,66.01,69.48,0
unity,CDM,Um Infect Agt Drug Susc Phenotype Pred Reg Genotypic Bioinfo,UM4000855,87900,,Phenotype infect agent drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,755.65,% of charge rate,95.00%,717.87,,,,717.87,755.65,0
unity,CDM,Um Infect Agt Drug Susc Phenotype Pred Reg Genotypic Bioinfo,UM4000855,87900,,Phenotype infect agent drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,755.65,% of charge rate,95.00%,717.87,,,,717.87,755.65,0
unity,CDM,Um Hiv-1 Reverse Transciptase & Protease Genees,UM4000856,87901,,Genotype dna hiv reverse t,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,492.50",% of charge rate,95.00%,"1,417.88",,,,"1,417.88","1,492.50",0
unity,CDM,Um Hiv-1 Reverse Transciptase & Protease Genees,UM4000856,87901,,Genotype dna hiv reverse t,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,492.50",% of charge rate,95.00%,"1,417.88",,,,"1,417.88","1,492.50",0
unity,CDM,Um Hep C Viral Rna Genotype,UM4000333,87902,,Genotype dna/rna hep c,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,433.42",% of charge rate,95.00%,"1,361.75",,,,"1,361.75","1,433.42",0
unity,CDM,Um Hep C Viral Rna Genotype,UM4000333,87902,,Genotype dna/rna hep c,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,433.42",% of charge rate,95.00%,"1,361.75",,,,"1,361.75","1,433.42",0
unity,CDM,Um Hiv-1 Integrase Genotype,UM4000857,87906,,Genotype dna/rna hiv,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,746.27,% of charge rate,95.00%,708.96,,,,708.96,746.27,0
unity,CDM,Um Hiv-1 Integrase Genotype,UM4000857,87906,,Genotype dna/rna hiv,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,746.27,% of charge rate,95.00%,708.96,,,,708.96,746.27,0
unity,CDM,"Um Cytology, Non-gyn",UM4010005,88104,,Cytopath fl nongyn smears,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.78,% of charge rate,95.00%,110.94,,,,110.94,116.78,0
unity,CDM,"Um Cytology, Non-gyn",UM4010005,88104,,Cytopath fl nongyn smears,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.78,% of charge rate,95.00%,110.94,,,,110.94,116.78,0
unity,CDM,"Um Cytopathology,tl,non-gyn",UM4000575,88112,,Cytopath cell enhance tech,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,119.89,% of charge rate,95.00%,113.9,,,,113.9,119.89,0
unity,CDM,"Um Cytopathology,tl,non-gyn",UM4000575,88112,,Cytopath cell enhance tech,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,119.89,% of charge rate,95.00%,113.9,,,,113.9,119.89,0
unity,CDM,"Um Cytopathology, Fish, Urine",UM4000865,88120,,Cytp urne 3-5 probes ea spec,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,602.74",% of charge rate,95.00%,"1,522.60",,,,"1,522.60","1,602.74",0
unity,CDM,"Um Cytopathology, Fish, Urine",UM4000865,88120,,Cytp urne 3-5 probes ea spec,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,602.74",% of charge rate,95.00%,"1,522.60",,,,"1,522.60","1,602.74",0
unity,CDM,Um Pap Smear - Thin Layer,UM4000118,88142,,Cytopath c/v thin layer,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.82,% of charge rate,95.00%,107.18,,,,107.18,112.82,0
unity,CDM,Um Pap Smear - Thin Layer,UM4000118,88142,,Cytopath c/v thin layer,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.82,% of charge rate,95.00%,107.18,,,,107.18,112.82,0
unity,CDM,"Um Cytopath Smear, Other",UM4010006,88161,,Cytopath smear other source,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.4,% of charge rate,95.00%,82.08,,,,82.08,86.4,0
unity,CDM,"Um Cytopath Smear, Other",UM4010006,88161,,Cytopath smear other source,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.4,% of charge rate,95.00%,82.08,,,,82.08,86.4,0
unity,CDM,Um Flow Cytometry -1st Mark,UM4010012,88184,,Flowcytometry/ tc 1 marker,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,214.22,% of charge rate,95.00%,203.51,,,,203.51,214.22,0
unity,CDM,Um Flow Cytometry -1st Mark,UM4010012,88184,,Flowcytometry/ tc 1 marker,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,214.22,% of charge rate,95.00%,203.51,,,,203.51,214.22,0
unity,CDM,Um Flow Cytometry Ea Add On,UM4010008,88185,,Flowcytometry/tc add-on,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,129.59,% of charge rate,95.00%,123.11,,,,123.11,129.59,0
unity,CDM,Um Flow Cytometry Ea Add On,UM4010008,88185,,Flowcytometry/tc add-on,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,129.59,% of charge rate,95.00%,123.11,,,,123.11,129.59,0
unity,CDM,Um Flow Cytometry Interpretation 2-8 Markers,UM4000900,88187,,Flowcytometry/read 2-8,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.51,% of charge rate,95.00%,95.48,,,,95.48,100.51,0
unity,CDM,Um Flow Cytometry Interpretation 2-8 Markers,UM4000900,88187,,Flowcytometry/read 2-8,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.51,% of charge rate,95.00%,95.48,,,,95.48,100.51,0
unity,CDM,"Um Flow Cytometry, Interpret",UM4010002,88188,,Flowcytometry/read 9-15,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.96,% of charge rate,95.00%,200.41,,,,200.41,210.96,0
unity,CDM,"Um Flow Cytometry, Interpret",UM4010002,88188,,Flowcytometry/read 9-15,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.96,% of charge rate,95.00%,200.41,,,,200.41,210.96,0
unity,CDM,"Um Chromosome Analysis,congenital",UM4000749,88230,,Tissue culture lymphocyte,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,648.65,% of charge rate,95.00%,616.22,,,,616.22,648.65,0
unity,CDM,"Um Chromosome Analysis,congenital",UM4000749,88230,,Tissue culture lymphocyte,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,648.65,% of charge rate,95.00%,616.22,,,,616.22,648.65,0
unity,CDM,"Um Chromoson Analysis, Congenital",UM4000750,88262,,Chromosome analysis 15-20,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,603.48,% of charge rate,95.00%,573.31,,,,573.31,603.48,0
unity,CDM,"Um Chromoson Analysis, Congenital",UM4000750,88262,,Chromosome analysis 15-20,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,603.48,% of charge rate,95.00%,573.31,,,,573.31,603.48,0
unity,CDM,"Um Mcg; Dna Probe, Individual",UM4000801,88271,,Cytogenetics dna probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,119.3,% of charge rate,95.00%,113.34,,,,113.34,119.3,0
unity,CDM,"Um Mcg; Dna Probe, Individual",UM4000801,88271,,Cytogenetics dna probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,119.3,% of charge rate,95.00%,113.34,,,,113.34,119.3,0
unity,CDM,Um Cytogenetics 10-30,UM4000894,88273,,Cytogenetics 10-30,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,186.25,% of charge rate,95.00%,176.94,,,,176.94,186.25,0
unity,CDM,Um Cytogenetics 10-30,UM4000894,88273,,Cytogenetics 10-30,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,186.25,% of charge rate,95.00%,176.94,,,,176.94,186.25,0
unity,CDM,"Um Mcg; Interphase In Situ Hybridization, Analyze 100-300",UM4000802,88275,,Cytogenetics 100-300,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,223.71,% of charge rate,95.00%,212.52,,,,212.52,223.71,0
unity,CDM,"Um Mcg; Interphase In Situ Hybridization, Analyze 100-300",UM4000802,88275,,Cytogenetics 100-300,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,223.71,% of charge rate,95.00%,212.52,,,,212.52,223.71,0
unity,CDM,"Um Chromosome Analysis, Congenital",UM4000751,88291,,Cyto/molecular report,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.81,% of charge rate,95.00%,72.02,,,,72.02,75.81,0
unity,CDM,"Um Chromosome Analysis, Congenital",UM4000751,88291,,Cyto/molecular report,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.81,% of charge rate,95.00%,72.02,,,,72.02,75.81,0
unity,CDM,Um Surgical Path. Level 1,UM4010007,88300,,Surgical path gross,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.23,% of charge rate,95.00%,37.27,,,,37.27,39.23,0
unity,CDM,Um Surgical Path. Level 1,UM4010007,88300,,Surgical path gross,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.23,% of charge rate,95.00%,37.27,,,,37.27,39.23,0
unity,CDM,Um Surgical Path. Level 2,UM4010003,88302,,Tissue exam by pathologist,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.11,% of charge rate,95.00%,78,,,,78,82.11,0
unity,CDM,Um Surgical Path. Level 2,UM4010003,88302,,Tissue exam by pathologist,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.11,% of charge rate,95.00%,78,,,,78,82.11,0
unity,CDM,Um Surgical Path Level 3,UM4010009,88304,,Tissue exam by pathologist,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,132.73,% of charge rate,95.00%,126.09,,,,126.09,132.73,0
unity,CDM,Um Surgical Path Level 3,UM4010009,88304,,Tissue exam by pathologist,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,132.73,% of charge rate,95.00%,126.09,,,,126.09,132.73,0
unity,CDM,Um Surgical Path Level 4,UM4010011,88305,,Tissue exam by pathologist,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,180.7,% of charge rate,95.00%,171.67,,,,171.67,180.7,0
unity,CDM,Um Surgical Path Level 4,UM4010011,88305,,Tissue exam by pathologist,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,180.7,% of charge rate,95.00%,171.67,,,,171.67,180.7,0
unity,CDM,Um Surgical Path. Level 5,UM4010001,88307,,Tissue exam by pathologist,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,562.04,% of charge rate,95.00%,533.94,,,,533.94,562.04,0
unity,CDM,Um Surgical Path. Level 5,UM4010001,88307,,Tissue exam by pathologist,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,562.04,% of charge rate,95.00%,533.94,,,,533.94,562.04,0
unity,CDM,Um Surgical Path. Level 6,UM4010013,88309,,Tissue exam by pathologist,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,798.33,% of charge rate,95.00%,758.41,,,,758.41,798.33,0
unity,CDM,Um Surgical Path. Level 6,UM4010013,88309,,Tissue exam by pathologist,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,798.33,% of charge rate,95.00%,758.41,,,,758.41,798.33,0
unity,CDM,Um Decalcification Procedure,UM4010019,88311,,Decalcify tissue,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.99,% of charge rate,95.00%,19.94,,,,19.94,20.99,0
unity,CDM,Um Decalcification Procedure,UM4010019,88311,,Decalcify tissue,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.99,% of charge rate,95.00%,19.94,,,,19.94,20.99,0
unity,CDM,Um Special Stains/microrgani,UM4010015,88312,,Special stains group 1,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.42,% of charge rate,95.00%,166.65,,,,166.65,175.42,0
unity,CDM,Um Special Stains/microrgani,UM4010015,88312,,Special stains group 1,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.42,% of charge rate,95.00%,166.65,,,,166.65,175.42,0
unity,CDM,Um Special Stain,UM4010010,88313,,Special stains group 2,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.16,% of charge rate,95.00%,133.15,,,,133.15,140.16,0
unity,CDM,Um Special Stain,UM4010010,88313,,Special stains group 2,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.16,% of charge rate,95.00%,133.15,,,,133.15,140.16,0
unity,CDM,Um Stain Ihc/icc Per Specimen,UM4000904,88341,,Immunohisto antb addl slide,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.62,% of charge rate,95.00%,28.14,,,,28.14,29.62,0
unity,CDM,Um Stain Ihc/icc Per Specimen,UM4000904,88341,,Immunohisto antb addl slide,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.62,% of charge rate,95.00%,28.14,,,,28.14,29.62,0
unity,CDM,Um Special Stain,UM4010016,88342,,Immunohisto antb 1st stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.49,% of charge rate,95.00%,159.12,,,,159.12,167.49,0
unity,CDM,Um Special Stain,UM4010016,88342,,Immunohisto antb 1st stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.49,% of charge rate,95.00%,159.12,,,,159.12,167.49,0
unity,CDM,Um Immunohistochemistry Tiss,UM4010018,88342,,Immunohisto antb 1st stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.49,% of charge rate,95.00%,159.12,,,,159.12,167.49,0
unity,CDM,Um Immunohistochemistry Tiss,UM4010018,88342,,Immunohisto antb 1st stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.49,% of charge rate,95.00%,159.12,,,,159.12,167.49,0
unity,CDM,"Um Immunofluoresenct Antibody Stain, 1st Time",UM4000931,88346,,Immunofluor antb 1st stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,159.57,% of charge rate,95.00%,151.59,,,,151.59,159.57,0
unity,CDM,"Um Immunofluoresenct Antibody Stain, 1st Time",UM4000931,88346,,Immunofluor antb 1st stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,159.57,% of charge rate,95.00%,151.59,,,,151.59,159.57,0
unity,CDM,"Um Immunofluoresenct Antibody Stain, Additional Times",UM4000932,88350,,Immunofluor antb addl stain,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.91,% of charge rate,95.00%,115.81,,,,115.81,121.91,0
unity,CDM,"Um Immunofluoresenct Antibody Stain, Additional Times",UM4000932,88350,,Immunofluor antb addl stain,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.91,% of charge rate,95.00%,115.81,,,,115.81,121.91,0
unity,CDM,Um Body Fluid Cell Ct W/diff,UM4000034,89051,,Body fluid cell count,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.79,% of charge rate,95.00%,67.25,,,,67.25,70.79,0
unity,CDM,Um Body Fluid Cell Ct W/diff,UM4000034,89051,,Body fluid cell count,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.79,% of charge rate,95.00%,67.25,,,,67.25,70.79,0
unity,CDM,Um Fecal Leukocyte Count,UM4000102,89055,,Leukocyte assessment fecal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.31,% of charge rate,95.00%,22.14,,,,22.14,23.31,0
unity,CDM,Um Fecal Leukocyte Count,UM4000102,89055,,Leukocyte assessment fecal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.31,% of charge rate,95.00%,22.14,,,,22.14,23.31,0
unity,CDM,Um Crystal Identification,UM4000091,89060,,Exam synovial fluid crystals,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,156.4,% of charge rate,95.00%,148.58,,,,148.58,156.4,0
unity,CDM,Um Crystal Identification,UM4000091,89060,,Exam synovial fluid crystals,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,156.4,% of charge rate,95.00%,148.58,,,,148.58,156.4,0
unity,CDM,Hc Aerosol Sputum Collection,3000003,89220,,Sputum specimen collection,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.8,% of charge rate,95.00%,45.41,,,,45.41,47.8,0
unity,CDM,Hc Aerosol Sputum Collection,3000003,89220,,Sputum specimen collection,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.8,% of charge rate,95.00%,45.41,,,,45.41,47.8,0
unity,CDM,Um Semen Analysis Post-vas,UM4000266,89321,,Semen anal sperm detection,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.07,% of charge rate,95.00%,63.72,,,,63.72,67.07,0
unity,CDM,Um Semen Analysis Post-vas,UM4000266,89321,,Semen anal sperm detection,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.07,% of charge rate,95.00%,63.72,,,,63.72,67.07,0
unity,CDM,SPEECH/HEARING THERAPY,4400001,92507,,Speech/hearing therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,257.43,% of charge rate,95.00%,244.56,,,,244.56,257.43,0
unity,CDM,SPEECH/HEARING THERAPY,4400001,92507,,Speech/hearing therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,257.43,% of charge rate,95.00%,244.56,,,,244.56,257.43,0
unity,CDM,Hc Laryngeal Function Study,5100017,92520,,Laryngeal function studies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,285,% of charge rate,95.00%,270.75,,,,270.75,285,0
unity,CDM,Hc Laryngeal Function Study,5100017,92520,,Laryngeal function studies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,285,% of charge rate,95.00%,270.75,,,,270.75,285,0
unity,CDM,EVAL OF SPEECH FLUENCY,4440005,92521,,Evaluation of speech fluency,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,410,% of charge rate,95.00%,389.5,,,,389.5,410,0
unity,CDM,EVAL OF SPEECH FLUENCY,4440005,92521,,Evaluation of speech fluency,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,410,% of charge rate,95.00%,389.5,,,,389.5,410,0
unity,CDM,SPEECH SOUND EVAL,4440006,92522,,Evaluate speech production,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,290,% of charge rate,95.00%,275.5,,,,275.5,290,0
unity,CDM,SPEECH SOUND EVAL,4440006,92522,,Evaluate speech production,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,290,% of charge rate,95.00%,275.5,,,,275.5,290,0
unity,CDM,SPEECH SOUND EVAL,4440007,92523,,Speech sound lang comprehen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,639.53,% of charge rate,95.00%,607.55,,,,607.55,639.53,0
unity,CDM,SPEECH SOUND EVAL,4440007,92523,,Speech sound lang comprehen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,639.53,% of charge rate,95.00%,607.55,,,,607.55,639.53,0
unity,CDM,VOICE/RESONANCE EVAL,4400025,92524,,Behavral qualit analys voice,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,VOICE/RESONANCE EVAL,4400025,92524,,Behavral qualit analys voice,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,DYSPHAGIA STUDY,4400003,92526,,Oral function therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235.63,% of charge rate,95.00%,223.85,,,,223.85,235.63,0
unity,CDM,DYSPHAGIA STUDY,4400003,92526,,Oral function therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235.63,% of charge rate,95.00%,223.85,,,,223.85,235.63,0
unity,CDM,Hc Eval Voice Prosthetic,4440000,92597,,Oral speech device eval,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.34,% of charge rate,95.00%,116.22,,,,116.22,122.34,0
unity,CDM,Hc Eval Voice Prosthetic,4440000,92597,,Oral speech device eval,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,122.34,% of charge rate,95.00%,116.22,,,,116.22,122.34,0
unity,CDM,SWALLOWING EVAL,4400007,92610,,Evaluate swallowing function,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.84,% of charge rate,95.00%,268.7,,,,268.7,282.84,0
unity,CDM,SWALLOWING EVAL,4400007,92610,,Evaluate swallowing function,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.84,% of charge rate,95.00%,268.7,,,,268.7,282.84,0
unity,CDM,CPR,4500092,92950,,Heart/lung resuscitation cpr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,175.00",% of charge rate,95.00%,"1,116.25",,,,"1,116.25","1,175.00",0
unity,CDM,CPR,4500092,92950,,Heart/lung resuscitation cpr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,175.00",% of charge rate,95.00%,"1,116.25",,,,"1,116.25","1,175.00",0
unity,CDM,Hc Temporary External Pacing,4500093,92953,,Temporary external pacing,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.32,% of charge rate,95.00%,39.25,,,,39.25,41.32,0
unity,CDM,Hc Temporary External Pacing,4500093,92953,,Temporary external pacing,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.32,% of charge rate,95.00%,39.25,,,,39.25,41.32,0
unity,CDM,EKG,7300000,93005,,Electrocardiogram tracing,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.02,% of charge rate,95.00%,38.02,,,,38.02,40.02,0
unity,CDM,EKG,7300000,93005,,Electrocardiogram tracing,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.02,% of charge rate,95.00%,38.02,,,,38.02,40.02,0
unity,CDM,STRESS TEST,4820000,93017,,Cardiovascular stress test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282,% of charge rate,95.00%,267.9,,,,267.9,282,0
unity,CDM,STRESS TEST,4820000,93017,,Cardiovascular stress test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282,% of charge rate,95.00%,267.9,,,,267.9,282,0
unity,CDM,"ECG,TRACING",7300002,93041,,Rhythm ecg tracing,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.96,% of charge rate,95.00%,20.86,,,,20.86,21.96,0
unity,CDM,"ECG,TRACING",7300002,93041,,Rhythm ecg tracing,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.96,% of charge rate,95.00%,20.86,,,,20.86,21.96,0
unity,CDM,Hc Ecg Monitor/record Up To 48 Hrs,7310000,93225,,Ecg monit/reprt up to 48 hrs,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.35,% of charge rate,95.00%,119.08,,,,119.08,125.35,0
unity,CDM,Hc Ecg Monitor/record Up To 48 Hrs,7310000,93225,,Ecg monit/reprt up to 48 hrs,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.35,% of charge rate,95.00%,119.08,,,,119.08,125.35,0
unity,CDM,Hc Echo Tranthoracic Complete,4800028,93303,,Echo transthoracic,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,611.95,% of charge rate,95.00%,581.35,,,,581.35,611.95,0
unity,CDM,Hc Echo Tranthoracic Complete,4800028,93303,,Echo transthoracic,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,611.95,% of charge rate,95.00%,581.35,,,,581.35,611.95,0
unity,CDM,Hc Tte W/doppler Complete,4800009,93306,,Tte w/doppler complete,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,729.3,% of charge rate,95.00%,692.84,,,,692.84,729.3,0
unity,CDM,Hc Tte W/doppler Complete,4800009,93306,,Tte w/doppler complete,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,729.3,% of charge rate,95.00%,692.84,,,,692.84,729.3,0
unity,CDM,ECHO EXAM COMPLETE,4800010,93307,,Tte w/o doppler complete,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,340.1,% of charge rate,95.00%,323.1,,,,323.1,340.1,0
unity,CDM,ECHO EXAM COMPLETE,4800010,93307,,Tte w/o doppler complete,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,340.1,% of charge rate,95.00%,323.1,,,,323.1,340.1,0
unity,CDM,ECHO EXAM LIMITED,4800011,93308,,Tte f-up or lmtd,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,259.19,% of charge rate,95.00%,246.23,,,,246.23,259.19,0
unity,CDM,ECHO EXAM LIMITED,4800011,93308,,Tte f-up or lmtd,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,259.19,% of charge rate,95.00%,246.23,,,,246.23,259.19,0
unity,CDM,Hc Use Of Echo Contrast Agnt During Stress Echo,4800095,93352,,Admin ecg contrast agent,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,134,% of charge rate,95.00%,127.3,,,,127.3,134,0
unity,CDM,Hc Use Of Echo Contrast Agnt During Stress Echo,4800095,93352,,Admin ecg contrast agent,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,134,% of charge rate,95.00%,127.3,,,,127.3,134,0
unity,CDM,CARDIAC REHAB/PHASE I NON-MONITORED,9430000,93797,,Cardiac rehab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.46,% of charge rate,95.00%,72.64,,,,72.64,76.46,0
unity,CDM,CARDIAC REHAB/PHASE I NON-MONITORED,9430000,93797,,Cardiac rehab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.46,% of charge rate,95.00%,72.64,,,,72.64,76.46,0
unity,CDM,CARD REHAB PHASE II,9430001,93798,,Cardiac rehab/monitor,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.64,% of charge rate,95.00%,104.16,,,,104.16,109.64,0
unity,CDM,CARD REHAB PHASE II,9430001,93798,,Cardiac rehab/monitor,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.64,% of charge rate,95.00%,104.16,,,,104.16,109.64,0
unity,CDM,CAROTID DOPPLER,9210009,93880,,Extracranial bilat study,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,654.82,% of charge rate,95.00%,622.08,,,,622.08,654.82,0
unity,CDM,CAROTID DOPPLER,9210009,93880,,Extracranial bilat study,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,654.82,% of charge rate,95.00%,622.08,,,,622.08,654.82,0
unity,CDM,Hc Extremity Study Vascular,9210013,93922,,Upr/l xtremity art 2 levels,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,401.67,% of charge rate,95.00%,381.59,,,,381.59,401.67,0
unity,CDM,Hc Extremity Study Vascular,9210013,93922,,Upr/l xtremity art 2 levels,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,401.67,% of charge rate,95.00%,381.59,,,,381.59,401.67,0
unity,CDM,DUPLEX LOWER EXTREMITY,9210016,93925,,Lower extremity study,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,798.96,% of charge rate,95.00%,759.01,,,,759.01,798.96,0
unity,CDM,DUPLEX LOWER EXTREMITY,9210016,93925,,Lower extremity study,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,798.96,% of charge rate,95.00%,759.01,,,,759.01,798.96,0
unity,CDM,VENOUS IMAGING,9210020,93970,,Extremity study,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,850,% of charge rate,95.00%,807.5,,,,807.5,850,0
unity,CDM,VENOUS IMAGING,9210020,93970,,Extremity study,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,850,% of charge rate,95.00%,807.5,,,,807.5,850,0
unity,CDM,SCAN EXTREMITY VEINS,9210021,93971,,Extremity study,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,750,% of charge rate,95.00%,712.5,,,,712.5,750,0
unity,CDM,SCAN EXTREMITY VEINS,9210021,93971,,Extremity study,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,750,% of charge rate,95.00%,712.5,,,,712.5,750,0
unity,CDM,Hc Duplex Abd Organ Follow Up,9210023,93976,,Vascular study,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,565.28,% of charge rate,95.00%,537.02,,,,537.02,565.28,0
unity,CDM,Hc Duplex Abd Organ Follow Up,9210023,93976,,Vascular study,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,565.28,% of charge rate,95.00%,537.02,,,,537.02,565.28,0
unity,CDM,"Hc Ventilation Assist,initial",4100000,94002,,Vent mgmt inpat init day,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.92,% of charge rate,95.00%,96.82,,,,96.82,101.92,0
unity,CDM,"Hc Ventilation Assist,initial",4100000,94002,,Vent mgmt inpat init day,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.92,% of charge rate,95.00%,96.82,,,,96.82,101.92,0
unity,CDM,Hc Spirometry,4600000,94010,,Breathing capacity test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96,% of charge rate,95.00%,91.2,,,,91.2,96,0
unity,CDM,Hc Spirometry,4600000,94010,,Breathing capacity test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96,% of charge rate,95.00%,91.2,,,,91.2,96,0
unity,CDM,PRE/POST SPIRO,4600002,94060,,Evaluation of wheezing,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,165,% of charge rate,95.00%,156.75,,,,156.75,165,0
unity,CDM,PRE/POST SPIRO,4600002,94060,,Evaluation of wheezing,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,165,% of charge rate,95.00%,156.75,,,,156.75,165,0
unity,CDM,Hc Mvv,4600005,94200,,Lung function test (mbc/mvv),,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78,% of charge rate,95.00%,74.1,,,,74.1,78,0
unity,CDM,Hc Mvv,4600005,94200,,Lung function test (mbc/mvv),,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78,% of charge rate,95.00%,74.1,,,,74.1,78,0
unity,CDM,Hc Loop,4600010,94375,,Respiratory flow volume loop,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,108,% of charge rate,95.00%,102.6,,,,102.6,108,0
unity,CDM,Hc Loop,4600010,94375,,Respiratory flow volume loop,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,108,% of charge rate,95.00%,102.6,,,,102.6,108,0
unity,CDM,Hc Exercise Test For Bronchospasm,4600061,94617,,Exercise tst brncspsm,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,216,% of charge rate,95.00%,205.2,,,,205.2,216,0
unity,CDM,Hc Exercise Test For Bronchospasm,4600061,94617,,Exercise tst brncspsm,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,216,% of charge rate,95.00%,205.2,,,,205.2,216,0
unity,CDM,Hc Pulmonary Stress Testing,4600060,94618,,Pulmonary stress testing,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.45,% of charge rate,95.00%,37.48,,,,37.48,39.45,0
unity,CDM,Hc Pulmonary Stress Testing,4600060,94618,,Pulmonary stress testing,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.45,% of charge rate,95.00%,37.48,,,,37.48,39.45,0
unity,CDM,AIRWAY INHALATION TRMT,4100003,94640,,Airway inhalation treatment,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.49,% of charge rate,95.00%,63.17,,,,63.17,66.49,0
unity,CDM,AIRWAY INHALATION TRMT,4100003,94640,,Airway inhalation treatment,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.49,% of charge rate,95.00%,63.17,,,,63.17,66.49,0
unity,CDM,Hc Cbt 1st Hour,4100005,94644,,Cbt 1st hour,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,177,% of charge rate,95.00%,168.15,,,,168.15,177,0
unity,CDM,Hc Cbt 1st Hour,4100005,94644,,Cbt 1st hour,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,177,% of charge rate,95.00%,168.15,,,,168.15,177,0
unity,CDM,Hc Cpap/day,4100007,94660,,Pos airway pressure cpap,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,228,% of charge rate,95.00%,216.6,,,,216.6,228,0
unity,CDM,Hc Cpap/day,4100007,94660,,Pos airway pressure cpap,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,228,% of charge rate,95.00%,216.6,,,,216.6,228,0
unity,CDM,Hc Demo/eval-aerosol,4100008,94664,,Evaluate pt use of inhaler,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.6,% of charge rate,95.00%,57.57,,,,57.57,60.6,0
unity,CDM,Hc Demo/eval-aerosol,4100008,94664,,Evaluate pt use of inhaler,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.6,% of charge rate,95.00%,57.57,,,,57.57,60.6,0
unity,CDM,"Hc Chest Physiotherapy,initial",4100009,94667,,Chest wall manipulation,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.78,% of charge rate,95.00%,85.29,,,,85.29,89.78,0
unity,CDM,"Hc Chest Physiotherapy,initial",4100009,94667,,Chest wall manipulation,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.78,% of charge rate,95.00%,85.29,,,,85.29,89.78,0
unity,CDM,"Hc Chest Physiotherapy,subsequent",4100010,94668,,Chest wall manipulation,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.15,% of charge rate,95.00%,110.34,,,,110.34,116.15,0
unity,CDM,"Hc Chest Physiotherapy,subsequent",4100010,94668,,Chest wall manipulation,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.15,% of charge rate,95.00%,110.34,,,,110.34,116.15,0
unity,CDM,Hc Oximetry Continuous,4600019,94762,,Measure blood oxygen level,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,145.6,% of charge rate,95.00%,138.32,,,,138.32,145.6,0
unity,CDM,Hc Oximetry Continuous,4600019,94762,,Measure blood oxygen level,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,145.6,% of charge rate,95.00%,138.32,,,,138.32,145.6,0
unity,CDM,Hc Co2 Expired Gas,4600020,94770,,Exhaled carbon dioxide test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.5,% of charge rate,95.00%,25.18,,,,25.18,26.5,0
unity,CDM,Hc Co2 Expired Gas,4600020,94770,,Exhaled carbon dioxide test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.5,% of charge rate,95.00%,25.18,,,,25.18,26.5,0
unity,CDM,Hc Mip/mep,4100011,94799,,Pulmonary service/procedure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15,% of charge rate,95.00%,14.25,,,,14.25,15,0
unity,CDM,Hc Mip/mep,4100011,94799,,Pulmonary service/procedure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15,% of charge rate,95.00%,14.25,,,,14.25,15,0
unity,CDM,Um Peak Flow/cap Pf-day,UM3480004,94799,,Pulmonary service/procedure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.14,% of charge rate,95.00%,44.78,,,,44.78,47.14,0
unity,CDM,Um Peak Flow/cap Pf-day,UM3480004,94799,,Pulmonary service/procedure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.14,% of charge rate,95.00%,44.78,,,,44.78,47.14,0
unity,CDM,Um Inc Breath Exerc,UM3480005,94799,,Pulmonary service/procedure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.99,% of charge rate,95.00%,27.54,,,,27.54,28.99,0
unity,CDM,Um Inc Breath Exerc,UM3480005,94799,,Pulmonary service/procedure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.99,% of charge rate,95.00%,27.54,,,,27.54,28.99,0
unity,CDM,Um Humidifier/trach Collar,UM3480030,94799,,Pulmonary service/procedure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,120,% of charge rate,95.00%,114,,,,114,120,0
unity,CDM,Um Humidifier/trach Collar,UM3480030,94799,,Pulmonary service/procedure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,120,% of charge rate,95.00%,114,,,,114,120,0
unity,CDM,"IMMUNOTHERAPY, ONE INJECTION",95115,95115,,Immunotherapy one injection,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.88,% of charge rate,95.00%,18.89,,,,18.89,19.88,0
unity,CDM,"IMMUNOTHERAPY, ONE INJECTION",95115,95115,,Immunotherapy one injection,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.88,% of charge rate,95.00%,18.89,,,,18.89,19.88,0
unity,CDM,"IMMUNOTHERAPY, 2+ INJECTIONS",95117,95117,,Immunotherapy injections,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.73,% of charge rate,95.00%,21.59,,,,21.59,22.73,0
unity,CDM,"IMMUNOTHERAPY, 2+ INJECTIONS",95117,95117,,Immunotherapy injections,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.73,% of charge rate,95.00%,21.59,,,,21.59,22.73,0
unity,CDM,Hc Mslt,9200034,95805,,Multiple sleep latency test,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,221.01",% of charge rate,95.00%,"1,159.96",,,,"1,159.96","1,221.01",0
unity,CDM,Hc Mslt,9200034,95805,,Multiple sleep latency test,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,221.01",% of charge rate,95.00%,"1,159.96",,,,"1,159.96","1,221.01",0
unity,CDM,SLEEP STUDY,9200036,95810,,Polysom 6/> yrs 4/> param,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,910.00",% of charge rate,95.00%,"1,814.50",,,,"1,814.50","1,910.00",0
unity,CDM,SLEEP STUDY,9200036,95810,,Polysom 6/> yrs 4/> param,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,910.00",% of charge rate,95.00%,"1,814.50",,,,"1,814.50","1,910.00",0
unity,CDM,SLEEP STUDY,9200037,95811,,Polysom 6/>yrs cpap 4/> parm,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,010.00",% of charge rate,95.00%,"1,909.50",,,,"1,909.50","2,010.00",0
unity,CDM,SLEEP STUDY,9200037,95811,,Polysom 6/>yrs cpap 4/> parm,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,010.00",% of charge rate,95.00%,"1,909.50",,,,"1,909.50","2,010.00",0
unity,CDM,APHASIA ASSESSMENT PER HR,4400010,96105,,Assessment of aphasia,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,226.24,% of charge rate,95.00%,214.93,,,,214.93,226.24,0
unity,CDM,APHASIA ASSESSMENT PER HR,4400010,96105,,Assessment of aphasia,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,226.24,% of charge rate,95.00%,214.93,,,,214.93,226.24,0
unity,CDM,Hc Cognitive Test/hr + Report,4440004,96125,,Cognitive test by hc pro,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Hc Cognitive Test/hr + Report,4440004,96125,,Cognitive test by hc pro,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,"HYDRATION,INITIAL",9400003,96360,,Hydration iv infusion init,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,394,% of charge rate,95.00%,374.3,,,,374.3,394,0
unity,CDM,"HYDRATION,INITIAL",9400003,96360,,Hydration iv infusion init,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,394,% of charge rate,95.00%,374.3,,,,374.3,394,0
unity,CDM,HYDRATION EA ADDL HR,9400004,96361,,Hydrate iv infusion add-on,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80,% of charge rate,95.00%,76,,,,76,80,0
unity,CDM,HYDRATION EA ADDL HR,9400004,96361,,Hydrate iv infusion add-on,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80,% of charge rate,95.00%,76,,,,76,80,0
unity,CDM,"INFUSION,INITIAL",9400005,96365,,Ther/proph/diag iv inf init,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,394,% of charge rate,95.00%,374.3,,,,374.3,394,0
unity,CDM,"INFUSION,INITIAL",9400005,96365,,Ther/proph/diag iv inf init,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,394,% of charge rate,95.00%,374.3,,,,374.3,394,0
unity,CDM,INFUSION EA ADDL HR,9400006,96366,,Ther/proph/diag iv inf addon,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80,% of charge rate,95.00%,76,,,,76,80,0
unity,CDM,INFUSION EA ADDL HR,9400006,96366,,Ther/proph/diag iv inf addon,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80,% of charge rate,95.00%,76,,,,76,80,0
unity,CDM,INFUSION ADDL,9400007,96367,,Tx/proph/dg addl seq iv inf,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,INFUSION ADDL,9400007,96367,,Tx/proph/dg addl seq iv inf,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,INFUSION,9400008,96368,,Ther/diag concurrent inf,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.15,% of charge rate,95.00%,57.14,,,,57.14,60.15,0
unity,CDM,INFUSION,9400008,96368,,Ther/diag concurrent inf,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.15,% of charge rate,95.00%,57.14,,,,57.14,60.15,0
unity,CDM,INJECTION,9400009,96372,,Ther/proph/diag inj sc/im,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,INJECTION,9400009,96372,,Ther/proph/diag inj sc/im,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,IV PUSH,9400011,96374,,Ther/proph/diag inj iv push,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,394,% of charge rate,95.00%,374.3,,,,374.3,394,0
unity,CDM,IV PUSH,9400011,96374,,Ther/proph/diag inj iv push,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,394,% of charge rate,95.00%,374.3,,,,374.3,394,0
unity,CDM,IV PUSH,9400012,96375,,Tx/pro/dx inj new drug addon,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.69,% of charge rate,95.00%,83.31,,,,83.31,87.69,0
unity,CDM,IV PUSH,9400012,96375,,Tx/pro/dx inj new drug addon,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.69,% of charge rate,95.00%,83.31,,,,83.31,87.69,0
unity,CDM,IV PUSH,9400013,96376,,Tx/pro/dx inj same drug adon,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.67,% of charge rate,95.00%,27.24,,,,27.24,28.67,0
unity,CDM,IV PUSH,9400013,96376,,Tx/pro/dx inj same drug adon,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.67,% of charge rate,95.00%,27.24,,,,27.24,28.67,0
unity,CDM,Hc Application On-body Injector,9400033,96377,,Applicaton on-body injector,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Hc Application On-body Injector,9400033,96377,,Applicaton on-body injector,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,CHEMO ADMINISTRATION,3310000,96401,,Chemo anti-neopl sq/im,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,3310000,96401,,Chemo anti-neopl sq/im,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,3310001,96402,,Chemo hormon antineopl sq/im,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,3310001,96402,,Chemo hormon antineopl sq/im,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,3350000,96409,,Chemo iv push sngl drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,410,% of charge rate,95.00%,389.5,,,,389.5,410,0
unity,CDM,CHEMO ADMINISTRATION,3350000,96409,,Chemo iv push sngl drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,410,% of charge rate,95.00%,389.5,,,,389.5,410,0
unity,CDM,CHEMO ADMINISTRATION,3350001,96411,,Chemo iv push addl drug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,225,% of charge rate,95.00%,213.75,,,,213.75,225,0
unity,CDM,CHEMO ADMINISTRATION,3350001,96411,,Chemo iv push addl drug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,225,% of charge rate,95.00%,213.75,,,,213.75,225,0
unity,CDM,CHEMO ADMINISTRATION,3350002,96413,,Chemo iv infusion 1 hr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,650,% of charge rate,95.00%,617.5,,,,617.5,650,0
unity,CDM,CHEMO ADMINISTRATION,3350002,96413,,Chemo iv infusion 1 hr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,650,% of charge rate,95.00%,617.5,,,,617.5,650,0
unity,CDM,CHEMO ADMINISTRATION,3350003,96415,,Chemo iv infusion addl hr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.44,% of charge rate,95.00%,107.77,,,,107.77,113.44,0
unity,CDM,CHEMO ADMINISTRATION,3350003,96415,,Chemo iv infusion addl hr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.44,% of charge rate,95.00%,107.77,,,,107.77,113.44,0
unity,CDM,Hc Chemo Prolong Infuse W/pump,9400014,96416,,Chemo prolong infuse w/pump,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,630,% of charge rate,95.00%,598.5,,,,598.5,630,0
unity,CDM,Hc Chemo Prolong Infuse W/pump,9400014,96416,,Chemo prolong infuse w/pump,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,630,% of charge rate,95.00%,598.5,,,,598.5,630,0
unity,CDM,CHEMO ADMINISTRATION,9400015,96417,,Chemo iv infus each addl seq,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,9400015,96417,,Chemo iv infus each addl seq,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,PORT FLUSH,9400017,96523,,Irrig drug delivery device,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.84,% of charge rate,95.00%,159.45,,,,159.45,167.84,0
unity,CDM,PORT FLUSH,9400017,96523,,Irrig drug delivery device,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.84,% of charge rate,95.00%,159.45,,,,159.45,167.84,0
unity,CDM,Hc Hot Or Cold Packs,4200003,97010,,Hot or cold packs therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.27,% of charge rate,95.00%,34.46,,,,34.46,36.27,0
unity,CDM,Hc Hot Or Cold Packs,4200003,97010,,Hot or cold packs therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.27,% of charge rate,95.00%,34.46,,,,34.46,36.27,0
unity,CDM,TRACTION,4200004,97012,,Mechanical traction therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.48,% of charge rate,95.00%,46.06,,,,46.06,48.48,0
unity,CDM,TRACTION,4200004,97012,,Mechanical traction therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.48,% of charge rate,95.00%,46.06,,,,46.06,48.48,0
unity,CDM,UNATTEND E-STIM,4200005,97014,,Electric stimulation therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.48,% of charge rate,95.00%,46.06,,,,46.06,48.48,0
unity,CDM,UNATTEND E-STIM,4200005,97014,,Electric stimulation therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.48,% of charge rate,95.00%,46.06,,,,46.06,48.48,0
unity,CDM,VASOPNEUMATIC DEVICE,4300001,97016,,Vasopneumatic device therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.47,% of charge rate,95.00%,41.3,,,,41.3,43.47,0
unity,CDM,VASOPNEUMATIC DEVICE,4300001,97016,,Vasopneumatic device therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.47,% of charge rate,95.00%,41.3,,,,41.3,43.47,0
unity,CDM,PARAFFIN BATH,4300002,97018,,Paraffin bath therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.82,% of charge rate,95.00%,22.63,,,,22.63,23.82,0
unity,CDM,PARAFFIN BATH,4300002,97018,,Paraffin bath therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.82,% of charge rate,95.00%,22.63,,,,22.63,23.82,0
unity,CDM,WHIRLPOOL,4300003,97022,,Whirlpool therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.05,% of charge rate,95.00%,48.5,,,,48.5,51.05,0
unity,CDM,WHIRLPOOL,4300003,97022,,Whirlpool therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.05,% of charge rate,95.00%,48.5,,,,48.5,51.05,0
unity,CDM,IONTOPHORESIS 15 MIN,4300006,97033,,Electric current therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.6,% of charge rate,95.00%,67.07,,,,67.07,70.6,0
unity,CDM,IONTOPHORESIS 15 MIN,4300006,97033,,Electric current therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.6,% of charge rate,95.00%,67.07,,,,67.07,70.6,0
unity,CDM,CONTRAST BATH 15 MIN,4300007,97034,,Contrast bath therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.84,% of charge rate,95.00%,38.8,,,,38.8,40.84,0
unity,CDM,CONTRAST BATH 15 MIN,4300007,97034,,Contrast bath therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.84,% of charge rate,95.00%,38.8,,,,38.8,40.84,0
unity,CDM,ULTRASOUND 15 MIN,4300008,97035,,Ultrasound therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.02,% of charge rate,95.00%,42.77,,,,42.77,45.02,0
unity,CDM,ULTRASOUND 15 MIN,4300008,97035,,Ultrasound therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.02,% of charge rate,95.00%,42.77,,,,42.77,45.02,0
unity,CDM,THERAP EXERCISE 15MIN,4300010,97110,,Therapeutic exercises,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.43,% of charge rate,95.00%,95.41,,,,95.41,100.43,0
unity,CDM,THERAP EXERCISE 15MIN,4300010,97110,,Therapeutic exercises,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,100.43,% of charge rate,95.00%,95.41,,,,95.41,100.43,0
unity,CDM,NEUROMUSC RE-ED 15MIN,4300011,97112,,Neuromuscular reeducation,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.29,% of charge rate,95.00%,108.58,,,,108.58,114.29,0
unity,CDM,NEUROMUSC RE-ED 15MIN,4300011,97112,,Neuromuscular reeducation,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,114.29,% of charge rate,95.00%,108.58,,,,108.58,114.29,0
unity,CDM,Hc Aquatic Therapy W Exercise,4200008,97113,,Aquatic therapy/exercises,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.97,% of charge rate,95.00%,92.12,,,,92.12,96.97,0
unity,CDM,Hc Aquatic Therapy W Exercise,4200008,97113,,Aquatic therapy/exercises,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,96.97,% of charge rate,95.00%,92.12,,,,92.12,96.97,0
unity,CDM,GAIT TRAINING,4200009,97116,,Gait training therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.28,% of charge rate,95.00%,94.32,,,,94.32,99.28,0
unity,CDM,GAIT TRAINING,4200009,97116,,Gait training therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,99.28,% of charge rate,95.00%,94.32,,,,94.32,99.28,0
unity,CDM,MASSAGE,4200010,97124,,Massage therapy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.41,% of charge rate,95.00%,57.39,,,,57.39,60.41,0
unity,CDM,MASSAGE,4200010,97124,,Massage therapy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.41,% of charge rate,95.00%,57.39,,,,57.39,60.41,0
unity,CDM,MANUAL THERAPY 15MIN,4300013,97140,,Manual therapy 1/> regions,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.2,% of charge rate,95.00%,86.64,,,,86.64,91.2,0
unity,CDM,MANUAL THERAPY 15MIN,4300013,97140,,Manual therapy 1/> regions,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.2,% of charge rate,95.00%,86.64,,,,86.64,91.2,0
unity,CDM,HC PT EVAL,4240010,97161,,Pt eval low complex 20 min,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,277,% of charge rate,95.00%,263.15,,,,263.15,277,0
unity,CDM,HC PT EVAL,4240010,97161,,Pt eval low complex 20 min,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,277,% of charge rate,95.00%,263.15,,,,263.15,277,0
unity,CDM,HC PT EVAL,4240011,97162,,Pt eval mod complex 30 min,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,297,% of charge rate,95.00%,282.15,,,,282.15,297,0
unity,CDM,HC PT EVAL,4240011,97162,,Pt eval mod complex 30 min,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,297,% of charge rate,95.00%,282.15,,,,282.15,297,0
unity,CDM,HC PT EVAL,4240012,97163,,Pt eval high complex 45 min,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,317,% of charge rate,95.00%,301.15,,,,301.15,317,0
unity,CDM,HC PT EVAL,4240012,97163,,Pt eval high complex 45 min,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,317,% of charge rate,95.00%,301.15,,,,301.15,317,0
unity,CDM,Hc Pt Re-eval Est Plan Of Care,4240014,97164,,Pt re-eval est plan care,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,188.17,% of charge rate,95.00%,178.76,,,,178.76,188.17,0
unity,CDM,Hc Pt Re-eval Est Plan Of Care,4240014,97164,,Pt re-eval est plan care,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,188.17,% of charge rate,95.00%,178.76,,,,178.76,188.17,0
unity,CDM,HC OT EVAL,4340010,97165,,Ot eval low complex 30 min,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,297,% of charge rate,95.00%,282.15,,,,282.15,297,0
unity,CDM,HC OT EVAL,4340010,97165,,Ot eval low complex 30 min,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,297,% of charge rate,95.00%,282.15,,,,282.15,297,0
unity,CDM,HC OT EVAL,4340011,97166,,Ot eval mod complex 45 min,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,317,% of charge rate,95.00%,301.15,,,,301.15,317,0
unity,CDM,HC OT EVAL,4340011,97166,,Ot eval mod complex 45 min,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,317,% of charge rate,95.00%,301.15,,,,301.15,317,0
unity,CDM,HC OT EVAL,4340012,97167,,Ot eval high complex 60 min,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,215,% of charge rate,95.00%,204.25,,,,204.25,215,0
unity,CDM,HC OT EVAL,4340012,97167,,Ot eval high complex 60 min,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,215,% of charge rate,95.00%,204.25,,,,204.25,215,0
unity,CDM,Hc Ot Re-eval Est Plan Of Care,4340014,97168,,Ot re-eval est plan care,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,145,% of charge rate,95.00%,137.75,,,,137.75,145,0
unity,CDM,Hc Ot Re-eval Est Plan Of Care,4340014,97168,,Ot re-eval est plan care,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,145,% of charge rate,95.00%,137.75,,,,137.75,145,0
unity,CDM,THERAPY ACTIVITY 15MIN,4300015,97530,,Therapeutic activities,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130.45,% of charge rate,95.00%,123.93,,,,123.93,130.45,0
unity,CDM,THERAPY ACTIVITY 15MIN,4300015,97530,,Therapeutic activities,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130.45,% of charge rate,95.00%,123.93,,,,123.93,130.45,0
unity,CDM,Hc S I Techniques 15 Min,4300017,97533,,Sensory integration,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.67,% of charge rate,95.00%,49.09,,,,49.09,51.67,0
unity,CDM,Hc S I Techniques 15 Min,4300017,97533,,Sensory integration,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.67,% of charge rate,95.00%,49.09,,,,49.09,51.67,0
unity,CDM,SELF-CARE/HM MGMT TX 15MIN,4300018,97535,,Self care mngment training,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.98,% of charge rate,95.00%,106.38,,,,106.38,111.98,0
unity,CDM,SELF-CARE/HM MGMT TX 15MIN,4300018,97535,,Self care mngment training,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.98,% of charge rate,95.00%,106.38,,,,106.38,111.98,0
unity,CDM,COM/WORK RE-INTEGRA 15 MIN,4300019,97537,,Community/work reintegration,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.6,% of charge rate,95.00%,67.07,,,,67.07,70.6,0
unity,CDM,COM/WORK RE-INTEGRA 15 MIN,4300019,97537,,Community/work reintegration,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.6,% of charge rate,95.00%,67.07,,,,67.07,70.6,0
unity,CDM,WHEELCHAIR MGMT/PROP 15 MIN,4300020,97542,,Wheelchair mngment training,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.45,% of charge rate,95.00%,67.88,,,,67.88,71.45,0
unity,CDM,WHEELCHAIR MGMT/PROP 15 MIN,4300020,97542,,Wheelchair mngment training,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.45,% of charge rate,95.00%,67.88,,,,67.88,71.45,0
unity,CDM,DEBRIDEMENT,4300023,97597,,Rmvl devital tis 20 cm/<,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,180.34,% of charge rate,95.00%,171.32,,,,171.32,180.34,0
unity,CDM,DEBRIDEMENT,4300023,97597,,Rmvl devital tis 20 cm/<,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,180.34,% of charge rate,95.00%,171.32,,,,171.32,180.34,0
unity,CDM,Hc Select Debride > 20 Sq Cent,4300024,97598,,Rmvl devital tis addl 20cm/<,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,186.8,% of charge rate,95.00%,177.46,,,,177.46,186.8,0
unity,CDM,Hc Select Debride > 20 Sq Cent,4300024,97598,,Rmvl devital tis addl 20cm/<,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,186.8,% of charge rate,95.00%,177.46,,,,177.46,186.8,0
unity,CDM,DEBRIDEMENT,4300025,97602,,Wound(s) care non-selective,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,312.65,% of charge rate,95.00%,297.02,,,,297.02,312.65,0
unity,CDM,DEBRIDEMENT,4300025,97602,,Wound(s) care non-selective,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,312.65,% of charge rate,95.00%,297.02,,,,297.02,312.65,0
unity,CDM,ORTHO MGT/TRAINING INITIAL,4200012,97760,,Orthotic mgmt&traing 1st enc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.46,% of charge rate,95.00%,84.04,,,,84.04,88.46,0
unity,CDM,ORTHO MGT/TRAINING INITIAL,4200012,97760,,Orthotic mgmt&traing 1st enc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.46,% of charge rate,95.00%,84.04,,,,84.04,88.46,0
unity,CDM,PROSTHETIC TRAINING 15 MIN,4200013,97761,,Prosthetic traing 1st enc,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,77.42,% of charge rate,95.00%,73.55,,,,73.55,77.42,0
unity,CDM,PROSTHETIC TRAINING 15 MIN,4200013,97761,,Prosthetic traing 1st enc,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,77.42,% of charge rate,95.00%,73.55,,,,73.55,77.42,0
unity,CDM,Hc Unlisted Service/procedure,4300026,97799,,Physical medicine procedure,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.96,% of charge rate,95.00%,69.31,,,,69.31,72.96,0
unity,CDM,Hc Unlisted Service/procedure,4300026,97799,,Physical medicine procedure,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.96,% of charge rate,95.00%,69.31,,,,69.31,72.96,0
unity,CDM,Um Mnt-15 Minutes,UM4370004,97802,,Medical nutrition indiv in,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83,% of charge rate,95.00%,78.85,,,,78.85,83,0
unity,CDM,Um Mnt-15 Minutes,UM4370004,97802,,Medical nutrition indiv in,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83,% of charge rate,95.00%,78.85,,,,78.85,83,0
unity,CDM,Um Mnt-re-assessment/15 Min,UM4370005,97803,,Med nutrition indiv subseq,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71,% of charge rate,95.00%,67.45,,,,67.45,71,0
unity,CDM,Um Mnt-re-assessment/15 Min,UM4370005,97803,,Med nutrition indiv subseq,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71,% of charge rate,95.00%,67.45,,,,67.45,71,0
unity,CDM,Um Mnt-group (2 Or More),UM4370003,97804,,Medical nutrition group,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40,% of charge rate,95.00%,38,,,,38,40,0
unity,CDM,Um Mnt-group (2 Or More),UM4370003,97804,,Medical nutrition group,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40,% of charge rate,95.00%,38,,,,38,40,0
unity,CDM,Um Specimen Collection/processing,UM4000178,99000,,Specimen handling office-lab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Specimen Collection/processing,UM4000178,99000,,Specimen handling office-lab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Specimen Handling,UM4000280,99000,,Specimen handling office-lab,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.54,% of charge rate,95.00%,20.46,,,,20.46,21.54,0
unity,CDM,Um Specimen Handling,UM4000280,99000,,Specimen handling office-lab,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.54,% of charge rate,95.00%,20.46,,,,20.46,21.54,0
unity,CDM,Um Drain Tube Attachment,UM3500001,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.38,% of charge rate,95.00%,55.46,,,,55.46,58.38,0
unity,CDM,Um Drain Tube Attachment,UM3500001,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.38,% of charge rate,95.00%,55.46,,,,55.46,58.38,0
unity,CDM,Um Dee Lee Suction Bac/shiel,UM3500007,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.28,% of charge rate,95.00%,26.87,,,,26.87,28.28,0
unity,CDM,Um Dee Lee Suction Bac/shiel,UM3500007,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.28,% of charge rate,95.00%,26.87,,,,26.87,28.28,0
unity,CDM,Um Adaptic,UM3500008,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.82,% of charge rate,95.00%,3.63,,,,3.63,3.82,0
unity,CDM,Um Adaptic,UM3500008,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.82,% of charge rate,95.00%,3.63,,,,3.63,3.82,0
unity,CDM,Um Bandage Esmark,UM3500015,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.43,% of charge rate,95.00%,51.71,,,,51.71,54.43,0
unity,CDM,Um Bandage Esmark,UM3500015,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.43,% of charge rate,95.00%,51.71,,,,51.71,54.43,0
unity,CDM,Um Wall Suction Cannister,UM3500016,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.1,% of charge rate,95.00%,6.75,,,,6.75,7.1,0
unity,CDM,Um Wall Suction Cannister,UM3500016,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.1,% of charge rate,95.00%,6.75,,,,6.75,7.1,0
unity,CDM,Um Skin Staples 35,UM3500022,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.87,% of charge rate,95.00%,34.08,,,,34.08,35.87,0
unity,CDM,Um Skin Staples 35,UM3500022,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.87,% of charge rate,95.00%,34.08,,,,34.08,35.87,0
unity,CDM,Um Xeroform Drsing Universal,UM3500028,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.23,% of charge rate,95.00%,13.52,,,,13.52,14.23,0
unity,CDM,Um Xeroform Drsing Universal,UM3500028,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.23,% of charge rate,95.00%,13.52,,,,13.52,14.23,0
unity,CDM,Um Telfa Pads Universal,UM3500032,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.82,% of charge rate,95.00%,3.63,,,,3.63,3.82,0
unity,CDM,Um Telfa Pads Universal,UM3500032,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.82,% of charge rate,95.00%,3.63,,,,3.63,3.82,0
unity,CDM,Um Binder Universal,UM3500035,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.1,% of charge rate,95.00%,62.8,,,,62.8,66.1,0
unity,CDM,Um Binder Universal,UM3500035,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.1,% of charge rate,95.00%,62.8,,,,62.8,66.1,0
unity,CDM,Um Sponge Laparotomy,UM3500038,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.23,% of charge rate,95.00%,13.52,,,,13.52,14.23,0
unity,CDM,Um Sponge Laparotomy,UM3500038,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.23,% of charge rate,95.00%,13.52,,,,13.52,14.23,0
unity,CDM,Um Warming Blanket,UM3500039,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.63,% of charge rate,95.00%,111.75,,,,111.75,117.63,0
unity,CDM,Um Warming Blanket,UM3500039,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.63,% of charge rate,95.00%,111.75,,,,111.75,117.63,0
unity,CDM,Um Ster Distilled 1000 Cc,UM3500041,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.34,% of charge rate,95.00%,10.77,,,,10.77,11.34,0
unity,CDM,Um Ster Distilled 1000 Cc,UM3500041,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.34,% of charge rate,95.00%,10.77,,,,10.77,11.34,0
unity,CDM,Um Sterile Cautery Disposabl,UM3500044,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.41,% of charge rate,95.00%,32.69,,,,32.69,34.41,0
unity,CDM,Um Sterile Cautery Disposabl,UM3500044,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.41,% of charge rate,95.00%,32.69,,,,32.69,34.41,0
unity,CDM,Um Vaseline Gauze Universal,UM3500048,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8,% of charge rate,95.00%,7.6,,,,7.6,8,0
unity,CDM,Um Vaseline Gauze Universal,UM3500048,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8,% of charge rate,95.00%,7.6,,,,7.6,8,0
unity,CDM,Um Sponges Peanut 1/p,UM3500055,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.34,% of charge rate,95.00%,12.67,,,,12.67,13.34,0
unity,CDM,Um Sponges Peanut 1/p,UM3500055,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.34,% of charge rate,95.00%,12.67,,,,12.67,13.34,0
unity,CDM,Um Cath Kit/female,UM3500057,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.02,% of charge rate,95.00%,34.22,,,,34.22,36.02,0
unity,CDM,Um Cath Kit/female,UM3500057,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.02,% of charge rate,95.00%,34.22,,,,34.22,36.02,0
unity,CDM,Um Suction Handle Yank,UM3500061,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.55,% of charge rate,95.00%,23.32,,,,23.32,24.55,0
unity,CDM,Um Suction Handle Yank,UM3500061,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.55,% of charge rate,95.00%,23.32,,,,23.32,24.55,0
unity,CDM,Um Cath Foley Coude,UM3500067,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.95,% of charge rate,95.00%,68.35,,,,68.35,71.95,0
unity,CDM,Um Cath Foley Coude,UM3500067,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.95,% of charge rate,95.00%,68.35,,,,68.35,71.95,0
unity,CDM,Um Veni-prep Kit,UM3500070,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.82,% of charge rate,95.00%,19.78,,,,19.78,20.82,0
unity,CDM,Um Veni-prep Kit,UM3500070,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.82,% of charge rate,95.00%,19.78,,,,19.78,20.82,0
unity,CDM,Um Salem Sump Tube,UM3500075,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.21,% of charge rate,95.00%,14.45,,,,14.45,15.21,0
unity,CDM,Um Salem Sump Tube,UM3500075,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.21,% of charge rate,95.00%,14.45,,,,14.45,15.21,0
unity,CDM,Um Neb H2o Collection Device,UM3500077,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.78,% of charge rate,95.00%,6.44,,,,6.44,6.78,0
unity,CDM,Um Neb H2o Collection Device,UM3500077,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.78,% of charge rate,95.00%,6.44,,,,6.44,6.78,0
unity,CDM,Um Cath Iv Universal,UM3500078,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.65,% of charge rate,95.00%,18.67,,,,18.67,19.65,0
unity,CDM,Um Cath Iv Universal,UM3500078,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.65,% of charge rate,95.00%,18.67,,,,18.67,19.65,0
unity,CDM,Um Syringe 2cc To 30cc,UM3500087,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.54,% of charge rate,95.00%,7.16,,,,7.16,7.54,0
unity,CDM,Um Syringe 2cc To 30cc,UM3500087,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.54,% of charge rate,95.00%,7.16,,,,7.16,7.54,0
unity,CDM,Um Thorancentesis Tray,UM3500091,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.63,% of charge rate,95.00%,84.2,,,,84.2,88.63,0
unity,CDM,Um Thorancentesis Tray,UM3500091,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.63,% of charge rate,95.00%,84.2,,,,84.2,88.63,0
unity,CDM,Um Veniloop Connector,UM3500092,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.3,% of charge rate,95.00%,15.49,,,,15.49,16.3,0
unity,CDM,Um Veniloop Connector,UM3500092,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.3,% of charge rate,95.00%,15.49,,,,15.49,16.3,0
unity,CDM,Um Gastrostomy Tube,UM3500096,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.17,% of charge rate,95.00%,155.01,,,,155.01,163.17,0
unity,CDM,Um Gastrostomy Tube,UM3500096,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,163.17,% of charge rate,95.00%,155.01,,,,155.01,163.17,0
unity,CDM,Um Bandage Elastic Universal,UM3500101,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.14,% of charge rate,95.00%,16.28,,,,16.28,17.14,0
unity,CDM,Um Bandage Elastic Universal,UM3500101,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.14,% of charge rate,95.00%,16.28,,,,16.28,17.14,0
unity,CDM,Um Ster 0.9% Sod Chl 500 Cc,UM3500106,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.25,% of charge rate,95.00%,7.84,,,,7.84,8.25,0
unity,CDM,Um Ster 0.9% Sod Chl 500 Cc,UM3500106,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.25,% of charge rate,95.00%,7.84,,,,7.84,8.25,0
unity,CDM,Um Heel & Elbow Protectors,UM3500111,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.52,% of charge rate,95.00%,29.94,,,,29.94,31.52,0
unity,CDM,Um Heel & Elbow Protectors,UM3500111,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.52,% of charge rate,95.00%,29.94,,,,29.94,31.52,0
unity,CDM,Um Suction Cath Kit,UM3500125,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.23,% of charge rate,95.00%,10.67,,,,10.67,11.23,0
unity,CDM,Um Suction Cath Kit,UM3500125,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.23,% of charge rate,95.00%,10.67,,,,10.67,11.23,0
unity,CDM,Um Suture Removal Kit,UM3500130,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.08,% of charge rate,95.00%,16.23,,,,16.23,17.08,0
unity,CDM,Um Suture Removal Kit,UM3500130,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.08,% of charge rate,95.00%,16.23,,,,16.23,17.08,0
unity,CDM,Um Penrose Drains,UM3500133,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.54,% of charge rate,95.00%,7.16,,,,7.16,7.54,0
unity,CDM,Um Penrose Drains,UM3500133,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.54,% of charge rate,95.00%,7.16,,,,7.16,7.54,0
unity,CDM,Um Sponge Gauze Universal,UM3500136,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.44,% of charge rate,95.00%,8.02,,,,8.02,8.44,0
unity,CDM,Um Sponge Gauze Universal,UM3500136,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.44,% of charge rate,95.00%,8.02,,,,8.02,8.44,0
unity,CDM,Um Pediatric U Bag,UM3500137,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.54,% of charge rate,95.00%,7.16,,,,7.16,7.54,0
unity,CDM,Um Pediatric U Bag,UM3500137,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.54,% of charge rate,95.00%,7.16,,,,7.16,7.54,0
unity,CDM,Um Saline Lock,UM3500139,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.32,% of charge rate,95.00%,96.25,,,,96.25,101.32,0
unity,CDM,Um Saline Lock,UM3500139,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.32,% of charge rate,95.00%,96.25,,,,96.25,101.32,0
unity,CDM,"Um Packing Strip, Plain 5 Yd",UM3500141,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.92,% of charge rate,95.00%,36.97,,,,36.97,38.92,0
unity,CDM,"Um Packing Strip, Plain 5 Yd",UM3500141,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.92,% of charge rate,95.00%,36.97,,,,36.97,38.92,0
unity,CDM,Um Surgical Poole Suction,UM3500142,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.15,% of charge rate,95.00%,28.64,,,,28.64,30.15,0
unity,CDM,Um Surgical Poole Suction,UM3500142,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.15,% of charge rate,95.00%,28.64,,,,28.64,30.15,0
unity,CDM,Um Catheterization Supp,UM3500148,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.86,% of charge rate,95.00%,111.02,,,,111.02,116.86,0
unity,CDM,Um Catheterization Supp,UM3500148,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.86,% of charge rate,95.00%,111.02,,,,111.02,116.86,0
unity,CDM,Um Cont Epidur Tray,UM3500153,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,149.96,% of charge rate,95.00%,142.46,,,,142.46,149.96,0
unity,CDM,Um Cont Epidur Tray,UM3500153,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,149.96,% of charge rate,95.00%,142.46,,,,142.46,149.96,0
unity,CDM,Um Cervical Collar-stiffneck,UM3500169,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.59,% of charge rate,95.00%,68.01,,,,68.01,71.59,0
unity,CDM,Um Cervical Collar-stiffneck,UM3500169,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.59,% of charge rate,95.00%,68.01,,,,68.01,71.59,0
unity,CDM,Um Nasal Packing-balloon,UM3500171,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,149,% of charge rate,95.00%,141.55,,,,141.55,149,0
unity,CDM,Um Nasal Packing-balloon,UM3500171,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,149,% of charge rate,95.00%,141.55,,,,141.55,149,0
unity,CDM,Um Mouthpiece,UM3500172,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.45,% of charge rate,95.00%,5.18,,,,5.18,5.45,0
unity,CDM,Um Mouthpiece,UM3500172,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.45,% of charge rate,95.00%,5.18,,,,5.18,5.45,0
unity,CDM,Um Bed Check Sensormat,UM3500183,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,157.89,% of charge rate,95.00%,150,,,,150,157.89,0
unity,CDM,Um Bed Check Sensormat,UM3500183,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,157.89,% of charge rate,95.00%,150,,,,150,157.89,0
unity,CDM,Um Suc Cath 14 Fr Argyl,UM3500186,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18.94,% of charge rate,95.00%,17.99,,,,17.99,18.94,0
unity,CDM,Um Suc Cath 14 Fr Argyl,UM3500186,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18.94,% of charge rate,95.00%,17.99,,,,17.99,18.94,0
unity,CDM,Um Connect Tube Plas 6',UM3500192,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.34,% of charge rate,95.00%,12.67,,,,12.67,13.34,0
unity,CDM,Um Connect Tube Plas 6',UM3500192,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.34,% of charge rate,95.00%,12.67,,,,12.67,13.34,0
unity,CDM,Um Kling Bandage 2,UM3500194,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.82,% of charge rate,95.00%,3.63,,,,3.63,3.82,0
unity,CDM,Um Kling Bandage 2,UM3500194,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.82,% of charge rate,95.00%,3.63,,,,3.63,3.82,0
unity,CDM,Um Abd Dressing 8 X 10,UM3500201,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.88,% of charge rate,95.00%,9.39,,,,9.39,9.88,0
unity,CDM,Um Abd Dressing 8 X 10,UM3500201,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.88,% of charge rate,95.00%,9.39,,,,9.39,9.88,0
unity,CDM,Um Drain Sponge Universal,UM3500209,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.04,% of charge rate,95.00%,2.89,,,,2.89,3.04,0
unity,CDM,Um Drain Sponge Universal,UM3500209,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.04,% of charge rate,95.00%,2.89,,,,2.89,3.04,0
unity,CDM,Um Suture Misc.,UM3500217,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.15,% of charge rate,95.00%,28.64,,,,28.64,30.15,0
unity,CDM,Um Suture Misc.,UM3500217,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.15,% of charge rate,95.00%,28.64,,,,28.64,30.15,0
unity,CDM,Um Jackson-pratt Drain,UM3500223,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,124.45,% of charge rate,95.00%,118.23,,,,118.23,124.45,0
unity,CDM,Um Jackson-pratt Drain,UM3500223,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,124.45,% of charge rate,95.00%,118.23,,,,118.23,124.45,0
unity,CDM,Um Rususcitator Pulmanex,UM3500224,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,145.27,% of charge rate,95.00%,138.01,,,,138.01,145.27,0
unity,CDM,Um Rususcitator Pulmanex,UM3500224,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,145.27,% of charge rate,95.00%,138.01,,,,138.01,145.27,0
unity,CDM,Um Cholangiogram Catheter,UM3500230,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.09,% of charge rate,95.00%,66.59,,,,66.59,70.09,0
unity,CDM,Um Cholangiogram Catheter,UM3500230,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70.09,% of charge rate,95.00%,66.59,,,,66.59,70.09,0
unity,CDM,Um Suture Regular,UM3500232,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.14,% of charge rate,95.00%,16.28,,,,16.28,17.14,0
unity,CDM,Um Suture Regular,UM3500232,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.14,% of charge rate,95.00%,16.28,,,,16.28,17.14,0
unity,CDM,Um Stap Extrac Disp,UM3500237,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.82,% of charge rate,95.00%,19.78,,,,19.78,20.82,0
unity,CDM,Um Stap Extrac Disp,UM3500237,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.82,% of charge rate,95.00%,19.78,,,,19.78,20.82,0
unity,CDM,Um Glidescope Disp Laryngoscope,UM3500338,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,240,% of charge rate,95.00%,228,,,,228,240,0
unity,CDM,Um Glidescope Disp Laryngoscope,UM3500338,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,240,% of charge rate,95.00%,228,,,,228,240,0
unity,CDM,Um Peg Tube,UM3500339,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,264.55,% of charge rate,95.00%,251.32,,,,251.32,264.55,0
unity,CDM,Um Peg Tube,UM3500339,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,264.55,% of charge rate,95.00%,251.32,,,,251.32,264.55,0
unity,CDM,Um Pall Blood Filter,UM3600014,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,244.26,% of charge rate,95.00%,232.05,,,,232.05,244.26,0
unity,CDM,Um Pall Blood Filter,UM3600014,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,244.26,% of charge rate,95.00%,232.05,,,,232.05,244.26,0
unity,CDM,HC PHLEBOTOMY,9400021,99195,,Phlebotomy,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,224.59,% of charge rate,95.00%,213.36,,,,213.36,224.59,0
unity,CDM,HC PHLEBOTOMY,9400021,99195,,Phlebotomy,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,224.59,% of charge rate,95.00%,213.36,,,,213.36,224.59,0
unity,CDM,Um Scheduled Dressing Change,UM3700014,99211,,Office/outpatient visit est,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.23,% of charge rate,95.00%,52.47,,,,52.47,55.23,0
unity,CDM,Um Scheduled Dressing Change,UM3700014,99211,,Office/outpatient visit est,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.23,% of charge rate,95.00%,52.47,,,,52.47,55.23,0
unity,CDM,Um Professional Service,UM3700038,99211,,Office/outpatient visit est,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.27,% of charge rate,95.00%,39.21,,,,39.21,41.27,0
unity,CDM,Um Professional Service,UM3700038,99211,,Office/outpatient visit est,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.27,% of charge rate,95.00%,39.21,,,,39.21,41.27,0
unity,CDM,Um Rn Services,UM3800048,99211,,Office/outpatient visit est,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41,% of charge rate,95.00%,38.95,,,,38.95,41,0
unity,CDM,Um Rn Services,UM3800048,99211,,Office/outpatient visit est,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41,% of charge rate,95.00%,38.95,,,,38.95,41,0
unity,CDM,ED LEVEL I,4500096,99281,,Emergency dept visit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140,% of charge rate,95.00%,133,,,,133,140,0
unity,CDM,ED LEVEL I,4500096,99281,,Emergency dept visit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140,% of charge rate,95.00%,133,,,,133,140,0
unity,CDM,ED LEVEL II,4500097,99282,,Emergency dept visit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,250,% of charge rate,95.00%,237.5,,,,237.5,250,0
unity,CDM,ED LEVEL II,4500097,99282,,Emergency dept visit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,250,% of charge rate,95.00%,237.5,,,,237.5,250,0
unity,CDM,ED LEVEL III,4500098,99283,,Emergency dept visit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,440,% of charge rate,95.00%,418,,,,418,440,0
unity,CDM,ED LEVEL III,4500098,99283,,Emergency dept visit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,440,% of charge rate,95.00%,418,,,,418,440,0
unity,CDM,ED LEVEL IV,4500099,99284,,Emergency dept visit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,710,% of charge rate,95.00%,674.5,,,,674.5,710,0
unity,CDM,ED LEVEL IV,4500099,99284,,Emergency dept visit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,710,% of charge rate,95.00%,674.5,,,,674.5,710,0
unity,CDM,ED LEVEL V,4500100,99285,,Emergency dept visit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,040.00",% of charge rate,95.00%,988,,,,988,"1,040.00",0
unity,CDM,ED LEVEL V,4500100,99285,,Emergency dept visit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,040.00",% of charge rate,95.00%,988,,,,988,"1,040.00",0
unity,CDM,CRITICAL CARE 1ST HOUR,4500101,99291,,Critical care first hour,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,900.00",% of charge rate,95.00%,"1,805.00",,,,"1,805.00","1,900.00",0
unity,CDM,CRITICAL CARE 1ST HOUR,4500101,99291,,Critical care first hour,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,900.00",% of charge rate,95.00%,"1,805.00",,,,"1,805.00","1,900.00",0
unity,CDM,HC BEHAV CHNG SMOKING 3-10 MIN,9420000,99406,,Behav chng smoking 3-10 min,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.55,% of charge rate,95.00%,50.87,,,,50.87,53.55,0
unity,CDM,HC BEHAV CHNG SMOKING 3-10 MIN,9420000,99406,,Behav chng smoking 3-10 min,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.55,% of charge rate,95.00%,50.87,,,,50.87,53.55,0
unity,CDM,HC BEHAV CHNG SMOKING > 10 MIN,9420001,99407,,Behav chng smoking > 10 min,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.14,% of charge rate,95.00%,96.08,,,,96.08,101.14,0
unity,CDM,HC BEHAV CHNG SMOKING > 10 MIN,9420001,99407,,Behav chng smoking > 10 min,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.14,% of charge rate,95.00%,96.08,,,,96.08,101.14,0
unity,CDM,Um Needle-huber (winged Core,UM3500168,A4212,,Non coring needle or stylet,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.55,% of charge rate,95.00%,23.32,,,,23.32,24.55,0
unity,CDM,Um Needle-huber (winged Core,UM3500168,A4212,,Non coring needle or stylet,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.55,% of charge rate,95.00%,23.32,,,,23.32,24.55,0
unity,CDM,Um Tray C Cath/drainage Bag,UM3500248,A4311,,Catheter w/o bag 2-way latex,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.11,% of charge rate,95.00%,25.75,,,,25.75,27.11,0
unity,CDM,Um Tray C Cath/drainage Bag,UM3500248,A4311,,Catheter w/o bag 2-way latex,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.11,% of charge rate,95.00%,25.75,,,,25.75,27.11,0
unity,CDM,Um Catheter Secure,UM3500097,A4333,,Urinary cath anchor device,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.14,% of charge rate,95.00%,16.28,,,,16.28,17.14,0
unity,CDM,Um Catheter Secure,UM3500097,A4333,,Urinary cath anchor device,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.14,% of charge rate,95.00%,16.28,,,,16.28,17.14,0
unity,CDM,Um Cath Foley Universal,UM3500135,A4338,,Indwelling catheter latex,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.83,% of charge rate,95.00%,32.14,,,,32.14,33.83,0
unity,CDM,Um Cath Foley Universal,UM3500135,A4338,,Indwelling catheter latex,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.83,% of charge rate,95.00%,32.14,,,,32.14,33.83,0
unity,CDM,Um Cath Tray W/o Cath,UM3500219,A4353,,Intermittent urinary cath,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.44,% of charge rate,95.00%,71.67,,,,71.67,75.44,0
unity,CDM,Um Cath Tray W/o Cath,UM3500219,A4353,,Intermittent urinary cath,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.44,% of charge rate,95.00%,71.67,,,,71.67,75.44,0
unity,CDM,Um Drainbag W/urine Met,UM3500140,A4357,,Bedside drainage bag,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.06,% of charge rate,95.00%,65.61,,,,65.61,69.06,0
unity,CDM,Um Drainbag W/urine Met,UM3500140,A4357,,Bedside drainage bag,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.06,% of charge rate,95.00%,65.61,,,,65.61,69.06,0
unity,CDM,Um Closed Drain Bag,UM3500086,A4358,,Urinary leg or abdomen bag,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.64,% of charge rate,95.00%,39.56,,,,39.56,41.64,0
unity,CDM,Um Closed Drain Bag,UM3500086,A4358,,Urinary leg or abdomen bag,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.64,% of charge rate,95.00%,39.56,,,,39.56,41.64,0
unity,CDM,Um Drain Leg Bag All Sizes,UM3500215,A4358,,Urinary leg or abdomen bag,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.67,% of charge rate,95.00%,21.54,,,,21.54,22.67,0
unity,CDM,Um Drain Leg Bag All Sizes,UM3500215,A4358,,Urinary leg or abdomen bag,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.67,% of charge rate,95.00%,21.54,,,,21.54,22.67,0
unity,CDM,Um Pf. Tape/roll,UM4310004,A4454,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18.36,% of charge rate,95.00%,17.44,,,,17.44,18.36,0
unity,CDM,Um Pf. Tape/roll,UM4310004,A4454,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18.36,% of charge rate,95.00%,17.44,,,,17.44,18.36,0
unity,CDM,Um Dermofit Elas Support/ft,UM4310024,A4460,,"BANDAGE, ELAS ECON 3IN",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.97,% of charge rate,95.00%,2.82,,,,2.82,2.97,0
unity,CDM,Um Dermofit Elas Support/ft,UM4310024,A4460,,"BANDAGE, ELAS ECON 3IN",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.97,% of charge rate,95.00%,2.82,,,,2.82,2.97,0
unity,CDM,Um Montgomery Straps,UM3500034,A4462,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.34,% of charge rate,95.00%,8.87,,,,8.87,9.34,0
unity,CDM,Um Montgomery Straps,UM3500034,A4462,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.34,% of charge rate,95.00%,8.87,,,,8.87,9.34,0
unity,CDM,"Um Ko, Patella Strap",UM4310030,A4466,,KNEE SUPPORT LG PATELLAR,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.96,% of charge rate,95.00%,48.41,,,,48.41,50.96,0
unity,CDM,"Um Ko, Patella Strap",UM4310030,A4466,,KNEE SUPPORT LG PATELLAR,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.96,% of charge rate,95.00%,48.41,,,,48.41,50.96,0
unity,CDM,Um Rib Belt,UM3500080,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.67,% of charge rate,95.00%,52.89,,,,52.89,55.67,0
unity,CDM,Um Rib Belt,UM3500080,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.67,% of charge rate,95.00%,52.89,,,,52.89,55.67,0
unity,CDM,Um Elbow Strap/tennis,UM3500173,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.22,% of charge rate,95.00%,34.41,,,,34.41,36.22,0
unity,CDM,Um Elbow Strap/tennis,UM3500173,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.22,% of charge rate,95.00%,34.41,,,,34.41,36.22,0
unity,CDM,Um Knee Brace Elastic,UM3500176,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15,% of charge rate,95.00%,14.25,,,,14.25,15,0
unity,CDM,Um Knee Brace Elastic,UM3500176,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15,% of charge rate,95.00%,14.25,,,,14.25,15,0
unity,CDM,"Um Ko, Sleeve",UM4310015,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.58,% of charge rate,95.00%,72.75,,,,72.75,76.58,0
unity,CDM,"Um Ko, Sleeve",UM4310015,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.58,% of charge rate,95.00%,72.75,,,,72.75,76.58,0
unity,CDM,"Um Ko, Elastic With Strap",UM4310016,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,92.6,% of charge rate,95.00%,87.97,,,,87.97,92.6,0
unity,CDM,"Um Ko, Elastic With Strap",UM4310016,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,92.6,% of charge rate,95.00%,87.97,,,,87.97,92.6,0
unity,CDM,Um Elbow Strap,UM4310025,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.89,% of charge rate,95.00%,26.5,,,,26.5,27.89,0
unity,CDM,Um Elbow Strap,UM4310025,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.89,% of charge rate,95.00%,26.5,,,,26.5,27.89,0
unity,CDM,Um Suture Set/small,UM3500088,A4550,,Surgical trays,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.14,% of charge rate,95.00%,83.73,,,,83.73,88.14,0
unity,CDM,Um Suture Set/small,UM3500088,A4550,,Surgical trays,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.14,% of charge rate,95.00%,83.73,,,,83.73,88.14,0
unity,CDM,Um Electrodes,UM4310020,A4556,,"Electrodes, pair",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.66,% of charge rate,95.00%,29.13,,,,29.13,30.66,0
unity,CDM,Um Electrodes,UM4310020,A4556,,"Electrodes, pair",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.66,% of charge rate,95.00%,29.13,,,,29.13,30.66,0
unity,CDM,Um Pessary;non-rubber;any Type,UM3500134,A4562,,"Pessary, non rubber,any type",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.57,% of charge rate,95.00%,89.84,,,,89.84,94.57,0
unity,CDM,Um Pessary;non-rubber;any Type,UM3500134,A4562,,"Pessary, non rubber,any type",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.57,% of charge rate,95.00%,89.84,,,,89.84,94.57,0
unity,CDM,Um Collar & Cuff Sling,UM3500043,A4565,,Slings,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.55,% of charge rate,95.00%,23.32,,,,23.32,24.55,0
unity,CDM,Um Collar & Cuff Sling,UM3500043,A4565,,Slings,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.55,% of charge rate,95.00%,23.32,,,,23.32,24.55,0
unity,CDM,Um Arm Sling Universal,UM3500081,A4565,,Slings,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.11,% of charge rate,95.00%,55.2,,,,55.2,58.11,0
unity,CDM,Um Arm Sling Universal,UM3500081,A4565,,Slings,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.11,% of charge rate,95.00%,55.2,,,,55.2,58.11,0
unity,CDM,Um Arm Sling Strap,UM3500143,A4565,,Slings,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.48,% of charge rate,95.00%,47.01,,,,47.01,49.48,0
unity,CDM,Um Arm Sling Strap,UM3500143,A4565,,Slings,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.48,% of charge rate,95.00%,47.01,,,,47.01,49.48,0
unity,CDM,Um Heated Wire Tubing,UM3470081,A4604,,Tubing with heating element,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.25,% of charge rate,95.00%,54.39,,,,54.39,57.25,0
unity,CDM,Um Heated Wire Tubing,UM3470081,A4604,,Tubing with heating element,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.25,% of charge rate,95.00%,54.39,,,,54.39,57.25,0
unity,CDM,Um Climate Line Tubing,UM3470086,A4604,,Tubing with heating element,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70,% of charge rate,95.00%,66.5,,,,66.5,70,0
unity,CDM,Um Climate Line Tubing,UM3470086,A4604,,Tubing with heating element,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,70,% of charge rate,95.00%,66.5,,,,66.5,70,0
unity,CDM,Um Peak Flow Rate Meter,UM3500127,A4614,,Hand-held pefr meter,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.74,% of charge rate,95.00%,39.65,,,,39.65,41.74,0
unity,CDM,Um Peak Flow Rate Meter,UM3500127,A4614,,Hand-held pefr meter,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.74,% of charge rate,95.00%,39.65,,,,39.65,41.74,0
unity,CDM,Um Nasal Cannula 3l-1616,UM3470040,A4615,,Cannula nasal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.46,% of charge rate,95.00%,3.29,,,,3.29,3.46,0
unity,CDM,Um Nasal Cannula 3l-1616,UM3470040,A4615,,Cannula nasal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.46,% of charge rate,95.00%,3.29,,,,3.29,3.46,0
unity,CDM,Um Nasal Cannula-1600,UM3470051,A4615,,Cannula nasal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3,% of charge rate,95.00%,2.85,,,,2.85,3,0
unity,CDM,Um Nasal Cannula-1600,UM3470051,A4615,,Cannula nasal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3,% of charge rate,95.00%,2.85,,,,2.85,3,0
unity,CDM,Um Nasal Cannula- 25 Ft,UM3470073,A4615,,Cannula nasal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4,% of charge rate,95.00%,3.8,,,,3.8,4,0
unity,CDM,Um Nasal Cannula- 25 Ft,UM3470073,A4615,,Cannula nasal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4,% of charge rate,95.00%,3.8,,,,3.8,4,0
unity,CDM,Um Nasal Canula 4 Ft,UM3470074,A4615,,Cannula nasal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,0
unity,CDM,Um Nasal Canula 4 Ft,UM3470074,A4615,,Cannula nasal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,0
unity,CDM,Um Nasal Cannula,UM3500155,A4615,,Cannula nasal,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.24,% of charge rate,95.00%,3.08,,,,3.08,3.24,0
unity,CDM,Um Nasal Cannula,UM3500155,A4615,,Cannula nasal,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.24,% of charge rate,95.00%,3.08,,,,3.08,3.24,0
unity,CDM,Um Connecting Tube 25 Ft.,UM3470055,A4616,,Tubing (oxygen) per foot,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.96,% of charge rate,95.00%,2.81,,,,2.81,2.96,0
unity,CDM,Um Connecting Tube 25 Ft.,UM3470055,A4616,,Tubing (oxygen) per foot,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.96,% of charge rate,95.00%,2.81,,,,2.81,2.96,0
unity,CDM,Um Oxygen Tubing - 7 Ft,UM3470076,A4616,,Tubing (oxygen) per foot,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3,% of charge rate,95.00%,2.85,,,,2.85,3,0
unity,CDM,Um Oxygen Tubing - 7 Ft,UM3470076,A4616,,Tubing (oxygen) per foot,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3,% of charge rate,95.00%,2.85,,,,2.85,3,0
unity,CDM,Um Connecting Tube Per Foot,UM3500147,A4616,,Tubing (oxygen) per foot,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,0.25,% of charge rate,95.00%,0.24,,,,0.24,0.25,0
unity,CDM,Um Connecting Tube Per Foot,UM3500147,A4616,,Tubing (oxygen) per foot,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,0.25,% of charge rate,95.00%,0.24,,,,0.24,0.25,0
unity,CDM,Um Spacer - Aero Chamber,UM3500040,A4627,,Spacer bag/reservoir,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.68,% of charge rate,95.00%,30.1,,,,30.1,31.68,0
unity,CDM,Um Spacer - Aero Chamber,UM3500040,A4627,,Spacer bag/reservoir,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.68,% of charge rate,95.00%,30.1,,,,30.1,31.68,0
unity,CDM,Um Suction Wand,UM3470026,A4628,,Oropharyngeal suction cath,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.5,% of charge rate,95.00%,6.18,,,,6.18,6.5,0
unity,CDM,Um Suction Wand,UM3470026,A4628,,Oropharyngeal suction cath,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.5,% of charge rate,95.00%,6.18,,,,6.18,6.5,0
unity,CDM,Um Replacem Tips/crutch/cane,UM4310013,A4637,,Repl tip cane/crutch/walker,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,0
unity,CDM,Um Replacem Tips/crutch/cane,UM4310013,A4637,,Repl tip cane/crutch/walker,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,0
unity,CDM,Um Profore Drsing Clinic Use,UM3500131,A4649,,Surgical supplies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Profore Drsing Clinic Use,UM3500131,A4649,,Surgical supplies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Profore Drsing - Hosp Use,UM3500185,A4649,,Surgical supplies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Profore Drsing - Hosp Use,UM3500185,A4649,,Surgical supplies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Ink Injector Single Use,UM3500334,A4649,,Surgical supplies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.27,% of charge rate,95.00%,47.76,,,,47.76,50.27,0
unity,CDM,Um Ink Injector Single Use,UM3500334,A4649,,Surgical supplies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.27,% of charge rate,95.00%,47.76,,,,47.76,50.27,0
unity,CDM,Um Snare Biopsy Forcep,UM3500335,A4649,,Surgical supplies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.27,% of charge rate,95.00%,15.46,,,,15.46,16.27,0
unity,CDM,Um Snare Biopsy Forcep,UM3500335,A4649,,Surgical supplies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.27,% of charge rate,95.00%,15.46,,,,15.46,16.27,0
unity,CDM,Um Dilator Balloon (esoph/colon),UM3500336,A4649,,Surgical supplies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,242.27,% of charge rate,95.00%,230.16,,,,230.16,242.27,0
unity,CDM,Um Dilator Balloon (esoph/colon),UM3500336,A4649,,Surgical supplies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,242.27,% of charge rate,95.00%,230.16,,,,230.16,242.27,0
unity,CDM,Um Dilator Syringe,UM3500337,A4649,,Surgical supplies,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235.21,% of charge rate,95.00%,223.45,,,,223.45,235.21,0
unity,CDM,Um Dilator Syringe,UM3500337,A4649,,Surgical supplies,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235.21,% of charge rate,95.00%,223.45,,,,223.45,235.21,0
unity,CDM,Um Dressing Melgisorb 4x4,UM3500290,A6196,,Alginate dressing <=16 sq in,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.68,% of charge rate,95.00%,3.5,,,,3.5,3.68,0
unity,CDM,Um Dressing Melgisorb 4x4,UM3500290,A6196,,Alginate dressing <=16 sq in,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.68,% of charge rate,95.00%,3.5,,,,3.5,3.68,0
unity,CDM,Um Aquacel Ag,UM3500309,A6197,,Alginate drsg >16 <=48 sq in,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.14,% of charge rate,95.00%,13.43,,,,13.43,14.14,0
unity,CDM,Um Aquacel Ag,UM3500309,A6197,,Alginate drsg >16 <=48 sq in,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.14,% of charge rate,95.00%,13.43,,,,13.43,14.14,0
unity,CDM,Um Tegaderm Drsg Universal,UM3500094,A6203,,Composite drsg <= 16 sq in,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.63,% of charge rate,95.00%,10.1,,,,10.1,10.63,0
unity,CDM,Um Tegaderm Drsg Universal,UM3500094,A6203,,Composite drsg <= 16 sq in,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.63,% of charge rate,95.00%,10.1,,,,10.1,10.63,0
unity,CDM,Um Antimicrobial Foam Dressing,UM3500289,A6209,,Foam drsg <=16 sq in w/o bdr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.75,% of charge rate,95.00%,13.06,,,,13.06,13.75,0
unity,CDM,Um Antimicrobial Foam Dressing,UM3500289,A6209,,Foam drsg <=16 sq in w/o bdr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.75,% of charge rate,95.00%,13.06,,,,13.06,13.75,0
unity,CDM,Um Aquacel Foam 6x6,UM3500310,A6210,,Foam drg >16<=48 sq in w/o b,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.44,% of charge rate,95.00%,14.67,,,,14.67,15.44,0
unity,CDM,Um Aquacel Foam 6x6,UM3500310,A6210,,Foam drg >16<=48 sq in w/o b,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.44,% of charge rate,95.00%,14.67,,,,14.67,15.44,0
unity,CDM,Um Meplix Unv Dressing,UM3500282,A6212,,Foam drg <=16 sq in w/border,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.91,% of charge rate,95.00%,28.41,,,,28.41,29.91,0
unity,CDM,Um Meplix Unv Dressing,UM3500282,A6212,,Foam drg <=16 sq in w/border,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.91,% of charge rate,95.00%,28.41,,,,28.41,29.91,0
unity,CDM,Um Biatain Heel Dressing,UM3500312,A6213,,Foam drg >16<=48 sq in w/bdr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.91,% of charge rate,95.00%,8.46,,,,8.46,8.91,0
unity,CDM,Um Biatain Heel Dressing,UM3500312,A6213,,Foam drg >16<=48 sq in w/bdr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.91,% of charge rate,95.00%,8.46,,,,8.46,8.91,0
unity,CDM,Um Adaptic Dressing Universa,UM3500218,A6223,,Gauze >16<=48 no w/sal w/o b,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.82,% of charge rate,95.00%,3.63,,,,3.63,3.82,0
unity,CDM,Um Adaptic Dressing Universa,UM3500218,A6223,,Gauze >16<=48 no w/sal w/o b,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.82,% of charge rate,95.00%,3.63,,,,3.63,3.82,0
unity,CDM,Um Duo Derm Dressing,UM3500071,A6237,,Hydrocolld drg <=16 in w/bdr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.28,% of charge rate,95.00%,26.87,,,,26.87,28.28,0
unity,CDM,Um Duo Derm Dressing,UM3500071,A6237,,Hydrocolld drg <=16 in w/bdr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.28,% of charge rate,95.00%,26.87,,,,26.87,28.28,0
unity,CDM,Um Elasto-gel Dressing 4 X 4,UM3500090,A6243,,Hydrogel drg >16<=48 w/o bdr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.97,% of charge rate,95.00%,37.02,,,,37.02,38.97,0
unity,CDM,Um Elasto-gel Dressing 4 X 4,UM3500090,A6243,,Hydrogel drg >16<=48 w/o bdr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.97,% of charge rate,95.00%,37.02,,,,37.02,38.97,0
unity,CDM,Um Abd Universal,UM3500076,A6252,,Absorpt drg >16 <=48 w/o bdr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.45,% of charge rate,95.00%,9.93,,,,9.93,10.45,0
unity,CDM,Um Abd Universal,UM3500076,A6252,,Absorpt drg >16 <=48 w/o bdr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.45,% of charge rate,95.00%,9.93,,,,9.93,10.45,0
unity,CDM,Um Dressing Sorbex,UM3500360,A6253,,Absorpt drg > 48 sq in w/o b,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,179.27,% of charge rate,95.00%,170.31,,,,170.31,179.27,0
unity,CDM,Um Dressing Sorbex,UM3500360,A6253,,Absorpt drg > 48 sq in w/o b,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,179.27,% of charge rate,95.00%,170.31,,,,170.31,179.27,0
unity,CDM,"Um Sponges, Excilon",UM3500054,A6402,,Sterile gauze <= 16 sq in,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.1,% of charge rate,95.00%,6.75,,,,6.75,7.1,0
unity,CDM,"Um Sponges, Excilon",UM3500054,A6402,,Sterile gauze <= 16 sq in,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.1,% of charge rate,95.00%,6.75,,,,6.75,7.1,0
unity,CDM,Um Kerlix Super Sponges,UM3500023,A6403,,Sterile gauze>16 <= 48 sq in,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.86,% of charge rate,95.00%,9.37,,,,9.37,9.86,0
unity,CDM,Um Kerlix Super Sponges,UM3500023,A6403,,Sterile gauze>16 <= 48 sq in,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.86,% of charge rate,95.00%,9.37,,,,9.37,9.86,0
unity,CDM,Um Kling Bandage 4,UM3500058,A6445,,Conform band s w <3IN/yd,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.45,% of charge rate,95.00%,4.23,,,,4.23,4.45,0
unity,CDM,Um Kling Bandage 4,UM3500058,A6445,,Conform band s w <3IN/yd,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.45,% of charge rate,95.00%,4.23,,,,4.23,4.45,0
unity,CDM,Um Kerlix Rolls 4 1/2,UM3500197,A6446,,Conform band s w>=3IN <5IN/yd,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.21,% of charge rate,95.00%,14.45,,,,14.45,15.21,0
unity,CDM,Um Kerlix Rolls 4 1/2,UM3500197,A6446,,Conform band s w>=3IN <5IN/yd,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.21,% of charge rate,95.00%,14.45,,,,14.45,15.21,0
unity,CDM,Um Jobst Fast Fit Stockings,UM4310007,A6532,,Compression stocking bk40-50,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130.19,% of charge rate,95.00%,123.68,,,,123.68,130.19,0
unity,CDM,Um Jobst Fast Fit Stockings,UM4310007,A6532,,Compression stocking bk40-50,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130.19,% of charge rate,95.00%,123.68,,,,123.68,130.19,0
unity,CDM,Um Disposable Suction Cont,UM3470072,A7000,,Disposable canister for pump,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.5,% of charge rate,95.00%,12.83,,,,12.83,13.5,0
unity,CDM,Um Disposable Suction Cont,UM3470072,A7000,,Disposable canister for pump,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.5,% of charge rate,95.00%,12.83,,,,12.83,13.5,0
unity,CDM,Um Suction Connect Tubing Lt,UM3470043,A7002,,Tubing used w suction pump,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.81,% of charge rate,95.00%,6.47,,,,6.47,6.81,0
unity,CDM,Um Suction Connect Tubing Lt,UM3470043,A7002,,Tubing used w suction pump,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.81,% of charge rate,95.00%,6.47,,,,6.47,6.81,0
unity,CDM,"Um Nebulizer, Disposable",UM3470066,A7003,,Nebulizer administration set,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.89,% of charge rate,95.00%,4.65,,,,4.65,4.89,0
unity,CDM,"Um Nebulizer, Disposable",UM3470066,A7003,,Nebulizer administration set,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.89,% of charge rate,95.00%,4.65,,,,4.65,4.89,0
unity,CDM,"Um Administ Set, Sm Vol Neb",UM3500146,A7004,,Disposable nebulizer sml vol,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.77,% of charge rate,95.00%,4.53,,,,4.53,4.77,0
unity,CDM,"Um Administ Set, Sm Vol Neb",UM3500146,A7004,,Disposable nebulizer sml vol,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.77,% of charge rate,95.00%,4.53,,,,4.53,4.77,0
unity,CDM,Um Disposable Neb Pre-fill,UM3500104,A7008,,Disposable nebulizer prefill,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.33,% of charge rate,95.00%,18.36,,,,18.36,19.33,0
unity,CDM,Um Disposable Neb Pre-fill,UM3500104,A7008,,Disposable nebulizer prefill,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.33,% of charge rate,95.00%,18.36,,,,18.36,19.33,0
unity,CDM,Um Aerosol Mask For Neb,UM3470009,A7015,,Aerosol mask used w nebulize,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.35,% of charge rate,95.00%,3.18,,,,3.18,3.35,0
unity,CDM,Um Aerosol Mask For Neb,UM3470009,A7015,,Aerosol mask used w nebulize,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.35,% of charge rate,95.00%,3.18,,,,3.18,3.35,0
unity,CDM,Um Replacement Cushion Combo,UM3470082,A7028,,Repl oral cushion combo mask,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.5,% of charge rate,95.00%,39.43,,,,39.43,41.5,0
unity,CDM,Um Replacement Cushion Combo,UM3470082,A7028,,Repl oral cushion combo mask,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.5,% of charge rate,95.00%,39.43,,,,39.43,41.5,0
unity,CDM,Um Replacement Pillow Combo,UM3470083,A7029,,Repl nasal pillow comb mask,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Replacement Pillow Combo,UM3470083,A7029,,Repl nasal pillow comb mask,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,0
unity,CDM,Um Full Face Application,UM3470068,A7030,,Cpap full face mask,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235,% of charge rate,95.00%,223.25,,,,223.25,235,0
unity,CDM,Um Full Face Application,UM3470068,A7030,,Cpap full face mask,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,235,% of charge rate,95.00%,223.25,,,,223.25,235,0
unity,CDM,Um Bipap Mask,UM3470322,A7030,,Cpap full face mask,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32,% of charge rate,95.00%,30.4,,,,30.4,32,0
unity,CDM,Um Bipap Mask,UM3470322,A7030,,Cpap full face mask,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32,% of charge rate,95.00%,30.4,,,,30.4,32,0
unity,CDM,Um Full Face Cushion,UM3470079,A7031,,Replacement facemask interfa,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69,% of charge rate,95.00%,65.55,,,,65.55,69,0
unity,CDM,Um Full Face Cushion,UM3470079,A7031,,Replacement facemask interfa,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69,% of charge rate,95.00%,65.55,,,,65.55,69,0
unity,CDM,Um Nasal Cushion,UM3470056,A7032,,Replacement nasal cushion,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50,% of charge rate,95.00%,47.5,,,,47.5,50,0
unity,CDM,Um Nasal Cushion,UM3470056,A7032,,Replacement nasal cushion,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50,% of charge rate,95.00%,47.5,,,,47.5,50,0
unity,CDM,Um Replacement Nasal Pillow,UM3470080,A7033,,Replacement nasal pillows,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.5,% of charge rate,95.00%,29.93,,,,29.93,31.5,0
unity,CDM,Um Replacement Nasal Pillow,UM3470080,A7033,,Replacement nasal pillows,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.5,% of charge rate,95.00%,29.93,,,,29.93,31.5,0
unity,CDM,Um Nasal Mask,UM3470017,A7034,,Nasal application device,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,147,% of charge rate,95.00%,139.65,,,,139.65,147,0
unity,CDM,Um Nasal Mask,UM3470017,A7034,,Nasal application device,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,147,% of charge rate,95.00%,139.65,,,,139.65,147,0
unity,CDM,Um Headgear,UM3470001,A7035,,Pos airway press headgear,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50,% of charge rate,95.00%,47.5,,,,47.5,50,0
unity,CDM,Um Headgear,UM3470001,A7035,,Pos airway press headgear,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50,% of charge rate,95.00%,47.5,,,,47.5,50,0
unity,CDM,Um Chin Strap,UM3470011,A7036,,Pos airway press chinstrap,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.84,% of charge rate,95.00%,30.25,,,,30.25,31.84,0
unity,CDM,Um Chin Strap,UM3470011,A7036,,Pos airway press chinstrap,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.84,% of charge rate,95.00%,30.25,,,,30.25,31.84,0
unity,CDM,Um Tubing/ 1 Month,UM3470005,A7037,,Pos airway pressure tubing,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,46.5,% of charge rate,95.00%,44.18,,,,44.18,46.5,0
unity,CDM,Um Tubing/ 1 Month,UM3470005,A7037,,Pos airway pressure tubing,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,46.5,% of charge rate,95.00%,44.18,,,,44.18,46.5,0
unity,CDM,Um Bipap Circut Accessory,UM3470323,A7037,,Pos airway pressure tubing,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Bipap Circut Accessory,UM3470323,A7037,,Pos airway pressure tubing,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Fil Disposable/ 2 Per Mth,UM3470050,A7038,,Pos airway pressure filter,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10,% of charge rate,95.00%,9.5,,,,9.5,10,0
unity,CDM,Um Fil Disposable/ 2 Per Mth,UM3470050,A7038,,Pos airway pressure filter,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10,% of charge rate,95.00%,9.5,,,,9.5,10,0
unity,CDM,Um Filt Non-disposable 6 Mth,UM3470049,A7039,,"Filter, non disposable w pap",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.2,% of charge rate,95.00%,25.84,,,,25.84,27.2,0
unity,CDM,Um Filt Non-disposable 6 Mth,UM3470049,A7039,,"Filter, non disposable w pap",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.2,% of charge rate,95.00%,25.84,,,,25.84,27.2,0
unity,CDM,Um Replacement - H2o Chamber,UM3470031,A7046,,"Repl water chamber, pap dev",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.68,% of charge rate,95.00%,32.95,,,,32.95,34.68,0
unity,CDM,Um Replacement - H2o Chamber,UM3470031,A7046,,"Repl water chamber, pap dev",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.68,% of charge rate,95.00%,32.95,,,,32.95,34.68,0
unity,CDM,Um Pleur X Vacuum Drainage Kit,UM3500340,A7048,,Vacuum drain bottle/tube kit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,124.78,% of charge rate,95.00%,118.54,,,,118.54,124.78,0
unity,CDM,Um Pleur X Vacuum Drainage Kit,UM3500340,A7048,,Vacuum drain bottle/tube kit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,124.78,% of charge rate,95.00%,118.54,,,,118.54,124.78,0
unity,CDM,NM CARDIOLITE PER SYRINGE,3430001,A9500,,Tc99m sestamibi,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,197.27,% of charge rate,95.00%,187.41,,,,187.41,197.27,0
unity,CDM,NM CARDIOLITE PER SYRINGE,3430001,A9500,,Tc99m sestamibi,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,197.27,% of charge rate,95.00%,187.41,,,,187.41,197.27,0
unity,CDM,Hc Mdp Per Dose,3430003,A9503,,Tc99m medronate,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,Hc Mdp Per Dose,3430003,A9503,,Tc99m medronate,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,130,% of charge rate,95.00%,123.5,,,,123.5,130,0
unity,CDM,Hc Ceretec Per Dose,3430010,A9521,,Tc99m exametazime,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Hc Ceretec Per Dose,3430010,A9521,,Tc99m exametazime,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Hc Choletec Per Dose,3430011,A9537,,Tc99m mebrofenin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Hc Choletec Per Dose,3430011,A9537,,Tc99m mebrofenin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Hc Nuc Mebrofenin,3430031,A9537,,Tc99m mebrofenin,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Hc Nuc Mebrofenin,3430031,A9537,,Tc99m mebrofenin,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Um Comp Bandage,UM3500308,A9776,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.6,% of charge rate,95.00%,11.02,,,,11.02,11.6,0
unity,CDM,Um Comp Bandage,UM3500308,A9776,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.6,% of charge rate,95.00%,11.02,,,,11.02,11.6,0
unity,CDM,Um Cold Compression Shoulder Pad,UM3500358,A9900,,Supply/accessory/service,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,180.61,% of charge rate,95.00%,171.58,,,,171.58,180.61,0
unity,CDM,Um Cold Compression Shoulder Pad,UM3500358,A9900,,Supply/accessory/service,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,180.61,% of charge rate,95.00%,171.58,,,,171.58,180.61,0
unity,CDM,Um Shoulder Pack,UM3500359,A9900,,Supply/accessory/service,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,303.42,% of charge rate,95.00%,288.25,,,,288.25,303.42,0
unity,CDM,Um Shoulder Pack,UM3500359,A9900,,Supply/accessory/service,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,303.42,% of charge rate,95.00%,288.25,,,,288.25,303.42,0
unity,CDM,"Um G-tube, Low Prof(mic-key)",UM3500242,B4088,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,135.2,% of charge rate,95.00%,128.44,,,,128.44,135.2,0
unity,CDM,"Um G-tube, Low Prof(mic-key)",UM3500242,B4088,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,135.2,% of charge rate,95.00%,128.44,,,,128.44,135.2,0
unity,CDM,Um Juggerknot 2.9,UM3500350,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,373.89,% of charge rate,95.00%,355.2,,,,355.2,373.89,0
unity,CDM,Um Juggerknot 2.9,UM3500350,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,373.89,% of charge rate,95.00%,355.2,,,,355.2,373.89,0
unity,CDM,Um Drill Bit 2.9 Short,UM3500351,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,245.43,% of charge rate,95.00%,233.16,,,,233.16,245.43,0
unity,CDM,Um Drill Bit 2.9 Short,UM3500351,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,245.43,% of charge rate,95.00%,233.16,,,,233.16,245.43,0
unity,CDM,Um Max Brd #2,UM3500352,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.01,% of charge rate,95.00%,199.51,,,,199.51,210.01,0
unity,CDM,Um Max Brd #2,UM3500352,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,210.01,% of charge rate,95.00%,199.51,,,,199.51,210.01,0
unity,CDM,Um Access 3.2 Mm,UM3500353,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246.68,% of charge rate,95.00%,234.35,,,,234.35,246.68,0
unity,CDM,Um Access 3.2 Mm,UM3500353,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246.68,% of charge rate,95.00%,234.35,,,,234.35,246.68,0
unity,CDM,Um Biomet Bone Cement,UM3500354,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,262.51,% of charge rate,95.00%,249.38,,,,249.38,262.51,0
unity,CDM,Um Biomet Bone Cement,UM3500354,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,262.51,% of charge rate,95.00%,249.38,,,,249.38,262.51,0
unity,CDM,Um Humeral Locking Plate,UM3500362,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,940.00",% of charge rate,95.00%,"1,843.00",,,,"1,843.00","1,940.00",0
unity,CDM,Um Humeral Locking Plate,UM3500362,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,940.00",% of charge rate,95.00%,"1,843.00",,,,"1,843.00","1,940.00",0
unity,CDM,Um Locking Screw 4.75 X 30,UM3500368,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,221.38,% of charge rate,95.00%,210.31,,,,210.31,221.38,0
unity,CDM,Um Locking Screw 4.75 X 30,UM3500368,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,221.38,% of charge rate,95.00%,210.31,,,,210.31,221.38,0
unity,CDM,Um Locking Screw 4.75 X 20,UM3500369,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,221.38,% of charge rate,95.00%,210.31,,,,210.31,221.38,0
unity,CDM,Um Locking Screw 4.75 X 20,UM3500369,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,221.38,% of charge rate,95.00%,210.31,,,,210.31,221.38,0
unity,CDM,Um Central Screw,UM3500370,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,221.38,% of charge rate,95.00%,210.31,,,,210.31,221.38,0
unity,CDM,Um Central Screw,UM3500370,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,221.38,% of charge rate,95.00%,210.31,,,,210.31,221.38,0
unity,CDM,Um Aug Screw,UM3500371,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246,% of charge rate,95.00%,233.7,,,,233.7,246,0
unity,CDM,Um Aug Screw,UM3500371,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246,% of charge rate,95.00%,233.7,,,,233.7,246,0
unity,CDM,Um Anchor Suture,UM3500372,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Um Anchor Suture,UM3500372,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Um Taper Nail,UM3500376,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,450,% of charge rate,95.00%,427.5,,,,427.5,450,0
unity,CDM,Um Taper Nail,UM3500376,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,450,% of charge rate,95.00%,427.5,,,,427.5,450,0
unity,CDM,Um Bb Tape Suture,UM3500378,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Um Bb Tape Suture,UM3500378,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Um Steimann Pin,UM3500380,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246.68,% of charge rate,95.00%,234.35,,,,234.35,246.68,0
unity,CDM,Um Steimann Pin,UM3500380,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246.68,% of charge rate,95.00%,234.35,,,,234.35,246.68,0
unity,CDM,Um Drill Bit,UM3500381,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246.68,% of charge rate,95.00%,234.35,,,,234.35,246.68,0
unity,CDM,Um Drill Bit,UM3500381,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,246.68,% of charge rate,95.00%,234.35,,,,234.35,246.68,0
unity,CDM,Um Bone Cement,UM3500388,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,262.5,% of charge rate,95.00%,249.38,,,,249.38,262.5,0
unity,CDM,Um Bone Cement,UM3500388,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,262.5,% of charge rate,95.00%,249.38,,,,249.38,262.5,0
unity,CDM,Um Link Anchor,UM3500389,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,535,% of charge rate,95.00%,508.25,,,,508.25,535,0
unity,CDM,Um Link Anchor,UM3500389,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,535,% of charge rate,95.00%,508.25,,,,508.25,535,0
unity,CDM,Um Brdband 2 Pk,UM3500392,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,252,% of charge rate,95.00%,239.4,,,,239.4,252,0
unity,CDM,Um Brdband 2 Pk,UM3500392,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,252,% of charge rate,95.00%,239.4,,,,239.4,252,0
unity,CDM,Um Hybrid Glenoid Base,UM3500346,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,012.50",% of charge rate,95.00%,"1,911.88",,,,"1,911.88","2,012.50",0
unity,CDM,Um Hybrid Glenoid Base,UM3500346,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,012.50",% of charge rate,95.00%,"1,911.88",,,,"1,911.88","2,012.50",0
unity,CDM,Um Hybrid Glenoid Post,UM3500347,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,718.75,% of charge rate,95.00%,682.81,,,,682.81,718.75,0
unity,CDM,Um Hybrid Glenoid Post,UM3500347,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,718.75,% of charge rate,95.00%,682.81,,,,682.81,718.75,0
unity,CDM,Um Stem Free Shoulder Humeral Head,UM3500348,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,142.01",% of charge rate,95.00%,"2,034.91",,,,"2,034.91","2,142.01",0
unity,CDM,Um Stem Free Shoulder Humeral Head,UM3500348,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,142.01",% of charge rate,95.00%,"2,034.91",,,,"2,034.91","2,142.01",0
unity,CDM,Um Stem Free Shoulder Humeral Anchor,UM3500349,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,843.75",% of charge rate,95.00%,"9,351.56",,,,"9,351.56","9,843.75",0
unity,CDM,Um Stem Free Shoulder Humeral Anchor,UM3500349,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,843.75",% of charge rate,95.00%,"9,351.56",,,,"9,351.56","9,843.75",0
unity,CDM,Um Baseplate Implant,UM3500363,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,281.25",% of charge rate,95.00%,"3,117.19",,,,"3,117.19","3,281.25",0
unity,CDM,Um Baseplate Implant,UM3500363,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,281.25",% of charge rate,95.00%,"3,117.19",,,,"3,117.19","3,281.25",0
unity,CDM,Um Prosthesis Cup,UM3500364,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,312.50",% of charge rate,95.00%,"2,196.88",,,,"2,196.88","2,312.50",0
unity,CDM,Um Prosthesis Cup,UM3500364,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,312.50",% of charge rate,95.00%,"2,196.88",,,,"2,196.88","2,312.50",0
unity,CDM,Um Prosthesis Body,UM3500365,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,625.00",% of charge rate,95.00%,"2,493.75",,,,"2,493.75","2,625.00",0
unity,CDM,Um Prosthesis Body,UM3500365,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,625.00",% of charge rate,95.00%,"2,493.75",,,,"2,493.75","2,625.00",0
unity,CDM,Um Glenosphere,UM3500366,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,731.25",% of charge rate,95.00%,"2,594.69",,,,"2,594.69","2,731.25",0
unity,CDM,Um Glenosphere,UM3500366,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,731.25",% of charge rate,95.00%,"2,594.69",,,,"2,594.69","2,731.25",0
unity,CDM,Um Humeral Stem,UM3500367,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,750.00",% of charge rate,95.00%,"5,462.50",,,,"5,462.50","5,750.00",0
unity,CDM,Um Humeral Stem,UM3500367,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,750.00",% of charge rate,95.00%,"5,462.50",,,,"5,462.50","5,750.00",0
unity,CDM,Um Humeral Head Pros,UM3500373,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,760.00",% of charge rate,95.00%,"2,622.00",,,,"2,622.00","2,760.00",0
unity,CDM,Um Humeral Head Pros,UM3500373,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,760.00",% of charge rate,95.00%,"2,622.00",,,,"2,622.00","2,760.00",0
unity,CDM,Um Modular Post,UM3500374,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,862.5,% of charge rate,95.00%,819.38,,,,819.38,862.5,0
unity,CDM,Um Modular Post,UM3500374,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,862.5,% of charge rate,95.00%,819.38,,,,819.38,862.5,0
unity,CDM,Um Modified Glenoid,UM3500375,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,493.75",% of charge rate,95.00%,"2,369.06",,,,"2,369.06","2,493.75",0
unity,CDM,Um Modified Glenoid,UM3500375,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,493.75",% of charge rate,95.00%,"2,369.06",,,,"2,369.06","2,493.75",0
unity,CDM,Um Primary Stem,UM3500377,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"6,900.00",% of charge rate,95.00%,"6,555.00",,,,"6,555.00","6,900.00",0
unity,CDM,Um Primary Stem,UM3500377,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"6,900.00",% of charge rate,95.00%,"6,555.00",,,,"6,555.00","6,900.00",0
unity,CDM,Um Reverse Glenoid Baseplate,UM3500379,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,875.00",% of charge rate,95.00%,"2,731.25",,,,"2,731.25","2,875.00",0
unity,CDM,Um Reverse Glenoid Baseplate,UM3500379,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,875.00",% of charge rate,95.00%,"2,731.25",,,,"2,731.25","2,875.00",0
unity,CDM,Um Auggment Baseplate,UM3500382,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,281.25",% of charge rate,95.00%,"3,117.19",,,,"3,117.19","3,281.25",0
unity,CDM,Um Auggment Baseplate,UM3500382,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,281.25",% of charge rate,95.00%,"3,117.19",,,,"3,117.19","3,281.25",0
unity,CDM,Um Humeral Locking Plate L,UM3500383,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,025.00",% of charge rate,95.00%,"2,873.75",,,,"2,873.75","3,025.00",0
unity,CDM,Um Humeral Locking Plate L,UM3500383,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,025.00",% of charge rate,95.00%,"2,873.75",,,,"2,873.75","3,025.00",0
unity,CDM,Um Versadval Glenoid Std,UM3500384,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,437.50",% of charge rate,95.00%,"2,315.63",,,,"2,315.63","2,437.50",0
unity,CDM,Um Versadval Glenoid Std,UM3500384,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,437.50",% of charge rate,95.00%,"2,315.63",,,,"2,315.63","2,437.50",0
unity,CDM,Um Stem Free Hum Head Anchor,UM3500386,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,843.75",% of charge rate,95.00%,"9,351.56",,,,"9,351.56","9,843.75",0
unity,CDM,Um Stem Free Hum Head Anchor,UM3500386,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,843.75",% of charge rate,95.00%,"9,351.56",,,,"9,351.56","9,843.75",0
unity,CDM,Um Stem Free Humeral Head,UM3500387,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,231.25",% of charge rate,95.00%,"2,119.69",,,,"2,119.69","2,231.25",0
unity,CDM,Um Stem Free Humeral Head,UM3500387,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,231.25",% of charge rate,95.00%,"2,119.69",,,,"2,119.69","2,231.25",0
unity,CDM,Um Comp Rv Sh Gd/bn,UM3500390,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,425.00",% of charge rate,95.00%,"1,353.75",,,,"1,353.75","1,425.00",0
unity,CDM,Um Comp Rv Sh Gd/bn,UM3500390,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,425.00",% of charge rate,95.00%,"1,353.75",,,,"1,353.75","1,425.00",0
unity,CDM,"Um Hum,tray",UM3500391,C1776,,Vit-E Liner,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,625.00",% of charge rate,95.00%,"2,493.75",,,,"2,493.75","2,625.00",0
unity,CDM,"Um Hum,tray",UM3500391,C1776,,Vit-E Liner,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,625.00",% of charge rate,95.00%,"2,493.75",,,,"2,493.75","2,625.00",0
unity,CDM,Um Mesh  Lge V-patch,UM3500249,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,685.31,% of charge rate,95.00%,651.04,,,,651.04,685.31,0
unity,CDM,Um Mesh  Lge V-patch,UM3500249,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,685.31,% of charge rate,95.00%,651.04,,,,651.04,685.31,0
unity,CDM,Um Mesh Proloop  Small Vpatc,UM3500250,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,416.21,% of charge rate,95.00%,395.4,,,,395.4,416.21,0
unity,CDM,Um Mesh Proloop  Small Vpatc,UM3500250,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,416.21,% of charge rate,95.00%,395.4,,,,395.4,416.21,0
unity,CDM,Um Mesh Vpatch Med,UM3500251,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,554.95,% of charge rate,95.00%,527.2,,,,527.2,554.95,0
unity,CDM,Um Mesh Vpatch Med,UM3500251,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,554.95,% of charge rate,95.00%,527.2,,,,527.2,554.95,0
unity,CDM,Um Mesh Gortex 01182111,UM3500253,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,708.00",% of charge rate,95.00%,"1,622.60",,,,"1,622.60","1,708.00",0
unity,CDM,Um Mesh Gortex 01182111,UM3500253,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,708.00",% of charge rate,95.00%,"1,622.60",,,,"1,622.60","1,708.00",0
unity,CDM,Um Mesh Cqur 10x15,UM3500255,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,403.66,% of charge rate,95.00%,383.48,,,,383.48,403.66,0
unity,CDM,Um Mesh Cqur 10x15,UM3500255,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,403.66,% of charge rate,95.00%,383.48,,,,383.48,403.66,0
unity,CDM,Um Mesh Cqur 4.5 Circle,UM3500256,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,686.51,% of charge rate,95.00%,652.18,,,,652.18,686.51,0
unity,CDM,Um Mesh Cqur 4.5 Circle,UM3500256,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,686.51,% of charge rate,95.00%,652.18,,,,652.18,686.51,0
unity,CDM,Um Mesh Tac Shield 15x20,UM3500257,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,980.72,% of charge rate,95.00%,931.68,,,,931.68,980.72,0
unity,CDM,Um Mesh Tac Shield 15x20,UM3500257,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,980.72,% of charge rate,95.00%,931.68,,,,931.68,980.72,0
unity,CDM,Um Mesh Tac Shield 22x27,UM3500258,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,778.46",% of charge rate,95.00%,"1,689.54",,,,"1,689.54","1,778.46",0
unity,CDM,Um Mesh Tac Shield 22x27,UM3500258,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,778.46",% of charge rate,95.00%,"1,689.54",,,,"1,689.54","1,778.46",0
unity,CDM,Um Mesh Tac Shield 7.5x15,UM3500259,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,560.93,% of charge rate,95.00%,532.88,,,,532.88,560.93,0
unity,CDM,Um Mesh Tac Shield 7.5x15,UM3500259,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,560.93,% of charge rate,95.00%,532.88,,,,532.88,560.93,0
unity,CDM,Um Mesh Gortex 0108121,UM3500260,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,725,% of charge rate,95.00%,688.75,,,,688.75,725,0
unity,CDM,Um Mesh Gortex 0108121,UM3500260,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,725,% of charge rate,95.00%,688.75,,,,688.75,725,0
unity,CDM,Um Mesh  Proloop Small,UM3500261,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.44,% of charge rate,95.00%,220.82,,,,220.82,232.44,0
unity,CDM,Um Mesh  Proloop Small,UM3500261,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.44,% of charge rate,95.00%,220.82,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop Med,UM3500262,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.44,% of charge rate,95.00%,220.82,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop Med,UM3500262,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.44,% of charge rate,95.00%,220.82,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop Lrg,UM3500263,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.44,% of charge rate,95.00%,220.82,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop Lrg,UM3500263,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.44,% of charge rate,95.00%,220.82,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop X-lg,UM3500264,C1781,,Mesh XL Plug,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,212.04,% of charge rate,95.00%,201.44,,,,201.44,212.04,0
unity,CDM,Um Mesh Proloop X-lg,UM3500264,C1781,,Mesh XL Plug,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,212.04,% of charge rate,95.00%,201.44,,,,201.44,212.04,0
unity,CDM,Um Canes/adjustable Or Fixed,UM4310002,E0100,,"LH CANE, ADJUSTABLE ALUMINUM",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.98,% of charge rate,95.00%,40.83,,,,40.83,42.98,0
unity,CDM,Um Canes/adjustable Or Fixed,UM4310002,E0100,,"LH CANE, ADJUSTABLE ALUMINUM",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.98,% of charge rate,95.00%,40.83,,,,40.83,42.98,0
unity,CDM,"Um Canes, Quad",UM4310006,E0105,,LH CANES,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.99,% of charge rate,95.00%,87.39,,,,87.39,91.99,0
unity,CDM,"Um Canes, Quad",UM4310006,E0105,,LH CANES,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,91.99,% of charge rate,95.00%,87.39,,,,87.39,91.99,0
unity,CDM,"Um Crutches, Forearm Alumin",UM4310012,E0110,,LH CRUTCH - FOREARM,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.5,% of charge rate,95.00%,136.33,,,,136.33,143.5,0
unity,CDM,"Um Crutches, Forearm Alumin",UM4310012,E0110,,LH CRUTCH - FOREARM,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.5,% of charge rate,95.00%,136.33,,,,136.33,143.5,0
unity,CDM,Um Crutches Adj Aluminum,UM3500051,E0114,,"CRUTCH, ALUM ADJ ADLT TAL",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.27,% of charge rate,95.00%,79.11,,,,79.11,83.27,0
unity,CDM,Um Crutches Adj Aluminum,UM3500051,E0114,,"CRUTCH, ALUM ADJ ADLT TAL",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.27,% of charge rate,95.00%,79.11,,,,79.11,83.27,0
unity,CDM,"Um Crutches, Underarm Alumin",UM4310026,E0114,,"CRUTCH, ALUM ADJ ADLT TAL",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.29,% of charge rate,95.00%,82.93,,,,82.93,87.29,0
unity,CDM,"Um Crutches, Underarm Alumin",UM4310026,E0114,,"CRUTCH, ALUM ADJ ADLT TAL",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.29,% of charge rate,95.00%,82.93,,,,82.93,87.29,0
unity,CDM,"Um Walker, Folding",UM4310028,E0135,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,155.07,% of charge rate,95.00%,147.32,,,,147.32,155.07,0
unity,CDM,"Um Walker, Folding",UM4310028,E0135,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,155.07,% of charge rate,95.00%,147.32,,,,147.32,155.07,0
unity,CDM,"Um Walker, Wheel Attachments",UM4310019,E0155,,LH WALKER WHEELS-NON/SWIVEL,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.6,% of charge rate,95.00%,50.92,,,,50.92,53.6,0
unity,CDM,"Um Walker, Wheel Attachments",UM4310019,E0155,,LH WALKER WHEELS-NON/SWIVEL,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.6,% of charge rate,95.00%,50.92,,,,50.92,53.6,0
unity,CDM,Um Prevalon Transfer Mat,UM3500343,E0190,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,202.83,% of charge rate,95.00%,192.69,,,,192.69,202.83,0
unity,CDM,Um Prevalon Transfer Mat,UM3500343,E0190,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,202.83,% of charge rate,95.00%,192.69,,,,192.69,202.83,0
unity,CDM,Um Air Tap Xxl,UM3500344,E0190,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,469.17,% of charge rate,95.00%,445.71,,,,445.71,469.17,0
unity,CDM,Um Air Tap Xxl,UM3500344,E0190,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,469.17,% of charge rate,95.00%,445.71,,,,445.71,469.17,0
unity,CDM,Um Prevalon Seating Positioner,UM3500345,E0190,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.86,% of charge rate,95.00%,159.47,,,,159.47,167.86,0
unity,CDM,Um Prevalon Seating Positioner,UM3500345,E0190,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,167.86,% of charge rate,95.00%,159.47,,,,159.47,167.86,0
unity,CDM,Um Cervical Roll/pillow,UM4310003,E0190,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.98,% of charge rate,95.00%,18.98,,,,18.98,19.98,0
unity,CDM,Um Cervical Roll/pillow,UM4310003,E0190,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.98,% of charge rate,95.00%,18.98,,,,18.98,19.98,0
unity,CDM,Um Head Positioner Ring,UM3500361,E0191,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,190.31,% of charge rate,95.00%,180.79,,,,180.79,190.31,0
unity,CDM,Um Head Positioner Ring,UM3500361,E0191,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,190.31,% of charge rate,95.00%,180.79,,,,180.79,190.31,0
unity,CDM,Um Polar Care Wave,UM3500357,E0218,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,285.01,% of charge rate,95.00%,270.76,,,,270.76,285.01,0
unity,CDM,Um Polar Care Wave,UM3500357,E0218,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,285.01,% of charge rate,95.00%,270.76,,,,270.76,285.01,0
unity,CDM,Um Oxygen Conserver Rental,UM3470014,E0431,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50,% of charge rate,95.00%,47.5,,,,47.5,50,0
unity,CDM,Um Oxygen Conserver Rental,UM3470014,E0431,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50,% of charge rate,95.00%,47.5,,,,47.5,50,0
unity,CDM,Um Conserver Purchase - New,UM3470024,E0431,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,389.54",% of charge rate,95.00%,"1,320.06",,,,"1,320.06","1,389.54",0
unity,CDM,Um Conserver Purchase - New,UM3470024,E0431,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,389.54",% of charge rate,95.00%,"1,320.06",,,,"1,320.06","1,389.54",0
unity,CDM,Um Oxygen Portable System,UM3470054,E0431,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50,% of charge rate,95.00%,47.5,,,,47.5,50,0
unity,CDM,Um Oxygen Portable System,UM3470054,E0431,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50,% of charge rate,95.00%,47.5,,,,47.5,50,0
unity,CDM,Um M Oxygen Contents,UM3470003,E0443,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10,% of charge rate,95.00%,9.5,,,,9.5,10,0
unity,CDM,Um M Oxygen Contents,UM3470003,E0443,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10,% of charge rate,95.00%,9.5,,,,9.5,10,0
unity,CDM,Um O2 Contents (system Owned,UM3470008,E0443,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97,% of charge rate,95.00%,92.15,,,,92.15,97,0
unity,CDM,Um O2 Contents (system Owned,UM3470008,E0443,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97,% of charge rate,95.00%,92.15,,,,92.15,97,0
unity,CDM,Um E-oxygen Contents,UM3470022,E0443,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um E-oxygen Contents,UM3470022,E0443,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Bipap-medicare 1st Month,UM3470010,E0470,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap-medicare 1st Month,UM3470010,E0470,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap (no Rate) Rental,UM3470012,E0470,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap (no Rate) Rental,UM3470012,E0470,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap Med 11th Acpt Rtl,UM3470032,E0470,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap Med 11th Acpt Rtl,UM3470032,E0470,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap Med 4th - 13th Mth,UM3470036,E0470,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap Med 4th - 13th Mth,UM3470036,E0470,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap After Rtl (purchase,UM3470046,E0470,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,705.25",% of charge rate,95.00%,"3,519.99",,,,"3,519.99","3,705.25",0
unity,CDM,Um Bipap After Rtl (purchase,UM3470046,E0470,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,705.25",% of charge rate,95.00%,"3,519.99",,,,"3,519.99","3,705.25",0
unity,CDM,Um Bipap Med 11th  13th Purc,UM3470062,E0470,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap Med 11th  13th Purc,UM3470062,E0470,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap-med 2nd & 3rd Month,UM3470067,E0470,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap-med 2nd & 3rd Month,UM3470067,E0470,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,320,% of charge rate,95.00%,304,,,,304,320,0
unity,CDM,Um Bipap Replacement,UM3470325,E0470,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,755.25",% of charge rate,95.00%,"3,567.49",,,,"3,567.49","3,755.25",0
unity,CDM,Um Bipap Replacement,UM3470325,E0470,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,755.25",% of charge rate,95.00%,"3,567.49",,,,"3,567.49","3,755.25",0
unity,CDM,Um Perscussor 1st Month,UM3470006,E0480,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Perscussor 1st Month,UM3470006,E0480,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Perscussor Rental,UM3470013,E0480,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Perscussor Rental,UM3470013,E0480,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Percussor 2nd & 3nd Month,UM3470033,E0480,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Percussor 2nd & 3nd Month,UM3470033,E0480,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Percussor Purchase,UM3470034,E0480,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,848.91,% of charge rate,95.00%,806.46,,,,806.46,848.91,0
unity,CDM,Um Percussor Purchase,UM3470034,E0480,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,848.91,% of charge rate,95.00%,806.46,,,,806.46,848.91,0
unity,CDM,Um Percssor 4th & 13th Month,UM3470057,E0480,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Percssor 4th & 13th Month,UM3470057,E0480,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,"Fc Acapella, All Sizes",FC3600312,E0484,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,132.55,% of charge rate,95.00%,125.92,,,,125.92,132.55,0
unity,CDM,"Fc Acapella, All Sizes",FC3600312,E0484,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,132.55,% of charge rate,95.00%,125.92,,,,125.92,132.55,0
unity,CDM,Um Flutter Valve,UM3470048,E0484,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73,% of charge rate,95.00%,69.35,,,,69.35,73,0
unity,CDM,Um Flutter Valve,UM3470048,E0484,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73,% of charge rate,95.00%,69.35,,,,69.35,73,0
unity,CDM,Um Acapella/pep,UM3480012,E0484,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.5,% of charge rate,95.00%,47.03,,,,47.03,49.5,0
unity,CDM,Um Acapella/pep,UM3480012,E0484,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.5,% of charge rate,95.00%,47.03,,,,47.03,49.5,0
unity,CDM,Um Chamber Humidificatio Jar,UM3470039,E0555,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.95,% of charge rate,95.00%,2.8,,,,2.8,2.95,0
unity,CDM,Um Chamber Humidificatio Jar,UM3470039,E0555,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.95,% of charge rate,95.00%,2.8,,,,2.8,2.95,0
unity,CDM,Um Cool Humidifier New,UM3470058,E0561,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,200,% of charge rate,95.00%,190,,,,190,200,0
unity,CDM,Um Cool Humidifier New,UM3470058,E0561,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,200,% of charge rate,95.00%,190,,,,190,200,0
unity,CDM,Um Cpap Non-heated Humififie,UM3470078,E0561,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,134,% of charge rate,95.00%,127.3,,,,127.3,134,0
unity,CDM,Um Cpap Non-heated Humififie,UM3470078,E0561,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,134,% of charge rate,95.00%,127.3,,,,127.3,134,0
unity,CDM,Um Cpap Humidifier Heated,UM3470004,E0562,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,400,% of charge rate,95.00%,380,,,,380,400,0
unity,CDM,Um Cpap Humidifier Heated,UM3470004,E0562,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,400,% of charge rate,95.00%,380,,,,380,400,0
unity,CDM,Um Heated Pap Humidifier,UM3470016,E0562,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.55,% of charge rate,95.00%,50.87,,,,50.87,53.55,0
unity,CDM,Um Heated Pap Humidifier,UM3470016,E0562,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.55,% of charge rate,95.00%,50.87,,,,50.87,53.55,0
unity,CDM,Um Heated Humidifer Used,UM3470029,E0562,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,350,% of charge rate,95.00%,332.5,,,,332.5,350,0
unity,CDM,Um Heated Humidifer Used,UM3470029,E0562,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,350,% of charge rate,95.00%,332.5,,,,332.5,350,0
unity,CDM,Um Heated Pap Purchase,UM3470085,E0562,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Um Heated Pap Purchase,UM3470085,E0562,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Um Compressor Air Soce Sales,UM3470064,E0565,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,091.59",% of charge rate,95.00%,"1,037.01",,,,"1,037.01","1,091.59",0
unity,CDM,Um Compressor Air Soce Sales,UM3470064,E0565,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,091.59",% of charge rate,95.00%,"1,037.01",,,,"1,037.01","1,091.59",0
unity,CDM,Um Nebulizer Rental Per Mth,UM3470002,E0570,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28,% of charge rate,95.00%,26.6,,,,26.6,28,0
unity,CDM,Um Nebulizer Rental Per Mth,UM3470002,E0570,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28,% of charge rate,95.00%,26.6,,,,26.6,28,0
unity,CDM,Um Nebulizer Purchase New,UM3470028,E0570,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,180,% of charge rate,95.00%,171,,,,171,180,0
unity,CDM,Um Nebulizer Purchase New,UM3470028,E0570,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,180,% of charge rate,95.00%,171,,,,171,180,0
unity,CDM,Um Neb Rental 4th - 13th Mth,UM3470035,E0570,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Neb Rental 4th - 13th Mth,UM3470035,E0570,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Neb Purchase After Rental,UM3470038,E0570,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,120,% of charge rate,95.00%,114,,,,114,120,0
unity,CDM,Um Neb Purchase After Rental,UM3470038,E0570,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,120,% of charge rate,95.00%,114,,,,114,120,0
unity,CDM,Um Neb Rtl 2nd & 3rd Month,UM3470045,E0570,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Neb Rtl 2nd & 3rd Month,UM3470045,E0570,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Nebulizer Rental 1st Mth,UM3470063,E0570,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Nebulizer Rental 1st Mth,UM3470063,E0570,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18,% of charge rate,95.00%,17.1,,,,17.1,18,0
unity,CDM,Um Pari Portable Nebulizer,UM3470021,E0571,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,328.38,% of charge rate,95.00%,311.96,,,,311.96,328.38,0
unity,CDM,Um Pari Portable Nebulizer,UM3470021,E0571,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,328.38,% of charge rate,95.00%,311.96,,,,311.96,328.38,0
unity,CDM,Um Suction Pump-new,UM3470015,E0600,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,589.89,% of charge rate,95.00%,560.4,,,,560.4,589.89,0
unity,CDM,Um Suction Pump-new,UM3470015,E0600,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,589.89,% of charge rate,95.00%,560.4,,,,560.4,589.89,0
unity,CDM,Um Suction Pump 4 -13th Mth,UM3470020,E0600,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60,% of charge rate,95.00%,57,,,,57,60,0
unity,CDM,Um Suction Pump 4 -13th Mth,UM3470020,E0600,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60,% of charge rate,95.00%,57,,,,57,60,0
unity,CDM,Um Suction Pump 2 & 3rd Mth,UM3470052,E0600,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60,% of charge rate,95.00%,57,,,,57,60,0
unity,CDM,Um Suction Pump 2 & 3rd Mth,UM3470052,E0600,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60,% of charge rate,95.00%,57,,,,57,60,0
unity,CDM,Um Capped Suction Pump Ms,UM3470053,E0600,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60,% of charge rate,95.00%,57,,,,57,60,0
unity,CDM,Um Capped Suction Pump Ms,UM3470053,E0600,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60,% of charge rate,95.00%,57,,,,57,60,0
unity,CDM,Um Suction Pump 1st Month,UM3470069,E0600,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60,% of charge rate,95.00%,57,,,,57,60,0
unity,CDM,Um Suction Pump 1st Month,UM3470069,E0600,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60,% of charge rate,95.00%,57,,,,57,60,0
unity,CDM,Um Cont Airway Pres/rental,UM3470030,E0601,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137,% of charge rate,95.00%,130.15,,,,130.15,137,0
unity,CDM,Um Cont Airway Pres/rental,UM3470030,E0601,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137,% of charge rate,95.00%,130.15,,,,130.15,137,0
unity,CDM,Um Cpap Purchase Aft Rental,UM3470037,E0601,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,528.10",% of charge rate,95.00%,"1,451.70",,,,"1,451.70","1,528.10",0
unity,CDM,Um Cpap Purchase Aft Rental,UM3470037,E0601,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,528.10",% of charge rate,95.00%,"1,451.70",,,,"1,451.70","1,528.10",0
unity,CDM,Um Cpap Med A  2nd & 3rd Mth,UM3470041,E0601,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112,% of charge rate,95.00%,106.4,,,,106.4,112,0
unity,CDM,Um Cpap Med A  2nd & 3rd Mth,UM3470041,E0601,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112,% of charge rate,95.00%,106.4,,,,106.4,112,0
unity,CDM,Um Cpap Purchase,UM3470044,E0601,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,350.00",% of charge rate,95.00%,"1,282.50",,,,"1,282.50","1,350.00",0
unity,CDM,Um Cpap Purchase,UM3470044,E0601,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,350.00",% of charge rate,95.00%,"1,282.50",,,,"1,282.50","1,350.00",0
unity,CDM,Um Cpap Med 4th - 13th Mth,UM3470060,E0601,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112,% of charge rate,95.00%,106.4,,,,106.4,112,0
unity,CDM,Um Cpap Med 4th - 13th Mth,UM3470060,E0601,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112,% of charge rate,95.00%,106.4,,,,106.4,112,0
unity,CDM,Um Cpap Medicare First Month,UM3470061,E0601,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112,% of charge rate,95.00%,106.4,,,,106.4,112,0
unity,CDM,Um Cpap Medicare First Month,UM3470061,E0601,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112,% of charge rate,95.00%,106.4,,,,106.4,112,0
unity,CDM,Um Cpap Purchase,UM3470084,E0601,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,365.00",% of charge rate,95.00%,"1,296.75",,,,"1,296.75","1,365.00",0
unity,CDM,Um Cpap Purchase,UM3470084,E0601,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,365.00",% of charge rate,95.00%,"1,296.75",,,,"1,296.75","1,365.00",0
unity,CDM,Um Cpap Replacement,UM3470324,E0601,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,355.00",% of charge rate,95.00%,"1,287.25",,,,"1,287.25","1,355.00",0
unity,CDM,Um Cpap Replacement,UM3470324,E0601,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,355.00",% of charge rate,95.00%,"1,287.25",,,,"1,287.25","1,355.00",0
unity,CDM,"Um Belt, Safety Walking",UM4310010,E0700,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.26,% of charge rate,95.00%,14.5,,,,14.5,15.26,0
unity,CDM,"Um Belt, Safety Walking",UM4310010,E0700,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.26,% of charge rate,95.00%,14.5,,,,14.5,15.26,0
unity,CDM,Um Cervical Tract/overdoor,UM4310027,E0860,,LH OVERDOOR PULLEY SET-UP,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.3,% of charge rate,95.00%,67.74,,,,67.74,71.3,0
unity,CDM,Um Cervical Tract/overdoor,UM4310027,E0860,,LH OVERDOOR PULLEY SET-UP,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.3,% of charge rate,95.00%,67.74,,,,67.74,71.3,0
unity,CDM,Um Oxygen Concentrator,UM3470007,E1390,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,200,% of charge rate,95.00%,190,,,,190,200,0
unity,CDM,Um Oxygen Concentrator,UM3470007,E1390,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,200,% of charge rate,95.00%,190,,,,190,200,0
unity,CDM,Um Concentrato O2 Sale - Usd,UM3470027,E1390,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,500.00",% of charge rate,95.00%,"1,425.00",,,,"1,425.00","1,500.00",0
unity,CDM,Um Concentrato O2 Sale - Usd,UM3470027,E1390,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,500.00",% of charge rate,95.00%,"1,425.00",,,,"1,425.00","1,500.00",0
unity,CDM,Um O2 Concentrator Pur New,UM3470047,E1390,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,800.00",% of charge rate,95.00%,"3,610.00",,,,"3,610.00","3,800.00",0
unity,CDM,Um O2 Concentrator Pur New,UM3470047,E1390,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,800.00",% of charge rate,95.00%,"3,610.00",,,,"3,610.00","3,800.00",0
unity,CDM,Um O2 Concentrator/ms,UM3470070,E1390,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Um O2 Concentrator/ms,UM3470070,E1390,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,360,% of charge rate,95.00%,342,,,,342,360,0
unity,CDM,Um Inogen Concentrator,UM3470101,E1390,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,560.00",% of charge rate,95.00%,"1,482.00",,,,"1,482.00","1,560.00",0
unity,CDM,Um Inogen Concentrator,UM3470101,E1390,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,560.00",% of charge rate,95.00%,"1,482.00",,,,"1,482.00","1,560.00",0
unity,CDM,Um Inogen Portable O2 Concentrator,UM3470100,E1392,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,905,% of charge rate,95.00%,859.75,,,,859.75,905,0
unity,CDM,Um Inogen Portable O2 Concentrator,UM3470100,E1392,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,905,% of charge rate,95.00%,859.75,,,,859.75,905,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470102,E1392,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.32,% of charge rate,95.00%,61.1,,,,61.1,64.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470102,E1392,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.32,% of charge rate,95.00%,61.1,,,,61.1,64.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470103,E1392,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.32,% of charge rate,95.00%,80.1,,,,80.1,84.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470103,E1392,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.32,% of charge rate,95.00%,80.1,,,,80.1,84.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470104,E1392,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.32,% of charge rate,95.00%,80.1,,,,80.1,84.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470104,E1392,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.32,% of charge rate,95.00%,80.1,,,,80.1,84.32,0
unity,CDM,Um Oxy Ears,UM3470077,E1399,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.5,% of charge rate,95.00%,2.38,,,,2.38,2.5,0
unity,CDM,Um Oxy Ears,UM3470077,E1399,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.5,% of charge rate,95.00%,2.38,,,,2.38,2.5,0
unity,CDM,"Um Pulleys, Overdoor",UM4310005,E1399,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.94,% of charge rate,95.00%,21.79,,,,21.79,22.94,0
unity,CDM,"Um Pulleys, Overdoor",UM4310005,E1399,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.94,% of charge rate,95.00%,21.79,,,,21.79,22.94,0
unity,CDM,Um Lumbar Roll,UM4310008,E1399,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.94,% of charge rate,95.00%,21.79,,,,21.79,22.94,0
unity,CDM,Um Lumbar Roll,UM4310008,E1399,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.94,% of charge rate,95.00%,21.79,,,,21.79,22.94,0
unity,CDM,Um Theraband/ft,UM4310011,E1399,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,1.62,% of charge rate,95.00%,1.54,,,,1.54,1.62,0
unity,CDM,Um Theraband/ft,UM4310011,E1399,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,1.62,% of charge rate,95.00%,1.54,,,,1.54,1.62,0
unity,CDM,Um Lumbar Cushion,UM4310021,E1399,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.66,% of charge rate,95.00%,29.13,,,,29.13,30.66,0
unity,CDM,Um Lumbar Cushion,UM4310021,E1399,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.66,% of charge rate,95.00%,29.13,,,,29.13,30.66,0
unity,CDM,"Um Icea Gripper, Cane/crutch",UM4310023,E1399,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.26,% of charge rate,95.00%,14.5,,,,14.5,15.26,0
unity,CDM,"Um Icea Gripper, Cane/crutch",UM4310023,E1399,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.26,% of charge rate,95.00%,14.5,,,,14.5,15.26,0
unity,CDM,Um Cold Pack,UM4310032,E1399,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.94,% of charge rate,95.00%,21.79,,,,21.79,22.94,0
unity,CDM,Um Cold Pack,UM4310032,E1399,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.94,% of charge rate,95.00%,21.79,,,,21.79,22.94,0
unity,CDM,Um Psa Screening,UM4000288,G0103,,Psa screening,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.44,% of charge rate,95.00%,97.32,,,,97.32,102.44,0
unity,CDM,Um Psa Screening,UM4000288,G0103,,Psa screening,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.44,% of charge rate,95.00%,97.32,,,,97.32,102.44,0
unity,CDM,Hc Diabetes Train/indiv 30 Min,9420004,G0108,,Diab manage trn  per indiv,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150,% of charge rate,95.00%,142.5,,,,142.5,150,0
unity,CDM,Hc Diabetes Train/indiv 30 Min,9420004,G0108,,Diab manage trn  per indiv,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150,% of charge rate,95.00%,142.5,,,,142.5,150,0
unity,CDM,Hc Diabetes Education,9420005,G0109,,Diab manage trn ind/group,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40,% of charge rate,95.00%,38,,,,38,40,0
unity,CDM,Hc Diabetes Education,9420005,G0109,,Diab manage trn ind/group,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40,% of charge rate,95.00%,38,,,,38,40,0
unity,CDM,Um Screening Pap Thin Layer,UM4000918,G0123,,Screen cerv/vag thin layer,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.82,% of charge rate,95.00%,107.18,,,,107.18,112.82,0
unity,CDM,Um Screening Pap Thin Layer,UM4000918,G0123,,Screen cerv/vag thin layer,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.82,% of charge rate,95.00%,107.18,,,,107.18,112.82,0
unity,CDM,TOMO DIGITAL MAMMO ADD-ON,4010008,G0279,,"Tomosynthesis, mammo",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.2,% of charge rate,95.00%,107.54,,,,107.54,113.2,0
unity,CDM,TOMO DIGITAL MAMMO ADD-ON,4010008,G0279,,"Tomosynthesis, mammo",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,113.2,% of charge rate,95.00%,107.54,,,,107.54,113.2,0
unity,CDM,LDCT FOR LUNG CANCER SCREEN,7700012,G0297,,Ldct for lung ca screen,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,670,% of charge rate,95.00%,636.5,,,,636.5,670,0
unity,CDM,LDCT FOR LUNG CANCER SCREEN,7700012,G0297,,Ldct for lung ca screen,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,670,% of charge rate,95.00%,636.5,,,,636.5,670,0
unity,CDM,Um Occult Blood Medicare Screening,UM4000121,G0328,,Fecal blood scrn immunoassay,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.56,% of charge rate,95.00%,84.13,,,,84.13,88.56,0
unity,CDM,Um Occult Blood Medicare Screening,UM4000121,G0328,,Fecal blood scrn immunoassay,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.56,% of charge rate,95.00%,84.13,,,,84.13,88.56,0
unity,CDM,HOURLY OBSERVATION,7620000,G0378,,Hospital observation per hr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,533.08,% of charge rate,95.00%,506.43,,,,506.43,533.08,0
unity,CDM,HOURLY OBSERVATION,7620000,G0378,,Hospital observation per hr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,533.08,% of charge rate,95.00%,506.43,,,,506.43,533.08,0
unity,CDM,Hc Hourly Observation W/monitor,7621000,G0378,,Hospital observation per hr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,025.63",% of charge rate,95.00%,974.35,,,,974.35,"1,025.63",0
unity,CDM,Hc Hourly Observation W/monitor,7621000,G0378,,Hospital observation per hr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,025.63",% of charge rate,95.00%,974.35,,,,974.35,"1,025.63",0
unity,CDM,Um Level I Trauma Activation,UMG0390LI,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"6,500.00",% of charge rate,95.00%,"6,175.00",,,,"6,175.00","6,500.00",0
unity,CDM,Um Level I Trauma Activation,UMG0390LI,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"6,500.00",% of charge rate,95.00%,"6,175.00",,,,"6,175.00","6,500.00",0
unity,CDM,Um Level Ii Trauma Activation,UMG0390LII,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,200.00",% of charge rate,95.00%,"3,040.00",,,,"3,040.00","3,200.00",0
unity,CDM,Um Level Ii Trauma Activation,UMG0390LII,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,200.00",% of charge rate,95.00%,"3,040.00",,,,"3,040.00","3,200.00",0
unity,CDM,Um Level Iii Trauma Activation,UMG0390LIII,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,600.00",% of charge rate,95.00%,"1,520.00",,,,"1,520.00","1,600.00",0
unity,CDM,Um Level Iii Trauma Activation,UMG0390LIII,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,600.00",% of charge rate,95.00%,"1,520.00",,,,"1,520.00","1,600.00",0
unity,CDM,Um Level Iv Trauma Activation,UMG0390LIV,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,825,% of charge rate,95.00%,783.75,,,,783.75,825,0
unity,CDM,Um Level Iv Trauma Activation,UMG0390LIV,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,825,% of charge rate,95.00%,783.75,,,,783.75,825,0
unity,CDM,Um Level V Trauma Activation,UMG0390LV,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,425,% of charge rate,95.00%,403.75,,,,403.75,425,0
unity,CDM,Um Level V Trauma Activation,UMG0390LV,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,425,% of charge rate,95.00%,403.75,,,,403.75,425,0
unity,CDM,Um Weight Mgmt/30 Min,UM4370007,G0447,,Behavior counsel obesity 15m,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.28,% of charge rate,95.00%,19.27,,,,19.27,20.28,0
unity,CDM,Um Weight Mgmt/30 Min,UM4370007,G0447,,Behavior counsel obesity 15m,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.28,% of charge rate,95.00%,19.27,,,,19.27,20.28,0
unity,CDM,Um Definitive Drug Id,UM4000806,G0481,,Drug test def 8-14 classes,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,Um Definitive Drug Id,UM4000806,G0481,,Drug test def 8-14 classes,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125,% of charge rate,95.00%,118.75,,,,118.75,125,0
unity,CDM,Um Collection Fee For Covid Testing,UM4000936,G2023,,Collection fee for Covid Probe,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.5,% of charge rate,95.00%,27.08,,,,27.08,28.5,0
unity,CDM,Um Collection Fee For Covid Testing,UM4000936,G2023,,Collection fee for Covid Probe,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.5,% of charge rate,95.00%,27.08,,,,27.08,28.5,0
unity,CDM,Um Cervical Collar Foam,UM3500220,L0120,,COLLAR CERVICAL FM REG M,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.96,% of charge rate,95.00%,46.51,,,,46.51,48.96,0
unity,CDM,Um Cervical Collar Foam,UM3500220,L0120,,COLLAR CERVICAL FM REG M,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.96,% of charge rate,95.00%,46.51,,,,46.51,48.96,0
unity,CDM,Um Si Belt/corset,UM4310029,L0621,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.83,% of charge rate,95.00%,150.89,,,,150.89,158.83,0
unity,CDM,Um Si Belt/corset,UM4310029,L0621,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,158.83,% of charge rate,95.00%,150.89,,,,150.89,158.83,0
unity,CDM,Um Lso/binder,UM4310031,L0628,,SACRO LUMBAR SUPP,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.53,% of charge rate,95.00%,120.2,,,,120.2,126.53,0
unity,CDM,Um Lso/binder,UM4310031,L0628,,SACRO LUMBAR SUPP,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,126.53,% of charge rate,95.00%,120.2,,,,120.2,126.53,0
unity,CDM,Um Knee Immobilizer All Size,UM3500195,L1830,,KNEE IMMOBILIZER 19IN FOAM,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,171.67,% of charge rate,95.00%,163.09,,,,163.09,171.67,0
unity,CDM,Um Knee Immobilizer All Size,UM3500195,L1830,,KNEE IMMOBILIZER 19IN FOAM,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,171.67,% of charge rate,95.00%,163.09,,,,163.09,171.67,0
unity,CDM,Um Ankle Brace Aoa,UM3500052,L1902,,ANKLE BRACE SM,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,161.76,% of charge rate,95.00%,153.67,,,,153.67,161.76,0
unity,CDM,Um Ankle Brace Aoa,UM3500052,L1902,,ANKLE BRACE SM,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,161.76,% of charge rate,95.00%,153.67,,,,153.67,161.76,0
unity,CDM,Um Elastic Brace Universal,UM3500188,L1902,,ANKLE BRACE SM,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.35,% of charge rate,95.00%,6.03,,,,6.03,6.35,0
unity,CDM,Um Elastic Brace Universal,UM3500188,L1902,,ANKLE BRACE SM,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.35,% of charge rate,95.00%,6.03,,,,6.03,6.35,0
unity,CDM,Um Ankle Brace Aoa,UM4310018,L1902,,ANKLE BRACE SM,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.16,% of charge rate,95.00%,105.6,,,,105.6,111.16,0
unity,CDM,Um Ankle Brace Aoa,UM4310018,L1902,,ANKLE BRACE SM,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.16,% of charge rate,95.00%,105.6,,,,105.6,111.16,0
unity,CDM,Um Cast Shoe-open Toe,UM3500203,L3260,,CAST SHOE XLG,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.83,% of charge rate,95.00%,32.14,,,,32.14,33.83,0
unity,CDM,Um Cast Shoe-open Toe,UM3500203,L3260,,CAST SHOE XLG,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.83,% of charge rate,95.00%,32.14,,,,32.14,33.83,0
unity,CDM,Um Heel Lift/wedge,UM4310001,L3350,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.4,% of charge rate,95.00%,32.68,,,,32.68,34.4,0
unity,CDM,Um Heel Lift/wedge,UM4310001,L3350,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.4,% of charge rate,95.00%,32.68,,,,32.68,34.4,0
unity,CDM,"Um Heel Cushion, Viscoheel",UM4310014,L3485,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.34,% of charge rate,95.00%,19.32,,,,19.32,20.34,0
unity,CDM,"Um Heel Cushion, Viscoheel",UM4310014,L3485,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.34,% of charge rate,95.00%,19.32,,,,19.32,20.34,0
unity,CDM,Um Splint Clavicle Universal,UM3500178,L3650,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.78,% of charge rate,95.00%,82.44,,,,82.44,86.78,0
unity,CDM,Um Splint Clavicle Universal,UM3500178,L3650,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.78,% of charge rate,95.00%,82.44,,,,82.44,86.78,0
unity,CDM,Um Shoulder Immobilizer Univ,UM3500208,L3660,,SHOULDER IMMO UNIV,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.94,% of charge rate,95.00%,101.59,,,,101.59,106.94,0
unity,CDM,Um Shoulder Immobilizer Univ,UM3500208,L3660,,SHOULDER IMMO UNIV,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.94,% of charge rate,95.00%,101.59,,,,101.59,106.94,0
unity,CDM,Um Sling Shot2 Med,UM3500355,L3670,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.32,% of charge rate,95.00%,110.5,,,,110.5,116.32,0
unity,CDM,Um Sling Shot2 Med,UM3500355,L3670,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.32,% of charge rate,95.00%,110.5,,,,110.5,116.32,0
unity,CDM,Um Sling Shot2 Large,UM3500356,L3670,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,285.01,% of charge rate,95.00%,270.76,,,,270.76,285.01,0
unity,CDM,Um Sling Shot2 Large,UM3500356,L3670,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,285.01,% of charge rate,95.00%,270.76,,,,270.76,285.01,0
unity,CDM,Um Wrist Brace All Sizes,UM3500167,L3908,,"WRIST, HAND STATIC PRE FAB",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.76,% of charge rate,95.00%,50.12,,,,50.12,52.76,0
unity,CDM,Um Wrist Brace All Sizes,UM3500167,L3908,,"WRIST, HAND STATIC PRE FAB",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.76,% of charge rate,95.00%,50.12,,,,50.12,52.76,0
unity,CDM,"Um Splint, Post Arm/wrist",UM3500235,L3908,,"WRIST, HAND STATIC PRE FAB",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.62,% of charge rate,95.00%,24.34,,,,24.34,25.62,0
unity,CDM,"Um Splint, Post Arm/wrist",UM3500235,L3908,,"WRIST, HAND STATIC PRE FAB",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.62,% of charge rate,95.00%,24.34,,,,24.34,25.62,0
unity,CDM,Um Brace Thumb Spica Universal,UM3500322,L3908,,"WRIST, HAND STATIC PRE FAB",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.72,% of charge rate,95.00%,12.08,,,,12.08,12.72,0
unity,CDM,Um Brace Thumb Spica Universal,UM3500322,L3908,,"WRIST, HAND STATIC PRE FAB",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.72,% of charge rate,95.00%,12.08,,,,12.08,12.72,0
unity,CDM,Um Brace Spica Universal,UM3500323,L3923,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.09,% of charge rate,95.00%,7.69,,,,7.69,8.09,0
unity,CDM,Um Brace Spica Universal,UM3500323,L3923,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.09,% of charge rate,95.00%,7.69,,,,7.69,8.09,0
unity,CDM,Um Hand/wrist Orthosis,UM3500243,L3984,,,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.12,% of charge rate,95.00%,77.06,,,,77.06,81.12,0
unity,CDM,Um Hand/wrist Orthosis,UM3500243,L3984,,,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.12,% of charge rate,95.00%,77.06,,,,77.06,81.12,0
unity,CDM,Um Elbow Brace - Elastic,UM3500222,L3999,,LH THUMB SPICA SPLINT-PROCARE,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.28,% of charge rate,95.00%,5.97,,,,5.97,6.28,0
unity,CDM,Um Elbow Brace - Elastic,UM3500222,L3999,,LH THUMB SPICA SPLINT-PROCARE,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.28,% of charge rate,95.00%,5.97,,,,5.97,6.28,0
unity,CDM,Um Cam Walker,UM3500221,L4386,,WALKER PREM EQUL LG,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,231.9,% of charge rate,95.00%,220.31,,,,220.31,231.9,0
unity,CDM,Um Cam Walker,UM3500221,L4386,,WALKER PREM EQUL LG,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,231.9,% of charge rate,95.00%,220.31,,,,220.31,231.9,0
unity,CDM,Um Screening Paper Thin Layer,UM4000916,P3001,,Screening pap smear by phys,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.82,% of charge rate,95.00%,107.18,,,,107.18,112.82,0
unity,CDM,Um Screening Paper Thin Layer,UM4000916,P3001,,Screening pap smear by phys,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.82,% of charge rate,95.00%,107.18,,,,107.18,112.82,0
unity,CDM,Um Rbc's Leukocytes Reduced,UM4050009,P9016,,Rbc leukocytes reduced,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,572.55,% of charge rate,95.00%,543.92,,,,543.92,572.55,0
unity,CDM,Um Rbc's Leukocytes Reduced,UM4050009,P9016,,Rbc leukocytes reduced,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,572.55,% of charge rate,95.00%,543.92,,,,543.92,572.55,0
unity,CDM,Um Fresh Frozen Plasma,UM4050008,P9017,,Plasma 1 donor frz w/in 8 hr,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.67,% of charge rate,95.00%,221.04,,,,221.04,232.67,0
unity,CDM,Um Fresh Frozen Plasma,UM4050008,P9017,,Plasma 1 donor frz w/in 8 hr,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,232.67,% of charge rate,95.00%,221.04,,,,221.04,232.67,0
unity,CDM,Um Red Blood Cells,UM4050004,P9021,,Red blood cells unit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,448.88,% of charge rate,95.00%,426.44,,,,426.44,448.88,0
unity,CDM,Um Red Blood Cells,UM4050004,P9021,,Red blood cells unit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,448.88,% of charge rate,95.00%,426.44,,,,426.44,448.88,0
unity,CDM,Um Rbc's Washed,UM4050003,P9022,,Washed red blood cells unit,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,922.11,% of charge rate,95.00%,876,,,,876,922.11,0
unity,CDM,Um Rbc's Washed,UM4050003,P9022,,Washed red blood cells unit,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,922.11,% of charge rate,95.00%,876,,,,876,922.11,0
unity,CDM,"Um Platelets, Pher, Leuko Re",UM4050010,P9035,,Platelet pheres leukoreduced,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,502.00",% of charge rate,95.00%,"1,426.90",,,,"1,426.90","1,502.00",0
unity,CDM,"Um Platelets, Pher, Leuko Re",UM4050010,P9035,,Platelet pheres leukoreduced,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,502.00",% of charge rate,95.00%,"1,426.90",,,,"1,426.90","1,502.00",0
unity,CDM,"Um Plt, Pher, Irrad Leuko Re",UM4050021,P9037,,Plate pheres leukoredu irrad,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,985.70",% of charge rate,95.00%,"1,886.42",,,,"1,886.42","1,985.70",0
unity,CDM,"Um Plt, Pher, Irrad Leuko Re",UM4050021,P9037,,Plate pheres leukoredu irrad,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,985.70",% of charge rate,95.00%,"1,886.42",,,,"1,886.42","1,985.70",0
unity,CDM,"Um Rbc's, Irrad, Leuko Reduc",UM4050020,P9040,,Rbc leukoreduced irradiated,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,804.07,% of charge rate,95.00%,763.87,,,,763.87,804.07,0
unity,CDM,"Um Rbc's, Irrad, Leuko Reduc",UM4050020,P9040,,Rbc leukoreduced irradiated,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,804.07,% of charge rate,95.00%,763.87,,,,763.87,804.07,0
unity,CDM,TELEHEALTH,7610010,Q3014,,Telehealth facility fee,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,TELEHEALTH,7610010,Q3014,,Telehealth facility fee,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,0
unity,CDM,Um Casting Long Arm Fiber-ad,UM3500033,Q4006,,Cast sup long arm adult fbrg,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.52,% of charge rate,95.00%,38.49,,,,38.49,40.52,0
unity,CDM,Um Casting Long Arm Fiber-ad,UM3500033,Q4006,,Cast sup long arm adult fbrg,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.52,% of charge rate,95.00%,38.49,,,,38.49,40.52,0
unity,CDM,Um Casting Long Arm Fiber-ch,UM3500013,Q4008,,Cast sup long arm ped fbrgls,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Casting Long Arm Fiber-ch,UM3500013,Q4008,,Cast sup long arm ped fbrgls,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm-fiber Ad+,UM3500064,Q4010,,Cast sup sht arm adult fbrgl,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm-fiber Ad+,UM3500064,Q4010,,Cast sup sht arm adult fbrgl,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm-fiber-ch,UM3500026,Q4012,,Cast sup sht arm ped fbrglas,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm-fiber-ch,UM3500026,Q4012,,Cast sup sht arm ped fbrglas,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm Splint-ad,UM3500042,Q4022,,Cast sup sht arm splint fbrg,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm Splint-ad,UM3500042,Q4022,,Cast sup sht arm splint fbrg,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.76,% of charge rate,95.00%,32.07,,,,32.07,33.76,0
unity,CDM,Um Casting Short Leg - Ad,UM3500228,Q4037,,Cast sup shrt leg plaster,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.05,% of charge rate,95.00%,51.35,,,,51.35,54.05,0
unity,CDM,Um Casting Short Leg - Ad,UM3500228,Q4037,,Cast sup shrt leg plaster,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.05,% of charge rate,95.00%,51.35,,,,51.35,54.05,0
unity,CDM,Um Castg -short Leg-fib-ad,UM3500240,Q4038,,Cast sup shrt leg fiberglass,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.47,% of charge rate,95.00%,52.7,,,,52.7,55.47,0
unity,CDM,Um Castg -short Leg-fib-ad,UM3500240,Q4038,,Cast sup shrt leg fiberglass,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.47,% of charge rate,95.00%,52.7,,,,52.7,55.47,0
unity,CDM,Um Cast Short Leg Splint-ad,UM3500241,Q4046,,Cast sup sht leg splnt fbrgl,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.65,% of charge rate,95.00%,36.72,,,,36.72,38.65,0
unity,CDM,Um Cast Short Leg Splint-ad,UM3500241,Q4046,,Cast sup sht leg splnt fbrgl,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.65,% of charge rate,95.00%,36.72,,,,36.72,38.65,0
unity,CDM,Um Casting Supplies,UM3500182,Q4047,,Cast sup sht leg splnt ped p,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.91,% of charge rate,95.00%,38.86,,,,38.86,40.91,0
unity,CDM,Um Casting Supplies,UM3500182,Q4047,,Cast sup sht leg splnt ped p,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.91,% of charge rate,95.00%,38.86,,,,38.86,40.91,0
unity,CDM,Um Finger Splint,UM3500014,Q4049,,"Finger splint, static",,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.44,% of charge rate,95.00%,6.12,,,,6.12,6.44,0
unity,CDM,Um Finger Splint,UM3500014,Q4049,,"Finger splint, static",,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.44,% of charge rate,95.00%,6.12,,,,6.12,6.44,0
unity,CDM,Hc Non-heu Tc-99m Add-on/dose,3430036,Q9969,,Non-heu tc-99m add-on/dose,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Hc Non-heu Tc-99m Add-on/dose,3430036,Q9969,,Non-heu tc-99m add-on/dose,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,90,% of charge rate,95.00%,85.5,,,,85.5,90,0
unity,CDM,Um O2 Conts - 1unit=1 Cu. Ft,UM3470018,S8120,,O2 contents gas cubic ft,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.48,% of charge rate,95.00%,2.36,,,,2.36,2.48,0
unity,CDM,Um O2 Conts - 1unit=1 Cu. Ft,UM3470018,S8120,,O2 contents gas cubic ft,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,2.48,% of charge rate,95.00%,2.36,,,,2.36,2.48,0
unity,CDM,Um Rosidal Soft Wrap,UM3500291,S8430,,Padding for comprssn bdg,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.5,% of charge rate,95.00%,13.78,,,,13.78,14.5,0
unity,CDM,Um Rosidal Soft Wrap,UM3500291,S8430,,Padding for comprssn bdg,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.5,% of charge rate,95.00%,13.78,,,,13.78,14.5,0
unity,CDM,Um Lens,UM3500049,V2632,,Post chmbr intraocular lens,,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,999.03,% of charge rate,95.00%,949.08,,,,949.08,999.03,0
unity,CDM,Um Lens,UM3500049,V2632,,Post chmbr intraocular lens,,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,999.03,% of charge rate,95.00%,949.08,,,,949.08,999.03,0
unity,CDM,ROOM & NURSING,1210000,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,200.00",% of charge rate,100.00%,"1,200.00",,,,"1,140.00","1,200.00",0
unity,CDM,Um Esophagogastorduodeno,UM3250003,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,857.60",% of charge rate,100.00%,"1,857.60",,,,"1,764.72","1,857.60",0
unity,CDM,Um Esophagogastorduodeno,UM3250003,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,857.60",% of charge rate,100.00%,"1,857.60",,,,"1,764.72","1,857.60",0
unity,CDM,Um Surgery 4 Hours,UM3250004,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"6,500.00",% of charge rate,100.00%,"6,500.00",,,,"6,175.00","6,500.00",0
unity,CDM,Um Surgery 4 Hours,UM3250004,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"6,500.00",% of charge rate,100.00%,"6,500.00",,,,"6,175.00","6,500.00",0
unity,CDM,Um Surgery 3.5 Hours,UM3250005,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,800.00",% of charge rate,100.00%,"5,800.00",,,,"5,510.00","5,800.00",0
unity,CDM,Um Surgery 3.5 Hours,UM3250005,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,800.00",% of charge rate,100.00%,"5,800.00",,,,"5,510.00","5,800.00",0
unity,CDM,Um Surgery 2.5 Hours,UM3250006,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,500.00",% of charge rate,100.00%,"4,500.00",,,,"4,275.00","4,500.00",0
unity,CDM,Um Surgery 2.5 Hours,UM3250006,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,500.00",% of charge rate,100.00%,"4,500.00",,,,"4,275.00","4,500.00",0
unity,CDM,Um Cataract Surgery - Simple,UM3250007,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,415.01",% of charge rate,100.00%,"2,415.01",,,,"2,294.26","2,415.01",0
unity,CDM,Um Cataract Surgery - Simple,UM3250007,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,415.01",% of charge rate,100.00%,"2,415.01",,,,"2,294.26","2,415.01",0
unity,CDM,Um Surgery 3 Hours,UM3250008,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,200.00",% of charge rate,100.00%,"5,200.00",,,,"4,940.00","5,200.00",0
unity,CDM,Um Surgery 3 Hours,UM3250008,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,200.00",% of charge rate,100.00%,"5,200.00",,,,"4,940.00","5,200.00",0
unity,CDM,Um Surgery 1 Hour,UM3250009,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,500.00",% of charge rate,100.00%,"2,500.00",,,,"2,375.00","2,500.00",0
unity,CDM,Um Surgery 1 Hour,UM3250009,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,500.00",% of charge rate,100.00%,"2,500.00",,,,"2,375.00","2,500.00",0
unity,CDM,Um Surgery .5 Hour,UM3250010,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,900.00",% of charge rate,100.00%,"1,900.00",,,,"1,805.00","1,900.00",0
unity,CDM,Um Surgery .5 Hour,UM3250010,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,900.00",% of charge rate,100.00%,"1,900.00",,,,"1,805.00","1,900.00",0
unity,CDM,Um Surgery 1.5 Hr,UM3250011,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,200.00",% of charge rate,100.00%,"3,200.00",,,,"3,040.00","3,200.00",0
unity,CDM,Um Surgery 1.5 Hr,UM3250011,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,200.00",% of charge rate,100.00%,"3,200.00",,,,"3,040.00","3,200.00",0
unity,CDM,Um Colonscopy Flex/sig,UM3250012,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,508.04",% of charge rate,100.00%,"1,508.04",,,,"1,432.64","1,508.04",0
unity,CDM,Um Colonscopy Flex/sig,UM3250012,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,508.04",% of charge rate,100.00%,"1,508.04",,,,"1,432.64","1,508.04",0
unity,CDM,Um Surgery 2 Hours,UM3250013,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,900.00",% of charge rate,100.00%,"3,900.00",,,,"3,705.00","3,900.00",0
unity,CDM,Um Surgery 2 Hours,UM3250013,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,900.00",% of charge rate,100.00%,"3,900.00",,,,"3,705.00","3,900.00",0
unity,CDM,Um Ortho Surg.5 Hour,UM3250015,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,700.00",% of charge rate,100.00%,"2,700.00",,,,"2,565.00","2,700.00",0
unity,CDM,Um Ortho Surg.5 Hour,UM3250015,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,700.00",% of charge rate,100.00%,"2,700.00",,,,"2,565.00","2,700.00",0
unity,CDM,Um Surgicel 2x3in,UM325001505,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65.99,% of charge rate,100.00%,65.99,,,,62.69,65.99,0
unity,CDM,Um Surgicel 2x3in,UM325001505,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65.99,% of charge rate,100.00%,65.99,,,,62.69,65.99,0
unity,CDM,Um Surgicel 4x8in,UM325001513,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,122.63,% of charge rate,100.00%,122.63,,,,116.5,122.63,0
unity,CDM,Um Surgicel 4x8in,UM325001513,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,122.63,% of charge rate,100.00%,122.63,,,,116.5,122.63,0
unity,CDM,Um Ortho Surg 1 Hour,UM3250016,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,500.00",% of charge rate,100.00%,"4,500.00",,,,"4,275.00","4,500.00",0
unity,CDM,Um Ortho Surg 1 Hour,UM3250016,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,500.00",% of charge rate,100.00%,"4,500.00",,,,"4,275.00","4,500.00",0
unity,CDM,Um Ortho Surg 1.5 Hour,UM3250017,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,760.00",% of charge rate,100.00%,"5,760.00",,,,"5,472.00","5,760.00",0
unity,CDM,Um Ortho Surg 1.5 Hour,UM3250017,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,760.00",% of charge rate,100.00%,"5,760.00",,,,"5,472.00","5,760.00",0
unity,CDM,Um Ortho Surg 2 Hours,UM3250018,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"7,020.00",% of charge rate,100.00%,"7,020.00",,,,"6,669.00","7,020.00",0
unity,CDM,Um Ortho Surg 2 Hours,UM3250018,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"7,020.00",% of charge rate,100.00%,"7,020.00",,,,"6,669.00","7,020.00",0
unity,CDM,Um Ortho Surg 2 .5 Hour,UM3250019,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"8,100.00",% of charge rate,100.00%,"8,100.00",,,,"7,695.00","8,100.00",0
unity,CDM,Um Ortho Surg 2 .5 Hour,UM3250019,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"8,100.00",% of charge rate,100.00%,"8,100.00",,,,"7,695.00","8,100.00",0
unity,CDM,Um Ortho Surg 3 Hour,UM3250020,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,360.00",% of charge rate,100.00%,"9,360.00",,,,"8,892.00","9,360.00",0
unity,CDM,Um Ortho Surg 3 Hour,UM3250020,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,360.00",% of charge rate,100.00%,"9,360.00",,,,"8,892.00","9,360.00",0
unity,CDM,Um Ortho Surg 3.5 Hour,UM3250021,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"10,440.00",% of charge rate,100.00%,"10,440.00",,,,"9,918.00","10,440.00",0
unity,CDM,Um Ortho Surg 3.5 Hour,UM3250021,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"10,440.00",% of charge rate,100.00%,"10,440.00",,,,"9,918.00","10,440.00",0
unity,CDM,Um Ortho Surg 4 Hour,UM3250022,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"11,700.00",% of charge rate,100.00%,"11,700.00",,,,"11,115.00","11,700.00",0
unity,CDM,Um Ortho Surg 4 Hour,UM3250022,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"11,700.00",% of charge rate,100.00%,"11,700.00",,,,"11,115.00","11,700.00",0
unity,CDM,Um Cataract Surgery - Complex,UM3250023,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,000.00",% of charge rate,100.00%,"3,000.00",,,,"2,850.00","3,000.00",0
unity,CDM,Um Cataract Surgery - Complex,UM3250023,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,000.00",% of charge rate,100.00%,"3,000.00",,,,"2,850.00","3,000.00",0
unity,CDM,Um Par-recovery Rm 3 Hrs,UM3300001,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,686.17,% of charge rate,100.00%,686.17,,,,651.86,686.17,0
unity,CDM,Um Par-recovery Rm 3 Hrs,UM3300001,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,686.17,% of charge rate,100.00%,686.17,,,,651.86,686.17,0
unity,CDM,Um Par-recovery Rm 1 1/2 Hr,UM3300002,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,537.85,% of charge rate,100.00%,537.85,,,,510.96,537.85,0
unity,CDM,Um Par-recovery Rm 1 1/2 Hr,UM3300002,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,537.85,% of charge rate,100.00%,537.85,,,,510.96,537.85,0
unity,CDM,Um Par-recovery Rm 1 Hr,UM3300003,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,400.54,% of charge rate,100.00%,400.54,,,,380.51,400.54,0
unity,CDM,Um Par-recovery Rm 1 Hr,UM3300003,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,400.54,% of charge rate,100.00%,400.54,,,,380.51,400.54,0
unity,CDM,Um Recovery First 2 Hours,UM3300004,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,498.16,% of charge rate,100.00%,498.16,,,,473.25,498.16,0
unity,CDM,Um Recovery First 2 Hours,UM3300004,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,498.16,% of charge rate,100.00%,498.16,,,,473.25,498.16,0
unity,CDM,Um Par-recovery Room-40 Mins,UM3300005,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,337.2,% of charge rate,100.00%,337.2,,,,320.34,337.2,0
unity,CDM,Um Par-recovery Room-40 Mins,UM3300005,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,337.2,% of charge rate,100.00%,337.2,,,,320.34,337.2,0
unity,CDM,Um Par-recovery Rm 1/2 Hr,UM3300006,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,253.02,% of charge rate,100.00%,253.02,,,,240.37,253.02,0
unity,CDM,Um Par-recovery Rm 1/2 Hr,UM3300006,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,253.02,% of charge rate,100.00%,253.02,,,,240.37,253.02,0
unity,CDM,Um Par-recovery Rm 2.5 Hr,UM3300007,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,558.63,% of charge rate,100.00%,558.63,,,,530.7,558.63,0
unity,CDM,Um Par-recovery Rm 2.5 Hr,UM3300007,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,558.63,% of charge rate,100.00%,558.63,,,,530.7,558.63,0
unity,CDM,Um Par-recovery Rm 2 Hrs,UM3300008,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,677.36,% of charge rate,100.00%,677.36,,,,643.49,677.36,0
unity,CDM,Um Par-recovery Rm 2 Hrs,UM3300008,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,677.36,% of charge rate,100.00%,677.36,,,,643.49,677.36,0
unity,CDM,UM 1/2 HOUR (AFTER 3 HOUR),UM3300009,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.8,% of charge rate,100.00%,25.8,,,,24.51,25.8,0
unity,CDM,UM 1/2 HOUR (AFTER 3 HOUR),UM3300009,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.8,% of charge rate,100.00%,25.8,,,,24.51,25.8,0
unity,CDM,Um Par-recovery First 2 Hours,UM3350004,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,498.16,% of charge rate,100.00%,498.16,,,,473.25,498.16,0
unity,CDM,Um Par-recovery First 2 Hours,UM3350004,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,498.16,% of charge rate,100.00%,498.16,,,,473.25,498.16,0
unity,CDM,Um Par-recovery Rm Addl 1/2 Hr,UM3350006,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,238.7,% of charge rate,100.00%,238.7,,,,226.77,238.7,0
unity,CDM,Um Par-recovery Rm Addl 1/2 Hr,UM3350006,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,238.7,% of charge rate,100.00%,238.7,,,,226.77,238.7,0
unity,CDM,Um 02 Concentr Sp Rental/day,UM3470023,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.39,% of charge rate,100.00%,12.39,,,,11.77,12.39,0
unity,CDM,Um 02 Concentr Sp Rental/day,UM3470023,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.39,% of charge rate,100.00%,12.39,,,,11.77,12.39,0
unity,CDM,Um Cpap Repair,UM3470042,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,242.52,% of charge rate,100.00%,242.52,,,,230.39,242.52,0
unity,CDM,Um Cpap Repair,UM3470042,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,242.52,% of charge rate,100.00%,242.52,,,,230.39,242.52,0
unity,CDM,Um O2 Concentrator-station>4l,UM3470105,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,84.32,% of charge rate,100.00%,84.32,,,,80.1,84.32,0
unity,CDM,Um O2 Concentrator-station>4l,UM3470105,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,84.32,% of charge rate,100.00%,84.32,,,,80.1,84.32,0
unity,CDM,Um Occup Pulmonary Screening,UM3480019,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Occup Pulmonary Screening,UM3480019,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Drug Screen Collection,UM3480022,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,19,20,0
unity,CDM,Um Drug Screen Collection,UM3480022,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,19,20,0
unity,CDM,Um Er Drug Screen Collection,UM3480024,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,55.63,% of charge rate,100.00%,55.63,,,,52.85,55.63,0
unity,CDM,Um Er Drug Screen Collection,UM3480024,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,55.63,% of charge rate,100.00%,55.63,,,,52.85,55.63,0
unity,CDM,Um Drug Screen After Hours,UM3480025,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75,% of charge rate,100.00%,75,,,,71.25,75,0
unity,CDM,Um Drug Screen After Hours,UM3480025,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75,% of charge rate,100.00%,75,,,,71.25,75,0
unity,CDM,Um Sequential Boots One Size,UM3500003,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.15,% of charge rate,100.00%,80.15,,,,76.14,80.15,0
unity,CDM,Um Sequential Boots One Size,UM3500003,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.15,% of charge rate,100.00%,80.15,,,,76.14,80.15,0
unity,CDM,Um K-wire 6 X .054,UM3500006,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,96.41,% of charge rate,100.00%,96.41,,,,91.59,96.41,0
unity,CDM,Um K-wire 6 X .054,UM3500006,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,96.41,% of charge rate,100.00%,96.41,,,,91.59,96.41,0
unity,CDM,Um Variabl Mask Nonrebrthing,UM3500011,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.61,% of charge rate,100.00%,7.61,,,,7.23,7.61,0
unity,CDM,Um Variabl Mask Nonrebrthing,UM3500011,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.61,% of charge rate,100.00%,7.61,,,,7.23,7.61,0
unity,CDM,Um Blade Fanous All Sizes,UM3500012,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,161.56,% of charge rate,100.00%,161.56,,,,153.48,161.56,0
unity,CDM,Um Blade Fanous All Sizes,UM3500012,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,161.56,% of charge rate,100.00%,161.56,,,,153.48,161.56,0
unity,CDM,Um Supp Por/cen Lin Infu/fsh,UM3500018,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Supp Por/cen Lin Infu/fsh,UM3500018,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Dispos Incentive Spiromet,UM3500021,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65.39,% of charge rate,100.00%,65.39,,,,62.12,65.39,0
unity,CDM,Um Dispos Incentive Spiromet,UM3500021,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65.39,% of charge rate,100.00%,65.39,,,,62.12,65.39,0
unity,CDM,Um Suture Set/large,UM3500024,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,122.96,% of charge rate,100.00%,122.96,,,,116.81,122.96,0
unity,CDM,Um Suture Set/large,UM3500024,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,122.96,% of charge rate,100.00%,122.96,,,,116.81,122.96,0
unity,CDM,Um Supp - Push / Centrl Line,UM3500031,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,77.62,% of charge rate,100.00%,77.62,,,,73.74,77.62,0
unity,CDM,Um Supp - Push / Centrl Line,UM3500031,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,77.62,% of charge rate,100.00%,77.62,,,,73.74,77.62,0
unity,CDM,Um Oxygen Er/outpatient,UM3500036,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.67,% of charge rate,100.00%,47.67,,,,45.29,47.67,0
unity,CDM,Um Oxygen Er/outpatient,UM3500036,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.67,% of charge rate,100.00%,47.67,,,,45.29,47.67,0
unity,CDM,Um Intubation Supplies,UM3500050,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.5,% of charge rate,100.00%,73.5,,,,69.83,73.5,0
unity,CDM,Um Intubation Supplies,UM3500050,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.5,% of charge rate,100.00%,73.5,,,,69.83,73.5,0
unity,CDM,Um Elastic Stock Knee Per Pr,UM3500060,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,44.13,% of charge rate,100.00%,44.13,,,,41.92,44.13,0
unity,CDM,Um Elastic Stock Knee Per Pr,UM3500060,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,44.13,% of charge rate,100.00%,44.13,,,,41.92,44.13,0
unity,CDM,Um Corregated Tubing -10 Ft.,UM3500073,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.49,% of charge rate,100.00%,41.49,,,,39.42,41.49,0
unity,CDM,Um Corregated Tubing -10 Ft.,UM3500073,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.49,% of charge rate,100.00%,41.49,,,,39.42,41.49,0
unity,CDM,Um Airway-nasopharyngeal,UM3500084,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.14,% of charge rate,100.00%,40.14,,,,38.13,40.14,0
unity,CDM,Um Airway-nasopharyngeal,UM3500084,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.14,% of charge rate,100.00%,40.14,,,,38.13,40.14,0
unity,CDM,Um Spinal Tray,UM3500093,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,205.49,% of charge rate,100.00%,205.49,,,,195.22,205.49,0
unity,CDM,Um Spinal Tray,UM3500093,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,205.49,% of charge rate,100.00%,205.49,,,,195.22,205.49,0
unity,CDM,Um Bone Screw 2.3,UM3500108,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,143,% of charge rate,100.00%,143,,,,135.85,143,0
unity,CDM,Um Bone Screw 2.3,UM3500108,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,143,% of charge rate,100.00%,143,,,,135.85,143,0
unity,CDM,Um Morgan Medi-flow Lens,UM3500110,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.1,% of charge rate,100.00%,66.1,,,,62.8,66.1,0
unity,CDM,Um Morgan Medi-flow Lens,UM3500110,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.1,% of charge rate,100.00%,66.1,,,,62.8,66.1,0
unity,CDM,Um 2.7 Cortical Screw(20mm),UM3500112,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69.94,% of charge rate,100.00%,69.94,,,,66.44,69.94,0
unity,CDM,Um 2.7 Cortical Screw(20mm),UM3500112,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69.94,% of charge rate,100.00%,69.94,,,,66.44,69.94,0
unity,CDM,Um Dress Sponges (tray),UM3500113,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,11.34,% of charge rate,100.00%,11.34,,,,10.77,11.34,0
unity,CDM,Um Dress Sponges (tray),UM3500113,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,11.34,% of charge rate,100.00%,11.34,,,,10.77,11.34,0
unity,CDM,Um Bone Wax,UM3500114,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49.08,% of charge rate,100.00%,49.08,,,,46.63,49.08,0
unity,CDM,Um Bone Wax,UM3500114,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49.08,% of charge rate,100.00%,49.08,,,,46.63,49.08,0
unity,CDM,Um Nasal Pack 7.5,UM3500123,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110.62,% of charge rate,100.00%,110.62,,,,105.09,110.62,0
unity,CDM,Um Nasal Pack 7.5,UM3500123,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110.62,% of charge rate,100.00%,110.62,,,,105.09,110.62,0
unity,CDM,Um Supp Port/centrl Line Fsh,UM3500129,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.21,% of charge rate,100.00%,72.21,,,,68.6,72.21,0
unity,CDM,Um Supp Port/centrl Line Fsh,UM3500129,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.21,% of charge rate,100.00%,72.21,,,,68.6,72.21,0
unity,CDM,Um Supplies Iv Push,UM3500156,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.02,% of charge rate,100.00%,34.02,,,,32.32,34.02,0
unity,CDM,Um Supplies Iv Push,UM3500156,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.02,% of charge rate,100.00%,34.02,,,,32.32,34.02,0
unity,CDM,Um Fluidair Bed,UM3500160,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,105.52,% of charge rate,100.00%,105.52,,,,100.24,105.52,0
unity,CDM,Um Fluidair Bed,UM3500160,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,105.52,% of charge rate,100.00%,105.52,,,,100.24,105.52,0
unity,CDM,Um Self Tap Cordial Scr 2.7,UM3500162,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,84.14,% of charge rate,100.00%,84.14,,,,79.93,84.14,0
unity,CDM,Um Self Tap Cordial Scr 2.7,UM3500162,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,84.14,% of charge rate,100.00%,84.14,,,,79.93,84.14,0
unity,CDM,Um Intubation Tray,UM3500170,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.5,% of charge rate,100.00%,73.5,,,,69.83,73.5,0
unity,CDM,Um Intubation Tray,UM3500170,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.5,% of charge rate,100.00%,73.5,,,,69.83,73.5,0
unity,CDM,Um K-wire 6 X .045,UM3500174,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,96.41,% of charge rate,100.00%,96.41,,,,91.59,96.41,0
unity,CDM,Um K-wire 6 X .045,UM3500174,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,96.41,% of charge rate,100.00%,96.41,,,,91.59,96.41,0
unity,CDM,Um Oxygen Contents Per Day,UM3500175,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,253.69,% of charge rate,100.00%,253.69,,,,241.01,253.69,0
unity,CDM,Um Oxygen Contents Per Day,UM3500175,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,253.69,% of charge rate,100.00%,253.69,,,,241.01,253.69,0
unity,CDM,Um Variable Mask Oxygen,UM3500189,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.61,% of charge rate,100.00%,7.61,,,,7.23,7.61,0
unity,CDM,Um Variable Mask Oxygen,UM3500189,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.61,% of charge rate,100.00%,7.61,,,,7.23,7.61,0
unity,CDM,Um Supp Iv Infusion/ Ctrl Li,UM3500199,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,128.98,% of charge rate,100.00%,128.98,,,,122.53,128.98,0
unity,CDM,Um Supp Iv Infusion/ Ctrl Li,UM3500199,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,128.98,% of charge rate,100.00%,128.98,,,,122.53,128.98,0
unity,CDM,Um Supplies  Iv Infusion,UM3500206,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,121.56,% of charge rate,100.00%,121.56,,,,115.48,121.56,0
unity,CDM,Um Supplies  Iv Infusion,UM3500206,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,121.56,% of charge rate,100.00%,121.56,,,,115.48,121.56,0
unity,CDM,Um Bur Medium 4mm,UM3500212,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,246.74,% of charge rate,100.00%,246.74,,,,234.4,246.74,0
unity,CDM,Um Bur Medium 4mm,UM3500212,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,246.74,% of charge rate,100.00%,246.74,,,,234.4,246.74,0
unity,CDM,Um Ensure-8 Oz-all Flavors,UM3500213,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.34,% of charge rate,100.00%,9.34,,,,8.87,9.34,0
unity,CDM,Um Ensure-8 Oz-all Flavors,UM3500213,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.34,% of charge rate,100.00%,9.34,,,,8.87,9.34,0
unity,CDM,Um Perfix Plug Universal,UM3500216,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,406.14,% of charge rate,100.00%,406.14,,,,385.83,406.14,0
unity,CDM,Um Perfix Plug Universal,UM3500216,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,406.14,% of charge rate,100.00%,406.14,,,,385.83,406.14,0
unity,CDM,Um Mask Aerosol,UM3500227,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.43,% of charge rate,100.00%,3.43,,,,3.26,3.43,0
unity,CDM,Um Mask Aerosol,UM3500227,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.43,% of charge rate,100.00%,3.43,,,,3.26,3.43,0
unity,CDM,Um Sterile Water Neb,UM3500231,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.59,% of charge rate,100.00%,4.59,,,,4.36,4.59,0
unity,CDM,Um Sterile Water Neb,UM3500231,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.59,% of charge rate,100.00%,4.59,,,,4.36,4.59,0
unity,CDM,Um Trach Mask,UM3500245,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,2.6,% of charge rate,100.00%,2.6,,,,2.47,2.6,0
unity,CDM,Um Trach Mask,UM3500245,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,2.6,% of charge rate,100.00%,2.6,,,,2.47,2.6,0
unity,CDM,Um Tray Picc Line Dressing,UM3500246,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.04,% of charge rate,100.00%,53.04,,,,50.39,53.04,0
unity,CDM,Um Tray Picc Line Dressing,UM3500246,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.04,% of charge rate,100.00%,53.04,,,,50.39,53.04,0
unity,CDM,Um Tray C Cath/meter Bag,UM3500247,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.04,% of charge rate,100.00%,40.04,,,,38.04,40.04,0
unity,CDM,Um Tray C Cath/meter Bag,UM3500247,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.04,% of charge rate,100.00%,40.04,,,,38.04,40.04,0
unity,CDM,Um Mesh Prolene 12x12,UM3500252,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,482.24,% of charge rate,100.00%,482.24,,,,458.13,482.24,0
unity,CDM,Um Mesh Prolene 12x12,UM3500252,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,482.24,% of charge rate,100.00%,482.24,,,,458.13,482.24,0
unity,CDM,Um Quicktrach,UM3500254,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,158.05,% of charge rate,100.00%,158.05,,,,150.15,158.05,0
unity,CDM,Um Quicktrach,UM3500254,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,158.05,% of charge rate,100.00%,158.05,,,,150.15,158.05,0
unity,CDM,Um Open Pack 1,UM3500265,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,102.40",% of charge rate,100.00%,"1,102.40",,,,"1,047.28","1,102.40",0
unity,CDM,Um Open Pack 1,UM3500265,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,102.40",% of charge rate,100.00%,"1,102.40",,,,"1,047.28","1,102.40",0
unity,CDM,Um Open Pack 2,UM3500266,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,378.00",% of charge rate,100.00%,"1,378.00",,,,"1,309.10","1,378.00",0
unity,CDM,Um Open Pack 2,UM3500266,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,378.00",% of charge rate,100.00%,"1,378.00",,,,"1,309.10","1,378.00",0
unity,CDM,Um Open Pack 3,UM3500267,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,653.60",% of charge rate,100.00%,"1,653.60",,,,"1,570.92","1,653.60",0
unity,CDM,Um Open Pack 3,UM3500267,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,653.60",% of charge rate,100.00%,"1,653.60",,,,"1,570.92","1,653.60",0
unity,CDM,Um Lap Pack 1,UM3500268,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,822.56",% of charge rate,100.00%,"2,822.56",,,,"2,681.43","2,822.56",0
unity,CDM,Um Lap Pack 1,UM3500268,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,822.56",% of charge rate,100.00%,"2,822.56",,,,"2,681.43","2,822.56",0
unity,CDM,Um Lap Pack Ii,UM3500269,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,949.92",% of charge rate,100.00%,"3,949.92",,,,"3,752.42","3,949.92",0
unity,CDM,Um Lap Pack Ii,UM3500269,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,949.92",% of charge rate,100.00%,"3,949.92",,,,"3,752.42","3,949.92",0
unity,CDM,Um Lap Pack I I I,UM3500270,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"7,257.12",% of charge rate,100.00%,"7,257.12",,,,"6,894.26","7,257.12",0
unity,CDM,Um Lap Pack I I I,UM3500270,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"7,257.12",% of charge rate,100.00%,"7,257.12",,,,"6,894.26","7,257.12",0
unity,CDM,Um Lap Pack Iv,UM3500271,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,834.08,% of charge rate,100.00%,834.08,,,,792.38,834.08,0
unity,CDM,Um Lap Pack Iv,UM3500271,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,834.08,% of charge rate,100.00%,834.08,,,,792.38,834.08,0
unity,CDM,Um On Q Pump,UM3500272,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,532.22,% of charge rate,100.00%,532.22,,,,505.61,532.22,0
unity,CDM,Um On Q Pump,UM3500272,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,532.22,% of charge rate,100.00%,532.22,,,,505.61,532.22,0
unity,CDM,Um Solution Clinimix 5/15,UM3500273,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.67,% of charge rate,100.00%,58.67,,,,55.74,58.67,0
unity,CDM,Um Solution Clinimix 5/15,UM3500273,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.67,% of charge rate,100.00%,58.67,,,,55.74,58.67,0
unity,CDM,Um Solution Clinimix 4/25,UM3500274,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50.75,% of charge rate,100.00%,50.75,,,,48.21,50.75,0
unity,CDM,Um Solution Clinimix 4/25,UM3500274,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50.75,% of charge rate,100.00%,50.75,,,,48.21,50.75,0
unity,CDM,Um Intra Lipids,UM3500275,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.5,% of charge rate,100.00%,40.5,,,,38.48,40.5,0
unity,CDM,Um Intra Lipids,UM3500275,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.5,% of charge rate,100.00%,40.5,,,,38.48,40.5,0
unity,CDM,Um Mesh Prolene 6x6,UM3500276,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,212.82,% of charge rate,100.00%,212.82,,,,202.18,212.82,0
unity,CDM,Um Mesh Prolene 6x6,UM3500276,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,212.82,% of charge rate,100.00%,212.82,,,,202.18,212.82,0
unity,CDM,Um Hinged Knee Splint,UM3500277,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.7,% of charge rate,100.00%,29.7,,,,28.22,29.7,0
unity,CDM,Um Hinged Knee Splint,UM3500277,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.7,% of charge rate,100.00%,29.7,,,,28.22,29.7,0
unity,CDM,Um Thumb Wrist Orthosis,UM3500278,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.01,% of charge rate,100.00%,62.01,,,,58.91,62.01,0
unity,CDM,Um Thumb Wrist Orthosis,UM3500278,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.01,% of charge rate,100.00%,62.01,,,,58.91,62.01,0
unity,CDM,Um 10x30 Bio Flat Sheet Mesh,UM3500279,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,837.2,% of charge rate,100.00%,837.2,,,,795.34,837.2,0
unity,CDM,Um 10x30 Bio Flat Sheet Mesh,UM3500279,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,837.2,% of charge rate,100.00%,837.2,,,,795.34,837.2,0
unity,CDM,Um 9x15 Bio Flat Sheet Mesh,UM3500280,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,451.80",% of charge rate,100.00%,"2,451.80",,,,"2,329.21","2,451.80",0
unity,CDM,Um 9x15 Bio Flat Sheet Mesh,UM3500280,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,451.80",% of charge rate,100.00%,"2,451.80",,,,"2,329.21","2,451.80",0
unity,CDM,Um Derabond,UM3500281,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.56,% of charge rate,100.00%,48.56,,,,46.13,48.56,0
unity,CDM,Um Derabond,UM3500281,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.56,% of charge rate,100.00%,48.56,,,,46.13,48.56,0
unity,CDM,Um Splint Fib/tib,UM3500283,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.45,% of charge rate,100.00%,47.45,,,,45.08,47.45,0
unity,CDM,Um Splint Fib/tib,UM3500283,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.45,% of charge rate,100.00%,47.45,,,,45.08,47.45,0
unity,CDM,Um Medihoney Unv,UM3500284,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.25,% of charge rate,100.00%,6.25,,,,5.94,6.25,0
unity,CDM,Um Medihoney Unv,UM3500284,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.25,% of charge rate,100.00%,6.25,,,,5.94,6.25,0
unity,CDM,Um Xtrasorb Unv,UM3500285,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,2.99,% of charge rate,100.00%,2.99,,,,2.84,2.99,0
unity,CDM,Um Xtrasorb Unv,UM3500285,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,2.99,% of charge rate,100.00%,2.99,,,,2.84,2.99,0
unity,CDM,CHEST DRAINAGE KIT,UM3500286,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.28,% of charge rate,100.00%,111.28,,,,105.72,111.28,0
unity,CDM,CHEST DRAINAGE KIT,UM3500286,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.28,% of charge rate,100.00%,111.28,,,,105.72,111.28,0
unity,CDM,PARACENTIS TRAY,UM3500287,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.79,% of charge rate,100.00%,52.79,,,,50.15,52.79,0
unity,CDM,PARACENTIS TRAY,UM3500287,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.79,% of charge rate,100.00%,52.79,,,,50.15,52.79,0
unity,CDM,Um Pleurx Procedure Pack,UM3500288,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100.51,% of charge rate,100.00%,100.51,,,,95.48,100.51,0
unity,CDM,Um Pleurx Procedure Pack,UM3500288,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100.51,% of charge rate,100.00%,100.51,,,,95.48,100.51,0
unity,CDM,Um Forcep Blue,UM3500292,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.51,% of charge rate,100.00%,9.51,,,,9.03,9.51,0
unity,CDM,Um Forcep Blue,UM3500292,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.51,% of charge rate,100.00%,9.51,,,,9.03,9.51,0
unity,CDM,Um Clip Applier,UM3500293,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,151.58,% of charge rate,100.00%,151.58,,,,144,151.58,0
unity,CDM,Um Clip Applier,UM3500293,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,151.58,% of charge rate,100.00%,151.58,,,,144,151.58,0
unity,CDM,Um Clip Applier 5mm,UM3500294,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,749.23,% of charge rate,100.00%,749.23,,,,711.77,749.23,0
unity,CDM,Um Clip Applier 5mm,UM3500294,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,749.23,% of charge rate,100.00%,749.23,,,,711.77,749.23,0
unity,CDM,Um Protack,UM3500295,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,711.2,% of charge rate,100.00%,711.2,,,,675.64,711.2,0
unity,CDM,Um Protack,UM3500295,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,711.2,% of charge rate,100.00%,711.2,,,,675.64,711.2,0
unity,CDM,Um Linear Cutter,UM3500296,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,576.6,% of charge rate,100.00%,576.6,,,,547.77,576.6,0
unity,CDM,Um Linear Cutter,UM3500296,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,576.6,% of charge rate,100.00%,576.6,,,,547.77,576.6,0
unity,CDM,Um Retriever Pouch,UM3500297,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.74,% of charge rate,100.00%,80.74,,,,76.7,80.74,0
unity,CDM,Um Retriever Pouch,UM3500297,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.74,% of charge rate,100.00%,80.74,,,,76.7,80.74,0
unity,CDM,Um Dissector Tip 5mm,UM3500298,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.01,% of charge rate,100.00%,27.01,,,,25.66,27.01,0
unity,CDM,Um Dissector Tip 5mm,UM3500298,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.01,% of charge rate,100.00%,27.01,,,,25.66,27.01,0
unity,CDM,Um Secure Strap 12,UM3500299,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,528.16,% of charge rate,100.00%,528.16,,,,501.75,528.16,0
unity,CDM,Um Secure Strap 12,UM3500299,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,528.16,% of charge rate,100.00%,528.16,,,,501.75,528.16,0
unity,CDM,Um Secure Strap 25,UM3500300,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,766.92,% of charge rate,100.00%,766.92,,,,728.57,766.92,0
unity,CDM,Um Secure Strap 25,UM3500300,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,766.92,% of charge rate,100.00%,766.92,,,,728.57,766.92,0
unity,CDM,Um Curved Scissors,UM3500301,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,492.3,% of charge rate,100.00%,492.3,,,,467.69,492.3,0
unity,CDM,Um Curved Scissors,UM3500301,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,492.3,% of charge rate,100.00%,492.3,,,,467.69,492.3,0
unity,CDM,Um Paddle Endo,UM3500303,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,485.9,% of charge rate,100.00%,485.9,,,,461.61,485.9,0
unity,CDM,Um Paddle Endo,UM3500303,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,485.9,% of charge rate,100.00%,485.9,,,,461.61,485.9,0
unity,CDM,Um Endo Stitch,UM3500304,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,388.21,% of charge rate,100.00%,388.21,,,,368.8,388.21,0
unity,CDM,Um Endo Stitch,UM3500304,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,388.21,% of charge rate,100.00%,388.21,,,,368.8,388.21,0
unity,CDM,Um Purestring,UM3500305,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,243.79,% of charge rate,100.00%,243.79,,,,231.6,243.79,0
unity,CDM,Um Purestring,UM3500305,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,243.79,% of charge rate,100.00%,243.79,,,,231.6,243.79,0
unity,CDM,Um Ligasure,UM3500306,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,849.09,% of charge rate,100.00%,849.09,,,,806.64,849.09,0
unity,CDM,Um Ligasure,UM3500306,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,849.09,% of charge rate,100.00%,849.09,,,,806.64,849.09,0
unity,CDM,Um Linear Cutter,UM3500307,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.21,% of charge rate,100.00%,71.21,,,,67.65,71.21,0
unity,CDM,Um Linear Cutter,UM3500307,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.21,% of charge rate,100.00%,71.21,,,,67.65,71.21,0
unity,CDM,Um Linear Cutter,UM3500314,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.78,% of charge rate,100.00%,88.78,,,,84.34,88.78,0
unity,CDM,Um Linear Cutter,UM3500314,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.78,% of charge rate,100.00%,88.78,,,,84.34,88.78,0
unity,CDM,Um Blue Reload 45,UM3500315,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,278.89,% of charge rate,100.00%,278.89,,,,264.95,278.89,0
unity,CDM,Um Blue Reload 45,UM3500315,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,278.89,% of charge rate,100.00%,278.89,,,,264.95,278.89,0
unity,CDM,Um Grey Reload 45,UM3500316,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,278.89,% of charge rate,100.00%,278.89,,,,264.95,278.89,0
unity,CDM,Um Grey Reload 45,UM3500316,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,278.89,% of charge rate,100.00%,278.89,,,,264.95,278.89,0
unity,CDM,Um Surgidac Single,UM3500317,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.77,% of charge rate,100.00%,80.77,,,,76.73,80.77,0
unity,CDM,Um Surgidac Single,UM3500317,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.77,% of charge rate,100.00%,80.77,,,,76.73,80.77,0
unity,CDM,Um Surgidac Triple,UM3500318,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,215.72,% of charge rate,100.00%,215.72,,,,204.93,215.72,0
unity,CDM,Um Surgidac Triple,UM3500318,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,215.72,% of charge rate,100.00%,215.72,,,,204.93,215.72,0
unity,CDM,Um Polysorb Single,UM3500319,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.77,% of charge rate,100.00%,80.77,,,,76.73,80.77,0
unity,CDM,Um Polysorb Single,UM3500319,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.77,% of charge rate,100.00%,80.77,,,,76.73,80.77,0
unity,CDM,Um Insorb Absorable Stapler,UM3500325,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93.08,% of charge rate,100.00%,93.08,,,,88.43,93.08,0
unity,CDM,Um Insorb Absorable Stapler,UM3500325,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93.08,% of charge rate,100.00%,93.08,,,,88.43,93.08,0
unity,CDM,Um Endoscopic Hemoclip,UM3500326,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,433.37,% of charge rate,100.00%,433.37,,,,411.7,433.37,0
unity,CDM,Um Endoscopic Hemoclip,UM3500326,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,433.37,% of charge rate,100.00%,433.37,,,,411.7,433.37,0
unity,CDM,Um Drsg Aquacel Ag Surgical,UM3500327,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.97,% of charge rate,100.00%,54.97,,,,52.22,54.97,0
unity,CDM,Um Drsg Aquacel Ag Surgical,UM3500327,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.97,% of charge rate,100.00%,54.97,,,,52.22,54.97,0
unity,CDM,Um Mesh Retrieval Polyp,UM3500329,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91.77,% of charge rate,100.00%,91.77,,,,87.18,91.77,0
unity,CDM,Um Mesh Retrieval Polyp,UM3500329,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91.77,% of charge rate,100.00%,91.77,,,,87.18,91.77,0
unity,CDM,Um Iv Pump Set,UM3600027,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,86.71,% of charge rate,100.00%,86.71,,,,82.37,86.71,0
unity,CDM,Um Iv Pump Set,UM3600027,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,86.71,% of charge rate,100.00%,86.71,,,,82.37,86.71,0
unity,CDM,Um Nitro Pump Set,UM3600028,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,118.41,% of charge rate,100.00%,118.41,,,,112.49,118.41,0
unity,CDM,Um Nitro Pump Set,UM3600028,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,118.41,% of charge rate,100.00%,118.41,,,,112.49,118.41,0
unity,CDM,Um Er Cast/splint Applicatio,UM3700001,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,249.97,% of charge rate,100.00%,249.97,,,,237.47,249.97,0
unity,CDM,Um Er Cast/splint Applicatio,UM3700001,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,249.97,% of charge rate,100.00%,249.97,,,,237.47,249.97,0
unity,CDM,Um Er Ear Irrigation,UM3700007,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,92.49,% of charge rate,100.00%,92.49,,,,87.87,92.49,0
unity,CDM,Um Er Ear Irrigation,UM3700007,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,92.49,% of charge rate,100.00%,92.49,,,,87.87,92.49,0
unity,CDM,Um Er Removal Foreign Body,UM3700009,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,545.27,% of charge rate,100.00%,545.27,,,,518.01,545.27,0
unity,CDM,Um Er Removal Foreign Body,UM3700009,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,545.27,% of charge rate,100.00%,545.27,,,,518.01,545.27,0
unity,CDM,Um Er Remov Foreign Body Eye,UM3700010,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,139.56,% of charge rate,100.00%,139.56,,,,132.58,139.56,0
unity,CDM,Um Er Remov Foreign Body Eye,UM3700010,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,139.56,% of charge rate,100.00%,139.56,,,,132.58,139.56,0
unity,CDM,Um Er Suture Level I,UM3700015,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,306,% of charge rate,100.00%,306,,,,290.7,306,0
unity,CDM,Um Er Suture Level I,UM3700015,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,306,% of charge rate,100.00%,306,,,,290.7,306,0
unity,CDM,Um Er Control Nasal Hemorrha,UM3700019,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,176.83,% of charge rate,100.00%,176.83,,,,167.99,176.83,0
unity,CDM,Um Er Control Nasal Hemorrha,UM3700019,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,176.83,% of charge rate,100.00%,176.83,,,,167.99,176.83,0
unity,CDM,"Um Er Burn Care, Medium",UM3700021,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,201.82,% of charge rate,100.00%,201.82,,,,191.73,201.82,0
unity,CDM,"Um Er Burn Care, Medium",UM3700021,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,201.82,% of charge rate,100.00%,201.82,,,,191.73,201.82,0
unity,CDM,"Um Er Burn Care, Small",UM3700026,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,306.34,% of charge rate,100.00%,306.34,,,,291.02,306.34,0
unity,CDM,"Um Er Burn Care, Small",UM3700026,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,306.34,% of charge rate,100.00%,306.34,,,,291.02,306.34,0
unity,CDM,Um Er Suture Level Ii,UM3700027,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,545.27,% of charge rate,100.00%,545.27,,,,518.01,545.27,0
unity,CDM,Um Er Suture Level Ii,UM3700027,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,545.27,% of charge rate,100.00%,545.27,,,,518.01,545.27,0
unity,CDM,Um Er Drainage Abscess,UM3700029,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,306.34,% of charge rate,100.00%,306.34,,,,291.02,306.34,0
unity,CDM,Um Er Drainage Abscess,UM3700029,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,306.34,% of charge rate,100.00%,306.34,,,,291.02,306.34,0
unity,CDM,"Um Er Burn Care, Large",UM3700030,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,201.82,% of charge rate,100.00%,201.82,,,,191.73,201.82,0
unity,CDM,"Um Er Burn Care, Large",UM3700030,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,201.82,% of charge rate,100.00%,201.82,,,,191.73,201.82,0
unity,CDM,Um Er Fract Care/disloca L I,UM3700041,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,251.29,% of charge rate,100.00%,251.29,,,,238.73,251.29,0
unity,CDM,Um Er Fract Care/disloca L I,UM3700041,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,251.29,% of charge rate,100.00%,251.29,,,,238.73,251.29,0
unity,CDM,Um Er Suture Level Iii,UM3700043,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,112.28",% of charge rate,100.00%,"2,112.28",,,,"2,006.67","2,112.28",0
unity,CDM,Um Er Suture Level Iii,UM3700043,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,112.28",% of charge rate,100.00%,"2,112.28",,,,"2,006.67","2,112.28",0
unity,CDM,Um Drain/inject Joint/bursa,UM3700052,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,357.8,% of charge rate,100.00%,357.8,,,,339.91,357.8,0
unity,CDM,Um Drain/inject Joint/bursa,UM3700052,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,357.8,% of charge rate,100.00%,357.8,,,,339.91,357.8,0
unity,CDM,Um Postage (sheriff's Dept),UM4000747,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.83,% of charge rate,100.00%,3.83,,,,3.64,3.83,0
unity,CDM,Um Postage (sheriff's Dept),UM4000747,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.83,% of charge rate,100.00%,3.83,,,,3.64,3.83,0
unity,CDM,Um Specimen Collection/processing,UM4000769,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Specimen Collection/processing,UM4000769,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Autopsy,UM4010004,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,732.68,% of charge rate,100.00%,732.68,,,,696.05,732.68,0
unity,CDM,Um Autopsy,UM4010004,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,732.68,% of charge rate,100.00%,732.68,,,,696.05,732.68,0
unity,CDM,Um Iv Starts Non Surg,UM4270001,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,86.11,% of charge rate,100.00%,86.11,,,,81.8,86.11,0
unity,CDM,Um Iv Starts Non Surg,UM4270001,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,86.11,% of charge rate,100.00%,86.11,,,,81.8,86.11,0
unity,CDM,Um Anesthesia/minute,UM4270003,,,,,,Professional,N/A,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,20,20,0
unity,CDM,Um Minor,UM4270004,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,177.88,% of charge rate,100.00%,177.88,,,,168.99,177.88,0
unity,CDM,Um Minor,UM4270004,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,177.88,% of charge rate,100.00%,177.88,,,,168.99,177.88,0
unity,CDM,Um Mask-vital Signs-anest,UM4270005,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.08,% of charge rate,100.00%,20.08,,,,19.08,20.08,0
unity,CDM,Um Mask-vital Signs-anest,UM4270005,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.08,% of charge rate,100.00%,20.08,,,,19.08,20.08,0
unity,CDM,Um Major,UM4270006,,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,233.87,% of charge rate,100.00%,233.87,,,,222.18,233.87,0
unity,CDM,Um Major,UM4270006,,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,233.87,% of charge rate,100.00%,233.87,,,,222.18,233.87,0
unity,CDM,Um Endoscopy-anesthesia P/m,UM4270008,,,,,,Professional,N/A,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,20,20,0
unity,CDM,PR DRAIN SKIN ABSCESS SIMPLE,10060,10060,,Drainage of skin abscess,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,255,% of charge rate,100.00%,255,,,,190.14,255,0
unity,CDM,PR DRAIN SKIN ABSCESS COMPLIC,10061,10061,,Drainage of skin abscess,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,445,% of charge rate,100.00%,445,,,,345.16,445,0
unity,CDM,PR REMOVE FOREIGN BODY SIMPLE,10120,10120,,Remove foreign body,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,325.83,% of charge rate,100.00%,325.83,,,,194.78,325.83,0
unity,CDM,PR REMOVE FOREIGN BODY COMPLIC,10121,10121,,Remove foreign body,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,588.48,% of charge rate,100.00%,588.48,,,,353.11,588.48,0
unity,CDM,PR DRAINAGE OF HEMATOMA/FLUID,10140,10140,,Drainage of hematoma/fluid,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,347.12,% of charge rate,100.00%,347.12,,,,225.91,347.12,0
unity,CDM,PR PUNCTURE DRAINAGE OF LESION,10160,10160,,Puncture drainage of lesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,277.56,% of charge rate,100.00%,277.56,,,,179.54,277.56,0
unity,CDM,"PR COMPLEX DRAINAGE, WOUND",10180,10180,,Complex drainage wound,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,405.82,% of charge rate,100.00%,405.82,,,,338.54,405.82,0
unity,CDM,"PR DEBRIDEMENT, INFECTED SKIN, UP TO 10% BSA",11000,11000,,Debride infected skin,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,115.01,% of charge rate,100.00%,115.01,,,,54.33,115.01,0
unity,CDM,"PR DEBRIDEMENT, SKIN, SUB-Q TISSUE,=<20 SQ CM",11042,11042,,Deb subq tissue 20 sq cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,265,% of charge rate,100.00%,265,,,,115.94,265,0
unity,CDM,"PR TRIM HYPERKERATOTIC SKIN LESION, ONE",11055,11055,,Trim skin lesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,120,% of charge rate,100.00%,120,,,,30.48,120,0
unity,CDM,TANGENTIAL BIOPSY SKIN SINGLE LESION,11102,11102,,Tangntl bx skin single les,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,210,% of charge rate,100.00%,210,,,,74.2,210,0
unity,CDM,PUNCH BIOPSY SKIN SINGLE LESION,11104,11104,,Punch bx skin single lesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,275,% of charge rate,100.00%,275,,,,92.75,275,0
unity,CDM,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,11105,11105,,Punch bx skin ea sep/addl,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,137.5,% of charge rate,100.00%,137.5,,,,50.35,137.5,0
unity,CDM,"PR REMOVAL OF SKIN TAGS, UP TO 15",11200,11200,,Removal of skin tags <w/15,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,186.7,% of charge rate,100.00%,186.7,,,,139.13,186.7,0
unity,CDM,"PR REMOVAL OF SKIN TAGS, EACH ADD 10",11201,11201,,Remove skin tags add-on,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,45,% of charge rate,100.00%,45,,,,31.14,45,0
unity,CDM,"PR SHAV SKIN LES <5MM TRUNK,ARM,LEG",11300,11300,,Shave skin lesion 0.5 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,209.42,% of charge rate,100.00%,209.42,,,,65.59,209.42,0
unity,CDM,"PR SHAV SKIN LES 6-10MM TRUNK,ARM,LEG",11301,11301,,Shave skin lesion 0.6-1.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,256.97,% of charge rate,100.00%,256.97,,,,99.38,256.97,0
unity,CDM,"PR SHAV SKIN LES 11-20MM TRUNK,ARM,LEG",11302,11302,,Shave skin lesion 1.1-2.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,302.41,% of charge rate,100.00%,302.41,,,,116.6,302.41,0
unity,CDM,"PR SHAV SKIN LES >21MM TRUNK,ARM,LEG",11303,11303,,Shave skin lesion >2.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,333.64,% of charge rate,100.00%,333.64,,,,137.14,333.64,0
unity,CDM,PR SHAV SKIN LES <5MM REMAINDR BODY,11305,11305,,Shave skin lesion 0.5 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,220,% of charge rate,100.00%,220,,,,74.86,220,0
unity,CDM,PR SHAV SKIN LES 6-10MM REMAINDR BODY,11306,11306,,Shave skin lesion 0.6-1.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,259.11,% of charge rate,100.00%,259.11,,,,96.06,259.11,0
unity,CDM,PR SHAV SKIN LES 11-20MM REMAINDR BODY,11307,11307,,Shave skin lesion 1.1-2.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,307.38,% of charge rate,100.00%,307.38,,,,123.89,307.38,0
unity,CDM,"PR SHAV SKIN LES <5MM FACE,FACIAL",11310,11310,,Shave skin lesion 0.5 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,243.5,% of charge rate,100.00%,243.5,,,,88.78,243.5,0
unity,CDM,"PR SHAV SKIN LES 6-10MM FACE,FACIAL",11311,11311,,Shave skin lesion 0.6-1.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,290,% of charge rate,100.00%,290,,,,121.24,290,0
unity,CDM,"PR SHAV SKIN LES 11-20MM FACE,FACIAL",11312,11312,,Shave skin lesion 1.1-2.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,345,% of charge rate,100.00%,345,,,,143.76,345,0
unity,CDM,"PR SHAV SKIN LES >21MM FACE,FACIAL",11313,11313,,Shave skin lesion >2.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,400,% of charge rate,100.00%,400,,,,186.83,400,0
unity,CDM,"PR EXC SKIN BENIG <5MM TRUNK,ARM,LEG",11400,11400,,Exc tr-ext b9+marg 0.5 cm<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,264.09,% of charge rate,100.00%,264.09,,,,154.36,264.09,0
unity,CDM,"PR EXC SKIN BENIG 0.6-1CM TRUNK,ARM,LEG",11401,11401,,Exc tr-ext b9+marg 0.6-1 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,318.74,% of charge rate,100.00%,318.74,,,,196.1,318.74,0
unity,CDM,"PR EXC SKIN BENIG 1.1-2CM TRUNK,ARM,LEG",11402,11402,,Exc tr-ext b9+marg 1.1-2 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,365,% of charge rate,100.00%,365,,,,216.64,365,0
unity,CDM,"PR EXC SKIN BENIG 2.1-3CM TRUNK,ARM,LEG",11403,11403,,Exc tr-ext b9+marg 2.1-3cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,420,% of charge rate,100.00%,420,,,,280.24,420,0
unity,CDM,"PR EXC SKIN BENIG 3.1-4CM TRUNK,ARM,LEG",11404,11404,,Exc tr-ext b9+marg 3.1-4 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,462.84,% of charge rate,100.00%,462.84,,,,308.73,462.84,0
unity,CDM,"PR EXC SKIN BENIG >4CM TRUNK,ARM,LEG",11406,11406,,Exc tr-ext b9+marg >4.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,685,% of charge rate,100.00%,685,,,,469.71,685,0
unity,CDM,PR EXC SKIN BENIG <5MM REMAINDR BODY,11420,11420,,Exc h-f-nk-sp b9+marg 0.5/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,265,% of charge rate,100.00%,265,,,,155.03,265,0
unity,CDM,PR EXC SKIN BENIG 0.6-1CM REMAINDR BODY,11421,11421,,Exc h-f-nk-sp b9+marg 0.6-1,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,336.48,% of charge rate,100.00%,336.48,,,,207.36,336.48,0
unity,CDM,PR EXC SKIN BENIG 1.1-2CM REMAINDR BODY,11422,11422,,Exc h-f-nk-sp b9+marg 1.1-2,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,380,% of charge rate,100.00%,380,,,,257.05,380,0
unity,CDM,PR EXC SKIN BENIG 2.1-3CM REMAINDR BODY,11423,11423,,Exc h-f-nk-sp b9+marg 2.1-3,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,430.89,% of charge rate,100.00%,430.89,,,,294.81,430.89,0
unity,CDM,PR EXC SKIN BENIG 3.1-4CM REMAINDR BODY,11424,11424,,Exc h-f-nk-sp b9+marg 3.1-4,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,494.78,% of charge rate,100.00%,494.78,,,,338.54,494.78,0
unity,CDM,PR EXC SKIN BENIG >4CM REMAINDR BODY,11426,11426,,Exc h-f-nk-sp b9+marg >4 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,725,% of charge rate,100.00%,725,,,,522.71,725,0
unity,CDM,"PR EXC SKIN BENIG <5MM FACE,FACIAL",11440,11440,,Exc face-mm b9+marg 0.5 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,297,% of charge rate,100.00%,297,,,,194.78,297,0
unity,CDM,"PR EXC SKIN BENIG 0.6-1CM FACE,FACIAL",11441,11441,,Exc face-mm b9+marg 0.6-1 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,367,% of charge rate,100.00%,367,,,,247.11,367,0
unity,CDM,"PR EXC SKIN BENIG 1.1-2CM FACE,FACIAL",11442,11442,,Exc face-mm b9+marg 1.1-2 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,410,% of charge rate,100.00%,410,,,,274.28,410,0
unity,CDM,"PR EXC SKIN BENIG 2.1-3CM FACE,FACIAL",11443,11443,,Exc face-mm b9+marg 2.1-3 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,476.32,% of charge rate,100.00%,476.32,,,,336.55,476.32,0
unity,CDM,"PR EXC SKIN BENIG 3.1-4CM FACE,FACIAL",11444,11444,,Exc face-mm b9+marg 3.1-4 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,594.87,% of charge rate,100.00%,594.87,,,,429.96,594.87,0
unity,CDM,"EXC SKIN MALIG <5MM TRUNK,ARM,LEG",11600,11600,,Exc tr-ext mal+marg 0.5 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,420,% of charge rate,100.00%,420,,,,229.23,420,0
unity,CDM,"PR EXC SKIN MALIG 0.6-1CM TRUNK,ARM,LEG",11601,11601,,Exc tr-ext mal+marg 0.6-1 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,495,% of charge rate,100.00%,495,,,,280.9,495,0
unity,CDM,"PR EXC SKIN MALIG 1.1-2CM TRUNK,ARM,LEG",11602,11602,,Exc tr-ext mal+marg 1.1-2 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,535,% of charge rate,100.00%,535,,,,306.74,535,0
unity,CDM,"PR EXC SKIN MALIG 2.1-3CM TRUNK,ARM,LEG",11603,11603,,Exc tr-ext mal+marg 2.1-3 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,601.26,% of charge rate,100.00%,601.26,,,,367.03,601.26,0
unity,CDM,"PR EXC SKIN MALIG 3.1-4CM TRUNK,ARM,LEG",11604,11604,,Exc tr-ext mal+marg 3.1-4 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,670.12,% of charge rate,100.00%,670.12,,,,405.45,670.12,0
unity,CDM,"PR EXC SKIN MALIG >4CM TRUNK,ARM,LEG",11606,11606,,Exc tr-ext mal+marg >4 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,975,% of charge rate,100.00%,975,,,,606.19,975,0
unity,CDM,PR EXC SKIN MALIG 0.6-1CM REMAINDR BODY,11621,11621,,Exc s/n/h/f/g mal+mrg 0.6-1,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,490.52,% of charge rate,100.00%,490.52,,,,282.89,490.52,0
unity,CDM,PR EXC SKIN MALIG 1.1-2CM REMAINDR BODY,11622,11622,,Exc s/n/h/f/g mal+mrg 1.1-2,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,547.31,% of charge rate,100.00%,547.31,,,,321.31,547.31,0
unity,CDM,PR EXC SKIN MALIG 2.1-3CM REMAINDR BODY,11623,11623,,Exc s/n/h/f/g mal+mrg 2.1-3,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,639.6,% of charge rate,100.00%,639.6,,,,399.49,639.6,0
unity,CDM,PR EXC SKIN MALIG 3.1-4CM REMAINDR BODY,11624,11624,,Exc s/n/h/f/g mal+mrg 3.1-4,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,719.09,% of charge rate,100.00%,719.09,,,,453.81,719.09,0
unity,CDM,PR EXC SKIN MALIG >4CM REMAINDR BODY,11626,11626,,Exc s/n/h/f/g mal+mrg >4 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,866.04,% of charge rate,100.00%,866.04,,,,559.15,866.04,0
unity,CDM,"PR EXC SKIN MALIG <5MM FACE,FACIAL",11640,11640,,Exc f/e/e/n/l mal+mrg 0.5cm<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,430.18,% of charge rate,100.00%,430.18,,,,237.84,430.18,0
unity,CDM,"PR EXC SKIN MALIG 0.6-1CM FACE,FACIAL",11641,11641,,Exc f/e/e/n/l mal+mrg 0.6-1,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,508.28,% of charge rate,100.00%,508.28,,,,294.81,508.28,0
unity,CDM,"PR EXC SKIN MALIG 1.1-2CM FACE,FACIAL",11642,11642,,Exc f/e/e/n/l mal+mrg 1.1-2,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,577.84,% of charge rate,100.00%,577.84,,,,345.83,577.84,0
unity,CDM,"PR EXC SKIN MALIG 2.1-3CM FACE,FACIAL",11643,11643,,Exc f/e/e/n/l mal+mrg 2.1-3,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,680.05,% of charge rate,100.00%,680.05,,,,433.94,680.05,0
unity,CDM,"PR EXC SKIN MALIG 3.1-4CM FACE,FACIAL",11644,11644,,Exc f/e/e/n/l mal+mrg 3.1-4,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,837.64,% of charge rate,100.00%,837.64,,,,539.28,837.64,0
unity,CDM,"PR EXC SKIN MALIG >4CM FACE,FACIAL",11646,11646,,Exc f/e/e/n/l mal+mrg >4 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,088.23",% of charge rate,100.00%,"1,088.23",,,,747.3,"1,088.23",0
unity,CDM,PR REMOVAL OF NAIL PLATE,11730,11730,,Removal of nail plate,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,235,% of charge rate,100.00%,235,,,,104.01,235,0
unity,CDM,PR DRAIN BLOOD FROM UNDER NAIL,11740,11740,,Drain blood from under nail,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,115,% of charge rate,100.00%,115,,,,59.63,115,0
unity,CDM,PR REMOVAL OF NAIL BED,11750,11750,,Removal of nail bed,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,472.07,% of charge rate,100.00%,472.07,,,,192.79,472.07,0
unity,CDM,PR RECONSTRUC OF NAIL BED,11760,11760,,Repair of nail bed,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,501.88,% of charge rate,100.00%,501.88,,,,217.96,501.88,0
unity,CDM,"PR EXCISION OF NAIL FOLD, TOE",11765,11765,,Excision of nail fold toe,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,380,% of charge rate,100.00%,380,,,,174.9,380,0
unity,CDM,REMV PILONIDAL LESION SIMPLE,11770,11770,,Remove pilonidal cyst simple,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,615,% of charge rate,100.00%,615,,,,353.78,615,0
unity,CDM,PR REMV PILONIDAL LESION EXTENS,11771,11771,,Remove pilonidal cyst exten,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,216.00",% of charge rate,100.00%,"1,216.00",,,,844.03,"1,216.00",0
unity,CDM,"PR INJECTION INTO SKIN LESIONS, UP TO 7",11900,11900,,Inject skin lesions </w 7,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,117.83,% of charge rate,100.00%,117.83,,,,57.64,117.83,0
unity,CDM,PR REMOVAL OF CONTRACEPTIVE CAPSUL,11976,11976,,Remove contraceptive capsule,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,306.67,% of charge rate,100.00%,306.67,,,,180.86,306.67,0
unity,CDM,INSERTION DRUG IMPLANT DEVICE,11981,11981,,Insert drug implant device,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,308,% of charge rate,100.00%,308,,,,123.23,308,0
unity,CDM,REMOVAL W/ REINSERT DRUG IMPLANT DEVICE,11983,11983,,Remove/insert drug implant,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,522.5,% of charge rate,100.00%,522.5,,,,199.41,522.5,0
unity,CDM,Hc Swing Bed,1200000,1200000,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,500,% of charge rate,100.00%,500,,,,475,500,0
unity,CDM,Hc Respite Care,1200002,1200002,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,325,% of charge rate,100.00%,325,,,,308.75,325,0
unity,CDM,PR REPR SUPERF WND BODY <2.5CM,12001,12001,,Rpr s/n/ax/gen/trnk 2.5cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,193.09,% of charge rate,100.00%,193.09,,,,86.13,193.09,0
unity,CDM,PR REPR SUP NPTERF WND BODY 2.6-7.5,12002,12002,,Rpr s/n/ax/gen/trnk2.6-7.5cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,233.55,% of charge rate,100.00%,233.55,,,,114.61,233.55,0
unity,CDM,PR REPR SUPERF WND BODY 7.6-12.5,12004,12004,,Rpr s/n/ax/gen/trk7.6-12.5cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,274.01,% of charge rate,100.00%,274.01,,,,142.44,274.01,0
unity,CDM,PR REPR SUPERF WND BODY 12.6-20,12005,12005,,Rpr s/n/a/gen/trk12.6-20.0cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,354.23,% of charge rate,100.00%,354.23,,,,185.5,354.23,0
unity,CDM,PR REPR SUPERF WND FACE <2.5CM,12011,12011,,Rpr f/e/e/n/l/m 2.5 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,235.69,% of charge rate,100.00%,235.69,,,,107.99,235.69,0
unity,CDM,PR REPR SUPERF WND FACE 2.6-5,12013,12013,,Rpr f/e/e/n/l/m 2.6-5.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,257.69,% of charge rate,100.00%,257.69,,,,113.95,257.69,0
unity,CDM,PR REPR SUPERF WND FACE 5.1-7.5,12014,12014,,Rpr f/e/e/n/l/m 5.1-7.5 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,300.99,% of charge rate,100.00%,300.99,,,,145.75,300.99,0
unity,CDM,PR REPR SUPERF WND FACE 7.6-12.5,12015,12015,,Rpr f/e/e/n/l/m 7.6-12.5 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,367,% of charge rate,100.00%,367,,,,184.18,367,0
unity,CDM,PR CLOSURE SUPERF WND DEHIS SIMPLE,12020,12020,,Closure of split wound,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,601.26,% of charge rate,100.00%,601.26,,,,359.74,601.26,0
unity,CDM,"PR LAYR CLOS WND TRUNK,ARM,LEG <2.5CM",12031,12031,,Intmd rpr s/a/t/ext 2.5 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,508.98,% of charge rate,100.00%,508.98,,,,288.85,508.98,0
unity,CDM,"PR LAYR CLOS WND TRUNK,ARM,LEG 2.6-7.5",12032,12032,,Intmd rpr s/a/t/ext 2.6-7.5,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,650.24,% of charge rate,100.00%,650.24,,,,361.73,650.24,0
unity,CDM,"PR LAYR CLOS WND TRUNK,ARM,LEG 7.6-12.5",12034,12034,,Intmd rpr s/tr/ext 7.6-12.5,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,690,% of charge rate,100.00%,690,,,,391.54,690,0
unity,CDM,"PR LAYR CLOS WND TRUNK,ARM,LEG 12.6-20",12035,12035,,Intmd rpr s/a/t/ext 12.6-20,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,829.83,% of charge rate,100.00%,829.83,,,,459.78,829.83,0
unity,CDM,PR LAYR CLOS WND REST BODY <2.5CM,12041,12041,,Intmd rpr n-hf/genit 2.5cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,530,% of charge rate,100.00%,530,,,,279.58,530,0
unity,CDM,PR LAYR CLOS WND REST BODY 2.6-7.5,12042,12042,,Intmd rpr n-hf/genit2.6-7.5,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,640,% of charge rate,100.00%,640,,,,373.65,640,0
unity,CDM,PR LAYR CLOS WND REST BODY 7.6-12.5,12044,12044,,Intmd rpr n-hf/genit7.6-12.5,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,790,% of charge rate,100.00%,790,,,,408.1,790,0
unity,CDM,"PR LAYR CLOS WND FACE,FACIAL <2.5CM",12051,12051,,Intmd rpr face/mm 2.5 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,570,% of charge rate,100.00%,570,,,,321.31,570,0
unity,CDM,"PR LAYR CLOS WND FACE,FACIAL 2.5-5",12052,12052,,Intmd rpr face/mm 2.6-5.0 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,626.81,% of charge rate,100.00%,626.81,,,,380.28,626.81,0
unity,CDM,"PR LAYR CLOS WND FACE,FACIAL 5.1-7.5",12053,12053,,Intmd rpr face/mm 5.1-7.5 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,740.4,% of charge rate,100.00%,740.4,,,,410.75,740.4,0
unity,CDM,"PR LAYR CLOS WND FACE,FACIAL 7.6-12.5",12054,12054,,Intmd rpr face/mm 7.6-12.5cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,789.38,% of charge rate,100.00%,789.38,,,,420.69,789.38,0
unity,CDM,HC ROOM & NURSING W/TELEMETRY,1211000,1211000,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,621.13",% of charge rate,100.00%,"1,621.13",,,,"1,540.07","1,621.13",0
unity,CDM,"PR REP,SKIN,SCALP/EXTREM+5CM/<",13122,13122,,Cmplx rpr s/a/l addl 5 cm/>,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,284.66,% of charge rate,100.00%,284.66,,,,160.33,284.66,0
unity,CDM,"PR REPR CMPL WND HEAD,FAC,HAND 1.1-2.5",13131,13131,,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,819.9,% of charge rate,100.00%,819.9,,,,466.4,819.9,0
unity,CDM,"PR REPR CMPL WND HEAD,FAC,HAND 2.6-7.5",13132,13132,,Cmplx rpr f/c/c/m/n/ax/g/h/f,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,040.00",% of charge rate,100.00%,"1,040.00",,,,583.66,"1,040.00",0
unity,CDM,PR SECD CLOS SURG WND EXTEN/COMPLIC,13160,13160,,Late closure of wound,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,707.23",% of charge rate,100.00%,"1,707.23",,,,"1,523.09","1,707.23",0
unity,CDM,PR INITIAL RX BURN(S) 1ST DEGREE,16000,16000,,Initial treatment of burn(s),,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,155,% of charge rate,100.00%,155,,,,88.11,155,0
unity,CDM,PR DRESS/DEBRID SMALL BURN NO ANES,16020,16020,,Dress/debrid p-thick burn s,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,173.92,% of charge rate,100.00%,173.92,,,,103.35,173.92,0
unity,CDM,PR DRESS/DEBRID MED BURN NO ANESTH,16025,16025,,Dress/debrid p-thick burn m,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,313.06,% of charge rate,100.00%,313.06,,,,210.68,313.06,0
unity,CDM,"PR DESTRUC PREMALIGNANT, FIRST LESION",17000,17000,,Destruct premalg lesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,173.92,% of charge rate,100.00%,173.92,,,,101.36,173.92,0
unity,CDM,"PR DESTRUC PREMALIGNANT,2-14 LESIONS",17003,17003,,Destruct premalg les 2-14,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,14.2,% of charge rate,100.00%,14.2,,,,3.98,14.2,0
unity,CDM,"DESTRUC BENIGN/PREMAL,15+ LESIONS",17004,17004,,Destroy premal lesions 15/>,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,330,% of charge rate,100.00%,330,,,,184.84,330,0
unity,CDM,PR DESTRUCTION BENIGN LESIONS UP TO 14,17110,17110,,Destruct b9 lesion 1-14,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,230,% of charge rate,100.00%,230,,,,126.54,230,0
unity,CDM,PR DESTRUCTION BENIGN LESIONS 15 OR MORE,17111,17111,,Destruct lesion 15 or more,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,281.83,% of charge rate,100.00%,281.83,,,,155.03,281.83,0
unity,CDM,PR PUNC/ASPIR BREAST CYST,19000,19000,,Drainage of breast lesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,238.51,% of charge rate,100.00%,238.51,,,,83.48,238.51,0
unity,CDM,"Hc Mastectomy,smpl,complete",4900284,19303,,Mast simple complete,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,302.84",% of charge rate,100.00%,"1,302.84",,,,"1,237.70","1,302.84",0
unity,CDM,"Hc Mastectomy,smpl,complete",4900284,19303,,Mast simple complete,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,302.84",% of charge rate,100.00%,"1,302.84",,,,"1,237.70","1,302.84",0
unity,CDM,PR DEEP MUSCLE BIOPSY,20205,20205,,Deep muscle biopsy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,357.5,% of charge rate,100.00%,357.5,,,,294.15,357.5,0
unity,CDM,PR INJECT TENDON SHEATH/LIGAMENT,20550,20550,,Inj tendon sheath/ligament,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,122.1,% of charge rate,100.00%,122.1,,,,74.86,122.1,0
unity,CDM,PR INJECT TENDON ORIGIN/INSERT,20551,20551,,Inj tendon origin/insertion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,126.36,% of charge rate,100.00%,126.36,,,,76.19,126.36,0
unity,CDM,"PR INJECT TRIGGER POINT, 1 OR 2",20552,20552,,Inj trigger point 1/2 muscl,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,120,% of charge rate,100.00%,120,,,,73.54,120,0
unity,CDM,"INJECT TRIGGER POINTS, > 3",20553,20553,,Inject trigger points 3/>,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,154,% of charge rate,100.00%,154,,,,82.81,154,0
unity,CDM,Hc Needle Insert W/o Inj 1 Or 2 Musc,4903367,20560,,Ndl insj w/o njx 1 or 2 musc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40,% of charge rate,100.00%,40,,,,38,40,0
unity,CDM,Hc Needle Insert W/o Inj 1 Or 2 Musc,4903367,20560,,Ndl insj w/o njx 1 or 2 musc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40,% of charge rate,100.00%,40,,,,38,40,0
unity,CDM,Hc Needle Insert W/o Inj 3+ Musc,4903368,20561,,Ndl insj w/o njx 3+ musc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,70,% of charge rate,100.00%,70,,,,66.5,70,0
unity,CDM,Hc Needle Insert W/o Inj 3+ Musc,4903368,20561,,Ndl insj w/o njx 3+ musc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,70,% of charge rate,100.00%,70,,,,66.5,70,0
unity,CDM,PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,20600,20600,,Drain/inj joint/bursa w/o us,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,105,% of charge rate,100.00%,105,,,,68.9,105,0
unity,CDM,PR ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,20604,20604,,Drain/inj joint/bursa w/us,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,159,% of charge rate,100.00%,159,,,,87.45,159,0
unity,CDM,Um Poct Us Injection Phalanges Joint,UM4022002,20604,,Drain/inj joint/bursa w/us,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,398,% of charge rate,100.00%,398,,,,378.1,398,0
unity,CDM,Um Poct Us Injection Phalanges Joint,UM4022002,20604,,Drain/inj joint/bursa w/us,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,398,% of charge rate,100.00%,398,,,,378.1,398,0
unity,CDM,PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,20605,20605,,Drain/inj joint/bursa w/o us,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,137.02,% of charge rate,100.00%,137.02,,,,71.55,137.02,0
unity,CDM,Um Poct Us Injection Medium Joint,UM4022003,20606,,Drain/inj joint/bursa w/us,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,883.87,% of charge rate,100.00%,883.87,,,,839.68,883.87,0
unity,CDM,Um Poct Us Injection Medium Joint,UM4022003,20606,,Drain/inj joint/bursa w/us,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,883.87,% of charge rate,100.00%,883.87,,,,839.68,883.87,0
unity,CDM,PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,20610,20610,,Drain/inj joint/bursa w/o us,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,129.23,% of charge rate,100.00%,129.23,,,,87.45,129.23,0
unity,CDM,Um Poct Us Injection Large Joint,UM4022004,20611,,Drain/inj joint/bursa w/us,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,425,% of charge rate,100.00%,425,,,,403.75,425,0
unity,CDM,Um Poct Us Injection Large Joint,UM4022004,20611,,Drain/inj joint/bursa w/us,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,425,% of charge rate,100.00%,425,,,,403.75,425,0
unity,CDM,PR BIOPSY SOFT TISSUE NECK/CHEST,21550,21550,,Biopsy of neck/chest,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,565.05,% of charge rate,100.00%,565.05,,,,296.14,565.05,0
unity,CDM,PR EXC NECK LES SC=3CM,21552,21552,,Exc neck les sc 3 cm/>,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,941.29,% of charge rate,100.00%,941.29,,,,853.96,946.25,0
unity,CDM,PR CLOSED RX CLAVICLE FRACTURE,23500,23500,,Treat clavicle fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,467.8,% of charge rate,100.00%,467.8,,,,418.7,467.8,0
unity,CDM,PR CLOSED RX SHLDR DISLOCATION,23650,23650,,Treat shoulder dislocation,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,672.96,% of charge rate,100.00%,672.96,,,,553.85,672.96,0
unity,CDM,"PR CLOSED RX SHLDR DISLOC,ANESTHESIA",23655,23655,,Treat shoulder dislocation,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,839.77,% of charge rate,100.00%,839.77,,,,771.15,854.49,0
unity,CDM,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM,24073,24073,,Ex arm/elbow tum deep 5 cm/>,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,450.26",% of charge rate,100.00%,"1,450.26",,,,"1,332.95","1,477.01",0
unity,CDM,PR CLOSED RX MID HUMERUS FRACTURE,24500,24500,,Treat humerus fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,764.53,% of charge rate,100.00%,764.53,,,,626.73,764.53,0
unity,CDM,"PR CLOSED RX RADIAL HEAD DISLOC,CHILD",24640,24640,,Treat elbow dislocation,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,305.95,% of charge rate,100.00%,305.95,,,,149.73,305.95,0
unity,CDM,PR CLOSED RX RADIAL HEAD/NECK FX,24650,24650,,Treat radius fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,560.79,% of charge rate,100.00%,560.79,,,,461.1,560.79,0
unity,CDM,PR EXCIS PRIMARY GANGLION WRIST,25111,25111,,Remove wrist tendon lesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,678.63,% of charge rate,100.00%,678.63,,,,612.15,678.63,0
unity,CDM,PR CLOSED RX ULNA SHAFT FX,25530,25530,,Treat fracture of ulna,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,506.86,% of charge rate,100.00%,506.86,,,,455.8,506.86,0
unity,CDM,PR CLOSED RX RAD/ULNA SHAFT FX,25560,25560,,Treat fracture radius & ulna,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,610,% of charge rate,100.00%,610,,,,484.29,610,0
unity,CDM,PR CLOSED RX DIST RAD/ULNA FX,25600,25600,,Treat fracture radius/ulna,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,715,% of charge rate,100.00%,715,,,,600.23,715,0
unity,CDM,"PR CLOSED RX DIST RAD/ULNA FX,MANIPUL",25605,25605,,Treat fracture radius/ulna,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,167.02",% of charge rate,100.00%,"1,167.02",,,,975.86,"1,167.02",0
unity,CDM,PR CLOSED RX NAVICULAR FX,25622,25622,,Treat wrist bone fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,653.08,% of charge rate,100.00%,653.08,,,,534.64,653.08,0
unity,CDM,"DRAIN FINGER ABSCESS,SIMPLE",26010,26010,,Drainage of finger abscess,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,569.61,% of charge rate,100.00%,569.61,,,,263.01,569.61,0
unity,CDM,PR CLOSED RX METACARPAL FX,26600,26600,,Treat metacarpal fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,640,% of charge rate,100.00%,640,,,,533.98,640,0
unity,CDM,"PR CLOSED RX METACARPAL FX,MANIP",26605,26605,,Treat metacarpal fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,700,% of charge rate,100.00%,700,,,,559.81,700,0
unity,CDM,PR CLOSED RX MC-P DISLOC,26700,26700,,Treat knuckle dislocation,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,690.71,% of charge rate,100.00%,690.71,,,,586.98,690.71,0
unity,CDM,PR CLOSE RX PROX/MID FING SHFT FX,26720,26720,,Treat finger fracture each,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,425.99,% of charge rate,100.00%,425.99,,,,352.45,425.99,0
unity,CDM,"PR CLOSE RX PROX/MID FING SHFT FX,MANIP",26725,26725,,Treat finger fracture each,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,719.09,% of charge rate,100.00%,719.09,,,,578.36,719.09,0
unity,CDM,PR CLOSE RX DIST FINGR FX,26750,26750,,Treat finger fracture each,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,394.68,% of charge rate,100.00%,394.68,,,,352.45,394.68,0
unity,CDM,"PR CLOSE RX DIST FINGR FX,MANIPULATN",26755,26755,,Treat finger fracture each,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,671.53,% of charge rate,100.00%,671.53,,,,521.39,671.53,0
unity,CDM,PR CLOSED RX IP JT DISLOCATION,26770,26770,,Treat finger dislocation,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,591.33,% of charge rate,100.00%,591.33,,,,490.91,591.33,0
unity,CDM,"PR INCIS/DRAIN THIGH/KNEE ABSCESS,DEEP",27301,27301,,Drain thigh/knee lesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,239.27",% of charge rate,100.00%,"1,239.27",,,,963.94,"1,239.27",0
unity,CDM,"PR REMV THIGH/KNEE TUMOR,SUBCUTANEOUS",27327,27327,,Exc thigh/knee les sc < 3 cm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,605,% of charge rate,100.00%,605,,,,596.91,661.42,0
unity,CDM,PR CLOSED RX TIBIAL PLATEAU FX,27530,27530,,Treat knee fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,648.11,% of charge rate,100.00%,648.11,,,,539.94,648.11,0
unity,CDM,PR CLOSED RX PROX/SHAFT FIBULA FX,27780,27780,,Treatment of fibula fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,658.76,% of charge rate,100.00%,658.76,,,,535.3,658.76,0
unity,CDM,PR CLOSED RX DIST FIBULA FX,27786,27786,,Treatment of ankle fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,680,% of charge rate,100.00%,680,,,,546.56,680,0
unity,CDM,PR CLOSED RX ANKLE DISLOCATN,27840,27840,,Treat ankle dislocation,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,796.47,% of charge rate,100.00%,796.47,,,,718.15,796.47,0
unity,CDM,PR CLOSED RX METATARSAL FX,28470,28470,,Treat metatarsal fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,476.32,% of charge rate,100.00%,476.32,,,,387.56,476.32,0
unity,CDM,PR CLOSED RX BIG TOE FRACTURE,28490,28490,,Treat big toe fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,316.6,% of charge rate,100.00%,316.6,,,,235.19,316.6,0
unity,CDM,PR CLOSED RX TOE FX,28510,28510,,Treatment of toe fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,266.2,% of charge rate,100.00%,266.2,,,,225.91,266.2,0
unity,CDM,"PR CLOSED RX TOE FX,MANIPULATN",28515,28515,,Treatment of toe fracture,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,355,% of charge rate,100.00%,355,,,,270.3,355,0
unity,CDM,PR APPLY LONG ARM CAST,29065,29065,,Application of long arm cast,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,207.28,% of charge rate,100.00%,207.28,,,,129.19,207.28,0
unity,CDM,PR APPLY FOREARM CAST,29075,29075,,Application of forearm cast,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,186.7,% of charge rate,100.00%,186.7,,,,116.6,186.7,0
unity,CDM,PR APPLY LONG ARM SPLINT,29105,29105,,Apply long arm splint,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,188.84,% of charge rate,100.00%,188.84,,,,80.16,188.84,0
unity,CDM,"PR APPLY FOREARM SPLINT,STATIC",29125,29125,,Apply forearm splint,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,140.56,% of charge rate,100.00%,140.56,,,,74.86,140.56,0
unity,CDM,"PR APPLY FINGER SPLINT,STATIC",29130,29130,,Application of finger splint,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,87.32,% of charge rate,100.00%,87.32,,,,56.31,87.32,0
unity,CDM,PR STRAPPING OF SHOULDER,29240,29240,,Strapping of shoulder,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,122.1,% of charge rate,100.00%,122.1,,,,35.78,122.1,0
unity,CDM,PR APPLY SHORT LEG CAST,29405,29405,,Apply short leg cast,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,175.34,% of charge rate,100.00%,175.34,,,,111.96,175.34,0
unity,CDM,PR APPLY LONG LEG SPLINT,29505,29505,,Application long leg splint,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,180.31,% of charge rate,100.00%,180.31,,,,96.06,180.31,0
unity,CDM,PR APPLY LOWER LEG SPLINT,29515,29515,,Application lower leg splint,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,154.76,% of charge rate,100.00%,154.76,,,,94.08,154.76,0
unity,CDM,PR APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,29581,29581,,Apply multlay comprs lwr leg,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,185,% of charge rate,100.00%,185,,,,53,185,0
unity,CDM,PR REMOVE NASAL FOREIGN BODY,30300,30300,,Remove nasal foreign body,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,276.13,% of charge rate,100.00%,276.13,,,,213.99,276.13,0
unity,CDM,"PR CTRL NOSEBLEED,ANTER,SIMPLE",30901,30901,,Control of nosebleed,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,280,% of charge rate,100.00%,280,,,,108.65,280,0
unity,CDM,"PR CTRL NOSEBLEED,POST,W/PACKS &/OR CAUT",30905,30905,,Control of nosebleed,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,560.79,% of charge rate,100.00%,560.79,,,,203.39,560.79,0
unity,CDM,PR INSERT EMERGENCY ENDOTRACH AIRWAY,31500,31500,,Insert emergency airway,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,228.58,% of charge rate,100.00%,228.58,,,,228.58,303.92,0
unity,CDM,Hc Insert Emergency Airway,4901106,31500,,Insert emergency airway,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,327,% of charge rate,100.00%,327,,,,310.65,327,0
unity,CDM,Hc Insert Emergency Airway,4901106,31500,,Insert emergency airway,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,327,% of charge rate,100.00%,327,,,,310.65,327,0
unity,CDM,Hc Suctioning,4901140,31720,,Clearance of airways,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,304.75,% of charge rate,100.00%,304.75,,,,289.51,304.75,0
unity,CDM,Hc Suctioning,4901140,31720,,Clearance of airways,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,304.75,% of charge rate,100.00%,304.75,,,,289.51,304.75,0
unity,CDM,TUBE THORACOSTOMY INCLUDES WATER SEAL,32551,32551,,Insertion of chest tube,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,407,% of charge rate,100.00%,407,,,,302.1,407,0
unity,CDM,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,32554,32554,,Aspirate pleura w/o imaging,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,220,% of charge rate,100.00%,220,,,,171.59,220,0
unity,CDM,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,32554,32554,,Aspirate pleura w/o imaging,,,Professional,N/A,Self-Pay,N/A,N/A,N/A,220,% of charge rate,100.00%,220,,,,171.59,220,0
unity,CDM,Um Venipuncture,UM4000046,36415,,Routine venipuncture,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.28,% of charge rate,100.00%,12.28,,,,11.67,12.28,0
unity,CDM,Um Venipuncture,UM4000046,36415,,Routine venipuncture,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.28,% of charge rate,100.00%,12.28,,,,11.67,12.28,0
unity,CDM,Um Capillary Puncture,UM4000880,36416,,Capillary blood draw,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.12,% of charge rate,100.00%,6.12,,,,5.81,6.12,0
unity,CDM,Um Capillary Puncture,UM4000880,36416,,Capillary blood draw,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.12,% of charge rate,100.00%,6.12,,,,5.81,6.12,0
unity,CDM,Hc Blood Admin 2+ Hrs,3910000,36430,,Blood transfusion service,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,790,% of charge rate,100.00%,790,,,,750.5,790,0
unity,CDM,Hc Blood Admin 2+ Hrs,3910000,36430,,Blood transfusion service,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,790,% of charge rate,100.00%,790,,,,750.5,790,0
unity,CDM,Hc Collect Blood Venous Device,4901266,36591,,Draw blood off venous device,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,165,% of charge rate,100.00%,165,,,,156.75,165,0
unity,CDM,Hc Collect Blood Venous Device,4901266,36591,,Draw blood off venous device,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,165,% of charge rate,100.00%,165,,,,156.75,165,0
unity,CDM,Hc Collect Blood Picc,4901267,36592,,Collect blood from picc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,165,% of charge rate,100.00%,165,,,,156.75,165,0
unity,CDM,Hc Collect Blood Picc,4901267,36592,,Collect blood from picc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,165,% of charge rate,100.00%,165,,,,156.75,165,0
unity,CDM,Hc Declot Vascular Device,4901268,36593,,Declot vascular device,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,600,% of charge rate,100.00%,600,,,,570,600,0
unity,CDM,Hc Declot Vascular Device,4901268,36593,,Declot vascular device,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,600,% of charge rate,100.00%,600,,,,570,600,0
unity,CDM,Um Arterial Blood Draw,UM3480020,36600,,Withdrawal of arterial blood,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,184.2,% of charge rate,100.00%,184.2,,,,174.99,184.2,0
unity,CDM,Um Arterial Blood Draw,UM3480020,36600,,Withdrawal of arterial blood,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,184.2,% of charge rate,100.00%,184.2,,,,174.99,184.2,0
unity,CDM,Hc Plcmt Of Needle Intraosseo,4500067,36680,,Insert needle bone cavity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,705,% of charge rate,100.00%,705,,,,669.75,705,0
unity,CDM,Hc Plcmt Of Needle Intraosseo,4500067,36680,,Insert needle bone cavity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,705,% of charge rate,100.00%,705,,,,669.75,705,0
unity,CDM,"PR BIOPSY/EXCISION, LYMPH NODE(S)",38500,38500,,Biopsy/removal lymph nodes,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,506,% of charge rate,100.00%,506,,,,488.93,541.77,0
unity,CDM,"PR BX/REMV,LYMPH NODE,DEEP CERV",38510,38510,,Biopsy/removal lymph nodes,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,880,% of charge rate,100.00%,880,,,,800.96,887.53,0
unity,CDM,"PR BX/REMV,LYMPH NODE,DEEP AXILL",38525,38525,,Biopsy/removal lymph nodes,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,921.4,% of charge rate,100.00%,921.4,,,,841.38,932.31,0
unity,CDM,"PR PARTIAL EXCIS LIP,WEDGE PRIM CLOS",40510,40510,,Partial excision of lip,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,742.5,% of charge rate,100.00%,742.5,,,,665.81,742.5,0
unity,CDM,PR ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,43220,43220,,Esophagoscopy balloon <30mm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,282.81,% of charge rate,100.00%,282.81,,,,225.25,282.81,0
unity,CDM,PR ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,43235,43235,,Egd diagnostic brush wash,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,315.35,% of charge rate,100.00%,315.35,,,,234.53,315.35,0
unity,CDM,PR EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,43239,43239,,Egd biopsy single/multiple,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,371.88,% of charge rate,100.00%,371.88,,,,264.34,371.88,0
unity,CDM,EGD FLEXIBLE FOREIGN BODY REMOVAL,43247,43247,,Egd remove foreign body,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,412.5,% of charge rate,100.00%,412.5,,,,338.54,412.5,0
unity,CDM,PR EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,43249,43249,,Esoph egd dilation <30 mm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,387.2,% of charge rate,100.00%,387.2,,,,292.83,387.2,0
unity,CDM,PR EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,43251,43251,,Egd remove lesion snare,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,440,% of charge rate,100.00%,440,,,,374.98,440,0
unity,CDM,"PR LAP,ESOPHAGOGAST FUNDOPLASTY",43280,43280,,Laparoscopy fundoplasty,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"2,381.00",% of charge rate,100.00%,"2,381.00",,,,"2,085.55","2,381.00",0
unity,CDM,"FREEING BOWEL ADHESION,ENTEROLYSIS",44005,44005,,Freeing of bowel adhesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"2,282.50",% of charge rate,100.00%,"2,282.50",,,,"2,110.06","2,338.11",0
unity,CDM,"PR INCIS COLON FOR EXPLOR,BX,FB REM",44025,44025,,Incision of large bowel,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"2,077.77",% of charge rate,100.00%,"2,077.77",,,,"1,895.41","2,100.26",0
unity,CDM,"PR REDUCE VOLVULUS,INTUSS,INTERN HERNIA",44050,44050,,Reduce bowel obstruction,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,962.77",% of charge rate,100.00%,"1,962.77",,,,"1,805.31","2,000.42",0
unity,CDM,PR PART REMOVAL COLON W ANASTOMOSIS,44140,44140,,Partial removal of colon,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"2,813.20",% of charge rate,100.00%,"2,813.20",,,,"2,588.39","2,868.13",0
unity,CDM,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,44300,44300,,Open bowel to skin,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,772.54",% of charge rate,100.00%,"1,772.54",,,,"1,625.78","1,801.48",0
unity,CDM,PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,44388,44388,,Colonoscopy thru stoma spx,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,668.17,% of charge rate,100.00%,668.17,,,,299.45,668.17,0
unity,CDM,PR APPENDECTOMY,44950,44950,,Appendectomy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,346.62",% of charge rate,100.00%,"1,346.62",,,,"1,240.86","1,374.97",0
unity,CDM,"LAP,APPENDECTOMY",44970,44970,,Laparoscopy appendectomy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,375.00",% of charge rate,100.00%,"1,375.00",,,,"1,158.71","1,375.00",0
unity,CDM,PR EXC RECTAL TUMOR TRANSANAL,45171,45171,,Exc rect tum transanal part,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,283.44",% of charge rate,100.00%,"1,283.44",,,,"1,159.38","1,284.68",0
unity,CDM,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,45330,45330,,Diagnostic sigmoidoscopy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,141.81,% of charge rate,100.00%,141.81,,,,106.66,141.81,0
unity,CDM,"PR SIGMOIDOSCOPY,BIOPSY",45331,45331,,Sigmoidoscopy and biopsy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,181.5,% of charge rate,100.00%,181.5,,,,136.48,181.5,0
unity,CDM,PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,45378,45378,,Diagnostic colonoscopy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,460,% of charge rate,100.00%,460,,,,354.44,460,0
unity,CDM,PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,45380,45380,,Colonoscopy and biopsy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,561.81,% of charge rate,100.00%,561.81,,,,383.59,561.81,0
unity,CDM,PR COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,45384,45384,,Colonoscopy w/lesion removal,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,585.72,% of charge rate,100.00%,585.72,,,,437.25,585.72,0
unity,CDM,PR COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,45385,45385,,Colonoscopy w/lesion removal,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,666.19,% of charge rate,100.00%,666.19,,,,486.94,666.19,0
unity,CDM,PR I&D PERIRECTAL ABSCESS,46040,46040,,Incision of rectal abscess,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,882.38,% of charge rate,100.00%,882.38,,,,805.6,892.67,0
unity,CDM,"PR I&D PERIANAL ABSCESS,SUPERFICIAL",46050,46050,,Incision of anal abscess,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,210.84,% of charge rate,100.00%,210.84,,,,188.81,210.84,0
unity,CDM,PR INCISE EXTERNAL HEMORRHOID,46083,46083,,Incise external hemorrhoid,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,227.16,% of charge rate,100.00%,227.16,,,,207.36,229.77,0
unity,CDM,"PR HEMORRHOIDECTOMY,EXTERNAL",46250,46250,,Remove ext hem groups 2+,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,669.42,% of charge rate,100.00%,669.42,,,,608.84,674.64,0
unity,CDM,"PR HEMORRHOIDECTOMY,INT/EXT,SIMPLE",46255,46255,,Remove int/ext hem 1 group,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,751.04,% of charge rate,100.00%,751.04,,,,682.38,756.12,0
unity,CDM,"PR REMOVAL ANAL FISTULA,SUBCUTANEOUS",46270,46270,,Remove anal fist subq,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,865,% of charge rate,100.00%,865,,,,757.24,865,0
unity,CDM,PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,46600,46600,,Diagnostic anoscopy spx,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,87.32,% of charge rate,100.00%,87.32,,,,77.51,87.32,0
unity,CDM,"LAP,CHOLECYSTECTOMY",47562,47562,,Laparoscopic cholecystectomy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,487.44",% of charge rate,100.00%,"1,487.44",,,,"1,271.34","1,487.44",0
unity,CDM,PR REMOVAL GALLBLADDER,47600,47600,,Removal of gallbladder,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"2,355.00",% of charge rate,100.00%,"2,355.00",,,,"2,065.01","2,355.00",0
unity,CDM,PR EXPLORATORY OF ABDOMEN,49000,49000,,Exploration of abdomen,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,618.51",% of charge rate,100.00%,"1,618.51",,,,"1,482.68","1,642.92",0
unity,CDM,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,49082,49082,,Abd paracentesis,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,157.31,% of charge rate,100.00%,157.31,,,,141.78,157.31,0
unity,CDM,Hc Abd Paracentesis W/imaging,4902347,49083,,Abd paracentesis w/imaging,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,450.00",% of charge rate,100.00%,"1,450.00",,,,"1,377.50","1,450.00",0
unity,CDM,Hc Abd Paracentesis W/imaging,4902347,49083,,Abd paracentesis w/imaging,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,450.00",% of charge rate,100.00%,"1,450.00",,,,"1,377.50","1,450.00",0
unity,CDM,PR ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE,49083,49083,,Abd paracentesis w/imaging,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,280.32,% of charge rate,100.00%,280.32,,,,206.04,280.32,0
unity,CDM,Um Poct Us Guidance Abd Paracentesis,UM4022006,49083,,Abd paracentesis w/imaging,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,265.00",% of charge rate,100.00%,"1,265.00",,,,"1,201.75","1,265.00",0
unity,CDM,Um Poct Us Guidance Abd Paracentesis,UM4022006,49083,,Abd paracentesis w/imaging,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,265.00",% of charge rate,100.00%,"1,265.00",,,,"1,201.75","1,265.00",0
unity,CDM,Hc Image Cath Fluid Peri/retro,4902574,49406,,Image cath fluid peri/retro,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,625.00",% of charge rate,100.00%,"2,625.00",,,,"2,493.75","2,625.00",0
unity,CDM,Hc Image Cath Fluid Peri/retro,4902574,49406,,Image cath fluid peri/retro,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,625.00",% of charge rate,100.00%,"2,625.00",,,,"2,493.75","2,625.00",0
unity,CDM,Um Poct Us Guidance Retroperitoneal Paracentesis,UM4022005,49406,,Image cath fluid peri/retro,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,293.73",% of charge rate,100.00%,"2,293.73",,,,"2,179.04","2,293.73",0
unity,CDM,Um Poct Us Guidance Retroperitoneal Paracentesis,UM4022005,49406,,Image cath fluid peri/retro,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,293.73",% of charge rate,100.00%,"2,293.73",,,,"2,179.04","2,293.73",0
unity,CDM,"PR REPAIR ING HERNIA,5+Y/O,REDUCIBL",49505,49505,,Prp i/hern init reduc >5 yr,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,145.00",% of charge rate,100.00%,"1,145.00",,,,"1,005.01","1,145.00",0
unity,CDM,"PR REPAIR ING HERNIA,5+Y/O,STRANG",49507,49507,,Prp i/hern init block >5 yr,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,232.80",% of charge rate,100.00%,"1,232.80",,,,"1,130.89","1,253.11",0
unity,CDM,"PR REPAIR RECURR INGUIN HERN,REDUCIBL",49520,49520,,Rerepair ing hernia reduce,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,327.46",% of charge rate,100.00%,"1,327.46",,,,"1,219.00","1,350.74",0
unity,CDM,"PR REPAIR INCISIONAL HERNIA,REDUCIBLE",49560,49560,,Rpr ventral hern init reduc,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,625.00",% of charge rate,100.00%,"1,625.00",,,,"1,424.38","1,625.00",0
unity,CDM,"PR REPAIR INCISIONAL HERNIA,STRANG",49561,49561,,Rpr ventral hern init block,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,949.29",% of charge rate,100.00%,"1,949.29",,,,"1,794.71","1,988.68",0
unity,CDM,"PR REPAIR RECURR INCIS HERNIA,REDUC",49565,49565,,Rerepair ventrl hern reduce,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,612.11",% of charge rate,100.00%,"1,612.11",,,,"1,482.68","1,642.92",0
unity,CDM,"PR REPAIR RECURR INCIS HERNIA,STRANG",49566,49566,,Rerepair ventrl hern block,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,969.88",% of charge rate,100.00%,"1,969.88",,,,"1,811.28","2,007.03",0
unity,CDM,IMPLANT MESH HERNIA REPAIR/DEBRIDEMENT CLOSURE,49568,49568,,Hernia repair w/mesh,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,590,% of charge rate,100.00%,590,,,,516.75,590,0
unity,CDM,"REPAIR UMBILICAL HERN,5+Y/O,REDUC",49585,49585,,Rpr umbil hern reduc > 5 yr,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,937.74,% of charge rate,100.00%,937.74,,,,858.6,951.39,0
unity,CDM,"REPAIR UMBILICAL HERN,5+Y/O,STRANG",49587,49587,,Rpr umbil hern block > 5 yr,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,004.47",% of charge rate,100.00%,"1,004.47",,,,918.23,"1,017.46",0
unity,CDM,"PR LAP,INGUINAL HERNIA REPR,INITIAL",49650,49650,,Lap ing hernia repair init,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,945,% of charge rate,100.00%,945,,,,828.13,945,0
unity,CDM,"PR LAP,INGUINAL HERNIA REPR,RECUR",49651,49651,,Lap ing hernia repair recur,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,225.00",% of charge rate,100.00%,"1,225.00",,,,"1,078.55","1,225.00",0
unity,CDM,Hc Insert Temp Bladder Catheter,4500078,51702,,Insert temp bladder cath,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,190,% of charge rate,100.00%,190,,,,180.5,190,0
unity,CDM,Hc Insert Temp Bladder Catheter,4500078,51702,,Insert temp bladder cath,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,190,% of charge rate,100.00%,190,,,,180.5,190,0
unity,CDM,"PR INSERT,TEMP INDWELLING BLAD CATH,SIMPLE",51702,51702,,Insert temp bladder cath,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,149.79,% of charge rate,100.00%,149.79,,,,49.03,149.79,0
unity,CDM,Hc Us Urine Capacity Measure,4901360,51798,,Us urine capacity measure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100,% of charge rate,100.00%,100,,,,95,100,0
unity,CDM,Hc Us Urine Capacity Measure,4901360,51798,,Us urine capacity measure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100,% of charge rate,100.00%,100,,,,95,100,0
unity,CDM,PR CIRCUMCISION W/REGIONAL BLOCK,54150,54150,,Circumcision w/regionl block,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,325.83,% of charge rate,100.00%,325.83,,,,188.15,325.83,0
unity,CDM,"PR INCIS/DRAIN SCROTUM/TESTIS,EPIDIDYM",54700,54700,,Drainage of scrotum,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,440,% of charge rate,100.00%,440,,,,409.43,453.67,0
unity,CDM,PR REMOVAL OF SPERM CORD LESION,55520,55520,,Removal of sperm cord lesion,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,812.79,% of charge rate,100.00%,812.79,,,,812.79,969.01,0
unity,CDM,PR BIOPSY OF UTERUS LINING,58100,58100,,Biopsy of uterus lining,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,232.84,% of charge rate,100.00%,232.84,,,,123.23,232.84,0
unity,CDM,PR TOTAL ABDOM HYSTERECTOMY,58150,58150,,Total hysterectomy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"2,120.37",% of charge rate,100.00%,"2,120.37",,,,"1,937.81","2,147.24",0
unity,CDM,REMOVE INTRAUTERINE DEVICE,58301,58301,,Remove intrauterine device,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,215,% of charge rate,100.00%,215,,,,129.19,215,0
unity,CDM,"PR OBSTETRICAL CARE,VAG DELIV ONLY",59409,59409,,Obstetrical care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,744.14",% of charge rate,100.00%,"1,744.14",,,,"1,558.86","1,744.14",0
unity,CDM,Hc Brachial Plexus Nerve Block,4901666,64415,,Njx aa&/strd brach plexus,,,Professional,N/A,Self-Pay,N/A,N/A,N/A,140,% of charge rate,100.00%,140,,,,121.24,140,0
unity,CDM,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,64450,64450,,Njx aa&/strd other pn/branch,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,110,% of charge rate,100.00%,110,,,,81.49,110,0
unity,CDM,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,64450,64450,,Njx aa&/strd other pn/branch,,,Professional,N/A,Self-Pay,N/A,N/A,N/A,110,% of charge rate,100.00%,110,,,,81.49,110,0
unity,CDM,"PR REMV F.B.,EYE,SUPERF CONJUNC",65205,65205,,Remove foreign body from eye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,120.68,% of charge rate,100.00%,120.68,,,,54.99,120.68,0
unity,CDM,"PR REMV F.B.,EYE,EMBED CONJUNC",65210,65210,,Remove foreign body from eye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,149.08,% of charge rate,100.00%,149.08,,,,68.9,149.08,0
unity,CDM,"PR REMV F.B.,EYE,CORNEA,NO SLIT",65220,65220,,Remove foreign body from eye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,124.23,% of charge rate,100.00%,124.23,,,,78.84,124.23,0
unity,CDM,YAG LASER,4901775,66821,,After cataract laser surgery,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,075.00",% of charge rate,100.00%,"1,075.00",,,,"1,021.25","1,075.00",0
unity,CDM,YAG LASER,4901775,66821,,After cataract laser surgery,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,075.00",% of charge rate,100.00%,"1,075.00",,,,"1,021.25","1,075.00",0
unity,CDM,"PR REMOVE EYELID FOREIGN BODY,EMBEDDED",67938,67938,,Remove eyelid foreign body,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,528.86,% of charge rate,100.00%,528.86,,,,217.3,528.86,0
unity,CDM,PR REMV EXT CANAL FOREIGN BODY,69200,69200,,Clear outer ear canal,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,269.76,% of charge rate,100.00%,269.76,,,,89.44,269.76,0
unity,CDM,PR REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,69209,69209,,Remove impacted ear wax uni,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,30,% of charge rate,100.00%,30,,,,26.5,30,0
unity,CDM,PR REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,69210,69210,,Remove impacted ear wax uni,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,110.75,% of charge rate,100.00%,110.75,,,,63.6,110.75,0
unity,CDM,XR-FB IN EYE,3200300,70030,,X-ray eye for foreign body,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,97.43,% of charge rate,100.00%,97.43,,,,92.56,97.43,0
unity,CDM,XR-FB IN EYE,3200300,70030,,X-ray eye for foreign body,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,97.43,% of charge rate,100.00%,97.43,,,,92.56,97.43,0
unity,CDM,XR-MANDIBLE <4 VIEWS,3200226,70100,,X-ray exam of jaw <4views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.63,% of charge rate,100.00%,116.63,,,,110.8,116.63,0
unity,CDM,XR-MANDIBLE <4 VIEWS,3200226,70100,,X-ray exam of jaw <4views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.63,% of charge rate,100.00%,116.63,,,,110.8,116.63,0
unity,CDM,XR-MANDIBLE 4+ VIEWS,3200228,70110,,X-ray exam of jaw 4/> views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,123.1,% of charge rate,100.00%,123.1,,,,116.95,123.1,0
unity,CDM,XR-MANDIBLE 4+ VIEWS,3200228,70110,,X-ray exam of jaw 4/> views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,123.1,% of charge rate,100.00%,123.1,,,,116.95,123.1,0
unity,CDM,PR X-RAY JAW 4+ VW,70110,70110,26,X-ray exam of jaw 4/> views,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,27.93,% of charge rate,100.00%,27.93,,,,23.85,27.93,0
unity,CDM,Hc Mastoid 1-2 Vws,3200317,70120,,X-ray exam of mastoids,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.48,% of charge rate,100.00%,111.48,,,,105.91,111.48,0
unity,CDM,Hc Mastoid 1-2 Vws,3200317,70120,,X-ray exam of mastoids,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.48,% of charge rate,100.00%,111.48,,,,105.91,111.48,0
unity,CDM,XR-MASTOIDS 3+ VIEWS,3200003,70130,,X-ray exam of mastoids,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,168.04,% of charge rate,100.00%,168.04,,,,159.64,168.04,0
unity,CDM,XR-MASTOIDS 3+ VIEWS,3200003,70130,,X-ray exam of mastoids,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,168.04,% of charge rate,100.00%,168.04,,,,159.64,168.04,0
unity,CDM,Hc Facial Bones Part,3200316,70140,,X-ray exam of facial bones,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,Hc Facial Bones Part,3200316,70140,,X-ray exam of facial bones,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,XRAY FACIAL BONES <3 VW,3200319,70140,,X-ray exam of facial bones,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,XRAY FACIAL BONES <3 VW,3200319,70140,,X-ray exam of facial bones,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,XR-FACIAL BONES 3+ VIEWS,3200004,70150,,X-ray exam of facial bones,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,136.02,% of charge rate,100.00%,136.02,,,,129.22,136.02,0
unity,CDM,XR-FACIAL BONES 3+ VIEWS,3200004,70150,,X-ray exam of facial bones,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,136.02,% of charge rate,100.00%,136.02,,,,129.22,136.02,0
unity,CDM,PR X-RAY FACIAL BONES 3+ VW,70150,70150,26,X-ray exam of facial bones,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,29.48,% of charge rate,100.00%,29.48,,,,25.18,29.48,0
unity,CDM,XR-NOSE BONES 3+ VIEWS,3200005,70160,,X-ray exam of nasal bones,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,126.63,% of charge rate,100.00%,126.63,,,,120.3,126.63,0
unity,CDM,XR-NOSE BONES 3+ VIEWS,3200005,70160,,X-ray exam of nasal bones,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,126.63,% of charge rate,100.00%,126.63,,,,120.3,126.63,0
unity,CDM,PR X-RAY NASAL BONES,70160,70160,26,X-ray exam of nasal bones,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.39,% of charge rate,100.00%,19.39,,,,16.56,19.39,0
unity,CDM,Hc Orbits Min 4 Views,3200006,70200,,X-ray exam of eye sockets,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,126.02,% of charge rate,100.00%,126.02,,,,119.72,126.02,0
unity,CDM,Hc Orbits Min 4 Views,3200006,70200,,X-ray exam of eye sockets,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,126.02,% of charge rate,100.00%,126.02,,,,119.72,126.02,0
unity,CDM,XR-SINUSES < 3 VIEWS,3200007,70210,,X-ray exam of sinuses,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93.7,% of charge rate,100.00%,93.7,,,,89.02,93.7,0
unity,CDM,XR-SINUSES < 3 VIEWS,3200007,70210,,X-ray exam of sinuses,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93.7,% of charge rate,100.00%,93.7,,,,89.02,93.7,0
unity,CDM,XR-SINUSES 3+ VIEWS,3200008,70220,,X-ray exam of sinuses,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.48,% of charge rate,100.00%,111.48,,,,105.91,111.48,0
unity,CDM,XR-SINUSES 3+ VIEWS,3200008,70220,,X-ray exam of sinuses,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.48,% of charge rate,100.00%,111.48,,,,105.91,111.48,0
unity,CDM,PR X-RAY SINUSES 3+ VW,70220,70220,26,X-ray exam of sinuses,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,27.93,% of charge rate,100.00%,27.93,,,,21.2,27.93,0
unity,CDM,XR-SKULL <4 VIEWS,3200009,70250,,X-ray exam of skull,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,115.04,% of charge rate,100.00%,115.04,,,,109.29,115.04,0
unity,CDM,XR-SKULL <4 VIEWS,3200009,70250,,X-ray exam of skull,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,115.04,% of charge rate,100.00%,115.04,,,,109.29,115.04,0
unity,CDM,PR X-RAY SKULL <4 VW,70250,70250,26,X-ray exam of skull,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,27.93,% of charge rate,100.00%,27.93,,,,19.21,27.93,0
unity,CDM,XR-SKULL 4+ VIEWS,3200010,70260,,X-ray exam of skull,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,136.02,% of charge rate,100.00%,136.02,,,,129.22,136.02,0
unity,CDM,XR-SKULL 4+ VIEWS,3200010,70260,,X-ray exam of skull,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,136.02,% of charge rate,100.00%,136.02,,,,129.22,136.02,0
unity,CDM,PR X-RAY SKULL 4+ VW,70260,70260,26,X-ray exam of skull,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,38.01,% of charge rate,100.00%,38.01,,,,27.16,38.01,0
unity,CDM,XR-TMJ,3200011,70330,,X-ray exam of jaw joints,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,155.08,% of charge rate,100.00%,155.08,,,,147.33,155.08,0
unity,CDM,XR-TMJ,3200011,70330,,X-ray exam of jaw joints,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,155.08,% of charge rate,100.00%,155.08,,,,147.33,155.08,0
unity,CDM,MRI-TMJ,6110000,70336,,Magnetic image jaw joint,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,888.12",% of charge rate,100.00%,"1,888.12",,,,"1,793.71","1,888.12",0
unity,CDM,MRI-TMJ,6110000,70336,,Magnetic image jaw joint,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,888.12",% of charge rate,100.00%,"1,888.12",,,,"1,793.71","1,888.12",0
unity,CDM,XR-SOFT TISSUE NECK,3200013,70360,,X-ray exam of neck,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,98.87,% of charge rate,100.00%,98.87,,,,93.93,98.87,0
unity,CDM,XR-SOFT TISSUE NECK,3200013,70360,,X-ray exam of neck,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,98.87,% of charge rate,100.00%,98.87,,,,93.93,98.87,0
unity,CDM,PR X-RAY NECK SOFT TISSUE,70360,70360,26,X-ray exam of neck,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,18.62,% of charge rate,100.00%,18.62,,,,17.23,19.09,0
unity,CDM,CT-BRAIN,3510000,70450,,Ct head/brain w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,590.1,% of charge rate,100.00%,590.1,,,,560.6,590.1,0
unity,CDM,CT-BRAIN,3510000,70450,,Ct head/brain w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,590.1,% of charge rate,100.00%,590.1,,,,560.6,590.1,0
unity,CDM,"PR CT SCAN,HEAD/BRAIN,W/O CONTRAST MATL",70450,70450,26,Ct head/brain w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,93.07,% of charge rate,100.00%,93.07,,,,80.16,93.07,0
unity,CDM,CT-BRAIN,3510001,70460,,Ct head/brain w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,859.63,% of charge rate,100.00%,859.63,,,,816.65,859.63,0
unity,CDM,CT-BRAIN,3510001,70460,,Ct head/brain w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,859.63,% of charge rate,100.00%,859.63,,,,816.65,859.63,0
unity,CDM,PR CT SCAN HEAD CONTRAST,70460,70460,26,Ct head/brain w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,124.11,% of charge rate,100.00%,124.11,,,,106,124.11,0
unity,CDM,CT-BRAIN,3510002,70470,,Ct head/brain w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,029.25",% of charge rate,100.00%,"1,029.25",,,,977.79,"1,029.25",0
unity,CDM,CT-BRAIN,3510002,70470,,Ct head/brain w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,029.25",% of charge rate,100.00%,"1,029.25",,,,977.79,"1,029.25",0
unity,CDM,PR CT SCAN HEAD COMBO,70470,70470,26,Ct head/brain w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,140.39,% of charge rate,100.00%,140.39,,,,119.25,140.39,0
unity,CDM,CT-EAR,3510003,70480,,Ct orbit/ear/fossa w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,359.88",% of charge rate,100.00%,"1,359.88",,,,"1,291.89","1,359.88",0
unity,CDM,CT-EAR,3510003,70480,,Ct orbit/ear/fossa w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,359.88",% of charge rate,100.00%,"1,359.88",,,,"1,291.89","1,359.88",0
unity,CDM,"PR CT SCAN,ORBIT/SELLA/POST FOSSA/EAR,W/O",70480,70480,26,Ct orbit/ear/fossa w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,141.94,% of charge rate,100.00%,141.94,,,,119.91,141.94,0
unity,CDM,CT EAR,3510004,70481,,Ct orbit/ear/fossa w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,442.77",% of charge rate,100.00%,"1,442.77",,,,"1,370.63","1,442.77",0
unity,CDM,CT EAR,3510004,70481,,Ct orbit/ear/fossa w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,442.77",% of charge rate,100.00%,"1,442.77",,,,"1,370.63","1,442.77",0
unity,CDM,CT-EAR,3510005,70482,,Ct orbit/ear/fossa w/o&w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,837.13",% of charge rate,100.00%,"1,837.13",,,,"1,745.27","1,837.13",0
unity,CDM,CT-EAR,3510005,70482,,Ct orbit/ear/fossa w/o&w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,837.13",% of charge rate,100.00%,"1,837.13",,,,"1,745.27","1,837.13",0
unity,CDM,PR CT SCAN SKULL COMBO,70482,70482,26,Ct orbit/ear/fossa w/o&w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,159.78,% of charge rate,100.00%,159.78,,,,118.59,159.78,0
unity,CDM,CT-FACIAL BONE,3510006,70486,,Ct maxillofacial w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,776.23,% of charge rate,100.00%,776.23,,,,737.42,776.23,0
unity,CDM,CT-FACIAL BONE,3510006,70486,,Ct maxillofacial w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,776.23,% of charge rate,100.00%,776.23,,,,737.42,776.23,0
unity,CDM,"PR CT SCAN,MAXILLOFACIAL AREA,W/O CONTRAST",70486,70486,26,Ct maxillofacial w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,125.65,% of charge rate,100.00%,125.65,,,,80.83,125.65,0
unity,CDM,CT-FACIAL BONES,3510007,70487,,Ct maxillofacial w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,902.92,% of charge rate,100.00%,902.92,,,,857.77,902.92,0
unity,CDM,CT-FACIAL BONES,3510007,70487,,Ct maxillofacial w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,902.92,% of charge rate,100.00%,902.92,,,,857.77,902.92,0
unity,CDM,CT-FACIAL BONES,3510008,70488,,Ct maxillofacial w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,128.67",% of charge rate,100.00%,"1,128.67",,,,"1,072.24","1,128.67",0
unity,CDM,CT-FACIAL BONES,3510008,70488,,Ct maxillofacial w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,128.67",% of charge rate,100.00%,"1,128.67",,,,"1,072.24","1,128.67",0
unity,CDM,CT-NECK,3500000,70490,,Ct soft tissue neck w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,895.08,% of charge rate,100.00%,895.08,,,,850.33,895.08,0
unity,CDM,CT-NECK,3500000,70490,,Ct soft tissue neck w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,895.08,% of charge rate,100.00%,895.08,,,,850.33,895.08,0
unity,CDM,CT-NECK,3500001,70491,,Ct soft tissue neck w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,156.79",% of charge rate,100.00%,"1,156.79",,,,"1,098.95","1,156.79",0
unity,CDM,CT-NECK,3500001,70491,,Ct soft tissue neck w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,156.79",% of charge rate,100.00%,"1,156.79",,,,"1,098.95","1,156.79",0
unity,CDM,PR CT NECK TISSUE CONTRAST,70491,70491,26,Ct soft tissue neck w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,152.02,% of charge rate,100.00%,152.02,,,,129.85,152.02,0
unity,CDM,CT-NECK,3500002,70492,,Ct sft tsue nck w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,320.75",% of charge rate,100.00%,"1,320.75",,,,"1,254.71","1,320.75",0
unity,CDM,CT-NECK,3500002,70492,,Ct sft tsue nck w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,320.75",% of charge rate,100.00%,"1,320.75",,,,"1,254.71","1,320.75",0
unity,CDM,PR CT NECK TISSUE COMBO,70492,70492,26,Ct sft tsue nck w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,159.78,% of charge rate,100.00%,159.78,,,,153.04,169.58,0
unity,CDM,Hc Cta Head,3500003,70496,,Ct angiography head,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,701.90",% of charge rate,100.00%,"3,701.90",,,,"3,516.81","3,701.90",0
unity,CDM,Hc Cta Head,3500003,70496,,Ct angiography head,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,701.90",% of charge rate,100.00%,"3,701.90",,,,"3,516.81","3,701.90",0
unity,CDM,Hc Cta Neck,3500004,70498,,Ct angiography neck,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,701.90",% of charge rate,100.00%,"3,701.90",,,,"3,516.81","3,701.90",0
unity,CDM,Hc Cta Neck,3500004,70498,,Ct angiography neck,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,701.90",% of charge rate,100.00%,"3,701.90",,,,"3,516.81","3,701.90",0
unity,CDM,MRI-EYE/FACE/NECK,6100000,70540,,Mri orbit/face/neck w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,035.70",% of charge rate,100.00%,"2,035.70",,,,"1,933.92","2,035.70",0
unity,CDM,MRI-EYE/FACE/NECK,6100000,70540,,Mri orbit/face/neck w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,035.70",% of charge rate,100.00%,"2,035.70",,,,"1,933.92","2,035.70",0
unity,CDM,MRI ORBIT/FACE/NECK,6100001,70542,,Mri orbit/face/neck w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,236.05",% of charge rate,100.00%,"2,236.05",,,,"2,124.25","2,236.05",0
unity,CDM,MRI ORBIT/FACE/NECK,6100001,70542,,Mri orbit/face/neck w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,236.05",% of charge rate,100.00%,"2,236.05",,,,"2,124.25","2,236.05",0
unity,CDM,MRI EYE/FACE/NECK,6100002,70543,,Mri orbt/fac/nck w/o &w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,787.83",% of charge rate,100.00%,"2,787.83",,,,"2,648.44","2,787.83",0
unity,CDM,MRI EYE/FACE/NECK,6100002,70543,,Mri orbt/fac/nck w/o &w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,787.83",% of charge rate,100.00%,"2,787.83",,,,"2,648.44","2,787.83",0
unity,CDM,"PR MRI, FACE, NECK, COMBO",70543,70543,26,Mri orbt/fac/nck w/o &w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,236.57,% of charge rate,100.00%,236.57,,,,200.74,236.57,0
unity,CDM,MRA-HEAD,6100003,70544,,Mr angiography head w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,313.60",% of charge rate,100.00%,"2,313.60",,,,"2,197.92","2,313.60",0
unity,CDM,MRA-HEAD,6100003,70544,,Mr angiography head w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,313.60",% of charge rate,100.00%,"2,313.60",,,,"2,197.92","2,313.60",0
unity,CDM,"PR MR ANGIO, HEAD",70544,70544,26,Mr angiography head w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,132.64,% of charge rate,100.00%,132.64,,,,112.63,132.64,0
unity,CDM,MRA-NECK,6100006,70547,,Mr angiography neck w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,320.00",% of charge rate,100.00%,"2,320.00",,,,"2,204.00","2,320.00",0
unity,CDM,MRA-NECK,6100006,70547,,Mr angiography neck w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,320.00",% of charge rate,100.00%,"2,320.00",,,,"2,204.00","2,320.00",0
unity,CDM,Hc Mra Neck W/dye,6100007,70548,,Mr angiography neck w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,460.63",% of charge rate,100.00%,"2,460.63",,,,"2,337.60","2,460.63",0
unity,CDM,Hc Mra Neck W/dye,6100007,70548,,Mr angiography neck w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,460.63",% of charge rate,100.00%,"2,460.63",,,,"2,337.60","2,460.63",0
unity,CDM,MRA-NECK,6100008,70549,,Mr angiograph neck w/o&w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,572.18",% of charge rate,100.00%,"3,572.18",,,,"3,393.57","3,572.18",0
unity,CDM,MRA-NECK,6100008,70549,,Mr angiograph neck w/o&w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,572.18",% of charge rate,100.00%,"3,572.18",,,,"3,393.57","3,572.18",0
unity,CDM,MRI-BRAIN/BRAIN STEM,6110001,70551,,Mri brain stem w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,705.24",% of charge rate,100.00%,"1,705.24",,,,"1,619.98","1,705.24",0
unity,CDM,MRI-BRAIN/BRAIN STEM,6110001,70551,,Mri brain stem w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,705.24",% of charge rate,100.00%,"1,705.24",,,,"1,619.98","1,705.24",0
unity,CDM,PR MRI BRAIN,70551,70551,26,Mri brain stem w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,162.89,% of charge rate,100.00%,162.89,,,,139.79,162.89,0
unity,CDM,MRI-BRAIN,6110002,70552,,Mri brain stem w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,766.56",% of charge rate,100.00%,"1,766.56",,,,"1,678.23","1,766.56",0
unity,CDM,MRI-BRAIN,6110002,70552,,Mri brain stem w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,766.56",% of charge rate,100.00%,"1,766.56",,,,"1,678.23","1,766.56",0
unity,CDM,MRI-BRAIN,6110003,70553,,Mri brain stem w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,520.00",% of charge rate,100.00%,"2,520.00",,,,"2,394.00","2,520.00",0
unity,CDM,MRI-BRAIN,6110003,70553,,Mri brain stem w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,520.00",% of charge rate,100.00%,"2,520.00",,,,"2,394.00","2,520.00",0
unity,CDM,PR MRI BRAIN COMBO,70553,70553,26,Mri brain stem w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,260.62,% of charge rate,100.00%,260.62,,,,215.31,260.62,0
unity,CDM,Hc Recovery Observation/hr,7100010,7100010,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,498.16,% of charge rate,100.00%,498.16,,,,473.25,498.16,0
unity,CDM,Hc Recovery Observation/hr,7100010,7100010,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,498.16,% of charge rate,100.00%,498.16,,,,473.25,498.16,0
unity,CDM,Hc Chest Multiple Views,3200314,71030,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.33,% of charge rate,100.00%,116.33,,,,110.51,116.33,0
unity,CDM,Hc Chest Multiple Views,3200314,71030,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.33,% of charge rate,100.00%,116.33,,,,110.51,116.33,0
unity,CDM,Hc Xray Chest 1 View,3240020,71045,,X-ray exam chest 1 view,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,59.78,% of charge rate,100.00%,59.78,,,,56.79,59.78,0
unity,CDM,Hc Xray Chest 1 View,3240020,71045,,X-ray exam chest 1 view,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,59.78,% of charge rate,100.00%,59.78,,,,56.79,59.78,0
unity,CDM,CHG RADIOLOGIC EXAM CHEST SINGLE VIEW,71045,71045,26,X-ray exam chest 1 view,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,20.17,% of charge rate,100.00%,20.17,,,,17.23,20.17,0
unity,CDM,Hc Xray Chest 2 Views,3240021,71046,,X-ray exam chest 2 views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,106.63,% of charge rate,100.00%,106.63,,,,101.3,106.63,0
unity,CDM,Hc Xray Chest 2 Views,3240021,71046,,X-ray exam chest 2 views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,106.63,% of charge rate,100.00%,106.63,,,,101.3,106.63,0
unity,CDM,CHG RADIOLOGIC EXAM CHEST 2 VIEWS,71046,71046,26,X-ray exam chest 2 views,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,24.05,% of charge rate,100.00%,24.05,,,,20.54,24.05,0
unity,CDM,Hc Xray Chest 3 Views,3240022,71047,,X-ray exam chest 3 views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90.47,% of charge rate,100.00%,90.47,,,,85.95,90.47,0
unity,CDM,Hc Xray Chest 3 Views,3240022,71047,,X-ray exam chest 3 views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90.47,% of charge rate,100.00%,90.47,,,,85.95,90.47,0
unity,CDM,CHG RADIOLOGIC EXAM CHEST 3 VIEWS,71047,71047,26,X-ray exam chest 3 views,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,30.25,% of charge rate,100.00%,30.25,,,,25.84,30.25,0
unity,CDM,CHG RADIOLOGIC EXAM CHEST 4+ VIEWS,71048,71048,26,X-ray exam chest 4+ views,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,18.34,% of charge rate,100.00%,18.34,,,,18.34,33.77,0
unity,CDM,XR-RIBS 2 VIEWS,3240007,71100,,X-ray exam ribs uni 2 views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,96.93,% of charge rate,100.00%,96.93,,,,92.08,96.93,0
unity,CDM,XR-RIBS 2 VIEWS,3240007,71100,,X-ray exam ribs uni 2 views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,96.93,% of charge rate,100.00%,96.93,,,,92.08,96.93,0
unity,CDM,PR X-RAY RIBS 2 VW UNILAT,71100,71100,26,X-ray exam ribs uni 2 views,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,24.82,% of charge rate,100.00%,24.82,,,,21.2,24.82,0
unity,CDM,XR-RIBS 3+ VIEWS,3240008,71101,,X-ray exam unilat ribs/chest,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,113.57,% of charge rate,100.00%,113.57,,,,107.89,113.57,0
unity,CDM,XR-RIBS 3+ VIEWS,3240008,71101,,X-ray exam unilat ribs/chest,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,113.57,% of charge rate,100.00%,113.57,,,,107.89,113.57,0
unity,CDM,"PR X-RAY RIBS, CHEST 3+ VW",71101,71101,26,X-ray exam unilat ribs/chest,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,29.48,% of charge rate,100.00%,29.48,,,,25.18,29.48,0
unity,CDM,XR-RIBS 3 VIEWS,3240009,71110,,X-ray exam ribs bil 3 views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.63,% of charge rate,100.00%,116.63,,,,110.8,116.63,0
unity,CDM,XR-RIBS 3 VIEWS,3240009,71110,,X-ray exam ribs bil 3 views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.63,% of charge rate,100.00%,116.63,,,,110.8,116.63,0
unity,CDM,XR-RIBS 4 VIEWS,3240010,71111,,X-ray exam ribs/chest4/> vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140.55,% of charge rate,100.00%,140.55,,,,133.52,140.55,0
unity,CDM,XR-RIBS 4 VIEWS,3240010,71111,,X-ray exam ribs/chest4/> vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140.55,% of charge rate,100.00%,140.55,,,,133.52,140.55,0
unity,CDM,XR-STERNUM 2+ VIEWS,3240011,71120,,X-ray exam breastbone 2/>vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,97.26,% of charge rate,100.00%,97.26,,,,92.4,97.26,0
unity,CDM,XR-STERNUM 2+ VIEWS,3240011,71120,,X-ray exam breastbone 2/>vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,97.26,% of charge rate,100.00%,97.26,,,,92.4,97.26,0
unity,CDM,Hc Sterno-clav Jts Min 3 V,3200230,71130,,X-ray strenoclavic jt 3/>vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,114.68,% of charge rate,100.00%,114.68,,,,108.95,114.68,0
unity,CDM,Hc Sterno-clav Jts Min 3 V,3200230,71130,,X-ray strenoclavic jt 3/>vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,114.68,% of charge rate,100.00%,114.68,,,,108.95,114.68,0
unity,CDM,PR X-RAY STERNO-CLAVICLUAR JT,71130,71130,26,X-ray strenoclavic jt 3/>vws,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,24.82,% of charge rate,100.00%,24.82,,,,21.2,24.82,0
unity,CDM,CT-THORAX,3520000,71250,,Ct thorax w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,899.91,% of charge rate,100.00%,899.91,,,,854.91,899.91,0
unity,CDM,CT-THORAX,3520000,71250,,Ct thorax w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,899.91,% of charge rate,100.00%,899.91,,,,854.91,899.91,0
unity,CDM,"PR CT SCAN,THORAX,W/O CONTRAST",71250,71250,26,Ct thorax w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,111.69,% of charge rate,100.00%,111.69,,,,108.65,120.39,0
unity,CDM,CT-THORAX,3520010,71260,,Ct thorax w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,161.65",% of charge rate,100.00%,"1,161.65",,,,"1,103.57","1,161.65",0
unity,CDM,CT-THORAX,3520010,71260,,Ct thorax w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,161.65",% of charge rate,100.00%,"1,161.65",,,,"1,103.57","1,161.65",0
unity,CDM,PR CAT SCAN OF CHEST CONTRAST,71260,71260,26,Ct thorax w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,137.29,% of charge rate,100.00%,137.29,,,,117.26,137.29,0
unity,CDM,CT THORAX,3520002,71270,,Ct thorax w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,436.29",% of charge rate,100.00%,"1,436.29",,,,"1,364.48","1,436.29",0
unity,CDM,CT THORAX,3520002,71270,,Ct thorax w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,436.29",% of charge rate,100.00%,"1,436.29",,,,"1,364.48","1,436.29",0
unity,CDM,PR CAT SCAN OF CHEST COMBO,71270,71270,26,Ct thorax w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,151.25,% of charge rate,100.00%,151.25,,,,129.19,151.25,0
unity,CDM,CT-CHEST,3500005,71275,,Ct angiography chest,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,699.13",% of charge rate,100.00%,"1,699.13",,,,"1,614.17","1,699.13",0
unity,CDM,CT-CHEST,3500005,71275,,Ct angiography chest,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,699.13",% of charge rate,100.00%,"1,699.13",,,,"1,614.17","1,699.13",0
unity,CDM,MRI-CHEST,6100009,71550,,Mri chest w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,135.25",% of charge rate,100.00%,"3,135.25",,,,"2,978.49","3,135.25",0
unity,CDM,MRI-CHEST,6100009,71550,,Mri chest w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,135.25",% of charge rate,100.00%,"3,135.25",,,,"2,978.49","3,135.25",0
unity,CDM,CHEST WO/W DYE,6100011,71552,,Mri chest w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,162.75",% of charge rate,100.00%,"4,162.75",,,,"3,954.61","4,162.75",0
unity,CDM,CHEST WO/W DYE,6100011,71552,,Mri chest w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,162.75",% of charge rate,100.00%,"4,162.75",,,,"3,954.61","4,162.75",0
unity,CDM,XR-SPINE SINGLE VIEW,3200232,72020,,X-ray exam of spine 1 view,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.63,% of charge rate,100.00%,64.63,,,,61.4,64.63,0
unity,CDM,XR-SPINE SINGLE VIEW,3200232,72020,,X-ray exam of spine 1 view,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.63,% of charge rate,100.00%,64.63,,,,61.4,64.63,0
unity,CDM,PR X-RAY SPINE ONE VIEW,72020,72020,26,X-ray exam of spine 1 view,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,17.06,% of charge rate,100.00%,17.06,,,,15.24,17.06,0
unity,CDM,XR-SPINE 2/3 VIEWS,3200233,72040,,X-ray exam neck spine 2-3 vw,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.71,% of charge rate,100.00%,85.71,,,,81.42,85.71,0
unity,CDM,XR-SPINE 2/3 VIEWS,3200233,72040,,X-ray exam neck spine 2-3 vw,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.71,% of charge rate,100.00%,85.71,,,,81.42,85.71,0
unity,CDM,CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS,72040,72040,26,X-ray exam neck spine 2-3 vw,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,31.41,% of charge rate,100.00%,31.41,,,,21.2,31.41,0
unity,CDM,XR-SPINE 4/5 VIEWS,3200017,72050,,X-ray exam neck spine 4/5vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125.59,% of charge rate,100.00%,125.59,,,,119.31,125.59,0
unity,CDM,XR-SPINE 4/5 VIEWS,3200017,72050,,X-ray exam neck spine 4/5vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125.59,% of charge rate,100.00%,125.59,,,,119.31,125.59,0
unity,CDM,CHG RADEX SPINE CERVICAL 4 OR 5 VIEWS,72050,72050,26,X-ray exam neck spine 4/5vws,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,35.68,% of charge rate,100.00%,35.68,,,,25.84,35.68,0
unity,CDM,XR-SPINE 6+ VIEWS,3200018,72052,,X-ray exam neck spine 6/>vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,166.38,% of charge rate,100.00%,166.38,,,,158.06,166.38,0
unity,CDM,XR-SPINE 6+ VIEWS,3200018,72052,,X-ray exam neck spine 6/>vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,166.38,% of charge rate,100.00%,166.38,,,,158.06,166.38,0
unity,CDM,XR-THORACIC SPINE 2 VIEWS,3200301,72070,,X-ray exam thorac spine 2vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.8,% of charge rate,100.00%,101.8,,,,96.71,101.8,0
unity,CDM,XR-THORACIC SPINE 2 VIEWS,3200301,72070,,X-ray exam thorac spine 2vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.8,% of charge rate,100.00%,101.8,,,,96.71,101.8,0
unity,CDM,Hc Thoracic Ap/lateral Spine,3200312,72070,,X-ray exam thorac spine 2vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.8,% of charge rate,100.00%,101.8,,,,96.71,101.8,0
unity,CDM,Hc Thoracic Ap/lateral Spine,3200312,72070,,X-ray exam thorac spine 2vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.8,% of charge rate,100.00%,101.8,,,,96.71,101.8,0
unity,CDM,PR X-RAY THORACIC SPINE 2 VW,72070,72070,26,X-ray exam thorac spine 2vws,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,24.82,% of charge rate,100.00%,24.82,,,,19.21,24.82,0
unity,CDM,XR-THORACIC SPINE 3 VIEWS,3200020,72072,,X-ray exam thorac spine 3vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.63,% of charge rate,100.00%,116.63,,,,110.8,116.63,0
unity,CDM,XR-THORACIC SPINE 3 VIEWS,3200020,72072,,X-ray exam thorac spine 3vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.63,% of charge rate,100.00%,116.63,,,,110.8,116.63,0
unity,CDM,PR X-RAY THORACIC SPINE+SWIM 3 VW,72072,72072,26,X-ray exam thorac spine 3vws,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,24.05,% of charge rate,100.00%,24.05,,,,21.86,24.23,0
unity,CDM,XR-TRUNK SPINE 2 VIEWS,3200022,72080,,X-ray exam thoracolmb 2/> vw,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.87,% of charge rate,100.00%,88.87,,,,84.43,88.87,0
unity,CDM,XR-TRUNK SPINE 2 VIEWS,3200022,72080,,X-ray exam thoracolmb 2/> vw,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.87,% of charge rate,100.00%,88.87,,,,84.43,88.87,0
unity,CDM,X-RAY EXAM ENTIRE SPINE 1 VW,3200339,72081,,X-ray exam entire spi 1 vw,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110,% of charge rate,100.00%,110,,,,104.5,110,0
unity,CDM,X-RAY EXAM ENTIRE SPINE 1 VW,3200339,72081,,X-ray exam entire spi 1 vw,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110,% of charge rate,100.00%,110,,,,104.5,110,0
unity,CDM,CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,72081,72081,26,X-ray exam entire spi 1 vw,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,33,% of charge rate,100.00%,33,,,,25.18,33,0
unity,CDM,X-RAY EXAM ENTIRE SPINE 2/3 VW,3200340,72082,,X-ray exam entire spi 2/3 vw,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,230,% of charge rate,100.00%,230,,,,218.5,230,0
unity,CDM,X-RAY EXAM ENTIRE SPINE 2/3 VW,3200340,72082,,X-ray exam entire spi 2/3 vw,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,230,% of charge rate,100.00%,230,,,,218.5,230,0
unity,CDM,CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,72082,72082,26,X-ray exam entire spi 2/3 vw,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,40.13,% of charge rate,100.00%,40.13,,,,30.48,40.13,0
unity,CDM,X-RAY EXAM ENITRE SPINE 4/5 VW,3200341,72083,,X-ray exam entire spi 4/5 vw,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,254.18,% of charge rate,100.00%,254.18,,,,241.47,254.18,0
unity,CDM,X-RAY EXAM ENITRE SPINE 4/5 VW,3200341,72083,,X-ray exam entire spi 4/5 vw,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,254.18,% of charge rate,100.00%,254.18,,,,241.47,254.18,0
unity,CDM,"Hc Xray Exam Of Spine,minimum Of 6 Views",3200370,72084,,X-ray exam entire spi 6/> vw,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,350,% of charge rate,100.00%,350,,,,332.5,350,0
unity,CDM,"Hc Xray Exam Of Spine,minimum Of 6 Views",3200370,72084,,X-ray exam entire spi 6/> vw,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,350,% of charge rate,100.00%,350,,,,332.5,350,0
unity,CDM,XR-LUMBAR SPINE 2 VIEWS,3200024,72100,,X-ray exam l-s spine 2/3 vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.63,% of charge rate,100.00%,116.63,,,,110.8,116.63,0
unity,CDM,XR-LUMBAR SPINE 2 VIEWS,3200024,72100,,X-ray exam l-s spine 2/3 vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.63,% of charge rate,100.00%,116.63,,,,110.8,116.63,0
unity,CDM,PR X-RAY LUMBAR SPINE 2/3 VW,72100,72100,26,X-ray exam l-s spine 2/3 vws,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,26.38,% of charge rate,100.00%,26.38,,,,21.2,26.38,0
unity,CDM,XR-LUMBAR SPINE,3200025,72110,,X-ray exam l-2 spine 4/>vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,158.65,% of charge rate,100.00%,158.65,,,,150.72,158.65,0
unity,CDM,XR-LUMBAR SPINE,3200025,72110,,X-ray exam l-2 spine 4/>vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,158.65,% of charge rate,100.00%,158.65,,,,150.72,158.65,0
unity,CDM,PR X-RAY LUMBAR SPINE 4 VW,72110,72110,26,X-ray exam l-2 spine 4/>vws,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,35.68,% of charge rate,100.00%,35.68,,,,24.51,35.68,0
unity,CDM,CT-CERVICAL SPINE,3520003,72125,,Ct neck spine w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,052.25",% of charge rate,100.00%,"1,052.25",,,,999.64,"1,052.25",0
unity,CDM,CT-CERVICAL SPINE,3520003,72125,,Ct neck spine w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,052.25",% of charge rate,100.00%,"1,052.25",,,,999.64,"1,052.25",0
unity,CDM,"PR CT SCAN,CERVICAL SPINE,W/O CONTRAST",72125,72125,26,Ct neck spine w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,136.14,% of charge rate,100.00%,136.14,,,,94.08,136.14,0
unity,CDM,CT-CERVICAL SPINE,3500006,72126,,Ct neck spine w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,339.75",% of charge rate,100.00%,"1,339.75",,,,"1,272.76","1,339.75",0
unity,CDM,CT-CERVICAL SPINE,3500006,72126,,Ct neck spine w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,339.75",% of charge rate,100.00%,"1,339.75",,,,"1,272.76","1,339.75",0
unity,CDM,CT-THORACIC SPINE,3500008,72128,,Ct chest spine w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,049.38",% of charge rate,100.00%,"1,049.38",,,,996.91,"1,049.38",0
unity,CDM,CT-THORACIC SPINE,3500008,72128,,Ct chest spine w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,049.38",% of charge rate,100.00%,"1,049.38",,,,996.91,"1,049.38",0
unity,CDM,"PR CT SCAN,THORACIC SPINE,W/O CONTRAST",72128,72128,26,Ct chest spine w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,128.07,% of charge rate,100.00%,128.07,,,,94.08,128.07,0
unity,CDM,CT-THORACIC SPINE,3500009,72129,,Ct chest spine w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,451.00",% of charge rate,100.00%,"1,451.00",,,,"1,378.45","1,451.00",0
unity,CDM,CT-THORACIC SPINE,3500009,72129,,Ct chest spine w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,451.00",% of charge rate,100.00%,"1,451.00",,,,"1,378.45","1,451.00",0
unity,CDM,CT-LUMBAR SPINE,3500011,72131,,Ct lumbar spine w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,043.63",% of charge rate,100.00%,"1,043.63",,,,991.45,"1,043.63",0
unity,CDM,CT-LUMBAR SPINE,3500011,72131,,Ct lumbar spine w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,043.63",% of charge rate,100.00%,"1,043.63",,,,991.45,"1,043.63",0
unity,CDM,"PR CT SCAN,LUMBAR SPINE,W/O CONTRAST",72131,72131,26,Ct lumbar spine w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,128.07,% of charge rate,100.00%,128.07,,,,94.08,128.07,0
unity,CDM,MRI-C-SPINE,6120000,72141,,Mri neck spine w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,628.75",% of charge rate,100.00%,"1,628.75",,,,"1,547.31","1,628.75",0
unity,CDM,MRI-C-SPINE,6120000,72141,,Mri neck spine w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,628.75",% of charge rate,100.00%,"1,628.75",,,,"1,547.31","1,628.75",0
unity,CDM,"PR MRI, CERV SPINE",72141,72141,26,Mri neck spine w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,177.63,% of charge rate,100.00%,177.63,,,,139.79,177.63,0
unity,CDM,MRI-C-SPINE,6120001,72142,,Mri neck spine w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,313.00",% of charge rate,100.00%,"2,313.00",,,,"2,197.35","2,313.00",0
unity,CDM,MRI-C-SPINE,6120001,72142,,Mri neck spine w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,313.00",% of charge rate,100.00%,"2,313.00",,,,"2,197.35","2,313.00",0
unity,CDM,MRI-T-SPINE,6120002,72146,,Mri chest spine w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,631.63",% of charge rate,100.00%,"1,631.63",,,,"1,550.05","1,631.63",0
unity,CDM,MRI-T-SPINE,6120002,72146,,Mri chest spine w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,631.63",% of charge rate,100.00%,"1,631.63",,,,"1,550.05","1,631.63",0
unity,CDM,"PR MRI, DORSAL SPINE",72146,72146,26,Mri chest spine w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,177.63,% of charge rate,100.00%,177.63,,,,139.79,177.63,0
unity,CDM,MRI-T-SPINE,6120003,72147,,Mri chest spine w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,301.50",% of charge rate,100.00%,"2,301.50",,,,"2,186.43","2,301.50",0
unity,CDM,MRI-T-SPINE,6120003,72147,,Mri chest spine w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,301.50",% of charge rate,100.00%,"2,301.50",,,,"2,186.43","2,301.50",0
unity,CDM,MRI-L-SPINE,6120004,72148,,Mri lumbar spine w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,631.63",% of charge rate,100.00%,"1,631.63",,,,"1,550.05","1,631.63",0
unity,CDM,MRI-L-SPINE,6120004,72148,,Mri lumbar spine w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,631.63",% of charge rate,100.00%,"1,631.63",,,,"1,550.05","1,631.63",0
unity,CDM,"PR MRI, LUMBAR SPINE",72148,72148,26,Mri lumbar spine w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,203.5,% of charge rate,100.00%,203.5,,,,139.79,203.5,0
unity,CDM,MRI-LUMBAR SPINE,6120005,72149,,Mri lumbar spine w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,281.38",% of charge rate,100.00%,"2,281.38",,,,"2,167.31","2,281.38",0
unity,CDM,MRI-LUMBAR SPINE,6120005,72149,,Mri lumbar spine w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,281.38",% of charge rate,100.00%,"2,281.38",,,,"2,167.31","2,281.38",0
unity,CDM,MRI-C-SPINE,6120006,72156,,Mri neck spine w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,540.13",% of charge rate,100.00%,"2,540.13",,,,"2,413.12","2,540.13",0
unity,CDM,MRI-C-SPINE,6120006,72156,,Mri neck spine w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,540.13",% of charge rate,100.00%,"2,540.13",,,,"2,413.12","2,540.13",0
unity,CDM,"PR MRI, CERV SPINE COMBO",72156,72156,26,Mri neck spine w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,284.66,% of charge rate,100.00%,284.66,,,,215.31,284.66,0
unity,CDM,T-SPINE,6120007,72157,,Mri chest spine w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,548.75",% of charge rate,100.00%,"2,548.75",,,,"2,421.31","2,548.75",0
unity,CDM,T-SPINE,6120007,72157,,Mri chest spine w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,548.75",% of charge rate,100.00%,"2,548.75",,,,"2,421.31","2,548.75",0
unity,CDM,"PR MRI, DORSAL SPINE COMBO",72157,72157,26,Mri chest spine w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,291.08,% of charge rate,100.00%,291.08,,,,215.31,291.08,0
unity,CDM,L-SPINE,6120008,72158,,Mri lumbar spine w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,534.38",% of charge rate,100.00%,"2,534.38",,,,"2,407.66","2,534.38",0
unity,CDM,L-SPINE,6120008,72158,,Mri lumbar spine w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,534.38",% of charge rate,100.00%,"2,534.38",,,,"2,407.66","2,534.38",0
unity,CDM,"PR MRI, LUMBAR SPINE COMBO",72158,72158,26,Mri lumbar spine w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,262.94,% of charge rate,100.00%,262.94,,,,215.31,262.94,0
unity,CDM,XRAY PELVIS,3200028,72170,,X-ray exam of pelvis,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,103.41,% of charge rate,100.00%,103.41,,,,98.24,103.41,0
unity,CDM,XRAY PELVIS,3200028,72170,,X-ray exam of pelvis,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,103.41,% of charge rate,100.00%,103.41,,,,98.24,103.41,0
unity,CDM,PR X-RAY PELVIS 1/2 VW,72170,72170,26,X-ray exam of pelvis,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,27.5,% of charge rate,100.00%,27.5,,,,16.56,27.5,0
unity,CDM,Hc Pelvis Minimum 3 Views,3200029,72190,,X-ray exam of pelvis,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,122.77,% of charge rate,100.00%,122.77,,,,116.63,122.77,0
unity,CDM,Hc Pelvis Minimum 3 Views,3200029,72190,,X-ray exam of pelvis,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,122.77,% of charge rate,100.00%,122.77,,,,116.63,122.77,0
unity,CDM,CT PELVIS,3520004,72192,,Ct pelvis w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,733.13,% of charge rate,100.00%,733.13,,,,696.47,733.13,0
unity,CDM,CT PELVIS,3520004,72192,,Ct pelvis w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,733.13,% of charge rate,100.00%,733.13,,,,696.47,733.13,0
unity,CDM,"PR CT SCAN,PELVIS,W/O CONTRAST",72192,72192,26,Ct pelvis w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,138.82,% of charge rate,100.00%,138.82,,,,102.03,138.82,0
unity,CDM,CT PELVIS,3520005,72193,,Ct pelvis w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,417.38",% of charge rate,100.00%,"1,417.38",,,,"1,346.51","1,417.38",0
unity,CDM,CT PELVIS,3520005,72193,,Ct pelvis w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,417.38",% of charge rate,100.00%,"1,417.38",,,,"1,346.51","1,417.38",0
unity,CDM,PR CT SCAN OF PELVIS CONTRAST,72193,72193,26,Ct pelvis w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,148.68,% of charge rate,100.00%,148.68,,,,108.65,148.68,0
unity,CDM,CT PELVIS,3520006,72194,,Ct pelvis w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,653.13",% of charge rate,100.00%,"1,653.13",,,,"1,570.47","1,653.13",0
unity,CDM,CT PELVIS,3520006,72194,,Ct pelvis w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,653.13",% of charge rate,100.00%,"1,653.13",,,,"1,570.47","1,653.13",0
unity,CDM,PR CT SCAN OF PELVIS COMBO,72194,72194,26,Ct pelvis w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,134.19,% of charge rate,100.00%,134.19,,,,114.61,134.19,0
unity,CDM,PELVIS,6100013,72195,,Mri pelvis w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,101.95",% of charge rate,100.00%,"2,101.95",,,,"1,996.85","2,101.95",0
unity,CDM,PELVIS,6100013,72195,,Mri pelvis w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,101.95",% of charge rate,100.00%,"2,101.95",,,,"1,996.85","2,101.95",0
unity,CDM,MRI-PELVIS,6100014,72196,,Mri pelvis w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,261.89",% of charge rate,100.00%,"2,261.89",,,,"2,148.80","2,261.89",0
unity,CDM,MRI-PELVIS,6100014,72196,,Mri pelvis w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,261.89",% of charge rate,100.00%,"2,261.89",,,,"2,148.80","2,261.89",0
unity,CDM,MRI PELVIS,6100015,72197,,Mri pelvis w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,733.67",% of charge rate,100.00%,"2,733.67",,,,"2,596.99","2,733.67",0
unity,CDM,MRI PELVIS,6100015,72197,,Mri pelvis w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,733.67",% of charge rate,100.00%,"2,733.67",,,,"2,596.99","2,733.67",0
unity,CDM,"PR MRI, PELVIS, COMBO",72197,72197,26,Mri pelvis w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,248.2,% of charge rate,100.00%,248.2,,,,205.38,248.2,0
unity,CDM,Hc Mra Pelvis W/wo Dye,6100016,72198,,Mr angio pelvis w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,911.00",% of charge rate,100.00%,"2,911.00",,,,"2,765.45","2,911.00",0
unity,CDM,Hc Mra Pelvis W/wo Dye,6100016,72198,,Mr angio pelvis w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,911.00",% of charge rate,100.00%,"2,911.00",,,,"2,765.45","2,911.00",0
unity,CDM,XRAY SACROILIAC JOINTS,3200030,72200,,X-ray exam si joints,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,96.08,% of charge rate,100.00%,96.08,,,,91.28,96.08,0
unity,CDM,XRAY SACROILIAC JOINTS,3200030,72200,,X-ray exam si joints,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,96.08,% of charge rate,100.00%,96.08,,,,91.28,96.08,0
unity,CDM,PR X-RAY SACROILIAC JTS <3 VW,72200,72200,26,X-ray exam si joints,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.39,% of charge rate,100.00%,19.39,,,,16.56,19.39,0
unity,CDM,Hc Sacroiliac Joints,3200031,72202,,X-ray exam si joints 3/> vws,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.42,% of charge rate,100.00%,111.42,,,,105.85,111.42,0
unity,CDM,Hc Sacroiliac Joints,3200031,72202,,X-ray exam si joints 3/> vws,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.42,% of charge rate,100.00%,111.42,,,,105.85,111.42,0
unity,CDM,XRAY  SACRUM & COCCYX,3200032,72220,,X-ray exam sacrum tailbone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,97.26,% of charge rate,100.00%,97.26,,,,92.4,97.26,0
unity,CDM,XRAY  SACRUM & COCCYX,3200032,72220,,X-ray exam sacrum tailbone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,97.26,% of charge rate,100.00%,97.26,,,,92.4,97.26,0
unity,CDM,PR X-RAY SACRUM/COCCYX 2+ VW,72220,72220,26,X-ray exam sacrum tailbone,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.39,% of charge rate,100.00%,19.39,,,,16.56,19.39,0
unity,CDM,XRAY CLAVICLE,3200041,73000,,X-ray exam of collar bone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,XRAY CLAVICLE,3200041,73000,,X-ray exam of collar bone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,PR X-RAY CLAVICLE,73000,73000,26,X-ray exam of collar bone,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,18.62,% of charge rate,100.00%,18.62,,,,15.9,18.62,0
unity,CDM,HC SCAPULA,3200042,73010,,X-ray exam of shoulder blade,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,103.7,% of charge rate,100.00%,103.7,,,,98.52,103.7,0
unity,CDM,HC SCAPULA,3200042,73010,,X-ray exam of shoulder blade,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,103.7,% of charge rate,100.00%,103.7,,,,98.52,103.7,0
unity,CDM,PR X-RAY SCAPULA,73010,73010,26,X-ray exam of shoulder blade,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,21.71,% of charge rate,100.00%,21.71,,,,17.23,21.71,0
unity,CDM,XRAY SHOULDER,3200043,73020,,X-ray exam of shoulder,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.86,% of charge rate,100.00%,67.86,,,,64.47,67.86,0
unity,CDM,XRAY SHOULDER,3200043,73020,,X-ray exam of shoulder,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.86,% of charge rate,100.00%,67.86,,,,64.47,67.86,0
unity,CDM,PR X-RAY SHOULDER 1 VW,73020,73020,26,X-ray exam of shoulder,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,17.06,% of charge rate,100.00%,17.06,,,,14.58,17.06,0
unity,CDM,XRAY SHOULDER,3200044,73030,,X-ray exam of shoulder,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.26,% of charge rate,100.00%,87.26,,,,82.9,87.26,0
unity,CDM,XRAY SHOULDER,3200044,73030,,X-ray exam of shoulder,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.26,% of charge rate,100.00%,87.26,,,,82.9,87.26,0
unity,CDM,PR X-RAY SHOULDER 2+ VW,73030,73030,26,X-ray exam of shoulder,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,22.5,% of charge rate,100.00%,22.5,,,,17.89,22.5,0
unity,CDM,XRAY AC JOINTS,3200046,73050,,X-ray exam of shoulders,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,121.48,% of charge rate,100.00%,121.48,,,,115.41,121.48,0
unity,CDM,XRAY AC JOINTS,3200046,73050,,X-ray exam of shoulders,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,121.48,% of charge rate,100.00%,121.48,,,,115.41,121.48,0
unity,CDM,XRAY HUMERUS,3200047,73060,,X-ray exam of humerus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,92.09,% of charge rate,100.00%,92.09,,,,87.49,92.09,0
unity,CDM,XRAY HUMERUS,3200047,73060,,X-ray exam of humerus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,92.09,% of charge rate,100.00%,92.09,,,,87.49,92.09,0
unity,CDM,PR X-RAY HUMERUS,73060,73060,26,X-ray exam of humerus,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.39,% of charge rate,100.00%,19.39,,,,15.9,19.39,0
unity,CDM,XRAY ELBOW,3200048,73070,,X-ray exam of elbow,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,XRAY ELBOW,3200048,73070,,X-ray exam of elbow,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,PR X-RAY ELBOW 2 VW,73070,73070,26,X-ray exam of elbow,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,17.83,% of charge rate,100.00%,17.83,,,,15.9,17.83,0
unity,CDM,XRAY ELBOW,3200049,73080,,X-ray exam of elbow,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100.18,% of charge rate,100.00%,100.18,,,,95.17,100.18,0
unity,CDM,XRAY ELBOW,3200049,73080,,X-ray exam of elbow,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100.18,% of charge rate,100.00%,100.18,,,,95.17,100.18,0
unity,CDM,XRAY FOREARM,3200051,73090,,X-ray exam of forearm,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.56,% of charge rate,100.00%,87.56,,,,83.18,87.56,0
unity,CDM,XRAY FOREARM,3200051,73090,,X-ray exam of forearm,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.56,% of charge rate,100.00%,87.56,,,,83.18,87.56,0
unity,CDM,PR X-RAY FOREARM 2 VW,73090,73090,26,X-ray exam of forearm,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,18.62,% of charge rate,100.00%,18.62,,,,15.9,18.62,0
unity,CDM,Hc Child Upper Extremity,3200052,73092,,X-ray exam of arm infant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,Hc Child Upper Extremity,3200052,73092,,X-ray exam of arm infant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,"PR X-RAY ARM, INFANT",73092,73092,26,X-ray exam of arm infant,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,18.62,% of charge rate,100.00%,18.62,,,,15.24,18.62,0
unity,CDM,XRAY WRIST,3200053,73100,,X-ray exam of wrist,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,105.05,% of charge rate,100.00%,105.05,,,,99.8,105.05,0
unity,CDM,XRAY WRIST,3200053,73100,,X-ray exam of wrist,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,105.05,% of charge rate,100.00%,105.05,,,,99.8,105.05,0
unity,CDM,PR X-RAY WRIST 2 VW,73100,73100,26,X-ray exam of wrist,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,20.94,% of charge rate,100.00%,20.94,,,,15.9,20.94,0
unity,CDM,XRAY WRIST,3200054,73110,,X-ray exam of wrist,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,119.58,% of charge rate,100.00%,119.58,,,,113.6,119.58,0
unity,CDM,XRAY WRIST,3200054,73110,,X-ray exam of wrist,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,119.58,% of charge rate,100.00%,119.58,,,,113.6,119.58,0
unity,CDM,PR X-RAY WRIST 3+ VW,73110,73110,26,X-ray exam of wrist,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.39,% of charge rate,100.00%,19.39,,,,16.56,19.39,0
unity,CDM,XRAY HAND,3200056,73120,,X-ray exam of hand,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,XRAY HAND,3200056,73120,,X-ray exam of hand,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,PR X-RAY HAND 2 VW,73120,73120,26,X-ray exam of hand,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,18.62,% of charge rate,100.00%,18.62,,,,15.9,18.62,0
unity,CDM,XRAY HAND,3200057,73130,,X-ray exam of hand,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,108.57,% of charge rate,100.00%,108.57,,,,103.14,108.57,0
unity,CDM,XRAY HAND,3200057,73130,,X-ray exam of hand,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,108.57,% of charge rate,100.00%,108.57,,,,103.14,108.57,0
unity,CDM,PR X-RAY HAND 3+ VW,73130,73130,26,X-ray exam of hand,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.39,% of charge rate,100.00%,19.39,,,,16.56,19.39,0
unity,CDM,XRAY FINGER,3200058,73140,,X-ray exam of finger(s),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,103.48,% of charge rate,100.00%,103.48,,,,98.31,103.48,0
unity,CDM,XRAY FINGER,3200058,73140,,X-ray exam of finger(s),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,103.48,% of charge rate,100.00%,103.48,,,,98.31,103.48,0
unity,CDM,PR X-RAY EXAM OF FINGER(S),73140,73140,26,X-ray exam of finger(s),,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,17.91,% of charge rate,100.00%,17.91,,,,13.25,17.91,0
unity,CDM,CT UPPER EXTREMITY,3500016,73200,,Ct upper extremity w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,040.75",% of charge rate,100.00%,"1,040.75",,,,988.71,"1,040.75",0
unity,CDM,CT UPPER EXTREMITY,3500016,73200,,Ct upper extremity w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,040.75",% of charge rate,100.00%,"1,040.75",,,,988.71,"1,040.75",0
unity,CDM,"PR CT SCAN,UPPER EXTREMITY,W/O CONTRAST",73200,73200,26,Ct upper extremity w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,111.69,% of charge rate,100.00%,111.69,,,,94.08,111.69,0
unity,CDM,CT UPPER EXTREMITY,3500017,73201,,Ct upper extremity w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,328.25",% of charge rate,100.00%,"1,328.25",,,,"1,261.84","1,328.25",0
unity,CDM,CT UPPER EXTREMITY,3500017,73201,,Ct upper extremity w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,328.25",% of charge rate,100.00%,"1,328.25",,,,"1,261.84","1,328.25",0
unity,CDM,UPPER EXT W/O DYE,6100017,73218,,Mri upper extremity w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,804.63",% of charge rate,100.00%,"2,804.63",,,,"2,664.40","2,804.63",0
unity,CDM,UPPER EXT W/O DYE,6100017,73218,,Mri upper extremity w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,804.63",% of charge rate,100.00%,"2,804.63",,,,"2,664.40","2,804.63",0
unity,CDM,Hc Upper Ext Wdye,6100018,73219,,Mri upper extremity w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,980.00",% of charge rate,100.00%,"2,980.00",,,,"2,831.00","2,980.00",0
unity,CDM,Hc Upper Ext Wdye,6100018,73219,,Mri upper extremity w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,980.00",% of charge rate,100.00%,"2,980.00",,,,"2,831.00","2,980.00",0
unity,CDM,MRI-UPPER EXTREMITY,6100019,73220,,Mri uppr extremity w/o&w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,526.25",% of charge rate,100.00%,"3,526.25",,,,"3,349.94","3,526.25",0
unity,CDM,MRI-UPPER EXTREMITY,6100019,73220,,Mri uppr extremity w/o&w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,526.25",% of charge rate,100.00%,"3,526.25",,,,"3,349.94","3,526.25",0
unity,CDM,MRI-UPPER EXTREMITY,6100020,73221,,Mri joint upr extrem w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,781.13",% of charge rate,100.00%,"1,781.13",,,,"1,692.07","1,781.13",0
unity,CDM,MRI-UPPER EXTREMITY,6100020,73221,,Mri joint upr extrem w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,781.13",% of charge rate,100.00%,"1,781.13",,,,"1,692.07","1,781.13",0
unity,CDM,"PR MRI, JOINT UPPER EXTREM",73221,73221,26,Mri joint upr extrem w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,152.02,% of charge rate,100.00%,152.02,,,,129.19,152.02,0
unity,CDM,Hc Mra Upper Ext W/wo Dye,6100023,73225,,Mr angio upr extr w/o&w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,905.25",% of charge rate,100.00%,"2,905.25",,,,"2,759.99","2,905.25",0
unity,CDM,Hc Mra Upper Ext W/wo Dye,6100023,73225,,Mr angio upr extr w/o&w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,905.25",% of charge rate,100.00%,"2,905.25",,,,"2,759.99","2,905.25",0
unity,CDM,X-RAY EXAM HIP UNI 1 VW,3200342,73501,,X-ray exam hip uni 1 view,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.4,% of charge rate,100.00%,87.4,,,,83.03,87.4,0
unity,CDM,X-RAY EXAM HIP UNI 1 VW,3200342,73501,,X-ray exam hip uni 1 view,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.4,% of charge rate,100.00%,87.4,,,,83.03,87.4,0
unity,CDM,X-RAY EXAM HIP UNI 2-3 VW,3200343,73502,,X-ray exam hip uni 2-3 views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,135.72,% of charge rate,100.00%,135.72,,,,128.93,135.72,0
unity,CDM,X-RAY EXAM HIP UNI 2-3 VW,3200343,73502,,X-ray exam hip uni 2-3 views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,135.72,% of charge rate,100.00%,135.72,,,,128.93,135.72,0
unity,CDM,Hc X-ray Exam Hip Bil 2 Vw,3200344,73521,,X-ray exam hips bi 2 views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,144.73,% of charge rate,100.00%,144.73,,,,137.49,144.73,0
unity,CDM,Hc X-ray Exam Hip Bil 2 Vw,3200344,73521,,X-ray exam hips bi 2 views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,144.73,% of charge rate,100.00%,144.73,,,,137.49,144.73,0
unity,CDM,X-RAY EXAM FEMUR 1 VW,3200345,73551,,X-ray exam of femur 1,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,84.49,% of charge rate,100.00%,84.49,,,,80.27,84.49,0
unity,CDM,X-RAY EXAM FEMUR 1 VW,3200345,73551,,X-ray exam of femur 1,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,84.49,% of charge rate,100.00%,84.49,,,,80.27,84.49,0
unity,CDM,X-RAY EXAM FEMUR 2/>,3200346,73552,,X-ray exam of femur 2/>,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,103.4,% of charge rate,100.00%,103.4,,,,98.23,103.4,0
unity,CDM,X-RAY EXAM FEMUR 2/>,3200346,73552,,X-ray exam of femur 2/>,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,103.4,% of charge rate,100.00%,103.4,,,,98.23,103.4,0
unity,CDM,XRAY KNEE,3200067,73560,,X-ray exam of knee 1 or 2,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.8,% of charge rate,100.00%,101.8,,,,96.71,101.8,0
unity,CDM,XRAY KNEE,3200067,73560,,X-ray exam of knee 1 or 2,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.8,% of charge rate,100.00%,101.8,,,,96.71,101.8,0
unity,CDM,PR X-RAY KNEE 1 OR 2 VIEW,73560,73560,26,X-ray exam of knee 1 or 2,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,21.71,% of charge rate,100.00%,21.71,,,,15.9,21.71,0
unity,CDM,XRAY KNEE,3200068,73562,,X-ray exam of knee 3,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,117.94,% of charge rate,100.00%,117.94,,,,112.04,117.94,0
unity,CDM,XRAY KNEE,3200068,73562,,X-ray exam of knee 3,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,117.94,% of charge rate,100.00%,117.94,,,,112.04,117.94,0
unity,CDM,Hc Knee Min 3 Views Bilateral,3200234,73562,,X-ray exam of knee 3,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,117.94,% of charge rate,100.00%,117.94,,,,112.04,117.94,0
unity,CDM,Hc Knee Min 3 Views Bilateral,3200234,73562,,X-ray exam of knee 3,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,117.94,% of charge rate,100.00%,117.94,,,,112.04,117.94,0
unity,CDM,PR X-RAY KNEE 3 VIEW,73562,73562,26,X-ray exam of knee 3,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,22.5,% of charge rate,100.00%,22.5,,,,17.89,22.5,0
unity,CDM,XRAY KNEE,3200069,73564,,X-ray exam knee 4 or more,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,131.72,% of charge rate,100.00%,131.72,,,,125.13,131.72,0
unity,CDM,XRAY KNEE,3200069,73564,,X-ray exam knee 4 or more,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,131.72,% of charge rate,100.00%,131.72,,,,125.13,131.72,0
unity,CDM,PR X-RAY KNEE 4+ VIEW,73564,73564,26,X-ray exam knee 4 or more,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,27.15,% of charge rate,100.00%,27.15,,,,21.2,27.15,0
unity,CDM,XRAY KNEES-STANDING,3200070,73565,,X-ray exam of knees,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,121.19,% of charge rate,100.00%,121.19,,,,115.13,121.19,0
unity,CDM,XRAY KNEES-STANDING,3200070,73565,,X-ray exam of knees,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,121.19,% of charge rate,100.00%,121.19,,,,115.13,121.19,0
unity,CDM,PR X-RAY KNEE BILAT STANDING,73565,73565,26,X-ray exam of knees,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,21.71,% of charge rate,100.00%,21.71,,,,16.56,21.71,0
unity,CDM,XRAY LOWER LEG,3200072,73590,,X-ray exam of lower leg,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90.47,% of charge rate,100.00%,90.47,,,,85.95,90.47,0
unity,CDM,XRAY LOWER LEG,3200072,73590,,X-ray exam of lower leg,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90.47,% of charge rate,100.00%,90.47,,,,85.95,90.47,0
unity,CDM,"PR X-RAY TIB + FIB, 2VW",73590,73590,26,X-ray exam of lower leg,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.39,% of charge rate,100.00%,19.39,,,,15.24,19.39,0
unity,CDM,Hc Child Lower Ext Min 2 Views,3200074,73592,,X-ray exam of leg infant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.87,% of charge rate,100.00%,88.87,,,,84.43,88.87,0
unity,CDM,Hc Child Lower Ext Min 2 Views,3200074,73592,,X-ray exam of leg infant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.87,% of charge rate,100.00%,88.87,,,,84.43,88.87,0
unity,CDM,XRAY ANKLE,3200075,73600,,X-ray exam of ankle,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,96.93,% of charge rate,100.00%,96.93,,,,92.08,96.93,0
unity,CDM,XRAY ANKLE,3200075,73600,,X-ray exam of ankle,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,96.93,% of charge rate,100.00%,96.93,,,,92.08,96.93,0
unity,CDM,PR X-RAY ANKLE 2 VW,73600,73600,26,X-ray exam of ankle,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,18.62,% of charge rate,100.00%,18.62,,,,15.9,18.62,0
unity,CDM,XRAY ANKLE,3200076,73610,,X-ray exam of ankle,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100.18,% of charge rate,100.00%,100.18,,,,95.17,100.18,0
unity,CDM,XRAY ANKLE,3200076,73610,,X-ray exam of ankle,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100.18,% of charge rate,100.00%,100.18,,,,95.17,100.18,0
unity,CDM,PR X-RAY ANKLE 3+ VW,73610,73610,26,X-ray exam of ankle,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.39,% of charge rate,100.00%,19.39,,,,16.56,19.39,0
unity,CDM,XRAY FOOT,3200078,73620,,X-ray exam of foot,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,82.4,% of charge rate,100.00%,82.4,,,,78.28,82.4,0
unity,CDM,XRAY FOOT,3200078,73620,,X-ray exam of foot,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,82.4,% of charge rate,100.00%,82.4,,,,78.28,82.4,0
unity,CDM,PR X-RAY FOOT 2 VW,73620,73620,26,X-ray exam of foot,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,17.06,% of charge rate,100.00%,17.06,,,,14.58,17.06,0
unity,CDM,XRAY FOOT,3200079,73630,,X-ray exam of foot,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.18,% of charge rate,100.00%,99.18,,,,94.22,99.18,0
unity,CDM,XRAY FOOT,3200079,73630,,X-ray exam of foot,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.18,% of charge rate,100.00%,99.18,,,,94.22,99.18,0
unity,CDM,PR X-RAY FOOT 3+ VW,73630,73630,26,X-ray exam of foot,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,18.62,% of charge rate,100.00%,18.62,,,,15.9,18.62,0
unity,CDM,XRAY HEEL,3200080,73650,,X-ray exam of heel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,XRAY HEEL,3200080,73650,,X-ray exam of heel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,PR X-RAY HEEL,73650,73650,26,X-ray exam of heel,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,17.83,% of charge rate,100.00%,17.83,,,,15.24,17.83,0
unity,CDM,XRAY TOE(S),3200081,73660,,X-ray exam of toe(s),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,96.08,% of charge rate,100.00%,96.08,,,,91.28,96.08,0
unity,CDM,XRAY TOE(S),3200081,73660,,X-ray exam of toe(s),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,96.08,% of charge rate,100.00%,96.08,,,,91.28,96.08,0
unity,CDM,PR X-RAY TOE(S),73660,73660,26,X-ray exam of toe(s),,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,14.74,% of charge rate,100.00%,14.74,,,,12.59,14.74,0
unity,CDM,CT LOWER EXTREMITY,3500020,73700,,Ct lower extremity w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,043.63",% of charge rate,100.00%,"1,043.63",,,,991.45,"1,043.63",0
unity,CDM,CT LOWER EXTREMITY,3500020,73700,,Ct lower extremity w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,043.63",% of charge rate,100.00%,"1,043.63",,,,991.45,"1,043.63",0
unity,CDM,"PR CT SCAN,LOWER EXTREMITY,W/O CONTRAST",73700,73700,26,Ct lower extremity w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,128.07,% of charge rate,100.00%,128.07,,,,94.08,128.07,0
unity,CDM,CT LOWER EXTREMITY,3500021,73701,,Ct lower extremity w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,351.25",% of charge rate,100.00%,"1,351.25",,,,"1,283.69","1,351.25",0
unity,CDM,CT LOWER EXTREMITY,3500021,73701,,Ct lower extremity w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,351.25",% of charge rate,100.00%,"1,351.25",,,,"1,283.69","1,351.25",0
unity,CDM,PR CT SCAN OF LEG CONTRAST,73701,73701,26,Ct lower extremity w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,148.68,% of charge rate,100.00%,148.68,,,,108.65,148.68,0
unity,CDM,MRI LOWER EXTREMITY,6100024,73718,,Mri lower extremity w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,069.64",% of charge rate,100.00%,"2,069.64",,,,"1,966.16","2,069.64",0
unity,CDM,MRI LOWER EXTREMITY,6100024,73718,,Mri lower extremity w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,069.64",% of charge rate,100.00%,"2,069.64",,,,"1,966.16","2,069.64",0
unity,CDM,"PR MRI, LOWER EXTREM",73718,73718,26,Mri lower extremity w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,148.93,% of charge rate,100.00%,148.93,,,,126.54,148.93,0
unity,CDM,MRI LOWER EXTREMITY,6100026,73720,,Mri lwr extremity w/o&w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,751.44",% of charge rate,100.00%,"2,751.44",,,,"2,613.87","2,751.44",0
unity,CDM,MRI LOWER EXTREMITY,6100026,73720,,Mri lwr extremity w/o&w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,751.44",% of charge rate,100.00%,"2,751.44",,,,"2,613.87","2,751.44",0
unity,CDM,"PR MRI, LOWER EXTR, W/O CONTRAST F/U BY CONTRAST",73720,73720,26,Mri lwr extremity w/o&w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,236.57,% of charge rate,100.00%,236.57,,,,200.74,236.57,0
unity,CDM,MRI LOWER EXTREMITY,6100027,73721,,Mri jnt of lwr extre w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,781.13",% of charge rate,100.00%,"1,781.13",,,,"1,692.07","1,781.13",0
unity,CDM,MRI LOWER EXTREMITY,6100027,73721,,Mri jnt of lwr extre w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,781.13",% of charge rate,100.00%,"1,781.13",,,,"1,692.07","1,781.13",0
unity,CDM,"PR MRI LOWER EXTREM JT, W/O CONTRAST",73721,73721,26,Mri jnt of lwr extre w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,152.02,% of charge rate,100.00%,152.02,,,,127.2,152.02,0
unity,CDM,LOWER EXT JOINT W/DYE,6100028,73722,,Mri joint of lwr extr w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,807.50",% of charge rate,100.00%,"2,807.50",,,,"2,667.13","2,807.50",0
unity,CDM,LOWER EXT JOINT W/DYE,6100028,73722,,Mri joint of lwr extr w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,807.50",% of charge rate,100.00%,"2,807.50",,,,"2,667.13","2,807.50",0
unity,CDM,LOWER EXT JOINT W/WO DYE,6100029,73723,,Mri joint lwr extr w/o&w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,299.13",% of charge rate,100.00%,"3,299.13",,,,"3,134.17","3,299.13",0
unity,CDM,LOWER EXT JOINT W/WO DYE,6100029,73723,,Mri joint lwr extr w/o&w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,299.13",% of charge rate,100.00%,"3,299.13",,,,"3,134.17","3,299.13",0
unity,CDM,Hc Mra Lower Ext W/wo Dye,6100030,73725,,Mr ang lwr ext w or w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,908.30",% of charge rate,100.00%,"2,908.30",,,,"2,762.89","2,908.30",0
unity,CDM,Hc Mra Lower Ext W/wo Dye,6100030,73725,,Mr ang lwr ext w or w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,908.30",% of charge rate,100.00%,"2,908.30",,,,"2,762.89","2,908.30",0
unity,CDM,Hc Abdomen Ap & Obique,3200313,74010,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90.37,% of charge rate,100.00%,90.37,,,,85.85,90.37,0
unity,CDM,Hc Abdomen Ap & Obique,3200313,74010,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90.37,% of charge rate,100.00%,90.37,,,,85.85,90.37,0
unity,CDM,Hc Xray Abdomen 1 View,3200360,74018,,X-ray exam abdomen 1 view,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.63,% of charge rate,100.00%,64.63,,,,61.4,64.63,0
unity,CDM,Hc Xray Abdomen 1 View,3200360,74018,,X-ray exam abdomen 1 view,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.63,% of charge rate,100.00%,64.63,,,,61.4,64.63,0
unity,CDM,CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW,74018,74018,26,X-ray exam abdomen 1 view,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,20.17,% of charge rate,100.00%,20.17,,,,17.23,20.17,0
unity,CDM,Hc Xray Abdomen 2 Views,3200361,74019,,X-ray exam abdomen 2 views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,106.63,% of charge rate,100.00%,106.63,,,,101.3,106.63,0
unity,CDM,Hc Xray Abdomen 2 Views,3200361,74019,,X-ray exam abdomen 2 views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,106.63,% of charge rate,100.00%,106.63,,,,101.3,106.63,0
unity,CDM,CHG RADIOLOGIC EXAM ABDOMEN 2 VIEWS,74019,74019,26,X-ray exam abdomen 2 views,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,29.48,% of charge rate,100.00%,29.48,,,,21.86,29.48,0
unity,CDM,Hc Xray Abdomen 3+ Views,3200362,74021,,X-ray exam abdomen 3+ views,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,127.64,% of charge rate,100.00%,127.64,,,,121.26,127.64,0
unity,CDM,Hc Xray Abdomen 3+ Views,3200362,74021,,X-ray exam abdomen 3+ views,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,127.64,% of charge rate,100.00%,127.64,,,,121.26,127.64,0
unity,CDM,CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,74021,74021,26,X-ray exam abdomen 3+ views,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,34.89,% of charge rate,100.00%,34.89,,,,25.18,34.89,0
unity,CDM,XRAY ABDOMEN,3200084,74022,,X-ray exam complete abdomen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,137.64,% of charge rate,100.00%,137.64,,,,130.76,137.64,0
unity,CDM,XRAY ABDOMEN,3200084,74022,,X-ray exam complete abdomen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,137.64,% of charge rate,100.00%,137.64,,,,130.76,137.64,0
unity,CDM,CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,74022,74022,26,X-ray exam complete abdomen,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,34.9,% of charge rate,100.00%,34.9,,,,29.81,34.9,0
unity,CDM,CT ABDOMEN,3520007,74150,,Ct abdomen w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,724.5,% of charge rate,100.00%,724.5,,,,688.28,724.5,0
unity,CDM,CT ABDOMEN,3520007,74150,,Ct abdomen w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,724.5,% of charge rate,100.00%,724.5,,,,688.28,724.5,0
unity,CDM,"PR CT SCAN,ABDOMEN,W/O CONTRAST",74150,74150,26,Ct abdomen w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,151.95,% of charge rate,100.00%,151.95,,,,111.96,151.95,0
unity,CDM,CT ABDOMEN,3520008,74160,,Ct abdomen w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,411.63",% of charge rate,100.00%,"1,411.63",,,,"1,341.05","1,411.63",0
unity,CDM,CT ABDOMEN,3520008,74160,,Ct abdomen w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,411.63",% of charge rate,100.00%,"1,411.63",,,,"1,341.05","1,411.63",0
unity,CDM,PR CT SCAN OF ABDOMEN CONTRAST,74160,74160,26,Ct abdomen w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,162.11,% of charge rate,100.00%,162.11,,,,119.91,162.11,0
unity,CDM,CT ABDOMEN,3520009,74170,,Ct abdomen w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,618.83",% of charge rate,100.00%,"1,618.83",,,,"1,537.89","1,618.83",0
unity,CDM,CT ABDOMEN,3520009,74170,,Ct abdomen w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,618.83",% of charge rate,100.00%,"1,618.83",,,,"1,537.89","1,618.83",0
unity,CDM,PR CT SCAN OF ABDOMEN COMBO,74170,74170,26,Ct abdomen w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,179.12,% of charge rate,100.00%,179.12,,,,131.84,179.12,0
unity,CDM,Hc Cta Abdomen/pelvis W/contrast,3520038,74174,,Ct angio abd&pelv w/o&w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,317.25",% of charge rate,100.00%,"2,317.25",,,,"2,201.39","2,317.25",0
unity,CDM,Hc Cta Abdomen/pelvis W/contrast,3520038,74174,,Ct angio abd&pelv w/o&w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,317.25",% of charge rate,100.00%,"2,317.25",,,,"2,201.39","2,317.25",0
unity,CDM,CT ABDOMEN/PELVIS,3520035,74176,,Ct abd & pelvis w/o contrast,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,959.6,% of charge rate,100.00%,959.6,,,,911.62,959.6,0
unity,CDM,CT ABDOMEN/PELVIS,3520035,74176,,Ct abd & pelvis w/o contrast,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,959.6,% of charge rate,100.00%,959.6,,,,911.62,959.6,0
unity,CDM,"CHG CT SCAN,ABDOMEN AND PELVIS,W/O CONTRAST",74176,74176,26,Ct abd & pelvis w/o contrast,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,222.11,% of charge rate,100.00%,222.11,,,,163.64,222.11,0
unity,CDM,CT ABDOMEN/PELVIS,3520036,74177,,Ct abd & pelv w/contrast,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,837.13",% of charge rate,100.00%,"1,837.13",,,,"1,745.27","1,837.13",0
unity,CDM,CT ABDOMEN/PELVIS,3520036,74177,,Ct abd & pelv w/contrast,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,837.13",% of charge rate,100.00%,"1,837.13",,,,"1,745.27","1,837.13",0
unity,CDM,"CHG CT SCAN,ABDOMEN AND PELVIS,W CONTRAST",74177,74177,26,Ct abd & pelv w/contrast,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,232.86,% of charge rate,100.00%,232.86,,,,171.59,232.86,0
unity,CDM,CT ABDOMEN/PELVIS,3520037,74178,,Ct abd & pelv 1/> regns,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,098.75",% of charge rate,100.00%,"2,098.75",,,,"1,993.81","2,098.75",0
unity,CDM,CT ABDOMEN/PELVIS,3520037,74178,,Ct abd & pelv 1/> regns,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,098.75",% of charge rate,100.00%,"2,098.75",,,,"1,993.81","2,098.75",0
unity,CDM,"CHG CT SCAN,ABDOMEN AND PELVIS,COMBO",74178,74178,26,Ct abd & pelv 1/> regns,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,255.26,% of charge rate,100.00%,255.26,,,,188.15,255.26,0
unity,CDM,MRI-ABDOMEN,6100031,74181,,Mri abdomen w/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,814.38",% of charge rate,100.00%,"1,814.38",,,,"1,723.66","1,814.38",0
unity,CDM,MRI-ABDOMEN,6100031,74181,,Mri abdomen w/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,814.38",% of charge rate,100.00%,"1,814.38",,,,"1,723.66","1,814.38",0
unity,CDM,"PR MRI, ABDOMEN (MRI)",74181,74181,26,Mri abdomen w/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,160.56,% of charge rate,100.00%,160.56,,,,137.8,160.56,0
unity,CDM,MRI ABDOMEN,6100033,74183,,Mri abdomen w/o & w/dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,740.11",% of charge rate,100.00%,"2,740.11",,,,"2,603.10","2,740.11",0
unity,CDM,MRI ABDOMEN,6100033,74183,,Mri abdomen w/o & w/dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,740.11",% of charge rate,100.00%,"2,740.11",,,,"2,603.10","2,740.11",0
unity,CDM,"PR MRI, ABDOMEN, COMBO",74183,74183,26,Mri abdomen w/o & w/dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,248.2,% of charge rate,100.00%,248.2,,,,205.38,248.2,0
unity,CDM,MRA ABDOMEN,6100034,74185,,Mri angio abdom w orw/o dye,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,919.63",% of charge rate,100.00%,"2,919.63",,,,"2,773.65","2,919.63",0
unity,CDM,MRA ABDOMEN,6100034,74185,,Mri angio abdom w orw/o dye,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,919.63",% of charge rate,100.00%,"2,919.63",,,,"2,773.65","2,919.63",0
unity,CDM,PR MR ANGIO ABDOMEN (MRA),74185,74185,26,Mri angio abdom w orw/o dye,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,227.52,% of charge rate,100.00%,227.52,,,,167.61,227.52,0
unity,CDM,Hc Chole Operative,3200100,74300,,X-ray bile ducts/pancreas,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,51.12,% of charge rate,100.00%,51.12,,,,48.56,51.12,0
unity,CDM,Hc Chole Operative,3200100,74300,,X-ray bile ducts/pancreas,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,51.12,% of charge rate,100.00%,51.12,,,,48.56,51.12,0
unity,CDM,PR X-RAY OPER CHOLANGIOGRAM,74300,74300,26,X-ray bile ducts/pancreas,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,46.57,% of charge rate,100.00%,46.57,,,,33.79,46.57,0
unity,CDM,Hc Cta Abdominal Arteries,3500031,75635,,Ct angio abdominal arteries,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,610.50",% of charge rate,100.00%,"2,610.50",,,,"2,479.98","2,610.50",0
unity,CDM,Hc Cta Abdominal Arteries,3500031,75635,,Ct angio abdominal arteries,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,610.50",% of charge rate,100.00%,"2,610.50",,,,"2,479.98","2,610.50",0
unity,CDM,Hc Ct Limited Or Localized Follow-up Study,3500027,76380,,Cat scan follow-up study,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,730.54,% of charge rate,100.00%,730.54,,,,694.01,730.54,0
unity,CDM,Hc Ct Limited Or Localized Follow-up Study,3500027,76380,,Cat scan follow-up study,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,730.54,% of charge rate,100.00%,730.54,,,,694.01,730.54,0
unity,CDM,US EXAM HEAD/NECK,4020004,76536,,Us exam of head and neck,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,402.29,% of charge rate,100.00%,402.29,,,,382.18,402.29,0
unity,CDM,US EXAM HEAD/NECK,4020004,76536,,Us exam of head and neck,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,402.29,% of charge rate,100.00%,402.29,,,,382.18,402.29,0
unity,CDM,"US,HEAD/NECK TISSUES,B-SCAN/REAL TIME",76536,76536,26,Us exam of head and neck,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,62.05,% of charge rate,100.00%,62.05,,,,53,62.05,0
unity,CDM,Hc Us Exam Chest,4020005,76604,,Us exam chest,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,277.9,% of charge rate,100.00%,277.9,,,,264.01,277.9,0
unity,CDM,Hc Us Exam Chest,4020005,76604,,Us exam chest,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,277.9,% of charge rate,100.00%,277.9,,,,264.01,277.9,0
unity,CDM,US EXAM ABDOMEN COMPLETE,4020007,76700,,Us exam abdom complete,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,374.84,% of charge rate,100.00%,374.84,,,,356.1,374.84,0
unity,CDM,US EXAM ABDOMEN COMPLETE,4020007,76700,,Us exam abdom complete,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,374.84,% of charge rate,100.00%,374.84,,,,356.1,374.84,0
unity,CDM,"US,ABDOM,B-SCAN &/OR REAL TIME,COMPLETE",76700,76700,26,Us exam abdom complete,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,89.2,% of charge rate,100.00%,89.2,,,,76.85,89.2,0
unity,CDM,US EXAM ABDOMEN LMTD,4020008,76705,,Echo exam of abdomen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,282.75,% of charge rate,100.00%,282.75,,,,268.61,282.75,0
unity,CDM,US EXAM ABDOMEN LMTD,4020008,76705,,Echo exam of abdomen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,282.75,% of charge rate,100.00%,282.75,,,,268.61,282.75,0
unity,CDM,"US, ABDOMEN LIMITED",76705,76705,,Echo exam of abdomen,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,59.23,% of charge rate,100.00%,59.23,,,,54.99,60.93,0
unity,CDM,Um Poct Us Fast,UM4022007,76705,,Echo exam of abdomen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,282.75,% of charge rate,100.00%,282.75,,,,268.61,282.75,0
unity,CDM,Um Poct Us Fast,UM4022007,76705,,Echo exam of abdomen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,282.75,% of charge rate,100.00%,282.75,,,,268.61,282.75,0
unity,CDM,Hc Ultrasound Exam Aaa Screen,4020080,76706,,Us abdl aorta screen aaa,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,375,% of charge rate,100.00%,375,,,,356.25,375,0
unity,CDM,Hc Ultrasound Exam Aaa Screen,4020080,76706,,Us abdl aorta screen aaa,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,375,% of charge rate,100.00%,375,,,,356.25,375,0
unity,CDM,US RENAL COMPLETE,4020009,76770,,Us exam abdo back wall comp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,348.97,% of charge rate,100.00%,348.97,,,,331.52,348.97,0
unity,CDM,US RENAL COMPLETE,4020009,76770,,Us exam abdo back wall comp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,348.97,% of charge rate,100.00%,348.97,,,,331.52,348.97,0
unity,CDM,"PR US,RETROPERIT,REAL TIME,COMPLETE",76770,76770,26,Us exam abdo back wall comp,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,81.44,% of charge rate,100.00%,81.44,,,,68.9,81.44,0
unity,CDM,US RENAL LMTD,4020010,76775,,Us exam abdo back wall lim,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,296.39,% of charge rate,100.00%,296.39,,,,281.57,296.39,0
unity,CDM,US RENAL LMTD,4020010,76775,,Us exam abdo back wall lim,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,296.39,% of charge rate,100.00%,296.39,,,,281.57,296.39,0
unity,CDM,"PR US, RETROPERITNL ABD,  LTD",76775,76775,26,Us exam abdo back wall lim,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,63.61,% of charge rate,100.00%,63.61,,,,54.33,63.61,0
unity,CDM,Hc Us Exam Spinal Canal,4020012,76800,,Us exam spinal canal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,375,% of charge rate,100.00%,375,,,,356.25,375,0
unity,CDM,Hc Us Exam Spinal Canal,4020012,76800,,Us exam spinal canal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,375,% of charge rate,100.00%,375,,,,356.25,375,0
unity,CDM,US OB COMPLETE(<14 WKS),4020013,76801,,Ob us < 14 wks single fetus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,332.82,% of charge rate,100.00%,332.82,,,,316.18,332.82,0
unity,CDM,US OB COMPLETE(<14 WKS),4020013,76801,,Ob us < 14 wks single fetus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,332.82,% of charge rate,100.00%,332.82,,,,316.18,332.82,0
unity,CDM,"US, OB < 14 WKS, SINGLE FETUS",76801,76801,26,Ob us < 14 wks single fetus,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,109.37,% of charge rate,100.00%,109.37,,,,93.41,109.37,0
unity,CDM,US PREGNANCY COMPLETE,4020015,76805,,Ob us >= 14 wks sngl fetus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,418.45,% of charge rate,100.00%,418.45,,,,397.53,418.45,0
unity,CDM,US PREGNANCY COMPLETE,4020015,76805,,Ob us >= 14 wks sngl fetus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,418.45,% of charge rate,100.00%,418.45,,,,397.53,418.45,0
unity,CDM,"US, OB >/= 14 WKS, SNGL FETUS",76805,76805,26,Ob us >= 14 wks sngl fetus,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,110.14,% of charge rate,100.00%,110.14,,,,93.41,110.14,0
unity,CDM,US PREGNANCY CMPLT ADDL FETUS,4020016,76810,,Ob us >= 14 wks addl fetus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,196.52,% of charge rate,100.00%,196.52,,,,186.69,196.52,0
unity,CDM,US PREGNANCY CMPLT ADDL FETUS,4020016,76810,,Ob us >= 14 wks addl fetus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,196.52,% of charge rate,100.00%,196.52,,,,186.69,196.52,0
unity,CDM,"US, OB >/= 14 WKS, ADDL FETUS",76810,76810,26,Ob us >= 14 wks addl fetus,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,108.58,% of charge rate,100.00%,108.58,,,,92.75,108.58,0
unity,CDM,US PREGNANCY LMTD,4020017,76815,,Ob us limited fetus(s),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,238.67,% of charge rate,100.00%,238.67,,,,226.74,238.67,0
unity,CDM,US PREGNANCY LMTD,4020017,76815,,Ob us limited fetus(s),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,238.67,% of charge rate,100.00%,238.67,,,,226.74,238.67,0
unity,CDM,"PR US,PREGNANT UTERUS,LIMITED, 1/> FETUSES",76815,76815,26,Ob us limited fetus(s),,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,70.58,% of charge rate,100.00%,70.58,,,,60.95,70.58,0
unity,CDM,Hc Follow Up/repeat Ob,4020018,76816,,Ob us follow-up per fetus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,326.36,% of charge rate,100.00%,326.36,,,,310.04,326.36,0
unity,CDM,Hc Follow Up/repeat Ob,4020018,76816,,Ob us follow-up per fetus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,326.36,% of charge rate,100.00%,326.36,,,,310.04,326.36,0
unity,CDM,US TRANSVAGINAL OB,4020019,76817,,Transvaginal us obstetric,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,269.8,% of charge rate,100.00%,269.8,,,,256.31,269.8,0
unity,CDM,US TRANSVAGINAL OB,4020019,76817,,Transvaginal us obstetric,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,269.8,% of charge rate,100.00%,269.8,,,,256.31,269.8,0
unity,CDM,"PR US,PREGNANT UTERUS,TRANSVAGINAL",76817,76817,26,Transvaginal us obstetric,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,83.77,% of charge rate,100.00%,83.77,,,,70.23,83.77,0
unity,CDM,US FETAL BIOPSY PROFILE,4020040,76818,,Fetal biophys profile w/nst,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,294.43,% of charge rate,100.00%,294.43,,,,279.71,294.43,0
unity,CDM,US FETAL BIOPSY PROFILE,4020040,76818,,Fetal biophys profile w/nst,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,294.43,% of charge rate,100.00%,294.43,,,,279.71,294.43,0
unity,CDM,Hc Bio Profile,4020020,76819,,Fetal biophys profil w/o nst,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,235,% of charge rate,100.00%,235,,,,223.25,235,0
unity,CDM,Hc Bio Profile,4020020,76819,,Fetal biophys profil w/o nst,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,235,% of charge rate,100.00%,235,,,,223.25,235,0
unity,CDM,US TRANSVAGINAL,4020022,76830,,Transvaginal us non-ob,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,399.05,% of charge rate,100.00%,399.05,,,,379.1,399.05,0
unity,CDM,US TRANSVAGINAL,4020022,76830,,Transvaginal us non-ob,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,399.05,% of charge rate,100.00%,399.05,,,,379.1,399.05,0
unity,CDM,"PR ECHOGRAPHY,TRANSVAGINAL",76830,76830,26,Transvaginal us non-ob,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,76.79,% of charge rate,100.00%,76.79,,,,64.93,76.79,0
unity,CDM,US PELVIC COMPLETE,4020024,76856,,Us exam pelvic complete,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,344.14,% of charge rate,100.00%,344.14,,,,326.93,344.14,0
unity,CDM,US PELVIC COMPLETE,4020024,76856,,Us exam pelvic complete,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,344.14,% of charge rate,100.00%,344.14,,,,326.93,344.14,0
unity,CDM,"PR US,PELVIC (NONOBSTETRIC),REAL TIME,COMPLETE",76856,76856,26,Us exam pelvic complete,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,76.01,% of charge rate,100.00%,76.01,,,,64.26,76.01,0
unity,CDM,US PELVIC LIMITED,4020025,76857,,Us exam pelvic limited,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,293.7,% of charge rate,100.00%,293.7,,,,279.02,293.7,0
unity,CDM,US PELVIC LIMITED,4020025,76857,,Us exam pelvic limited,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,293.7,% of charge rate,100.00%,293.7,,,,279.02,293.7,0
unity,CDM,US SCROTUM,4020026,76870,,Us exam scrotum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,326.23,% of charge rate,100.00%,326.23,,,,309.92,326.23,0
unity,CDM,US SCROTUM,4020026,76870,,Us exam scrotum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,326.23,% of charge rate,100.00%,326.23,,,,309.92,326.23,0
unity,CDM,"PR ECHO,SCROTUM & CONTENTS",76870,76870,26,Us exam scrotum,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,70.58,% of charge rate,100.00%,70.58,,,,59.63,70.58,0
unity,CDM,US EXTREMITY,4020075,76882,,Us lmtd jt/nonvasc xtr strux,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,146.57,% of charge rate,100.00%,146.57,,,,139.24,146.57,0
unity,CDM,US EXTREMITY,4020075,76882,,Us lmtd jt/nonvasc xtr strux,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,146.57,% of charge rate,100.00%,146.57,,,,139.24,146.57,0
unity,CDM,"PR US GUIDE, VASCULAR ACCESS",76937,76937,,Us guide vascular access,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,33.38,% of charge rate,100.00%,33.38,,,,27.16,33.38,0
unity,CDM,Um Poct Us Guidance Iv,UM4022000,76937,,Us guide vascular access,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69.94,% of charge rate,100.00%,69.94,,,,66.44,69.94,0
unity,CDM,Um Poct Us Guidance Iv,UM4022000,76937,,Us guide vascular access,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69.94,% of charge rate,100.00%,69.94,,,,66.44,69.94,0
unity,CDM,Hc Us Guidance/ndl Placement,4020035,76942,,Echo guide for biopsy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,113.66,% of charge rate,100.00%,113.66,,,,107.98,113.66,0
unity,CDM,Hc Us Guidance/ndl Placement,4020035,76942,,Echo guide for biopsy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,113.66,% of charge rate,100.00%,113.66,,,,107.98,113.66,0
unity,CDM,PR SONO GUIDED NEEDLE PLACEMENT,76942,76942,,Echo guide for biopsy,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,74.91,% of charge rate,100.00%,74.91,,,,59.63,74.91,0
unity,CDM,Um Poct Us Biopsy,UM4022001,76942,,Echo guide for biopsy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,114.46,% of charge rate,100.00%,114.46,,,,108.74,114.46,0
unity,CDM,Um Poct Us Biopsy,UM4022001,76942,,Echo guide for biopsy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,114.46,% of charge rate,100.00%,114.46,,,,108.74,114.46,0
unity,CDM,Hc Us Study Follow Up Repeat,3200318,76970,,Ultrasound exam follow-up,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,336.05,% of charge rate,100.00%,336.05,,,,319.25,336.05,0
unity,CDM,Hc Us Study Follow Up Repeat,3200318,76970,,Ultrasound exam follow-up,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,336.05,% of charge rate,100.00%,336.05,,,,319.25,336.05,0
unity,CDM,Hc Diagnostic Mammo Tomo Unilateral,4010010,77061,,Breast tomosynthesis uni,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,86.78,% of charge rate,100.00%,86.78,,,,82.44,86.78,0
unity,CDM,Hc Diagnostic Mammo Tomo Unilateral,4010010,77061,,Breast tomosynthesis uni,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,86.78,% of charge rate,100.00%,86.78,,,,82.44,86.78,0
unity,CDM,Hc Diagnostic Mammo Tomo Bilat,4010011,77062,,Breast tomosynthesis bi,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,132.06,% of charge rate,100.00%,132.06,,,,125.46,132.06,0
unity,CDM,Hc Diagnostic Mammo Tomo Bilat,4010011,77062,,Breast tomosynthesis bi,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,132.06,% of charge rate,100.00%,132.06,,,,125.46,132.06,0
unity,CDM,Hc Tomo Screening Bilat Add-on,4030005,77063,,Breast tomosynthesis bi,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,113.48,% of charge rate,100.00%,113.48,,,,107.81,113.48,0
unity,CDM,Hc Tomo Screening Bilat Add-on,4030005,77063,,Breast tomosynthesis bi,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,113.48,% of charge rate,100.00%,113.48,,,,107.81,113.48,0
unity,CDM,HC MAMMO OF ONE BREAST,4010015,77065,,Dx mammo incl cad uni,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,404.46,% of charge rate,100.00%,404.46,,,,384.24,404.46,0
unity,CDM,HC MAMMO OF ONE BREAST,4010015,77065,,Dx mammo incl cad uni,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,404.46,% of charge rate,100.00%,404.46,,,,384.24,404.46,0
unity,CDM,CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,77065,77065,26,Dx mammo incl cad uni,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,103.4,% of charge rate,100.00%,103.4,,,,76.85,103.4,0
unity,CDM,HC MAMMO OF BOTH BREASTS,4010016,77066,,Dx mammo incl cad bi,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,517.58,% of charge rate,100.00%,517.58,,,,491.7,517.58,0
unity,CDM,HC MAMMO OF BOTH BREASTS,4010016,77066,,Dx mammo incl cad bi,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,517.58,% of charge rate,100.00%,517.58,,,,491.7,517.58,0
unity,CDM,CHG DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,77066,77066,26,Dx mammo incl cad bi,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,127.6,% of charge rate,100.00%,127.6,,,,94.08,127.6,0
unity,CDM,HC MAMMO OF BOTH BREASTS,4030015,77067,,Scr mammo bi incl cad,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,427.7,% of charge rate,100.00%,427.7,,,,406.32,427.7,0
unity,CDM,HC MAMMO OF BOTH BREASTS,4030015,77067,,Scr mammo bi incl cad,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,427.7,% of charge rate,100.00%,427.7,,,,406.32,427.7,0
unity,CDM,CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,77067,77067,26,Scr mammo bi incl cad,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,91.21,% of charge rate,100.00%,91.21,,,,72.21,91.21,0
unity,CDM,Hc X-ray Bone Age Studies,3200212,77072,,X-rays for bone age,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,55.38,% of charge rate,100.00%,55.38,,,,52.61,55.38,0
unity,CDM,Hc X-ray Bone Age Studies,3200212,77072,,X-rays for bone age,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,55.38,% of charge rate,100.00%,55.38,,,,52.61,55.38,0
unity,CDM,Hc Scanogram,3200213,77073,,X-rays bone length studies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,115.08,% of charge rate,100.00%,115.08,,,,109.33,115.08,0
unity,CDM,Hc Scanogram,3200213,77073,,X-rays bone length studies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,115.08,% of charge rate,100.00%,115.08,,,,109.33,115.08,0
unity,CDM,Hc Bone Survey Lmtd,3200214,77074,,X-rays bone survey limited,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.26,% of charge rate,100.00%,195.26,,,,185.5,195.26,0
unity,CDM,Hc Bone Survey Lmtd,3200214,77074,,X-rays bone survey limited,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.26,% of charge rate,100.00%,195.26,,,,185.5,195.26,0
unity,CDM,Hc Bone Survey Complete,3200215,77075,,X-rays bone survey complete,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,283.58,% of charge rate,100.00%,283.58,,,,269.4,283.58,0
unity,CDM,Hc Bone Survey Complete,3200215,77075,,X-rays bone survey complete,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,283.58,% of charge rate,100.00%,283.58,,,,269.4,283.58,0
unity,CDM,"Hc Joint Survey,sngl V,2 Or M Joints",3200217,77077,,Joint survey single view,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,98.77,% of charge rate,100.00%,98.77,,,,93.83,98.77,0
unity,CDM,"Hc Joint Survey,sngl V,2 Or M Joints",3200217,77077,,Joint survey single view,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,98.77,% of charge rate,100.00%,98.77,,,,93.83,98.77,0
unity,CDM,DEXASCAN,3200218,77080,,Dxa bone density axial,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,264.47,% of charge rate,100.00%,264.47,,,,251.25,264.47,0
unity,CDM,DEXASCAN,3200218,77080,,Dxa bone density axial,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,264.47,% of charge rate,100.00%,264.47,,,,251.25,264.47,0
unity,CDM,"PR DEXA,BONE DENSITY,AXIAL SKELETON",77080,77080,26,Dxa bone density axial,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,22.5,% of charge rate,100.00%,22.5,,,,18.55,22.5,0
unity,CDM,"Hc Dexa 1 Or More Sties,axial Skeleton,w/vfa",3200277,77085,,Dxa bone density study,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,299.96,% of charge rate,100.00%,299.96,,,,284.96,299.96,0
unity,CDM,"Hc Dexa 1 Or More Sties,axial Skeleton,w/vfa",3200277,77085,,Dxa bone density study,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,299.96,% of charge rate,100.00%,299.96,,,,284.96,299.96,0
unity,CDM,NM LIVER SPLEEN SCAN,3410013,78215,,Liver and spleen imaging,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,804.59,% of charge rate,100.00%,804.59,,,,764.36,804.59,0
unity,CDM,NM LIVER SPLEEN SCAN,3410013,78215,,Liver and spleen imaging,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,804.59,% of charge rate,100.00%,804.59,,,,764.36,804.59,0
unity,CDM,HIDA IMAGE,3410075,78226,,Hepatobiliary system imaging,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,318.00",% of charge rate,100.00%,"1,318.00",,,,"1,252.10","1,318.00",0
unity,CDM,HIDA IMAGE,3410075,78226,,Hepatobiliary system imaging,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,318.00",% of charge rate,100.00%,"1,318.00",,,,"1,252.10","1,318.00",0
unity,CDM,HIDA IMAGE,3410076,78227,,Hepatobil syst image w/drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,914.54",% of charge rate,100.00%,"1,914.54",,,,"1,818.81","1,914.54",0
unity,CDM,HIDA IMAGE,3410076,78227,,Hepatobil syst image w/drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,914.54",% of charge rate,100.00%,"1,914.54",,,,"1,818.81","1,914.54",0
unity,CDM,NM MECKELS,3410024,78290,,Meckels divert exam,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,329.58",% of charge rate,100.00%,"1,329.58",,,,"1,263.10","1,329.58",0
unity,CDM,NM MECKELS,3410024,78290,,Meckels divert exam,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,329.58",% of charge rate,100.00%,"1,329.58",,,,"1,263.10","1,329.58",0
unity,CDM,BONE LIMITED,3410025,78300,,Bone imaging limited area,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,891.03,% of charge rate,100.00%,891.03,,,,846.48,891.03,0
unity,CDM,BONE LIMITED,3410025,78300,,Bone imaging limited area,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,891.03,% of charge rate,100.00%,891.03,,,,846.48,891.03,0
unity,CDM,"PR BONE IMAGING, LIMITED AREA",78300,78300,26,Bone imaging limited area,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,79.71,% of charge rate,100.00%,79.71,,,,58.3,79.71,0
unity,CDM,NM BONE SCAN,3410026,78305,,Bone imaging multiple areas,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,070.91",% of charge rate,100.00%,"1,070.91",,,,"1,017.36","1,070.91",0
unity,CDM,NM BONE SCAN,3410026,78305,,Bone imaging multiple areas,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,070.91",% of charge rate,100.00%,"1,070.91",,,,"1,017.36","1,070.91",0
unity,CDM,"PR BONE IMAGING, MULTIPLE AREAS",78305,78305,26,Bone imaging multiple areas,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,104.8,% of charge rate,100.00%,104.8,,,,77.51,104.8,0
unity,CDM,BONE SCAN,3410027,78306,,Bone imaging whole body,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,163.77",% of charge rate,100.00%,"1,163.77",,,,"1,105.58","1,163.77",0
unity,CDM,BONE SCAN,3410027,78306,,Bone imaging whole body,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,163.77",% of charge rate,100.00%,"1,163.77",,,,"1,105.58","1,163.77",0
unity,CDM,"PR BONE IMAGING, WHOLE BODY",78306,78306,26,Bone imaging whole body,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,108.37,% of charge rate,100.00%,108.37,,,,80.16,108.37,0
unity,CDM,BONE SCAN,3410028,78315,,Bone imaging 3 phase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,402.38",% of charge rate,100.00%,"1,402.38",,,,"1,332.26","1,402.38",0
unity,CDM,BONE SCAN,3410028,78315,,Bone imaging 3 phase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,402.38",% of charge rate,100.00%,"1,402.38",,,,"1,332.26","1,402.38",0
unity,CDM,NM MUSCLE IMAGE,3410036,78452,,Ht muscle image spect mult,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,760.37",% of charge rate,100.00%,"1,760.37",,,,"1,672.35","1,760.37",0
unity,CDM,NM MUSCLE IMAGE,3410036,78452,,Ht muscle image spect mult,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,760.37",% of charge rate,100.00%,"1,760.37",,,,"1,672.35","1,760.37",0
unity,CDM,CARDIAC BLOOD POOL (MUGA),3410039,78472,,Gated heart planar single,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,808.91,% of charge rate,100.00%,808.91,,,,768.46,808.91,0
unity,CDM,CARDIAC BLOOD POOL (MUGA),3410039,78472,,Gated heart planar single,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,808.91,% of charge rate,100.00%,808.91,,,,768.46,808.91,0
unity,CDM,NM MUGA SCAN,3410040,78473,,Gated heart multiple,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,965.95,% of charge rate,100.00%,965.95,,,,917.65,965.95,0
unity,CDM,NM MUGA SCAN,3410040,78473,,Gated heart multiple,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,965.95,% of charge rate,100.00%,965.95,,,,917.65,965.95,0
unity,CDM,NM MUGA SCAN,3410087,78494,,Heart image spect,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,751.08,% of charge rate,100.00%,751.08,,,,713.53,751.08,0
unity,CDM,NM MUGA SCAN,3410087,78494,,Heart image spect,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,751.08,% of charge rate,100.00%,751.08,,,,713.53,751.08,0
unity,CDM,NM PERFUSION LUNG,3410046,78580,,Lung perfusion imaging,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,868.6,% of charge rate,100.00%,868.6,,,,825.17,868.6,0
unity,CDM,NM PERFUSION LUNG,3410046,78580,,Lung perfusion imaging,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,868.6,% of charge rate,100.00%,868.6,,,,825.17,868.6,0
unity,CDM,PR PULMONARY PERFUSION IMAGING PARTICULATE,78580,78580,26,Lung perfusion imaging,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,93.14,% of charge rate,100.00%,93.14,,,,68.24,93.14,0
unity,CDM,NM RENAL SCAN,3410057,78700,,Kidney imaging morphol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,644.16,% of charge rate,100.00%,644.16,,,,611.95,644.16,0
unity,CDM,NM RENAL SCAN,3410057,78700,,Kidney imaging morphol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,644.16,% of charge rate,100.00%,644.16,,,,611.95,644.16,0
unity,CDM,NM KIDNEY IMAGING,3410088,78701,,Kidney imaging with flow,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,883.74,% of charge rate,100.00%,883.74,,,,839.55,883.74,0
unity,CDM,NM KIDNEY IMAGING,3410088,78701,,Kidney imaging with flow,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,883.74,% of charge rate,100.00%,883.74,,,,839.55,883.74,0
unity,CDM,NM RENOGRAM,3410058,78707,,K flow/funct image w/o drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,878.91,% of charge rate,100.00%,878.91,,,,834.96,878.91,0
unity,CDM,NM RENOGRAM,3410058,78707,,K flow/funct image w/o drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,878.91,% of charge rate,100.00%,878.91,,,,834.96,878.91,0
unity,CDM,Um Basic Metabolic Panel,UM4000132,80048,,Metabolic panel total ca,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.08,% of charge rate,100.00%,47.08,,,,44.73,47.08,0
unity,CDM,Um Basic Metabolic Panel,UM4000132,80048,,Metabolic panel total ca,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.08,% of charge rate,100.00%,47.08,,,,44.73,47.08,0
unity,CDM,Um General Health Panel,UM4000803,80050,,General health panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,150,% of charge rate,100.00%,150,,,,142.5,150,0
unity,CDM,Um General Health Panel,UM4000803,80050,,General health panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,150,% of charge rate,100.00%,150,,,,142.5,150,0
unity,CDM,Um Electrolyte Panel,UM4000335,80051,,Electrolyte panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,39.08,% of charge rate,100.00%,39.08,,,,37.13,39.08,0
unity,CDM,Um Electrolyte Panel,UM4000335,80051,,Electrolyte panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,39.08,% of charge rate,100.00%,39.08,,,,37.13,39.08,0
unity,CDM,Um Comp. Metabolic Panel,UM4000345,80053,,Comprehen metabolic panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.85,% of charge rate,100.00%,58.85,,,,55.91,58.85,0
unity,CDM,Um Comp. Metabolic Panel,UM4000345,80053,,Comprehen metabolic panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.85,% of charge rate,100.00%,58.85,,,,55.91,58.85,0
unity,CDM,Um Prenatal Profile,UM4000151,80055,,Obstetric panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,359.23,% of charge rate,100.00%,359.23,,,,341.27,359.23,0
unity,CDM,Um Prenatal Profile,UM4000151,80055,,Obstetric panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,359.23,% of charge rate,100.00%,359.23,,,,341.27,359.23,0
unity,CDM,Um Lipid Panel,UM4000249,80061,,Lipid panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.91,% of charge rate,100.00%,67.91,,,,64.51,67.91,0
unity,CDM,Um Lipid Panel,UM4000249,80061,,Lipid panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.91,% of charge rate,100.00%,67.91,,,,64.51,67.91,0
unity,CDM,Um Renal Panel,UM4000207,80069,,Renal function panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.37,% of charge rate,100.00%,48.37,,,,45.95,48.37,0
unity,CDM,Um Renal Panel,UM4000207,80069,,Renal function panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.37,% of charge rate,100.00%,48.37,,,,45.95,48.37,0
unity,CDM,Um Hepatitis (acute) Panel,UM4000133,80074,,Acute hepatitis panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,253.35,% of charge rate,100.00%,253.35,,,,240.68,253.35,0
unity,CDM,Um Hepatitis (acute) Panel,UM4000133,80074,,Acute hepatitis panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,253.35,% of charge rate,100.00%,253.35,,,,240.68,253.35,0
unity,CDM,Um Liver Function Panel,UM4000192,80076,,Hepatic function panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.49,% of charge rate,100.00%,45.49,,,,43.22,45.49,0
unity,CDM,Um Liver Function Panel,UM4000192,80076,,Hepatic function panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.49,% of charge rate,100.00%,45.49,,,,43.22,45.49,0
unity,CDM,Um Obstetric Panel With Hiv,UM4000773,80081,,Obstetric panel,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,417.4,% of charge rate,100.00%,417.4,,,,396.53,417.4,0
unity,CDM,Um Obstetric Panel With Hiv,UM4000773,80081,,Obstetric panel,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,417.4,% of charge rate,100.00%,417.4,,,,396.53,417.4,0
unity,CDM,Um Carbamazepine  (tegretol),UM4000206,80156,,Assay carbamazepine total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,81.05,% of charge rate,100.00%,81.05,,,,77,81.05,0
unity,CDM,Um Carbamazepine  (tegretol),UM4000206,80156,,Assay carbamazepine total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,81.05,% of charge rate,100.00%,81.05,,,,77,81.05,0
unity,CDM,"Um Carbamezipine, Free",UM4000404,80157,,Assay carbamazepine free,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.81,% of charge rate,100.00%,73.81,,,,70.12,73.81,0
unity,CDM,"Um Carbamezipine, Free",UM4000404,80157,,Assay carbamazepine free,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.81,% of charge rate,100.00%,73.81,,,,70.12,73.81,0
unity,CDM,Um Cyclosporins,UM4000445,80158,,Drug assay cyclosporine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,136.6,% of charge rate,100.00%,136.6,,,,129.77,136.6,0
unity,CDM,Um Cyclosporins,UM4000445,80158,,Drug assay cyclosporine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,136.6,% of charge rate,100.00%,136.6,,,,129.77,136.6,0
unity,CDM,Um Digoxin,UM4000031,80162,,Assay of digoxin total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.9,% of charge rate,100.00%,73.9,,,,70.21,73.9,0
unity,CDM,Um Digoxin,UM4000031,80162,,Assay of digoxin total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.9,% of charge rate,100.00%,73.9,,,,70.21,73.9,0
unity,CDM,Um Depakene (valproic Acid),UM4000272,80164,,Assay dipropylacetic acd tot,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75.44,% of charge rate,100.00%,75.44,,,,71.67,75.44,0
unity,CDM,Um Depakene (valproic Acid),UM4000272,80164,,Assay dipropylacetic acd tot,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75.44,% of charge rate,100.00%,75.44,,,,71.67,75.44,0
unity,CDM,Um Ethosuximide (zarontin),UM4000308,80168,,Assay of ethosuximide,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91,% of charge rate,100.00%,91,,,,86.45,91,0
unity,CDM,Um Ethosuximide (zarontin),UM4000308,80168,,Assay of ethosuximide,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91,% of charge rate,100.00%,91,,,,86.45,91,0
unity,CDM,Um Everolimus,UM4000792,80169,,Drug assay everolimus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.51,% of charge rate,100.00%,76.51,,,,72.68,76.51,0
unity,CDM,Um Everolimus,UM4000792,80169,,Drug assay everolimus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.51,% of charge rate,100.00%,76.51,,,,72.68,76.51,0
unity,CDM,Um Gentamicin,UM4000065,80170,,Assay of gentamicin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91.24,% of charge rate,100.00%,91.24,,,,86.68,91.24,0
unity,CDM,Um Gentamicin,UM4000065,80170,,Assay of gentamicin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91.24,% of charge rate,100.00%,91.24,,,,86.68,91.24,0
unity,CDM,Um Neurontin (gabapentin),UM4000060,80171,,Drug screen quant gabapentin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,0
unity,CDM,Um Neurontin (gabapentin),UM4000060,80171,,Drug screen quant gabapentin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,0
unity,CDM,Um Lamotrigine,UM4000243,80175,,Drug screen quan lamotrigine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,0
unity,CDM,Um Lamotrigine,UM4000243,80175,,Drug screen quan lamotrigine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,0
unity,CDM,Um Keppra Assay,UM4000205,80177,,Drug scrn quan levetiracetam,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,0
unity,CDM,Um Keppra Assay,UM4000205,80177,,Drug scrn quan levetiracetam,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,0
unity,CDM,Um Lithium,UM4000072,80178,,Assay of lithium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.79,% of charge rate,100.00%,36.79,,,,34.95,36.79,0
unity,CDM,Um Lithium,UM4000072,80178,,Assay of lithium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.79,% of charge rate,100.00%,36.79,,,,34.95,36.79,0
unity,CDM,Um Mycophenolic Acid,UM4000884,80180,,Drug scrn quan mycophenolate,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,104.64,% of charge rate,100.00%,104.64,,,,99.41,104.64,0
unity,CDM,Um Mycophenolic Acid,UM4000884,80180,,Drug scrn quan mycophenolate,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,104.64,% of charge rate,100.00%,104.64,,,,99.41,104.64,0
unity,CDM,"Um Carbamaepine 10,11 Epoxid",UM4000562,80183,,Drug scrn quant oxcarbazepin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,0
unity,CDM,"Um Carbamaepine 10,11 Epoxid",UM4000562,80183,,Drug scrn quant oxcarbazepin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,0
unity,CDM,Um Phenobarbital,UM4000167,80184,,Assay of phenobarbital,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,63.76,% of charge rate,100.00%,63.76,,,,60.57,63.76,0
unity,CDM,Um Phenobarbital,UM4000167,80184,,Assay of phenobarbital,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,63.76,% of charge rate,100.00%,63.76,,,,60.57,63.76,0
unity,CDM,Um Dilantin (phenytoin),UM4000319,80185,,Assay of phenytoin total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.81,% of charge rate,100.00%,73.81,,,,70.12,73.81,0
unity,CDM,Um Dilantin (phenytoin),UM4000319,80185,,Assay of phenytoin total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.81,% of charge rate,100.00%,73.81,,,,70.12,73.81,0
unity,CDM,Um Dilantin-unbound (free),UM4000022,80186,,Assay of phenytoin free,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.64,% of charge rate,100.00%,76.64,,,,72.81,76.64,0
unity,CDM,Um Dilantin-unbound (free),UM4000022,80186,,Assay of phenytoin free,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.64,% of charge rate,100.00%,76.64,,,,72.81,76.64,0
unity,CDM,Um Primadone (mysoline),UM4000015,80188,,Assay of primidone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,136.43,% of charge rate,100.00%,136.43,,,,129.61,136.43,0
unity,CDM,Um Primadone (mysoline),UM4000015,80188,,Assay of primidone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,136.43,% of charge rate,100.00%,136.43,,,,129.61,136.43,0
unity,CDM,Um Tacrolimus,UM4000808,80197,,Assay of tacrolimus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.51,% of charge rate,100.00%,76.51,,,,72.68,76.51,0
unity,CDM,Um Tacrolimus,UM4000808,80197,,Assay of tacrolimus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.51,% of charge rate,100.00%,76.51,,,,72.68,76.51,0
unity,CDM,Um Theophylline,UM4000182,80198,,Assay of theophylline,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78.8,% of charge rate,100.00%,78.8,,,,74.86,78.8,0
unity,CDM,Um Theophylline,UM4000182,80198,,Assay of theophylline,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78.8,% of charge rate,100.00%,78.8,,,,74.86,78.8,0
unity,CDM,Um Gabitril (tiagibine),UM4000074,80199,,Drug screen quant tiagabine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100.61,% of charge rate,100.00%,100.61,,,,95.58,100.61,0
unity,CDM,Um Gabitril (tiagibine),UM4000074,80199,,Drug screen quant tiagabine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100.61,% of charge rate,100.00%,100.61,,,,95.58,100.61,0
unity,CDM,Um Tobramycin,UM4000360,80200,,Assay of tobramycin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125.21,% of charge rate,100.00%,125.21,,,,118.95,125.21,0
unity,CDM,Um Tobramycin,UM4000360,80200,,Assay of tobramycin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125.21,% of charge rate,100.00%,125.21,,,,118.95,125.21,0
unity,CDM,Um Topiramate,UM4000187,80201,,Assay of topiramate,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,158.33,% of charge rate,100.00%,158.33,,,,150.41,158.33,0
unity,CDM,Um Topiramate,UM4000187,80201,,Assay of topiramate,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,158.33,% of charge rate,100.00%,158.33,,,,150.41,158.33,0
unity,CDM,Um Vancomycin,UM4000250,80202,,Assay of vancomycin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75.44,% of charge rate,100.00%,75.44,,,,71.67,75.44,0
unity,CDM,Um Vancomycin,UM4000250,80202,,Assay of vancomycin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75.44,% of charge rate,100.00%,75.44,,,,71.67,75.44,0
unity,CDM,Um Zonisamide,UM4000799,80203,,Drug screen quant zonisamide,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.85,% of charge rate,100.00%,73.85,,,,70.16,73.85,0
unity,CDM,Um Zonisamide,UM4000799,80203,,Drug screen quant zonisamide,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.85,% of charge rate,100.00%,73.85,,,,70.16,73.85,0
unity,CDM,UM ACETAMINOPHEN [TYLENOL],UM4000127,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.69,% of charge rate,100.00%,79.69,,,,75.71,79.69,0
unity,CDM,UM ACETAMINOPHEN [TYLENOL],UM4000127,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.69,% of charge rate,100.00%,79.69,,,,75.71,79.69,0
unity,CDM,Um Salicylate,UM4000144,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.69,% of charge rate,100.00%,79.69,,,,75.71,79.69,0
unity,CDM,Um Salicylate,UM4000144,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.69,% of charge rate,100.00%,79.69,,,,75.71,79.69,0
unity,CDM,Um Risperidone,UM4000197,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,150.7,% of charge rate,100.00%,150.7,,,,143.17,150.7,0
unity,CDM,Um Risperidone,UM4000197,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,150.7,% of charge rate,100.00%,150.7,,,,143.17,150.7,0
unity,CDM,Um Trileptal (oxcarbzepine),UM4000341,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.25,% of charge rate,100.00%,76.25,,,,72.44,76.25,0
unity,CDM,Um Trileptal (oxcarbzepine),UM4000341,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.25,% of charge rate,100.00%,76.25,,,,72.44,76.25,0
unity,CDM,Um Posaconazole,UM4000568,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,257.58,% of charge rate,100.00%,257.58,,,,244.7,257.58,0
unity,CDM,Um Posaconazole,UM4000568,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,257.58,% of charge rate,100.00%,257.58,,,,244.7,257.58,0
unity,CDM,"Um Methylphenidate Metabolite Quant,urine",UM4000718,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,163.38,% of charge rate,100.00%,163.38,,,,155.21,163.38,0
unity,CDM,"Um Methylphenidate Metabolite Quant,urine",UM4000718,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,163.38,% of charge rate,100.00%,163.38,,,,155.21,163.38,0
unity,CDM,"Um Clonidine,serum",UM4000719,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,355.56,% of charge rate,100.00%,355.56,,,,337.78,355.56,0
unity,CDM,"Um Clonidine,serum",UM4000719,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,355.56,% of charge rate,100.00%,355.56,,,,337.78,355.56,0
unity,CDM,Um Voriconazole,UM4000732,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,222.57,% of charge rate,100.00%,222.57,,,,211.44,222.57,0
unity,CDM,Um Voriconazole,UM4000732,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,222.57,% of charge rate,100.00%,222.57,,,,211.44,222.57,0
unity,CDM,Um Quetiapine (seroquel),UM4000746,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,167.38,% of charge rate,100.00%,167.38,,,,159.01,167.38,0
unity,CDM,Um Quetiapine (seroquel),UM4000746,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,167.38,% of charge rate,100.00%,167.38,,,,159.01,167.38,0
unity,CDM,Um Lacosamide,UM4000859,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.42,% of charge rate,100.00%,79.42,,,,75.45,79.42,0
unity,CDM,Um Lacosamide,UM4000859,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.42,% of charge rate,100.00%,79.42,,,,75.45,79.42,0
unity,CDM,Um Adalimumab Level,UM4000869,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.42,% of charge rate,100.00%,79.42,,,,75.45,79.42,0
unity,CDM,Um Adalimumab Level,UM4000869,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.42,% of charge rate,100.00%,79.42,,,,75.45,79.42,0
unity,CDM,Um Amiodarone,UM4000920,80299,,Quantitative assay drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.6,% of charge rate,100.00%,99.6,,,,94.62,99.6,0
unity,CDM,Um Amiodarone,UM4000920,80299,,Quantitative assay drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.6,% of charge rate,100.00%,99.6,,,,94.62,99.6,0
unity,CDM,Um Urine Drug Screen (uds),UM4000456,80306,,Drug test prsmv instrmnt,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,84.99,% of charge rate,100.00%,84.99,,,,80.74,84.99,0
unity,CDM,Um Urine Drug Screen (uds),UM4000456,80306,,Drug test prsmv instrmnt,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,84.99,% of charge rate,100.00%,84.99,,,,80.74,84.99,0
unity,CDM,Um Alcohol,UM4000146,80307,,Drug test prsmv chem anlyzr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,235.61,% of charge rate,100.00%,235.61,,,,223.83,235.61,0
unity,CDM,Um Alcohol,UM4000146,80307,,Drug test prsmv chem anlyzr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,235.61,% of charge rate,100.00%,235.61,,,,223.83,235.61,0
unity,CDM,Um Presumptive Drug Id,UM4000805,80307,,Drug test prsmv chem anlyzr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,Um Presumptive Drug Id,UM4000805,80307,,Drug test prsmv chem anlyzr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,"Um Nicotine, Cotinine",UM4000435,80323,,Alkaloids nos,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,131.33,% of charge rate,100.00%,131.33,,,,124.76,131.33,0
unity,CDM,"Um Nicotine, Cotinine",UM4000435,80323,,Alkaloids nos,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,131.33,% of charge rate,100.00%,131.33,,,,124.76,131.33,0
unity,CDM,"Um Amphetamines,quant,urine",UM4000713,80324,,Drug screen amphetamines 1/2,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,168.38,% of charge rate,100.00%,168.38,,,,159.96,168.38,0
unity,CDM,"Um Amphetamines,quant,urine",UM4000713,80324,,Drug screen amphetamines 1/2,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,168.38,% of charge rate,100.00%,168.38,,,,159.96,168.38,0
unity,CDM,"Um Methamphetamine And Metabolite, Quant, Urine",UM4000752,80324,,Drug screen amphetamines 1/2,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,108.67,% of charge rate,100.00%,108.67,,,,103.24,108.67,0
unity,CDM,"Um Methamphetamine And Metabolite, Quant, Urine",UM4000752,80324,,Drug screen amphetamines 1/2,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,108.67,% of charge rate,100.00%,108.67,,,,103.24,108.67,0
unity,CDM,Um Imipramine,UM4000004,80335,,Antidepressant tricyclic 1/2,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,122.46,% of charge rate,100.00%,122.46,,,,116.34,122.46,0
unity,CDM,Um Imipramine,UM4000004,80335,,Antidepressant tricyclic 1/2,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,122.46,% of charge rate,100.00%,122.46,,,,116.34,122.46,0
unity,CDM,Um Clomipramine,UM4000837,80335,,Antidepressant tricyclic 1/2,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,105.18,% of charge rate,100.00%,105.18,,,,99.92,105.18,0
unity,CDM,Um Clomipramine,UM4000837,80335,,Antidepressant tricyclic 1/2,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,105.18,% of charge rate,100.00%,105.18,,,,99.92,105.18,0
unity,CDM,Um Trazodone,UM4000891,80338,,Antidepressant not specified,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,105.18,% of charge rate,100.00%,105.18,,,,99.92,105.18,0
unity,CDM,Um Trazodone,UM4000891,80338,,Antidepressant not specified,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,105.18,% of charge rate,100.00%,105.18,,,,99.92,105.18,0
unity,CDM,Um Wellbuterin,UM4000892,80338,,Antidepressant not specified,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,105.18,% of charge rate,100.00%,105.18,,,,99.92,105.18,0
unity,CDM,Um Wellbuterin,UM4000892,80338,,Antidepressant not specified,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,105.18,% of charge rate,100.00%,105.18,,,,99.92,105.18,0
unity,CDM,Um Clozapine,UM4000765,80342,,Antipsychotics nos 1-3,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,104.48,% of charge rate,100.00%,104.48,,,,99.26,104.48,0
unity,CDM,Um Clozapine,UM4000765,80342,,Antipsychotics nos 1-3,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,104.48,% of charge rate,100.00%,104.48,,,,99.26,104.48,0
unity,CDM,Um Thioridazine,UM4000775,80342,,Antipsychotics nos 1-3,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78.29,% of charge rate,100.00%,78.29,,,,74.38,78.29,0
unity,CDM,Um Thioridazine,UM4000775,80342,,Antipsychotics nos 1-3,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78.29,% of charge rate,100.00%,78.29,,,,74.38,78.29,0
unity,CDM,Um Benzodiazepines,UM4000090,80346,,Benzodiazepines1-12,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110.22,% of charge rate,100.00%,110.22,,,,104.71,110.22,0
unity,CDM,Um Benzodiazepines,UM4000090,80346,,Benzodiazepines1-12,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110.22,% of charge rate,100.00%,110.22,,,,104.71,110.22,0
unity,CDM,Um Clonazepam,UM4000722,80346,,Benzodiazepines1-12,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110.22,% of charge rate,100.00%,110.22,,,,104.71,110.22,0
unity,CDM,Um Clonazepam,UM4000722,80346,,Benzodiazepines1-12,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110.22,% of charge rate,100.00%,110.22,,,,104.71,110.22,0
unity,CDM,Um Lorazepam,UM4000872,80346,,Benzodiazepines1-12,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,107.01,% of charge rate,100.00%,107.01,,,,101.66,107.01,0
unity,CDM,Um Lorazepam,UM4000872,80346,,Benzodiazepines1-12,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,107.01,% of charge rate,100.00%,107.01,,,,101.66,107.01,0
unity,CDM,"Um Cocaine, Urine",UM4000763,80353,,Drug screening cocaine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,128.16,% of charge rate,100.00%,128.16,,,,121.75,128.16,0
unity,CDM,"Um Cocaine, Urine",UM4000763,80353,,Drug screening cocaine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,128.16,% of charge rate,100.00%,128.16,,,,121.75,128.16,0
unity,CDM,"Um Fentanyl And Norfentanyl, Urine Confirm",UM4000791,80354,,Drug screening fentanyl,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,98.2,% of charge rate,100.00%,98.2,,,,93.29,98.2,0
unity,CDM,"Um Fentanyl And Norfentanyl, Urine Confirm",UM4000791,80354,,Drug screening fentanyl,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,98.2,% of charge rate,100.00%,98.2,,,,93.29,98.2,0
unity,CDM,METHADONE,UM4000761,80358,,Drug screening methadone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125.03,% of charge rate,100.00%,125.03,,,,118.78,125.03,0
unity,CDM,METHADONE,UM4000761,80358,,Drug screening methadone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125.03,% of charge rate,100.00%,125.03,,,,118.78,125.03,0
unity,CDM,Um Opiates Assay,UM4000432,80361,,Opiates 1 or more,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,168.38,% of charge rate,100.00%,168.38,,,,159.96,168.38,0
unity,CDM,Um Opiates Assay,UM4000432,80361,,Opiates 1 or more,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,168.38,% of charge rate,100.00%,168.38,,,,159.96,168.38,0
unity,CDM,Um Pain Mgmt/oxycodone Only,UM4000608,80365,,Drug screening oxycodone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,105.08,% of charge rate,100.00%,105.08,,,,99.83,105.08,0
unity,CDM,Um Pain Mgmt/oxycodone Only,UM4000608,80365,,Drug screening oxycodone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,105.08,% of charge rate,100.00%,105.08,,,,99.83,105.08,0
unity,CDM,Um Tramadol,UM4000774,80373,,Drug screening tramadol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,98.2,% of charge rate,100.00%,98.2,,,,93.29,98.2,0
unity,CDM,Um Tramadol,UM4000774,80373,,Drug screening tramadol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,98.2,% of charge rate,100.00%,98.2,,,,93.29,98.2,0
unity,CDM,Um Drug Screen Stereoisomer Analysis,UM4000893,80374,,Stereoisomer analysis,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,128.52,% of charge rate,100.00%,128.52,,,,122.09,128.52,0
unity,CDM,Um Drug Screen Stereoisomer Analysis,UM4000893,80374,,Stereoisomer analysis,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,128.52,% of charge rate,100.00%,128.52,,,,122.09,128.52,0
unity,CDM,Um Urine Dipstick And Micro,UM4000062,81001,,Urinalysis auto w/scope,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,17.62,% of charge rate,100.00%,17.62,,,,16.74,17.62,0
unity,CDM,Um Urine Dipstick And Micro,UM4000062,81001,,Urinalysis auto w/scope,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,17.62,% of charge rate,100.00%,17.62,,,,16.74,17.62,0
unity,CDM,"Um Urinalysis, Dipstick Only",UM4000100,81003,,Urinalysis auto w/o scope,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.51,% of charge rate,100.00%,12.51,,,,11.88,12.51,0
unity,CDM,"Um Urinalysis, Dipstick Only",UM4000100,81003,,Urinalysis auto w/o scope,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.51,% of charge rate,100.00%,12.51,,,,11.88,12.51,0
unity,CDM,"Um Urinalysis, Qual/semiqua",UM4000406,81005,,Urinalysis,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.08,% of charge rate,100.00%,12.08,,,,11.48,12.08,0
unity,CDM,"Um Urinalysis, Qual/semiqua",UM4000406,81005,,Urinalysis,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.08,% of charge rate,100.00%,12.08,,,,11.48,12.08,0
unity,CDM,"Um Urine, Microscopic Only",UM4000316,81015,,Microscopic exam of urine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,16.95,% of charge rate,100.00%,16.95,,,,16.1,16.95,0
unity,CDM,"Um Urine, Microscopic Only",UM4000316,81015,,Microscopic exam of urine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,16.95,% of charge rate,100.00%,16.95,,,,16.1,16.95,0
unity,CDM,"Um Preg, Hcg,qual,urine",UM4000457,81025,,Urine pregnancy test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,35.22,% of charge rate,100.00%,35.22,,,,33.46,35.22,0
unity,CDM,"Um Preg, Hcg,qual,urine",UM4000457,81025,,Urine pregnancy test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,35.22,% of charge rate,100.00%,35.22,,,,33.46,35.22,0
unity,CDM,Um Urine Volume Measurement,UM4000352,81050,,Urinalysis volume measure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,16.7,% of charge rate,100.00%,16.7,,,,15.87,16.7,0
unity,CDM,Um Urine Volume Measurement,UM4000352,81050,,Urinalysis volume measure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,16.7,% of charge rate,100.00%,16.7,,,,15.87,16.7,0
unity,CDM,Um Genomic Alterations,UM4000945,81229,,Cytogen m array copy no&snp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,942.21",% of charge rate,100.00%,"2,942.21",,,,"2,795.10","2,942.21",0
unity,CDM,Um Genomic Alterations,UM4000945,81229,,Cytogen m array copy no&snp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,942.21",% of charge rate,100.00%,"2,942.21",,,,"2,795.10","2,942.21",0
unity,CDM,Um Factor Ii G20210a Mutation,UM4000576,81240,,F2 gene,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,328.35,% of charge rate,100.00%,328.35,,,,311.93,328.35,0
unity,CDM,Um Factor Ii G20210a Mutation,UM4000576,81240,,F2 gene,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,328.35,% of charge rate,100.00%,328.35,,,,311.93,328.35,0
unity,CDM,Um Factor V (leiden) Mutation Analysis,UM81241,81241,,F5 gene,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,420.95,% of charge rate,100.00%,420.95,,,,399.9,420.95,0
unity,CDM,Um Factor V (leiden) Mutation Analysis,UM81241,81241,,F5 gene,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,420.95,% of charge rate,100.00%,420.95,,,,399.9,420.95,0
unity,CDM,Um Fragile X Syndrome,UM4000812,81243,,Fmr1 gene detection,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,311.47,% of charge rate,100.00%,311.47,,,,295.9,311.47,0
unity,CDM,Um Fragile X Syndrome,UM4000812,81243,,Fmr1 gene detection,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,311.47,% of charge rate,100.00%,311.47,,,,295.9,311.47,0
unity,CDM,Um Hereditary Hemochromotosis Dna Mutations,UM4000710,81256,,Hfe gene,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,661.73,% of charge rate,100.00%,661.73,,,,628.64,661.73,0
unity,CDM,Um Hereditary Hemochromotosis Dna Mutations,UM4000710,81256,,Hfe gene,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,661.73,% of charge rate,100.00%,661.73,,,,628.64,661.73,0
unity,CDM,Um Jak2 V617f,UM4000867,81270,,Jak2 gene,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,531.4,% of charge rate,100.00%,531.4,,,,504.83,531.4,0
unity,CDM,Um Jak2 V617f,UM4000867,81270,,Jak2 gene,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,531.4,% of charge rate,100.00%,531.4,,,,504.83,531.4,0
unity,CDM,"Um Mthfr,gene Analysis,dna",UM4000728,81291,,Mthfr gene,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,378.18,% of charge rate,100.00%,378.18,,,,359.27,378.18,0
unity,CDM,"Um Mthfr,gene Analysis,dna",UM4000728,81291,,Mthfr gene,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,378.18,% of charge rate,100.00%,378.18,,,,359.27,378.18,0
unity,CDM,"Um Hla Class I Typing Low Resolution, Complete",UM4000934,81372,,Hla i typing complete lr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,910,% of charge rate,100.00%,910,,,,864.5,910,0
unity,CDM,"Um Hla Class I Typing Low Resolution, Complete",UM4000934,81372,,Hla i typing complete lr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,910,% of charge rate,100.00%,910,,,,864.5,910,0
unity,CDM,Um Hla - Dq Typing,UM4000541,81377,,Hla ii type 1 ag equiv lr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,462.83,% of charge rate,100.00%,462.83,,,,439.69,462.83,0
unity,CDM,Um Hla - Dq Typing,UM4000541,81377,,Hla ii type 1 ag equiv lr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,462.83,% of charge rate,100.00%,462.83,,,,439.69,462.83,0
unity,CDM,Um Hla Class I Typing High Resolution One Allele/allele Group,UM4000854,81381,,Hla i typing 1 allele hr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,548.31,% of charge rate,100.00%,548.31,,,,520.89,548.31,0
unity,CDM,Um Hla Class I Typing High Resolution One Allele/allele Group,UM4000854,81381,,Hla i typing 1 allele hr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,548.31,% of charge rate,100.00%,548.31,,,,520.89,548.31,0
unity,CDM,Um Hereditary Colon Cancer Multi-gene Panel,UM4000781,81435,,Hereditary colon ca dsordrs,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,415.80",% of charge rate,100.00%,"3,415.80",,,,"3,245.01","3,415.80",0
unity,CDM,Um Hereditary Colon Cancer Multi-gene Panel,UM4000781,81435,,Hereditary colon ca dsordrs,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,415.80",% of charge rate,100.00%,"3,415.80",,,,"3,245.01","3,415.80",0
unity,CDM,Um Quad Screen Maternal,UM4000861,81511,,Ftl cgen abnor four anal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,374.54,% of charge rate,100.00%,374.54,,,,355.81,374.54,0
unity,CDM,Um Quad Screen Maternal,UM4000861,81511,,Ftl cgen abnor four anal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,374.54,% of charge rate,100.00%,374.54,,,,355.81,374.54,0
unity,CDM,"Um Acylcarnitines, Quant",UM4000396,82017,,Acylcarnitines quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,226.21,% of charge rate,100.00%,226.21,,,,214.9,226.21,0
unity,CDM,"Um Acylcarnitines, Quant",UM4000396,82017,,Acylcarnitines quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,226.21,% of charge rate,100.00%,226.21,,,,214.9,226.21,0
unity,CDM,Um Acth,UM4000159,82024,,Assay of acth,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,215.06,% of charge rate,100.00%,215.06,,,,204.31,215.06,0
unity,CDM,Um Acth,UM4000159,82024,,Assay of acth,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,215.06,% of charge rate,100.00%,215.06,,,,204.31,215.06,0
unity,CDM,Um Albumin,UM4000242,82040,,Assay of serum albumin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.54,% of charge rate,100.00%,27.54,,,,26.16,27.54,0
unity,CDM,Um Albumin,UM4000242,82040,,Assay of serum albumin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.54,% of charge rate,100.00%,27.54,,,,26.16,27.54,0
unity,CDM,"Um Albumin, Other Than Serum",UM4000346,82042,,Other source albumin quan ea,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,"Um Albumin, Other Than Serum",UM4000346,82042,,Other source albumin quan ea,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,"Um Microalbumin, Urine Quantification",UM4000907,82043,,Ur albumin quantitative,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.94,% of charge rate,100.00%,32.94,,,,31.29,32.94,0
unity,CDM,"Um Microalbumin, Urine Quantification",UM4000907,82043,,Ur albumin quantitative,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.94,% of charge rate,100.00%,32.94,,,,31.29,32.94,0
unity,CDM,"Um Micro Albumin, Urine",UM4000263,82044,,Ur albumin semiquantitative,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.48,% of charge rate,100.00%,25.48,,,,24.21,25.48,0
unity,CDM,"Um Micro Albumin, Urine",UM4000263,82044,,Ur albumin semiquantitative,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.48,% of charge rate,100.00%,25.48,,,,24.21,25.48,0
unity,CDM,Um Breathe Alcohol Confirm,UM3480021,82075,,Assay of breath ethanol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Breathe Alcohol Confirm,UM3480021,82075,,Assay of breath ethanol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,"Um Alcohol, Breath",UM3480023,82075,,Assay of breath ethanol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,"Um Alcohol, Breath",UM3480023,82075,,Assay of breath ethanol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Aldolase,UM4000363,82085,,Assay of aldolase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.05,% of charge rate,100.00%,54.05,,,,51.35,54.05,0
unity,CDM,Um Aldolase,UM4000363,82085,,Assay of aldolase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.05,% of charge rate,100.00%,54.05,,,,51.35,54.05,0
unity,CDM,Um Aldosterone,UM4000019,82088,,Assay of aldosterone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,282.54,% of charge rate,100.00%,282.54,,,,268.41,282.54,0
unity,CDM,Um Aldosterone,UM4000019,82088,,Assay of aldosterone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,282.54,% of charge rate,100.00%,282.54,,,,268.41,282.54,0
unity,CDM,Um Alpha-1-antitrypsin,UM4000158,82103,,Alpha-1-antitrypsin total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,74.82,% of charge rate,100.00%,74.82,,,,71.08,74.82,0
unity,CDM,Um Alpha-1-antitrypsin,UM4000158,82103,,Alpha-1-antitrypsin total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,74.82,% of charge rate,100.00%,74.82,,,,71.08,74.82,0
unity,CDM,"Um Alpha-1 Antigrypsin, Phen",UM4000431,82104,,Alpha-1-antitrypsin pheno,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.5,% of charge rate,100.00%,80.5,,,,76.48,80.5,0
unity,CDM,"Um Alpha-1 Antigrypsin, Phen",UM4000431,82104,,Alpha-1-antitrypsin pheno,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.5,% of charge rate,100.00%,80.5,,,,76.48,80.5,0
unity,CDM,Um Alpha-fetoprotein; Serum,UM4000362,82105,,Alpha-fetoprotein serum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93.41,% of charge rate,100.00%,93.41,,,,88.74,93.41,0
unity,CDM,Um Alpha-fetoprotein; Serum,UM4000362,82105,,Alpha-fetoprotein serum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93.41,% of charge rate,100.00%,93.41,,,,88.74,93.41,0
unity,CDM,"Um Aluminum, Whole Blood",UM4000776,82108,,Assay of aluminum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,141.92,% of charge rate,100.00%,141.92,,,,134.82,141.92,0
unity,CDM,"Um Aluminum, Whole Blood",UM4000776,82108,,Assay of aluminum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,141.92,% of charge rate,100.00%,141.92,,,,134.82,141.92,0
unity,CDM,"Um Amino Acids, Urine",UM4000933,82136,,Amino acids quant 2-5,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,97.8,% of charge rate,100.00%,97.8,,,,92.91,97.8,0
unity,CDM,"Um Amino Acids, Urine",UM4000933,82136,,Amino acids quant 2-5,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,97.8,% of charge rate,100.00%,97.8,,,,92.91,97.8,0
unity,CDM,"Um Amino Acid, 6 Or Mr, Plas",UM4000264,82139,,Amino acids quan 6 or more,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,287.67,% of charge rate,100.00%,287.67,,,,273.29,287.67,0
unity,CDM,"Um Amino Acid, 6 Or Mr, Plas",UM4000264,82139,,Amino acids quan 6 or more,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,287.67,% of charge rate,100.00%,287.67,,,,273.29,287.67,0
unity,CDM,Um Ammonia,UM4000188,82140,,Assay of ammonia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,81.14,% of charge rate,100.00%,81.14,,,,77.08,81.14,0
unity,CDM,Um Ammonia,UM4000188,82140,,Assay of ammonia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,81.14,% of charge rate,100.00%,81.14,,,,77.08,81.14,0
unity,CDM,Um Amylase,UM4000075,82150,,Assay of amylase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.08,% of charge rate,100.00%,36.08,,,,34.28,36.08,0
unity,CDM,Um Amylase,UM4000075,82150,,Assay of amylase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.08,% of charge rate,100.00%,36.08,,,,34.28,36.08,0
unity,CDM,Um Androstenedione,UM4000395,82157,,Assay of androstenedione,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,239.2,% of charge rate,100.00%,239.2,,,,227.24,239.2,0
unity,CDM,Um Androstenedione,UM4000395,82157,,Assay of androstenedione,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,239.2,% of charge rate,100.00%,239.2,,,,227.24,239.2,0
unity,CDM,Um Angiotensin 1 Assay,UM4000388,82164,,Angiotensin i enzyme test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,81.31,% of charge rate,100.00%,81.31,,,,77.24,81.31,0
unity,CDM,Um Angiotensin 1 Assay,UM4000388,82164,,Angiotensin i enzyme test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,81.31,% of charge rate,100.00%,81.31,,,,77.24,81.31,0
unity,CDM,"Um Apolipoprotein, Each",UM4000179,82172,,Assay of apolipoprotein,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,160.08,% of charge rate,100.00%,160.08,,,,152.08,160.08,0
unity,CDM,"Um Apolipoprotein, Each",UM4000179,82172,,Assay of apolipoprotein,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,160.08,% of charge rate,100.00%,160.08,,,,152.08,160.08,0
unity,CDM,Um Arsenic,UM4000058,82175,,Assay of arsenic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,126.78,% of charge rate,100.00%,126.78,,,,120.44,126.78,0
unity,CDM,Um Arsenic,UM4000058,82175,,Assay of arsenic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,126.78,% of charge rate,100.00%,126.78,,,,120.44,126.78,0
unity,CDM,Um Vitamin C,UM4000745,82180,,Assay of ascorbic acid,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,82.7,% of charge rate,100.00%,82.7,,,,78.57,82.7,0
unity,CDM,Um Vitamin C,UM4000745,82180,,Assay of ascorbic acid,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,82.7,% of charge rate,100.00%,82.7,,,,78.57,82.7,0
unity,CDM,Um Barbituates Gc/ms Urine,UM4000714,82205,,BARBITURATES- WHOLE BLOOD,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,168.38,% of charge rate,100.00%,168.38,,,,159.96,168.38,0
unity,CDM,Um Barbituates Gc/ms Urine,UM4000714,82205,,BARBITURATES- WHOLE BLOOD,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,168.38,% of charge rate,100.00%,168.38,,,,159.96,168.38,0
unity,CDM,Um Beta-2 Microglobulin,UM4000130,82232,,Assay of beta-2 protein,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90.07,% of charge rate,100.00%,90.07,,,,85.57,90.07,0
unity,CDM,Um Beta-2 Microglobulin,UM4000130,82232,,Assay of beta-2 protein,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90.07,% of charge rate,100.00%,90.07,,,,85.57,90.07,0
unity,CDM,"Um Bile Acids, Total Serum",UM4000795,82239,,Bile acids total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.98,% of charge rate,100.00%,41.98,,,,39.88,41.98,0
unity,CDM,"Um Bile Acids, Total Serum",UM4000795,82239,,Bile acids total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.98,% of charge rate,100.00%,41.98,,,,39.88,41.98,0
unity,CDM,Um Bilirubin Total,UM4000049,82247,,Bilirubin total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.92,% of charge rate,100.00%,27.92,,,,26.52,27.92,0
unity,CDM,Um Bilirubin Total,UM4000049,82247,,Bilirubin total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.92,% of charge rate,100.00%,27.92,,,,26.52,27.92,0
unity,CDM,Um Bilirubin Direct,UM4000312,82248,,Bilirubin direct,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.92,% of charge rate,100.00%,27.92,,,,26.52,27.92,0
unity,CDM,Um Bilirubin Direct,UM4000312,82248,,Bilirubin direct,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.92,% of charge rate,100.00%,27.92,,,,26.52,27.92,0
unity,CDM,"Um Occult Blood, Screening",UM4000203,82270,,Occult blood feces,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.57,% of charge rate,100.00%,15.57,,,,14.79,15.57,0
unity,CDM,"Um Occult Blood, Screening",UM4000203,82270,,Occult blood feces,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.57,% of charge rate,100.00%,15.57,,,,14.79,15.57,0
unity,CDM,Um Occult Blood- Gastric,UM4000150,82271,,Occult blood other sources,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.57,% of charge rate,100.00%,15.57,,,,14.79,15.57,0
unity,CDM,Um Occult Blood- Gastric,UM4000150,82271,,Occult blood other sources,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.57,% of charge rate,100.00%,15.57,,,,14.79,15.57,0
unity,CDM,Um Occult Blood (hemosure) Diagnostic,UM4000573,82274,,Assay test for blood fecal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.56,% of charge rate,100.00%,88.56,,,,84.13,88.56,0
unity,CDM,Um Occult Blood (hemosure) Diagnostic,UM4000573,82274,,Assay test for blood fecal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.56,% of charge rate,100.00%,88.56,,,,84.13,88.56,0
unity,CDM,Um Vitamin D 25-hydroxy,UM4000059,82306,,Vitamin d 25 hydroxy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,164.9,% of charge rate,100.00%,164.9,,,,156.66,164.9,0
unity,CDM,Um Vitamin D 25-hydroxy,UM4000059,82306,,Vitamin d 25 hydroxy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,164.9,% of charge rate,100.00%,164.9,,,,156.66,164.9,0
unity,CDM,Um Calcitonin,UM4000838,82308,,Assay of calcitonin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,155.32,% of charge rate,100.00%,155.32,,,,147.55,155.32,0
unity,CDM,Um Calcitonin,UM4000838,82308,,Assay of calcitonin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,155.32,% of charge rate,100.00%,155.32,,,,147.55,155.32,0
unity,CDM,"Um Calcium, Serum",UM4000013,82310,,Assay of calcium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.69,% of charge rate,100.00%,28.69,,,,27.26,28.69,0
unity,CDM,"Um Calcium, Serum",UM4000013,82310,,Assay of calcium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.69,% of charge rate,100.00%,28.69,,,,27.26,28.69,0
unity,CDM,"Um Calcium, Random Urine",UM4000902,82310,,Assay of calcium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.69,% of charge rate,100.00%,28.69,,,,27.26,28.69,0
unity,CDM,"Um Calcium, Random Urine",UM4000902,82310,,Assay of calcium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.69,% of charge rate,100.00%,28.69,,,,27.26,28.69,0
unity,CDM,"Um Calcium, Ionized",UM4000063,82330,,Assay of calcium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.08,% of charge rate,100.00%,76.08,,,,72.28,76.08,0
unity,CDM,"Um Calcium, Ionized",UM4000063,82330,,Assay of calcium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.08,% of charge rate,100.00%,76.08,,,,72.28,76.08,0
unity,CDM,"Um Calcium - Urine, Quant",UM4000045,82340,,Assay of calcium in urine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.58,% of charge rate,100.00%,33.58,,,,31.9,33.58,0
unity,CDM,"Um Calcium - Urine, Quant",UM4000045,82340,,Assay of calcium in urine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.58,% of charge rate,100.00%,33.58,,,,31.9,33.58,0
unity,CDM,Um Calculus(stone) Assay,UM4000194,82365,,Calculus spectroscopy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.81,% of charge rate,100.00%,71.81,,,,68.22,71.81,0
unity,CDM,Um Calculus(stone) Assay,UM4000194,82365,,Calculus spectroscopy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.81,% of charge rate,100.00%,71.81,,,,68.22,71.81,0
unity,CDM,Um Co2 Carbon Dioxide,UM4000117,82374,,Assay blood carbon dioxide,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,150,% of charge rate,100.00%,150,,,,142.5,150,0
unity,CDM,Um Co2 Carbon Dioxide,UM4000117,82374,,Assay blood carbon dioxide,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,150,% of charge rate,100.00%,150,,,,142.5,150,0
unity,CDM,Um Co (carboxyhemoglobin),UM4000126,82375,,Assay carboxyhb quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,42.54,% of charge rate,100.00%,42.54,,,,40.41,42.54,0
unity,CDM,Um Co (carboxyhemoglobin),UM4000126,82375,,Assay carboxyhb quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,42.54,% of charge rate,100.00%,42.54,,,,40.41,42.54,0
unity,CDM,Um Cea,UM4000089,82378,,Carcinoembryonic antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,105.63,% of charge rate,100.00%,105.63,,,,100.35,105.63,0
unity,CDM,Um Cea,UM4000089,82378,,Carcinoembryonic antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,105.63,% of charge rate,100.00%,105.63,,,,100.35,105.63,0
unity,CDM,Um Carnitine,UM4000155,82379,,Assay of carnitine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,265.08,% of charge rate,100.00%,265.08,,,,251.83,265.08,0
unity,CDM,Um Carnitine,UM4000155,82379,,Assay of carnitine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,265.08,% of charge rate,100.00%,265.08,,,,251.83,265.08,0
unity,CDM,Um Carotene,UM4000201,82380,,Assay of carotene,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,123.33,% of charge rate,100.00%,123.33,,,,117.16,123.33,0
unity,CDM,Um Carotene,UM4000201,82380,,Assay of carotene,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,123.33,% of charge rate,100.00%,123.33,,,,117.16,123.33,0
unity,CDM,"Um Catcholmns, Fract/tot Pla",UM4000044,82384,,Assay three catecholamines,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140.56,% of charge rate,100.00%,140.56,,,,133.53,140.56,0
unity,CDM,"Um Catcholmns, Fract/tot Pla",UM4000044,82384,,Assay three catecholamines,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140.56,% of charge rate,100.00%,140.56,,,,133.53,140.56,0
unity,CDM,Um Cathcholines Fract/total 24 Hr Uriine,UM4000813,82384,,Assay three catecholamines,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140.56,% of charge rate,100.00%,140.56,,,,133.53,140.56,0
unity,CDM,Um Cathcholines Fract/total 24 Hr Uriine,UM4000813,82384,,Assay three catecholamines,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140.56,% of charge rate,100.00%,140.56,,,,133.53,140.56,0
unity,CDM,"Um Catcholines Fractionated, Serum",UM4000814,82384,,Assay three catecholamines,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140.56,% of charge rate,100.00%,140.56,,,,133.53,140.56,0
unity,CDM,"Um Catcholines Fractionated, Serum",UM4000814,82384,,Assay three catecholamines,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140.56,% of charge rate,100.00%,140.56,,,,133.53,140.56,0
unity,CDM,Um Ceruloplasmin,UM4000184,82390,,Assay of ceruloplasmin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,59.8,% of charge rate,100.00%,59.8,,,,56.81,59.8,0
unity,CDM,Um Ceruloplasmin,UM4000184,82390,,Assay of ceruloplasmin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,59.8,% of charge rate,100.00%,59.8,,,,56.81,59.8,0
unity,CDM,Um Ttg(tissue Transglutamase),UM4000529,82397,,Chemiluminescent assay,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um Ttg(tissue Transglutamase),UM4000529,82397,,Chemiluminescent assay,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um Inhibin B,UM4000858,82397,,Chemiluminescent assay,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,81.87,% of charge rate,100.00%,81.87,,,,77.78,81.87,0
unity,CDM,Um Inhibin B,UM4000858,82397,,Chemiluminescent assay,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,81.87,% of charge rate,100.00%,81.87,,,,77.78,81.87,0
unity,CDM,Um Chloride,UM4000285,82435,,Assay of blood chloride,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.59,% of charge rate,100.00%,25.59,,,,24.31,25.59,0
unity,CDM,Um Chloride,UM4000285,82435,,Assay of blood chloride,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.59,% of charge rate,100.00%,25.59,,,,24.31,25.59,0
unity,CDM,Um Chloride Urine,UM4000005,82436,,Assay of urine chloride,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.98,% of charge rate,100.00%,27.98,,,,26.58,27.98,0
unity,CDM,Um Chloride Urine,UM4000005,82436,,Assay of urine chloride,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.98,% of charge rate,100.00%,27.98,,,,26.58,27.98,0
unity,CDM,Um Cholesterol,UM4000029,82465,,Assay bld/serum cholesterol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.2,% of charge rate,100.00%,24.2,,,,22.99,24.2,0
unity,CDM,Um Cholesterol,UM4000029,82465,,Assay bld/serum cholesterol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.2,% of charge rate,100.00%,24.2,,,,22.99,24.2,0
unity,CDM,"Um Cholinesterase, Serum",UM4000268,82480,,Assay serum cholinesterase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,43.88,% of charge rate,100.00%,43.88,,,,41.69,43.88,0
unity,CDM,"Um Cholinesterase, Serum",UM4000268,82480,,Assay serum cholinesterase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,43.88,% of charge rate,100.00%,43.88,,,,41.69,43.88,0
unity,CDM,Um Citrate,UM4000191,82507,,Assay of citrate,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,286.66,% of charge rate,100.00%,286.66,,,,272.33,286.66,0
unity,CDM,Um Citrate,UM4000191,82507,,Assay of citrate,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,286.66,% of charge rate,100.00%,286.66,,,,272.33,286.66,0
unity,CDM,Um Copper Serum,UM4000359,82525,,Assay of copper,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.7,% of charge rate,100.00%,67.7,,,,64.32,67.7,0
unity,CDM,Um Copper Serum,UM4000359,82525,,Assay of copper,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.7,% of charge rate,100.00%,67.7,,,,64.32,67.7,0
unity,CDM,"Um Copper, Urine",UM4000941,82525,,Assay of copper,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.7,% of charge rate,100.00%,67.7,,,,64.32,67.7,0
unity,CDM,"Um Copper, Urine",UM4000941,82525,,Assay of copper,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.7,% of charge rate,100.00%,67.7,,,,64.32,67.7,0
unity,CDM,"Um Cortisol, Free",UM4000008,82530,,Cortisol free,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,151.95,% of charge rate,100.00%,151.95,,,,144.35,151.95,0
unity,CDM,"Um Cortisol, Free",UM4000008,82530,,Cortisol free,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,151.95,% of charge rate,100.00%,151.95,,,,144.35,151.95,0
unity,CDM,"Um Cortisol, Total",UM4000326,82533,,Total cortisol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90.8,% of charge rate,100.00%,90.8,,,,86.26,90.8,0
unity,CDM,"Um Cortisol, Total",UM4000326,82533,,Total cortisol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90.8,% of charge rate,100.00%,90.8,,,,86.26,90.8,0
unity,CDM,"Um Gc/ms, Hplc/ms",UM4000330,82542,,Col chromotography qual/quan,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100.51,% of charge rate,100.00%,100.51,,,,95.48,100.51,0
unity,CDM,"Um Gc/ms, Hplc/ms",UM4000330,82542,,Col chromotography qual/quan,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100.51,% of charge rate,100.00%,100.51,,,,95.48,100.51,0
unity,CDM,Um Tpmt Column Chromatography,UM4000835,82542,,Col chromotography qual/quan,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,104.7,% of charge rate,100.00%,104.7,,,,99.47,104.7,0
unity,CDM,Um Tpmt Column Chromatography,UM4000835,82542,,Col chromotography qual/quan,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,104.7,% of charge rate,100.00%,104.7,,,,99.47,104.7,0
unity,CDM,"Um Iodine, Serum Or Plasma",UM4000919,82542,,Col chromotography qual/quan,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,104.7,% of charge rate,100.00%,104.7,,,,99.47,104.7,0
unity,CDM,"Um Iodine, Serum Or Plasma",UM4000919,82542,,Col chromotography qual/quan,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,104.7,% of charge rate,100.00%,104.7,,,,99.47,104.7,0
unity,CDM,"Um Organic Acid Component, Quant.",UM4000944,82542,,Col chromotography qual/quan,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,365.8,% of charge rate,100.00%,365.8,,,,347.51,365.8,0
unity,CDM,"Um Organic Acid Component, Quant.",UM4000944,82542,,Col chromotography qual/quan,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,365.8,% of charge rate,100.00%,365.8,,,,347.51,365.8,0
unity,CDM,"Um Ck, Total",UM4000314,82550,,Assay of ck (cpk),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.31,% of charge rate,100.00%,36.31,,,,34.49,36.31,0
unity,CDM,"Um Ck, Total",UM4000314,82550,,Assay of ck (cpk),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.31,% of charge rate,100.00%,36.31,,,,34.49,36.31,0
unity,CDM,Um Ck-mb,UM4000343,82553,,Creatine mb fraction,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.29,% of charge rate,100.00%,64.29,,,,61.08,64.29,0
unity,CDM,Um Ck-mb,UM4000343,82553,,Creatine mb fraction,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.29,% of charge rate,100.00%,64.29,,,,61.08,64.29,0
unity,CDM,Um Creatinine,UM4000294,82565,,Assay of creatinine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.53,% of charge rate,100.00%,28.53,,,,27.1,28.53,0
unity,CDM,Um Creatinine,UM4000294,82565,,Assay of creatinine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.53,% of charge rate,100.00%,28.53,,,,27.1,28.53,0
unity,CDM,"Um Creatinine, Urine",UM4000260,82570,,Assay of urine creatinine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,"Um Creatinine, Urine",UM4000260,82570,,Assay of urine creatinine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Creatinine-cl Urine,UM4000086,82575,,Creatinine clearance test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.64,% of charge rate,100.00%,52.64,,,,50.01,52.64,0
unity,CDM,Um Creatinine-cl Urine,UM4000086,82575,,Creatinine clearance test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.64,% of charge rate,100.00%,52.64,,,,50.01,52.64,0
unity,CDM,Um Cryoglobulin,UM4000237,82595,,Assay of cryoglobulin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.33,% of charge rate,100.00%,58.33,,,,55.41,58.33,0
unity,CDM,Um Cryoglobulin,UM4000237,82595,,Assay of cryoglobulin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.33,% of charge rate,100.00%,58.33,,,,55.41,58.33,0
unity,CDM,Um Vitamin B-12,UM4000039,82607,,Vitamin b-12,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.93,% of charge rate,100.00%,83.93,,,,79.73,83.93,0
unity,CDM,Um Vitamin B-12,UM4000039,82607,,Vitamin b-12,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.93,% of charge rate,100.00%,83.93,,,,79.73,83.93,0
unity,CDM,Um Vit B12 Binding Capacity,UM4000241,82608,,B-12 binding capacity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,97.97,% of charge rate,100.00%,97.97,,,,93.07,97.97,0
unity,CDM,Um Vit B12 Binding Capacity,UM4000241,82608,,B-12 binding capacity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,97.97,% of charge rate,100.00%,97.97,,,,93.07,97.97,0
unity,CDM,Um Dhea,UM4000211,82626,,Dehydroepiandrosterone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140.68,% of charge rate,100.00%,140.68,,,,133.65,140.68,0
unity,CDM,Um Dhea,UM4000211,82626,,Dehydroepiandrosterone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140.68,% of charge rate,100.00%,140.68,,,,133.65,140.68,0
unity,CDM,Um Dehydroepiandosterone,UM4000216,82627,,Dehydroepiandrosterone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,123.81,% of charge rate,100.00%,123.81,,,,117.62,123.81,0
unity,CDM,Um Dehydroepiandosterone,UM4000216,82627,,Dehydroepiandrosterone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,123.81,% of charge rate,100.00%,123.81,,,,117.62,123.81,0
unity,CDM,Um Dihydrotestosterone (dht),UM4000394,82651,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,172.05,% of charge rate,100.00%,172.05,,,,163.45,172.05,0
unity,CDM,Um Dihydrotestosterone (dht),UM4000394,82651,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,172.05,% of charge rate,100.00%,172.05,,,,163.45,172.05,0
unity,CDM,"Um Vit D, 1, 25 Oh",UM4000364,82652,,Vit d 1 25-dihydroxy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,216.3,% of charge rate,100.00%,216.3,,,,205.49,216.3,0
unity,CDM,"Um Vit D, 1, 25 Oh",UM4000364,82652,,Vit d 1 25-dihydroxy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,216.3,% of charge rate,100.00%,216.3,,,,205.49,216.3,0
unity,CDM,"Um Pancreatic Elastase, Fecal",UM4000866,82656,,Pancreatic elastase fecal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.86,% of charge rate,100.00%,66.86,,,,63.52,66.86,0
unity,CDM,"Um Pancreatic Elastase, Fecal",UM4000866,82656,,Pancreatic elastase fecal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.86,% of charge rate,100.00%,66.86,,,,63.52,66.86,0
unity,CDM,Um Tpmt Enzyme Activity,UM4000836,82657,,Enzyme cell activity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,104.7,% of charge rate,100.00%,104.7,,,,99.47,104.7,0
unity,CDM,Um Tpmt Enzyme Activity,UM4000836,82657,,Enzyme cell activity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,104.7,% of charge rate,100.00%,104.7,,,,99.47,104.7,0
unity,CDM,Um Erythropoietin,UM4000172,82668,,Assay of erythropoietin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,104.68,% of charge rate,100.00%,104.68,,,,99.45,104.68,0
unity,CDM,Um Erythropoietin,UM4000172,82668,,Assay of erythropoietin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,104.68,% of charge rate,100.00%,104.68,,,,99.45,104.68,0
unity,CDM,Um Estradiol,UM4000189,82670,,Assay of estradiol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,155.6,% of charge rate,100.00%,155.6,,,,147.82,155.6,0
unity,CDM,Um Estradiol,UM4000189,82670,,Assay of estradiol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,155.6,% of charge rate,100.00%,155.6,,,,147.82,155.6,0
unity,CDM,"Um Estrogens, Total",UM4000390,82672,,Assay of estrogen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,158.24,% of charge rate,100.00%,158.24,,,,150.33,158.24,0
unity,CDM,"Um Estrogens, Total",UM4000390,82672,,Assay of estrogen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,158.24,% of charge rate,100.00%,158.24,,,,150.33,158.24,0
unity,CDM,Um Estrodial,UM4000366,82677,,Assay of estriol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,151.73,% of charge rate,100.00%,151.73,,,,144.14,151.73,0
unity,CDM,Um Estrodial,UM4000366,82677,,Assay of estriol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,151.73,% of charge rate,100.00%,151.73,,,,144.14,151.73,0
unity,CDM,Um Fecal Fat (lipids),UM4000174,82705,,Fats/lipids feces qual,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.65,% of charge rate,100.00%,76.65,,,,72.82,76.65,0
unity,CDM,Um Fecal Fat (lipids),UM4000174,82705,,Fats/lipids feces qual,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.65,% of charge rate,100.00%,76.65,,,,72.82,76.65,0
unity,CDM,Um Ferritin,UM4000055,82728,,Assay of ferritin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75.88,% of charge rate,100.00%,75.88,,,,72.09,75.88,0
unity,CDM,Um Ferritin,UM4000055,82728,,Assay of ferritin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75.88,% of charge rate,100.00%,75.88,,,,72.09,75.88,0
unity,CDM,Um Folate (folic Acid),UM4000225,82746,,Assay of folic acid serum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,81.86,% of charge rate,100.00%,81.86,,,,77.77,81.86,0
unity,CDM,Um Folate (folic Acid),UM4000225,82746,,Assay of folic acid serum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,81.86,% of charge rate,100.00%,81.86,,,,77.77,81.86,0
unity,CDM,"Um Folate, Rbc",UM4000279,82747,,Assay of folic acid rbc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,95.89,% of charge rate,100.00%,95.89,,,,91.1,95.89,0
unity,CDM,"Um Folate, Rbc",UM4000279,82747,,Assay of folic acid rbc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,95.89,% of charge rate,100.00%,95.89,,,,91.1,95.89,0
unity,CDM,"Um Immunoglobins(iga,igm,igg",UM4000554,82784,,Assay iga/igd/igg/igm each,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,51.8,% of charge rate,100.00%,51.8,,,,49.21,51.8,0
unity,CDM,"Um Immunoglobins(iga,igm,igg",UM4000554,82784,,Assay iga/igd/igg/igm each,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,51.8,% of charge rate,100.00%,51.8,,,,49.21,51.8,0
unity,CDM,"Um Gammaglobin, (ige)",UM4000373,82785,,Assay of ige,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91.66,% of charge rate,100.00%,91.66,,,,87.08,91.66,0
unity,CDM,"Um Gammaglobin, (ige)",UM4000373,82785,,Assay of ige,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91.66,% of charge rate,100.00%,91.66,,,,87.08,91.66,0
unity,CDM,"Um Immunoglob G, Subclass 1",UM82787,82787,,Igg 1 2 3 or 4 each,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,259.07,% of charge rate,100.00%,259.07,,,,246.12,259.07,0
unity,CDM,"Um Immunoglob G, Subclass 1",UM82787,82787,,Igg 1 2 3 or 4 each,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,259.07,% of charge rate,100.00%,259.07,,,,246.12,259.07,0
unity,CDM,Um Blood Ph Only,UM4000580,82800,,Blood ph,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54,% of charge rate,100.00%,54,,,,51.3,54,0
unity,CDM,Um Blood Ph Only,UM4000580,82800,,Blood ph,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54,% of charge rate,100.00%,54,,,,51.3,54,0
unity,CDM,Um Blood Gases W/o2 Sat,UM3480013,82805,,Blood gases w/o2 saturation,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,386.2,% of charge rate,100.00%,386.2,,,,366.89,386.2,0
unity,CDM,Um Blood Gases W/o2 Sat,UM3480013,82805,,Blood gases w/o2 saturation,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,386.2,% of charge rate,100.00%,386.2,,,,366.89,386.2,0
unity,CDM,Um Gastrin,UM4000923,82941,,Assay of gastrin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,104.7,% of charge rate,100.00%,104.7,,,,99.47,104.7,0
unity,CDM,Um Gastrin,UM4000923,82941,,Assay of gastrin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,104.7,% of charge rate,100.00%,104.7,,,,99.47,104.7,0
unity,CDM,Um Glucose Other Fluid,UM4000073,82945,,Glucose other fluid,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.41,% of charge rate,100.00%,21.41,,,,20.34,21.41,0
unity,CDM,Um Glucose Other Fluid,UM4000073,82945,,Glucose other fluid,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.41,% of charge rate,100.00%,21.41,,,,20.34,21.41,0
unity,CDM,Um Glucose - Quantitative,UM4000375,82947,,Assay glucose blood quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.86,% of charge rate,100.00%,21.86,,,,20.77,21.86,0
unity,CDM,Um Glucose - Quantitative,UM4000375,82947,,Assay glucose blood quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.86,% of charge rate,100.00%,21.86,,,,20.77,21.86,0
unity,CDM,Um Glucose Post Dose,UM4000306,82950,,Glucose test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,Um Glucose Post Dose,UM4000306,82950,,Glucose test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,"Um Glucose Tol.,  3 Specs",UM4000300,82951,,Glucose tolerance test (gtt),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.65,% of charge rate,100.00%,71.65,,,,68.07,71.65,0
unity,CDM,"Um Glucose Tol.,  3 Specs",UM4000300,82951,,Glucose tolerance test (gtt),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.65,% of charge rate,100.00%,71.65,,,,68.07,71.65,0
unity,CDM,"Um Lactose Tol.,5 Specs",UM4000712,82951,,Glucose tolerance test (gtt),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.3,% of charge rate,100.00%,99.3,,,,94.34,99.3,0
unity,CDM,"Um Lactose Tol.,5 Specs",UM4000712,82951,,Glucose tolerance test (gtt),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.3,% of charge rate,100.00%,99.3,,,,94.34,99.3,0
unity,CDM,Um Glu.tol/add Spec. Each,UM4000270,82952,,Gtt-added samples,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.83,% of charge rate,100.00%,21.83,,,,20.74,21.83,0
unity,CDM,Um Glu.tol/add Spec. Each,UM4000270,82952,,Gtt-added samples,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.83,% of charge rate,100.00%,21.83,,,,20.74,21.83,0
unity,CDM,Um G (6) Pd-enzyme Quant,UM4000149,82955,,Assay of g6pd enzyme,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.97,% of charge rate,100.00%,53.97,,,,51.27,53.97,0
unity,CDM,Um G (6) Pd-enzyme Quant,UM4000149,82955,,Assay of g6pd enzyme,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.97,% of charge rate,100.00%,53.97,,,,51.27,53.97,0
unity,CDM,"Um Glucose, Reagent Strip",UM4000057,82962,,Glucose blood test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,10.07,% of charge rate,100.00%,10.07,,,,9.57,10.07,0
unity,CDM,"Um Glucose, Reagent Strip",UM4000057,82962,,Glucose blood test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,10.07,% of charge rate,100.00%,10.07,,,,9.57,10.07,0
unity,CDM,Um Ggt,UM4000040,82977,,Assay of ggt,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.09,% of charge rate,100.00%,40.09,,,,38.09,40.09,0
unity,CDM,Um Ggt,UM4000040,82977,,Assay of ggt,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.09,% of charge rate,100.00%,40.09,,,,38.09,40.09,0
unity,CDM,Um Glutathiome,UM4000905,82978,,Assay of glutathione,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78.56,% of charge rate,100.00%,78.56,,,,74.63,78.56,0
unity,CDM,Um Glutathiome,UM4000905,82978,,Assay of glutathione,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78.56,% of charge rate,100.00%,78.56,,,,74.63,78.56,0
unity,CDM,"Um Folicle Stim Hormone, Fsh",UM4000180,83001,,Assay of gonadotropin (fsh),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,103.45,% of charge rate,100.00%,103.45,,,,98.28,103.45,0
unity,CDM,"Um Folicle Stim Hormone, Fsh",UM4000180,83001,,Assay of gonadotropin (fsh),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,103.45,% of charge rate,100.00%,103.45,,,,98.28,103.45,0
unity,CDM,Um Luteinizing Hormone (lh),UM4000110,83002,,Assay of gonadotropin (lh),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,103.09,% of charge rate,100.00%,103.09,,,,97.94,103.09,0
unity,CDM,Um Luteinizing Hormone (lh),UM4000110,83002,,Assay of gonadotropin (lh),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,103.09,% of charge rate,100.00%,103.09,,,,97.94,103.09,0
unity,CDM,"Um Haptoglobin, Quantitative",UM4000283,83010,,Assay of haptoglobin quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,117.88,% of charge rate,100.00%,117.88,,,,111.99,117.88,0
unity,CDM,"Um Haptoglobin, Quantitative",UM4000283,83010,,Assay of haptoglobin quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,117.88,% of charge rate,100.00%,117.88,,,,111.99,117.88,0
unity,CDM,Um Hgb Electrophoresis Cascade,UM4000709,83020,,Hemoglobin electrophoresis,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,178.41,% of charge rate,100.00%,178.41,,,,169.49,178.41,0
unity,CDM,Um Hgb Electrophoresis Cascade,UM4000709,83020,,Hemoglobin electrophoresis,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,178.41,% of charge rate,100.00%,178.41,,,,169.49,178.41,0
unity,CDM,"Um Fractionated Hgb, Chrom",UM4000229,83021,,Hemoglobin chromotography,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,308.78,% of charge rate,100.00%,308.78,,,,293.34,308.78,0
unity,CDM,"Um Fractionated Hgb, Chrom",UM4000229,83021,,Hemoglobin chromotography,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,308.78,% of charge rate,100.00%,308.78,,,,293.34,308.78,0
unity,CDM,"Um Hgb,glycated (hgb A1c)",UM4000068,83036,,Glycosylated hemoglobin test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.05,% of charge rate,100.00%,54.05,,,,51.35,54.05,0
unity,CDM,"Um Hgb,glycated (hgb A1c)",UM4000068,83036,,Glycosylated hemoglobin test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.05,% of charge rate,100.00%,54.05,,,,51.35,54.05,0
unity,CDM,Um Histamine,UM4000906,83088,,Assay of histamine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,162.7,% of charge rate,100.00%,162.7,,,,154.57,162.7,0
unity,CDM,Um Histamine,UM4000906,83088,,Assay of histamine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,162.7,% of charge rate,100.00%,162.7,,,,154.57,162.7,0
unity,CDM,Um Homocysteine,UM4000177,83090,,Assay of homocystine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93.91,% of charge rate,100.00%,93.91,,,,89.21,93.91,0
unity,CDM,Um Homocysteine,UM4000177,83090,,Assay of homocystine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93.91,% of charge rate,100.00%,93.91,,,,89.21,93.91,0
unity,CDM,Um Hydrocortisteroid,UM4000215,83491,,Assay of corticosteroids 17,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,97.53,% of charge rate,100.00%,97.53,,,,92.65,97.53,0
unity,CDM,Um Hydrocortisteroid,UM4000215,83491,,Assay of corticosteroids 17,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,97.53,% of charge rate,100.00%,97.53,,,,92.65,97.53,0
unity,CDM,Um Hiaa 5,UM4000193,83497,,Assay of 5-hiaa,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.81,% of charge rate,100.00%,71.81,,,,68.22,71.81,0
unity,CDM,Um Hiaa 5,UM4000193,83497,,Assay of 5-hiaa,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.81,% of charge rate,100.00%,71.81,,,,68.22,71.81,0
unity,CDM,"Um Hydroxyprogesterone, 17-d",UM4000042,83498,,Assay of progesterone 17-d,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,151.26,% of charge rate,100.00%,151.26,,,,143.7,151.26,0
unity,CDM,"Um Hydroxyprogesterone, 17-d",UM4000042,83498,,Assay of progesterone 17-d,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,151.26,% of charge rate,100.00%,151.26,,,,143.7,151.26,0
unity,CDM,Um M2(mitochondvial Ab)(ama),UM4000486,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um M2(mitochondvial Ab)(ama),UM4000486,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um Mpo (myeloperoxidase),UM4000487,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,103.17,% of charge rate,100.00%,103.17,,,,98.01,103.17,0
unity,CDM,Um Mpo (myeloperoxidase),UM4000487,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,103.17,% of charge rate,100.00%,103.17,,,,98.01,103.17,0
unity,CDM,Um Pr3 (proteinase 3 Ab),UM4000491,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,95.63,% of charge rate,100.00%,95.63,,,,90.85,95.63,0
unity,CDM,Um Pr3 (proteinase 3 Ab),UM4000491,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,95.63,% of charge rate,100.00%,95.63,,,,90.85,95.63,0
unity,CDM,Um Srp(signal Recog Particle,UM4000495,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110.04,% of charge rate,100.00%,110.04,,,,104.54,110.04,0
unity,CDM,Um Srp(signal Recog Particle,UM4000495,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110.04,% of charge rate,100.00%,110.04,,,,104.54,110.04,0
unity,CDM,Um Ttg(tissue Transglutamase,UM4000496,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.86,% of charge rate,100.00%,66.86,,,,63.52,66.86,0
unity,CDM,Um Ttg(tissue Transglutamase,UM4000496,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.86,% of charge rate,100.00%,66.86,,,,63.52,66.86,0
unity,CDM,"Um Gliadin Ab, Iga",UM4000510,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,"Um Gliadin Ab, Iga",UM4000510,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um Histone Abs,UM4000516,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um Histone Abs,UM4000516,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um Ribosomal P Antibody,UM4000908,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,63.52,% of charge rate,100.00%,63.52,,,,60.34,63.52,0
unity,CDM,Um Ribosomal P Antibody,UM4000908,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,63.52,% of charge rate,100.00%,63.52,,,,60.34,63.52,0
unity,CDM,Um Bullous Pemphigoid Igg Antibody,UM4000930,83516,,Immunoassay nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.86,% of charge rate,100.00%,66.86,,,,63.52,66.86,0
unity,CDM,Um Bullous Pemphigoid Igg Antibody,UM4000930,83516,,Immunoassay nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.86,% of charge rate,100.00%,66.86,,,,63.52,66.86,0
unity,CDM,Um Pth Related Protein,UM4000103,83519,,Ria nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,214.74,% of charge rate,100.00%,214.74,,,,204,214.74,0
unity,CDM,Um Pth Related Protein,UM4000103,83519,,Ria nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,214.74,% of charge rate,100.00%,214.74,,,,204,214.74,0
unity,CDM,Um Acetylchol Rec Bind Ab,UM4000408,83519,,Ria nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,230.48,% of charge rate,100.00%,230.48,,,,218.96,230.48,0
unity,CDM,Um Acetylchol Rec Bind Ab,UM4000408,83519,,Ria nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,230.48,% of charge rate,100.00%,230.48,,,,218.96,230.48,0
unity,CDM,Um Gad 65 A6,UM4000555,83519,,Ria nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,243.33,% of charge rate,100.00%,243.33,,,,231.16,243.33,0
unity,CDM,Um Gad 65 A6,UM4000555,83519,,Ria nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,243.33,% of charge rate,100.00%,243.33,,,,231.16,243.33,0
unity,CDM,"Um Igf I,binding Protein",UM4000726,83519,,Ria nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,166.71,% of charge rate,100.00%,166.71,,,,158.37,166.71,0
unity,CDM,"Um Igf I,binding Protein",UM4000726,83519,,Ria nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,166.71,% of charge rate,100.00%,166.71,,,,158.37,166.71,0
unity,CDM,Um Ria Nonantibody,UM4000790,83519,,Ria nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.07,% of charge rate,100.00%,45.07,,,,42.82,45.07,0
unity,CDM,Um Ria Nonantibody,UM4000790,83519,,Ria nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.07,% of charge rate,100.00%,45.07,,,,42.82,45.07,0
unity,CDM,Um Tsh Receptor Binding Antibody,UM4000873,83519,,Ria nonantibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,46.92,% of charge rate,100.00%,46.92,,,,44.57,46.92,0
unity,CDM,Um Tsh Receptor Binding Antibody,UM4000873,83519,,Ria nonantibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,46.92,% of charge rate,100.00%,46.92,,,,44.57,46.92,0
unity,CDM,"Um Immunoassay, Unspec",UM4000296,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,"Um Immunoassay, Unspec",UM4000296,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Anti Gbm,UM4000449,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,173.31,% of charge rate,100.00%,173.31,,,,164.64,173.31,0
unity,CDM,Um Anti Gbm,UM4000449,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,173.31,% of charge rate,100.00%,173.31,,,,164.64,173.31,0
unity,CDM,Um Centromere Ab (cma),UM4000506,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um Centromere Ab (cma),UM4000506,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.23,% of charge rate,100.00%,64.23,,,,61.02,64.23,0
unity,CDM,Um Phosphatidylethanolamine,UM4000523,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,103.17,% of charge rate,100.00%,103.17,,,,98.01,103.17,0
unity,CDM,Um Phosphatidylethanolamine,UM4000523,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,103.17,% of charge rate,100.00%,103.17,,,,98.01,103.17,0
unity,CDM,"Um Ribosomal Ab,igg",UM4000700,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,108.6,% of charge rate,100.00%,108.6,,,,103.17,108.6,0
unity,CDM,"Um Ribosomal Ab,igg",UM4000700,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,108.6,% of charge rate,100.00%,108.6,,,,103.17,108.6,0
unity,CDM,Um Anti-mullerian Hormone,UM4000748,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Anti-mullerian Hormone,UM4000748,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Kappa/lambda Free Light Chain,UM4000914,83520,,Immunoassay quant nos nonab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,Um Kappa/lambda Free Light Chain,UM4000914,83520,,Immunoassay quant nos nonab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.64,% of charge rate,100.00%,85.64,,,,81.36,85.64,0
unity,CDM,"Um Insulin Assay, Total",UM4000328,83525,,Assay of insulin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,63.63,% of charge rate,100.00%,63.63,,,,60.45,63.63,0
unity,CDM,"Um Insulin Assay, Total",UM4000328,83525,,Assay of insulin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,63.63,% of charge rate,100.00%,63.63,,,,60.45,63.63,0
unity,CDM,Um Insulin Assay,UM4000175,83527,,Assay of insulin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Insulin Assay,UM4000175,83527,,Assay of insulin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Iron,UM4000147,83540,,Assay of iron,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.08,% of charge rate,100.00%,36.08,,,,34.28,36.08,0
unity,CDM,Um Iron,UM4000147,83540,,Assay of iron,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.08,% of charge rate,100.00%,36.08,,,,34.28,36.08,0
unity,CDM,Um Iron Binding (ibc),UM4000254,83550,,Iron binding test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.66,% of charge rate,100.00%,48.66,,,,46.23,48.66,0
unity,CDM,Um Iron Binding (ibc),UM4000254,83550,,Iron binding test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.66,% of charge rate,100.00%,48.66,,,,46.23,48.66,0
unity,CDM,Um Lactic Acid,UM4000433,83605,,Assay of lactic acid,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.28,% of charge rate,100.00%,58.28,,,,55.37,58.28,0
unity,CDM,Um Lactic Acid,UM4000433,83605,,Assay of lactic acid,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.28,% of charge rate,100.00%,58.28,,,,55.37,58.28,0
unity,CDM,Um Ldh,UM4000056,83615,,Lactate (ld) (ldh) enzyme,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.61,% of charge rate,100.00%,33.61,,,,31.93,33.61,0
unity,CDM,Um Ldh,UM4000056,83615,,Lactate (ld) (ldh) enzyme,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.61,% of charge rate,100.00%,33.61,,,,31.93,33.61,0
unity,CDM,Um Lactoferrin (stool Wbgs),UM4000571,83630,,Lactoferrin fecal (qual),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,109.28,% of charge rate,100.00%,109.28,,,,103.82,109.28,0
unity,CDM,Um Lactoferrin (stool Wbgs),UM4000571,83630,,Lactoferrin fecal (qual),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,109.28,% of charge rate,100.00%,109.28,,,,103.82,109.28,0
unity,CDM,Um Lead,UM4000099,83655,,Assay of lead,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.44,% of charge rate,100.00%,99.44,,,,94.47,99.44,0
unity,CDM,Um Lead,UM4000099,83655,,Assay of lead,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.44,% of charge rate,100.00%,99.44,,,,94.47,99.44,0
unity,CDM,Um Lipase,UM4000267,83690,,Assay of lipase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.36,% of charge rate,100.00%,38.36,,,,36.44,38.36,0
unity,CDM,Um Lipase,UM4000267,83690,,Assay of lipase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.36,% of charge rate,100.00%,38.36,,,,36.44,38.36,0
unity,CDM,Um Hdl Cholesteral,UM4000271,83718,,Assay of lipoprotein,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.92,% of charge rate,100.00%,38.92,,,,36.97,38.92,0
unity,CDM,Um Hdl Cholesteral,UM4000271,83718,,Assay of lipoprotein,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.92,% of charge rate,100.00%,38.92,,,,36.97,38.92,0
unity,CDM,Um Ldl Cholesterol Direct,UM4000340,83721,,Assay of blood lipoprotein,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.1,% of charge rate,100.00%,53.1,,,,50.45,53.1,0
unity,CDM,Um Ldl Cholesterol Direct,UM4000340,83721,,Assay of blood lipoprotein,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.1,% of charge rate,100.00%,53.1,,,,50.45,53.1,0
unity,CDM,Um Magnesium,UM4000181,83735,,Assay of magnesium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.31,% of charge rate,100.00%,37.31,,,,35.44,37.31,0
unity,CDM,Um Magnesium,UM4000181,83735,,Assay of magnesium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.31,% of charge rate,100.00%,37.31,,,,35.44,37.31,0
unity,CDM,"Um Magnesium,24 Hr Urine",UM4000729,83735,,Assay of magnesium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.31,% of charge rate,100.00%,37.31,,,,35.44,37.31,0
unity,CDM,"Um Magnesium,24 Hr Urine",UM4000729,83735,,Assay of magnesium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.31,% of charge rate,100.00%,37.31,,,,35.44,37.31,0
unity,CDM,"Um Magnesium, Random Urine",UM4000903,83735,,Assay of magnesium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.31,% of charge rate,100.00%,37.31,,,,35.44,37.31,0
unity,CDM,"Um Magnesium, Random Urine",UM4000903,83735,,Assay of magnesium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.31,% of charge rate,100.00%,37.31,,,,35.44,37.31,0
unity,CDM,Um Clomipramine/anafranil,UM4000450,83789,,Mass spectrometry qual/quan,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,157.88,% of charge rate,100.00%,157.88,,,,149.99,157.88,0
unity,CDM,Um Clomipramine/anafranil,UM4000450,83789,,Mass spectrometry qual/quan,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,157.88,% of charge rate,100.00%,157.88,,,,149.99,157.88,0
unity,CDM,Um Tpmt Activity,UM4000742,83789,,Mass spectrometry qual/quan,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,457.65,% of charge rate,100.00%,457.65,,,,434.77,457.65,0
unity,CDM,Um Tpmt Activity,UM4000742,83789,,Mass spectrometry qual/quan,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,457.65,% of charge rate,100.00%,457.65,,,,434.77,457.65,0
unity,CDM,"Um Mercury, Blood",UM4000310,83825,,Assay of mercury,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,141.98,% of charge rate,100.00%,141.98,,,,134.88,141.98,0
unity,CDM,"Um Mercury, Blood",UM4000310,83825,,Assay of mercury,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,141.98,% of charge rate,100.00%,141.98,,,,134.88,141.98,0
unity,CDM,"Um Metanephrines, Plasma",UM4000047,83835,,Assay of metanephrines,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.36,% of charge rate,100.00%,94.36,,,,89.64,94.36,0
unity,CDM,"Um Metanephrines, Plasma",UM4000047,83835,,Assay of metanephrines,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.36,% of charge rate,100.00%,94.36,,,,89.64,94.36,0
unity,CDM,"Um Metanephrines, 24hr Urine",UM4000425,83835,,Assay of metanephrines,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,95.24,% of charge rate,100.00%,95.24,,,,90.48,95.24,0
unity,CDM,"Um Metanephrines, 24hr Urine",UM4000425,83835,,Assay of metanephrines,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,95.24,% of charge rate,100.00%,95.24,,,,90.48,95.24,0
unity,CDM,"Um Metanephrines, Ua Random",UM4000426,83835,,Assay of metanephrines,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,95.24,% of charge rate,100.00%,95.24,,,,90.48,95.24,0
unity,CDM,"Um Metanephrines, Ua Random",UM4000426,83835,,Assay of metanephrines,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,95.24,% of charge rate,100.00%,95.24,,,,90.48,95.24,0
unity,CDM,Um Mucin Synovial Fluid,UM4000355,83872,,Assay synovial fluid mucin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.64,% of charge rate,100.00%,32.64,,,,31.01,32.64,0
unity,CDM,Um Mucin Synovial Fluid,UM4000355,83872,,Assay synovial fluid mucin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.64,% of charge rate,100.00%,32.64,,,,31.01,32.64,0
unity,CDM,"Um Myoglobin, Serum",UM4000170,83874,,Assay of myoglobin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,197.94,% of charge rate,100.00%,197.94,,,,188.04,197.94,0
unity,CDM,"Um Myoglobin, Serum",UM4000170,83874,,Assay of myoglobin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,197.94,% of charge rate,100.00%,197.94,,,,188.04,197.94,0
unity,CDM,"Um Myoglobin, Urine",UM4000422,83874,,Assay of myoglobin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91.68,% of charge rate,100.00%,91.68,,,,87.1,91.68,0
unity,CDM,"Um Myoglobin, Urine",UM4000422,83874,,Assay of myoglobin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91.68,% of charge rate,100.00%,91.68,,,,87.1,91.68,0
unity,CDM,Um Bnp(natriuretic Peptide),UM4000165,83880,,Assay of natriuretic peptide,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,189.01,% of charge rate,100.00%,189.01,,,,179.56,189.01,0
unity,CDM,Um Bnp(natriuretic Peptide),UM4000165,83880,,Assay of natriuretic peptide,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,189.01,% of charge rate,100.00%,189.01,,,,179.56,189.01,0
unity,CDM,Um Kappa/lamda-light Chains,UM4000556,83883,,Assay nephelometry not spec,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,61.59,% of charge rate,100.00%,61.59,,,,58.51,61.59,0
unity,CDM,Um Kappa/lamda-light Chains,UM4000556,83883,,Assay nephelometry not spec,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,61.59,% of charge rate,100.00%,61.59,,,,58.51,61.59,0
unity,CDM,Um C1 Esterase Inhibitor Antigen,UM4000809,83883,,Assay nephelometry not spec,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,61.66,% of charge rate,100.00%,61.66,,,,58.58,61.66,0
unity,CDM,Um C1 Esterase Inhibitor Antigen,UM4000809,83883,,Assay nephelometry not spec,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,61.66,% of charge rate,100.00%,61.66,,,,58.58,61.66,0
unity,CDM,"Um Nephelometry, Alpha-2 Macroglobulin",UM4000818,83883,,Assay nephelometry not spec,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,138.16,% of charge rate,100.00%,138.16,,,,131.25,138.16,0
unity,CDM,"Um Nephelometry, Alpha-2 Macroglobulin",UM4000818,83883,,Assay nephelometry not spec,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,138.16,% of charge rate,100.00%,138.16,,,,131.25,138.16,0
unity,CDM,"Um Mol Diag., Amplif, Target",UM4000392,83900,,LH MOLECULE NUCLEIC AMPLIFICATION 2 SEQUENC,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,176.66,% of charge rate,100.00%,176.66,,,,167.83,176.66,0
unity,CDM,"Um Mol Diag., Amplif, Target",UM4000392,83900,,LH MOLECULE NUCLEIC AMPLIFICATION 2 SEQUENC,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,176.66,% of charge rate,100.00%,176.66,,,,167.83,176.66,0
unity,CDM,Um Nucleotidase-5,UM4000208,83915,,Assay of nucleotidase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.11,% of charge rate,100.00%,62.11,,,,59,62.11,0
unity,CDM,Um Nucleotidase-5,UM4000208,83915,,Assay of nucleotidase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.11,% of charge rate,100.00%,62.11,,,,59,62.11,0
unity,CDM,Um 5 Nucleotidase,UM4000800,83915,,Assay of nucleotidase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.15,% of charge rate,100.00%,62.15,,,,59.04,62.15,0
unity,CDM,Um 5 Nucleotidase,UM4000800,83915,,Assay of nucleotidase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.15,% of charge rate,100.00%,62.15,,,,59.04,62.15,0
unity,CDM,"Um Organic Acids, Total, Ea",UM4000317,83918,,Organic acids total quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,499.66,% of charge rate,100.00%,499.66,,,,474.68,499.66,0
unity,CDM,"Um Organic Acids, Total, Ea",UM4000317,83918,,Organic acids total quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,499.66,% of charge rate,100.00%,499.66,,,,474.68,499.66,0
unity,CDM,"Um Organic Acids, Qualitativ",UM4000557,83919,,Organic acids qual each,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,492.06,% of charge rate,100.00%,492.06,,,,467.46,492.06,0
unity,CDM,"Um Organic Acids, Qualitativ",UM4000557,83919,,Organic acids qual each,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,492.06,% of charge rate,100.00%,492.06,,,,467.46,492.06,0
unity,CDM,Um Methylmalonic Acid,UM4000305,83921,,Organic acid single quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91.62,% of charge rate,100.00%,91.62,,,,87.04,91.62,0
unity,CDM,Um Methylmalonic Acid,UM4000305,83921,,Organic acid single quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91.62,% of charge rate,100.00%,91.62,,,,87.04,91.62,0
unity,CDM,Um Osmolality  Serum,UM4000134,83930,,Assay of blood osmolality,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.79,% of charge rate,100.00%,36.79,,,,34.95,36.79,0
unity,CDM,Um Osmolality  Serum,UM4000134,83930,,Assay of blood osmolality,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.79,% of charge rate,100.00%,36.79,,,,34.95,36.79,0
unity,CDM,Um Osmolality-urine,UM4000003,83935,,Assay of urine osmolality,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.93,% of charge rate,100.00%,37.93,,,,36.03,37.93,0
unity,CDM,Um Osmolality-urine,UM4000003,83935,,Assay of urine osmolality,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.93,% of charge rate,100.00%,37.93,,,,36.03,37.93,0
unity,CDM,Um Oxalate - Urine,UM4000076,83945,,Assay of oxalate,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.65,% of charge rate,100.00%,71.65,,,,68.07,71.65,0
unity,CDM,Um Oxalate - Urine,UM4000076,83945,,Assay of oxalate,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.65,% of charge rate,100.00%,71.65,,,,68.07,71.65,0
unity,CDM,Um Her 2,UM4000550,83950,,Oncoprotein her-2/neu,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,358.63,% of charge rate,100.00%,358.63,,,,340.7,358.63,0
unity,CDM,Um Her 2,UM4000550,83950,,Oncoprotein her-2/neu,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,358.63,% of charge rate,100.00%,358.63,,,,340.7,358.63,0
unity,CDM,Um Pth-intact,UM4000166,83970,,Assay of parathormone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,229.79,% of charge rate,100.00%,229.79,,,,218.3,229.79,0
unity,CDM,Um Pth-intact,UM4000166,83970,,Assay of parathormone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,229.79,% of charge rate,100.00%,229.79,,,,218.3,229.79,0
unity,CDM,Um Body Fluid Acid Assay,UM4000357,83986,,Assay ph body fluid nos,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,19.93,% of charge rate,100.00%,19.93,,,,18.93,19.93,0
unity,CDM,Um Body Fluid Acid Assay,UM4000357,83986,,Assay ph body fluid nos,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,19.93,% of charge rate,100.00%,19.93,,,,18.93,19.93,0
unity,CDM,"Um Phencyclide, Urine, Conf",UM4000921,83992,,Assay for phencyclidine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.55,% of charge rate,100.00%,80.55,,,,76.52,80.55,0
unity,CDM,"Um Phencyclide, Urine, Conf",UM4000921,83992,,Assay for phencyclidine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.55,% of charge rate,100.00%,80.55,,,,76.52,80.55,0
unity,CDM,"Um Calprotectin, Feces",UM4000797,83993,,Assay for calprotectin fecal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,109.33,% of charge rate,100.00%,109.33,,,,103.86,109.33,0
unity,CDM,"Um Calprotectin, Feces",UM4000797,83993,,Assay for calprotectin fecal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,109.33,% of charge rate,100.00%,109.33,,,,103.86,109.33,0
unity,CDM,Um Pku Neonatal,UM4000030,84030,,Assay of blood pku,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90.52,% of charge rate,100.00%,90.52,,,,85.99,90.52,0
unity,CDM,Um Pku Neonatal,UM4000030,84030,,Assay of blood pku,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90.52,% of charge rate,100.00%,90.52,,,,85.99,90.52,0
unity,CDM,Um Alkaline Phosphatase,UM4000161,84075,,Assay alkaline phosphatase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Alkaline Phosphatase,UM4000161,84075,,Assay alkaline phosphatase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Alp Isoenzymes,UM4000258,84080,,Assay alkaline phosphatases,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,82.35,% of charge rate,100.00%,82.35,,,,78.23,82.35,0
unity,CDM,Um Alp Isoenzymes,UM4000258,84080,,Assay alkaline phosphatases,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,82.35,% of charge rate,100.00%,82.35,,,,78.23,82.35,0
unity,CDM,Um Bone Alkaline Phosphatase,UM4000834,84080,,Assay alkaline phosphatases,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.72,% of charge rate,100.00%,85.72,,,,81.43,85.72,0
unity,CDM,Um Bone Alkaline Phosphatase,UM4000834,84080,,Assay alkaline phosphatases,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.72,% of charge rate,100.00%,85.72,,,,81.43,85.72,0
unity,CDM,Um Phosphorus,UM4000233,84100,,Assay of phosphorus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.42,% of charge rate,100.00%,26.42,,,,25.1,26.42,0
unity,CDM,Um Phosphorus,UM4000233,84100,,Assay of phosphorus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.42,% of charge rate,100.00%,26.42,,,,25.1,26.42,0
unity,CDM,Um Phosphorus Urine,UM4000011,84105,,Assay of urine phosphorus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Phosphorus Urine,UM4000011,84105,,Assay of urine phosphorus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,"Um Porphrins Ua, Quant",UM4000218,84120,,Assay of urine porphyrins,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,149.5,% of charge rate,100.00%,149.5,,,,142.03,149.5,0
unity,CDM,"Um Porphrins Ua, Quant",UM4000218,84120,,Assay of urine porphyrins,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,149.5,% of charge rate,100.00%,149.5,,,,142.03,149.5,0
unity,CDM,Um Potassium,UM4000050,84132,,Assay of serum potassium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.59,% of charge rate,100.00%,25.59,,,,24.31,25.59,0
unity,CDM,Um Potassium,UM4000050,84132,,Assay of serum potassium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.59,% of charge rate,100.00%,25.59,,,,24.31,25.59,0
unity,CDM,"Um Potassium, Urine",UM4000131,84133,,Assay of urine potassium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.94,% of charge rate,100.00%,23.94,,,,22.74,23.94,0
unity,CDM,"Um Potassium, Urine",UM4000131,84133,,Assay of urine potassium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.94,% of charge rate,100.00%,23.94,,,,22.74,23.94,0
unity,CDM,Um Prealbumin,UM4000311,84134,,Assay of prealbumin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,109.57,% of charge rate,100.00%,109.57,,,,104.09,109.57,0
unity,CDM,Um Prealbumin,UM4000311,84134,,Assay of prealbumin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,109.57,% of charge rate,100.00%,109.57,,,,104.09,109.57,0
unity,CDM,Um Progesterone,UM4000313,84144,,Assay of progesterone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.15,% of charge rate,100.00%,116.15,,,,110.34,116.15,0
unity,CDM,Um Progesterone,UM4000313,84144,,Assay of progesterone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.15,% of charge rate,100.00%,116.15,,,,110.34,116.15,0
unity,CDM,Um Procalcitonin,UM4000943,84145,,Procalcitonin (pct),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,150.18,% of charge rate,100.00%,150.18,,,,142.67,150.18,0
unity,CDM,Um Procalcitonin,UM4000943,84145,,Procalcitonin (pct),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,150.18,% of charge rate,100.00%,150.18,,,,142.67,150.18,0
unity,CDM,Um Prolactin,UM4000224,84146,,Assay of prolactin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,107.9,% of charge rate,100.00%,107.9,,,,102.51,107.9,0
unity,CDM,Um Prolactin,UM4000224,84146,,Assay of prolactin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,107.9,% of charge rate,100.00%,107.9,,,,102.51,107.9,0
unity,CDM,Um Psa,UM4000023,84153,,Assay of psa total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,102.44,% of charge rate,100.00%,102.44,,,,97.32,102.44,0
unity,CDM,Um Psa,UM4000023,84153,,Assay of psa total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,102.44,% of charge rate,100.00%,102.44,,,,97.32,102.44,0
unity,CDM,"Um Psa,free",UM4000084,84154,,Assay of psa free,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,102.44,% of charge rate,100.00%,102.44,,,,97.32,102.44,0
unity,CDM,"Um Psa,free",UM4000084,84154,,Assay of psa free,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,102.44,% of charge rate,100.00%,102.44,,,,97.32,102.44,0
unity,CDM,Um Protein Total,UM4000385,84155,,Assay of protein serum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.41,% of charge rate,100.00%,20.41,,,,19.39,20.41,0
unity,CDM,Um Protein Total,UM4000385,84155,,Assay of protein serum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.41,% of charge rate,100.00%,20.41,,,,19.39,20.41,0
unity,CDM,"Um Protein, Total, Urine",UM4000321,84156,,Assay of protein urine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.01,% of charge rate,100.00%,20.01,,,,19.01,20.01,0
unity,CDM,"Um Protein, Total, Urine",UM4000321,84156,,Assay of protein urine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.01,% of charge rate,100.00%,20.01,,,,19.01,20.01,0
unity,CDM,"Um Protein,total; Other Fluid",UM4000890,84157,,Assay of protein other,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.25,% of charge rate,100.00%,21.25,,,,20.19,21.25,0
unity,CDM,"Um Protein,total; Other Fluid",UM4000890,84157,,Assay of protein other,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.25,% of charge rate,100.00%,21.25,,,,20.19,21.25,0
unity,CDM,Um Protein E-phoresis-serum,UM4000052,84165,,Protein e-phoresis serum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,59.8,% of charge rate,100.00%,59.8,,,,56.81,59.8,0
unity,CDM,Um Protein E-phoresis-serum,UM4000052,84165,,Protein e-phoresis serum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,59.8,% of charge rate,100.00%,59.8,,,,56.81,59.8,0
unity,CDM,"Um Protein E-phoresis, Urine",UM4000244,84166,,Protein e-phoresis/urine/csf,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.33,% of charge rate,100.00%,99.33,,,,94.36,99.33,0
unity,CDM,"Um Protein E-phoresis, Urine",UM4000244,84166,,Protein e-phoresis/urine/csf,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.33,% of charge rate,100.00%,99.33,,,,94.36,99.33,0
unity,CDM,Um Vitamin B6/pyridoxal Phos,UM4000454,84207,,Assay of vitamin b-6,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,289.47,% of charge rate,100.00%,289.47,,,,275,289.47,0
unity,CDM,Um Vitamin B6/pyridoxal Phos,UM4000454,84207,,Assay of vitamin b-6,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,289.47,% of charge rate,100.00%,289.47,,,,275,289.47,0
unity,CDM,Um Pyridocal 5-phosphate,UM4000820,84207,,Assay of vitamin b-6,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,156.54,% of charge rate,100.00%,156.54,,,,148.71,156.54,0
unity,CDM,Um Pyridocal 5-phosphate,UM4000820,84207,,Assay of vitamin b-6,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,156.54,% of charge rate,100.00%,156.54,,,,148.71,156.54,0
unity,CDM,Um Pyruvic Acid,UM4000937,84210,,Assay of pyruvate,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,130.03,% of charge rate,100.00%,130.03,,,,123.53,130.03,0
unity,CDM,Um Pyruvic Acid,UM4000937,84210,,Assay of pyruvate,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,130.03,% of charge rate,100.00%,130.03,,,,123.53,130.03,0
unity,CDM,Um Acetylcholine Receptor Ab,UM4000297,84238,,Assay nonendocrine receptor,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,203.58,% of charge rate,100.00%,203.58,,,,193.4,203.58,0
unity,CDM,Um Acetylcholine Receptor Ab,UM4000297,84238,,Assay nonendocrine receptor,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,203.58,% of charge rate,100.00%,203.58,,,,193.4,203.58,0
unity,CDM,"Um Receptor Assay,soluble Transferrin",UM4000730,84238,,Assay nonendocrine receptor,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,203.58,% of charge rate,100.00%,203.58,,,,193.4,203.58,0
unity,CDM,"Um Receptor Assay,soluble Transferrin",UM4000730,84238,,Assay nonendocrine receptor,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,203.58,% of charge rate,100.00%,203.58,,,,193.4,203.58,0
unity,CDM,Um Renin,UM4000098,84244,,Assay of renin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,166.67,% of charge rate,100.00%,166.67,,,,158.34,166.67,0
unity,CDM,Um Renin,UM4000098,84244,,Assay of renin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,166.67,% of charge rate,100.00%,166.67,,,,158.34,166.67,0
unity,CDM,Um Vitamin B2/riboflavin,UM4000453,84252,,Assay of vitamin b-2,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,232.27,% of charge rate,100.00%,232.27,,,,220.66,232.27,0
unity,CDM,Um Vitamin B2/riboflavin,UM4000453,84252,,Assay of vitamin b-2,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,232.27,% of charge rate,100.00%,232.27,,,,220.66,232.27,0
unity,CDM,Um Selenium Assay,UM4000324,84255,,Assay of selenium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,142.15,% of charge rate,100.00%,142.15,,,,135.04,142.15,0
unity,CDM,Um Selenium Assay,UM4000324,84255,,Assay of selenium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,142.15,% of charge rate,100.00%,142.15,,,,135.04,142.15,0
unity,CDM,Um Sex Hormone Binding Globulin,UM4000889,84270,,Assay of sex hormone globul,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125.98,% of charge rate,100.00%,125.98,,,,119.68,125.98,0
unity,CDM,Um Sex Hormone Binding Globulin,UM4000889,84270,,Assay of sex hormone globul,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125.98,% of charge rate,100.00%,125.98,,,,119.68,125.98,0
unity,CDM,Um Sodium; Serum,UM4000079,84295,,Assay of serum sodium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.82,% of charge rate,100.00%,26.82,,,,25.48,26.82,0
unity,CDM,Um Sodium; Serum,UM4000079,84295,,Assay of serum sodium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.82,% of charge rate,100.00%,26.82,,,,25.48,26.82,0
unity,CDM,"Um Sodium, Urine",UM4000154,84300,,Assay of urine sodium,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.06,% of charge rate,100.00%,27.06,,,,25.71,27.06,0
unity,CDM,"Um Sodium, Urine",UM4000154,84300,,Assay of urine sodium,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.06,% of charge rate,100.00%,27.06,,,,25.71,27.06,0
unity,CDM,"Um Pyrroles, Urine",UM4000762,84311,,Spectrophotometry,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112.7,% of charge rate,100.00%,112.7,,,,107.07,112.7,0
unity,CDM,"Um Pyrroles, Urine",UM4000762,84311,,Spectrophotometry,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112.7,% of charge rate,100.00%,112.7,,,,107.07,112.7,0
unity,CDM,Um Sp. Gravity Body Fluid,UM4000365,84315,,Body fluid specific gravity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.94,% of charge rate,100.00%,13.94,,,,13.24,13.94,0
unity,CDM,Um Sp. Gravity Body Fluid,UM4000365,84315,,Body fluid specific gravity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.94,% of charge rate,100.00%,13.94,,,,13.24,13.94,0
unity,CDM,"Um Reducing Substance, Stool",UM4000173,84377,,Sugars multiple qual,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.55,% of charge rate,100.00%,76.55,,,,72.72,76.55,0
unity,CDM,"Um Reducing Substance, Stool",UM4000173,84377,,Sugars multiple qual,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.55,% of charge rate,100.00%,76.55,,,,72.72,76.55,0
unity,CDM,Um Urine Sulfate,UM4000839,84392,,Assay of urine sulfate,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.52,% of charge rate,100.00%,27.52,,,,26.14,27.52,0
unity,CDM,Um Urine Sulfate,UM4000839,84392,,Assay of urine sulfate,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.52,% of charge rate,100.00%,27.52,,,,26.14,27.52,0
unity,CDM,"Um Testosterone, Free",UM4000199,84402,,Assay of free testosterone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,141.8,% of charge rate,100.00%,141.8,,,,134.71,141.8,0
unity,CDM,"Um Testosterone, Free",UM4000199,84402,,Assay of free testosterone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,141.8,% of charge rate,100.00%,141.8,,,,134.71,141.8,0
unity,CDM,"Um Testosterone, Total",UM4000164,84403,,Assay of total testosterone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,143.76,% of charge rate,100.00%,143.76,,,,136.57,143.76,0
unity,CDM,"Um Testosterone, Total",UM4000164,84403,,Assay of total testosterone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,143.76,% of charge rate,100.00%,143.76,,,,136.57,143.76,0
unity,CDM,"Um Vit B-1/thiamine,plasma",UM4000369,84425,,Assay of vitamin b-1,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,176.67,% of charge rate,100.00%,176.67,,,,167.84,176.67,0
unity,CDM,"Um Vit B-1/thiamine,plasma",UM4000369,84425,,Assay of vitamin b-1,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,176.67,% of charge rate,100.00%,176.67,,,,167.84,176.67,0
unity,CDM,Um Thyroglobulin,UM4000186,84432,,Assay of thyroglobulin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,89.48,% of charge rate,100.00%,89.48,,,,85.01,89.48,0
unity,CDM,Um Thyroglobulin,UM4000186,84432,,Assay of thyroglobulin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,89.48,% of charge rate,100.00%,89.48,,,,85.01,89.48,0
unity,CDM,Um T 4 Total/thyroxine,UM4000111,84436,,Assay of total thyroxine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.24,% of charge rate,100.00%,38.24,,,,36.33,38.24,0
unity,CDM,Um T 4 Total/thyroxine,UM4000111,84436,,Assay of total thyroxine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.24,% of charge rate,100.00%,38.24,,,,36.33,38.24,0
unity,CDM,Um T4 Neonatal,UM4000210,84437,,Assay of neonatal thyroxine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.35,% of charge rate,100.00%,31.35,,,,29.78,31.35,0
unity,CDM,Um T4 Neonatal,UM4000210,84437,,Assay of neonatal thyroxine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.35,% of charge rate,100.00%,31.35,,,,29.78,31.35,0
unity,CDM,"Um T4/throxin, Free",UM4000255,84439,,Assay of free thyroxine,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.08,% of charge rate,100.00%,45.08,,,,42.83,45.08,0
unity,CDM,"Um T4/throxin, Free",UM4000255,84439,,Assay of free thyroxine,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.08,% of charge rate,100.00%,45.08,,,,42.83,45.08,0
unity,CDM,Um Tsh,UM4000123,84443,,Assay thyroid stim hormone,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93.55,% of charge rate,100.00%,93.55,,,,88.87,93.55,0
unity,CDM,Um Tsh,UM4000123,84443,,Assay thyroid stim hormone,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93.55,% of charge rate,100.00%,93.55,,,,88.87,93.55,0
unity,CDM,Um Thyroid Stimulating Ig B,UM4000038,84445,,Assay of tsi globulin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,283.12,% of charge rate,100.00%,283.12,,,,268.96,283.12,0
unity,CDM,Um Thyroid Stimulating Ig B,UM4000038,84445,,Assay of tsi globulin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,283.12,% of charge rate,100.00%,283.12,,,,268.96,283.12,0
unity,CDM,Um Vitamin E,UM4000108,84446,,Assay of vitamin e,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.2,% of charge rate,100.00%,94.2,,,,89.49,94.2,0
unity,CDM,Um Vitamin E,UM4000108,84446,,Assay of vitamin e,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.2,% of charge rate,100.00%,94.2,,,,89.49,94.2,0
unity,CDM,Um Ast,UM4000014,84450,,Transferase (ast) (sgot),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Ast,UM4000014,84450,,Transferase (ast) (sgot),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Alt,UM4000026,84460,,Alanine amino (alt) (sgpt),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.5,% of charge rate,100.00%,29.5,,,,28.03,29.5,0
unity,CDM,Um Alt,UM4000026,84460,,Alanine amino (alt) (sgpt),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.5,% of charge rate,100.00%,29.5,,,,28.03,29.5,0
unity,CDM,Um Tranferrin,UM4000037,84466,,Assay of transferrin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.09,% of charge rate,100.00%,71.09,,,,67.54,71.09,0
unity,CDM,Um Tranferrin,UM4000037,84466,,Assay of transferrin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.09,% of charge rate,100.00%,71.09,,,,67.54,71.09,0
unity,CDM,Um Triglycerides,UM4000069,84478,,Assay of triglycerides,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.03,% of charge rate,100.00%,32.03,,,,30.43,32.03,0
unity,CDM,Um Triglycerides,UM4000069,84478,,Assay of triglycerides,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.03,% of charge rate,100.00%,32.03,,,,30.43,32.03,0
unity,CDM,Um T3  Or T4 Uptake,UM4000273,84479,,Assay of thyroid (t3 or t4),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,Um T3  Or T4 Uptake,UM4000273,84479,,Assay of thyroid (t3 or t4),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,"Um T3, Total",UM4000124,84480,,Assay triiodothyronine (t3),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78.94,% of charge rate,100.00%,78.94,,,,74.99,78.94,0
unity,CDM,"Um T3, Total",UM4000124,84480,,Assay triiodothyronine (t3),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78.94,% of charge rate,100.00%,78.94,,,,74.99,78.94,0
unity,CDM,Um T3 Free,UM4000282,84481,,Free assay (ft-3),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.36,% of charge rate,100.00%,94.36,,,,89.64,94.36,0
unity,CDM,Um T3 Free,UM4000282,84481,,Free assay (ft-3),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.36,% of charge rate,100.00%,94.36,,,,89.64,94.36,0
unity,CDM,Um T3-reverse Assay,UM4000214,84482,,T3 reverse,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,278.33,% of charge rate,100.00%,278.33,,,,264.41,278.33,0
unity,CDM,Um T3-reverse Assay,UM4000214,84482,,T3 reverse,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,278.33,% of charge rate,100.00%,278.33,,,,264.41,278.33,0
unity,CDM,"Um Troponin, Quant",UM4000033,84484,,Assay of troponin quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.23,% of charge rate,100.00%,37.23,,,,35.37,37.23,0
unity,CDM,"Um Troponin, Quant",UM4000033,84484,,Assay of troponin quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.23,% of charge rate,100.00%,37.23,,,,35.37,37.23,0
unity,CDM,Um Urea Nitrogen (bun),UM4000169,84520,,Assay of urea nitrogen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.98,% of charge rate,100.00%,21.98,,,,20.88,21.98,0
unity,CDM,Um Urea Nitrogen (bun),UM4000169,84520,,Assay of urea nitrogen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.98,% of charge rate,100.00%,21.98,,,,20.88,21.98,0
unity,CDM,"Um Urea Nitrogen, Urine",UM4000142,84540,,Assay of urine/urea-n,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,"Um Urea Nitrogen, Urine",UM4000142,84540,,Assay of urine/urea-n,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,"Um Uric Acid , Blood",UM4000219,84550,,Assay of blood/uric acid,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.15,% of charge rate,100.00%,25.15,,,,23.89,25.15,0
unity,CDM,"Um Uric Acid , Blood",UM4000219,84550,,Assay of blood/uric acid,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.15,% of charge rate,100.00%,25.15,,,,23.89,25.15,0
unity,CDM,"Um Uric Acid, Other Source",UM4000113,84560,,Assay of urine/uric acid,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.19,% of charge rate,100.00%,48.19,,,,45.78,48.19,0
unity,CDM,"Um Uric Acid, Other Source",UM4000113,84560,,Assay of urine/uric acid,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.19,% of charge rate,100.00%,48.19,,,,45.78,48.19,0
unity,CDM,"Um Uric Acid, Urine",UM4000407,84560,,Assay of urine/uric acid,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,"Um Uric Acid, Urine",UM4000407,84560,,Assay of urine/uric acid,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,Um Vma Urine,UM4000337,84585,,Assay of urine vma,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,86.33,% of charge rate,100.00%,86.33,,,,82.01,86.33,0
unity,CDM,Um Vma Urine,UM4000337,84585,,Assay of urine vma,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,86.33,% of charge rate,100.00%,86.33,,,,82.01,86.33,0
unity,CDM,Um Vasoactive Intestinal Poplypeptide,UM4000922,84586,,Assay of vip,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,209.8,% of charge rate,100.00%,209.8,,,,199.31,209.8,0
unity,CDM,Um Vasoactive Intestinal Poplypeptide,UM4000922,84586,,Assay of vip,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,209.8,% of charge rate,100.00%,209.8,,,,199.31,209.8,0
unity,CDM,Um Vitamin A (retinol),UM4000559,84590,,Assay of vitamin a,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,142.3,% of charge rate,100.00%,142.3,,,,135.19,142.3,0
unity,CDM,Um Vitamin A (retinol),UM4000559,84590,,Assay of vitamin a,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,142.3,% of charge rate,100.00%,142.3,,,,135.19,142.3,0
unity,CDM,Um Vitamin B3,UM4000546,84591,,Assay of nos vitamin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,205.72,% of charge rate,100.00%,205.72,,,,195.43,205.72,0
unity,CDM,Um Vitamin B3,UM4000546,84591,,Assay of nos vitamin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,205.72,% of charge rate,100.00%,205.72,,,,195.43,205.72,0
unity,CDM,"Um Zinc, Plasma",UM4000094,84630,,Assay of zinc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,63.37,% of charge rate,100.00%,63.37,,,,60.2,63.37,0
unity,CDM,"Um Zinc, Plasma",UM4000094,84630,,Assay of zinc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,63.37,% of charge rate,100.00%,63.37,,,,60.2,63.37,0
unity,CDM,"Um Zinc, 24-hr Urine",UM4000419,84630,,Assay of zinc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,63.37,% of charge rate,100.00%,63.37,,,,60.2,63.37,0
unity,CDM,"Um Zinc, 24-hr Urine",UM4000419,84630,,Assay of zinc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,63.37,% of charge rate,100.00%,63.37,,,,60.2,63.37,0
unity,CDM,"Um Zinc, Random Urine",UM4000420,84630,,Assay of zinc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,74.16,% of charge rate,100.00%,74.16,,,,70.45,74.16,0
unity,CDM,"Um Zinc, Random Urine",UM4000420,84630,,Assay of zinc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,74.16,% of charge rate,100.00%,74.16,,,,70.45,74.16,0
unity,CDM,Um C-peptide,UM4000153,84681,,Assay of c-peptide,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,115.85,% of charge rate,100.00%,115.85,,,,110.06,115.85,0
unity,CDM,Um C-peptide,UM4000153,84681,,Assay of c-peptide,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,115.85,% of charge rate,100.00%,115.85,,,,110.06,115.85,0
unity,CDM,"Um Hcg, Quantitative",UM4000135,84702,,Chorionic gonadotropin test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.85,% of charge rate,100.00%,83.85,,,,79.66,83.85,0
unity,CDM,"Um Hcg, Quantitative",UM4000135,84702,,Chorionic gonadotropin test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.85,% of charge rate,100.00%,83.85,,,,79.66,83.85,0
unity,CDM,"Um Pregnancy Test, Hcg Qual",UM4000006,84703,,Chorionic gonadotropin assay,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.83,% of charge rate,100.00%,41.83,,,,39.74,41.83,0
unity,CDM,"Um Pregnancy Test, Hcg Qual",UM4000006,84703,,Chorionic gonadotropin assay,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.83,% of charge rate,100.00%,41.83,,,,39.74,41.83,0
unity,CDM,Um Bleeding Time,UM4000235,85002,,Bleeding time test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.55,% of charge rate,100.00%,24.55,,,,23.32,24.55,0
unity,CDM,Um Bleeding Time,UM4000235,85002,,Bleeding time test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.55,% of charge rate,100.00%,24.55,,,,23.32,24.55,0
unity,CDM,"Um Differential, Automated",UM4000547,85004,,Automated diff wbc count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,"Um Differential, Automated",UM4000547,85004,,Automated diff wbc count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,"Um Differential, Wbc",UM4000092,85007,,Bl smear w/diff wbc count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,19.12,% of charge rate,100.00%,19.12,,,,18.16,19.12,0
unity,CDM,"Um Differential, Wbc",UM4000092,85007,,Bl smear w/diff wbc count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,19.12,% of charge rate,100.00%,19.12,,,,18.16,19.12,0
unity,CDM,Um Morphology Manual Exam,UM4000303,85008,,Bl smear w/o diff wbc count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,19.12,% of charge rate,100.00%,19.12,,,,18.16,19.12,0
unity,CDM,Um Morphology Manual Exam,UM4000303,85008,,Bl smear w/o diff wbc count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,19.12,% of charge rate,100.00%,19.12,,,,18.16,19.12,0
unity,CDM,"Um Differential, Buffy Coat",UM4000088,85009,,Manual diff wbc count b-coat,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.7,% of charge rate,100.00%,20.7,,,,19.67,20.7,0
unity,CDM,"Um Differential, Buffy Coat",UM4000088,85009,,Manual diff wbc count b-coat,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.7,% of charge rate,100.00%,20.7,,,,19.67,20.7,0
unity,CDM,Um Hematocrit,UM4000238,85014,,Hematocrit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.17,% of charge rate,100.00%,13.17,,,,12.51,13.17,0
unity,CDM,Um Hematocrit,UM4000238,85014,,Hematocrit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.17,% of charge rate,100.00%,13.17,,,,12.51,13.17,0
unity,CDM,Um Hemoglobin,UM4000347,85018,,Hemoglobin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.17,% of charge rate,100.00%,13.17,,,,12.51,13.17,0
unity,CDM,Um Hemoglobin,UM4000347,85018,,Hemoglobin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.17,% of charge rate,100.00%,13.17,,,,12.51,13.17,0
unity,CDM,Um Cbc With Diff Screen,UM4000325,85025,,Complete cbc w/auto diff wbc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,43.32,% of charge rate,100.00%,43.32,,,,41.15,43.32,0
unity,CDM,Um Cbc With Diff Screen,UM4000325,85025,,Complete cbc w/auto diff wbc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,43.32,% of charge rate,100.00%,43.32,,,,41.15,43.32,0
unity,CDM,Um Hemogram,UM4000077,85027,,Complete cbc automated,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,Um Hemogram,UM4000077,85027,,Complete cbc automated,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,Um Reticulocyte Count,UM4000227,85045,,Automated reticulocyte count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.3,% of charge rate,100.00%,22.3,,,,21.19,22.3,0
unity,CDM,Um Reticulocyte Count,UM4000227,85045,,Automated reticulocyte count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.3,% of charge rate,100.00%,22.3,,,,21.19,22.3,0
unity,CDM,Um Wbc,UM4000348,85048,,Automated leukocyte count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,14.16,% of charge rate,100.00%,14.16,,,,13.45,14.16,0
unity,CDM,Um Wbc,UM4000348,85048,,Automated leukocyte count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,14.16,% of charge rate,100.00%,14.16,,,,13.45,14.16,0
unity,CDM,Um Platelet Count,UM4000304,85049,,Automated platelet count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.89,% of charge rate,100.00%,24.89,,,,23.65,24.89,0
unity,CDM,Um Platelet Count,UM4000304,85049,,Automated platelet count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.89,% of charge rate,100.00%,24.89,,,,23.65,24.89,0
unity,CDM,Um Smears To Pathologist,UM4000318,85060,,Blood smear interpretation,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,51.37,% of charge rate,100.00%,51.37,,,,48.8,51.37,0
unity,CDM,Um Smears To Pathologist,UM4000318,85060,,Blood smear interpretation,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,51.37,% of charge rate,100.00%,51.37,,,,48.8,51.37,0
unity,CDM,"Um Factor V Test, Clotting",UM4000252,85220,,Blooc clot factor v test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,175.82,% of charge rate,100.00%,175.82,,,,167.03,175.82,0
unity,CDM,"Um Factor V Test, Clotting",UM4000252,85220,,Blooc clot factor v test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,175.82,% of charge rate,100.00%,175.82,,,,167.03,175.82,0
unity,CDM,Um Factor Vii Activity,UM4000771,85230,,Clot factor vii proconvertin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.77,% of charge rate,100.00%,99.77,,,,94.78,99.77,0
unity,CDM,Um Factor Vii Activity,UM4000771,85230,,Clot factor vii proconvertin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.77,% of charge rate,100.00%,99.77,,,,94.78,99.77,0
unity,CDM,Um Factor Viii Activity,UM4000265,85240,,Clot factor viii ahg 1 stage,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.32,% of charge rate,100.00%,66.32,,,,63,66.32,0
unity,CDM,Um Factor Viii Activity,UM4000265,85240,,Clot factor viii ahg 1 stage,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.32,% of charge rate,100.00%,66.32,,,,63,66.32,0
unity,CDM,Um Ristocetin Cofactor Activ,UM4000286,85245,,Clot factor viii vw ristoctn,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,223.33,% of charge rate,100.00%,223.33,,,,212.16,223.33,0
unity,CDM,Um Ristocetin Cofactor Activ,UM4000286,85245,,Clot factor viii vw ristoctn,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,223.33,% of charge rate,100.00%,223.33,,,,212.16,223.33,0
unity,CDM,Um Vwf Antigen,UM4000295,85246,,Clot factor viii vw antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,283.75,% of charge rate,100.00%,283.75,,,,269.56,283.75,0
unity,CDM,Um Vwf Antigen,UM4000295,85246,,Clot factor viii vw antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,283.75,% of charge rate,100.00%,283.75,,,,269.56,283.75,0
unity,CDM,Um Von Willebrand Factor Antigen,UM4000885,85246,,Clot factor viii vw antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,133,% of charge rate,100.00%,133,,,,126.35,133,0
unity,CDM,Um Von Willebrand Factor Antigen,UM4000885,85246,,Clot factor viii vw antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,133,% of charge rate,100.00%,133,,,,126.35,133,0
unity,CDM,"Um Vonwillebrand Ag, Multime",UM4000563,85247,,Clot factor viii multimetric,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,134.92",% of charge rate,100.00%,"1,134.92",,,,"1,078.17","1,134.92",0
unity,CDM,"Um Vonwillebrand Ag, Multime",UM4000563,85247,,Clot factor viii multimetric,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,134.92",% of charge rate,100.00%,"1,134.92",,,,"1,078.17","1,134.92",0
unity,CDM,Um Factor Ix,UM4000882,85250,,Clot factor ix ptc/chrstmas,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110.39,% of charge rate,100.00%,110.39,,,,104.87,110.39,0
unity,CDM,Um Factor Ix,UM4000882,85250,,Clot factor ix ptc/chrstmas,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110.39,% of charge rate,100.00%,110.39,,,,104.87,110.39,0
unity,CDM,Um Factor Xi,UM4000370,85270,,Clot factor xi pta,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,175.82,% of charge rate,100.00%,175.82,,,,167.03,175.82,0
unity,CDM,Um Factor Xi,UM4000370,85270,,Clot factor xi pta,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,175.82,% of charge rate,100.00%,175.82,,,,167.03,175.82,0
unity,CDM,Um Factor Xii,UM4000883,85280,,Clot factor xii hageman,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112.16,% of charge rate,100.00%,112.16,,,,106.55,112.16,0
unity,CDM,Um Factor Xii,UM4000883,85280,,Clot factor xii hageman,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112.16,% of charge rate,100.00%,112.16,,,,106.55,112.16,0
unity,CDM,Um Factor Viii Clot Solubili,UM4000565,85291,,Clot factor xiii fibrin scrn,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,Um Factor Viii Clot Solubili,UM4000565,85291,,Clot factor xiii fibrin scrn,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,Um Antithrombin Iii Activity,UM4000109,85300,,Antithrombin iii activity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.01,% of charge rate,100.00%,66.01,,,,62.71,66.01,0
unity,CDM,Um Antithrombin Iii Activity,UM4000109,85300,,Antithrombin iii activity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.01,% of charge rate,100.00%,66.01,,,,62.71,66.01,0
unity,CDM,Um Antithrombin Iii Ref Ag,UM4000427,85300,,Antithrombin iii activity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,178.21,% of charge rate,100.00%,178.21,,,,169.3,178.21,0
unity,CDM,Um Antithrombin Iii Ref Ag,UM4000427,85300,,Antithrombin iii activity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,178.21,% of charge rate,100.00%,178.21,,,,169.3,178.21,0
unity,CDM,Um Antithrombin Iii Antigen,UM4000351,85301,,Antithrombin iii antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,184.6,% of charge rate,100.00%,184.6,,,,175.37,184.6,0
unity,CDM,Um Antithrombin Iii Antigen,UM4000351,85301,,Antithrombin iii antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,184.6,% of charge rate,100.00%,184.6,,,,175.37,184.6,0
unity,CDM,Um Protein C Antigen,UM4000437,85302,,Clot inhibit prot c antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.94,% of charge rate,100.00%,66.94,,,,63.59,66.94,0
unity,CDM,Um Protein C Antigen,UM4000437,85302,,Clot inhibit prot c antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.94,% of charge rate,100.00%,66.94,,,,63.59,66.94,0
unity,CDM,Um Protein C Activity,UM4000438,85303,,Clot inhibit prot c activity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,257.72,% of charge rate,100.00%,257.72,,,,244.83,257.72,0
unity,CDM,Um Protein C Activity,UM4000438,85303,,Clot inhibit prot c activity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,257.72,% of charge rate,100.00%,257.72,,,,244.83,257.72,0
unity,CDM,Um Protein S Antigen-total,UM4000600,85305,,Clot inhibit prot s total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,228.96,% of charge rate,100.00%,228.96,,,,217.51,228.96,0
unity,CDM,Um Protein S Antigen-total,UM4000600,85305,,Clot inhibit prot s total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,228.96,% of charge rate,100.00%,228.96,,,,217.51,228.96,0
unity,CDM,Um Protein S Antigen-free,UM4000601,85306,,Clot inhibit prot s free,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,228.96,% of charge rate,100.00%,228.96,,,,217.51,228.96,0
unity,CDM,Um Protein S Antigen-free,UM4000601,85306,,Clot inhibit prot s free,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,228.96,% of charge rate,100.00%,228.96,,,,217.51,228.96,0
unity,CDM,Um Protein S Activity,UM4000868,85306,,Clot inhibit prot s free,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,68.3,% of charge rate,100.00%,68.3,,,,64.89,68.3,0
unity,CDM,Um Protein S Activity,UM4000868,85306,,Clot inhibit prot s free,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,68.3,% of charge rate,100.00%,68.3,,,,64.89,68.3,0
unity,CDM,Um Activated Protein C Resistence,UM4000604,85307,,Assay activated protein c,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65.57,% of charge rate,100.00%,65.57,,,,62.29,65.57,0
unity,CDM,Um Activated Protein C Resistence,UM4000604,85307,,Assay activated protein c,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65.57,% of charge rate,100.00%,65.57,,,,62.29,65.57,0
unity,CDM,Um Fibrin Monomer,UM4000772,85362,,Fibrin degradation products,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.4,% of charge rate,100.00%,38.4,,,,36.48,38.4,0
unity,CDM,Um Fibrin Monomer,UM4000772,85362,,Fibrin degradation products,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.4,% of charge rate,100.00%,38.4,,,,36.48,38.4,0
unity,CDM,Um Fibrum Degradation Products,UM4000605,85366,,Fibrinogen test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.65,% of charge rate,100.00%,64.65,,,,61.42,64.65,0
unity,CDM,Um Fibrum Degradation Products,UM4000605,85366,,Fibrinogen test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.65,% of charge rate,100.00%,64.65,,,,61.42,64.65,0
unity,CDM,Um Fibrin Degradat Prod Quan,UM4000105,85379,,Fibrin degradation quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.13,% of charge rate,100.00%,45.13,,,,42.87,45.13,0
unity,CDM,Um Fibrin Degradat Prod Quan,UM4000105,85379,,Fibrin degradation quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.13,% of charge rate,100.00%,45.13,,,,42.87,45.13,0
unity,CDM,"Um D-dimer, Quantitative",UM4000240,85379,,Fibrin degradation quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.13,% of charge rate,100.00%,45.13,,,,42.87,45.13,0
unity,CDM,"Um D-dimer, Quantitative",UM4000240,85379,,Fibrin degradation quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.13,% of charge rate,100.00%,45.13,,,,42.87,45.13,0
unity,CDM,Um Fibrinogen; Activity,UM4000320,85384,,Fibrinogen activity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.3,% of charge rate,100.00%,47.3,,,,44.94,47.3,0
unity,CDM,Um Fibrinogen; Activity,UM4000320,85384,,Fibrinogen activity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.3,% of charge rate,100.00%,47.3,,,,44.94,47.3,0
unity,CDM,Um Von Willebrand Disease Profile Tech Interp,UM4000912,85390,,Fibrinolysins screen i&r,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.77,% of charge rate,100.00%,76.77,,,,72.93,76.77,0
unity,CDM,Um Von Willebrand Disease Profile Tech Interp,UM4000912,85390,,Fibrinolysins screen i&r,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.77,% of charge rate,100.00%,76.77,,,,72.93,76.77,0
unity,CDM,Um Von Willebrand Factor Activity,UM4000886,85397,,Clotting funct activity,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,133,% of charge rate,100.00%,133,,,,126.35,133,0
unity,CDM,Um Von Willebrand Factor Activity,UM4000886,85397,,Clotting funct activity,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,133,% of charge rate,100.00%,133,,,,126.35,133,0
unity,CDM,Um Fetal Maternal Hemorr Scr,UM4050012,85460,,Hemoglobin fetal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,42.22,% of charge rate,100.00%,42.22,,,,40.11,42.22,0
unity,CDM,Um Fetal Maternal Hemorr Scr,UM4050012,85460,,Hemoglobin fetal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,42.22,% of charge rate,100.00%,42.22,,,,40.11,42.22,0
unity,CDM,Um Heparin Xa Assay,UM4000539,85520,,Heparin assay,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.9,% of charge rate,100.00%,72.9,,,,69.26,72.9,0
unity,CDM,Um Heparin Xa Assay,UM4000539,85520,,Heparin assay,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.9,% of charge rate,100.00%,72.9,,,,69.26,72.9,0
unity,CDM,Um Bm Iron Stain,UM4000247,85536,,Iron stain peripheral blood,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,Um Bm Iron Stain,UM4000247,85536,,Iron stain peripheral blood,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,"Um Iron Stain, Periph Blood",UM4000315,85536,,Iron stain peripheral blood,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,"Um Iron Stain, Periph Blood",UM4000315,85536,,Iron stain peripheral blood,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.05,% of charge rate,100.00%,36.05,,,,34.25,36.05,0
unity,CDM,Um Lysozyme (muramidase)seru,UM4000338,85549,,Muramidase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110.52,% of charge rate,100.00%,110.52,,,,104.99,110.52,0
unity,CDM,Um Lysozyme (muramidase)seru,UM4000338,85549,,Muramidase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110.52,% of charge rate,100.00%,110.52,,,,104.99,110.52,0
unity,CDM,Um Lysozyme (muramidase) Ua,UM4000430,85549,,Muramidase,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110.52,% of charge rate,100.00%,110.52,,,,104.99,110.52,0
unity,CDM,Um Lysozyme (muramidase) Ua,UM4000430,85549,,Muramidase,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110.52,% of charge rate,100.00%,110.52,,,,104.99,110.52,0
unity,CDM,Um Prothombin Time,UM4000012,85610,,Prothrombin time,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.86,% of charge rate,100.00%,21.86,,,,20.77,21.86,0
unity,CDM,Um Prothombin Time,UM4000012,85610,,Prothrombin time,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.86,% of charge rate,100.00%,21.86,,,,20.77,21.86,0
unity,CDM,Um Lupus Anticoagulant(rvvt),UM4000533,85613,,Russell viper venom diluted,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.43,% of charge rate,100.00%,71.43,,,,67.86,71.43,0
unity,CDM,Um Lupus Anticoagulant(rvvt),UM4000533,85613,,Russell viper venom diluted,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.43,% of charge rate,100.00%,71.43,,,,67.86,71.43,0
unity,CDM,Um Sed Rate Automated,UM4000331,85652,,Rbc sed rate automated,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.05,% of charge rate,100.00%,15.05,,,,14.3,15.05,0
unity,CDM,Um Sed Rate Automated,UM4000331,85652,,Rbc sed rate automated,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.05,% of charge rate,100.00%,15.05,,,,14.3,15.05,0
unity,CDM,Um Sickling Of Rbc,UM4000104,85660,,Rbc sickle cell test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.89,% of charge rate,100.00%,60.89,,,,57.85,60.89,0
unity,CDM,Um Sickling Of Rbc,UM4000104,85660,,Rbc sickle cell test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.89,% of charge rate,100.00%,60.89,,,,57.85,60.89,0
unity,CDM,Um Thrombin Time,UM4000564,85670,,Thrombin time plasma,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.02,% of charge rate,100.00%,94.02,,,,89.32,94.02,0
unity,CDM,Um Thrombin Time,UM4000564,85670,,Thrombin time plasma,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.02,% of charge rate,100.00%,94.02,,,,89.32,94.02,0
unity,CDM,Um Thromboplastin Inhibition,UM4000139,85705,,Thromboplastin inhibition,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.4,% of charge rate,100.00%,32.4,,,,30.78,32.4,0
unity,CDM,Um Thromboplastin Inhibition,UM4000139,85705,,Thromboplastin inhibition,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.4,% of charge rate,100.00%,32.4,,,,30.78,32.4,0
unity,CDM,Um Aptt,UM4000212,85730,,Thromboplastin time partial,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.41,% of charge rate,100.00%,33.41,,,,31.74,33.41,0
unity,CDM,Um Aptt,UM4000212,85730,,Thromboplastin time partial,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.41,% of charge rate,100.00%,33.41,,,,31.74,33.41,0
unity,CDM,Um Lupus Anticoagulant (ptt),UM4000534,85730,,Thromboplastin time partial,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.41,% of charge rate,100.00%,33.41,,,,31.74,33.41,0
unity,CDM,Um Lupus Anticoagulant (ptt),UM4000534,85730,,Thromboplastin time partial,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.41,% of charge rate,100.00%,33.41,,,,31.74,33.41,0
unity,CDM,"Um Ptt,substitution (plasmafraction)",UM4000603,85730,,Thromboplastin time partial,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,105.24,% of charge rate,100.00%,105.24,,,,99.98,105.24,0
unity,CDM,"Um Ptt,substitution (plasmafraction)",UM4000603,85730,,Thromboplastin time partial,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,105.24,% of charge rate,100.00%,105.24,,,,99.98,105.24,0
unity,CDM,"Um Viscosity, Serum",UM4000096,85810,,Blood viscosity examination,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,"Um Viscosity, Serum",UM4000096,85810,,Blood viscosity examination,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Urine Eosinophil,UM4000743,85999,,Hematology procedure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,51.14,% of charge rate,100.00%,51.14,,,,48.58,51.14,0
unity,CDM,Um Urine Eosinophil,UM4000743,85999,,Hematology procedure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,51.14,% of charge rate,100.00%,51.14,,,,48.58,51.14,0
unity,CDM,Um Allergen Specific Igg Quantitative/semi Quant Ea. Allergen,UM4000807,86001,,Allergen specific igg,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.65,% of charge rate,100.00%,26.65,,,,25.32,26.65,0
unity,CDM,Um Allergen Specific Igg Quantitative/semi Quant Ea. Allergen,UM4000807,86001,,Allergen specific igg,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.65,% of charge rate,100.00%,26.65,,,,25.32,26.65,0
unity,CDM,"Um Allergen Specific Ige, Ea",UM4000542,86003,,Allg spec ige crude xtrc ea,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,55.86,% of charge rate,100.00%,55.86,,,,53.07,55.86,0
unity,CDM,"Um Allergen Specific Ige, Ea",UM4000542,86003,,Allg spec ige crude xtrc ea,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,55.86,% of charge rate,100.00%,55.86,,,,53.07,55.86,0
unity,CDM,Um Antibody Id Leukocytes,UM4000257,86021,,Wbc antibody identification,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,208.5,% of charge rate,100.00%,208.5,,,,198.08,208.5,0
unity,CDM,Um Antibody Id Leukocytes,UM4000257,86021,,Wbc antibody identification,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,208.5,% of charge rate,100.00%,208.5,,,,198.08,208.5,0
unity,CDM,Um Platelet Antibody,UM4000436,86022,,Platelet antibodies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,102.3,% of charge rate,100.00%,102.3,,,,97.19,102.3,0
unity,CDM,Um Platelet Antibody,UM4000436,86022,,Platelet antibodies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,102.3,% of charge rate,100.00%,102.3,,,,97.19,102.3,0
unity,CDM,"Um Platelet Ag, Direct",UM4000066,86023,,Immunoglobulin assay,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,226,% of charge rate,100.00%,226,,,,214.7,226,0
unity,CDM,"Um Platelet Ag, Direct",UM4000066,86023,,Immunoglobulin assay,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,226,% of charge rate,100.00%,226,,,,214.7,226,0
unity,CDM,Um Ana (hep-2) Screen,UM4000466,86038,,Antinuclear antibodies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.3,% of charge rate,100.00%,67.3,,,,63.94,67.3,0
unity,CDM,Um Ana (hep-2) Screen,UM4000466,86038,,Antinuclear antibodies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.3,% of charge rate,100.00%,67.3,,,,63.94,67.3,0
unity,CDM,Um Ana (hep-) Titer,UM4000467,86039,,Antinuclear antibodies (ana),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.15,% of charge rate,100.00%,62.15,,,,59.04,62.15,0
unity,CDM,Um Ana (hep-) Titer,UM4000467,86039,,Antinuclear antibodies (ana),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.15,% of charge rate,100.00%,62.15,,,,59.04,62.15,0
unity,CDM,Um Aso Titer,UM4000036,86060,,Antistreptolysin o titer,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.64,% of charge rate,100.00%,40.64,,,,38.61,40.64,0
unity,CDM,Um Aso Titer,UM4000036,86060,,Antistreptolysin o titer,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.64,% of charge rate,100.00%,40.64,,,,38.61,40.64,0
unity,CDM,Um Crp/c Reactive Protein,UM4000349,86140,,C-reactive protein,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Crp/c Reactive Protein,UM4000349,86140,,C-reactive protein,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Crp (hs),UM4000085,86141,,C-reactive protein hs,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Crp (hs),UM4000085,86141,,C-reactive protein hs,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Beta-2 Glycoprotein 1,UM4000468,86146,,Beta-2 glycoprotein antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,118.45,% of charge rate,100.00%,118.45,,,,112.53,118.45,0
unity,CDM,Um Beta-2 Glycoprotein 1,UM4000468,86146,,Beta-2 glycoprotein antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,118.45,% of charge rate,100.00%,118.45,,,,112.53,118.45,0
unity,CDM,Um Cardiolipin Ab(phospholip,UM4000511,86147,,Cardiolipin antibody ea ig,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,118.45,% of charge rate,100.00%,118.45,,,,112.53,118.45,0
unity,CDM,Um Cardiolipin Ab(phospholip,UM4000511,86147,,Cardiolipin antibody ea ig,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,118.45,% of charge rate,100.00%,118.45,,,,112.53,118.45,0
unity,CDM,Um Anti-phosohatidylserine,UM4000860,86148,,Anti-phospholipid antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93.15,% of charge rate,100.00%,93.15,,,,88.49,93.15,0
unity,CDM,Um Anti-phosohatidylserine,UM4000860,86148,,Anti-phospholipid antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93.15,% of charge rate,100.00%,93.15,,,,88.49,93.15,0
unity,CDM,"Um Cold Agglutinin, Titer",UM4000383,86157,,Cold agglutinin titer,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.4,% of charge rate,100.00%,32.4,,,,30.78,32.4,0
unity,CDM,"Um Cold Agglutinin, Titer",UM4000383,86157,,Cold agglutinin titer,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.4,% of charge rate,100.00%,32.4,,,,30.78,32.4,0
unity,CDM,Um C3 (complement C3),UM4000503,86160,,Complement antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.88,% of charge rate,100.00%,66.88,,,,63.54,66.88,0
unity,CDM,Um C3 (complement C3),UM4000503,86160,,Complement antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.88,% of charge rate,100.00%,66.88,,,,63.54,66.88,0
unity,CDM,Um C4 (complement C4),UM4000504,86160,,Complement antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.88,% of charge rate,100.00%,66.88,,,,63.54,66.88,0
unity,CDM,Um C4 (complement C4),UM4000504,86160,,Complement antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.88,% of charge rate,100.00%,66.88,,,,63.54,66.88,0
unity,CDM,"Um Complement, Total (ch50)",UM4000051,86162,,Complement total (ch50),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,113.14,% of charge rate,100.00%,113.14,,,,107.48,113.14,0
unity,CDM,"Um Complement, Total (ch50)",UM4000051,86162,,Complement total (ch50),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,113.14,% of charge rate,100.00%,113.14,,,,107.48,113.14,0
unity,CDM,Um Ccp(cyclic Citrul Peptide,UM4000507,86200,,Ccp antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Ccp(cyclic Citrul Peptide,UM4000507,86200,,Ccp antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Dnase-b Ab,UM4000405,86215,,Deoxyribonuclease antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,89.16,% of charge rate,100.00%,89.16,,,,84.7,89.16,0
unity,CDM,Um Dnase-b Ab,UM4000405,86215,,Deoxyribonuclease antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,89.16,% of charge rate,100.00%,89.16,,,,84.7,89.16,0
unity,CDM,Um Ds-dna(dna Double Strand),UM4000508,86225,,Dna antibody native,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.46,% of charge rate,100.00%,76.46,,,,72.64,76.46,0
unity,CDM,Um Ds-dna(dna Double Strand),UM4000508,86225,,Dna antibody native,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.46,% of charge rate,100.00%,76.46,,,,72.64,76.46,0
unity,CDM,"Um Ssa(sjogrens,syndrome)may",UM4000463,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,"Um Ssa(sjogrens,syndrome)may",UM4000463,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,"Um Ssb(sjogrens,syndrome)may",UM4000464,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,"Um Ssb(sjogrens,syndrome)may",UM4000464,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,Um Pm-scl Ab (pm-1 Ab),UM4000490,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.96,% of charge rate,100.00%,83.96,,,,79.76,83.96,0
unity,CDM,Um Pm-scl Ab (pm-1 Ab),UM4000490,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.96,% of charge rate,100.00%,83.96,,,,79.76,83.96,0
unity,CDM,"Um Jo - I Ab, Igg",UM4000517,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,"Um Jo - I Ab, Igg",UM4000517,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,Um Rnp (ribonuclear Protein),UM4000526,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,Um Rnp (ribonuclear Protein),UM4000526,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,Um Scl-70 Ab(scleroderma),UM4000527,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,Um Scl-70 Ab(scleroderma),UM4000527,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,Um Sm Ab (anti-smith),UM4000528,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,Um Sm Ab (anti-smith),UM4000528,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.87,% of charge rate,100.00%,99.87,,,,94.88,99.87,0
unity,CDM,Um Chromatin (nuclcosomal) Ab,UM4000701,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125.4,% of charge rate,100.00%,125.4,,,,119.13,125.4,0
unity,CDM,Um Chromatin (nuclcosomal) Ab,UM4000701,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125.4,% of charge rate,100.00%,125.4,,,,119.13,125.4,0
unity,CDM,Um Centromere B Antibody,UM4000909,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,98.83,% of charge rate,100.00%,98.83,,,,93.89,98.83,0
unity,CDM,Um Centromere B Antibody,UM4000909,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,98.83,% of charge rate,100.00%,98.83,,,,93.89,98.83,0
unity,CDM,Um Sm/rnp Antibody,UM4000910,86235,,Nuclear antigen antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,98.83,% of charge rate,100.00%,98.83,,,,93.89,98.83,0
unity,CDM,Um Sm/rnp Antibody,UM4000910,86235,,Nuclear antigen antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,98.83,% of charge rate,100.00%,98.83,,,,93.89,98.83,0
unity,CDM,Um Anca(cytoplasm Neutscreen,UM4000478,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,265,% of charge rate,100.00%,265,,,,251.75,265,0
unity,CDM,Um Anca(cytoplasm Neutscreen,UM4000478,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,265,% of charge rate,100.00%,265,,,,251.75,265,0
unity,CDM,Um Smooth Muscle Ab,UM4000535,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,Um Smooth Muscle Ab,UM4000535,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,Um Striated Muscle Abs,UM4000552,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,Um Striated Muscle Abs,UM4000552,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,Um Parietal Cell Ab,UM4000560,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,Um Parietal Cell Ab,UM4000560,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,"Um Fluorescent Antibody Screen, Unspec",UM4000789,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.14,% of charge rate,100.00%,67.14,,,,63.78,67.14,0
unity,CDM,"Um Fluorescent Antibody Screen, Unspec",UM4000789,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.14,% of charge rate,100.00%,67.14,,,,63.78,67.14,0
unity,CDM,"Um Endomysial Antibody, Iga",UM4000871,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69.86,% of charge rate,100.00%,69.86,,,,66.37,69.86,0
unity,CDM,"Um Endomysial Antibody, Iga",UM4000871,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69.86,% of charge rate,100.00%,69.86,,,,66.37,69.86,0
unity,CDM,Um Nmda Receptor Antibody,UM4000928,86255,,Fluorescent antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,530,% of charge rate,100.00%,530,,,,503.5,530,0
unity,CDM,Um Nmda Receptor Antibody,UM4000928,86255,,Fluorescent antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,530,% of charge rate,100.00%,530,,,,503.5,530,0
unity,CDM,Um Fluorescent Ab Titer,UM4000115,86256,,Fluorescent antibody titer,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,Um Fluorescent Ab Titer,UM4000115,86256,,Fluorescent antibody titer,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,Um Endomysial Ab,UM4000475,86256,,Fluorescent antibody titer,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,178.57,% of charge rate,100.00%,178.57,,,,169.64,178.57,0
unity,CDM,Um Endomysial Ab,UM4000475,86256,,Fluorescent antibody titer,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,178.57,% of charge rate,100.00%,178.57,,,,169.64,178.57,0
unity,CDM,Um Anca Titer,UM4000479,86256,,Fluorescent antibody titer,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,178.57,% of charge rate,100.00%,178.57,,,,169.64,178.57,0
unity,CDM,Um Anca Titer,UM4000479,86256,,Fluorescent antibody titer,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,178.57,% of charge rate,100.00%,178.57,,,,169.64,178.57,0
unity,CDM,Um Hemagglutination Inhibit,UM4000157,86280,,Hemagglutination inhibition,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.08,% of charge rate,100.00%,45.08,,,,42.83,45.08,0
unity,CDM,Um Hemagglutination Inhibit,UM4000157,86280,,Hemagglutination inhibition,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.08,% of charge rate,100.00%,45.08,,,,42.83,45.08,0
unity,CDM,Um Breast Cancer Antigen 27.29,UM4000209,86300,,Immunoassay tumor ca 15-3,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,115.91,% of charge rate,100.00%,115.91,,,,110.11,115.91,0
unity,CDM,Um Breast Cancer Antigen 27.29,UM4000209,86300,,Immunoassay tumor ca 15-3,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,115.91,% of charge rate,100.00%,115.91,,,,110.11,115.91,0
unity,CDM,Um Cancer Antigen 15-3,UM4000863,86300,,Immunoassay tumor ca 15-3,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,115.91,% of charge rate,100.00%,115.91,,,,110.11,115.91,0
unity,CDM,Um Cancer Antigen 15-3,UM4000863,86300,,Immunoassay tumor ca 15-3,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,115.91,% of charge rate,100.00%,115.91,,,,110.11,115.91,0
unity,CDM,Um Immunoassay Tumor Ca 19-9,UM4000093,86301,,Immunoassay tumor ca 19-9,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,115.91,% of charge rate,100.00%,115.91,,,,110.11,115.91,0
unity,CDM,Um Immunoassay Tumor Ca 19-9,UM4000093,86301,,Immunoassay tumor ca 19-9,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,115.91,% of charge rate,100.00%,115.91,,,,110.11,115.91,0
unity,CDM,Um Ca-125,UM4000307,86304,,Immunoassay tumor ca 125,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,115.91,% of charge rate,100.00%,115.91,,,,110.11,115.91,0
unity,CDM,Um Ca-125,UM4000307,86304,,Immunoassay tumor ca 125,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,115.91,% of charge rate,100.00%,115.91,,,,110.11,115.91,0
unity,CDM,Um Mono Test,UM4000106,86308,,Heterophile antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Mono Test,UM4000106,86308,,Heterophile antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Chromogranin A Level,UM4000540,86316,,Immunoassay tumor other,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,209.66,% of charge rate,100.00%,209.66,,,,199.18,209.66,0
unity,CDM,Um Chromogranin A Level,UM4000540,86316,,Immunoassay tumor other,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,209.66,% of charge rate,100.00%,209.66,,,,199.18,209.66,0
unity,CDM,"Um Hep B Surface Ab, Quant.",UM4000543,86317,,Immunoassay infectious agent,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.49,% of charge rate,100.00%,83.49,,,,79.32,83.49,0
unity,CDM,"Um Hep B Surface Ab, Quant.",UM4000543,86317,,Immunoassay infectious agent,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.49,% of charge rate,100.00%,83.49,,,,79.32,83.49,0
unity,CDM,"Um Strep Pneumo Ab, Igg, 23 Serotypes",UM4000753,86317,,Immunoassay infectious agent,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.49,% of charge rate,100.00%,83.49,,,,79.32,83.49,0
unity,CDM,"Um Strep Pneumo Ab, Igg, 23 Serotypes",UM4000753,86317,,Immunoassay infectious agent,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.49,% of charge rate,100.00%,83.49,,,,79.32,83.49,0
unity,CDM,Um H.  Pylori,UM4000125,86318,,Immunoassay infectious agent,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um H.  Pylori,UM4000125,86318,,Immunoassay infectious agent,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.08,% of charge rate,100.00%,72.08,,,,68.48,72.08,0
unity,CDM,Um Rubella Igg,UM4000876,86318,,Immunoassay infectious agent,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,43,% of charge rate,100.00%,43,,,,40.85,43,0
unity,CDM,Um Rubella Igg,UM4000876,86318,,Immunoassay infectious agent,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,43,% of charge rate,100.00%,43,,,,40.85,43,0
unity,CDM,"Um Immundodiffus, Gel, Qual",UM4000162,86331,,Immunodiffusion ouchterlony,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.36,% of charge rate,100.00%,32.36,,,,30.74,32.36,0
unity,CDM,"Um Immundodiffus, Gel, Qual",UM4000162,86331,,Immunodiffusion ouchterlony,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.36,% of charge rate,100.00%,32.36,,,,30.74,32.36,0
unity,CDM,"Um Immunoe-phoresis, Serum",UM4000190,86334,,Immunofix e-phoresis serum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,124.38,% of charge rate,100.00%,124.38,,,,118.16,124.38,0
unity,CDM,"Um Immunoe-phoresis, Serum",UM4000190,86334,,Immunofix e-phoresis serum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,124.38,% of charge rate,100.00%,124.38,,,,118.16,124.38,0
unity,CDM,Um Immunofix E-phnesis/csf,UM4000198,86335,,Immunfix e-phorsis/urine/csf,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,163.43,% of charge rate,100.00%,163.43,,,,155.26,163.43,0
unity,CDM,Um Immunofix E-phnesis/csf,UM4000198,86335,,Immunfix e-phorsis/urine/csf,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,163.43,% of charge rate,100.00%,163.43,,,,155.26,163.43,0
unity,CDM,"Um Immunofixation, Urine",UM4000766,86335,,Immunfix e-phorsis/urine/csf,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,163.5,% of charge rate,100.00%,163.5,,,,155.33,163.5,0
unity,CDM,"Um Immunofixation, Urine",UM4000766,86335,,Immunfix e-phorsis/urine/csf,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,163.5,% of charge rate,100.00%,163.5,,,,155.33,163.5,0
unity,CDM,"Um Beta 2 Transferrin, Nasal Drainage",UM4000870,86335,,Immunfix e-phorsis/urine/csf,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,170.15,% of charge rate,100.00%,170.15,,,,161.64,170.15,0
unity,CDM,"Um Beta 2 Transferrin, Nasal Drainage",UM4000870,86335,,Immunfix e-phorsis/urine/csf,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,170.15,% of charge rate,100.00%,170.15,,,,161.64,170.15,0
unity,CDM,Um Inhibin A,UM4000163,86336,,Inhibin a,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,220.96,% of charge rate,100.00%,220.96,,,,209.91,220.96,0
unity,CDM,Um Inhibin A,UM4000163,86336,,Inhibin a,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,220.96,% of charge rate,100.00%,220.96,,,,209.91,220.96,0
unity,CDM,Um Insulin Autoantibodies,UM4000851,86337,,Insulin antibodies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,124.13,% of charge rate,100.00%,124.13,,,,117.92,124.13,0
unity,CDM,Um Insulin Autoantibodies,UM4000851,86337,,Insulin antibodies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,124.13,% of charge rate,100.00%,124.13,,,,117.92,124.13,0
unity,CDM,Um Interferon Ab,UM4000386,86340,,Intrinsic factor antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,98.23,% of charge rate,100.00%,98.23,,,,93.32,98.23,0
unity,CDM,Um Interferon Ab,UM4000386,86340,,Intrinsic factor antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,98.23,% of charge rate,100.00%,98.23,,,,93.32,98.23,0
unity,CDM,Um Intrinsic Factor Blkng Ab,UM4000561,86340,,Intrinsic factor antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,129.06,% of charge rate,100.00%,129.06,,,,122.61,129.06,0
unity,CDM,Um Intrinsic Factor Blkng Ab,UM4000561,86340,,Intrinsic factor antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,129.06,% of charge rate,100.00%,129.06,,,,122.61,129.06,0
unity,CDM,Um Glutamic Acid Autoantibody,UM4000852,86341,,Islet cell antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,114.7,% of charge rate,100.00%,114.7,,,,108.97,114.7,0
unity,CDM,Um Glutamic Acid Autoantibody,UM4000852,86341,,Islet cell antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,114.7,% of charge rate,100.00%,114.7,,,,108.97,114.7,0
unity,CDM,Um Islet Cell Antibody,UM4000853,86341,,Islet cell antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,114.7,% of charge rate,100.00%,114.7,,,,108.97,114.7,0
unity,CDM,Um Islet Cell Antibody,UM4000853,86341,,Islet cell antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,114.7,% of charge rate,100.00%,114.7,,,,108.97,114.7,0
unity,CDM,Um Gad 65 Neurological Syndrome Antibody,UM4000929,86341,,Islet cell antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,390,% of charge rate,100.00%,390,,,,370.5,390,0
unity,CDM,Um Gad 65 Neurological Syndrome Antibody,UM4000929,86341,,Islet cell antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,390,% of charge rate,100.00%,390,,,,370.5,390,0
unity,CDM,"Um B Cells, Total Count",UM4000399,86355,,B cells total count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,210.04,% of charge rate,100.00%,210.04,,,,199.54,210.04,0
unity,CDM,"Um B Cells, Total Count",UM4000399,86355,,B cells total count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,210.04,% of charge rate,100.00%,210.04,,,,199.54,210.04,0
unity,CDM,Um B Cells Total Count/flow Cytometry,UM4000754,86355,,B cells total count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,210.03,% of charge rate,100.00%,210.03,,,,199.53,210.03,0
unity,CDM,Um B Cells Total Count/flow Cytometry,UM4000754,86355,,B cells total count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,210.03,% of charge rate,100.00%,210.03,,,,199.53,210.03,0
unity,CDM,"Um Mononuclear Cell Antigen, Quant",UM4000927,86356,,Mononuclear cell antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,175,% of charge rate,100.00%,175,,,,166.25,175,0
unity,CDM,"Um Mononuclear Cell Antigen, Quant",UM4000927,86356,,Mononuclear cell antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,175,% of charge rate,100.00%,175,,,,166.25,175,0
unity,CDM,"Um Nk Cells, Total Count",UM4000400,86357,,Nk cells total count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,210.04,% of charge rate,100.00%,210.04,,,,199.54,210.04,0
unity,CDM,"Um Nk Cells, Total Count",UM4000400,86357,,Nk cells total count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,210.04,% of charge rate,100.00%,210.04,,,,199.54,210.04,0
unity,CDM,Um T Cells Total Count/flow Cytometry,UM4000755,86359,,T cells total count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,210.03,% of charge rate,100.00%,210.03,,,,199.53,210.03,0
unity,CDM,Um T Cells Total Count/flow Cytometry,UM4000755,86359,,T cells total count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,210.03,% of charge rate,100.00%,210.03,,,,199.53,210.03,0
unity,CDM,Um T Cells Absolute Ct/ratio,UM4000401,86360,,T cell absolute count/ratio,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,261.61,% of charge rate,100.00%,261.61,,,,248.53,261.61,0
unity,CDM,Um T Cells Absolute Ct/ratio,UM4000401,86360,,T cell absolute count/ratio,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,261.61,% of charge rate,100.00%,261.61,,,,248.53,261.61,0
unity,CDM,Um Cd4,UM4000911,86361,,T cell absolute count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,147.53,% of charge rate,100.00%,147.53,,,,140.15,147.53,0
unity,CDM,Um Cd4,UM4000911,86361,,T cell absolute count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,147.53,% of charge rate,100.00%,147.53,,,,140.15,147.53,0
unity,CDM,Um Microsomal Ab/same As Tpo,UM4000522,86376,,Microsomal antibody each,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,81.02,% of charge rate,100.00%,81.02,,,,76.97,81.02,0
unity,CDM,Um Microsomal Ab/same As Tpo,UM4000522,86376,,Microsomal antibody each,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,81.02,% of charge rate,100.00%,81.02,,,,76.97,81.02,0
unity,CDM,"Um Particle Agglutinatin, Ag",UM4000122,86403,,Particle agglut antbdy scrn,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,56.75,% of charge rate,100.00%,56.75,,,,53.91,56.75,0
unity,CDM,"Um Particle Agglutinatin, Ag",UM4000122,86403,,Particle agglut antbdy scrn,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,56.75,% of charge rate,100.00%,56.75,,,,53.91,56.75,0
unity,CDM,"Um Strep Pneumoniae Ag,urine",UM4000716,86403,,Particle agglut antbdy scrn,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99,% of charge rate,100.00%,99,,,,94.05,99,0
unity,CDM,"Um Strep Pneumoniae Ag,urine",UM4000716,86403,,Particle agglut antbdy scrn,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99,% of charge rate,100.00%,99,,,,94.05,99,0
unity,CDM,"Um Rheumatoid Factor, Quant",UM4000202,86431,,Rheumatoid factor quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.6,% of charge rate,100.00%,31.6,,,,30.02,31.6,0
unity,CDM,"Um Rheumatoid Factor, Quant",UM4000202,86431,,Rheumatoid factor quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.6,% of charge rate,100.00%,31.6,,,,30.02,31.6,0
unity,CDM,Um Quantiferon-tb Gold,UM4000498,86480,,Tb test cell immun measure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29,% of charge rate,100.00%,29,,,,27.55,29,0
unity,CDM,Um Quantiferon-tb Gold,UM4000498,86480,,Tb test cell immun measure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29,% of charge rate,100.00%,29,,,,27.55,29,0
unity,CDM,TB INTRADERMAL TEST,86580,86580,,Tb intradermal test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,19,20,0
unity,CDM,TB INTRADERMAL TEST,86580,86580,,Tb intradermal test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,19,20,0
unity,CDM,Um Tb Tine Test,UM4000380,86580,,Tb intradermal test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.28,% of charge rate,100.00%,21.28,,,,20.22,21.28,0
unity,CDM,Um Tb Tine Test,UM4000380,86580,,Tb intradermal test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.28,% of charge rate,100.00%,21.28,,,,20.22,21.28,0
unity,CDM,Um Serology (rpr),UM4000160,86592,,Syphilis test non-trep qual,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Serology (rpr),UM4000160,86592,,Syphilis test non-trep qual,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Vdrl,UM4000819,86592,,Syphilis test non-trep qual,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.78,% of charge rate,100.00%,23.78,,,,22.59,23.78,0
unity,CDM,Um Vdrl,UM4000819,86592,,Syphilis test non-trep qual,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.78,% of charge rate,100.00%,23.78,,,,22.59,23.78,0
unity,CDM,Um Adenovirus Antibody,UM4000021,86603,,Adenovirus antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91.94,% of charge rate,100.00%,91.94,,,,87.34,91.94,0
unity,CDM,Um Adenovirus Antibody,UM4000021,86603,,Adenovirus antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91.94,% of charge rate,100.00%,91.94,,,,87.34,91.94,0
unity,CDM,Um Aspergillus Antibody,UM4000299,86606,,Aspergillus antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.76,% of charge rate,100.00%,71.76,,,,68.17,71.76,0
unity,CDM,Um Aspergillus Antibody,UM4000299,86606,,Aspergillus antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.76,% of charge rate,100.00%,71.76,,,,68.17,71.76,0
unity,CDM,"Um Antibody, Listeria",UM4000544,86609,,Bacterium antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,163.86,% of charge rate,100.00%,163.86,,,,155.67,163.86,0
unity,CDM,"Um Antibody, Listeria",UM4000544,86609,,Bacterium antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,163.86,% of charge rate,100.00%,163.86,,,,155.67,163.86,0
unity,CDM,Um Bartonella Antibody,UM4000926,86611,,Bartonella antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.4,% of charge rate,100.00%,60.4,,,,57.38,60.4,0
unity,CDM,Um Bartonella Antibody,UM4000926,86611,,Bartonella antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.4,% of charge rate,100.00%,60.4,,,,57.38,60.4,0
unity,CDM,Um Blastomyces Antibody,UM4000097,86612,,Blastomyces antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.5,% of charge rate,100.00%,62.5,,,,59.38,62.5,0
unity,CDM,Um Blastomyces Antibody,UM4000097,86612,,Blastomyces antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.5,% of charge rate,100.00%,62.5,,,,59.38,62.5,0
unity,CDM,Um Bordatella Antibody,UM4000293,86615,,Bordetella antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.45,% of charge rate,100.00%,73.45,,,,69.78,73.45,0
unity,CDM,Um Bordatella Antibody,UM4000293,86615,,Bordetella antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.45,% of charge rate,100.00%,73.45,,,,69.78,73.45,0
unity,CDM,Um Lyme Disease Igg W Blot,UM4000376,86617,,Lyme disease antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,138.15,% of charge rate,100.00%,138.15,,,,131.24,138.15,0
unity,CDM,Um Lyme Disease Igg W Blot,UM4000376,86617,,Lyme disease antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,138.15,% of charge rate,100.00%,138.15,,,,131.24,138.15,0
unity,CDM,"Um Lyme Disease Ab, Wb Conf",UM4000061,86618,,Lyme disease antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.83,% of charge rate,100.00%,94.83,,,,90.09,94.83,0
unity,CDM,"Um Lyme Disease Ab, Wb Conf",UM4000061,86618,,Lyme disease antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.83,% of charge rate,100.00%,94.83,,,,90.09,94.83,0
unity,CDM,Um Chlamydia Antibody,UM4000339,86631,,Chlamydia antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65.84,% of charge rate,100.00%,65.84,,,,62.55,65.84,0
unity,CDM,Um Chlamydia Antibody,UM4000339,86631,,Chlamydia antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65.84,% of charge rate,100.00%,65.84,,,,62.55,65.84,0
unity,CDM,"Um Chlamydia , Igm",UM4000223,86632,,Chlamydia igm antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,70.64,% of charge rate,100.00%,70.64,,,,67.11,70.64,0
unity,CDM,"Um Chlamydia , Igm",UM4000223,86632,,Chlamydia igm antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,70.64,% of charge rate,100.00%,70.64,,,,67.11,70.64,0
unity,CDM,"Um Coccidoides, Ab(igg,igm)",UM4000302,86635,,Coccidioides antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.5,% of charge rate,100.00%,62.5,,,,59.38,62.5,0
unity,CDM,"Um Coccidoides, Ab(igg,igm)",UM4000302,86635,,Coccidioides antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.5,% of charge rate,100.00%,62.5,,,,59.38,62.5,0
unity,CDM,Um Cytomegalovirus (cmv),UM4000298,86644,,Cmv antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,Um Cytomegalovirus (cmv),UM4000298,86644,,Cmv antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,"Um Cytomegolvirus (cmv), Igm",UM4000128,86645,,Cmv antibody igm,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.55,% of charge rate,100.00%,79.55,,,,75.57,79.55,0
unity,CDM,"Um Cytomegolvirus (cmv), Igm",UM4000128,86645,,Cmv antibody igm,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.55,% of charge rate,100.00%,79.55,,,,75.57,79.55,0
unity,CDM,Um Diphtheria Toxoid Igg Ab,UM4000757,86648,,Diphtheria antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,84.67,% of charge rate,100.00%,84.67,,,,80.44,84.67,0
unity,CDM,Um Diphtheria Toxoid Igg Ab,UM4000757,86648,,Diphtheria antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,84.67,% of charge rate,100.00%,84.67,,,,80.44,84.67,0
unity,CDM,Um Coxsackie Antibody,UM4000925,86658,,Enterovirus antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,70.3,% of charge rate,100.00%,70.3,,,,66.79,70.3,0
unity,CDM,Um Coxsackie Antibody,UM4000925,86658,,Enterovirus antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,70.3,% of charge rate,100.00%,70.3,,,,66.79,70.3,0
unity,CDM,Um Epstein Barr Antibody,UM4000041,86664,,Epstein-barr nuclear antigen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,Um Epstein Barr Antibody,UM4000041,86664,,Epstein-barr nuclear antigen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,"Um Epstein-barr Virus, Viral",UM4000054,86665,,Epstein-barr capsid vca,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.55,% of charge rate,100.00%,79.55,,,,75.57,79.55,0
unity,CDM,"Um Epstein-barr Virus, Viral",UM4000054,86665,,Epstein-barr capsid vca,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.55,% of charge rate,100.00%,79.55,,,,75.57,79.55,0
unity,CDM,ANAPLASMA/ERLICHIA AB PANEL,UM4000759,86666,,Ehrlichia antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.86,% of charge rate,100.00%,101.86,,,,96.77,101.86,0
unity,CDM,ANAPLASMA/ERLICHIA AB PANEL,UM4000759,86666,,Ehrlichia antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.86,% of charge rate,100.00%,101.86,,,,96.77,101.86,0
unity,CDM,"Um Antibody, Fungus Nos",UM4000444,86671,,Fungus nes antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.5,% of charge rate,100.00%,62.5,,,,59.38,62.5,0
unity,CDM,"Um Antibody, Fungus Nos",UM4000444,86671,,Fungus nes antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.5,% of charge rate,100.00%,62.5,,,,59.38,62.5,0
unity,CDM,"Um H.pylori Igg, Igm, Iga",UM4000446,86677,,Helicobacter pylori antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.82,% of charge rate,100.00%,80.82,,,,76.78,80.82,0
unity,CDM,"Um H.pylori Igg, Igm, Iga",UM4000446,86677,,Helicobacter pylori antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.82,% of charge rate,100.00%,80.82,,,,76.78,80.82,0
unity,CDM,"Um Echinococcus Antibody, Serum",UM4000816,86682,,Helminth antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.64,% of charge rate,100.00%,57.64,,,,54.76,57.64,0
unity,CDM,"Um Echinococcus Antibody, Serum",UM4000816,86682,,Helminth antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.64,% of charge rate,100.00%,57.64,,,,54.76,57.64,0
unity,CDM,Um Cysticercus Antibody,UM4000942,86682,,Helminth antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.89,% of charge rate,100.00%,72.89,,,,69.25,72.89,0
unity,CDM,Um Cysticercus Antibody,UM4000942,86682,,Helminth antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.89,% of charge rate,100.00%,72.89,,,,69.25,72.89,0
unity,CDM,"Um Herpes Simplex,non-spec",UM4000071,86694,,Herpes simplex nes antbdy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,"Um Herpes Simplex,non-spec",UM4000071,86694,,Herpes simplex nes antbdy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,Um Herpes Simplex Test,UM4000141,86695,,Herpes simplex type 1 test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.45,% of charge rate,100.00%,73.45,,,,69.78,73.45,0
unity,CDM,Um Herpes Simplex Test,UM4000141,86695,,Herpes simplex type 1 test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.45,% of charge rate,100.00%,73.45,,,,69.78,73.45,0
unity,CDM,Um Herpes Simplex Test,UM4000141A,86695,,Herpes simplex type 1 test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.45,% of charge rate,100.00%,73.45,,,,69.78,73.45,0
unity,CDM,Um Herpes Simplex Test,UM4000141A,86695,,Herpes simplex type 1 test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.45,% of charge rate,100.00%,73.45,,,,69.78,73.45,0
unity,CDM,Um Herpes Simplex Type 2,UM4000289,86696,,Herpes simplex type 2 test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,107.76,% of charge rate,100.00%,107.76,,,,102.37,107.76,0
unity,CDM,Um Herpes Simplex Type 2,UM4000289,86696,,Herpes simplex type 2 test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,107.76,% of charge rate,100.00%,107.76,,,,102.37,107.76,0
unity,CDM,Um Herpes Simplex Type 2,UM4000289A,86696,,Herpes simplex type 2 test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,107.76,% of charge rate,100.00%,107.76,,,,102.37,107.76,0
unity,CDM,Um Herpes Simplex Type 2,UM4000289A,86696,,Herpes simplex type 2 test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,107.76,% of charge rate,100.00%,107.76,,,,102.37,107.76,0
unity,CDM,"Um Histoplasma Ab, Immuno",UM4000020,86698,,Histoplasma antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.5,% of charge rate,100.00%,62.5,,,,59.38,62.5,0
unity,CDM,"Um Histoplasma Ab, Immuno",UM4000020,86698,,Histoplasma antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.5,% of charge rate,100.00%,62.5,,,,59.38,62.5,0
unity,CDM,Um Hiv 1/2 Eia,UM86703,86703,,Hiv-1/hiv-2 1 result antbdy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,56.82,% of charge rate,100.00%,56.82,,,,53.98,56.82,0
unity,CDM,Um Hiv 1/2 Eia,UM86703,86703,,Hiv-1/hiv-2 1 result antbdy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,56.82,% of charge rate,100.00%,56.82,,,,53.98,56.82,0
unity,CDM,"Um Hep B Core Ab, Total",UM4000080,86704,,Hep b core antibody total,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,"Um Hep B Core Ab, Total",UM4000080,86704,,Hep b core antibody total,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.09,% of charge rate,100.00%,67.09,,,,63.74,67.09,0
unity,CDM,Um Hb Core Ab Igm,UM4000371,86705,,Hep b core antibody igm,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65.54,% of charge rate,100.00%,65.54,,,,62.26,65.54,0
unity,CDM,Um Hb Core Ab Igm,UM4000371,86705,,Hep b core antibody igm,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65.54,% of charge rate,100.00%,65.54,,,,62.26,65.54,0
unity,CDM,Um Hepatitis B Surface Ab,UM4000137,86706,,Hep b surface antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,59.8,% of charge rate,100.00%,59.8,,,,56.81,59.8,0
unity,CDM,Um Hepatitis B Surface Ab,UM4000137,86706,,Hep b surface antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,59.8,% of charge rate,100.00%,59.8,,,,56.81,59.8,0
unity,CDM,Um Hepatitis Be Antibody,UM4000028,86707,,Hepatitis be antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.4,% of charge rate,100.00%,64.4,,,,61.18,64.4,0
unity,CDM,Um Hepatitis Be Antibody,UM4000028,86707,,Hepatitis be antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.4,% of charge rate,100.00%,64.4,,,,61.18,64.4,0
unity,CDM,"Um Hep A, Ab, Total",UM4000213,86708,,Hepatitis a antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69,% of charge rate,100.00%,69,,,,65.55,69,0
unity,CDM,"Um Hep A, Ab, Total",UM4000213,86708,,Hepatitis a antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69,% of charge rate,100.00%,69,,,,65.55,69,0
unity,CDM,"Um Hepatitis A Ab, Igm",UM4000548,86709,,Hepatitis a igm antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.89,% of charge rate,100.00%,53.89,,,,51.2,53.89,0
unity,CDM,"Um Hepatitis A Ab, Igm",UM4000548,86709,,Hepatitis a igm antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.89,% of charge rate,100.00%,53.89,,,,51.2,53.89,0
unity,CDM,Um Mumps Antibody,UM4000221,86735,,Mumps antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.68,% of charge rate,100.00%,72.68,,,,69.05,72.68,0
unity,CDM,Um Mumps Antibody,UM4000221,86735,,Mumps antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.68,% of charge rate,100.00%,72.68,,,,69.05,72.68,0
unity,CDM,Um Mycoplasma Antibody,UM4000251,86738,,Mycoplasma antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.74,% of charge rate,100.00%,73.74,,,,70.05,73.74,0
unity,CDM,Um Mycoplasma Antibody,UM4000251,86738,,Mycoplasma antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.74,% of charge rate,100.00%,73.74,,,,70.05,73.74,0
unity,CDM,Um Norcardia Antibody,UM4000381,86744,,Nocardia antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.45,% of charge rate,100.00%,73.45,,,,69.78,73.45,0
unity,CDM,Um Norcardia Antibody,UM4000381,86744,,Nocardia antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.45,% of charge rate,100.00%,73.45,,,,69.78,73.45,0
unity,CDM,Um Parvovirus(igg/igm),UM4000138,86747,,Parvovirus antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.5,% of charge rate,100.00%,87.5,,,,83.13,87.5,0
unity,CDM,Um Parvovirus(igg/igm),UM4000138,86747,,Parvovirus antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.5,% of charge rate,100.00%,87.5,,,,83.13,87.5,0
unity,CDM,BABESIA AB,UM4000760,86753,,Protozoa antibody nos,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.89,% of charge rate,100.00%,62.89,,,,59.75,62.89,0
unity,CDM,BABESIA AB,UM4000760,86753,,Protozoa antibody nos,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.89,% of charge rate,100.00%,62.89,,,,59.75,62.89,0
unity,CDM,"Um E. Histolytica Antibody, Serum",UM4000815,86753,,Protozoa antibody nos,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.64,% of charge rate,100.00%,57.64,,,,54.76,57.64,0
unity,CDM,"Um E. Histolytica Antibody, Serum",UM4000815,86753,,Protozoa antibody nos,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.64,% of charge rate,100.00%,57.64,,,,54.76,57.64,0
unity,CDM,Um Rsv Antibody,UM4000332,86756,,Respiratory virus antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.81,% of charge rate,100.00%,71.81,,,,68.22,71.81,0
unity,CDM,Um Rsv Antibody,UM4000332,86756,,Respiratory virus antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.81,% of charge rate,100.00%,71.81,,,,68.22,71.81,0
unity,CDM,Um Rickettsia Antibody,UM4000924,86757,,Rickettsia antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,110.95,% of charge rate,100.00%,110.95,,,,105.4,110.95,0
unity,CDM,Um Rickettsia Antibody,UM4000924,86757,,Rickettsia antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,110.95,% of charge rate,100.00%,110.95,,,,105.4,110.95,0
unity,CDM,"Um Rubella, Acute Phase, Igm",UM4000329,86762,,Rubella antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,"Um Rubella, Acute Phase, Igm",UM4000329,86762,,Rubella antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,Um Rubella Antibody Igg,UM4000551,86762,,Rubella antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,Um Rubella Antibody Igg,UM4000551,86762,,Rubella antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,"Um Rubeola, Acute Phase, Igm",UM4000016,86765,,Rubeola antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.74,% of charge rate,100.00%,71.74,,,,68.15,71.74,0
unity,CDM,"Um Rubeola, Acute Phase, Igm",UM4000016,86765,,Rubeola antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.74,% of charge rate,100.00%,71.74,,,,68.15,71.74,0
unity,CDM,"Um Rubeola(measles) Ab, Igg",UM4000553,86765,,Rubeola antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.74,% of charge rate,100.00%,71.74,,,,68.15,71.74,0
unity,CDM,"Um Rubeola(measles) Ab, Igg",UM4000553,86765,,Rubeola antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.74,% of charge rate,100.00%,71.74,,,,68.15,71.74,0
unity,CDM,Um Covid-19 Igg Antibody,UM4000938,86769,,Antibody Coronavirus,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80,% of charge rate,100.00%,80,,,,76,80,0
unity,CDM,Um Covid-19 Igg Antibody,UM4000938,86769,,Antibody Coronavirus,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80,% of charge rate,100.00%,80,,,,76,80,0
unity,CDM,Um Tetanus Toxoid Igg Ab,UM4000756,86774,,Tetanus antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,82.39,% of charge rate,100.00%,82.39,,,,78.27,82.39,0
unity,CDM,Um Tetanus Toxoid Igg Ab,UM4000756,86774,,Tetanus antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,82.39,% of charge rate,100.00%,82.39,,,,78.27,82.39,0
unity,CDM,Um Toxoplasma Antibody Igg,UM4000367,86777,,Toxoplasma antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,Um Toxoplasma Antibody Igg,UM4000367,86777,,Toxoplasma antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,Um Toxoplasma Antibody Igm,UM4000007,86778,,Toxoplasma antibody igm,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.55,% of charge rate,100.00%,79.55,,,,75.57,79.55,0
unity,CDM,Um Toxoplasma Antibody Igm,UM4000007,86778,,Toxoplasma antibody igm,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.55,% of charge rate,100.00%,79.55,,,,75.57,79.55,0
unity,CDM,Um Syphillis Ab Igg & Igm,UM4000451,86780,,Treponema pallidum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.69,% of charge rate,100.00%,73.69,,,,70.01,73.69,0
unity,CDM,Um Syphillis Ab Igg & Igm,UM4000451,86780,,Treponema pallidum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.69,% of charge rate,100.00%,73.69,,,,70.01,73.69,0
unity,CDM,Um Treponema Pallidum Antibody(fta-ab),UM4000780,86780,,Treponema pallidum,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.77,% of charge rate,100.00%,73.77,,,,70.08,73.77,0
unity,CDM,Um Treponema Pallidum Antibody(fta-ab),UM4000780,86780,,Treponema pallidum,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.77,% of charge rate,100.00%,73.77,,,,70.08,73.77,0
unity,CDM,Um Varicella-zoster Igg,UM4000185,86787,,Varicella-zoster antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.74,% of charge rate,100.00%,71.74,,,,68.15,71.74,0
unity,CDM,Um Varicella-zoster Igg,UM4000185,86787,,Varicella-zoster antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.74,% of charge rate,100.00%,71.74,,,,68.15,71.74,0
unity,CDM,"Um Varicella-zoster, Igm",UM4000413,86787,,Varicella-zoster antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,117.46,% of charge rate,100.00%,117.46,,,,111.59,117.46,0
unity,CDM,"Um Varicella-zoster, Igm",UM4000413,86787,,Varicella-zoster antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,117.46,% of charge rate,100.00%,117.46,,,,111.59,117.46,0
unity,CDM,"Um West Nile,igg/igm",UM4000725,86788,,West nile virus ab igm,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.55,% of charge rate,100.00%,79.55,,,,75.57,79.55,0
unity,CDM,"Um West Nile,igg/igm",UM4000725,86788,,West nile virus ab igm,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.55,% of charge rate,100.00%,79.55,,,,75.57,79.55,0
unity,CDM,Um West Nile Virus Antibody,UM4000358,86789,,West nile virus antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,Um West Nile Virus Antibody,UM4000358,86789,,West nile virus antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.14,% of charge rate,100.00%,80.14,,,,76.13,80.14,0
unity,CDM,Um Virus Ab (nos),UM4000398,86790,,Virus antibody nos,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.74,% of charge rate,100.00%,71.74,,,,68.15,71.74,0
unity,CDM,Um Virus Ab (nos),UM4000398,86790,,Virus antibody nos,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.74,% of charge rate,100.00%,71.74,,,,68.15,71.74,0
unity,CDM,Um Hantavirus Ab,UM4000545,86790,,Virus antibody nos,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,175.83,% of charge rate,100.00%,175.83,,,,167.04,175.83,0
unity,CDM,Um Hantavirus Ab,UM4000545,86790,,Virus antibody nos,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,175.83,% of charge rate,100.00%,175.83,,,,167.04,175.83,0
unity,CDM,Um Herpes Virus 6 Igg,UM4000778,86790,,Virus antibody nos,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.76,% of charge rate,100.00%,71.76,,,,68.17,71.76,0
unity,CDM,Um Herpes Virus 6 Igg,UM4000778,86790,,Virus antibody nos,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.76,% of charge rate,100.00%,71.76,,,,68.17,71.76,0
unity,CDM,Um Herpes Virus 6 Igm,UM4000779,86790,,Virus antibody nos,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.76,% of charge rate,100.00%,71.76,,,,68.17,71.76,0
unity,CDM,Um Herpes Virus 6 Igm,UM4000779,86790,,Virus antibody nos,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.76,% of charge rate,100.00%,71.76,,,,68.17,71.76,0
unity,CDM,Um Thyroglobulin Anitbody,UM4000354,86800,,Thyroglobulin antibody,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.56,% of charge rate,100.00%,88.56,,,,84.13,88.56,0
unity,CDM,Um Thyroglobulin Anitbody,UM4000354,86800,,Thyroglobulin antibody,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.56,% of charge rate,100.00%,88.56,,,,84.13,88.56,0
unity,CDM,Um Hep C Antibody,UM4000120,86803,,Hepatitis c ab test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.49,% of charge rate,100.00%,79.49,,,,75.52,79.49,0
unity,CDM,Um Hep C Antibody,UM4000120,86803,,Hepatitis c ab test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.49,% of charge rate,100.00%,79.49,,,,75.52,79.49,0
unity,CDM,"Um Anti Hcv, Riba",UM4000239,86804,,Hep c ab test confirm,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,356.11,% of charge rate,100.00%,356.11,,,,338.3,356.11,0
unity,CDM,"Um Anti Hcv, Riba",UM4000239,86804,,Hep c ab test confirm,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,356.11,% of charge rate,100.00%,356.11,,,,338.3,356.11,0
unity,CDM,Um Hla-b27 Antigen,UM4000342,86812,,Hla typing a b or c,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,143.7,% of charge rate,100.00%,143.7,,,,136.52,143.7,0
unity,CDM,Um Hla-b27 Antigen,UM4000342,86812,,Hla typing a b or c,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,143.7,% of charge rate,100.00%,143.7,,,,136.52,143.7,0
unity,CDM,Um Antibody Screening,UM4050002,86850,,Rbc antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,109.31,% of charge rate,100.00%,109.31,,,,103.84,109.31,0
unity,CDM,Um Antibody Screening,UM4050002,86850,,Rbc antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,109.31,% of charge rate,100.00%,109.31,,,,103.84,109.31,0
unity,CDM,Um Antibody Screen-ubs,UM4050024,86850,,Rbc antibody screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,134,% of charge rate,100.00%,134,,,,127.3,134,0
unity,CDM,Um Antibody Screen-ubs,UM4050024,86850,,Rbc antibody screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,134,% of charge rate,100.00%,134,,,,127.3,134,0
unity,CDM,Um Antibody Elution (rbc),UM4050016,86860,,Rbc antibody elution,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,179.79,% of charge rate,100.00%,179.79,,,,170.8,179.79,0
unity,CDM,Um Antibody Elution (rbc),UM4050016,86860,,Rbc antibody elution,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,179.79,% of charge rate,100.00%,179.79,,,,170.8,179.79,0
unity,CDM,Um Antibody Identifica Pan,UM4050006,86870,,Rbc antibody identification,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,287.51,% of charge rate,100.00%,287.51,,,,273.13,287.51,0
unity,CDM,Um Antibody Identifica Pan,UM4050006,86870,,Rbc antibody identification,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,287.51,% of charge rate,100.00%,287.51,,,,273.13,287.51,0
unity,CDM,Um Direct Coombs,UM4050001,86880,,Coombs test direct,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.66,% of charge rate,100.00%,53.66,,,,50.98,53.66,0
unity,CDM,Um Direct Coombs,UM4050001,86880,,Coombs test direct,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.66,% of charge rate,100.00%,53.66,,,,50.98,53.66,0
unity,CDM,"Um Antibody Titration, Per Antibody",UM4000810,86886,,Coombs test indirect titer,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,"Um Antibody Titration, Per Antibody",UM4000810,86886,,Coombs test indirect titer,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Abo Grouping,UM4050013,86900,,Blood typing serologic abo,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,16.63,% of charge rate,100.00%,16.63,,,,15.8,16.63,0
unity,CDM,Um Abo Grouping,UM4050013,86900,,Blood typing serologic abo,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,16.63,% of charge rate,100.00%,16.63,,,,15.8,16.63,0
unity,CDM,Um Rh Typing,UM4050018,86901,,Blood typing serologic rh(d),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,16.63,% of charge rate,100.00%,16.63,,,,15.8,16.63,0
unity,CDM,Um Rh Typing,UM4050018,86901,,Blood typing serologic rh(d),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,16.63,% of charge rate,100.00%,16.63,,,,15.8,16.63,0
unity,CDM,Um Antigen Typing,UM4050019,86902,,Blood type antigen donor ea,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,42,% of charge rate,100.00%,42,,,,39.9,42,0
unity,CDM,Um Antigen Typing,UM4050019,86902,,Blood type antigen donor ea,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,42,% of charge rate,100.00%,42,,,,39.9,42,0
unity,CDM,Um Antigen Tpg Dnr Class Ii,UM4050022,86902,,Blood type antigen donor ea,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85,% of charge rate,100.00%,85,,,,80.75,85,0
unity,CDM,Um Antigen Tpg Dnr Class Ii,UM4050022,86902,,Blood type antigen donor ea,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85,% of charge rate,100.00%,85,,,,80.75,85,0
unity,CDM,Um Antigen Tpg Dnr Class Iii,UM4050023,86902,,Blood type antigen donor ea,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,144,% of charge rate,100.00%,144,,,,136.8,144,0
unity,CDM,Um Antigen Tpg Dnr Class Iii,UM4050023,86902,,Blood type antigen donor ea,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,144,% of charge rate,100.00%,144,,,,136.8,144,0
unity,CDM,Um Crossmatch Immediate Spin,UM4050014,86920,,Compatibility test spin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,179.79,% of charge rate,100.00%,179.79,,,,170.8,179.79,0
unity,CDM,Um Crossmatch Immediate Spin,UM4050014,86920,,Compatibility test spin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,179.79,% of charge rate,100.00%,179.79,,,,170.8,179.79,0
unity,CDM,"Um Crossmatch, Antiglob Tech",UM4050007,86922,,Compatibility test antiglob,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,179.79,% of charge rate,100.00%,179.79,,,,170.8,179.79,0
unity,CDM,"Um Crossmatch, Antiglob Tech",UM4050007,86922,,Compatibility test antiglob,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,179.79,% of charge rate,100.00%,179.79,,,,170.8,179.79,0
unity,CDM,Um Irradiation/blood Product,UM4050011,86945,,Blood product/irradiation,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,120,% of charge rate,100.00%,120,,,,114,120,0
unity,CDM,Um Irradiation/blood Product,UM4050011,86945,,Blood product/irradiation,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,120,% of charge rate,100.00%,120,,,,114,120,0
unity,CDM,UM RBCs PRETREATM ANTIB DET,UM4050005,86970,,Rbc pretx incubatj w/chemicl,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.67,% of charge rate,100.00%,52.67,,,,50.04,52.67,0
unity,CDM,UM RBCs PRETREATM ANTIB DET,UM4050005,86970,,Rbc pretx incubatj w/chemicl,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.67,% of charge rate,100.00%,52.67,,,,50.04,52.67,0
unity,CDM,Um Concentration Inf Agents,UM4000336,87015,,Specimen infect agnt concntj,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.18,% of charge rate,100.00%,37.18,,,,35.32,37.18,0
unity,CDM,Um Concentration Inf Agents,UM4000336,87015,,Specimen infect agnt concntj,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.18,% of charge rate,100.00%,37.18,,,,35.32,37.18,0
unity,CDM,Um Culture-blood,UM4000274,87040,,Blood culture for bacteria,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.48,% of charge rate,100.00%,57.48,,,,54.61,57.48,0
unity,CDM,Um Culture-blood,UM4000274,87040,,Blood culture for bacteria,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.48,% of charge rate,100.00%,57.48,,,,54.61,57.48,0
unity,CDM,Um Culture Stool,UM4000322,87045,,Feces culture aerobic bact,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.52,% of charge rate,100.00%,52.52,,,,49.89,52.52,0
unity,CDM,Um Culture Stool,UM4000322,87045,,Feces culture aerobic bact,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.52,% of charge rate,100.00%,52.52,,,,49.89,52.52,0
unity,CDM,"Um Stool Culture, Ea Addl",UM4000168,87046,,Stool cultr aerobic bact ea,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.52,% of charge rate,100.00%,52.52,,,,49.89,52.52,0
unity,CDM,"Um Stool Culture, Ea Addl",UM4000168,87046,,Stool cultr aerobic bact ea,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.52,% of charge rate,100.00%,52.52,,,,49.89,52.52,0
unity,CDM,"Um Culture, Bacterial",UM4000095,87070,,Culture othr specimn aerobic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.97,% of charge rate,100.00%,47.97,,,,45.57,47.97,0
unity,CDM,"Um Culture, Bacterial",UM4000095,87070,,Culture othr specimn aerobic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.97,% of charge rate,100.00%,47.97,,,,45.57,47.97,0
unity,CDM,Um Strep Screen Grp B,UM4000262,87070,,Culture othr specimn aerobic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.97,% of charge rate,100.00%,47.97,,,,45.57,47.97,0
unity,CDM,Um Strep Screen Grp B,UM4000262,87070,,Culture othr specimn aerobic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.97,% of charge rate,100.00%,47.97,,,,45.57,47.97,0
unity,CDM,Um Culture-throat & Nose,UM4000275,87070,,Culture othr specimn aerobic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.97,% of charge rate,100.00%,47.97,,,,45.57,47.97,0
unity,CDM,Um Culture-throat & Nose,UM4000275,87070,,Culture othr specimn aerobic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.97,% of charge rate,100.00%,47.97,,,,45.57,47.97,0
unity,CDM,Um Culture Bacterial Other Referred,UM4000736,87070,,Culture othr specimn aerobic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.97,% of charge rate,100.00%,47.97,,,,45.57,47.97,0
unity,CDM,Um Culture Bacterial Other Referred,UM4000736,87070,,Culture othr specimn aerobic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.97,% of charge rate,100.00%,47.97,,,,45.57,47.97,0
unity,CDM,Um Culture-anaerobic Iso/id,UM4000278,87075,,Cultr bacteria except blood,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.68,% of charge rate,100.00%,52.68,,,,50.05,52.68,0
unity,CDM,Um Culture-anaerobic Iso/id,UM4000278,87075,,Cultr bacteria except blood,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.68,% of charge rate,100.00%,52.68,,,,50.05,52.68,0
unity,CDM,"Um Culture, Anaerobe, Def Id",UM4000048,87076,,Culture anaerobe ident each,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.01,% of charge rate,100.00%,45.01,,,,42.76,45.01,0
unity,CDM,"Um Culture, Anaerobe, Def Id",UM4000048,87076,,Culture anaerobe ident each,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.01,% of charge rate,100.00%,45.01,,,,42.76,45.01,0
unity,CDM,"Um Aerobic Isolate, Addl Id",UM4000107,87077,,Culture aerobic identify,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.01,% of charge rate,100.00%,45.01,,,,42.76,45.01,0
unity,CDM,"Um Aerobic Isolate, Addl Id",UM4000107,87077,,Culture aerobic identify,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.01,% of charge rate,100.00%,45.01,,,,42.76,45.01,0
unity,CDM,"Um Clo Test, Rapid Urease",UM4000434,87077,,Culture aerobic identify,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.01,% of charge rate,100.00%,45.01,,,,42.76,45.01,0
unity,CDM,"Um Clo Test, Rapid Urease",UM4000434,87077,,Culture aerobic identify,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.01,% of charge rate,100.00%,45.01,,,,42.76,45.01,0
unity,CDM,Um Culture Aerobic Id Referred,UM4000733,87077,,Culture aerobic identify,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.01,% of charge rate,100.00%,45.01,,,,42.76,45.01,0
unity,CDM,Um Culture Aerobic Id Referred,UM4000733,87077,,Culture aerobic identify,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.01,% of charge rate,100.00%,45.01,,,,42.76,45.01,0
unity,CDM,Um Mrsa Screen,UM4000067,87081,,Culture screen only,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.03,% of charge rate,100.00%,31.03,,,,29.48,31.03,0
unity,CDM,Um Mrsa Screen,UM4000067,87081,,Culture screen only,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.03,% of charge rate,100.00%,31.03,,,,29.48,31.03,0
unity,CDM,Um Grp B Strep,UM4000731,87081,,Culture screen only,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.64,% of charge rate,100.00%,31.64,,,,30.06,31.64,0
unity,CDM,Um Grp B Strep,UM4000731,87081,,Culture screen only,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.64,% of charge rate,100.00%,31.64,,,,30.06,31.64,0
unity,CDM,Um Culture Screen Only Referred,UM4000735,87081,,Culture screen only,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.64,% of charge rate,100.00%,31.64,,,,30.06,31.64,0
unity,CDM,Um Culture Screen Only Referred,UM4000735,87081,,Culture screen only,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.64,% of charge rate,100.00%,31.64,,,,30.06,31.64,0
unity,CDM,Um Vre Screen,UM4000811,87081,,Culture screen only,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.64,% of charge rate,100.00%,31.64,,,,30.06,31.64,0
unity,CDM,Um Vre Screen,UM4000811,87081,,Culture screen only,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.64,% of charge rate,100.00%,31.64,,,,30.06,31.64,0
unity,CDM,Um Urine Culture Colony Ct,UM4000291,87086,,Urine culture/colony count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,44.95,% of charge rate,100.00%,44.95,,,,42.7,44.95,0
unity,CDM,Um Urine Culture Colony Ct,UM4000291,87086,,Urine culture/colony count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,44.95,% of charge rate,100.00%,44.95,,,,42.7,44.95,0
unity,CDM,"Um Culture-urine, Pres Id",UM4000176,87088,,Urine bacteria culture,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.08,% of charge rate,100.00%,45.08,,,,42.83,45.08,0
unity,CDM,"Um Culture-urine, Pres Id",UM4000176,87088,,Urine bacteria culture,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.08,% of charge rate,100.00%,45.08,,,,42.83,45.08,0
unity,CDM,Um Culture Fungal Skin/nail,UM4000549,87101,,Skin fungi culture,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,42.98,% of charge rate,100.00%,42.98,,,,40.83,42.98,0
unity,CDM,Um Culture Fungal Skin/nail,UM4000549,87101,,Skin fungi culture,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,42.98,% of charge rate,100.00%,42.98,,,,40.83,42.98,0
unity,CDM,"Um Culture,fungal Isolation",UM4000119,87102,,Fungus isolation culture,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,46.81,% of charge rate,100.00%,46.81,,,,44.47,46.81,0
unity,CDM,"Um Culture,fungal Isolation",UM4000119,87102,,Fungus isolation culture,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,46.81,% of charge rate,100.00%,46.81,,,,44.47,46.81,0
unity,CDM,"Um Blood Culture, Fungal",UM4000879,87103,,Blood fungus culture,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.29,% of charge rate,100.00%,52.29,,,,49.68,52.29,0
unity,CDM,"Um Blood Culture, Fungal",UM4000879,87103,,Blood fungus culture,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.29,% of charge rate,100.00%,52.29,,,,49.68,52.29,0
unity,CDM,Um Fungus Culture Id (yeast),UM4000770,87106,,Fungi identification yeast,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.52,% of charge rate,100.00%,57.52,,,,54.64,57.52,0
unity,CDM,Um Fungus Culture Id (yeast),UM4000770,87106,,Fungi identification yeast,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.52,% of charge rate,100.00%,57.52,,,,54.64,57.52,0
unity,CDM,Um Culture Fungus Id,UM4000740,87107,,Fungi identification mold,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.48,% of charge rate,100.00%,57.48,,,,54.61,57.48,0
unity,CDM,Um Culture Fungus Id,UM4000740,87107,,Fungi identification mold,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.48,% of charge rate,100.00%,57.48,,,,54.61,57.48,0
unity,CDM,"Um Culture, Mycoplasma",UM4000377,87109,,Mycoplasma,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.65,% of charge rate,100.00%,85.65,,,,81.37,85.65,0
unity,CDM,"Um Culture, Mycoplasma",UM4000377,87109,,Mycoplasma,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.65,% of charge rate,100.00%,85.65,,,,81.37,85.65,0
unity,CDM,"Um Culture, Mycobacteria",UM4000276,87116,,Mycobacteria culture,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.59,% of charge rate,100.00%,29.59,,,,28.11,29.59,0
unity,CDM,"Um Culture, Mycobacteria",UM4000276,87116,,Mycobacteria culture,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.59,% of charge rate,100.00%,29.59,,,,28.11,29.59,0
unity,CDM,Um Culture Tb (mycobacteria),UM4000204,87118,,Mycobacteric identification,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.94,% of charge rate,100.00%,60.94,,,,57.89,60.94,0
unity,CDM,Um Culture Tb (mycobacteria),UM4000204,87118,,Mycobacteric identification,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.94,% of charge rate,100.00%,60.94,,,,57.89,60.94,0
unity,CDM,Um Culture Typing,UM4000356,87140,,Culture type immunofluoresc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.04,% of charge rate,100.00%,31.04,,,,29.49,31.04,0
unity,CDM,Um Culture Typing,UM4000356,87140,,Culture type immunofluoresc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.04,% of charge rate,100.00%,31.04,,,,29.49,31.04,0
unity,CDM,Um Culture Typing,UM4000532,87147,,Culture type immunologic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Culture Typing,UM4000532,87147,,Culture type immunologic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.82,% of charge rate,100.00%,28.82,,,,27.38,28.82,0
unity,CDM,Um Culture Typing Dna Probe,UM4000741,87149,,Dna/rna direct probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.64,% of charge rate,100.00%,111.64,,,,106.06,111.64,0
unity,CDM,Um Culture Typing Dna Probe,UM4000741,87149,,Dna/rna direct probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.64,% of charge rate,100.00%,111.64,,,,106.06,111.64,0
unity,CDM,"Um Culture, Typing, Id By Dna/rna Ampl Probe Per Organism",UM4000833,87150,,Dna/rna amplified probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,"Um Culture, Typing, Id By Dna/rna Ampl Probe Per Organism",UM4000833,87150,,Dna/rna amplified probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,Um Dna/rna Sequencing,UM4000850,87153,,Dna/rna sequencing,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,668.77,% of charge rate,100.00%,668.77,,,,635.33,668.77,0
unity,CDM,Um Dna/rna Sequencing,UM4000850,87153,,Dna/rna sequencing,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,668.77,% of charge rate,100.00%,668.77,,,,635.33,668.77,0
unity,CDM,"Um Macroscopic Examiniation, Arthropod",UM4000888,87168,,Macroscopic exam arthropod,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.77,% of charge rate,100.00%,24.77,,,,23.53,24.77,0
unity,CDM,"Um Macroscopic Examiniation, Arthropod",UM4000888,87168,,Macroscopic exam arthropod,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.77,% of charge rate,100.00%,24.77,,,,23.53,24.77,0
unity,CDM,Um O&p Macroscopic Exam,UM4000259,87169,,Macroscopic exam parasite,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um O&p Macroscopic Exam,UM4000259,87169,,Macroscopic exam parasite,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Pinworm Exam,UM4000384,87172,,Pinworm exam,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Pinworm Exam,UM4000384,87172,,Pinworm exam,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um O&p Concentrate/id (ph),UM4000724,87177,,Ova and parasites smears,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49.54,% of charge rate,100.00%,49.54,,,,47.06,49.54,0
unity,CDM,Um O&p Concentrate/id (ph),UM4000724,87177,,Ova and parasites smears,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49.54,% of charge rate,100.00%,49.54,,,,47.06,49.54,0
unity,CDM,Um E Test Sensitivity,UM4000234,87181,,Microbe susceptible diffuse,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,Um E Test Sensitivity,UM4000234,87181,,Microbe susceptible diffuse,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,"Um Sensitivity, K-b",UM4000232,87184,,Microbe susceptible disk,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.43,% of charge rate,100.00%,38.43,,,,36.51,38.43,0
unity,CDM,"Um Sensitivity, K-b",UM4000232,87184,,Microbe susceptible disk,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.43,% of charge rate,100.00%,38.43,,,,36.51,38.43,0
unity,CDM,Um Beta Lactamase Sens,UM4000236,87185,,Microbe susceptible enzyme,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,Um Beta Lactamase Sens,UM4000236,87185,,Microbe susceptible enzyme,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.45,% of charge rate,100.00%,26.45,,,,25.13,26.45,0
unity,CDM,"Um Sensitivity, Mic",UM4000350,87186,,Microbe susceptible mic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.92,% of charge rate,100.00%,38.92,,,,36.97,38.92,0
unity,CDM,"Um Sensitivity, Mic",UM4000350,87186,,Microbe susceptible mic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.92,% of charge rate,100.00%,38.92,,,,36.97,38.92,0
unity,CDM,"Um Sensitivity, Mycobacterium",UM4000793,87186,,Microbe susceptible mic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,150,% of charge rate,100.00%,150,,,,142.5,150,0
unity,CDM,"Um Sensitivity, Mycobacterium",UM4000793,87186,,Microbe susceptible mic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,150,% of charge rate,100.00%,150,,,,142.5,150,0
unity,CDM,Um Gram Stain,UM4000148,87205,,Smear gram stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Gram Stain,UM4000148,87205,,Smear gram stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Gram Stain Referred,UM4000737,87205,,Smear gram stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Gram Stain Referred,UM4000737,87205,,Smear gram stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Fluoro Acid Fast Stain,UM4000253,87206,,Smear fluorescent/acid stai,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.91,% of charge rate,100.00%,29.91,,,,28.41,29.91,0
unity,CDM,Um Fluoro Acid Fast Stain,UM4000253,87206,,Smear fluorescent/acid stai,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.91,% of charge rate,100.00%,29.91,,,,28.41,29.91,0
unity,CDM,Um Ova & Parasite Stain,UM4000246,87207,,Smear special stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.37,% of charge rate,100.00%,33.37,,,,31.7,33.37,0
unity,CDM,Um Ova & Parasite Stain,UM4000246,87207,,Smear special stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.37,% of charge rate,100.00%,33.37,,,,31.7,33.37,0
unity,CDM,"Um Parasites, Blood Giemsa Stain",UM4000798,87207,,Smear special stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.37,% of charge rate,100.00%,33.37,,,,31.7,33.37,0
unity,CDM,"Um Parasites, Blood Giemsa Stain",UM4000798,87207,,Smear special stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.37,% of charge rate,100.00%,33.37,,,,31.7,33.37,0
unity,CDM,Um O&p Trichrome Stain (ph),UM4000723,87209,,Smear complex stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100.07,% of charge rate,100.00%,100.07,,,,95.07,100.07,0
unity,CDM,Um O&p Trichrome Stain (ph),UM4000723,87209,,Smear complex stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100.07,% of charge rate,100.00%,100.07,,,,95.07,100.07,0
unity,CDM,Um Wet Prep,UM4000018,87210,,Smear wet mount saline/ink,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Wet Prep,UM4000018,87210,,Smear wet mount saline/ink,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Koh Slide,UM4000372,87220,,Tissue exam for fungi,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,Um Koh Slide,UM4000372,87220,,Tissue exam for fungi,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.79,% of charge rate,100.00%,23.79,,,,22.6,23.79,0
unity,CDM,"Um Virus Rapid Culture, Resp",UM4000027,87254,,Virus inoculation shell via,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,208.7,% of charge rate,100.00%,208.7,,,,198.27,208.7,0
unity,CDM,"Um Virus Rapid Culture, Resp",UM4000027,87254,,Virus inoculation shell via,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,208.7,% of charge rate,100.00%,208.7,,,,198.27,208.7,0
unity,CDM,Um Virus Isolation; Centrifuge Enhanced Technique,UM4000864,87254,,Virus inoculation shell via,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,113.39,% of charge rate,100.00%,113.39,,,,107.72,113.39,0
unity,CDM,Um Virus Isolation; Centrifuge Enhanced Technique,UM4000864,87254,,Virus inoculation shell via,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,113.39,% of charge rate,100.00%,113.39,,,,107.72,113.39,0
unity,CDM,"Um Virus Isolation, Enzymat",UM4000403,87255,,Genet virus isolate hsv,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,188.58,% of charge rate,100.00%,188.58,,,,179.15,188.58,0
unity,CDM,"Um Virus Isolation, Enzymat",UM4000403,87255,,Genet virus isolate hsv,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,188.58,% of charge rate,100.00%,188.58,,,,179.15,188.58,0
unity,CDM,"Um Pertussis Ag, If",UM4000269,87265,,Pertussis ag if,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,"Um Pertussis Ag, If",UM4000269,87265,,Pertussis ag if,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,"Um Crypto, Antigen, If",UM4000256,87272,,Cryptosporidium ag if,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,"Um Crypto, Antigen, If",UM4000256,87272,,Cryptosporidium ag if,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,"Um Parainfluenzae, Ag,if",UM4000017,87279,,Parainfluenza ag if,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,171.6,% of charge rate,100.00%,171.6,,,,163.02,171.6,0
unity,CDM,"Um Parainfluenzae, Ag,if",UM4000017,87279,,Parainfluenza ag if,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,171.6,% of charge rate,100.00%,171.6,,,,163.02,171.6,0
unity,CDM,Um Aspergillus Ag,UM4000537,87305,,Aspergillus ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,154.55,% of charge rate,100.00%,154.55,,,,146.82,154.55,0
unity,CDM,Um Aspergillus Ag,UM4000537,87305,,Aspergillus ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,154.55,% of charge rate,100.00%,154.55,,,,146.82,154.55,0
unity,CDM,Um C Diff Toxins Eia,UM4000569,87324,,Clostridium ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um C Diff Toxins Eia,UM4000569,87324,,Clostridium ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Ova & Parasites,UM4000379,87328,,Cryptosporidium ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Ova & Parasites,UM4000379,87328,,Cryptosporidium ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Giardia,UM4000195,87329,,Giardia ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Giardia,UM4000195,87329,,Giardia ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,"Um H Pylori Stool Ag,referred",UM4000217,87338,,Hpylori stool ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,224.36,% of charge rate,100.00%,224.36,,,,213.14,224.36,0
unity,CDM,"Um H Pylori Stool Ag,referred",UM4000217,87338,,Hpylori stool ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,224.36,% of charge rate,100.00%,224.36,,,,213.14,224.36,0
unity,CDM,Um H. Pylori Stool Ag,UM4000572,87338,,Hpylori stool ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um H. Pylori Stool Ag,UM4000572,87338,,Hpylori stool ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Hepatitis Bsag,UM4000200,87340,,Hepatitis b surface ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.43,% of charge rate,100.00%,54.43,,,,51.71,54.43,0
unity,CDM,Um Hepatitis Bsag,UM4000200,87340,,Hepatitis b surface ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.43,% of charge rate,100.00%,54.43,,,,51.71,54.43,0
unity,CDM,Um Hbsag Neutralization,UM4000382,87341,,Hepatitis b surface ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.43,% of charge rate,100.00%,54.43,,,,51.71,54.43,0
unity,CDM,Um Hbsag Neutralization,UM4000382,87341,,Hepatitis b surface ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.43,% of charge rate,100.00%,54.43,,,,51.71,54.43,0
unity,CDM,Um Hepatitis Be Antigen,UM4000301,87350,,Hepatitis be ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.15,% of charge rate,100.00%,64.15,,,,60.94,64.15,0
unity,CDM,Um Hepatitis Be Antigen,UM4000301,87350,,Hepatitis be ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.15,% of charge rate,100.00%,64.15,,,,60.94,64.15,0
unity,CDM,"Um Histplama Cps, At, Eia,ur",UM4000323,87385,,Histoplasma capsul ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,141.13,% of charge rate,100.00%,141.13,,,,134.07,141.13,0
unity,CDM,"Um Histplama Cps, At, Eia,ur",UM4000323,87385,,Histoplasma capsul ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,141.13,% of charge rate,100.00%,141.13,,,,134.07,141.13,0
unity,CDM,Um Hiv Screening,UM4000281,87389,,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49.46,% of charge rate,100.00%,49.46,,,,46.99,49.46,0
unity,CDM,Um Hiv Screening,UM4000281,87389,,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49.46,% of charge rate,100.00%,49.46,,,,46.99,49.46,0
unity,CDM,Um Hiv-1 Antigen W/ Hiv-1 & 2 Antibody,UM4000862,87389,,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,126.96,% of charge rate,100.00%,126.96,,,,120.61,126.96,0
unity,CDM,Um Hiv-1 Antigen W/ Hiv-1 & 2 Antibody,UM4000862,87389,,Hiv-1 ag w/hiv-1 & hiv-2 ab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,126.96,% of charge rate,100.00%,126.96,,,,120.61,126.96,0
unity,CDM,"Um Rsv, Eia-screening",UM4000231,87420,,Resp syncytial ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,"Um Rsv, Eia-screening",UM4000231,87420,,Resp syncytial ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Rotavirus,UM4000156,87425,,Rotavirus ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Rotavirus,UM4000156,87425,,Rotavirus ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Shiga-like Toxin,UM4000734,87427,,Shiga-like toxin ag ia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Shiga-like Toxin,UM4000734,87427,,Shiga-like toxin ag ia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Beta-d-glucans(fungitell),UM4000538,87449,,Ag detect nos ia mult,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,150.77,% of charge rate,100.00%,150.77,,,,143.23,150.77,0
unity,CDM,Um Beta-d-glucans(fungitell),UM4000538,87449,,Ag detect nos ia mult,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,150.77,% of charge rate,100.00%,150.77,,,,143.23,150.77,0
unity,CDM,Um C Diff Ag Eia,UM4000570,87449,,Ag detect nos ia mult,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um C Diff Ag Eia,UM4000570,87449,,Ag detect nos ia mult,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,"Um Legionella Ag,urine",UM4000717,87449,,Ag detect nos ia mult,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,107.59,% of charge rate,100.00%,107.59,,,,102.21,107.59,0
unity,CDM,"Um Legionella Ag,urine",UM4000717,87449,,Ag detect nos ia mult,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,107.59,% of charge rate,100.00%,107.59,,,,102.21,107.59,0
unity,CDM,Um Legionella Ag Urine,UM4000738,87450,,Ag detect nos ia single,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,0
unity,CDM,Um Legionella Ag Urine,UM4000738,87450,,Ag detect nos ia single,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,0
unity,CDM,Um Strep Pneumo Ag Urine,UM4000739,87450,,Ag detect nos ia single,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,0
unity,CDM,Um Strep Pneumo Ag Urine,UM4000739,87450,,Ag detect nos ia single,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,0
unity,CDM,"Um Lyme Disease,pcr",UM4000767,87476,,Lyme dis dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,"Um Lyme Disease,pcr",UM4000767,87476,,Lyme dis dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,Um Candida Sp Direct Probe,UM4000782,87480,,Candida dna dir probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.72,% of charge rate,100.00%,111.72,,,,106.13,111.72,0
unity,CDM,Um Candida Sp Direct Probe,UM4000782,87480,,Candida dna dir probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.72,% of charge rate,100.00%,111.72,,,,106.13,111.72,0
unity,CDM,"Um Chlamydia Pneumo, Amp Probe",UM4000847,87486,,Chylmd pneum dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,"Um Chlamydia Pneumo, Amp Probe",UM4000847,87486,,Chylmd pneum dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Chlamydia Dna Probe,UM4000183,87491,,Chylmd trach dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.5,% of charge rate,100.00%,48.5,,,,46.08,48.5,0
unity,CDM,Um Chlamydia Dna Probe,UM4000183,87491,,Chylmd trach dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.5,% of charge rate,100.00%,48.5,,,,46.08,48.5,0
unity,CDM,Um Clostridium Difficile,UM4000290,87493,,C diff amplified probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,Um Clostridium Difficile,UM4000290,87493,,C diff amplified probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,"Um Cmv / Pcr, Quant",UM4000536,87497,,Cytomeg dna quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,419.23,% of charge rate,100.00%,419.23,,,,398.27,419.23,0
unity,CDM,"Um Cmv / Pcr, Quant",UM4000536,87497,,Cytomeg dna quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,419.23,% of charge rate,100.00%,419.23,,,,398.27,419.23,0
unity,CDM,"Um Vre Screen,pcr",UM4000720,87500,,Vanomycin dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,"Um Vre Screen,pcr",UM4000720,87500,,Vanomycin dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,Um Influenzae Dna Amp Probe,UM4000758,87502,,Influenza dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,167,% of charge rate,100.00%,167,,,,158.65,167,0
unity,CDM,Um Influenzae Dna Amp Probe,UM4000758,87502,,Influenza dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,167,% of charge rate,100.00%,167,,,,158.65,167,0
unity,CDM,"Um Rsv, Amp Probe",UM4000844,87502,,Influenza dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,307,% of charge rate,100.00%,307,,,,291.65,307,0
unity,CDM,"Um Rsv, Amp Probe",UM4000844,87502,,Influenza dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,307,% of charge rate,100.00%,307,,,,291.65,307,0
unity,CDM,Um Enteric Pathogen Panel,UM4000764,87506,,Iadna-dna/rna probe tq 6-11,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,190,% of charge rate,100.00%,190,,,,180.5,190,0
unity,CDM,Um Enteric Pathogen Panel,UM4000764,87506,,Iadna-dna/rna probe tq 6-11,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,190,% of charge rate,100.00%,190,,,,180.5,190,0
unity,CDM,Um Gi Panel Pcr,UM4000939,87507,,Iadna-dna/rna probe tq 12-25,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,225,% of charge rate,100.00%,225,,,,213.75,225,0
unity,CDM,Um Gi Panel Pcr,UM4000939,87507,,Iadna-dna/rna probe tq 12-25,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,225,% of charge rate,100.00%,225,,,,213.75,225,0
unity,CDM,Um Gardnerella Vagininalis Direct Probe,UM4000783,87510,,Gardner vag dna dir probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.72,% of charge rate,100.00%,111.72,,,,106.13,111.72,0
unity,CDM,Um Gardnerella Vagininalis Direct Probe,UM4000783,87510,,Gardner vag dna dir probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.72,% of charge rate,100.00%,111.72,,,,106.13,111.72,0
unity,CDM,"Um Hepatitis B, Dna Pb,qual",UM4000032,87516,,Hepatitis b dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,276.28,% of charge rate,100.00%,276.28,,,,262.47,276.28,0
unity,CDM,"Um Hepatitis B, Dna Pb,qual",UM4000032,87516,,Hepatitis b dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,276.28,% of charge rate,100.00%,276.28,,,,262.47,276.28,0
unity,CDM,"Um Hep C Rna, Amp Probe",UM4000327,87521,,Hepatitis c probe&rvrs trnsc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,356.41,% of charge rate,100.00%,356.41,,,,338.59,356.41,0
unity,CDM,"Um Hep C Rna, Amp Probe",UM4000327,87521,,Hepatitis c probe&rvrs trnsc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,356.41,% of charge rate,100.00%,356.41,,,,338.59,356.41,0
unity,CDM,"Um Hepatitis C-rna,quant",UM4000222,87522,,Hepatitis c revrs trnscrpj,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,710.57,% of charge rate,100.00%,710.57,,,,675.04,710.57,0
unity,CDM,"Um Hepatitis C-rna,quant",UM4000222,87522,,Hepatitis c revrs trnscrpj,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,710.57,% of charge rate,100.00%,710.57,,,,675.04,710.57,0
unity,CDM,"Um Hcv-rna, Quant Pcr",UM4000424,87522,,Hepatitis c revrs trnscrpj,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,394.68,% of charge rate,100.00%,394.68,,,,374.95,394.68,0
unity,CDM,"Um Hcv-rna, Quant Pcr",UM4000424,87522,,Hepatitis c revrs trnscrpj,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,394.68,% of charge rate,100.00%,394.68,,,,374.95,394.68,0
unity,CDM,Um Hsv Dna Amplified Probe,UM4000043,87529,,Hsv dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,Um Hsv Dna Amplified Probe,UM4000043,87529,,Hsv dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,Um Hsv1/hsv2 By Pcr,UM4000116,87529,,Hsv dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,Um Hsv1/hsv2 By Pcr,UM4000116,87529,,Hsv dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,"UM RBC ANTIGENS, OTHER THAN ABO OR  RH, EACH",UM4000794,87536,,Hiv-1 quant&revrse trnscrpj,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,474.03,% of charge rate,100.00%,474.03,,,,450.33,474.03,0
unity,CDM,"UM RBC ANTIGENS, OTHER THAN ABO OR  RH, EACH",UM4000794,87536,,Hiv-1 quant&revrse trnscrpj,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,474.03,% of charge rate,100.00%,474.03,,,,450.33,474.03,0
unity,CDM,"Um Mycobacteria, Pcr-respira",UM4000143,87556,,M.tuberculo dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,229.81,% of charge rate,100.00%,229.81,,,,218.32,229.81,0
unity,CDM,"Um Mycobacteria, Pcr-respira",UM4000143,87556,,M.tuberculo dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,229.81,% of charge rate,100.00%,229.81,,,,218.32,229.81,0
unity,CDM,"Um Mycobact, Pcr Non Resp",UM4000421,87556,,M.tuberculo dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,218.53,% of charge rate,100.00%,218.53,,,,207.6,218.53,0
unity,CDM,"Um Mycobact, Pcr Non Resp",UM4000421,87556,,M.tuberculo dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,218.53,% of charge rate,100.00%,218.53,,,,207.6,218.53,0
unity,CDM,"Um Mycoplasma Pneumo, Amp Probe",UM4000848,87581,,M.pneumon dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,"Um Mycoplasma Pneumo, Amp Probe",UM4000848,87581,,M.pneumon dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,"Um N. Gonorrhoeae, Dna, Amb Probe",UM4000817,87591,,N.gonorrhoeae dna amp prob,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.5,% of charge rate,100.00%,48.5,,,,46.08,48.5,0
unity,CDM,"Um N. Gonorrhoeae, Dna, Amb Probe",UM4000817,87591,,N.gonorrhoeae dna amp prob,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.5,% of charge rate,100.00%,48.5,,,,46.08,48.5,0
unity,CDM,Um Hpv - High Risk Types,UM4000821,87624,,Hpv high-risk types,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,Um Hpv - High Risk Types,UM4000821,87624,,Hpv high-risk types,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,Um Hpv Types 16 & 18 Only,UM4000804,87625,,Hpv types 16 & 18 only,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,Um Hpv Types 16 & 18 Only,UM4000804,87625,,Hpv types 16 & 18 only,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,Um Rsv & Influenza 3-5 Targets,UM4000899,87631,,Resp virus 3-5 targets,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,458,% of charge rate,100.00%,458,,,,435.1,458,0
unity,CDM,Um Rsv & Influenza 3-5 Targets,UM4000899,87631,,Resp virus 3-5 targets,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,458,% of charge rate,100.00%,458,,,,435.1,458,0
unity,CDM,"Um Covid / Influenza, 3-5 Targets Pcr",UM4000940,87631,,Resp virus 3-5 targets,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,310,% of charge rate,100.00%,310,,,,294.5,310,0
unity,CDM,"Um Covid / Influenza, 3-5 Targets Pcr",UM4000940,87631,,Resp virus 3-5 targets,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,310,% of charge rate,100.00%,310,,,,294.5,310,0
unity,CDM,Um Respiratory Virus 12-25 Targets,UM4000845,87633,,Resp virus 12-25 targets,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Respiratory Virus 12-25 Targets,UM4000845,87633,,Resp virus 12-25 targets,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,"Um Infectious Agent Detection By Nucleic Acid, Sars-cov-2",UM4000935,87635,,Sars-Covid -19- PROBE,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140,% of charge rate,100.00%,140,,,,133,140,0
unity,CDM,"Um Infectious Agent Detection By Nucleic Acid, Sars-cov-2",UM4000935,87635,,Sars-Covid -19- PROBE,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140,% of charge rate,100.00%,140,,,,133,140,0
unity,CDM,"Um Mrsa Screen,pcr",UM4000715,87641,,Mr-staph dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,"Um Mrsa Screen,pcr",UM4000715,87641,,Mr-staph dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,Um Strep A Dna Amplified Probe,UM4000768,87651,,Strep a dna amp probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,Um Strep A Dna Amplified Probe,UM4000768,87651,,Strep a dna amp probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,Um Trichomonas Vaginalis Direct Probe,UM4000784,87660,,Trichomonas vagin dir probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.72,% of charge rate,100.00%,111.72,,,,106.13,111.72,0
unity,CDM,Um Trichomonas Vaginalis Direct Probe,UM4000784,87660,,Trichomonas vagin dir probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.72,% of charge rate,100.00%,111.72,,,,106.13,111.72,0
unity,CDM,"Um Trichomonas Vaginalis, Rna, Qual",UM4000796,87661,,Trichomonas vaginalis amplif,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,"Um Trichomonas Vaginalis, Rna, Qual",UM4000796,87661,,Trichomonas vaginalis amplif,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.5,% of charge rate,100.00%,195.5,,,,185.73,195.5,0
unity,CDM,"Um Amp Probe, Each Organism",UM4000374,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,191.49,% of charge rate,100.00%,191.49,,,,181.92,191.49,0
unity,CDM,"Um Amp Probe, Each Organism",UM4000374,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,191.49,% of charge rate,100.00%,191.49,,,,181.92,191.49,0
unity,CDM,"Um Varicella Zoster Pcr,qual",UM4000727,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,308.87,% of charge rate,100.00%,308.87,,,,293.43,308.87,0
unity,CDM,"Um Varicella Zoster Pcr,qual",UM4000727,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,308.87,% of charge rate,100.00%,308.87,,,,293.43,308.87,0
unity,CDM,Um Bordetella Pertussis Pcr,UM4000744,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Bordetella Pertussis Pcr,UM4000744,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,"Um Mycoplasma Genitalium, Mol Detect",UM4000840,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Mycoplasma Genitalium, Mol Detect",UM4000840,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Mycoplasma Hominis, Mol Detect",UM4000841,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Mycoplasma Hominis, Mol Detect",UM4000841,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Ureaplasma Urealyticum, Mol Detect",UM4000842,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Ureaplasma Urealyticum, Mol Detect",UM4000842,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Ureaplasma Parvum, Mol Detect",UM4000843,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Ureaplasma Parvum, Mol Detect",UM4000843,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Detect Agent Nos, Dna, Amplified",UM4000846,87798,,Detect agent nos dna amp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Detect Agent Nos, Dna, Amplified",UM4000846,87798,,Detect agent nos dna amp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,203.45,% of charge rate,100.00%,203.45,,,,193.28,203.45,0
unity,CDM,"Um Bk Virus, Pcr, Quant",UM4000558,87799,,Detect agent nos dna quant,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,639.31,% of charge rate,100.00%,639.31,,,,607.34,639.31,0
unity,CDM,"Um Bk Virus, Pcr, Quant",UM4000558,87799,,Detect agent nos dna quant,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,639.31,% of charge rate,100.00%,639.31,,,,607.34,639.31,0
unity,CDM,Um Bordetella Culture,UM4000877,87801,,Detect agnt mult dna ampli,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85,% of charge rate,100.00%,85,,,,80.75,85,0
unity,CDM,Um Bordetella Culture,UM4000877,87801,,Detect agnt mult dna ampli,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85,% of charge rate,100.00%,85,,,,80.75,85,0
unity,CDM,"Um Varicella Zoster, Amplified Probe Technique",UM4000878,87801,,Detect agnt mult dna ampli,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,"Um Varicella Zoster, Amplified Probe Technique",UM4000878,87801,,Detect agnt mult dna ampli,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,195.42,% of charge rate,100.00%,195.42,,,,185.65,195.42,0
unity,CDM,Um Influenza A,UM4000152,87804,,Influenza assay w/optic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Influenza A,UM4000152,87804,,Influenza assay w/optic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Influenzae B,UM4000458,87804,,Influenza assay w/optic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Influenzae B,UM4000458,87804,,Influenza assay w/optic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Rsv Antigen,UM4000226,87807,,Rsv assay w/optic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93,% of charge rate,100.00%,93,,,,88.35,93,0
unity,CDM,Um Rsv Antigen,UM4000226,87807,,Rsv assay w/optic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93,% of charge rate,100.00%,93,,,,88.35,93,0
unity,CDM,Um Strep A Screen,UM4000136,87880,,Strep a assay w/optic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Strep A Screen,UM4000136,87880,,Strep a assay w/optic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.8,% of charge rate,100.00%,66.8,,,,63.46,66.8,0
unity,CDM,Um Agent Nos Assay W/optic,UM4000849,87899,,Agent nos assay w/optic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69.48,% of charge rate,100.00%,69.48,,,,66.01,69.48,0
unity,CDM,Um Agent Nos Assay W/optic,UM4000849,87899,,Agent nos assay w/optic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69.48,% of charge rate,100.00%,69.48,,,,66.01,69.48,0
unity,CDM,Um Infect Agt Drug Susc Phenotype Pred Reg Genotypic Bioinfo,UM4000855,87900,,Phenotype infect agent drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,755.65,% of charge rate,100.00%,755.65,,,,717.87,755.65,0
unity,CDM,Um Infect Agt Drug Susc Phenotype Pred Reg Genotypic Bioinfo,UM4000855,87900,,Phenotype infect agent drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,755.65,% of charge rate,100.00%,755.65,,,,717.87,755.65,0
unity,CDM,Um Hiv-1 Reverse Transciptase & Protease Genees,UM4000856,87901,,Genotype dna hiv reverse t,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,492.50",% of charge rate,100.00%,"1,492.50",,,,"1,417.88","1,492.50",0
unity,CDM,Um Hiv-1 Reverse Transciptase & Protease Genees,UM4000856,87901,,Genotype dna hiv reverse t,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,492.50",% of charge rate,100.00%,"1,492.50",,,,"1,417.88","1,492.50",0
unity,CDM,Um Hep C Viral Rna Genotype,UM4000333,87902,,Genotype dna/rna hep c,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,433.42",% of charge rate,100.00%,"1,433.42",,,,"1,361.75","1,433.42",0
unity,CDM,Um Hep C Viral Rna Genotype,UM4000333,87902,,Genotype dna/rna hep c,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,433.42",% of charge rate,100.00%,"1,433.42",,,,"1,361.75","1,433.42",0
unity,CDM,Um Hiv-1 Integrase Genotype,UM4000857,87906,,Genotype dna/rna hiv,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,746.27,% of charge rate,100.00%,746.27,,,,708.96,746.27,0
unity,CDM,Um Hiv-1 Integrase Genotype,UM4000857,87906,,Genotype dna/rna hiv,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,746.27,% of charge rate,100.00%,746.27,,,,708.96,746.27,0
unity,CDM,"Um Cytology, Non-gyn",UM4010005,88104,,Cytopath fl nongyn smears,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.78,% of charge rate,100.00%,116.78,,,,110.94,116.78,0
unity,CDM,"Um Cytology, Non-gyn",UM4010005,88104,,Cytopath fl nongyn smears,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.78,% of charge rate,100.00%,116.78,,,,110.94,116.78,0
unity,CDM,"Um Cytopathology,tl,non-gyn",UM4000575,88112,,Cytopath cell enhance tech,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,119.89,% of charge rate,100.00%,119.89,,,,113.9,119.89,0
unity,CDM,"Um Cytopathology,tl,non-gyn",UM4000575,88112,,Cytopath cell enhance tech,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,119.89,% of charge rate,100.00%,119.89,,,,113.9,119.89,0
unity,CDM,"Um Cytopathology, Fish, Urine",UM4000865,88120,,Cytp urne 3-5 probes ea spec,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,602.74",% of charge rate,100.00%,"1,602.74",,,,"1,522.60","1,602.74",0
unity,CDM,"Um Cytopathology, Fish, Urine",UM4000865,88120,,Cytp urne 3-5 probes ea spec,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,602.74",% of charge rate,100.00%,"1,602.74",,,,"1,522.60","1,602.74",0
unity,CDM,Um Pap Smear - Thin Layer,UM4000118,88142,,Cytopath c/v thin layer,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112.82,% of charge rate,100.00%,112.82,,,,107.18,112.82,0
unity,CDM,Um Pap Smear - Thin Layer,UM4000118,88142,,Cytopath c/v thin layer,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112.82,% of charge rate,100.00%,112.82,,,,107.18,112.82,0
unity,CDM,"Um Cytopath Smear, Other",UM4010006,88161,,Cytopath smear other source,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,86.4,% of charge rate,100.00%,86.4,,,,82.08,86.4,0
unity,CDM,"Um Cytopath Smear, Other",UM4010006,88161,,Cytopath smear other source,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,86.4,% of charge rate,100.00%,86.4,,,,82.08,86.4,0
unity,CDM,Um Flow Cytometry -1st Mark,UM4010012,88184,,Flowcytometry/ tc 1 marker,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,214.22,% of charge rate,100.00%,214.22,,,,203.51,214.22,0
unity,CDM,Um Flow Cytometry -1st Mark,UM4010012,88184,,Flowcytometry/ tc 1 marker,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,214.22,% of charge rate,100.00%,214.22,,,,203.51,214.22,0
unity,CDM,Um Flow Cytometry Ea Add On,UM4010008,88185,,Flowcytometry/tc add-on,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,129.59,% of charge rate,100.00%,129.59,,,,123.11,129.59,0
unity,CDM,Um Flow Cytometry Ea Add On,UM4010008,88185,,Flowcytometry/tc add-on,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,129.59,% of charge rate,100.00%,129.59,,,,123.11,129.59,0
unity,CDM,Um Flow Cytometry Interpretation 2-8 Markers,UM4000900,88187,,Flowcytometry/read 2-8,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100.51,% of charge rate,100.00%,100.51,,,,95.48,100.51,0
unity,CDM,Um Flow Cytometry Interpretation 2-8 Markers,UM4000900,88187,,Flowcytometry/read 2-8,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100.51,% of charge rate,100.00%,100.51,,,,95.48,100.51,0
unity,CDM,"Um Flow Cytometry, Interpret",UM4010002,88188,,Flowcytometry/read 9-15,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,210.96,% of charge rate,100.00%,210.96,,,,200.41,210.96,0
unity,CDM,"Um Flow Cytometry, Interpret",UM4010002,88188,,Flowcytometry/read 9-15,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,210.96,% of charge rate,100.00%,210.96,,,,200.41,210.96,0
unity,CDM,"Um Chromosome Analysis,congenital",UM4000749,88230,,Tissue culture lymphocyte,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,648.65,% of charge rate,100.00%,648.65,,,,616.22,648.65,0
unity,CDM,"Um Chromosome Analysis,congenital",UM4000749,88230,,Tissue culture lymphocyte,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,648.65,% of charge rate,100.00%,648.65,,,,616.22,648.65,0
unity,CDM,"Um Chromoson Analysis, Congenital",UM4000750,88262,,Chromosome analysis 15-20,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,603.48,% of charge rate,100.00%,603.48,,,,573.31,603.48,0
unity,CDM,"Um Chromoson Analysis, Congenital",UM4000750,88262,,Chromosome analysis 15-20,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,603.48,% of charge rate,100.00%,603.48,,,,573.31,603.48,0
unity,CDM,"Um Mcg; Dna Probe, Individual",UM4000801,88271,,Cytogenetics dna probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,119.3,% of charge rate,100.00%,119.3,,,,113.34,119.3,0
unity,CDM,"Um Mcg; Dna Probe, Individual",UM4000801,88271,,Cytogenetics dna probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,119.3,% of charge rate,100.00%,119.3,,,,113.34,119.3,0
unity,CDM,Um Cytogenetics 10-30,UM4000894,88273,,Cytogenetics 10-30,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,186.25,% of charge rate,100.00%,186.25,,,,176.94,186.25,0
unity,CDM,Um Cytogenetics 10-30,UM4000894,88273,,Cytogenetics 10-30,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,186.25,% of charge rate,100.00%,186.25,,,,176.94,186.25,0
unity,CDM,"Um Mcg; Interphase In Situ Hybridization, Analyze 100-300",UM4000802,88275,,Cytogenetics 100-300,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,223.71,% of charge rate,100.00%,223.71,,,,212.52,223.71,0
unity,CDM,"Um Mcg; Interphase In Situ Hybridization, Analyze 100-300",UM4000802,88275,,Cytogenetics 100-300,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,223.71,% of charge rate,100.00%,223.71,,,,212.52,223.71,0
unity,CDM,"Um Chromosome Analysis, Congenital",UM4000751,88291,,Cyto/molecular report,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75.81,% of charge rate,100.00%,75.81,,,,72.02,75.81,0
unity,CDM,"Um Chromosome Analysis, Congenital",UM4000751,88291,,Cyto/molecular report,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75.81,% of charge rate,100.00%,75.81,,,,72.02,75.81,0
unity,CDM,Um Surgical Path. Level 1,UM4010007,88300,,Surgical path gross,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,39.23,% of charge rate,100.00%,39.23,,,,37.27,39.23,0
unity,CDM,Um Surgical Path. Level 1,UM4010007,88300,,Surgical path gross,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,39.23,% of charge rate,100.00%,39.23,,,,37.27,39.23,0
unity,CDM,Um Surgical Path. Level 2,UM4010003,88302,,Tissue exam by pathologist,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,82.11,% of charge rate,100.00%,82.11,,,,78,82.11,0
unity,CDM,Um Surgical Path. Level 2,UM4010003,88302,,Tissue exam by pathologist,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,82.11,% of charge rate,100.00%,82.11,,,,78,82.11,0
unity,CDM,Um Surgical Path Level 3,UM4010009,88304,,Tissue exam by pathologist,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,132.73,% of charge rate,100.00%,132.73,,,,126.09,132.73,0
unity,CDM,Um Surgical Path Level 3,UM4010009,88304,,Tissue exam by pathologist,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,132.73,% of charge rate,100.00%,132.73,,,,126.09,132.73,0
unity,CDM,Um Surgical Path Level 4,UM4010011,88305,,Tissue exam by pathologist,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,180.7,% of charge rate,100.00%,180.7,,,,171.67,180.7,0
unity,CDM,Um Surgical Path Level 4,UM4010011,88305,,Tissue exam by pathologist,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,180.7,% of charge rate,100.00%,180.7,,,,171.67,180.7,0
unity,CDM,Um Surgical Path. Level 5,UM4010001,88307,,Tissue exam by pathologist,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,562.04,% of charge rate,100.00%,562.04,,,,533.94,562.04,0
unity,CDM,Um Surgical Path. Level 5,UM4010001,88307,,Tissue exam by pathologist,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,562.04,% of charge rate,100.00%,562.04,,,,533.94,562.04,0
unity,CDM,Um Surgical Path. Level 6,UM4010013,88309,,Tissue exam by pathologist,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,798.33,% of charge rate,100.00%,798.33,,,,758.41,798.33,0
unity,CDM,Um Surgical Path. Level 6,UM4010013,88309,,Tissue exam by pathologist,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,798.33,% of charge rate,100.00%,798.33,,,,758.41,798.33,0
unity,CDM,Um Decalcification Procedure,UM4010019,88311,,Decalcify tissue,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.99,% of charge rate,100.00%,20.99,,,,19.94,20.99,0
unity,CDM,Um Decalcification Procedure,UM4010019,88311,,Decalcify tissue,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.99,% of charge rate,100.00%,20.99,,,,19.94,20.99,0
unity,CDM,Um Special Stains/microrgani,UM4010015,88312,,Special stains group 1,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,175.42,% of charge rate,100.00%,175.42,,,,166.65,175.42,0
unity,CDM,Um Special Stains/microrgani,UM4010015,88312,,Special stains group 1,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,175.42,% of charge rate,100.00%,175.42,,,,166.65,175.42,0
unity,CDM,Um Special Stain,UM4010010,88313,,Special stains group 2,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140.16,% of charge rate,100.00%,140.16,,,,133.15,140.16,0
unity,CDM,Um Special Stain,UM4010010,88313,,Special stains group 2,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140.16,% of charge rate,100.00%,140.16,,,,133.15,140.16,0
unity,CDM,Um Stain Ihc/icc Per Specimen,UM4000904,88341,,Immunohisto antb addl slide,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.62,% of charge rate,100.00%,29.62,,,,28.14,29.62,0
unity,CDM,Um Stain Ihc/icc Per Specimen,UM4000904,88341,,Immunohisto antb addl slide,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.62,% of charge rate,100.00%,29.62,,,,28.14,29.62,0
unity,CDM,Um Special Stain,UM4010016,88342,,Immunohisto antb 1st stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,167.49,% of charge rate,100.00%,167.49,,,,159.12,167.49,0
unity,CDM,Um Special Stain,UM4010016,88342,,Immunohisto antb 1st stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,167.49,% of charge rate,100.00%,167.49,,,,159.12,167.49,0
unity,CDM,Um Immunohistochemistry Tiss,UM4010018,88342,,Immunohisto antb 1st stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,167.49,% of charge rate,100.00%,167.49,,,,159.12,167.49,0
unity,CDM,Um Immunohistochemistry Tiss,UM4010018,88342,,Immunohisto antb 1st stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,167.49,% of charge rate,100.00%,167.49,,,,159.12,167.49,0
unity,CDM,"Um Immunofluoresenct Antibody Stain, 1st Time",UM4000931,88346,,Immunofluor antb 1st stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,159.57,% of charge rate,100.00%,159.57,,,,151.59,159.57,0
unity,CDM,"Um Immunofluoresenct Antibody Stain, 1st Time",UM4000931,88346,,Immunofluor antb 1st stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,159.57,% of charge rate,100.00%,159.57,,,,151.59,159.57,0
unity,CDM,"Um Immunofluoresenct Antibody Stain, Additional Times",UM4000932,88350,,Immunofluor antb addl stain,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,121.91,% of charge rate,100.00%,121.91,,,,115.81,121.91,0
unity,CDM,"Um Immunofluoresenct Antibody Stain, Additional Times",UM4000932,88350,,Immunofluor antb addl stain,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,121.91,% of charge rate,100.00%,121.91,,,,115.81,121.91,0
unity,CDM,Um Body Fluid Cell Ct W/diff,UM4000034,89051,,Body fluid cell count,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,70.79,% of charge rate,100.00%,70.79,,,,67.25,70.79,0
unity,CDM,Um Body Fluid Cell Ct W/diff,UM4000034,89051,,Body fluid cell count,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,70.79,% of charge rate,100.00%,70.79,,,,67.25,70.79,0
unity,CDM,Um Fecal Leukocyte Count,UM4000102,89055,,Leukocyte assessment fecal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.31,% of charge rate,100.00%,23.31,,,,22.14,23.31,0
unity,CDM,Um Fecal Leukocyte Count,UM4000102,89055,,Leukocyte assessment fecal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.31,% of charge rate,100.00%,23.31,,,,22.14,23.31,0
unity,CDM,Um Crystal Identification,UM4000091,89060,,Exam synovial fluid crystals,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,156.4,% of charge rate,100.00%,156.4,,,,148.58,156.4,0
unity,CDM,Um Crystal Identification,UM4000091,89060,,Exam synovial fluid crystals,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,156.4,% of charge rate,100.00%,156.4,,,,148.58,156.4,0
unity,CDM,Hc Aerosol Sputum Collection,3000003,89220,,Sputum specimen collection,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.8,% of charge rate,100.00%,47.8,,,,45.41,47.8,0
unity,CDM,Hc Aerosol Sputum Collection,3000003,89220,,Sputum specimen collection,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.8,% of charge rate,100.00%,47.8,,,,45.41,47.8,0
unity,CDM,Um Semen Analysis Post-vas,UM4000266,89321,,Semen anal sperm detection,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.07,% of charge rate,100.00%,67.07,,,,63.72,67.07,0
unity,CDM,Um Semen Analysis Post-vas,UM4000266,89321,,Semen anal sperm detection,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.07,% of charge rate,100.00%,67.07,,,,63.72,67.07,0
unity,CDM,"PR IMMUNIZ ADMIN,1 SINGLE/COMB VAC/TOXOID",90471,90471,,Immunization admin,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,33.57,% of charge rate,100.00%,33.57,,,,24.8,33.57,0
unity,CDM,"PR IMMUNIZ,ADMIN,EACH ADDL",90472,90472,,Immunization admin each add,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,21,% of charge rate,100.00%,21,,,,21,26.43,0
unity,CDM,"PR IMMUNIZ ADMIN,INTRANASAL/ORAL,1 VAC/TOX",90473,90473,,Immune admin oral/nasal,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,40.47,% of charge rate,100.00%,40.47,,,,24.8,40.47,0
unity,CDM,PR MENB-4C RECOMBNT PROT & OUTER MEMB VESIC VACC IM,90620,90620,,Menb-4c vacc 2 dose im,,58160-0976-20,Professional,Clinic,Self-Pay,N/A,N/A,N/A,243.61,% of charge rate,100.00%,243.61,,,,182.71,243.61,0
unity,CDM,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,90632,90632,,Hepa vaccine adult im,,58160-0826-52,Professional,Clinic,Self-Pay,N/A,N/A,N/A,68,% of charge rate,100.00%,68,,,,59.91,68,0
unity,CDM,PR HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,90633,90633,,Hepa vacc ped/adol 2 dose im,,58160-0825-52,Professional,Clinic,Self-Pay,N/A,N/A,N/A,48.56,% of charge rate,100.00%,48.56,,,,35.42,48.56,0
unity,CDM,PR HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,90648,90648,,Hib prp-t vaccine 4 dose im,,58160-0818-11,Professional,Clinic,Self-Pay,N/A,N/A,N/A,17.72,% of charge rate,100.00%,17.72,,,,17.36,17.72,0
unity,CDM,PR 9VHPV VACC 2/3 DOSE SCHED IM USE,90651,90651,,9vhpv vaccine 2/3 dose im,,00006-4121-02,Professional,Clinic,Self-Pay,N/A,N/A,N/A,336.48,% of charge rate,100.00%,336.48,,,,232.36,336.48,0
unity,CDM,IIV VACCINE PRESERV FREE INCREASED AG COUNT IM,90662,90662,,Iiv no prsv increased ag im,,70461-0020-03,Professional,Clinic,Self-Pay,N/A,N/A,N/A,63.8,% of charge rate,100.00%,63.8,,,,60.98,63.8,0
unity,CDM,PR PCV13 VACCINE FOR INTRAMUSCULAR USE,90670,90670,,Pcv13 vaccine im,,00005-1971-02,Professional,Clinic,Self-Pay,N/A,N/A,N/A,299.22,% of charge rate,100.00%,299.22,,,,214.62,299.22,0
unity,CDM,"RABIES VACCINE, IM",90675,90675,,Rabies vaccine im,,58160-0964-12,Professional,Clinic,Self-Pay,N/A,N/A,N/A,840.17,% of charge rate,100.00%,840.17,,,,277.82,840.17,0
unity,CDM,PR RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE,90680,90680,,Rv5 vacc 3 dose live oral,,00006-4047-41,Professional,Clinic,Self-Pay,N/A,N/A,N/A,125.58,% of charge rate,100.00%,125.58,,,,86.09,125.58,0
unity,CDM,IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE,90685,90685,,Iiv4 vacc no prsv 0.25 ml im,,33332-0220-20,Professional,Clinic,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,21.13,25,0
unity,CDM,IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE,90686,90686,,Iiv4 vacc no prsv 0.5 ml im,,33332-0320-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,19.58,25,0
unity,CDM,DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE,90696,90696,,Dtap-ipv vaccine 4-6 yrs im,,58160-0812-52,Professional,Clinic,Self-Pay,N/A,N/A,N/A,76.21,% of charge rate,100.00%,76.21,,,,54.18,76.21,0
unity,CDM,"PR DTAP IMMUN,IM,<7 YRS",90700,90700,SL,Dtap vaccine < 7 yrs im,,58160-0810-52,Professional,Clinic,Self-Pay,N/A,N/A,N/A,0.01,% of charge rate,100.00%,0.01,,,,0.01,25.51,0
unity,CDM,"PR MMR VIRUS IMMUNIZATION, SUBCUT",90707,90707,,Mmr vaccine sc,,00006-4681-00,Professional,Clinic,Self-Pay,N/A,N/A,N/A,116.53,% of charge rate,100.00%,116.53,,,,79.87,116.53,0
unity,CDM,"PR COMBINED VACCINE,MMR+VARICELLA,SUB-Q",90710,90710,,Mmrv vaccine sc,,00006-4171-00 ,Professional,Clinic,Self-Pay,N/A,N/A,N/A,334.41,% of charge rate,100.00%,334.41,,,,228.93,334.41,0
unity,CDM,"PR POLIOMYELITIS IMMUNIZATN,INACTV,SUB-Q",90713,90713,SL,Poliovirus ipv sc/im,,49281-0860-10,Professional,Clinic,Self-Pay,N/A,N/A,N/A,0.01,% of charge rate,100.00%,0.01,,,,0.01,34.11,0
unity,CDM,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,90714,90714,,Td vacc no presv 7 yrs+ im,,49281-0215-15,Professional,Clinic,Self-Pay,N/A,N/A,N/A,49.68,% of charge rate,100.00%,49.68,,,,25.11,49.68,0
unity,CDM,"PR TDAP VACCINE >7 YO, IM",90715,90715,,Tdap vaccine 7 yrs/> im,,58160-0842-52 ,Professional,Clinic,Self-Pay,N/A,N/A,N/A,61.93,% of charge rate,100.00%,61.93,,,,33.64,61.93,0
unity,CDM,PR VAR VACCINE LIVE FOR SUBCUTANEOUS USE,90716,90716,,Var vaccine live subq,,00006-4827-00,Professional,Clinic,Self-Pay,N/A,N/A,N/A,192.39,% of charge rate,100.00%,192.39,,,,138.31,192.39,0
unity,CDM,PR DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,90723,90723,,Dtap-hep b-ipv vaccine im,,58160-0811-52,Professional,Clinic,Self-Pay,N/A,N/A,N/A,117.43,% of charge rate,100.00%,117.43,,,,83.94,117.43,0
unity,CDM,PR PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,90732,90732,,Ppsv23 vacc 2 yrs+ subq/im,,00006-4837-03,Professional,Clinic,Self-Pay,N/A,N/A,N/A,158.87,% of charge rate,100.00%,158.87,,,,114.21,158.87,0
unity,CDM,PR MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE,90734,90734,,Menacwyd/menacwycrm vacc im,,58160-0955-09 ,Professional,Clinic,Self-Pay,N/A,N/A,N/A,174.84,% of charge rate,100.00%,174.84,,,,125.5,174.84,0
unity,CDM,PR HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,90744,90744,,Hepb vacc 3 dose ped/adol im,,58160-0820-52,Professional,Clinic,Self-Pay,N/A,N/A,N/A,28,% of charge rate,100.00%,28,,,,26.9,28,0
unity,CDM,PR HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,90746,90746,,Hepb vaccine 3 dose adult im,,58160-0821-52,Professional,Clinic,Self-Pay,N/A,N/A,N/A,88.17,% of charge rate,100.00%,88.17,,,,67.06,88.17,0
unity,CDM,PR HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX,90750,90750,,Hzv vacc recombinant im,,58160-0823-11,Professional,Clinic,Self-Pay,N/A,N/A,N/A,224.43,% of charge rate,100.00%,224.43,,,,154.44,224.43,0
unity,CDM,SPEECH/HEARING THERAPY,4400001,92507,,Speech/hearing therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,257.43,% of charge rate,100.00%,257.43,,,,244.56,257.43,0
unity,CDM,SPEECH/HEARING THERAPY,4400001,92507,,Speech/hearing therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,257.43,% of charge rate,100.00%,257.43,,,,244.56,257.43,0
unity,CDM,Hc Laryngeal Function Study,5100017,92520,,Laryngeal function studies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,285,% of charge rate,100.00%,285,,,,270.75,285,0
unity,CDM,Hc Laryngeal Function Study,5100017,92520,,Laryngeal function studies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,285,% of charge rate,100.00%,285,,,,270.75,285,0
unity,CDM,EVAL OF SPEECH FLUENCY,4440005,92521,,Evaluation of speech fluency,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,410,% of charge rate,100.00%,410,,,,389.5,410,0
unity,CDM,EVAL OF SPEECH FLUENCY,4440005,92521,,Evaluation of speech fluency,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,410,% of charge rate,100.00%,410,,,,389.5,410,0
unity,CDM,SPEECH SOUND EVAL,4440006,92522,,Evaluate speech production,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,290,% of charge rate,100.00%,290,,,,275.5,290,0
unity,CDM,SPEECH SOUND EVAL,4440006,92522,,Evaluate speech production,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,290,% of charge rate,100.00%,290,,,,275.5,290,0
unity,CDM,SPEECH SOUND EVAL,4440007,92523,,Speech sound lang comprehen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,639.53,% of charge rate,100.00%,639.53,,,,607.55,639.53,0
unity,CDM,SPEECH SOUND EVAL,4440007,92523,,Speech sound lang comprehen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,639.53,% of charge rate,100.00%,639.53,,,,607.55,639.53,0
unity,CDM,VOICE/RESONANCE EVAL,4400025,92524,,Behavral qualit analys voice,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,VOICE/RESONANCE EVAL,4400025,92524,,Behavral qualit analys voice,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,DYSPHAGIA STUDY,4400003,92526,,Oral function therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,235.63,% of charge rate,100.00%,235.63,,,,223.85,235.63,0
unity,CDM,DYSPHAGIA STUDY,4400003,92526,,Oral function therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,235.63,% of charge rate,100.00%,235.63,,,,223.85,235.63,0
unity,CDM,PR TYMPANOMETRY,92567,92567,,Tympanometry,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,22.01,% of charge rate,100.00%,22.01,,,,19.22,22.76,0
unity,CDM,Hc Eval Voice Prosthetic,4440000,92597,,Oral speech device eval,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,122.34,% of charge rate,100.00%,122.34,,,,116.22,122.34,0
unity,CDM,Hc Eval Voice Prosthetic,4440000,92597,,Oral speech device eval,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,122.34,% of charge rate,100.00%,122.34,,,,116.22,122.34,0
unity,CDM,SWALLOWING EVAL,4400007,92610,,Evaluate swallowing function,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,282.84,% of charge rate,100.00%,282.84,,,,268.7,282.84,0
unity,CDM,SWALLOWING EVAL,4400007,92610,,Evaluate swallowing function,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,282.84,% of charge rate,100.00%,282.84,,,,268.7,282.84,0
unity,CDM,CPR,4500092,92950,,Heart/lung resuscitation cpr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,175.00",% of charge rate,100.00%,"1,175.00",,,,"1,116.25","1,175.00",0
unity,CDM,CPR,4500092,92950,,Heart/lung resuscitation cpr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,175.00",% of charge rate,100.00%,"1,175.00",,,,"1,116.25","1,175.00",0
unity,CDM,PR HEART/LUNG RESUSCITATION (CPR),92950,92950,,Heart/lung resuscitation cpr,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,381.92,% of charge rate,100.00%,381.92,,,,332.32,393.48,0
unity,CDM,Hc Temporary External Pacing,4500093,92953,,Temporary external pacing,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.32,% of charge rate,100.00%,41.32,,,,39.25,41.32,0
unity,CDM,Hc Temporary External Pacing,4500093,92953,,Temporary external pacing,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.32,% of charge rate,100.00%,41.32,,,,39.25,41.32,0
unity,CDM,EKG,7300000,93005,,Electrocardiogram tracing,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.02,% of charge rate,100.00%,40.02,,,,38.02,40.02,0
unity,CDM,EKG,7300000,93005,,Electrocardiogram tracing,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.02,% of charge rate,100.00%,40.02,,,,38.02,40.02,0
unity,CDM,PR ELECTROCARDIOGRAM REPORT,93010,93010,,Electrocardiogram report,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,14.88,20,0
unity,CDM,STRESS TEST,4820000,93017,,Cardiovascular stress test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,282,% of charge rate,100.00%,282,,,,267.9,282,0
unity,CDM,STRESS TEST,4820000,93017,,Cardiovascular stress test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,282,% of charge rate,100.00%,282,,,,267.9,282,0
unity,CDM,"ECG,TRACING",7300002,93041,,Rhythm ecg tracing,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.96,% of charge rate,100.00%,21.96,,,,20.86,21.96,0
unity,CDM,"ECG,TRACING",7300002,93041,,Rhythm ecg tracing,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.96,% of charge rate,100.00%,21.96,,,,20.86,21.96,0
unity,CDM,Hc Ecg Monitor/record Up To 48 Hrs,7310000,93225,,Ecg monit/reprt up to 48 hrs,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125.35,% of charge rate,100.00%,125.35,,,,119.08,125.35,0
unity,CDM,Hc Ecg Monitor/record Up To 48 Hrs,7310000,93225,,Ecg monit/reprt up to 48 hrs,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125.35,% of charge rate,100.00%,125.35,,,,119.08,125.35,0
unity,CDM,Hc Echo Tranthoracic Complete,4800028,93303,,Echo transthoracic,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,611.95,% of charge rate,100.00%,611.95,,,,581.35,611.95,0
unity,CDM,Hc Echo Tranthoracic Complete,4800028,93303,,Echo transthoracic,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,611.95,% of charge rate,100.00%,611.95,,,,581.35,611.95,0
unity,CDM,Hc Tte W/doppler Complete,4800009,93306,,Tte w/doppler complete,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,729.3,% of charge rate,100.00%,729.3,,,,692.84,729.3,0
unity,CDM,Hc Tte W/doppler Complete,4800009,93306,,Tte w/doppler complete,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,729.3,% of charge rate,100.00%,729.3,,,,692.84,729.3,0
unity,CDM,ECHO EXAM COMPLETE,4800010,93307,,Tte w/o doppler complete,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,340.1,% of charge rate,100.00%,340.1,,,,323.1,340.1,0
unity,CDM,ECHO EXAM COMPLETE,4800010,93307,,Tte w/o doppler complete,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,340.1,% of charge rate,100.00%,340.1,,,,323.1,340.1,0
unity,CDM,ECHO EXAM LIMITED,4800011,93308,,Tte f-up or lmtd,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,259.19,% of charge rate,100.00%,259.19,,,,246.23,259.19,0
unity,CDM,ECHO EXAM LIMITED,4800011,93308,,Tte f-up or lmtd,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,259.19,% of charge rate,100.00%,259.19,,,,246.23,259.19,0
unity,CDM,Hc Use Of Echo Contrast Agnt During Stress Echo,4800095,93352,,Admin ecg contrast agent,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,134,% of charge rate,100.00%,134,,,,127.3,134,0
unity,CDM,Hc Use Of Echo Contrast Agnt During Stress Echo,4800095,93352,,Admin ecg contrast agent,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,134,% of charge rate,100.00%,134,,,,127.3,134,0
unity,CDM,CARDIAC REHAB/PHASE I NON-MONITORED,9430000,93797,,Cardiac rehab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.46,% of charge rate,100.00%,76.46,,,,72.64,76.46,0
unity,CDM,CARDIAC REHAB/PHASE I NON-MONITORED,9430000,93797,,Cardiac rehab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.46,% of charge rate,100.00%,76.46,,,,72.64,76.46,0
unity,CDM,CARD REHAB PHASE II,9430001,93798,,Cardiac rehab/monitor,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,109.64,% of charge rate,100.00%,109.64,,,,104.16,109.64,0
unity,CDM,CARD REHAB PHASE II,9430001,93798,,Cardiac rehab/monitor,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,109.64,% of charge rate,100.00%,109.64,,,,104.16,109.64,0
unity,CDM,CAROTID DOPPLER,9210009,93880,,Extracranial bilat study,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,654.82,% of charge rate,100.00%,654.82,,,,622.08,654.82,0
unity,CDM,CAROTID DOPPLER,9210009,93880,,Extracranial bilat study,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,654.82,% of charge rate,100.00%,654.82,,,,622.08,654.82,0
unity,CDM,"PR DUPLEX SCAN EXTRACRANIAL,BILAT",93880,93880,26,Extracranial bilat study,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,63.07,% of charge rate,100.00%,63.07,,,,63.07,82.95,0
unity,CDM,Hc Extremity Study Vascular,9210013,93922,,Upr/l xtremity art 2 levels,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,401.67,% of charge rate,100.00%,401.67,,,,381.59,401.67,0
unity,CDM,Hc Extremity Study Vascular,9210013,93922,,Upr/l xtremity art 2 levels,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,401.67,% of charge rate,100.00%,401.67,,,,381.59,401.67,0
unity,CDM,DUPLEX LOWER EXTREMITY,9210016,93925,,Lower extremity study,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,798.96,% of charge rate,100.00%,798.96,,,,759.01,798.96,0
unity,CDM,DUPLEX LOWER EXTREMITY,9210016,93925,,Lower extremity study,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,798.96,% of charge rate,100.00%,798.96,,,,759.01,798.96,0
unity,CDM,VENOUS IMAGING,9210020,93970,,Extremity study,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,850,% of charge rate,100.00%,850,,,,807.5,850,0
unity,CDM,VENOUS IMAGING,9210020,93970,,Extremity study,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,850,% of charge rate,100.00%,850,,,,807.5,850,0
unity,CDM,"PR DUPLEX EXTREM VENOUS,BILAT",93970,93970,26,Extremity study,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,71.76,% of charge rate,100.00%,71.76,,,,60.76,71.94,0
unity,CDM,SCAN EXTREMITY VEINS,9210021,93971,,Extremity study,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,750,% of charge rate,100.00%,750,,,,712.5,750,0
unity,CDM,SCAN EXTREMITY VEINS,9210021,93971,,Extremity study,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,750,% of charge rate,100.00%,750,,,,712.5,750,0
unity,CDM,"PR DUPLEX EXTREM VENOUS,UNI OR LTD",93971,93971,26,Extremity study,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,47.12,% of charge rate,100.00%,47.12,,,,39.06,47.12,0
unity,CDM,Hc Duplex Abd Organ Follow Up,9210023,93976,,Vascular study,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,565.28,% of charge rate,100.00%,565.28,,,,537.02,565.28,0
unity,CDM,Hc Duplex Abd Organ Follow Up,9210023,93976,,Vascular study,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,565.28,% of charge rate,100.00%,565.28,,,,537.02,565.28,0
unity,CDM,"Hc Ventilation Assist,initial",4100000,94002,,Vent mgmt inpat init day,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.92,% of charge rate,100.00%,101.92,,,,96.82,101.92,0
unity,CDM,"Hc Ventilation Assist,initial",4100000,94002,,Vent mgmt inpat init day,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.92,% of charge rate,100.00%,101.92,,,,96.82,101.92,0
unity,CDM,Hc Spirometry,4600000,94010,,Breathing capacity test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,96,% of charge rate,100.00%,96,,,,91.2,96,0
unity,CDM,Hc Spirometry,4600000,94010,,Breathing capacity test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,96,% of charge rate,100.00%,96,,,,91.2,96,0
unity,CDM,PRE/POST SPIRO,4600002,94060,,Evaluation of wheezing,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,165,% of charge rate,100.00%,165,,,,156.75,165,0
unity,CDM,PRE/POST SPIRO,4600002,94060,,Evaluation of wheezing,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,165,% of charge rate,100.00%,165,,,,156.75,165,0
unity,CDM,Hc Mvv,4600005,94200,,Lung function test (mbc/mvv),,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78,% of charge rate,100.00%,78,,,,74.1,78,0
unity,CDM,Hc Mvv,4600005,94200,,Lung function test (mbc/mvv),,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78,% of charge rate,100.00%,78,,,,74.1,78,0
unity,CDM,Hc Loop,4600010,94375,,Respiratory flow volume loop,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,108,% of charge rate,100.00%,108,,,,102.6,108,0
unity,CDM,Hc Loop,4600010,94375,,Respiratory flow volume loop,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,108,% of charge rate,100.00%,108,,,,102.6,108,0
unity,CDM,Hc Exercise Test For Bronchospasm,4600061,94617,,Exercise tst brncspsm,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,216,% of charge rate,100.00%,216,,,,205.2,216,0
unity,CDM,Hc Exercise Test For Bronchospasm,4600061,94617,,Exercise tst brncspsm,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,216,% of charge rate,100.00%,216,,,,205.2,216,0
unity,CDM,Hc Pulmonary Stress Testing,4600060,94618,,Pulmonary stress testing,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,39.45,% of charge rate,100.00%,39.45,,,,37.48,39.45,0
unity,CDM,Hc Pulmonary Stress Testing,4600060,94618,,Pulmonary stress testing,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,39.45,% of charge rate,100.00%,39.45,,,,37.48,39.45,0
unity,CDM,AIRWAY INHALATION TRMT,4100003,94640,,Airway inhalation treatment,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.49,% of charge rate,100.00%,66.49,,,,63.17,66.49,0
unity,CDM,AIRWAY INHALATION TRMT,4100003,94640,,Airway inhalation treatment,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.49,% of charge rate,100.00%,66.49,,,,63.17,66.49,0
unity,CDM,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,94640,94640,,Airway inhalation treatment,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,44,% of charge rate,100.00%,44,,,,31,44,0
unity,CDM,Hc Cbt 1st Hour,4100005,94644,,Cbt 1st hour,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,177,% of charge rate,100.00%,177,,,,168.15,177,0
unity,CDM,Hc Cbt 1st Hour,4100005,94644,,Cbt 1st hour,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,177,% of charge rate,100.00%,177,,,,168.15,177,0
unity,CDM,Hc Cpap/day,4100007,94660,,Pos airway pressure cpap,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,228,% of charge rate,100.00%,228,,,,216.6,228,0
unity,CDM,Hc Cpap/day,4100007,94660,,Pos airway pressure cpap,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,228,% of charge rate,100.00%,228,,,,216.6,228,0
unity,CDM,Hc Demo/eval-aerosol,4100008,94664,,Evaluate pt use of inhaler,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.6,% of charge rate,100.00%,60.6,,,,57.57,60.6,0
unity,CDM,Hc Demo/eval-aerosol,4100008,94664,,Evaluate pt use of inhaler,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.6,% of charge rate,100.00%,60.6,,,,57.57,60.6,0
unity,CDM,"Hc Chest Physiotherapy,initial",4100009,94667,,Chest wall manipulation,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,89.78,% of charge rate,100.00%,89.78,,,,85.29,89.78,0
unity,CDM,"Hc Chest Physiotherapy,initial",4100009,94667,,Chest wall manipulation,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,89.78,% of charge rate,100.00%,89.78,,,,85.29,89.78,0
unity,CDM,"Hc Chest Physiotherapy,subsequent",4100010,94668,,Chest wall manipulation,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.15,% of charge rate,100.00%,116.15,,,,110.34,116.15,0
unity,CDM,"Hc Chest Physiotherapy,subsequent",4100010,94668,,Chest wall manipulation,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.15,% of charge rate,100.00%,116.15,,,,110.34,116.15,0
unity,CDM,Hc Oximetry Continuous,4600019,94762,,Measure blood oxygen level,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,145.6,% of charge rate,100.00%,145.6,,,,138.32,145.6,0
unity,CDM,Hc Oximetry Continuous,4600019,94762,,Measure blood oxygen level,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,145.6,% of charge rate,100.00%,145.6,,,,138.32,145.6,0
unity,CDM,Hc Co2 Expired Gas,4600020,94770,,Exhaled carbon dioxide test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.5,% of charge rate,100.00%,26.5,,,,25.18,26.5,0
unity,CDM,Hc Co2 Expired Gas,4600020,94770,,Exhaled carbon dioxide test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.5,% of charge rate,100.00%,26.5,,,,25.18,26.5,0
unity,CDM,Hc Mip/mep,4100011,94799,,Pulmonary service/procedure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15,% of charge rate,100.00%,15,,,,14.25,15,0
unity,CDM,Hc Mip/mep,4100011,94799,,Pulmonary service/procedure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15,% of charge rate,100.00%,15,,,,14.25,15,0
unity,CDM,Um Peak Flow/cap Pf-day,UM3480004,94799,,Pulmonary service/procedure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.14,% of charge rate,100.00%,47.14,,,,44.78,47.14,0
unity,CDM,Um Peak Flow/cap Pf-day,UM3480004,94799,,Pulmonary service/procedure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.14,% of charge rate,100.00%,47.14,,,,44.78,47.14,0
unity,CDM,Um Inc Breath Exerc,UM3480005,94799,,Pulmonary service/procedure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.99,% of charge rate,100.00%,28.99,,,,27.54,28.99,0
unity,CDM,Um Inc Breath Exerc,UM3480005,94799,,Pulmonary service/procedure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.99,% of charge rate,100.00%,28.99,,,,27.54,28.99,0
unity,CDM,Um Humidifier/trach Collar,UM3480030,94799,,Pulmonary service/procedure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,120,% of charge rate,100.00%,120,,,,114,120,0
unity,CDM,Um Humidifier/trach Collar,UM3480030,94799,,Pulmonary service/procedure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,120,% of charge rate,100.00%,120,,,,114,120,0
unity,CDM,"PR IMMUNOTHERAPY, ONE INJECTION",95115,95115,,Immunotherapy one injection,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,19.88,% of charge rate,100.00%,19.88,,,,16.12,19.88,0
unity,CDM,"IMMUNOTHERAPY, ONE INJECTION",95115,95115,,Immunotherapy one injection,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,19.88,% of charge rate,100.00%,19.88,,,,18.89,19.88,0
unity,CDM,"IMMUNOTHERAPY, ONE INJECTION",95115,95115,,Immunotherapy one injection,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,19.88,% of charge rate,100.00%,19.88,,,,18.89,19.88,0
unity,CDM,"PR IMMUNOTHERAPY, 2+ INJECTIONS",95117,95117,,Immunotherapy injections,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,22.73,% of charge rate,100.00%,22.73,,,,18.6,22.73,0
unity,CDM,"IMMUNOTHERAPY, 2+ INJECTIONS",95117,95117,,Immunotherapy injections,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.73,% of charge rate,100.00%,22.73,,,,21.59,22.73,0
unity,CDM,"IMMUNOTHERAPY, 2+ INJECTIONS",95117,95117,,Immunotherapy injections,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.73,% of charge rate,100.00%,22.73,,,,21.59,22.73,0
unity,CDM,Hc Mslt,9200034,95805,,Multiple sleep latency test,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,221.01",% of charge rate,100.00%,"1,221.01",,,,"1,159.96","1,221.01",0
unity,CDM,Hc Mslt,9200034,95805,,Multiple sleep latency test,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,221.01",% of charge rate,100.00%,"1,221.01",,,,"1,159.96","1,221.01",0
unity,CDM,SLEEP STUDY,9200036,95810,,Polysom 6/> yrs 4/> param,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,910.00",% of charge rate,100.00%,"1,910.00",,,,"1,814.50","1,910.00",0
unity,CDM,SLEEP STUDY,9200036,95810,,Polysom 6/> yrs 4/> param,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,910.00",% of charge rate,100.00%,"1,910.00",,,,"1,814.50","1,910.00",0
unity,CDM,SLEEP STUDY,9200037,95811,,Polysom 6/>yrs cpap 4/> parm,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,010.00",% of charge rate,100.00%,"2,010.00",,,,"1,909.50","2,010.00",0
unity,CDM,SLEEP STUDY,9200037,95811,,Polysom 6/>yrs cpap 4/> parm,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,010.00",% of charge rate,100.00%,"2,010.00",,,,"1,909.50","2,010.00",0
unity,CDM,APHASIA ASSESSMENT PER HR,4400010,96105,,Assessment of aphasia,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,226.24,% of charge rate,100.00%,226.24,,,,214.93,226.24,0
unity,CDM,APHASIA ASSESSMENT PER HR,4400010,96105,,Assessment of aphasia,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,226.24,% of charge rate,100.00%,226.24,,,,214.93,226.24,0
unity,CDM,Hc Cognitive Test/hr + Report,4440004,96125,,Cognitive test by hc pro,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Hc Cognitive Test/hr + Report,4440004,96125,,Cognitive test by hc pro,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,"HYDRATION,INITIAL",9400003,96360,,Hydration iv infusion init,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,394,% of charge rate,100.00%,394,,,,374.3,394,0
unity,CDM,"HYDRATION,INITIAL",9400003,96360,,Hydration iv infusion init,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,394,% of charge rate,100.00%,394,,,,374.3,394,0
unity,CDM,HYDRATION EA ADDL HR,9400004,96361,,Hydrate iv infusion add-on,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80,% of charge rate,100.00%,80,,,,76,80,0
unity,CDM,HYDRATION EA ADDL HR,9400004,96361,,Hydrate iv infusion add-on,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80,% of charge rate,100.00%,80,,,,76,80,0
unity,CDM,"INFUSION,INITIAL",9400005,96365,,Ther/proph/diag iv inf init,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,394,% of charge rate,100.00%,394,,,,374.3,394,0
unity,CDM,"INFUSION,INITIAL",9400005,96365,,Ther/proph/diag iv inf init,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,394,% of charge rate,100.00%,394,,,,374.3,394,0
unity,CDM,INFUSION EA ADDL HR,9400006,96366,,Ther/proph/diag iv inf addon,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80,% of charge rate,100.00%,80,,,,76,80,0
unity,CDM,INFUSION EA ADDL HR,9400006,96366,,Ther/proph/diag iv inf addon,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80,% of charge rate,100.00%,80,,,,76,80,0
unity,CDM,INFUSION ADDL,9400007,96367,,Tx/proph/dg addl seq iv inf,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,INFUSION ADDL,9400007,96367,,Tx/proph/dg addl seq iv inf,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,INFUSION,9400008,96368,,Ther/diag concurrent inf,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.15,% of charge rate,100.00%,60.15,,,,57.14,60.15,0
unity,CDM,INFUSION,9400008,96368,,Ther/diag concurrent inf,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.15,% of charge rate,100.00%,60.15,,,,57.14,60.15,0
unity,CDM,INJECTION,9400009,96372,,Ther/proph/diag inj sc/im,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,INJECTION,9400009,96372,,Ther/proph/diag inj sc/im,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,PR THER PROPHYLACTIC/DX INJECTION SUBQ/IM,96372,96372,,Ther/proph/diag inj sc/im,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,37,% of charge rate,100.00%,37,,,,24.8,37,0
unity,CDM,IV PUSH,9400011,96374,,Ther/proph/diag inj iv push,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,394,% of charge rate,100.00%,394,,,,374.3,394,0
unity,CDM,IV PUSH,9400011,96374,,Ther/proph/diag inj iv push,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,394,% of charge rate,100.00%,394,,,,374.3,394,0
unity,CDM,IV PUSH,9400012,96375,,Tx/pro/dx inj new drug addon,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.69,% of charge rate,100.00%,87.69,,,,83.31,87.69,0
unity,CDM,IV PUSH,9400012,96375,,Tx/pro/dx inj new drug addon,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.69,% of charge rate,100.00%,87.69,,,,83.31,87.69,0
unity,CDM,IV PUSH,9400013,96376,,Tx/pro/dx inj same drug adon,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.67,% of charge rate,100.00%,28.67,,,,27.24,28.67,0
unity,CDM,IV PUSH,9400013,96376,,Tx/pro/dx inj same drug adon,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.67,% of charge rate,100.00%,28.67,,,,27.24,28.67,0
unity,CDM,Hc Application On-body Injector,9400033,96377,,Applicaton on-body injector,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Hc Application On-body Injector,9400033,96377,,Applicaton on-body injector,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,CHEMO ADMINISTRATION,3310000,96401,,Chemo anti-neopl sq/im,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,3310000,96401,,Chemo anti-neopl sq/im,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,3310001,96402,,Chemo hormon antineopl sq/im,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,3310001,96402,,Chemo hormon antineopl sq/im,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,3350000,96409,,Chemo iv push sngl drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,410,% of charge rate,100.00%,410,,,,389.5,410,0
unity,CDM,CHEMO ADMINISTRATION,3350000,96409,,Chemo iv push sngl drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,410,% of charge rate,100.00%,410,,,,389.5,410,0
unity,CDM,CHEMO ADMINISTRATION,3350001,96411,,Chemo iv push addl drug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,225,% of charge rate,100.00%,225,,,,213.75,225,0
unity,CDM,CHEMO ADMINISTRATION,3350001,96411,,Chemo iv push addl drug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,225,% of charge rate,100.00%,225,,,,213.75,225,0
unity,CDM,CHEMO ADMINISTRATION,3350002,96413,,Chemo iv infusion 1 hr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,650,% of charge rate,100.00%,650,,,,617.5,650,0
unity,CDM,CHEMO ADMINISTRATION,3350002,96413,,Chemo iv infusion 1 hr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,650,% of charge rate,100.00%,650,,,,617.5,650,0
unity,CDM,CHEMO ADMINISTRATION,3350003,96415,,Chemo iv infusion addl hr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,113.44,% of charge rate,100.00%,113.44,,,,107.77,113.44,0
unity,CDM,CHEMO ADMINISTRATION,3350003,96415,,Chemo iv infusion addl hr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,113.44,% of charge rate,100.00%,113.44,,,,107.77,113.44,0
unity,CDM,Hc Chemo Prolong Infuse W/pump,9400014,96416,,Chemo prolong infuse w/pump,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,630,% of charge rate,100.00%,630,,,,598.5,630,0
unity,CDM,Hc Chemo Prolong Infuse W/pump,9400014,96416,,Chemo prolong infuse w/pump,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,630,% of charge rate,100.00%,630,,,,598.5,630,0
unity,CDM,CHEMO ADMINISTRATION,9400015,96417,,Chemo iv infus each addl seq,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,CHEMO ADMINISTRATION,9400015,96417,,Chemo iv infus each addl seq,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,PORT FLUSH,9400017,96523,,Irrig drug delivery device,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,167.84,% of charge rate,100.00%,167.84,,,,159.45,167.84,0
unity,CDM,PORT FLUSH,9400017,96523,,Irrig drug delivery device,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,167.84,% of charge rate,100.00%,167.84,,,,159.45,167.84,0
unity,CDM,Hc Hot Or Cold Packs,4200003,97010,,Hot or cold packs therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.27,% of charge rate,100.00%,36.27,,,,34.46,36.27,0
unity,CDM,Hc Hot Or Cold Packs,4200003,97010,,Hot or cold packs therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.27,% of charge rate,100.00%,36.27,,,,34.46,36.27,0
unity,CDM,TRACTION,4200004,97012,,Mechanical traction therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.48,% of charge rate,100.00%,48.48,,,,46.06,48.48,0
unity,CDM,TRACTION,4200004,97012,,Mechanical traction therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.48,% of charge rate,100.00%,48.48,,,,46.06,48.48,0
unity,CDM,UNATTEND E-STIM,4200005,97014,,Electric stimulation therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.48,% of charge rate,100.00%,48.48,,,,46.06,48.48,0
unity,CDM,UNATTEND E-STIM,4200005,97014,,Electric stimulation therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.48,% of charge rate,100.00%,48.48,,,,46.06,48.48,0
unity,CDM,VASOPNEUMATIC DEVICE,4300001,97016,,Vasopneumatic device therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,43.47,% of charge rate,100.00%,43.47,,,,41.3,43.47,0
unity,CDM,VASOPNEUMATIC DEVICE,4300001,97016,,Vasopneumatic device therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,43.47,% of charge rate,100.00%,43.47,,,,41.3,43.47,0
unity,CDM,PARAFFIN BATH,4300002,97018,,Paraffin bath therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.82,% of charge rate,100.00%,23.82,,,,22.63,23.82,0
unity,CDM,PARAFFIN BATH,4300002,97018,,Paraffin bath therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.82,% of charge rate,100.00%,23.82,,,,22.63,23.82,0
unity,CDM,WHIRLPOOL,4300003,97022,,Whirlpool therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,51.05,% of charge rate,100.00%,51.05,,,,48.5,51.05,0
unity,CDM,WHIRLPOOL,4300003,97022,,Whirlpool therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,51.05,% of charge rate,100.00%,51.05,,,,48.5,51.05,0
unity,CDM,IONTOPHORESIS 15 MIN,4300006,97033,,Electric current therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,70.6,% of charge rate,100.00%,70.6,,,,67.07,70.6,0
unity,CDM,IONTOPHORESIS 15 MIN,4300006,97033,,Electric current therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,70.6,% of charge rate,100.00%,70.6,,,,67.07,70.6,0
unity,CDM,CONTRAST BATH 15 MIN,4300007,97034,,Contrast bath therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.84,% of charge rate,100.00%,40.84,,,,38.8,40.84,0
unity,CDM,CONTRAST BATH 15 MIN,4300007,97034,,Contrast bath therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.84,% of charge rate,100.00%,40.84,,,,38.8,40.84,0
unity,CDM,ULTRASOUND 15 MIN,4300008,97035,,Ultrasound therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.02,% of charge rate,100.00%,45.02,,,,42.77,45.02,0
unity,CDM,ULTRASOUND 15 MIN,4300008,97035,,Ultrasound therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.02,% of charge rate,100.00%,45.02,,,,42.77,45.02,0
unity,CDM,THERAP EXERCISE 15MIN,4300010,97110,,Therapeutic exercises,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,100.43,% of charge rate,100.00%,100.43,,,,95.41,100.43,0
unity,CDM,THERAP EXERCISE 15MIN,4300010,97110,,Therapeutic exercises,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,100.43,% of charge rate,100.00%,100.43,,,,95.41,100.43,0
unity,CDM,NEUROMUSC RE-ED 15MIN,4300011,97112,,Neuromuscular reeducation,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,114.29,% of charge rate,100.00%,114.29,,,,108.58,114.29,0
unity,CDM,NEUROMUSC RE-ED 15MIN,4300011,97112,,Neuromuscular reeducation,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,114.29,% of charge rate,100.00%,114.29,,,,108.58,114.29,0
unity,CDM,Hc Aquatic Therapy W Exercise,4200008,97113,,Aquatic therapy/exercises,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,96.97,% of charge rate,100.00%,96.97,,,,92.12,96.97,0
unity,CDM,Hc Aquatic Therapy W Exercise,4200008,97113,,Aquatic therapy/exercises,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,96.97,% of charge rate,100.00%,96.97,,,,92.12,96.97,0
unity,CDM,GAIT TRAINING,4200009,97116,,Gait training therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,99.28,% of charge rate,100.00%,99.28,,,,94.32,99.28,0
unity,CDM,GAIT TRAINING,4200009,97116,,Gait training therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,99.28,% of charge rate,100.00%,99.28,,,,94.32,99.28,0
unity,CDM,MASSAGE,4200010,97124,,Massage therapy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.41,% of charge rate,100.00%,60.41,,,,57.39,60.41,0
unity,CDM,MASSAGE,4200010,97124,,Massage therapy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.41,% of charge rate,100.00%,60.41,,,,57.39,60.41,0
unity,CDM,MANUAL THERAPY 15MIN,4300013,97140,,Manual therapy 1/> regions,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91.2,% of charge rate,100.00%,91.2,,,,86.64,91.2,0
unity,CDM,MANUAL THERAPY 15MIN,4300013,97140,,Manual therapy 1/> regions,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91.2,% of charge rate,100.00%,91.2,,,,86.64,91.2,0
unity,CDM,HC PT EVAL,4240010,97161,,Pt eval low complex 20 min,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,277,% of charge rate,100.00%,277,,,,263.15,277,0
unity,CDM,HC PT EVAL,4240010,97161,,Pt eval low complex 20 min,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,277,% of charge rate,100.00%,277,,,,263.15,277,0
unity,CDM,HC PT EVAL,4240011,97162,,Pt eval mod complex 30 min,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,297,% of charge rate,100.00%,297,,,,282.15,297,0
unity,CDM,HC PT EVAL,4240011,97162,,Pt eval mod complex 30 min,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,297,% of charge rate,100.00%,297,,,,282.15,297,0
unity,CDM,HC PT EVAL,4240012,97163,,Pt eval high complex 45 min,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,317,% of charge rate,100.00%,317,,,,301.15,317,0
unity,CDM,HC PT EVAL,4240012,97163,,Pt eval high complex 45 min,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,317,% of charge rate,100.00%,317,,,,301.15,317,0
unity,CDM,Hc Pt Re-eval Est Plan Of Care,4240014,97164,,Pt re-eval est plan care,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,188.17,% of charge rate,100.00%,188.17,,,,178.76,188.17,0
unity,CDM,Hc Pt Re-eval Est Plan Of Care,4240014,97164,,Pt re-eval est plan care,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,188.17,% of charge rate,100.00%,188.17,,,,178.76,188.17,0
unity,CDM,HC OT EVAL,4340010,97165,,Ot eval low complex 30 min,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,297,% of charge rate,100.00%,297,,,,282.15,297,0
unity,CDM,HC OT EVAL,4340010,97165,,Ot eval low complex 30 min,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,297,% of charge rate,100.00%,297,,,,282.15,297,0
unity,CDM,HC OT EVAL,4340011,97166,,Ot eval mod complex 45 min,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,317,% of charge rate,100.00%,317,,,,301.15,317,0
unity,CDM,HC OT EVAL,4340011,97166,,Ot eval mod complex 45 min,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,317,% of charge rate,100.00%,317,,,,301.15,317,0
unity,CDM,HC OT EVAL,4340012,97167,,Ot eval high complex 60 min,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,215,% of charge rate,100.00%,215,,,,204.25,215,0
unity,CDM,HC OT EVAL,4340012,97167,,Ot eval high complex 60 min,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,215,% of charge rate,100.00%,215,,,,204.25,215,0
unity,CDM,Hc Ot Re-eval Est Plan Of Care,4340014,97168,,Ot re-eval est plan care,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,145,% of charge rate,100.00%,145,,,,137.75,145,0
unity,CDM,Hc Ot Re-eval Est Plan Of Care,4340014,97168,,Ot re-eval est plan care,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,145,% of charge rate,100.00%,145,,,,137.75,145,0
unity,CDM,THERAPY ACTIVITY 15MIN,4300015,97530,,Therapeutic activities,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,130.45,% of charge rate,100.00%,130.45,,,,123.93,130.45,0
unity,CDM,THERAPY ACTIVITY 15MIN,4300015,97530,,Therapeutic activities,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,130.45,% of charge rate,100.00%,130.45,,,,123.93,130.45,0
unity,CDM,Hc S I Techniques 15 Min,4300017,97533,,Sensory integration,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,51.67,% of charge rate,100.00%,51.67,,,,49.09,51.67,0
unity,CDM,Hc S I Techniques 15 Min,4300017,97533,,Sensory integration,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,51.67,% of charge rate,100.00%,51.67,,,,49.09,51.67,0
unity,CDM,SELF-CARE/HM MGMT TX 15MIN,4300018,97535,,Self care mngment training,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.98,% of charge rate,100.00%,111.98,,,,106.38,111.98,0
unity,CDM,SELF-CARE/HM MGMT TX 15MIN,4300018,97535,,Self care mngment training,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.98,% of charge rate,100.00%,111.98,,,,106.38,111.98,0
unity,CDM,COM/WORK RE-INTEGRA 15 MIN,4300019,97537,,Community/work reintegration,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,70.6,% of charge rate,100.00%,70.6,,,,67.07,70.6,0
unity,CDM,COM/WORK RE-INTEGRA 15 MIN,4300019,97537,,Community/work reintegration,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,70.6,% of charge rate,100.00%,70.6,,,,67.07,70.6,0
unity,CDM,WHEELCHAIR MGMT/PROP 15 MIN,4300020,97542,,Wheelchair mngment training,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.45,% of charge rate,100.00%,71.45,,,,67.88,71.45,0
unity,CDM,WHEELCHAIR MGMT/PROP 15 MIN,4300020,97542,,Wheelchair mngment training,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.45,% of charge rate,100.00%,71.45,,,,67.88,71.45,0
unity,CDM,DEBRIDEMENT,4300023,97597,,Rmvl devital tis 20 cm/<,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,180.34,% of charge rate,100.00%,180.34,,,,171.32,180.34,0
unity,CDM,DEBRIDEMENT,4300023,97597,,Rmvl devital tis 20 cm/<,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,180.34,% of charge rate,100.00%,180.34,,,,171.32,180.34,0
unity,CDM,DEBRIDEMENT OPEN WOUND 20 SQ CM<,97597,97597,,Rmvl devital tis 20 cm/<,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,190,% of charge rate,100.00%,190,,,,47.78,190,0
unity,CDM,Hc Select Debride > 20 Sq Cent,4300024,97598,,Rmvl devital tis addl 20cm/<,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,186.8,% of charge rate,100.00%,186.8,,,,177.46,186.8,0
unity,CDM,Hc Select Debride > 20 Sq Cent,4300024,97598,,Rmvl devital tis addl 20cm/<,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,186.8,% of charge rate,100.00%,186.8,,,,177.46,186.8,0
unity,CDM,DEBRIDEMENT,4300025,97602,,Wound(s) care non-selective,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,312.65,% of charge rate,100.00%,312.65,,,,297.02,312.65,0
unity,CDM,DEBRIDEMENT,4300025,97602,,Wound(s) care non-selective,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,312.65,% of charge rate,100.00%,312.65,,,,297.02,312.65,0
unity,CDM,ORTHO MGT/TRAINING INITIAL,4200012,97760,,Orthotic mgmt&traing 1st enc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.46,% of charge rate,100.00%,88.46,,,,84.04,88.46,0
unity,CDM,ORTHO MGT/TRAINING INITIAL,4200012,97760,,Orthotic mgmt&traing 1st enc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.46,% of charge rate,100.00%,88.46,,,,84.04,88.46,0
unity,CDM,PROSTHETIC TRAINING 15 MIN,4200013,97761,,Prosthetic traing 1st enc,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,77.42,% of charge rate,100.00%,77.42,,,,73.55,77.42,0
unity,CDM,PROSTHETIC TRAINING 15 MIN,4200013,97761,,Prosthetic traing 1st enc,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,77.42,% of charge rate,100.00%,77.42,,,,73.55,77.42,0
unity,CDM,Hc Unlisted Service/procedure,4300026,97799,,Physical medicine procedure,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.96,% of charge rate,100.00%,72.96,,,,69.31,72.96,0
unity,CDM,Hc Unlisted Service/procedure,4300026,97799,,Physical medicine procedure,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.96,% of charge rate,100.00%,72.96,,,,69.31,72.96,0
unity,CDM,Um Mnt-15 Minutes,UM4370004,97802,,Medical nutrition indiv in,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83,% of charge rate,100.00%,83,,,,78.85,83,0
unity,CDM,Um Mnt-15 Minutes,UM4370004,97802,,Medical nutrition indiv in,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83,% of charge rate,100.00%,83,,,,78.85,83,0
unity,CDM,Um Mnt-re-assessment/15 Min,UM4370005,97803,,Med nutrition indiv subseq,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71,% of charge rate,100.00%,71,,,,67.45,71,0
unity,CDM,Um Mnt-re-assessment/15 Min,UM4370005,97803,,Med nutrition indiv subseq,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71,% of charge rate,100.00%,71,,,,67.45,71,0
unity,CDM,Um Mnt-group (2 Or More),UM4370003,97804,,Medical nutrition group,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40,% of charge rate,100.00%,40,,,,38,40,0
unity,CDM,Um Mnt-group (2 Or More),UM4370003,97804,,Medical nutrition group,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40,% of charge rate,100.00%,40,,,,38,40,0
unity,CDM,Um Specimen Collection/processing,UM4000178,99000,,Specimen handling office-lab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Specimen Collection/processing,UM4000178,99000,,Specimen handling office-lab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Specimen Handling,UM4000280,99000,,Specimen handling office-lab,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.54,% of charge rate,100.00%,21.54,,,,20.46,21.54,0
unity,CDM,Um Specimen Handling,UM4000280,99000,,Specimen handling office-lab,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.54,% of charge rate,100.00%,21.54,,,,20.46,21.54,0
unity,CDM,PR POST-OP FOLLOW-UP VISIT,99024,99024,,Postop follow-up visit,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,0,% of charge rate,100.00%,0,,,,3.05,3.05,0
unity,CDM,Um Drain Tube Attachment,UM3500001,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.38,% of charge rate,100.00%,58.38,,,,55.46,58.38,0
unity,CDM,Um Drain Tube Attachment,UM3500001,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.38,% of charge rate,100.00%,58.38,,,,55.46,58.38,0
unity,CDM,Um Dee Lee Suction Bac/shiel,UM3500007,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.28,% of charge rate,100.00%,28.28,,,,26.87,28.28,0
unity,CDM,Um Dee Lee Suction Bac/shiel,UM3500007,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.28,% of charge rate,100.00%,28.28,,,,26.87,28.28,0
unity,CDM,Um Adaptic,UM3500008,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.82,% of charge rate,100.00%,3.82,,,,3.63,3.82,0
unity,CDM,Um Adaptic,UM3500008,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.82,% of charge rate,100.00%,3.82,,,,3.63,3.82,0
unity,CDM,Um Bandage Esmark,UM3500015,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.43,% of charge rate,100.00%,54.43,,,,51.71,54.43,0
unity,CDM,Um Bandage Esmark,UM3500015,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.43,% of charge rate,100.00%,54.43,,,,51.71,54.43,0
unity,CDM,Um Wall Suction Cannister,UM3500016,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.1,% of charge rate,100.00%,7.1,,,,6.75,7.1,0
unity,CDM,Um Wall Suction Cannister,UM3500016,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.1,% of charge rate,100.00%,7.1,,,,6.75,7.1,0
unity,CDM,Um Skin Staples 35,UM3500022,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,35.87,% of charge rate,100.00%,35.87,,,,34.08,35.87,0
unity,CDM,Um Skin Staples 35,UM3500022,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,35.87,% of charge rate,100.00%,35.87,,,,34.08,35.87,0
unity,CDM,Um Xeroform Drsing Universal,UM3500028,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,14.23,% of charge rate,100.00%,14.23,,,,13.52,14.23,0
unity,CDM,Um Xeroform Drsing Universal,UM3500028,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,14.23,% of charge rate,100.00%,14.23,,,,13.52,14.23,0
unity,CDM,Um Telfa Pads Universal,UM3500032,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.82,% of charge rate,100.00%,3.82,,,,3.63,3.82,0
unity,CDM,Um Telfa Pads Universal,UM3500032,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.82,% of charge rate,100.00%,3.82,,,,3.63,3.82,0
unity,CDM,Um Binder Universal,UM3500035,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.1,% of charge rate,100.00%,66.1,,,,62.8,66.1,0
unity,CDM,Um Binder Universal,UM3500035,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.1,% of charge rate,100.00%,66.1,,,,62.8,66.1,0
unity,CDM,Um Sponge Laparotomy,UM3500038,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,14.23,% of charge rate,100.00%,14.23,,,,13.52,14.23,0
unity,CDM,Um Sponge Laparotomy,UM3500038,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,14.23,% of charge rate,100.00%,14.23,,,,13.52,14.23,0
unity,CDM,Um Warming Blanket,UM3500039,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,117.63,% of charge rate,100.00%,117.63,,,,111.75,117.63,0
unity,CDM,Um Warming Blanket,UM3500039,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,117.63,% of charge rate,100.00%,117.63,,,,111.75,117.63,0
unity,CDM,Um Ster Distilled 1000 Cc,UM3500041,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,11.34,% of charge rate,100.00%,11.34,,,,10.77,11.34,0
unity,CDM,Um Ster Distilled 1000 Cc,UM3500041,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,11.34,% of charge rate,100.00%,11.34,,,,10.77,11.34,0
unity,CDM,Um Sterile Cautery Disposabl,UM3500044,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.41,% of charge rate,100.00%,34.41,,,,32.69,34.41,0
unity,CDM,Um Sterile Cautery Disposabl,UM3500044,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.41,% of charge rate,100.00%,34.41,,,,32.69,34.41,0
unity,CDM,Um Vaseline Gauze Universal,UM3500048,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8,% of charge rate,100.00%,8,,,,7.6,8,0
unity,CDM,Um Vaseline Gauze Universal,UM3500048,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8,% of charge rate,100.00%,8,,,,7.6,8,0
unity,CDM,Um Sponges Peanut 1/p,UM3500055,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.34,% of charge rate,100.00%,13.34,,,,12.67,13.34,0
unity,CDM,Um Sponges Peanut 1/p,UM3500055,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.34,% of charge rate,100.00%,13.34,,,,12.67,13.34,0
unity,CDM,Um Cath Kit/female,UM3500057,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.02,% of charge rate,100.00%,36.02,,,,34.22,36.02,0
unity,CDM,Um Cath Kit/female,UM3500057,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.02,% of charge rate,100.00%,36.02,,,,34.22,36.02,0
unity,CDM,Um Suction Handle Yank,UM3500061,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.55,% of charge rate,100.00%,24.55,,,,23.32,24.55,0
unity,CDM,Um Suction Handle Yank,UM3500061,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.55,% of charge rate,100.00%,24.55,,,,23.32,24.55,0
unity,CDM,Um Cath Foley Coude,UM3500067,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.95,% of charge rate,100.00%,71.95,,,,68.35,71.95,0
unity,CDM,Um Cath Foley Coude,UM3500067,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.95,% of charge rate,100.00%,71.95,,,,68.35,71.95,0
unity,CDM,Um Veni-prep Kit,UM3500070,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.82,% of charge rate,100.00%,20.82,,,,19.78,20.82,0
unity,CDM,Um Veni-prep Kit,UM3500070,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.82,% of charge rate,100.00%,20.82,,,,19.78,20.82,0
unity,CDM,Um Salem Sump Tube,UM3500075,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.21,% of charge rate,100.00%,15.21,,,,14.45,15.21,0
unity,CDM,Um Salem Sump Tube,UM3500075,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.21,% of charge rate,100.00%,15.21,,,,14.45,15.21,0
unity,CDM,Um Neb H2o Collection Device,UM3500077,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.78,% of charge rate,100.00%,6.78,,,,6.44,6.78,0
unity,CDM,Um Neb H2o Collection Device,UM3500077,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.78,% of charge rate,100.00%,6.78,,,,6.44,6.78,0
unity,CDM,Um Cath Iv Universal,UM3500078,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,19.65,% of charge rate,100.00%,19.65,,,,18.67,19.65,0
unity,CDM,Um Cath Iv Universal,UM3500078,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,19.65,% of charge rate,100.00%,19.65,,,,18.67,19.65,0
unity,CDM,Um Syringe 2cc To 30cc,UM3500087,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.54,% of charge rate,100.00%,7.54,,,,7.16,7.54,0
unity,CDM,Um Syringe 2cc To 30cc,UM3500087,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.54,% of charge rate,100.00%,7.54,,,,7.16,7.54,0
unity,CDM,Um Thorancentesis Tray,UM3500091,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.63,% of charge rate,100.00%,88.63,,,,84.2,88.63,0
unity,CDM,Um Thorancentesis Tray,UM3500091,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.63,% of charge rate,100.00%,88.63,,,,84.2,88.63,0
unity,CDM,Um Veniloop Connector,UM3500092,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,16.3,% of charge rate,100.00%,16.3,,,,15.49,16.3,0
unity,CDM,Um Veniloop Connector,UM3500092,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,16.3,% of charge rate,100.00%,16.3,,,,15.49,16.3,0
unity,CDM,Um Gastrostomy Tube,UM3500096,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,163.17,% of charge rate,100.00%,163.17,,,,155.01,163.17,0
unity,CDM,Um Gastrostomy Tube,UM3500096,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,163.17,% of charge rate,100.00%,163.17,,,,155.01,163.17,0
unity,CDM,Um Bandage Elastic Universal,UM3500101,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,17.14,% of charge rate,100.00%,17.14,,,,16.28,17.14,0
unity,CDM,Um Bandage Elastic Universal,UM3500101,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,17.14,% of charge rate,100.00%,17.14,,,,16.28,17.14,0
unity,CDM,Um Ster 0.9% Sod Chl 500 Cc,UM3500106,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.25,% of charge rate,100.00%,8.25,,,,7.84,8.25,0
unity,CDM,Um Ster 0.9% Sod Chl 500 Cc,UM3500106,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.25,% of charge rate,100.00%,8.25,,,,7.84,8.25,0
unity,CDM,Um Heel & Elbow Protectors,UM3500111,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.52,% of charge rate,100.00%,31.52,,,,29.94,31.52,0
unity,CDM,Um Heel & Elbow Protectors,UM3500111,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.52,% of charge rate,100.00%,31.52,,,,29.94,31.52,0
unity,CDM,Um Suction Cath Kit,UM3500125,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,11.23,% of charge rate,100.00%,11.23,,,,10.67,11.23,0
unity,CDM,Um Suction Cath Kit,UM3500125,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,11.23,% of charge rate,100.00%,11.23,,,,10.67,11.23,0
unity,CDM,Um Suture Removal Kit,UM3500130,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,17.08,% of charge rate,100.00%,17.08,,,,16.23,17.08,0
unity,CDM,Um Suture Removal Kit,UM3500130,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,17.08,% of charge rate,100.00%,17.08,,,,16.23,17.08,0
unity,CDM,Um Penrose Drains,UM3500133,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.54,% of charge rate,100.00%,7.54,,,,7.16,7.54,0
unity,CDM,Um Penrose Drains,UM3500133,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.54,% of charge rate,100.00%,7.54,,,,7.16,7.54,0
unity,CDM,Um Sponge Gauze Universal,UM3500136,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.44,% of charge rate,100.00%,8.44,,,,8.02,8.44,0
unity,CDM,Um Sponge Gauze Universal,UM3500136,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.44,% of charge rate,100.00%,8.44,,,,8.02,8.44,0
unity,CDM,Um Pediatric U Bag,UM3500137,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.54,% of charge rate,100.00%,7.54,,,,7.16,7.54,0
unity,CDM,Um Pediatric U Bag,UM3500137,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.54,% of charge rate,100.00%,7.54,,,,7.16,7.54,0
unity,CDM,Um Saline Lock,UM3500139,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.32,% of charge rate,100.00%,101.32,,,,96.25,101.32,0
unity,CDM,Um Saline Lock,UM3500139,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.32,% of charge rate,100.00%,101.32,,,,96.25,101.32,0
unity,CDM,"Um Packing Strip, Plain 5 Yd",UM3500141,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.92,% of charge rate,100.00%,38.92,,,,36.97,38.92,0
unity,CDM,"Um Packing Strip, Plain 5 Yd",UM3500141,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.92,% of charge rate,100.00%,38.92,,,,36.97,38.92,0
unity,CDM,Um Surgical Poole Suction,UM3500142,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,30.15,% of charge rate,100.00%,30.15,,,,28.64,30.15,0
unity,CDM,Um Surgical Poole Suction,UM3500142,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,30.15,% of charge rate,100.00%,30.15,,,,28.64,30.15,0
unity,CDM,Um Catheterization Supp,UM3500148,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.86,% of charge rate,100.00%,116.86,,,,111.02,116.86,0
unity,CDM,Um Catheterization Supp,UM3500148,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.86,% of charge rate,100.00%,116.86,,,,111.02,116.86,0
unity,CDM,Um Cont Epidur Tray,UM3500153,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,149.96,% of charge rate,100.00%,149.96,,,,142.46,149.96,0
unity,CDM,Um Cont Epidur Tray,UM3500153,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,149.96,% of charge rate,100.00%,149.96,,,,142.46,149.96,0
unity,CDM,Um Cervical Collar-stiffneck,UM3500169,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.59,% of charge rate,100.00%,71.59,,,,68.01,71.59,0
unity,CDM,Um Cervical Collar-stiffneck,UM3500169,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.59,% of charge rate,100.00%,71.59,,,,68.01,71.59,0
unity,CDM,Um Nasal Packing-balloon,UM3500171,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,149,% of charge rate,100.00%,149,,,,141.55,149,0
unity,CDM,Um Nasal Packing-balloon,UM3500171,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,149,% of charge rate,100.00%,149,,,,141.55,149,0
unity,CDM,Um Mouthpiece,UM3500172,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.45,% of charge rate,100.00%,5.45,,,,5.18,5.45,0
unity,CDM,Um Mouthpiece,UM3500172,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.45,% of charge rate,100.00%,5.45,,,,5.18,5.45,0
unity,CDM,Um Bed Check Sensormat,UM3500183,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,157.89,% of charge rate,100.00%,157.89,,,,150,157.89,0
unity,CDM,Um Bed Check Sensormat,UM3500183,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,157.89,% of charge rate,100.00%,157.89,,,,150,157.89,0
unity,CDM,Um Suc Cath 14 Fr Argyl,UM3500186,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,18.94,% of charge rate,100.00%,18.94,,,,17.99,18.94,0
unity,CDM,Um Suc Cath 14 Fr Argyl,UM3500186,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,18.94,% of charge rate,100.00%,18.94,,,,17.99,18.94,0
unity,CDM,Um Connect Tube Plas 6',UM3500192,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.34,% of charge rate,100.00%,13.34,,,,12.67,13.34,0
unity,CDM,Um Connect Tube Plas 6',UM3500192,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.34,% of charge rate,100.00%,13.34,,,,12.67,13.34,0
unity,CDM,Um Kling Bandage 2,UM3500194,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.82,% of charge rate,100.00%,3.82,,,,3.63,3.82,0
unity,CDM,Um Kling Bandage 2,UM3500194,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.82,% of charge rate,100.00%,3.82,,,,3.63,3.82,0
unity,CDM,Um Abd Dressing 8 X 10,UM3500201,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.88,% of charge rate,100.00%,9.88,,,,9.39,9.88,0
unity,CDM,Um Abd Dressing 8 X 10,UM3500201,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.88,% of charge rate,100.00%,9.88,,,,9.39,9.88,0
unity,CDM,Um Drain Sponge Universal,UM3500209,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.04,% of charge rate,100.00%,3.04,,,,2.89,3.04,0
unity,CDM,Um Drain Sponge Universal,UM3500209,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.04,% of charge rate,100.00%,3.04,,,,2.89,3.04,0
unity,CDM,Um Suture Misc.,UM3500217,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,30.15,% of charge rate,100.00%,30.15,,,,28.64,30.15,0
unity,CDM,Um Suture Misc.,UM3500217,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,30.15,% of charge rate,100.00%,30.15,,,,28.64,30.15,0
unity,CDM,Um Jackson-pratt Drain,UM3500223,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,124.45,% of charge rate,100.00%,124.45,,,,118.23,124.45,0
unity,CDM,Um Jackson-pratt Drain,UM3500223,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,124.45,% of charge rate,100.00%,124.45,,,,118.23,124.45,0
unity,CDM,Um Rususcitator Pulmanex,UM3500224,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,145.27,% of charge rate,100.00%,145.27,,,,138.01,145.27,0
unity,CDM,Um Rususcitator Pulmanex,UM3500224,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,145.27,% of charge rate,100.00%,145.27,,,,138.01,145.27,0
unity,CDM,Um Cholangiogram Catheter,UM3500230,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,70.09,% of charge rate,100.00%,70.09,,,,66.59,70.09,0
unity,CDM,Um Cholangiogram Catheter,UM3500230,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,70.09,% of charge rate,100.00%,70.09,,,,66.59,70.09,0
unity,CDM,Um Suture Regular,UM3500232,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,17.14,% of charge rate,100.00%,17.14,,,,16.28,17.14,0
unity,CDM,Um Suture Regular,UM3500232,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,17.14,% of charge rate,100.00%,17.14,,,,16.28,17.14,0
unity,CDM,Um Stap Extrac Disp,UM3500237,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.82,% of charge rate,100.00%,20.82,,,,19.78,20.82,0
unity,CDM,Um Stap Extrac Disp,UM3500237,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.82,% of charge rate,100.00%,20.82,,,,19.78,20.82,0
unity,CDM,Um Glidescope Disp Laryngoscope,UM3500338,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,240,% of charge rate,100.00%,240,,,,228,240,0
unity,CDM,Um Glidescope Disp Laryngoscope,UM3500338,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,240,% of charge rate,100.00%,240,,,,228,240,0
unity,CDM,Um Peg Tube,UM3500339,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,264.55,% of charge rate,100.00%,264.55,,,,251.32,264.55,0
unity,CDM,Um Peg Tube,UM3500339,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,264.55,% of charge rate,100.00%,264.55,,,,251.32,264.55,0
unity,CDM,Um Pall Blood Filter,UM3600014,99070,,Special supplies phys/qhp,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,244.26,% of charge rate,100.00%,244.26,,,,232.05,244.26,0
unity,CDM,Um Pall Blood Filter,UM3600014,99070,,Special supplies phys/qhp,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,244.26,% of charge rate,100.00%,244.26,,,,232.05,244.26,0
unity,CDM,HC PHLEBOTOMY,9400021,99195,,Phlebotomy,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,224.59,% of charge rate,100.00%,224.59,,,,213.36,224.59,0
unity,CDM,HC PHLEBOTOMY,9400021,99195,,Phlebotomy,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,224.59,% of charge rate,100.00%,224.59,,,,213.36,224.59,0
unity,CDM,PR OFFICE OUTPATIENT NEW 10 MINUTES,99201,99201,,Office/outpatient visit new,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,98,% of charge rate,100.00%,98,,,,46.5,98,0
unity,CDM,PR OFFICE OUTPATIENT NEW 20 MINUTES,99202,99202,,Office/outpatient visit new,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,163,% of charge rate,100.00%,163,,,,88.66,163,0
unity,CDM,PR OFFICE OUTPATIENT NEW 30 MINUTES,99203,99203,,Office/outpatient visit new,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,230,% of charge rate,100.00%,230,,,,132.68,230,0
unity,CDM,PR OFFICE OUTPATIENT NEW 45 MINUTES,99204,99204,,Office/outpatient visit new,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,350,% of charge rate,100.00%,350,,,,226.92,350,0
unity,CDM,PR OFFICE OUTPATIENT NEW 60 MINUTES,99205,99205,,Office/outpatient visit new,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,440,% of charge rate,100.00%,440,,,,296.36,440,0
unity,CDM,Hc Office Visit-est Patient Level 1,7610005,99211,,Office/outpatient visit est,,,Professional,N/A,Self-Pay,N/A,N/A,N/A,26.69,% of charge rate,100.00%,26.69,,,,16.12,26.69,0
unity,CDM,PR OFFICE OUTPATIENT VISIT 5 MINUTES,99211,99211,,Office/outpatient visit est,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,16.12,50,0
unity,CDM,Um Scheduled Dressing Change,UM3700014,99211,,Office/outpatient visit est,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,55.23,% of charge rate,100.00%,55.23,,,,52.47,55.23,0
unity,CDM,Um Scheduled Dressing Change,UM3700014,99211,,Office/outpatient visit est,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,55.23,% of charge rate,100.00%,55.23,,,,52.47,55.23,0
unity,CDM,Um Professional Service,UM3700038,99211,,Office/outpatient visit est,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.27,% of charge rate,100.00%,41.27,,,,39.21,41.27,0
unity,CDM,Um Professional Service,UM3700038,99211,,Office/outpatient visit est,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.27,% of charge rate,100.00%,41.27,,,,39.21,41.27,0
unity,CDM,Um Rn Services,UM3800048,99211,,Office/outpatient visit est,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41,% of charge rate,100.00%,41,,,,38.95,41,0
unity,CDM,Um Rn Services,UM3800048,99211,,Office/outpatient visit est,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41,% of charge rate,100.00%,41,,,,38.95,41,0
unity,CDM,PR OFFICE OUTPATIENT VISIT 10 MINUTES,99212,99212,,Office/outpatient visit est,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,97,% of charge rate,100.00%,97,,,,45.26,97,0
unity,CDM,PR OFFICE OUTPATIENT VISIT 15 MINUTES,99213,99213,,Office/outpatient visit est,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,158,% of charge rate,100.00%,158,,,,89.9,158,0
unity,CDM,PR OFFICE OUTPATIENT VISIT 25 MINUTES,99214,99214,,Office/outpatient visit est,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,230,% of charge rate,100.00%,230,,,,138.26,230,0
unity,CDM,PR OFFICE OUTPATIENT VISIT 40 MINUTES,99215,99215,,Office/outpatient visit est,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,300,% of charge rate,100.00%,300,,,,195.3,300,0
unity,CDM,PR OBSERVATION CARE DISCHARGE MANAGEMENT,99217,99217,,Observation care discharge,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,155,% of charge rate,100.00%,155,,,,127.1,155,0
unity,CDM,PR INITIAL OBSERVATION CARE/DAY 30 MINUTES,99218,99218,,Initial observation care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,214,% of charge rate,100.00%,214,,,,174.84,214,0
unity,CDM,PR INITIAL OBSERVATION CARE/DAY 50 MINUTES,99219,99219,,Initial observation care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,290,% of charge rate,100.00%,290,,,,237.46,290,0
unity,CDM,PR INITIAL OBSERVATION CARE/DAY 70 MINUTES,99220,99220,,Initial observation care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,395,% of charge rate,100.00%,395,,,,323.64,395,0
unity,CDM,PR INITIAL HOSPITAL CARE/DAY 30 MINUTES,99221,99221,,Initial hospital care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,215,% of charge rate,100.00%,215,,,,178.56,215,0
unity,CDM,PR INITIAL HOSPITAL CARE/DAY 50 MINUTES,99222,99222,,Initial hospital care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,290,% of charge rate,100.00%,290,,,,241.18,290,0
unity,CDM,PR INITIAL HOSPITAL CARE/DAY 70 MINUTES,99223,99223,,Initial hospital care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,430,% of charge rate,100.00%,430,,,,354.02,430,0
unity,CDM,PR SBSQ OBSERVATION CARE/DAY 15 MINUTES,99224,99224,,Subsequent observation care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,85,% of charge rate,100.00%,85,,,,69.44,85,0
unity,CDM,PR SBSQ OBSERVATION CARE/DAY 25 MINUTES,99225,99225,,Subsequent observation care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,155,% of charge rate,100.00%,155,,,,127.1,155,0
unity,CDM,PR SBSQ OBSERVATION CARE/DAY 35 MINUTES,99226,99226,,Subsequent observation care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,225,% of charge rate,100.00%,225,,,,182.9,225,0
unity,CDM,PR SBSQ HOSPITAL CARE/DAY 15 MINUTES,99231,99231,,Subsequent hospital care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,85,% of charge rate,100.00%,85,,,,68.82,85,0
unity,CDM,PR SBSQ HOSPITAL CARE/DAY 25 MINUTES,99232,99232,,Subsequent hospital care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,155,% of charge rate,100.00%,155,,,,126.48,155,0
unity,CDM,PR SBSQ HOSPITAL CARE/DAY 35 MINUTES,99233,99233,,Subsequent hospital care,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,225,% of charge rate,100.00%,225,,,,182.28,225,0
unity,CDM,PR OBSERVATION/INPATIENT HOSPITAL CARE 40 MINUTES,99234,99234,,Observ/hosp same date,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,285,% of charge rate,100.00%,285,,,,233.74,285,0
unity,CDM,PR OBSERVATION/INPATIENT HOSPITAL CARE 50 MINUTES,99235,99235,,Observ/hosp same date,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,295.74,360,0
unity,CDM,PR OBSERVATION/INPATIENT HOSPITAL CARE 55 MINUTES,99236,99236,,Observ/hosp same date,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,465,% of charge rate,100.00%,465,,,,380.68,465,0
unity,CDM,"PR HOSPITAL DISCHARGE DAY,<30 MIN",99238,99238,,Hospital discharge day,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,155,% of charge rate,100.00%,155,,,,127.72,155,0
unity,CDM,"PR HOSPITAL DISCHARGE DAY,>30 MIN",99239,99239,,Hospital discharge day,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,230,% of charge rate,100.00%,230,,,,187.24,230,0
unity,CDM,PR OFFICE CONSULTATION NEW/ESTAB PATIENT 15 MIN,99241,99241,,Office consultation,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,97.26,% of charge rate,100.00%,97.26,,,,57.66,97.26,0
unity,CDM,ED LEVEL I,4500096,99281,,Emergency dept visit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140,% of charge rate,100.00%,140,,,,133,140,0
unity,CDM,ED LEVEL I,4500096,99281,,Emergency dept visit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140,% of charge rate,100.00%,140,,,,133,140,0
unity,CDM,PR EMERGENCY DEPARTMENT VISIT LIMITED/MINOR PROB,99281,99281,,Emergency dept visit,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,39.68,50,0
unity,CDM,ED LEVEL II,4500097,99282,,Emergency dept visit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,250,% of charge rate,100.00%,250,,,,237.5,250,0
unity,CDM,ED LEVEL II,4500097,99282,,Emergency dept visit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,250,% of charge rate,100.00%,250,,,,237.5,250,0
unity,CDM,PR EMERGENCY DEPARTMENT VISIT LOW/MODER SEVERITY,99282,99282,,Emergency dept visit,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,76.26,90.29,0
unity,CDM,ED LEVEL III,4500098,99283,,Emergency dept visit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,440,% of charge rate,100.00%,440,,,,418,440,0
unity,CDM,ED LEVEL III,4500098,99283,,Emergency dept visit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,440,% of charge rate,100.00%,440,,,,418,440,0
unity,CDM,PR EMERGENCY DEPARTMENT VISIT MODERATE SEVERITY,99283,99283,,Emergency dept visit,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,114.08,135.07,0
unity,CDM,ED LEVEL IV,4500099,99284,,Emergency dept visit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,710,% of charge rate,100.00%,710,,,,674.5,710,0
unity,CDM,ED LEVEL IV,4500099,99284,,Emergency dept visit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,710,% of charge rate,100.00%,710,,,,674.5,710,0
unity,CDM,PR EMERGENCY DEPARTMENT VISIT HIGH/URGENT SEVERITY,99284,99284,,Emergency dept visit,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,250,% of charge rate,100.00%,250,,,,209.56,250,0
unity,CDM,ED LEVEL V,4500100,99285,,Emergency dept visit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,040.00",% of charge rate,100.00%,"1,040.00",,,,988,"1,040.00",0
unity,CDM,ED LEVEL V,4500100,99285,,Emergency dept visit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,040.00",% of charge rate,100.00%,"1,040.00",,,,988,"1,040.00",0
unity,CDM,PR EMERGENCY DEPT VISIT HIGH SEVERITY&THREAT FUNCJ,99285,99285,,Emergency dept visit,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,370,% of charge rate,100.00%,370,,,,304.42,370,0
unity,CDM,CRITICAL CARE 1ST HOUR,4500101,99291,,Critical care first hour,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,900.00",% of charge rate,100.00%,"1,900.00",,,,"1,805.00","1,900.00",0
unity,CDM,CRITICAL CARE 1ST HOUR,4500101,99291,,Critical care first hour,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,900.00",% of charge rate,100.00%,"1,900.00",,,,"1,805.00","1,900.00",0
unity,CDM,"PR CRITICAL CARE, E/M 30-74 MINUTES",99291,99291,,Critical care first hour,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,480,% of charge rate,100.00%,480,,,,389.36,480,0
unity,CDM,"PR CRITICAL CARE, ADDL 30 MIN",99292,99292,,Critical care addl 30 min,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,262,% of charge rate,100.00%,262,,,,195.92,262,0
unity,CDM,INITIAL NURSING FACILITY CARE/DAY 25 MINUTES,99304,99304,,Nursing facility care init,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,195,% of charge rate,100.00%,195,,,,158.1,195,0
unity,CDM,INITIAL NURSING FACILITY CARE/DAY 35 MINUTES,99305,99305,,Nursing facility care init,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,235.13,% of charge rate,100.00%,235.13,,,,226.3,267.95,0
unity,CDM,SBSQ NURSING FACILITY CARE/DAY E/M STABLE 10 MIN,99307,99307,,Nursing fac care subseq,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,95,% of charge rate,100.00%,95,,,,76.88,95,0
unity,CDM,SBSQ NURSING FACIL CARE/DAY MINOR COMPLJ 15 MIN,99308,99308,,Nursing fac care subseq,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,145,% of charge rate,100.00%,145,,,,120.9,145,0
unity,CDM,SBSQ NURSING FACIL CARE/DAY NEW PROBLEM 25 MIN,99309,99309,,Nursing fac care subseq,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,195,% of charge rate,100.00%,195,,,,159.34,195,0
unity,CDM,"PR NURSING FAC DISCHRGE DAY,1-30 MIN",99315,99315,,Nursing fac discharge day,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,149.08,% of charge rate,100.00%,149.08,,,,128.34,151.96,0
unity,CDM,"PR NURSING FAC DISCHRGE DAY,MORE 30 MIN",99316,99316,,Nursing fac discharge day,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,213.68,% of charge rate,100.00%,213.68,,,,184.14,218.03,0
unity,CDM,"PR PREVENTIVE VISIT,NEW,INFANT < 1 YR",99381,99381,,Init pm e/m new pat infant,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,238,% of charge rate,100.00%,238,,,,135.78,238,0
unity,CDM,"PR PREVENTIVE VISIT,NEW,AGE 1-4",99382,99382,,Init pm e/m new pat 1-4 yrs,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,238.51,% of charge rate,100.00%,238.51,,,,145.08,238.51,0
unity,CDM,"PR PREVENTIVE VISIT,NEW,AGE5-11",99383,99383,,Prev visit new age 5-11,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,255,% of charge rate,100.00%,255,,,,153.76,255,0
unity,CDM,"PR PREVENTIVE VISIT,NEW,12-17",99384,99384,,Prev visit new age 12-17,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,290,% of charge rate,100.00%,290,,,,181.66,290,0
unity,CDM,"PR PREVENTIVE VISIT,NEW,18-39",99385,99385,,Prev visit new age 18-39,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,282,% of charge rate,100.00%,282,,,,174.22,282,0
unity,CDM,"PR PREVENTIVE VISIT,NEW,40-64",99386,99386,,Prev visit new age 40-64,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,325,% of charge rate,100.00%,325,,,,211.42,325,0
unity,CDM,"PR PREVENTIVE VISIT,NEW,65 & OVER",99387,99387,,Init pm e/m new pat 65+ yrs,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,342.17,% of charge rate,100.00%,342.17,,,,227.54,342.17,0
unity,CDM,"PR PREVENTIVE VISIT,EST, INFANT < 1 YR",99391,99391,,Per pm reeval est pat infant,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,210,% of charge rate,100.00%,210,,,,124.62,210,0
unity,CDM,"PR PREVENTIVE VISIT,EST,AGE 1-4",99392,99392,,Prev visit est age 1-4,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,225,% of charge rate,100.00%,225,,,,135.78,225,0
unity,CDM,"PR PREVENTIVE VISIT,EST,AGE5-11",99393,99393,,Prev visit est age 5-11,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,225,% of charge rate,100.00%,225,,,,135.78,225,0
unity,CDM,"PR PREVENTIVE VISIT,EST,12-17",99394,99394,,Prev visit est age 12-17,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,250,% of charge rate,100.00%,250,,,,153.76,250,0
unity,CDM,"PR PREVENTIVE VISIT,EST,18-39",99395,99395,,Prev visit est age 18-39,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,250,% of charge rate,100.00%,250,,,,158.1,250,0
unity,CDM,"PR PREVENTIVE VISIT,EST,40-64",99396,99396,,Prev visit est age 40-64,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,270,% of charge rate,100.00%,270,,,,172.36,270,0
unity,CDM,"PR PREVENTIVE VISIT,EST,65 & OVER",99397,99397,,Per pm reeval est pat 65+ yr,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,290,% of charge rate,100.00%,290,,,,181.66,290,0
unity,CDM,HC BEHAV CHNG SMOKING 3-10 MIN,9420000,99406,,Behav chng smoking 3-10 min,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,53.55,% of charge rate,100.00%,53.55,,,,21.7,53.55,0
unity,CDM,HC BEHAV CHNG SMOKING 3-10 MIN,9420000,99406,,Behav chng smoking 3-10 min,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.55,% of charge rate,100.00%,53.55,,,,50.87,53.55,0
unity,CDM,HC BEHAV CHNG SMOKING 3-10 MIN,9420000,99406,,Behav chng smoking 3-10 min,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.55,% of charge rate,100.00%,53.55,,,,50.87,53.55,0
unity,CDM,HC BEHAV CHNG SMOKING > 10 MIN,9420001,99407,,Behav chng smoking > 10 min,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,101.14,% of charge rate,100.00%,101.14,,,,45.88,101.14,0
unity,CDM,HC BEHAV CHNG SMOKING > 10 MIN,9420001,99407,,Behav chng smoking > 10 min,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.14,% of charge rate,100.00%,101.14,,,,96.08,101.14,0
unity,CDM,HC BEHAV CHNG SMOKING > 10 MIN,9420001,99407,,Behav chng smoking > 10 min,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.14,% of charge rate,100.00%,101.14,,,,96.08,101.14,0
unity,CDM,PR UNLISTED PREVENTIVE SERVICE,99429,99429,,Unlisted preventive service,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,147.49,% of charge rate,100.00%,147.49,,,,147.49,147.49,0
unity,CDM,Um Needle-huber (winged Core,UM3500168,A4212,,Non coring needle or stylet,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.55,% of charge rate,100.00%,24.55,,,,23.32,24.55,0
unity,CDM,Um Needle-huber (winged Core,UM3500168,A4212,,Non coring needle or stylet,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.55,% of charge rate,100.00%,24.55,,,,23.32,24.55,0
unity,CDM,Um Tray C Cath/drainage Bag,UM3500248,A4311,,Catheter w/o bag 2-way latex,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.11,% of charge rate,100.00%,27.11,,,,25.75,27.11,0
unity,CDM,Um Tray C Cath/drainage Bag,UM3500248,A4311,,Catheter w/o bag 2-way latex,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.11,% of charge rate,100.00%,27.11,,,,25.75,27.11,0
unity,CDM,Um Catheter Secure,UM3500097,A4333,,Urinary cath anchor device,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,17.14,% of charge rate,100.00%,17.14,,,,16.28,17.14,0
unity,CDM,Um Catheter Secure,UM3500097,A4333,,Urinary cath anchor device,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,17.14,% of charge rate,100.00%,17.14,,,,16.28,17.14,0
unity,CDM,Um Cath Foley Universal,UM3500135,A4338,,Indwelling catheter latex,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.83,% of charge rate,100.00%,33.83,,,,32.14,33.83,0
unity,CDM,Um Cath Foley Universal,UM3500135,A4338,,Indwelling catheter latex,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.83,% of charge rate,100.00%,33.83,,,,32.14,33.83,0
unity,CDM,Um Cath Tray W/o Cath,UM3500219,A4353,,Intermittent urinary cath,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75.44,% of charge rate,100.00%,75.44,,,,71.67,75.44,0
unity,CDM,Um Cath Tray W/o Cath,UM3500219,A4353,,Intermittent urinary cath,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75.44,% of charge rate,100.00%,75.44,,,,71.67,75.44,0
unity,CDM,Um Drainbag W/urine Met,UM3500140,A4357,,Bedside drainage bag,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69.06,% of charge rate,100.00%,69.06,,,,65.61,69.06,0
unity,CDM,Um Drainbag W/urine Met,UM3500140,A4357,,Bedside drainage bag,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69.06,% of charge rate,100.00%,69.06,,,,65.61,69.06,0
unity,CDM,Um Closed Drain Bag,UM3500086,A4358,,Urinary leg or abdomen bag,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.64,% of charge rate,100.00%,41.64,,,,39.56,41.64,0
unity,CDM,Um Closed Drain Bag,UM3500086,A4358,,Urinary leg or abdomen bag,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.64,% of charge rate,100.00%,41.64,,,,39.56,41.64,0
unity,CDM,Um Drain Leg Bag All Sizes,UM3500215,A4358,,Urinary leg or abdomen bag,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.67,% of charge rate,100.00%,22.67,,,,21.54,22.67,0
unity,CDM,Um Drain Leg Bag All Sizes,UM3500215,A4358,,Urinary leg or abdomen bag,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.67,% of charge rate,100.00%,22.67,,,,21.54,22.67,0
unity,CDM,Um Pf. Tape/roll,UM4310004,A4454,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,18.36,% of charge rate,100.00%,18.36,,,,17.44,18.36,0
unity,CDM,Um Pf. Tape/roll,UM4310004,A4454,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,18.36,% of charge rate,100.00%,18.36,,,,17.44,18.36,0
unity,CDM,Um Dermofit Elas Support/ft,UM4310024,A4460,,"BANDAGE, ELAS ECON 3IN",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,2.97,% of charge rate,100.00%,2.97,,,,2.82,2.97,0
unity,CDM,Um Dermofit Elas Support/ft,UM4310024,A4460,,"BANDAGE, ELAS ECON 3IN",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,2.97,% of charge rate,100.00%,2.97,,,,2.82,2.97,0
unity,CDM,Um Montgomery Straps,UM3500034,A4462,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.34,% of charge rate,100.00%,9.34,,,,8.87,9.34,0
unity,CDM,Um Montgomery Straps,UM3500034,A4462,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.34,% of charge rate,100.00%,9.34,,,,8.87,9.34,0
unity,CDM,"Um Ko, Patella Strap",UM4310030,A4466,,KNEE SUPPORT LG PATELLAR,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50.96,% of charge rate,100.00%,50.96,,,,48.41,50.96,0
unity,CDM,"Um Ko, Patella Strap",UM4310030,A4466,,KNEE SUPPORT LG PATELLAR,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50.96,% of charge rate,100.00%,50.96,,,,48.41,50.96,0
unity,CDM,Um Rib Belt,UM3500080,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,55.67,% of charge rate,100.00%,55.67,,,,52.89,55.67,0
unity,CDM,Um Rib Belt,UM3500080,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,55.67,% of charge rate,100.00%,55.67,,,,52.89,55.67,0
unity,CDM,Um Elbow Strap/tennis,UM3500173,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.22,% of charge rate,100.00%,36.22,,,,34.41,36.22,0
unity,CDM,Um Elbow Strap/tennis,UM3500173,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.22,% of charge rate,100.00%,36.22,,,,34.41,36.22,0
unity,CDM,Um Knee Brace Elastic,UM3500176,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15,% of charge rate,100.00%,15,,,,14.25,15,0
unity,CDM,Um Knee Brace Elastic,UM3500176,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15,% of charge rate,100.00%,15,,,,14.25,15,0
unity,CDM,"Um Ko, Sleeve",UM4310015,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.58,% of charge rate,100.00%,76.58,,,,72.75,76.58,0
unity,CDM,"Um Ko, Sleeve",UM4310015,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.58,% of charge rate,100.00%,76.58,,,,72.75,76.58,0
unity,CDM,"Um Ko, Elastic With Strap",UM4310016,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,92.6,% of charge rate,100.00%,92.6,,,,87.97,92.6,0
unity,CDM,"Um Ko, Elastic With Strap",UM4310016,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,92.6,% of charge rate,100.00%,92.6,,,,87.97,92.6,0
unity,CDM,Um Elbow Strap,UM4310025,A4467,,Belt strap sleev grmnt cover,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.89,% of charge rate,100.00%,27.89,,,,26.5,27.89,0
unity,CDM,Um Elbow Strap,UM4310025,A4467,,Belt strap sleev grmnt cover,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.89,% of charge rate,100.00%,27.89,,,,26.5,27.89,0
unity,CDM,Um Suture Set/small,UM3500088,A4550,,Surgical trays,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.14,% of charge rate,100.00%,88.14,,,,83.73,88.14,0
unity,CDM,Um Suture Set/small,UM3500088,A4550,,Surgical trays,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.14,% of charge rate,100.00%,88.14,,,,83.73,88.14,0
unity,CDM,Um Electrodes,UM4310020,A4556,,"Electrodes, pair",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,30.66,% of charge rate,100.00%,30.66,,,,29.13,30.66,0
unity,CDM,Um Electrodes,UM4310020,A4556,,"Electrodes, pair",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,30.66,% of charge rate,100.00%,30.66,,,,29.13,30.66,0
unity,CDM,Um Pessary;non-rubber;any Type,UM3500134,A4562,,"Pessary, non rubber,any type",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.57,% of charge rate,100.00%,94.57,,,,89.84,94.57,0
unity,CDM,Um Pessary;non-rubber;any Type,UM3500134,A4562,,"Pessary, non rubber,any type",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.57,% of charge rate,100.00%,94.57,,,,89.84,94.57,0
unity,CDM,Um Collar & Cuff Sling,UM3500043,A4565,,Slings,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.55,% of charge rate,100.00%,24.55,,,,23.32,24.55,0
unity,CDM,Um Collar & Cuff Sling,UM3500043,A4565,,Slings,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.55,% of charge rate,100.00%,24.55,,,,23.32,24.55,0
unity,CDM,Um Arm Sling Universal,UM3500081,A4565,,Slings,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.11,% of charge rate,100.00%,58.11,,,,55.2,58.11,0
unity,CDM,Um Arm Sling Universal,UM3500081,A4565,,Slings,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.11,% of charge rate,100.00%,58.11,,,,55.2,58.11,0
unity,CDM,Um Arm Sling Strap,UM3500143,A4565,,Slings,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49.48,% of charge rate,100.00%,49.48,,,,47.01,49.48,0
unity,CDM,Um Arm Sling Strap,UM3500143,A4565,,Slings,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49.48,% of charge rate,100.00%,49.48,,,,47.01,49.48,0
unity,CDM,Um Heated Wire Tubing,UM3470081,A4604,,Tubing with heating element,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.25,% of charge rate,100.00%,57.25,,,,54.39,57.25,0
unity,CDM,Um Heated Wire Tubing,UM3470081,A4604,,Tubing with heating element,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.25,% of charge rate,100.00%,57.25,,,,54.39,57.25,0
unity,CDM,Um Climate Line Tubing,UM3470086,A4604,,Tubing with heating element,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,70,% of charge rate,100.00%,70,,,,66.5,70,0
unity,CDM,Um Climate Line Tubing,UM3470086,A4604,,Tubing with heating element,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,70,% of charge rate,100.00%,70,,,,66.5,70,0
unity,CDM,Um Peak Flow Rate Meter,UM3500127,A4614,,Hand-held pefr meter,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.74,% of charge rate,100.00%,41.74,,,,39.65,41.74,0
unity,CDM,Um Peak Flow Rate Meter,UM3500127,A4614,,Hand-held pefr meter,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.74,% of charge rate,100.00%,41.74,,,,39.65,41.74,0
unity,CDM,Um Nasal Cannula 3l-1616,UM3470040,A4615,,Cannula nasal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.46,% of charge rate,100.00%,3.46,,,,3.29,3.46,0
unity,CDM,Um Nasal Cannula 3l-1616,UM3470040,A4615,,Cannula nasal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.46,% of charge rate,100.00%,3.46,,,,3.29,3.46,0
unity,CDM,Um Nasal Cannula-1600,UM3470051,A4615,,Cannula nasal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3,% of charge rate,100.00%,3,,,,2.85,3,0
unity,CDM,Um Nasal Cannula-1600,UM3470051,A4615,,Cannula nasal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3,% of charge rate,100.00%,3,,,,2.85,3,0
unity,CDM,Um Nasal Cannula- 25 Ft,UM3470073,A4615,,Cannula nasal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4,% of charge rate,100.00%,4,,,,3.8,4,0
unity,CDM,Um Nasal Cannula- 25 Ft,UM3470073,A4615,,Cannula nasal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4,% of charge rate,100.00%,4,,,,3.8,4,0
unity,CDM,Um Nasal Canula 4 Ft,UM3470074,A4615,,Cannula nasal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,0
unity,CDM,Um Nasal Canula 4 Ft,UM3470074,A4615,,Cannula nasal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,0
unity,CDM,Um Nasal Cannula,UM3500155,A4615,,Cannula nasal,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.24,% of charge rate,100.00%,3.24,,,,3.08,3.24,0
unity,CDM,Um Nasal Cannula,UM3500155,A4615,,Cannula nasal,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.24,% of charge rate,100.00%,3.24,,,,3.08,3.24,0
unity,CDM,Um Connecting Tube 25 Ft.,UM3470055,A4616,,Tubing (oxygen) per foot,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,2.96,% of charge rate,100.00%,2.96,,,,2.81,2.96,0
unity,CDM,Um Connecting Tube 25 Ft.,UM3470055,A4616,,Tubing (oxygen) per foot,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,2.96,% of charge rate,100.00%,2.96,,,,2.81,2.96,0
unity,CDM,Um Oxygen Tubing - 7 Ft,UM3470076,A4616,,Tubing (oxygen) per foot,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3,% of charge rate,100.00%,3,,,,2.85,3,0
unity,CDM,Um Oxygen Tubing - 7 Ft,UM3470076,A4616,,Tubing (oxygen) per foot,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3,% of charge rate,100.00%,3,,,,2.85,3,0
unity,CDM,Um Connecting Tube Per Foot,UM3500147,A4616,,Tubing (oxygen) per foot,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,0.25,% of charge rate,100.00%,0.25,,,,0.24,0.25,0
unity,CDM,Um Connecting Tube Per Foot,UM3500147,A4616,,Tubing (oxygen) per foot,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,0.25,% of charge rate,100.00%,0.25,,,,0.24,0.25,0
unity,CDM,Um Spacer - Aero Chamber,UM3500040,A4627,,Spacer bag/reservoir,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.68,% of charge rate,100.00%,31.68,,,,30.1,31.68,0
unity,CDM,Um Spacer - Aero Chamber,UM3500040,A4627,,Spacer bag/reservoir,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.68,% of charge rate,100.00%,31.68,,,,30.1,31.68,0
unity,CDM,Um Suction Wand,UM3470026,A4628,,Oropharyngeal suction cath,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.5,% of charge rate,100.00%,6.5,,,,6.18,6.5,0
unity,CDM,Um Suction Wand,UM3470026,A4628,,Oropharyngeal suction cath,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.5,% of charge rate,100.00%,6.5,,,,6.18,6.5,0
unity,CDM,Um Replacem Tips/crutch/cane,UM4310013,A4637,,Repl tip cane/crutch/walker,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,0
unity,CDM,Um Replacem Tips/crutch/cane,UM4310013,A4637,,Repl tip cane/crutch/walker,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,0
unity,CDM,Um Profore Drsing Clinic Use,UM3500131,A4649,,Surgical supplies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Profore Drsing Clinic Use,UM3500131,A4649,,Surgical supplies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Profore Drsing - Hosp Use,UM3500185,A4649,,Surgical supplies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Profore Drsing - Hosp Use,UM3500185,A4649,,Surgical supplies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Ink Injector Single Use,UM3500334,A4649,,Surgical supplies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50.27,% of charge rate,100.00%,50.27,,,,47.76,50.27,0
unity,CDM,Um Ink Injector Single Use,UM3500334,A4649,,Surgical supplies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50.27,% of charge rate,100.00%,50.27,,,,47.76,50.27,0
unity,CDM,Um Snare Biopsy Forcep,UM3500335,A4649,,Surgical supplies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,16.27,% of charge rate,100.00%,16.27,,,,15.46,16.27,0
unity,CDM,Um Snare Biopsy Forcep,UM3500335,A4649,,Surgical supplies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,16.27,% of charge rate,100.00%,16.27,,,,15.46,16.27,0
unity,CDM,Um Dilator Balloon (esoph/colon),UM3500336,A4649,,Surgical supplies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,242.27,% of charge rate,100.00%,242.27,,,,230.16,242.27,0
unity,CDM,Um Dilator Balloon (esoph/colon),UM3500336,A4649,,Surgical supplies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,242.27,% of charge rate,100.00%,242.27,,,,230.16,242.27,0
unity,CDM,Um Dilator Syringe,UM3500337,A4649,,Surgical supplies,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,235.21,% of charge rate,100.00%,235.21,,,,223.45,235.21,0
unity,CDM,Um Dilator Syringe,UM3500337,A4649,,Surgical supplies,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,235.21,% of charge rate,100.00%,235.21,,,,223.45,235.21,0
unity,CDM,Um Dressing Melgisorb 4x4,UM3500290,A6196,,Alginate dressing <=16 sq in,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.68,% of charge rate,100.00%,3.68,,,,3.5,3.68,0
unity,CDM,Um Dressing Melgisorb 4x4,UM3500290,A6196,,Alginate dressing <=16 sq in,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.68,% of charge rate,100.00%,3.68,,,,3.5,3.68,0
unity,CDM,Um Aquacel Ag,UM3500309,A6197,,Alginate drsg >16 <=48 sq in,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,14.14,% of charge rate,100.00%,14.14,,,,13.43,14.14,0
unity,CDM,Um Aquacel Ag,UM3500309,A6197,,Alginate drsg >16 <=48 sq in,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,14.14,% of charge rate,100.00%,14.14,,,,13.43,14.14,0
unity,CDM,Um Tegaderm Drsg Universal,UM3500094,A6203,,Composite drsg <= 16 sq in,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,10.63,% of charge rate,100.00%,10.63,,,,10.1,10.63,0
unity,CDM,Um Tegaderm Drsg Universal,UM3500094,A6203,,Composite drsg <= 16 sq in,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,10.63,% of charge rate,100.00%,10.63,,,,10.1,10.63,0
unity,CDM,Um Antimicrobial Foam Dressing,UM3500289,A6209,,Foam drsg <=16 sq in w/o bdr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.75,% of charge rate,100.00%,13.75,,,,13.06,13.75,0
unity,CDM,Um Antimicrobial Foam Dressing,UM3500289,A6209,,Foam drsg <=16 sq in w/o bdr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.75,% of charge rate,100.00%,13.75,,,,13.06,13.75,0
unity,CDM,Um Aquacel Foam 6x6,UM3500310,A6210,,Foam drg >16<=48 sq in w/o b,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.44,% of charge rate,100.00%,15.44,,,,14.67,15.44,0
unity,CDM,Um Aquacel Foam 6x6,UM3500310,A6210,,Foam drg >16<=48 sq in w/o b,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.44,% of charge rate,100.00%,15.44,,,,14.67,15.44,0
unity,CDM,Um Meplix Unv Dressing,UM3500282,A6212,,Foam drg <=16 sq in w/border,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.91,% of charge rate,100.00%,29.91,,,,28.41,29.91,0
unity,CDM,Um Meplix Unv Dressing,UM3500282,A6212,,Foam drg <=16 sq in w/border,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.91,% of charge rate,100.00%,29.91,,,,28.41,29.91,0
unity,CDM,Um Biatain Heel Dressing,UM3500312,A6213,,Foam drg >16<=48 sq in w/bdr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.91,% of charge rate,100.00%,8.91,,,,8.46,8.91,0
unity,CDM,Um Biatain Heel Dressing,UM3500312,A6213,,Foam drg >16<=48 sq in w/bdr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.91,% of charge rate,100.00%,8.91,,,,8.46,8.91,0
unity,CDM,Um Adaptic Dressing Universa,UM3500218,A6223,,Gauze >16<=48 no w/sal w/o b,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.82,% of charge rate,100.00%,3.82,,,,3.63,3.82,0
unity,CDM,Um Adaptic Dressing Universa,UM3500218,A6223,,Gauze >16<=48 no w/sal w/o b,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.82,% of charge rate,100.00%,3.82,,,,3.63,3.82,0
unity,CDM,Um Duo Derm Dressing,UM3500071,A6237,,Hydrocolld drg <=16 in w/bdr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.28,% of charge rate,100.00%,28.28,,,,26.87,28.28,0
unity,CDM,Um Duo Derm Dressing,UM3500071,A6237,,Hydrocolld drg <=16 in w/bdr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.28,% of charge rate,100.00%,28.28,,,,26.87,28.28,0
unity,CDM,Um Elasto-gel Dressing 4 X 4,UM3500090,A6243,,Hydrogel drg >16<=48 w/o bdr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.97,% of charge rate,100.00%,38.97,,,,37.02,38.97,0
unity,CDM,Um Elasto-gel Dressing 4 X 4,UM3500090,A6243,,Hydrogel drg >16<=48 w/o bdr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.97,% of charge rate,100.00%,38.97,,,,37.02,38.97,0
unity,CDM,Um Abd Universal,UM3500076,A6252,,Absorpt drg >16 <=48 w/o bdr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,10.45,% of charge rate,100.00%,10.45,,,,9.93,10.45,0
unity,CDM,Um Abd Universal,UM3500076,A6252,,Absorpt drg >16 <=48 w/o bdr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,10.45,% of charge rate,100.00%,10.45,,,,9.93,10.45,0
unity,CDM,Um Dressing Sorbex,UM3500360,A6253,,Absorpt drg > 48 sq in w/o b,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,179.27,% of charge rate,100.00%,179.27,,,,170.31,179.27,0
unity,CDM,Um Dressing Sorbex,UM3500360,A6253,,Absorpt drg > 48 sq in w/o b,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,179.27,% of charge rate,100.00%,179.27,,,,170.31,179.27,0
unity,CDM,"Um Sponges, Excilon",UM3500054,A6402,,Sterile gauze <= 16 sq in,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.1,% of charge rate,100.00%,7.1,,,,6.75,7.1,0
unity,CDM,"Um Sponges, Excilon",UM3500054,A6402,,Sterile gauze <= 16 sq in,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.1,% of charge rate,100.00%,7.1,,,,6.75,7.1,0
unity,CDM,Um Kerlix Super Sponges,UM3500023,A6403,,Sterile gauze>16 <= 48 sq in,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.86,% of charge rate,100.00%,9.86,,,,9.37,9.86,0
unity,CDM,Um Kerlix Super Sponges,UM3500023,A6403,,Sterile gauze>16 <= 48 sq in,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.86,% of charge rate,100.00%,9.86,,,,9.37,9.86,0
unity,CDM,Um Kling Bandage 4,UM3500058,A6445,,Conform band s w <3IN/yd,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.45,% of charge rate,100.00%,4.45,,,,4.23,4.45,0
unity,CDM,Um Kling Bandage 4,UM3500058,A6445,,Conform band s w <3IN/yd,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.45,% of charge rate,100.00%,4.45,,,,4.23,4.45,0
unity,CDM,Um Kerlix Rolls 4 1/2,UM3500197,A6446,,Conform band s w>=3IN <5IN/yd,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.21,% of charge rate,100.00%,15.21,,,,14.45,15.21,0
unity,CDM,Um Kerlix Rolls 4 1/2,UM3500197,A6446,,Conform band s w>=3IN <5IN/yd,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.21,% of charge rate,100.00%,15.21,,,,14.45,15.21,0
unity,CDM,Um Jobst Fast Fit Stockings,UM4310007,A6532,,Compression stocking bk40-50,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,130.19,% of charge rate,100.00%,130.19,,,,123.68,130.19,0
unity,CDM,Um Jobst Fast Fit Stockings,UM4310007,A6532,,Compression stocking bk40-50,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,130.19,% of charge rate,100.00%,130.19,,,,123.68,130.19,0
unity,CDM,Um Disposable Suction Cont,UM3470072,A7000,,Disposable canister for pump,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.5,% of charge rate,100.00%,13.5,,,,12.83,13.5,0
unity,CDM,Um Disposable Suction Cont,UM3470072,A7000,,Disposable canister for pump,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.5,% of charge rate,100.00%,13.5,,,,12.83,13.5,0
unity,CDM,Um Suction Connect Tubing Lt,UM3470043,A7002,,Tubing used w suction pump,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.81,% of charge rate,100.00%,6.81,,,,6.47,6.81,0
unity,CDM,Um Suction Connect Tubing Lt,UM3470043,A7002,,Tubing used w suction pump,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.81,% of charge rate,100.00%,6.81,,,,6.47,6.81,0
unity,CDM,"Um Nebulizer, Disposable",UM3470066,A7003,,Nebulizer administration set,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.89,% of charge rate,100.00%,4.89,,,,4.65,4.89,0
unity,CDM,"Um Nebulizer, Disposable",UM3470066,A7003,,Nebulizer administration set,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.89,% of charge rate,100.00%,4.89,,,,4.65,4.89,0
unity,CDM,"Um Administ Set, Sm Vol Neb",UM3500146,A7004,,Disposable nebulizer sml vol,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.77,% of charge rate,100.00%,4.77,,,,4.53,4.77,0
unity,CDM,"Um Administ Set, Sm Vol Neb",UM3500146,A7004,,Disposable nebulizer sml vol,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.77,% of charge rate,100.00%,4.77,,,,4.53,4.77,0
unity,CDM,Um Disposable Neb Pre-fill,UM3500104,A7008,,Disposable nebulizer prefill,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,19.33,% of charge rate,100.00%,19.33,,,,18.36,19.33,0
unity,CDM,Um Disposable Neb Pre-fill,UM3500104,A7008,,Disposable nebulizer prefill,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,19.33,% of charge rate,100.00%,19.33,,,,18.36,19.33,0
unity,CDM,Um Aerosol Mask For Neb,UM3470009,A7015,,Aerosol mask used w nebulize,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.35,% of charge rate,100.00%,3.35,,,,3.18,3.35,0
unity,CDM,Um Aerosol Mask For Neb,UM3470009,A7015,,Aerosol mask used w nebulize,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.35,% of charge rate,100.00%,3.35,,,,3.18,3.35,0
unity,CDM,Um Replacement Cushion Combo,UM3470082,A7028,,Repl oral cushion combo mask,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.5,% of charge rate,100.00%,41.5,,,,39.43,41.5,0
unity,CDM,Um Replacement Cushion Combo,UM3470082,A7028,,Repl oral cushion combo mask,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.5,% of charge rate,100.00%,41.5,,,,39.43,41.5,0
unity,CDM,Um Replacement Pillow Combo,UM3470083,A7029,,Repl nasal pillow comb mask,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Replacement Pillow Combo,UM3470083,A7029,,Repl nasal pillow comb mask,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,0
unity,CDM,Um Full Face Application,UM3470068,A7030,,Cpap full face mask,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,235,% of charge rate,100.00%,235,,,,223.25,235,0
unity,CDM,Um Full Face Application,UM3470068,A7030,,Cpap full face mask,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,235,% of charge rate,100.00%,235,,,,223.25,235,0
unity,CDM,Um Bipap Mask,UM3470322,A7030,,Cpap full face mask,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32,% of charge rate,100.00%,32,,,,30.4,32,0
unity,CDM,Um Bipap Mask,UM3470322,A7030,,Cpap full face mask,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32,% of charge rate,100.00%,32,,,,30.4,32,0
unity,CDM,Um Full Face Cushion,UM3470079,A7031,,Replacement facemask interfa,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69,% of charge rate,100.00%,69,,,,65.55,69,0
unity,CDM,Um Full Face Cushion,UM3470079,A7031,,Replacement facemask interfa,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69,% of charge rate,100.00%,69,,,,65.55,69,0
unity,CDM,Um Nasal Cushion,UM3470056,A7032,,Replacement nasal cushion,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,47.5,50,0
unity,CDM,Um Nasal Cushion,UM3470056,A7032,,Replacement nasal cushion,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,47.5,50,0
unity,CDM,Um Replacement Nasal Pillow,UM3470080,A7033,,Replacement nasal pillows,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.5,% of charge rate,100.00%,31.5,,,,29.93,31.5,0
unity,CDM,Um Replacement Nasal Pillow,UM3470080,A7033,,Replacement nasal pillows,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.5,% of charge rate,100.00%,31.5,,,,29.93,31.5,0
unity,CDM,Um Nasal Mask,UM3470017,A7034,,Nasal application device,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,147,% of charge rate,100.00%,147,,,,139.65,147,0
unity,CDM,Um Nasal Mask,UM3470017,A7034,,Nasal application device,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,147,% of charge rate,100.00%,147,,,,139.65,147,0
unity,CDM,Um Headgear,UM3470001,A7035,,Pos airway press headgear,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,47.5,50,0
unity,CDM,Um Headgear,UM3470001,A7035,,Pos airway press headgear,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,47.5,50,0
unity,CDM,Um Chin Strap,UM3470011,A7036,,Pos airway press chinstrap,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.84,% of charge rate,100.00%,31.84,,,,30.25,31.84,0
unity,CDM,Um Chin Strap,UM3470011,A7036,,Pos airway press chinstrap,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.84,% of charge rate,100.00%,31.84,,,,30.25,31.84,0
unity,CDM,Um Tubing/ 1 Month,UM3470005,A7037,,Pos airway pressure tubing,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,46.5,% of charge rate,100.00%,46.5,,,,44.18,46.5,0
unity,CDM,Um Tubing/ 1 Month,UM3470005,A7037,,Pos airway pressure tubing,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,46.5,% of charge rate,100.00%,46.5,,,,44.18,46.5,0
unity,CDM,Um Bipap Circut Accessory,UM3470323,A7037,,Pos airway pressure tubing,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Bipap Circut Accessory,UM3470323,A7037,,Pos airway pressure tubing,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Fil Disposable/ 2 Per Mth,UM3470050,A7038,,Pos airway pressure filter,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,10,% of charge rate,100.00%,10,,,,9.5,10,0
unity,CDM,Um Fil Disposable/ 2 Per Mth,UM3470050,A7038,,Pos airway pressure filter,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,10,% of charge rate,100.00%,10,,,,9.5,10,0
unity,CDM,Um Filt Non-disposable 6 Mth,UM3470049,A7039,,"Filter, non disposable w pap",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.2,% of charge rate,100.00%,27.2,,,,25.84,27.2,0
unity,CDM,Um Filt Non-disposable 6 Mth,UM3470049,A7039,,"Filter, non disposable w pap",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.2,% of charge rate,100.00%,27.2,,,,25.84,27.2,0
unity,CDM,Um Replacement - H2o Chamber,UM3470031,A7046,,"Repl water chamber, pap dev",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.68,% of charge rate,100.00%,34.68,,,,32.95,34.68,0
unity,CDM,Um Replacement - H2o Chamber,UM3470031,A7046,,"Repl water chamber, pap dev",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.68,% of charge rate,100.00%,34.68,,,,32.95,34.68,0
unity,CDM,Um Pleur X Vacuum Drainage Kit,UM3500340,A7048,,Vacuum drain bottle/tube kit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,124.78,% of charge rate,100.00%,124.78,,,,118.54,124.78,0
unity,CDM,Um Pleur X Vacuum Drainage Kit,UM3500340,A7048,,Vacuum drain bottle/tube kit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,124.78,% of charge rate,100.00%,124.78,,,,118.54,124.78,0
unity,CDM,NM CARDIOLITE PER SYRINGE,3430001,A9500,,Tc99m sestamibi,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,197.27,% of charge rate,100.00%,197.27,,,,187.41,197.27,0
unity,CDM,NM CARDIOLITE PER SYRINGE,3430001,A9500,,Tc99m sestamibi,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,197.27,% of charge rate,100.00%,197.27,,,,187.41,197.27,0
unity,CDM,Hc Mdp Per Dose,3430003,A9503,,Tc99m medronate,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,Hc Mdp Per Dose,3430003,A9503,,Tc99m medronate,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,130,% of charge rate,100.00%,130,,,,123.5,130,0
unity,CDM,Hc Ceretec Per Dose,3430010,A9521,,Tc99m exametazime,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Hc Ceretec Per Dose,3430010,A9521,,Tc99m exametazime,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Hc Choletec Per Dose,3430011,A9537,,Tc99m mebrofenin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Hc Choletec Per Dose,3430011,A9537,,Tc99m mebrofenin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Hc Nuc Mebrofenin,3430031,A9537,,Tc99m mebrofenin,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Hc Nuc Mebrofenin,3430031,A9537,,Tc99m mebrofenin,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Um Comp Bandage,UM3500308,A9776,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,11.6,% of charge rate,100.00%,11.6,,,,11.02,11.6,0
unity,CDM,Um Comp Bandage,UM3500308,A9776,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,11.6,% of charge rate,100.00%,11.6,,,,11.02,11.6,0
unity,CDM,Um Cold Compression Shoulder Pad,UM3500358,A9900,,Supply/accessory/service,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,180.61,% of charge rate,100.00%,180.61,,,,171.58,180.61,0
unity,CDM,Um Cold Compression Shoulder Pad,UM3500358,A9900,,Supply/accessory/service,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,180.61,% of charge rate,100.00%,180.61,,,,171.58,180.61,0
unity,CDM,Um Shoulder Pack,UM3500359,A9900,,Supply/accessory/service,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,303.42,% of charge rate,100.00%,303.42,,,,288.25,303.42,0
unity,CDM,Um Shoulder Pack,UM3500359,A9900,,Supply/accessory/service,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,303.42,% of charge rate,100.00%,303.42,,,,288.25,303.42,0
unity,CDM,"Um G-tube, Low Prof(mic-key)",UM3500242,B4088,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,135.2,% of charge rate,100.00%,135.2,,,,128.44,135.2,0
unity,CDM,"Um G-tube, Low Prof(mic-key)",UM3500242,B4088,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,135.2,% of charge rate,100.00%,135.2,,,,128.44,135.2,0
unity,CDM,Um Juggerknot 2.9,UM3500350,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,373.89,% of charge rate,100.00%,373.89,,,,355.2,373.89,0
unity,CDM,Um Juggerknot 2.9,UM3500350,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,373.89,% of charge rate,100.00%,373.89,,,,355.2,373.89,0
unity,CDM,Um Drill Bit 2.9 Short,UM3500351,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,245.43,% of charge rate,100.00%,245.43,,,,233.16,245.43,0
unity,CDM,Um Drill Bit 2.9 Short,UM3500351,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,245.43,% of charge rate,100.00%,245.43,,,,233.16,245.43,0
unity,CDM,Um Max Brd #2,UM3500352,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,210.01,% of charge rate,100.00%,210.01,,,,199.51,210.01,0
unity,CDM,Um Max Brd #2,UM3500352,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,210.01,% of charge rate,100.00%,210.01,,,,199.51,210.01,0
unity,CDM,Um Access 3.2 Mm,UM3500353,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,246.68,% of charge rate,100.00%,246.68,,,,234.35,246.68,0
unity,CDM,Um Access 3.2 Mm,UM3500353,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,246.68,% of charge rate,100.00%,246.68,,,,234.35,246.68,0
unity,CDM,Um Biomet Bone Cement,UM3500354,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,262.51,% of charge rate,100.00%,262.51,,,,249.38,262.51,0
unity,CDM,Um Biomet Bone Cement,UM3500354,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,262.51,% of charge rate,100.00%,262.51,,,,249.38,262.51,0
unity,CDM,Um Humeral Locking Plate,UM3500362,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,940.00",% of charge rate,100.00%,"1,940.00",,,,"1,843.00","1,940.00",0
unity,CDM,Um Humeral Locking Plate,UM3500362,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,940.00",% of charge rate,100.00%,"1,940.00",,,,"1,843.00","1,940.00",0
unity,CDM,Um Locking Screw 4.75 X 30,UM3500368,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,221.38,% of charge rate,100.00%,221.38,,,,210.31,221.38,0
unity,CDM,Um Locking Screw 4.75 X 30,UM3500368,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,221.38,% of charge rate,100.00%,221.38,,,,210.31,221.38,0
unity,CDM,Um Locking Screw 4.75 X 20,UM3500369,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,221.38,% of charge rate,100.00%,221.38,,,,210.31,221.38,0
unity,CDM,Um Locking Screw 4.75 X 20,UM3500369,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,221.38,% of charge rate,100.00%,221.38,,,,210.31,221.38,0
unity,CDM,Um Central Screw,UM3500370,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,221.38,% of charge rate,100.00%,221.38,,,,210.31,221.38,0
unity,CDM,Um Central Screw,UM3500370,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,221.38,% of charge rate,100.00%,221.38,,,,210.31,221.38,0
unity,CDM,Um Aug Screw,UM3500371,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,246,% of charge rate,100.00%,246,,,,233.7,246,0
unity,CDM,Um Aug Screw,UM3500371,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,246,% of charge rate,100.00%,246,,,,233.7,246,0
unity,CDM,Um Anchor Suture,UM3500372,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Um Anchor Suture,UM3500372,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Um Taper Nail,UM3500376,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,450,% of charge rate,100.00%,450,,,,427.5,450,0
unity,CDM,Um Taper Nail,UM3500376,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,450,% of charge rate,100.00%,450,,,,427.5,450,0
unity,CDM,Um Bb Tape Suture,UM3500378,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Um Bb Tape Suture,UM3500378,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Um Steimann Pin,UM3500380,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,246.68,% of charge rate,100.00%,246.68,,,,234.35,246.68,0
unity,CDM,Um Steimann Pin,UM3500380,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,246.68,% of charge rate,100.00%,246.68,,,,234.35,246.68,0
unity,CDM,Um Drill Bit,UM3500381,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,246.68,% of charge rate,100.00%,246.68,,,,234.35,246.68,0
unity,CDM,Um Drill Bit,UM3500381,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,246.68,% of charge rate,100.00%,246.68,,,,234.35,246.68,0
unity,CDM,Um Bone Cement,UM3500388,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,262.5,% of charge rate,100.00%,262.5,,,,249.38,262.5,0
unity,CDM,Um Bone Cement,UM3500388,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,262.5,% of charge rate,100.00%,262.5,,,,249.38,262.5,0
unity,CDM,Um Link Anchor,UM3500389,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,535,% of charge rate,100.00%,535,,,,508.25,535,0
unity,CDM,Um Link Anchor,UM3500389,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,535,% of charge rate,100.00%,535,,,,508.25,535,0
unity,CDM,Um Brdband 2 Pk,UM3500392,C1713,,Wire Ortho 18g,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,252,% of charge rate,100.00%,252,,,,239.4,252,0
unity,CDM,Um Brdband 2 Pk,UM3500392,C1713,,Wire Ortho 18g,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,252,% of charge rate,100.00%,252,,,,239.4,252,0
unity,CDM,Um Hybrid Glenoid Base,UM3500346,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,012.50",% of charge rate,100.00%,"2,012.50",,,,"1,911.88","2,012.50",0
unity,CDM,Um Hybrid Glenoid Base,UM3500346,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,012.50",% of charge rate,100.00%,"2,012.50",,,,"1,911.88","2,012.50",0
unity,CDM,Um Hybrid Glenoid Post,UM3500347,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,718.75,% of charge rate,100.00%,718.75,,,,682.81,718.75,0
unity,CDM,Um Hybrid Glenoid Post,UM3500347,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,718.75,% of charge rate,100.00%,718.75,,,,682.81,718.75,0
unity,CDM,Um Stem Free Shoulder Humeral Head,UM3500348,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,142.01",% of charge rate,100.00%,"2,142.01",,,,"2,034.91","2,142.01",0
unity,CDM,Um Stem Free Shoulder Humeral Head,UM3500348,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,142.01",% of charge rate,100.00%,"2,142.01",,,,"2,034.91","2,142.01",0
unity,CDM,Um Stem Free Shoulder Humeral Anchor,UM3500349,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,843.75",% of charge rate,100.00%,"9,843.75",,,,"9,351.56","9,843.75",0
unity,CDM,Um Stem Free Shoulder Humeral Anchor,UM3500349,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,843.75",% of charge rate,100.00%,"9,843.75",,,,"9,351.56","9,843.75",0
unity,CDM,Um Baseplate Implant,UM3500363,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,281.25",% of charge rate,100.00%,"3,281.25",,,,"3,117.19","3,281.25",0
unity,CDM,Um Baseplate Implant,UM3500363,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,281.25",% of charge rate,100.00%,"3,281.25",,,,"3,117.19","3,281.25",0
unity,CDM,Um Prosthesis Cup,UM3500364,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,312.50",% of charge rate,100.00%,"2,312.50",,,,"2,196.88","2,312.50",0
unity,CDM,Um Prosthesis Cup,UM3500364,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,312.50",% of charge rate,100.00%,"2,312.50",,,,"2,196.88","2,312.50",0
unity,CDM,Um Prosthesis Body,UM3500365,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,625.00",% of charge rate,100.00%,"2,625.00",,,,"2,493.75","2,625.00",0
unity,CDM,Um Prosthesis Body,UM3500365,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,625.00",% of charge rate,100.00%,"2,625.00",,,,"2,493.75","2,625.00",0
unity,CDM,Um Glenosphere,UM3500366,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,731.25",% of charge rate,100.00%,"2,731.25",,,,"2,594.69","2,731.25",0
unity,CDM,Um Glenosphere,UM3500366,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,731.25",% of charge rate,100.00%,"2,731.25",,,,"2,594.69","2,731.25",0
unity,CDM,Um Humeral Stem,UM3500367,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,750.00",% of charge rate,100.00%,"5,750.00",,,,"5,462.50","5,750.00",0
unity,CDM,Um Humeral Stem,UM3500367,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,750.00",% of charge rate,100.00%,"5,750.00",,,,"5,462.50","5,750.00",0
unity,CDM,Um Humeral Head Pros,UM3500373,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,760.00",% of charge rate,100.00%,"2,760.00",,,,"2,622.00","2,760.00",0
unity,CDM,Um Humeral Head Pros,UM3500373,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,760.00",% of charge rate,100.00%,"2,760.00",,,,"2,622.00","2,760.00",0
unity,CDM,Um Modular Post,UM3500374,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,862.5,% of charge rate,100.00%,862.5,,,,819.38,862.5,0
unity,CDM,Um Modular Post,UM3500374,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,862.5,% of charge rate,100.00%,862.5,,,,819.38,862.5,0
unity,CDM,Um Modified Glenoid,UM3500375,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,493.75",% of charge rate,100.00%,"2,493.75",,,,"2,369.06","2,493.75",0
unity,CDM,Um Modified Glenoid,UM3500375,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,493.75",% of charge rate,100.00%,"2,493.75",,,,"2,369.06","2,493.75",0
unity,CDM,Um Primary Stem,UM3500377,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"6,900.00",% of charge rate,100.00%,"6,900.00",,,,"6,555.00","6,900.00",0
unity,CDM,Um Primary Stem,UM3500377,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"6,900.00",% of charge rate,100.00%,"6,900.00",,,,"6,555.00","6,900.00",0
unity,CDM,Um Reverse Glenoid Baseplate,UM3500379,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,875.00",% of charge rate,100.00%,"2,875.00",,,,"2,731.25","2,875.00",0
unity,CDM,Um Reverse Glenoid Baseplate,UM3500379,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,875.00",% of charge rate,100.00%,"2,875.00",,,,"2,731.25","2,875.00",0
unity,CDM,Um Auggment Baseplate,UM3500382,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,281.25",% of charge rate,100.00%,"3,281.25",,,,"3,117.19","3,281.25",0
unity,CDM,Um Auggment Baseplate,UM3500382,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,281.25",% of charge rate,100.00%,"3,281.25",,,,"3,117.19","3,281.25",0
unity,CDM,Um Humeral Locking Plate L,UM3500383,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,025.00",% of charge rate,100.00%,"3,025.00",,,,"2,873.75","3,025.00",0
unity,CDM,Um Humeral Locking Plate L,UM3500383,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,025.00",% of charge rate,100.00%,"3,025.00",,,,"2,873.75","3,025.00",0
unity,CDM,Um Versadval Glenoid Std,UM3500384,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,437.50",% of charge rate,100.00%,"2,437.50",,,,"2,315.63","2,437.50",0
unity,CDM,Um Versadval Glenoid Std,UM3500384,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,437.50",% of charge rate,100.00%,"2,437.50",,,,"2,315.63","2,437.50",0
unity,CDM,Um Stem Free Hum Head Anchor,UM3500386,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,843.75",% of charge rate,100.00%,"9,843.75",,,,"9,351.56","9,843.75",0
unity,CDM,Um Stem Free Hum Head Anchor,UM3500386,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,843.75",% of charge rate,100.00%,"9,843.75",,,,"9,351.56","9,843.75",0
unity,CDM,Um Stem Free Humeral Head,UM3500387,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,231.25",% of charge rate,100.00%,"2,231.25",,,,"2,119.69","2,231.25",0
unity,CDM,Um Stem Free Humeral Head,UM3500387,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,231.25",% of charge rate,100.00%,"2,231.25",,,,"2,119.69","2,231.25",0
unity,CDM,Um Comp Rv Sh Gd/bn,UM3500390,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,425.00",% of charge rate,100.00%,"1,425.00",,,,"1,353.75","1,425.00",0
unity,CDM,Um Comp Rv Sh Gd/bn,UM3500390,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,425.00",% of charge rate,100.00%,"1,425.00",,,,"1,353.75","1,425.00",0
unity,CDM,"Um Hum,tray",UM3500391,C1776,,Vit-E Liner,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,625.00",% of charge rate,100.00%,"2,625.00",,,,"2,493.75","2,625.00",0
unity,CDM,"Um Hum,tray",UM3500391,C1776,,Vit-E Liner,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,625.00",% of charge rate,100.00%,"2,625.00",,,,"2,493.75","2,625.00",0
unity,CDM,Um Mesh  Lge V-patch,UM3500249,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,685.31,% of charge rate,100.00%,685.31,,,,651.04,685.31,0
unity,CDM,Um Mesh  Lge V-patch,UM3500249,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,685.31,% of charge rate,100.00%,685.31,,,,651.04,685.31,0
unity,CDM,Um Mesh Proloop  Small Vpatc,UM3500250,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,416.21,% of charge rate,100.00%,416.21,,,,395.4,416.21,0
unity,CDM,Um Mesh Proloop  Small Vpatc,UM3500250,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,416.21,% of charge rate,100.00%,416.21,,,,395.4,416.21,0
unity,CDM,Um Mesh Vpatch Med,UM3500251,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,554.95,% of charge rate,100.00%,554.95,,,,527.2,554.95,0
unity,CDM,Um Mesh Vpatch Med,UM3500251,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,554.95,% of charge rate,100.00%,554.95,,,,527.2,554.95,0
unity,CDM,Um Mesh Gortex 01182111,UM3500253,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,708.00",% of charge rate,100.00%,"1,708.00",,,,"1,622.60","1,708.00",0
unity,CDM,Um Mesh Gortex 01182111,UM3500253,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,708.00",% of charge rate,100.00%,"1,708.00",,,,"1,622.60","1,708.00",0
unity,CDM,Um Mesh Cqur 10x15,UM3500255,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,403.66,% of charge rate,100.00%,403.66,,,,383.48,403.66,0
unity,CDM,Um Mesh Cqur 10x15,UM3500255,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,403.66,% of charge rate,100.00%,403.66,,,,383.48,403.66,0
unity,CDM,Um Mesh Cqur 4.5 Circle,UM3500256,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,686.51,% of charge rate,100.00%,686.51,,,,652.18,686.51,0
unity,CDM,Um Mesh Cqur 4.5 Circle,UM3500256,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,686.51,% of charge rate,100.00%,686.51,,,,652.18,686.51,0
unity,CDM,Um Mesh Tac Shield 15x20,UM3500257,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,980.72,% of charge rate,100.00%,980.72,,,,931.68,980.72,0
unity,CDM,Um Mesh Tac Shield 15x20,UM3500257,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,980.72,% of charge rate,100.00%,980.72,,,,931.68,980.72,0
unity,CDM,Um Mesh Tac Shield 22x27,UM3500258,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,778.46",% of charge rate,100.00%,"1,778.46",,,,"1,689.54","1,778.46",0
unity,CDM,Um Mesh Tac Shield 22x27,UM3500258,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,778.46",% of charge rate,100.00%,"1,778.46",,,,"1,689.54","1,778.46",0
unity,CDM,Um Mesh Tac Shield 7.5x15,UM3500259,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,560.93,% of charge rate,100.00%,560.93,,,,532.88,560.93,0
unity,CDM,Um Mesh Tac Shield 7.5x15,UM3500259,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,560.93,% of charge rate,100.00%,560.93,,,,532.88,560.93,0
unity,CDM,Um Mesh Gortex 0108121,UM3500260,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,725,% of charge rate,100.00%,725,,,,688.75,725,0
unity,CDM,Um Mesh Gortex 0108121,UM3500260,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,725,% of charge rate,100.00%,725,,,,688.75,725,0
unity,CDM,Um Mesh  Proloop Small,UM3500261,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,232.44,% of charge rate,100.00%,232.44,,,,220.82,232.44,0
unity,CDM,Um Mesh  Proloop Small,UM3500261,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,232.44,% of charge rate,100.00%,232.44,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop Med,UM3500262,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,232.44,% of charge rate,100.00%,232.44,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop Med,UM3500262,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,232.44,% of charge rate,100.00%,232.44,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop Lrg,UM3500263,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,232.44,% of charge rate,100.00%,232.44,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop Lrg,UM3500263,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,232.44,% of charge rate,100.00%,232.44,,,,220.82,232.44,0
unity,CDM,Um Mesh Proloop X-lg,UM3500264,C1781,,Mesh XL Plug,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,212.04,% of charge rate,100.00%,212.04,,,,201.44,212.04,0
unity,CDM,Um Mesh Proloop X-lg,UM3500264,C1781,,Mesh XL Plug,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,212.04,% of charge rate,100.00%,212.04,,,,201.44,212.04,0
unity,CDM,Um Canes/adjustable Or Fixed,UM4310002,E0100,,"LH CANE, ADJUSTABLE ALUMINUM",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,42.98,% of charge rate,100.00%,42.98,,,,40.83,42.98,0
unity,CDM,Um Canes/adjustable Or Fixed,UM4310002,E0100,,"LH CANE, ADJUSTABLE ALUMINUM",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,42.98,% of charge rate,100.00%,42.98,,,,40.83,42.98,0
unity,CDM,"Um Canes, Quad",UM4310006,E0105,,LH CANES,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,91.99,% of charge rate,100.00%,91.99,,,,87.39,91.99,0
unity,CDM,"Um Canes, Quad",UM4310006,E0105,,LH CANES,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,91.99,% of charge rate,100.00%,91.99,,,,87.39,91.99,0
unity,CDM,"Um Crutches, Forearm Alumin",UM4310012,E0110,,LH CRUTCH - FOREARM,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,143.5,% of charge rate,100.00%,143.5,,,,136.33,143.5,0
unity,CDM,"Um Crutches, Forearm Alumin",UM4310012,E0110,,LH CRUTCH - FOREARM,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,143.5,% of charge rate,100.00%,143.5,,,,136.33,143.5,0
unity,CDM,Um Crutches Adj Aluminum,UM3500051,E0114,,"CRUTCH, ALUM ADJ ADLT TAL",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.27,% of charge rate,100.00%,83.27,,,,79.11,83.27,0
unity,CDM,Um Crutches Adj Aluminum,UM3500051,E0114,,"CRUTCH, ALUM ADJ ADLT TAL",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.27,% of charge rate,100.00%,83.27,,,,79.11,83.27,0
unity,CDM,"Um Crutches, Underarm Alumin",UM4310026,E0114,,"CRUTCH, ALUM ADJ ADLT TAL",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.29,% of charge rate,100.00%,87.29,,,,82.93,87.29,0
unity,CDM,"Um Crutches, Underarm Alumin",UM4310026,E0114,,"CRUTCH, ALUM ADJ ADLT TAL",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.29,% of charge rate,100.00%,87.29,,,,82.93,87.29,0
unity,CDM,"Um Walker, Folding",UM4310028,E0135,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,155.07,% of charge rate,100.00%,155.07,,,,147.32,155.07,0
unity,CDM,"Um Walker, Folding",UM4310028,E0135,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,155.07,% of charge rate,100.00%,155.07,,,,147.32,155.07,0
unity,CDM,"Um Walker, Wheel Attachments",UM4310019,E0155,,LH WALKER WHEELS-NON/SWIVEL,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.6,% of charge rate,100.00%,53.6,,,,50.92,53.6,0
unity,CDM,"Um Walker, Wheel Attachments",UM4310019,E0155,,LH WALKER WHEELS-NON/SWIVEL,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.6,% of charge rate,100.00%,53.6,,,,50.92,53.6,0
unity,CDM,Um Prevalon Transfer Mat,UM3500343,E0190,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,202.83,% of charge rate,100.00%,202.83,,,,192.69,202.83,0
unity,CDM,Um Prevalon Transfer Mat,UM3500343,E0190,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,202.83,% of charge rate,100.00%,202.83,,,,192.69,202.83,0
unity,CDM,Um Air Tap Xxl,UM3500344,E0190,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,469.17,% of charge rate,100.00%,469.17,,,,445.71,469.17,0
unity,CDM,Um Air Tap Xxl,UM3500344,E0190,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,469.17,% of charge rate,100.00%,469.17,,,,445.71,469.17,0
unity,CDM,Um Prevalon Seating Positioner,UM3500345,E0190,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,167.86,% of charge rate,100.00%,167.86,,,,159.47,167.86,0
unity,CDM,Um Prevalon Seating Positioner,UM3500345,E0190,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,167.86,% of charge rate,100.00%,167.86,,,,159.47,167.86,0
unity,CDM,Um Cervical Roll/pillow,UM4310003,E0190,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,19.98,% of charge rate,100.00%,19.98,,,,18.98,19.98,0
unity,CDM,Um Cervical Roll/pillow,UM4310003,E0190,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,19.98,% of charge rate,100.00%,19.98,,,,18.98,19.98,0
unity,CDM,Um Head Positioner Ring,UM3500361,E0191,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,190.31,% of charge rate,100.00%,190.31,,,,180.79,190.31,0
unity,CDM,Um Head Positioner Ring,UM3500361,E0191,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,190.31,% of charge rate,100.00%,190.31,,,,180.79,190.31,0
unity,CDM,Um Polar Care Wave,UM3500357,E0218,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,285.01,% of charge rate,100.00%,285.01,,,,270.76,285.01,0
unity,CDM,Um Polar Care Wave,UM3500357,E0218,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,285.01,% of charge rate,100.00%,285.01,,,,270.76,285.01,0
unity,CDM,Um Oxygen Conserver Rental,UM3470014,E0431,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,47.5,50,0
unity,CDM,Um Oxygen Conserver Rental,UM3470014,E0431,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,47.5,50,0
unity,CDM,Um Conserver Purchase - New,UM3470024,E0431,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,389.54",% of charge rate,100.00%,"1,389.54",,,,"1,320.06","1,389.54",0
unity,CDM,Um Conserver Purchase - New,UM3470024,E0431,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,389.54",% of charge rate,100.00%,"1,389.54",,,,"1,320.06","1,389.54",0
unity,CDM,Um Oxygen Portable System,UM3470054,E0431,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,47.5,50,0
unity,CDM,Um Oxygen Portable System,UM3470054,E0431,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50,% of charge rate,100.00%,50,,,,47.5,50,0
unity,CDM,Um M Oxygen Contents,UM3470003,E0443,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,10,% of charge rate,100.00%,10,,,,9.5,10,0
unity,CDM,Um M Oxygen Contents,UM3470003,E0443,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,10,% of charge rate,100.00%,10,,,,9.5,10,0
unity,CDM,Um O2 Contents (system Owned,UM3470008,E0443,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,97,% of charge rate,100.00%,97,,,,92.15,97,0
unity,CDM,Um O2 Contents (system Owned,UM3470008,E0443,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,97,% of charge rate,100.00%,97,,,,92.15,97,0
unity,CDM,Um E-oxygen Contents,UM3470022,E0443,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um E-oxygen Contents,UM3470022,E0443,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Bipap-medicare 1st Month,UM3470010,E0470,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap-medicare 1st Month,UM3470010,E0470,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap (no Rate) Rental,UM3470012,E0470,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap (no Rate) Rental,UM3470012,E0470,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap Med 11th Acpt Rtl,UM3470032,E0470,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap Med 11th Acpt Rtl,UM3470032,E0470,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap Med 4th - 13th Mth,UM3470036,E0470,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap Med 4th - 13th Mth,UM3470036,E0470,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap After Rtl (purchase,UM3470046,E0470,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,705.25",% of charge rate,100.00%,"3,705.25",,,,"3,519.99","3,705.25",0
unity,CDM,Um Bipap After Rtl (purchase,UM3470046,E0470,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,705.25",% of charge rate,100.00%,"3,705.25",,,,"3,519.99","3,705.25",0
unity,CDM,Um Bipap Med 11th  13th Purc,UM3470062,E0470,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap Med 11th  13th Purc,UM3470062,E0470,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap-med 2nd & 3rd Month,UM3470067,E0470,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap-med 2nd & 3rd Month,UM3470067,E0470,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,320,% of charge rate,100.00%,320,,,,304,320,0
unity,CDM,Um Bipap Replacement,UM3470325,E0470,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,755.25",% of charge rate,100.00%,"3,755.25",,,,"3,567.49","3,755.25",0
unity,CDM,Um Bipap Replacement,UM3470325,E0470,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,755.25",% of charge rate,100.00%,"3,755.25",,,,"3,567.49","3,755.25",0
unity,CDM,Um Perscussor 1st Month,UM3470006,E0480,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Perscussor 1st Month,UM3470006,E0480,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Perscussor Rental,UM3470013,E0480,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Perscussor Rental,UM3470013,E0480,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Percussor 2nd & 3nd Month,UM3470033,E0480,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Percussor 2nd & 3nd Month,UM3470033,E0480,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Percussor Purchase,UM3470034,E0480,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,848.91,% of charge rate,100.00%,848.91,,,,806.46,848.91,0
unity,CDM,Um Percussor Purchase,UM3470034,E0480,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,848.91,% of charge rate,100.00%,848.91,,,,806.46,848.91,0
unity,CDM,Um Percssor 4th & 13th Month,UM3470057,E0480,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Percssor 4th & 13th Month,UM3470057,E0480,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,"Fc Acapella, All Sizes",FC3600312,E0484,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,132.55,% of charge rate,100.00%,132.55,,,,125.92,132.55,0
unity,CDM,"Fc Acapella, All Sizes",FC3600312,E0484,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,132.55,% of charge rate,100.00%,132.55,,,,125.92,132.55,0
unity,CDM,Um Flutter Valve,UM3470048,E0484,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73,% of charge rate,100.00%,73,,,,69.35,73,0
unity,CDM,Um Flutter Valve,UM3470048,E0484,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73,% of charge rate,100.00%,73,,,,69.35,73,0
unity,CDM,Um Acapella/pep,UM3480012,E0484,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49.5,% of charge rate,100.00%,49.5,,,,47.03,49.5,0
unity,CDM,Um Acapella/pep,UM3480012,E0484,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49.5,% of charge rate,100.00%,49.5,,,,47.03,49.5,0
unity,CDM,Um Chamber Humidificatio Jar,UM3470039,E0555,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,2.95,% of charge rate,100.00%,2.95,,,,2.8,2.95,0
unity,CDM,Um Chamber Humidificatio Jar,UM3470039,E0555,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,2.95,% of charge rate,100.00%,2.95,,,,2.8,2.95,0
unity,CDM,Um Cool Humidifier New,UM3470058,E0561,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,200,% of charge rate,100.00%,200,,,,190,200,0
unity,CDM,Um Cool Humidifier New,UM3470058,E0561,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,200,% of charge rate,100.00%,200,,,,190,200,0
unity,CDM,Um Cpap Non-heated Humififie,UM3470078,E0561,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,134,% of charge rate,100.00%,134,,,,127.3,134,0
unity,CDM,Um Cpap Non-heated Humififie,UM3470078,E0561,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,134,% of charge rate,100.00%,134,,,,127.3,134,0
unity,CDM,Um Cpap Humidifier Heated,UM3470004,E0562,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,400,% of charge rate,100.00%,400,,,,380,400,0
unity,CDM,Um Cpap Humidifier Heated,UM3470004,E0562,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,400,% of charge rate,100.00%,400,,,,380,400,0
unity,CDM,Um Heated Pap Humidifier,UM3470016,E0562,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.55,% of charge rate,100.00%,53.55,,,,50.87,53.55,0
unity,CDM,Um Heated Pap Humidifier,UM3470016,E0562,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.55,% of charge rate,100.00%,53.55,,,,50.87,53.55,0
unity,CDM,Um Heated Humidifer Used,UM3470029,E0562,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,350,% of charge rate,100.00%,350,,,,332.5,350,0
unity,CDM,Um Heated Humidifer Used,UM3470029,E0562,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,350,% of charge rate,100.00%,350,,,,332.5,350,0
unity,CDM,Um Heated Pap Purchase,UM3470085,E0562,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Um Heated Pap Purchase,UM3470085,E0562,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Um Compressor Air Soce Sales,UM3470064,E0565,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,091.59",% of charge rate,100.00%,"1,091.59",,,,"1,037.01","1,091.59",0
unity,CDM,Um Compressor Air Soce Sales,UM3470064,E0565,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,091.59",% of charge rate,100.00%,"1,091.59",,,,"1,037.01","1,091.59",0
unity,CDM,Um Nebulizer Rental Per Mth,UM3470002,E0570,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28,% of charge rate,100.00%,28,,,,26.6,28,0
unity,CDM,Um Nebulizer Rental Per Mth,UM3470002,E0570,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28,% of charge rate,100.00%,28,,,,26.6,28,0
unity,CDM,Um Nebulizer Purchase New,UM3470028,E0570,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,180,% of charge rate,100.00%,180,,,,171,180,0
unity,CDM,Um Nebulizer Purchase New,UM3470028,E0570,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,180,% of charge rate,100.00%,180,,,,171,180,0
unity,CDM,Um Neb Rental 4th - 13th Mth,UM3470035,E0570,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Neb Rental 4th - 13th Mth,UM3470035,E0570,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Neb Purchase After Rental,UM3470038,E0570,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,120,% of charge rate,100.00%,120,,,,114,120,0
unity,CDM,Um Neb Purchase After Rental,UM3470038,E0570,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,120,% of charge rate,100.00%,120,,,,114,120,0
unity,CDM,Um Neb Rtl 2nd & 3rd Month,UM3470045,E0570,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Neb Rtl 2nd & 3rd Month,UM3470045,E0570,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Nebulizer Rental 1st Mth,UM3470063,E0570,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Nebulizer Rental 1st Mth,UM3470063,E0570,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,18,% of charge rate,100.00%,18,,,,17.1,18,0
unity,CDM,Um Pari Portable Nebulizer,UM3470021,E0571,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,328.38,% of charge rate,100.00%,328.38,,,,311.96,328.38,0
unity,CDM,Um Pari Portable Nebulizer,UM3470021,E0571,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,328.38,% of charge rate,100.00%,328.38,,,,311.96,328.38,0
unity,CDM,Um Suction Pump-new,UM3470015,E0600,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,589.89,% of charge rate,100.00%,589.89,,,,560.4,589.89,0
unity,CDM,Um Suction Pump-new,UM3470015,E0600,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,589.89,% of charge rate,100.00%,589.89,,,,560.4,589.89,0
unity,CDM,Um Suction Pump 4 -13th Mth,UM3470020,E0600,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60,% of charge rate,100.00%,60,,,,57,60,0
unity,CDM,Um Suction Pump 4 -13th Mth,UM3470020,E0600,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60,% of charge rate,100.00%,60,,,,57,60,0
unity,CDM,Um Suction Pump 2 & 3rd Mth,UM3470052,E0600,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60,% of charge rate,100.00%,60,,,,57,60,0
unity,CDM,Um Suction Pump 2 & 3rd Mth,UM3470052,E0600,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60,% of charge rate,100.00%,60,,,,57,60,0
unity,CDM,Um Capped Suction Pump Ms,UM3470053,E0600,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60,% of charge rate,100.00%,60,,,,57,60,0
unity,CDM,Um Capped Suction Pump Ms,UM3470053,E0600,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60,% of charge rate,100.00%,60,,,,57,60,0
unity,CDM,Um Suction Pump 1st Month,UM3470069,E0600,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60,% of charge rate,100.00%,60,,,,57,60,0
unity,CDM,Um Suction Pump 1st Month,UM3470069,E0600,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60,% of charge rate,100.00%,60,,,,57,60,0
unity,CDM,Um Cont Airway Pres/rental,UM3470030,E0601,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,137,% of charge rate,100.00%,137,,,,130.15,137,0
unity,CDM,Um Cont Airway Pres/rental,UM3470030,E0601,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,137,% of charge rate,100.00%,137,,,,130.15,137,0
unity,CDM,Um Cpap Purchase Aft Rental,UM3470037,E0601,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,528.10",% of charge rate,100.00%,"1,528.10",,,,"1,451.70","1,528.10",0
unity,CDM,Um Cpap Purchase Aft Rental,UM3470037,E0601,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,528.10",% of charge rate,100.00%,"1,528.10",,,,"1,451.70","1,528.10",0
unity,CDM,Um Cpap Med A  2nd & 3rd Mth,UM3470041,E0601,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112,% of charge rate,100.00%,112,,,,106.4,112,0
unity,CDM,Um Cpap Med A  2nd & 3rd Mth,UM3470041,E0601,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112,% of charge rate,100.00%,112,,,,106.4,112,0
unity,CDM,Um Cpap Purchase,UM3470044,E0601,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,350.00",% of charge rate,100.00%,"1,350.00",,,,"1,282.50","1,350.00",0
unity,CDM,Um Cpap Purchase,UM3470044,E0601,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,350.00",% of charge rate,100.00%,"1,350.00",,,,"1,282.50","1,350.00",0
unity,CDM,Um Cpap Med 4th - 13th Mth,UM3470060,E0601,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112,% of charge rate,100.00%,112,,,,106.4,112,0
unity,CDM,Um Cpap Med 4th - 13th Mth,UM3470060,E0601,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112,% of charge rate,100.00%,112,,,,106.4,112,0
unity,CDM,Um Cpap Medicare First Month,UM3470061,E0601,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112,% of charge rate,100.00%,112,,,,106.4,112,0
unity,CDM,Um Cpap Medicare First Month,UM3470061,E0601,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112,% of charge rate,100.00%,112,,,,106.4,112,0
unity,CDM,Um Cpap Purchase,UM3470084,E0601,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,365.00",% of charge rate,100.00%,"1,365.00",,,,"1,296.75","1,365.00",0
unity,CDM,Um Cpap Purchase,UM3470084,E0601,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,365.00",% of charge rate,100.00%,"1,365.00",,,,"1,296.75","1,365.00",0
unity,CDM,Um Cpap Replacement,UM3470324,E0601,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,355.00",% of charge rate,100.00%,"1,355.00",,,,"1,287.25","1,355.00",0
unity,CDM,Um Cpap Replacement,UM3470324,E0601,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,355.00",% of charge rate,100.00%,"1,355.00",,,,"1,287.25","1,355.00",0
unity,CDM,"Um Belt, Safety Walking",UM4310010,E0700,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.26,% of charge rate,100.00%,15.26,,,,14.5,15.26,0
unity,CDM,"Um Belt, Safety Walking",UM4310010,E0700,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.26,% of charge rate,100.00%,15.26,,,,14.5,15.26,0
unity,CDM,Um Cervical Tract/overdoor,UM4310027,E0860,,LH OVERDOOR PULLEY SET-UP,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.3,% of charge rate,100.00%,71.3,,,,67.74,71.3,0
unity,CDM,Um Cervical Tract/overdoor,UM4310027,E0860,,LH OVERDOOR PULLEY SET-UP,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.3,% of charge rate,100.00%,71.3,,,,67.74,71.3,0
unity,CDM,Um Oxygen Concentrator,UM3470007,E1390,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,200,% of charge rate,100.00%,200,,,,190,200,0
unity,CDM,Um Oxygen Concentrator,UM3470007,E1390,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,200,% of charge rate,100.00%,200,,,,190,200,0
unity,CDM,Um Concentrato O2 Sale - Usd,UM3470027,E1390,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,500.00",% of charge rate,100.00%,"1,500.00",,,,"1,425.00","1,500.00",0
unity,CDM,Um Concentrato O2 Sale - Usd,UM3470027,E1390,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,500.00",% of charge rate,100.00%,"1,500.00",,,,"1,425.00","1,500.00",0
unity,CDM,Um O2 Concentrator Pur New,UM3470047,E1390,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,800.00",% of charge rate,100.00%,"3,800.00",,,,"3,610.00","3,800.00",0
unity,CDM,Um O2 Concentrator Pur New,UM3470047,E1390,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,800.00",% of charge rate,100.00%,"3,800.00",,,,"3,610.00","3,800.00",0
unity,CDM,Um O2 Concentrator/ms,UM3470070,E1390,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Um O2 Concentrator/ms,UM3470070,E1390,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,360,% of charge rate,100.00%,360,,,,342,360,0
unity,CDM,Um Inogen Concentrator,UM3470101,E1390,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,560.00",% of charge rate,100.00%,"1,560.00",,,,"1,482.00","1,560.00",0
unity,CDM,Um Inogen Concentrator,UM3470101,E1390,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,560.00",% of charge rate,100.00%,"1,560.00",,,,"1,482.00","1,560.00",0
unity,CDM,Um Inogen Portable O2 Concentrator,UM3470100,E1392,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,905,% of charge rate,100.00%,905,,,,859.75,905,0
unity,CDM,Um Inogen Portable O2 Concentrator,UM3470100,E1392,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,905,% of charge rate,100.00%,905,,,,859.75,905,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470102,E1392,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.32,% of charge rate,100.00%,64.32,,,,61.1,64.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470102,E1392,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.32,% of charge rate,100.00%,64.32,,,,61.1,64.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470103,E1392,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,84.32,% of charge rate,100.00%,84.32,,,,80.1,84.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470103,E1392,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,84.32,% of charge rate,100.00%,84.32,,,,80.1,84.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470104,E1392,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,84.32,% of charge rate,100.00%,84.32,,,,80.1,84.32,0
unity,CDM,Um Rental Portable O2 Concentrator,UM3470104,E1392,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,84.32,% of charge rate,100.00%,84.32,,,,80.1,84.32,0
unity,CDM,Um Oxy Ears,UM3470077,E1399,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,2.5,% of charge rate,100.00%,2.5,,,,2.38,2.5,0
unity,CDM,Um Oxy Ears,UM3470077,E1399,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,2.5,% of charge rate,100.00%,2.5,,,,2.38,2.5,0
unity,CDM,"Um Pulleys, Overdoor",UM4310005,E1399,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.94,% of charge rate,100.00%,22.94,,,,21.79,22.94,0
unity,CDM,"Um Pulleys, Overdoor",UM4310005,E1399,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.94,% of charge rate,100.00%,22.94,,,,21.79,22.94,0
unity,CDM,Um Lumbar Roll,UM4310008,E1399,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.94,% of charge rate,100.00%,22.94,,,,21.79,22.94,0
unity,CDM,Um Lumbar Roll,UM4310008,E1399,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.94,% of charge rate,100.00%,22.94,,,,21.79,22.94,0
unity,CDM,Um Theraband/ft,UM4310011,E1399,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,1.62,% of charge rate,100.00%,1.62,,,,1.54,1.62,0
unity,CDM,Um Theraband/ft,UM4310011,E1399,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,1.62,% of charge rate,100.00%,1.62,,,,1.54,1.62,0
unity,CDM,Um Lumbar Cushion,UM4310021,E1399,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,30.66,% of charge rate,100.00%,30.66,,,,29.13,30.66,0
unity,CDM,Um Lumbar Cushion,UM4310021,E1399,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,30.66,% of charge rate,100.00%,30.66,,,,29.13,30.66,0
unity,CDM,"Um Icea Gripper, Cane/crutch",UM4310023,E1399,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.26,% of charge rate,100.00%,15.26,,,,14.5,15.26,0
unity,CDM,"Um Icea Gripper, Cane/crutch",UM4310023,E1399,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.26,% of charge rate,100.00%,15.26,,,,14.5,15.26,0
unity,CDM,Um Cold Pack,UM4310032,E1399,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.94,% of charge rate,100.00%,22.94,,,,21.79,22.94,0
unity,CDM,Um Cold Pack,UM4310032,E1399,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.94,% of charge rate,100.00%,22.94,,,,21.79,22.94,0
unity,CDM,Um Psa Screening,UM4000288,G0103,,Psa screening,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,102.44,% of charge rate,100.00%,102.44,,,,97.32,102.44,0
unity,CDM,Um Psa Screening,UM4000288,G0103,,Psa screening,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,102.44,% of charge rate,100.00%,102.44,,,,97.32,102.44,0
unity,CDM,PR CA SCREEN;FLEXI SIGMOIDSCOPE,G0104,G0104,,Ca screen;flexi sigmoidscope,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,137.02,% of charge rate,100.00%,137.02,,,,99.82,137.02,0
unity,CDM,PR COLORECTAL SCRN; HI RISK IND,G0105,G0105,,Colorectal scrn; hi risk ind,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,469.74,% of charge rate,100.00%,469.74,,,,331.08,469.74,0
unity,CDM,Hc Diabetes Train/indiv 30 Min,9420004,G0108,,Diab manage trn  per indiv,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,150,% of charge rate,100.00%,150,,,,142.5,150,0
unity,CDM,Hc Diabetes Train/indiv 30 Min,9420004,G0108,,Diab manage trn  per indiv,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,150,% of charge rate,100.00%,150,,,,142.5,150,0
unity,CDM,Hc Diabetes Education,9420005,G0109,,Diab manage trn ind/group,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40,% of charge rate,100.00%,40,,,,38,40,0
unity,CDM,Hc Diabetes Education,9420005,G0109,,Diab manage trn ind/group,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40,% of charge rate,100.00%,40,,,,38,40,0
unity,CDM,PR COLON CA SCRN NOT HI RSK IND,G0121,G0121,,Colon ca scrn not hi rsk ind,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,469.74,% of charge rate,100.00%,469.74,,,,332.32,469.74,0
unity,CDM,Um Screening Pap Thin Layer,UM4000918,G0123,,Screen cerv/vag thin layer,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112.82,% of charge rate,100.00%,112.82,,,,107.18,112.82,0
unity,CDM,Um Screening Pap Thin Layer,UM4000918,G0123,,Screen cerv/vag thin layer,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112.82,% of charge rate,100.00%,112.82,,,,107.18,112.82,0
unity,CDM,PR WOUND CLOSURE BY ADHESIVE,G0168,G0168,,Wound closure by adhesive,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,200,% of charge rate,100.00%,200,,,,33.48,200,0
unity,CDM,TOMO DIGITAL MAMMO ADD-ON,4010008,G0279,,"Tomosynthesis, mammo",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,113.2,% of charge rate,100.00%,113.2,,,,107.54,113.2,0
unity,CDM,TOMO DIGITAL MAMMO ADD-ON,4010008,G0279,,"Tomosynthesis, mammo",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,113.2,% of charge rate,100.00%,113.2,,,,107.54,113.2,0
unity,CDM,LDCT FOR LUNG CANCER SCREEN,7700012,G0297,,Ldct for lung ca screen,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,670,% of charge rate,100.00%,670,,,,636.5,670,0
unity,CDM,LDCT FOR LUNG CANCER SCREEN,7700012,G0297,,Ldct for lung ca screen,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,670,% of charge rate,100.00%,670,,,,636.5,670,0
unity,CDM,Um Occult Blood Medicare Screening,UM4000121,G0328,,Fecal blood scrn immunoassay,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.56,% of charge rate,100.00%,88.56,,,,84.13,88.56,0
unity,CDM,Um Occult Blood Medicare Screening,UM4000121,G0328,,Fecal blood scrn immunoassay,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.56,% of charge rate,100.00%,88.56,,,,84.13,88.56,0
unity,CDM,HOURLY OBSERVATION,7620000,G0378,,Hospital observation per hr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,533.08,% of charge rate,100.00%,533.08,,,,506.43,533.08,0
unity,CDM,HOURLY OBSERVATION,7620000,G0378,,Hospital observation per hr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,533.08,% of charge rate,100.00%,533.08,,,,506.43,533.08,0
unity,CDM,Hc Hourly Observation W/monitor,7621000,G0378,,Hospital observation per hr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,025.63",% of charge rate,100.00%,"1,025.63",,,,974.35,"1,025.63",0
unity,CDM,Hc Hourly Observation W/monitor,7621000,G0378,,Hospital observation per hr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,025.63",% of charge rate,100.00%,"1,025.63",,,,974.35,"1,025.63",0
unity,CDM,Um Level I Trauma Activation,UMG0390LI,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"6,500.00",% of charge rate,100.00%,"6,500.00",,,,"6,175.00","6,500.00",0
unity,CDM,Um Level I Trauma Activation,UMG0390LI,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"6,500.00",% of charge rate,100.00%,"6,500.00",,,,"6,175.00","6,500.00",0
unity,CDM,Um Level Ii Trauma Activation,UMG0390LII,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,200.00",% of charge rate,100.00%,"3,200.00",,,,"3,040.00","3,200.00",0
unity,CDM,Um Level Ii Trauma Activation,UMG0390LII,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,200.00",% of charge rate,100.00%,"3,200.00",,,,"3,040.00","3,200.00",0
unity,CDM,Um Level Iii Trauma Activation,UMG0390LIII,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,600.00",% of charge rate,100.00%,"1,600.00",,,,"1,520.00","1,600.00",0
unity,CDM,Um Level Iii Trauma Activation,UMG0390LIII,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,600.00",% of charge rate,100.00%,"1,600.00",,,,"1,520.00","1,600.00",0
unity,CDM,Um Level Iv Trauma Activation,UMG0390LIV,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,825,% of charge rate,100.00%,825,,,,783.75,825,0
unity,CDM,Um Level Iv Trauma Activation,UMG0390LIV,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,825,% of charge rate,100.00%,825,,,,783.75,825,0
unity,CDM,Um Level V Trauma Activation,UMG0390LV,G0390,,Trauma respons w/hosp criti,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,425,% of charge rate,100.00%,425,,,,403.75,425,0
unity,CDM,Um Level V Trauma Activation,UMG0390LV,G0390,,Trauma respons w/hosp criti,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,425,% of charge rate,100.00%,425,,,,403.75,425,0
unity,CDM,"PR ELECTROCARDIOGRAM,REPORT IPPE",G0405,G0405,,Ekg interpret & report preve,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,17.04,% of charge rate,100.00%,17.04,,,,14.88,17.62,0
unity,CDM,"PR PPPS, INITIAL VISIT",G0438,G0438,,"Ppps, initial visit",,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,211.64,% of charge rate,100.00%,211.64,,,,211.64,351.63,0
unity,CDM,"PR PPPS, SUBSEQ VISIT",G0439,G0439,,"Ppps, subseq visit",,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,143,% of charge rate,100.00%,143,,,,143,238.58,0
unity,CDM,Um Weight Mgmt/30 Min,UM4370007,G0447,,Behavior counsel obesity 15m,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.28,% of charge rate,100.00%,20.28,,,,19.27,20.28,0
unity,CDM,Um Weight Mgmt/30 Min,UM4370007,G0447,,Behavior counsel obesity 15m,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.28,% of charge rate,100.00%,20.28,,,,19.27,20.28,0
unity,CDM,Um Definitive Drug Id,UM4000806,G0481,,Drug test def 8-14 classes,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,Um Definitive Drug Id,UM4000806,G0481,,Drug test def 8-14 classes,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125,% of charge rate,100.00%,125,,,,118.75,125,0
unity,CDM,Ccm/bhi by rhc/fqhc 20min mo,G0511,G0511,,Ccm/bhi by rhc/fqhc 20min mo,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,135,% of charge rate,100.00%,135,,,,114.7,135.81,0
unity,CDM,Um Collection Fee For Covid Testing,UM4000936,G2023,,Collection fee for Covid Probe,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.5,% of charge rate,100.00%,28.5,,,,27.08,28.5,0
unity,CDM,Um Collection Fee For Covid Testing,UM4000936,G2023,,Collection fee for Covid Probe,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.5,% of charge rate,100.00%,28.5,,,,27.08,28.5,0
unity,CDM,Adrenalin epinephrine inject,J0171,J0171,,Adrenalin epinephrine inject,,00409-4921-34,Professional,Clinic,Self-Pay,N/A,N/A,N/A,1.14,% of charge rate,100.00%,1.14,,,,0.82,1.14,0
unity,CDM,Penicillin g benzathine inj,J0561,J0561,,Penicillin g benzathine inj,,60793-0702-10,Professional,Clinic,Self-Pay,N/A,N/A,N/A,34.03,% of charge rate,100.00%,34.03,,,,13.76,34.03,0
unity,CDM,CEFTRIAXONE SODIUM INJECTION 1 GM,J0696,J0696,,Ceftriaxone sodium injection,,00409-7332-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,33,% of charge rate,100.00%,33,,,,0.6,33,0
unity,CDM,CEFTRIAXONE SODIUM INJECTION 250 MG,J0696,J0696,,Ceftriaxone sodium injection,,00781-3206-95,Professional,Clinic,Self-Pay,N/A,N/A,N/A,8.25,% of charge rate,100.00%,8.25,,,,0.6,33,0
unity,CDM,METHYLPREDNISOLONE 40 MG INJ,J1030,J1030,,Methylprednisolone 40 mg inj,,00009-3073-23,Professional,Clinic,Self-Pay,N/A,N/A,N/A,39.85,% of charge rate,100.00%,39.85,,,,6.29,39.85,0
unity,CDM,METHYLPREDNISOLONE 80 MG INJ,J1040,J1040,,Methylprednisolone 80 mg inj,,70121-1574-05,Professional,Clinic,Self-Pay,N/A,N/A,N/A,50.74,% of charge rate,100.00%,50.74,,,,11.9,50.74,0
unity,CDM,Medroxyprogesterone acetate,J1050,J1050,,Medroxyprogesterone acetate,,00548-5400-25,Professional,Clinic,Self-Pay,N/A,N/A,N/A,0.51,% of charge rate,100.00%,0.51,,,,0.51,0.56,0
unity,CDM,Inj testosterone cypionate,J1071,J1071,,Inj testosterone cypionate,,00009-0086-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,0.11,% of charge rate,100.00%,0.11,,,,0.03,0.11,0
unity,CDM,DEXAMETHASONE 10 mg/ml,J1100,J1100,,Dexamethasone sodium phos,,00641-0367-2,Professional,Clinic,Self-Pay,N/A,N/A,N/A,24.2,% of charge rate,100.00%,24.2,,,,0.12,24.2,0
unity,CDM,DEXAMETHASONE 4mg/ml,J1100,J1100,,Dexamethasone sodium phos,,67457-0423-12 ,Professional,Clinic,Self-Pay,N/A,N/A,N/A,9.68,% of charge rate,100.00%,9.68,,,,0.12,24.2,0
unity,CDM,DIPHENHYDRAMINE HCL INJECTIO,J1200,J1200,,Diphenhydramine hcl injectio,,00641-0376-25,Professional,Clinic,Self-Pay,N/A,N/A,N/A,2.71,% of charge rate,100.00%,2.71,,,,0.9,2.71,0
unity,CDM,KETOROLAC TROMETHAMINE INJ,J1885,J1885,,Ketorolac tromethamine inj,,63323-0162-02,Professional,Clinic,Self-Pay,N/A,N/A,N/A,5.44,% of charge rate,100.00%,5.44,,,,0.52,5.44,0
unity,CDM,FUROSEMIDE INJECTION,J1940,J1940,,Furosemide injection,,00409-6102-04,Professional,Clinic,Self-Pay,N/A,N/A,N/A,2.09,% of charge rate,100.00%,2.09,,,,0.59,2.09,0
unity,CDM,LORAZEPAM INJECTION,J2060,J2060,,Lorazepam injection,,00641-6048-25,Professional,Clinic,Self-Pay,N/A,N/A,N/A,23.93,% of charge rate,100.00%,23.93,,,,0.7,23.93,0
unity,CDM,ONDANSETRON HCL INJECTION,J2405,J2405,,Ondansetron hcl injection,,60505-6130-05,Professional,Clinic,Self-Pay,N/A,N/A,N/A,1.14,% of charge rate,100.00%,1.14,,,,0.09,1.14,0
unity,CDM,METOCLOPRAMIDE HCL INJECTION,J2765,J2765,,Metoclopramide hcl injection,,00703-4502-04,Professional,Clinic,Self-Pay,N/A,N/A,N/A,3.41,% of charge rate,100.00%,3.41,,,,1.2,3.41,0
unity,CDM,Pr Rhophylac Injection,J2791,J2791,,Rhophylac injection,,00562-7805-05,Professional,Clinic,Self-Pay,N/A,N/A,N/A,192.5,% of charge rate,100.00%,192.5,,,,4.76,192.5,0
unity,CDM,METHYLPREDNISOLONE INJECTION,J2920,J2920,,Methylprednisolone injection,,00009-3073-23,Professional,Clinic,Self-Pay,N/A,N/A,N/A,5.5,% of charge rate,100.00%,5.5,,,,4.58,5.5,0
unity,CDM,METHYLPREDNISOLONE INJECTION,J2930,J2930,,Methylprednisolone injection,,70121-1574-05,Professional,Clinic,Self-Pay,N/A,N/A,N/A,7.25,% of charge rate,100.00%,7.25,,,,6.32,7.25,0
unity,CDM,TRIAMCINOLONE ACETONIDE INJ,J3301,J3301,,Triamcinolone acet inj nos,,70121-1651-05,Professional,Clinic,Self-Pay,N/A,N/A,N/A,10.75,% of charge rate,100.00%,10.75,,,,1.56,10.75,0
unity,CDM,THIAMINE HCL 100 MG,J3411,J3411,,Thiamine hcl 100 mg,,63323-0013-09,Professional,Clinic,Self-Pay,N/A,N/A,N/A,13.72,% of charge rate,100.00%,13.72,,,,1.65,13.72,0
unity,CDM,VITAMIN B12 INJECTION,J3420,J3420,,Vitamin b12 injection,,69680-0112-25,Professional,Clinic,Self-Pay,N/A,N/A,N/A,10,% of charge rate,100.00%,10,,,,2.21,10,0
unity,CDM,Pr Candida 0.1ml,J3490.37,J3490,,Drugs unclassified injection,,59584-0138-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,57.92,% of charge rate,100.00%,57.92,,,,57.92,57.92,0
unity,CDM,"Mirena, 52 mg",J7298,J7298,,"Mirena, 52 mg",,50419-0423-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"1,200.00",% of charge rate,100.00%,"1,200.00",,,,972.58,"1,200.00",0
unity,CDM,INTRAUT COPPER CONTRACEPTIVE,J7300,J7300,,Intraut copper contraceptive,,59365-5128-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,"2,301.20",% of charge rate,100.00%,"2,301.20",,,,902.19,"2,301.20",0
unity,CDM,Pr Etonogestrel Implant System,J7307,J7307,,Etonogestrel implant system,,00052-4330-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,990,% of charge rate,100.00%,990,,,,953.51,990,0
unity,CDM,LEVULAN KERISTICK,J7308,J7308,,Aminolevulinic acid hcl top,,67308-101-06,Professional,Clinic,Self-Pay,N/A,N/A,N/A,522.5,% of charge rate,100.00%,522.5,,,,392.37,522.5,0
unity,CDM,Pr Euflexxa Inj Per Dose,J7323,J7323,,Euflexxa inj per dose,,55566-4100-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,878.13,% of charge rate,100.00%,878.13,,,,144.69,878.13,0
unity,CDM,Pr Albuterol Inhalation Ud,J7613,J7613,,Albuterol non-comp unit,,00487-9501-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,3.85,% of charge rate,100.00%,3.85,,,,0.04,3.85,0
unity,CDM,Albuterol non-compounded,J7620,J7620,,Albuterol ipratrop non-comp,,00487-9501-01,Professional,Clinic,Self-Pay,N/A,N/A,N/A,3.85,% of charge rate,100.00%,3.85,,,,0.13,3.85,0
unity,CDM,LEUPROLIDE ACETATE SUSPNSION,J9217,J9217,,Leuprolide acetate suspnsion,,62935-0753-75,Professional,Clinic,Self-Pay,N/A,N/A,N/A,301.85,% of charge rate,100.00%,301.85,,,,241.58,301.85,0
unity,CDM,Um Cervical Collar Foam,UM3500220,L0120,,COLLAR CERVICAL FM REG M,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.96,% of charge rate,100.00%,48.96,,,,46.51,48.96,0
unity,CDM,Um Cervical Collar Foam,UM3500220,L0120,,COLLAR CERVICAL FM REG M,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.96,% of charge rate,100.00%,48.96,,,,46.51,48.96,0
unity,CDM,Um Si Belt/corset,UM4310029,L0621,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,158.83,% of charge rate,100.00%,158.83,,,,150.89,158.83,0
unity,CDM,Um Si Belt/corset,UM4310029,L0621,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,158.83,% of charge rate,100.00%,158.83,,,,150.89,158.83,0
unity,CDM,Um Lso/binder,UM4310031,L0628,,SACRO LUMBAR SUPP,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,126.53,% of charge rate,100.00%,126.53,,,,120.2,126.53,0
unity,CDM,Um Lso/binder,UM4310031,L0628,,SACRO LUMBAR SUPP,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,126.53,% of charge rate,100.00%,126.53,,,,120.2,126.53,0
unity,CDM,Um Knee Immobilizer All Size,UM3500195,L1830,,KNEE IMMOBILIZER 19IN FOAM,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,171.67,% of charge rate,100.00%,171.67,,,,163.09,171.67,0
unity,CDM,Um Knee Immobilizer All Size,UM3500195,L1830,,KNEE IMMOBILIZER 19IN FOAM,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,171.67,% of charge rate,100.00%,171.67,,,,163.09,171.67,0
unity,CDM,Um Ankle Brace Aoa,UM3500052,L1902,,ANKLE BRACE SM,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,161.76,% of charge rate,100.00%,161.76,,,,153.67,161.76,0
unity,CDM,Um Ankle Brace Aoa,UM3500052,L1902,,ANKLE BRACE SM,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,161.76,% of charge rate,100.00%,161.76,,,,153.67,161.76,0
unity,CDM,Um Elastic Brace Universal,UM3500188,L1902,,ANKLE BRACE SM,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.35,% of charge rate,100.00%,6.35,,,,6.03,6.35,0
unity,CDM,Um Elastic Brace Universal,UM3500188,L1902,,ANKLE BRACE SM,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.35,% of charge rate,100.00%,6.35,,,,6.03,6.35,0
unity,CDM,Um Ankle Brace Aoa,UM4310018,L1902,,ANKLE BRACE SM,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.16,% of charge rate,100.00%,111.16,,,,105.6,111.16,0
unity,CDM,Um Ankle Brace Aoa,UM4310018,L1902,,ANKLE BRACE SM,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.16,% of charge rate,100.00%,111.16,,,,105.6,111.16,0
unity,CDM,Um Cast Shoe-open Toe,UM3500203,L3260,,CAST SHOE XLG,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.83,% of charge rate,100.00%,33.83,,,,32.14,33.83,0
unity,CDM,Um Cast Shoe-open Toe,UM3500203,L3260,,CAST SHOE XLG,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.83,% of charge rate,100.00%,33.83,,,,32.14,33.83,0
unity,CDM,Um Heel Lift/wedge,UM4310001,L3350,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.4,% of charge rate,100.00%,34.4,,,,32.68,34.4,0
unity,CDM,Um Heel Lift/wedge,UM4310001,L3350,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.4,% of charge rate,100.00%,34.4,,,,32.68,34.4,0
unity,CDM,"Um Heel Cushion, Viscoheel",UM4310014,L3485,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.34,% of charge rate,100.00%,20.34,,,,19.32,20.34,0
unity,CDM,"Um Heel Cushion, Viscoheel",UM4310014,L3485,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.34,% of charge rate,100.00%,20.34,,,,19.32,20.34,0
unity,CDM,Um Splint Clavicle Universal,UM3500178,L3650,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,86.78,% of charge rate,100.00%,86.78,,,,82.44,86.78,0
unity,CDM,Um Splint Clavicle Universal,UM3500178,L3650,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,86.78,% of charge rate,100.00%,86.78,,,,82.44,86.78,0
unity,CDM,Um Shoulder Immobilizer Univ,UM3500208,L3660,,SHOULDER IMMO UNIV,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,106.94,% of charge rate,100.00%,106.94,,,,101.59,106.94,0
unity,CDM,Um Shoulder Immobilizer Univ,UM3500208,L3660,,SHOULDER IMMO UNIV,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,106.94,% of charge rate,100.00%,106.94,,,,101.59,106.94,0
unity,CDM,Um Sling Shot2 Med,UM3500355,L3670,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.32,% of charge rate,100.00%,116.32,,,,110.5,116.32,0
unity,CDM,Um Sling Shot2 Med,UM3500355,L3670,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.32,% of charge rate,100.00%,116.32,,,,110.5,116.32,0
unity,CDM,Um Sling Shot2 Large,UM3500356,L3670,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,285.01,% of charge rate,100.00%,285.01,,,,270.76,285.01,0
unity,CDM,Um Sling Shot2 Large,UM3500356,L3670,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,285.01,% of charge rate,100.00%,285.01,,,,270.76,285.01,0
unity,CDM,Um Wrist Brace All Sizes,UM3500167,L3908,,"WRIST, HAND STATIC PRE FAB",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.76,% of charge rate,100.00%,52.76,,,,50.12,52.76,0
unity,CDM,Um Wrist Brace All Sizes,UM3500167,L3908,,"WRIST, HAND STATIC PRE FAB",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.76,% of charge rate,100.00%,52.76,,,,50.12,52.76,0
unity,CDM,"Um Splint, Post Arm/wrist",UM3500235,L3908,,"WRIST, HAND STATIC PRE FAB",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.62,% of charge rate,100.00%,25.62,,,,24.34,25.62,0
unity,CDM,"Um Splint, Post Arm/wrist",UM3500235,L3908,,"WRIST, HAND STATIC PRE FAB",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.62,% of charge rate,100.00%,25.62,,,,24.34,25.62,0
unity,CDM,Um Brace Thumb Spica Universal,UM3500322,L3908,,"WRIST, HAND STATIC PRE FAB",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.72,% of charge rate,100.00%,12.72,,,,12.08,12.72,0
unity,CDM,Um Brace Thumb Spica Universal,UM3500322,L3908,,"WRIST, HAND STATIC PRE FAB",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.72,% of charge rate,100.00%,12.72,,,,12.08,12.72,0
unity,CDM,Um Brace Spica Universal,UM3500323,L3923,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.09,% of charge rate,100.00%,8.09,,,,7.69,8.09,0
unity,CDM,Um Brace Spica Universal,UM3500323,L3923,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.09,% of charge rate,100.00%,8.09,,,,7.69,8.09,0
unity,CDM,Um Hand/wrist Orthosis,UM3500243,L3984,,,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,81.12,% of charge rate,100.00%,81.12,,,,77.06,81.12,0
unity,CDM,Um Hand/wrist Orthosis,UM3500243,L3984,,,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,81.12,% of charge rate,100.00%,81.12,,,,77.06,81.12,0
unity,CDM,Um Elbow Brace - Elastic,UM3500222,L3999,,LH THUMB SPICA SPLINT-PROCARE,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.28,% of charge rate,100.00%,6.28,,,,5.97,6.28,0
unity,CDM,Um Elbow Brace - Elastic,UM3500222,L3999,,LH THUMB SPICA SPLINT-PROCARE,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.28,% of charge rate,100.00%,6.28,,,,5.97,6.28,0
unity,CDM,Um Cam Walker,UM3500221,L4386,,WALKER PREM EQUL LG,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,231.9,% of charge rate,100.00%,231.9,,,,220.31,231.9,0
unity,CDM,Um Cam Walker,UM3500221,L4386,,WALKER PREM EQUL LG,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,231.9,% of charge rate,100.00%,231.9,,,,220.31,231.9,0
unity,CDM,Um Screening Paper Thin Layer,UM4000916,P3001,,Screening pap smear by phys,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112.82,% of charge rate,100.00%,112.82,,,,107.18,112.82,0
unity,CDM,Um Screening Paper Thin Layer,UM4000916,P3001,,Screening pap smear by phys,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112.82,% of charge rate,100.00%,112.82,,,,107.18,112.82,0
unity,CDM,Um Rbc's Leukocytes Reduced,UM4050009,P9016,,Rbc leukocytes reduced,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,572.55,% of charge rate,100.00%,572.55,,,,543.92,572.55,0
unity,CDM,Um Rbc's Leukocytes Reduced,UM4050009,P9016,,Rbc leukocytes reduced,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,572.55,% of charge rate,100.00%,572.55,,,,543.92,572.55,0
unity,CDM,Um Fresh Frozen Plasma,UM4050008,P9017,,Plasma 1 donor frz w/in 8 hr,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,232.67,% of charge rate,100.00%,232.67,,,,221.04,232.67,0
unity,CDM,Um Fresh Frozen Plasma,UM4050008,P9017,,Plasma 1 donor frz w/in 8 hr,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,232.67,% of charge rate,100.00%,232.67,,,,221.04,232.67,0
unity,CDM,Um Red Blood Cells,UM4050004,P9021,,Red blood cells unit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,448.88,% of charge rate,100.00%,448.88,,,,426.44,448.88,0
unity,CDM,Um Red Blood Cells,UM4050004,P9021,,Red blood cells unit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,448.88,% of charge rate,100.00%,448.88,,,,426.44,448.88,0
unity,CDM,Um Rbc's Washed,UM4050003,P9022,,Washed red blood cells unit,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,922.11,% of charge rate,100.00%,922.11,,,,876,922.11,0
unity,CDM,Um Rbc's Washed,UM4050003,P9022,,Washed red blood cells unit,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,922.11,% of charge rate,100.00%,922.11,,,,876,922.11,0
unity,CDM,"Um Platelets, Pher, Leuko Re",UM4050010,P9035,,Platelet pheres leukoreduced,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,502.00",% of charge rate,100.00%,"1,502.00",,,,"1,426.90","1,502.00",0
unity,CDM,"Um Platelets, Pher, Leuko Re",UM4050010,P9035,,Platelet pheres leukoreduced,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,502.00",% of charge rate,100.00%,"1,502.00",,,,"1,426.90","1,502.00",0
unity,CDM,"Um Plt, Pher, Irrad Leuko Re",UM4050021,P9037,,Plate pheres leukoredu irrad,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,985.70",% of charge rate,100.00%,"1,985.70",,,,"1,886.42","1,985.70",0
unity,CDM,"Um Plt, Pher, Irrad Leuko Re",UM4050021,P9037,,Plate pheres leukoredu irrad,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,985.70",% of charge rate,100.00%,"1,985.70",,,,"1,886.42","1,985.70",0
unity,CDM,"Um Rbc's, Irrad, Leuko Reduc",UM4050020,P9040,,Rbc leukoreduced irradiated,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,804.07,% of charge rate,100.00%,804.07,,,,763.87,804.07,0
unity,CDM,"Um Rbc's, Irrad, Leuko Reduc",UM4050020,P9040,,Rbc leukoreduced irradiated,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,804.07,% of charge rate,100.00%,804.07,,,,763.87,804.07,0
unity,CDM,TELEHEALTH,7610010,Q3014,,Telehealth facility fee,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,TELEHEALTH,7610010,Q3014,,Telehealth facility fee,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,0
unity,CDM,Um Casting Long Arm Fiber-ad,UM3500033,Q4006,,Cast sup long arm adult fbrg,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.52,% of charge rate,100.00%,40.52,,,,38.49,40.52,0
unity,CDM,Um Casting Long Arm Fiber-ad,UM3500033,Q4006,,Cast sup long arm adult fbrg,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.52,% of charge rate,100.00%,40.52,,,,38.49,40.52,0
unity,CDM,Um Casting Long Arm Fiber-ch,UM3500013,Q4008,,Cast sup long arm ped fbrgls,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Casting Long Arm Fiber-ch,UM3500013,Q4008,,Cast sup long arm ped fbrgls,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm-fiber Ad+,UM3500064,Q4010,,Cast sup sht arm adult fbrgl,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm-fiber Ad+,UM3500064,Q4010,,Cast sup sht arm adult fbrgl,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm-fiber-ch,UM3500026,Q4012,,Cast sup sht arm ped fbrglas,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm-fiber-ch,UM3500026,Q4012,,Cast sup sht arm ped fbrglas,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm Splint-ad,UM3500042,Q4022,,Cast sup sht arm splint fbrg,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Cast Short Arm Splint-ad,UM3500042,Q4022,,Cast sup sht arm splint fbrg,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.76,% of charge rate,100.00%,33.76,,,,32.07,33.76,0
unity,CDM,Um Casting Short Leg - Ad,UM3500228,Q4037,,Cast sup shrt leg plaster,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.05,% of charge rate,100.00%,54.05,,,,51.35,54.05,0
unity,CDM,Um Casting Short Leg - Ad,UM3500228,Q4037,,Cast sup shrt leg plaster,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.05,% of charge rate,100.00%,54.05,,,,51.35,54.05,0
unity,CDM,Um Castg -short Leg-fib-ad,UM3500240,Q4038,,Cast sup shrt leg fiberglass,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,55.47,% of charge rate,100.00%,55.47,,,,52.7,55.47,0
unity,CDM,Um Castg -short Leg-fib-ad,UM3500240,Q4038,,Cast sup shrt leg fiberglass,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,55.47,% of charge rate,100.00%,55.47,,,,52.7,55.47,0
unity,CDM,Um Cast Short Leg Splint-ad,UM3500241,Q4046,,Cast sup sht leg splnt fbrgl,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.65,% of charge rate,100.00%,38.65,,,,36.72,38.65,0
unity,CDM,Um Cast Short Leg Splint-ad,UM3500241,Q4046,,Cast sup sht leg splnt fbrgl,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.65,% of charge rate,100.00%,38.65,,,,36.72,38.65,0
unity,CDM,Um Casting Supplies,UM3500182,Q4047,,Cast sup sht leg splnt ped p,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.91,% of charge rate,100.00%,40.91,,,,38.86,40.91,0
unity,CDM,Um Casting Supplies,UM3500182,Q4047,,Cast sup sht leg splnt ped p,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.91,% of charge rate,100.00%,40.91,,,,38.86,40.91,0
unity,CDM,Um Finger Splint,UM3500014,Q4049,,"Finger splint, static",,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.44,% of charge rate,100.00%,6.44,,,,6.12,6.44,0
unity,CDM,Um Finger Splint,UM3500014,Q4049,,"Finger splint, static",,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.44,% of charge rate,100.00%,6.44,,,,6.12,6.44,0
unity,CDM,Hc Non-heu Tc-99m Add-on/dose,3430036,Q9969,,Non-heu tc-99m add-on/dose,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Hc Non-heu Tc-99m Add-on/dose,3430036,Q9969,,Non-heu tc-99m add-on/dose,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,90,% of charge rate,100.00%,90,,,,85.5,90,0
unity,CDM,Um O2 Conts - 1unit=1 Cu. Ft,UM3470018,S8120,,O2 contents gas cubic ft,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,2.48,% of charge rate,100.00%,2.48,,,,2.36,2.48,0
unity,CDM,Um O2 Conts - 1unit=1 Cu. Ft,UM3470018,S8120,,O2 contents gas cubic ft,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,2.48,% of charge rate,100.00%,2.48,,,,2.36,2.48,0
unity,CDM,Um Rosidal Soft Wrap,UM3500291,S8430,,Padding for comprssn bdg,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,14.5,% of charge rate,100.00%,14.5,,,,13.78,14.5,0
unity,CDM,Um Rosidal Soft Wrap,UM3500291,S8430,,Padding for comprssn bdg,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,14.5,% of charge rate,100.00%,14.5,,,,13.78,14.5,0
unity,CDM,Um Lens,UM3500049,V2632,,Post chmbr intraocular lens,,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,999.03,% of charge rate,100.00%,999.03,,,,949.08,999.03,0
unity,CDM,Um Lens,UM3500049,V2632,,Post chmbr intraocular lens,,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,999.03,% of charge rate,100.00%,999.03,,,,949.08,999.03,0
unity,CDM,Pr Wsi Case Manager Visit,9000404,W0300,,,,,Professional,Clinic,Self-Pay,N/A,N/A,N/A,121,% of charge rate,100.00%,121,,,,121,121,0
unity,CDM,Pr Wsi Case Manager Visit,9000404,W0300,,,,,Professional,N/A,Self-Pay,N/A,N/A,N/A,121,% of charge rate,100.00%,121,,,,121,121,0
unity,NDC,TOBRAMYCIN 0.3 % OP SOLN,127425,2500005,,,5 mL,62332-0518-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56.35,% of charge rate,95.00%,53.53,,,,53.53,56.35,1
unity,NDC,TOBRAMYCIN 0.3 % OP SOLN,127425,2500005,,,5 mL,62332-0518-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56.35,% of charge rate,95.00%,53.53,,,,53.53,56.35,1
unity,NDC,FLURBIPROFEN SODIUM 0.03 % OP SOLN,10080,2500006,,,2.5 mL,69292-0722-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.03,% of charge rate,95.00%,23.78,,,,23.78,25.03,1
unity,NDC,FLURBIPROFEN SODIUM 0.03 % OP SOLN,10080,2500006,,,2.5 mL,69292-0722-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.03,% of charge rate,95.00%,23.78,,,,23.78,25.03,1
unity,NDC,IOHEXOL 140 MG/ML IV SOLN,10318,2500006,,,50 mL,00407-1401-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,127.42,% of charge rate,95.00%,121.05,,,,121.05,127.42,1
unity,NDC,IOHEXOL 140 MG/ML IV SOLN,10318,2500006,,,50 mL,00407-1401-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,127.42,% of charge rate,95.00%,121.05,,,,121.05,127.42,1
unity,NDC,PEG 3350 17 G PO PACK,103952,2500006,,,1 Packet,00904-6931-81,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.99,% of charge rate,95.00%,7.59,,,,7.59,7.99,1
unity,NDC,PEG 3350 17 G PO PACK,103952,2500006,,,1 Packet,00904-6931-86,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.99,% of charge rate,95.00%,7.59,,,,7.59,7.99,1
unity,NDC,PEG 3350 17 G PO PACK,103952,2500006,,,1 Packet,00904-6931-86,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.99,% of charge rate,95.00%,7.59,,,,7.59,7.99,1
unity,NDC,PEG 3350 17 G PO PACK,103952,2500006,,,1 Packet,00904-6931-81,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.99,% of charge rate,95.00%,7.59,,,,7.59,7.99,1
unity,NDC,LIDOCAINE-EPINEPHRINE 1 %-1:100000 INJ SOLN,10427,2500006,,,1 mL,00409-3178-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,26.5,1
unity,NDC,LIDOCAINE-EPINEPHRINE 1 %-1:100000 INJ SOLN,10427,2500006,,,1 mL,63323-0482-27,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.5,% of charge rate,95.00%,25.18,,,,20.66,26.5,1
unity,NDC,LIDOCAINE-EPINEPHRINE 1 %-1:100000 INJ SOLN,10427,2500006,,,1 mL,63323-0482-27,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.5,% of charge rate,95.00%,25.18,,,,20.66,26.5,1
unity,NDC,LIDOCAINE-EPINEPHRINE 1 %-1:100000 INJ SOLN,10427,2500006,,,1 mL,00409-3178-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,26.5,1
unity,NDC,LIDOCAINE-EPINEPHRINE 2 %-1:100000 INJ SOLN,10430,2500006,,,20 mL,00409-3182-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE-EPINEPHRINE 2 %-1:100000 INJ SOLN,10430,2500006,,,20 mL,00409-3182-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE-PRILOCAINE 2.5-2.5 % EX CREA,10434,2500006,,,30 g,00115-1468-45,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,153.05,% of charge rate,95.00%,145.4,,,,145.4,153.05,1
unity,NDC,LIDOCAINE-PRILOCAINE 2.5-2.5 % EX CREA,10434,2500006,,,30 g,00115-1468-45,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,153.05,% of charge rate,95.00%,145.4,,,,145.4,153.05,1
unity,NDC,TAMSULOSIN HCL 0.4 MG PO CAPS,105936,2500006,,,1 Cap,00904-6401-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TAMSULOSIN HCL 0.4 MG PO CAPS,105936,2500006,,,1 Cap,00904-6401-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MUPIROCIN 2 % EX OINT,10674,2500006,,,22 g,51672-1312-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.17,% of charge rate,95.00%,27.71,,,,27.71,29.17,1
unity,NDC,MUPIROCIN 2 % EX OINT,10674,2500006,,,22 g,51672-1312-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.17,% of charge rate,95.00%,27.71,,,,27.71,29.17,1
unity,NDC,NEOMYCIN-POLYMYXIN-DEXAMETH 3.5-10000-0.1 OP SUSP,108871,2500006,,,5 mL,24208-0830-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.74,% of charge rate,95.00%,50.1,,,,50.1,52.74,1
unity,NDC,NEOMYCIN-POLYMYXIN-DEXAMETH 3.5-10000-0.1 OP SUSP,108871,2500006,,,5 mL,24208-0830-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,52.74,% of charge rate,95.00%,50.1,,,,50.1,52.74,1
unity,NDC,PENICILLIN G BENZATHINE 2400000 UNIT/4ML IM SUSP,111058,2500006,,,4 mL,60793-0702-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,912.23,% of charge rate,95.00%,866.62,,,,866.62,912.23,1
unity,NDC,PENICILLIN G BENZATHINE 2400000 UNIT/4ML IM SUSP,111058,2500006,,,4 mL,60793-0702-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,912.23,% of charge rate,95.00%,866.62,,,,866.62,912.23,1
unity,NDC,TICAGRELOR 90 MG PO TABS,112719,2500006,,,1 Tab,00186-0777-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.51,% of charge rate,95.00%,28.03,,,,28.03,29.51,1
unity,NDC,TICAGRELOR 90 MG PO TABS,112719,2500006,,,1 Tab,00186-0777-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.51,% of charge rate,95.00%,28.03,,,,28.03,29.51,1
unity,NDC,OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR,113272,2500006,,,60 mL,47781-0384-26,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,675.65,% of charge rate,95.00%,641.87,,,,641.87,675.65,1
unity,NDC,OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR,113272,2500006,,,60 mL,47781-0384-26,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,675.65,% of charge rate,95.00%,641.87,,,,641.87,675.65,1
unity,NDC,SILVER NITRATE-POT NITRATE 75-25 % EX MISC,11359,2500006,,,1 Each,12870-0001-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SILVER NITRATE-POT NITRATE 75-25 % EX MISC,11359,2500006,,,1 Each,12870-0001-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP SUSP,11567,2500006,,,2.5 mL,24208-0295-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,159.2,% of charge rate,95.00%,151.24,,,,151.24,159.2,1
unity,NDC,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP SUSP,11567,2500006,,,2.5 mL,24208-0295-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,159.2,% of charge rate,95.00%,151.24,,,,151.24,159.2,1
unity,NDC,VANCOMYCIN HCL 125 MG PO CAPS,11628,2500006,,,1 Cap,00121-0867-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.83,% of charge rate,95.00%,26.44,,,,26.44,27.83,1
unity,NDC,VANCOMYCIN HCL 125 MG PO CAPS,11628,2500006,,,1 Cap,00121-0867-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.83,% of charge rate,95.00%,26.44,,,,26.44,27.83,1
unity,NDC,RACEPINEPHRINE HCL 2.25 % IN NEBU,117196,2500006,,,0.5 mL,00487-2784-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.22,% of charge rate,95.00%,11.61,,,,11.61,12.22,1
unity,NDC,RACEPINEPHRINE HCL 2.25 % IN NEBU,117196,2500006,,,0.5 mL,00487-2784-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.22,% of charge rate,95.00%,11.61,,,,11.61,12.22,1
unity,NDC,THERA-TABS M PO TABS,117881,2500006,,,1 Tab,00904-5492-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,THERA-TABS M PO TABS,117881,2500006,,,1 Tab,00904-5492-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACT IN AERS,119339,2500006,,,4 g,00597-0024-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,937.29,% of charge rate,95.00%,890.43,,,,890.43,937.29,1
unity,NDC,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACT IN AERS,119339,2500006,,,4 g,00597-0024-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,937.29,% of charge rate,95.00%,890.43,,,,890.43,937.29,1
unity,NDC,INFUVITE ADULT IV INJ,122126,2500006,,,10 mL,54643-9007-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.28,% of charge rate,95.00%,27.82,,,,27.82,29.28,1
unity,NDC,INFUVITE ADULT IV INJ,122126,2500006,,,10 mL,54643-9007-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.28,% of charge rate,95.00%,27.82,,,,27.82,29.28,1
unity,NDC,BUPIVACAINE HCL 0.25 % INJ SOLN,1222,2500006,,,50 mL,63323-0465-57,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUPIVACAINE HCL 0.25 % INJ SOLN,1222,2500006,,,50 mL,63323-0465-57,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUPIVACAINE HCL 0.5 % INJ SOLN,1223,2500006,,,50 mL,63323-0467-57,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUPIVACAINE HCL 0.5 % INJ SOLN,1223,2500006,,,50 mL,63323-0467-57,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,CANAGLIFLOZIN 100 MG PO TABS,123456,2500006,,,1 Tab,50458-0140-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.24,% of charge rate,95.00%,75.28,,,,75.28,79.24,1
unity,NDC,CANAGLIFLOZIN 100 MG PO TABS,123456,2500006,,,1 Tab,50458-0140-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,79.24,% of charge rate,95.00%,75.28,,,,75.28,79.24,1
unity,NDC,PB-HYOSCY-ATROPINE-SCOPOLAMINE 16.2 MG/5ML PO ELIX,129297,2500006,,,2 mL,75826-0127-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.64,% of charge rate,95.00%,34.81,,,,34.81,36.64,1
unity,NDC,PB-HYOSCY-ATROPINE-SCOPOLAMINE 16.2 MG/5ML PO ELIX,129297,2500006,,,2 mL,75826-0127-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,36.64,% of charge rate,95.00%,34.81,,,,34.81,36.64,1
unity,NDC,CALCIUM CHLORIDE 10 % IV SOLN,1306,2500006,,,10 mL,00409-1631-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.1,% of charge rate,95.00%,41.9,,,,41.9,44.1,1
unity,NDC,CALCIUM CHLORIDE 10 % IV SOLN,1306,2500006,,,10 mL,00409-1631-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.1,% of charge rate,95.00%,41.9,,,,41.9,44.1,1
unity,NDC,SCOPOLAMINE 1 MG/3DAYS TD PT72,130961,2500006,,,1 Patch,45802-0580-84,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.8,% of charge rate,95.00%,64.41,,,,64.41,67.8,1
unity,NDC,SCOPOLAMINE 1 MG/3DAYS TD PT72,130961,2500006,,,1 Patch,45802-0580-84,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.8,% of charge rate,95.00%,64.41,,,,64.41,67.8,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00409-3375-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.08,% of charge rate,95.00%,78.93,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00703-1153-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.08,% of charge rate,95.00%,78.93,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00703-1153-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.08,% of charge rate,95.00%,78.93,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00703-1153-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.08,% of charge rate,95.00%,78.93,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00703-1153-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.08,% of charge rate,95.00%,78.93,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00409-3375-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,83.08,% of charge rate,95.00%,78.93,,,,78.93,83.08,1
unity,NDC,TIOTROPIUM BROMIDE-OLODATEROL 2.5-2.5 MCG/ACT IN AERS,132149,2500006,,,4 g,00597-0155-70,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,146.08,% of charge rate,95.00%,138.78,,,,138.78,146.08,1
unity,NDC,TIOTROPIUM BROMIDE-OLODATEROL 2.5-2.5 MCG/ACT IN AERS,132149,2500006,,,4 g,00597-0155-70,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,146.08,% of charge rate,95.00%,138.78,,,,138.78,146.08,1
unity,NDC,TRANEXAMIC ACID 1000 MG/10ML IV SOLN,134922,2500006,,,5 mL,61990-0611-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.35,% of charge rate,95.00%,25.03,,,,25.03,26.35,1
unity,NDC,TRANEXAMIC ACID 1000 MG/10ML IV SOLN,134922,2500006,,,5 mL,61990-0611-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.35,% of charge rate,95.00%,25.03,,,,25.03,26.35,1
unity,NDC,TRANEXAMIC ACID 1000 MG/10ML IV SOLN,134922,2500006,,,5 mL,61990-0611-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.35,% of charge rate,95.00%,25.03,,,,25.03,26.35,1
unity,NDC,TRANEXAMIC ACID 1000 MG/10ML IV SOLN,134922,2500006,,,5 mL,61990-0611-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.35,% of charge rate,95.00%,25.03,,,,25.03,26.35,1
unity,NDC,EPHEDRINE SULFATE 50 MG/ML IV SOLN,135960,2500006,,,1 mL,17478-0955-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.26,% of charge rate,95.00%,81,,,,81,85.26,1
unity,NDC,EPHEDRINE SULFATE 50 MG/ML IV SOLN,135960,2500006,,,1 mL,17478-0955-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,85.26,% of charge rate,95.00%,81,,,,81,85.26,1
unity,NDC,BACITRACIN ZINC 500 UNIT/GM EX OINT,13818,2500006,,,1 g,45802-0060-70,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,BACITRACIN ZINC 500 UNIT/GM EX OINT,13818,2500006,,,1 g,45802-0060-70,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,BENZOCAINE 20 % MT AERO,139175,2500006,,,57 Spray,00283-0679-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.84,% of charge rate,95.00%,115.75,,,,115.75,121.84,1
unity,NDC,BENZOCAINE 20 % MT AERO,139175,2500006,,,57 Spray,00283-0679-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.84,% of charge rate,95.00%,115.75,,,,115.75,121.84,1
unity,NDC,ALFENTANIL HCL 1000 MCG/2ML IV SOLN,142013,2500006,,,2 mL,17478-0067-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ALFENTANIL HCL 1000 MCG/2ML IV SOLN,142013,2500006,,,2 mL,17478-0067-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX GEL,144902,2500006,,,5 mL,17478-0711-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.85,% of charge rate,95.00%,68.26,,,,68.26,71.85,1
unity,NDC,LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX GEL,144902,2500006,,,5 mL,17478-0711-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.85,% of charge rate,95.00%,68.26,,,,68.26,71.85,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,0.5 mL,63323-0186-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,20 mL,00409-4888-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,20 mL,00409-4888-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,20 mL,00409-4888-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,20 mL,00409-4888-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,0.5 mL,63323-0186-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SENNA 8.8 MG/5ML PO LIQD,147094,2500006,,,237 mL,00536-1266-59,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.49,% of charge rate,95.00%,51.77,,,,51.77,54.49,1
unity,NDC,SENNA 8.8 MG/5ML PO LIQD,147094,2500006,,,237 mL,00536-1266-59,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.49,% of charge rate,95.00%,51.77,,,,51.77,54.49,1
unity,NDC,CENTRUM PO LIQD,1481,2500006,,,5 mL,00005-4344-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CENTRUM PO LIQD,1481,2500006,,,5 mL,00005-4344-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,REMDESIVIR 100 MG IV SOLR,148141,2500006,,,20 mL,61958-2901-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,353.50",% of charge rate,95.00%,"1,285.83",,,,"1,285.83","1,353.50",1
unity,NDC,REMDESIVIR 100 MG IV SOLR,148141,2500006,,,20 mL,61958-2901-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,353.50",% of charge rate,95.00%,"1,285.83",,,,"1,285.83","1,353.50",1
unity,NDC,CALCITONIN (SALMON) 200 UNIT/ACT NA SOLN,15738,2500006,,,3.7 mL,49884-0161-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.97,% of charge rate,95.00%,61.72,,,,61.72,64.97,1
unity,NDC,CALCITONIN (SALMON) 200 UNIT/ACT NA SOLN,15738,2500006,,,3.7 mL,49884-0161-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.97,% of charge rate,95.00%,61.72,,,,61.72,64.97,1
unity,NDC,IPRATROPIUM BROMIDE 0.06 % NA SOLN,16071,2500006,,,15 mL,00054-0046-41,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.35,% of charge rate,95.00%,74.43,,,,74.43,78.35,1
unity,NDC,IPRATROPIUM BROMIDE 0.06 % NA SOLN,16071,2500006,,,15 mL,00054-0046-41,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.35,% of charge rate,95.00%,74.43,,,,74.43,78.35,1
unity,NDC,CANDIDA ALBICANS SKN TST ANTGN ID SOLN,17524,2500006,,,0.1 mL,59584-0138-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.92,% of charge rate,95.00%,55.02,,,,55.02,57.92,1
unity,NDC,CANDIDA ALBICANS SKN TST ANTGN ID SOLN,17524,2500006,,,0.1 mL,59584-0138-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.92,% of charge rate,95.00%,55.02,,,,55.02,57.92,1
unity,NDC,ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT IN AERS,17837,2500006,,,8 g,00173-0682-24,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.15,% of charge rate,95.00%,72.34,,,,72.34,76.15,1
unity,NDC,ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT IN AERS,17837,2500006,,,8 g,00173-0682-24,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,76.15,% of charge rate,95.00%,72.34,,,,72.34,76.15,1
unity,NDC,SENNA 8.6 MG PO TABS,18138,2500006,,,1 Tab,00904-6522-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SENNA 8.6 MG PO TABS,18138,2500006,,,1 Tab,00904-6522-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BENZOCAINE 20 % MT SOLN,19696,2500006,,,1 Spray,00283-0610-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.5,% of charge rate,95.00%,37.53,,,,37.53,39.5,1
unity,NDC,BENZOCAINE 20 % MT SOLN,19696,2500006,,,1 Spray,00283-0610-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.5,% of charge rate,95.00%,37.53,,,,37.53,39.5,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,10 mL,00143-9311-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.34,% of charge rate,95.00%,27.87,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,10 mL,00409-6695-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.34,% of charge rate,95.00%,27.87,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,20 mL,00143-9311-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.19,% of charge rate,95.00%,22.03,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,20 mL,00143-9311-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.19,% of charge rate,95.00%,22.03,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,10 mL,00409-6695-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.34,% of charge rate,95.00%,27.87,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,10 mL,00143-9311-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.34,% of charge rate,95.00%,27.87,,,,22.03,29.34,1
unity,NDC,QUETIAPINE FUMARATE 200 MG PO TABS,21825,2500006,,,1 Tab,00904-6641-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,QUETIAPINE FUMARATE 200 MG PO TABS,21825,2500006,,,1 Tab,00904-6641-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IRBESARTAN 300 MG PO TABS,21849,2500006,,,1 Tab,42658-0123-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IRBESARTAN 300 MG PO TABS,21849,2500006,,,1 Tab,42658-0123-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DEXTROSE 10 % IV SOLN,2357,2500006,,,500 mL,00409-7930-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.01,% of charge rate,95.00%,65.56,,,,65.56,69.01,1
unity,NDC,DEXTROSE 10 % IV SOLN,2357,2500006,,,500 mL,00409-7930-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.01,% of charge rate,95.00%,65.56,,,,65.56,69.01,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-4902-34,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-4902-64,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-7517-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-7517-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-4902-64,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-4902-34,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIPHENHYDRAMINE HCL 25 MG PO CAPS,2509,2500006,,,1 Cap,00904-5306-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DIPHENHYDRAMINE HCL 25 MG PO CAPS,2509,2500006,,,1 Cap,00904-5306-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DOCUSATE SODIUM 150 MG/15ML PO LIQD,2569,2500006,,,10 mL,50383-0771-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.85,% of charge rate,95.00%,3.66,,,,3.66,3.85,1
unity,NDC,DOCUSATE SODIUM 150 MG/15ML PO LIQD,2569,2500006,,,10 mL,50383-0771-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.85,% of charge rate,95.00%,3.66,,,,3.66,3.85,1
unity,NDC,DOCUSATE SODIUM 150 MG/15ML PO LIQD,2569,2500006,,,10 mL,50383-0771-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.85,% of charge rate,95.00%,3.66,,,,3.66,3.85,1
unity,NDC,DOCUSATE SODIUM 150 MG/15ML PO LIQD,2569,2500006,,,10 mL,50383-0771-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.85,% of charge rate,95.00%,3.66,,,,3.66,3.85,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG IV SOLR,2622,2500006,,,100 mg,68382-0910-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.02,% of charge rate,95.00%,83.62,,,,83.62,88.02,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG IV SOLR,2622,2500006,,,100 mg,68382-0910-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.02,% of charge rate,95.00%,83.62,,,,83.62,88.02,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG IV SOLR,2622,2500006,,,100 mg,68382-0910-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.02,% of charge rate,95.00%,83.62,,,,83.62,88.02,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG IV SOLR,2622,2500006,,,100 mg,68382-0910-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.02,% of charge rate,95.00%,83.62,,,,83.62,88.02,1
unity,NDC,FLUTICASONE-SALMETEROL 250-50 MCG/DOSE IN AEPB,26538,2500006,,,14 Each,00173-0696-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,298.52,% of charge rate,95.00%,283.59,,,,283.59,298.52,1
unity,NDC,FLUTICASONE-SALMETEROL 250-50 MCG/DOSE IN AEPB,26538,2500006,,,14 Each,00173-0696-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,298.52,% of charge rate,95.00%,283.59,,,,283.59,298.52,1
unity,NDC,FLUTICASONE-SALMETEROL 500-50 MCG/DOSE IN AEPB,26539,2500006,,,60 Each,00378-9322-32,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,931.70",% of charge rate,95.00%,"2,785.12",,,,"2,785.12","2,931.70",1
unity,NDC,FLUTICASONE-SALMETEROL 500-50 MCG/DOSE IN AEPB,26539,2500006,,,60 Each,00378-9322-32,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,931.70",% of charge rate,95.00%,"2,785.12",,,,"2,785.12","2,931.70",1
unity,NDC,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5ML PO SYRP,27345,2500006,,,5 mL,00536-1184-97,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5ML PO SYRP,27345,2500006,,,5 mL,00536-1184-97,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CRANBERRY 250 MG PO CAPS,27448,2500006,,,1 Each,35046-0007-51,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CRANBERRY 250 MG PO CAPS,27448,2500006,,,1 Each,35046-0007-51,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FLUORESCEIN SODIUM 1 MG OP STRP,27663,2500006,,,1 Strip,17238-0900-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FLUORESCEIN SODIUM 1 MG OP STRP,27663,2500006,,,1 Strip,17238-0900-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IOPAMIDOL 61 % IV SOLN,27737,2500006,,,50 mL,00270-1315-35,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,154.31,% of charge rate,95.00%,146.59,,,,146.59,154.31,1
unity,NDC,IOPAMIDOL 61 % IV SOLN,27737,2500006,,,50 mL,00270-1315-35,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,154.31,% of charge rate,95.00%,146.59,,,,146.59,154.31,1
unity,NDC,LIDOCAINE VISCOUS HCL 2 % MT SOLN,27898,2500006,,,15 mL,50383-0775-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.36,% of charge rate,95.00%,5.09,,,,3.33,5.36,1
unity,NDC,LIDOCAINE VISCOUS HCL 2 % MT SOLN,27898,2500006,,,5 mL,50383-0775-17,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,5.36,1
unity,NDC,LIDOCAINE VISCOUS HCL 2 % MT SOLN,27898,2500006,,,5 mL,50383-0775-17,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,5.36,1
unity,NDC,LIDOCAINE VISCOUS HCL 2 % MT SOLN,27898,2500006,,,15 mL,50383-0775-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.36,% of charge rate,95.00%,5.09,,,,3.33,5.36,1
unity,NDC,OLANZAPINE 20 MG PO TABS,28158,2500006,,,1 Tab,00904-6287-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OLANZAPINE 20 MG PO TABS,28158,2500006,,,1 Tab,00904-6287-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,EPHEDRINE SULFATE 50 MG/ML INJ SOLN,2833,2500006,,,1 mL,14789-0014-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.5,% of charge rate,95.00%,55.58,,,,55.58,58.5,1
unity,NDC,EPHEDRINE SULFATE 50 MG/ML INJ SOLN,2833,2500006,,,1 mL,14789-0014-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.5,% of charge rate,95.00%,55.58,,,,55.58,58.5,1
unity,NDC,PHOSPHA 250 NEUTRAL 155-852-130 MG PO TABS,29296,2500006,,,1 Tab,64980-0104-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PHOSPHA 250 NEUTRAL 155-852-130 MG PO TABS,29296,2500006,,,1 Tab,64980-0104-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FLEET ENEMA 7-19 GM/118ML REC ENEM,3123,2500006,,,1 Enema,00132-0201-40,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.45,% of charge rate,95.00%,7.08,,,,7.08,7.45,1
unity,NDC,FLEET ENEMA 7-19 GM/118ML REC ENEM,3123,2500006,,,1 Enema,00132-0201-40,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.45,% of charge rate,95.00%,7.08,,,,7.08,7.45,1
unity,NDC,FOLIC ACID 5 MG/ML INJ SOLN,3232,2500006,,,1 mL,63323-0184-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FOLIC ACID 5 MG/ML INJ SOLN,3232,2500006,,,1 mL,63323-0184-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,3497,2500006,,,2 mL,70069-0011-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.19,% of charge rate,95.00%,71.43,,,,71.43,75.19,1
unity,NDC,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,3497,2500006,,,2 mL,70069-0011-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.19,% of charge rate,95.00%,71.43,,,,71.43,75.19,1
unity,NDC,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,3497,2500006,,,2 mL,70069-0011-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.19,% of charge rate,95.00%,71.43,,,,71.43,75.19,1
unity,NDC,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,3497,2500006,,,2 mL,70069-0011-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.19,% of charge rate,95.00%,71.43,,,,71.43,75.19,1
unity,NDC,MOXIFLOXACIN HCL 0.5 % OP SOLN,35699,2500006,,,3 mL,00065-4013-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,224.5,% of charge rate,95.00%,213.28,,,,213.28,224.5,1
unity,NDC,MOXIFLOXACIN HCL 0.5 % OP SOLN,35699,2500006,,,3 mL,00065-4013-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,224.5,% of charge rate,95.00%,213.28,,,,213.28,224.5,1
unity,NDC,CHOLESTYRAMINE LIGHT 4 G PO POWD,37655,2500006,,,52.5 Packet,49884-0466-67,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,164.21,% of charge rate,95.00%,156,,,,156,164.21,1
unity,NDC,CHOLESTYRAMINE LIGHT 4 G PO POWD,37655,2500006,,,52.5 Packet,49884-0466-67,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,164.21,% of charge rate,95.00%,156,,,,156,164.21,1
unity,NDC,ALUMINUM-MAGNESIUM-SIMETHICONE 200-200-20 MG/5ML PO SUSP,38285,2500006,,,30 mL,00121-1761-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.41,% of charge rate,95.00%,12.74,,,,12.74,13.41,1
unity,NDC,ALUMINUM-MAGNESIUM-SIMETHICONE 200-200-20 MG/5ML PO SUSP,38285,2500006,,,30 mL,00121-1761-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.41,% of charge rate,95.00%,12.74,,,,12.74,13.41,1
unity,NDC,NYSTATIN 100000 UNIT/GM EX POWD,39136,2500006,,,15 g,00832-0465-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.12,% of charge rate,95.00%,19.11,,,,19.11,20.12,1
unity,NDC,NYSTATIN 100000 UNIT/GM EX POWD,39136,2500006,,,15 g,00832-0465-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.12,% of charge rate,95.00%,19.11,,,,19.11,20.12,1
unity,NDC,NYAMYC 100000 UNIT/GM EX POWD,41288,2500006,,,15 g,00832-0465-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.12,% of charge rate,95.00%,19.11,,,,19.11,20.12,1
unity,NDC,NYAMYC 100000 UNIT/GM EX POWD,41288,2500006,,,15 g,00832-0465-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.12,% of charge rate,95.00%,19.11,,,,19.11,20.12,1
unity,NDC,KETAMINE HCL 50 MG/ML INJ SOLN,4238,2500006,,,10 mL,00143-9508-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.25,% of charge rate,95.00%,22.09,,,,22.09,23.25,1
unity,NDC,KETAMINE HCL 50 MG/ML INJ SOLN,4238,2500006,,,10 mL,00143-9508-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.25,% of charge rate,95.00%,22.09,,,,22.09,23.25,1
unity,NDC,KETAMINE HCL 50 MG/ML INJ SOLN,4238,2500006,,,10 mL,00143-9508-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.25,% of charge rate,95.00%,22.09,,,,22.09,23.25,1
unity,NDC,KETAMINE HCL 50 MG/ML INJ SOLN,4238,2500006,,,10 mL,00143-9508-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.25,% of charge rate,95.00%,22.09,,,,22.09,23.25,1
unity,NDC,GI COCKTAIL (MYLANTA-LIDOCAINE-DONNATAL) OMNI,4530441,2500006,,,10 mL,99408-0003-93,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.04,% of charge rate,95.00%,33.29,,,,33.29,35.04,1
unity,NDC,GI COCKTAIL (MYLANTA-LIDOCAINE-DONNATAL) OMNI,4530441,2500006,,,10 mL,99408-0003-93,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.04,% of charge rate,95.00%,33.29,,,,33.29,35.04,1
unity,NDC,MIRACLE MOUTHWASH UM BOTTLE,454026,2500006,,,30 mL,99408-0004-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.43,% of charge rate,95.00%,33.66,,,,33.66,35.43,1
unity,NDC,MIRACLE MOUTHWASH UM BOTTLE,454026,2500006,,,30 mL,99408-0004-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.43,% of charge rate,95.00%,33.66,,,,33.66,35.43,1
unity,NDC,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,5595,2500006,,,1 Cap,50268-0623-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.6,% of charge rate,95.00%,8.17,,,,8.17,8.6,1
unity,NDC,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,5595,2500006,,,1 Cap,50268-0623-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.6,% of charge rate,95.00%,8.17,,,,8.17,8.6,1
unity,NDC,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,5595,2500006,,,1 Cap,50268-0623-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.6,% of charge rate,95.00%,8.17,,,,8.17,8.6,1
unity,NDC,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,5595,2500006,,,1 Cap,50268-0623-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.6,% of charge rate,95.00%,8.17,,,,8.17,8.6,1
unity,NDC,OXYMETAZOLINE HCL 0.05 % NA SOLN,5943,2500006,,,30 mL,00904-6761-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.04,% of charge rate,95.00%,6.69,,,,6.69,7.04,1
unity,NDC,OXYMETAZOLINE HCL 0.05 % NA SOLN,5943,2500006,,,30 mL,00904-6761-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.04,% of charge rate,95.00%,6.69,,,,6.69,7.04,1
unity,NDC,LIDOCAINE 4% OPHTHALMIC DROPS,600049,2500006,,,10 Drop,99408-0000-43,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,LIDOCAINE 4% OPHTHALMIC DROPS,600049,2500006,,,10 Drop,99408-0000-43,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,DILATING EYE COCKTAIL FOR CATARACTS (SIMPLE),600051,2500006,,,0.5 mL,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20,% of charge rate,95.00%,19,,,,19,20,1
unity,NDC,DILATING EYE COCKTAIL FOR CATARACTS (SIMPLE),600051,2500006,,,0.5 mL,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20,% of charge rate,95.00%,19,,,,19,20,1
unity,NDC,LET TOPICAL GEL,600451,2500006,,,3 mL,05446-0607-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.05,% of charge rate,95.00%,55.15,,,,55.15,58.05,1
unity,NDC,LET TOPICAL GEL,600451,2500006,,,3 mL,05446-0607-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.05,% of charge rate,95.00%,55.15,,,,55.15,58.05,1
unity,NDC,POVIDONE-IODINE 10 % EX OINT,6455,2500006,,,1 g,52380-0126-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,101.5,1
unity,NDC,POVIDONE-IODINE 10 % EX OINT,6455,2500006,,,28.35 g,00904-1102-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.5,% of charge rate,95.00%,96.43,,,,3.33,101.5,1
unity,NDC,POVIDONE-IODINE 10 % EX OINT,6455,2500006,,,28.35 g,00904-1102-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.5,% of charge rate,95.00%,96.43,,,,3.33,101.5,1
unity,NDC,POVIDONE-IODINE 10 % EX OINT,6455,2500006,,,1 g,52380-0126-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,101.5,1
unity,NDC,PROPARACAINE HCL 0.5 % OP SOLN,6644,2500006,,,15 mL,61314-0016-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.59,% of charge rate,95.00%,96.51,,,,96.51,101.59,1
unity,NDC,PROPARACAINE HCL 0.5 % OP SOLN,6644,2500006,,,15 mL,61314-0016-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,101.59,% of charge rate,95.00%,96.51,,,,96.51,101.59,1
unity,NDC,QUETIAPINE FUMARATE 50 MG PO TABS,70397,2500006,,,1 Tab,00904-6639-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,QUETIAPINE FUMARATE 50 MG PO TABS,70397,2500006,,,1 Tab,00904-6639-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LUBIPROSTONE 24 MCG PO CAPS,70472,2500006,,,1 Cap,64764-0240-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.2,% of charge rate,95.00%,22.99,,,,22.99,24.2,1
unity,NDC,LUBIPROSTONE 24 MCG PO CAPS,70472,2500006,,,1 Cap,64764-0240-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.2,% of charge rate,95.00%,22.99,,,,22.99,24.2,1
unity,NDC,FLUTICASONE PROPIONATE 50 MCG/ACT NA SUSP,70536,2500006,,,16 g,60505-0829-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.64,% of charge rate,95.00%,19.61,,,,19.61,20.64,1
unity,NDC,FLUTICASONE PROPIONATE 50 MCG/ACT NA SUSP,70536,2500006,,,16 g,60505-0829-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.64,% of charge rate,95.00%,19.61,,,,19.61,20.64,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,25 g,67877-0124-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.96,% of charge rate,95.00%,24.66,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,400 g,67877-0124-40,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,183.5,% of charge rate,95.00%,174.33,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,50 g,61570-0131-50,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.49,% of charge rate,95.00%,32.77,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,50 g,61570-0131-50,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.49,% of charge rate,95.00%,32.77,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,400 g,67877-0124-40,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,183.5,% of charge rate,95.00%,174.33,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,25 g,67877-0124-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.96,% of charge rate,95.00%,24.66,,,,24.66,183.5,1
unity,NDC,SODIUM BICARBONATE 4.2 % IV SOLN,7306,2500006,,,10 mL,00409-5534-34,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.41,% of charge rate,95.00%,83.04,,,,83.04,87.41,1
unity,NDC,SODIUM BICARBONATE 4.2 % IV SOLN,7306,2500006,,,10 mL,00409-5534-34,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.41,% of charge rate,95.00%,83.04,,,,83.04,87.41,1
unity,NDC,SODIUM BICARBONATE 8.4 % IV SOLN,7309,2500006,,,50 mL,76329-3352-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.85,% of charge rate,95.00%,47.36,,,,47.36,49.85,1
unity,NDC,SODIUM BICARBONATE 8.4 % IV SOLN,7309,2500006,,,50 mL,76329-3352-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.85,% of charge rate,95.00%,47.36,,,,47.36,49.85,1
unity,NDC,SODIUM CHLORIDE 3 % IV SOLN,7321,2500006,,,500 mL,63323-0530-75,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,77.25,% of charge rate,95.00%,73.39,,,,73.39,77.25,1
unity,NDC,SODIUM CHLORIDE 3 % IV SOLN,7321,2500006,,,500 mL,63323-0530-75,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,77.25,% of charge rate,95.00%,73.39,,,,73.39,77.25,1
unity,NDC,ATROPINE SULFATE 1 % OP SOLN,736,2500006,,,2 mL,17478-0215-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.79,% of charge rate,95.00%,167,,,,167,175.79,1
unity,NDC,ATROPINE SULFATE 1 % OP SOLN,736,2500006,,,2 mL,17478-0215-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,175.79,% of charge rate,95.00%,167,,,,167,175.79,1
unity,NDC,TETRACAINE HCL 0.5 % OP SOLN,7795,2500006,,,4 mL,00065-0741-14,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.01,% of charge rate,95.00%,38.96,,,,38.96,41.01,1
unity,NDC,TETRACAINE HCL 0.5 % OP SOLN,7795,2500006,,,4 mL,00065-0741-14,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,41.01,% of charge rate,95.00%,38.96,,,,38.96,41.01,1
unity,NDC,BUDESONIDE-FORMOTEROL FUMARATE 80-4.5 MCG/ACT IN AERO,81453,2500006,,,6.9 g,00186-0372-28,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,431.4,% of charge rate,95.00%,409.83,,,,409.83,431.4,1
unity,NDC,BUDESONIDE-FORMOTEROL FUMARATE 80-4.5 MCG/ACT IN AERO,81453,2500006,,,6.9 g,00186-0372-28,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,431.4,% of charge rate,95.00%,409.83,,,,409.83,431.4,1
unity,NDC,BUDESONIDE-FORMOTEROL FUMARATE 160-4.5 MCG/ACT IN AERO,81454,2500006,,,6 g,00186-0370-28,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,431.37,% of charge rate,95.00%,409.8,,,,409.8,431.37,1
unity,NDC,BUDESONIDE-FORMOTEROL FUMARATE 160-4.5 MCG/ACT IN AERO,81454,2500006,,,6 g,00186-0370-28,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,431.37,% of charge rate,95.00%,409.8,,,,409.8,431.37,1
unity,NDC,TROPICAMIDE 1 % OP SOLN,8250,2500006,,,15 mL,17478-0102-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,161.05,% of charge rate,95.00%,153,,,,153,161.05,1
unity,NDC,TROPICAMIDE 1 % OP SOLN,8250,2500006,,,15 mL,17478-0102-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,161.05,% of charge rate,95.00%,153,,,,153,161.05,1
unity,NDC,KERR INSTA-CHAR IN SORBITOL 50 GM/240ML PO LIQD,82604,2500006,,,240 mL,66689-0203-08,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,613.27,% of charge rate,95.00%,582.61,,,,582.61,613.27,1
unity,NDC,KERR INSTA-CHAR IN SORBITOL 50 GM/240ML PO LIQD,82604,2500006,,,240 mL,66689-0203-08,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,613.27,% of charge rate,95.00%,582.61,,,,582.61,613.27,1
unity,NDC,BACITRACIN 500 UNIT/GM EX OINT,850,2500006,,,28.4 g,00713-0280-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.28,% of charge rate,95.00%,19.27,,,,19.27,20.28,1
unity,NDC,BACITRACIN 500 UNIT/GM EX OINT,850,2500006,,,28.4 g,00713-0280-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.28,% of charge rate,95.00%,19.27,,,,19.27,20.28,1
unity,NDC,BACITRACIN-NEOMYCIN-POLYMYXIN 400-5-5000 EX OINT,854,2500006,,,1 g,47682-0223-35,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,49,1
unity,NDC,BACITRACIN-NEOMYCIN-POLYMYXIN 400-5-5000 EX OINT,854,2500006,,,14 g,45802-0143-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49,% of charge rate,95.00%,46.55,,,,3.33,49,1
unity,NDC,BACITRACIN-NEOMYCIN-POLYMYXIN 400-5-5000 EX OINT,854,2500006,,,14 g,45802-0143-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49,% of charge rate,95.00%,46.55,,,,3.33,49,1
unity,NDC,BACITRACIN-NEOMYCIN-POLYMYXIN 400-5-5000 EX OINT,854,2500006,,,1 g,47682-0223-35,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,49,1
unity,NDC,VITAMIN C 500 MG PO TABS,8680,2500006,,,1 Tab,00904-0523-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,VITAMIN C 500 MG PO TABS,8680,2500006,,,1 Tab,00904-0523-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FORMOTEROL FUMARATE 20 MCG/2ML IN NEBU,88225,2500006,,,2 mL,49502-0605-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.76,% of charge rate,95.00%,26.37,,,,26.37,27.76,1
unity,NDC,FORMOTEROL FUMARATE 20 MCG/2ML IN NEBU,88225,2500006,,,2 mL,49502-0605-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.76,% of charge rate,95.00%,26.37,,,,26.37,27.76,1
unity,NDC,ACETAZOLAMIDE ER 500 MG PO CP12,8962,2500006,,,1 Cap,50742-0233-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.87,% of charge rate,95.00%,16.03,,,,16.03,16.87,1
unity,NDC,ACETAZOLAMIDE ER 500 MG PO CP12,8962,2500006,,,1 Cap,50742-0233-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,16.87,% of charge rate,95.00%,16.03,,,,16.03,16.87,1
unity,NDC,ACETIC ACID 0.25 % IRR SOLN,8963,2500006,,,"1,000 mL",00338-0656-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.12,% of charge rate,95.00%,22.91,,,,22.91,24.12,1
unity,NDC,ACETIC ACID 0.25 % IRR SOLN,8963,2500006,,,"1,000 mL",00338-0656-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.12,% of charge rate,95.00%,22.91,,,,22.91,24.12,1
unity,NDC,APRACLONIDINE HCL 0.5 % OP SOLN,9119,2500006,,,5 mL,61314-0665-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.91,% of charge rate,95.00%,135.76,,,,135.76,142.91,1
unity,NDC,APRACLONIDINE HCL 0.5 % OP SOLN,9119,2500006,,,5 mL,61314-0665-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.91,% of charge rate,95.00%,135.76,,,,135.76,142.91,1
unity,NDC,LUBIPROSTONE 8 MCG PO CAPS,91534,2500006,,,1 Cap,64764-0080-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.2,% of charge rate,95.00%,22.99,,,,22.99,24.2,1
unity,NDC,LUBIPROSTONE 8 MCG PO CAPS,91534,2500006,,,1 Cap,64764-0080-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.2,% of charge rate,95.00%,22.99,,,,22.99,24.2,1
unity,NDC,METOPROLOL TARTRATE 5 MG/5ML IV SOLN,92079,2500006,,,5 mL,00409-1778-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,METOPROLOL TARTRATE 5 MG/5ML IV SOLN,92079,2500006,,,5 mL,00409-1778-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,METOPROLOL TARTRATE 5 MG/5ML IV SOLN,92079,2500006,,,5 mL,00409-1778-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,METOPROLOL TARTRATE 5 MG/5ML IV SOLN,92079,2500006,,,5 mL,00409-1778-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,1 mL,00641-6008-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,4 mL,00409-1412-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,4 mL,00641-6008-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,4 mL,00641-6008-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,4 mL,00409-1412-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,1 mL,00641-6008-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,BUTAMBEN-TETRACAINE-BENZOCAINE 2-2-14 % EX AERO,9328,2500006,,,5 g,10223-0201-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.73,% of charge rate,95.00%,135.59,,,,135.59,142.73,1
unity,NDC,BUTAMBEN-TETRACAINE-BENZOCAINE 2-2-14 % EX AERO,9328,2500006,,,5 g,10223-0201-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.73,% of charge rate,95.00%,135.59,,,,135.59,142.73,1
unity,NDC,NICARDIPINE HCL IN NACL 20-0.86 MG/200ML-% IV SOLN,94295,2500006,,,200 mL,10122-0313-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,187.94,% of charge rate,95.00%,178.54,,,,178.54,187.94,1
unity,NDC,NICARDIPINE HCL IN NACL 20-0.86 MG/200ML-% IV SOLN,94295,2500006,,,200 mL,10122-0313-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,187.94,% of charge rate,95.00%,178.54,,,,178.54,187.94,1
unity,NDC,NICARDIPINE HCL IN NACL 20-0.86 MG/200ML-% IV SOLN,94295,2500006,,,200 mL,10122-0313-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,187.94,% of charge rate,95.00%,178.54,,,,178.54,187.94,1
unity,NDC,NICARDIPINE HCL IN NACL 20-0.86 MG/200ML-% IV SOLN,94295,2500006,,,200 mL,10122-0313-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,187.94,% of charge rate,95.00%,178.54,,,,178.54,187.94,1
unity,NDC,FESOTERODINE FUMARATE ER 8 MG PO TB24,94538,2500006,,,1 Tab,00069-0244-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.23,% of charge rate,95.00%,44.87,,,,44.87,47.23,1
unity,NDC,FESOTERODINE FUMARATE ER 8 MG PO TB24,94538,2500006,,,1 Tab,00069-0244-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.23,% of charge rate,95.00%,44.87,,,,44.87,47.23,1
unity,NDC,ROCURONIUM BROMIDE 50 MG/5ML IV SOLN,94816,2500006,,,5 mL,00409-9558-49,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ROCURONIUM BROMIDE 50 MG/5ML IV SOLN,94816,2500006,,,5 mL,00409-9558-49,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 25 MG/5ML IV SOLN,95600,2500006,,,1 mL,17478-0937-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 25 MG/5ML IV SOLN,95600,2500006,,,1 mL,17478-0937-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,1 mL,70860-0301-42,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,10 mL,00641-6014-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,10 mL,00641-6014-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,10 mL,00641-6014-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,10 mL,00641-6014-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,1 mL,70860-0301-42,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PREDNISOLONE 15 MG/5ML PO SOLN,95828,2500006,,,240 mL,50383-0042-24,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.8,% of charge rate,95.00%,47.31,,,,47.31,49.8,1
unity,NDC,PREDNISOLONE 15 MG/5ML PO SOLN,95828,2500006,,,240 mL,50383-0042-24,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.8,% of charge rate,95.00%,47.31,,,,47.31,49.8,1
unity,NDC,BIOTENE ORALBALANCE DRY MOUTH MT GEL,96008,2500006,,,42 g,48582-0512-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.75,% of charge rate,95.00%,30.16,,,,30.16,31.75,1
unity,NDC,BIOTENE ORALBALANCE DRY MOUTH MT GEL,96008,2500006,,,42 g,48582-0512-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.75,% of charge rate,95.00%,30.16,,,,30.16,31.75,1
unity,NDC,CIPROFLOXACIN HCL 0.3 % OP SOLN,9610,2500006,,,5 mL,69315-0308-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.11,% of charge rate,95.00%,26.7,,,,26.7,28.11,1
unity,NDC,CIPROFLOXACIN HCL 0.3 % OP SOLN,9610,2500006,,,5 mL,69315-0308-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.11,% of charge rate,95.00%,26.7,,,,26.7,28.11,1
unity,NDC,CLOBETASOL PROPIONATE 0.05 % EX OINT,9631,2500006,,,30 g,51672-1259-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.88,% of charge rate,95.00%,57.84,,,,57.84,60.88,1
unity,NDC,CLOBETASOL PROPIONATE 0.05 % EX OINT,9631,2500006,,,30 g,51672-1259-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.88,% of charge rate,95.00%,57.84,,,,57.84,60.88,1
unity,NDC,CYCLOPENTOLATE HCL 2 % OP SOLN,9700,2500006,,,2 mL,17478-0097-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.02,% of charge rate,95.00%,71.27,,,,71.27,75.02,1
unity,NDC,CYCLOPENTOLATE HCL 2 % OP SOLN,9700,2500006,,,2 mL,17478-0097-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,75.02,% of charge rate,95.00%,71.27,,,,71.27,75.02,1
unity,NDC,ENALAPRILAT 1.25 MG/ML IV INJ,9929,2500006,,,1 mL,00143-9787-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.58,% of charge rate,95.00%,21.45,,,,21.45,22.58,1
unity,NDC,ENALAPRILAT 1.25 MG/ML IV INJ,9929,2500006,,,1 mL,00143-9787-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.58,% of charge rate,95.00%,21.45,,,,21.45,22.58,1
unity,NDC,ENALAPRILAT 1.25 MG/ML IV INJ,9929,2500006,,,1 mL,00143-9787-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.58,% of charge rate,95.00%,21.45,,,,21.45,22.58,1
unity,NDC,ENALAPRILAT 1.25 MG/ML IV INJ,9929,2500006,,,1 mL,00143-9787-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.58,% of charge rate,95.00%,21.45,,,,21.45,22.58,1
unity,NDC,NITROGLYCERIN IN D5W 100-5 MCG/ML-% IV SOLN,15858,2580001,,,250 mL,00338-1047-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.53,% of charge rate,95.00%,105.95,,,,105.95,111.53,1
unity,NDC,NITROGLYCERIN IN D5W 100-5 MCG/ML-% IV SOLN,15858,2580001,,,250 mL,00338-1047-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.53,% of charge rate,95.00%,105.95,,,,105.95,111.53,1
unity,NDC,KCL IN DEXTROSE-NACL 20-5-0.45 MEQ/L-%-% IV SOLN,9801,2580001,,,"1,000 mL",00338-0671-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,68.86,% of charge rate,95.00%,65.42,,,,65.42,68.86,1
unity,NDC,KCL IN DEXTROSE-NACL 20-5-0.45 MEQ/L-%-% IV SOLN,9801,2580001,,,"1,000 mL",00338-0671-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,68.86,% of charge rate,95.00%,65.42,,,,65.42,68.86,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,10 mL,00409-1966-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,30 mL,00409-1966-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,30 mL,00409-1966-07,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,30 mL,00409-1966-07,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,30 mL,00409-1966-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,10 mL,00409-1966-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,INSULIN ASPART PROT & ASPART (70-30) 100 UNIT/ML SC SUPN,127459,6360000,,,300 Units,00169-3696-19,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.68,% of charge rate,95.00%,89,,,,89,93.68,1
unity,NDC,INSULIN ASPART PROT & ASPART (70-30) 100 UNIT/ML SC SUPN,127459,6360000,,,300 Units,00169-3696-19,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.68,% of charge rate,95.00%,89,,,,89,93.68,1
unity,NDC,INSULIN GLARGINE (BASAGLAR) 100 UNIT/ML SC SOPN,4.08E+08,6360000,,,300 Units,00002-7715-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.26,% of charge rate,95.00%,63.9,,,,63.9,67.26,1
unity,NDC,INSULIN GLARGINE (BASAGLAR) 100 UNIT/ML SC SOPN,4.08E+08,6360000,,,300 Units,00002-7715-59,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.26,% of charge rate,95.00%,63.9,,,,63.9,67.26,1
unity,NDC,INSULIN GLARGINE (BASAGLAR) 100 UNIT/ML SC SOPN,4.08E+08,6360000,,,300 Units,00002-7715-59,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.26,% of charge rate,95.00%,63.9,,,,63.9,67.26,1
unity,NDC,INSULIN GLARGINE (BASAGLAR) 100 UNIT/ML SC SOPN,4.08E+08,6360000,,,300 Units,00002-7715-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.26,% of charge rate,95.00%,63.9,,,,63.9,67.26,1
unity,NDC,NALOXONE HCL 4 MG/0.1ML NA LIQD,134093,6360005,,,0.1 mL,69547-0353-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,162.36,% of charge rate,95.00%,154.24,,,,154.24,162.36,1
unity,NDC,NALOXONE HCL 4 MG/0.1ML NA LIQD,134093,6360005,,,0.1 mL,69547-0353-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,162.36,% of charge rate,95.00%,154.24,,,,154.24,162.36,1
unity,NDC,FAMOTIDINE 20 MG PO TABS,10011,6370005,,,1 Tab,63739-0645-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FAMOTIDINE 20 MG PO TABS,10011,6370005,,,1 Tab,63739-0645-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FINASTERIDE 5 MG PO TABS,10037,6370005,,,1 Tab,00904-6830-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FINASTERIDE 5 MG PO TABS,10037,6370005,,,1 Tab,00904-6830-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FLUCONAZOLE 100 MG PO TABS,10044,6370005,,,1 Tab,00904-6500-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.92,% of charge rate,95.00%,6.57,,,,6.57,6.92,1
unity,NDC,FLUCONAZOLE 100 MG PO TABS,10044,6370005,,,1 Tab,00904-6500-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.92,% of charge rate,95.00%,6.57,,,,6.57,6.92,1
unity,NDC,FLUDROCORTISONE ACETATE 0.1 MG PO TABS,10054,6370005,,,1 Tab,00115-7033-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.05,% of charge rate,95.00%,8.6,,,,8.6,9.05,1
unity,NDC,FLUDROCORTISONE ACETATE 0.1 MG PO TABS,10054,6370005,,,1 Tab,00115-7033-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.05,% of charge rate,95.00%,8.6,,,,8.6,9.05,1
unity,NDC,FLUORESCEIN-PROPARACAINE 0.25-0.5 % OP SOLN,10062,6370005,,,5 mL,59390-0205-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.48,% of charge rate,95.00%,80.26,,,,80.26,84.48,1
unity,NDC,FLUORESCEIN-PROPARACAINE 0.25-0.5 % OP SOLN,10062,6370005,,,5 mL,59390-0205-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,84.48,% of charge rate,95.00%,80.26,,,,80.26,84.48,1
unity,NDC,FLUOXETINE HCL 20 MG PO CAPS,10070,6370005,,,1 Cap,00904-5785-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FLUOXETINE HCL 20 MG PO CAPS,10070,6370005,,,1 Cap,00904-5785-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLIPIZIDE 5 MG PO TABS,10117,6370005,,,1 Tab,00904-6637-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLIPIZIDE 5 MG PO TABS,10117,6370005,,,1 Tab,00904-6637-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLYCOPYRROLATE 1 MG PO TABS,10130,6370005,,,1 Tab,60687-0458-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLYCOPYRROLATE 1 MG PO TABS,10130,6370005,,,1 Tab,60687-0458-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLYCOPYRROLATE 1 MG PO TABS,10130,6370005,,,1 Tab,60687-0458-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLYCOPYRROLATE 1 MG PO TABS,10130,6370005,,,1 Tab,60687-0458-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 500 MG PO TABS,102,6370005,,,1 Tab,50580-0412-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 500 MG PO TABS,102,6370005,,,1 Tab,50580-0412-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDROXYCHLOROQUINE SULFATE 200 MG PO TABS,10235,6370005,,,1 Tab,00378-0373-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.27,% of charge rate,95.00%,8.81,,,,8.81,9.27,1
unity,NDC,HYDROXYCHLOROQUINE SULFATE 200 MG PO TABS,10235,6370005,,,1 Tab,00378-0373-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.27,% of charge rate,95.00%,8.81,,,,8.81,9.27,1
unity,NDC,IBUPROFEN 100 MG/5ML PO SUSP,10246,6370005,,,30 mL,68094-0494-59,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.97,% of charge rate,95.00%,22.77,,,,22.77,23.97,1
unity,NDC,IBUPROFEN 100 MG/5ML PO SUSP,10246,6370005,,,30 mL,68094-0494-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.97,% of charge rate,95.00%,22.77,,,,22.77,23.97,1
unity,NDC,IBUPROFEN 100 MG/5ML PO SUSP,10246,6370005,,,30 mL,68094-0494-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.97,% of charge rate,95.00%,22.77,,,,22.77,23.97,1
unity,NDC,IBUPROFEN 100 MG/5ML PO SUSP,10246,6370005,,,30 mL,68094-0494-59,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.97,% of charge rate,95.00%,22.77,,,,22.77,23.97,1
unity,NDC,BETAMETHASONE DIPROPIONATE 0.05 % EX CREA,1027,6370005,,,15 g,00168-0055-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.49,% of charge rate,95.00%,85.02,,,,85.02,89.49,1
unity,NDC,BETAMETHASONE DIPROPIONATE 0.05 % EX CREA,1027,6370005,,,15 g,00168-0055-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.49,% of charge rate,95.00%,85.02,,,,85.02,89.49,1
unity,NDC,ACETAMINOPHEN 120 MG REC SUPP,103,6370005,,,1 Suppository,45802-0732-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 120 MG REC SUPP,103,6370005,,,1 Suppository,45802-0732-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 120 MG REC SUPP,103,6370005,,,1 Suppository,45802-0732-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 120 MG REC SUPP,103,6370005,,,1 Suppository,45802-0732-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,K PHOS MONO-SOD PHOS DI & MONO 155-852-130 MG PO TABS,10365,6370005,,,1 Tab,64980-0104-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,K PHOS MONO-SOD PHOS DI & MONO 155-852-130 MG PO TABS,10365,6370005,,,1 Tab,64980-0104-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,KETOCONAZOLE 2 % EX CREA,10368,6370005,,,15 g,51672-1298-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.84,% of charge rate,95.00%,27.4,,,,27.4,28.84,1
unity,NDC,KETOCONAZOLE 2 % EX CREA,10368,6370005,,,15 g,51672-1298-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.84,% of charge rate,95.00%,27.4,,,,27.4,28.84,1
unity,NDC,KETOROLAC TROMETHAMINE 10 MG PO TABS,10371,6370005,,,1 Tab,00093-0314-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.59,% of charge rate,95.00%,6.26,,,,6.26,6.59,1
unity,NDC,KETOROLAC TROMETHAMINE 10 MG PO TABS,10371,6370005,,,1 Tab,00093-0314-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.59,% of charge rate,95.00%,6.26,,,,6.26,6.59,1
unity,NDC,LABETALOL HCL 100 MG PO TABS,10373,6370005,,,1 Tab,00904-5928-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LABETALOL HCL 100 MG PO TABS,10373,6370005,,,1 Tab,00904-5928-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 325 MG REC SUPP,104,6370005,,,1 Suppository,51672-2116-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7,% of charge rate,95.00%,6.65,,,,6.65,7,1
unity,NDC,ACETAMINOPHEN 325 MG REC SUPP,104,6370005,,,1 Suppository,51672-2116-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7,% of charge rate,95.00%,6.65,,,,6.65,7,1
unity,NDC,LEVOTHYROXINE SODIUM 88 MCG PO TABS,10403,6370005,,,1 Tab,42292-0038-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.96,% of charge rate,95.00%,3.76,,,,3.76,3.96,1
unity,NDC,LEVOTHYROXINE SODIUM 88 MCG PO TABS,10403,6370005,,,1 Tab,42292-0038-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.96,% of charge rate,95.00%,3.76,,,,3.76,3.96,1
unity,NDC,LEVOTHYROXINE SODIUM 88 MCG PO TABS,10403,6370005,,,1 Tab,42292-0038-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.96,% of charge rate,95.00%,3.76,,,,3.76,3.96,1
unity,NDC,LEVOTHYROXINE SODIUM 88 MCG PO TABS,10403,6370005,,,1 Tab,42292-0038-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.96,% of charge rate,95.00%,3.76,,,,3.76,3.96,1
unity,NDC,LEVOTHYROXINE SODIUM 112 MCG PO TABS,10404,6370005,,,1 Tab,00904-6954-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.35,% of charge rate,95.00%,4.13,,,,4.13,4.35,1
unity,NDC,LEVOTHYROXINE SODIUM 112 MCG PO TABS,10404,6370005,,,1 Tab,00904-6954-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.35,% of charge rate,95.00%,4.13,,,,4.13,4.35,1
unity,NDC,LISINOPRIL 10 MG PO TABS,10449,6370005,,,1 Tab,60687-0325-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 10 MG PO TABS,10449,6370005,,,1 Tab,60687-0325-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 10 MG PO TABS,10449,6370005,,,1 Tab,60687-0325-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 10 MG PO TABS,10449,6370005,,,1 Tab,60687-0325-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DICLOFENAC SODIUM 1 % TD GEL,104494,6370005,,,100 g,65162-0833-66,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.03,% of charge rate,95.00%,74.13,,,,74.13,78.03,1
unity,NDC,DICLOFENAC SODIUM 1 % TD GEL,104494,6370005,,,100 g,65162-0833-66,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.03,% of charge rate,95.00%,74.13,,,,74.13,78.03,1
unity,NDC,LISINOPRIL 5 MG PO TABS,10451,6370005,,,1 Tab,00904-6797-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 5 MG PO TABS,10451,6370005,,,1 Tab,00904-6797-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 650 MG REC SUPP,105,6370005,,,1 Suppository,45802-0730-32,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 650 MG REC SUPP,105,6370005,,,1 Suppository,45802-0730-32,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL 500 MG PO TABS,10544,6370005,,,1 Tab,00904-6689-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL 500 MG PO TABS,10544,6370005,,,1 Tab,00904-6689-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOLAZONE 5 MG PO TABS,10588,6370005,,,1 Tab,00904-6915-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.08,% of charge rate,95.00%,14.33,,,,14.33,15.08,1
unity,NDC,METOLAZONE 5 MG PO TABS,10588,6370005,,,1 Tab,00904-6915-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.08,% of charge rate,95.00%,14.33,,,,14.33,15.08,1
unity,NDC,MIDODRINE HCL 5 MG PO TABS,10610,6370005,,,1 Tab,50268-0562-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.54,% of charge rate,95.00%,8.11,,,,8.11,8.54,1
unity,NDC,MIDODRINE HCL 5 MG PO TABS,10610,6370005,,,1 Tab,50268-0562-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.54,% of charge rate,95.00%,8.11,,,,8.11,8.54,1
unity,NDC,MIDODRINE HCL 5 MG PO TABS,10610,6370005,,,1 Tab,50268-0562-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.54,% of charge rate,95.00%,8.11,,,,8.11,8.54,1
unity,NDC,MIDODRINE HCL 5 MG PO TABS,10610,6370005,,,1 Tab,50268-0562-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.54,% of charge rate,95.00%,8.11,,,,8.11,8.54,1
unity,NDC,MISOPROSTOL 100 MCG PO TABS,10628,6370005,,,1 Tab,43386-0160-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.77,% of charge rate,95.00%,5.48,,,,5.48,5.77,1
unity,NDC,MISOPROSTOL 100 MCG PO TABS,10628,6370005,,,1 Tab,43386-0160-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.77,% of charge rate,95.00%,5.48,,,,5.48,5.77,1
unity,NDC,NITROFURANTOIN MONOHYD MACRO 100 MG PO CAPS,10724,6370005,,,1 Cap,47781-0303-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,NITROFURANTOIN MONOHYD MACRO 100 MG PO CAPS,10724,6370005,,,1 Cap,47781-0303-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FLORAJEN3 PO CAPS,107845,6370005,,,1 Cap,39423-0000-50,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.68,% of charge rate,95.00%,3.5,,,,3.5,3.68,1
unity,NDC,FLORAJEN3 PO CAPS,107845,6370005,,,1 Cap,39423-0000-50,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.68,% of charge rate,95.00%,3.5,,,,3.5,3.68,1
unity,NDC,BISACODYL 5 MG PO TBEC,1079,6370005,,,1 Tab,00904-6407-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,BISACODYL 5 MG PO TBEC,1079,6370005,,,1 Tab,00904-6407-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,BISACODYL 10 MG REC SUPP,1080,6370005,,,1 Suppository,00574-7050-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BISACODYL 10 MG REC SUPP,1080,6370005,,,1 Suppository,00574-7050-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OXYCODONE HCL 5 MG PO TABS,10814,6370005,,,1 Tab,00406-0552-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OXYCODONE HCL 5 MG PO TABS,10814,6370005,,,1 Tab,00406-0552-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FISH OIL 1000 MG PO CPDR,110727,6370005,,,1 Cap,77333-0308-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FISH OIL 1000 MG PO CPDR,110727,6370005,,,1 Cap,77333-0308-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FISH OIL 1000 MG PO CPDR,110727,6370005,,,1 Cap,77333-0308-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FISH OIL 1000 MG PO CPDR,110727,6370005,,,1 Cap,77333-0308-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PRAVASTATIN SODIUM 10 MG PO TABS,11110,6370005,,,1 Tab,00904-5891-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PRAVASTATIN SODIUM 10 MG PO TABS,11110,6370005,,,1 Tab,00904-5891-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PRAVASTATIN SODIUM 40 MG PO TABS,11112,6370005,,,1 Tab,00904-5893-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.8,% of charge rate,95.00%,4.56,,,,4.56,4.8,1
unity,NDC,PRAVASTATIN SODIUM 40 MG PO TABS,11112,6370005,,,1 Tab,00904-5893-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.8,% of charge rate,95.00%,4.56,,,,4.56,4.8,1
unity,NDC,PSYLLIUM 58.12 % PO PACK,111303,6370005,,,1 Packet,37000-0024-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.79,% of charge rate,95.00%,3.6,,,,3.6,3.79,1
unity,NDC,PSYLLIUM 58.12 % PO PACK,111303,6370005,,,1 Packet,37000-0024-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.79,% of charge rate,95.00%,3.6,,,,3.6,3.79,1
unity,NDC,PROMETHAZINE HCL 12.5 MG REC SUPP,11143,6370005,,,1 Suppository,00713-0536-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.85,% of charge rate,95.00%,34.06,,,,34.06,35.85,1
unity,NDC,PROMETHAZINE HCL 12.5 MG REC SUPP,11143,6370005,,,1 Suppository,00713-0536-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.85,% of charge rate,95.00%,34.06,,,,34.06,35.85,1
unity,NDC,PROMETHAZINE HCL 25 MG REC SUPP,11144,6370005,,,1 Suppository,00713-0526-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.09,% of charge rate,95.00%,23.84,,,,23.84,25.09,1
unity,NDC,PROMETHAZINE HCL 25 MG REC SUPP,11144,6370005,,,1 Suppository,00713-0526-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.09,% of charge rate,95.00%,23.84,,,,23.84,25.09,1
unity,NDC,RIVAROXABAN 10 MG PO TABS,112558,6370005,,,1 Tab,50458-0580-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.01,% of charge rate,95.00%,40.86,,,,40.86,43.01,1
unity,NDC,RIVAROXABAN 10 MG PO TABS,112558,6370005,,,1 Tab,50458-0580-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.01,% of charge rate,95.00%,40.86,,,,40.86,43.01,1
unity,NDC,SERTRALINE HCL 100 MG PO TABS,11350,6370005,,,1 Tab,60687-0253-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 100 MG PO TABS,11350,6370005,,,1 Tab,60687-0253-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 100 MG PO TABS,11350,6370005,,,1 Tab,60687-0253-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 100 MG PO TABS,11350,6370005,,,1 Tab,60687-0253-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 50 MG PO TABS,11351,6370005,,,1 Tab,60687-0242-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 50 MG PO TABS,11351,6370005,,,1 Tab,60687-0242-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 50 MG PO TABS,11351,6370005,,,1 Tab,60687-0242-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 50 MG PO TABS,11351,6370005,,,1 Tab,60687-0242-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 20 MG PO TABS,11365,6370005,,,1 Tab,63739-0572-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 20 MG PO TABS,11365,6370005,,,1 Tab,63739-0572-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 40 MG PO TABS,11366,6370005,,,1 Tab,60687-0210-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 40 MG PO TABS,11366,6370005,,,1 Tab,60687-0210-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 40 MG PO TABS,11366,6370005,,,1 Tab,60687-0210-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 40 MG PO TABS,11366,6370005,,,1 Tab,60687-0210-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FERROUS GLUCONATE 324 (37.5 FE) MG PO TABS,113993,6370005,,,1 Tab,00904-2137-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FERROUS GLUCONATE 324 (37.5 FE) MG PO TABS,113993,6370005,,,1 Tab,00904-2137-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SOTALOL HCL 80 MG PO TABS,11421,6370005,,,1 Tab,60505-0080-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SOTALOL HCL 80 MG PO TABS,11421,6370005,,,1 Tab,60505-0080-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SUCRALFATE 1 G PO TABS,11442,6370005,,,1 Tab,51079-0753-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SUCRALFATE 1 G PO TABS,11442,6370005,,,1 Tab,51079-0753-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SUCRALFATE 1 G PO TABS,11442,6370005,,,1 Tab,51079-0753-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SUCRALFATE 1 G PO TABS,11442,6370005,,,1 Tab,51079-0753-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TIMOLOL MALEATE 0.5 % OP SOLN,11562,6370005,,,10 mL,60758-0801-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.12,% of charge rate,95.00%,22.91,,,,17.36,24.12,1
unity,NDC,TIMOLOL MALEATE 0.5 % OP SOLN,11562,6370005,,,5 mL,60758-0801-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18.27,% of charge rate,95.00%,17.36,,,,17.36,24.12,1
unity,NDC,TIMOLOL MALEATE 0.5 % OP SOLN,11562,6370005,,,5 mL,60758-0801-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,18.27,% of charge rate,95.00%,17.36,,,,17.36,24.12,1
unity,NDC,TIMOLOL MALEATE 0.5 % OP SOLN,11562,6370005,,,10 mL,60758-0801-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.12,% of charge rate,95.00%,22.91,,,,17.36,24.12,1
unity,NDC,FIRST-OMEPRAZOLE 2 MG/ML PO SUSP,115805,6370005,,,10 mL,65628-0070-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.28,% of charge rate,95.00%,27.82,,,,27.82,29.28,1
unity,NDC,FIRST-OMEPRAZOLE 2 MG/ML PO SUSP,115805,6370005,,,10 mL,65628-0070-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.28,% of charge rate,95.00%,27.82,,,,27.82,29.28,1
unity,NDC,TRICHLOROACETIC ACID 80 % EX LIQD,11589,6370005,,,15 mL,10481-3008-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,153.37,% of charge rate,95.00%,145.7,,,,145.7,153.37,1
unity,NDC,TRICHLOROACETIC ACID 80 % EX LIQD,11589,6370005,,,15 mL,10481-3008-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,153.37,% of charge rate,95.00%,145.7,,,,145.7,153.37,1
unity,NDC,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG PO TABS,11599,6370005,,,1 Tab,00904-2725-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG PO TABS,11599,6370005,,,1 Tab,00904-2725-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 1 MG PO TABS,11664,6370005,,,1 Tab,00832-1211-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 1 MG PO TABS,11664,6370005,,,1 Tab,00832-1211-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ZOLPIDEM TARTRATE 5 MG PO TABS,11701,6370005,,,1 Tab,00904-6082-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ZOLPIDEM TARTRATE 5 MG PO TABS,11701,6370005,,,1 Tab,00904-6082-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MIRABEGRON ER 25 MG PO TB24,119992,6370005,,,1 Tab,00469-2601-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.98,% of charge rate,95.00%,49.38,,,,49.38,51.98,1
unity,NDC,MIRABEGRON ER 25 MG PO TB24,119992,6370005,,,1 Tab,00469-2601-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,51.98,% of charge rate,95.00%,49.38,,,,49.38,51.98,1
unity,NDC,MORPHINE SULFATE (CONCENTRATE) 100 MG/5ML PO SOLN,120211,6370005,,,1 mL,00054-0517-44,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MORPHINE SULFATE (CONCENTRATE) 100 MG/5ML PO SOLN,120211,6370005,,,1 mL,00054-0517-44,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MECLIZINE HCL 12.5 MG PO TABS,12024,6370005,,,1 Tab,50268-0522-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MECLIZINE HCL 12.5 MG PO TABS,12024,6370005,,,1 Tab,50268-0522-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MECLIZINE HCL 12.5 MG PO TABS,12024,6370005,,,1 Tab,50268-0522-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MECLIZINE HCL 12.5 MG PO TABS,12024,6370005,,,1 Tab,50268-0522-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MAGNESIUM OXIDE 400 (240 MG) MG PO TABS,120711,6370005,,,1 Tab,10006-0700-28,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MAGNESIUM OXIDE 400 (240 MG) MG PO TABS,120711,6370005,,,1 Tab,10006-0700-28,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FOLTANX 3-35-2 MG PO TABS,121637,6370005,,,1 Tab,51991-0813-90,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.25,% of charge rate,95.00%,6.89,,,,6.89,7.25,1
unity,NDC,FOLTANX 3-35-2 MG PO TABS,121637,6370005,,,1 Tab,51991-0813-90,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.25,% of charge rate,95.00%,6.89,,,,6.89,7.25,1
unity,NDC,APIXABAN 5 MG PO TABS,122294,6370005,,,1 Tab,00003-0894-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.52,% of charge rate,95.00%,22.34,,,,22.34,23.52,1
unity,NDC,APIXABAN 5 MG PO TABS,122294,6370005,,,1 Tab,00003-0894-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.52,% of charge rate,95.00%,22.34,,,,22.34,23.52,1
unity,NDC,MORPHINE SULFATE ER 15 MG PO TBCR,123107,6370005,,,1 Tab,42858-0801-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MORPHINE SULFATE ER 15 MG PO TBCR,123107,6370005,,,1 Tab,42858-0801-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,12556,6370005,,,5 mL,60687-0267-56,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.29,% of charge rate,95.00%,11.68,,,,11.68,12.29,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,12556,6370005,,,10 mL,60687-0267-42,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.29,% of charge rate,95.00%,11.68,,,,11.68,12.29,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,12556,6370005,,,10 mL,60687-0267-42,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.29,% of charge rate,95.00%,11.68,,,,11.68,12.29,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,12556,6370005,,,5 mL,60687-0267-56,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.29,% of charge rate,95.00%,11.68,,,,11.68,12.29,1
unity,NDC,OXYCODONE HCL ER 10 MG PO T12A,125737,6370005,,,1 Tab,59011-0410-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.43,% of charge rate,95.00%,24.16,,,,24.16,25.43,1
unity,NDC,OXYCODONE HCL ER 10 MG PO T12A,125737,6370005,,,1 Tab,59011-0410-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.43,% of charge rate,95.00%,24.16,,,,24.16,25.43,1
unity,NDC,OXYCODONE HCL ER 40 MG PO T12A,125742,6370005,,,1 Tab,59011-0440-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.73,% of charge rate,95.00%,51.99,,,,51.99,54.73,1
unity,NDC,OXYCODONE HCL ER 40 MG PO T12A,125742,6370005,,,1 Tab,59011-0440-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.73,% of charge rate,95.00%,51.99,,,,51.99,54.73,1
unity,NDC,DAPAGLIFLOZIN PROPANEDIOL 5 MG PO TABS,126943,6370005,,,1 Tab,00310-6205-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.43,% of charge rate,95.00%,69.76,,,,69.76,73.43,1
unity,NDC,DAPAGLIFLOZIN PROPANEDIOL 5 MG PO TABS,126943,6370005,,,1 Tab,00310-6205-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,73.43,% of charge rate,95.00%,69.76,,,,69.76,73.43,1
unity,NDC,TRIAMTERENE-HCTZ 37.5-25 MG PO CAPS,12729,6370005,,,1 Cap,00527-1632-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRIAMTERENE-HCTZ 37.5-25 MG PO CAPS,12729,6370005,,,1 Cap,00527-1632-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,EMPAGLIFLOZIN 10 MG PO TABS,129061,6370005,,,1 Tab,00597-0152-37,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.86,% of charge rate,95.00%,56.87,,,,56.87,59.86,1
unity,NDC,EMPAGLIFLOZIN 10 MG PO TABS,129061,6370005,,,1 Tab,00597-0152-37,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.86,% of charge rate,95.00%,56.87,,,,56.87,59.86,1
unity,NDC,VERAPAMIL HCL ER 240 MG PO TBCR,13073,6370005,,,1 Tab,68462-0260-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,VERAPAMIL HCL ER 240 MG PO TBCR,13073,6370005,,,1 Tab,68462-0260-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CARBAMIDE PEROXIDE 6.5 % OTIC SOLN,1359,6370005,,,15 mL,00904-6627-35,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.39,% of charge rate,95.00%,19.37,,,,19.37,20.39,1
unity,NDC,CARBAMIDE PEROXIDE 6.5 % OTIC SOLN,1359,6370005,,,15 mL,00904-6627-35,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.39,% of charge rate,95.00%,19.37,,,,19.37,20.39,1
unity,NDC,ASPIRIN EC 325 MG PO TBEC,13654,6370005,,,1 Tab,63739-0523-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ASPIRIN EC 325 MG PO TBEC,13654,6370005,,,1 Tab,63739-0523-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,COLESTIPOL HCL 1 G PO TABS,13884,6370005,,,1 Tab,00115-5211-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.97,% of charge rate,95.00%,5.67,,,,5.67,5.97,1
unity,NDC,COLESTIPOL HCL 1 G PO TABS,13884,6370005,,,1 Tab,00115-5211-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.97,% of charge rate,95.00%,5.67,,,,5.67,5.97,1
unity,NDC,ACETAMINOPHEN 325 MG/10.15ML PO SOLN,138925,6370005,,,5 mL,00121-1314-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.59,% of charge rate,95.00%,6.26,,,,6.26,6.59,1
unity,NDC,ACETAMINOPHEN 325 MG/10.15ML PO SOLN,138925,6370005,,,5 mL,00121-1314-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.59,% of charge rate,95.00%,6.26,,,,6.26,6.59,1
unity,NDC,VALPROATE SODIUM 250 MG/5ML PO SOLN,139174,6370005,,,5 mL,68094-0193-59,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,VALPROATE SODIUM 250 MG/5ML PO SOLN,139174,6370005,,,5 mL,68094-0193-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,VALPROATE SODIUM 250 MG/5ML PO SOLN,139174,6370005,,,5 mL,68094-0193-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,VALPROATE SODIUM 250 MG/5ML PO SOLN,139174,6370005,,,5 mL,68094-0193-59,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,LAMOTRIGINE 100 MG PO TABS,13982,6370005,,,1 Tab,68084-0319-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LAMOTRIGINE 100 MG PO TABS,13982,6370005,,,1 Tab,68084-0319-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BIOTENE DRY MOUTH MOISTURIZING MT SOLN,139825,6370005,,,45 mL,48582-0001-55,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.91,% of charge rate,95.00%,34.11,,,,34.11,35.91,1
unity,NDC,BIOTENE DRY MOUTH MOISTURIZING MT SOLN,139825,6370005,,,45 mL,48582-0001-55,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.91,% of charge rate,95.00%,34.11,,,,34.11,35.91,1
unity,NDC,CARBOXYMETHYLCELLULOSE SOD PF 1 % OP GEL,140766,6370005,,,150 Drop,00023-4554-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.62,% of charge rate,95.00%,31.94,,,,31.94,33.62,1
unity,NDC,CARBOXYMETHYLCELLULOSE SOD PF 1 % OP GEL,140766,6370005,,,150 Drop,00023-4554-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,33.62,% of charge rate,95.00%,31.94,,,,31.94,33.62,1
unity,NDC,ACETAMINOPHEN-CODEINE #3 300-30 MG PO TABS,14087,6370005,,,1 Tab,00406-0484-23,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN-CODEINE #3 300-30 MG PO TABS,14087,6370005,,,1 Tab,00406-0484-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN-CODEINE #3 300-30 MG PO TABS,14087,6370005,,,1 Tab,00406-0484-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN-CODEINE #3 300-30 MG PO TABS,14087,6370005,,,1 Tab,00406-0484-23,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,KETOCONAZOLE 2 % EX SHAM,14132,6370005,,,120 mL,45802-0465-64,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.5,% of charge rate,95.00%,37.53,,,,37.53,39.5,1
unity,NDC,KETOCONAZOLE 2 % EX SHAM,14132,6370005,,,120 mL,45802-0465-64,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,39.5,% of charge rate,95.00%,37.53,,,,37.53,39.5,1
unity,NDC,CLONIDINE 0.1 MG/24HR TD PTWK,143423,6370005,,,1 Patch,00591-3508-54,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137.79,% of charge rate,95.00%,130.9,,,,130.9,137.79,1
unity,NDC,CLONIDINE 0.1 MG/24HR TD PTWK,143423,6370005,,,1 Patch,00591-3508-54,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137.79,% of charge rate,95.00%,130.9,,,,130.9,137.79,1
unity,NDC,DORZOLAMIDE HCL 2 % OP SOLN,14471,6370005,,,10 mL,61314-0019-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.79,% of charge rate,95.00%,29.25,,,,29.25,30.79,1
unity,NDC,DORZOLAMIDE HCL 2 % OP SOLN,14471,6370005,,,10 mL,61314-0019-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.79,% of charge rate,95.00%,29.25,,,,29.25,30.79,1
unity,NDC,OYSTER SHELL CALCIUM/D 500-5 MG-MCG PO TABS,145180,6370005,,,1 Tab,51645-0828-99,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OYSTER SHELL CALCIUM/D 500-5 MG-MCG PO TABS,145180,6370005,,,1 Tab,51645-0828-99,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,INSULIN LISPRO (1 UNIT DIAL) 100 UNIT/ML SC SOPN,146248,6370005,,,300 Units,00002-8799-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.5,% of charge rate,95.00%,268.38,,,,268.38,282.5,1
unity,NDC,INSULIN LISPRO (1 UNIT DIAL) 100 UNIT/ML SC SOPN,146248,6370005,,,300 Units,00002-8799-59,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.5,% of charge rate,95.00%,268.38,,,,268.38,282.5,1
unity,NDC,INSULIN LISPRO (1 UNIT DIAL) 100 UNIT/ML SC SOPN,146248,6370005,,,300 Units,00002-8799-59,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.5,% of charge rate,95.00%,268.38,,,,268.38,282.5,1
unity,NDC,INSULIN LISPRO (1 UNIT DIAL) 100 UNIT/ML SC SOPN,146248,6370005,,,300 Units,00002-8799-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,282.5,% of charge rate,95.00%,268.38,,,,268.38,282.5,1
unity,NDC,VERAPAMIL HCL ER 180 MG PO TBCR,14626,6370005,,,1 Tab,68462-0293-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,VERAPAMIL HCL ER 180 MG PO TBCR,14626,6370005,,,1 Tab,68462-0293-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRAMADOL HCL 50 MG PO TABS,14632,6370005,,,1 Tab,51079-0991-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRAMADOL HCL 50 MG PO TABS,14632,6370005,,,1 Tab,51079-0991-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LOSARTAN POTASSIUM 50 MG PO TABS,14824,6370005,,,1 Tab,00904-7048-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LOSARTAN POTASSIUM 50 MG PO TABS,14824,6370005,,,1 Tab,00904-7048-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 25 MG PO TABS,15748,6370005,,,1 Tab,00904-6303-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 25 MG PO TABS,15748,6370005,,,1 Tab,00904-6303-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 12.5 MG PO TABS,15749,6370005,,,1 Tab,00904-6302-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.59,% of charge rate,95.00%,5.31,,,,5.31,5.59,1
unity,NDC,CARVEDILOL 12.5 MG PO TABS,15749,6370005,,,1 Tab,00904-6302-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.59,% of charge rate,95.00%,5.31,,,,5.31,5.59,1
unity,NDC,AZITHROMYCIN 100 MG/5ML PO SUSR,15796,6370005,,,15 mL,42806-0147-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.69,% of charge rate,95.00%,55.76,,,,55.76,58.69,1
unity,NDC,AZITHROMYCIN 100 MG/5ML PO SUSR,15796,6370005,,,15 mL,42806-0147-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.69,% of charge rate,95.00%,55.76,,,,55.76,58.69,1
unity,NDC,GLUCOSE 4 G PO CHEW,16050,6370005,,,1 Tab,00904-6710-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLUCOSE 4 G PO CHEW,16050,6370005,,,1 Tab,00904-6710-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DESMOPRESSIN ACETATE 0.2 MG PO TABS,16053,6370005,,,1 Tab,50268-0221-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.67,% of charge rate,95.00%,10.14,,,,10.14,10.67,1
unity,NDC,DESMOPRESSIN ACETATE 0.2 MG PO TABS,16053,6370005,,,1 Tab,50268-0221-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.67,% of charge rate,95.00%,10.14,,,,10.14,10.67,1
unity,NDC,DESMOPRESSIN ACETATE 0.2 MG PO TABS,16053,6370005,,,1 Tab,50268-0221-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.67,% of charge rate,95.00%,10.14,,,,10.14,10.67,1
unity,NDC,DESMOPRESSIN ACETATE 0.2 MG PO TABS,16053,6370005,,,1 Tab,50268-0221-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.67,% of charge rate,95.00%,10.14,,,,10.14,10.67,1
unity,NDC,CHLORDIAZEPOXIDE HCL 25 MG PO CAPS,1623,6370005,,,1 Cap,00555-0159-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CHLORDIAZEPOXIDE HCL 25 MG PO CAPS,1623,6370005,,,1 Cap,00555-0159-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLIMEPIRIDE 1 MG PO TABS,16355,6370005,,,2 Tab,16729-0001-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7,% of charge rate,95.00%,6.65,,,,6.65,7,1
unity,NDC,GLIMEPIRIDE 1 MG PO TABS,16355,6370005,,,2 Tab,16729-0001-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7,% of charge rate,95.00%,6.65,,,,6.65,7,1
unity,NDC,GLIMEPIRIDE 2 MG PO TABS,16356,6370005,,,1 Tab,50268-0359-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.96,% of charge rate,95.00%,3.76,,,,3.76,3.96,1
unity,NDC,GLIMEPIRIDE 2 MG PO TABS,16356,6370005,,,1 Tab,50268-0359-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.96,% of charge rate,95.00%,3.76,,,,3.76,3.96,1
unity,NDC,GLIMEPIRIDE 2 MG PO TABS,16356,6370005,,,1 Tab,50268-0359-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.96,% of charge rate,95.00%,3.76,,,,3.76,3.96,1
unity,NDC,GLIMEPIRIDE 2 MG PO TABS,16356,6370005,,,1 Tab,50268-0359-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.96,% of charge rate,95.00%,3.76,,,,3.76,3.96,1
unity,NDC,CHLORTHALIDONE 25 MG PO TABS,1661,6370005,,,1 Tab,64980-0303-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.66,% of charge rate,95.00%,9.18,,,,9.18,9.66,1
unity,NDC,CHLORTHALIDONE 25 MG PO TABS,1661,6370005,,,1 Tab,64980-0303-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.66,% of charge rate,95.00%,9.18,,,,9.18,9.66,1
unity,NDC,PAROXETINE HCL 10 MG PO TABS,16632,6370005,,,1 Tab,50268-0640-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PAROXETINE HCL 10 MG PO TABS,16632,6370005,,,1 Tab,50268-0640-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PAROXETINE HCL 40 MG PO TABS,16633,6370005,,,1 Tab,00378-7004-93,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.36,% of charge rate,95.00%,6.04,,,,6.04,6.36,1
unity,NDC,PAROXETINE HCL 40 MG PO TABS,16633,6370005,,,1 Tab,00378-7004-93,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.36,% of charge rate,95.00%,6.04,,,,6.04,6.36,1
unity,NDC,MELATONIN 3 MG PO TABS,16830,6370005,,,1 Tab,77333-0516-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MELATONIN 3 MG PO TABS,16830,6370005,,,1 Tab,77333-0516-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MELATONIN 3 MG PO TABS,16830,6370005,,,1 Tab,77333-0516-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MELATONIN 3 MG PO TABS,16830,6370005,,,1 Tab,77333-0516-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLINDAMYCIN HCL 150 MG PO CAPS,1740,6370005,,,1 Cap,00904-5959-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLINDAMYCIN HCL 150 MG PO CAPS,1740,6370005,,,1 Cap,00904-5959-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLONIDINE HCL 0.1 MG PO TABS,1755,6370005,,,1 Tab,29300-0135-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLONIDINE HCL 0.1 MG PO TABS,1755,6370005,,,1 Tab,29300-0135-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLOTRIMAZOLE 1 % EX CREA,1767,6370005,,,28.35 g,00904-7822-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.26,% of charge rate,95.00%,14.5,,,,14.5,15.26,1
unity,NDC,CLOTRIMAZOLE 1 % EX CREA,1767,6370005,,,28.35 g,00904-7822-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.26,% of charge rate,95.00%,14.5,,,,14.5,15.26,1
unity,NDC,GABAPENTIN 300 MG PO CAPS,18308,6370005,,,1 Cap,00904-6666-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 300 MG PO CAPS,18308,6370005,,,1 Cap,00904-6666-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 100 MG PO CAPS,18309,6370005,,,1 Cap,00904-6665-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 100 MG PO CAPS,18309,6370005,,,1 Cap,00904-6665-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,RISPERIDONE 1 MG PO TABS,18313,6370005,,,1 Tab,00904-6359-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,RISPERIDONE 1 MG PO TABS,18313,6370005,,,1 Tab,00904-6359-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 3.125 MG PO TABS,18551,6370005,,,1 Tab,00904-6300-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 3.125 MG PO TABS,18551,6370005,,,1 Tab,00904-6300-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LATANOPROST 0.005 % OP SOLN,18621,6370005,,,2.5 mL,61314-0547-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.3,% of charge rate,95.00%,28.79,,,,28.79,30.3,1
unity,NDC,LATANOPROST 0.005 % OP SOLN,18621,6370005,,,2.5 mL,61314-0547-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.3,% of charge rate,95.00%,28.79,,,,28.79,30.3,1
unity,NDC,DONEPEZIL HCL 10 MG PO TABS,18787,6370005,,,1 Tab,00904-6478-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DONEPEZIL HCL 10 MG PO TABS,18787,6370005,,,1 Tab,00904-6478-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LEVOFLOXACIN 500 MG PO TABS,18919,6370005,,,1 Tab,00904-6352-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LEVOFLOXACIN 500 MG PO TABS,18919,6370005,,,1 Tab,00904-6352-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ATORVASTATIN CALCIUM 10 MG PO TABS,19176,6370005,,,1 Tab,00904-6290-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ATORVASTATIN CALCIUM 10 MG PO TABS,19176,6370005,,,1 Tab,00904-6290-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ATORVASTATIN CALCIUM 40 MG PO TABS,19177,6370005,,,1 Tab,00904-6292-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ATORVASTATIN CALCIUM 40 MG PO TABS,19177,6370005,,,1 Tab,00904-6292-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DICLOFENAC SODIUM 0.1 % OP SOLN,19714,6370005,,,5 mL,17478-0892-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,74.79,% of charge rate,95.00%,71.05,,,,71.05,74.79,1
unity,NDC,DICLOFENAC SODIUM 0.1 % OP SOLN,19714,6370005,,,5 mL,17478-0892-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,74.79,% of charge rate,95.00%,71.05,,,,71.05,74.79,1
unity,NDC,KETOROLAC TROMETHAMINE 0.5 % OP SOLN,19733,6370005,,,5 mL,60505-1003-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.39,% of charge rate,95.00%,24.12,,,,24.12,25.39,1
unity,NDC,KETOROLAC TROMETHAMINE 0.5 % OP SOLN,19733,6370005,,,5 mL,60505-1003-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.39,% of charge rate,95.00%,24.12,,,,24.12,25.39,1
unity,NDC,CYCLOBENZAPRINE HCL 10 MG PO TABS,2017,6370005,,,1 Tab,63739-0531-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CYCLOBENZAPRINE HCL 10 MG PO TABS,2017,6370005,,,1 Tab,63739-0531-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACTIDOSE WITH SORBITOL 50 GM/240ML PO LIQD,20589,6370005,,,240 mL,00574-0120-76,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,613.27,% of charge rate,95.00%,582.61,,,,582.61,613.27,1
unity,NDC,ACTIDOSE WITH SORBITOL 50 GM/240ML PO LIQD,20589,6370005,,,240 mL,00574-0120-76,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,613.27,% of charge rate,95.00%,582.61,,,,582.61,613.27,1
unity,NDC,AZITHROMYCIN 250 MG PO TABS,20943,6370005,,,1 Tab,00904-6708-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.57,% of charge rate,95.00%,8.14,,,,8.14,8.57,1
unity,NDC,AZITHROMYCIN 250 MG PO TABS,20943,6370005,,,1 Tab,00904-6708-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.57,% of charge rate,95.00%,8.14,,,,8.14,8.57,1
unity,NDC,CITALOPRAM HYDROBROMIDE 20 MG PO TABS,21062,6370005,,,1 Tab,00904-6085-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CITALOPRAM HYDROBROMIDE 20 MG PO TABS,21062,6370005,,,1 Tab,00904-6085-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FEXOFENADINE HCL 60 MG PO TABS,21529,6370005,,,1 Tab,45802-0425-78,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FEXOFENADINE HCL 60 MG PO TABS,21529,6370005,,,1 Tab,45802-0425-78,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ROPINIROLE HCL 1 MG PO TABS,21689,6370005,,,1 Tab,00904-6374-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,ROPINIROLE HCL 1 MG PO TABS,21689,6370005,,,1 Tab,00904-6374-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,QUETIAPINE FUMARATE 25 MG PO TABS,21823,6370005,,,1 Tab,00904-6638-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.46,% of charge rate,95.00%,4.24,,,,4.24,4.46,1
unity,NDC,QUETIAPINE FUMARATE 25 MG PO TABS,21823,6370005,,,1 Tab,00904-6638-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.46,% of charge rate,95.00%,4.24,,,,4.24,4.46,1
unity,NDC,IRBESARTAN 75 MG PO TABS,21847,6370005,,,1 Tab,33342-0047-07,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IRBESARTAN 75 MG PO TABS,21847,6370005,,,1 Tab,33342-0047-07,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLOPIDOGREL BISULFATE 75 MG PO TABS,22142,6370005,,,1 Tab,00904-6294-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLOPIDOGREL BISULFATE 75 MG PO TABS,22142,6370005,,,1 Tab,00904-6294-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,RALOXIFENE HCL 60 MG PO TABS,22143,6370005,,,1 Tab,69097-0825-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,RALOXIFENE HCL 60 MG PO TABS,22143,6370005,,,1 Tab,69097-0825-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CEFDINIR 300 MG PO CAPS,22289,6370005,,,1 Cap,57237-0099-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.41,% of charge rate,95.00%,5.14,,,,5.14,5.41,1
unity,NDC,CEFDINIR 300 MG PO CAPS,22289,6370005,,,1 Cap,57237-0099-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.41,% of charge rate,95.00%,5.14,,,,5.14,5.41,1
unity,NDC,MONTELUKAST SODIUM 10 MG PO TABS,22509,6370005,,,1 Tab,00904-6808-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MONTELUKAST SODIUM 10 MG PO TABS,22509,6370005,,,1 Tab,00904-6808-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LOSARTAN POTASSIUM 100 MG PO TABS,22588,6370005,,,1 Tab,63739-0698-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LOSARTAN POTASSIUM 100 MG PO TABS,22588,6370005,,,1 Tab,63739-0698-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PRAMIPEXOLE DIHYDROCHLORIDE 0.5 MG PO TABS,22719,6370005,,,1 Tab,57237-0182-90,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.37,% of charge rate,95.00%,5.1,,,,5.1,5.37,1
unity,NDC,PRAMIPEXOLE DIHYDROCHLORIDE 0.5 MG PO TABS,22719,6370005,,,1 Tab,57237-0182-90,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.37,% of charge rate,95.00%,5.1,,,,5.1,5.37,1
unity,NDC,DORZOLAMIDE HCL-TIMOLOL MAL 22.3-6.8 MG/ML OP SOLN,22982,6370005,,,10 mL,70069-0051-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.58,% of charge rate,95.00%,106,,,,106,111.58,1
unity,NDC,DORZOLAMIDE HCL-TIMOLOL MAL 22.3-6.8 MG/ML OP SOLN,22982,6370005,,,10 mL,70069-0051-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,111.58,% of charge rate,95.00%,106,,,,106,111.58,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP SOLN,2335,6370005,,,5 mL,24208-0720-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,0,% of charge rate,95.00%,0,,,,,,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP SOLN,2335,6370005,,,5 mL,24208-0720-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,0,% of charge rate,95.00%,0,,,,,,1
unity,NDC,DIAZEPAM 5 MG PO TABS,2405,6370005,,,1 Tab,00172-3926-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DIAZEPAM 5 MG PO TABS,2405,6370005,,,1 Tab,00172-3926-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,24216,6370005,,,1 Tab,96295-0138-81,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,24216,6370005,,,1 Tab,63739-0432-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,24216,6370005,,,1 Tab,63739-0432-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,24216,6370005,,,1 Tab,96295-0138-81,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL 1000 MG PO TABS,24398,6370005,,,1 Tab,00904-6691-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL 1000 MG PO TABS,24398,6370005,,,1 Tab,00904-6691-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DIGOXIN 250 MCG PO TABS,2445,6370005,,,1 Tab,00904-5922-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.67,% of charge rate,95.00%,6.34,,,,6.34,6.67,1
unity,NDC,DIGOXIN 250 MCG PO TABS,2445,6370005,,,1 Tab,00904-5922-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.67,% of charge rate,95.00%,6.34,,,,6.34,6.67,1
unity,NDC,CELECOXIB 100 MG PO CAPS,24500,6370005,,,1 Cap,00904-6502-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.36,% of charge rate,95.00%,5.09,,,,5.09,5.36,1
unity,NDC,CELECOXIB 100 MG PO CAPS,24500,6370005,,,1 Cap,00904-6502-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.36,% of charge rate,95.00%,5.09,,,,5.09,5.36,1
unity,NDC,ISOSORBIDE MONONITRATE ER 30 MG PO TB24,24521,6370005,,,1 Tab,00904-6449-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ISOSORBIDE MONONITRATE ER 30 MG PO TB24,24521,6370005,,,1 Tab,00904-6449-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRIPLE ANTIBIOTIC 3.5-400-5000 EX OINT,24696,6370005,,,1 Each,45802-0143-70,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRIPLE ANTIBIOTIC 3.5-400-5000 EX OINT,24696,6370005,,,1 Each,45802-0143-70,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OXYBUTYNIN CHLORIDE ER 15 MG PO TB24,24723,6370005,,,1 Tab,27241-0157-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OXYBUTYNIN CHLORIDE ER 15 MG PO TB24,24723,6370005,,,1 Tab,27241-0157-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL 60 MG PO TABS,2476,6370005,,,1 Tab,00093-0319-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL 60 MG PO TABS,2476,6370005,,,1 Tab,00093-0319-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO ELIX,2511,6370005,,,10 mL,00121-0978-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.34,% of charge rate,95.00%,10.77,,,,10.77,11.34,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO ELIX,2511,6370005,,,10 mL,00121-0978-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.34,% of charge rate,95.00%,10.77,,,,10.77,11.34,1
unity,NDC,CIPROFLOXACIN HCL 500 MG PO TABS,25119,6370005,,,1 Tab,68084-0070-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CIPROFLOXACIN HCL 500 MG PO TABS,25119,6370005,,,1 Tab,68084-0070-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,2516,6370005,,,1 Tab,59762-1061-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,2516,6370005,,,1 Tab,59762-1061-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 400 MG/5ML PO SUSR,25246,6370005,,,100 mL,00093-4161-73,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.92,% of charge rate,95.00%,14.17,,,,14.17,14.92,1
unity,NDC,AMOXICILLIN 400 MG/5ML PO SUSR,25246,6370005,,,100 mL,00093-4161-73,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,14.92,% of charge rate,95.00%,14.17,,,,14.17,14.92,1
unity,NDC,POLYETHYLENE GLYCOL 3350 17 G PO PACK,25424,6370005,,,1 Each,00904-6422-81,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.55,% of charge rate,95.00%,9.07,,,,9.07,9.55,1
unity,NDC,POLYETHYLENE GLYCOL 3350 17 G PO PACK,25424,6370005,,,1 Each,00904-6422-81,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.55,% of charge rate,95.00%,9.07,,,,9.07,9.55,1
unity,NDC,RISPERIDONE 0.5 MG PO TABS,25520,6370005,,,1 Tab,00904-6358-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,RISPERIDONE 0.5 MG PO TABS,25520,6370005,,,1 Tab,00904-6358-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DOCUSATE SODIUM 100 MG PO CAPS,2566,6370005,,,1 Cap,00904-6455-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DOCUSATE SODIUM 100 MG PO CAPS,2566,6370005,,,1 Cap,00904-6455-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 600 MG PO TABS,25855,6370005,,,1 Tab,00904-6823-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 600 MG PO TABS,25855,6370005,,,1 Tab,00904-6823-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 20 MG PO TBEC,26224,6370005,,,1 Tab,50268-0636-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 20 MG PO TBEC,26224,6370005,,,1 Tab,50268-0636-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 20 MG PO TBEC,26224,6370005,,,1 Tab,50268-0636-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 20 MG PO TBEC,26224,6370005,,,1 Tab,50268-0636-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG PO TBEC,26225,6370005,,,1 Tab,00904-6474-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG PO TBEC,26225,6370005,,,1 Tab,00904-6474-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG PO CAPS,2623,6370005,,,1 Cap,00904-0428-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.38,% of charge rate,95.00%,7.96,,,,7.96,8.38,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG PO CAPS,2623,6370005,,,1 Cap,00904-0428-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.38,% of charge rate,95.00%,7.96,,,,7.96,8.38,1
unity,NDC,OSELTAMIVIR PHOSPHATE 75 MG PO CAPS,26546,6370005,,,1 Cap,68180-0677-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.7,% of charge rate,95.00%,31.07,,,,31.07,32.7,1
unity,NDC,OSELTAMIVIR PHOSPHATE 75 MG PO CAPS,26546,6370005,,,1 Cap,68180-0677-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.7,% of charge rate,95.00%,31.07,,,,31.07,32.7,1
unity,NDC,LEVETIRACETAM 500 MG PO TABS,26817,6370005,,,1 Tab,00904-6052-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LEVETIRACETAM 500 MG PO TABS,26817,6370005,,,1 Tab,00904-6052-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TROLAMINE SALICYLATE 10 % EX CREA,27680,6370005,,,85 g,41167-0057-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.63,% of charge rate,95.00%,26.25,,,,26.25,27.63,1
unity,NDC,TROLAMINE SALICYLATE 10 % EX CREA,27680,6370005,,,85 g,41167-0057-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.63,% of charge rate,95.00%,26.25,,,,26.25,27.63,1
unity,NDC,OMEPRAZOLE 20 MG PO CPDR,27694,6370005,,,1 Cap,68084-0128-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OMEPRAZOLE 20 MG PO CPDR,27694,6370005,,,1 Cap,68084-0128-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OMEPRAZOLE 20 MG PO CPDR,27694,6370005,,,1 Cap,68084-0128-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OMEPRAZOLE 20 MG PO CPDR,27694,6370005,,,1 Cap,68084-0128-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ONDANSETRON 4 MG PO TBDP,27697,6370005,,,1 Tab,68462-0157-13,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ONDANSETRON 4 MG PO TBDP,27697,6370005,,,1 Tab,68462-0157-40,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ONDANSETRON 4 MG PO TBDP,27697,6370005,,,1 Tab,68462-0157-40,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ONDANSETRON 4 MG PO TBDP,27697,6370005,,,1 Tab,68462-0157-13,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,NICOTINE 7 MG/24HR TD PT24,27860,6370005,,,1 Patch,00536-5894-88,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.55,% of charge rate,95.00%,9.07,,,,9.07,9.55,1
unity,NDC,NICOTINE 7 MG/24HR TD PT24,27860,6370005,,,1 Patch,00536-5894-88,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.55,% of charge rate,95.00%,9.07,,,,9.07,9.55,1
unity,NDC,NICOTINE 14 MG/24HR TD PT24,27862,6370005,,,1 Patch,70000-0511-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.94,% of charge rate,95.00%,9.44,,,,9.44,9.94,1
unity,NDC,NICOTINE 14 MG/24HR TD PT24,27862,6370005,,,1 Patch,70000-0511-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.94,% of charge rate,95.00%,9.44,,,,9.44,9.94,1
unity,NDC,NICOTINE 21 MG/24HR TD PT24,27863,6370005,,,1 Patch,00536-5896-88,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.44,% of charge rate,95.00%,8.97,,,,8.97,9.44,1
unity,NDC,NICOTINE 21 MG/24HR TD PT24,27863,6370005,,,1 Patch,00536-5896-88,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.44,% of charge rate,95.00%,8.97,,,,8.97,9.44,1
unity,NDC,FENTANYL 25 MCG/HR TD PT72,27905,6370005,,,1 Patch,60505-7081-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.11,% of charge rate,95.00%,18.15,,,,18.15,19.11,1
unity,NDC,FENTANYL 25 MCG/HR TD PT72,27905,6370005,,,1 Patch,60505-7081-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,19.11,% of charge rate,95.00%,18.15,,,,18.15,19.11,1
unity,NDC,FENTANYL 50 MCG/HR TD PT72,27906,6370005,,,1 Patch,60505-7007-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.95,% of charge rate,95.00%,26.55,,,,26.55,27.95,1
unity,NDC,FENTANYL 50 MCG/HR TD PT72,27906,6370005,,,1 Patch,60505-7007-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,27.95,% of charge rate,95.00%,26.55,,,,26.55,27.95,1
unity,NDC,SODIUM POLYSTYRENE SULFONATE 15 GM/60ML PO SUSP,27999,6370005,,,60 mL,46287-0006-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.42,% of charge rate,95.00%,40.3,,,,40.3,42.42,1
unity,NDC,SODIUM POLYSTYRENE SULFONATE 15 GM/60ML PO SUSP,27999,6370005,,,60 mL,46287-0006-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.42,% of charge rate,95.00%,40.3,,,,40.3,42.42,1
unity,NDC,OLANZAPINE 5 MG PO TBDP,28159,6370005,,,1 Tab,33342-0083-07,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.52,% of charge rate,95.00%,4.29,,,,4.29,4.52,1
unity,NDC,OLANZAPINE 5 MG PO TBDP,28159,6370005,,,1 Tab,33342-0083-07,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.52,% of charge rate,95.00%,4.29,,,,4.29,4.52,1
unity,NDC,LIDOCAINE 5 % EX PTCH,28203,6370005,,,1 Patch,00591-2679-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.25,% of charge rate,95.00%,14.49,,,,14.49,15.25,1
unity,NDC,LIDOCAINE 5 % EX PTCH,28203,6370005,,,1 Patch,00591-2679-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,15.25,% of charge rate,95.00%,14.49,,,,14.49,15.25,1
unity,NDC,LINEZOLID 600 MG PO TABS,28224,6370005,,,1 Tab,67877-0419-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.72,% of charge rate,95.00%,10.18,,,,10.18,10.72,1
unity,NDC,LINEZOLID 600 MG PO TABS,28224,6370005,,,1 Tab,67877-0419-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,10.72,% of charge rate,95.00%,10.18,,,,10.18,10.72,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,28384,6370005,,,1 Tab,00406-0125-23,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.41,% of charge rate,95.00%,4.19,,,,4.19,4.41,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,28384,6370005,,,1 Tab,00406-0125-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.41,% of charge rate,95.00%,4.19,,,,4.19,4.41,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,28384,6370005,,,1 Tab,00406-0125-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.41,% of charge rate,95.00%,4.19,,,,4.19,4.41,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,28384,6370005,,,1 Tab,00406-0125-23,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.41,% of charge rate,95.00%,4.19,,,,4.19,4.41,1
unity,NDC,NIFEDIPINE ER OSMOTIC RELEASE 30 MG PO TB24,28643,6370005,,,1 Tab,50742-0260-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,NIFEDIPINE ER OSMOTIC RELEASE 30 MG PO TB24,28643,6370005,,,1 Tab,50742-0260-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,NEOMYCIN-POLYMYXIN-HC 3.5-10000-1 OTIC SUSP,28810,6370005,,,10 mL,24208-0635-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,139.61,% of charge rate,95.00%,132.63,,,,132.63,139.61,1
unity,NDC,NEOMYCIN-POLYMYXIN-HC 3.5-10000-1 OTIC SUSP,28810,6370005,,,10 mL,24208-0635-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,139.61,% of charge rate,95.00%,132.63,,,,132.63,139.61,1
unity,NDC,MAGNESIUM HYDROXIDE 400 MG/5ML PO SUSP,28836,6370005,,,30 mL,00904-6846-73,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.89,% of charge rate,95.00%,9.4,,,,9.4,9.89,1
unity,NDC,MAGNESIUM HYDROXIDE 400 MG/5ML PO SUSP,28836,6370005,,,30 mL,00904-6846-73,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.89,% of charge rate,95.00%,9.4,,,,9.4,9.89,1
unity,NDC,ERYTHROMYCIN 5 MG/GM OP OINT,2888,6370005,,,3.5 g,24208-0910-55,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.95,% of charge rate,95.00%,34.15,,,,34.15,35.95,1
unity,NDC,ERYTHROMYCIN 5 MG/GM OP OINT,2888,6370005,,,3.5 g,24208-0910-55,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,35.95,% of charge rate,95.00%,34.15,,,,34.15,35.95,1
unity,NDC,OXYCODONE HCL 15 MG PO TABS,28899,6370005,,,1 Tab,57664-0187-88,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,OXYCODONE HCL 15 MG PO TABS,28899,6370005,,,1 Tab,57664-0187-88,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,METFORMIN HCL ER 500 MG PO TB24,28995,6370005,,,1 Tab,62756-0142-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL ER 500 MG PO TB24,28995,6370005,,,1 Tab,62756-0142-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ALENDRONATE SODIUM 70 MG PO TABS,29048,6370005,,,1 Tab,69097-0224-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ALENDRONATE SODIUM 70 MG PO TABS,29048,6370005,,,1 Tab,69097-0224-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 120 MG PO CP24,29270,6370005,,,1 Cap,63739-0014-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 120 MG PO CP24,29270,6370005,,,1 Cap,63739-0014-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,29272,6370005,,,1 Cap,60687-0206-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,29272,6370005,,,1 Cap,60687-0206-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,29272,6370005,,,1 Cap,60687-0206-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,29272,6370005,,,1 Cap,60687-0206-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 240 MG PO CP24,29274,6370005,,,1 Cap,60687-0217-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.58,% of charge rate,95.00%,4.35,,,,4.35,4.58,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 240 MG PO CP24,29274,6370005,,,1 Cap,60687-0217-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.58,% of charge rate,95.00%,4.35,,,,4.35,4.58,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 240 MG PO CP24,29274,6370005,,,1 Cap,60687-0217-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.58,% of charge rate,95.00%,4.35,,,,4.35,4.58,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 240 MG PO CP24,29274,6370005,,,1 Cap,60687-0217-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.58,% of charge rate,95.00%,4.35,,,,4.35,4.58,1
unity,NDC,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % EX CREA,29424,6370005,,,15 g,68462-0298-17,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,128.74,% of charge rate,95.00%,122.3,,,,122.3,128.74,1
unity,NDC,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % EX CREA,29424,6370005,,,15 g,68462-0298-17,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,128.74,% of charge rate,95.00%,122.3,,,,122.3,128.74,1
unity,NDC,METOPROLOL SUCCINATE ER 25 MG PO TB24,29858,6370005,,,1 Tab,00904-6322-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL SUCCINATE ER 25 MG PO TB24,29858,6370005,,,1 Tab,00904-6322-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL SUCCINATE ER 50 MG PO TB24,30070,6370005,,,1 Tab,00904-6323-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.57,% of charge rate,95.00%,3.39,,,,3.39,3.57,1
unity,NDC,METOPROLOL SUCCINATE ER 50 MG PO TB24,30070,6370005,,,1 Tab,00904-6323-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.57,% of charge rate,95.00%,3.39,,,,3.39,3.57,1
unity,NDC,CITALOPRAM HYDROBROMIDE 10 MG PO TABS,30264,6370005,,,1 Tab,00904-6084-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,CITALOPRAM HYDROBROMIDE 10 MG PO TABS,30264,6370005,,,1 Tab,00904-6084-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,FERROUS SULFATE 220 (44 FE) MG/5ML PO ELIX,3069,6370005,,,5 mL,50383-0778-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FERROUS SULFATE 220 (44 FE) MG/5ML PO ELIX,3069,6370005,,,5 mL,50383-0778-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FERROUS SULFATE 325 (65 FE) MG PO TABS,3074,6370005,,,1 Tab,00904-7591-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FERROUS SULFATE 325 (65 FE) MG PO TABS,3074,6370005,,,1 Tab,00904-7591-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ALLOPURINOL 100 MG PO TABS,310,6370005,,,1 Tab,00904-6571-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ALLOPURINOL 100 MG PO TABS,310,6370005,,,1 Tab,00904-6571-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ALLOPURINOL 300 MG PO TABS,311,6370005,,,1 Tab,00904-6572-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.85,% of charge rate,95.00%,3.66,,,,3.66,3.85,1
unity,NDC,ALLOPURINOL 300 MG PO TABS,311,6370005,,,1 Tab,00904-6572-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.85,% of charge rate,95.00%,3.66,,,,3.66,3.85,1
unity,NDC,FLEET PEDIATRIC 3.5-9.5 GM/59ML REC ENEM,3128,6370005,,,1 Enema,00132-0202-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.88,% of charge rate,95.00%,8.44,,,,8.44,8.88,1
unity,NDC,FLEET PEDIATRIC 3.5-9.5 GM/59ML REC ENEM,3128,6370005,,,1 Enema,00132-0202-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.88,% of charge rate,95.00%,8.44,,,,8.44,8.88,1
unity,NDC,FOLIC ACID 1 MG PO TABS,3233,6370005,,,1 Tab,65162-0361-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FOLIC ACID 1 MG PO TABS,3233,6370005,,,1 Tab,65162-0361-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OLMESARTAN MEDOXOMIL 20 MG PO TABS,32762,6370005,,,1 Tab,68462-0437-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OLMESARTAN MEDOXOMIL 20 MG PO TABS,32762,6370005,,,1 Tab,68462-0437-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 20 MG PO TABS,3294,6370005,,,1 Tab,51079-0072-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 20 MG PO TABS,3294,6370005,,,1 Tab,51079-0072-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 20 MG PO TABS,3294,6370005,,,1 Tab,51079-0072-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 20 MG PO TABS,3294,6370005,,,1 Tab,51079-0072-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 40 MG PO TABS,3295,6370005,,,1 Tab,51079-0073-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 40 MG PO TABS,3295,6370005,,,1 Tab,51079-0073-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 40 MG PO TABS,3295,6370005,,,1 Tab,51079-0073-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 40 MG PO TABS,3295,6370005,,,1 Tab,51079-0073-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,33227,6370005,,,1 Tab,00093-2274-34,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.63,% of charge rate,95.00%,3.45,,,,3.45,3.63,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,33227,6370005,,,1 Tab,00093-2274-34,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.63,% of charge rate,95.00%,3.45,,,,3.45,3.63,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,33228,6370005,,,1 Tab,00093-2275-34,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.74,% of charge rate,95.00%,3.55,,,,3.55,3.74,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,33228,6370005,,,1 Tab,00093-2275-34,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.74,% of charge rate,95.00%,3.55,,,,3.55,3.74,1
unity,NDC,ESCITALOPRAM OXALATE 10 MG PO TABS,33512,6370005,,,1 Tab,00904-6426-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ESCITALOPRAM OXALATE 10 MG PO TABS,33512,6370005,,,1 Tab,00904-6426-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,VALSARTAN 40 MG PO TABS,33541,6370005,,,1 Tab,00378-5807-93,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,VALSARTAN 40 MG PO TABS,33541,6370005,,,1 Tab,00378-5807-93,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GEMFIBROZIL 600 MG PO TABS,3378,6370005,,,1 Tab,69097-0821-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.63,% of charge rate,95.00%,4.4,,,,4.4,4.63,1
unity,NDC,GEMFIBROZIL 600 MG PO TABS,3378,6370005,,,1 Tab,69097-0821-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.63,% of charge rate,95.00%,4.4,,,,4.4,4.63,1
unity,NDC,EZETIMIBE 10 MG PO TABS,34153,6370005,,,1 Tab,67877-0490-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.9,% of charge rate,95.00%,3.71,,,,3.71,3.9,1
unity,NDC,EZETIMIBE 10 MG PO TABS,34153,6370005,,,1 Tab,67877-0490-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.9,% of charge rate,95.00%,3.71,,,,3.71,3.9,1
unity,NDC,GENTAMICIN SULFATE 0.1 % EX OINT,3424,6370005,,,15 g,45802-0046-35,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.8,% of charge rate,95.00%,38.76,,,,38.76,40.8,1
unity,NDC,GENTAMICIN SULFATE 0.1 % EX OINT,3424,6370005,,,15 g,45802-0046-35,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.8,% of charge rate,95.00%,38.76,,,,38.76,40.8,1
unity,NDC,GENTAMICIN SULFATE 0.3 % OP SOLN,3428,6370005,,,75 Drop,60758-0188-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.85,% of charge rate,95.00%,20.76,,,,20.76,21.85,1
unity,NDC,GENTAMICIN SULFATE 0.3 % OP SOLN,3428,6370005,,,75 Drop,60758-0188-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.85,% of charge rate,95.00%,20.76,,,,20.76,21.85,1
unity,NDC,GENTIAN VIOLET 1 % EX SOLN,3430,6370005,,,59 mL,00395-1003-92,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.97,% of charge rate,95.00%,22.77,,,,22.77,23.97,1
unity,NDC,GENTIAN VIOLET 1 % EX SOLN,3430,6370005,,,59 mL,00395-1003-92,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.97,% of charge rate,95.00%,22.77,,,,22.77,23.97,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,34505,6370005,,,1 Tab,00904-6824-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,34505,6370005,,,1 Tab,00904-6824-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,NICOTINE POLACRILEX 2 MG MT LOZG,34769,6370005,,,1 Lozenge,70000-0349-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.76,% of charge rate,95.00%,7.37,,,,7.37,7.76,1
unity,NDC,NICOTINE POLACRILEX 2 MG MT LOZG,34769,6370005,,,1 Lozenge,70000-0349-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.76,% of charge rate,95.00%,7.37,,,,7.37,7.76,1
unity,NDC,NICOTINE POLACRILEX 4 MG MT LOZG,34770,6370005,,,24 Lozenge,00135-0511-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.98,% of charge rate,95.00%,93.08,,,,93.08,97.98,1
unity,NDC,NICOTINE POLACRILEX 4 MG MT LOZG,34770,6370005,,,24 Lozenge,00135-0511-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,97.98,% of charge rate,95.00%,93.08,,,,93.08,97.98,1
unity,NDC,GLYBURIDE 5 MG PO TABS,3489,6370005,,,1 Tab,23155-0058-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLYBURIDE 5 MG PO TABS,3489,6370005,,,1 Tab,23155-0058-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 20 MG PO TABS,35135,6370005,,,1 Tab,50268-0710-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 20 MG PO TABS,35135,6370005,,,1 Tab,50268-0710-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 20 MG PO TABS,35135,6370005,,,1 Tab,50268-0710-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 20 MG PO TABS,35135,6370005,,,1 Tab,50268-0710-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HALOPERIDOL LACTATE 2 MG/ML PO CONC,3585,6370005,,,0.5 mL,00121-0581-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HALOPERIDOL LACTATE 2 MG/ML PO CONC,3585,6370005,,,0.5 mL,00121-0581-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,35943,6370005,,,1 Tab,00245-5319-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,35943,6370005,,,1 Tab,00245-5319-89,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,35943,6370005,,,1 Tab,00245-5319-89,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,35943,6370005,,,1 Tab,00245-5319-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LEVETIRACETAM 100 MG/ML PO SOLN,36590,6370005,,,473 mL,51991-0651-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,530.31,% of charge rate,95.00%,503.79,,,,503.79,530.31,1
unity,NDC,LEVETIRACETAM 100 MG/ML PO SOLN,36590,6370005,,,473 mL,51991-0651-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,530.31,% of charge rate,95.00%,503.79,,,,503.79,530.31,1
unity,NDC,ROSUVASTATIN CALCIUM 5 MG PO TABS,36612,6370005,,,1 Tab,65862-0293-90,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 5 MG PO TABS,36612,6370005,,,1 Tab,65862-0293-90,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BUPROPION HCL ER (XL) 150 MG PO TB24,36775,6370005,,,1 Tab,50268-0140-13,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.17,% of charge rate,95.00%,3.96,,,,3.96,4.17,1
unity,NDC,BUPROPION HCL ER (XL) 150 MG PO TB24,36775,6370005,,,1 Tab,50268-0140-13,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.17,% of charge rate,95.00%,3.96,,,,3.96,4.17,1
unity,NDC,MEMANTINE HCL 10 MG PO TABS,36966,6370005,,,1 Tab,00904-6506-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.57,% of charge rate,95.00%,3.39,,,,3.39,3.57,1
unity,NDC,MEMANTINE HCL 10 MG PO TABS,36966,6370005,,,1 Tab,00904-6506-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.57,% of charge rate,95.00%,3.39,,,,3.39,3.57,1
unity,NDC,HYDRALAZINE HCL 10 MG PO TABS,3698,6370005,,,1 Tab,23155-0001-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDRALAZINE HCL 10 MG PO TABS,3698,6370005,,,1 Tab,23155-0001-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDRALAZINE HCL 25 MG PO TABS,3700,6370005,,,1 Tab,23155-0002-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDRALAZINE HCL 25 MG PO TABS,3700,6370005,,,1 Tab,23155-0002-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDROCHLOROTHIAZIDE 25 MG PO TABS,3720,6370005,,,1 Tab,16729-0183-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDROCHLOROTHIAZIDE 25 MG PO TABS,3720,6370005,,,1 Tab,16729-0183-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDROCORTISONE 1 % EX CREA,3726,6370005,,,28 g,00904-7623-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.17,% of charge rate,95.00%,8.71,,,,8.71,9.17,1
unity,NDC,HYDROCORTISONE 1 % EX CREA,3726,6370005,,,28 g,00904-7623-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.17,% of charge rate,95.00%,8.71,,,,8.71,9.17,1
unity,NDC,HYDROCORTISONE 2.5 % EX CREA,3727,6370005,,,30 g,00168-0080-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.4,% of charge rate,95.00%,11.78,,,,11.78,12.4,1
unity,NDC,HYDROCORTISONE 2.5 % EX CREA,3727,6370005,,,30 g,00168-0080-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.4,% of charge rate,95.00%,11.78,,,,11.78,12.4,1
unity,NDC,HYDROCORTISONE ACETATE 25 MG REC SUPP,3738,6370005,,,1 Suppository,00713-0503-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.69,% of charge rate,95.00%,19.66,,,,19.66,20.69,1
unity,NDC,HYDROCORTISONE ACETATE 25 MG REC SUPP,3738,6370005,,,1 Suppository,00713-0503-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.69,% of charge rate,95.00%,19.66,,,,19.66,20.69,1
unity,NDC,HYDROCORTISONE ACETATE 25 MG REC SUPP,3738,6370005,,,1 Suppository,00713-0503-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.69,% of charge rate,95.00%,19.66,,,,19.66,20.69,1
unity,NDC,HYDROCORTISONE ACETATE 25 MG REC SUPP,3738,6370005,,,1 Suppository,00713-0503-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.69,% of charge rate,95.00%,19.66,,,,19.66,20.69,1
unity,NDC,HYDROMORPHONE HCL 2 MG PO TABS,3760,6370005,,,1 Tab,42858-0301-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDROMORPHONE HCL 2 MG PO TABS,3760,6370005,,,1 Tab,42858-0301-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 25 MG PO TABS,37637,6370005,,,1 Tab,51079-0255-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 25 MG PO TABS,37637,6370005,,,1 Tab,51079-0255-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 25 MG PO TABS,37637,6370005,,,1 Tab,51079-0255-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 25 MG PO TABS,37637,6370005,,,1 Tab,51079-0255-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR,37642,6370005,,,100 mL,59762-0016-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137.9,% of charge rate,95.00%,131.01,,,,131.01,137.9,1
unity,NDC,CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR,37642,6370005,,,100 mL,59762-0016-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137.9,% of charge rate,95.00%,131.01,,,,131.01,137.9,1
unity,NDC,GUAIFENESIN ER 600 MG PO TB12,37651,6370005,,,1 Tab,68084-0572-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.08,% of charge rate,95.00%,5.78,,,,5.78,6.08,1
unity,NDC,GUAIFENESIN ER 600 MG PO TB12,37651,6370005,,,1 Tab,68084-0572-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.08,% of charge rate,95.00%,5.78,,,,5.78,6.08,1
unity,NDC,GUAIFENESIN ER 600 MG PO TB12,37651,6370005,,,1 Tab,68084-0572-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.08,% of charge rate,95.00%,5.78,,,,5.78,6.08,1
unity,NDC,GUAIFENESIN ER 600 MG PO TB12,37651,6370005,,,1 Tab,68084-0572-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.08,% of charge rate,95.00%,5.78,,,,5.78,6.08,1
unity,NDC,HYDROXYZINE HCL 25 MG PO TABS,3774,6370005,,,1 Tab,00904-6617-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.52,% of charge rate,95.00%,4.29,,,,4.29,4.52,1
unity,NDC,HYDROXYZINE HCL 25 MG PO TABS,3774,6370005,,,1 Tab,00904-6617-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.52,% of charge rate,95.00%,4.29,,,,4.29,4.52,1
unity,NDC,I-VITE PO TABS,3808,6370005,,,1 Tab,00536-5090-08,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,I-VITE PO TABS,3808,6370005,,,1 Tab,00536-5090-08,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ORPHENADRINE CITRATE ER 100 MG PO TB12,38213,6370005,,,1 Tab,43386-0480-24,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.33,% of charge rate,95.00%,8.86,,,,8.86,9.33,1
unity,NDC,ORPHENADRINE CITRATE ER 100 MG PO TB12,38213,6370005,,,1 Tab,43386-0480-24,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.33,% of charge rate,95.00%,8.86,,,,8.86,9.33,1
unity,NDC,PROPRANOLOL HCL ER 80 MG PO CP24,38225,6370005,,,1 Cap,51991-0818-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.83,% of charge rate,95.00%,9.34,,,,9.34,9.83,1
unity,NDC,PROPRANOLOL HCL ER 80 MG PO CP24,38225,6370005,,,1 Cap,51991-0818-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.83,% of charge rate,95.00%,9.34,,,,9.34,9.83,1
unity,NDC,PROPRANOLOL HCL ER 120 MG PO CP24,38226,6370005,,,1 Cap,51991-0819-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.03,% of charge rate,95.00%,5.73,,,,5.73,6.03,1
unity,NDC,PROPRANOLOL HCL ER 120 MG PO CP24,38226,6370005,,,1 Cap,51991-0819-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.03,% of charge rate,95.00%,5.73,,,,5.73,6.03,1
unity,NDC,LACTULOSE 10 GM/15ML PO SOLN,38245,6370005,,,15 mL,50383-0779-17,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.44,% of charge rate,95.00%,4.22,,,,4.22,4.44,1
unity,NDC,LACTULOSE 10 GM/15ML PO SOLN,38245,6370005,,,15 mL,50383-0779-17,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.44,% of charge rate,95.00%,4.22,,,,4.22,4.44,1
unity,NDC,TIOTROPIUM BROMIDE MONOHYDRATE 18 MCG IN CAPS,38315,6370005,,,5 Cap,00597-0075-75,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,171.23,% of charge rate,95.00%,162.67,,,,162.67,171.23,1
unity,NDC,TIOTROPIUM BROMIDE MONOHYDRATE 18 MCG IN CAPS,38315,6370005,,,5 Cap,00597-0075-75,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,171.23,% of charge rate,95.00%,162.67,,,,162.67,171.23,1
unity,NDC,IBUPROFEN 400 MG PO TABS,3843,6370005,,,1 Tab,00904-5853-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IBUPROFEN 400 MG PO TABS,3843,6370005,,,1 Tab,00904-5853-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IBUPROFEN 600 MG PO TABS,3844,6370005,,,1 Tab,00904-5854-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IBUPROFEN 600 MG PO TABS,3844,6370005,,,1 Tab,00904-5854-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SILVASORB EX GEL,38626,6370005,,,45 g,08327-0309-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,145.12,% of charge rate,95.00%,137.86,,,,137.86,145.12,1
unity,NDC,SILVASORB EX GEL,38626,6370005,,,45 g,08327-0309-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,145.12,% of charge rate,95.00%,137.86,,,,137.86,145.12,1
unity,NDC,INDOMETHACIN 25 MG PO CAPS,3897,6370005,,,1 Cap,50268-0430-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,INDOMETHACIN 25 MG PO CAPS,3897,6370005,,,1 Cap,50268-0430-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,INDOMETHACIN 25 MG PO CAPS,3897,6370005,,,1 Cap,50268-0430-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,INDOMETHACIN 25 MG PO CAPS,3897,6370005,,,1 Cap,50268-0430-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,EMTRICITABINE-TENOFOVIR DF 200-300 MG PO TABS,39255,6370005,,,1 Tab,61958-0701-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144.63,% of charge rate,95.00%,137.4,,,,137.4,144.63,1
unity,NDC,EMTRICITABINE-TENOFOVIR DF 200-300 MG PO TABS,39255,6370005,,,1 Tab,61958-0701-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144.63,% of charge rate,95.00%,137.4,,,,137.4,144.63,1
unity,NDC,DULOXETINE HCL 20 MG PO CPEP,39275,6370005,,,1 Cap,00904-6452-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.36,% of charge rate,95.00%,6.04,,,,6.04,6.36,1
unity,NDC,DULOXETINE HCL 20 MG PO CPEP,39275,6370005,,,1 Cap,00904-6452-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.36,% of charge rate,95.00%,6.04,,,,6.04,6.36,1
unity,NDC,DULOXETINE HCL 30 MG PO CPEP,39276,6370005,,,1 Cap,00904-6453-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.9,% of charge rate,95.00%,3.71,,,,3.71,3.9,1
unity,NDC,DULOXETINE HCL 30 MG PO CPEP,39276,6370005,,,1 Cap,00904-6453-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.9,% of charge rate,95.00%,3.71,,,,3.71,3.9,1
unity,NDC,FENOFIBRATE 48 MG PO TABS,40009,6370005,,,1 Tab,63304-0448-90,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.23,% of charge rate,95.00%,11.62,,,,11.62,12.23,1
unity,NDC,FENOFIBRATE 48 MG PO TABS,40009,6370005,,,1 Tab,63304-0448-90,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.23,% of charge rate,95.00%,11.62,,,,11.62,12.23,1
unity,NDC,FENOFIBRATE 145 MG PO TABS,40010,6370005,,,1 Tab,68180-0361-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.88,% of charge rate,95.00%,21.74,,,,21.74,22.88,1
unity,NDC,FENOFIBRATE 145 MG PO TABS,40010,6370005,,,1 Tab,68180-0361-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,22.88,% of charge rate,95.00%,21.74,,,,21.74,22.88,1
unity,NDC,GLYCERIN (LAXATIVE) 2 G REC SUPP,41003,6370005,,,1 Suppository,00132-0079-50,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GLYCERIN (LAXATIVE) 2 G REC SUPP,41003,6370005,,,1 Suppository,00132-0079-50,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,FENTANYL 12 MCG/HR TD PT72,41382,6370005,,,1 Patch,00378-9119-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.51,% of charge rate,95.00%,30.88,,,,30.88,32.51,1
unity,NDC,FENTANYL 12 MCG/HR TD PT72,41382,6370005,,,1 Patch,00378-9119-98,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.51,% of charge rate,95.00%,30.88,,,,30.88,32.51,1
unity,NDC,FENTANYL 12 MCG/HR TD PT72,41382,6370005,,,1 Patch,00378-9119-98,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.51,% of charge rate,95.00%,30.88,,,,30.88,32.51,1
unity,NDC,FENTANYL 12 MCG/HR TD PT72,41382,6370005,,,1 Patch,00378-9119-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.51,% of charge rate,95.00%,30.88,,,,30.88,32.51,1
unity,NDC,LIDOCAINE 5 % EX OINT,41831,6370005,,,36 g,52565-0008-14,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.08,% of charge rate,95.00%,54.23,,,,54.23,57.08,1
unity,NDC,LIDOCAINE 5 % EX OINT,41831,6370005,,,36 g,52565-0008-14,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.08,% of charge rate,95.00%,54.23,,,,54.23,57.08,1
unity,NDC,PREGABALIN 75 MG PO CAPS,42164,6370005,,,1 Cap,00071-1014-68,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.76,% of charge rate,95.00%,29.22,,,,29.22,30.76,1
unity,NDC,PREGABALIN 75 MG PO CAPS,42164,6370005,,,1 Cap,00071-1014-68,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.76,% of charge rate,95.00%,29.22,,,,29.22,30.76,1
unity,NDC,PREGABALIN 100 MG PO CAPS,42165,6370005,,,1 Cap,00904-7001-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.79,% of charge rate,95.00%,3.6,,,,3.6,3.79,1
unity,NDC,PREGABALIN 100 MG PO CAPS,42165,6370005,,,1 Cap,00904-7001-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.79,% of charge rate,95.00%,3.6,,,,3.6,3.79,1
unity,NDC,AMITRIPTYLINE HCL 10 MG PO TABS,432,6370005,,,1 Tab,16729-0171-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 10 MG PO TABS,432,6370005,,,1 Tab,16729-0171-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 25 MG PO TABS,435,6370005,,,1 Tab,60687-0433-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 25 MG PO TABS,435,6370005,,,1 Tab,60687-0433-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 25 MG PO TABS,435,6370005,,,1 Tab,60687-0433-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 25 MG PO TABS,435,6370005,,,1 Tab,60687-0433-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LEVOTHYROXINE SODIUM 50 MCG PO TABS,4421,6370005,,,2 Tab,00904-6950-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7,% of charge rate,95.00%,6.65,,,,6.65,7,1
unity,NDC,LEVOTHYROXINE SODIUM 50 MCG PO TABS,4421,6370005,,,2 Tab,00904-6950-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7,% of charge rate,95.00%,6.65,,,,6.65,7,1
unity,NDC,LEVOTHYROXINE SODIUM 75 MCG PO TABS,4422,6370005,,,2 Tab,00904-6951-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.7,% of charge rate,95.00%,7.32,,,,7.32,7.7,1
unity,NDC,LEVOTHYROXINE SODIUM 75 MCG PO TABS,4422,6370005,,,2 Tab,00904-6951-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,7.7,% of charge rate,95.00%,7.32,,,,7.32,7.7,1
unity,NDC,LEVOTHYROXINE SODIUM 100 MCG PO TABS,4423,6370005,,,1 Tab,00904-6953-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.46,% of charge rate,95.00%,4.24,,,,4.24,4.46,1
unity,NDC,LEVOTHYROXINE SODIUM 100 MCG PO TABS,4423,6370005,,,1 Tab,00904-6953-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.46,% of charge rate,95.00%,4.24,,,,4.24,4.46,1
unity,NDC,AMOXICILLIN 250 MG PO CAPS,450,6370005,,,1 Cap,00781-2020-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 250 MG PO CAPS,450,6370005,,,1 Cap,00781-2020-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 500 MG PO CAPS,451,6370005,,,1 Cap,00093-3109-53,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 500 MG PO CAPS,451,6370005,,,1 Cap,00093-3109-53,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 20 MG PO TABS,4526,6370005,,,1 Tab,00904-6799-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 20 MG PO TABS,4526,6370005,,,1 Tab,00904-6799-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LITHIUM CARBONATE 150 MG PO CAPS,4528,6370005,,,1 Cap,00054-8526-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LITHIUM CARBONATE 150 MG PO CAPS,4528,6370005,,,1 Cap,00054-8526-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 125 MG/5ML PO SUSR,453,6370005,,,5 mL,00781-6039-46,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 125 MG/5ML PO SUSR,453,6370005,,,5 mL,00781-6039-46,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LOPERAMIDE HCL 2 MG PO CAPS,4560,6370005,,,1 Cap,60687-0229-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.41,% of charge rate,95.00%,4.19,,,,4.19,4.41,1
unity,NDC,LOPERAMIDE HCL 2 MG PO CAPS,4560,6370005,,,1 Cap,60687-0229-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.41,% of charge rate,95.00%,4.19,,,,4.19,4.41,1
unity,NDC,LOPERAMIDE HCL 2 MG PO CAPS,4560,6370005,,,1 Cap,60687-0229-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.41,% of charge rate,95.00%,4.19,,,,4.19,4.41,1
unity,NDC,LOPERAMIDE HCL 2 MG PO CAPS,4560,6370005,,,1 Cap,60687-0229-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.41,% of charge rate,95.00%,4.19,,,,4.19,4.41,1
unity,NDC,LORAZEPAM 0.5 MG PO TABS,4572,6370005,,,1 Tab,00904-6007-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LORAZEPAM 0.5 MG PO TABS,4572,6370005,,,1 Tab,00904-6007-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LORAZEPAM 1 MG PO TABS,4573,6370005,,,1 Tab,00904-6008-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,LORAZEPAM 1 MG PO TABS,4573,6370005,,,1 Tab,00904-6008-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MAGNESIUM CITRATE PO SOLN,4712,6370005,,,296 mL,70000-0424-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.12,% of charge rate,95.00%,7.71,,,,7.71,8.12,1
unity,NDC,MAGNESIUM CITRATE PO SOLN,4712,6370005,,,296 mL,70000-0424-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,8.12,% of charge rate,95.00%,7.71,,,,7.71,8.12,1
unity,NDC,METHYLPHENIDATE HCL 10 MG PO TABS,4986,6370005,,,1 Tab,10702-0101-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,METHYLPHENIDATE HCL 10 MG PO TABS,4986,6370005,,,1 Tab,10702-0101-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,METOCLOPRAMIDE HCL 10 MG PO TABS,5005,6370005,,,1 Tab,68084-0676-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOCLOPRAMIDE HCL 10 MG PO TABS,5005,6370005,,,1 Tab,68084-0676-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOCLOPRAMIDE HCL 10 MG PO TABS,5005,6370005,,,1 Tab,68084-0676-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOCLOPRAMIDE HCL 10 MG PO TABS,5005,6370005,,,1 Tab,68084-0676-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 50 MG PO TABS,5009,6370005,,,1 Tab,51079-0801-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 50 MG PO TABS,5009,6370005,,,1 Tab,51079-0801-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 50 MG PO TABS,5009,6370005,,,1 Tab,51079-0801-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 50 MG PO TABS,5009,6370005,,,1 Tab,51079-0801-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METRONIDAZOLE 250 MG PO TABS,5015,6370005,,,1 Tab,00904-1453-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,METRONIDAZOLE 250 MG PO TABS,5015,6370005,,,1 Tab,00904-1453-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MICONAZOLE NITRATE 2 % EX CREA,5039,6370005,,,28 g,00472-0735-56,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.62,% of charge rate,95.00%,19.59,,,,19.59,20.62,1
unity,NDC,MICONAZOLE NITRATE 2 % EX CREA,5039,6370005,,,28 g,00472-0735-56,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,20.62,% of charge rate,95.00%,19.59,,,,19.59,20.62,1
unity,NDC,MINERAL OIL REC ENEM,5087,6370005,,,2 Enema,00132-0301-40,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.51,% of charge rate,95.00%,23.28,,,,23.28,24.51,1
unity,NDC,MINERAL OIL REC ENEM,5087,6370005,,,2 Enema,00132-0301-40,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.51,% of charge rate,95.00%,23.28,,,,23.28,24.51,1
unity,NDC,MINOCYCLINE HCL 100 MG PO CAPS,5110,6370005,,,1 Cap,60687-0336-65,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,MINOCYCLINE HCL 100 MG PO CAPS,5110,6370005,,,1 Cap,60687-0336-65,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,NAPROXEN 250 MG PO TABS,5391,6370005,,,1 Tab,50268-0594-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,NAPROXEN 250 MG PO TABS,5391,6370005,,,1 Tab,50268-0594-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,NITROGLYCERIN 0.4 MG SL SUBL,5604,6370005,,,1 Tab,59762-3304-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.79,% of charge rate,95.00%,3.6,,,,3.6,3.79,1
unity,NDC,NITROGLYCERIN 0.4 MG SL SUBL,5604,6370005,,,1 Tab,59762-3304-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.79,% of charge rate,95.00%,3.6,,,,3.6,3.79,1
unity,NDC,NORTRIPTYLINE HCL 50 MG PO CAPS,5676,6370005,,,1 Cap,50268-0605-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,NORTRIPTYLINE HCL 50 MG PO CAPS,5676,6370005,,,1 Cap,50268-0605-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,NORTRIPTYLINE HCL 50 MG PO CAPS,5676,6370005,,,1 Cap,50268-0605-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,NORTRIPTYLINE HCL 50 MG PO CAPS,5676,6370005,,,1 Cap,50268-0605-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,NYSTATIN 100000 UNIT/GM EX CREA,5749,6370005,,,30 g,45802-0059-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.8,% of charge rate,95.00%,23.56,,,,23.56,24.8,1
unity,NDC,NYSTATIN 100000 UNIT/GM EX CREA,5749,6370005,,,30 g,45802-0059-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.8,% of charge rate,95.00%,23.56,,,,23.56,24.8,1
unity,NDC,NYSTATIN 100000 UNIT/ML MT SUSP,5751,6370005,,,5 mL,66689-0037-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.13,% of charge rate,95.00%,3.92,,,,3.92,4.13,1
unity,NDC,NYSTATIN 100000 UNIT/ML MT SUSP,5751,6370005,,,5 mL,66689-0037-50,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.13,% of charge rate,95.00%,3.92,,,,3.92,4.13,1
unity,NDC,NYSTATIN 100000 UNIT/ML MT SUSP,5751,6370005,,,5 mL,66689-0037-50,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.13,% of charge rate,95.00%,3.92,,,,3.92,4.13,1
unity,NDC,NYSTATIN 100000 UNIT/ML MT SUSP,5751,6370005,,,5 mL,66689-0037-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.13,% of charge rate,95.00%,3.92,,,,3.92,4.13,1
unity,NDC,OXYBUTYNIN CHLORIDE 5 MG PO TABS,5938,6370005,,,1 Tab,00904-2821-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OXYBUTYNIN CHLORIDE 5 MG PO TABS,5938,6370005,,,1 Tab,00904-2821-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,5940,6370005,,,1 Tab,00406-0512-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,5940,6370005,,,1 Tab,00406-0512-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PENICILLIN V POTASSIUM 250 MG PO TABS,6092,6370005,,,1 Tab,65862-0175-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PENICILLIN V POTASSIUM 250 MG PO TABS,6092,6370005,,,1 Tab,65862-0175-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PHENYTOIN SODIUM EXTENDED 100 MG PO CAPS,6257,6370005,,,1 Cap,51672-4111-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,PHENYTOIN SODIUM EXTENDED 100 MG PO CAPS,6257,6370005,,,1 Cap,51672-4111-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,ASCORBIC ACID 500 MG PO TABS,664,6370005,,,1 Tab,00904-0523-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ASCORBIC ACID 500 MG PO TABS,664,6370005,,,1 Tab,00904-0523-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 10 MG PO TABS,6656,6370005,,,1 Tab,00904-6550-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 10 MG PO TABS,6656,6370005,,,1 Tab,00904-6550-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 40 MG PO TABS,6658,6370005,,,1 Tab,50268-0702-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 40 MG PO TABS,6658,6370005,,,1 Tab,50268-0702-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 40 MG PO TABS,6658,6370005,,,1 Tab,50268-0702-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 40 MG PO TABS,6658,6370005,,,1 Tab,50268-0702-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ASPIRIN 81 MG PO CHEW,680,6370005,,,1 Tab,63739-0434-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ASPIRIN 81 MG PO CHEW,680,6370005,,,1 Tab,63739-0434-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ASPIRIN 81 MG PO TBEC,688,6370005,,,1 Tab,63739-0212-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ASPIRIN 81 MG PO TBEC,688,6370005,,,1 Tab,63739-0212-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ASPIRIN 300 MG REC SUPP,693,6370005,,,1 Suppository,00574-7034-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.89,% of charge rate,95.00%,9.4,,,,9.4,9.89,1
unity,NDC,ASPIRIN 300 MG REC SUPP,693,6370005,,,1 Suppository,00574-7034-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.89,% of charge rate,95.00%,9.4,,,,9.4,9.89,1
unity,NDC,ATENOLOL 50 MG PO TABS,718,6370005,,,1 Tab,51079-0684-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ATENOLOL 50 MG PO TABS,718,6370005,,,1 Tab,51079-0684-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ATENOLOL 50 MG PO TABS,718,6370005,,,1 Tab,51079-0684-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ATENOLOL 50 MG PO TABS,718,6370005,,,1 Tab,51079-0684-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMETHICONE 80 MG PO CHEW,7227,6370005,,,1 Tab,00904-5068-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMETHICONE 80 MG PO CHEW,7227,6370005,,,1 Tab,00904-5068-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SIMETHICONE 40 MG/0.6ML PO SUSP,7228,6370005,,,30 mL,00536-2220-75,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.7,% of charge rate,95.00%,57.67,,,,57.67,60.7,1
unity,NDC,SIMETHICONE 40 MG/0.6ML PO SUSP,7228,6370005,,,30 mL,00536-2220-75,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.7,% of charge rate,95.00%,57.67,,,,57.67,60.7,1
unity,NDC,SODIUM BICARBONATE 650 MG PO TABS,7313,6370005,,,1 Tab,00223-1721-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SODIUM BICARBONATE 650 MG PO TABS,7313,6370005,,,1 Tab,00223-1721-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SODIUM CHLORIDE 1 G PO TABS,7328,6370005,,,1 Tab,69367-0220-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SODIUM CHLORIDE 1 G PO TABS,7328,6370005,,,1 Tab,69367-0220-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SULFACETAMIDE SODIUM 10 % OP SOLN,7359,6370005,,,15 mL,24208-0670-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.44,% of charge rate,95.00%,136.27,,,,136.27,143.44,1
unity,NDC,SULFACETAMIDE SODIUM 10 % OP SOLN,7359,6370005,,,15 mL,24208-0670-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.44,% of charge rate,95.00%,136.27,,,,136.27,143.44,1
unity,NDC,SPIRONOLACTONE 25 MG PO TABS,7437,6370005,,,1 Tab,00904-6927-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SPIRONOLACTONE 25 MG PO TABS,7437,6370005,,,1 Tab,00904-6927-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,STRESS FORMULA/ZINC PO TABS,7523,6370005,,,1 Tab,54629-0597-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,STRESS FORMULA/ZINC PO TABS,7523,6370005,,,1 Tab,54629-0597-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DAKINS (1/4 STRENGTH) 0.125 % EX SOLN,76724,6370005,,,473 mL,00436-0672-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,46.08,% of charge rate,95.00%,43.78,,,,43.78,46.08,1
unity,NDC,DAKINS (1/4 STRENGTH) 0.125 % EX SOLN,76724,6370005,,,473 mL,00436-0672-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,46.08,% of charge rate,95.00%,43.78,,,,43.78,46.08,1
unity,NDC,MEGESTROL ACETATE 400 MG/10ML PO SUSP,76824,6370005,,,10 mL,00121-4776-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.79,% of charge rate,95.00%,12.15,,,,12.15,12.79,1
unity,NDC,MEGESTROL ACETATE 400 MG/10ML PO SUSP,76824,6370005,,,10 mL,00121-4776-40,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.79,% of charge rate,95.00%,12.15,,,,12.15,12.79,1
unity,NDC,MEGESTROL ACETATE 400 MG/10ML PO SUSP,76824,6370005,,,10 mL,00121-4776-40,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.79,% of charge rate,95.00%,12.15,,,,12.15,12.79,1
unity,NDC,MEGESTROL ACETATE 400 MG/10ML PO SUSP,76824,6370005,,,10 mL,00121-4776-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,12.79,% of charge rate,95.00%,12.15,,,,12.15,12.79,1
unity,NDC,POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN,76913,6370005,,,15 mL,00121-1680-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.45,% of charge rate,95.00%,32.73,,,,32.73,34.45,1
unity,NDC,POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN,76913,6370005,,,15 mL,00121-1680-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.45,% of charge rate,95.00%,32.73,,,,32.73,34.45,1
unity,NDC,POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN,76913,6370005,,,15 mL,00121-1680-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.45,% of charge rate,95.00%,32.73,,,,32.73,34.45,1
unity,NDC,POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN,76913,6370005,,,15 mL,00121-1680-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.45,% of charge rate,95.00%,32.73,,,,32.73,34.45,1
unity,NDC,TEMAZEPAM 15 MG PO CAPS,7753,6370005,,,1 Cap,00228-2076-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TEMAZEPAM 15 MG PO CAPS,7753,6370005,,,1 Cap,00228-2076-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,77616,6370005,,,1 Tab,00006-0112-28,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.5,% of charge rate,95.00%,57.48,,,,57.48,60.5,1
unity,NDC,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,77616,6370005,,,1 Tab,00006-0112-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.5,% of charge rate,95.00%,57.48,,,,57.48,60.5,1
unity,NDC,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,77616,6370005,,,1 Tab,00006-0112-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.5,% of charge rate,95.00%,57.48,,,,57.48,60.5,1
unity,NDC,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,77616,6370005,,,1 Tab,00006-0112-28,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.5,% of charge rate,95.00%,57.48,,,,57.48,60.5,1
unity,NDC,GUAIFENESIN-CODEINE 100-10 MG/5ML PO SYRP,78003,6370005,,,3 mL,00121-0775-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GUAIFENESIN-CODEINE 100-10 MG/5ML PO SYRP,78003,6370005,,,3 mL,00121-0775-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GUAIFENESIN-CODEINE 100-10 MG/5ML PO SOLN,79088,6370005,,,3 mL,00121-0775-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GUAIFENESIN-CODEINE 100-10 MG/5ML PO SOLN,79088,6370005,,,3 mL,00121-0775-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRAZODONE HCL 100 MG PO TABS,8083,6370005,,,1 Tab,00904-6869-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRAZODONE HCL 100 MG PO TABS,8083,6370005,,,1 Tab,00904-6869-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRAZODONE HCL 50 MG PO TABS,8085,6370005,,,1 Tab,00904-6868-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRAZODONE HCL 50 MG PO TABS,8085,6370005,,,1 Tab,00904-6868-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,TRIAMCINOLONE ACETONIDE 0.1 % EX CREA,8113,6370005,,,15 g,67877-0251-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.06,% of charge rate,95.00%,10.51,,,,10.51,11.06,1
unity,NDC,TRIAMCINOLONE ACETONIDE 0.1 % EX CREA,8113,6370005,,,15 g,67877-0251-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,11.06,% of charge rate,95.00%,10.51,,,,10.51,11.06,1
unity,NDC,GLUCOSE 40 % PO GEL,81823,6370005,,,37.5 g,00574-0070-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.32,% of charge rate,95.00%,36.4,,,,36.4,38.32,1
unity,NDC,GLUCOSE 40 % PO GEL,81823,6370005,,,37.5 g,00574-0070-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.32,% of charge rate,95.00%,36.4,,,,36.4,38.32,1
unity,NDC,BACLOFEN 10 MG PO TABS,860,6370005,,,1 Tab,00904-6475-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BACLOFEN 10 MG PO TABS,860,6370005,,,1 Tab,00904-6475-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BACLOFEN 20 MG PO TABS,861,6370005,,,1 Tab,00904-6476-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.49,% of charge rate,95.00%,4.27,,,,4.27,4.49,1
unity,NDC,BACLOFEN 20 MG PO TABS,861,6370005,,,1 Tab,00904-6476-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.49,% of charge rate,95.00%,4.27,,,,4.27,4.49,1
unity,NDC,VITAMIN B-12 500 MCG PO TABS,8657,6370005,,,1 Tab,77333-0937-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,VITAMIN B-12 500 MCG PO TABS,8657,6370005,,,1 Tab,77333-0937-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,51672-4028-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,62584-0984-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,62584-0984-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,62584-0984-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,62584-0984-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,51672-4028-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 5 MG PO TABS,8751,6370005,,,1 Tab,62584-0994-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 5 MG PO TABS,8751,6370005,,,1 Tab,62584-0994-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 5 MG PO TABS,8751,6370005,,,1 Tab,62584-0994-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 5 MG PO TABS,8751,6370005,,,1 Tab,62584-0994-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,OXYCODONE HCL 10 MG PO TABS,87795,6370005,,,1 Tab,68382-0794-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.58,% of charge rate,95.00%,4.35,,,,4.35,4.58,1
unity,NDC,OXYCODONE HCL 10 MG PO TABS,87795,6370005,,,1 Tab,68382-0794-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.58,% of charge rate,95.00%,4.35,,,,4.35,4.58,1
unity,NDC,OSELTAMIVIR PHOSPHATE 30 MG PO CAPS,88704,6370005,,,1 Cap,68180-0675-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.89,% of charge rate,95.00%,28.4,,,,28.4,29.89,1
unity,NDC,OSELTAMIVIR PHOSPHATE 30 MG PO CAPS,88704,6370005,,,1 Cap,68180-0675-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.89,% of charge rate,95.00%,28.4,,,,28.4,29.89,1
unity,NDC,NEBIVOLOL HCL 10 MG PO TABS,89286,6370005,,,1 Tab,00456-1410-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.34,% of charge rate,95.00%,27.87,,,,27.87,29.34,1
unity,NDC,NEBIVOLOL HCL 10 MG PO TABS,89286,6370005,,,1 Tab,00456-1410-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,29.34,% of charge rate,95.00%,27.87,,,,27.87,29.34,1
unity,NDC,ACYCLOVIR 400 MG PO TABS,8971,6370005,,,1 Tab,50268-0061-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACYCLOVIR 400 MG PO TABS,8971,6370005,,,1 Tab,50268-0061-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACYCLOVIR 400 MG PO TABS,8971,6370005,,,1 Tab,50268-0061-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACYCLOVIR 400 MG PO TABS,8971,6370005,,,1 Tab,50268-0061-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMIODARONE HCL 200 MG PO TABS,9066,6370005,,,1 Tab,00245-0147-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMIODARONE HCL 200 MG PO TABS,9066,6370005,,,1 Tab,00245-0147-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMLODIPINE BESYLATE 5 MG PO TABS,9071,6370005,,,1 Tab,00904-6370-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMLODIPINE BESYLATE 5 MG PO TABS,9071,6370005,,,1 Tab,00904-6370-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5ML PO SUSR,9080,6370005,,,3 mL,72508-0204-07,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.89,% of charge rate,95.00%,9.4,,,,9.4,9.89,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5ML PO SUSR,9080,6370005,,,3 mL,72508-0204-07,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.89,% of charge rate,95.00%,9.4,,,,9.4,9.89,1
unity,NDC,PHENAZOPYRIDINE HCL 97.5 MG PO TABS,91386,6370005,,,1 Tab,49781-0139-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PHENAZOPYRIDINE HCL 97.5 MG PO TABS,91386,6370005,,,1 Tab,49781-0139-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BENAZEPRIL HCL 20 MG PO TABS,9221,6370005,,,1 Tab,43547-0337-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BENAZEPRIL HCL 20 MG PO TABS,9221,6370005,,,1 Tab,43547-0337-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BUMETANIDE 0.5 MG PO TABS,9309,6370005,,,1 Tab,50268-0130-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.27,% of charge rate,95.00%,4.06,,,,4.06,4.27,1
unity,NDC,BUMETANIDE 0.5 MG PO TABS,9309,6370005,,,1 Tab,50268-0130-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.27,% of charge rate,95.00%,4.06,,,,4.06,4.27,1
unity,NDC,BUMETANIDE 0.5 MG PO TABS,9309,6370005,,,1 Tab,50268-0130-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.27,% of charge rate,95.00%,4.06,,,,4.06,4.27,1
unity,NDC,BUMETANIDE 0.5 MG PO TABS,9309,6370005,,,1 Tab,50268-0130-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.27,% of charge rate,95.00%,4.06,,,,4.06,4.27,1
unity,NDC,BUMETANIDE 1 MG PO TABS,9310,6370005,,,1 Tab,00904-7016-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.26,% of charge rate,95.00%,4.05,,,,4.05,4.26,1
unity,NDC,BUMETANIDE 1 MG PO TABS,9310,6370005,,,1 Tab,00904-7016-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.26,% of charge rate,95.00%,4.05,,,,4.05,4.26,1
unity,NDC,BUSPIRONE HCL 10 MG PO TABS,9323,6370005,,,1 Tab,51079-0986-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BUSPIRONE HCL 10 MG PO TABS,9323,6370005,,,1 Tab,51079-0986-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BUSPIRONE HCL 5 MG PO TABS,9324,6370005,,,1 Tab,51079-0985-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BUSPIRONE HCL 5 MG PO TABS,9324,6370005,,,1 Tab,51079-0985-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CALCITRIOL 0.25 MCG PO CAPS,9350,6370005,,,1 Cap,60687-0345-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CALCITRIOL 0.25 MCG PO CAPS,9350,6370005,,,1 Cap,60687-0345-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CALCITRIOL 0.25 MCG PO CAPS,9350,6370005,,,1 Cap,60687-0345-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CALCITRIOL 0.25 MCG PO CAPS,9350,6370005,,,1 Cap,60687-0345-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CALCIUM CARBONATE ANTACID 500 MG PO CHEW,9385,6370005,,,1 Tab,68084-0988-32,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.58,% of charge rate,95.00%,5.3,,,,5.3,5.58,1
unity,NDC,CALCIUM CARBONATE ANTACID 500 MG PO CHEW,9385,6370005,,,1 Tab,68084-0988-32,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.58,% of charge rate,95.00%,5.3,,,,5.3,5.58,1
unity,NDC,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,9407,6370005,,,1 Tab,68084-0093-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,9407,6370005,,,1 Tab,68084-0093-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CEFPODOXIME PROXETIL 200 MG PO TABS,9469,6370005,,,1 Tab,65862-0096-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.86,% of charge rate,95.00%,20.77,,,,20.77,21.86,1
unity,NDC,CEFPODOXIME PROXETIL 200 MG PO TABS,9469,6370005,,,1 Tab,65862-0096-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.86,% of charge rate,95.00%,20.77,,,,20.77,21.86,1
unity,NDC,CEPHALEXIN 500 MG PO CAPS,9500,6370005,,,1 Cap,60687-0163-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,1
unity,NDC,CEPHALEXIN 500 MG PO CAPS,9500,6370005,,,1 Cap,60687-0163-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,1
unity,NDC,CEPHALEXIN 500 MG PO CAPS,9500,6370005,,,1 Cap,60687-0163-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,1
unity,NDC,CEPHALEXIN 500 MG PO CAPS,9500,6370005,,,1 Cap,60687-0163-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,1
unity,NDC,CEPHALEXIN 125 MG/5ML PO SUSR,9501,6370005,,,100 mL,67877-0544-88,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,1
unity,NDC,CEPHALEXIN 125 MG/5ML PO SUSR,9501,6370005,,,100 mL,67877-0544-88,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,66.34,% of charge rate,95.00%,63.02,,,,63.02,66.34,1
unity,NDC,CEPHALEXIN 250 MG/5ML PO SUSR,9502,6370005,,,100 mL,00093-4177-73,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.7,% of charge rate,95.00%,66.22,,,,66.22,69.7,1
unity,NDC,CEPHALEXIN 250 MG/5ML PO SUSR,9502,6370005,,,100 mL,00093-4177-73,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.7,% of charge rate,95.00%,66.22,,,,66.22,69.7,1
unity,NDC,CETIRIZINE HCL 10 MG PO TABS,9506,6370005,,,1 Tab,00904-6717-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CETIRIZINE HCL 10 MG PO TABS,9506,6370005,,,1 Tab,00904-6717-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN,9516,6370005,,,15 mL,00116-2001-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN,9516,6370005,,,15 mL,00116-2001-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLONAZEPAM 0.5 MG PO TABS,9637,6370005,,,1 Tab,43547-0406-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLONAZEPAM 0.5 MG PO TABS,9637,6370005,,,1 Tab,43547-0406-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLOTRIMAZOLE 10 MG MT TROC,9644,6370005,,,1 Tab,00054-4146-22,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CLOTRIMAZOLE 10 MG MT TROC,9644,6370005,,,1 Tab,00054-4146-22,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BENZONATATE 100 MG PO CAPS,988,6370005,,,1 Cap,67877-0573-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BENZONATATE 100 MG PO CAPS,988,6370005,,,1 Cap,67877-0573-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DOXAZOSIN MESYLATE 2 MG PO TABS,9895,6370005,,,1 Tab,68084-0851-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.02,% of charge rate,95.00%,4.77,,,,4.77,5.02,1
unity,NDC,DOXAZOSIN MESYLATE 2 MG PO TABS,9895,6370005,,,1 Tab,68084-0851-95,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.02,% of charge rate,95.00%,4.77,,,,4.77,5.02,1
unity,NDC,DOXAZOSIN MESYLATE 2 MG PO TABS,9895,6370005,,,1 Tab,68084-0851-95,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.02,% of charge rate,95.00%,4.77,,,,4.77,5.02,1
unity,NDC,DOXAZOSIN MESYLATE 2 MG PO TABS,9895,6370005,,,1 Tab,68084-0851-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5.02,% of charge rate,95.00%,4.77,,,,4.77,5.02,1
unity,NDC,DOXYCYCLINE MONOHYDRATE 100 MG PO CAPS,9900,6370005,,,1 Cap,68084-0743-32,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DOXYCYCLINE MONOHYDRATE 100 MG PO CAPS,9900,6370005,,,1 Cap,68084-0743-33,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DOXYCYCLINE MONOHYDRATE 100 MG PO CAPS,9900,6370005,,,1 Cap,68084-0743-33,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DOXYCYCLINE MONOHYDRATE 100 MG PO CAPS,9900,6370005,,,1 Cap,68084-0743-32,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ENALAPRIL MALEATE 10 MG PO TABS,9924,6370005,,,1 Tab,00904-5610-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ENALAPRIL MALEATE 10 MG PO TABS,9924,6370005,,,1 Tab,00904-5610-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BENZTROPINE MESYLATE 0.5 MG PO TABS,998,6370005,,,1 Tab,76385-0103-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,BENZTROPINE MESYLATE 0.5 MG PO TABS,998,6370005,,,1 Tab,76385-0103-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.3,% of charge rate,95.00%,4.09,,,,4.09,4.3,1
unity,NDC,TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,8259,86580,,Tb intradermal test,0.1 mL,49281-0752-22,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,8259,86580,,Tb intradermal test,0.1 mL,49281-0752-21,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,8259,86580,,Tb intradermal test,0.1 mL,49281-0752-21,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,8259,86580,,Tb intradermal test,0.1 mL,49281-0752-22,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,RABIES IMMUNE GLOBULIN 300 UNIT/ML INJ SOLN,142371,90375,,Rabies ig im/sc,1 mL,13533-0318-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,214.53",% of charge rate,95.00%,"1,153.80",,,,"1,153.80","1,214.53",1
unity,NDC,RABIES IMMUNE GLOBULIN 300 UNIT/ML INJ SOLN,142371,90375,,Rabies ig im/sc,1 mL,13533-0318-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,214.53",% of charge rate,95.00%,"1,153.80",,,,"1,153.80","1,214.53",1
unity,NDC,MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,130593,90620,,Menb-4c vacc 2 dose im,0.5 mL,58160-0976-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,243.61,% of charge rate,95.00%,231.43,,,,231.43,243.61,1
unity,NDC,MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,130593,90620,,Menb-4c vacc 2 dose im,0.5 mL,58160-0976-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,243.61,% of charge rate,95.00%,231.43,,,,231.43,243.61,1
unity,NDC,MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,130593,90620,,Menb-4c vacc 2 dose im,0.5 mL,58160-0976-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,243.61,% of charge rate,95.00%,231.43,,,,231.43,243.61,1
unity,NDC,MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,130593,90620,,Menb-4c vacc 2 dose im,0.5 mL,58160-0976-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,243.61,% of charge rate,95.00%,231.43,,,,231.43,243.61,1
unity,NDC,HEPATITIS A VACCINE 1440 EL U/ML IM SUSP,91034,90632,,Hepa vaccine adult im,1 mL,58160-0826-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.52,% of charge rate,95.00%,93.59,,,,93.59,98.52,1
unity,NDC,HEPATITIS A VACCINE 1440 EL U/ML IM SUSP,91034,90632,,Hepa vaccine adult im,1 mL,58160-0826-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,98.52,% of charge rate,95.00%,93.59,,,,93.59,98.52,1
unity,NDC,HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSP,91033,90633,,Hepa vacc ped/adol 2 dose im,0.5 mL,58160-0825-43,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.56,% of charge rate,95.00%,46.13,,,,46.13,48.56,1
unity,NDC,HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSP,91033,90633,,Hepa vacc ped/adol 2 dose im,0.5 mL,58160-0825-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.56,% of charge rate,95.00%,46.13,,,,46.13,48.56,1
unity,NDC,HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSP,91033,90633,,Hepa vacc ped/adol 2 dose im,0.5 mL,58160-0825-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.56,% of charge rate,95.00%,46.13,,,,46.13,48.56,1
unity,NDC,HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSP,91033,90633,,Hepa vacc ped/adol 2 dose im,0.5 mL,58160-0825-43,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.56,% of charge rate,95.00%,46.13,,,,46.13,48.56,1
unity,NDC,HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG INJ SOLR,129283,90648,,Hib prp-t vaccine 4 dose im,0.5 mL,58160-0818-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.72,% of charge rate,95.00%,16.83,,,,16.83,17.72,1
unity,NDC,HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG INJ SOLR,129283,90648,,Hib prp-t vaccine 4 dose im,0.5 mL,58160-0818-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,17.72,% of charge rate,95.00%,16.83,,,,16.83,17.72,1
unity,NDC,HPV 9-VALENT RECOMB VACCINE IM SUSY,130390,90651,,9vhpv vaccine 2/3 dose im,0.5 mL,00006-4121-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,336.48,% of charge rate,95.00%,319.66,,,,319.66,336.48,1
unity,NDC,HPV 9-VALENT RECOMB VACCINE IM SUSY,130390,90651,,9vhpv vaccine 2/3 dose im,0.5 mL,00006-4121-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,336.48,% of charge rate,95.00%,319.66,,,,319.66,336.48,1
unity,NDC,HPV 9-VALENT RECOMB VACCINE IM SUSY,130390,90651,,9vhpv vaccine 2/3 dose im,0.5 mL,00006-4121-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,336.48,% of charge rate,95.00%,319.66,,,,319.66,336.48,1
unity,NDC,HPV 9-VALENT RECOMB VACCINE IM SUSY,130390,90651,,9vhpv vaccine 2/3 dose im,0.5 mL,00006-4121-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,336.48,% of charge rate,95.00%,319.66,,,,319.66,336.48,1
unity,NDC,INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY,136361,90653,,Iiv adjuvant vaccine im,0.5 mL,70461-0020-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,1
unity,NDC,INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY,136361,90653,,Iiv adjuvant vaccine im,0.5 mL,70461-0020-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,1
unity,NDC,INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY,136361,90653,,Iiv adjuvant vaccine im,0.5 mL,70461-0020-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,1
unity,NDC,INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY,136361,90653,,Iiv adjuvant vaccine im,0.5 mL,70461-0020-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,65,% of charge rate,95.00%,61.75,,,,61.75,65,1
unity,NDC,PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP,105941,90670,,Pcv13 vaccine im,0.5 mL,00005-1971-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,296.72,% of charge rate,95.00%,281.88,,,,281.88,296.72,1
unity,NDC,PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP,105941,90670,,Pcv13 vaccine im,0.5 mL,00005-1971-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,296.72,% of charge rate,95.00%,281.88,,,,281.88,296.72,1
unity,NDC,PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP,105941,90670,,Pcv13 vaccine im,0.5 mL,00005-1971-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,296.72,% of charge rate,95.00%,281.88,,,,281.88,296.72,1
unity,NDC,PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP,105941,90670,,Pcv13 vaccine im,0.5 mL,00005-1971-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,296.72,% of charge rate,95.00%,281.88,,,,281.88,296.72,1
unity,NDC,"RABIES VACCINE, PCEC IM SUSR",22120,90675,,Rabies vaccine im,1 mL,58160-0964-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,495.63,% of charge rate,95.00%,470.85,,,,470.85,495.63,1
unity,NDC,"RABIES VACCINE, PCEC IM SUSR",22120,90675,,Rabies vaccine im,1 mL,58160-0964-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,495.63,% of charge rate,95.00%,470.85,,,,470.85,495.63,1
unity,NDC,ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,125719,90680,,Rv5 vacc 3 dose live oral,2 mL,00006-4047-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.58,% of charge rate,95.00%,119.3,,,,119.3,125.58,1
unity,NDC,ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,125719,90680,,Rv5 vacc 3 dose live oral,2 mL,00006-4047-41,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.58,% of charge rate,95.00%,119.3,,,,119.3,125.58,1
unity,NDC,ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,125719,90680,,Rv5 vacc 3 dose live oral,2 mL,00006-4047-41,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.58,% of charge rate,95.00%,119.3,,,,119.3,125.58,1
unity,NDC,ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,125719,90680,,Rv5 vacc 3 dose live oral,2 mL,00006-4047-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,125.58,% of charge rate,95.00%,119.3,,,,119.3,125.58,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.25 ML IM SUSY,131179,90685,,Iiv4 vacc no prsv 0.25 ml im,0.25 mL,33332-0220-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.25 ML IM SUSY,131179,90685,,Iiv4 vacc no prsv 0.25 ml im,0.25 mL,33332-0220-21,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.25 ML IM SUSY,131179,90685,,Iiv4 vacc no prsv 0.25 ml im,0.25 mL,33332-0220-21,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.25 ML IM SUSY,131179,90685,,Iiv4 vacc no prsv 0.25 ml im,0.25 mL,33332-0220-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.5 ML IM SUSY,131180,90686,,Iiv4 vacc no prsv 0.5 ml im,0.5 mL,33332-0320-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.5 ML IM SUSY,131180,90686,,Iiv4 vacc no prsv 0.5 ml im,0.5 mL,33332-0320-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.5 ML IM SUSY,131180,90686,,Iiv4 vacc no prsv 0.5 ml im,0.5 mL,33332-0320-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.5 ML IM SUSY,131180,90686,,Iiv4 vacc no prsv 0.5 ml im,0.5 mL,33332-0320-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25,% of charge rate,95.00%,23.75,,,,23.75,25,1
unity,NDC,DTAP-IPV VACCINE IM SUSP,92804,90696,,Dtap-ipv vaccine 4-6 yrs im,0.5 mL,58160-0812-43,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.29,% of charge rate,95.00%,68.68,,,,68.68,72.29,1
unity,NDC,DTAP-IPV VACCINE IM SUSP,92804,90696,,Dtap-ipv vaccine 4-6 yrs im,0.5 mL,58160-0812-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.29,% of charge rate,95.00%,68.68,,,,68.68,72.29,1
unity,NDC,DTAP-IPV VACCINE IM SUSP,92804,90696,,Dtap-ipv vaccine 4-6 yrs im,0.5 mL,58160-0812-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.29,% of charge rate,95.00%,68.68,,,,68.68,72.29,1
unity,NDC,DTAP-IPV VACCINE IM SUSP,92804,90696,,Dtap-ipv vaccine 4-6 yrs im,0.5 mL,58160-0812-43,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,72.29,% of charge rate,95.00%,68.68,,,,68.68,72.29,1
unity,NDC,DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP,19451,90700,,Dtap vaccine < 7 yrs im,0.5 mL,58160-0810-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.96,% of charge rate,95.00%,30.36,,,,30.36,31.96,1
unity,NDC,DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP,19451,90700,,Dtap vaccine < 7 yrs im,0.5 mL,58160-0810-43,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.96,% of charge rate,95.00%,30.36,,,,30.36,31.96,1
unity,NDC,DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP,19451,90700,,Dtap vaccine < 7 yrs im,0.5 mL,58160-0810-43,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.96,% of charge rate,95.00%,30.36,,,,30.36,31.96,1
unity,NDC,DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP,19451,90700,,Dtap vaccine < 7 yrs im,0.5 mL,58160-0810-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,31.96,% of charge rate,95.00%,30.36,,,,30.36,31.96,1
unity,NDC,"MEASLES, MUMPS & RUBELLA VAC INJ SOLR",146230,90707,,Mmr vaccine sc,0.5 mL,00006-4681-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.53,% of charge rate,95.00%,110.7,,,,110.7,116.53,1
unity,NDC,"MEASLES, MUMPS & RUBELLA VAC INJ SOLR",146230,90707,,Mmr vaccine sc,0.5 mL,00006-4681-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.53,% of charge rate,95.00%,110.7,,,,110.7,116.53,1
unity,NDC,"MEASLES, MUMPS & RUBELLA VAC INJ SOLR",146230,90707,,Mmr vaccine sc,0.5 mL,00006-4681-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.53,% of charge rate,95.00%,110.7,,,,110.7,116.53,1
unity,NDC,"MEASLES, MUMPS & RUBELLA VAC INJ SOLR",146230,90707,,Mmr vaccine sc,0.5 mL,00006-4681-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.53,% of charge rate,95.00%,110.7,,,,110.7,116.53,1
unity,NDC,MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR,143426,90710,,Mmrv vaccine sc,0.5 mL,00006-4171-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,334.41,% of charge rate,95.00%,317.69,,,,317.69,334.41,1
unity,NDC,MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR,143426,90710,,Mmrv vaccine sc,0.5 mL,00006-4171-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,334.41,% of charge rate,95.00%,317.69,,,,317.69,334.41,1
unity,NDC,MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR,143426,90710,,Mmrv vaccine sc,0.5 mL,00006-4171-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,334.41,% of charge rate,95.00%,317.69,,,,317.69,334.41,1
unity,NDC,MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR,143426,90710,,Mmrv vaccine sc,0.5 mL,00006-4171-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,334.41,% of charge rate,95.00%,317.69,,,,317.69,334.41,1
unity,NDC,TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,11515,90714,,Td vacc no presv 7 yrs+ im,0.5 mL,49281-0215-15,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.16,% of charge rate,95.00%,42.9,,,,42.9,45.16,1
unity,NDC,TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,11515,90714,,Td vacc no presv 7 yrs+ im,0.5 mL,49281-0215-88,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.16,% of charge rate,95.00%,42.9,,,,42.9,45.16,1
unity,NDC,TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,11515,90714,,Td vacc no presv 7 yrs+ im,0.5 mL,49281-0215-88,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.16,% of charge rate,95.00%,42.9,,,,42.9,45.16,1
unity,NDC,TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,11515,90714,,Td vacc no presv 7 yrs+ im,0.5 mL,49281-0215-15,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.16,% of charge rate,95.00%,42.9,,,,42.9,45.16,1
unity,NDC,TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP,41293,90715,,Tdap vaccine 7 yrs/> im,0.5 mL,58160-0842-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.93,% of charge rate,95.00%,58.83,,,,58.83,61.93,1
unity,NDC,TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP,41293,90715,,Tdap vaccine 7 yrs/> im,0.5 mL,58160-0842-43,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.93,% of charge rate,95.00%,58.83,,,,58.83,61.93,1
unity,NDC,TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP,41293,90715,,Tdap vaccine 7 yrs/> im,0.5 mL,58160-0842-43,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.93,% of charge rate,95.00%,58.83,,,,58.83,61.93,1
unity,NDC,TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP,41293,90715,,Tdap vaccine 7 yrs/> im,0.5 mL,58160-0842-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.93,% of charge rate,95.00%,58.83,,,,58.83,61.93,1
unity,NDC,VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML SC INJ,117216,90716,,Var vaccine live subq,0.5 mL,00006-4827-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,192.39,% of charge rate,95.00%,182.77,,,,182.77,192.39,1
unity,NDC,VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML SC INJ,117216,90716,,Var vaccine live subq,0.5 mL,00006-4827-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,192.39,% of charge rate,95.00%,182.77,,,,182.77,192.39,1
unity,NDC,VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML SC INJ,117216,90716,,Var vaccine live subq,0.5 mL,00006-4827-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,192.39,% of charge rate,95.00%,182.77,,,,182.77,192.39,1
unity,NDC,VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML SC INJ,117216,90716,,Var vaccine live subq,0.5 mL,00006-4827-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,192.39,% of charge rate,95.00%,182.77,,,,182.77,192.39,1
unity,NDC,DTAP-HEPATITIS B RECOMB-IPV IM SUSP,34550,90723,,Dtap-hep b-ipv vaccine im,0.5 mL,58160-0811-43,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.43,% of charge rate,95.00%,111.56,,,,111.56,117.43,1
unity,NDC,DTAP-HEPATITIS B RECOMB-IPV IM SUSP,34550,90723,,Dtap-hep b-ipv vaccine im,0.5 mL,58160-0811-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.43,% of charge rate,95.00%,111.56,,,,111.56,117.43,1
unity,NDC,DTAP-HEPATITIS B RECOMB-IPV IM SUSP,34550,90723,,Dtap-hep b-ipv vaccine im,0.5 mL,58160-0811-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.43,% of charge rate,95.00%,111.56,,,,111.56,117.43,1
unity,NDC,DTAP-HEPATITIS B RECOMB-IPV IM SUSP,34550,90723,,Dtap-hep b-ipv vaccine im,0.5 mL,58160-0811-43,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,117.43,% of charge rate,95.00%,111.56,,,,111.56,117.43,1
unity,NDC,PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJ INJ,11037,90732,,Ppsv23 vacc 2 yrs+ subq/im,0.5 mL,00006-4837-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144.53,% of charge rate,95.00%,137.3,,,,137.3,144.53,1
unity,NDC,PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJ INJ,11037,90732,,Ppsv23 vacc 2 yrs+ subq/im,0.5 mL,00006-4837-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144.53,% of charge rate,95.00%,137.3,,,,137.3,144.53,1
unity,NDC,PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJ INJ,11037,90732,,Ppsv23 vacc 2 yrs+ subq/im,0.5 mL,00006-4837-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144.53,% of charge rate,95.00%,137.3,,,,137.3,144.53,1
unity,NDC,PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJ INJ,11037,90732,,Ppsv23 vacc 2 yrs+ subq/im,0.5 mL,00006-4837-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,144.53,% of charge rate,95.00%,137.3,,,,137.3,144.53,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR,105726,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,58160-0955-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,187.71,% of charge rate,95.00%,178.32,,,,178.32,187.71,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR,105726,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,58160-0955-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,187.71,% of charge rate,95.00%,178.32,,,,178.32,187.71,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 CONJ IM INJ,40540,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,49281-0589-58,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,174.84,% of charge rate,95.00%,166.1,,,,166.1,174.84,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 CONJ IM INJ,40540,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,49281-0589-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,174.84,% of charge rate,95.00%,166.1,,,,166.1,174.84,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 CONJ IM INJ,40540,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,49281-0589-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,174.84,% of charge rate,95.00%,166.1,,,,166.1,174.84,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 CONJ IM INJ,40540,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,49281-0589-58,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,174.84,% of charge rate,95.00%,166.1,,,,166.1,174.84,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJ SUSP,27325,90744,,Hepb vacc 3 dose ped/adol im,0.5 mL,58160-0820-43,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.62,% of charge rate,95.00%,32.89,,,,32.89,34.62,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJ SUSP,27325,90744,,Hepb vacc 3 dose ped/adol im,0.5 mL,58160-0820-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.62,% of charge rate,95.00%,32.89,,,,32.89,34.62,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJ SUSP,27325,90744,,Hepb vacc 3 dose ped/adol im,0.5 mL,58160-0820-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.62,% of charge rate,95.00%,32.89,,,,32.89,34.62,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJ SUSP,27325,90744,,Hepb vacc 3 dose ped/adol im,0.5 mL,58160-0820-43,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.62,% of charge rate,95.00%,32.89,,,,32.89,34.62,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/ML INJ SUSP,27324,90746,,Hepb vaccine 3 dose adult im,1 mL,00006-4995-41,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.72,% of charge rate,95.00%,85.23,,,,85.23,89.72,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/ML INJ SUSP,27324,90746,,Hepb vaccine 3 dose adult im,1 mL,00006-4995-41,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,89.72,% of charge rate,95.00%,85.23,,,,85.23,89.72,1
unity,NDC,ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,141122,90750,,Hzv vacc recombinant im,0.5 mL,58160-0819-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,223.8,% of charge rate,95.00%,212.61,,,,212.61,223.8,1
unity,NDC,ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,141122,90750,,Hzv vacc recombinant im,0.5 mL,58160-0823-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,223.8,% of charge rate,95.00%,212.61,,,,212.61,223.8,1
unity,NDC,ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,141122,90750,,Hzv vacc recombinant im,0.5 mL,58160-0819-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,223.8,% of charge rate,95.00%,212.61,,,,212.61,223.8,1
unity,NDC,ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,141122,90750,,Hzv vacc recombinant im,0.5 mL,58160-0823-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,223.8,% of charge rate,95.00%,212.61,,,,212.61,223.8,1
unity,NDC,PROCHLORPERAZINE 25 MG REC SUPP,11138,99070,,Special supplies phys/qhp,1 Suppository,00713-0135-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.72,% of charge rate,95.00%,13.03,,,,13.03,13.72,1
unity,NDC,PROCHLORPERAZINE 25 MG REC SUPP,11138,99070,,Special supplies phys/qhp,1 Suppository,00713-0135-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,13.72,% of charge rate,95.00%,13.03,,,,13.03,13.72,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,63807-0100-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,63807-0100-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,92670-0012-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",5 mL,08290-3065-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-0940-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-3065-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-3065-53,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08881-5701-21,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08881-5791-21,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08881-5791-21,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08881-5701-21,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-3065-53,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-3065-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-0940-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",5 mL,08290-3065-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,92670-0012-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,63807-0100-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,63807-0100-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,5,% of charge rate,95.00%,4.75,,,,4.75,5,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",50 mL,00409-4887-50,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",10 mL,00409-4887-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",10 mL,00409-4887-17,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",20 mL,00409-4887-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",20 mL,00409-4887-23,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",20 mL,00409-4887-23,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",20 mL,00409-4887-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",10 mL,00409-4887-17,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",10 mL,00409-4887-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",50 mL,00409-4887-50,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HYDRALAZINE HCL 50 MG PO TABS,3701,A9270,,Non-covered item or service,1 Tab,00904-6442-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDRALAZINE HCL 50 MG PO TABS,3701,A9270,,Non-covered item or service,1 Tab,00904-6442-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,GADOBUTROL 1 MMOL/ML IV SOLN,111718,A9585,,Gadobutrol injection,10 mL,50419-0325-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87,% of charge rate,95.00%,82.65,,,,82.65,87,1
unity,NDC,GADOBUTROL 1 MMOL/ML IV SOLN,111718,A9585,,Gadobutrol injection,10 mL,50419-0325-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87,% of charge rate,95.00%,82.65,,,,82.65,87,1
unity,NDC,BUPIVACAINE LIPOSOME 1.3 % INJ SUSP,115193,C9290,,BUPIVACAINE LIPOSOME 266mg/20mL vial (266 Jcode units/vial),5 mL,65250-0266-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,217.59,% of charge rate,95.00%,206.71,,,,206.71,217.59,1
unity,NDC,BUPIVACAINE LIPOSOME 1.3 % INJ SUSP,115193,C9290,,BUPIVACAINE LIPOSOME 266mg/20mL vial (266 Jcode units/vial),5 mL,65250-0266-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,217.59,% of charge rate,95.00%,206.71,,,,206.71,217.59,1
unity,NDC,LIRAGLUTIDE 18 MG/3ML SC SOPN,127467,C9399,,,3 mL,00169-4060-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,751.63,% of charge rate,95.00%,714.05,,,,714.05,751.63,1
unity,NDC,LIRAGLUTIDE 18 MG/3ML SC SOPN,127467,C9399,,,3 mL,00169-4060-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,751.63,% of charge rate,95.00%,714.05,,,,714.05,751.63,1
unity,NDC,ACETAMINOPHEN 10 MG/ML IV SOLN,110322,J0131,,Acetaminophen injection,100 mL,43825-0102-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,205.97,% of charge rate,95.00%,195.67,,,,195.67,205.97,1
unity,NDC,ACETAMINOPHEN 10 MG/ML IV SOLN,110322,J0131,,Acetaminophen injection,100 mL,43825-0102-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,205.97,% of charge rate,95.00%,195.67,,,,195.67,205.97,1
unity,NDC,ACETYLCYSTEINE 200 MG/ML IV SOLN,38303,J0132,,Acetylcysteine injection,30 mL,25021-0812-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,165.14,% of charge rate,95.00%,156.88,,,,156.88,165.14,1
unity,NDC,ACETYLCYSTEINE 200 MG/ML IV SOLN,38303,J0132,,Acetylcysteine injection,30 mL,25021-0812-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,165.14,% of charge rate,95.00%,156.88,,,,156.88,165.14,1
unity,NDC,ADENOSINE 6 MG/2ML IV SOLN,38703,J0153,,Adenosine inj 1mg,1 mL,17478-0542-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ADENOSINE 6 MG/2ML IV SOLN,38703,J0153,,Adenosine inj 1mg,1 mL,17478-0542-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,42023-0159-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,54288-0103-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,54288-0103-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,54288-0103-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,54288-0103-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,42023-0159-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,53.38,% of charge rate,95.00%,50.71,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE 1 MG/10ML INJ SOSY,143129,J0171,,Adrenalin epinephrine inject,10 mL,00409-4921-34,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.97,% of charge rate,95.00%,31.32,,,,31.32,32.97,1
unity,NDC,EPINEPHRINE 1 MG/10ML INJ SOSY,143129,J0171,,Adrenalin epinephrine inject,10 mL,00409-4921-34,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.97,% of charge rate,95.00%,31.32,,,,31.32,32.97,1
unity,NDC,AMIODARONE HCL 150 MG/3ML IV SOLN,93167,J0282,,Amiodarone hcl,3 mL,63323-0616-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMIODARONE HCL 150 MG/3ML IV SOLN,93167,J0282,,Amiodarone hcl,3 mL,63323-0616-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN SODIUM 1 G INJ SOLR,469,J0290,,Ampicillin 500 mg inj,"1,000 mg",55150-0113-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN SODIUM 1 G INJ SOLR,469,J0290,,Ampicillin 500 mg inj,"1,000 mg",55150-0113-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN SODIUM 2 G INJ SOLR,472,J0290,,Ampicillin 500 mg inj,2 g,55150-0114-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN SODIUM 2 G INJ SOLR,472,J0290,,Ampicillin 500 mg inj,2 g,55150-0114-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 1.5 (1-0.5) G INJ SOLR,9083,J0295,,Ampicillin sulbactam 1.5 gm,1.5 g,55150-0116-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 1.5 (1-0.5) G INJ SOLR,9083,J0295,,Ampicillin sulbactam 1.5 gm,1.5 g,71288-0005-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 1.5 (1-0.5) G INJ SOLR,9083,J0295,,Ampicillin sulbactam 1.5 gm,1.5 g,71288-0005-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 1.5 (1-0.5) G INJ SOLR,9083,J0295,,Ampicillin sulbactam 1.5 gm,1.5 g,55150-0116-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 3 (2-1) G INJ SOLR,9084,J0295,,Ampicillin sulbactam 1.5 gm,3 g,00049-0014-83,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 3 (2-1) G INJ SOLR,9084,J0295,,Ampicillin sulbactam 1.5 gm,3 g,00049-0014-83,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN,7536,J0330,,Succinycholine chloride inj,10 mL,51991-0964-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.8,% of charge rate,95.00%,55.86,,,,55.86,58.8,1
unity,NDC,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN,7536,J0330,,Succinycholine chloride inj,10 mL,51991-0964-99,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.8,% of charge rate,95.00%,55.86,,,,55.86,58.8,1
unity,NDC,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN,7536,J0330,,Succinycholine chloride inj,10 mL,51991-0964-99,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.8,% of charge rate,95.00%,55.86,,,,55.86,58.8,1
unity,NDC,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN,7536,J0330,,Succinycholine chloride inj,10 mL,51991-0964-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.8,% of charge rate,95.00%,55.86,,,,55.86,58.8,1
unity,NDC,HYDRALAZINE HCL 20 MG/ML INJ SOLN,3697,J0360,,Hydralazine hcl injection,1 mL,63323-0614-55,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.81,% of charge rate,95.00%,48.27,,,,48.27,50.81,1
unity,NDC,HYDRALAZINE HCL 20 MG/ML INJ SOLN,3697,J0360,,Hydralazine hcl injection,1 mL,63323-0614-55,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.81,% of charge rate,95.00%,48.27,,,,48.27,50.81,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70436-0019-82,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70860-0100-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70860-0100-41,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70860-0100-41,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70860-0100-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70436-0019-82,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ATROPINE SULFATE 1 MG/10ML INJ SOSY,139198,J0461,,Atropine sulfate injection,10 mL,00409-1630-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.12,% of charge rate,95.00%,28.61,,,,28.61,30.12,1
unity,NDC,ATROPINE SULFATE 1 MG/10ML INJ SOSY,139198,J0461,,Atropine sulfate injection,10 mL,00409-1630-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,30.12,% of charge rate,95.00%,28.61,,,,28.61,30.12,1
unity,NDC,ATROPINE SULFATE 0.4 MG/ML INJ SOLN,731,J0461,,Atropine sulfate injection,1 mL,00517-0401-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.54,% of charge rate,95.00%,24.26,,,,24.26,25.54,1
unity,NDC,ATROPINE SULFATE 0.4 MG/ML INJ SOLN,731,J0461,,Atropine sulfate injection,1 mL,00517-0401-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,25.54,% of charge rate,95.00%,24.26,,,,24.26,25.54,1
unity,NDC,DICYCLOMINE HCL 20 MG PO TABS,2420,J0500,,Dicyclomine injection,1 Tab,60687-0380-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DICYCLOMINE HCL 20 MG PO TABS,2420,J0500,,Dicyclomine injection,1 Tab,60687-0380-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DICYCLOMINE HCL 20 MG PO TABS,2420,J0500,,Dicyclomine injection,1 Tab,60687-0380-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DICYCLOMINE HCL 20 MG PO TABS,2420,J0500,,Dicyclomine injection,1 Tab,60687-0380-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,CALCIUM GLUCONATE 10 % IV SOLN,1312,J0610,,Calcium gluconate injection,5 mL,63323-0360-19,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.14,% of charge rate,95.00%,22.93,,,,22.93,24.14,1
unity,NDC,CALCIUM GLUCONATE 10 % IV SOLN,1312,J0610,,Calcium gluconate injection,5 mL,63323-0360-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.14,% of charge rate,95.00%,22.93,,,,22.93,24.14,1
unity,NDC,CALCIUM GLUCONATE 10 % IV SOLN,1312,J0610,,Calcium gluconate injection,5 mL,63323-0360-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.14,% of charge rate,95.00%,22.93,,,,22.93,24.14,1
unity,NDC,CALCIUM GLUCONATE 10 % IV SOLN,1312,J0610,,Calcium gluconate injection,5 mL,63323-0360-19,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,24.14,% of charge rate,95.00%,22.93,,,,22.93,24.14,1
unity,NDC,LEUCOVORIN CALCIUM 500 MG INJ SOLR,23617,J0640,,Leucovorin calcium injection,500 mg,63323-0711-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,204.51,% of charge rate,95.00%,194.28,,,,194.28,204.51,1
unity,NDC,LEUCOVORIN CALCIUM 500 MG INJ SOLR,23617,J0640,,Leucovorin calcium injection,500 mg,63323-0711-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,204.51,% of charge rate,95.00%,194.28,,,,194.28,204.51,1
unity,NDC,LEUCOVORIN CALCIUM 350 MG INJ SOLR,4393,J0640,,Leucovorin calcium injection,350 mg,00703-5145-91,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.15,% of charge rate,95.00%,46.69,,,,46.69,49.15,1
unity,NDC,LEUCOVORIN CALCIUM 350 MG INJ SOLR,4393,J0640,,Leucovorin calcium injection,350 mg,00703-5145-91,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,49.15,% of charge rate,95.00%,46.69,,,,46.69,49.15,1
unity,NDC,CEFAZOLIN SODIUM-DEXTROSE 1-4 GM-%(50ML) IV SOLR,143541,J0690,,Cefazolin sodium injection,50 mL,00264-3103-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.79,% of charge rate,95.00%,82.45,,,,82.45,86.79,1
unity,NDC,CEFAZOLIN SODIUM-DEXTROSE 1-4 GM-%(50ML) IV SOLR,143541,J0690,,Cefazolin sodium injection,50 mL,00264-3103-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.79,% of charge rate,95.00%,82.45,,,,82.45,86.79,1
unity,NDC,CEFTOLOZANE-TAZOBACTAM 1.5 (1-0.5) G IV SOLR,130445,J0695,,Inj ceftolozane tazobactam,1.5 g,67919-0030-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,324.78,% of charge rate,95.00%,308.54,,,,308.54,324.78,1
unity,NDC,CEFTOLOZANE-TAZOBACTAM 1.5 (1-0.5) G IV SOLR,130445,J0695,,Inj ceftolozane tazobactam,1.5 g,67919-0030-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,324.78,% of charge rate,95.00%,308.54,,,,308.54,324.78,1
unity,NDC,CEFTRIAXONE SODIUM-DEXTROSE 1-3.74 GM-%(50ML) IV SOLR,143539,J0696,,Ceftriaxone sodium injection,50 mL,00264-3153-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.87,% of charge rate,95.00%,104.38,,,,104.38,109.87,1
unity,NDC,CEFTRIAXONE SODIUM-DEXTROSE 1-3.74 GM-%(50ML) IV SOLR,143539,J0696,,Ceftriaxone sodium injection,50 mL,00264-3153-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,109.87,% of charge rate,95.00%,104.38,,,,104.38,109.87,1
unity,NDC,CEFTRIAXONE SODIUM-DEXTROSE 2-2.22 GM-%(50ML) IV SOLR,143546,J0696,,Ceftriaxone sodium injection,50 mL,00264-3155-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137.51,% of charge rate,95.00%,130.63,,,,130.63,137.51,1
unity,NDC,CEFTRIAXONE SODIUM-DEXTROSE 2-2.22 GM-%(50ML) IV SOLR,143546,J0696,,Ceftriaxone sodium injection,50 mL,00264-3155-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,137.51,% of charge rate,95.00%,130.63,,,,130.63,137.51,1
unity,NDC,CEFTRIAXONE SODIUM 1 G INJ SOLR,9487,J0696,,Ceftriaxone sodium injection,1 g,25021-0106-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.5,% of charge rate,95.00%,25.18,,,,25.18,26.5,1
unity,NDC,CEFTRIAXONE SODIUM 1 G INJ SOLR,9487,J0696,,Ceftriaxone sodium injection,1 g,25021-0106-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,26.5,% of charge rate,95.00%,25.18,,,,25.18,26.5,1
unity,NDC,CEFTAROLINE FOSAMIL 600 MG IV SOLR,109957,J0712,,Ceftaroline fosamil inj,600 mg,00456-0600-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,509.02,% of charge rate,95.00%,483.57,,,,483.57,509.02,1
unity,NDC,CEFTAROLINE FOSAMIL 600 MG IV SOLR,109957,J0712,,Ceftaroline fosamil inj,600 mg,00456-0600-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,509.02,% of charge rate,95.00%,483.57,,,,483.57,509.02,1
unity,NDC,CEFTAROLINE FOSAMIL 600 MG IV SOLR,109957,J0712,,Ceftaroline fosamil inj,600 mg,00456-0600-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,509.02,% of charge rate,95.00%,483.57,,,,483.57,509.02,1
unity,NDC,CEFTAROLINE FOSAMIL 600 MG IV SOLR,109957,J0712,,Ceftaroline fosamil inj,600 mg,00456-0600-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,509.02,% of charge rate,95.00%,483.57,,,,483.57,509.02,1
unity,NDC,CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN,91238,J0744,,Ciprofloxacin iv,200 mL,36000-0298-24,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.8,% of charge rate,95.00%,55.86,,,,55.86,58.8,1
unity,NDC,CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN,91238,J0744,,Ciprofloxacin iv,200 mL,36000-0298-24,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,58.8,% of charge rate,95.00%,55.86,,,,55.86,58.8,1
unity,NDC,PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJ SOLN,144862,J0780,,Prochlorperazine injection,1 mL,23155-0294-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.71,% of charge rate,95.00%,38.67,,,,38.67,40.71,1
unity,NDC,PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJ SOLN,144862,J0780,,Prochlorperazine injection,2 mL,23155-0294-42,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.71,% of charge rate,95.00%,38.67,,,,38.67,40.71,1
unity,NDC,PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJ SOLN,144862,J0780,,Prochlorperazine injection,2 mL,23155-0294-42,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.71,% of charge rate,95.00%,38.67,,,,38.67,40.71,1
unity,NDC,PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJ SOLN,144862,J0780,,Prochlorperazine injection,1 mL,23155-0294-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.71,% of charge rate,95.00%,38.67,,,,38.67,40.71,1
unity,NDC,DAPTOMYCIN 350 MG IV SOLR,142780,J0878,,Daptomycin injection,350 mg,16729-0434-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,187.93,% of charge rate,95.00%,178.53,,,,178.53,187.93,1
unity,NDC,DAPTOMYCIN 350 MG IV SOLR,142780,J0878,,Daptomycin injection,350 mg,16729-0434-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,187.93,% of charge rate,95.00%,178.53,,,,178.53,187.93,1
unity,NDC,DAPTOMYCIN 500 MG IV SOLR,36989,J0878,,Daptomycin injection,500 mg,69097-0807-37,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,253.18,% of charge rate,95.00%,240.52,,,,240.52,253.18,1
unity,NDC,DAPTOMYCIN 500 MG IV SOLR,36989,J0878,,Daptomycin injection,500 mg,69097-0807-37,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,253.18,% of charge rate,95.00%,240.52,,,,240.52,253.18,1
unity,NDC,DARBEPOETIN ALFA 40 MCG/0.4ML INJ SOSY,133115,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0021-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,437.75,% of charge rate,95.00%,415.86,,,,415.86,437.75,1
unity,NDC,DARBEPOETIN ALFA 40 MCG/0.4ML INJ SOSY,133115,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0021-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,437.75,% of charge rate,95.00%,415.86,,,,415.86,437.75,1
unity,NDC,DARBEPOETIN ALFA 40 MCG/0.4ML INJ SOSY,133115,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0021-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,437.75,% of charge rate,95.00%,415.86,,,,415.86,437.75,1
unity,NDC,DARBEPOETIN ALFA 40 MCG/0.4ML INJ SOSY,133115,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0021-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,437.75,% of charge rate,95.00%,415.86,,,,415.86,437.75,1
unity,NDC,DARBEPOETIN ALFA 60 MCG/0.3ML INJ SOSY,133117,J0882,,"Darbepoetin alfa, esrd use",0.3 mL,55513-0023-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,618.97",% of charge rate,95.00%,"2,488.02",,,,"2,488.02","2,618.97",1
unity,NDC,DARBEPOETIN ALFA 60 MCG/0.3ML INJ SOSY,133117,J0882,,"Darbepoetin alfa, esrd use",0.3 mL,55513-0023-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,618.97",% of charge rate,95.00%,"2,488.02",,,,"2,488.02","2,618.97",1
unity,NDC,DARBEPOETIN ALFA 60 MCG/0.3ML INJ SOSY,133117,J0882,,"Darbepoetin alfa, esrd use",0.3 mL,55513-0023-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,618.97",% of charge rate,95.00%,"2,488.02",,,,"2,488.02","2,618.97",1
unity,NDC,DARBEPOETIN ALFA 60 MCG/0.3ML INJ SOSY,133117,J0882,,"Darbepoetin alfa, esrd use",0.3 mL,55513-0023-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,618.97",% of charge rate,95.00%,"2,488.02",,,,"2,488.02","2,618.97",1
unity,NDC,DARBEPOETIN ALFA 100 MCG/0.5ML INJ SOSY,133120,J0882,,"Darbepoetin alfa, esrd use",0.5 mL,55513-0025-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,909.07",% of charge rate,95.00%,"1,813.62",,,,"1,813.62","1,909.07",1
unity,NDC,DARBEPOETIN ALFA 100 MCG/0.5ML INJ SOSY,133120,J0882,,"Darbepoetin alfa, esrd use",0.5 mL,55513-0025-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,909.07",% of charge rate,95.00%,"1,813.62",,,,"1,813.62","1,909.07",1
unity,NDC,DARBEPOETIN ALFA 100 MCG/0.5ML INJ SOSY,133120,J0882,,"Darbepoetin alfa, esrd use",0.5 mL,55513-0025-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,909.07",% of charge rate,95.00%,"1,813.62",,,,"1,813.62","1,909.07",1
unity,NDC,DARBEPOETIN ALFA 100 MCG/0.5ML INJ SOSY,133120,J0882,,"Darbepoetin alfa, esrd use",0.5 mL,55513-0025-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,909.07",% of charge rate,95.00%,"1,813.62",,,,"1,813.62","1,909.07",1
unity,NDC,DARBEPOETIN ALFA 200 MCG/0.4ML INJ SOSY,133124,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0028-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,800.39",% of charge rate,95.00%,"3,610.37",,,,"3,610.37","3,800.39",1
unity,NDC,DARBEPOETIN ALFA 200 MCG/0.4ML INJ SOSY,133124,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0028-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,800.39",% of charge rate,95.00%,"3,610.37",,,,"3,610.37","3,800.39",1
unity,NDC,DARBEPOETIN ALFA 300 MCG/0.6ML INJ SOSY,133125,J0882,,"Darbepoetin alfa, esrd use",0.6 mL,55513-0111-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,724.18",% of charge rate,95.00%,"5,437.97",,,,"5,437.97","5,724.18",1
unity,NDC,DARBEPOETIN ALFA 300 MCG/0.6ML INJ SOSY,133125,J0882,,"Darbepoetin alfa, esrd use",0.6 mL,55513-0111-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,724.18",% of charge rate,95.00%,"5,437.97",,,,"5,437.97","5,724.18",1
unity,NDC,DENOSUMAB 120 MG/1.7ML SC SOLN,109717,J0897,,Denosumab injection,1.7 mL,55513-0730-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"6,065.96",% of charge rate,95.00%,"5,762.66",,,,"5,762.66","6,065.96",1
unity,NDC,DENOSUMAB 120 MG/1.7ML SC SOLN,109717,J0897,,Denosumab injection,1.7 mL,55513-0730-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"6,065.96",% of charge rate,95.00%,"5,762.66",,,,"5,762.66","6,065.96",1
unity,NDC,DENOSUMAB 60 MG/ML SC SOSY,144893,J0897,,Denosumab injection,1 mL,55513-0710-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,298.43",% of charge rate,95.00%,"3,133.51",,,,"3,133.51","3,298.43",1
unity,NDC,DENOSUMAB 60 MG/ML SC SOSY,144893,J0897,,Denosumab injection,1 mL,55513-0710-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,298.43",% of charge rate,95.00%,"3,133.51",,,,"3,133.51","3,298.43",1
unity,NDC,METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP,4995,J1030,,Methylprednisolone 40 mg inj,1 mL,00009-3073-23,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP,4995,J1030,,Methylprednisolone 40 mg inj,1 mL,00009-3073-23,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP,4996,J1040,,Methylprednisolone 80 mg inj,1 mL,70121-1574-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.47,% of charge rate,95.00%,51.75,,,,51.75,54.47,1
unity,NDC,METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP,4996,J1040,,Methylprednisolone 80 mg inj,1 mL,70121-1574-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.47,% of charge rate,95.00%,51.75,,,,51.75,54.47,1
unity,NDC,METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP,4996,J1040,,Methylprednisolone 80 mg inj,1 mL,70121-1574-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.47,% of charge rate,95.00%,51.75,,,,51.75,54.47,1
unity,NDC,METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP,4996,J1040,,Methylprednisolone 80 mg inj,1 mL,70121-1574-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.47,% of charge rate,95.00%,51.75,,,,51.75,54.47,1
unity,NDC,MEDROXYPROGESTERONE ACETATE 150 MG/ML IM SUSP,19736,J1050,,Medroxyprogesterone acetate,1 mL,00548-5400-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,185.48,% of charge rate,95.00%,176.21,,,,176.21,185.48,1
unity,NDC,MEDROXYPROGESTERONE ACETATE 150 MG/ML IM SUSP,19736,J1050,,Medroxyprogesterone acetate,1 mL,00548-5400-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,185.48,% of charge rate,95.00%,176.21,,,,176.21,185.48,1
unity,NDC,MEDROXYPROGESTERONE ACETATE 150 MG/ML IM SUSP,19736,J1050,,Medroxyprogesterone acetate,1 mL,00548-5400-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,185.48,% of charge rate,95.00%,176.21,,,,176.21,185.48,1
unity,NDC,MEDROXYPROGESTERONE ACETATE 150 MG/ML IM SUSP,19736,J1050,,Medroxyprogesterone acetate,1 mL,00548-5400-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,185.48,% of charge rate,95.00%,176.21,,,,176.21,185.48,1
unity,NDC,TESTOSTERONE CYPIONATE 200 MG/ML IM SOLN,129294,J1071,,Inj testosterone cypionate,1 mL,00009-0417-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,TESTOSTERONE CYPIONATE 200 MG/ML IM SOLN,129294,J1071,,Inj testosterone cypionate,1 mL,00009-0417-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,0.5 mL,00641-6146-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,1 mL,67457-0422-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,5 mL,67457-0422-54,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,5 mL,67457-0422-54,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,1 mL,67457-0422-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,0.5 mL,00641-6146-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN,2331,J1100,,Dexamethasone sodium phos,1 mL,00641-0367-21,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN,2331,J1100,,Dexamethasone sodium phos,1 mL,00641-0367-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN,2331,J1100,,Dexamethasone sodium phos,1 mL,00641-0367-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN,2331,J1100,,Dexamethasone sodium phos,1 mL,00641-0367-21,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN,2332,J1100,,Dexamethasone sodium phos,1 mL,67457-0423-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN,2332,J1100,,Dexamethasone sodium phos,1 mL,67457-0423-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIGOXIN 0.25 MG/ML INJ SOLN,2442,J1160,,Digoxin injection,2 mL,00641-1410-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIGOXIN 0.25 MG/ML INJ SOLN,2442,J1160,,Digoxin injection,2 mL,00641-1410-35,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIGOXIN 0.25 MG/ML INJ SOLN,2442,J1160,,Digoxin injection,2 mL,00641-1410-35,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIGOXIN 0.25 MG/ML INJ SOLN,2442,J1160,,Digoxin injection,2 mL,00641-1410-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PHENYTOIN SODIUM 50 MG/ML INJ SOLN,6256,J1165,,Phenytoin sodium injection,5 mL,00641-2555-45,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PHENYTOIN SODIUM 50 MG/ML INJ SOLN,6256,J1165,,Phenytoin sodium injection,5 mL,00641-2555-45,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HYDROMORPHONE HCL 2 MG/ML INJ SOLN,3758,J1170,,Hydromorphone injection,1 mL,00641-0121-21,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,240.7,% of charge rate,95.00%,228.67,,,,228.67,240.7,1
unity,NDC,HYDROMORPHONE HCL 2 MG/ML INJ SOLN,3758,J1170,,Hydromorphone injection,1 mL,00641-0121-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,240.7,% of charge rate,95.00%,228.67,,,,228.67,240.7,1
unity,NDC,HYDROMORPHONE HCL 2 MG/ML INJ SOLN,3758,J1170,,Hydromorphone injection,1 mL,00641-0121-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,240.7,% of charge rate,95.00%,228.67,,,,228.67,240.7,1
unity,NDC,HYDROMORPHONE HCL 2 MG/ML INJ SOLN,3758,J1170,,Hydromorphone injection,1 mL,00641-0121-21,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,240.7,% of charge rate,95.00%,228.67,,,,228.67,240.7,1
unity,NDC,DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN,2508,J1200,,Diphenhydramine hcl injectio,1 mL,00641-0376-21,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN,2508,J1200,,Diphenhydramine hcl injectio,1 mL,00641-0376-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN,2508,J1200,,Diphenhydramine hcl injectio,1 mL,00641-0376-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN,2508,J1200,,Diphenhydramine hcl injectio,1 mL,00641-0376-21,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DOPAMINE IN D5W 1.6-5 MG/ML-% IV SOLN,14845,J1265,,Dopamine injection,500 mL,00409-7809-24,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.89,% of charge rate,95.00%,115.8,,,,115.8,121.89,1
unity,NDC,DOPAMINE IN D5W 1.6-5 MG/ML-% IV SOLN,14845,J1265,,Dopamine injection,500 mL,00409-7809-24,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,121.89,% of charge rate,95.00%,115.8,,,,115.8,121.89,1
unity,NDC,ERTAPENEM SODIUM 1 G INJ SOLR,111716,J1335,,Ertapenem injection,1 g,00006-3843-71,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,333.68,% of charge rate,95.00%,317,,,,317,333.68,1
unity,NDC,ERTAPENEM SODIUM 1 G INJ SOLR,111716,J1335,,Ertapenem injection,1 g,00006-3843-71,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,333.68,% of charge rate,95.00%,317,,,,317,333.68,1
unity,NDC,FERRIC CARBOXYMALTOSE 750 MG/15ML IV SOLN,125094,J1439,,Inj ferric carboxymaltos 1mg,15 mL,00517-0650-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,362.17",% of charge rate,95.00%,"2,244.06",,,,"2,244.06","2,362.17",1
unity,NDC,FERRIC CARBOXYMALTOSE 750 MG/15ML IV SOLN,125094,J1439,,Inj ferric carboxymaltos 1mg,15 mL,00517-0650-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,362.17",% of charge rate,95.00%,"2,244.06",,,,"2,244.06","2,362.17",1
unity,NDC,TBO-FILGRASTIM 480 MCG/0.8ML SC SOSY,126460,J1447,,Inj tbo filgrastim 1 microg,0.8 mL,63459-0912-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,935.71,% of charge rate,95.00%,888.92,,,,888.92,935.71,1
unity,NDC,TBO-FILGRASTIM 480 MCG/0.8ML SC SOSY,126460,J1447,,Inj tbo filgrastim 1 microg,0.8 mL,63459-0912-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,935.71,% of charge rate,95.00%,888.92,,,,888.92,935.71,1
unity,NDC,FLUCONAZOLE IN SODIUM CHLORIDE 400-0.9 MG/200ML-% IV SOLN,10050,J1450,,Fluconazole,200 mL,25021-0184-87,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.75,% of charge rate,95.00%,82.41,,,,82.41,86.75,1
unity,NDC,FLUCONAZOLE IN SODIUM CHLORIDE 400-0.9 MG/200ML-% IV SOLN,10050,J1450,,Fluconazole,200 mL,25021-0184-87,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,86.75,% of charge rate,95.00%,82.41,,,,82.41,86.75,1
unity,NDC,FOSAPREPITANT DIMEGLUMINE 150 MG IV SOLR,109696,J1453,,Fosaprepitant injection,150 mg,00006-3061-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,864.54,% of charge rate,95.00%,821.31,,,,821.31,864.54,1
unity,NDC,FOSAPREPITANT DIMEGLUMINE 150 MG IV SOLR,109696,J1453,,Fosaprepitant injection,150 mg,00006-3061-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,864.54,% of charge rate,95.00%,821.31,,,,821.31,864.54,1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 5 GM/50ML IV SOLN,111095,J1459,,Inj ivig privigen 500 mg,50 mL,44206-0436-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,137.85",% of charge rate,95.00%,"1,080.96",,,,"1,080.96","1,137.85",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 5 GM/50ML IV SOLN,111095,J1459,,Inj ivig privigen 500 mg,50 mL,44206-0436-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,137.85",% of charge rate,95.00%,"1,080.96",,,,"1,080.96","1,137.85",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 40 GM/400ML IV SOLN,124319,J1459,,Inj ivig privigen 500 mg,400 mL,44206-0439-40,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"8,564.10",% of charge rate,95.00%,"8,135.90",,,,"8,135.90","8,564.10",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 40 GM/400ML IV SOLN,124319,J1459,,Inj ivig privigen 500 mg,400 mL,44206-0439-40,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"8,564.10",% of charge rate,95.00%,"8,135.90",,,,"8,135.90","8,564.10",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 10 GM/100ML IV SOLN,111096,J1568,,Octagam injection,100 mL,44206-0437-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,176.42",% of charge rate,95.00%,"2,067.60",,,,"2,067.60","2,176.42",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 10 GM/100ML IV SOLN,111096,J1568,,Octagam injection,100 mL,44206-0437-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,176.42",% of charge rate,95.00%,"2,067.60",,,,"2,067.60","2,176.42",1
unity,NDC,GENTAMICIN SULFATE 40 MG/ML INJ SOLN,3426,J1580,,Garamycin gentamicin inj,2 mL,63323-0010-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,GENTAMICIN SULFATE 40 MG/ML INJ SOLN,3426,J1580,,Garamycin gentamicin inj,2 mL,63323-0010-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,GOLIMUMAB 50 MG/4ML IV SOLN,125072,J1602,,Golimumab for iv use 1mg,4 mL,57894-0350-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,896.36",% of charge rate,95.00%,"4,651.54",,,,"4,651.54","4,896.36",1
unity,NDC,GOLIMUMAB 50 MG/4ML IV SOLN,125072,J1602,,Golimumab for iv use 1mg,4 mL,57894-0350-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,896.36",% of charge rate,95.00%,"4,651.54",,,,"4,651.54","4,896.36",1
unity,NDC,GLUCAGON (RDNA) 1 MG INJ KIT,24869,J1610,,Glucagon hydrochloride/1 mg,1 mL,00002-8031-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,556.52,% of charge rate,95.00%,528.69,,,,528.69,556.52,1
unity,NDC,GLUCAGON (RDNA) 1 MG INJ KIT,24869,J1610,,Glucagon hydrochloride/1 mg,1 mL,00002-8031-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,556.52,% of charge rate,95.00%,528.69,,,,528.69,556.52,1
unity,NDC,GLUCAGON HCL RDNA (DIAGNOSTIC) 1 MG INJ SOLR,41581,J1610,,Glucagon hydrochloride/1 mg,1 mL,00597-0260-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,280.12,% of charge rate,95.00%,266.11,,,,266.11,280.12,1
unity,NDC,GLUCAGON HCL RDNA (DIAGNOSTIC) 1 MG INJ SOLR,41581,J1610,,Glucagon hydrochloride/1 mg,1 mL,00597-0260-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,280.12,% of charge rate,95.00%,266.11,,,,266.11,280.12,1
unity,NDC,GRANISETRON HCL 1 MG/ML IV SOLN,12552,J1626,,Granisetron hcl injection,1 mL,17478-0546-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.22,% of charge rate,95.00%,35.36,,,,35.36,37.22,1
unity,NDC,GRANISETRON HCL 1 MG/ML IV SOLN,12552,J1626,,Granisetron hcl injection,1 mL,17478-0546-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.22,% of charge rate,95.00%,35.36,,,,35.36,37.22,1
unity,NDC,HALOPERIDOL LACTATE 5 MG/ML INJ SOLN,3584,J1630,,Haloperidol injection,1 mL,63323-0474-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HALOPERIDOL LACTATE 5 MG/ML INJ SOLN,3584,J1630,,Haloperidol injection,1 mL,63323-0474-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HALOPERIDOL LACTATE 5 MG/ML INJ SOLN,3584,J1630,,Haloperidol injection,1 mL,63323-0474-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HALOPERIDOL LACTATE 5 MG/ML INJ SOLN,3584,J1630,,Haloperidol injection,1 mL,63323-0474-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM LOCK FLUSH 100 UNIT/ML IV SOLN,15235,J1642,,Inj heparin sodium per 10 u,5 mL,64253-0333-35,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM LOCK FLUSH 100 UNIT/ML IV SOLN,15235,J1642,,Inj heparin sodium per 10 u,5 mL,64253-0333-35,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN LOCK FLUSH 10 UNIT/ML IV SOLN,37994,J1642,,Inj heparin sodium per 10 u,1 mL,63323-0544-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN LOCK FLUSH 10 UNIT/ML IV SOLN,37994,J1642,,Inj heparin sodium per 10 u,1 mL,63323-0544-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 10000 UNIT/ML INJ SOLN,10177,J1644,,Inj heparin sodium per 1000u,1 mL,00409-2721-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 10000 UNIT/ML INJ SOLN,10177,J1644,,Inj heparin sodium per 1000u,1 mL,00409-2721-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 10000 UNIT/ML INJ SOLN,10177,J1644,,Inj heparin sodium per 1000u,1 mL,00409-2721-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 10000 UNIT/ML INJ SOLN,10177,J1644,,Inj heparin sodium per 1000u,1 mL,00409-2721-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 5000 UNIT/ML INJ SOLN,10181,J1644,,Inj heparin sodium per 1000u,1 mL,00641-0400-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 5000 UNIT/ML INJ SOLN,10181,J1644,,Inj heparin sodium per 1000u,1 mL,00641-0400-37,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 5000 UNIT/ML INJ SOLN,10181,J1644,,Inj heparin sodium per 1000u,1 mL,00641-0400-37,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 5000 UNIT/ML INJ SOLN,10181,J1644,,Inj heparin sodium per 1000u,1 mL,00641-0400-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,HEPARIN (PORCINE) IN NACL 25000-0.45 UT/250ML-% IV SOLN,136837,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) IN NACL 25000-0.45 UT/250ML-% IV SOLN,136837,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) IN NACL 25000-0.45 UT/250ML-% IV SOLN,136837,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) IN NACL 25000-0.45 UT/250ML-% IV SOLN,136837,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) LOW INTENSITY 25000 UNITS IN 1/2 NS 250ML,454030,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) LOW INTENSITY 25000 UNITS IN 1/2 NS 250ML,454030,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) LOW INTENSITY 25000 UNITS IN 1/2 NS 250ML,454030,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) LOW INTENSITY 25000 UNITS IN 1/2 NS 250ML,454030,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) HIGH INTENSITY 25000 UNITS IN 1/2 NS 250ML,454031,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) HIGH INTENSITY 25000 UNITS IN 1/2 NS 250ML,454031,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) HIGH INTENSITY 25000 UNITS IN 1/2 NS 250ML,454031,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) HIGH INTENSITY 25000 UNITS IN 1/2 NS 250ML,454031,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,ENOXAPARIN SODIUM 30 MG/0.3ML SC SOLN,108201,J1650,,Inj enoxaparin sodium,0.3 mL,63323-0533-13,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 30 MG/0.3ML SC SOLN,108201,J1650,,Inj enoxaparin sodium,0.3 mL,63323-0533-93,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 30 MG/0.3ML SC SOLN,108201,J1650,,Inj enoxaparin sodium,0.3 mL,63323-0533-93,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 30 MG/0.3ML SC SOLN,108201,J1650,,Inj enoxaparin sodium,0.3 mL,63323-0533-13,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 40 MG/0.4ML SC SOLN,108202,J1650,,Inj enoxaparin sodium,0.4 mL,63323-0535-87,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 40 MG/0.4ML SC SOLN,108202,J1650,,Inj enoxaparin sodium,0.4 mL,63323-0535-98,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 40 MG/0.4ML SC SOLN,108202,J1650,,Inj enoxaparin sodium,0.4 mL,63323-0535-98,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 40 MG/0.4ML SC SOLN,108202,J1650,,Inj enoxaparin sodium,0.4 mL,63323-0535-87,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FONDAPARINUX SODIUM 7.5 MG/0.6ML SC SOLN,111038,J1652,,Fondaparinux sodium,0.6 mL,55150-0232-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.99,% of charge rate,95.00%,101.64,,,,101.64,106.99,1
unity,NDC,FONDAPARINUX SODIUM 7.5 MG/0.6ML SC SOLN,111038,J1652,,Fondaparinux sodium,0.6 mL,55150-0232-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.99,% of charge rate,95.00%,101.64,,,,101.64,106.99,1
unity,NDC,FONDAPARINUX SODIUM 7.5 MG/0.6ML SC SOLN,111038,J1652,,Fondaparinux sodium,0.6 mL,55150-0232-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.99,% of charge rate,95.00%,101.64,,,,101.64,106.99,1
unity,NDC,FONDAPARINUX SODIUM 7.5 MG/0.6ML SC SOLN,111038,J1652,,Fondaparinux sodium,0.6 mL,55150-0232-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,106.99,% of charge rate,95.00%,101.64,,,,101.64,106.99,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 100 MG INJ SOLR,127470,J1720,,Hydrocortisone sodium succ i,2 mL,00009-0825-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.11,% of charge rate,95.00%,52.35,,,,52.35,55.11,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 100 MG INJ SOLR,127470,J1720,,Hydrocortisone sodium succ i,2 mL,00009-0825-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,55.11,% of charge rate,95.00%,52.35,,,,52.35,55.11,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 250 MG INJ SOLR,127471,J1720,,Hydrocortisone sodium succ i,1 mL,00009-0013-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.9,% of charge rate,95.00%,36.96,,,,36.96,102.27,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 250 MG INJ SOLR,127471,J1720,,Hydrocortisone sodium succ i,1 mL,00009-0013-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.27,% of charge rate,95.00%,97.16,,,,36.96,102.27,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 250 MG INJ SOLR,127471,J1720,,Hydrocortisone sodium succ i,1 mL,00009-0013-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.27,% of charge rate,95.00%,97.16,,,,36.96,102.27,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 250 MG INJ SOLR,127471,J1720,,Hydrocortisone sodium succ i,1 mL,00009-0013-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,38.9,% of charge rate,95.00%,36.96,,,,36.96,102.27,1
unity,NDC,IBANDRONATE SODIUM 3 MG/3ML IV SOLN,114401,J1740,,Ibandronate sodium injection,3 mL,67457-0524-33,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,184.3,% of charge rate,95.00%,175.09,,,,175.09,184.3,1
unity,NDC,IBANDRONATE SODIUM 3 MG/3ML IV SOLN,114401,J1740,,Ibandronate sodium injection,3 mL,67457-0524-33,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,184.3,% of charge rate,95.00%,175.09,,,,175.09,184.3,1
unity,NDC,INFLIXIMAB 100 MG IV SOLR,23796,J1745,,Infliximab not biosimil 10mg,100 mg,57894-0030-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,853.02",% of charge rate,95.00%,"2,710.37",,,,"2,710.37","2,853.02",1
unity,NDC,INFLIXIMAB 100 MG IV SOLR,23796,J1745,,Infliximab not biosimil 10mg,100 mg,57894-0030-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,853.02",% of charge rate,95.00%,"2,710.37",,,,"2,710.37","2,853.02",1
unity,NDC,IRON SUCROSE 20 MG/ML IV SOLN,29132,J1756,,Iron sucrose injection,5 mL,00517-2340-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150.79,% of charge rate,95.00%,143.25,,,,143.25,150.79,1
unity,NDC,IRON SUCROSE 20 MG/ML IV SOLN,29132,J1756,,Iron sucrose injection,5 mL,00517-2340-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,150.79,% of charge rate,95.00%,143.25,,,,143.25,150.79,1
unity,NDC,DROPERIDOL 2.5 MG/ML INJ SOLN,2654,J1790,,Droperidol injection,0.124 mL,00517-9702-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,37.61,1
unity,NDC,DROPERIDOL 2.5 MG/ML INJ SOLN,2654,J1790,,Droperidol injection,2 mL,00517-9702-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.61,% of charge rate,95.00%,35.73,,,,20.66,37.61,1
unity,NDC,DROPERIDOL 2.5 MG/ML INJ SOLN,2654,J1790,,Droperidol injection,2 mL,00517-9702-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.61,% of charge rate,95.00%,35.73,,,,20.66,37.61,1
unity,NDC,DROPERIDOL 2.5 MG/ML INJ SOLN,2654,J1790,,Droperidol injection,0.124 mL,00517-9702-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,37.61,1
unity,NDC,PROPRANOLOL HCL 1 MG/ML IV SOLN,29335,J1800,,Propranolol injection,1 mL,00143-9872-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROPRANOLOL HCL 1 MG/ML IV SOLN,29335,J1800,,Propranolol injection,1 mL,00143-9872-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROPRANOLOL HCL 1 MG/ML IV SOLN,29335,J1800,,Propranolol injection,1 mL,00143-9872-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROPRANOLOL HCL 1 MG/ML IV SOLN,29335,J1800,,Propranolol injection,1 mL,00143-9872-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,10289,J1815,,Insulin injection,300 Units,00002-8215-17,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.33,% of charge rate,95.00%,20.26,,,,20.26,21.33,1
unity,NDC,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,10289,J1815,,Insulin injection,300 Units,00002-8215-17,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.33,% of charge rate,95.00%,20.26,,,,20.26,21.33,1
unity,NDC,INSULIN ASPART 100 UNIT/ML SC SOPN,127449,J1815,,Insulin injection,300 Units,00169-6339-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.79,% of charge rate,95.00%,97.65,,,,97.65,102.79,1
unity,NDC,INSULIN ASPART 100 UNIT/ML SC SOPN,127449,J1815,,Insulin injection,300 Units,00169-6339-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.79,% of charge rate,95.00%,97.65,,,,97.65,102.79,1
unity,NDC,INSULIN GLARGINE 100 UNIT/ML SC SOPN,127451,J1815,,Insulin injection,300 Units,00088-5020-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.39,% of charge rate,95.00%,97.27,,,,97.27,102.39,1
unity,NDC,INSULIN GLARGINE 100 UNIT/ML SC SOPN,127451,J1815,,Insulin injection,300 Units,00088-5020-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.39,% of charge rate,95.00%,97.27,,,,97.27,102.39,1
unity,NDC,INSULIN GLARGINE 100 UNIT/ML SC SOPN,127451,J1815,,Insulin injection,300 Units,00088-5020-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.39,% of charge rate,95.00%,97.27,,,,97.27,102.39,1
unity,NDC,INSULIN GLARGINE 100 UNIT/ML SC SOPN,127451,J1815,,Insulin injection,300 Units,00088-5020-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,102.39,% of charge rate,95.00%,97.27,,,,97.27,102.39,1
unity,NDC,INSULIN LISPRO 100 UNIT/ML SC SOLN,17405,J1817,,Insulin for insulin pump use,300 Units,00002-7510-17,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.21,% of charge rate,95.00%,63.85,,,,63.85,67.21,1
unity,NDC,INSULIN LISPRO 100 UNIT/ML SC SOLN,17405,J1817,,Insulin for insulin pump use,300 Units,00002-7510-17,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.21,% of charge rate,95.00%,63.85,,,,63.85,67.21,1
unity,NDC,KETOROLAC TROMETHAMINE 60 MG/2ML IM SOLN,96064,J1885,,Ketorolac tromethamine inj,2 mL,63323-0162-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,KETOROLAC TROMETHAMINE 60 MG/2ML IM SOLN,96064,J1885,,Ketorolac tromethamine inj,2 mL,63323-0162-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FUROSEMIDE 10 MG/ML INJ SOLN,3291,J1940,,Furosemide injection,4 mL,00409-6102-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FUROSEMIDE 10 MG/ML INJ SOLN,3291,J1940,,Furosemide injection,4 mL,00409-6102-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LEUPROLIDE ACETATE 3.75 MG IM KIT,13691,J1950,,Leuprolide acetate /3.75 mg,3.75 mg,00074-3641-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,355.50",% of charge rate,95.00%,"3,187.73",,,,"3,187.73","3,355.50",1
unity,NDC,LEUPROLIDE ACETATE 3.75 MG IM KIT,13691,J1950,,Leuprolide acetate /3.75 mg,3.75 mg,00074-3641-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"3,355.50",% of charge rate,95.00%,"3,187.73",,,,"3,187.73","3,355.50",1
unity,NDC,LEUPROLIDE ACETATE (3 MONTH) 11.25 MG IM KIT,21044,J1950,,Leuprolide acetate /3.75 mg,11.25 mg,00074-3663-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"10,087.68",% of charge rate,95.00%,"9,583.30",,,,"9,583.30","10,087.68",1
unity,NDC,LEUPROLIDE ACETATE (3 MONTH) 11.25 MG IM KIT,21044,J1950,,Leuprolide acetate /3.75 mg,11.25 mg,00074-3663-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"10,087.68",% of charge rate,95.00%,"9,583.30",,,,"9,583.30","10,087.68",1
unity,NDC,LEVETIRACETAM 500 MG/5ML IV SOLN,77195,J1953,,Levetiracetam injection,5 mL,55150-0177-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LEVETIRACETAM 500 MG/5ML IV SOLN,77195,J1953,,Levetiracetam injection,5 mL,55150-0177-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LEVOFLOXACIN IN D5W 500 MG/100ML IV SOLN,111127,J1956,,Levofloxacin injection,100 mL,44567-0436-24,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,LEVOFLOXACIN IN D5W 500 MG/100ML IV SOLN,111127,J1956,,Levofloxacin injection,100 mL,44567-0436-24,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,LEVOFLOXACIN IN D5W 750 MG/150ML IV SOLN,111128,J1956,,Levofloxacin injection,150 mL,00409-0528-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.43,% of charge rate,95.00%,59.31,,,,59.31,62.43,1
unity,NDC,LEVOFLOXACIN IN D5W 750 MG/150ML IV SOLN,111128,J1956,,Levofloxacin injection,150 mL,00409-0528-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,62.43,% of charge rate,95.00%,59.31,,,,59.31,62.43,1
unity,NDC,LIDOCAINE HCL (PF) 4 % INJ SOLN,134921,J2001,,Lidocaine injection,5 mL,00409-4283-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 4 % INJ SOLN,134921,J2001,,Lidocaine injection,5 mL,00409-4283-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (CARDIAC) 100 MG/5ML IV SOSY,144889,J2001,,Lidocaine injection,1 mL,00409-4903-34,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (CARDIAC) 100 MG/5ML IV SOSY,144889,J2001,,Lidocaine injection,1 mL,00409-4903-34,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,500 mL,00338-0409-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.82,% of charge rate,95.00%,135.68,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,250 mL,00264-9594-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,77.25,% of charge rate,95.00%,73.39,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,500 mL,00264-9594-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.82,% of charge rate,95.00%,135.68,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,500 mL,00264-9594-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.82,% of charge rate,95.00%,135.68,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,250 mL,00264-9594-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,77.25,% of charge rate,95.00%,73.39,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,500 mL,00338-0409-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,142.82,% of charge rate,95.00%,135.68,,,,73.39,142.82,1
unity,NDC,LINEZOLID 600 MG/300ML IV SOLN,134899,J2020,,Linezolid injection,300 mL,00009-5140-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,156.21,% of charge rate,95.00%,148.4,,,,148.4,156.21,1
unity,NDC,LINEZOLID 600 MG/300ML IV SOLN,134899,J2020,,Linezolid injection,300 mL,00009-5140-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,156.21,% of charge rate,95.00%,148.4,,,,148.4,156.21,1
unity,NDC,LINEZOLID 600 MG/300ML IV SOLN,134899,J2020,,Linezolid injection,300 mL,00009-5140-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,156.21,% of charge rate,95.00%,148.4,,,,148.4,156.21,1
unity,NDC,LINEZOLID 600 MG/300ML IV SOLN,134899,J2020,,Linezolid injection,300 mL,00009-5140-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,156.21,% of charge rate,95.00%,148.4,,,,148.4,156.21,1
unity,NDC,LORAZEPAM 2 MG/ML INJ SOLN,10467,J2060,,Lorazepam injection,2 mg,00641-6048-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LORAZEPAM 2 MG/ML INJ SOLN,10467,J2060,,Lorazepam injection,2 mg,00641-6048-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MANNITOL 20 % IV SOLN,4749,J2150,,Mannitol injection,500 mL,00990-7715-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.51,% of charge rate,95.00%,90.73,,,,90.73,95.51,1
unity,NDC,MANNITOL 20 % IV SOLN,4749,J2150,,Mannitol injection,500 mL,00990-7715-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,95.51,% of charge rate,95.00%,90.73,,,,90.73,95.51,1
unity,NDC,MEROPENEM-SODIUM CHLORIDE 1 GM/50ML IV SOLR,133553,J2185,,Meropenem,50 mL,00264-3185-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,139.43,% of charge rate,95.00%,132.46,,,,132.46,139.43,1
unity,NDC,MEROPENEM-SODIUM CHLORIDE 1 GM/50ML IV SOLR,133553,J2185,,Meropenem,50 mL,00264-3185-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,139.43,% of charge rate,95.00%,132.46,,,,132.46,139.43,1
unity,NDC,MEROPENEM 500 MG IV SOLR,17379,J2185,,Meropenem,500 mg,63323-0507-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MEROPENEM 500 MG IV SOLR,17379,J2185,,Meropenem,500 mg,63323-0507-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MEROPENEM 1 G IV SOLR,17380,J2185,,Meropenem,0.5 g,55150-0208-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MEROPENEM 1 G IV SOLR,17380,J2185,,Meropenem,0.5 g,55150-0208-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL (PF) 5 MG/ML INJ SOLN,146237,J2250,,Inj midazolam hydrochloride,1 mL,00409-2308-49,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL (PF) 5 MG/ML INJ SOLN,146237,J2250,,Inj midazolam hydrochloride,1 mL,00409-2308-49,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL (PF) 2 MG/2ML INJ SOLN,146238,J2250,,Inj midazolam hydrochloride,2 mL,00409-2305-17,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL (PF) 2 MG/2ML INJ SOLN,146238,J2250,,Inj midazolam hydrochloride,2 mL,00409-2305-17,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL 50 MG/10ML INJ SOLN,93604,J2250,,Inj midazolam hydrochloride,10 mL,00641-6060-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL 50 MG/10ML INJ SOLN,93604,J2250,,Inj midazolam hydrochloride,10 mL,00641-6060-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL 50 MG/10ML INJ SOLN,93604,J2250,,Inj midazolam hydrochloride,10 mL,00641-6060-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL 50 MG/10ML INJ SOLN,93604,J2250,,Inj midazolam hydrochloride,10 mL,00641-6060-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,120512,J2270,,Morphine sulfate injection,1 mL,00641-6125-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,120512,J2270,,Morphine sulfate injection,1 mL,00641-6125-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,120512,J2270,,Morphine sulfate injection,1 mL,00641-6125-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,120512,J2270,,Morphine sulfate injection,1 mL,00641-6125-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 10 MG/ML IV SOLN,120514,J2270,,Morphine sulfate injection,1 mL,00641-6127-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 10 MG/ML IV SOLN,120514,J2270,,Morphine sulfate injection,1 mL,00641-6127-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 10 MG/ML IV SOLN,120514,J2270,,Morphine sulfate injection,1 mL,00641-6127-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 10 MG/ML IV SOLN,120514,J2270,,Morphine sulfate injection,1 mL,00641-6127-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,NALOXONE HCL 2 MG/2ML INJ SOSY,137261,J2310,,Inj naloxone hydrochloride,2 mL,76329-3369-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.42,% of charge rate,95.00%,106.8,,,,106.8,112.42,1
unity,NDC,NALOXONE HCL 2 MG/2ML INJ SOSY,137261,J2310,,Inj naloxone hydrochloride,2 mL,76329-3369-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,112.42,% of charge rate,95.00%,106.8,,,,106.8,112.42,1
unity,NDC,NALOXONE HCL 0.4 MG/ML INJ SOLN,5373,J2310,,Inj naloxone hydrochloride,1 mL,00409-1215-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.94,% of charge rate,95.00%,43.64,,,,43.64,45.94,1
unity,NDC,NALOXONE HCL 0.4 MG/ML INJ SOLN,5373,J2310,,Inj naloxone hydrochloride,1 mL,00409-1215-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.94,% of charge rate,95.00%,43.64,,,,43.64,45.94,1
unity,NDC,OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN,91278,J2354,,"Octreotide inj, non-depot",1 mL,00641-6174-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN,91278,J2354,,"Octreotide inj, non-depot",1 mL,00641-6174-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN,91278,J2354,,"Octreotide inj, non-depot",1 mL,00641-6174-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN,91278,J2354,,"Octreotide inj, non-depot",1 mL,00641-6174-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN,91281,J2354,,"Octreotide inj, non-depot",1 mL,63323-0377-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.27,% of charge rate,95.00%,43.01,,,,43.01,45.27,1
unity,NDC,OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN,91281,J2354,,"Octreotide inj, non-depot",1 mL,63323-0377-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,45.27,% of charge rate,95.00%,43.01,,,,43.01,45.27,1
unity,NDC,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,5886,J2360,,Orphenadrine injection,2 mL,17478-0538-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,5886,J2360,,Orphenadrine injection,2 mL,17478-0538-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PHENYLEPHRINE HCL 10 MG/ML IV SOLN,129812,J2370,,Phenylephrine hcl injection,1 mL,76014-0004-33,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.06,% of charge rate,95.00%,26.66,,,,26.66,28.06,1
unity,NDC,PHENYLEPHRINE HCL 10 MG/ML IV SOLN,129812,J2370,,Phenylephrine hcl injection,1 mL,76014-0004-33,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.06,% of charge rate,95.00%,26.66,,,,26.66,28.06,1
unity,NDC,ONDANSETRON HCL 4 MG/2ML INJ SOLN,94173,J2405,,Ondansetron hcl injection,2 mL,60505-6130-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ONDANSETRON HCL 4 MG/2ML INJ SOLN,94173,J2405,,Ondansetron hcl injection,2 mL,60505-6130-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PALONOSETRON HCL 0.25 MG/5ML IV SOLN,36591,J2469,,Palonosetron hcl,5 mL,60505-6193-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.7,% of charge rate,95.00%,64.32,,,,64.32,67.7,1
unity,NDC,PALONOSETRON HCL 0.25 MG/5ML IV SOLN,36591,J2469,,Palonosetron hcl,5 mL,60505-6193-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.7,% of charge rate,95.00%,64.32,,,,64.32,67.7,1
unity,NDC,PEGFILGRASTIM 6 MG/0.6ML SC SOSY,133089,J2505,,"Injection, pegfilgrastim 6mg",0.6 mL,55513-0190-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"12,345.94",% of charge rate,95.00%,"11,728.64",,,,"11,728.64","12,345.94",1
unity,NDC,PEGFILGRASTIM 6 MG/0.6ML SC SOSY,133089,J2505,,"Injection, pegfilgrastim 6mg",0.6 mL,55513-0190-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"12,345.94",% of charge rate,95.00%,"11,728.64",,,,"11,728.64","12,345.94",1
unity,NDC,PEGFILGRASTIM 6 MG/0.6ML SC PSKT,133090,J2505,,"Injection, pegfilgrastim 6mg",0.6 mL,55513-0192-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"11,504.94",% of charge rate,95.00%,"10,929.69",,,,"10,929.69","11,504.94",1
unity,NDC,PEGFILGRASTIM 6 MG/0.6ML SC PSKT,133090,J2505,,"Injection, pegfilgrastim 6mg",0.6 mL,55513-0192-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"11,504.94",% of charge rate,95.00%,"10,929.69",,,,"10,929.69","11,504.94",1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 4.5 (4-0.5) G IV SOLR,18302,J2543,,Piperacillin/tazobactam,4.5 g,00781-9214-91,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.44,% of charge rate,95.00%,27.02,,,,27.02,28.44,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 4.5 (4-0.5) G IV SOLR,18302,J2543,,Piperacillin/tazobactam,4.5 g,00781-9214-91,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.44,% of charge rate,95.00%,27.02,,,,27.02,28.44,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 3.375 (3-0.375) G IV SOLR,18303,J2543,,Piperacillin/tazobactam,3.375 g,61990-0120-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 3.375 (3-0.375) G IV SOLR,18303,J2543,,Piperacillin/tazobactam,3.375 g,61990-0120-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 3.375 (3-0.375) G IV SOLR,18303,J2543,,Piperacillin/tazobactam,3.375 g,61990-0120-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 3.375 (3-0.375) G IV SOLR,18303,J2543,,Piperacillin/tazobactam,3.375 g,61990-0120-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROMETHAZINE HCL 25 MG/ML INJ SOLN,6618,J2550,,Promethazine hcl injection,1 mL,00641-0928-21,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROMETHAZINE HCL 25 MG/ML INJ SOLN,6618,J2550,,Promethazine hcl injection,1 mL,00641-0928-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROMETHAZINE HCL 25 MG/ML INJ SOLN,6618,J2550,,Promethazine hcl injection,1 mL,00641-0928-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROMETHAZINE HCL 25 MG/ML INJ SOLN,6618,J2550,,Promethazine hcl injection,1 mL,00641-0928-21,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,OXYTOCIN 10 UNIT/ML INJ SOLN,5944,J2590,,Oxytocin injection,1 mL,63323-0012-07,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,OXYTOCIN 10 UNIT/ML INJ SOLN,5944,J2590,,Oxytocin injection,1 mL,63323-0012-07,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROCAINAMIDE HCL 100 MG/ML INJ SOLN,6562,J2690,,Procainamide hcl injection,1 mL,76329-3399-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROCAINAMIDE HCL 100 MG/ML INJ SOLN,6562,J2690,,Procainamide hcl injection,1 mL,76329-3399-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PROPOFOL 1000 MG/100ML IV EMUL,134930,J2704,,"Inj, propofol, 10 mg",100 mL,63323-0269-65,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.35,% of charge rate,95.00%,83.93,,,,83.93,88.35,1
unity,NDC,PROPOFOL 1000 MG/100ML IV EMUL,134930,J2704,,"Inj, propofol, 10 mg",100 mL,63323-0269-65,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,88.35,% of charge rate,95.00%,83.93,,,,83.93,88.35,1
unity,NDC,PROPOFOL INFUSION 200MG/20ML IV,600500,J2704,,"Inj, propofol, 10 mg",20 mL,00409-4699-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.36,% of charge rate,95.00%,74.44,,,,74.44,78.36,1
unity,NDC,PROPOFOL INFUSION 200MG/20ML IV,600500,J2704,,"Inj, propofol, 10 mg",20 mL,00409-4699-50,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.36,% of charge rate,95.00%,74.44,,,,74.44,78.36,1
unity,NDC,PROPOFOL INFUSION 200MG/20ML IV,600500,J2704,,"Inj, propofol, 10 mg",20 mL,00409-4699-50,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.36,% of charge rate,95.00%,74.44,,,,74.44,78.36,1
unity,NDC,PROPOFOL INFUSION 200MG/20ML IV,600500,J2704,,"Inj, propofol, 10 mg",20 mL,00409-4699-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,78.36,% of charge rate,95.00%,74.44,,,,74.44,78.36,1
unity,NDC,NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN,124650,J2710,,Neostigmine methylslfte inj,1 mL,63323-0415-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN,124650,J2710,,Neostigmine methylslfte inj,1 mL,63323-0415-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PHENTOLAMINE MESYLATE 5 MG INJ SOLR,10947,J2760,,Phentolaine mesylate inj,0.5 mg,51224-0012-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.13,% of charge rate,95.00%,89.42,,,,89.42,94.13,1
unity,NDC,PHENTOLAMINE MESYLATE 5 MG INJ SOLR,10947,J2760,,Phentolaine mesylate inj,0.5 mg,51224-0012-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.13,% of charge rate,95.00%,89.42,,,,89.42,94.13,1
unity,NDC,METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN,5002,J2765,,Metoclopramide hcl injection,2 mL,00703-4502-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN,5002,J2765,,Metoclopramide hcl injection,2 mL,00703-4502-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ROPIVACAINE HCL 5 MG/ML INJ SOLN,18195,J2795,,Ropivacaine hcl injection,15 mL,17478-0081-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.51,% of charge rate,95.00%,35.63,,,,35.63,37.51,1
unity,NDC,ROPIVACAINE HCL 5 MG/ML INJ SOLN,18195,J2795,,Ropivacaine hcl injection,15 mL,17478-0081-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,37.51,% of charge rate,95.00%,35.63,,,,35.63,37.51,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR,10580,J2920,,Methylprednisolone injection,1 mL,00009-0039-32,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.39,% of charge rate,95.00%,26.97,,,,26.97,28.39,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR,10580,J2920,,Methylprednisolone injection,1 mL,00009-0039-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.39,% of charge rate,95.00%,26.97,,,,26.97,28.39,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR,10580,J2920,,Methylprednisolone injection,1 mL,00009-0039-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.39,% of charge rate,95.00%,26.97,,,,26.97,28.39,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR,10580,J2920,,Methylprednisolone injection,1 mL,00009-0039-32,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,28.39,% of charge rate,95.00%,26.97,,,,26.97,28.39,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 1000 MG INJ SOLR,10577,J2930,,Methylprednisolone injection,"1,000 mg",63323-0265-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.24,% of charge rate,95.00%,89.53,,,,89.53,94.24,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 1000 MG INJ SOLR,10577,J2930,,Methylprednisolone injection,"1,000 mg",63323-0265-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.24,% of charge rate,95.00%,89.53,,,,89.53,94.24,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR,10578,J2930,,Methylprednisolone injection,2 mL,00009-0047-26,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.1,% of charge rate,95.00%,41.9,,,,41.9,44.1,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR,10578,J2930,,Methylprednisolone injection,2 mL,00009-0047-27,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.1,% of charge rate,95.00%,41.9,,,,41.9,44.1,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR,10578,J2930,,Methylprednisolone injection,2 mL,00009-0047-27,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.1,% of charge rate,95.00%,41.9,,,,41.9,44.1,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR,10578,J2930,,Methylprednisolone injection,2 mL,00009-0047-26,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,44.1,% of charge rate,95.00%,41.9,,,,41.9,44.1,1
unity,NDC,ALTEPLASE 2 MG INJ SOLR,31310,J2997,,Alteplase recombinant,2 mg,50242-0041-64,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,397.22,% of charge rate,95.00%,377.36,,,,377.36,397.22,1
unity,NDC,ALTEPLASE 2 MG INJ SOLR,31310,J2997,,Alteplase recombinant,2 mg,50242-0041-64,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,397.22,% of charge rate,95.00%,377.36,,,,377.36,397.22,1
unity,NDC,ALTEPLASE 100 MG IV SOLR,9002,J2997,,Alteplase recombinant,90 mL,50242-0085-27,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"20,431.89",% of charge rate,95.00%,"19,410.30",,,,"19,410.30","20,431.89",1
unity,NDC,ALTEPLASE 100 MG IV SOLR,9002,J2997,,Alteplase recombinant,90 mL,50242-0085-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"20,431.89",% of charge rate,95.00%,"19,410.30",,,,"19,410.30","20,431.89",1
unity,NDC,ALTEPLASE 100 MG IV SOLR,9002,J2997,,Alteplase recombinant,90 mL,50242-0085-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"20,431.89",% of charge rate,95.00%,"19,410.30",,,,"19,410.30","20,431.89",1
unity,NDC,ALTEPLASE 100 MG IV SOLR,9002,J2997,,Alteplase recombinant,90 mL,50242-0085-27,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"20,431.89",% of charge rate,95.00%,"19,410.30",,,,"19,410.30","20,431.89",1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,0.5 mL,00409-9094-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,0.5 mL,17478-0030-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,2 mL,00409-9094-22,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,2 mL,00409-9094-22,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,0.5 mL,17478-0030-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,0.5 mL,00409-9094-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SUMATRIPTAN SUCCINATE 6 MG/0.5ML SC SOLN,95691,J3030,,Sumatriptan succinate / 6 mg,0.5 mL,55150-0173-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.42,% of charge rate,95.00%,40.3,,,,40.3,42.42,1
unity,NDC,SUMATRIPTAN SUCCINATE 6 MG/0.5ML SC SOLN,95691,J3030,,Sumatriptan succinate / 6 mg,0.5 mL,55150-0173-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,42.42,% of charge rate,95.00%,40.3,,,,40.3,42.42,1
unity,NDC,TELAVANCIN HCL 750 MG IV SOLR,103887,J3095,,Telavancin injection,50 mL,62847-0001-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,134.94",% of charge rate,95.00%,"1,078.19",,,,"1,078.19","1,134.94",1
unity,NDC,TELAVANCIN HCL 750 MG IV SOLR,103887,J3095,,Telavancin injection,50 mL,62847-0001-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,134.94",% of charge rate,95.00%,"1,078.19",,,,"1,078.19","1,134.94",1
unity,NDC,TENECTEPLASE 50 MG IV KIT,28530,J3101,,Tenecteplase injection,6 mL,50242-0120-47,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,647.83",% of charge rate,95.00%,"9,165.44",,,,"9,165.44","9,647.83",1
unity,NDC,TENECTEPLASE 50 MG IV KIT,28530,J3101,,Tenecteplase injection,6 mL,50242-0120-47,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,647.83",% of charge rate,95.00%,"9,165.44",,,,"9,165.44","9,647.83",1
unity,NDC,TERBUTALINE SULFATE 1 MG/ML INJ SOLN,11507,J3105,,Terbutaline sulfate inj,1 mL,00143-9746-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,TERBUTALINE SULFATE 1 MG/ML INJ SOLN,11507,J3105,,Terbutaline sulfate inj,1 mL,00143-9746-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ROMOSOZUMAB-AQQG 105 MG/1.17ML SC SOSY,145223,J3111,,Inj. romosozumab-aqqg 1 mg,2.34 mL,55513-0880-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,747.97",% of charge rate,95.00%,"4,510.57",,,,"4,510.57","4,747.97",1
unity,NDC,ROMOSOZUMAB-AQQG 105 MG/1.17ML SC SOSY,145223,J3111,,Inj. romosozumab-aqqg 1 mg,2.34 mL,55513-0880-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"4,747.97",% of charge rate,95.00%,"4,510.57",,,,"4,510.57","4,747.97",1
unity,NDC,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,8120,J3301,,Triamcinolone acet inj nos,1 mL,70121-1651-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.09,% of charge rate,95.00%,40.94,,,,40.94,43.09,1
unity,NDC,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,8120,J3301,,Triamcinolone acet inj nos,1 mL,70121-1651-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,43.09,% of charge rate,95.00%,40.94,,,,40.94,43.09,1
unity,NDC,DIAZEPAM 5 MG/ML INJ SOLN,2401,J3360,,Diazepam injection,0.5 mL,69339-0136-32,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,DIAZEPAM 5 MG/ML INJ SOLN,2401,J3360,,Diazepam injection,0.5 mL,69339-0136-32,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1 G IV SOLR,143427,J3370,,Vancomycin hcl injection,1 g,70860-0105-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1 G IV SOLR,143427,J3370,,Vancomycin hcl injection,1 g,70860-0105-41,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1 G IV SOLR,143427,J3370,,Vancomycin hcl injection,1 g,70860-0105-41,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1 G IV SOLR,143427,J3370,,Vancomycin hcl injection,1 g,70860-0105-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1000 MG/200ML IV SOLN,144907,J3370,,Vancomycin hcl injection,200 mL,70594-0042-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.76,% of charge rate,95.00%,90.02,,,,90.02,94.76,1
unity,NDC,VANCOMYCIN HCL 1000 MG/200ML IV SOLN,144907,J3370,,Vancomycin hcl injection,200 mL,70594-0042-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.76,% of charge rate,95.00%,90.02,,,,90.02,94.76,1
unity,NDC,VANCOMYCIN HCL 1000 MG/200ML IV SOLN,144907,J3370,,Vancomycin hcl injection,200 mL,70594-0042-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.76,% of charge rate,95.00%,90.02,,,,90.02,94.76,1
unity,NDC,VANCOMYCIN HCL 1000 MG/200ML IV SOLN,144907,J3370,,Vancomycin hcl injection,200 mL,70594-0042-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,94.76,% of charge rate,95.00%,90.02,,,,90.02,94.76,1
unity,NDC,VANCOMYCIN HCL 1500 MG/300ML IV SOLN,144908,J3370,,Vancomycin hcl injection,300 mL,70594-0043-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.88,% of charge rate,95.00%,112.94,,,,112.94,118.88,1
unity,NDC,VANCOMYCIN HCL 1500 MG/300ML IV SOLN,144908,J3370,,Vancomycin hcl injection,300 mL,70594-0043-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.88,% of charge rate,95.00%,112.94,,,,112.94,118.88,1
unity,NDC,VANCOMYCIN HCL 1500 MG/300ML IV SOLN,144908,J3370,,Vancomycin hcl injection,300 mL,70594-0043-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.88,% of charge rate,95.00%,112.94,,,,112.94,118.88,1
unity,NDC,VANCOMYCIN HCL 1500 MG/300ML IV SOLN,144908,J3370,,Vancomycin hcl injection,300 mL,70594-0043-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,118.88,% of charge rate,95.00%,112.94,,,,112.94,118.88,1
unity,NDC,VANCOMYCIN HCL 2000 MG/400ML IV SOLN,145814,J3370,,Vancomycin hcl injection,400 mL,70594-0044-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.01,% of charge rate,95.00%,135.86,,,,135.86,143.01,1
unity,NDC,VANCOMYCIN HCL 2000 MG/400ML IV SOLN,145814,J3370,,Vancomycin hcl injection,400 mL,70594-0044-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.01,% of charge rate,95.00%,135.86,,,,135.86,143.01,1
unity,NDC,VANCOMYCIN HCL 2000 MG/400ML IV SOLN,145814,J3370,,Vancomycin hcl injection,400 mL,70594-0044-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.01,% of charge rate,95.00%,135.86,,,,135.86,143.01,1
unity,NDC,VANCOMYCIN HCL 2000 MG/400ML IV SOLN,145814,J3370,,Vancomycin hcl injection,400 mL,70594-0044-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,143.01,% of charge rate,95.00%,135.86,,,,135.86,143.01,1
unity,NDC,VANCOMYCIN HCL 500 MG IV SOLR,8443,J3370,,Vancomycin hcl injection,500 mg,47781-0598-07,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 500 MG IV SOLR,8443,J3370,,Vancomycin hcl injection,500 mg,47781-0598-91,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 500 MG IV SOLR,8443,J3370,,Vancomycin hcl injection,500 mg,47781-0598-91,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 500 MG IV SOLR,8443,J3370,,Vancomycin hcl injection,500 mg,47781-0598-07,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,THIAMINE HCL 100 MG/ML INJ SOLN,7876,J3411,,Thiamine hcl 100 mg,2 mL,63323-0013-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.36,% of charge rate,95.00%,30.74,,,,30.74,32.36,1
unity,NDC,THIAMINE HCL 100 MG/ML INJ SOLN,7876,J3411,,Thiamine hcl 100 mg,2 mL,63323-0013-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,32.36,% of charge rate,95.00%,30.74,,,,30.74,32.36,1
unity,NDC,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,2007,J3420,,Vitamin b12 injection,1 mL,69680-0112-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,2007,J3420,,Vitamin b12 injection,1 mL,69680-0112-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,2007,J3420,,Vitamin b12 injection,1 mL,69680-0112-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,2007,J3420,,Vitamin b12 injection,1 mL,69680-0112-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,VITAMIN K1 1 MG/0.5ML INJ SOLN,41624,J3430,,Vitamin k phytonadione inj,0.5 mL,00409-9157-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.86,% of charge rate,95.00%,22.67,,,,22.67,23.86,1
unity,NDC,VITAMIN K1 1 MG/0.5ML INJ SOLN,41624,J3430,,Vitamin k phytonadione inj,0.5 mL,00409-9157-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,23.86,% of charge rate,95.00%,22.67,,,,22.67,23.86,1
unity,NDC,VITAMIN K1 10 MG/ML INJ SOLN,8718,J3430,,Vitamin k phytonadione inj,1 mL,00409-9158-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.31,% of charge rate,95.00%,133.29,,,,133.29,140.31,1
unity,NDC,VITAMIN K1 10 MG/ML INJ SOLN,8718,J3430,,Vitamin k phytonadione inj,1 mL,00409-9158-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,140.31,% of charge rate,95.00%,133.29,,,,133.29,140.31,1
unity,NDC,MAGNESIUM SULFATE 2 GM/50ML IV SOLN,133084,J3475,,Inj magnesium sulfate,50 mL,44567-0420-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.74,% of charge rate,95.00%,89.05,,,,89.05,93.74,1
unity,NDC,MAGNESIUM SULFATE 2 GM/50ML IV SOLN,133084,J3475,,Inj magnesium sulfate,50 mL,44567-0420-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,93.74,% of charge rate,95.00%,89.05,,,,89.05,93.74,1
unity,NDC,MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN,139184,J3475,,Inj magnesium sulfate,100 mL,44567-0410-24,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.18,% of charge rate,95.00%,63.82,,,,63.82,67.18,1
unity,NDC,MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN,139184,J3475,,Inj magnesium sulfate,100 mL,44567-0410-24,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,67.18,% of charge rate,95.00%,63.82,,,,63.82,67.18,1
unity,NDC,MAGNESIUM SULFATE 50 % INJ SOLN,4720,J3475,,Inj magnesium sulfate,2 mL,63323-0064-23,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,MAGNESIUM SULFATE 50 % INJ SOLN,4720,J3475,,Inj magnesium sulfate,2 mL,63323-0064-23,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,POTASSIUM CHLORIDE 10 MEQ/100ML IV SOLN,11074,J3480,,Inj potassium chloride,100 mL,00338-0709-48,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.66,% of charge rate,95.00%,68.08,,,,68.08,71.66,1
unity,NDC,POTASSIUM CHLORIDE 10 MEQ/100ML IV SOLN,11074,J3480,,Inj potassium chloride,100 mL,00338-0709-48,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,71.66,% of charge rate,95.00%,68.08,,,,68.08,71.66,1
unity,NDC,POTASSIUM CHLORIDE IN NACL 20-0.9 MEQ/L-% IV SOLN,11081,J3480,,Inj potassium chloride,"1,000 mL",00264-7865-00,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.27,% of charge rate,95.00%,60.11,,,,60.11,63.27,1
unity,NDC,POTASSIUM CHLORIDE IN NACL 20-0.9 MEQ/L-% IV SOLN,11081,J3480,,Inj potassium chloride,"1,000 mL",00264-7865-00,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.27,% of charge rate,95.00%,60.11,,,,60.11,63.27,1
unity,NDC,POTASSIUM CHLORIDE IN NACL 20-0.45 MEQ/L-% IV SOLN,36046,J3480,,Inj potassium chloride,"1,000 mL",00990-9257-39,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,POTASSIUM CHLORIDE IN NACL 20-0.45 MEQ/L-% IV SOLN,36046,J3480,,Inj potassium chloride,"1,000 mL",00990-9257-39,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,80.04,% of charge rate,95.00%,76.04,,,,76.04,80.04,1
unity,NDC,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,6429,J3480,,Inj potassium chloride,20 mL,00409-6653-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,6429,J3480,,Inj potassium chloride,20 mL,00409-6653-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,ZOLEDRONIC ACID 5 MG/100ML IV SOLN,81434,J3489,,Zoledronic acid 1mg,100 mL,55111-0688-52,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,791.30",% of charge rate,95.00%,"2,651.74",,,,"2,651.74","2,791.30",1
unity,NDC,ZOLEDRONIC ACID 5 MG/100ML IV SOLN,81434,J3489,,Zoledronic acid 1mg,100 mL,55111-0688-52,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,791.30",% of charge rate,95.00%,"2,651.74",,,,"2,651.74","2,791.30",1
unity,NDC,LABETALOL HCL 5 MG/ML IV SOLN,10372,J3490,,Drugs unclassified injection,20 mL,00409-2267-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LABETALOL HCL 5 MG/ML IV SOLN,10372,J3490,,Drugs unclassified injection,20 mL,00409-2267-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 1 % INJ SOLN,106253,J3490,,Drugs unclassified injection,1 mL,63323-0492-57,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 1 % INJ SOLN,106253,J3490,,Drugs unclassified injection,1 mL,63323-0492-57,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 2 % INJ SOLN,106254,J3490,,Drugs unclassified injection,1 mL,00143-9594-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 2 % INJ SOLN,106254,J3490,,Drugs unclassified injection,1 mL,00143-9594-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 2 % INJ SOLN,106254,J3490,,Drugs unclassified injection,1 mL,00143-9594-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 2 % INJ SOLN,106254,J3490,,Drugs unclassified injection,1 mL,00143-9594-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 0.5 % INJ SOLN,108973,J3490,,Drugs unclassified injection,50 mL,00409-4278-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 0.5 % INJ SOLN,108973,J3490,,Drugs unclassified injection,50 mL,00409-4278-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FAMOTIDINE 20 MG/2ML IV SOLN,127474,J3490,,Drugs unclassified injection,2 mL,00641-6022-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FAMOTIDINE 20 MG/2ML IV SOLN,127474,J3490,,Drugs unclassified injection,1 mL,00641-6022-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FAMOTIDINE 20 MG/2ML IV SOLN,127474,J3490,,Drugs unclassified injection,1 mL,00641-6022-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FAMOTIDINE 20 MG/2ML IV SOLN,127474,J3490,,Drugs unclassified injection,2 mL,00641-6022-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML PO SUSP,22560,J3490,,Drugs unclassified injection,60 mL,99408-0003-81,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.55,% of charge rate,95.00%,46.12,,,,46.12,48.55,1
unity,NDC,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML PO SUSP,22560,J3490,,Drugs unclassified injection,60 mL,99408-0003-81,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,48.55,% of charge rate,95.00%,46.12,,,,46.12,48.55,1
unity,NDC,FLUMAZENIL 0.5 MG/5ML IV SOLN,39744,J3490,,Drugs unclassified injection,5 mL,00143-9684-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,FLUMAZENIL 0.5 MG/5ML IV SOLN,39744,J3490,,Drugs unclassified injection,5 mL,00143-9684-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL 0.5 % INJ SOLN,4451,J3490,,Drugs unclassified injection,50 mL,00409-4275-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL 0.5 % INJ SOLN,4451,J3490,,Drugs unclassified injection,50 mL,00409-4275-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,METRONIDAZOLE IN NACL 5-0.79 MG/ML-% IV SOLN,5018,J3490,,Drugs unclassified injection,100 mL,00409-7811-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56,% of charge rate,95.00%,53.2,,,,53.2,56,1
unity,NDC,METRONIDAZOLE IN NACL 5-0.79 MG/ML-% IV SOLN,5018,J3490,,Drugs unclassified injection,100 mL,00409-7811-24,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56,% of charge rate,95.00%,53.2,,,,53.2,56,1
unity,NDC,METRONIDAZOLE IN NACL 5-0.79 MG/ML-% IV SOLN,5018,J3490,,Drugs unclassified injection,100 mL,00409-7811-24,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56,% of charge rate,95.00%,53.2,,,,53.2,56,1
unity,NDC,METRONIDAZOLE IN NACL 5-0.79 MG/ML-% IV SOLN,5018,J3490,,Drugs unclassified injection,100 mL,00409-7811-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,56,% of charge rate,95.00%,53.2,,,,53.2,56,1
unity,NDC,VERAPAMIL HCL 2.5 MG/ML IV SOLN,8527,J3490,,Drugs unclassified injection,2 mL,70069-0271-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.95,% of charge rate,95.00%,77.85,,,,77.85,81.95,1
unity,NDC,VERAPAMIL HCL 2.5 MG/ML IV SOLN,8527,J3490,,Drugs unclassified injection,2 mL,70069-0271-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,81.95,% of charge rate,95.00%,77.85,,,,77.85,81.95,1
unity,NDC,AZTREONAM 2 G INJ SOLR,9186,J3490,,Drugs unclassified injection,2 g,00003-2570-16,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,133.45,% of charge rate,95.00%,126.78,,,,126.78,133.45,1
unity,NDC,AZTREONAM 2 G INJ SOLR,9186,J3490,,Drugs unclassified injection,2 g,00003-2570-16,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,133.45,% of charge rate,95.00%,126.78,,,,126.78,133.45,1
unity,NDC,LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX PRSY,146450,J3490.23,,,10 mL,76329-3011-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.83,% of charge rate,95.00%,33.09,,,,33.09,34.83,1
unity,NDC,LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX PRSY,146450,J3490.23,,,10 mL,76329-3011-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,34.83,% of charge rate,95.00%,33.09,,,,33.09,34.83,1
unity,NDC,EXENATIDE ER 2 MG SC PEN,128782,J3590,,Unclassified biologics,1 Each,00310-6530-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,449.77,% of charge rate,95.00%,427.28,,,,427.28,449.77,1
unity,NDC,EXENATIDE ER 2 MG SC PEN,128782,J3590,,Unclassified biologics,1 Each,00310-6530-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,449.77,% of charge rate,95.00%,427.28,,,,427.28,449.77,1
unity,NDC,EXENATIDE ER 2 MG SC PEN,128782,J3590,,Unclassified biologics,1 Each,00310-6530-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,449.77,% of charge rate,95.00%,427.28,,,,427.28,449.77,1
unity,NDC,EXENATIDE ER 2 MG SC PEN,128782,J3590,,Unclassified biologics,1 Each,00310-6530-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,449.77,% of charge rate,95.00%,427.28,,,,427.28,449.77,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00338-0049-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.48,% of charge rate,95.00%,57.46,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00990-7983-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.48,% of charge rate,95.00%,57.46,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,250 mL,00264-7800-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.9,% of charge rate,95.00%,45.51,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,250 mL,00990-7983-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.9,% of charge rate,95.00%,45.51,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,50 mL,00990-7984-13,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.36,% of charge rate,95.00%,56.39,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00264-7800-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.48,% of charge rate,95.00%,57.46,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,"1,000 mL",00264-7800-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.27,% of charge rate,95.00%,60.11,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,"1,000 mL",00990-7983-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.27,% of charge rate,95.00%,60.11,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00338-0049-48,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.03,% of charge rate,95.00%,57.98,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00990-7984-23,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.03,% of charge rate,95.00%,57.98,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00990-7984-37,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.03,% of charge rate,95.00%,57.98,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00990-7984-37,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.03,% of charge rate,95.00%,57.98,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00990-7984-23,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.03,% of charge rate,95.00%,57.98,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00338-0049-48,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,61.03,% of charge rate,95.00%,57.98,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,"1,000 mL",00990-7983-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.27,% of charge rate,95.00%,60.11,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,"1,000 mL",00264-7800-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,63.27,% of charge rate,95.00%,60.11,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00264-7800-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.48,% of charge rate,95.00%,57.46,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,50 mL,00990-7984-13,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,59.36,% of charge rate,95.00%,56.39,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,250 mL,00990-7983-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.9,% of charge rate,95.00%,45.51,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,250 mL,00264-7800-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,47.9,% of charge rate,95.00%,45.51,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00990-7983-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.48,% of charge rate,95.00%,57.46,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00338-0049-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,60.48,% of charge rate,95.00%,57.46,,,,45.51,63.27,1
unity,NDC,DEXTROSE-NACL 5-0.45 % IV SOLN,15861,J7042,,5% dextrose/normal saline,500 mL,00409-7926-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,74.45,% of charge rate,95.00%,70.73,,,,54.8,74.45,1
unity,NDC,DEXTROSE-NACL 5-0.45 % IV SOLN,15861,J7042,,5% dextrose/normal saline,"1,000 mL",00990-7926-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,74.45,1
unity,NDC,DEXTROSE-NACL 5-0.45 % IV SOLN,15861,J7042,,5% dextrose/normal saline,"1,000 mL",00990-7926-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,74.45,1
unity,NDC,DEXTROSE-NACL 5-0.45 % IV SOLN,15861,J7042,,5% dextrose/normal saline,500 mL,00409-7926-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,74.45,% of charge rate,95.00%,70.73,,,,54.8,74.45,1
unity,NDC,DEXTROSE-NACL 5-0.9 % IV SOLN,15882,J7042,,5% dextrose/normal saline,"1,000 mL",00990-7941-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,DEXTROSE-NACL 5-0.9 % IV SOLN,15882,J7042,,5% dextrose/normal saline,"1,000 mL",00990-7941-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,250 mL,00990-7922-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.5,% of charge rate,95.00%,38.48,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,"1,000 mL",00990-7922-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,100 mL,00338-0017-38,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.12,% of charge rate,95.00%,54.26,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,100 mL,00990-7923-37,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.12,% of charge rate,95.00%,54.26,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,250 mL,00338-0017-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.5,% of charge rate,95.00%,38.48,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,250 mL,00338-0017-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.5,% of charge rate,95.00%,38.48,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,100 mL,00990-7923-37,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.12,% of charge rate,95.00%,54.26,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,100 mL,00338-0017-38,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.12,% of charge rate,95.00%,54.26,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,"1,000 mL",00990-7922-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,250 mL,00990-7922-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,40.5,% of charge rate,95.00%,38.48,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN NON-PVC BAGS,40812364,J7060,,5% dextrose/water,250 mL,00264-7510-20,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.67,% of charge rate,95.00%,61.44,,,,52.15,64.67,1
unity,NDC,DEXTROSE 5 % IV SOLN NON-PVC BAGS,40812364,J7060,,5% dextrose/water,500 mL,00264-7510-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.89,% of charge rate,95.00%,52.15,,,,52.15,64.67,1
unity,NDC,DEXTROSE 5 % IV SOLN NON-PVC BAGS,40812364,J7060,,5% dextrose/water,500 mL,00264-7510-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,54.89,% of charge rate,95.00%,52.15,,,,52.15,64.67,1
unity,NDC,DEXTROSE 5 % IV SOLN NON-PVC BAGS,40812364,J7060,,5% dextrose/water,250 mL,00264-7510-20,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.67,% of charge rate,95.00%,61.44,,,,52.15,64.67,1
unity,NDC,LACTATED RINGERS IV SOLN,4318,J7120,,Ringers lactate infusion,"1,000 mL",00990-7953-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,LACTATED RINGERS IV SOLN,4318,J7120,,Ringers lactate infusion,500 mL,00409-7953-03,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,LACTATED RINGERS IV SOLN,4318,J7120,,Ringers lactate infusion,500 mL,00409-7953-03,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,LACTATED RINGERS IV SOLN,4318,J7120,,Ringers lactate infusion,"1,000 mL",00990-7953-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,DEXTROSE IN LACTATED RINGERS 5 % IV SOLN,9788,J7121,,5% dextrose in lac ringers,"1,000 mL",00990-7929-09,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,DEXTROSE IN LACTATED RINGERS 5 % IV SOLN,9788,J7121,,5% dextrose in lac ringers,"1,000 mL",00990-7929-09,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,57.68,% of charge rate,95.00%,54.8,,,,54.8,57.68,1
unity,NDC,LEVONORGESTREL 20 MCG/24HR IU IUD,29280,J7298,,"Mirena, 52 mg",1 Each,50419-0423-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,480.63",% of charge rate,95.00%,"2,356.60",,,,"2,356.60","2,480.63",1
unity,NDC,LEVONORGESTREL 20 MCG/24HR IU IUD,29280,J7298,,"Mirena, 52 mg",1 Each,50419-0423-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,480.63",% of charge rate,95.00%,"2,356.60",,,,"2,356.60","2,480.63",1
unity,NDC,PARAGARD INTRAUTERINE COPPER IU IUD,6040,J7300,,Intraut copper contraceptive,1 Each,59365-5128-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,301.20",% of charge rate,95.00%,"2,186.14",,,,"2,186.14","2,301.20",1
unity,NDC,PARAGARD INTRAUTERINE COPPER IU IUD,6040,J7300,,Intraut copper contraceptive,1 Each,59365-5128-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,301.20",% of charge rate,95.00%,"2,186.14",,,,"2,186.14","2,301.20",1
unity,NDC,ETONOGESTREL 68 MG SC IMPL,77012,J7307,,Etonogestrel implant system,68 mg,00052-4330-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,316.28",% of charge rate,95.00%,"2,200.47",,,,"2,200.47","2,316.28",1
unity,NDC,ETONOGESTREL 68 MG SC IMPL,77012,J7307,,Etonogestrel implant system,68 mg,00052-4330-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,316.28",% of charge rate,95.00%,"2,200.47",,,,"2,200.47","2,316.28",1
unity,NDC,SODIUM HYALURONATE 60 MG/3ML IX PRSY,141170,J7318,,"Inj, durolane 1 mg",3 mL,89130-2020-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,211.47",% of charge rate,95.00%,"2,100.90",,,,"2,100.90","2,211.47",1
unity,NDC,SODIUM HYALURONATE 60 MG/3ML IX PRSY,141170,J7318,,"Inj, durolane 1 mg",3 mL,89130-2020-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,211.47",% of charge rate,95.00%,"2,100.90",,,,"2,100.90","2,211.47",1
unity,NDC,ACETAMINOPHEN 325 MG PO TABS,101,J7323,,Euflexxa inj per dose,1 Tab,00904-6773-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 325 MG PO TABS,101,J7323,,Euflexxa inj per dose,1 Tab,00904-6773-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,EUFLEXXA 20 MG/2ML IX SOLN,600170,J7323,,Euflexxa inj per dose,2 mL,55566-4100-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,879.13,% of charge rate,95.00%,835.17,,,,835.17,879.13,1
unity,NDC,EUFLEXXA 20 MG/2ML IX SOLN,600170,J7323,,Euflexxa inj per dose,2 mL,55566-4100-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,879.13,% of charge rate,95.00%,835.17,,,,835.17,879.13,1
unity,NDC,PREDNISONE 1 MG PO TABS,6493,J7512,,Prednisone ir or dr oral 1mg,1 Tab,00054-8739-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 1 MG PO TABS,6493,J7512,,Prednisone ir or dr oral 1mg,1 Tab,00054-8739-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 10 MG PO TABS,6494,J7512,,Prednisone ir or dr oral 1mg,1 Tab,00904-6923-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 10 MG PO TABS,6494,J7512,,Prednisone ir or dr oral 1mg,1 Tab,00904-6923-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 20 MG PO TABS,6496,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0145-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 20 MG PO TABS,6496,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0145-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 5 MG PO TABS,6497,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0122-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 5 MG PO TABS,6497,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0122-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 5 MG PO TABS,6497,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0122-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PREDNISONE 5 MG PO TABS,6497,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0122-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ARFORMOTEROL TARTRATE 15 MCG/2ML IN NEBU,77581,J7605,,Arformoterol non-comp unit,2 mL,63402-0911-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.28,% of charge rate,95.00%,65.82,,,,65.82,69.28,1
unity,NDC,ARFORMOTEROL TARTRATE 15 MCG/2ML IN NEBU,77581,J7605,,Arformoterol non-comp unit,2 mL,63402-0911-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,69.28,% of charge rate,95.00%,65.82,,,,65.82,69.28,1
unity,NDC,ACETYLCYSTEINE 20 % IN SOLN,123,J7608,,Acetylcysteine non-comp unit,4 mL,00517-7604-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.53,% of charge rate,95.00%,20.45,,,,20.45,21.53,1
unity,NDC,ACETYLCYSTEINE 20 % IN SOLN,123,J7608,,Acetylcysteine non-comp unit,4 mL,00517-7604-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.53,% of charge rate,95.00%,20.45,,,,20.45,21.53,1
unity,NDC,ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% IN NEBU,250,J7613,,Albuterol non-comp unit,3 mL,00487-9501-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% IN NEBU,250,J7613,,Albuterol non-comp unit,3 mL,00487-9501-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML IN SOLN,94009,J7620,,Albuterol ipratrop non-comp,3 mL,00378-9671-31,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML IN SOLN,94009,J7620,,Albuterol ipratrop non-comp,3 mL,00378-9671-93,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML IN SOLN,94009,J7620,,Albuterol ipratrop non-comp,3 mL,00378-9671-93,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML IN SOLN,94009,J7620,,Albuterol ipratrop non-comp,3 mL,00378-9671-31,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,BUDESONIDE 0.5 MG/2ML IN SUSP,28775,J7626,,Budesonide non-comp unit,1 Each,00487-9701-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.92,% of charge rate,95.00%,48.37,,,,48.37,50.92,1
unity,NDC,BUDESONIDE 0.5 MG/2ML IN SUSP,28775,J7626,,Budesonide non-comp unit,1 Each,00487-9701-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,50.92,% of charge rate,95.00%,48.37,,,,48.37,50.92,1
unity,NDC,DEXAMETHASONE 0.5 MG/5ML PO SOLN,2320,J8540,,Oral dexamethasone,5 mL,00054-3177-63,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DEXAMETHASONE 0.5 MG/5ML PO SOLN,2320,J8540,,Oral dexamethasone,5 mL,00054-3177-63,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DEXAMETHASONE 4 MG PO TABS,2327,J8540,,Oral dexamethasone,1 Tab,00054-8175-25,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.31,% of charge rate,95.00%,5.99,,,,5.99,6.31,1
unity,NDC,DEXAMETHASONE 4 MG PO TABS,2327,J8540,,Oral dexamethasone,1 Tab,00054-8175-25,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.31,% of charge rate,95.00%,5.99,,,,5.99,6.31,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML ORAL SOLN,600448,J8540,,Oral dexamethasone,0.5 mL,99408-0003-44,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.07,% of charge rate,95.00%,3.87,,,,3.87,6.64,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML ORAL SOLN,600448,J8540,,Oral dexamethasone,1 mL,63323-0165-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.64,% of charge rate,95.00%,6.31,,,,3.87,6.64,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML ORAL SOLN,600448,J8540,,Oral dexamethasone,1 mL,63323-0165-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,6.64,% of charge rate,95.00%,6.31,,,,3.87,6.64,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML ORAL SOLN,600448,J8540,,Oral dexamethasone,0.5 mL,99408-0003-44,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,4.07,% of charge rate,95.00%,3.87,,,,3.87,6.64,1
unity,NDC,AZACITIDINE 100 MG INJ SUSR,78420,J9025,,Azacitidine injection,100 mg,00781-3253-94,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,831.5,% of charge rate,95.00%,789.93,,,,789.93,831.5,1
unity,NDC,AZACITIDINE 100 MG INJ SUSR,78420,J9025,,Azacitidine injection,100 mg,00781-3253-94,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,831.5,% of charge rate,95.00%,789.93,,,,789.93,831.5,1
unity,NDC,BEVACIZUMAB 100 MG/4ML IV SOLN,111073,J9035,,Bevacizumab injection,0.05 mL,50242-0060-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.9,% of charge rate,95.00%,83.51,,,,83.51,87.9,1
unity,NDC,BEVACIZUMAB 100 MG/4ML IV SOLN,111073,J9035,,Bevacizumab injection,0.05 mL,50242-0060-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.9,% of charge rate,95.00%,83.51,,,,83.51,87.9,1
unity,NDC,BEVACIZUMAB 400 MG/16ML IV SOLN,111074,J9035,,Bevacizumab injection,16 mL,50242-0061-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"8,350.38",% of charge rate,95.00%,"7,932.86",,,,"7,932.86","8,350.38",1
unity,NDC,BEVACIZUMAB 400 MG/16ML IV SOLN,111074,J9035,,Bevacizumab injection,16 mL,50242-0061-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"8,350.38",% of charge rate,95.00%,"7,932.86",,,,"7,932.86","8,350.38",1
unity,NDC,DURVALUMAB 120 MG/2.4ML IV SOLN,139943,J9173,,"Inj., durvalumab, 10 mg",2.4 mL,00310-4500-12,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,281.88",% of charge rate,95.00%,"2,167.79",,,,"2,167.79","2,281.88",1
unity,NDC,DURVALUMAB 120 MG/2.4ML IV SOLN,139943,J9173,,"Inj., durvalumab, 10 mg",2.4 mL,00310-4500-12,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,281.88",% of charge rate,95.00%,"2,167.79",,,,"2,167.79","2,281.88",1
unity,NDC,DURVALUMAB 500 MG/10ML IV SOLN,139944,J9173,,"Inj., durvalumab, 10 mg",10 mL,00310-4611-50,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,311.50",% of charge rate,95.00%,"8,845.93",,,,"8,845.93","9,311.50",1
unity,NDC,DURVALUMAB 500 MG/10ML IV SOLN,139944,J9173,,"Inj., durvalumab, 10 mg",10 mL,00310-4611-50,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,311.50",% of charge rate,95.00%,"8,845.93",,,,"8,845.93","9,311.50",1
unity,NDC,FLUOROURACIL 1 GM/20ML IV SOLN,82204,J9190,,Fluorouracil injection,20 mL,16729-0276-67,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.68,% of charge rate,95.00%,78.55,,,,78.55,82.68,1
unity,NDC,FLUOROURACIL 1 GM/20ML IV SOLN,82204,J9190,,Fluorouracil injection,20 mL,16729-0276-67,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,82.68,% of charge rate,95.00%,78.55,,,,78.55,82.68,1
unity,NDC,LEUPROLIDE ACETATE (4 MONTH) 30 MG SC KIT,35236,J9217,,Leuprolide acetate suspnsion,30 mg,62935-0303-30,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,210.50",% of charge rate,95.00%,"1,149.98",,,,"1,149.98","1,210.50",1
unity,NDC,LEUPROLIDE ACETATE (4 MONTH) 30 MG SC KIT,35236,J9217,,Leuprolide acetate suspnsion,30 mg,62935-0303-30,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,210.50",% of charge rate,95.00%,"1,149.98",,,,"1,149.98","1,210.50",1
unity,NDC,LEUPROLIDE ACETATE (6 MONTH) 45 MG SC KIT,40801,J9217,,Leuprolide acetate suspnsion,45 mg,62935-0453-45,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,826.70",% of charge rate,95.00%,"1,735.37",,,,"1,735.37","1,826.70",1
unity,NDC,LEUPROLIDE ACETATE (6 MONTH) 45 MG SC KIT,40801,J9217,,Leuprolide acetate suspnsion,45 mg,62935-0453-45,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,826.70",% of charge rate,95.00%,"1,735.37",,,,"1,735.37","1,826.70",1
unity,NDC,PEMBROLIZUMAB 100 MG/4ML IV SOLN,130696,J9271,,Inj pembrolizumab,4 mL,00006-3026-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"12,516.52",% of charge rate,95.00%,"11,890.69",,,,"11,890.69","12,516.52",1
unity,NDC,PEMBROLIZUMAB 100 MG/4ML IV SOLN,130696,J9271,,Inj pembrolizumab,4 mL,00006-3026-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"12,516.52",% of charge rate,95.00%,"11,890.69",,,,"11,890.69","12,516.52",1
unity,NDC,NIVOLUMAB 240 MG/24ML IV SOLN,141539,J9299,,"Injection, nivolumab",24 mL,00003-3734-13,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"17,171.14",% of charge rate,95.00%,"16,312.58",,,,"16,312.58","17,171.14",1
unity,NDC,NIVOLUMAB 240 MG/24ML IV SOLN,141539,J9299,,"Injection, nivolumab",24 mL,00003-3734-13,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"17,171.14",% of charge rate,95.00%,"16,312.58",,,,"16,312.58","17,171.14",1
unity,NDC,FULVESTRANT 250 MG/5ML IM SOLN,111104,J9395,,"Injection, fulvestrant",10 mL,00310-0720-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,009.25",% of charge rate,95.00%,"4,758.79",,,,"4,758.79","5,009.25",1
unity,NDC,FULVESTRANT 250 MG/5ML IM SOLN,111104,J9395,,"Injection, fulvestrant",10 mL,00310-0720-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"5,009.25",% of charge rate,95.00%,"4,758.79",,,,"4,758.79","5,009.25",1
unity,NDC,ALBUMIN HUMAN 25 % IV SOLN,8981,P9046,,"Albumin (human), 25%, 20 ml",100 mL,00944-0493-02,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,272.96,% of charge rate,95.00%,259.31,,,,259.31,272.96,1
unity,NDC,ALBUMIN HUMAN 25 % IV SOLN,8981,P9046,,"Albumin (human), 25%, 20 ml",100 mL,00944-0493-02,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,272.96,% of charge rate,95.00%,259.31,,,,259.31,272.96,1
unity,NDC,FERUMOXYTOL 510 MG/17ML IV SOLN,96660,Q0138,,"Ferumoxytol, non-esrd",17 mL,59338-0775-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,692.31",% of charge rate,95.00%,"2,557.69",,,,"2,557.69","2,692.31",1
unity,NDC,FERUMOXYTOL 510 MG/17ML IV SOLN,96660,Q0138,,"Ferumoxytol, non-esrd",17 mL,59338-0775-10,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,692.31",% of charge rate,95.00%,"2,557.69",,,,"2,557.69","2,692.31",1
unity,NDC,FERUMOXYTOL 510 MG/17ML IV SOLN,96660,Q0138,,"Ferumoxytol, non-esrd",17 mL,59338-0775-10,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,692.31",% of charge rate,95.00%,"2,557.69",,,,"2,557.69","2,692.31",1
unity,NDC,FERUMOXYTOL 510 MG/17ML IV SOLN,96660,Q0138,,"Ferumoxytol, non-esrd",17 mL,59338-0775-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"2,692.31",% of charge rate,95.00%,"2,557.69",,,,"2,557.69","2,692.31",1
unity,NDC,PROCHLORPERAZINE MALEATE 10 MG PO TABS,6582,Q0164,,Prochlorperazine maleate 5mg,1 Tab,59746-0115-06,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PROCHLORPERAZINE MALEATE 10 MG PO TABS,6582,Q0164,,Prochlorperazine maleate 5mg,1 Tab,59746-0115-06,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,DRONABINOL 2.5 MG PO CAPS,9904,Q0167,,Dronabinol 2.5mg oral,1 Cap,67877-0568-60,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.77,% of charge rate,95.00%,9.28,,,,9.28,9.77,1
unity,NDC,DRONABINOL 2.5 MG PO CAPS,9904,Q0167,,Dronabinol 2.5mg oral,1 Cap,67877-0568-60,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,9.77,% of charge rate,95.00%,9.28,,,,9.28,9.77,1
unity,NDC,PROMETHAZINE HCL 25 MG PO TABS,6622,Q0169,,Promethazine hcl 12.5mg oral,1 Tab,00904-6461-61,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,PROMETHAZINE HCL 25 MG PO TABS,6622,Q0169,,Promethazine hcl 12.5mg oral,1 Tab,00904-6461-61,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.5,% of charge rate,95.00%,3.33,,,,3.33,3.5,1
unity,NDC,HYDROXYZINE PAMOATE 25 MG PO CAPS,3777,Q0177,,Hydroxyzine pamoate 25mg,1 Cap,68084-0847-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,1
unity,NDC,HYDROXYZINE PAMOATE 25 MG PO CAPS,3777,Q0177,,Hydroxyzine pamoate 25mg,1 Cap,68084-0847-11,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,1
unity,NDC,HYDROXYZINE PAMOATE 25 MG PO CAPS,3777,Q0177,,Hydroxyzine pamoate 25mg,1 Cap,68084-0847-11,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,1
unity,NDC,HYDROXYZINE PAMOATE 25 MG PO CAPS,3777,Q0177,,Hydroxyzine pamoate 25mg,1 Cap,68084-0847-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,3.51,% of charge rate,95.00%,3.33,,,,3.33,3.51,1
unity,NDC,FILGRASTIM-SNDZ 300 MCG/0.5ML INJ SOSY,133079,Q5101,,"Injection, zarxio",0.5 mL,61314-0318-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,597.5,% of charge rate,95.00%,567.63,,,,567.63,597.5,1
unity,NDC,FILGRASTIM-SNDZ 300 MCG/0.5ML INJ SOSY,133079,Q5101,,"Injection, zarxio",0.5 mL,61314-0318-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,597.5,% of charge rate,95.00%,567.63,,,,567.63,597.5,1
unity,NDC,FILGRASTIM-SNDZ 480 MCG/0.8ML INJ SOSY,133080,Q5101,,"Injection, zarxio",0.8 mL,61314-0326-05,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,847.05,% of charge rate,95.00%,804.7,,,,804.7,847.05,1
unity,NDC,FILGRASTIM-SNDZ 480 MCG/0.8ML INJ SOSY,133080,Q5101,,"Injection, zarxio",0.8 mL,61314-0326-05,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,847.05,% of charge rate,95.00%,804.7,,,,804.7,847.05,1
unity,NDC,INFLIXIMAB-DYYB 100 MG IV SOLR,137250,Q5103,,"Injection, inflectra",100 mg,00069-0809-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,369.85",% of charge rate,95.00%,"1,301.36",,,,"1,301.36","1,369.85",1
unity,NDC,INFLIXIMAB-DYYB 100 MG IV SOLR,137250,Q5103,,"Injection, inflectra",100 mg,00069-0809-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,369.85",% of charge rate,95.00%,"1,301.36",,,,"1,301.36","1,369.85",1
unity,NDC,BEVACIZUMAB-AWWB 100 MG/4ML IV SOLN,145807,Q5107,,Inj mvasi 10 mg,4 mL,55513-0206-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,793.44",% of charge rate,95.00%,"1,703.77",,,,"1,703.77","1,793.44",1
unity,NDC,BEVACIZUMAB-AWWB 100 MG/4ML IV SOLN,145807,Q5107,,Inj mvasi 10 mg,4 mL,55513-0206-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"1,793.44",% of charge rate,95.00%,"1,703.77",,,,"1,703.77","1,793.44",1
unity,NDC,PEGFILGRASTIM-CBQV 6 MG/0.6ML SC SOSY,144183,Q5111,,"Injection, udenyca 0.5 mg",0.6 mL,70114-0101-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,004.81",% of charge rate,95.00%,"8,554.57",,,,"8,554.57","9,004.81",1
unity,NDC,PEGFILGRASTIM-CBQV 6 MG/0.6ML SC SOSY,144183,Q5111,,"Injection, udenyca 0.5 mg",0.6 mL,70114-0101-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,"9,004.81",% of charge rate,95.00%,"8,554.57",,,,"8,554.57","9,004.81",1
unity,NDC,PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP,127708,Q9957,,"Inj perflutren lip micros,ml",2 mL,11994-0011-04,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,287.5,% of charge rate,95.00%,273.13,,,,273.13,287.5,1
unity,NDC,PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP,127708,Q9957,,"Inj perflutren lip micros,ml",2 mL,11994-0011-04,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,287.5,% of charge rate,95.00%,273.13,,,,273.13,287.5,1
unity,NDC,IOHEXOL 350 MG/ML IV SOLN,10323,Q9967,,"Locm 300-399mg/ml iodine,1ml",55 mL,00407-1414-90,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.17,% of charge rate,95.00%,60.96,,,,60.96,116.67,1
unity,NDC,IOHEXOL 350 MG/ML IV SOLN,10323,Q9967,,"Locm 300-399mg/ml iodine,1ml",100 mL,00407-1414-91,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.67,% of charge rate,95.00%,110.84,,,,60.96,116.67,1
unity,NDC,IOHEXOL 350 MG/ML IV SOLN,10323,Q9967,,"Locm 300-399mg/ml iodine,1ml",100 mL,00407-1414-91,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,116.67,% of charge rate,95.00%,110.84,,,,60.96,116.67,1
unity,NDC,IOHEXOL 350 MG/ML IV SOLN,10323,Q9967,,"Locm 300-399mg/ml iodine,1ml",55 mL,00407-1414-90,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,64.17,% of charge rate,95.00%,60.96,,,,60.96,116.67,1
unity,NDC,IOPAMIDOL 76 % IV SOLN,10328,Q9967,,"Locm 300-399mg/ml iodine,1ml",100 mL,00270-1316-35,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.5,% of charge rate,95.00%,83.13,,,,83.13,87.5,1
unity,NDC,IOPAMIDOL 76 % IV SOLN,10328,Q9967,,"Locm 300-399mg/ml iodine,1ml",100 mL,00270-1316-35,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,87.5,% of charge rate,95.00%,83.13,,,,83.13,87.5,1
unity,NDC,CONTRAST MATERIAL,2550003,Q9967,,"Locm 300-399mg/ml iodine,1ml",1,,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,0.17,% of charge rate,95.00%,0.16,,,,0.16,0.17,1
unity,NDC,CONTRAST MATERIAL,2550003,Q9967,,"Locm 300-399mg/ml iodine,1ml",1,,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,0.17,% of charge rate,95.00%,0.16,,,,0.16,0.17,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,62756-0129-44,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,00008-0923-51,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,62756-0129-40,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,62756-0129-40,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,00008-0923-51,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,62756-0129-44,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,21.75,% of charge rate,95.00%,20.66,,,,20.66,21.75,1
unity,NDC,OLANZAPINE 10 MG IM SOLR,38263,S0166,,Inj olanzapine 2.5mg,10 mg,00517-0955-01,Inpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,123.16,% of charge rate,95.00%,117,,,,117,123.16,1
unity,NDC,OLANZAPINE 10 MG IM SOLR,38263,S0166,,Inj olanzapine 2.5mg,10 mg,00517-0955-01,Outpatient,N/A,Sanford Health Plan,N/A,N/A,N/A,123.16,% of charge rate,95.00%,117,,,,117,123.16,1
unity,NDC,TOBRAMYCIN 0.3 % OP SOLN,127425,2500005,,,5 mL,62332-0518-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,56.35,% of charge rate,100.00%,56.35,,,,53.53,56.35,1
unity,NDC,TOBRAMYCIN 0.3 % OP SOLN,127425,2500005,,,5 mL,62332-0518-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,56.35,% of charge rate,100.00%,56.35,,,,53.53,56.35,1
unity,NDC,FLURBIPROFEN SODIUM 0.03 % OP SOLN,10080,2500006,,,2.5 mL,69292-0722-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.03,% of charge rate,100.00%,25.03,,,,23.78,25.03,1
unity,NDC,FLURBIPROFEN SODIUM 0.03 % OP SOLN,10080,2500006,,,2.5 mL,69292-0722-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.03,% of charge rate,100.00%,25.03,,,,23.78,25.03,1
unity,NDC,IOHEXOL 140 MG/ML IV SOLN,10318,2500006,,,50 mL,00407-1401-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,127.42,% of charge rate,100.00%,127.42,,,,121.05,127.42,1
unity,NDC,IOHEXOL 140 MG/ML IV SOLN,10318,2500006,,,50 mL,00407-1401-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,127.42,% of charge rate,100.00%,127.42,,,,121.05,127.42,1
unity,NDC,PEG 3350 17 G PO PACK,103952,2500006,,,1 Packet,00904-6931-81,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.99,% of charge rate,100.00%,7.99,,,,7.59,7.99,1
unity,NDC,PEG 3350 17 G PO PACK,103952,2500006,,,1 Packet,00904-6931-86,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.99,% of charge rate,100.00%,7.99,,,,7.59,7.99,1
unity,NDC,PEG 3350 17 G PO PACK,103952,2500006,,,1 Packet,00904-6931-86,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.99,% of charge rate,100.00%,7.99,,,,7.59,7.99,1
unity,NDC,PEG 3350 17 G PO PACK,103952,2500006,,,1 Packet,00904-6931-81,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.99,% of charge rate,100.00%,7.99,,,,7.59,7.99,1
unity,NDC,LIDOCAINE-EPINEPHRINE 1 %-1:100000 INJ SOLN,10427,2500006,,,1 mL,00409-3178-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,26.5,1
unity,NDC,LIDOCAINE-EPINEPHRINE 1 %-1:100000 INJ SOLN,10427,2500006,,,1 mL,63323-0482-27,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.5,% of charge rate,100.00%,26.5,,,,20.66,26.5,1
unity,NDC,LIDOCAINE-EPINEPHRINE 1 %-1:100000 INJ SOLN,10427,2500006,,,1 mL,63323-0482-27,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.5,% of charge rate,100.00%,26.5,,,,20.66,26.5,1
unity,NDC,LIDOCAINE-EPINEPHRINE 1 %-1:100000 INJ SOLN,10427,2500006,,,1 mL,00409-3178-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,26.5,1
unity,NDC,LIDOCAINE-EPINEPHRINE 2 %-1:100000 INJ SOLN,10430,2500006,,,20 mL,00409-3182-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE-EPINEPHRINE 2 %-1:100000 INJ SOLN,10430,2500006,,,20 mL,00409-3182-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE-PRILOCAINE 2.5-2.5 % EX CREA,10434,2500006,,,30 g,00115-1468-45,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,153.05,% of charge rate,100.00%,153.05,,,,145.4,153.05,1
unity,NDC,LIDOCAINE-PRILOCAINE 2.5-2.5 % EX CREA,10434,2500006,,,30 g,00115-1468-45,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,153.05,% of charge rate,100.00%,153.05,,,,145.4,153.05,1
unity,NDC,TAMSULOSIN HCL 0.4 MG PO CAPS,105936,2500006,,,1 Cap,00904-6401-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TAMSULOSIN HCL 0.4 MG PO CAPS,105936,2500006,,,1 Cap,00904-6401-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MUPIROCIN 2 % EX OINT,10674,2500006,,,22 g,51672-1312-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.17,% of charge rate,100.00%,29.17,,,,27.71,29.17,1
unity,NDC,MUPIROCIN 2 % EX OINT,10674,2500006,,,22 g,51672-1312-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.17,% of charge rate,100.00%,29.17,,,,27.71,29.17,1
unity,NDC,NEOMYCIN-POLYMYXIN-DEXAMETH 3.5-10000-0.1 OP SUSP,108871,2500006,,,5 mL,24208-0830-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,52.74,% of charge rate,100.00%,52.74,,,,50.1,52.74,1
unity,NDC,NEOMYCIN-POLYMYXIN-DEXAMETH 3.5-10000-0.1 OP SUSP,108871,2500006,,,5 mL,24208-0830-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,52.74,% of charge rate,100.00%,52.74,,,,50.1,52.74,1
unity,NDC,PENICILLIN G BENZATHINE 2400000 UNIT/4ML IM SUSP,111058,2500006,,,4 mL,60793-0702-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,912.23,% of charge rate,100.00%,912.23,,,,866.62,912.23,1
unity,NDC,PENICILLIN G BENZATHINE 2400000 UNIT/4ML IM SUSP,111058,2500006,,,4 mL,60793-0702-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,912.23,% of charge rate,100.00%,912.23,,,,866.62,912.23,1
unity,NDC,TICAGRELOR 90 MG PO TABS,112719,2500006,,,1 Tab,00186-0777-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.51,% of charge rate,100.00%,29.51,,,,28.03,29.51,1
unity,NDC,TICAGRELOR 90 MG PO TABS,112719,2500006,,,1 Tab,00186-0777-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.51,% of charge rate,100.00%,29.51,,,,28.03,29.51,1
unity,NDC,OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR,113272,2500006,,,60 mL,47781-0384-26,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,675.65,% of charge rate,100.00%,675.65,,,,641.87,675.65,1
unity,NDC,OSELTAMIVIR PHOSPHATE 6 MG/ML PO SUSR,113272,2500006,,,60 mL,47781-0384-26,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,675.65,% of charge rate,100.00%,675.65,,,,641.87,675.65,1
unity,NDC,SILVER NITRATE-POT NITRATE 75-25 % EX MISC,11359,2500006,,,1 Each,12870-0001-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SILVER NITRATE-POT NITRATE 75-25 % EX MISC,11359,2500006,,,1 Each,12870-0001-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP SUSP,11567,2500006,,,2.5 mL,24208-0295-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,159.2,% of charge rate,100.00%,159.2,,,,151.24,159.2,1
unity,NDC,TOBRAMYCIN-DEXAMETHASONE 0.3-0.1 % OP SUSP,11567,2500006,,,2.5 mL,24208-0295-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,159.2,% of charge rate,100.00%,159.2,,,,151.24,159.2,1
unity,NDC,VANCOMYCIN HCL 125 MG PO CAPS,11628,2500006,,,1 Cap,00121-0867-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.83,% of charge rate,100.00%,27.83,,,,26.44,27.83,1
unity,NDC,VANCOMYCIN HCL 125 MG PO CAPS,11628,2500006,,,1 Cap,00121-0867-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.83,% of charge rate,100.00%,27.83,,,,26.44,27.83,1
unity,NDC,RACEPINEPHRINE HCL 2.25 % IN NEBU,117196,2500006,,,0.5 mL,00487-2784-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.22,% of charge rate,100.00%,12.22,,,,11.61,12.22,1
unity,NDC,RACEPINEPHRINE HCL 2.25 % IN NEBU,117196,2500006,,,0.5 mL,00487-2784-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.22,% of charge rate,100.00%,12.22,,,,11.61,12.22,1
unity,NDC,THERA-TABS M PO TABS,117881,2500006,,,1 Tab,00904-5492-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,THERA-TABS M PO TABS,117881,2500006,,,1 Tab,00904-5492-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACT IN AERS,119339,2500006,,,4 g,00597-0024-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,937.29,% of charge rate,100.00%,937.29,,,,890.43,937.29,1
unity,NDC,IPRATROPIUM-ALBUTEROL 20-100 MCG/ACT IN AERS,119339,2500006,,,4 g,00597-0024-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,937.29,% of charge rate,100.00%,937.29,,,,890.43,937.29,1
unity,NDC,INFUVITE ADULT IV INJ,122126,2500006,,,10 mL,54643-9007-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.28,% of charge rate,100.00%,29.28,,,,27.82,29.28,1
unity,NDC,INFUVITE ADULT IV INJ,122126,2500006,,,10 mL,54643-9007-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.28,% of charge rate,100.00%,29.28,,,,27.82,29.28,1
unity,NDC,BUPIVACAINE HCL 0.25 % INJ SOLN,1222,2500006,,,50 mL,63323-0465-57,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUPIVACAINE HCL 0.25 % INJ SOLN,1222,2500006,,,50 mL,63323-0465-57,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUPIVACAINE HCL 0.5 % INJ SOLN,1223,2500006,,,50 mL,63323-0467-57,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUPIVACAINE HCL 0.5 % INJ SOLN,1223,2500006,,,50 mL,63323-0467-57,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,CANAGLIFLOZIN 100 MG PO TABS,123456,2500006,,,1 Tab,50458-0140-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,79.24,% of charge rate,100.00%,79.24,,,,75.28,79.24,1
unity,NDC,CANAGLIFLOZIN 100 MG PO TABS,123456,2500006,,,1 Tab,50458-0140-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,79.24,% of charge rate,100.00%,79.24,,,,75.28,79.24,1
unity,NDC,PB-HYOSCY-ATROPINE-SCOPOLAMINE 16.2 MG/5ML PO ELIX,129297,2500006,,,2 mL,75826-0127-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,36.64,% of charge rate,100.00%,36.64,,,,34.81,36.64,1
unity,NDC,PB-HYOSCY-ATROPINE-SCOPOLAMINE 16.2 MG/5ML PO ELIX,129297,2500006,,,2 mL,75826-0127-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,36.64,% of charge rate,100.00%,36.64,,,,34.81,36.64,1
unity,NDC,CALCIUM CHLORIDE 10 % IV SOLN,1306,2500006,,,10 mL,00409-1631-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,44.1,% of charge rate,100.00%,44.1,,,,41.9,44.1,1
unity,NDC,CALCIUM CHLORIDE 10 % IV SOLN,1306,2500006,,,10 mL,00409-1631-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,44.1,% of charge rate,100.00%,44.1,,,,41.9,44.1,1
unity,NDC,SCOPOLAMINE 1 MG/3DAYS TD PT72,130961,2500006,,,1 Patch,45802-0580-84,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.8,% of charge rate,100.00%,67.8,,,,64.41,67.8,1
unity,NDC,SCOPOLAMINE 1 MG/3DAYS TD PT72,130961,2500006,,,1 Patch,45802-0580-84,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.8,% of charge rate,100.00%,67.8,,,,64.41,67.8,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00409-3375-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.08,% of charge rate,100.00%,83.08,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00703-1153-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.08,% of charge rate,100.00%,83.08,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00703-1153-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,83.08,% of charge rate,100.00%,83.08,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00703-1153-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.08,% of charge rate,100.00%,83.08,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00703-1153-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.08,% of charge rate,100.00%,83.08,,,,78.93,83.08,1
unity,NDC,NOREPINEPHRINE BITARTRATE 1 MG/ML IV SOLN,131372,2500006,,,4 mL,00409-3375-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,83.08,% of charge rate,100.00%,83.08,,,,78.93,83.08,1
unity,NDC,TIOTROPIUM BROMIDE-OLODATEROL 2.5-2.5 MCG/ACT IN AERS,132149,2500006,,,4 g,00597-0155-70,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,146.08,% of charge rate,100.00%,146.08,,,,138.78,146.08,1
unity,NDC,TIOTROPIUM BROMIDE-OLODATEROL 2.5-2.5 MCG/ACT IN AERS,132149,2500006,,,4 g,00597-0155-70,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,146.08,% of charge rate,100.00%,146.08,,,,138.78,146.08,1
unity,NDC,TRANEXAMIC ACID 1000 MG/10ML IV SOLN,134922,2500006,,,5 mL,61990-0611-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.35,% of charge rate,100.00%,26.35,,,,25.03,26.35,1
unity,NDC,TRANEXAMIC ACID 1000 MG/10ML IV SOLN,134922,2500006,,,5 mL,61990-0611-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.35,% of charge rate,100.00%,26.35,,,,25.03,26.35,1
unity,NDC,TRANEXAMIC ACID 1000 MG/10ML IV SOLN,134922,2500006,,,5 mL,61990-0611-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.35,% of charge rate,100.00%,26.35,,,,25.03,26.35,1
unity,NDC,TRANEXAMIC ACID 1000 MG/10ML IV SOLN,134922,2500006,,,5 mL,61990-0611-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.35,% of charge rate,100.00%,26.35,,,,25.03,26.35,1
unity,NDC,EPHEDRINE SULFATE 50 MG/ML IV SOLN,135960,2500006,,,1 mL,17478-0955-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,85.26,% of charge rate,100.00%,85.26,,,,81,85.26,1
unity,NDC,EPHEDRINE SULFATE 50 MG/ML IV SOLN,135960,2500006,,,1 mL,17478-0955-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,85.26,% of charge rate,100.00%,85.26,,,,81,85.26,1
unity,NDC,BACITRACIN ZINC 500 UNIT/GM EX OINT,13818,2500006,,,1 g,45802-0060-70,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,BACITRACIN ZINC 500 UNIT/GM EX OINT,13818,2500006,,,1 g,45802-0060-70,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,BENZOCAINE 20 % MT AERO,139175,2500006,,,57 Spray,00283-0679-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,121.84,% of charge rate,100.00%,121.84,,,,115.75,121.84,1
unity,NDC,BENZOCAINE 20 % MT AERO,139175,2500006,,,57 Spray,00283-0679-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,121.84,% of charge rate,100.00%,121.84,,,,115.75,121.84,1
unity,NDC,ALFENTANIL HCL 1000 MCG/2ML IV SOLN,142013,2500006,,,2 mL,17478-0067-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ALFENTANIL HCL 1000 MCG/2ML IV SOLN,142013,2500006,,,2 mL,17478-0067-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX GEL,144902,2500006,,,5 mL,17478-0711-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.85,% of charge rate,100.00%,71.85,,,,68.26,71.85,1
unity,NDC,LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX GEL,144902,2500006,,,5 mL,17478-0711-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.85,% of charge rate,100.00%,71.85,,,,68.26,71.85,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,20 mL,00409-4888-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,0.5 mL,63323-0186-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,20 mL,00409-4888-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,20 mL,00409-4888-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,0.5 mL,63323-0186-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE (PF) 0.9 % INJ SOLN,146258,2500006,,,20 mL,00409-4888-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SENNA 8.8 MG/5ML PO LIQD,147094,2500006,,,237 mL,00536-1266-59,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.49,% of charge rate,100.00%,54.49,,,,51.77,54.49,1
unity,NDC,SENNA 8.8 MG/5ML PO LIQD,147094,2500006,,,237 mL,00536-1266-59,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.49,% of charge rate,100.00%,54.49,,,,51.77,54.49,1
unity,NDC,CENTRUM PO LIQD,1481,2500006,,,5 mL,00005-4344-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CENTRUM PO LIQD,1481,2500006,,,5 mL,00005-4344-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,REMDESIVIR 100 MG IV SOLR,148141,2500006,,,20 mL,61958-2901-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,353.50",% of charge rate,100.00%,"1,353.50",,,,"1,285.83","1,353.50",1
unity,NDC,REMDESIVIR 100 MG IV SOLR,148141,2500006,,,20 mL,61958-2901-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,353.50",% of charge rate,100.00%,"1,353.50",,,,"1,285.83","1,353.50",1
unity,NDC,CALCITONIN (SALMON) 200 UNIT/ACT NA SOLN,15738,2500006,,,3.7 mL,49884-0161-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.97,% of charge rate,100.00%,64.97,,,,61.72,64.97,1
unity,NDC,CALCITONIN (SALMON) 200 UNIT/ACT NA SOLN,15738,2500006,,,3.7 mL,49884-0161-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.97,% of charge rate,100.00%,64.97,,,,61.72,64.97,1
unity,NDC,IPRATROPIUM BROMIDE 0.06 % NA SOLN,16071,2500006,,,15 mL,00054-0046-41,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78.35,% of charge rate,100.00%,78.35,,,,74.43,78.35,1
unity,NDC,IPRATROPIUM BROMIDE 0.06 % NA SOLN,16071,2500006,,,15 mL,00054-0046-41,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78.35,% of charge rate,100.00%,78.35,,,,74.43,78.35,1
unity,NDC,CANDIDA ALBICANS SKN TST ANTGN ID SOLN,17524,2500006,,,0.1 mL,59584-0138-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.92,% of charge rate,100.00%,57.92,,,,55.02,57.92,1
unity,NDC,CANDIDA ALBICANS SKN TST ANTGN ID SOLN,17524,2500006,,,0.1 mL,59584-0138-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.92,% of charge rate,100.00%,57.92,,,,55.02,57.92,1
unity,NDC,ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT IN AERS,17837,2500006,,,8 g,00173-0682-24,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,76.15,% of charge rate,100.00%,76.15,,,,72.34,76.15,1
unity,NDC,ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT IN AERS,17837,2500006,,,8 g,00173-0682-24,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,76.15,% of charge rate,100.00%,76.15,,,,72.34,76.15,1
unity,NDC,SENNA 8.6 MG PO TABS,18138,2500006,,,1 Tab,00904-6522-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SENNA 8.6 MG PO TABS,18138,2500006,,,1 Tab,00904-6522-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BENZOCAINE 20 % MT SOLN,19696,2500006,,,1 Spray,00283-0610-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,39.5,% of charge rate,100.00%,39.5,,,,37.53,39.5,1
unity,NDC,BENZOCAINE 20 % MT SOLN,19696,2500006,,,1 Spray,00283-0610-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,39.5,% of charge rate,100.00%,39.5,,,,37.53,39.5,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,10 mL,00143-9311-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.34,% of charge rate,100.00%,29.34,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,10 mL,00409-6695-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.34,% of charge rate,100.00%,29.34,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,20 mL,00143-9311-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.19,% of charge rate,100.00%,23.19,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,20 mL,00143-9311-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.19,% of charge rate,100.00%,23.19,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,10 mL,00409-6695-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.34,% of charge rate,100.00%,29.34,,,,22.03,29.34,1
unity,NDC,ETOMIDATE 2 MG/ML IV SOLN,20472,2500006,,,10 mL,00143-9311-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.34,% of charge rate,100.00%,29.34,,,,22.03,29.34,1
unity,NDC,QUETIAPINE FUMARATE 200 MG PO TABS,21825,2500006,,,1 Tab,00904-6641-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,QUETIAPINE FUMARATE 200 MG PO TABS,21825,2500006,,,1 Tab,00904-6641-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IRBESARTAN 300 MG PO TABS,21849,2500006,,,1 Tab,42658-0123-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IRBESARTAN 300 MG PO TABS,21849,2500006,,,1 Tab,42658-0123-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DEXTROSE 10 % IV SOLN,2357,2500006,,,500 mL,00409-7930-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69.01,% of charge rate,100.00%,69.01,,,,65.56,69.01,1
unity,NDC,DEXTROSE 10 % IV SOLN,2357,2500006,,,500 mL,00409-7930-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69.01,% of charge rate,100.00%,69.01,,,,65.56,69.01,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-4902-34,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-4902-64,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-7517-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-7517-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-4902-64,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXTROSE 50 % IV SOLN,2365,2500006,,,50 mL,00409-4902-34,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIPHENHYDRAMINE HCL 25 MG PO CAPS,2509,2500006,,,1 Cap,00904-5306-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DIPHENHYDRAMINE HCL 25 MG PO CAPS,2509,2500006,,,1 Cap,00904-5306-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DOCUSATE SODIUM 150 MG/15ML PO LIQD,2569,2500006,,,10 mL,50383-0771-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.85,% of charge rate,100.00%,3.85,,,,3.66,3.85,1
unity,NDC,DOCUSATE SODIUM 150 MG/15ML PO LIQD,2569,2500006,,,10 mL,50383-0771-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.85,% of charge rate,100.00%,3.85,,,,3.66,3.85,1
unity,NDC,DOCUSATE SODIUM 150 MG/15ML PO LIQD,2569,2500006,,,10 mL,50383-0771-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.85,% of charge rate,100.00%,3.85,,,,3.66,3.85,1
unity,NDC,DOCUSATE SODIUM 150 MG/15ML PO LIQD,2569,2500006,,,10 mL,50383-0771-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.85,% of charge rate,100.00%,3.85,,,,3.66,3.85,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG IV SOLR,2622,2500006,,,100 mg,68382-0910-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.02,% of charge rate,100.00%,88.02,,,,83.62,88.02,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG IV SOLR,2622,2500006,,,100 mg,68382-0910-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.02,% of charge rate,100.00%,88.02,,,,83.62,88.02,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG IV SOLR,2622,2500006,,,100 mg,68382-0910-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.02,% of charge rate,100.00%,88.02,,,,83.62,88.02,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG IV SOLR,2622,2500006,,,100 mg,68382-0910-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.02,% of charge rate,100.00%,88.02,,,,83.62,88.02,1
unity,NDC,FLUTICASONE-SALMETEROL 250-50 MCG/DOSE IN AEPB,26538,2500006,,,14 Each,00173-0696-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,298.52,% of charge rate,100.00%,298.52,,,,283.59,298.52,1
unity,NDC,FLUTICASONE-SALMETEROL 250-50 MCG/DOSE IN AEPB,26538,2500006,,,14 Each,00173-0696-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,298.52,% of charge rate,100.00%,298.52,,,,283.59,298.52,1
unity,NDC,FLUTICASONE-SALMETEROL 500-50 MCG/DOSE IN AEPB,26539,2500006,,,60 Each,00378-9322-32,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,931.70",% of charge rate,100.00%,"2,931.70",,,,"2,785.12","2,931.70",1
unity,NDC,FLUTICASONE-SALMETEROL 500-50 MCG/DOSE IN AEPB,26539,2500006,,,60 Each,00378-9322-32,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,931.70",% of charge rate,100.00%,"2,931.70",,,,"2,785.12","2,931.70",1
unity,NDC,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5ML PO SYRP,27345,2500006,,,5 mL,00536-1184-97,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DEXTROMETHORPHAN-GUAIFENESIN 10-100 MG/5ML PO SYRP,27345,2500006,,,5 mL,00536-1184-97,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CRANBERRY 250 MG PO CAPS,27448,2500006,,,1 Each,35046-0007-51,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CRANBERRY 250 MG PO CAPS,27448,2500006,,,1 Each,35046-0007-51,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FLUORESCEIN SODIUM 1 MG OP STRP,27663,2500006,,,1 Strip,17238-0900-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FLUORESCEIN SODIUM 1 MG OP STRP,27663,2500006,,,1 Strip,17238-0900-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IOPAMIDOL 61 % IV SOLN,27737,2500006,,,50 mL,00270-1315-35,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,154.31,% of charge rate,100.00%,154.31,,,,146.59,154.31,1
unity,NDC,IOPAMIDOL 61 % IV SOLN,27737,2500006,,,50 mL,00270-1315-35,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,154.31,% of charge rate,100.00%,154.31,,,,146.59,154.31,1
unity,NDC,LIDOCAINE VISCOUS HCL 2 % MT SOLN,27898,2500006,,,15 mL,50383-0775-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.36,% of charge rate,100.00%,5.36,,,,3.33,5.36,1
unity,NDC,LIDOCAINE VISCOUS HCL 2 % MT SOLN,27898,2500006,,,5 mL,50383-0775-17,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,5.36,1
unity,NDC,LIDOCAINE VISCOUS HCL 2 % MT SOLN,27898,2500006,,,5 mL,50383-0775-17,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,5.36,1
unity,NDC,LIDOCAINE VISCOUS HCL 2 % MT SOLN,27898,2500006,,,15 mL,50383-0775-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.36,% of charge rate,100.00%,5.36,,,,3.33,5.36,1
unity,NDC,OLANZAPINE 20 MG PO TABS,28158,2500006,,,1 Tab,00904-6287-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OLANZAPINE 20 MG PO TABS,28158,2500006,,,1 Tab,00904-6287-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,EPHEDRINE SULFATE 50 MG/ML INJ SOLN,2833,2500006,,,1 mL,14789-0014-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.5,% of charge rate,100.00%,58.5,,,,55.58,58.5,1
unity,NDC,EPHEDRINE SULFATE 50 MG/ML INJ SOLN,2833,2500006,,,1 mL,14789-0014-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.5,% of charge rate,100.00%,58.5,,,,55.58,58.5,1
unity,NDC,PHOSPHA 250 NEUTRAL 155-852-130 MG PO TABS,29296,2500006,,,1 Tab,64980-0104-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PHOSPHA 250 NEUTRAL 155-852-130 MG PO TABS,29296,2500006,,,1 Tab,64980-0104-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FLEET ENEMA 7-19 GM/118ML REC ENEM,3123,2500006,,,1 Enema,00132-0201-40,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.45,% of charge rate,100.00%,7.45,,,,7.08,7.45,1
unity,NDC,FLEET ENEMA 7-19 GM/118ML REC ENEM,3123,2500006,,,1 Enema,00132-0201-40,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.45,% of charge rate,100.00%,7.45,,,,7.08,7.45,1
unity,NDC,FOLIC ACID 5 MG/ML INJ SOLN,3232,2500006,,,1 mL,63323-0184-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FOLIC ACID 5 MG/ML INJ SOLN,3232,2500006,,,1 mL,63323-0184-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,3497,2500006,,,2 mL,70069-0011-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75.19,% of charge rate,100.00%,75.19,,,,71.43,75.19,1
unity,NDC,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,3497,2500006,,,2 mL,70069-0011-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75.19,% of charge rate,100.00%,75.19,,,,71.43,75.19,1
unity,NDC,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,3497,2500006,,,2 mL,70069-0011-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75.19,% of charge rate,100.00%,75.19,,,,71.43,75.19,1
unity,NDC,GLYCOPYRROLATE 0.2 MG/ML INJ SOLN,3497,2500006,,,2 mL,70069-0011-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75.19,% of charge rate,100.00%,75.19,,,,71.43,75.19,1
unity,NDC,MOXIFLOXACIN HCL 0.5 % OP SOLN,35699,2500006,,,3 mL,00065-4013-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,224.5,% of charge rate,100.00%,224.5,,,,213.28,224.5,1
unity,NDC,MOXIFLOXACIN HCL 0.5 % OP SOLN,35699,2500006,,,3 mL,00065-4013-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,224.5,% of charge rate,100.00%,224.5,,,,213.28,224.5,1
unity,NDC,CHOLESTYRAMINE LIGHT 4 G PO POWD,37655,2500006,,,52.5 Packet,49884-0466-67,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,164.21,% of charge rate,100.00%,164.21,,,,156,164.21,1
unity,NDC,CHOLESTYRAMINE LIGHT 4 G PO POWD,37655,2500006,,,52.5 Packet,49884-0466-67,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,164.21,% of charge rate,100.00%,164.21,,,,156,164.21,1
unity,NDC,ALUMINUM-MAGNESIUM-SIMETHICONE 200-200-20 MG/5ML PO SUSP,38285,2500006,,,30 mL,00121-1761-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.41,% of charge rate,100.00%,13.41,,,,12.74,13.41,1
unity,NDC,ALUMINUM-MAGNESIUM-SIMETHICONE 200-200-20 MG/5ML PO SUSP,38285,2500006,,,30 mL,00121-1761-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.41,% of charge rate,100.00%,13.41,,,,12.74,13.41,1
unity,NDC,NYSTATIN 100000 UNIT/GM EX POWD,39136,2500006,,,15 g,00832-0465-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.12,% of charge rate,100.00%,20.12,,,,19.11,20.12,1
unity,NDC,NYSTATIN 100000 UNIT/GM EX POWD,39136,2500006,,,15 g,00832-0465-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.12,% of charge rate,100.00%,20.12,,,,19.11,20.12,1
unity,NDC,NYAMYC 100000 UNIT/GM EX POWD,41288,2500006,,,15 g,00832-0465-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.12,% of charge rate,100.00%,20.12,,,,19.11,20.12,1
unity,NDC,NYAMYC 100000 UNIT/GM EX POWD,41288,2500006,,,15 g,00832-0465-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.12,% of charge rate,100.00%,20.12,,,,19.11,20.12,1
unity,NDC,KETAMINE HCL 50 MG/ML INJ SOLN,4238,2500006,,,10 mL,00143-9508-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.25,% of charge rate,100.00%,23.25,,,,22.09,23.25,1
unity,NDC,KETAMINE HCL 50 MG/ML INJ SOLN,4238,2500006,,,10 mL,00143-9508-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.25,% of charge rate,100.00%,23.25,,,,22.09,23.25,1
unity,NDC,KETAMINE HCL 50 MG/ML INJ SOLN,4238,2500006,,,10 mL,00143-9508-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.25,% of charge rate,100.00%,23.25,,,,22.09,23.25,1
unity,NDC,KETAMINE HCL 50 MG/ML INJ SOLN,4238,2500006,,,10 mL,00143-9508-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.25,% of charge rate,100.00%,23.25,,,,22.09,23.25,1
unity,NDC,GI COCKTAIL (MYLANTA-LIDOCAINE-DONNATAL) OMNI,4530441,2500006,,,10 mL,99408-0003-93,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,35.04,% of charge rate,100.00%,35.04,,,,33.29,35.04,1
unity,NDC,GI COCKTAIL (MYLANTA-LIDOCAINE-DONNATAL) OMNI,4530441,2500006,,,10 mL,99408-0003-93,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,35.04,% of charge rate,100.00%,35.04,,,,33.29,35.04,1
unity,NDC,MIRACLE MOUTHWASH UM BOTTLE,454026,2500006,,,30 mL,99408-0004-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,35.43,% of charge rate,100.00%,35.43,,,,33.66,35.43,1
unity,NDC,MIRACLE MOUTHWASH UM BOTTLE,454026,2500006,,,30 mL,99408-0004-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,35.43,% of charge rate,100.00%,35.43,,,,33.66,35.43,1
unity,NDC,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,5595,2500006,,,1 Cap,50268-0623-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.6,% of charge rate,100.00%,8.6,,,,8.17,8.6,1
unity,NDC,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,5595,2500006,,,1 Cap,50268-0623-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.6,% of charge rate,100.00%,8.6,,,,8.17,8.6,1
unity,NDC,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,5595,2500006,,,1 Cap,50268-0623-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.6,% of charge rate,100.00%,8.6,,,,8.17,8.6,1
unity,NDC,NITROFURANTOIN MACROCRYSTAL 50 MG PO CAPS,5595,2500006,,,1 Cap,50268-0623-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.6,% of charge rate,100.00%,8.6,,,,8.17,8.6,1
unity,NDC,OXYMETAZOLINE HCL 0.05 % NA SOLN,5943,2500006,,,30 mL,00904-6761-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.04,% of charge rate,100.00%,7.04,,,,6.69,7.04,1
unity,NDC,OXYMETAZOLINE HCL 0.05 % NA SOLN,5943,2500006,,,30 mL,00904-6761-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.04,% of charge rate,100.00%,7.04,,,,6.69,7.04,1
unity,NDC,LIDOCAINE 4% OPHTHALMIC DROPS,600049,2500006,,,10 Drop,99408-0000-43,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,LIDOCAINE 4% OPHTHALMIC DROPS,600049,2500006,,,10 Drop,99408-0000-43,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,DILATING EYE COCKTAIL FOR CATARACTS (SIMPLE),600051,2500006,,,0.5 mL,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,19,20,1
unity,NDC,DILATING EYE COCKTAIL FOR CATARACTS (SIMPLE),600051,2500006,,,0.5 mL,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20,% of charge rate,100.00%,20,,,,19,20,1
unity,NDC,LET TOPICAL GEL,600451,2500006,,,3 mL,05446-0607-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.05,% of charge rate,100.00%,58.05,,,,55.15,58.05,1
unity,NDC,LET TOPICAL GEL,600451,2500006,,,3 mL,05446-0607-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.05,% of charge rate,100.00%,58.05,,,,55.15,58.05,1
unity,NDC,POVIDONE-IODINE 10 % EX OINT,6455,2500006,,,1 g,52380-0126-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,101.5,1
unity,NDC,POVIDONE-IODINE 10 % EX OINT,6455,2500006,,,28.35 g,00904-1102-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.5,% of charge rate,100.00%,101.5,,,,3.33,101.5,1
unity,NDC,POVIDONE-IODINE 10 % EX OINT,6455,2500006,,,28.35 g,00904-1102-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.5,% of charge rate,100.00%,101.5,,,,3.33,101.5,1
unity,NDC,POVIDONE-IODINE 10 % EX OINT,6455,2500006,,,1 g,52380-0126-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,101.5,1
unity,NDC,PROPARACAINE HCL 0.5 % OP SOLN,6644,2500006,,,15 mL,61314-0016-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,101.59,% of charge rate,100.00%,101.59,,,,96.51,101.59,1
unity,NDC,PROPARACAINE HCL 0.5 % OP SOLN,6644,2500006,,,15 mL,61314-0016-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,101.59,% of charge rate,100.00%,101.59,,,,96.51,101.59,1
unity,NDC,QUETIAPINE FUMARATE 50 MG PO TABS,70397,2500006,,,1 Tab,00904-6639-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,QUETIAPINE FUMARATE 50 MG PO TABS,70397,2500006,,,1 Tab,00904-6639-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LUBIPROSTONE 24 MCG PO CAPS,70472,2500006,,,1 Cap,64764-0240-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.2,% of charge rate,100.00%,24.2,,,,22.99,24.2,1
unity,NDC,LUBIPROSTONE 24 MCG PO CAPS,70472,2500006,,,1 Cap,64764-0240-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.2,% of charge rate,100.00%,24.2,,,,22.99,24.2,1
unity,NDC,FLUTICASONE PROPIONATE 50 MCG/ACT NA SUSP,70536,2500006,,,16 g,60505-0829-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.64,% of charge rate,100.00%,20.64,,,,19.61,20.64,1
unity,NDC,FLUTICASONE PROPIONATE 50 MCG/ACT NA SUSP,70536,2500006,,,16 g,60505-0829-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.64,% of charge rate,100.00%,20.64,,,,19.61,20.64,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,25 g,67877-0124-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.96,% of charge rate,100.00%,25.96,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,400 g,67877-0124-40,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,183.5,% of charge rate,100.00%,183.5,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,50 g,61570-0131-50,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.49,% of charge rate,100.00%,34.49,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,50 g,61570-0131-50,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.49,% of charge rate,100.00%,34.49,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,400 g,67877-0124-40,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,183.5,% of charge rate,100.00%,183.5,,,,24.66,183.5,1
unity,NDC,SILVER SULFADIAZINE 1 % EX CREA,7224,2500006,,,25 g,67877-0124-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.96,% of charge rate,100.00%,25.96,,,,24.66,183.5,1
unity,NDC,SODIUM BICARBONATE 4.2 % IV SOLN,7306,2500006,,,10 mL,00409-5534-34,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.41,% of charge rate,100.00%,87.41,,,,83.04,87.41,1
unity,NDC,SODIUM BICARBONATE 4.2 % IV SOLN,7306,2500006,,,10 mL,00409-5534-34,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.41,% of charge rate,100.00%,87.41,,,,83.04,87.41,1
unity,NDC,SODIUM BICARBONATE 8.4 % IV SOLN,7309,2500006,,,50 mL,76329-3352-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49.85,% of charge rate,100.00%,49.85,,,,47.36,49.85,1
unity,NDC,SODIUM BICARBONATE 8.4 % IV SOLN,7309,2500006,,,50 mL,76329-3352-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49.85,% of charge rate,100.00%,49.85,,,,47.36,49.85,1
unity,NDC,SODIUM CHLORIDE 3 % IV SOLN,7321,2500006,,,500 mL,63323-0530-75,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,77.25,% of charge rate,100.00%,77.25,,,,73.39,77.25,1
unity,NDC,SODIUM CHLORIDE 3 % IV SOLN,7321,2500006,,,500 mL,63323-0530-75,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,77.25,% of charge rate,100.00%,77.25,,,,73.39,77.25,1
unity,NDC,ATROPINE SULFATE 1 % OP SOLN,736,2500006,,,2 mL,17478-0215-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,175.79,% of charge rate,100.00%,175.79,,,,167,175.79,1
unity,NDC,ATROPINE SULFATE 1 % OP SOLN,736,2500006,,,2 mL,17478-0215-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,175.79,% of charge rate,100.00%,175.79,,,,167,175.79,1
unity,NDC,TETRACAINE HCL 0.5 % OP SOLN,7795,2500006,,,4 mL,00065-0741-14,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,41.01,% of charge rate,100.00%,41.01,,,,38.96,41.01,1
unity,NDC,TETRACAINE HCL 0.5 % OP SOLN,7795,2500006,,,4 mL,00065-0741-14,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,41.01,% of charge rate,100.00%,41.01,,,,38.96,41.01,1
unity,NDC,BUDESONIDE-FORMOTEROL FUMARATE 80-4.5 MCG/ACT IN AERO,81453,2500006,,,6.9 g,00186-0372-28,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,431.4,% of charge rate,100.00%,431.4,,,,409.83,431.4,1
unity,NDC,BUDESONIDE-FORMOTEROL FUMARATE 80-4.5 MCG/ACT IN AERO,81453,2500006,,,6.9 g,00186-0372-28,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,431.4,% of charge rate,100.00%,431.4,,,,409.83,431.4,1
unity,NDC,BUDESONIDE-FORMOTEROL FUMARATE 160-4.5 MCG/ACT IN AERO,81454,2500006,,,6 g,00186-0370-28,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,431.37,% of charge rate,100.00%,431.37,,,,409.8,431.37,1
unity,NDC,BUDESONIDE-FORMOTEROL FUMARATE 160-4.5 MCG/ACT IN AERO,81454,2500006,,,6 g,00186-0370-28,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,431.37,% of charge rate,100.00%,431.37,,,,409.8,431.37,1
unity,NDC,TROPICAMIDE 1 % OP SOLN,8250,2500006,,,15 mL,17478-0102-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,161.05,% of charge rate,100.00%,161.05,,,,153,161.05,1
unity,NDC,TROPICAMIDE 1 % OP SOLN,8250,2500006,,,15 mL,17478-0102-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,161.05,% of charge rate,100.00%,161.05,,,,153,161.05,1
unity,NDC,KERR INSTA-CHAR IN SORBITOL 50 GM/240ML PO LIQD,82604,2500006,,,240 mL,66689-0203-08,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,613.27,% of charge rate,100.00%,613.27,,,,582.61,613.27,1
unity,NDC,KERR INSTA-CHAR IN SORBITOL 50 GM/240ML PO LIQD,82604,2500006,,,240 mL,66689-0203-08,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,613.27,% of charge rate,100.00%,613.27,,,,582.61,613.27,1
unity,NDC,BACITRACIN 500 UNIT/GM EX OINT,850,2500006,,,28.4 g,00713-0280-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.28,% of charge rate,100.00%,20.28,,,,19.27,20.28,1
unity,NDC,BACITRACIN 500 UNIT/GM EX OINT,850,2500006,,,28.4 g,00713-0280-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.28,% of charge rate,100.00%,20.28,,,,19.27,20.28,1
unity,NDC,BACITRACIN-NEOMYCIN-POLYMYXIN 400-5-5000 EX OINT,854,2500006,,,1 g,47682-0223-35,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,49,1
unity,NDC,BACITRACIN-NEOMYCIN-POLYMYXIN 400-5-5000 EX OINT,854,2500006,,,14 g,45802-0143-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49,% of charge rate,100.00%,49,,,,3.33,49,1
unity,NDC,BACITRACIN-NEOMYCIN-POLYMYXIN 400-5-5000 EX OINT,854,2500006,,,14 g,45802-0143-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49,% of charge rate,100.00%,49,,,,3.33,49,1
unity,NDC,BACITRACIN-NEOMYCIN-POLYMYXIN 400-5-5000 EX OINT,854,2500006,,,1 g,47682-0223-35,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,49,1
unity,NDC,VITAMIN C 500 MG PO TABS,8680,2500006,,,1 Tab,00904-0523-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,VITAMIN C 500 MG PO TABS,8680,2500006,,,1 Tab,00904-0523-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FORMOTEROL FUMARATE 20 MCG/2ML IN NEBU,88225,2500006,,,2 mL,49502-0605-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.76,% of charge rate,100.00%,27.76,,,,26.37,27.76,1
unity,NDC,FORMOTEROL FUMARATE 20 MCG/2ML IN NEBU,88225,2500006,,,2 mL,49502-0605-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.76,% of charge rate,100.00%,27.76,,,,26.37,27.76,1
unity,NDC,ACETAZOLAMIDE ER 500 MG PO CP12,8962,2500006,,,1 Cap,50742-0233-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,16.87,% of charge rate,100.00%,16.87,,,,16.03,16.87,1
unity,NDC,ACETAZOLAMIDE ER 500 MG PO CP12,8962,2500006,,,1 Cap,50742-0233-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,16.87,% of charge rate,100.00%,16.87,,,,16.03,16.87,1
unity,NDC,ACETIC ACID 0.25 % IRR SOLN,8963,2500006,,,"1,000 mL",00338-0656-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.12,% of charge rate,100.00%,24.12,,,,22.91,24.12,1
unity,NDC,ACETIC ACID 0.25 % IRR SOLN,8963,2500006,,,"1,000 mL",00338-0656-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.12,% of charge rate,100.00%,24.12,,,,22.91,24.12,1
unity,NDC,APRACLONIDINE HCL 0.5 % OP SOLN,9119,2500006,,,5 mL,61314-0665-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,142.91,% of charge rate,100.00%,142.91,,,,135.76,142.91,1
unity,NDC,APRACLONIDINE HCL 0.5 % OP SOLN,9119,2500006,,,5 mL,61314-0665-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,142.91,% of charge rate,100.00%,142.91,,,,135.76,142.91,1
unity,NDC,LUBIPROSTONE 8 MCG PO CAPS,91534,2500006,,,1 Cap,64764-0080-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.2,% of charge rate,100.00%,24.2,,,,22.99,24.2,1
unity,NDC,LUBIPROSTONE 8 MCG PO CAPS,91534,2500006,,,1 Cap,64764-0080-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.2,% of charge rate,100.00%,24.2,,,,22.99,24.2,1
unity,NDC,METOPROLOL TARTRATE 5 MG/5ML IV SOLN,92079,2500006,,,5 mL,00409-1778-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,METOPROLOL TARTRATE 5 MG/5ML IV SOLN,92079,2500006,,,5 mL,00409-1778-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,METOPROLOL TARTRATE 5 MG/5ML IV SOLN,92079,2500006,,,5 mL,00409-1778-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,METOPROLOL TARTRATE 5 MG/5ML IV SOLN,92079,2500006,,,5 mL,00409-1778-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,1 mL,00641-6008-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,4 mL,00409-1412-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,4 mL,00641-6008-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,4 mL,00641-6008-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,4 mL,00409-1412-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUMETANIDE 0.25 MG/ML INJ SOLN,9308,2500006,,,1 mL,00641-6008-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,BUTAMBEN-TETRACAINE-BENZOCAINE 2-2-14 % EX AERO,9328,2500006,,,5 g,10223-0201-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,142.73,% of charge rate,100.00%,142.73,,,,135.59,142.73,1
unity,NDC,BUTAMBEN-TETRACAINE-BENZOCAINE 2-2-14 % EX AERO,9328,2500006,,,5 g,10223-0201-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,142.73,% of charge rate,100.00%,142.73,,,,135.59,142.73,1
unity,NDC,NICARDIPINE HCL IN NACL 20-0.86 MG/200ML-% IV SOLN,94295,2500006,,,200 mL,10122-0313-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,187.94,% of charge rate,100.00%,187.94,,,,178.54,187.94,1
unity,NDC,NICARDIPINE HCL IN NACL 20-0.86 MG/200ML-% IV SOLN,94295,2500006,,,200 mL,10122-0313-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,187.94,% of charge rate,100.00%,187.94,,,,178.54,187.94,1
unity,NDC,NICARDIPINE HCL IN NACL 20-0.86 MG/200ML-% IV SOLN,94295,2500006,,,200 mL,10122-0313-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,187.94,% of charge rate,100.00%,187.94,,,,178.54,187.94,1
unity,NDC,NICARDIPINE HCL IN NACL 20-0.86 MG/200ML-% IV SOLN,94295,2500006,,,200 mL,10122-0313-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,187.94,% of charge rate,100.00%,187.94,,,,178.54,187.94,1
unity,NDC,FESOTERODINE FUMARATE ER 8 MG PO TB24,94538,2500006,,,1 Tab,00069-0244-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.23,% of charge rate,100.00%,47.23,,,,44.87,47.23,1
unity,NDC,FESOTERODINE FUMARATE ER 8 MG PO TB24,94538,2500006,,,1 Tab,00069-0244-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.23,% of charge rate,100.00%,47.23,,,,44.87,47.23,1
unity,NDC,ROCURONIUM BROMIDE 50 MG/5ML IV SOLN,94816,2500006,,,5 mL,00409-9558-49,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ROCURONIUM BROMIDE 50 MG/5ML IV SOLN,94816,2500006,,,5 mL,00409-9558-49,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 25 MG/5ML IV SOLN,95600,2500006,,,1 mL,17478-0937-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 25 MG/5ML IV SOLN,95600,2500006,,,1 mL,17478-0937-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,1 mL,70860-0301-42,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,10 mL,00641-6014-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,10 mL,00641-6014-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,10 mL,00641-6014-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,10 mL,00641-6014-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DILTIAZEM HCL 50 MG/10ML IV SOLN,95602,2500006,,,1 mL,70860-0301-42,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PREDNISOLONE 15 MG/5ML PO SOLN,95828,2500006,,,240 mL,50383-0042-24,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49.8,% of charge rate,100.00%,49.8,,,,47.31,49.8,1
unity,NDC,PREDNISOLONE 15 MG/5ML PO SOLN,95828,2500006,,,240 mL,50383-0042-24,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49.8,% of charge rate,100.00%,49.8,,,,47.31,49.8,1
unity,NDC,BIOTENE ORALBALANCE DRY MOUTH MT GEL,96008,2500006,,,42 g,48582-0512-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.75,% of charge rate,100.00%,31.75,,,,30.16,31.75,1
unity,NDC,BIOTENE ORALBALANCE DRY MOUTH MT GEL,96008,2500006,,,42 g,48582-0512-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.75,% of charge rate,100.00%,31.75,,,,30.16,31.75,1
unity,NDC,CIPROFLOXACIN HCL 0.3 % OP SOLN,9610,2500006,,,5 mL,69315-0308-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.11,% of charge rate,100.00%,28.11,,,,26.7,28.11,1
unity,NDC,CIPROFLOXACIN HCL 0.3 % OP SOLN,9610,2500006,,,5 mL,69315-0308-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.11,% of charge rate,100.00%,28.11,,,,26.7,28.11,1
unity,NDC,CLOBETASOL PROPIONATE 0.05 % EX OINT,9631,2500006,,,30 g,51672-1259-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.88,% of charge rate,100.00%,60.88,,,,57.84,60.88,1
unity,NDC,CLOBETASOL PROPIONATE 0.05 % EX OINT,9631,2500006,,,30 g,51672-1259-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.88,% of charge rate,100.00%,60.88,,,,57.84,60.88,1
unity,NDC,CYCLOPENTOLATE HCL 2 % OP SOLN,9700,2500006,,,2 mL,17478-0097-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,75.02,% of charge rate,100.00%,75.02,,,,71.27,75.02,1
unity,NDC,CYCLOPENTOLATE HCL 2 % OP SOLN,9700,2500006,,,2 mL,17478-0097-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,75.02,% of charge rate,100.00%,75.02,,,,71.27,75.02,1
unity,NDC,ENALAPRILAT 1.25 MG/ML IV INJ,9929,2500006,,,1 mL,00143-9787-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.58,% of charge rate,100.00%,22.58,,,,21.45,22.58,1
unity,NDC,ENALAPRILAT 1.25 MG/ML IV INJ,9929,2500006,,,1 mL,00143-9787-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.58,% of charge rate,100.00%,22.58,,,,21.45,22.58,1
unity,NDC,ENALAPRILAT 1.25 MG/ML IV INJ,9929,2500006,,,1 mL,00143-9787-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.58,% of charge rate,100.00%,22.58,,,,21.45,22.58,1
unity,NDC,ENALAPRILAT 1.25 MG/ML IV INJ,9929,2500006,,,1 mL,00143-9787-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.58,% of charge rate,100.00%,22.58,,,,21.45,22.58,1
unity,NDC,NITROGLYCERIN IN D5W 100-5 MCG/ML-% IV SOLN,15858,2580001,,,250 mL,00338-1047-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.53,% of charge rate,100.00%,111.53,,,,105.95,111.53,1
unity,NDC,NITROGLYCERIN IN D5W 100-5 MCG/ML-% IV SOLN,15858,2580001,,,250 mL,00338-1047-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.53,% of charge rate,100.00%,111.53,,,,105.95,111.53,1
unity,NDC,KCL IN DEXTROSE-NACL 20-5-0.45 MEQ/L-%-% IV SOLN,9801,2580001,,,"1,000 mL",00338-0671-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,68.86,% of charge rate,100.00%,68.86,,,,65.42,68.86,1
unity,NDC,KCL IN DEXTROSE-NACL 20-5-0.45 MEQ/L-%-% IV SOLN,9801,2580001,,,"1,000 mL",00338-0671-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,68.86,% of charge rate,100.00%,68.86,,,,65.42,68.86,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,30 mL,00409-1966-07,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,10 mL,00409-1966-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,30 mL,00409-1966-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,30 mL,00409-1966-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,10 mL,00409-1966-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SODIUM CHLORIDE BACTERIOSTATIC 0.9 % INJ SOLN,14923,2580005,,,30 mL,00409-1966-07,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,INSULIN ASPART PROT & ASPART (70-30) 100 UNIT/ML SC SUPN,127459,6360000,,,300 Units,00169-3696-19,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93.68,% of charge rate,100.00%,93.68,,,,89,93.68,1
unity,NDC,INSULIN ASPART PROT & ASPART (70-30) 100 UNIT/ML SC SUPN,127459,6360000,,,300 Units,00169-3696-19,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93.68,% of charge rate,100.00%,93.68,,,,89,93.68,1
unity,NDC,INSULIN GLARGINE (BASAGLAR) 100 UNIT/ML SC SOPN,4.08E+08,6360000,,,300 Units,00002-7715-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.26,% of charge rate,100.00%,67.26,,,,63.9,67.26,1
unity,NDC,INSULIN GLARGINE (BASAGLAR) 100 UNIT/ML SC SOPN,4.08E+08,6360000,,,300 Units,00002-7715-59,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.26,% of charge rate,100.00%,67.26,,,,63.9,67.26,1
unity,NDC,INSULIN GLARGINE (BASAGLAR) 100 UNIT/ML SC SOPN,4.08E+08,6360000,,,300 Units,00002-7715-59,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.26,% of charge rate,100.00%,67.26,,,,63.9,67.26,1
unity,NDC,INSULIN GLARGINE (BASAGLAR) 100 UNIT/ML SC SOPN,4.08E+08,6360000,,,300 Units,00002-7715-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.26,% of charge rate,100.00%,67.26,,,,63.9,67.26,1
unity,NDC,NALOXONE HCL 4 MG/0.1ML NA LIQD,134093,6360005,,,0.1 mL,69547-0353-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,162.36,% of charge rate,100.00%,162.36,,,,154.24,162.36,1
unity,NDC,NALOXONE HCL 4 MG/0.1ML NA LIQD,134093,6360005,,,0.1 mL,69547-0353-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,162.36,% of charge rate,100.00%,162.36,,,,154.24,162.36,1
unity,NDC,FAMOTIDINE 20 MG PO TABS,10011,6370005,,,1 Tab,63739-0645-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FAMOTIDINE 20 MG PO TABS,10011,6370005,,,1 Tab,63739-0645-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FINASTERIDE 5 MG PO TABS,10037,6370005,,,1 Tab,00904-6830-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FINASTERIDE 5 MG PO TABS,10037,6370005,,,1 Tab,00904-6830-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FLUCONAZOLE 100 MG PO TABS,10044,6370005,,,1 Tab,00904-6500-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.92,% of charge rate,100.00%,6.92,,,,6.57,6.92,1
unity,NDC,FLUCONAZOLE 100 MG PO TABS,10044,6370005,,,1 Tab,00904-6500-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.92,% of charge rate,100.00%,6.92,,,,6.57,6.92,1
unity,NDC,FLUDROCORTISONE ACETATE 0.1 MG PO TABS,10054,6370005,,,1 Tab,00115-7033-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.05,% of charge rate,100.00%,9.05,,,,8.6,9.05,1
unity,NDC,FLUDROCORTISONE ACETATE 0.1 MG PO TABS,10054,6370005,,,1 Tab,00115-7033-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.05,% of charge rate,100.00%,9.05,,,,8.6,9.05,1
unity,NDC,FLUORESCEIN-PROPARACAINE 0.25-0.5 % OP SOLN,10062,6370005,,,5 mL,59390-0205-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,84.48,% of charge rate,100.00%,84.48,,,,80.26,84.48,1
unity,NDC,FLUORESCEIN-PROPARACAINE 0.25-0.5 % OP SOLN,10062,6370005,,,5 mL,59390-0205-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,84.48,% of charge rate,100.00%,84.48,,,,80.26,84.48,1
unity,NDC,FLUOXETINE HCL 20 MG PO CAPS,10070,6370005,,,1 Cap,00904-5785-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FLUOXETINE HCL 20 MG PO CAPS,10070,6370005,,,1 Cap,00904-5785-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLIPIZIDE 5 MG PO TABS,10117,6370005,,,1 Tab,00904-6637-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLIPIZIDE 5 MG PO TABS,10117,6370005,,,1 Tab,00904-6637-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLYCOPYRROLATE 1 MG PO TABS,10130,6370005,,,1 Tab,60687-0458-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLYCOPYRROLATE 1 MG PO TABS,10130,6370005,,,1 Tab,60687-0458-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLYCOPYRROLATE 1 MG PO TABS,10130,6370005,,,1 Tab,60687-0458-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLYCOPYRROLATE 1 MG PO TABS,10130,6370005,,,1 Tab,60687-0458-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 500 MG PO TABS,102,6370005,,,1 Tab,50580-0412-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 500 MG PO TABS,102,6370005,,,1 Tab,50580-0412-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDROXYCHLOROQUINE SULFATE 200 MG PO TABS,10235,6370005,,,1 Tab,00378-0373-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.27,% of charge rate,100.00%,9.27,,,,8.81,9.27,1
unity,NDC,HYDROXYCHLOROQUINE SULFATE 200 MG PO TABS,10235,6370005,,,1 Tab,00378-0373-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.27,% of charge rate,100.00%,9.27,,,,8.81,9.27,1
unity,NDC,IBUPROFEN 100 MG/5ML PO SUSP,10246,6370005,,,30 mL,68094-0494-59,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.97,% of charge rate,100.00%,23.97,,,,22.77,23.97,1
unity,NDC,IBUPROFEN 100 MG/5ML PO SUSP,10246,6370005,,,30 mL,68094-0494-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.97,% of charge rate,100.00%,23.97,,,,22.77,23.97,1
unity,NDC,IBUPROFEN 100 MG/5ML PO SUSP,10246,6370005,,,30 mL,68094-0494-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.97,% of charge rate,100.00%,23.97,,,,22.77,23.97,1
unity,NDC,IBUPROFEN 100 MG/5ML PO SUSP,10246,6370005,,,30 mL,68094-0494-59,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.97,% of charge rate,100.00%,23.97,,,,22.77,23.97,1
unity,NDC,BETAMETHASONE DIPROPIONATE 0.05 % EX CREA,1027,6370005,,,15 g,00168-0055-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,89.49,% of charge rate,100.00%,89.49,,,,85.02,89.49,1
unity,NDC,BETAMETHASONE DIPROPIONATE 0.05 % EX CREA,1027,6370005,,,15 g,00168-0055-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,89.49,% of charge rate,100.00%,89.49,,,,85.02,89.49,1
unity,NDC,ACETAMINOPHEN 120 MG REC SUPP,103,6370005,,,1 Suppository,45802-0732-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 120 MG REC SUPP,103,6370005,,,1 Suppository,45802-0732-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 120 MG REC SUPP,103,6370005,,,1 Suppository,45802-0732-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 120 MG REC SUPP,103,6370005,,,1 Suppository,45802-0732-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,K PHOS MONO-SOD PHOS DI & MONO 155-852-130 MG PO TABS,10365,6370005,,,1 Tab,64980-0104-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,K PHOS MONO-SOD PHOS DI & MONO 155-852-130 MG PO TABS,10365,6370005,,,1 Tab,64980-0104-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,KETOCONAZOLE 2 % EX CREA,10368,6370005,,,15 g,51672-1298-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.84,% of charge rate,100.00%,28.84,,,,27.4,28.84,1
unity,NDC,KETOCONAZOLE 2 % EX CREA,10368,6370005,,,15 g,51672-1298-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.84,% of charge rate,100.00%,28.84,,,,27.4,28.84,1
unity,NDC,KETOROLAC TROMETHAMINE 10 MG PO TABS,10371,6370005,,,1 Tab,00093-0314-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.59,% of charge rate,100.00%,6.59,,,,6.26,6.59,1
unity,NDC,KETOROLAC TROMETHAMINE 10 MG PO TABS,10371,6370005,,,1 Tab,00093-0314-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.59,% of charge rate,100.00%,6.59,,,,6.26,6.59,1
unity,NDC,LABETALOL HCL 100 MG PO TABS,10373,6370005,,,1 Tab,00904-5928-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LABETALOL HCL 100 MG PO TABS,10373,6370005,,,1 Tab,00904-5928-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 325 MG REC SUPP,104,6370005,,,1 Suppository,51672-2116-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7,% of charge rate,100.00%,7,,,,6.65,7,1
unity,NDC,ACETAMINOPHEN 325 MG REC SUPP,104,6370005,,,1 Suppository,51672-2116-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7,% of charge rate,100.00%,7,,,,6.65,7,1
unity,NDC,LEVOTHYROXINE SODIUM 88 MCG PO TABS,10403,6370005,,,1 Tab,42292-0038-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.96,% of charge rate,100.00%,3.96,,,,3.76,3.96,1
unity,NDC,LEVOTHYROXINE SODIUM 88 MCG PO TABS,10403,6370005,,,1 Tab,42292-0038-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.96,% of charge rate,100.00%,3.96,,,,3.76,3.96,1
unity,NDC,LEVOTHYROXINE SODIUM 88 MCG PO TABS,10403,6370005,,,1 Tab,42292-0038-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.96,% of charge rate,100.00%,3.96,,,,3.76,3.96,1
unity,NDC,LEVOTHYROXINE SODIUM 88 MCG PO TABS,10403,6370005,,,1 Tab,42292-0038-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.96,% of charge rate,100.00%,3.96,,,,3.76,3.96,1
unity,NDC,LEVOTHYROXINE SODIUM 112 MCG PO TABS,10404,6370005,,,1 Tab,00904-6954-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.35,% of charge rate,100.00%,4.35,,,,4.13,4.35,1
unity,NDC,LEVOTHYROXINE SODIUM 112 MCG PO TABS,10404,6370005,,,1 Tab,00904-6954-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.35,% of charge rate,100.00%,4.35,,,,4.13,4.35,1
unity,NDC,LISINOPRIL 10 MG PO TABS,10449,6370005,,,1 Tab,60687-0325-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 10 MG PO TABS,10449,6370005,,,1 Tab,60687-0325-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 10 MG PO TABS,10449,6370005,,,1 Tab,60687-0325-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 10 MG PO TABS,10449,6370005,,,1 Tab,60687-0325-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DICLOFENAC SODIUM 1 % TD GEL,104494,6370005,,,100 g,65162-0833-66,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78.03,% of charge rate,100.00%,78.03,,,,74.13,78.03,1
unity,NDC,DICLOFENAC SODIUM 1 % TD GEL,104494,6370005,,,100 g,65162-0833-66,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78.03,% of charge rate,100.00%,78.03,,,,74.13,78.03,1
unity,NDC,LISINOPRIL 5 MG PO TABS,10451,6370005,,,1 Tab,00904-6797-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 5 MG PO TABS,10451,6370005,,,1 Tab,00904-6797-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 650 MG REC SUPP,105,6370005,,,1 Suppository,45802-0730-32,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 650 MG REC SUPP,105,6370005,,,1 Suppository,45802-0730-32,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL 500 MG PO TABS,10544,6370005,,,1 Tab,00904-6689-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL 500 MG PO TABS,10544,6370005,,,1 Tab,00904-6689-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOLAZONE 5 MG PO TABS,10588,6370005,,,1 Tab,00904-6915-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.08,% of charge rate,100.00%,15.08,,,,14.33,15.08,1
unity,NDC,METOLAZONE 5 MG PO TABS,10588,6370005,,,1 Tab,00904-6915-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.08,% of charge rate,100.00%,15.08,,,,14.33,15.08,1
unity,NDC,MIDODRINE HCL 5 MG PO TABS,10610,6370005,,,1 Tab,50268-0562-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.54,% of charge rate,100.00%,8.54,,,,8.11,8.54,1
unity,NDC,MIDODRINE HCL 5 MG PO TABS,10610,6370005,,,1 Tab,50268-0562-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.54,% of charge rate,100.00%,8.54,,,,8.11,8.54,1
unity,NDC,MIDODRINE HCL 5 MG PO TABS,10610,6370005,,,1 Tab,50268-0562-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.54,% of charge rate,100.00%,8.54,,,,8.11,8.54,1
unity,NDC,MIDODRINE HCL 5 MG PO TABS,10610,6370005,,,1 Tab,50268-0562-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.54,% of charge rate,100.00%,8.54,,,,8.11,8.54,1
unity,NDC,MISOPROSTOL 100 MCG PO TABS,10628,6370005,,,1 Tab,43386-0160-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.77,% of charge rate,100.00%,5.77,,,,5.48,5.77,1
unity,NDC,MISOPROSTOL 100 MCG PO TABS,10628,6370005,,,1 Tab,43386-0160-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.77,% of charge rate,100.00%,5.77,,,,5.48,5.77,1
unity,NDC,NITROFURANTOIN MONOHYD MACRO 100 MG PO CAPS,10724,6370005,,,1 Cap,47781-0303-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,NITROFURANTOIN MONOHYD MACRO 100 MG PO CAPS,10724,6370005,,,1 Cap,47781-0303-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FLORAJEN3 PO CAPS,107845,6370005,,,1 Cap,39423-0000-50,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.68,% of charge rate,100.00%,3.68,,,,3.5,3.68,1
unity,NDC,FLORAJEN3 PO CAPS,107845,6370005,,,1 Cap,39423-0000-50,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.68,% of charge rate,100.00%,3.68,,,,3.5,3.68,1
unity,NDC,BISACODYL 5 MG PO TBEC,1079,6370005,,,1 Tab,00904-6407-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,BISACODYL 5 MG PO TBEC,1079,6370005,,,1 Tab,00904-6407-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,BISACODYL 10 MG REC SUPP,1080,6370005,,,1 Suppository,00574-7050-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BISACODYL 10 MG REC SUPP,1080,6370005,,,1 Suppository,00574-7050-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OXYCODONE HCL 5 MG PO TABS,10814,6370005,,,1 Tab,00406-0552-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OXYCODONE HCL 5 MG PO TABS,10814,6370005,,,1 Tab,00406-0552-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FISH OIL 1000 MG PO CPDR,110727,6370005,,,1 Cap,77333-0308-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FISH OIL 1000 MG PO CPDR,110727,6370005,,,1 Cap,77333-0308-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FISH OIL 1000 MG PO CPDR,110727,6370005,,,1 Cap,77333-0308-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FISH OIL 1000 MG PO CPDR,110727,6370005,,,1 Cap,77333-0308-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PRAVASTATIN SODIUM 10 MG PO TABS,11110,6370005,,,1 Tab,00904-5891-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PRAVASTATIN SODIUM 10 MG PO TABS,11110,6370005,,,1 Tab,00904-5891-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PRAVASTATIN SODIUM 40 MG PO TABS,11112,6370005,,,1 Tab,00904-5893-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.8,% of charge rate,100.00%,4.8,,,,4.56,4.8,1
unity,NDC,PRAVASTATIN SODIUM 40 MG PO TABS,11112,6370005,,,1 Tab,00904-5893-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.8,% of charge rate,100.00%,4.8,,,,4.56,4.8,1
unity,NDC,PSYLLIUM 58.12 % PO PACK,111303,6370005,,,1 Packet,37000-0024-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.79,% of charge rate,100.00%,3.79,,,,3.6,3.79,1
unity,NDC,PSYLLIUM 58.12 % PO PACK,111303,6370005,,,1 Packet,37000-0024-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.79,% of charge rate,100.00%,3.79,,,,3.6,3.79,1
unity,NDC,PROMETHAZINE HCL 12.5 MG REC SUPP,11143,6370005,,,1 Suppository,00713-0536-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,35.85,% of charge rate,100.00%,35.85,,,,34.06,35.85,1
unity,NDC,PROMETHAZINE HCL 12.5 MG REC SUPP,11143,6370005,,,1 Suppository,00713-0536-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,35.85,% of charge rate,100.00%,35.85,,,,34.06,35.85,1
unity,NDC,PROMETHAZINE HCL 25 MG REC SUPP,11144,6370005,,,1 Suppository,00713-0526-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.09,% of charge rate,100.00%,25.09,,,,23.84,25.09,1
unity,NDC,PROMETHAZINE HCL 25 MG REC SUPP,11144,6370005,,,1 Suppository,00713-0526-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.09,% of charge rate,100.00%,25.09,,,,23.84,25.09,1
unity,NDC,RIVAROXABAN 10 MG PO TABS,112558,6370005,,,1 Tab,50458-0580-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,43.01,% of charge rate,100.00%,43.01,,,,40.86,43.01,1
unity,NDC,RIVAROXABAN 10 MG PO TABS,112558,6370005,,,1 Tab,50458-0580-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,43.01,% of charge rate,100.00%,43.01,,,,40.86,43.01,1
unity,NDC,SERTRALINE HCL 100 MG PO TABS,11350,6370005,,,1 Tab,60687-0253-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 100 MG PO TABS,11350,6370005,,,1 Tab,60687-0253-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 100 MG PO TABS,11350,6370005,,,1 Tab,60687-0253-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 100 MG PO TABS,11350,6370005,,,1 Tab,60687-0253-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 50 MG PO TABS,11351,6370005,,,1 Tab,60687-0242-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 50 MG PO TABS,11351,6370005,,,1 Tab,60687-0242-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 50 MG PO TABS,11351,6370005,,,1 Tab,60687-0242-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SERTRALINE HCL 50 MG PO TABS,11351,6370005,,,1 Tab,60687-0242-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 20 MG PO TABS,11365,6370005,,,1 Tab,63739-0572-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 20 MG PO TABS,11365,6370005,,,1 Tab,63739-0572-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 40 MG PO TABS,11366,6370005,,,1 Tab,60687-0210-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 40 MG PO TABS,11366,6370005,,,1 Tab,60687-0210-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 40 MG PO TABS,11366,6370005,,,1 Tab,60687-0210-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMVASTATIN 40 MG PO TABS,11366,6370005,,,1 Tab,60687-0210-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FERROUS GLUCONATE 324 (37.5 FE) MG PO TABS,113993,6370005,,,1 Tab,00904-2137-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FERROUS GLUCONATE 324 (37.5 FE) MG PO TABS,113993,6370005,,,1 Tab,00904-2137-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SOTALOL HCL 80 MG PO TABS,11421,6370005,,,1 Tab,60505-0080-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SOTALOL HCL 80 MG PO TABS,11421,6370005,,,1 Tab,60505-0080-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SUCRALFATE 1 G PO TABS,11442,6370005,,,1 Tab,51079-0753-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SUCRALFATE 1 G PO TABS,11442,6370005,,,1 Tab,51079-0753-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SUCRALFATE 1 G PO TABS,11442,6370005,,,1 Tab,51079-0753-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SUCRALFATE 1 G PO TABS,11442,6370005,,,1 Tab,51079-0753-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TIMOLOL MALEATE 0.5 % OP SOLN,11562,6370005,,,10 mL,60758-0801-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.12,% of charge rate,100.00%,24.12,,,,17.36,24.12,1
unity,NDC,TIMOLOL MALEATE 0.5 % OP SOLN,11562,6370005,,,5 mL,60758-0801-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,18.27,% of charge rate,100.00%,18.27,,,,17.36,24.12,1
unity,NDC,TIMOLOL MALEATE 0.5 % OP SOLN,11562,6370005,,,5 mL,60758-0801-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,18.27,% of charge rate,100.00%,18.27,,,,17.36,24.12,1
unity,NDC,TIMOLOL MALEATE 0.5 % OP SOLN,11562,6370005,,,10 mL,60758-0801-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.12,% of charge rate,100.00%,24.12,,,,17.36,24.12,1
unity,NDC,FIRST-OMEPRAZOLE 2 MG/ML PO SUSP,115805,6370005,,,10 mL,65628-0070-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.28,% of charge rate,100.00%,29.28,,,,27.82,29.28,1
unity,NDC,FIRST-OMEPRAZOLE 2 MG/ML PO SUSP,115805,6370005,,,10 mL,65628-0070-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.28,% of charge rate,100.00%,29.28,,,,27.82,29.28,1
unity,NDC,TRICHLOROACETIC ACID 80 % EX LIQD,11589,6370005,,,15 mL,10481-3008-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,153.37,% of charge rate,100.00%,153.37,,,,145.7,153.37,1
unity,NDC,TRICHLOROACETIC ACID 80 % EX LIQD,11589,6370005,,,15 mL,10481-3008-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,153.37,% of charge rate,100.00%,153.37,,,,145.7,153.37,1
unity,NDC,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG PO TABS,11599,6370005,,,1 Tab,00904-2725-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SULFAMETHOXAZOLE-TRIMETHOPRIM 800-160 MG PO TABS,11599,6370005,,,1 Tab,00904-2725-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 1 MG PO TABS,11664,6370005,,,1 Tab,00832-1211-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 1 MG PO TABS,11664,6370005,,,1 Tab,00832-1211-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ZOLPIDEM TARTRATE 5 MG PO TABS,11701,6370005,,,1 Tab,00904-6082-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ZOLPIDEM TARTRATE 5 MG PO TABS,11701,6370005,,,1 Tab,00904-6082-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MIRABEGRON ER 25 MG PO TB24,119992,6370005,,,1 Tab,00469-2601-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,51.98,% of charge rate,100.00%,51.98,,,,49.38,51.98,1
unity,NDC,MIRABEGRON ER 25 MG PO TB24,119992,6370005,,,1 Tab,00469-2601-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,51.98,% of charge rate,100.00%,51.98,,,,49.38,51.98,1
unity,NDC,MORPHINE SULFATE (CONCENTRATE) 100 MG/5ML PO SOLN,120211,6370005,,,1 mL,00054-0517-44,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MORPHINE SULFATE (CONCENTRATE) 100 MG/5ML PO SOLN,120211,6370005,,,1 mL,00054-0517-44,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MECLIZINE HCL 12.5 MG PO TABS,12024,6370005,,,1 Tab,50268-0522-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MECLIZINE HCL 12.5 MG PO TABS,12024,6370005,,,1 Tab,50268-0522-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MECLIZINE HCL 12.5 MG PO TABS,12024,6370005,,,1 Tab,50268-0522-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MECLIZINE HCL 12.5 MG PO TABS,12024,6370005,,,1 Tab,50268-0522-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MAGNESIUM OXIDE 400 (240 MG) MG PO TABS,120711,6370005,,,1 Tab,10006-0700-28,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MAGNESIUM OXIDE 400 (240 MG) MG PO TABS,120711,6370005,,,1 Tab,10006-0700-28,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FOLTANX 3-35-2 MG PO TABS,121637,6370005,,,1 Tab,51991-0813-90,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.25,% of charge rate,100.00%,7.25,,,,6.89,7.25,1
unity,NDC,FOLTANX 3-35-2 MG PO TABS,121637,6370005,,,1 Tab,51991-0813-90,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.25,% of charge rate,100.00%,7.25,,,,6.89,7.25,1
unity,NDC,APIXABAN 5 MG PO TABS,122294,6370005,,,1 Tab,00003-0894-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.52,% of charge rate,100.00%,23.52,,,,22.34,23.52,1
unity,NDC,APIXABAN 5 MG PO TABS,122294,6370005,,,1 Tab,00003-0894-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.52,% of charge rate,100.00%,23.52,,,,22.34,23.52,1
unity,NDC,MORPHINE SULFATE ER 15 MG PO TBCR,123107,6370005,,,1 Tab,42858-0801-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MORPHINE SULFATE ER 15 MG PO TBCR,123107,6370005,,,1 Tab,42858-0801-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,12556,6370005,,,5 mL,60687-0267-56,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.29,% of charge rate,100.00%,12.29,,,,11.68,12.29,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,12556,6370005,,,10 mL,60687-0267-42,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.29,% of charge rate,100.00%,12.29,,,,11.68,12.29,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,12556,6370005,,,10 mL,60687-0267-42,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.29,% of charge rate,100.00%,12.29,,,,11.68,12.29,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO LIQD,12556,6370005,,,5 mL,60687-0267-56,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.29,% of charge rate,100.00%,12.29,,,,11.68,12.29,1
unity,NDC,OXYCODONE HCL ER 10 MG PO T12A,125737,6370005,,,1 Tab,59011-0410-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.43,% of charge rate,100.00%,25.43,,,,24.16,25.43,1
unity,NDC,OXYCODONE HCL ER 10 MG PO T12A,125737,6370005,,,1 Tab,59011-0410-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.43,% of charge rate,100.00%,25.43,,,,24.16,25.43,1
unity,NDC,OXYCODONE HCL ER 40 MG PO T12A,125742,6370005,,,1 Tab,59011-0440-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.73,% of charge rate,100.00%,54.73,,,,51.99,54.73,1
unity,NDC,OXYCODONE HCL ER 40 MG PO T12A,125742,6370005,,,1 Tab,59011-0440-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.73,% of charge rate,100.00%,54.73,,,,51.99,54.73,1
unity,NDC,DAPAGLIFLOZIN PROPANEDIOL 5 MG PO TABS,126943,6370005,,,1 Tab,00310-6205-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,73.43,% of charge rate,100.00%,73.43,,,,69.76,73.43,1
unity,NDC,DAPAGLIFLOZIN PROPANEDIOL 5 MG PO TABS,126943,6370005,,,1 Tab,00310-6205-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,73.43,% of charge rate,100.00%,73.43,,,,69.76,73.43,1
unity,NDC,TRIAMTERENE-HCTZ 37.5-25 MG PO CAPS,12729,6370005,,,1 Cap,00527-1632-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRIAMTERENE-HCTZ 37.5-25 MG PO CAPS,12729,6370005,,,1 Cap,00527-1632-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,EMPAGLIFLOZIN 10 MG PO TABS,129061,6370005,,,1 Tab,00597-0152-37,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,59.86,% of charge rate,100.00%,59.86,,,,56.87,59.86,1
unity,NDC,EMPAGLIFLOZIN 10 MG PO TABS,129061,6370005,,,1 Tab,00597-0152-37,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,59.86,% of charge rate,100.00%,59.86,,,,56.87,59.86,1
unity,NDC,VERAPAMIL HCL ER 240 MG PO TBCR,13073,6370005,,,1 Tab,68462-0260-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,VERAPAMIL HCL ER 240 MG PO TBCR,13073,6370005,,,1 Tab,68462-0260-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CARBAMIDE PEROXIDE 6.5 % OTIC SOLN,1359,6370005,,,15 mL,00904-6627-35,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.39,% of charge rate,100.00%,20.39,,,,19.37,20.39,1
unity,NDC,CARBAMIDE PEROXIDE 6.5 % OTIC SOLN,1359,6370005,,,15 mL,00904-6627-35,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.39,% of charge rate,100.00%,20.39,,,,19.37,20.39,1
unity,NDC,ASPIRIN EC 325 MG PO TBEC,13654,6370005,,,1 Tab,63739-0523-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ASPIRIN EC 325 MG PO TBEC,13654,6370005,,,1 Tab,63739-0523-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,COLESTIPOL HCL 1 G PO TABS,13884,6370005,,,1 Tab,00115-5211-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.97,% of charge rate,100.00%,5.97,,,,5.67,5.97,1
unity,NDC,COLESTIPOL HCL 1 G PO TABS,13884,6370005,,,1 Tab,00115-5211-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.97,% of charge rate,100.00%,5.97,,,,5.67,5.97,1
unity,NDC,ACETAMINOPHEN 325 MG/10.15ML PO SOLN,138925,6370005,,,5 mL,00121-1314-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.59,% of charge rate,100.00%,6.59,,,,6.26,6.59,1
unity,NDC,ACETAMINOPHEN 325 MG/10.15ML PO SOLN,138925,6370005,,,5 mL,00121-1314-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.59,% of charge rate,100.00%,6.59,,,,6.26,6.59,1
unity,NDC,VALPROATE SODIUM 250 MG/5ML PO SOLN,139174,6370005,,,5 mL,68094-0193-59,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,VALPROATE SODIUM 250 MG/5ML PO SOLN,139174,6370005,,,5 mL,68094-0193-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,VALPROATE SODIUM 250 MG/5ML PO SOLN,139174,6370005,,,5 mL,68094-0193-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,VALPROATE SODIUM 250 MG/5ML PO SOLN,139174,6370005,,,5 mL,68094-0193-59,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,LAMOTRIGINE 100 MG PO TABS,13982,6370005,,,1 Tab,68084-0319-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LAMOTRIGINE 100 MG PO TABS,13982,6370005,,,1 Tab,68084-0319-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BIOTENE DRY MOUTH MOISTURIZING MT SOLN,139825,6370005,,,45 mL,48582-0001-55,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,35.91,% of charge rate,100.00%,35.91,,,,34.11,35.91,1
unity,NDC,BIOTENE DRY MOUTH MOISTURIZING MT SOLN,139825,6370005,,,45 mL,48582-0001-55,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,35.91,% of charge rate,100.00%,35.91,,,,34.11,35.91,1
unity,NDC,CARBOXYMETHYLCELLULOSE SOD PF 1 % OP GEL,140766,6370005,,,150 Drop,00023-4554-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,33.62,% of charge rate,100.00%,33.62,,,,31.94,33.62,1
unity,NDC,CARBOXYMETHYLCELLULOSE SOD PF 1 % OP GEL,140766,6370005,,,150 Drop,00023-4554-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,33.62,% of charge rate,100.00%,33.62,,,,31.94,33.62,1
unity,NDC,ACETAMINOPHEN-CODEINE #3 300-30 MG PO TABS,14087,6370005,,,1 Tab,00406-0484-23,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN-CODEINE #3 300-30 MG PO TABS,14087,6370005,,,1 Tab,00406-0484-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN-CODEINE #3 300-30 MG PO TABS,14087,6370005,,,1 Tab,00406-0484-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN-CODEINE #3 300-30 MG PO TABS,14087,6370005,,,1 Tab,00406-0484-23,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,KETOCONAZOLE 2 % EX SHAM,14132,6370005,,,120 mL,45802-0465-64,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,39.5,% of charge rate,100.00%,39.5,,,,37.53,39.5,1
unity,NDC,KETOCONAZOLE 2 % EX SHAM,14132,6370005,,,120 mL,45802-0465-64,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,39.5,% of charge rate,100.00%,39.5,,,,37.53,39.5,1
unity,NDC,CLONIDINE 0.1 MG/24HR TD PTWK,143423,6370005,,,1 Patch,00591-3508-54,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,137.79,% of charge rate,100.00%,137.79,,,,130.9,137.79,1
unity,NDC,CLONIDINE 0.1 MG/24HR TD PTWK,143423,6370005,,,1 Patch,00591-3508-54,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,137.79,% of charge rate,100.00%,137.79,,,,130.9,137.79,1
unity,NDC,DORZOLAMIDE HCL 2 % OP SOLN,14471,6370005,,,10 mL,61314-0019-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,30.79,% of charge rate,100.00%,30.79,,,,29.25,30.79,1
unity,NDC,DORZOLAMIDE HCL 2 % OP SOLN,14471,6370005,,,10 mL,61314-0019-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,30.79,% of charge rate,100.00%,30.79,,,,29.25,30.79,1
unity,NDC,OYSTER SHELL CALCIUM/D 500-5 MG-MCG PO TABS,145180,6370005,,,1 Tab,51645-0828-99,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OYSTER SHELL CALCIUM/D 500-5 MG-MCG PO TABS,145180,6370005,,,1 Tab,51645-0828-99,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,INSULIN LISPRO (1 UNIT DIAL) 100 UNIT/ML SC SOPN,146248,6370005,,,300 Units,00002-8799-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,282.5,% of charge rate,100.00%,282.5,,,,268.38,282.5,1
unity,NDC,INSULIN LISPRO (1 UNIT DIAL) 100 UNIT/ML SC SOPN,146248,6370005,,,300 Units,00002-8799-59,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,282.5,% of charge rate,100.00%,282.5,,,,268.38,282.5,1
unity,NDC,INSULIN LISPRO (1 UNIT DIAL) 100 UNIT/ML SC SOPN,146248,6370005,,,300 Units,00002-8799-59,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,282.5,% of charge rate,100.00%,282.5,,,,268.38,282.5,1
unity,NDC,INSULIN LISPRO (1 UNIT DIAL) 100 UNIT/ML SC SOPN,146248,6370005,,,300 Units,00002-8799-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,282.5,% of charge rate,100.00%,282.5,,,,268.38,282.5,1
unity,NDC,VERAPAMIL HCL ER 180 MG PO TBCR,14626,6370005,,,1 Tab,68462-0293-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,VERAPAMIL HCL ER 180 MG PO TBCR,14626,6370005,,,1 Tab,68462-0293-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRAMADOL HCL 50 MG PO TABS,14632,6370005,,,1 Tab,51079-0991-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRAMADOL HCL 50 MG PO TABS,14632,6370005,,,1 Tab,51079-0991-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LOSARTAN POTASSIUM 50 MG PO TABS,14824,6370005,,,1 Tab,00904-7048-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LOSARTAN POTASSIUM 50 MG PO TABS,14824,6370005,,,1 Tab,00904-7048-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 25 MG PO TABS,15748,6370005,,,1 Tab,00904-6303-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 25 MG PO TABS,15748,6370005,,,1 Tab,00904-6303-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 12.5 MG PO TABS,15749,6370005,,,1 Tab,00904-6302-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.59,% of charge rate,100.00%,5.59,,,,5.31,5.59,1
unity,NDC,CARVEDILOL 12.5 MG PO TABS,15749,6370005,,,1 Tab,00904-6302-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.59,% of charge rate,100.00%,5.59,,,,5.31,5.59,1
unity,NDC,AZITHROMYCIN 100 MG/5ML PO SUSR,15796,6370005,,,15 mL,42806-0147-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.69,% of charge rate,100.00%,58.69,,,,55.76,58.69,1
unity,NDC,AZITHROMYCIN 100 MG/5ML PO SUSR,15796,6370005,,,15 mL,42806-0147-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.69,% of charge rate,100.00%,58.69,,,,55.76,58.69,1
unity,NDC,GLUCOSE 4 G PO CHEW,16050,6370005,,,1 Tab,00904-6710-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLUCOSE 4 G PO CHEW,16050,6370005,,,1 Tab,00904-6710-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DESMOPRESSIN ACETATE 0.2 MG PO TABS,16053,6370005,,,1 Tab,50268-0221-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,10.67,% of charge rate,100.00%,10.67,,,,10.14,10.67,1
unity,NDC,DESMOPRESSIN ACETATE 0.2 MG PO TABS,16053,6370005,,,1 Tab,50268-0221-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,10.67,% of charge rate,100.00%,10.67,,,,10.14,10.67,1
unity,NDC,DESMOPRESSIN ACETATE 0.2 MG PO TABS,16053,6370005,,,1 Tab,50268-0221-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,10.67,% of charge rate,100.00%,10.67,,,,10.14,10.67,1
unity,NDC,DESMOPRESSIN ACETATE 0.2 MG PO TABS,16053,6370005,,,1 Tab,50268-0221-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,10.67,% of charge rate,100.00%,10.67,,,,10.14,10.67,1
unity,NDC,CHLORDIAZEPOXIDE HCL 25 MG PO CAPS,1623,6370005,,,1 Cap,00555-0159-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CHLORDIAZEPOXIDE HCL 25 MG PO CAPS,1623,6370005,,,1 Cap,00555-0159-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLIMEPIRIDE 1 MG PO TABS,16355,6370005,,,2 Tab,16729-0001-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7,% of charge rate,100.00%,7,,,,6.65,7,1
unity,NDC,GLIMEPIRIDE 1 MG PO TABS,16355,6370005,,,2 Tab,16729-0001-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7,% of charge rate,100.00%,7,,,,6.65,7,1
unity,NDC,GLIMEPIRIDE 2 MG PO TABS,16356,6370005,,,1 Tab,50268-0359-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.96,% of charge rate,100.00%,3.96,,,,3.76,3.96,1
unity,NDC,GLIMEPIRIDE 2 MG PO TABS,16356,6370005,,,1 Tab,50268-0359-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.96,% of charge rate,100.00%,3.96,,,,3.76,3.96,1
unity,NDC,GLIMEPIRIDE 2 MG PO TABS,16356,6370005,,,1 Tab,50268-0359-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.96,% of charge rate,100.00%,3.96,,,,3.76,3.96,1
unity,NDC,GLIMEPIRIDE 2 MG PO TABS,16356,6370005,,,1 Tab,50268-0359-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.96,% of charge rate,100.00%,3.96,,,,3.76,3.96,1
unity,NDC,CHLORTHALIDONE 25 MG PO TABS,1661,6370005,,,1 Tab,64980-0303-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.66,% of charge rate,100.00%,9.66,,,,9.18,9.66,1
unity,NDC,CHLORTHALIDONE 25 MG PO TABS,1661,6370005,,,1 Tab,64980-0303-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.66,% of charge rate,100.00%,9.66,,,,9.18,9.66,1
unity,NDC,PAROXETINE HCL 10 MG PO TABS,16632,6370005,,,1 Tab,50268-0640-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PAROXETINE HCL 10 MG PO TABS,16632,6370005,,,1 Tab,50268-0640-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PAROXETINE HCL 40 MG PO TABS,16633,6370005,,,1 Tab,00378-7004-93,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.36,% of charge rate,100.00%,6.36,,,,6.04,6.36,1
unity,NDC,PAROXETINE HCL 40 MG PO TABS,16633,6370005,,,1 Tab,00378-7004-93,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.36,% of charge rate,100.00%,6.36,,,,6.04,6.36,1
unity,NDC,MELATONIN 3 MG PO TABS,16830,6370005,,,1 Tab,77333-0516-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MELATONIN 3 MG PO TABS,16830,6370005,,,1 Tab,77333-0516-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MELATONIN 3 MG PO TABS,16830,6370005,,,1 Tab,77333-0516-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MELATONIN 3 MG PO TABS,16830,6370005,,,1 Tab,77333-0516-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLINDAMYCIN HCL 150 MG PO CAPS,1740,6370005,,,1 Cap,00904-5959-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLINDAMYCIN HCL 150 MG PO CAPS,1740,6370005,,,1 Cap,00904-5959-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLONIDINE HCL 0.1 MG PO TABS,1755,6370005,,,1 Tab,29300-0135-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLONIDINE HCL 0.1 MG PO TABS,1755,6370005,,,1 Tab,29300-0135-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLOTRIMAZOLE 1 % EX CREA,1767,6370005,,,28.35 g,00904-7822-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.26,% of charge rate,100.00%,15.26,,,,14.5,15.26,1
unity,NDC,CLOTRIMAZOLE 1 % EX CREA,1767,6370005,,,28.35 g,00904-7822-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.26,% of charge rate,100.00%,15.26,,,,14.5,15.26,1
unity,NDC,GABAPENTIN 300 MG PO CAPS,18308,6370005,,,1 Cap,00904-6666-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 300 MG PO CAPS,18308,6370005,,,1 Cap,00904-6666-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 100 MG PO CAPS,18309,6370005,,,1 Cap,00904-6665-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 100 MG PO CAPS,18309,6370005,,,1 Cap,00904-6665-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,RISPERIDONE 1 MG PO TABS,18313,6370005,,,1 Tab,00904-6359-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,RISPERIDONE 1 MG PO TABS,18313,6370005,,,1 Tab,00904-6359-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 3.125 MG PO TABS,18551,6370005,,,1 Tab,00904-6300-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CARVEDILOL 3.125 MG PO TABS,18551,6370005,,,1 Tab,00904-6300-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LATANOPROST 0.005 % OP SOLN,18621,6370005,,,2.5 mL,61314-0547-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,30.3,% of charge rate,100.00%,30.3,,,,28.79,30.3,1
unity,NDC,LATANOPROST 0.005 % OP SOLN,18621,6370005,,,2.5 mL,61314-0547-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,30.3,% of charge rate,100.00%,30.3,,,,28.79,30.3,1
unity,NDC,DONEPEZIL HCL 10 MG PO TABS,18787,6370005,,,1 Tab,00904-6478-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DONEPEZIL HCL 10 MG PO TABS,18787,6370005,,,1 Tab,00904-6478-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LEVOFLOXACIN 500 MG PO TABS,18919,6370005,,,1 Tab,00904-6352-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LEVOFLOXACIN 500 MG PO TABS,18919,6370005,,,1 Tab,00904-6352-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ATORVASTATIN CALCIUM 10 MG PO TABS,19176,6370005,,,1 Tab,00904-6290-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ATORVASTATIN CALCIUM 10 MG PO TABS,19176,6370005,,,1 Tab,00904-6290-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ATORVASTATIN CALCIUM 40 MG PO TABS,19177,6370005,,,1 Tab,00904-6292-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ATORVASTATIN CALCIUM 40 MG PO TABS,19177,6370005,,,1 Tab,00904-6292-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DICLOFENAC SODIUM 0.1 % OP SOLN,19714,6370005,,,5 mL,17478-0892-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,74.79,% of charge rate,100.00%,74.79,,,,71.05,74.79,1
unity,NDC,DICLOFENAC SODIUM 0.1 % OP SOLN,19714,6370005,,,5 mL,17478-0892-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,74.79,% of charge rate,100.00%,74.79,,,,71.05,74.79,1
unity,NDC,KETOROLAC TROMETHAMINE 0.5 % OP SOLN,19733,6370005,,,5 mL,60505-1003-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.39,% of charge rate,100.00%,25.39,,,,24.12,25.39,1
unity,NDC,KETOROLAC TROMETHAMINE 0.5 % OP SOLN,19733,6370005,,,5 mL,60505-1003-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.39,% of charge rate,100.00%,25.39,,,,24.12,25.39,1
unity,NDC,CYCLOBENZAPRINE HCL 10 MG PO TABS,2017,6370005,,,1 Tab,63739-0531-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CYCLOBENZAPRINE HCL 10 MG PO TABS,2017,6370005,,,1 Tab,63739-0531-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACTIDOSE WITH SORBITOL 50 GM/240ML PO LIQD,20589,6370005,,,240 mL,00574-0120-76,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,613.27,% of charge rate,100.00%,613.27,,,,582.61,613.27,1
unity,NDC,ACTIDOSE WITH SORBITOL 50 GM/240ML PO LIQD,20589,6370005,,,240 mL,00574-0120-76,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,613.27,% of charge rate,100.00%,613.27,,,,582.61,613.27,1
unity,NDC,AZITHROMYCIN 250 MG PO TABS,20943,6370005,,,1 Tab,00904-6708-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.57,% of charge rate,100.00%,8.57,,,,8.14,8.57,1
unity,NDC,AZITHROMYCIN 250 MG PO TABS,20943,6370005,,,1 Tab,00904-6708-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.57,% of charge rate,100.00%,8.57,,,,8.14,8.57,1
unity,NDC,CITALOPRAM HYDROBROMIDE 20 MG PO TABS,21062,6370005,,,1 Tab,00904-6085-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CITALOPRAM HYDROBROMIDE 20 MG PO TABS,21062,6370005,,,1 Tab,00904-6085-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FEXOFENADINE HCL 60 MG PO TABS,21529,6370005,,,1 Tab,45802-0425-78,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FEXOFENADINE HCL 60 MG PO TABS,21529,6370005,,,1 Tab,45802-0425-78,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ROPINIROLE HCL 1 MG PO TABS,21689,6370005,,,1 Tab,00904-6374-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,ROPINIROLE HCL 1 MG PO TABS,21689,6370005,,,1 Tab,00904-6374-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,QUETIAPINE FUMARATE 25 MG PO TABS,21823,6370005,,,1 Tab,00904-6638-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.46,% of charge rate,100.00%,4.46,,,,4.24,4.46,1
unity,NDC,QUETIAPINE FUMARATE 25 MG PO TABS,21823,6370005,,,1 Tab,00904-6638-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.46,% of charge rate,100.00%,4.46,,,,4.24,4.46,1
unity,NDC,IRBESARTAN 75 MG PO TABS,21847,6370005,,,1 Tab,33342-0047-07,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IRBESARTAN 75 MG PO TABS,21847,6370005,,,1 Tab,33342-0047-07,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLOPIDOGREL BISULFATE 75 MG PO TABS,22142,6370005,,,1 Tab,00904-6294-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLOPIDOGREL BISULFATE 75 MG PO TABS,22142,6370005,,,1 Tab,00904-6294-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,RALOXIFENE HCL 60 MG PO TABS,22143,6370005,,,1 Tab,69097-0825-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,RALOXIFENE HCL 60 MG PO TABS,22143,6370005,,,1 Tab,69097-0825-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CEFDINIR 300 MG PO CAPS,22289,6370005,,,1 Cap,57237-0099-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.41,% of charge rate,100.00%,5.41,,,,5.14,5.41,1
unity,NDC,CEFDINIR 300 MG PO CAPS,22289,6370005,,,1 Cap,57237-0099-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.41,% of charge rate,100.00%,5.41,,,,5.14,5.41,1
unity,NDC,MONTELUKAST SODIUM 10 MG PO TABS,22509,6370005,,,1 Tab,00904-6808-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MONTELUKAST SODIUM 10 MG PO TABS,22509,6370005,,,1 Tab,00904-6808-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LOSARTAN POTASSIUM 100 MG PO TABS,22588,6370005,,,1 Tab,63739-0698-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LOSARTAN POTASSIUM 100 MG PO TABS,22588,6370005,,,1 Tab,63739-0698-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PRAMIPEXOLE DIHYDROCHLORIDE 0.5 MG PO TABS,22719,6370005,,,1 Tab,57237-0182-90,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.37,% of charge rate,100.00%,5.37,,,,5.1,5.37,1
unity,NDC,PRAMIPEXOLE DIHYDROCHLORIDE 0.5 MG PO TABS,22719,6370005,,,1 Tab,57237-0182-90,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.37,% of charge rate,100.00%,5.37,,,,5.1,5.37,1
unity,NDC,DORZOLAMIDE HCL-TIMOLOL MAL 22.3-6.8 MG/ML OP SOLN,22982,6370005,,,10 mL,70069-0051-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,111.58,% of charge rate,100.00%,111.58,,,,106,111.58,1
unity,NDC,DORZOLAMIDE HCL-TIMOLOL MAL 22.3-6.8 MG/ML OP SOLN,22982,6370005,,,10 mL,70069-0051-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,111.58,% of charge rate,100.00%,111.58,,,,106,111.58,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP SOLN,2335,6370005,,,5 mL,24208-0720-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,0,% of charge rate,100.00%,0,,,,,,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 0.1 % OP SOLN,2335,6370005,,,5 mL,24208-0720-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,0,% of charge rate,100.00%,0,,,,,,1
unity,NDC,DIAZEPAM 5 MG PO TABS,2405,6370005,,,1 Tab,00172-3926-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DIAZEPAM 5 MG PO TABS,2405,6370005,,,1 Tab,00172-3926-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,24216,6370005,,,1 Tab,96295-0138-81,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,24216,6370005,,,1 Tab,63739-0432-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,24216,6370005,,,1 Tab,63739-0432-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SENNOSIDES-DOCUSATE SODIUM 8.6-50 MG PO TABS,24216,6370005,,,1 Tab,96295-0138-81,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL 1000 MG PO TABS,24398,6370005,,,1 Tab,00904-6691-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL 1000 MG PO TABS,24398,6370005,,,1 Tab,00904-6691-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DIGOXIN 250 MCG PO TABS,2445,6370005,,,1 Tab,00904-5922-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.67,% of charge rate,100.00%,6.67,,,,6.34,6.67,1
unity,NDC,DIGOXIN 250 MCG PO TABS,2445,6370005,,,1 Tab,00904-5922-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.67,% of charge rate,100.00%,6.67,,,,6.34,6.67,1
unity,NDC,CELECOXIB 100 MG PO CAPS,24500,6370005,,,1 Cap,00904-6502-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.36,% of charge rate,100.00%,5.36,,,,5.09,5.36,1
unity,NDC,CELECOXIB 100 MG PO CAPS,24500,6370005,,,1 Cap,00904-6502-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.36,% of charge rate,100.00%,5.36,,,,5.09,5.36,1
unity,NDC,ISOSORBIDE MONONITRATE ER 30 MG PO TB24,24521,6370005,,,1 Tab,00904-6449-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ISOSORBIDE MONONITRATE ER 30 MG PO TB24,24521,6370005,,,1 Tab,00904-6449-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRIPLE ANTIBIOTIC 3.5-400-5000 EX OINT,24696,6370005,,,1 Each,45802-0143-70,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRIPLE ANTIBIOTIC 3.5-400-5000 EX OINT,24696,6370005,,,1 Each,45802-0143-70,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OXYBUTYNIN CHLORIDE ER 15 MG PO TB24,24723,6370005,,,1 Tab,27241-0157-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OXYBUTYNIN CHLORIDE ER 15 MG PO TB24,24723,6370005,,,1 Tab,27241-0157-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL 60 MG PO TABS,2476,6370005,,,1 Tab,00093-0319-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL 60 MG PO TABS,2476,6370005,,,1 Tab,00093-0319-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO ELIX,2511,6370005,,,10 mL,00121-0978-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,11.34,% of charge rate,100.00%,11.34,,,,10.77,11.34,1
unity,NDC,DIPHENHYDRAMINE HCL 12.5 MG/5ML PO ELIX,2511,6370005,,,10 mL,00121-0978-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,11.34,% of charge rate,100.00%,11.34,,,,10.77,11.34,1
unity,NDC,CIPROFLOXACIN HCL 500 MG PO TABS,25119,6370005,,,1 Tab,68084-0070-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CIPROFLOXACIN HCL 500 MG PO TABS,25119,6370005,,,1 Tab,68084-0070-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,2516,6370005,,,1 Tab,59762-1061-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DIPHENOXYLATE-ATROPINE 2.5-0.025 MG PO TABS,2516,6370005,,,1 Tab,59762-1061-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 400 MG/5ML PO SUSR,25246,6370005,,,100 mL,00093-4161-73,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,14.92,% of charge rate,100.00%,14.92,,,,14.17,14.92,1
unity,NDC,AMOXICILLIN 400 MG/5ML PO SUSR,25246,6370005,,,100 mL,00093-4161-73,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,14.92,% of charge rate,100.00%,14.92,,,,14.17,14.92,1
unity,NDC,POLYETHYLENE GLYCOL 3350 17 G PO PACK,25424,6370005,,,1 Each,00904-6422-81,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.55,% of charge rate,100.00%,9.55,,,,9.07,9.55,1
unity,NDC,POLYETHYLENE GLYCOL 3350 17 G PO PACK,25424,6370005,,,1 Each,00904-6422-81,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.55,% of charge rate,100.00%,9.55,,,,9.07,9.55,1
unity,NDC,RISPERIDONE 0.5 MG PO TABS,25520,6370005,,,1 Tab,00904-6358-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,RISPERIDONE 0.5 MG PO TABS,25520,6370005,,,1 Tab,00904-6358-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DOCUSATE SODIUM 100 MG PO CAPS,2566,6370005,,,1 Cap,00904-6455-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DOCUSATE SODIUM 100 MG PO CAPS,2566,6370005,,,1 Cap,00904-6455-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 600 MG PO TABS,25855,6370005,,,1 Tab,00904-6823-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GABAPENTIN 600 MG PO TABS,25855,6370005,,,1 Tab,00904-6823-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 20 MG PO TBEC,26224,6370005,,,1 Tab,50268-0636-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 20 MG PO TBEC,26224,6370005,,,1 Tab,50268-0636-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 20 MG PO TBEC,26224,6370005,,,1 Tab,50268-0636-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 20 MG PO TBEC,26224,6370005,,,1 Tab,50268-0636-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG PO TBEC,26225,6370005,,,1 Tab,00904-6474-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG PO TBEC,26225,6370005,,,1 Tab,00904-6474-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG PO CAPS,2623,6370005,,,1 Cap,00904-0428-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.38,% of charge rate,100.00%,8.38,,,,7.96,8.38,1
unity,NDC,DOXYCYCLINE HYCLATE 100 MG PO CAPS,2623,6370005,,,1 Cap,00904-0428-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.38,% of charge rate,100.00%,8.38,,,,7.96,8.38,1
unity,NDC,OSELTAMIVIR PHOSPHATE 75 MG PO CAPS,26546,6370005,,,1 Cap,68180-0677-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.7,% of charge rate,100.00%,32.7,,,,31.07,32.7,1
unity,NDC,OSELTAMIVIR PHOSPHATE 75 MG PO CAPS,26546,6370005,,,1 Cap,68180-0677-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.7,% of charge rate,100.00%,32.7,,,,31.07,32.7,1
unity,NDC,LEVETIRACETAM 500 MG PO TABS,26817,6370005,,,1 Tab,00904-6052-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LEVETIRACETAM 500 MG PO TABS,26817,6370005,,,1 Tab,00904-6052-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TROLAMINE SALICYLATE 10 % EX CREA,27680,6370005,,,85 g,41167-0057-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.63,% of charge rate,100.00%,27.63,,,,26.25,27.63,1
unity,NDC,TROLAMINE SALICYLATE 10 % EX CREA,27680,6370005,,,85 g,41167-0057-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.63,% of charge rate,100.00%,27.63,,,,26.25,27.63,1
unity,NDC,OMEPRAZOLE 20 MG PO CPDR,27694,6370005,,,1 Cap,68084-0128-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OMEPRAZOLE 20 MG PO CPDR,27694,6370005,,,1 Cap,68084-0128-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OMEPRAZOLE 20 MG PO CPDR,27694,6370005,,,1 Cap,68084-0128-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OMEPRAZOLE 20 MG PO CPDR,27694,6370005,,,1 Cap,68084-0128-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ONDANSETRON 4 MG PO TBDP,27697,6370005,,,1 Tab,68462-0157-13,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ONDANSETRON 4 MG PO TBDP,27697,6370005,,,1 Tab,68462-0157-40,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ONDANSETRON 4 MG PO TBDP,27697,6370005,,,1 Tab,68462-0157-40,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ONDANSETRON 4 MG PO TBDP,27697,6370005,,,1 Tab,68462-0157-13,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,NICOTINE 7 MG/24HR TD PT24,27860,6370005,,,1 Patch,00536-5894-88,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.55,% of charge rate,100.00%,9.55,,,,9.07,9.55,1
unity,NDC,NICOTINE 7 MG/24HR TD PT24,27860,6370005,,,1 Patch,00536-5894-88,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.55,% of charge rate,100.00%,9.55,,,,9.07,9.55,1
unity,NDC,NICOTINE 14 MG/24HR TD PT24,27862,6370005,,,1 Patch,70000-0511-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.94,% of charge rate,100.00%,9.94,,,,9.44,9.94,1
unity,NDC,NICOTINE 14 MG/24HR TD PT24,27862,6370005,,,1 Patch,70000-0511-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.94,% of charge rate,100.00%,9.94,,,,9.44,9.94,1
unity,NDC,NICOTINE 21 MG/24HR TD PT24,27863,6370005,,,1 Patch,00536-5896-88,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.44,% of charge rate,100.00%,9.44,,,,8.97,9.44,1
unity,NDC,NICOTINE 21 MG/24HR TD PT24,27863,6370005,,,1 Patch,00536-5896-88,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.44,% of charge rate,100.00%,9.44,,,,8.97,9.44,1
unity,NDC,FENTANYL 25 MCG/HR TD PT72,27905,6370005,,,1 Patch,60505-7081-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,19.11,% of charge rate,100.00%,19.11,,,,18.15,19.11,1
unity,NDC,FENTANYL 25 MCG/HR TD PT72,27905,6370005,,,1 Patch,60505-7081-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,19.11,% of charge rate,100.00%,19.11,,,,18.15,19.11,1
unity,NDC,FENTANYL 50 MCG/HR TD PT72,27906,6370005,,,1 Patch,60505-7007-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,27.95,% of charge rate,100.00%,27.95,,,,26.55,27.95,1
unity,NDC,FENTANYL 50 MCG/HR TD PT72,27906,6370005,,,1 Patch,60505-7007-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,27.95,% of charge rate,100.00%,27.95,,,,26.55,27.95,1
unity,NDC,SODIUM POLYSTYRENE SULFONATE 15 GM/60ML PO SUSP,27999,6370005,,,60 mL,46287-0006-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,42.42,% of charge rate,100.00%,42.42,,,,40.3,42.42,1
unity,NDC,SODIUM POLYSTYRENE SULFONATE 15 GM/60ML PO SUSP,27999,6370005,,,60 mL,46287-0006-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,42.42,% of charge rate,100.00%,42.42,,,,40.3,42.42,1
unity,NDC,OLANZAPINE 5 MG PO TBDP,28159,6370005,,,1 Tab,33342-0083-07,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.52,% of charge rate,100.00%,4.52,,,,4.29,4.52,1
unity,NDC,OLANZAPINE 5 MG PO TBDP,28159,6370005,,,1 Tab,33342-0083-07,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.52,% of charge rate,100.00%,4.52,,,,4.29,4.52,1
unity,NDC,LIDOCAINE 5 % EX PTCH,28203,6370005,,,1 Patch,00591-2679-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,15.25,% of charge rate,100.00%,15.25,,,,14.49,15.25,1
unity,NDC,LIDOCAINE 5 % EX PTCH,28203,6370005,,,1 Patch,00591-2679-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,15.25,% of charge rate,100.00%,15.25,,,,14.49,15.25,1
unity,NDC,LINEZOLID 600 MG PO TABS,28224,6370005,,,1 Tab,67877-0419-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,10.72,% of charge rate,100.00%,10.72,,,,10.18,10.72,1
unity,NDC,LINEZOLID 600 MG PO TABS,28224,6370005,,,1 Tab,67877-0419-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,10.72,% of charge rate,100.00%,10.72,,,,10.18,10.72,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,28384,6370005,,,1 Tab,00406-0125-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.41,% of charge rate,100.00%,4.41,,,,4.19,4.41,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,28384,6370005,,,1 Tab,00406-0125-23,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.41,% of charge rate,100.00%,4.41,,,,4.19,4.41,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,28384,6370005,,,1 Tab,00406-0125-23,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.41,% of charge rate,100.00%,4.41,,,,4.19,4.41,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 10-325 MG PO TABS,28384,6370005,,,1 Tab,00406-0125-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.41,% of charge rate,100.00%,4.41,,,,4.19,4.41,1
unity,NDC,NIFEDIPINE ER OSMOTIC RELEASE 30 MG PO TB24,28643,6370005,,,1 Tab,50742-0260-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,NIFEDIPINE ER OSMOTIC RELEASE 30 MG PO TB24,28643,6370005,,,1 Tab,50742-0260-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,NEOMYCIN-POLYMYXIN-HC 3.5-10000-1 OTIC SUSP,28810,6370005,,,10 mL,24208-0635-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,139.61,% of charge rate,100.00%,139.61,,,,132.63,139.61,1
unity,NDC,NEOMYCIN-POLYMYXIN-HC 3.5-10000-1 OTIC SUSP,28810,6370005,,,10 mL,24208-0635-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,139.61,% of charge rate,100.00%,139.61,,,,132.63,139.61,1
unity,NDC,MAGNESIUM HYDROXIDE 400 MG/5ML PO SUSP,28836,6370005,,,30 mL,00904-6846-73,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.89,% of charge rate,100.00%,9.89,,,,9.4,9.89,1
unity,NDC,MAGNESIUM HYDROXIDE 400 MG/5ML PO SUSP,28836,6370005,,,30 mL,00904-6846-73,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.89,% of charge rate,100.00%,9.89,,,,9.4,9.89,1
unity,NDC,ERYTHROMYCIN 5 MG/GM OP OINT,2888,6370005,,,3.5 g,24208-0910-55,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,35.95,% of charge rate,100.00%,35.95,,,,34.15,35.95,1
unity,NDC,ERYTHROMYCIN 5 MG/GM OP OINT,2888,6370005,,,3.5 g,24208-0910-55,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,35.95,% of charge rate,100.00%,35.95,,,,34.15,35.95,1
unity,NDC,OXYCODONE HCL 15 MG PO TABS,28899,6370005,,,1 Tab,57664-0187-88,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,OXYCODONE HCL 15 MG PO TABS,28899,6370005,,,1 Tab,57664-0187-88,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,METFORMIN HCL ER 500 MG PO TB24,28995,6370005,,,1 Tab,62756-0142-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METFORMIN HCL ER 500 MG PO TB24,28995,6370005,,,1 Tab,62756-0142-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ALENDRONATE SODIUM 70 MG PO TABS,29048,6370005,,,1 Tab,69097-0224-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ALENDRONATE SODIUM 70 MG PO TABS,29048,6370005,,,1 Tab,69097-0224-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 120 MG PO CP24,29270,6370005,,,1 Cap,63739-0014-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 120 MG PO CP24,29270,6370005,,,1 Cap,63739-0014-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,29272,6370005,,,1 Cap,60687-0206-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,29272,6370005,,,1 Cap,60687-0206-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,29272,6370005,,,1 Cap,60687-0206-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 180 MG PO CP24,29272,6370005,,,1 Cap,60687-0206-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 240 MG PO CP24,29274,6370005,,,1 Cap,60687-0217-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.58,% of charge rate,100.00%,4.58,,,,4.35,4.58,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 240 MG PO CP24,29274,6370005,,,1 Cap,60687-0217-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.58,% of charge rate,100.00%,4.58,,,,4.35,4.58,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 240 MG PO CP24,29274,6370005,,,1 Cap,60687-0217-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.58,% of charge rate,100.00%,4.58,,,,4.35,4.58,1
unity,NDC,DILTIAZEM HCL ER COATED BEADS 240 MG PO CP24,29274,6370005,,,1 Cap,60687-0217-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.58,% of charge rate,100.00%,4.58,,,,4.35,4.58,1
unity,NDC,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % EX CREA,29424,6370005,,,15 g,68462-0298-17,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,128.74,% of charge rate,100.00%,128.74,,,,122.3,128.74,1
unity,NDC,CLOTRIMAZOLE-BETAMETHASONE 1-0.05 % EX CREA,29424,6370005,,,15 g,68462-0298-17,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,128.74,% of charge rate,100.00%,128.74,,,,122.3,128.74,1
unity,NDC,METOPROLOL SUCCINATE ER 25 MG PO TB24,29858,6370005,,,1 Tab,00904-6322-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL SUCCINATE ER 25 MG PO TB24,29858,6370005,,,1 Tab,00904-6322-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL SUCCINATE ER 50 MG PO TB24,30070,6370005,,,1 Tab,00904-6323-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.57,% of charge rate,100.00%,3.57,,,,3.39,3.57,1
unity,NDC,METOPROLOL SUCCINATE ER 50 MG PO TB24,30070,6370005,,,1 Tab,00904-6323-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.57,% of charge rate,100.00%,3.57,,,,3.39,3.57,1
unity,NDC,CITALOPRAM HYDROBROMIDE 10 MG PO TABS,30264,6370005,,,1 Tab,00904-6084-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,CITALOPRAM HYDROBROMIDE 10 MG PO TABS,30264,6370005,,,1 Tab,00904-6084-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,FERROUS SULFATE 220 (44 FE) MG/5ML PO ELIX,3069,6370005,,,5 mL,50383-0778-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FERROUS SULFATE 220 (44 FE) MG/5ML PO ELIX,3069,6370005,,,5 mL,50383-0778-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FERROUS SULFATE 325 (65 FE) MG PO TABS,3074,6370005,,,1 Tab,00904-7591-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FERROUS SULFATE 325 (65 FE) MG PO TABS,3074,6370005,,,1 Tab,00904-7591-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ALLOPURINOL 100 MG PO TABS,310,6370005,,,1 Tab,00904-6571-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ALLOPURINOL 100 MG PO TABS,310,6370005,,,1 Tab,00904-6571-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ALLOPURINOL 300 MG PO TABS,311,6370005,,,1 Tab,00904-6572-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.85,% of charge rate,100.00%,3.85,,,,3.66,3.85,1
unity,NDC,ALLOPURINOL 300 MG PO TABS,311,6370005,,,1 Tab,00904-6572-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.85,% of charge rate,100.00%,3.85,,,,3.66,3.85,1
unity,NDC,FLEET PEDIATRIC 3.5-9.5 GM/59ML REC ENEM,3128,6370005,,,1 Enema,00132-0202-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.88,% of charge rate,100.00%,8.88,,,,8.44,8.88,1
unity,NDC,FLEET PEDIATRIC 3.5-9.5 GM/59ML REC ENEM,3128,6370005,,,1 Enema,00132-0202-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.88,% of charge rate,100.00%,8.88,,,,8.44,8.88,1
unity,NDC,FOLIC ACID 1 MG PO TABS,3233,6370005,,,1 Tab,65162-0361-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FOLIC ACID 1 MG PO TABS,3233,6370005,,,1 Tab,65162-0361-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OLMESARTAN MEDOXOMIL 20 MG PO TABS,32762,6370005,,,1 Tab,68462-0437-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OLMESARTAN MEDOXOMIL 20 MG PO TABS,32762,6370005,,,1 Tab,68462-0437-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 20 MG PO TABS,3294,6370005,,,1 Tab,51079-0072-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 20 MG PO TABS,3294,6370005,,,1 Tab,51079-0072-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 20 MG PO TABS,3294,6370005,,,1 Tab,51079-0072-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 20 MG PO TABS,3294,6370005,,,1 Tab,51079-0072-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 40 MG PO TABS,3295,6370005,,,1 Tab,51079-0073-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 40 MG PO TABS,3295,6370005,,,1 Tab,51079-0073-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 40 MG PO TABS,3295,6370005,,,1 Tab,51079-0073-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FUROSEMIDE 40 MG PO TABS,3295,6370005,,,1 Tab,51079-0073-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,33227,6370005,,,1 Tab,00093-2274-34,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.63,% of charge rate,100.00%,3.63,,,,3.45,3.63,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 500-125 MG PO TABS,33227,6370005,,,1 Tab,00093-2274-34,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.63,% of charge rate,100.00%,3.63,,,,3.45,3.63,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,33228,6370005,,,1 Tab,00093-2275-34,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.74,% of charge rate,100.00%,3.74,,,,3.55,3.74,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 875-125 MG PO TABS,33228,6370005,,,1 Tab,00093-2275-34,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.74,% of charge rate,100.00%,3.74,,,,3.55,3.74,1
unity,NDC,ESCITALOPRAM OXALATE 10 MG PO TABS,33512,6370005,,,1 Tab,00904-6426-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ESCITALOPRAM OXALATE 10 MG PO TABS,33512,6370005,,,1 Tab,00904-6426-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,VALSARTAN 40 MG PO TABS,33541,6370005,,,1 Tab,00378-5807-93,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,VALSARTAN 40 MG PO TABS,33541,6370005,,,1 Tab,00378-5807-93,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GEMFIBROZIL 600 MG PO TABS,3378,6370005,,,1 Tab,69097-0821-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.63,% of charge rate,100.00%,4.63,,,,4.4,4.63,1
unity,NDC,GEMFIBROZIL 600 MG PO TABS,3378,6370005,,,1 Tab,69097-0821-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.63,% of charge rate,100.00%,4.63,,,,4.4,4.63,1
unity,NDC,EZETIMIBE 10 MG PO TABS,34153,6370005,,,1 Tab,67877-0490-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.9,% of charge rate,100.00%,3.9,,,,3.71,3.9,1
unity,NDC,EZETIMIBE 10 MG PO TABS,34153,6370005,,,1 Tab,67877-0490-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.9,% of charge rate,100.00%,3.9,,,,3.71,3.9,1
unity,NDC,GENTAMICIN SULFATE 0.1 % EX OINT,3424,6370005,,,15 g,45802-0046-35,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.8,% of charge rate,100.00%,40.8,,,,38.76,40.8,1
unity,NDC,GENTAMICIN SULFATE 0.1 % EX OINT,3424,6370005,,,15 g,45802-0046-35,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.8,% of charge rate,100.00%,40.8,,,,38.76,40.8,1
unity,NDC,GENTAMICIN SULFATE 0.3 % OP SOLN,3428,6370005,,,75 Drop,60758-0188-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.85,% of charge rate,100.00%,21.85,,,,20.76,21.85,1
unity,NDC,GENTAMICIN SULFATE 0.3 % OP SOLN,3428,6370005,,,75 Drop,60758-0188-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.85,% of charge rate,100.00%,21.85,,,,20.76,21.85,1
unity,NDC,GENTIAN VIOLET 1 % EX SOLN,3430,6370005,,,59 mL,00395-1003-92,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.97,% of charge rate,100.00%,23.97,,,,22.77,23.97,1
unity,NDC,GENTIAN VIOLET 1 % EX SOLN,3430,6370005,,,59 mL,00395-1003-92,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.97,% of charge rate,100.00%,23.97,,,,22.77,23.97,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,34505,6370005,,,1 Tab,00904-6824-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDROCODONE-ACETAMINOPHEN 5-325 MG PO TABS,34505,6370005,,,1 Tab,00904-6824-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,NICOTINE POLACRILEX 2 MG MT LOZG,34769,6370005,,,1 Lozenge,70000-0349-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.76,% of charge rate,100.00%,7.76,,,,7.37,7.76,1
unity,NDC,NICOTINE POLACRILEX 2 MG MT LOZG,34769,6370005,,,1 Lozenge,70000-0349-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.76,% of charge rate,100.00%,7.76,,,,7.37,7.76,1
unity,NDC,NICOTINE POLACRILEX 4 MG MT LOZG,34770,6370005,,,24 Lozenge,00135-0511-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,97.98,% of charge rate,100.00%,97.98,,,,93.08,97.98,1
unity,NDC,NICOTINE POLACRILEX 4 MG MT LOZG,34770,6370005,,,24 Lozenge,00135-0511-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,97.98,% of charge rate,100.00%,97.98,,,,93.08,97.98,1
unity,NDC,GLYBURIDE 5 MG PO TABS,3489,6370005,,,1 Tab,23155-0058-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLYBURIDE 5 MG PO TABS,3489,6370005,,,1 Tab,23155-0058-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 20 MG PO TABS,35135,6370005,,,1 Tab,50268-0710-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 20 MG PO TABS,35135,6370005,,,1 Tab,50268-0710-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 20 MG PO TABS,35135,6370005,,,1 Tab,50268-0710-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 20 MG PO TABS,35135,6370005,,,1 Tab,50268-0710-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HALOPERIDOL LACTATE 2 MG/ML PO CONC,3585,6370005,,,0.5 mL,00121-0581-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HALOPERIDOL LACTATE 2 MG/ML PO CONC,3585,6370005,,,0.5 mL,00121-0581-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,35943,6370005,,,1 Tab,00245-5319-89,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,35943,6370005,,,1 Tab,00245-5319-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,35943,6370005,,,1 Tab,00245-5319-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,POTASSIUM CHLORIDE CRYS ER 20 MEQ PO TBCR,35943,6370005,,,1 Tab,00245-5319-89,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LEVETIRACETAM 100 MG/ML PO SOLN,36590,6370005,,,473 mL,51991-0651-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,530.31,% of charge rate,100.00%,530.31,,,,503.79,530.31,1
unity,NDC,LEVETIRACETAM 100 MG/ML PO SOLN,36590,6370005,,,473 mL,51991-0651-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,530.31,% of charge rate,100.00%,530.31,,,,503.79,530.31,1
unity,NDC,ROSUVASTATIN CALCIUM 5 MG PO TABS,36612,6370005,,,1 Tab,65862-0293-90,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ROSUVASTATIN CALCIUM 5 MG PO TABS,36612,6370005,,,1 Tab,65862-0293-90,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BUPROPION HCL ER (XL) 150 MG PO TB24,36775,6370005,,,1 Tab,50268-0140-13,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.17,% of charge rate,100.00%,4.17,,,,3.96,4.17,1
unity,NDC,BUPROPION HCL ER (XL) 150 MG PO TB24,36775,6370005,,,1 Tab,50268-0140-13,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.17,% of charge rate,100.00%,4.17,,,,3.96,4.17,1
unity,NDC,MEMANTINE HCL 10 MG PO TABS,36966,6370005,,,1 Tab,00904-6506-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.57,% of charge rate,100.00%,3.57,,,,3.39,3.57,1
unity,NDC,MEMANTINE HCL 10 MG PO TABS,36966,6370005,,,1 Tab,00904-6506-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.57,% of charge rate,100.00%,3.57,,,,3.39,3.57,1
unity,NDC,HYDRALAZINE HCL 10 MG PO TABS,3698,6370005,,,1 Tab,23155-0001-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDRALAZINE HCL 10 MG PO TABS,3698,6370005,,,1 Tab,23155-0001-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDRALAZINE HCL 25 MG PO TABS,3700,6370005,,,1 Tab,23155-0002-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDRALAZINE HCL 25 MG PO TABS,3700,6370005,,,1 Tab,23155-0002-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDROCHLOROTHIAZIDE 25 MG PO TABS,3720,6370005,,,1 Tab,16729-0183-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDROCHLOROTHIAZIDE 25 MG PO TABS,3720,6370005,,,1 Tab,16729-0183-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDROCORTISONE 1 % EX CREA,3726,6370005,,,28 g,00904-7623-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.17,% of charge rate,100.00%,9.17,,,,8.71,9.17,1
unity,NDC,HYDROCORTISONE 1 % EX CREA,3726,6370005,,,28 g,00904-7623-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.17,% of charge rate,100.00%,9.17,,,,8.71,9.17,1
unity,NDC,HYDROCORTISONE 2.5 % EX CREA,3727,6370005,,,30 g,00168-0080-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.4,% of charge rate,100.00%,12.4,,,,11.78,12.4,1
unity,NDC,HYDROCORTISONE 2.5 % EX CREA,3727,6370005,,,30 g,00168-0080-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.4,% of charge rate,100.00%,12.4,,,,11.78,12.4,1
unity,NDC,HYDROCORTISONE ACETATE 25 MG REC SUPP,3738,6370005,,,1 Suppository,00713-0503-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.69,% of charge rate,100.00%,20.69,,,,19.66,20.69,1
unity,NDC,HYDROCORTISONE ACETATE 25 MG REC SUPP,3738,6370005,,,1 Suppository,00713-0503-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.69,% of charge rate,100.00%,20.69,,,,19.66,20.69,1
unity,NDC,HYDROCORTISONE ACETATE 25 MG REC SUPP,3738,6370005,,,1 Suppository,00713-0503-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.69,% of charge rate,100.00%,20.69,,,,19.66,20.69,1
unity,NDC,HYDROCORTISONE ACETATE 25 MG REC SUPP,3738,6370005,,,1 Suppository,00713-0503-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.69,% of charge rate,100.00%,20.69,,,,19.66,20.69,1
unity,NDC,HYDROMORPHONE HCL 2 MG PO TABS,3760,6370005,,,1 Tab,42858-0301-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDROMORPHONE HCL 2 MG PO TABS,3760,6370005,,,1 Tab,42858-0301-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 25 MG PO TABS,37637,6370005,,,1 Tab,51079-0255-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 25 MG PO TABS,37637,6370005,,,1 Tab,51079-0255-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 25 MG PO TABS,37637,6370005,,,1 Tab,51079-0255-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 25 MG PO TABS,37637,6370005,,,1 Tab,51079-0255-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR,37642,6370005,,,100 mL,59762-0016-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,137.9,% of charge rate,100.00%,137.9,,,,131.01,137.9,1
unity,NDC,CLINDAMYCIN PALMITATE HCL 75 MG/5ML PO SOLR,37642,6370005,,,100 mL,59762-0016-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,137.9,% of charge rate,100.00%,137.9,,,,131.01,137.9,1
unity,NDC,GUAIFENESIN ER 600 MG PO TB12,37651,6370005,,,1 Tab,68084-0572-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.08,% of charge rate,100.00%,6.08,,,,5.78,6.08,1
unity,NDC,GUAIFENESIN ER 600 MG PO TB12,37651,6370005,,,1 Tab,68084-0572-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.08,% of charge rate,100.00%,6.08,,,,5.78,6.08,1
unity,NDC,GUAIFENESIN ER 600 MG PO TB12,37651,6370005,,,1 Tab,68084-0572-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.08,% of charge rate,100.00%,6.08,,,,5.78,6.08,1
unity,NDC,GUAIFENESIN ER 600 MG PO TB12,37651,6370005,,,1 Tab,68084-0572-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.08,% of charge rate,100.00%,6.08,,,,5.78,6.08,1
unity,NDC,HYDROXYZINE HCL 25 MG PO TABS,3774,6370005,,,1 Tab,00904-6617-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.52,% of charge rate,100.00%,4.52,,,,4.29,4.52,1
unity,NDC,HYDROXYZINE HCL 25 MG PO TABS,3774,6370005,,,1 Tab,00904-6617-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.52,% of charge rate,100.00%,4.52,,,,4.29,4.52,1
unity,NDC,I-VITE PO TABS,3808,6370005,,,1 Tab,00536-5090-08,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,I-VITE PO TABS,3808,6370005,,,1 Tab,00536-5090-08,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ORPHENADRINE CITRATE ER 100 MG PO TB12,38213,6370005,,,1 Tab,43386-0480-24,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.33,% of charge rate,100.00%,9.33,,,,8.86,9.33,1
unity,NDC,ORPHENADRINE CITRATE ER 100 MG PO TB12,38213,6370005,,,1 Tab,43386-0480-24,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.33,% of charge rate,100.00%,9.33,,,,8.86,9.33,1
unity,NDC,PROPRANOLOL HCL ER 80 MG PO CP24,38225,6370005,,,1 Cap,51991-0818-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.83,% of charge rate,100.00%,9.83,,,,9.34,9.83,1
unity,NDC,PROPRANOLOL HCL ER 80 MG PO CP24,38225,6370005,,,1 Cap,51991-0818-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.83,% of charge rate,100.00%,9.83,,,,9.34,9.83,1
unity,NDC,PROPRANOLOL HCL ER 120 MG PO CP24,38226,6370005,,,1 Cap,51991-0819-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.03,% of charge rate,100.00%,6.03,,,,5.73,6.03,1
unity,NDC,PROPRANOLOL HCL ER 120 MG PO CP24,38226,6370005,,,1 Cap,51991-0819-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.03,% of charge rate,100.00%,6.03,,,,5.73,6.03,1
unity,NDC,LACTULOSE 10 GM/15ML PO SOLN,38245,6370005,,,15 mL,50383-0779-17,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.44,% of charge rate,100.00%,4.44,,,,4.22,4.44,1
unity,NDC,LACTULOSE 10 GM/15ML PO SOLN,38245,6370005,,,15 mL,50383-0779-17,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.44,% of charge rate,100.00%,4.44,,,,4.22,4.44,1
unity,NDC,TIOTROPIUM BROMIDE MONOHYDRATE 18 MCG IN CAPS,38315,6370005,,,5 Cap,00597-0075-75,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,171.23,% of charge rate,100.00%,171.23,,,,162.67,171.23,1
unity,NDC,TIOTROPIUM BROMIDE MONOHYDRATE 18 MCG IN CAPS,38315,6370005,,,5 Cap,00597-0075-75,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,171.23,% of charge rate,100.00%,171.23,,,,162.67,171.23,1
unity,NDC,IBUPROFEN 400 MG PO TABS,3843,6370005,,,1 Tab,00904-5853-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IBUPROFEN 400 MG PO TABS,3843,6370005,,,1 Tab,00904-5853-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IBUPROFEN 600 MG PO TABS,3844,6370005,,,1 Tab,00904-5854-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IBUPROFEN 600 MG PO TABS,3844,6370005,,,1 Tab,00904-5854-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SILVASORB EX GEL,38626,6370005,,,45 g,08327-0309-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,145.12,% of charge rate,100.00%,145.12,,,,137.86,145.12,1
unity,NDC,SILVASORB EX GEL,38626,6370005,,,45 g,08327-0309-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,145.12,% of charge rate,100.00%,145.12,,,,137.86,145.12,1
unity,NDC,INDOMETHACIN 25 MG PO CAPS,3897,6370005,,,1 Cap,50268-0430-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,INDOMETHACIN 25 MG PO CAPS,3897,6370005,,,1 Cap,50268-0430-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,INDOMETHACIN 25 MG PO CAPS,3897,6370005,,,1 Cap,50268-0430-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,INDOMETHACIN 25 MG PO CAPS,3897,6370005,,,1 Cap,50268-0430-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,EMTRICITABINE-TENOFOVIR DF 200-300 MG PO TABS,39255,6370005,,,1 Tab,61958-0701-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,144.63,% of charge rate,100.00%,144.63,,,,137.4,144.63,1
unity,NDC,EMTRICITABINE-TENOFOVIR DF 200-300 MG PO TABS,39255,6370005,,,1 Tab,61958-0701-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,144.63,% of charge rate,100.00%,144.63,,,,137.4,144.63,1
unity,NDC,DULOXETINE HCL 20 MG PO CPEP,39275,6370005,,,1 Cap,00904-6452-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.36,% of charge rate,100.00%,6.36,,,,6.04,6.36,1
unity,NDC,DULOXETINE HCL 20 MG PO CPEP,39275,6370005,,,1 Cap,00904-6452-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.36,% of charge rate,100.00%,6.36,,,,6.04,6.36,1
unity,NDC,DULOXETINE HCL 30 MG PO CPEP,39276,6370005,,,1 Cap,00904-6453-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.9,% of charge rate,100.00%,3.9,,,,3.71,3.9,1
unity,NDC,DULOXETINE HCL 30 MG PO CPEP,39276,6370005,,,1 Cap,00904-6453-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.9,% of charge rate,100.00%,3.9,,,,3.71,3.9,1
unity,NDC,FENOFIBRATE 48 MG PO TABS,40009,6370005,,,1 Tab,63304-0448-90,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.23,% of charge rate,100.00%,12.23,,,,11.62,12.23,1
unity,NDC,FENOFIBRATE 48 MG PO TABS,40009,6370005,,,1 Tab,63304-0448-90,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.23,% of charge rate,100.00%,12.23,,,,11.62,12.23,1
unity,NDC,FENOFIBRATE 145 MG PO TABS,40010,6370005,,,1 Tab,68180-0361-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,22.88,% of charge rate,100.00%,22.88,,,,21.74,22.88,1
unity,NDC,FENOFIBRATE 145 MG PO TABS,40010,6370005,,,1 Tab,68180-0361-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,22.88,% of charge rate,100.00%,22.88,,,,21.74,22.88,1
unity,NDC,GLYCERIN (LAXATIVE) 2 G REC SUPP,41003,6370005,,,1 Suppository,00132-0079-50,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GLYCERIN (LAXATIVE) 2 G REC SUPP,41003,6370005,,,1 Suppository,00132-0079-50,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,FENTANYL 12 MCG/HR TD PT72,41382,6370005,,,1 Patch,00378-9119-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.51,% of charge rate,100.00%,32.51,,,,30.88,32.51,1
unity,NDC,FENTANYL 12 MCG/HR TD PT72,41382,6370005,,,1 Patch,00378-9119-98,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.51,% of charge rate,100.00%,32.51,,,,30.88,32.51,1
unity,NDC,FENTANYL 12 MCG/HR TD PT72,41382,6370005,,,1 Patch,00378-9119-98,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.51,% of charge rate,100.00%,32.51,,,,30.88,32.51,1
unity,NDC,FENTANYL 12 MCG/HR TD PT72,41382,6370005,,,1 Patch,00378-9119-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.51,% of charge rate,100.00%,32.51,,,,30.88,32.51,1
unity,NDC,LIDOCAINE 5 % EX OINT,41831,6370005,,,36 g,52565-0008-14,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.08,% of charge rate,100.00%,57.08,,,,54.23,57.08,1
unity,NDC,LIDOCAINE 5 % EX OINT,41831,6370005,,,36 g,52565-0008-14,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.08,% of charge rate,100.00%,57.08,,,,54.23,57.08,1
unity,NDC,PREGABALIN 75 MG PO CAPS,42164,6370005,,,1 Cap,00071-1014-68,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,30.76,% of charge rate,100.00%,30.76,,,,29.22,30.76,1
unity,NDC,PREGABALIN 75 MG PO CAPS,42164,6370005,,,1 Cap,00071-1014-68,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,30.76,% of charge rate,100.00%,30.76,,,,29.22,30.76,1
unity,NDC,PREGABALIN 100 MG PO CAPS,42165,6370005,,,1 Cap,00904-7001-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.79,% of charge rate,100.00%,3.79,,,,3.6,3.79,1
unity,NDC,PREGABALIN 100 MG PO CAPS,42165,6370005,,,1 Cap,00904-7001-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.79,% of charge rate,100.00%,3.79,,,,3.6,3.79,1
unity,NDC,AMITRIPTYLINE HCL 10 MG PO TABS,432,6370005,,,1 Tab,16729-0171-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 10 MG PO TABS,432,6370005,,,1 Tab,16729-0171-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 25 MG PO TABS,435,6370005,,,1 Tab,60687-0433-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 25 MG PO TABS,435,6370005,,,1 Tab,60687-0433-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 25 MG PO TABS,435,6370005,,,1 Tab,60687-0433-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMITRIPTYLINE HCL 25 MG PO TABS,435,6370005,,,1 Tab,60687-0433-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LEVOTHYROXINE SODIUM 50 MCG PO TABS,4421,6370005,,,2 Tab,00904-6950-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7,% of charge rate,100.00%,7,,,,6.65,7,1
unity,NDC,LEVOTHYROXINE SODIUM 50 MCG PO TABS,4421,6370005,,,2 Tab,00904-6950-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7,% of charge rate,100.00%,7,,,,6.65,7,1
unity,NDC,LEVOTHYROXINE SODIUM 75 MCG PO TABS,4422,6370005,,,2 Tab,00904-6951-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,7.7,% of charge rate,100.00%,7.7,,,,7.32,7.7,1
unity,NDC,LEVOTHYROXINE SODIUM 75 MCG PO TABS,4422,6370005,,,2 Tab,00904-6951-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,7.7,% of charge rate,100.00%,7.7,,,,7.32,7.7,1
unity,NDC,LEVOTHYROXINE SODIUM 100 MCG PO TABS,4423,6370005,,,1 Tab,00904-6953-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.46,% of charge rate,100.00%,4.46,,,,4.24,4.46,1
unity,NDC,LEVOTHYROXINE SODIUM 100 MCG PO TABS,4423,6370005,,,1 Tab,00904-6953-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.46,% of charge rate,100.00%,4.46,,,,4.24,4.46,1
unity,NDC,AMOXICILLIN 250 MG PO CAPS,450,6370005,,,1 Cap,00781-2020-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 250 MG PO CAPS,450,6370005,,,1 Cap,00781-2020-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 500 MG PO CAPS,451,6370005,,,1 Cap,00093-3109-53,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 500 MG PO CAPS,451,6370005,,,1 Cap,00093-3109-53,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 20 MG PO TABS,4526,6370005,,,1 Tab,00904-6799-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LISINOPRIL 20 MG PO TABS,4526,6370005,,,1 Tab,00904-6799-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LITHIUM CARBONATE 150 MG PO CAPS,4528,6370005,,,1 Cap,00054-8526-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LITHIUM CARBONATE 150 MG PO CAPS,4528,6370005,,,1 Cap,00054-8526-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 125 MG/5ML PO SUSR,453,6370005,,,5 mL,00781-6039-46,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN 125 MG/5ML PO SUSR,453,6370005,,,5 mL,00781-6039-46,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LOPERAMIDE HCL 2 MG PO CAPS,4560,6370005,,,1 Cap,60687-0229-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.41,% of charge rate,100.00%,4.41,,,,4.19,4.41,1
unity,NDC,LOPERAMIDE HCL 2 MG PO CAPS,4560,6370005,,,1 Cap,60687-0229-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.41,% of charge rate,100.00%,4.41,,,,4.19,4.41,1
unity,NDC,LOPERAMIDE HCL 2 MG PO CAPS,4560,6370005,,,1 Cap,60687-0229-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.41,% of charge rate,100.00%,4.41,,,,4.19,4.41,1
unity,NDC,LOPERAMIDE HCL 2 MG PO CAPS,4560,6370005,,,1 Cap,60687-0229-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.41,% of charge rate,100.00%,4.41,,,,4.19,4.41,1
unity,NDC,LORAZEPAM 0.5 MG PO TABS,4572,6370005,,,1 Tab,00904-6007-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LORAZEPAM 0.5 MG PO TABS,4572,6370005,,,1 Tab,00904-6007-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LORAZEPAM 1 MG PO TABS,4573,6370005,,,1 Tab,00904-6008-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,LORAZEPAM 1 MG PO TABS,4573,6370005,,,1 Tab,00904-6008-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MAGNESIUM CITRATE PO SOLN,4712,6370005,,,296 mL,70000-0424-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,8.12,% of charge rate,100.00%,8.12,,,,7.71,8.12,1
unity,NDC,MAGNESIUM CITRATE PO SOLN,4712,6370005,,,296 mL,70000-0424-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,8.12,% of charge rate,100.00%,8.12,,,,7.71,8.12,1
unity,NDC,METHYLPHENIDATE HCL 10 MG PO TABS,4986,6370005,,,1 Tab,10702-0101-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,METHYLPHENIDATE HCL 10 MG PO TABS,4986,6370005,,,1 Tab,10702-0101-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,METOCLOPRAMIDE HCL 10 MG PO TABS,5005,6370005,,,1 Tab,68084-0676-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOCLOPRAMIDE HCL 10 MG PO TABS,5005,6370005,,,1 Tab,68084-0676-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOCLOPRAMIDE HCL 10 MG PO TABS,5005,6370005,,,1 Tab,68084-0676-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOCLOPRAMIDE HCL 10 MG PO TABS,5005,6370005,,,1 Tab,68084-0676-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 50 MG PO TABS,5009,6370005,,,1 Tab,51079-0801-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 50 MG PO TABS,5009,6370005,,,1 Tab,51079-0801-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 50 MG PO TABS,5009,6370005,,,1 Tab,51079-0801-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METOPROLOL TARTRATE 50 MG PO TABS,5009,6370005,,,1 Tab,51079-0801-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METRONIDAZOLE 250 MG PO TABS,5015,6370005,,,1 Tab,00904-1453-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,METRONIDAZOLE 250 MG PO TABS,5015,6370005,,,1 Tab,00904-1453-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MICONAZOLE NITRATE 2 % EX CREA,5039,6370005,,,28 g,00472-0735-56,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,20.62,% of charge rate,100.00%,20.62,,,,19.59,20.62,1
unity,NDC,MICONAZOLE NITRATE 2 % EX CREA,5039,6370005,,,28 g,00472-0735-56,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,20.62,% of charge rate,100.00%,20.62,,,,19.59,20.62,1
unity,NDC,MINERAL OIL REC ENEM,5087,6370005,,,2 Enema,00132-0301-40,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.51,% of charge rate,100.00%,24.51,,,,23.28,24.51,1
unity,NDC,MINERAL OIL REC ENEM,5087,6370005,,,2 Enema,00132-0301-40,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.51,% of charge rate,100.00%,24.51,,,,23.28,24.51,1
unity,NDC,MINOCYCLINE HCL 100 MG PO CAPS,5110,6370005,,,1 Cap,60687-0336-65,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,MINOCYCLINE HCL 100 MG PO CAPS,5110,6370005,,,1 Cap,60687-0336-65,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,NAPROXEN 250 MG PO TABS,5391,6370005,,,1 Tab,50268-0594-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,NAPROXEN 250 MG PO TABS,5391,6370005,,,1 Tab,50268-0594-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,NITROGLYCERIN 0.4 MG SL SUBL,5604,6370005,,,1 Tab,59762-3304-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.79,% of charge rate,100.00%,3.79,,,,3.6,3.79,1
unity,NDC,NITROGLYCERIN 0.4 MG SL SUBL,5604,6370005,,,1 Tab,59762-3304-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.79,% of charge rate,100.00%,3.79,,,,3.6,3.79,1
unity,NDC,NORTRIPTYLINE HCL 50 MG PO CAPS,5676,6370005,,,1 Cap,50268-0605-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,NORTRIPTYLINE HCL 50 MG PO CAPS,5676,6370005,,,1 Cap,50268-0605-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,NORTRIPTYLINE HCL 50 MG PO CAPS,5676,6370005,,,1 Cap,50268-0605-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,NORTRIPTYLINE HCL 50 MG PO CAPS,5676,6370005,,,1 Cap,50268-0605-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,NYSTATIN 100000 UNIT/GM EX CREA,5749,6370005,,,30 g,45802-0059-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.8,% of charge rate,100.00%,24.8,,,,23.56,24.8,1
unity,NDC,NYSTATIN 100000 UNIT/GM EX CREA,5749,6370005,,,30 g,45802-0059-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.8,% of charge rate,100.00%,24.8,,,,23.56,24.8,1
unity,NDC,NYSTATIN 100000 UNIT/ML MT SUSP,5751,6370005,,,5 mL,66689-0037-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.13,% of charge rate,100.00%,4.13,,,,3.92,4.13,1
unity,NDC,NYSTATIN 100000 UNIT/ML MT SUSP,5751,6370005,,,5 mL,66689-0037-50,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.13,% of charge rate,100.00%,4.13,,,,3.92,4.13,1
unity,NDC,NYSTATIN 100000 UNIT/ML MT SUSP,5751,6370005,,,5 mL,66689-0037-50,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.13,% of charge rate,100.00%,4.13,,,,3.92,4.13,1
unity,NDC,NYSTATIN 100000 UNIT/ML MT SUSP,5751,6370005,,,5 mL,66689-0037-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.13,% of charge rate,100.00%,4.13,,,,3.92,4.13,1
unity,NDC,OXYBUTYNIN CHLORIDE 5 MG PO TABS,5938,6370005,,,1 Tab,00904-2821-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OXYBUTYNIN CHLORIDE 5 MG PO TABS,5938,6370005,,,1 Tab,00904-2821-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,5940,6370005,,,1 Tab,00406-0512-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OXYCODONE-ACETAMINOPHEN 5-325 MG PO TABS,5940,6370005,,,1 Tab,00406-0512-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PENICILLIN V POTASSIUM 250 MG PO TABS,6092,6370005,,,1 Tab,65862-0175-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PENICILLIN V POTASSIUM 250 MG PO TABS,6092,6370005,,,1 Tab,65862-0175-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PHENYTOIN SODIUM EXTENDED 100 MG PO CAPS,6257,6370005,,,1 Cap,51672-4111-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,PHENYTOIN SODIUM EXTENDED 100 MG PO CAPS,6257,6370005,,,1 Cap,51672-4111-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,ASCORBIC ACID 500 MG PO TABS,664,6370005,,,1 Tab,00904-0523-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ASCORBIC ACID 500 MG PO TABS,664,6370005,,,1 Tab,00904-0523-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 10 MG PO TABS,6656,6370005,,,1 Tab,00904-6550-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 10 MG PO TABS,6656,6370005,,,1 Tab,00904-6550-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 40 MG PO TABS,6658,6370005,,,1 Tab,50268-0702-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 40 MG PO TABS,6658,6370005,,,1 Tab,50268-0702-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 40 MG PO TABS,6658,6370005,,,1 Tab,50268-0702-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PROPRANOLOL HCL 40 MG PO TABS,6658,6370005,,,1 Tab,50268-0702-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ASPIRIN 81 MG PO CHEW,680,6370005,,,1 Tab,63739-0434-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ASPIRIN 81 MG PO CHEW,680,6370005,,,1 Tab,63739-0434-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ASPIRIN 81 MG PO TBEC,688,6370005,,,1 Tab,63739-0212-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ASPIRIN 81 MG PO TBEC,688,6370005,,,1 Tab,63739-0212-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ASPIRIN 300 MG REC SUPP,693,6370005,,,1 Suppository,00574-7034-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.89,% of charge rate,100.00%,9.89,,,,9.4,9.89,1
unity,NDC,ASPIRIN 300 MG REC SUPP,693,6370005,,,1 Suppository,00574-7034-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.89,% of charge rate,100.00%,9.89,,,,9.4,9.89,1
unity,NDC,ATENOLOL 50 MG PO TABS,718,6370005,,,1 Tab,51079-0684-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ATENOLOL 50 MG PO TABS,718,6370005,,,1 Tab,51079-0684-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ATENOLOL 50 MG PO TABS,718,6370005,,,1 Tab,51079-0684-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ATENOLOL 50 MG PO TABS,718,6370005,,,1 Tab,51079-0684-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMETHICONE 80 MG PO CHEW,7227,6370005,,,1 Tab,00904-5068-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMETHICONE 80 MG PO CHEW,7227,6370005,,,1 Tab,00904-5068-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SIMETHICONE 40 MG/0.6ML PO SUSP,7228,6370005,,,30 mL,00536-2220-75,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.7,% of charge rate,100.00%,60.7,,,,57.67,60.7,1
unity,NDC,SIMETHICONE 40 MG/0.6ML PO SUSP,7228,6370005,,,30 mL,00536-2220-75,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.7,% of charge rate,100.00%,60.7,,,,57.67,60.7,1
unity,NDC,SODIUM BICARBONATE 650 MG PO TABS,7313,6370005,,,1 Tab,00223-1721-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SODIUM BICARBONATE 650 MG PO TABS,7313,6370005,,,1 Tab,00223-1721-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SODIUM CHLORIDE 1 G PO TABS,7328,6370005,,,1 Tab,69367-0220-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SODIUM CHLORIDE 1 G PO TABS,7328,6370005,,,1 Tab,69367-0220-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SULFACETAMIDE SODIUM 10 % OP SOLN,7359,6370005,,,15 mL,24208-0670-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,143.44,% of charge rate,100.00%,143.44,,,,136.27,143.44,1
unity,NDC,SULFACETAMIDE SODIUM 10 % OP SOLN,7359,6370005,,,15 mL,24208-0670-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,143.44,% of charge rate,100.00%,143.44,,,,136.27,143.44,1
unity,NDC,SPIRONOLACTONE 25 MG PO TABS,7437,6370005,,,1 Tab,00904-6927-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SPIRONOLACTONE 25 MG PO TABS,7437,6370005,,,1 Tab,00904-6927-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,STRESS FORMULA/ZINC PO TABS,7523,6370005,,,1 Tab,54629-0597-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,STRESS FORMULA/ZINC PO TABS,7523,6370005,,,1 Tab,54629-0597-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DAKINS (1/4 STRENGTH) 0.125 % EX SOLN,76724,6370005,,,473 mL,00436-0672-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,46.08,% of charge rate,100.00%,46.08,,,,43.78,46.08,1
unity,NDC,DAKINS (1/4 STRENGTH) 0.125 % EX SOLN,76724,6370005,,,473 mL,00436-0672-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,46.08,% of charge rate,100.00%,46.08,,,,43.78,46.08,1
unity,NDC,MEGESTROL ACETATE 400 MG/10ML PO SUSP,76824,6370005,,,10 mL,00121-4776-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.79,% of charge rate,100.00%,12.79,,,,12.15,12.79,1
unity,NDC,MEGESTROL ACETATE 400 MG/10ML PO SUSP,76824,6370005,,,10 mL,00121-4776-40,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,12.79,% of charge rate,100.00%,12.79,,,,12.15,12.79,1
unity,NDC,MEGESTROL ACETATE 400 MG/10ML PO SUSP,76824,6370005,,,10 mL,00121-4776-40,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.79,% of charge rate,100.00%,12.79,,,,12.15,12.79,1
unity,NDC,MEGESTROL ACETATE 400 MG/10ML PO SUSP,76824,6370005,,,10 mL,00121-4776-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,12.79,% of charge rate,100.00%,12.79,,,,12.15,12.79,1
unity,NDC,POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN,76913,6370005,,,15 mL,00121-1680-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.45,% of charge rate,100.00%,34.45,,,,32.73,34.45,1
unity,NDC,POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN,76913,6370005,,,15 mL,00121-1680-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.45,% of charge rate,100.00%,34.45,,,,32.73,34.45,1
unity,NDC,POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN,76913,6370005,,,15 mL,00121-1680-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.45,% of charge rate,100.00%,34.45,,,,32.73,34.45,1
unity,NDC,POTASSIUM CHLORIDE 20 MEQ/15ML (10%) PO SOLN,76913,6370005,,,15 mL,00121-1680-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.45,% of charge rate,100.00%,34.45,,,,32.73,34.45,1
unity,NDC,TEMAZEPAM 15 MG PO CAPS,7753,6370005,,,1 Cap,00228-2076-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TEMAZEPAM 15 MG PO CAPS,7753,6370005,,,1 Cap,00228-2076-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,77616,6370005,,,1 Tab,00006-0112-28,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.5,% of charge rate,100.00%,60.5,,,,57.48,60.5,1
unity,NDC,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,77616,6370005,,,1 Tab,00006-0112-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.5,% of charge rate,100.00%,60.5,,,,57.48,60.5,1
unity,NDC,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,77616,6370005,,,1 Tab,00006-0112-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.5,% of charge rate,100.00%,60.5,,,,57.48,60.5,1
unity,NDC,SITAGLIPTIN PHOSPHATE 50 MG PO TABS,77616,6370005,,,1 Tab,00006-0112-28,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.5,% of charge rate,100.00%,60.5,,,,57.48,60.5,1
unity,NDC,GUAIFENESIN-CODEINE 100-10 MG/5ML PO SYRP,78003,6370005,,,3 mL,00121-0775-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GUAIFENESIN-CODEINE 100-10 MG/5ML PO SYRP,78003,6370005,,,3 mL,00121-0775-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GUAIFENESIN-CODEINE 100-10 MG/5ML PO SOLN,79088,6370005,,,3 mL,00121-0775-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GUAIFENESIN-CODEINE 100-10 MG/5ML PO SOLN,79088,6370005,,,3 mL,00121-0775-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRAZODONE HCL 100 MG PO TABS,8083,6370005,,,1 Tab,00904-6869-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRAZODONE HCL 100 MG PO TABS,8083,6370005,,,1 Tab,00904-6869-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRAZODONE HCL 50 MG PO TABS,8085,6370005,,,1 Tab,00904-6868-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRAZODONE HCL 50 MG PO TABS,8085,6370005,,,1 Tab,00904-6868-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,TRIAMCINOLONE ACETONIDE 0.1 % EX CREA,8113,6370005,,,15 g,67877-0251-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,11.06,% of charge rate,100.00%,11.06,,,,10.51,11.06,1
unity,NDC,TRIAMCINOLONE ACETONIDE 0.1 % EX CREA,8113,6370005,,,15 g,67877-0251-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,11.06,% of charge rate,100.00%,11.06,,,,10.51,11.06,1
unity,NDC,GLUCOSE 40 % PO GEL,81823,6370005,,,37.5 g,00574-0070-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.32,% of charge rate,100.00%,38.32,,,,36.4,38.32,1
unity,NDC,GLUCOSE 40 % PO GEL,81823,6370005,,,37.5 g,00574-0070-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.32,% of charge rate,100.00%,38.32,,,,36.4,38.32,1
unity,NDC,BACLOFEN 10 MG PO TABS,860,6370005,,,1 Tab,00904-6475-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BACLOFEN 10 MG PO TABS,860,6370005,,,1 Tab,00904-6475-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BACLOFEN 20 MG PO TABS,861,6370005,,,1 Tab,00904-6476-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.49,% of charge rate,100.00%,4.49,,,,4.27,4.49,1
unity,NDC,BACLOFEN 20 MG PO TABS,861,6370005,,,1 Tab,00904-6476-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.49,% of charge rate,100.00%,4.49,,,,4.27,4.49,1
unity,NDC,VITAMIN B-12 500 MCG PO TABS,8657,6370005,,,1 Tab,77333-0937-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,VITAMIN B-12 500 MCG PO TABS,8657,6370005,,,1 Tab,77333-0937-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,51672-4028-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,62584-0984-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,62584-0984-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,62584-0984-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,62584-0984-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 2 MG PO TABS,8749,6370005,,,1 Tab,51672-4028-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,3.33,5,1
unity,NDC,WARFARIN SODIUM 5 MG PO TABS,8751,6370005,,,1 Tab,62584-0994-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 5 MG PO TABS,8751,6370005,,,1 Tab,62584-0994-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 5 MG PO TABS,8751,6370005,,,1 Tab,62584-0994-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,WARFARIN SODIUM 5 MG PO TABS,8751,6370005,,,1 Tab,62584-0994-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,OXYCODONE HCL 10 MG PO TABS,87795,6370005,,,1 Tab,68382-0794-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.58,% of charge rate,100.00%,4.58,,,,4.35,4.58,1
unity,NDC,OXYCODONE HCL 10 MG PO TABS,87795,6370005,,,1 Tab,68382-0794-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.58,% of charge rate,100.00%,4.58,,,,4.35,4.58,1
unity,NDC,OSELTAMIVIR PHOSPHATE 30 MG PO CAPS,88704,6370005,,,1 Cap,68180-0675-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.89,% of charge rate,100.00%,29.89,,,,28.4,29.89,1
unity,NDC,OSELTAMIVIR PHOSPHATE 30 MG PO CAPS,88704,6370005,,,1 Cap,68180-0675-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.89,% of charge rate,100.00%,29.89,,,,28.4,29.89,1
unity,NDC,NEBIVOLOL HCL 10 MG PO TABS,89286,6370005,,,1 Tab,00456-1410-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,29.34,% of charge rate,100.00%,29.34,,,,27.87,29.34,1
unity,NDC,NEBIVOLOL HCL 10 MG PO TABS,89286,6370005,,,1 Tab,00456-1410-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,29.34,% of charge rate,100.00%,29.34,,,,27.87,29.34,1
unity,NDC,ACYCLOVIR 400 MG PO TABS,8971,6370005,,,1 Tab,50268-0061-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACYCLOVIR 400 MG PO TABS,8971,6370005,,,1 Tab,50268-0061-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACYCLOVIR 400 MG PO TABS,8971,6370005,,,1 Tab,50268-0061-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACYCLOVIR 400 MG PO TABS,8971,6370005,,,1 Tab,50268-0061-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMIODARONE HCL 200 MG PO TABS,9066,6370005,,,1 Tab,00245-0147-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMIODARONE HCL 200 MG PO TABS,9066,6370005,,,1 Tab,00245-0147-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMLODIPINE BESYLATE 5 MG PO TABS,9071,6370005,,,1 Tab,00904-6370-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMLODIPINE BESYLATE 5 MG PO TABS,9071,6370005,,,1 Tab,00904-6370-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5ML PO SUSR,9080,6370005,,,3 mL,72508-0204-07,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.89,% of charge rate,100.00%,9.89,,,,9.4,9.89,1
unity,NDC,AMOXICILLIN-POT CLAVULANATE 250-62.5 MG/5ML PO SUSR,9080,6370005,,,3 mL,72508-0204-07,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.89,% of charge rate,100.00%,9.89,,,,9.4,9.89,1
unity,NDC,PHENAZOPYRIDINE HCL 97.5 MG PO TABS,91386,6370005,,,1 Tab,49781-0139-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PHENAZOPYRIDINE HCL 97.5 MG PO TABS,91386,6370005,,,1 Tab,49781-0139-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BENAZEPRIL HCL 20 MG PO TABS,9221,6370005,,,1 Tab,43547-0337-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BENAZEPRIL HCL 20 MG PO TABS,9221,6370005,,,1 Tab,43547-0337-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BUMETANIDE 0.5 MG PO TABS,9309,6370005,,,1 Tab,50268-0130-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.27,% of charge rate,100.00%,4.27,,,,4.06,4.27,1
unity,NDC,BUMETANIDE 0.5 MG PO TABS,9309,6370005,,,1 Tab,50268-0130-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.27,% of charge rate,100.00%,4.27,,,,4.06,4.27,1
unity,NDC,BUMETANIDE 0.5 MG PO TABS,9309,6370005,,,1 Tab,50268-0130-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.27,% of charge rate,100.00%,4.27,,,,4.06,4.27,1
unity,NDC,BUMETANIDE 0.5 MG PO TABS,9309,6370005,,,1 Tab,50268-0130-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.27,% of charge rate,100.00%,4.27,,,,4.06,4.27,1
unity,NDC,BUMETANIDE 1 MG PO TABS,9310,6370005,,,1 Tab,00904-7016-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.26,% of charge rate,100.00%,4.26,,,,4.05,4.26,1
unity,NDC,BUMETANIDE 1 MG PO TABS,9310,6370005,,,1 Tab,00904-7016-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.26,% of charge rate,100.00%,4.26,,,,4.05,4.26,1
unity,NDC,BUSPIRONE HCL 10 MG PO TABS,9323,6370005,,,1 Tab,51079-0986-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BUSPIRONE HCL 10 MG PO TABS,9323,6370005,,,1 Tab,51079-0986-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BUSPIRONE HCL 5 MG PO TABS,9324,6370005,,,1 Tab,51079-0985-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BUSPIRONE HCL 5 MG PO TABS,9324,6370005,,,1 Tab,51079-0985-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CALCITRIOL 0.25 MCG PO CAPS,9350,6370005,,,1 Cap,60687-0345-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CALCITRIOL 0.25 MCG PO CAPS,9350,6370005,,,1 Cap,60687-0345-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CALCITRIOL 0.25 MCG PO CAPS,9350,6370005,,,1 Cap,60687-0345-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CALCITRIOL 0.25 MCG PO CAPS,9350,6370005,,,1 Cap,60687-0345-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CALCIUM CARBONATE ANTACID 500 MG PO CHEW,9385,6370005,,,1 Tab,68084-0988-32,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.58,% of charge rate,100.00%,5.58,,,,5.3,5.58,1
unity,NDC,CALCIUM CARBONATE ANTACID 500 MG PO CHEW,9385,6370005,,,1 Tab,68084-0988-32,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.58,% of charge rate,100.00%,5.58,,,,5.3,5.58,1
unity,NDC,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,9407,6370005,,,1 Tab,68084-0093-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CARBIDOPA-LEVODOPA 25-100 MG PO TABS,9407,6370005,,,1 Tab,68084-0093-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CEFPODOXIME PROXETIL 200 MG PO TABS,9469,6370005,,,1 Tab,65862-0096-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.86,% of charge rate,100.00%,21.86,,,,20.77,21.86,1
unity,NDC,CEFPODOXIME PROXETIL 200 MG PO TABS,9469,6370005,,,1 Tab,65862-0096-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.86,% of charge rate,100.00%,21.86,,,,20.77,21.86,1
unity,NDC,CEPHALEXIN 500 MG PO CAPS,9500,6370005,,,1 Cap,60687-0163-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,1
unity,NDC,CEPHALEXIN 500 MG PO CAPS,9500,6370005,,,1 Cap,60687-0163-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,1
unity,NDC,CEPHALEXIN 500 MG PO CAPS,9500,6370005,,,1 Cap,60687-0163-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,1
unity,NDC,CEPHALEXIN 500 MG PO CAPS,9500,6370005,,,1 Cap,60687-0163-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,1
unity,NDC,CEPHALEXIN 125 MG/5ML PO SUSR,9501,6370005,,,100 mL,67877-0544-88,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,1
unity,NDC,CEPHALEXIN 125 MG/5ML PO SUSR,9501,6370005,,,100 mL,67877-0544-88,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,66.34,% of charge rate,100.00%,66.34,,,,63.02,66.34,1
unity,NDC,CEPHALEXIN 250 MG/5ML PO SUSR,9502,6370005,,,100 mL,00093-4177-73,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69.7,% of charge rate,100.00%,69.7,,,,66.22,69.7,1
unity,NDC,CEPHALEXIN 250 MG/5ML PO SUSR,9502,6370005,,,100 mL,00093-4177-73,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69.7,% of charge rate,100.00%,69.7,,,,66.22,69.7,1
unity,NDC,CETIRIZINE HCL 10 MG PO TABS,9506,6370005,,,1 Tab,00904-6717-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CETIRIZINE HCL 10 MG PO TABS,9506,6370005,,,1 Tab,00904-6717-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN,9516,6370005,,,15 mL,00116-2001-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CHLORHEXIDINE GLUCONATE 0.12 % MT SOLN,9516,6370005,,,15 mL,00116-2001-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLONAZEPAM 0.5 MG PO TABS,9637,6370005,,,1 Tab,43547-0406-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLONAZEPAM 0.5 MG PO TABS,9637,6370005,,,1 Tab,43547-0406-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLOTRIMAZOLE 10 MG MT TROC,9644,6370005,,,1 Tab,00054-4146-22,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CLOTRIMAZOLE 10 MG MT TROC,9644,6370005,,,1 Tab,00054-4146-22,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BENZONATATE 100 MG PO CAPS,988,6370005,,,1 Cap,67877-0573-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BENZONATATE 100 MG PO CAPS,988,6370005,,,1 Cap,67877-0573-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DOXAZOSIN MESYLATE 2 MG PO TABS,9895,6370005,,,1 Tab,68084-0851-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.02,% of charge rate,100.00%,5.02,,,,4.77,5.02,1
unity,NDC,DOXAZOSIN MESYLATE 2 MG PO TABS,9895,6370005,,,1 Tab,68084-0851-95,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5.02,% of charge rate,100.00%,5.02,,,,4.77,5.02,1
unity,NDC,DOXAZOSIN MESYLATE 2 MG PO TABS,9895,6370005,,,1 Tab,68084-0851-95,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.02,% of charge rate,100.00%,5.02,,,,4.77,5.02,1
unity,NDC,DOXAZOSIN MESYLATE 2 MG PO TABS,9895,6370005,,,1 Tab,68084-0851-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5.02,% of charge rate,100.00%,5.02,,,,4.77,5.02,1
unity,NDC,DOXYCYCLINE MONOHYDRATE 100 MG PO CAPS,9900,6370005,,,1 Cap,68084-0743-32,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DOXYCYCLINE MONOHYDRATE 100 MG PO CAPS,9900,6370005,,,1 Cap,68084-0743-33,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DOXYCYCLINE MONOHYDRATE 100 MG PO CAPS,9900,6370005,,,1 Cap,68084-0743-33,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DOXYCYCLINE MONOHYDRATE 100 MG PO CAPS,9900,6370005,,,1 Cap,68084-0743-32,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ENALAPRIL MALEATE 10 MG PO TABS,9924,6370005,,,1 Tab,00904-5610-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ENALAPRIL MALEATE 10 MG PO TABS,9924,6370005,,,1 Tab,00904-5610-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BENZTROPINE MESYLATE 0.5 MG PO TABS,998,6370005,,,1 Tab,76385-0103-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,BENZTROPINE MESYLATE 0.5 MG PO TABS,998,6370005,,,1 Tab,76385-0103-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.3,% of charge rate,100.00%,4.3,,,,4.09,4.3,1
unity,NDC,TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,8259,86580,,Tb intradermal test,0.1 mL,49281-0752-22,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,8259,86580,,Tb intradermal test,0.1 mL,49281-0752-21,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,8259,86580,,Tb intradermal test,0.1 mL,49281-0752-21,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,TUBERCULIN PPD 5 UNIT/0.1ML ID SOLN,8259,86580,,Tb intradermal test,0.1 mL,49281-0752-22,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,RABIES IMMUNE GLOBULIN 300 UNIT/ML INJ SOLN,142371,90375,,Rabies ig im/sc,1 mL,13533-0318-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,214.53",% of charge rate,100.00%,"1,214.53",,,,"1,153.80","1,214.53",1
unity,NDC,RABIES IMMUNE GLOBULIN 300 UNIT/ML INJ SOLN,142371,90375,,Rabies ig im/sc,1 mL,13533-0318-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,214.53",% of charge rate,100.00%,"1,214.53",,,,"1,153.80","1,214.53",1
unity,NDC,MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,130593,90620,,Menb-4c vacc 2 dose im,0.5 mL,58160-0976-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,243.61,% of charge rate,100.00%,243.61,,,,231.43,243.61,1
unity,NDC,MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,130593,90620,,Menb-4c vacc 2 dose im,0.5 mL,58160-0976-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,243.61,% of charge rate,100.00%,243.61,,,,231.43,243.61,1
unity,NDC,MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,130593,90620,,Menb-4c vacc 2 dose im,0.5 mL,58160-0976-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,243.61,% of charge rate,100.00%,243.61,,,,231.43,243.61,1
unity,NDC,MENINGOCOCCAL B RECOMB OMV ADJ IM SUSY,130593,90620,,Menb-4c vacc 2 dose im,0.5 mL,58160-0976-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,243.61,% of charge rate,100.00%,243.61,,,,231.43,243.61,1
unity,NDC,HEPATITIS A VACCINE 1440 EL U/ML IM SUSP,91034,90632,,Hepa vaccine adult im,1 mL,58160-0826-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,98.52,% of charge rate,100.00%,98.52,,,,93.59,98.52,1
unity,NDC,HEPATITIS A VACCINE 1440 EL U/ML IM SUSP,91034,90632,,Hepa vaccine adult im,1 mL,58160-0826-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,98.52,% of charge rate,100.00%,98.52,,,,93.59,98.52,1
unity,NDC,HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSP,91033,90633,,Hepa vacc ped/adol 2 dose im,0.5 mL,58160-0825-43,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.56,% of charge rate,100.00%,48.56,,,,46.13,48.56,1
unity,NDC,HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSP,91033,90633,,Hepa vacc ped/adol 2 dose im,0.5 mL,58160-0825-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.56,% of charge rate,100.00%,48.56,,,,46.13,48.56,1
unity,NDC,HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSP,91033,90633,,Hepa vacc ped/adol 2 dose im,0.5 mL,58160-0825-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.56,% of charge rate,100.00%,48.56,,,,46.13,48.56,1
unity,NDC,HEPATITIS A VACCINE 720 EL U/0.5ML IM SUSP,91033,90633,,Hepa vacc ped/adol 2 dose im,0.5 mL,58160-0825-43,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.56,% of charge rate,100.00%,48.56,,,,46.13,48.56,1
unity,NDC,HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG INJ SOLR,129283,90648,,Hib prp-t vaccine 4 dose im,0.5 mL,58160-0818-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,17.72,% of charge rate,100.00%,17.72,,,,16.83,17.72,1
unity,NDC,HAEMOPHILUS B POLYSAC CONJ VAC 10 MCG INJ SOLR,129283,90648,,Hib prp-t vaccine 4 dose im,0.5 mL,58160-0818-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,17.72,% of charge rate,100.00%,17.72,,,,16.83,17.72,1
unity,NDC,HPV 9-VALENT RECOMB VACCINE IM SUSY,130390,90651,,9vhpv vaccine 2/3 dose im,0.5 mL,00006-4121-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,336.48,% of charge rate,100.00%,336.48,,,,319.66,336.48,1
unity,NDC,HPV 9-VALENT RECOMB VACCINE IM SUSY,130390,90651,,9vhpv vaccine 2/3 dose im,0.5 mL,00006-4121-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,336.48,% of charge rate,100.00%,336.48,,,,319.66,336.48,1
unity,NDC,HPV 9-VALENT RECOMB VACCINE IM SUSY,130390,90651,,9vhpv vaccine 2/3 dose im,0.5 mL,00006-4121-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,336.48,% of charge rate,100.00%,336.48,,,,319.66,336.48,1
unity,NDC,HPV 9-VALENT RECOMB VACCINE IM SUSY,130390,90651,,9vhpv vaccine 2/3 dose im,0.5 mL,00006-4121-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,336.48,% of charge rate,100.00%,336.48,,,,319.66,336.48,1
unity,NDC,INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY,136361,90653,,Iiv adjuvant vaccine im,0.5 mL,70461-0020-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,1
unity,NDC,INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY,136361,90653,,Iiv adjuvant vaccine im,0.5 mL,70461-0020-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,1
unity,NDC,INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY,136361,90653,,Iiv adjuvant vaccine im,0.5 mL,70461-0020-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,1
unity,NDC,INFLUENZA VAC A&B SURF ANT ADJ 0.5 ML IM SUSY,136361,90653,,Iiv adjuvant vaccine im,0.5 mL,70461-0020-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,65,% of charge rate,100.00%,65,,,,61.75,65,1
unity,NDC,PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP,105941,90670,,Pcv13 vaccine im,0.5 mL,00005-1971-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,296.72,% of charge rate,100.00%,296.72,,,,281.88,296.72,1
unity,NDC,PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP,105941,90670,,Pcv13 vaccine im,0.5 mL,00005-1971-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,296.72,% of charge rate,100.00%,296.72,,,,281.88,296.72,1
unity,NDC,PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP,105941,90670,,Pcv13 vaccine im,0.5 mL,00005-1971-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,296.72,% of charge rate,100.00%,296.72,,,,281.88,296.72,1
unity,NDC,PNEUMOCOCCAL 13-VAL CONJ VACC IM SUSP,105941,90670,,Pcv13 vaccine im,0.5 mL,00005-1971-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,296.72,% of charge rate,100.00%,296.72,,,,281.88,296.72,1
unity,NDC,"RABIES VACCINE, PCEC IM SUSR",22120,90675,,Rabies vaccine im,1 mL,58160-0964-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,495.63,% of charge rate,100.00%,495.63,,,,470.85,495.63,1
unity,NDC,"RABIES VACCINE, PCEC IM SUSR",22120,90675,,Rabies vaccine im,1 mL,58160-0964-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,495.63,% of charge rate,100.00%,495.63,,,,470.85,495.63,1
unity,NDC,ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,125719,90680,,Rv5 vacc 3 dose live oral,2 mL,00006-4047-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125.58,% of charge rate,100.00%,125.58,,,,119.3,125.58,1
unity,NDC,ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,125719,90680,,Rv5 vacc 3 dose live oral,2 mL,00006-4047-41,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,125.58,% of charge rate,100.00%,125.58,,,,119.3,125.58,1
unity,NDC,ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,125719,90680,,Rv5 vacc 3 dose live oral,2 mL,00006-4047-41,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125.58,% of charge rate,100.00%,125.58,,,,119.3,125.58,1
unity,NDC,ROTAVIRUS VAC LIVE PENTAVALENT PO SOLN,125719,90680,,Rv5 vacc 3 dose live oral,2 mL,00006-4047-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,125.58,% of charge rate,100.00%,125.58,,,,119.3,125.58,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.25 ML IM SUSY,131179,90685,,Iiv4 vacc no prsv 0.25 ml im,0.25 mL,33332-0220-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.25 ML IM SUSY,131179,90685,,Iiv4 vacc no prsv 0.25 ml im,0.25 mL,33332-0220-21,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.25 ML IM SUSY,131179,90685,,Iiv4 vacc no prsv 0.25 ml im,0.25 mL,33332-0220-21,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.25 ML IM SUSY,131179,90685,,Iiv4 vacc no prsv 0.25 ml im,0.25 mL,33332-0220-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.5 ML IM SUSY,131180,90686,,Iiv4 vacc no prsv 0.5 ml im,0.5 mL,33332-0320-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.5 ML IM SUSY,131180,90686,,Iiv4 vacc no prsv 0.5 ml im,0.5 mL,33332-0320-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.5 ML IM SUSY,131180,90686,,Iiv4 vacc no prsv 0.5 ml im,0.5 mL,33332-0320-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,1
unity,NDC,INFLUENZA VAC SPLIT QUAD 0.5 ML IM SUSY,131180,90686,,Iiv4 vacc no prsv 0.5 ml im,0.5 mL,33332-0320-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25,% of charge rate,100.00%,25,,,,23.75,25,1
unity,NDC,DTAP-IPV VACCINE IM SUSP,92804,90696,,Dtap-ipv vaccine 4-6 yrs im,0.5 mL,58160-0812-43,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.29,% of charge rate,100.00%,72.29,,,,68.68,72.29,1
unity,NDC,DTAP-IPV VACCINE IM SUSP,92804,90696,,Dtap-ipv vaccine 4-6 yrs im,0.5 mL,58160-0812-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,72.29,% of charge rate,100.00%,72.29,,,,68.68,72.29,1
unity,NDC,DTAP-IPV VACCINE IM SUSP,92804,90696,,Dtap-ipv vaccine 4-6 yrs im,0.5 mL,58160-0812-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.29,% of charge rate,100.00%,72.29,,,,68.68,72.29,1
unity,NDC,DTAP-IPV VACCINE IM SUSP,92804,90696,,Dtap-ipv vaccine 4-6 yrs im,0.5 mL,58160-0812-43,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,72.29,% of charge rate,100.00%,72.29,,,,68.68,72.29,1
unity,NDC,DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP,19451,90700,,Dtap vaccine < 7 yrs im,0.5 mL,58160-0810-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.96,% of charge rate,100.00%,31.96,,,,30.36,31.96,1
unity,NDC,DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP,19451,90700,,Dtap vaccine < 7 yrs im,0.5 mL,58160-0810-43,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,31.96,% of charge rate,100.00%,31.96,,,,30.36,31.96,1
unity,NDC,DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP,19451,90700,,Dtap vaccine < 7 yrs im,0.5 mL,58160-0810-43,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.96,% of charge rate,100.00%,31.96,,,,30.36,31.96,1
unity,NDC,DIPHTH-ACELL PERTUSSIS-TETANUS 25-58-10 LF-MCG/0.5 IM SUSP,19451,90700,,Dtap vaccine < 7 yrs im,0.5 mL,58160-0810-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,31.96,% of charge rate,100.00%,31.96,,,,30.36,31.96,1
unity,NDC,"MEASLES, MUMPS & RUBELLA VAC INJ SOLR",146230,90707,,Mmr vaccine sc,0.5 mL,00006-4681-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.53,% of charge rate,100.00%,116.53,,,,110.7,116.53,1
unity,NDC,"MEASLES, MUMPS & RUBELLA VAC INJ SOLR",146230,90707,,Mmr vaccine sc,0.5 mL,00006-4681-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.53,% of charge rate,100.00%,116.53,,,,110.7,116.53,1
unity,NDC,"MEASLES, MUMPS & RUBELLA VAC INJ SOLR",146230,90707,,Mmr vaccine sc,0.5 mL,00006-4681-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.53,% of charge rate,100.00%,116.53,,,,110.7,116.53,1
unity,NDC,"MEASLES, MUMPS & RUBELLA VAC INJ SOLR",146230,90707,,Mmr vaccine sc,0.5 mL,00006-4681-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.53,% of charge rate,100.00%,116.53,,,,110.7,116.53,1
unity,NDC,MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR,143426,90710,,Mmrv vaccine sc,0.5 mL,00006-4171-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,334.41,% of charge rate,100.00%,334.41,,,,317.69,334.41,1
unity,NDC,MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR,143426,90710,,Mmrv vaccine sc,0.5 mL,00006-4171-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,334.41,% of charge rate,100.00%,334.41,,,,317.69,334.41,1
unity,NDC,MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR,143426,90710,,Mmrv vaccine sc,0.5 mL,00006-4171-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,334.41,% of charge rate,100.00%,334.41,,,,317.69,334.41,1
unity,NDC,MEASLES-MUMPS-RUBELLA-VARICELL SC SUSR,143426,90710,,Mmrv vaccine sc,0.5 mL,00006-4171-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,334.41,% of charge rate,100.00%,334.41,,,,317.69,334.41,1
unity,NDC,TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,11515,90714,,Td vacc no presv 7 yrs+ im,0.5 mL,49281-0215-15,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.16,% of charge rate,100.00%,45.16,,,,42.9,45.16,1
unity,NDC,TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,11515,90714,,Td vacc no presv 7 yrs+ im,0.5 mL,49281-0215-88,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.16,% of charge rate,100.00%,45.16,,,,42.9,45.16,1
unity,NDC,TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,11515,90714,,Td vacc no presv 7 yrs+ im,0.5 mL,49281-0215-88,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.16,% of charge rate,100.00%,45.16,,,,42.9,45.16,1
unity,NDC,TETANUS-DIPHTHERIA TOXOIDS TD 5-2 LFU IM INJ,11515,90714,,Td vacc no presv 7 yrs+ im,0.5 mL,49281-0215-15,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.16,% of charge rate,100.00%,45.16,,,,42.9,45.16,1
unity,NDC,TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP,41293,90715,,Tdap vaccine 7 yrs/> im,0.5 mL,58160-0842-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,61.93,% of charge rate,100.00%,61.93,,,,58.83,61.93,1
unity,NDC,TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP,41293,90715,,Tdap vaccine 7 yrs/> im,0.5 mL,58160-0842-43,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,61.93,% of charge rate,100.00%,61.93,,,,58.83,61.93,1
unity,NDC,TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP,41293,90715,,Tdap vaccine 7 yrs/> im,0.5 mL,58160-0842-43,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,61.93,% of charge rate,100.00%,61.93,,,,58.83,61.93,1
unity,NDC,TETANUS-DIPHTH-ACELL PERTUSSIS 5-2.5-18.5 LF-MCG/0.5 IM SUSP,41293,90715,,Tdap vaccine 7 yrs/> im,0.5 mL,58160-0842-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,61.93,% of charge rate,100.00%,61.93,,,,58.83,61.93,1
unity,NDC,VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML SC INJ,117216,90716,,Var vaccine live subq,0.5 mL,00006-4827-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,192.39,% of charge rate,100.00%,192.39,,,,182.77,192.39,1
unity,NDC,VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML SC INJ,117216,90716,,Var vaccine live subq,0.5 mL,00006-4827-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,192.39,% of charge rate,100.00%,192.39,,,,182.77,192.39,1
unity,NDC,VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML SC INJ,117216,90716,,Var vaccine live subq,0.5 mL,00006-4827-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,192.39,% of charge rate,100.00%,192.39,,,,182.77,192.39,1
unity,NDC,VARICELLA VIRUS VACCINE LIVE 1350 PFU/0.5ML SC INJ,117216,90716,,Var vaccine live subq,0.5 mL,00006-4827-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,192.39,% of charge rate,100.00%,192.39,,,,182.77,192.39,1
unity,NDC,DTAP-HEPATITIS B RECOMB-IPV IM SUSP,34550,90723,,Dtap-hep b-ipv vaccine im,0.5 mL,58160-0811-43,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,117.43,% of charge rate,100.00%,117.43,,,,111.56,117.43,1
unity,NDC,DTAP-HEPATITIS B RECOMB-IPV IM SUSP,34550,90723,,Dtap-hep b-ipv vaccine im,0.5 mL,58160-0811-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,117.43,% of charge rate,100.00%,117.43,,,,111.56,117.43,1
unity,NDC,DTAP-HEPATITIS B RECOMB-IPV IM SUSP,34550,90723,,Dtap-hep b-ipv vaccine im,0.5 mL,58160-0811-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,117.43,% of charge rate,100.00%,117.43,,,,111.56,117.43,1
unity,NDC,DTAP-HEPATITIS B RECOMB-IPV IM SUSP,34550,90723,,Dtap-hep b-ipv vaccine im,0.5 mL,58160-0811-43,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,117.43,% of charge rate,100.00%,117.43,,,,111.56,117.43,1
unity,NDC,PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJ INJ,11037,90732,,Ppsv23 vacc 2 yrs+ subq/im,0.5 mL,00006-4837-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,144.53,% of charge rate,100.00%,144.53,,,,137.3,144.53,1
unity,NDC,PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJ INJ,11037,90732,,Ppsv23 vacc 2 yrs+ subq/im,0.5 mL,00006-4837-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,144.53,% of charge rate,100.00%,144.53,,,,137.3,144.53,1
unity,NDC,PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJ INJ,11037,90732,,Ppsv23 vacc 2 yrs+ subq/im,0.5 mL,00006-4837-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,144.53,% of charge rate,100.00%,144.53,,,,137.3,144.53,1
unity,NDC,PNEUMOCOCCAL VAC POLYVALENT 25 MCG/0.5ML INJ INJ,11037,90732,,Ppsv23 vacc 2 yrs+ subq/im,0.5 mL,00006-4837-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,144.53,% of charge rate,100.00%,144.53,,,,137.3,144.53,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR,105726,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,58160-0955-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,187.71,% of charge rate,100.00%,187.71,,,,178.32,187.71,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 OLIG IM SOLR,105726,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,58160-0955-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,187.71,% of charge rate,100.00%,187.71,,,,178.32,187.71,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 CONJ IM INJ,40540,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,49281-0589-58,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,174.84,% of charge rate,100.00%,174.84,,,,166.1,174.84,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 CONJ IM INJ,40540,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,49281-0589-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,174.84,% of charge rate,100.00%,174.84,,,,166.1,174.84,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 CONJ IM INJ,40540,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,49281-0589-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,174.84,% of charge rate,100.00%,174.84,,,,166.1,174.84,1
unity,NDC,MENINGOCOCCAL A C Y&W-135 CONJ IM INJ,40540,90734,,Menacwyd/menacwycrm vacc im,0.5 mL,49281-0589-58,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,174.84,% of charge rate,100.00%,174.84,,,,166.1,174.84,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJ SUSP,27325,90744,,Hepb vacc 3 dose ped/adol im,0.5 mL,58160-0820-43,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.62,% of charge rate,100.00%,34.62,,,,32.89,34.62,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJ SUSP,27325,90744,,Hepb vacc 3 dose ped/adol im,0.5 mL,58160-0820-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.62,% of charge rate,100.00%,34.62,,,,32.89,34.62,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJ SUSP,27325,90744,,Hepb vacc 3 dose ped/adol im,0.5 mL,58160-0820-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.62,% of charge rate,100.00%,34.62,,,,32.89,34.62,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/0.5ML INJ SUSP,27325,90744,,Hepb vacc 3 dose ped/adol im,0.5 mL,58160-0820-43,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.62,% of charge rate,100.00%,34.62,,,,32.89,34.62,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/ML INJ SUSP,27324,90746,,Hepb vaccine 3 dose adult im,1 mL,00006-4995-41,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,89.72,% of charge rate,100.00%,89.72,,,,85.23,89.72,1
unity,NDC,HEPATITIS B VAC RECOMBINANT 10 MCG/ML INJ SUSP,27324,90746,,Hepb vaccine 3 dose adult im,1 mL,00006-4995-41,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,89.72,% of charge rate,100.00%,89.72,,,,85.23,89.72,1
unity,NDC,ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,141122,90750,,Hzv vacc recombinant im,0.5 mL,58160-0819-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,223.8,% of charge rate,100.00%,223.8,,,,212.61,223.8,1
unity,NDC,ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,141122,90750,,Hzv vacc recombinant im,0.5 mL,58160-0823-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,223.8,% of charge rate,100.00%,223.8,,,,212.61,223.8,1
unity,NDC,ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,141122,90750,,Hzv vacc recombinant im,0.5 mL,58160-0819-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,223.8,% of charge rate,100.00%,223.8,,,,212.61,223.8,1
unity,NDC,ZOSTER VAC RECOMB ADJUVANTED 50 MCG/0.5ML IM SUSR,141122,90750,,Hzv vacc recombinant im,0.5 mL,58160-0823-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,223.8,% of charge rate,100.00%,223.8,,,,212.61,223.8,1
unity,NDC,PROCHLORPERAZINE 25 MG REC SUPP,11138,99070,,Special supplies phys/qhp,1 Suppository,00713-0135-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,13.72,% of charge rate,100.00%,13.72,,,,13.03,13.72,1
unity,NDC,PROCHLORPERAZINE 25 MG REC SUPP,11138,99070,,Special supplies phys/qhp,1 Suppository,00713-0135-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,13.72,% of charge rate,100.00%,13.72,,,,13.03,13.72,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,63807-0100-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,63807-0100-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,92670-0012-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",5 mL,08290-3065-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-0940-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-3065-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-3065-53,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08881-5701-21,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08881-5791-21,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08881-5791-21,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08881-5701-21,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-3065-53,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-3065-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,08290-0940-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",5 mL,08290-3065-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,92670-0012-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,63807-0100-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,SODIUM CHLORIDE FLUSH 0.9 % IV SOLN,106810,A4216,,"Sterile water/saline, 10 ml",10 mL,63807-0100-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,5,% of charge rate,100.00%,5,,,,4.75,5,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",50 mL,00409-4887-50,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",10 mL,00409-4887-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",10 mL,00409-4887-17,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",20 mL,00409-4887-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",20 mL,00409-4887-23,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",20 mL,00409-4887-23,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",20 mL,00409-4887-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",10 mL,00409-4887-17,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",10 mL,00409-4887-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,STERILE WATER FOR INJECTION INJ SOLN,7484,A4216,,"Sterile water/saline, 10 ml",50 mL,00409-4887-50,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HYDRALAZINE HCL 50 MG PO TABS,3701,A9270,,Non-covered item or service,1 Tab,00904-6442-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDRALAZINE HCL 50 MG PO TABS,3701,A9270,,Non-covered item or service,1 Tab,00904-6442-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,GADOBUTROL 1 MMOL/ML IV SOLN,111718,A9585,,Gadobutrol injection,10 mL,50419-0325-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87,% of charge rate,100.00%,87,,,,82.65,87,1
unity,NDC,GADOBUTROL 1 MMOL/ML IV SOLN,111718,A9585,,Gadobutrol injection,10 mL,50419-0325-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87,% of charge rate,100.00%,87,,,,82.65,87,1
unity,NDC,BUPIVACAINE LIPOSOME 1.3 % INJ SUSP,115193,C9290,,BUPIVACAINE LIPOSOME 266mg/20mL vial (266 Jcode units/vial),5 mL,65250-0266-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,217.59,% of charge rate,100.00%,217.59,,,,206.71,217.59,1
unity,NDC,BUPIVACAINE LIPOSOME 1.3 % INJ SUSP,115193,C9290,,BUPIVACAINE LIPOSOME 266mg/20mL vial (266 Jcode units/vial),5 mL,65250-0266-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,217.59,% of charge rate,100.00%,217.59,,,,206.71,217.59,1
unity,NDC,LIRAGLUTIDE 18 MG/3ML SC SOPN,127467,C9399,,,3 mL,00169-4060-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,751.63,% of charge rate,100.00%,751.63,,,,714.05,751.63,1
unity,NDC,LIRAGLUTIDE 18 MG/3ML SC SOPN,127467,C9399,,,3 mL,00169-4060-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,751.63,% of charge rate,100.00%,751.63,,,,714.05,751.63,1
unity,NDC,ACETAMINOPHEN 10 MG/ML IV SOLN,110322,J0131,,Acetaminophen injection,100 mL,43825-0102-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,205.97,% of charge rate,100.00%,205.97,,,,195.67,205.97,1
unity,NDC,ACETAMINOPHEN 10 MG/ML IV SOLN,110322,J0131,,Acetaminophen injection,100 mL,43825-0102-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,205.97,% of charge rate,100.00%,205.97,,,,195.67,205.97,1
unity,NDC,ACETYLCYSTEINE 200 MG/ML IV SOLN,38303,J0132,,Acetylcysteine injection,30 mL,25021-0812-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,165.14,% of charge rate,100.00%,165.14,,,,156.88,165.14,1
unity,NDC,ACETYLCYSTEINE 200 MG/ML IV SOLN,38303,J0132,,Acetylcysteine injection,30 mL,25021-0812-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,165.14,% of charge rate,100.00%,165.14,,,,156.88,165.14,1
unity,NDC,ADENOSINE 6 MG/2ML IV SOLN,38703,J0153,,Adenosine inj 1mg,1 mL,17478-0542-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ADENOSINE 6 MG/2ML IV SOLN,38703,J0153,,Adenosine inj 1mg,1 mL,17478-0542-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,54288-0103-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,42023-0159-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,54288-0103-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,54288-0103-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,42023-0159-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE PF 1 MG/ML INJ SOLN,140776,J0171,,Adrenalin epinephrine inject,1 mL,54288-0103-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,53.38,% of charge rate,100.00%,53.38,,,,50.71,53.38,1
unity,NDC,EPINEPHRINE 1 MG/10ML INJ SOSY,143129,J0171,,Adrenalin epinephrine inject,10 mL,00409-4921-34,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.97,% of charge rate,100.00%,32.97,,,,31.32,32.97,1
unity,NDC,EPINEPHRINE 1 MG/10ML INJ SOSY,143129,J0171,,Adrenalin epinephrine inject,10 mL,00409-4921-34,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.97,% of charge rate,100.00%,32.97,,,,31.32,32.97,1
unity,NDC,AMIODARONE HCL 150 MG/3ML IV SOLN,93167,J0282,,Amiodarone hcl,3 mL,63323-0616-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMIODARONE HCL 150 MG/3ML IV SOLN,93167,J0282,,Amiodarone hcl,3 mL,63323-0616-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN SODIUM 1 G INJ SOLR,469,J0290,,Ampicillin 500 mg inj,"1,000 mg",55150-0113-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN SODIUM 1 G INJ SOLR,469,J0290,,Ampicillin 500 mg inj,"1,000 mg",55150-0113-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN SODIUM 2 G INJ SOLR,472,J0290,,Ampicillin 500 mg inj,2 g,55150-0114-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN SODIUM 2 G INJ SOLR,472,J0290,,Ampicillin 500 mg inj,2 g,55150-0114-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 1.5 (1-0.5) G INJ SOLR,9083,J0295,,Ampicillin sulbactam 1.5 gm,1.5 g,55150-0116-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 1.5 (1-0.5) G INJ SOLR,9083,J0295,,Ampicillin sulbactam 1.5 gm,1.5 g,71288-0005-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 1.5 (1-0.5) G INJ SOLR,9083,J0295,,Ampicillin sulbactam 1.5 gm,1.5 g,71288-0005-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 1.5 (1-0.5) G INJ SOLR,9083,J0295,,Ampicillin sulbactam 1.5 gm,1.5 g,55150-0116-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 3 (2-1) G INJ SOLR,9084,J0295,,Ampicillin sulbactam 1.5 gm,3 g,00049-0014-83,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AMPICILLIN-SULBACTAM SODIUM 3 (2-1) G INJ SOLR,9084,J0295,,Ampicillin sulbactam 1.5 gm,3 g,00049-0014-83,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN,7536,J0330,,Succinycholine chloride inj,10 mL,51991-0964-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.8,% of charge rate,100.00%,58.8,,,,55.86,58.8,1
unity,NDC,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN,7536,J0330,,Succinycholine chloride inj,10 mL,51991-0964-99,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.8,% of charge rate,100.00%,58.8,,,,55.86,58.8,1
unity,NDC,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN,7536,J0330,,Succinycholine chloride inj,10 mL,51991-0964-99,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.8,% of charge rate,100.00%,58.8,,,,55.86,58.8,1
unity,NDC,SUCCINYLCHOLINE CHLORIDE 20 MG/ML INJ SOLN,7536,J0330,,Succinycholine chloride inj,10 mL,51991-0964-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.8,% of charge rate,100.00%,58.8,,,,55.86,58.8,1
unity,NDC,HYDRALAZINE HCL 20 MG/ML INJ SOLN,3697,J0360,,Hydralazine hcl injection,1 mL,63323-0614-55,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50.81,% of charge rate,100.00%,50.81,,,,48.27,50.81,1
unity,NDC,HYDRALAZINE HCL 20 MG/ML INJ SOLN,3697,J0360,,Hydralazine hcl injection,1 mL,63323-0614-55,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50.81,% of charge rate,100.00%,50.81,,,,48.27,50.81,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70436-0019-82,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70860-0100-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70860-0100-41,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70860-0100-41,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70860-0100-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,AZITHROMYCIN 500 MG IV SOLR,21063,J0456,,Azithromycin,500 mg,70436-0019-82,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ATROPINE SULFATE 1 MG/10ML INJ SOSY,139198,J0461,,Atropine sulfate injection,10 mL,00409-1630-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,30.12,% of charge rate,100.00%,30.12,,,,28.61,30.12,1
unity,NDC,ATROPINE SULFATE 1 MG/10ML INJ SOSY,139198,J0461,,Atropine sulfate injection,10 mL,00409-1630-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,30.12,% of charge rate,100.00%,30.12,,,,28.61,30.12,1
unity,NDC,ATROPINE SULFATE 0.4 MG/ML INJ SOLN,731,J0461,,Atropine sulfate injection,1 mL,00517-0401-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,25.54,% of charge rate,100.00%,25.54,,,,24.26,25.54,1
unity,NDC,ATROPINE SULFATE 0.4 MG/ML INJ SOLN,731,J0461,,Atropine sulfate injection,1 mL,00517-0401-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,25.54,% of charge rate,100.00%,25.54,,,,24.26,25.54,1
unity,NDC,DICYCLOMINE HCL 20 MG PO TABS,2420,J0500,,Dicyclomine injection,1 Tab,60687-0380-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DICYCLOMINE HCL 20 MG PO TABS,2420,J0500,,Dicyclomine injection,1 Tab,60687-0380-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DICYCLOMINE HCL 20 MG PO TABS,2420,J0500,,Dicyclomine injection,1 Tab,60687-0380-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DICYCLOMINE HCL 20 MG PO TABS,2420,J0500,,Dicyclomine injection,1 Tab,60687-0380-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,CALCIUM GLUCONATE 10 % IV SOLN,1312,J0610,,Calcium gluconate injection,5 mL,63323-0360-19,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.14,% of charge rate,100.00%,24.14,,,,22.93,24.14,1
unity,NDC,CALCIUM GLUCONATE 10 % IV SOLN,1312,J0610,,Calcium gluconate injection,5 mL,63323-0360-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,24.14,% of charge rate,100.00%,24.14,,,,22.93,24.14,1
unity,NDC,CALCIUM GLUCONATE 10 % IV SOLN,1312,J0610,,Calcium gluconate injection,5 mL,63323-0360-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.14,% of charge rate,100.00%,24.14,,,,22.93,24.14,1
unity,NDC,CALCIUM GLUCONATE 10 % IV SOLN,1312,J0610,,Calcium gluconate injection,5 mL,63323-0360-19,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,24.14,% of charge rate,100.00%,24.14,,,,22.93,24.14,1
unity,NDC,LEUCOVORIN CALCIUM 500 MG INJ SOLR,23617,J0640,,Leucovorin calcium injection,500 mg,63323-0711-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,204.51,% of charge rate,100.00%,204.51,,,,194.28,204.51,1
unity,NDC,LEUCOVORIN CALCIUM 500 MG INJ SOLR,23617,J0640,,Leucovorin calcium injection,500 mg,63323-0711-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,204.51,% of charge rate,100.00%,204.51,,,,194.28,204.51,1
unity,NDC,LEUCOVORIN CALCIUM 350 MG INJ SOLR,4393,J0640,,Leucovorin calcium injection,350 mg,00703-5145-91,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,49.15,% of charge rate,100.00%,49.15,,,,46.69,49.15,1
unity,NDC,LEUCOVORIN CALCIUM 350 MG INJ SOLR,4393,J0640,,Leucovorin calcium injection,350 mg,00703-5145-91,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,49.15,% of charge rate,100.00%,49.15,,,,46.69,49.15,1
unity,NDC,CEFAZOLIN SODIUM-DEXTROSE 1-4 GM-%(50ML) IV SOLR,143541,J0690,,Cefazolin sodium injection,50 mL,00264-3103-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,86.79,% of charge rate,100.00%,86.79,,,,82.45,86.79,1
unity,NDC,CEFAZOLIN SODIUM-DEXTROSE 1-4 GM-%(50ML) IV SOLR,143541,J0690,,Cefazolin sodium injection,50 mL,00264-3103-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,86.79,% of charge rate,100.00%,86.79,,,,82.45,86.79,1
unity,NDC,CEFTOLOZANE-TAZOBACTAM 1.5 (1-0.5) G IV SOLR,130445,J0695,,Inj ceftolozane tazobactam,1.5 g,67919-0030-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,324.78,% of charge rate,100.00%,324.78,,,,308.54,324.78,1
unity,NDC,CEFTOLOZANE-TAZOBACTAM 1.5 (1-0.5) G IV SOLR,130445,J0695,,Inj ceftolozane tazobactam,1.5 g,67919-0030-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,324.78,% of charge rate,100.00%,324.78,,,,308.54,324.78,1
unity,NDC,CEFTRIAXONE SODIUM-DEXTROSE 1-3.74 GM-%(50ML) IV SOLR,143539,J0696,,Ceftriaxone sodium injection,50 mL,00264-3153-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,109.87,% of charge rate,100.00%,109.87,,,,104.38,109.87,1
unity,NDC,CEFTRIAXONE SODIUM-DEXTROSE 1-3.74 GM-%(50ML) IV SOLR,143539,J0696,,Ceftriaxone sodium injection,50 mL,00264-3153-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,109.87,% of charge rate,100.00%,109.87,,,,104.38,109.87,1
unity,NDC,CEFTRIAXONE SODIUM-DEXTROSE 2-2.22 GM-%(50ML) IV SOLR,143546,J0696,,Ceftriaxone sodium injection,50 mL,00264-3155-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,137.51,% of charge rate,100.00%,137.51,,,,130.63,137.51,1
unity,NDC,CEFTRIAXONE SODIUM-DEXTROSE 2-2.22 GM-%(50ML) IV SOLR,143546,J0696,,Ceftriaxone sodium injection,50 mL,00264-3155-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,137.51,% of charge rate,100.00%,137.51,,,,130.63,137.51,1
unity,NDC,CEFTRIAXONE SODIUM 1 G INJ SOLR,9487,J0696,,Ceftriaxone sodium injection,1 g,25021-0106-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,26.5,% of charge rate,100.00%,26.5,,,,25.18,26.5,1
unity,NDC,CEFTRIAXONE SODIUM 1 G INJ SOLR,9487,J0696,,Ceftriaxone sodium injection,1 g,25021-0106-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,26.5,% of charge rate,100.00%,26.5,,,,25.18,26.5,1
unity,NDC,CEFTAROLINE FOSAMIL 600 MG IV SOLR,109957,J0712,,Ceftaroline fosamil inj,600 mg,00456-0600-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,509.02,% of charge rate,100.00%,509.02,,,,483.57,509.02,1
unity,NDC,CEFTAROLINE FOSAMIL 600 MG IV SOLR,109957,J0712,,Ceftaroline fosamil inj,600 mg,00456-0600-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,509.02,% of charge rate,100.00%,509.02,,,,483.57,509.02,1
unity,NDC,CEFTAROLINE FOSAMIL 600 MG IV SOLR,109957,J0712,,Ceftaroline fosamil inj,600 mg,00456-0600-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,509.02,% of charge rate,100.00%,509.02,,,,483.57,509.02,1
unity,NDC,CEFTAROLINE FOSAMIL 600 MG IV SOLR,109957,J0712,,Ceftaroline fosamil inj,600 mg,00456-0600-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,509.02,% of charge rate,100.00%,509.02,,,,483.57,509.02,1
unity,NDC,CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN,91238,J0744,,Ciprofloxacin iv,200 mL,36000-0298-24,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,58.8,% of charge rate,100.00%,58.8,,,,55.86,58.8,1
unity,NDC,CIPROFLOXACIN IN D5W 400 MG/200ML IV SOLN,91238,J0744,,Ciprofloxacin iv,200 mL,36000-0298-24,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,58.8,% of charge rate,100.00%,58.8,,,,55.86,58.8,1
unity,NDC,PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJ SOLN,144862,J0780,,Prochlorperazine injection,1 mL,23155-0294-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.71,% of charge rate,100.00%,40.71,,,,38.67,40.71,1
unity,NDC,PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJ SOLN,144862,J0780,,Prochlorperazine injection,2 mL,23155-0294-42,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.71,% of charge rate,100.00%,40.71,,,,38.67,40.71,1
unity,NDC,PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJ SOLN,144862,J0780,,Prochlorperazine injection,2 mL,23155-0294-42,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.71,% of charge rate,100.00%,40.71,,,,38.67,40.71,1
unity,NDC,PROCHLORPERAZINE EDISYLATE 10 MG/2ML INJ SOLN,144862,J0780,,Prochlorperazine injection,1 mL,23155-0294-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.71,% of charge rate,100.00%,40.71,,,,38.67,40.71,1
unity,NDC,DAPTOMYCIN 350 MG IV SOLR,142780,J0878,,Daptomycin injection,350 mg,16729-0434-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,187.93,% of charge rate,100.00%,187.93,,,,178.53,187.93,1
unity,NDC,DAPTOMYCIN 350 MG IV SOLR,142780,J0878,,Daptomycin injection,350 mg,16729-0434-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,187.93,% of charge rate,100.00%,187.93,,,,178.53,187.93,1
unity,NDC,DAPTOMYCIN 500 MG IV SOLR,36989,J0878,,Daptomycin injection,500 mg,69097-0807-37,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,253.18,% of charge rate,100.00%,253.18,,,,240.52,253.18,1
unity,NDC,DAPTOMYCIN 500 MG IV SOLR,36989,J0878,,Daptomycin injection,500 mg,69097-0807-37,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,253.18,% of charge rate,100.00%,253.18,,,,240.52,253.18,1
unity,NDC,DARBEPOETIN ALFA 40 MCG/0.4ML INJ SOSY,133115,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0021-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,437.75,% of charge rate,100.00%,437.75,,,,415.86,437.75,1
unity,NDC,DARBEPOETIN ALFA 40 MCG/0.4ML INJ SOSY,133115,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0021-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,437.75,% of charge rate,100.00%,437.75,,,,415.86,437.75,1
unity,NDC,DARBEPOETIN ALFA 40 MCG/0.4ML INJ SOSY,133115,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0021-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,437.75,% of charge rate,100.00%,437.75,,,,415.86,437.75,1
unity,NDC,DARBEPOETIN ALFA 40 MCG/0.4ML INJ SOSY,133115,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0021-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,437.75,% of charge rate,100.00%,437.75,,,,415.86,437.75,1
unity,NDC,DARBEPOETIN ALFA 60 MCG/0.3ML INJ SOSY,133117,J0882,,"Darbepoetin alfa, esrd use",0.3 mL,55513-0023-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,618.97",% of charge rate,100.00%,"2,618.97",,,,"2,488.02","2,618.97",1
unity,NDC,DARBEPOETIN ALFA 60 MCG/0.3ML INJ SOSY,133117,J0882,,"Darbepoetin alfa, esrd use",0.3 mL,55513-0023-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,618.97",% of charge rate,100.00%,"2,618.97",,,,"2,488.02","2,618.97",1
unity,NDC,DARBEPOETIN ALFA 60 MCG/0.3ML INJ SOSY,133117,J0882,,"Darbepoetin alfa, esrd use",0.3 mL,55513-0023-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,618.97",% of charge rate,100.00%,"2,618.97",,,,"2,488.02","2,618.97",1
unity,NDC,DARBEPOETIN ALFA 60 MCG/0.3ML INJ SOSY,133117,J0882,,"Darbepoetin alfa, esrd use",0.3 mL,55513-0023-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,618.97",% of charge rate,100.00%,"2,618.97",,,,"2,488.02","2,618.97",1
unity,NDC,DARBEPOETIN ALFA 100 MCG/0.5ML INJ SOSY,133120,J0882,,"Darbepoetin alfa, esrd use",0.5 mL,55513-0025-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,909.07",% of charge rate,100.00%,"1,909.07",,,,"1,813.62","1,909.07",1
unity,NDC,DARBEPOETIN ALFA 100 MCG/0.5ML INJ SOSY,133120,J0882,,"Darbepoetin alfa, esrd use",0.5 mL,55513-0025-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,909.07",% of charge rate,100.00%,"1,909.07",,,,"1,813.62","1,909.07",1
unity,NDC,DARBEPOETIN ALFA 100 MCG/0.5ML INJ SOSY,133120,J0882,,"Darbepoetin alfa, esrd use",0.5 mL,55513-0025-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,909.07",% of charge rate,100.00%,"1,909.07",,,,"1,813.62","1,909.07",1
unity,NDC,DARBEPOETIN ALFA 100 MCG/0.5ML INJ SOSY,133120,J0882,,"Darbepoetin alfa, esrd use",0.5 mL,55513-0025-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,909.07",% of charge rate,100.00%,"1,909.07",,,,"1,813.62","1,909.07",1
unity,NDC,DARBEPOETIN ALFA 200 MCG/0.4ML INJ SOSY,133124,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0028-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,800.39",% of charge rate,100.00%,"3,800.39",,,,"3,610.37","3,800.39",1
unity,NDC,DARBEPOETIN ALFA 200 MCG/0.4ML INJ SOSY,133124,J0882,,"Darbepoetin alfa, esrd use",0.4 mL,55513-0028-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,800.39",% of charge rate,100.00%,"3,800.39",,,,"3,610.37","3,800.39",1
unity,NDC,DARBEPOETIN ALFA 300 MCG/0.6ML INJ SOSY,133125,J0882,,"Darbepoetin alfa, esrd use",0.6 mL,55513-0111-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,724.18",% of charge rate,100.00%,"5,724.18",,,,"5,437.97","5,724.18",1
unity,NDC,DARBEPOETIN ALFA 300 MCG/0.6ML INJ SOSY,133125,J0882,,"Darbepoetin alfa, esrd use",0.6 mL,55513-0111-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,724.18",% of charge rate,100.00%,"5,724.18",,,,"5,437.97","5,724.18",1
unity,NDC,DENOSUMAB 120 MG/1.7ML SC SOLN,109717,J0897,,Denosumab injection,1.7 mL,55513-0730-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"6,065.96",% of charge rate,100.00%,"6,065.96",,,,"5,762.66","6,065.96",1
unity,NDC,DENOSUMAB 120 MG/1.7ML SC SOLN,109717,J0897,,Denosumab injection,1.7 mL,55513-0730-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"6,065.96",% of charge rate,100.00%,"6,065.96",,,,"5,762.66","6,065.96",1
unity,NDC,DENOSUMAB 60 MG/ML SC SOSY,144893,J0897,,Denosumab injection,1 mL,55513-0710-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,298.43",% of charge rate,100.00%,"3,298.43",,,,"3,133.51","3,298.43",1
unity,NDC,DENOSUMAB 60 MG/ML SC SOSY,144893,J0897,,Denosumab injection,1 mL,55513-0710-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,298.43",% of charge rate,100.00%,"3,298.43",,,,"3,133.51","3,298.43",1
unity,NDC,METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP,4995,J1030,,Methylprednisolone 40 mg inj,1 mL,00009-3073-23,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,METHYLPREDNISOLONE ACETATE 40 MG/ML INJ SUSP,4995,J1030,,Methylprednisolone 40 mg inj,1 mL,00009-3073-23,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP,4996,J1040,,Methylprednisolone 80 mg inj,1 mL,70121-1574-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.47,% of charge rate,100.00%,54.47,,,,51.75,54.47,1
unity,NDC,METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP,4996,J1040,,Methylprednisolone 80 mg inj,1 mL,70121-1574-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.47,% of charge rate,100.00%,54.47,,,,51.75,54.47,1
unity,NDC,METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP,4996,J1040,,Methylprednisolone 80 mg inj,1 mL,70121-1574-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.47,% of charge rate,100.00%,54.47,,,,51.75,54.47,1
unity,NDC,METHYLPREDNISOLONE ACETATE 80 MG/ML INJ SUSP,4996,J1040,,Methylprednisolone 80 mg inj,1 mL,70121-1574-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.47,% of charge rate,100.00%,54.47,,,,51.75,54.47,1
unity,NDC,MEDROXYPROGESTERONE ACETATE 150 MG/ML IM SUSP,19736,J1050,,Medroxyprogesterone acetate,1 mL,00548-5400-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,185.48,% of charge rate,100.00%,185.48,,,,176.21,185.48,1
unity,NDC,MEDROXYPROGESTERONE ACETATE 150 MG/ML IM SUSP,19736,J1050,,Medroxyprogesterone acetate,1 mL,00548-5400-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,185.48,% of charge rate,100.00%,185.48,,,,176.21,185.48,1
unity,NDC,MEDROXYPROGESTERONE ACETATE 150 MG/ML IM SUSP,19736,J1050,,Medroxyprogesterone acetate,1 mL,00548-5400-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,185.48,% of charge rate,100.00%,185.48,,,,176.21,185.48,1
unity,NDC,MEDROXYPROGESTERONE ACETATE 150 MG/ML IM SUSP,19736,J1050,,Medroxyprogesterone acetate,1 mL,00548-5400-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,185.48,% of charge rate,100.00%,185.48,,,,176.21,185.48,1
unity,NDC,TESTOSTERONE CYPIONATE 200 MG/ML IM SOLN,129294,J1071,,Inj testosterone cypionate,1 mL,00009-0417-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,TESTOSTERONE CYPIONATE 200 MG/ML IM SOLN,129294,J1071,,Inj testosterone cypionate,1 mL,00009-0417-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,5 mL,67457-0422-54,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,0.5 mL,00641-6146-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,1 mL,67457-0422-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,1 mL,67457-0422-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,0.5 mL,00641-6146-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 20 MG/5ML INJ SOLN,127478,J1100,,Dexamethasone sodium phos,5 mL,67457-0422-54,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN,2331,J1100,,Dexamethasone sodium phos,1 mL,00641-0367-21,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN,2331,J1100,,Dexamethasone sodium phos,1 mL,00641-0367-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN,2331,J1100,,Dexamethasone sodium phos,1 mL,00641-0367-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 10 MG/ML INJ SOLN,2331,J1100,,Dexamethasone sodium phos,1 mL,00641-0367-21,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN,2332,J1100,,Dexamethasone sodium phos,1 mL,67457-0423-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML INJ SOLN,2332,J1100,,Dexamethasone sodium phos,1 mL,67457-0423-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIGOXIN 0.25 MG/ML INJ SOLN,2442,J1160,,Digoxin injection,2 mL,00641-1410-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIGOXIN 0.25 MG/ML INJ SOLN,2442,J1160,,Digoxin injection,2 mL,00641-1410-35,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIGOXIN 0.25 MG/ML INJ SOLN,2442,J1160,,Digoxin injection,2 mL,00641-1410-35,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIGOXIN 0.25 MG/ML INJ SOLN,2442,J1160,,Digoxin injection,2 mL,00641-1410-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PHENYTOIN SODIUM 50 MG/ML INJ SOLN,6256,J1165,,Phenytoin sodium injection,5 mL,00641-2555-45,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PHENYTOIN SODIUM 50 MG/ML INJ SOLN,6256,J1165,,Phenytoin sodium injection,5 mL,00641-2555-45,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HYDROMORPHONE HCL 2 MG/ML INJ SOLN,3758,J1170,,Hydromorphone injection,1 mL,00641-0121-21,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,240.7,% of charge rate,100.00%,240.7,,,,228.67,240.7,1
unity,NDC,HYDROMORPHONE HCL 2 MG/ML INJ SOLN,3758,J1170,,Hydromorphone injection,1 mL,00641-0121-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,240.7,% of charge rate,100.00%,240.7,,,,228.67,240.7,1
unity,NDC,HYDROMORPHONE HCL 2 MG/ML INJ SOLN,3758,J1170,,Hydromorphone injection,1 mL,00641-0121-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,240.7,% of charge rate,100.00%,240.7,,,,228.67,240.7,1
unity,NDC,HYDROMORPHONE HCL 2 MG/ML INJ SOLN,3758,J1170,,Hydromorphone injection,1 mL,00641-0121-21,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,240.7,% of charge rate,100.00%,240.7,,,,228.67,240.7,1
unity,NDC,DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN,2508,J1200,,Diphenhydramine hcl injectio,1 mL,00641-0376-21,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN,2508,J1200,,Diphenhydramine hcl injectio,1 mL,00641-0376-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN,2508,J1200,,Diphenhydramine hcl injectio,1 mL,00641-0376-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIPHENHYDRAMINE HCL 50 MG/ML INJ SOLN,2508,J1200,,Diphenhydramine hcl injectio,1 mL,00641-0376-21,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DOPAMINE IN D5W 1.6-5 MG/ML-% IV SOLN,14845,J1265,,Dopamine injection,500 mL,00409-7809-24,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,121.89,% of charge rate,100.00%,121.89,,,,115.8,121.89,1
unity,NDC,DOPAMINE IN D5W 1.6-5 MG/ML-% IV SOLN,14845,J1265,,Dopamine injection,500 mL,00409-7809-24,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,121.89,% of charge rate,100.00%,121.89,,,,115.8,121.89,1
unity,NDC,ERTAPENEM SODIUM 1 G INJ SOLR,111716,J1335,,Ertapenem injection,1 g,00006-3843-71,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,333.68,% of charge rate,100.00%,333.68,,,,317,333.68,1
unity,NDC,ERTAPENEM SODIUM 1 G INJ SOLR,111716,J1335,,Ertapenem injection,1 g,00006-3843-71,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,333.68,% of charge rate,100.00%,333.68,,,,317,333.68,1
unity,NDC,FERRIC CARBOXYMALTOSE 750 MG/15ML IV SOLN,125094,J1439,,Inj ferric carboxymaltos 1mg,15 mL,00517-0650-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,362.17",% of charge rate,100.00%,"2,362.17",,,,"2,244.06","2,362.17",1
unity,NDC,FERRIC CARBOXYMALTOSE 750 MG/15ML IV SOLN,125094,J1439,,Inj ferric carboxymaltos 1mg,15 mL,00517-0650-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,362.17",% of charge rate,100.00%,"2,362.17",,,,"2,244.06","2,362.17",1
unity,NDC,TBO-FILGRASTIM 480 MCG/0.8ML SC SOSY,126460,J1447,,Inj tbo filgrastim 1 microg,0.8 mL,63459-0912-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,935.71,% of charge rate,100.00%,935.71,,,,888.92,935.71,1
unity,NDC,TBO-FILGRASTIM 480 MCG/0.8ML SC SOSY,126460,J1447,,Inj tbo filgrastim 1 microg,0.8 mL,63459-0912-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,935.71,% of charge rate,100.00%,935.71,,,,888.92,935.71,1
unity,NDC,FLUCONAZOLE IN SODIUM CHLORIDE 400-0.9 MG/200ML-% IV SOLN,10050,J1450,,Fluconazole,200 mL,25021-0184-87,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,86.75,% of charge rate,100.00%,86.75,,,,82.41,86.75,1
unity,NDC,FLUCONAZOLE IN SODIUM CHLORIDE 400-0.9 MG/200ML-% IV SOLN,10050,J1450,,Fluconazole,200 mL,25021-0184-87,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,86.75,% of charge rate,100.00%,86.75,,,,82.41,86.75,1
unity,NDC,FOSAPREPITANT DIMEGLUMINE 150 MG IV SOLR,109696,J1453,,Fosaprepitant injection,150 mg,00006-3061-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,864.54,% of charge rate,100.00%,864.54,,,,821.31,864.54,1
unity,NDC,FOSAPREPITANT DIMEGLUMINE 150 MG IV SOLR,109696,J1453,,Fosaprepitant injection,150 mg,00006-3061-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,864.54,% of charge rate,100.00%,864.54,,,,821.31,864.54,1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 5 GM/50ML IV SOLN,111095,J1459,,Inj ivig privigen 500 mg,50 mL,44206-0436-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,137.85",% of charge rate,100.00%,"1,137.85",,,,"1,080.96","1,137.85",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 5 GM/50ML IV SOLN,111095,J1459,,Inj ivig privigen 500 mg,50 mL,44206-0436-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,137.85",% of charge rate,100.00%,"1,137.85",,,,"1,080.96","1,137.85",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 40 GM/400ML IV SOLN,124319,J1459,,Inj ivig privigen 500 mg,400 mL,44206-0439-40,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"8,564.10",% of charge rate,100.00%,"8,564.10",,,,"8,135.90","8,564.10",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 40 GM/400ML IV SOLN,124319,J1459,,Inj ivig privigen 500 mg,400 mL,44206-0439-40,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"8,564.10",% of charge rate,100.00%,"8,564.10",,,,"8,135.90","8,564.10",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 10 GM/100ML IV SOLN,111096,J1568,,Octagam injection,100 mL,44206-0437-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,176.42",% of charge rate,100.00%,"2,176.42",,,,"2,067.60","2,176.42",1
unity,NDC,IMMUNE GLOBULIN (HUMAN) 10 GM/100ML IV SOLN,111096,J1568,,Octagam injection,100 mL,44206-0437-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,176.42",% of charge rate,100.00%,"2,176.42",,,,"2,067.60","2,176.42",1
unity,NDC,GENTAMICIN SULFATE 40 MG/ML INJ SOLN,3426,J1580,,Garamycin gentamicin inj,2 mL,63323-0010-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,GENTAMICIN SULFATE 40 MG/ML INJ SOLN,3426,J1580,,Garamycin gentamicin inj,2 mL,63323-0010-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,GOLIMUMAB 50 MG/4ML IV SOLN,125072,J1602,,Golimumab for iv use 1mg,4 mL,57894-0350-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,896.36",% of charge rate,100.00%,"4,896.36",,,,"4,651.54","4,896.36",1
unity,NDC,GOLIMUMAB 50 MG/4ML IV SOLN,125072,J1602,,Golimumab for iv use 1mg,4 mL,57894-0350-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,896.36",% of charge rate,100.00%,"4,896.36",,,,"4,651.54","4,896.36",1
unity,NDC,GLUCAGON (RDNA) 1 MG INJ KIT,24869,J1610,,Glucagon hydrochloride/1 mg,1 mL,00002-8031-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,556.52,% of charge rate,100.00%,556.52,,,,528.69,556.52,1
unity,NDC,GLUCAGON (RDNA) 1 MG INJ KIT,24869,J1610,,Glucagon hydrochloride/1 mg,1 mL,00002-8031-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,556.52,% of charge rate,100.00%,556.52,,,,528.69,556.52,1
unity,NDC,GLUCAGON HCL RDNA (DIAGNOSTIC) 1 MG INJ SOLR,41581,J1610,,Glucagon hydrochloride/1 mg,1 mL,00597-0260-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,280.12,% of charge rate,100.00%,280.12,,,,266.11,280.12,1
unity,NDC,GLUCAGON HCL RDNA (DIAGNOSTIC) 1 MG INJ SOLR,41581,J1610,,Glucagon hydrochloride/1 mg,1 mL,00597-0260-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,280.12,% of charge rate,100.00%,280.12,,,,266.11,280.12,1
unity,NDC,GRANISETRON HCL 1 MG/ML IV SOLN,12552,J1626,,Granisetron hcl injection,1 mL,17478-0546-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.22,% of charge rate,100.00%,37.22,,,,35.36,37.22,1
unity,NDC,GRANISETRON HCL 1 MG/ML IV SOLN,12552,J1626,,Granisetron hcl injection,1 mL,17478-0546-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.22,% of charge rate,100.00%,37.22,,,,35.36,37.22,1
unity,NDC,HALOPERIDOL LACTATE 5 MG/ML INJ SOLN,3584,J1630,,Haloperidol injection,1 mL,63323-0474-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HALOPERIDOL LACTATE 5 MG/ML INJ SOLN,3584,J1630,,Haloperidol injection,1 mL,63323-0474-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HALOPERIDOL LACTATE 5 MG/ML INJ SOLN,3584,J1630,,Haloperidol injection,1 mL,63323-0474-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HALOPERIDOL LACTATE 5 MG/ML INJ SOLN,3584,J1630,,Haloperidol injection,1 mL,63323-0474-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM LOCK FLUSH 100 UNIT/ML IV SOLN,15235,J1642,,Inj heparin sodium per 10 u,5 mL,64253-0333-35,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM LOCK FLUSH 100 UNIT/ML IV SOLN,15235,J1642,,Inj heparin sodium per 10 u,5 mL,64253-0333-35,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN LOCK FLUSH 10 UNIT/ML IV SOLN,37994,J1642,,Inj heparin sodium per 10 u,1 mL,63323-0544-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN LOCK FLUSH 10 UNIT/ML IV SOLN,37994,J1642,,Inj heparin sodium per 10 u,1 mL,63323-0544-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 10000 UNIT/ML INJ SOLN,10177,J1644,,Inj heparin sodium per 1000u,1 mL,00409-2721-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 10000 UNIT/ML INJ SOLN,10177,J1644,,Inj heparin sodium per 1000u,1 mL,00409-2721-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 10000 UNIT/ML INJ SOLN,10177,J1644,,Inj heparin sodium per 1000u,1 mL,00409-2721-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 10000 UNIT/ML INJ SOLN,10177,J1644,,Inj heparin sodium per 1000u,1 mL,00409-2721-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 5000 UNIT/ML INJ SOLN,10181,J1644,,Inj heparin sodium per 1000u,1 mL,00641-0400-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 5000 UNIT/ML INJ SOLN,10181,J1644,,Inj heparin sodium per 1000u,1 mL,00641-0400-37,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 5000 UNIT/ML INJ SOLN,10181,J1644,,Inj heparin sodium per 1000u,1 mL,00641-0400-37,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN SODIUM (PORCINE) 5000 UNIT/ML INJ SOLN,10181,J1644,,Inj heparin sodium per 1000u,1 mL,00641-0400-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,HEPARIN (PORCINE) IN NACL 25000-0.45 UT/250ML-% IV SOLN,136837,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) IN NACL 25000-0.45 UT/250ML-% IV SOLN,136837,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) IN NACL 25000-0.45 UT/250ML-% IV SOLN,136837,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) IN NACL 25000-0.45 UT/250ML-% IV SOLN,136837,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) LOW INTENSITY 25000 UNITS IN 1/2 NS 250ML,454030,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) LOW INTENSITY 25000 UNITS IN 1/2 NS 250ML,454030,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) LOW INTENSITY 25000 UNITS IN 1/2 NS 250ML,454030,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) LOW INTENSITY 25000 UNITS IN 1/2 NS 250ML,454030,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) HIGH INTENSITY 25000 UNITS IN 1/2 NS 250ML,454031,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) HIGH INTENSITY 25000 UNITS IN 1/2 NS 250ML,454031,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) HIGH INTENSITY 25000 UNITS IN 1/2 NS 250ML,454031,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-62,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,HEPARIN (PORCINE) HIGH INTENSITY 25000 UNITS IN 1/2 NS 250ML,454031,J1644,,Inj heparin sodium per 1000u,250 mL,00409-7650-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,ENOXAPARIN SODIUM 30 MG/0.3ML SC SOLN,108201,J1650,,Inj enoxaparin sodium,0.3 mL,63323-0533-13,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 30 MG/0.3ML SC SOLN,108201,J1650,,Inj enoxaparin sodium,0.3 mL,63323-0533-93,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 30 MG/0.3ML SC SOLN,108201,J1650,,Inj enoxaparin sodium,0.3 mL,63323-0533-93,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 30 MG/0.3ML SC SOLN,108201,J1650,,Inj enoxaparin sodium,0.3 mL,63323-0533-13,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 40 MG/0.4ML SC SOLN,108202,J1650,,Inj enoxaparin sodium,0.4 mL,63323-0535-87,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 40 MG/0.4ML SC SOLN,108202,J1650,,Inj enoxaparin sodium,0.4 mL,63323-0535-98,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 40 MG/0.4ML SC SOLN,108202,J1650,,Inj enoxaparin sodium,0.4 mL,63323-0535-98,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ENOXAPARIN SODIUM 40 MG/0.4ML SC SOLN,108202,J1650,,Inj enoxaparin sodium,0.4 mL,63323-0535-87,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FONDAPARINUX SODIUM 7.5 MG/0.6ML SC SOLN,111038,J1652,,Fondaparinux sodium,0.6 mL,55150-0232-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,106.99,% of charge rate,100.00%,106.99,,,,101.64,106.99,1
unity,NDC,FONDAPARINUX SODIUM 7.5 MG/0.6ML SC SOLN,111038,J1652,,Fondaparinux sodium,0.6 mL,55150-0232-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,106.99,% of charge rate,100.00%,106.99,,,,101.64,106.99,1
unity,NDC,FONDAPARINUX SODIUM 7.5 MG/0.6ML SC SOLN,111038,J1652,,Fondaparinux sodium,0.6 mL,55150-0232-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,106.99,% of charge rate,100.00%,106.99,,,,101.64,106.99,1
unity,NDC,FONDAPARINUX SODIUM 7.5 MG/0.6ML SC SOLN,111038,J1652,,Fondaparinux sodium,0.6 mL,55150-0232-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,106.99,% of charge rate,100.00%,106.99,,,,101.64,106.99,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 100 MG INJ SOLR,127470,J1720,,Hydrocortisone sodium succ i,2 mL,00009-0825-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,55.11,% of charge rate,100.00%,55.11,,,,52.35,55.11,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 100 MG INJ SOLR,127470,J1720,,Hydrocortisone sodium succ i,2 mL,00009-0825-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,55.11,% of charge rate,100.00%,55.11,,,,52.35,55.11,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 250 MG INJ SOLR,127471,J1720,,Hydrocortisone sodium succ i,1 mL,00009-0013-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,38.9,% of charge rate,100.00%,38.9,,,,36.96,102.27,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 250 MG INJ SOLR,127471,J1720,,Hydrocortisone sodium succ i,1 mL,00009-0013-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,102.27,% of charge rate,100.00%,102.27,,,,36.96,102.27,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 250 MG INJ SOLR,127471,J1720,,Hydrocortisone sodium succ i,1 mL,00009-0013-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,102.27,% of charge rate,100.00%,102.27,,,,36.96,102.27,1
unity,NDC,HYDROCORTISONE NA SUCCINATE PF 250 MG INJ SOLR,127471,J1720,,Hydrocortisone sodium succ i,1 mL,00009-0013-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,38.9,% of charge rate,100.00%,38.9,,,,36.96,102.27,1
unity,NDC,IBANDRONATE SODIUM 3 MG/3ML IV SOLN,114401,J1740,,Ibandronate sodium injection,3 mL,67457-0524-33,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,184.3,% of charge rate,100.00%,184.3,,,,175.09,184.3,1
unity,NDC,IBANDRONATE SODIUM 3 MG/3ML IV SOLN,114401,J1740,,Ibandronate sodium injection,3 mL,67457-0524-33,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,184.3,% of charge rate,100.00%,184.3,,,,175.09,184.3,1
unity,NDC,INFLIXIMAB 100 MG IV SOLR,23796,J1745,,Infliximab not biosimil 10mg,100 mg,57894-0030-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,853.02",% of charge rate,100.00%,"2,853.02",,,,"2,710.37","2,853.02",1
unity,NDC,INFLIXIMAB 100 MG IV SOLR,23796,J1745,,Infliximab not biosimil 10mg,100 mg,57894-0030-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,853.02",% of charge rate,100.00%,"2,853.02",,,,"2,710.37","2,853.02",1
unity,NDC,IRON SUCROSE 20 MG/ML IV SOLN,29132,J1756,,Iron sucrose injection,5 mL,00517-2340-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,150.79,% of charge rate,100.00%,150.79,,,,143.25,150.79,1
unity,NDC,IRON SUCROSE 20 MG/ML IV SOLN,29132,J1756,,Iron sucrose injection,5 mL,00517-2340-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,150.79,% of charge rate,100.00%,150.79,,,,143.25,150.79,1
unity,NDC,DROPERIDOL 2.5 MG/ML INJ SOLN,2654,J1790,,Droperidol injection,0.124 mL,00517-9702-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,37.61,1
unity,NDC,DROPERIDOL 2.5 MG/ML INJ SOLN,2654,J1790,,Droperidol injection,2 mL,00517-9702-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.61,% of charge rate,100.00%,37.61,,,,20.66,37.61,1
unity,NDC,DROPERIDOL 2.5 MG/ML INJ SOLN,2654,J1790,,Droperidol injection,2 mL,00517-9702-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.61,% of charge rate,100.00%,37.61,,,,20.66,37.61,1
unity,NDC,DROPERIDOL 2.5 MG/ML INJ SOLN,2654,J1790,,Droperidol injection,0.124 mL,00517-9702-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,37.61,1
unity,NDC,PROPRANOLOL HCL 1 MG/ML IV SOLN,29335,J1800,,Propranolol injection,1 mL,00143-9872-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROPRANOLOL HCL 1 MG/ML IV SOLN,29335,J1800,,Propranolol injection,1 mL,00143-9872-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROPRANOLOL HCL 1 MG/ML IV SOLN,29335,J1800,,Propranolol injection,1 mL,00143-9872-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROPRANOLOL HCL 1 MG/ML IV SOLN,29335,J1800,,Propranolol injection,1 mL,00143-9872-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,10289,J1815,,Insulin injection,300 Units,00002-8215-17,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.33,% of charge rate,100.00%,21.33,,,,20.26,21.33,1
unity,NDC,INSULIN REGULAR HUMAN 100 UNIT/ML INJ SOLN,10289,J1815,,Insulin injection,300 Units,00002-8215-17,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.33,% of charge rate,100.00%,21.33,,,,20.26,21.33,1
unity,NDC,INSULIN ASPART 100 UNIT/ML SC SOPN,127449,J1815,,Insulin injection,300 Units,00169-6339-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,102.79,% of charge rate,100.00%,102.79,,,,97.65,102.79,1
unity,NDC,INSULIN ASPART 100 UNIT/ML SC SOPN,127449,J1815,,Insulin injection,300 Units,00169-6339-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,102.79,% of charge rate,100.00%,102.79,,,,97.65,102.79,1
unity,NDC,INSULIN GLARGINE 100 UNIT/ML SC SOPN,127451,J1815,,Insulin injection,300 Units,00088-5020-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,102.39,% of charge rate,100.00%,102.39,,,,97.27,102.39,1
unity,NDC,INSULIN GLARGINE 100 UNIT/ML SC SOPN,127451,J1815,,Insulin injection,300 Units,00088-5020-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,102.39,% of charge rate,100.00%,102.39,,,,97.27,102.39,1
unity,NDC,INSULIN GLARGINE 100 UNIT/ML SC SOPN,127451,J1815,,Insulin injection,300 Units,00088-5020-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,102.39,% of charge rate,100.00%,102.39,,,,97.27,102.39,1
unity,NDC,INSULIN GLARGINE 100 UNIT/ML SC SOPN,127451,J1815,,Insulin injection,300 Units,00088-5020-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,102.39,% of charge rate,100.00%,102.39,,,,97.27,102.39,1
unity,NDC,INSULIN LISPRO 100 UNIT/ML SC SOLN,17405,J1817,,Insulin for insulin pump use,300 Units,00002-7510-17,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.21,% of charge rate,100.00%,67.21,,,,63.85,67.21,1
unity,NDC,INSULIN LISPRO 100 UNIT/ML SC SOLN,17405,J1817,,Insulin for insulin pump use,300 Units,00002-7510-17,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.21,% of charge rate,100.00%,67.21,,,,63.85,67.21,1
unity,NDC,KETOROLAC TROMETHAMINE 60 MG/2ML IM SOLN,96064,J1885,,Ketorolac tromethamine inj,2 mL,63323-0162-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,KETOROLAC TROMETHAMINE 60 MG/2ML IM SOLN,96064,J1885,,Ketorolac tromethamine inj,2 mL,63323-0162-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FUROSEMIDE 10 MG/ML INJ SOLN,3291,J1940,,Furosemide injection,4 mL,00409-6102-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FUROSEMIDE 10 MG/ML INJ SOLN,3291,J1940,,Furosemide injection,4 mL,00409-6102-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LEUPROLIDE ACETATE 3.75 MG IM KIT,13691,J1950,,Leuprolide acetate /3.75 mg,3.75 mg,00074-3641-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,355.50",% of charge rate,100.00%,"3,355.50",,,,"3,187.73","3,355.50",1
unity,NDC,LEUPROLIDE ACETATE 3.75 MG IM KIT,13691,J1950,,Leuprolide acetate /3.75 mg,3.75 mg,00074-3641-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"3,355.50",% of charge rate,100.00%,"3,355.50",,,,"3,187.73","3,355.50",1
unity,NDC,LEUPROLIDE ACETATE (3 MONTH) 11.25 MG IM KIT,21044,J1950,,Leuprolide acetate /3.75 mg,11.25 mg,00074-3663-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"10,087.68",% of charge rate,100.00%,"10,087.68",,,,"9,583.30","10,087.68",1
unity,NDC,LEUPROLIDE ACETATE (3 MONTH) 11.25 MG IM KIT,21044,J1950,,Leuprolide acetate /3.75 mg,11.25 mg,00074-3663-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"10,087.68",% of charge rate,100.00%,"10,087.68",,,,"9,583.30","10,087.68",1
unity,NDC,LEVETIRACETAM 500 MG/5ML IV SOLN,77195,J1953,,Levetiracetam injection,5 mL,55150-0177-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LEVETIRACETAM 500 MG/5ML IV SOLN,77195,J1953,,Levetiracetam injection,5 mL,55150-0177-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LEVOFLOXACIN IN D5W 500 MG/100ML IV SOLN,111127,J1956,,Levofloxacin injection,100 mL,44567-0436-24,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,LEVOFLOXACIN IN D5W 500 MG/100ML IV SOLN,111127,J1956,,Levofloxacin injection,100 mL,44567-0436-24,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,LEVOFLOXACIN IN D5W 750 MG/150ML IV SOLN,111128,J1956,,Levofloxacin injection,150 mL,00409-0528-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,62.43,% of charge rate,100.00%,62.43,,,,59.31,62.43,1
unity,NDC,LEVOFLOXACIN IN D5W 750 MG/150ML IV SOLN,111128,J1956,,Levofloxacin injection,150 mL,00409-0528-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,62.43,% of charge rate,100.00%,62.43,,,,59.31,62.43,1
unity,NDC,LIDOCAINE HCL (PF) 4 % INJ SOLN,134921,J2001,,Lidocaine injection,5 mL,00409-4283-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 4 % INJ SOLN,134921,J2001,,Lidocaine injection,5 mL,00409-4283-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (CARDIAC) 100 MG/5ML IV SOSY,144889,J2001,,Lidocaine injection,1 mL,00409-4903-34,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (CARDIAC) 100 MG/5ML IV SOSY,144889,J2001,,Lidocaine injection,1 mL,00409-4903-34,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,500 mL,00338-0409-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,142.82,% of charge rate,100.00%,142.82,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,250 mL,00264-9594-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,77.25,% of charge rate,100.00%,77.25,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,500 mL,00264-9594-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,142.82,% of charge rate,100.00%,142.82,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,500 mL,00264-9594-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,142.82,% of charge rate,100.00%,142.82,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,250 mL,00264-9594-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,77.25,% of charge rate,100.00%,77.25,,,,73.39,142.82,1
unity,NDC,LIDOCAINE IN D5W 4-5 MG/ML-% IV SOLN,14868,J2001,,Lidocaine injection,500 mL,00338-0409-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,142.82,% of charge rate,100.00%,142.82,,,,73.39,142.82,1
unity,NDC,LINEZOLID 600 MG/300ML IV SOLN,134899,J2020,,Linezolid injection,300 mL,00009-5140-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,156.21,% of charge rate,100.00%,156.21,,,,148.4,156.21,1
unity,NDC,LINEZOLID 600 MG/300ML IV SOLN,134899,J2020,,Linezolid injection,300 mL,00009-5140-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,156.21,% of charge rate,100.00%,156.21,,,,148.4,156.21,1
unity,NDC,LINEZOLID 600 MG/300ML IV SOLN,134899,J2020,,Linezolid injection,300 mL,00009-5140-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,156.21,% of charge rate,100.00%,156.21,,,,148.4,156.21,1
unity,NDC,LINEZOLID 600 MG/300ML IV SOLN,134899,J2020,,Linezolid injection,300 mL,00009-5140-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,156.21,% of charge rate,100.00%,156.21,,,,148.4,156.21,1
unity,NDC,LORAZEPAM 2 MG/ML INJ SOLN,10467,J2060,,Lorazepam injection,2 mg,00641-6048-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LORAZEPAM 2 MG/ML INJ SOLN,10467,J2060,,Lorazepam injection,2 mg,00641-6048-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MANNITOL 20 % IV SOLN,4749,J2150,,Mannitol injection,500 mL,00990-7715-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,95.51,% of charge rate,100.00%,95.51,,,,90.73,95.51,1
unity,NDC,MANNITOL 20 % IV SOLN,4749,J2150,,Mannitol injection,500 mL,00990-7715-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,95.51,% of charge rate,100.00%,95.51,,,,90.73,95.51,1
unity,NDC,MEROPENEM-SODIUM CHLORIDE 1 GM/50ML IV SOLR,133553,J2185,,Meropenem,50 mL,00264-3185-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,139.43,% of charge rate,100.00%,139.43,,,,132.46,139.43,1
unity,NDC,MEROPENEM-SODIUM CHLORIDE 1 GM/50ML IV SOLR,133553,J2185,,Meropenem,50 mL,00264-3185-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,139.43,% of charge rate,100.00%,139.43,,,,132.46,139.43,1
unity,NDC,MEROPENEM 500 MG IV SOLR,17379,J2185,,Meropenem,500 mg,63323-0507-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MEROPENEM 500 MG IV SOLR,17379,J2185,,Meropenem,500 mg,63323-0507-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MEROPENEM 1 G IV SOLR,17380,J2185,,Meropenem,0.5 g,55150-0208-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MEROPENEM 1 G IV SOLR,17380,J2185,,Meropenem,0.5 g,55150-0208-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL (PF) 5 MG/ML INJ SOLN,146237,J2250,,Inj midazolam hydrochloride,1 mL,00409-2308-49,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL (PF) 5 MG/ML INJ SOLN,146237,J2250,,Inj midazolam hydrochloride,1 mL,00409-2308-49,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL (PF) 2 MG/2ML INJ SOLN,146238,J2250,,Inj midazolam hydrochloride,2 mL,00409-2305-17,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL (PF) 2 MG/2ML INJ SOLN,146238,J2250,,Inj midazolam hydrochloride,2 mL,00409-2305-17,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL 50 MG/10ML INJ SOLN,93604,J2250,,Inj midazolam hydrochloride,10 mL,00641-6060-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL 50 MG/10ML INJ SOLN,93604,J2250,,Inj midazolam hydrochloride,10 mL,00641-6060-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL 50 MG/10ML INJ SOLN,93604,J2250,,Inj midazolam hydrochloride,10 mL,00641-6060-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MIDAZOLAM HCL 50 MG/10ML INJ SOLN,93604,J2250,,Inj midazolam hydrochloride,10 mL,00641-6060-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,120512,J2270,,Morphine sulfate injection,1 mL,00641-6125-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,120512,J2270,,Morphine sulfate injection,1 mL,00641-6125-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,120512,J2270,,Morphine sulfate injection,1 mL,00641-6125-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 4 MG/ML IV SOLN,120512,J2270,,Morphine sulfate injection,1 mL,00641-6125-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 10 MG/ML IV SOLN,120514,J2270,,Morphine sulfate injection,1 mL,00641-6127-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 10 MG/ML IV SOLN,120514,J2270,,Morphine sulfate injection,1 mL,00641-6127-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 10 MG/ML IV SOLN,120514,J2270,,Morphine sulfate injection,1 mL,00641-6127-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MORPHINE SULFATE (PF) 10 MG/ML IV SOLN,120514,J2270,,Morphine sulfate injection,1 mL,00641-6127-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,NALOXONE HCL 2 MG/2ML INJ SOSY,137261,J2310,,Inj naloxone hydrochloride,2 mL,76329-3369-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,112.42,% of charge rate,100.00%,112.42,,,,106.8,112.42,1
unity,NDC,NALOXONE HCL 2 MG/2ML INJ SOSY,137261,J2310,,Inj naloxone hydrochloride,2 mL,76329-3369-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,112.42,% of charge rate,100.00%,112.42,,,,106.8,112.42,1
unity,NDC,NALOXONE HCL 0.4 MG/ML INJ SOLN,5373,J2310,,Inj naloxone hydrochloride,1 mL,00409-1215-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.94,% of charge rate,100.00%,45.94,,,,43.64,45.94,1
unity,NDC,NALOXONE HCL 0.4 MG/ML INJ SOLN,5373,J2310,,Inj naloxone hydrochloride,1 mL,00409-1215-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.94,% of charge rate,100.00%,45.94,,,,43.64,45.94,1
unity,NDC,OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN,91278,J2354,,"Octreotide inj, non-depot",1 mL,00641-6174-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN,91278,J2354,,"Octreotide inj, non-depot",1 mL,00641-6174-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN,91278,J2354,,"Octreotide inj, non-depot",1 mL,00641-6174-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,OCTREOTIDE ACETATE 50 MCG/ML INJ SOLN,91278,J2354,,"Octreotide inj, non-depot",1 mL,00641-6174-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN,91281,J2354,,"Octreotide inj, non-depot",1 mL,63323-0377-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,45.27,% of charge rate,100.00%,45.27,,,,43.01,45.27,1
unity,NDC,OCTREOTIDE ACETATE 500 MCG/ML INJ SOLN,91281,J2354,,"Octreotide inj, non-depot",1 mL,63323-0377-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,45.27,% of charge rate,100.00%,45.27,,,,43.01,45.27,1
unity,NDC,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,5886,J2360,,Orphenadrine injection,2 mL,17478-0538-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ORPHENADRINE CITRATE 30 MG/ML INJ SOLN,5886,J2360,,Orphenadrine injection,2 mL,17478-0538-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PHENYLEPHRINE HCL 10 MG/ML IV SOLN,129812,J2370,,Phenylephrine hcl injection,1 mL,76014-0004-33,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.06,% of charge rate,100.00%,28.06,,,,26.66,28.06,1
unity,NDC,PHENYLEPHRINE HCL 10 MG/ML IV SOLN,129812,J2370,,Phenylephrine hcl injection,1 mL,76014-0004-33,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.06,% of charge rate,100.00%,28.06,,,,26.66,28.06,1
unity,NDC,ONDANSETRON HCL 4 MG/2ML INJ SOLN,94173,J2405,,Ondansetron hcl injection,2 mL,60505-6130-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ONDANSETRON HCL 4 MG/2ML INJ SOLN,94173,J2405,,Ondansetron hcl injection,2 mL,60505-6130-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PALONOSETRON HCL 0.25 MG/5ML IV SOLN,36591,J2469,,Palonosetron hcl,5 mL,60505-6193-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.7,% of charge rate,100.00%,67.7,,,,64.32,67.7,1
unity,NDC,PALONOSETRON HCL 0.25 MG/5ML IV SOLN,36591,J2469,,Palonosetron hcl,5 mL,60505-6193-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.7,% of charge rate,100.00%,67.7,,,,64.32,67.7,1
unity,NDC,PEGFILGRASTIM 6 MG/0.6ML SC SOSY,133089,J2505,,"Injection, pegfilgrastim 6mg",0.6 mL,55513-0190-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"12,345.94",% of charge rate,100.00%,"12,345.94",,,,"11,728.64","12,345.94",1
unity,NDC,PEGFILGRASTIM 6 MG/0.6ML SC SOSY,133089,J2505,,"Injection, pegfilgrastim 6mg",0.6 mL,55513-0190-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"12,345.94",% of charge rate,100.00%,"12,345.94",,,,"11,728.64","12,345.94",1
unity,NDC,PEGFILGRASTIM 6 MG/0.6ML SC PSKT,133090,J2505,,"Injection, pegfilgrastim 6mg",0.6 mL,55513-0192-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"11,504.94",% of charge rate,100.00%,"11,504.94",,,,"10,929.69","11,504.94",1
unity,NDC,PEGFILGRASTIM 6 MG/0.6ML SC PSKT,133090,J2505,,"Injection, pegfilgrastim 6mg",0.6 mL,55513-0192-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"11,504.94",% of charge rate,100.00%,"11,504.94",,,,"10,929.69","11,504.94",1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 4.5 (4-0.5) G IV SOLR,18302,J2543,,Piperacillin/tazobactam,4.5 g,00781-9214-91,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.44,% of charge rate,100.00%,28.44,,,,27.02,28.44,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 4.5 (4-0.5) G IV SOLR,18302,J2543,,Piperacillin/tazobactam,4.5 g,00781-9214-91,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.44,% of charge rate,100.00%,28.44,,,,27.02,28.44,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 3.375 (3-0.375) G IV SOLR,18303,J2543,,Piperacillin/tazobactam,3.375 g,61990-0120-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 3.375 (3-0.375) G IV SOLR,18303,J2543,,Piperacillin/tazobactam,3.375 g,61990-0120-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 3.375 (3-0.375) G IV SOLR,18303,J2543,,Piperacillin/tazobactam,3.375 g,61990-0120-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PIPERACILLIN SOD-TAZOBACTAM SO 3.375 (3-0.375) G IV SOLR,18303,J2543,,Piperacillin/tazobactam,3.375 g,61990-0120-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROMETHAZINE HCL 25 MG/ML INJ SOLN,6618,J2550,,Promethazine hcl injection,1 mL,00641-0928-21,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROMETHAZINE HCL 25 MG/ML INJ SOLN,6618,J2550,,Promethazine hcl injection,1 mL,00641-0928-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROMETHAZINE HCL 25 MG/ML INJ SOLN,6618,J2550,,Promethazine hcl injection,1 mL,00641-0928-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROMETHAZINE HCL 25 MG/ML INJ SOLN,6618,J2550,,Promethazine hcl injection,1 mL,00641-0928-21,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,OXYTOCIN 10 UNIT/ML INJ SOLN,5944,J2590,,Oxytocin injection,1 mL,63323-0012-07,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,OXYTOCIN 10 UNIT/ML INJ SOLN,5944,J2590,,Oxytocin injection,1 mL,63323-0012-07,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROCAINAMIDE HCL 100 MG/ML INJ SOLN,6562,J2690,,Procainamide hcl injection,1 mL,76329-3399-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROCAINAMIDE HCL 100 MG/ML INJ SOLN,6562,J2690,,Procainamide hcl injection,1 mL,76329-3399-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PROPOFOL 1000 MG/100ML IV EMUL,134930,J2704,,"Inj, propofol, 10 mg",100 mL,63323-0269-65,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,88.35,% of charge rate,100.00%,88.35,,,,83.93,88.35,1
unity,NDC,PROPOFOL 1000 MG/100ML IV EMUL,134930,J2704,,"Inj, propofol, 10 mg",100 mL,63323-0269-65,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,88.35,% of charge rate,100.00%,88.35,,,,83.93,88.35,1
unity,NDC,PROPOFOL INFUSION 200MG/20ML IV,600500,J2704,,"Inj, propofol, 10 mg",20 mL,00409-4699-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78.36,% of charge rate,100.00%,78.36,,,,74.44,78.36,1
unity,NDC,PROPOFOL INFUSION 200MG/20ML IV,600500,J2704,,"Inj, propofol, 10 mg",20 mL,00409-4699-50,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,78.36,% of charge rate,100.00%,78.36,,,,74.44,78.36,1
unity,NDC,PROPOFOL INFUSION 200MG/20ML IV,600500,J2704,,"Inj, propofol, 10 mg",20 mL,00409-4699-50,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78.36,% of charge rate,100.00%,78.36,,,,74.44,78.36,1
unity,NDC,PROPOFOL INFUSION 200MG/20ML IV,600500,J2704,,"Inj, propofol, 10 mg",20 mL,00409-4699-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,78.36,% of charge rate,100.00%,78.36,,,,74.44,78.36,1
unity,NDC,NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN,124650,J2710,,Neostigmine methylslfte inj,1 mL,63323-0415-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,NEOSTIGMINE METHYLSULFATE 10 MG/10ML IV SOLN,124650,J2710,,Neostigmine methylslfte inj,1 mL,63323-0415-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PHENTOLAMINE MESYLATE 5 MG INJ SOLR,10947,J2760,,Phentolaine mesylate inj,0.5 mg,51224-0012-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.13,% of charge rate,100.00%,94.13,,,,89.42,94.13,1
unity,NDC,PHENTOLAMINE MESYLATE 5 MG INJ SOLR,10947,J2760,,Phentolaine mesylate inj,0.5 mg,51224-0012-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.13,% of charge rate,100.00%,94.13,,,,89.42,94.13,1
unity,NDC,METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN,5002,J2765,,Metoclopramide hcl injection,2 mL,00703-4502-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,METOCLOPRAMIDE HCL 5 MG/ML INJ SOLN,5002,J2765,,Metoclopramide hcl injection,2 mL,00703-4502-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ROPIVACAINE HCL 5 MG/ML INJ SOLN,18195,J2795,,Ropivacaine hcl injection,15 mL,17478-0081-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,37.51,% of charge rate,100.00%,37.51,,,,35.63,37.51,1
unity,NDC,ROPIVACAINE HCL 5 MG/ML INJ SOLN,18195,J2795,,Ropivacaine hcl injection,15 mL,17478-0081-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,37.51,% of charge rate,100.00%,37.51,,,,35.63,37.51,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR,10580,J2920,,Methylprednisolone injection,1 mL,00009-0039-32,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.39,% of charge rate,100.00%,28.39,,,,26.97,28.39,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR,10580,J2920,,Methylprednisolone injection,1 mL,00009-0039-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,28.39,% of charge rate,100.00%,28.39,,,,26.97,28.39,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR,10580,J2920,,Methylprednisolone injection,1 mL,00009-0039-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.39,% of charge rate,100.00%,28.39,,,,26.97,28.39,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 40 MG INJ SOLR,10580,J2920,,Methylprednisolone injection,1 mL,00009-0039-32,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,28.39,% of charge rate,100.00%,28.39,,,,26.97,28.39,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 1000 MG INJ SOLR,10577,J2930,,Methylprednisolone injection,"1,000 mg",63323-0265-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.24,% of charge rate,100.00%,94.24,,,,89.53,94.24,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 1000 MG INJ SOLR,10577,J2930,,Methylprednisolone injection,"1,000 mg",63323-0265-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.24,% of charge rate,100.00%,94.24,,,,89.53,94.24,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR,10578,J2930,,Methylprednisolone injection,2 mL,00009-0047-26,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,44.1,% of charge rate,100.00%,44.1,,,,41.9,44.1,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR,10578,J2930,,Methylprednisolone injection,2 mL,00009-0047-27,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,44.1,% of charge rate,100.00%,44.1,,,,41.9,44.1,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR,10578,J2930,,Methylprednisolone injection,2 mL,00009-0047-27,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,44.1,% of charge rate,100.00%,44.1,,,,41.9,44.1,1
unity,NDC,METHYLPREDNISOLONE SODIUM SUCC 125 MG INJ SOLR,10578,J2930,,Methylprednisolone injection,2 mL,00009-0047-26,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,44.1,% of charge rate,100.00%,44.1,,,,41.9,44.1,1
unity,NDC,ALTEPLASE 2 MG INJ SOLR,31310,J2997,,Alteplase recombinant,2 mg,50242-0041-64,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,397.22,% of charge rate,100.00%,397.22,,,,377.36,397.22,1
unity,NDC,ALTEPLASE 2 MG INJ SOLR,31310,J2997,,Alteplase recombinant,2 mg,50242-0041-64,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,397.22,% of charge rate,100.00%,397.22,,,,377.36,397.22,1
unity,NDC,ALTEPLASE 100 MG IV SOLR,9002,J2997,,Alteplase recombinant,90 mL,50242-0085-27,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"20,431.89",% of charge rate,100.00%,"20,431.89",,,,"19,410.30","20,431.89",1
unity,NDC,ALTEPLASE 100 MG IV SOLR,9002,J2997,,Alteplase recombinant,90 mL,50242-0085-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"20,431.89",% of charge rate,100.00%,"20,431.89",,,,"19,410.30","20,431.89",1
unity,NDC,ALTEPLASE 100 MG IV SOLR,9002,J2997,,Alteplase recombinant,90 mL,50242-0085-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"20,431.89",% of charge rate,100.00%,"20,431.89",,,,"19,410.30","20,431.89",1
unity,NDC,ALTEPLASE 100 MG IV SOLR,9002,J2997,,Alteplase recombinant,90 mL,50242-0085-27,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"20,431.89",% of charge rate,100.00%,"20,431.89",,,,"19,410.30","20,431.89",1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,0.5 mL,00409-9094-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,0.5 mL,17478-0030-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,2 mL,00409-9094-22,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,2 mL,00409-9094-22,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,0.5 mL,17478-0030-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FENTANYL CITRATE (PF) 100 MCG/2ML INJ SOLN,134932,J3010,,Fentanyl citrate injection,0.5 mL,00409-9094-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SUMATRIPTAN SUCCINATE 6 MG/0.5ML SC SOLN,95691,J3030,,Sumatriptan succinate / 6 mg,0.5 mL,55150-0173-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,42.42,% of charge rate,100.00%,42.42,,,,40.3,42.42,1
unity,NDC,SUMATRIPTAN SUCCINATE 6 MG/0.5ML SC SOLN,95691,J3030,,Sumatriptan succinate / 6 mg,0.5 mL,55150-0173-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,42.42,% of charge rate,100.00%,42.42,,,,40.3,42.42,1
unity,NDC,TELAVANCIN HCL 750 MG IV SOLR,103887,J3095,,Telavancin injection,50 mL,62847-0001-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,134.94",% of charge rate,100.00%,"1,134.94",,,,"1,078.19","1,134.94",1
unity,NDC,TELAVANCIN HCL 750 MG IV SOLR,103887,J3095,,Telavancin injection,50 mL,62847-0001-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,134.94",% of charge rate,100.00%,"1,134.94",,,,"1,078.19","1,134.94",1
unity,NDC,TENECTEPLASE 50 MG IV KIT,28530,J3101,,Tenecteplase injection,6 mL,50242-0120-47,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,647.83",% of charge rate,100.00%,"9,647.83",,,,"9,165.44","9,647.83",1
unity,NDC,TENECTEPLASE 50 MG IV KIT,28530,J3101,,Tenecteplase injection,6 mL,50242-0120-47,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,647.83",% of charge rate,100.00%,"9,647.83",,,,"9,165.44","9,647.83",1
unity,NDC,TERBUTALINE SULFATE 1 MG/ML INJ SOLN,11507,J3105,,Terbutaline sulfate inj,1 mL,00143-9746-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,TERBUTALINE SULFATE 1 MG/ML INJ SOLN,11507,J3105,,Terbutaline sulfate inj,1 mL,00143-9746-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ROMOSOZUMAB-AQQG 105 MG/1.17ML SC SOSY,145223,J3111,,Inj. romosozumab-aqqg 1 mg,2.34 mL,55513-0880-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,747.97",% of charge rate,100.00%,"4,747.97",,,,"4,510.57","4,747.97",1
unity,NDC,ROMOSOZUMAB-AQQG 105 MG/1.17ML SC SOSY,145223,J3111,,Inj. romosozumab-aqqg 1 mg,2.34 mL,55513-0880-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"4,747.97",% of charge rate,100.00%,"4,747.97",,,,"4,510.57","4,747.97",1
unity,NDC,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,8120,J3301,,Triamcinolone acet inj nos,1 mL,70121-1651-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,43.09,% of charge rate,100.00%,43.09,,,,40.94,43.09,1
unity,NDC,TRIAMCINOLONE ACETONIDE 40 MG/ML INJ SUSP,8120,J3301,,Triamcinolone acet inj nos,1 mL,70121-1651-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,43.09,% of charge rate,100.00%,43.09,,,,40.94,43.09,1
unity,NDC,DIAZEPAM 5 MG/ML INJ SOLN,2401,J3360,,Diazepam injection,0.5 mL,69339-0136-32,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,DIAZEPAM 5 MG/ML INJ SOLN,2401,J3360,,Diazepam injection,0.5 mL,69339-0136-32,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1 G IV SOLR,143427,J3370,,Vancomycin hcl injection,1 g,70860-0105-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1 G IV SOLR,143427,J3370,,Vancomycin hcl injection,1 g,70860-0105-41,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1 G IV SOLR,143427,J3370,,Vancomycin hcl injection,1 g,70860-0105-41,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1 G IV SOLR,143427,J3370,,Vancomycin hcl injection,1 g,70860-0105-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 1000 MG/200ML IV SOLN,144907,J3370,,Vancomycin hcl injection,200 mL,70594-0042-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.76,% of charge rate,100.00%,94.76,,,,90.02,94.76,1
unity,NDC,VANCOMYCIN HCL 1000 MG/200ML IV SOLN,144907,J3370,,Vancomycin hcl injection,200 mL,70594-0042-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,94.76,% of charge rate,100.00%,94.76,,,,90.02,94.76,1
unity,NDC,VANCOMYCIN HCL 1000 MG/200ML IV SOLN,144907,J3370,,Vancomycin hcl injection,200 mL,70594-0042-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.76,% of charge rate,100.00%,94.76,,,,90.02,94.76,1
unity,NDC,VANCOMYCIN HCL 1000 MG/200ML IV SOLN,144907,J3370,,Vancomycin hcl injection,200 mL,70594-0042-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,94.76,% of charge rate,100.00%,94.76,,,,90.02,94.76,1
unity,NDC,VANCOMYCIN HCL 1500 MG/300ML IV SOLN,144908,J3370,,Vancomycin hcl injection,300 mL,70594-0043-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,118.88,% of charge rate,100.00%,118.88,,,,112.94,118.88,1
unity,NDC,VANCOMYCIN HCL 1500 MG/300ML IV SOLN,144908,J3370,,Vancomycin hcl injection,300 mL,70594-0043-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,118.88,% of charge rate,100.00%,118.88,,,,112.94,118.88,1
unity,NDC,VANCOMYCIN HCL 1500 MG/300ML IV SOLN,144908,J3370,,Vancomycin hcl injection,300 mL,70594-0043-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,118.88,% of charge rate,100.00%,118.88,,,,112.94,118.88,1
unity,NDC,VANCOMYCIN HCL 1500 MG/300ML IV SOLN,144908,J3370,,Vancomycin hcl injection,300 mL,70594-0043-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,118.88,% of charge rate,100.00%,118.88,,,,112.94,118.88,1
unity,NDC,VANCOMYCIN HCL 2000 MG/400ML IV SOLN,145814,J3370,,Vancomycin hcl injection,400 mL,70594-0044-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,143.01,% of charge rate,100.00%,143.01,,,,135.86,143.01,1
unity,NDC,VANCOMYCIN HCL 2000 MG/400ML IV SOLN,145814,J3370,,Vancomycin hcl injection,400 mL,70594-0044-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,143.01,% of charge rate,100.00%,143.01,,,,135.86,143.01,1
unity,NDC,VANCOMYCIN HCL 2000 MG/400ML IV SOLN,145814,J3370,,Vancomycin hcl injection,400 mL,70594-0044-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,143.01,% of charge rate,100.00%,143.01,,,,135.86,143.01,1
unity,NDC,VANCOMYCIN HCL 2000 MG/400ML IV SOLN,145814,J3370,,Vancomycin hcl injection,400 mL,70594-0044-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,143.01,% of charge rate,100.00%,143.01,,,,135.86,143.01,1
unity,NDC,VANCOMYCIN HCL 500 MG IV SOLR,8443,J3370,,Vancomycin hcl injection,500 mg,47781-0598-07,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 500 MG IV SOLR,8443,J3370,,Vancomycin hcl injection,500 mg,47781-0598-91,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 500 MG IV SOLR,8443,J3370,,Vancomycin hcl injection,500 mg,47781-0598-91,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VANCOMYCIN HCL 500 MG IV SOLR,8443,J3370,,Vancomycin hcl injection,500 mg,47781-0598-07,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,THIAMINE HCL 100 MG/ML INJ SOLN,7876,J3411,,Thiamine hcl 100 mg,2 mL,63323-0013-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,32.36,% of charge rate,100.00%,32.36,,,,30.74,32.36,1
unity,NDC,THIAMINE HCL 100 MG/ML INJ SOLN,7876,J3411,,Thiamine hcl 100 mg,2 mL,63323-0013-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,32.36,% of charge rate,100.00%,32.36,,,,30.74,32.36,1
unity,NDC,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,2007,J3420,,Vitamin b12 injection,1 mL,69680-0112-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,2007,J3420,,Vitamin b12 injection,1 mL,69680-0112-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,2007,J3420,,Vitamin b12 injection,1 mL,69680-0112-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,CYANOCOBALAMIN 1000 MCG/ML INJ SOLN,2007,J3420,,Vitamin b12 injection,1 mL,69680-0112-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,VITAMIN K1 1 MG/0.5ML INJ SOLN,41624,J3430,,Vitamin k phytonadione inj,0.5 mL,00409-9157-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,23.86,% of charge rate,100.00%,23.86,,,,22.67,23.86,1
unity,NDC,VITAMIN K1 1 MG/0.5ML INJ SOLN,41624,J3430,,Vitamin k phytonadione inj,0.5 mL,00409-9157-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,23.86,% of charge rate,100.00%,23.86,,,,22.67,23.86,1
unity,NDC,VITAMIN K1 10 MG/ML INJ SOLN,8718,J3430,,Vitamin k phytonadione inj,1 mL,00409-9158-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,140.31,% of charge rate,100.00%,140.31,,,,133.29,140.31,1
unity,NDC,VITAMIN K1 10 MG/ML INJ SOLN,8718,J3430,,Vitamin k phytonadione inj,1 mL,00409-9158-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,140.31,% of charge rate,100.00%,140.31,,,,133.29,140.31,1
unity,NDC,MAGNESIUM SULFATE 2 GM/50ML IV SOLN,133084,J3475,,Inj magnesium sulfate,50 mL,44567-0420-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,93.74,% of charge rate,100.00%,93.74,,,,89.05,93.74,1
unity,NDC,MAGNESIUM SULFATE 2 GM/50ML IV SOLN,133084,J3475,,Inj magnesium sulfate,50 mL,44567-0420-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,93.74,% of charge rate,100.00%,93.74,,,,89.05,93.74,1
unity,NDC,MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN,139184,J3475,,Inj magnesium sulfate,100 mL,44567-0410-24,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,67.18,% of charge rate,100.00%,67.18,,,,63.82,67.18,1
unity,NDC,MAGNESIUM SULFATE IN D5W 1-5 GM/100ML-% IV SOLN,139184,J3475,,Inj magnesium sulfate,100 mL,44567-0410-24,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,67.18,% of charge rate,100.00%,67.18,,,,63.82,67.18,1
unity,NDC,MAGNESIUM SULFATE 50 % INJ SOLN,4720,J3475,,Inj magnesium sulfate,2 mL,63323-0064-23,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,MAGNESIUM SULFATE 50 % INJ SOLN,4720,J3475,,Inj magnesium sulfate,2 mL,63323-0064-23,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,POTASSIUM CHLORIDE 10 MEQ/100ML IV SOLN,11074,J3480,,Inj potassium chloride,100 mL,00338-0709-48,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,71.66,% of charge rate,100.00%,71.66,,,,68.08,71.66,1
unity,NDC,POTASSIUM CHLORIDE 10 MEQ/100ML IV SOLN,11074,J3480,,Inj potassium chloride,100 mL,00338-0709-48,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,71.66,% of charge rate,100.00%,71.66,,,,68.08,71.66,1
unity,NDC,POTASSIUM CHLORIDE IN NACL 20-0.9 MEQ/L-% IV SOLN,11081,J3480,,Inj potassium chloride,"1,000 mL",00264-7865-00,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,63.27,% of charge rate,100.00%,63.27,,,,60.11,63.27,1
unity,NDC,POTASSIUM CHLORIDE IN NACL 20-0.9 MEQ/L-% IV SOLN,11081,J3480,,Inj potassium chloride,"1,000 mL",00264-7865-00,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,63.27,% of charge rate,100.00%,63.27,,,,60.11,63.27,1
unity,NDC,POTASSIUM CHLORIDE IN NACL 20-0.45 MEQ/L-% IV SOLN,36046,J3480,,Inj potassium chloride,"1,000 mL",00990-9257-39,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,POTASSIUM CHLORIDE IN NACL 20-0.45 MEQ/L-% IV SOLN,36046,J3480,,Inj potassium chloride,"1,000 mL",00990-9257-39,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,80.04,% of charge rate,100.00%,80.04,,,,76.04,80.04,1
unity,NDC,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,6429,J3480,,Inj potassium chloride,20 mL,00409-6653-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,POTASSIUM CHLORIDE 2 MEQ/ML IV SOLN,6429,J3480,,Inj potassium chloride,20 mL,00409-6653-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,ZOLEDRONIC ACID 5 MG/100ML IV SOLN,81434,J3489,,Zoledronic acid 1mg,100 mL,55111-0688-52,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,791.30",% of charge rate,100.00%,"2,791.30",,,,"2,651.74","2,791.30",1
unity,NDC,ZOLEDRONIC ACID 5 MG/100ML IV SOLN,81434,J3489,,Zoledronic acid 1mg,100 mL,55111-0688-52,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,791.30",% of charge rate,100.00%,"2,791.30",,,,"2,651.74","2,791.30",1
unity,NDC,LABETALOL HCL 5 MG/ML IV SOLN,10372,J3490,,Drugs unclassified injection,20 mL,00409-2267-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LABETALOL HCL 5 MG/ML IV SOLN,10372,J3490,,Drugs unclassified injection,20 mL,00409-2267-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 1 % INJ SOLN,106253,J3490,,Drugs unclassified injection,1 mL,63323-0492-57,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 1 % INJ SOLN,106253,J3490,,Drugs unclassified injection,1 mL,63323-0492-57,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 2 % INJ SOLN,106254,J3490,,Drugs unclassified injection,1 mL,00143-9594-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 2 % INJ SOLN,106254,J3490,,Drugs unclassified injection,1 mL,00143-9594-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 2 % INJ SOLN,106254,J3490,,Drugs unclassified injection,1 mL,00143-9594-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 2 % INJ SOLN,106254,J3490,,Drugs unclassified injection,1 mL,00143-9594-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 0.5 % INJ SOLN,108973,J3490,,Drugs unclassified injection,50 mL,00409-4278-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL (PF) 0.5 % INJ SOLN,108973,J3490,,Drugs unclassified injection,50 mL,00409-4278-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FAMOTIDINE 20 MG/2ML IV SOLN,127474,J3490,,Drugs unclassified injection,2 mL,00641-6022-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FAMOTIDINE 20 MG/2ML IV SOLN,127474,J3490,,Drugs unclassified injection,1 mL,00641-6022-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FAMOTIDINE 20 MG/2ML IV SOLN,127474,J3490,,Drugs unclassified injection,1 mL,00641-6022-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FAMOTIDINE 20 MG/2ML IV SOLN,127474,J3490,,Drugs unclassified injection,2 mL,00641-6022-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML PO SUSP,22560,J3490,,Drugs unclassified injection,60 mL,99408-0003-81,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,48.55,% of charge rate,100.00%,48.55,,,,46.12,48.55,1
unity,NDC,SULFAMETHOXAZOLE-TRIMETHOPRIM 200-40 MG/5ML PO SUSP,22560,J3490,,Drugs unclassified injection,60 mL,99408-0003-81,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,48.55,% of charge rate,100.00%,48.55,,,,46.12,48.55,1
unity,NDC,FLUMAZENIL 0.5 MG/5ML IV SOLN,39744,J3490,,Drugs unclassified injection,5 mL,00143-9684-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,FLUMAZENIL 0.5 MG/5ML IV SOLN,39744,J3490,,Drugs unclassified injection,5 mL,00143-9684-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL 0.5 % INJ SOLN,4451,J3490,,Drugs unclassified injection,50 mL,00409-4275-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,LIDOCAINE HCL 0.5 % INJ SOLN,4451,J3490,,Drugs unclassified injection,50 mL,00409-4275-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,METRONIDAZOLE IN NACL 5-0.79 MG/ML-% IV SOLN,5018,J3490,,Drugs unclassified injection,100 mL,00409-7811-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,56,% of charge rate,100.00%,56,,,,53.2,56,1
unity,NDC,METRONIDAZOLE IN NACL 5-0.79 MG/ML-% IV SOLN,5018,J3490,,Drugs unclassified injection,100 mL,00409-7811-24,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,56,% of charge rate,100.00%,56,,,,53.2,56,1
unity,NDC,METRONIDAZOLE IN NACL 5-0.79 MG/ML-% IV SOLN,5018,J3490,,Drugs unclassified injection,100 mL,00409-7811-24,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,56,% of charge rate,100.00%,56,,,,53.2,56,1
unity,NDC,METRONIDAZOLE IN NACL 5-0.79 MG/ML-% IV SOLN,5018,J3490,,Drugs unclassified injection,100 mL,00409-7811-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,56,% of charge rate,100.00%,56,,,,53.2,56,1
unity,NDC,VERAPAMIL HCL 2.5 MG/ML IV SOLN,8527,J3490,,Drugs unclassified injection,2 mL,70069-0271-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,81.95,% of charge rate,100.00%,81.95,,,,77.85,81.95,1
unity,NDC,VERAPAMIL HCL 2.5 MG/ML IV SOLN,8527,J3490,,Drugs unclassified injection,2 mL,70069-0271-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,81.95,% of charge rate,100.00%,81.95,,,,77.85,81.95,1
unity,NDC,AZTREONAM 2 G INJ SOLR,9186,J3490,,Drugs unclassified injection,2 g,00003-2570-16,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,133.45,% of charge rate,100.00%,133.45,,,,126.78,133.45,1
unity,NDC,AZTREONAM 2 G INJ SOLR,9186,J3490,,Drugs unclassified injection,2 g,00003-2570-16,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,133.45,% of charge rate,100.00%,133.45,,,,126.78,133.45,1
unity,NDC,LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX PRSY,146450,J3490.23,,,10 mL,76329-3011-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,34.83,% of charge rate,100.00%,34.83,,,,33.09,34.83,1
unity,NDC,LIDOCAINE HCL URETHRAL/MUCOSAL 2 % EX PRSY,146450,J3490.23,,,10 mL,76329-3011-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,34.83,% of charge rate,100.00%,34.83,,,,33.09,34.83,1
unity,NDC,EXENATIDE ER 2 MG SC PEN,128782,J3590,,Unclassified biologics,1 Each,00310-6530-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,449.77,% of charge rate,100.00%,449.77,,,,427.28,449.77,1
unity,NDC,EXENATIDE ER 2 MG SC PEN,128782,J3590,,Unclassified biologics,1 Each,00310-6530-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,449.77,% of charge rate,100.00%,449.77,,,,427.28,449.77,1
unity,NDC,EXENATIDE ER 2 MG SC PEN,128782,J3590,,Unclassified biologics,1 Each,00310-6530-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,449.77,% of charge rate,100.00%,449.77,,,,427.28,449.77,1
unity,NDC,EXENATIDE ER 2 MG SC PEN,128782,J3590,,Unclassified biologics,1 Each,00310-6530-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,449.77,% of charge rate,100.00%,449.77,,,,427.28,449.77,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00338-0049-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.48,% of charge rate,100.00%,60.48,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00990-7983-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.48,% of charge rate,100.00%,60.48,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,250 mL,00264-7800-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.9,% of charge rate,100.00%,47.9,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,250 mL,00990-7983-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,47.9,% of charge rate,100.00%,47.9,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,50 mL,00990-7984-13,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,59.36,% of charge rate,100.00%,59.36,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00264-7800-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,60.48,% of charge rate,100.00%,60.48,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,"1,000 mL",00264-7800-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,63.27,% of charge rate,100.00%,63.27,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,"1,000 mL",00990-7983-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,63.27,% of charge rate,100.00%,63.27,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00338-0049-48,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,61.03,% of charge rate,100.00%,61.03,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00990-7984-23,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,61.03,% of charge rate,100.00%,61.03,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00990-7984-37,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,61.03,% of charge rate,100.00%,61.03,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00990-7984-37,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,61.03,% of charge rate,100.00%,61.03,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00990-7984-23,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,61.03,% of charge rate,100.00%,61.03,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,100 mL,00338-0049-48,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,61.03,% of charge rate,100.00%,61.03,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,"1,000 mL",00990-7983-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,63.27,% of charge rate,100.00%,63.27,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,"1,000 mL",00264-7800-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,63.27,% of charge rate,100.00%,63.27,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00264-7800-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.48,% of charge rate,100.00%,60.48,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,50 mL,00990-7984-13,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,59.36,% of charge rate,100.00%,59.36,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,250 mL,00990-7983-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.9,% of charge rate,100.00%,47.9,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,250 mL,00264-7800-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,47.9,% of charge rate,100.00%,47.9,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00990-7983-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.48,% of charge rate,100.00%,60.48,,,,45.51,63.27,1
unity,NDC,SODIUM CHLORIDE 0.9 % IV SOLN,27838,J7030,,Normal saline solution infus,500 mL,00338-0049-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,60.48,% of charge rate,100.00%,60.48,,,,45.51,63.27,1
unity,NDC,DEXTROSE-NACL 5-0.45 % IV SOLN,15861,J7042,,5% dextrose/normal saline,500 mL,00409-7926-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,74.45,% of charge rate,100.00%,74.45,,,,54.8,74.45,1
unity,NDC,DEXTROSE-NACL 5-0.45 % IV SOLN,15861,J7042,,5% dextrose/normal saline,"1,000 mL",00990-7926-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,74.45,1
unity,NDC,DEXTROSE-NACL 5-0.45 % IV SOLN,15861,J7042,,5% dextrose/normal saline,"1,000 mL",00990-7926-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,74.45,1
unity,NDC,DEXTROSE-NACL 5-0.45 % IV SOLN,15861,J7042,,5% dextrose/normal saline,500 mL,00409-7926-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,74.45,% of charge rate,100.00%,74.45,,,,54.8,74.45,1
unity,NDC,DEXTROSE-NACL 5-0.9 % IV SOLN,15882,J7042,,5% dextrose/normal saline,"1,000 mL",00990-7941-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,DEXTROSE-NACL 5-0.9 % IV SOLN,15882,J7042,,5% dextrose/normal saline,"1,000 mL",00990-7941-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,250 mL,00990-7922-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.5,% of charge rate,100.00%,40.5,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,"1,000 mL",00990-7922-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,100 mL,00338-0017-38,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.12,% of charge rate,100.00%,57.12,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,100 mL,00990-7923-37,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.12,% of charge rate,100.00%,57.12,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,250 mL,00338-0017-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,40.5,% of charge rate,100.00%,40.5,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,250 mL,00338-0017-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.5,% of charge rate,100.00%,40.5,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,100 mL,00990-7923-37,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.12,% of charge rate,100.00%,57.12,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,100 mL,00338-0017-38,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.12,% of charge rate,100.00%,57.12,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,"1,000 mL",00990-7922-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN,2364,J7060,,5% dextrose/water,250 mL,00990-7922-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,40.5,% of charge rate,100.00%,40.5,,,,38.48,57.68,1
unity,NDC,DEXTROSE 5 % IV SOLN NON-PVC BAGS,40812364,J7060,,5% dextrose/water,250 mL,00264-7510-20,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.67,% of charge rate,100.00%,64.67,,,,52.15,64.67,1
unity,NDC,DEXTROSE 5 % IV SOLN NON-PVC BAGS,40812364,J7060,,5% dextrose/water,500 mL,00264-7510-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,54.89,% of charge rate,100.00%,54.89,,,,52.15,64.67,1
unity,NDC,DEXTROSE 5 % IV SOLN NON-PVC BAGS,40812364,J7060,,5% dextrose/water,500 mL,00264-7510-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,54.89,% of charge rate,100.00%,54.89,,,,52.15,64.67,1
unity,NDC,DEXTROSE 5 % IV SOLN NON-PVC BAGS,40812364,J7060,,5% dextrose/water,250 mL,00264-7510-20,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.67,% of charge rate,100.00%,64.67,,,,52.15,64.67,1
unity,NDC,LACTATED RINGERS IV SOLN,4318,J7120,,Ringers lactate infusion,"1,000 mL",00990-7953-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,LACTATED RINGERS IV SOLN,4318,J7120,,Ringers lactate infusion,500 mL,00409-7953-03,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,LACTATED RINGERS IV SOLN,4318,J7120,,Ringers lactate infusion,500 mL,00409-7953-03,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,LACTATED RINGERS IV SOLN,4318,J7120,,Ringers lactate infusion,"1,000 mL",00990-7953-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,DEXTROSE IN LACTATED RINGERS 5 % IV SOLN,9788,J7121,,5% dextrose in lac ringers,"1,000 mL",00990-7929-09,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,DEXTROSE IN LACTATED RINGERS 5 % IV SOLN,9788,J7121,,5% dextrose in lac ringers,"1,000 mL",00990-7929-09,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,57.68,% of charge rate,100.00%,57.68,,,,54.8,57.68,1
unity,NDC,LEVONORGESTREL 20 MCG/24HR IU IUD,29280,J7298,,"Mirena, 52 mg",1 Each,50419-0423-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,480.63",% of charge rate,100.00%,"2,480.63",,,,"2,356.60","2,480.63",1
unity,NDC,LEVONORGESTREL 20 MCG/24HR IU IUD,29280,J7298,,"Mirena, 52 mg",1 Each,50419-0423-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,480.63",% of charge rate,100.00%,"2,480.63",,,,"2,356.60","2,480.63",1
unity,NDC,PARAGARD INTRAUTERINE COPPER IU IUD,6040,J7300,,Intraut copper contraceptive,1 Each,59365-5128-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,301.20",% of charge rate,100.00%,"2,301.20",,,,"2,186.14","2,301.20",1
unity,NDC,PARAGARD INTRAUTERINE COPPER IU IUD,6040,J7300,,Intraut copper contraceptive,1 Each,59365-5128-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,301.20",% of charge rate,100.00%,"2,301.20",,,,"2,186.14","2,301.20",1
unity,NDC,ETONOGESTREL 68 MG SC IMPL,77012,J7307,,Etonogestrel implant system,68 mg,00052-4330-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,316.28",% of charge rate,100.00%,"2,316.28",,,,"2,200.47","2,316.28",1
unity,NDC,ETONOGESTREL 68 MG SC IMPL,77012,J7307,,Etonogestrel implant system,68 mg,00052-4330-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,316.28",% of charge rate,100.00%,"2,316.28",,,,"2,200.47","2,316.28",1
unity,NDC,SODIUM HYALURONATE 60 MG/3ML IX PRSY,141170,J7318,,"Inj, durolane 1 mg",3 mL,89130-2020-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,211.47",% of charge rate,100.00%,"2,211.47",,,,"2,100.90","2,211.47",1
unity,NDC,SODIUM HYALURONATE 60 MG/3ML IX PRSY,141170,J7318,,"Inj, durolane 1 mg",3 mL,89130-2020-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,211.47",% of charge rate,100.00%,"2,211.47",,,,"2,100.90","2,211.47",1
unity,NDC,ACETAMINOPHEN 325 MG PO TABS,101,J7323,,Euflexxa inj per dose,1 Tab,00904-6773-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ACETAMINOPHEN 325 MG PO TABS,101,J7323,,Euflexxa inj per dose,1 Tab,00904-6773-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,EUFLEXXA 20 MG/2ML IX SOLN,600170,J7323,,Euflexxa inj per dose,2 mL,55566-4100-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,879.13,% of charge rate,100.00%,879.13,,,,835.17,879.13,1
unity,NDC,EUFLEXXA 20 MG/2ML IX SOLN,600170,J7323,,Euflexxa inj per dose,2 mL,55566-4100-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,879.13,% of charge rate,100.00%,879.13,,,,835.17,879.13,1
unity,NDC,PREDNISONE 1 MG PO TABS,6493,J7512,,Prednisone ir or dr oral 1mg,1 Tab,00054-8739-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 1 MG PO TABS,6493,J7512,,Prednisone ir or dr oral 1mg,1 Tab,00054-8739-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 10 MG PO TABS,6494,J7512,,Prednisone ir or dr oral 1mg,1 Tab,00904-6923-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 10 MG PO TABS,6494,J7512,,Prednisone ir or dr oral 1mg,1 Tab,00904-6923-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 20 MG PO TABS,6496,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0145-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 20 MG PO TABS,6496,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0145-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 5 MG PO TABS,6497,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0122-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 5 MG PO TABS,6497,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0122-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 5 MG PO TABS,6497,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0122-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PREDNISONE 5 MG PO TABS,6497,J7512,,Prednisone ir or dr oral 1mg,1 Tab,60687-0122-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ARFORMOTEROL TARTRATE 15 MCG/2ML IN NEBU,77581,J7605,,Arformoterol non-comp unit,2 mL,63402-0911-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,69.28,% of charge rate,100.00%,69.28,,,,65.82,69.28,1
unity,NDC,ARFORMOTEROL TARTRATE 15 MCG/2ML IN NEBU,77581,J7605,,Arformoterol non-comp unit,2 mL,63402-0911-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,69.28,% of charge rate,100.00%,69.28,,,,65.82,69.28,1
unity,NDC,ACETYLCYSTEINE 20 % IN SOLN,123,J7608,,Acetylcysteine non-comp unit,4 mL,00517-7604-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.53,% of charge rate,100.00%,21.53,,,,20.45,21.53,1
unity,NDC,ACETYLCYSTEINE 20 % IN SOLN,123,J7608,,Acetylcysteine non-comp unit,4 mL,00517-7604-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.53,% of charge rate,100.00%,21.53,,,,20.45,21.53,1
unity,NDC,ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% IN NEBU,250,J7613,,Albuterol non-comp unit,3 mL,00487-9501-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% IN NEBU,250,J7613,,Albuterol non-comp unit,3 mL,00487-9501-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML IN SOLN,94009,J7620,,Albuterol ipratrop non-comp,3 mL,00378-9671-31,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML IN SOLN,94009,J7620,,Albuterol ipratrop non-comp,3 mL,00378-9671-93,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML IN SOLN,94009,J7620,,Albuterol ipratrop non-comp,3 mL,00378-9671-93,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,IPRATROPIUM-ALBUTEROL 0.5-2.5 (3) MG/3ML IN SOLN,94009,J7620,,Albuterol ipratrop non-comp,3 mL,00378-9671-31,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,BUDESONIDE 0.5 MG/2ML IN SUSP,28775,J7626,,Budesonide non-comp unit,1 Each,00487-9701-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,50.92,% of charge rate,100.00%,50.92,,,,48.37,50.92,1
unity,NDC,BUDESONIDE 0.5 MG/2ML IN SUSP,28775,J7626,,Budesonide non-comp unit,1 Each,00487-9701-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,50.92,% of charge rate,100.00%,50.92,,,,48.37,50.92,1
unity,NDC,DEXAMETHASONE 0.5 MG/5ML PO SOLN,2320,J8540,,Oral dexamethasone,5 mL,00054-3177-63,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DEXAMETHASONE 0.5 MG/5ML PO SOLN,2320,J8540,,Oral dexamethasone,5 mL,00054-3177-63,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DEXAMETHASONE 4 MG PO TABS,2327,J8540,,Oral dexamethasone,1 Tab,00054-8175-25,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.31,% of charge rate,100.00%,6.31,,,,5.99,6.31,1
unity,NDC,DEXAMETHASONE 4 MG PO TABS,2327,J8540,,Oral dexamethasone,1 Tab,00054-8175-25,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.31,% of charge rate,100.00%,6.31,,,,5.99,6.31,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML ORAL SOLN,600448,J8540,,Oral dexamethasone,0.5 mL,99408-0003-44,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,4.07,% of charge rate,100.00%,4.07,,,,3.87,6.64,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML ORAL SOLN,600448,J8540,,Oral dexamethasone,1 mL,63323-0165-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,6.64,% of charge rate,100.00%,6.64,,,,3.87,6.64,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML ORAL SOLN,600448,J8540,,Oral dexamethasone,1 mL,63323-0165-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,6.64,% of charge rate,100.00%,6.64,,,,3.87,6.64,1
unity,NDC,DEXAMETHASONE SODIUM PHOSPHATE 4 MG/ML ORAL SOLN,600448,J8540,,Oral dexamethasone,0.5 mL,99408-0003-44,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,4.07,% of charge rate,100.00%,4.07,,,,3.87,6.64,1
unity,NDC,AZACITIDINE 100 MG INJ SUSR,78420,J9025,,Azacitidine injection,100 mg,00781-3253-94,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,831.5,% of charge rate,100.00%,831.5,,,,789.93,831.5,1
unity,NDC,AZACITIDINE 100 MG INJ SUSR,78420,J9025,,Azacitidine injection,100 mg,00781-3253-94,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,831.5,% of charge rate,100.00%,831.5,,,,789.93,831.5,1
unity,NDC,BEVACIZUMAB 100 MG/4ML IV SOLN,111073,J9035,,Bevacizumab injection,0.05 mL,50242-0060-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.9,% of charge rate,100.00%,87.9,,,,83.51,87.9,1
unity,NDC,BEVACIZUMAB 100 MG/4ML IV SOLN,111073,J9035,,Bevacizumab injection,0.05 mL,50242-0060-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.9,% of charge rate,100.00%,87.9,,,,83.51,87.9,1
unity,NDC,BEVACIZUMAB 400 MG/16ML IV SOLN,111074,J9035,,Bevacizumab injection,16 mL,50242-0061-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"8,350.38",% of charge rate,100.00%,"8,350.38",,,,"7,932.86","8,350.38",1
unity,NDC,BEVACIZUMAB 400 MG/16ML IV SOLN,111074,J9035,,Bevacizumab injection,16 mL,50242-0061-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"8,350.38",% of charge rate,100.00%,"8,350.38",,,,"7,932.86","8,350.38",1
unity,NDC,DURVALUMAB 120 MG/2.4ML IV SOLN,139943,J9173,,"Inj., durvalumab, 10 mg",2.4 mL,00310-4500-12,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,281.88",% of charge rate,100.00%,"2,281.88",,,,"2,167.79","2,281.88",1
unity,NDC,DURVALUMAB 120 MG/2.4ML IV SOLN,139943,J9173,,"Inj., durvalumab, 10 mg",2.4 mL,00310-4500-12,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,281.88",% of charge rate,100.00%,"2,281.88",,,,"2,167.79","2,281.88",1
unity,NDC,DURVALUMAB 500 MG/10ML IV SOLN,139944,J9173,,"Inj., durvalumab, 10 mg",10 mL,00310-4611-50,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,311.50",% of charge rate,100.00%,"9,311.50",,,,"8,845.93","9,311.50",1
unity,NDC,DURVALUMAB 500 MG/10ML IV SOLN,139944,J9173,,"Inj., durvalumab, 10 mg",10 mL,00310-4611-50,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,311.50",% of charge rate,100.00%,"9,311.50",,,,"8,845.93","9,311.50",1
unity,NDC,FLUOROURACIL 1 GM/20ML IV SOLN,82204,J9190,,Fluorouracil injection,20 mL,16729-0276-67,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,82.68,% of charge rate,100.00%,82.68,,,,78.55,82.68,1
unity,NDC,FLUOROURACIL 1 GM/20ML IV SOLN,82204,J9190,,Fluorouracil injection,20 mL,16729-0276-67,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,82.68,% of charge rate,100.00%,82.68,,,,78.55,82.68,1
unity,NDC,LEUPROLIDE ACETATE (4 MONTH) 30 MG SC KIT,35236,J9217,,Leuprolide acetate suspnsion,30 mg,62935-0303-30,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,210.50",% of charge rate,100.00%,"1,210.50",,,,"1,149.98","1,210.50",1
unity,NDC,LEUPROLIDE ACETATE (4 MONTH) 30 MG SC KIT,35236,J9217,,Leuprolide acetate suspnsion,30 mg,62935-0303-30,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,210.50",% of charge rate,100.00%,"1,210.50",,,,"1,149.98","1,210.50",1
unity,NDC,LEUPROLIDE ACETATE (6 MONTH) 45 MG SC KIT,40801,J9217,,Leuprolide acetate suspnsion,45 mg,62935-0453-45,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,826.70",% of charge rate,100.00%,"1,826.70",,,,"1,735.37","1,826.70",1
unity,NDC,LEUPROLIDE ACETATE (6 MONTH) 45 MG SC KIT,40801,J9217,,Leuprolide acetate suspnsion,45 mg,62935-0453-45,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,826.70",% of charge rate,100.00%,"1,826.70",,,,"1,735.37","1,826.70",1
unity,NDC,PEMBROLIZUMAB 100 MG/4ML IV SOLN,130696,J9271,,Inj pembrolizumab,4 mL,00006-3026-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"12,516.52",% of charge rate,100.00%,"12,516.52",,,,"11,890.69","12,516.52",1
unity,NDC,PEMBROLIZUMAB 100 MG/4ML IV SOLN,130696,J9271,,Inj pembrolizumab,4 mL,00006-3026-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"12,516.52",% of charge rate,100.00%,"12,516.52",,,,"11,890.69","12,516.52",1
unity,NDC,NIVOLUMAB 240 MG/24ML IV SOLN,141539,J9299,,"Injection, nivolumab",24 mL,00003-3734-13,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"17,171.14",% of charge rate,100.00%,"17,171.14",,,,"16,312.58","17,171.14",1
unity,NDC,NIVOLUMAB 240 MG/24ML IV SOLN,141539,J9299,,"Injection, nivolumab",24 mL,00003-3734-13,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"17,171.14",% of charge rate,100.00%,"17,171.14",,,,"16,312.58","17,171.14",1
unity,NDC,FULVESTRANT 250 MG/5ML IM SOLN,111104,J9395,,"Injection, fulvestrant",10 mL,00310-0720-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,009.25",% of charge rate,100.00%,"5,009.25",,,,"4,758.79","5,009.25",1
unity,NDC,FULVESTRANT 250 MG/5ML IM SOLN,111104,J9395,,"Injection, fulvestrant",10 mL,00310-0720-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"5,009.25",% of charge rate,100.00%,"5,009.25",,,,"4,758.79","5,009.25",1
unity,NDC,ALBUMIN HUMAN 25 % IV SOLN,8981,P9046,,"Albumin (human), 25%, 20 ml",100 mL,00944-0493-02,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,272.96,% of charge rate,100.00%,272.96,,,,259.31,272.96,1
unity,NDC,ALBUMIN HUMAN 25 % IV SOLN,8981,P9046,,"Albumin (human), 25%, 20 ml",100 mL,00944-0493-02,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,272.96,% of charge rate,100.00%,272.96,,,,259.31,272.96,1
unity,NDC,FERUMOXYTOL 510 MG/17ML IV SOLN,96660,Q0138,,"Ferumoxytol, non-esrd",17 mL,59338-0775-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,692.31",% of charge rate,100.00%,"2,692.31",,,,"2,557.69","2,692.31",1
unity,NDC,FERUMOXYTOL 510 MG/17ML IV SOLN,96660,Q0138,,"Ferumoxytol, non-esrd",17 mL,59338-0775-10,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,692.31",% of charge rate,100.00%,"2,692.31",,,,"2,557.69","2,692.31",1
unity,NDC,FERUMOXYTOL 510 MG/17ML IV SOLN,96660,Q0138,,"Ferumoxytol, non-esrd",17 mL,59338-0775-10,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,692.31",% of charge rate,100.00%,"2,692.31",,,,"2,557.69","2,692.31",1
unity,NDC,FERUMOXYTOL 510 MG/17ML IV SOLN,96660,Q0138,,"Ferumoxytol, non-esrd",17 mL,59338-0775-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"2,692.31",% of charge rate,100.00%,"2,692.31",,,,"2,557.69","2,692.31",1
unity,NDC,PROCHLORPERAZINE MALEATE 10 MG PO TABS,6582,Q0164,,Prochlorperazine maleate 5mg,1 Tab,59746-0115-06,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PROCHLORPERAZINE MALEATE 10 MG PO TABS,6582,Q0164,,Prochlorperazine maleate 5mg,1 Tab,59746-0115-06,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,DRONABINOL 2.5 MG PO CAPS,9904,Q0167,,Dronabinol 2.5mg oral,1 Cap,67877-0568-60,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,9.77,% of charge rate,100.00%,9.77,,,,9.28,9.77,1
unity,NDC,DRONABINOL 2.5 MG PO CAPS,9904,Q0167,,Dronabinol 2.5mg oral,1 Cap,67877-0568-60,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,9.77,% of charge rate,100.00%,9.77,,,,9.28,9.77,1
unity,NDC,PROMETHAZINE HCL 25 MG PO TABS,6622,Q0169,,Promethazine hcl 12.5mg oral,1 Tab,00904-6461-61,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,PROMETHAZINE HCL 25 MG PO TABS,6622,Q0169,,Promethazine hcl 12.5mg oral,1 Tab,00904-6461-61,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.5,% of charge rate,100.00%,3.5,,,,3.33,3.5,1
unity,NDC,HYDROXYZINE PAMOATE 25 MG PO CAPS,3777,Q0177,,Hydroxyzine pamoate 25mg,1 Cap,68084-0847-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,1
unity,NDC,HYDROXYZINE PAMOATE 25 MG PO CAPS,3777,Q0177,,Hydroxyzine pamoate 25mg,1 Cap,68084-0847-11,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,1
unity,NDC,HYDROXYZINE PAMOATE 25 MG PO CAPS,3777,Q0177,,Hydroxyzine pamoate 25mg,1 Cap,68084-0847-11,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,1
unity,NDC,HYDROXYZINE PAMOATE 25 MG PO CAPS,3777,Q0177,,Hydroxyzine pamoate 25mg,1 Cap,68084-0847-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,3.51,% of charge rate,100.00%,3.51,,,,3.33,3.51,1
unity,NDC,FILGRASTIM-SNDZ 300 MCG/0.5ML INJ SOSY,133079,Q5101,,"Injection, zarxio",0.5 mL,61314-0318-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,597.5,% of charge rate,100.00%,597.5,,,,567.63,597.5,1
unity,NDC,FILGRASTIM-SNDZ 300 MCG/0.5ML INJ SOSY,133079,Q5101,,"Injection, zarxio",0.5 mL,61314-0318-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,597.5,% of charge rate,100.00%,597.5,,,,567.63,597.5,1
unity,NDC,FILGRASTIM-SNDZ 480 MCG/0.8ML INJ SOSY,133080,Q5101,,"Injection, zarxio",0.8 mL,61314-0326-05,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,847.05,% of charge rate,100.00%,847.05,,,,804.7,847.05,1
unity,NDC,FILGRASTIM-SNDZ 480 MCG/0.8ML INJ SOSY,133080,Q5101,,"Injection, zarxio",0.8 mL,61314-0326-05,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,847.05,% of charge rate,100.00%,847.05,,,,804.7,847.05,1
unity,NDC,INFLIXIMAB-DYYB 100 MG IV SOLR,137250,Q5103,,"Injection, inflectra",100 mg,00069-0809-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,369.85",% of charge rate,100.00%,"1,369.85",,,,"1,301.36","1,369.85",1
unity,NDC,INFLIXIMAB-DYYB 100 MG IV SOLR,137250,Q5103,,"Injection, inflectra",100 mg,00069-0809-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,369.85",% of charge rate,100.00%,"1,369.85",,,,"1,301.36","1,369.85",1
unity,NDC,BEVACIZUMAB-AWWB 100 MG/4ML IV SOLN,145807,Q5107,,Inj mvasi 10 mg,4 mL,55513-0206-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,793.44",% of charge rate,100.00%,"1,793.44",,,,"1,703.77","1,793.44",1
unity,NDC,BEVACIZUMAB-AWWB 100 MG/4ML IV SOLN,145807,Q5107,,Inj mvasi 10 mg,4 mL,55513-0206-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"1,793.44",% of charge rate,100.00%,"1,793.44",,,,"1,703.77","1,793.44",1
unity,NDC,PEGFILGRASTIM-CBQV 6 MG/0.6ML SC SOSY,144183,Q5111,,"Injection, udenyca 0.5 mg",0.6 mL,70114-0101-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,004.81",% of charge rate,100.00%,"9,004.81",,,,"8,554.57","9,004.81",1
unity,NDC,PEGFILGRASTIM-CBQV 6 MG/0.6ML SC SOSY,144183,Q5111,,"Injection, udenyca 0.5 mg",0.6 mL,70114-0101-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,"9,004.81",% of charge rate,100.00%,"9,004.81",,,,"8,554.57","9,004.81",1
unity,NDC,PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP,127708,Q9957,,"Inj perflutren lip micros,ml",2 mL,11994-0011-04,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,287.5,% of charge rate,100.00%,287.5,,,,273.13,287.5,1
unity,NDC,PERFLUTREN LIPID MICROSPHERE 6.52 MG/ML IV SUSP,127708,Q9957,,"Inj perflutren lip micros,ml",2 mL,11994-0011-04,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,287.5,% of charge rate,100.00%,287.5,,,,273.13,287.5,1
unity,NDC,IOHEXOL 350 MG/ML IV SOLN,10323,Q9967,,"Locm 300-399mg/ml iodine,1ml",55 mL,00407-1414-90,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,64.17,% of charge rate,100.00%,64.17,,,,60.96,116.67,1
unity,NDC,IOHEXOL 350 MG/ML IV SOLN,10323,Q9967,,"Locm 300-399mg/ml iodine,1ml",100 mL,00407-1414-91,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,116.67,% of charge rate,100.00%,116.67,,,,60.96,116.67,1
unity,NDC,IOHEXOL 350 MG/ML IV SOLN,10323,Q9967,,"Locm 300-399mg/ml iodine,1ml",100 mL,00407-1414-91,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,116.67,% of charge rate,100.00%,116.67,,,,60.96,116.67,1
unity,NDC,IOHEXOL 350 MG/ML IV SOLN,10323,Q9967,,"Locm 300-399mg/ml iodine,1ml",55 mL,00407-1414-90,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,64.17,% of charge rate,100.00%,64.17,,,,60.96,116.67,1
unity,NDC,IOPAMIDOL 76 % IV SOLN,10328,Q9967,,"Locm 300-399mg/ml iodine,1ml",100 mL,00270-1316-35,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,87.5,% of charge rate,100.00%,87.5,,,,83.13,87.5,1
unity,NDC,IOPAMIDOL 76 % IV SOLN,10328,Q9967,,"Locm 300-399mg/ml iodine,1ml",100 mL,00270-1316-35,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,87.5,% of charge rate,100.00%,87.5,,,,83.13,87.5,1
unity,NDC,CONTRAST MATERIAL,2550003,Q9967,,"Locm 300-399mg/ml iodine,1ml",1,,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,0.17,% of charge rate,100.00%,0.17,,,,0.16,0.17,1
unity,NDC,CONTRAST MATERIAL,2550003,Q9967,,"Locm 300-399mg/ml iodine,1ml",1,,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,0.17,% of charge rate,100.00%,0.17,,,,0.16,0.17,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,62756-0129-44,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,00008-0923-51,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,62756-0129-40,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,62756-0129-40,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,00008-0923-51,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,PANTOPRAZOLE SODIUM 40 MG IV SOLR,26226,S0164,,Injection pantroprazole,40 mg,62756-0129-44,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,21.75,% of charge rate,100.00%,21.75,,,,20.66,21.75,1
unity,NDC,OLANZAPINE 10 MG IM SOLR,38263,S0166,,Inj olanzapine 2.5mg,10 mg,00517-0955-01,Inpatient,N/A,Self-Pay,N/A,N/A,N/A,123.16,% of charge rate,100.00%,123.16,,,,117,123.16,1
unity,NDC,OLANZAPINE 10 MG IM SOLR,38263,S0166,,Inj olanzapine 2.5mg,10 mg,00517-0955-01,Outpatient,N/A,Self-Pay,N/A,N/A,N/A,123.16,% of charge rate,100.00%,123.16,,,,117,123.16,1
unity,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W CC,,71,,NONSPECIFIC CEREBROVASCULAR DISORDERS W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"9,483.40",% of charge rate,,"9,483.40","9,483.40","9,483.40","9,483.40",,,0
unity,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC,,95,,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"40,187.86",% of charge rate,,"40,187.86","40,187.86","40,187.86","40,187.86",,,0
unity,DRG,PLEURAL EFFUSION W/O CC/MCC,,188,,PLEURAL EFFUSION W/O CC/MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"3,967.03",% of charge rate,,"3,967.03","3,967.03","3,967.03","3,967.03",,,0
unity,DRG,PULMONARY EDEMA & RESPIRATORY FAILURE,,189,,PULMONARY EDEMA & RESPIRATORY FAILURE,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"5,995.25",% of charge rate,,"5,995.25","5,995.25","5,995.25","5,995.25",,,0
unity,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC,,190,,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"9,757.13",% of charge rate,,"9,757.13","9,757.13","9,757.13","9,757.13",,,0
unity,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC,,192,,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"10,748.68",% of charge rate,,"10,748.68","10,748.68","10,748.68","10,748.68",,,0
unity,DRG,SIMPLE PNEUMONIA & PLEURISY W MCC,,193,,SIMPLE PNEUMONIA & PLEURISY W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"9,799.57",% of charge rate,,"9,799.57","9,799.57","9,799.57","9,799.57",,,0
unity,DRG,SIMPLE PNEUMONIA & PLEURISY W CC,,194,,SIMPLE PNEUMONIA & PLEURISY W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"5,995.75",% of charge rate,,"5,995.75","5,995.75","5,995.75","5,995.75",,,0
unity,DRG,RESPIRATORY SIGNS & SYMPTOMS,,204,,RESPIRATORY SIGNS & SYMPTOMS,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"1,570.13",% of charge rate,,"1,570.13","1,570.13","1,570.13","1,570.13",,,0
unity,DRG,ACUTE & SUBACUTE ENDOCARDITIS W MCC,,288,,ACUTE & SUBACUTE ENDOCARDITIS W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"39,533.53",% of charge rate,,"39,533.53","39,533.53","39,533.53","39,533.53",,,0
unity,DRG,HEART FAILURE & SHOCK W MCC,,291,,HEART FAILURE & SHOCK W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"7,194.43",% of charge rate,,"7,194.43","7,194.43","7,194.43","7,194.43",,,0
unity,DRG,HEART FAILURE & SHOCK W CC,,292,,HEART FAILURE & SHOCK W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"4,084.48",% of charge rate,,"4,084.48","4,084.48","4,084.48","4,084.48",,,0
unity,DRG,HEART FAILURE & SHOCK W/O CC/MCC,,293,,HEART FAILURE & SHOCK W/O CC/MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"3,379.15",% of charge rate,,"3,379.15","3,379.15","3,379.15","3,379.15",,,0
unity,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC,,308,,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"7,173.64",% of charge rate,,"7,173.64","7,173.64","7,173.64","7,173.64",,,0
unity,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC,,309,,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"3,997.65",% of charge rate,,"3,997.65","3,997.65","3,997.65","3,997.65",,,0
unity,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,,310,,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"12,585.03",% of charge rate,,"12,585.03","12,585.03","12,585.03","12,585.03",,,0
unity,DRG,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,,372,,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"4,293.29",% of charge rate,,"4,293.29","4,293.29","4,293.29","4,293.29",,,0
unity,DRG,G.I. OBSTRUCTION W CC,,389,,G.I. OBSTRUCTION W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"9,130.22",% of charge rate,,"9,130.22","9,130.22","9,130.22","9,130.22",,,0
unity,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC",,392,,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC",,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"8,861.18",% of charge rate,,"8,861.18","8,861.18","8,861.18","8,861.18",,,0
unity,DRG,"DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W MCC",,441,,"DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W MCC",,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"1,399.61",% of charge rate,,"1,399.61","1,399.61","1,399.61","1,399.61",,,0
unity,DRG,DISORDERS OF THE BILIARY TRACT W MCC,,444,,DISORDERS OF THE BILIARY TRACT W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"8,638.55",% of charge rate,,"8,638.55","8,638.55","8,638.55","8,638.55",,,0
unity,DRG,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,483,,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"38,044.65",% of charge rate,,"38,044.65","38,044.65","38,044.65","38,044.65",,,0
unity,DRG,MEDICAL BACK PROBLEMS W/O MCC,,552,,MEDICAL BACK PROBLEMS W/O MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"5,843.38",% of charge rate,,"5,843.38","5,843.38","5,843.38","5,843.38",,,0
unity,DRG,BONE DISEASES & ARTHROPATHIES W/O MCC,,554,,BONE DISEASES & ARTHROPATHIES W/O MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"5,458.01",% of charge rate,,"5,458.01","5,458.01","5,458.01","5,458.01",,,0
unity,DRG,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC,,555,,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"4,462.15",% of charge rate,,"4,462.15","4,462.15","4,462.15","4,462.15",,,0
unity,DRG,"TENDONITIS, MYOSITIS & BURSITIS W/O MCC",,558,,"TENDONITIS, MYOSITIS & BURSITIS W/O MCC",,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"11,029.20",% of charge rate,,"11,029.20","11,029.20","11,029.20","11,029.20",,,0
unity,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC",,560,,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC",,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"7,509.08",% of charge rate,,"7,509.08","7,509.08","7,509.08","7,509.08",,,0
unity,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC",,561,,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC",,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"20,620.40",% of charge rate,,"20,620.40","20,620.40","20,620.40","20,620.40",,,0
unity,DRG,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC,,565,,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"8,494.29",% of charge rate,,"8,494.29","8,494.29","8,494.29","8,494.29",,,0
unity,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC",,605,,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC",,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"5,083.35",% of charge rate,,"5,083.35","5,083.35","5,083.35","5,083.35",,,0
unity,DRG,DIABETES W CC,,638,,DIABETES W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"11,123.88",% of charge rate,,"11,123.88","11,123.88","11,123.88","11,123.88",,,0
unity,DRG,"MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W MCC",,640,,"MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W MCC",,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"6,996.81",% of charge rate,,"6,996.81","6,996.81","6,996.81","6,996.81",,,0
unity,DRG,"MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W/O MCC",,641,,"MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W/O MCC",,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"4,813.71",% of charge rate,,"4,813.71","4,813.71","4,813.71","4,813.71",,,0
unity,DRG,ENDOCRINE DISORDERS W CC,,644,,ENDOCRINE DISORDERS W CC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"4,912.85",% of charge rate,,"4,912.85","4,912.85","4,912.85","4,912.85",,,0
unity,DRG,RENAL FAILURE W MCC,,682,,RENAL FAILURE W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"1,775.63",% of charge rate,,"1,775.63","1,775.63","1,775.63","1,775.63",,,0
unity,DRG,RENAL FAILURE W/O CC/MCC,,684,,RENAL FAILURE W/O CC/MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"3,871.52",% of charge rate,,"3,871.52","3,871.52","3,871.52","3,871.52",,,0
unity,DRG,KIDNEY & URINARY TRACT INFECTIONS W MCC,,689,,KIDNEY & URINARY TRACT INFECTIONS W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"4,799.40",% of charge rate,,"4,799.40","4,799.40","4,799.40","4,799.40",,,0
unity,DRG,KIDNEY & URINARY TRACT INFECTIONS W/O MCC,,690,,KIDNEY & URINARY TRACT INFECTIONS W/O MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"3,941.57",% of charge rate,,"3,941.57","3,941.57","3,941.57","3,941.57",,,0
unity,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC,,698,,OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"3,921.85",% of charge rate,,"3,921.85","3,921.85","3,921.85","3,921.85",,,0
unity,DRG,RED BLOOD CELL DISORDERS W MCC,,811,,RED BLOOD CELL DISORDERS W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"1,057.32",% of charge rate,,"1,057.32","1,057.32","1,057.32","1,057.32",,,0
unity,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC,,897,,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"3,529.12",% of charge rate,,"3,529.12","3,529.12","3,529.12","3,529.12",,,0
unity,DRG,SIGNS & SYMPTOMS W MCC,,947,,SIGNS & SYMPTOMS W MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"7,864.93",% of charge rate,,"7,864.93","7,864.93","7,864.93","7,864.93",,,0
unity,DRG,SIGNS & SYMPTOMS W/O MCC,,948,,SIGNS & SYMPTOMS W/O MCC,,,Inpatient,Hospital,Self-Pay,N/A,N/A,N/A,"8,970.51",% of charge rate,,"8,970.51","8,970.51","8,970.51","8,970.51",,,0
unity,DRG,NONSPECIFIC CEREBROVASCULAR DISORDERS W CC,,71,,NONSPECIFIC CEREBROVASCULAR DISORDERS W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"9,483.40",% of charge rate,95%,"9,009.23","9,009.23","9,009.23","9,009.23",,,0
unity,DRG,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC,,95,,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"40,187.86",% of charge rate,95%,"38,178.47","38,178.47","38,178.47","38,178.47",,,0
unity,DRG,PLEURAL EFFUSION W/O CC/MCC,,188,,PLEURAL EFFUSION W/O CC/MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"3,967.03",% of charge rate,95%,"3,768.68","3,768.68","3,768.68","3,768.68",,,0
unity,DRG,PULMONARY EDEMA & RESPIRATORY FAILURE,,189,,PULMONARY EDEMA & RESPIRATORY FAILURE,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"5,995.25",% of charge rate,95%,"5,695.49","5,695.49","5,695.49","5,695.49",,,0
unity,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC,,190,,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"9,757.13",% of charge rate,95%,"9,269.27","9,269.27","9,269.27","9,269.27",,,0
unity,DRG,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC,,192,,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"10,748.68",% of charge rate,95%,"10,211.25","10,211.25","10,211.25","10,211.25",,,0
unity,DRG,SIMPLE PNEUMONIA & PLEURISY W MCC,,193,,SIMPLE PNEUMONIA & PLEURISY W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"9,799.57",% of charge rate,95%,"9,309.59","9,309.59","9,309.59","9,309.59",,,0
unity,DRG,SIMPLE PNEUMONIA & PLEURISY W CC,,194,,SIMPLE PNEUMONIA & PLEURISY W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"5,995.75",% of charge rate,95%,"5,695.96","5,695.96","5,695.96","5,695.96",,,0
unity,DRG,RESPIRATORY SIGNS & SYMPTOMS,,204,,RESPIRATORY SIGNS & SYMPTOMS,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"1,570.13",% of charge rate,95%,"1,491.62","1,491.62","1,491.62","1,491.62",,,0
unity,DRG,ACUTE & SUBACUTE ENDOCARDITIS W MCC,,288,,ACUTE & SUBACUTE ENDOCARDITIS W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"39,533.53",% of charge rate,95%,"37,556.85","37,556.85","37,556.85","37,556.85",,,0
unity,DRG,HEART FAILURE & SHOCK W MCC,,291,,HEART FAILURE & SHOCK W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"7,194.43",% of charge rate,95%,"6,834.71","6,834.71","6,834.71","6,834.71",,,0
unity,DRG,HEART FAILURE & SHOCK W CC,,292,,HEART FAILURE & SHOCK W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"4,084.48",% of charge rate,95%,"3,880.26","3,880.26","3,880.26","3,880.26",,,0
unity,DRG,HEART FAILURE & SHOCK W/O CC/MCC,,293,,HEART FAILURE & SHOCK W/O CC/MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"3,379.15",% of charge rate,95%,"3,210.19","3,210.19","3,210.19","3,210.19",,,0
unity,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC,,308,,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"7,173.64",% of charge rate,95%,"6,814.96","6,814.96","6,814.96","6,814.96",,,0
unity,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC,,309,,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"3,997.65",% of charge rate,95%,"3,797.77","3,797.77","3,797.77","3,797.77",,,0
unity,DRG,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,,310,,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"12,585.03",% of charge rate,95%,"11,955.78","11,955.78","11,955.78","11,955.78",,,0
unity,DRG,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,,372,,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"4,293.29",% of charge rate,95%,"4,078.63","4,078.63","4,078.63","4,078.63",,,0
unity,DRG,G.I. OBSTRUCTION W CC,,389,,G.I. OBSTRUCTION W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"9,130.22",% of charge rate,95%,"8,673.71","8,673.71","8,673.71","8,673.71",,,0
unity,DRG,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC",,392,,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC",,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"8,861.18",% of charge rate,95%,"8,418.12","8,418.12","8,418.12","8,418.12",,,0
unity,DRG,"DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W MCC",,441,,"DISORDERS OF LIVER EXCEPT MALIG, CIRR, ALC HEPA W MCC",,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"1,399.61",% of charge rate,95%,"1,329.63","1,329.63","1,329.63","1,329.63",,,0
unity,DRG,DISORDERS OF THE BILIARY TRACT W MCC,,444,,DISORDERS OF THE BILIARY TRACT W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"8,638.55",% of charge rate,95%,"8,206.62","8,206.62","8,206.62","8,206.62",,,0
unity,DRG,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,483,,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"38,044.65",% of charge rate,95%,"36,142.42","36,142.42","36,142.42","36,142.42",,,0
unity,DRG,MEDICAL BACK PROBLEMS W/O MCC,,552,,MEDICAL BACK PROBLEMS W/O MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"5,843.38",% of charge rate,95%,"5,551.21","5,551.21","5,551.21","5,551.21",,,0
unity,DRG,BONE DISEASES & ARTHROPATHIES W/O MCC,,554,,BONE DISEASES & ARTHROPATHIES W/O MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"5,458.01",% of charge rate,95%,"5,185.11","5,185.11","5,185.11","5,185.11",,,0
unity,DRG,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC,,555,,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"4,462.15",% of charge rate,95%,"4,239.04","4,239.04","4,239.04","4,239.04",,,0
unity,DRG,"TENDONITIS, MYOSITIS & BURSITIS W/O MCC",,558,,"TENDONITIS, MYOSITIS & BURSITIS W/O MCC",,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"11,029.20",% of charge rate,95%,"10,477.74","10,477.74","10,477.74","10,477.74",,,0
unity,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC",,560,,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC",,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"7,509.08",% of charge rate,95%,"7,133.63","7,133.63","7,133.63","7,133.63",,,0
unity,DRG,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC",,561,,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC",,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"20,620.40",% of charge rate,95%,"19,589.38","19,589.38","19,589.38","19,589.38",,,0
unity,DRG,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC,,565,,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"8,494.29",% of charge rate,95%,"8,069.58","8,069.58","8,069.58","8,069.58",,,0
unity,DRG,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC",,605,,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC",,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"5,083.35",% of charge rate,95%,"4,829.18","4,829.18","4,829.18","4,829.18",,,0
unity,DRG,DIABETES W CC,,638,,DIABETES W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"11,123.88",% of charge rate,95%,"10,567.69","10,567.69","10,567.69","10,567.69",,,0
unity,DRG,"MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W MCC",,640,,"MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W MCC",,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"6,996.81",% of charge rate,95%,"6,646.97","6,646.97","6,646.97","6,646.97",,,0
unity,DRG,"MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W/O MCC",,641,,"MISC DISORDERS OF NUTRITION, METABOLISM, FLUIDS/ELECTROLYTES W/O MCC",,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"4,813.71",% of charge rate,95%,"4,573.02","4,573.02","4,573.02","4,573.02",,,0
unity,DRG,ENDOCRINE DISORDERS W CC,,644,,ENDOCRINE DISORDERS W CC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"4,912.85",% of charge rate,95%,"4,667.21","4,667.21","4,667.21","4,667.21",,,0
unity,DRG,RENAL FAILURE W MCC,,682,,RENAL FAILURE W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"1,775.63",% of charge rate,95%,"1,686.85","1,686.85","1,686.85","1,686.85",,,0
unity,DRG,RENAL FAILURE W/O CC/MCC,,684,,RENAL FAILURE W/O CC/MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"3,871.52",% of charge rate,95%,"3,677.94","3,677.94","3,677.94","3,677.94",,,0
unity,DRG,KIDNEY & URINARY TRACT INFECTIONS W MCC,,689,,KIDNEY & URINARY TRACT INFECTIONS W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"4,799.40",% of charge rate,95%,"4,559.43","4,559.43","4,559.43","4,559.43",,,0
unity,DRG,KIDNEY & URINARY TRACT INFECTIONS W/O MCC,,690,,KIDNEY & URINARY TRACT INFECTIONS W/O MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"3,941.57",% of charge rate,95%,"3,744.49","3,744.49","3,744.49","3,744.49",,,0
unity,DRG,OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC,,698,,OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"3,921.85",% of charge rate,95%,"3,725.76","3,725.76","3,725.76","3,725.76",,,0
unity,DRG,RED BLOOD CELL DISORDERS W MCC,,811,,RED BLOOD CELL DISORDERS W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"1,057.32",% of charge rate,95%,"1,004.45","1,004.45","1,004.45","1,004.45",,,0
unity,DRG,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC,,897,,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"3,529.12",% of charge rate,95%,"3,352.66","3,352.66","3,352.66","3,352.66",,,0
unity,DRG,SIGNS & SYMPTOMS W MCC,,947,,SIGNS & SYMPTOMS W MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"7,864.93",% of charge rate,95%,"7,471.68","7,471.68","7,471.68","7,471.68",,,0
unity,DRG,SIGNS & SYMPTOMS W/O MCC,,948,,SIGNS & SYMPTOMS W/O MCC,,,Inpatient,Hospital,Sanford Health Plan,N/A,N/A,N/A,"8,970.51",% of charge rate,95%,"8,521.98","8,521.98","8,521.98","8,521.98",,,0
unity,% of charge,Swing bed,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota Blue Plus,,85% of charge,,,% of charge,,,,,,,,0
unity,% of charge,All other,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota Blue Plus,,70% of charge,,,% of charge,,,,,,,,0
unity,% of charge,Outlier,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota Blue Plus,,.8402 ratio of cost to charge for outliers,,,% of charge,,,,,,,,0
unity,% of charge,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield Minnesota Medicare Advantage,,100% of Blue Cross Medicare rates,,,% of charge,,,,,,,,0
unity,% of charge,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield Minnesota Medicare Platinum,,100% of Blue Cross Medicare rates,,,% of charge,,,,,,,,0
unity,% of charge,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield Minnesota Medicare Secure,,100% of Blue Cross Medicare rates,,,% of charge,,,,,,,,0
unity,% of charge,Outlier,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota MHCP,,.8402 ratio of cost to charge for outliers,,,% of charge,,,,,,,,0
unity,% of charge,All other,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota MHCP,,55% of charge,,,% of charge,,,,,,,,0
unity,% of charge,Swing bed,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota MHCP,,70% of charge,,,% of charge,,,,,,,,0
unity,% of charge,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Medicare,,interim rate of 71% of charge,,,% of charge,,,,,,,,0
unity,APR DRG,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota,,APR DRG v35,,,APR DRG,,,,,,,,0
unity,APR DRG,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota Blue Plus,,"APR DRG v35 base rate $15,298.76",,,APR DRG,,,,,,,,0
unity,APR DRG,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota MHCP,,"APR DRG v35 base rate $11,642.40",,,APR DRG,,,,,,,,0
unity,DRG,APR DRG 001 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 001 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$133,754.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 001 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 001 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$134,671.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 001 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 001 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$163,200.27 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 001 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 001 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$270,170.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 002 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 002 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$143,394.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 002 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 002 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$175,105.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 002 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 002 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$244,809.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 002 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 002 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$348,469.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 004 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 004 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$112,776.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 004 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 004 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$121,911.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 004 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 004 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$173,728.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 004 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 004 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$215,732.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 005 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 005 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$84,405.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 005 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 005 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$90,128.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 005 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 005 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$113,876.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 005 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 005 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$164,507.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 006 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 006 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$98,612.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 006 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 006 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$143,855.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 006 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 006 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$170,437.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 006 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 006 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$243,827.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 007 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 007 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$138,197.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 007 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 007 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$153,656.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 007 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 007 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$222,568.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 007 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 007 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$340,836.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 008 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 008 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,296.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 008 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 008 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$83,296.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 008 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 008 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$108,894.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 008 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 008 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$164,579.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 009 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 009 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$67,132.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 009 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 009 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$86,405.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 009 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 009 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$124,030.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 009 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 009 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$240,032.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 020 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 020 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,947.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 020 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 020 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,580.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 020 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 020 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$55,230.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 020 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 020 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$92,104.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 021 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 021 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,614.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 021 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 021 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$45,547.20 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 021 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 021 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$82,331.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 021 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 021 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$146,348.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 022 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 022 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,123.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 022 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 022 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,761.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 022 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 022 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,870.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 022 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 022 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$78,282.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 023 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 023 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,298.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 023 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 023 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,378.84 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 023 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 023 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$79,340.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 023 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 023 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$98,250.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 024 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 024 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,097.27 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 024 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 024 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,674.96 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 024 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 024 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,688.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 024 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 024 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,079.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 026 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 026 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,923.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 026 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 026 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,753.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 026 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 026 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,121.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 026 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 026 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$70,217.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 027 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 027 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,581.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 027 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 027 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,559.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 027 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 027 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$53,023.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 027 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 027 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$88,311.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 029 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 029 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,240.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 029 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 029 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,256.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 029 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 029 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,532.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 029 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 029 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$68,651.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 030 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 030 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,044.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 030 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 030 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$81,393.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 030 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 030 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$120,482.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 030 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 030 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$161,418.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 040 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 040 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,197.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 040 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 040 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,216.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 040 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 040 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,794.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 040 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 040 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,068.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 041 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 041 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,281.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 041 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 041 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,737.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 041 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 041 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,793.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 041 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 041 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,257.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 042 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 042 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,277.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 042 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 042 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,309.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 042 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 042 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,107.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 042 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 042 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,275.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 043 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 043 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,021.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 043 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 043 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,548.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 043 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 043 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,368.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 043 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 043 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,155.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 044 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 044 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,988.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 044 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 044 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,083.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 044 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 044 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,521.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 044 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 044 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,913.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 045 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 045 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,814.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 045 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 045 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,105.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 045 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 045 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,877.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 045 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 045 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,005.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 046 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 046 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,403.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 046 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 046 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,449.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 046 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 046 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,788.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 046 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 046 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,078.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 047 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 047 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,259.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 047 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 047 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,188.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 047 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 047 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,352.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 047 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 047 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,402.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 048 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 048 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,359.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 048 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 048 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,348.20 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 048 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 048 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,352.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 048 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 048 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,610.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 049 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 049 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,627.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 049 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 049 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,500.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 049 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 049 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,378.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 049 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 049 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$60,365.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 050 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 050 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,615.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 050 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 050 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,304.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 050 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 050 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,108.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 050 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 050 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$93,297.84 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 051 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 051 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,541.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 051 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 051 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,688.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 051 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 051 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,310.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 051 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 051 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,664.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 052 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 052 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,209.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 052 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 052 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,495.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 052 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 052 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,721.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 052 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 052 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,727.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 053 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 053 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,622.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 053 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 053 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,396.20 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 053 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 053 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,170.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 053 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 053 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,123.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 054 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 054 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,776.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 054 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 054 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,232.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 054 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 054 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,304.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 054 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 054 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,952.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 055 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 055 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,861.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 055 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 055 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,756.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 055 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 055 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,041.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 055 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 055 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,403.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 056 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 056 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,638.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 056 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 056 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,899.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 056 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 056 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,394.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 056 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 056 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,413.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 057 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 057 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,861.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 057 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 057 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,308.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 057 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 057 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,839.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 057 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 057 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,916.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 058 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 058 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,508.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 058 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 058 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,909.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 058 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 058 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,262.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 058 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 058 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$58,540.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 059 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 059 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,892.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 059 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 059 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,167.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 059 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 059 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,918.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 059 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 059 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,576.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 073 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 073 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,747.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 073 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 073 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,866.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 073 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 073 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,664.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 073 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 073 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$61,485.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 082 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 082 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,275.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 082 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 082 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,850.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 082 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 082 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,084.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 082 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 082 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,861.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 089 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 089 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,566.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 089 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 089 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,307.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 089 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 089 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,553.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 089 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 089 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$102,254.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 091 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 091 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,000.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 091 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 091 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,652.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 091 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 091 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,978.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 091 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 091 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$104,933.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 092 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 092 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,058.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 092 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 092 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,854.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 092 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 092 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$45,110.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 092 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 092 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$97,771.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 095 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 095 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,981.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 095 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 095 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,618.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 095 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 095 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,876.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 095 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 095 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,319.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 097 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 097 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,847.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 097 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 097 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,338.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 097 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 097 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,279.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 097 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 097 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$50,979.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 098 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 098 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,976.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 098 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 098 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,673.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 098 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 098 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,799.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 098 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 098 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,060.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 110 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 110 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,384.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 110 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 110 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,930.86 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 110 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 110 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,288.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 110 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 110 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,510.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 111 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 111 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,882.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 111 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 111 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,972.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 111 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 111 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,354.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 111 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 111 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,789.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 113 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 113 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,411.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 113 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 113 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,672.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 113 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 113 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,605.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 113 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 113 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,900.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 114 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 114 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,934.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 114 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 114 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,883.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 114 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 114 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,532.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 114 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 114 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,662.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 115 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 115 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,290.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 115 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 115 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,905.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 115 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 115 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,030.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 115 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 115 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,059.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 120 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 120 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,635.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 120 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 120 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$50,795.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 120 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 120 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$64,229.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 120 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 120 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$98,273.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 121 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 121 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,362.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 121 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 121 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,243.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 121 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 121 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,409.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 121 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 121 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$70,455.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 130 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 130 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$55,976.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 130 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 130 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,605.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 130 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 130 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$93,592.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 130 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 130 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$107,629.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 131 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 131 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,211.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 131 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 131 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,191.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 131 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 131 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,422.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 131 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 131 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$53,072.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 132 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 132 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,885.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 132 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 132 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,889.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 132 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 132 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,817.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 132 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 132 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,668.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 133 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 133 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,270.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 133 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 133 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,984.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 133 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 133 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,095.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 133 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 133 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,770.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 134 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 134 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,073.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 134 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 134 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,204.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 134 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 134 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,174.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 134 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 134 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,535.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 135 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 135 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,017.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 135 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 135 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,406.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 135 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 135 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,004.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 135 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 135 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,360.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 136 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 136 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,685.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 136 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 136 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,562.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 136 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 136 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,696.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 136 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 136 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$53,451.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 137 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 137 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,966.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 137 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 137 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,357.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 137 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 137 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,196.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 137 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 137 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,604.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 138 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 138 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,467.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 138 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 138 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,693.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 138 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 138 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,644.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 138 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 138 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,532.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 139 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 139 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,232.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 139 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 139 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,718.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 139 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 139 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,951.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 139 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 139 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,200.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 140 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 140 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,283.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 140 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 140 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,709.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 140 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 140 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,031.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 140 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 140 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,928.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 141 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 141 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,381.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 141 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 141 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,893.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 141 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 141 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,202.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 141 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 141 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,220.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 142 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 142 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,889.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 142 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 142 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,825.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 142 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 142 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,799.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 142 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 142 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,355.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 143 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 143 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,653.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 143 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 143 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,485.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 143 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 143 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,618.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 143 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 143 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,808.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 144 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 144 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,259.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 144 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 144 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,877.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 144 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 144 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,990.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 144 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 144 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,619.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 145 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 145 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,778.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 145 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 145 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,104.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 145 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 145 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,685.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 145 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 145 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,099.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 160 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 160 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,913.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 160 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 160 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$76,902.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 160 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 160 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$100,588.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 160 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 160 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$175,114.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 161 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 161 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$174,262.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 161 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 161 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$218,599.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 161 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 161 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$306,385.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 161 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 161 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$383,538.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 162 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 162 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$76,442.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 162 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 162 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$88,991.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 162 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 162 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$96,590.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 162 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 162 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$142,825.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 163 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 163 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,850.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 163 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 163 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,920.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 163 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 163 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$88,042.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 163 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 163 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$138,681.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 165 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 165 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,842.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 165 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 165 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$61,709.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 165 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 165 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$77,221.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 165 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 165 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$102,997.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 166 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 166 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$44,144.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 166 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 166 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$51,065.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 166 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 166 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,303.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 166 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 166 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$120,351.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 167 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 167 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$45,367.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 167 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 167 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,606.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 167 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 167 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,030.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 167 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 167 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$116,489.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 169 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 169 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$44,242.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 169 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 169 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,736.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 169 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 169 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$61,472.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 169 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 169 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$92,131.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 170 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 170 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,356.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 170 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 170 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,118.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 170 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 170 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,208.27 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 170 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 170 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,944.20 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 171 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 171 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,714.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 171 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 171 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,980.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 171 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 171 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,073.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 171 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 171 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$53,916.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 174 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 174 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,193.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 174 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 174 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,410.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 174 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 174 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,193.86 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 174 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 174 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$71,780.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 175 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 175 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,677.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 175 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 175 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,952.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 175 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 175 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,649.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 175 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 175 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,969.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 176 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 176 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,028.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 176 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 176 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,192.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 176 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 176 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$50,254.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 176 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 176 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$85,559.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 177 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 177 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,012.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 177 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 177 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,396.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 177 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 177 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,999.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 177 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 177 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,894.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 178 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 178 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$74,664.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 178 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 178 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$87,550.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 178 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 178 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$103,377.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 178 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 178 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$147,388.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 179 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 179 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$54,846.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 179 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 179 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,183.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 179 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 179 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$83,270.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 179 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 179 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$117,584.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 180 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 180 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,920.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 180 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 180 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,050.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 180 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 180 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,705.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 180 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 180 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,464.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 181 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 181 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,236.54 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 181 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 181 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,644.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 181 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 181 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$55,343.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 181 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 181 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$79,502.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 182 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 182 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,152.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 182 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 182 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,023.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 182 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 182 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$62,405.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 182 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 182 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$73,186.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 183 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 183 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$73,030.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 183 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 183 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$78,075.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 183 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 183 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$88,409.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 183 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 183 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$127,269.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 190 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 190 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,208.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 190 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 190 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,296.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 190 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 190 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,966.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 190 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 190 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,847.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 191 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 191 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,164.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 191 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 191 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,063.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 191 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 191 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,549.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 191 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 191 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,787.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 192 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 192 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,968.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 192 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 192 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,343.91 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 192 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 192 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,310.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 192 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 192 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,573.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 193 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 193 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,663.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 193 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 193 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,461.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 193 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 193 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,326.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 193 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 193 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,150.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 194 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 194 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,470.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 194 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 194 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,630.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 194 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 194 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,484.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 194 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 194 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,967.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 196 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 196 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,045.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 196 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 196 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,258.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 196 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 196 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,718.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 196 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 196 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,242.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 197 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 197 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,092.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 197 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 197 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,648.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 197 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 197 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,960.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 197 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 197 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$50,444.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 198 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 198 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,005.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 198 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 198 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,850.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 198 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 198 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,626.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 198 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 198 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,957.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 199 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 199 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,821.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 199 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 199 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,364.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 199 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 199 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,413.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 199 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 199 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,209.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 200 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 200 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,559.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 200 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 200 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,528.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 200 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 200 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,840.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 200 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 200 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,576.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 201 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 201 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,535.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 201 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 201 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,299.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 201 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 201 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,883.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 201 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 201 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,644.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 203 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 203 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,033.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 203 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 203 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,029.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 203 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 203 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,593.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 203 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 203 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,184.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 204 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 204 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,929.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 204 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 204 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,987.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 204 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 204 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,074.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 204 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 204 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,111.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 205 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 205 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,112.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 205 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 205 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,997.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 205 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 205 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,363.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 205 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 205 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,599.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 206 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 206 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,427.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 206 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 206 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,159.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 206 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 206 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,177.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 206 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 206 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,076.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 207 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 207 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,238.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 207 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 207 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,602.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 207 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 207 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,754.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 207 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 207 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,496.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 220 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 220 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,425.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 220 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 220 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,769.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 220 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 220 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$44,416.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 220 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 220 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$91,020.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 222 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 222 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,294.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 222 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 222 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,084.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 222 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 222 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,224.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 222 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 222 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,592.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 223 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 223 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,108.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 223 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 223 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,582.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 223 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 223 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,121.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 223 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 223 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$62,991.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 224 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 224 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,640.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 224 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 224 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,270.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 224 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 224 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,876.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 224 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 224 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$68,930.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 226 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 226 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,985.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 226 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 226 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,162.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 226 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 226 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,071.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 226 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 226 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,416.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 227 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 227 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,455.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 227 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 227 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,315.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 227 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 227 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,698.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 227 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 227 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$80,834.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 228 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 228 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,921.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 228 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 228 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,037.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 228 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 228 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$50,967.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 228 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 228 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$96,137.20 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 229 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 229 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,208.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 229 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 229 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,856.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 229 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 229 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,994.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 229 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 229 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,899.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 230 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 230 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,205.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 230 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 230 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,614.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 230 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 230 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$49,787.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 230 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 230 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$92,210.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 231 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 231 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,012.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 231 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 231 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,766.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 231 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 231 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$46,570.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 231 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 231 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,097.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 232 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 232 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,664.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 232 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 232 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,151.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 232 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 232 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,772.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 232 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 232 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$77,546.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 233 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 233 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,113.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 233 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 233 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,832.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 233 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 233 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,534.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 233 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 233 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$58,585.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 234 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 234 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,360.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 234 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 234 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,421.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 234 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 234 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,525.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 234 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 234 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$46,059.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 240 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 240 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,201.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 240 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 240 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,620.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 240 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 240 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,743.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 240 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 240 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,708.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 241 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 241 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,188.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 241 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 241 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,306.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 241 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 241 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,327.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 241 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 241 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,911.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 242 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 242 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,763.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 242 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 242 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,139.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 242 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 242 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,624.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 242 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 242 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,996.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 243 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 243 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,674.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 243 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 243 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,237.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 243 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 243 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,391.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 243 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 243 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,619.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 244 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 244 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,948.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 244 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 244 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,425.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 244 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 244 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,949.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 244 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 244 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,539.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 245 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 245 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,810.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 245 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 245 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,407.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 245 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 245 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,474.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 245 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 245 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,819.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 246 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 246 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,775.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 246 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 246 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,008.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 246 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 246 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,728.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 246 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 246 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,598.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 247 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 247 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,913.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 247 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 247 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,789.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 247 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 247 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,383.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 247 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 247 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,619.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 248 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 248 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,636.96 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 248 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 248 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,532.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 248 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 248 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,113.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 248 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 248 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,283.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 249 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 249 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,974.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 249 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 249 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,155.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 249 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 249 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,002.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 249 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 249 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,078.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 251 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 251 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,384.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 251 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 251 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,592.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 251 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 251 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,195.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 251 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 251 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,432.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 252 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 252 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,326.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 252 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 252 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,923.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 252 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 252 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,157.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 252 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 252 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,299.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 253 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 253 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,136.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 253 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 253 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,613.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 253 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 253 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,606.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 253 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 253 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,946.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 254 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 254 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,333.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 254 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 254 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,504.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 254 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 254 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,165.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 254 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 254 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,291.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 260 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 260 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,258.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 260 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 260 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,504.96 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 260 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 260 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,387.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 260 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 260 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$104,592.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 261 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 261 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,796.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 261 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 261 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,647.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 261 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 261 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$49,786.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 261 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 261 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$79,047.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 263 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 263 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,358.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 263 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 263 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,648.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 263 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 263 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,116.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 263 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 263 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$60,345.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 264 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 264 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,569.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 264 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 264 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,744.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 264 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 264 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,530.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 264 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 264 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$82,264.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 279 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 279 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,700.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 279 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 279 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,531.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 279 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 279 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,735.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 279 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 279 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,172.20 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 280 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 280 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,348.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 280 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 280 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,736.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 280 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 280 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,043.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 280 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 280 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$41,920.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 281 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 281 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,821.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 281 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 281 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,098.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 281 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 281 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,086.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 281 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 281 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,693.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 282 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 282 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,570.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 282 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 282 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,566.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 282 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 282 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,967.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 282 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 282 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$46,279.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 283 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 283 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,904.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 283 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 283 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,090.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 283 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 283 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,535.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 283 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 283 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,763.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 284 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 284 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,104.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 284 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 284 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,128.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 284 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 284 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,196.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 284 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 284 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,535.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 301 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 301 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,486.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 301 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 301 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,386.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 301 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 301 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,051.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 301 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 301 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,170.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 302 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 302 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,590.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 302 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 302 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,878.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 302 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 302 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,959.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 302 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 302 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,030.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 303 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 303 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$69,834.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 303 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 303 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$86,024.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 303 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 303 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$122,226.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 303 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 303 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$164,287.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 304 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 304 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,404.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 304 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 304 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$51,231.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 304 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 304 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$60,469.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 304 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 304 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$118,061.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 305 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 305 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,752.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 305 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 305 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,747.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 305 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 305 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,910.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 305 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 305 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$78,833.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 308 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 308 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,333.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 308 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 308 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,430.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 308 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 308 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,480.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 308 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 308 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$51,890.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 309 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 309 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,661.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 309 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 309 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,450.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 309 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 309 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,904.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 309 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 309 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$84,816.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 310 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 310 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,033.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 310 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 310 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,215.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 310 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 310 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,300.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 310 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 310 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,172.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 312 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 312 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,217.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 312 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 312 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,760.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 312 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 312 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$47,512.91 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 312 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 312 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$87,690.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 313 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 313 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,050.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 313 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 313 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,145.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 313 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 313 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$46,429.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 313 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 313 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$54,931.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 314 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 314 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,757.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 314 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 314 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,241.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 314 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 314 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,264.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 314 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 314 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$50,759.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 315 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 315 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,236.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 315 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 315 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,610.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 315 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 315 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,389.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 315 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 315 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,038.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 316 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 316 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,147.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 316 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 316 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,955.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 316 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 316 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,008.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 316 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 316 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,154.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 317 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 317 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,193.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 317 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 317 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,630.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 317 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 317 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,675.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 317 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 317 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,145.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 320 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 320 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,202.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 320 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 320 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,751.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 320 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 320 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,201.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 320 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 320 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$60,669.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 321 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 321 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,334.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 321 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 321 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,577.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 321 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 321 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$45,761.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 321 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 321 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$75,417.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 322 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 322 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,019.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 322 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 322 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,575.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 322 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 322 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,719.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 322 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 322 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$61,372.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 340 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 340 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,586.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 340 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 340 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,882.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 340 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 340 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,917.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 340 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 340 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,147.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 341 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 341 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,369.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 341 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 341 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,466.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 341 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 341 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,847.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 341 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 341 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,059.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 342 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 342 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,616.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 342 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 342 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,742.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 342 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 342 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,978.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 342 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 342 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,516.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 343 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 343 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,177.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 343 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 343 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,257.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 343 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 343 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,662.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 343 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 343 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,473.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 344 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 344 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,975.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 344 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 344 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,945.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 344 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 344 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,873.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 344 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 344 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,562.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 346 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 346 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,182.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 346 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 346 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,146.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 346 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 346 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,031.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 346 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 346 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$53,144.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 347 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 347 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,076.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 347 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 347 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,156.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 347 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 347 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,000.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 347 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 347 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,635.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 349 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 349 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,577.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 349 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 349 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,428.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 349 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 349 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,977.84 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 349 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 349 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,239.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 351 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 351 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,534.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 351 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 351 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,372.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 351 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 351 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,196.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 351 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 351 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,075.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 361 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 361 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,759.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 361 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 361 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,706.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 361 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 361 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,878.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 361 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 361 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$69,308.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 362 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 362 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,842.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 362 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 362 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,522.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 362 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 362 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,462.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 362 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 362 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,305.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 363 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 363 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,376.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 363 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 363 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,424.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 363 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 363 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,723.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 363 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 363 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$44,074.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 364 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 364 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,508.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 364 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 364 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,177.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 364 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 364 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,966.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 364 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 364 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$51,888.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 380 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 380 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,260.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 380 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 380 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,363.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 380 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 380 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,777.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 380 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 380 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$41,863.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 381 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 381 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,498.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 381 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 381 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,052.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 381 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 381 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,841.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 381 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 381 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,434.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 382 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 382 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,876.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 382 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 382 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,335.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 382 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 382 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,805.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 382 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 382 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,787.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 383 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 383 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,770.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 383 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 383 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,341.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 383 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 383 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,525.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 383 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 383 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,195.91 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 384 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 384 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,726.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 384 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 384 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,265.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 384 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 384 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,276.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 384 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 384 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,454.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 385 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 385 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,152.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 385 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 385 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,604.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 385 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 385 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,675.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 385 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 385 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,626.91 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 401 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 401 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,398.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 401 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 401 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$41,786.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 401 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 401 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$49,454.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 401 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 401 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$72,998.84 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 403 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 403 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,521.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 403 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 403 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,359.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 403 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 403 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,050.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 403 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 403 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$79,273.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 404 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 404 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,660.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 404 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 404 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,489.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 404 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 404 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,440.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 404 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 404 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$74,821.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 405 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 405 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,763.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 405 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 405 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,741.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 405 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 405 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,435.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 405 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 405 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$77,830.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 420 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 420 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,050.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 420 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 420 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,119.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 420 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 420 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,115.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 420 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 420 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,837.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 421 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 421 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,370.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 421 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 421 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,077.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 421 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 421 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,849.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 421 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 421 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,423.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 422 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 422 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,363.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 422 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 422 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,940.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 422 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 422 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,805.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 422 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 422 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,783.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 423 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 423 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,043.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 423 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 423 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,381.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 423 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 423 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,044.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 423 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 423 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$62,317.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 424 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 424 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,357.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 424 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 424 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,851.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 424 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 424 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,947.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 424 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 424 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,648.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 425 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 425 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,669.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 425 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 425 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,098.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 425 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 425 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,824.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 425 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 425 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,781.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 426 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 426 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,647.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 426 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 426 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,477.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 426 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 426 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,331.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 426 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 426 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,396.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 427 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 427 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,632.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 427 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 427 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,612.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 427 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 427 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,681.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 427 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 427 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,053.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 440 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 440 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$147,195.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 440 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 440 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$289,453.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 440 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 440 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$346,445.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 440 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 440 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$509,910.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 441 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 441 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,893.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 441 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 441 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,739.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 441 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 441 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$49,361.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 441 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 441 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$102,603.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 442 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 442 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,441.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 442 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 442 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,297.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 442 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 442 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$47,279.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 442 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 442 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$68,557.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 443 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 443 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,633.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 443 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 443 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,639.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 443 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 443 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,273.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 443 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 443 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,525.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 444 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 444 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,039.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 444 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 444 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,827.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 444 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 444 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,538.96 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 444 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 444 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$70,003.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 445 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 445 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,077.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 445 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 445 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,389.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 445 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 445 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,720.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 445 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 445 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$53,234.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 446 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 446 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,138.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 446 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 446 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,840.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 446 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 446 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,390.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 446 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 446 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$49,061.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 447 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 447 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,203.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 447 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 447 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,570.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 447 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 447 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,005.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 447 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 447 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$74,706.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 461 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 461 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,925.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 461 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 461 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,516.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 461 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 461 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,856.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 461 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 461 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,075.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 462 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 462 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,525.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 462 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 462 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,558.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 462 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 462 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,992.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 462 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 462 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,232.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 463 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 463 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,259.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 463 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 463 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,216.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 463 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 463 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,199.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 463 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 463 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,466.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 465 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 465 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,179.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 465 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 465 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,675.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 465 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 465 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,086.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 465 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 465 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,989.27 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 466 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 466 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,442.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 466 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 466 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,378.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 466 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 466 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,394.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 466 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 466 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,020.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 468 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 468 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,824.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 468 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 468 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,043.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 468 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 468 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,899.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 468 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 468 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,858.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 469 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 469 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,613.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 469 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 469 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,908.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 469 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 469 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,597.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 469 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 469 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,773.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 470 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 470 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,369.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 470 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 470 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,482.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 470 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 470 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,811.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 470 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 470 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,884.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 480 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 480 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,960.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 480 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 480 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,312.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 480 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 480 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,538.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 480 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 480 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$75,655.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 482 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 482 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,146.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 482 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 482 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,771.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 482 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 482 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,328.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 482 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 482 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$47,915.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 483 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 483 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,707.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 483 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 483 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,581.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 483 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 483 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,424.84 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 483 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 483 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$58,085.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 484 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 484 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,860.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 484 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 484 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,163.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 484 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 484 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,777.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 484 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 484 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$64,644.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 500 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 500 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,428.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 500 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 500 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,859.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 500 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 500 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,590.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 500 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 500 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,471.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 501 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 501 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,140.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 501 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 501 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,493.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 501 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 501 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,507.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 501 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 501 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,445.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 510 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 510 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,816.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 510 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 510 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,670.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 510 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 510 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,370.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 510 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 510 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$71,614.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 511 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 511 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,228.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 511 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 511 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,524.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 511 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 511 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,392.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 511 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 511 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$82,132.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 512 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 512 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,572.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 512 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 512 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,861.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 512 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 512 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,742.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 512 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 512 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,791.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 513 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 513 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,057.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 513 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 513 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,471.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 513 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 513 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,579.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 513 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 513 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,561.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 514 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 514 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,116.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 514 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 514 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,036.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 514 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 514 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,825.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 514 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 514 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$62,800.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 517 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 517 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,571.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 517 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 517 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,259.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 517 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 517 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,496.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 517 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 517 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,243.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 518 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 518 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,684.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 518 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 518 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,003.27 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 518 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 518 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,194.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 518 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 518 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$64,352.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 519 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 519 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,880.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 519 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 519 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,406.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 519 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 519 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,565.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 519 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 519 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$62,289.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 530 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 530 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,329.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 530 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 530 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,084.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 530 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 530 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,180.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 530 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 530 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,310.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 531 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 531 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,547.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 531 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 531 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,600.96 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 531 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 531 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,095.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 531 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 531 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,132.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 532 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 532 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,041.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 532 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 532 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,528.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 532 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 532 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,275.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 532 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 532 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,629.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 539 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 539 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,128.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 539 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 539 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,908.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 539 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 539 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,996.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 539 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 539 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,788.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 540 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 540 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,867.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 540 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 540 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,247.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 540 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 540 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,046.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 540 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 540 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,629.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 541 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 541 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,922.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 541 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 541 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,152.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 541 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 541 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,158.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 541 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 541 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,992.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 542 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 542 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,475.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 542 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 542 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,171.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 542 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 542 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,598.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 542 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 542 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,666.86 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 543 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 543 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,210.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 543 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 543 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,043.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 543 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 543 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,807.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 543 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 543 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,522.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 547 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 547 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,918.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 547 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 547 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,101.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 547 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 547 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,514.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 547 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 547 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$47,498.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 548 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 548 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,148.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 548 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 548 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,932.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 548 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 548 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,228.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 548 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 548 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$49,774.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 560 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 560 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,163.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 560 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 560 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,044.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 560 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 560 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,298.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 560 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 560 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,954.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 561 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 561 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,163.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 561 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 561 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,112.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 561 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 561 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,996.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 561 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 561 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,762.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 564 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 564 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$4,871.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 564 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 564 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,654.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 564 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 564 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,935.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 564 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 564 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,614.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 566 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 566 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,304.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 566 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 566 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,969.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 566 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 566 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,055.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 566 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 566 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,634.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 580 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 580 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,369.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 580 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 580 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,689.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 580 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 580 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,130.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 580 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 580 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,136.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 581 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 581 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$2,414.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 581 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 581 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$2,898.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 581 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 581 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$4,819.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 581 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 581 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,220.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 583 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 583 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$181,826.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 583 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 583 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$287,114.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 583 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 583 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$302,277.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 583 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 583 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$496,151.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 588 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 588 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$121,211.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 588 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 588 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$175,357.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 588 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 588 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$255,798.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 588 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 588 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$508,195.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 589 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 589 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$351,660.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 589 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 589 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$319,692.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 589 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 589 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$304,468.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 589 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 589 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$4,212.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 591 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 591 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$3,861.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 591 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 591 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$289,463.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 591 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 591 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$329,655.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 591 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 591 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$385,829.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 593 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 593 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$205,815.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 593 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 593 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$228,683.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 593 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 593 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$230,065.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 593 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 593 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$354,293.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 602 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 602 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$73,713.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 602 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 602 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$178,352.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 602 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 602 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$202,686.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 602 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 602 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$308,655.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 603 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 603 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,529.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 603 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 603 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$113,004.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 603 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 603 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$206,423.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 603 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 603 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$242,114.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 607 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 607 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$81,702.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 607 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 607 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$127,835.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 607 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 607 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$159,320.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 607 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 607 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$236,927.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 608 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 608 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$56,154.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 608 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 608 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$84,591.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 608 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 608 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$119,849.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 608 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 608 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$212,072.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 609 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 609 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,023.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 609 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 609 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$90,815.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 609 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 609 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$153,038.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 609 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 609 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$329,860.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 611 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 611 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,846.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 611 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 611 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$54,436.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 611 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 611 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$104,011.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 611 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 611 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$175,523.50 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 612 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 612 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,712.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 612 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 612 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$78,526.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 612 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 612 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$115,665.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 612 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 612 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$151,450.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 613 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 613 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,907.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 613 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 613 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$75,163.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 613 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 613 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$103,102.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 613 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 613 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$135,626.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 614 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 614 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,711.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 614 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 614 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$51,127.86 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 614 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 614 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$91,141.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 614 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 614 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$143,590.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 621 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 621 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,403.18 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 621 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 621 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,425.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 621 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 621 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$66,917.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 621 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 621 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$149,184.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 622 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 622 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,853.84 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 622 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 622 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,861.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 622 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 622 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$79,337.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 622 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 622 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$103,280.93 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 623 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 623 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,561.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 623 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 623 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,075.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 623 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 623 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$60,382.91 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 623 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 623 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$72,545.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 625 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 625 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$38,724.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 625 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 625 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,179.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 625 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 625 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$86,498.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 625 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 625 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$95,149.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 626 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 626 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$3,998.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 626 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 626 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,929.54 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 626 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 626 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,108.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 626 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 626 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$61,064.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 630 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 630 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$51,231.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 630 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 630 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$92,100.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 630 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 630 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$155,491.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 630 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 630 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$270,234.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 631 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 631 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,661.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 631 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 631 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$55,470.86 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 631 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 631 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$105,062.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 631 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 631 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$241,562.85 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 633 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 633 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,687.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 633 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 633 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,375.17 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 633 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 633 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,542.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 633 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 633 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$114,938.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 634 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 634 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,318.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 634 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 634 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,426.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 634 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 634 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,607.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 634 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 634 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$78,328.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 636 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 636 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,606.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 636 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 636 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,814.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 636 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 636 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,311.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 636 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 636 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,005.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 639 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 639 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,403.63 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 639 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 639 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,911.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 639 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 639 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,282.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 639 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 639 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$56,398.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 640 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 640 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$2,213.84 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 640 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 640 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$4,142.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 640 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 640 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,822.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 640 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 640 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$56,022.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 650 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 650 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,709.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 650 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 650 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,712.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 650 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 650 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,337.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 650 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 650 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$71,159.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 651 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 651 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,777.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 651 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 651 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,951.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 651 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 651 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,318.22 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 651 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 651 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$90,278.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 660 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 660 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,776.45 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 660 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 660 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,901.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 660 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 660 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$41,969.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 660 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 660 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,205.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 661 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 661 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,401.86 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 661 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 661 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,770.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 661 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 661 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,302.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 661 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 661 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$47,380.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 662 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 662 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,902.69 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 662 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 662 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,768.91 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 662 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 662 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,679.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 662 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 662 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,893.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 663 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 663 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,274.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 663 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 663 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,498.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 663 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 663 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,375.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 663 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 663 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,890.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 680 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 680 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,206.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 680 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 680 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,097.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 680 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 680 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$57,553.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 680 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 680 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$91,300.92 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 681 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 681 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,432.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 681 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 681 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$28,056.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 681 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 681 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$44,981.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 681 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 681 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$74,627.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 690 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 690 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,414.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 690 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 690 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$51,474.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 690 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 690 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$56,603.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 690 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 690 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$122,673.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 691 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 691 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,048.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 691 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 691 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,421.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 691 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 691 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,157.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 691 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 691 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$52,842.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 692 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 692 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,975.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 692 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 692 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,232.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 692 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 692 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,439.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 692 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 692 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,975.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 694 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 694 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,779.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 694 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 694 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,950.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 694 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 694 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,190.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 694 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 694 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,053.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 695 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 695 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,779.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 695 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 695 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,938.23 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 695 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 695 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,437.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 695 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 695 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$150,874.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 696 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 696 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,304.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 696 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 696 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,999.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 696 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 696 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,973.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 696 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 696 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$59,182.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 710 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 710 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,273.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 710 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 710 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,527.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 710 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 710 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,324.61 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 710 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 710 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$94,901.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 711 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 711 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,252.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 711 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 711 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,463.58 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 711 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 711 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,087.05 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 711 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 711 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$70,389.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 720 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 720 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,470.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 720 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 720 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,749.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 720 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 720 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,952.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 720 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 720 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$51,745.96 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 721 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 721 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,593.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 721 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 721 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,017.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 721 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 721 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,270.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 721 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 721 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,986.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 722 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 722 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,674.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 722 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 722 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,301.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 722 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 722 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,623.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 722 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 722 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,713.54 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 723 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 723 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,947.66 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 723 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 723 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,470.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 723 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 723 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,592.27 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 723 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 723 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,014.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 724 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 724 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,492.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 724 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 724 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,040.64 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 724 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 724 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,949.84 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 724 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 724 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$56,665.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 740 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 740 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,796.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 740 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 740 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,679.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 740 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 740 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$44,327.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 740 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 740 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$95,270.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 750 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 750 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,886.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 750 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 750 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,335.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 750 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 750 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,566.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 750 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 750 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$50,691.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 751 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 751 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,488.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 751 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 751 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,787.08 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 751 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 751 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,788.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 751 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 751 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,743.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 752 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 752 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$2,919.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 752 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 752 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,258.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 752 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 752 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,256.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 752 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 752 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,175.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 753 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 753 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,524.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 753 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 753 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,565.52 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 753 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 753 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,917.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 753 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 753 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,902.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 754 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 754 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$4,718.90 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 754 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 754 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,195.79 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 754 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 754 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,626.55 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 754 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 754 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,774.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 755 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 755 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$3,705.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 755 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 755 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,637.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 755 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 755 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,959.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 755 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 755 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,260.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 756 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 756 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,319.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 756 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 756 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,628.21 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 756 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 756 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,860.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 756 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 756 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,140.59 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 757 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 757 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,690.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 757 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 757 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,054.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 757 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 757 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,330.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 757 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 757 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,640.96 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 758 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 758 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$4,854.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 758 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 758 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,686.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 758 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 758 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,705.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 758 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 758 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,399.00 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 759 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 759 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,588.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 759 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 759 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,972.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 759 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 759 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,692.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 759 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 759 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$71,905.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 760 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 760 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,539.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 760 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 760 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,415.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 760 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 760 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,736.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 760 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 760 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,196.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 770 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 770 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$3,478.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 770 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 770 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$3,613.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 770 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 770 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,186.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 770 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 770 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,306.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 772 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 772 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,806.51 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 772 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 772 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,885.20 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 772 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 772 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,044.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 772 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 772 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,877.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 773 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 773 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$3,693.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 773 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 773 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,513.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 773 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 773 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,555.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 773 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 773 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,752.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 774 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 774 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$2,976.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 774 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 774 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$4,903.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 774 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 774 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,192.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 774 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 774 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,979.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 775 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 775 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$3,048.86 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 775 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 775 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$4,763.47 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 775 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 775 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,850.74 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 775 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 775 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,717.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 776 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 776 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$5,547.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 776 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 776 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,524.03 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 776 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 776 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,152.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 776 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 776 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,451.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 792 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 792 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,273.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 792 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 792 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$41,080.88 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 792 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 792 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$60,390.34 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 792 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 792 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$100,450.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 793 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 793 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,548.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 793 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 793 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,696.91 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 793 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 793 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,830.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 793 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 793 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,402.06 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 794 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 794 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,956.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 794 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 794 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,120.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 794 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 794 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,738.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 794 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 794 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$53,377.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 810 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 810 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,008.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 810 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 810 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,682.96 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 810 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 810 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,868.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 810 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 810 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$34,002.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 811 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 811 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,067.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 811 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 811 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,170.41 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 811 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 811 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,992.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 811 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 811 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,785.83 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 812 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 812 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,960.97 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 812 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 812 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,102.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 812 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 812 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,176.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 812 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 812 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,554.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 813 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 813 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,415.46 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 813 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 813 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,592.16 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 813 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 813 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,444.78 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 813 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 813 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,958.19 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 815 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 815 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$8,865.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 815 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 815 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,821.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 815 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 815 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,394.09 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 815 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 815 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$39,988.82 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 816 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 816 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,959.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 816 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 816 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,127.27 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 816 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 816 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,201.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 816 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 816 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$18,128.25 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 817 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 817 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,332.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 817 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 817 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,635.53 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 817 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 817 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,991.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 817 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 817 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$44,752.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 841 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 841 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$56,016.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 841 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 841 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,761.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 841 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 841 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$130,524.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 841 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 841 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$269,489.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 842 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 842 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,365.75 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 842 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 842 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$33,423.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 842 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 842 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$60,341.31 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 842 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 842 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$139,072.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 843 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 843 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,312.99 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 843 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 843 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,531.29 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 843 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 843 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,226.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 843 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 843 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,327.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 844 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 844 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$6,160.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 844 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 844 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,926.57 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 844 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 844 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$16,376.49 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 844 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 844 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$37,792.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 850 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 850 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,118.65 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 850 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 850 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,256.72 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 850 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 850 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$43,262.04 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 850 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 850 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$95,308.13 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 860 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 860 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,063.15 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 860 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 860 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,217.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 860 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 860 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,046.36 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 860 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 860 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,999.67 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 861 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 861 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,837.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 861 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 861 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,596.56 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 861 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 861 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,954.07 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 861 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 861 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,053.33 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 862 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 862 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$7,870.28 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 862 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 862 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,357.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 862 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 862 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$20,966.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 862 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 862 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$23,532.10 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 863 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 863 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,403.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 863 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 863 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,867.44 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 863 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 863 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$71,380.80 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 863 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 863 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$132,949.38 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 890 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 890 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,496.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 890 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 890 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,531.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 890 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 890 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$40,116.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 890 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 890 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$42,178.89 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 892 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 892 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,770.62 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 892 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 892 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$12,223.68 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 892 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 892 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,074.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 892 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 892 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$26,689.43 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 893 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 893 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$10,763.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 893 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 893 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$13,214.71 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 893 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 893 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$17,906.86 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 893 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 893 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$29,757.60 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 894 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 894 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$9,366.48 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 894 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 894 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,237.11 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 894 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 894 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$15,342.37 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 894 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 894 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$19,310.94 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 910 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 910 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,675.54 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 910 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 910 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$46,380.73 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 910 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 910 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$55,820.02 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 910 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 910 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$93,446.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 911 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 911 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$27,738.40 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 911 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 911 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$36,425.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 911 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 911 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$48,267.70 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 911 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 911 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$98,939.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 912 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 912 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$31,781.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 912 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 912 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$32,078.42 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 912 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 912 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$63,115.30 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 912 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 912 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$78,029.76 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 930 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 930 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,679.87 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 930 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 930 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$11,899.77 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 930 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 930 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$22,355.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 930 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 930 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$53,696.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 950 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 950 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$25,019.39 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 950 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 950 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,293.98 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 950 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 950 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$41,293.35 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 950 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 950 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$115,991.95 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 951 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 951 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,960.12 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 951 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 951 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$24,399.81 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 951 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 951 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$35,803.32 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 951 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 951 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$118,629.24 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 952 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 952 SOI 1,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$14,360.26 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 952 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 952 SOI 2,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$21,801.14 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 952 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 952 SOI 3,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$30,814.01 ",,DRG,,,,,,,,0
unity,DRG,APR DRG 952 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 952 SOI 4,BCBSND Inpatient Base APR DRG schedule grouper v37.1,"$64,057.30 ",,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 001 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 001 SOI 1,Cost Outlier Threshold $567550,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 001 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 001 SOI 2,Cost Outlier Threshold $567550,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 001 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 001 SOI 3,Cost Outlier Threshold $567550,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 001 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 001 SOI 4,Cost Outlier Threshold $567550,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 002 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 002 SOI 1,Cost Outlier Threshold $1003070,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 002 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 002 SOI 2,Cost Outlier Threshold $1003070,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 002 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 002 SOI 3,Cost Outlier Threshold $1003070,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 002 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 002 SOI 4,Cost Outlier Threshold $1003070,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 004 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 004 SOI 1,Cost Outlier Threshold $381749,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 004 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 004 SOI 2,Cost Outlier Threshold $381749,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 004 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 004 SOI 3,Cost Outlier Threshold $381749,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 004 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 004 SOI 4,Cost Outlier Threshold $381749,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 005 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 005 SOI 1,Cost Outlier Threshold $233797,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 005 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 005 SOI 2,Cost Outlier Threshold $233797,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 005 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 005 SOI 3,Cost Outlier Threshold $233797,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 005 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 005 SOI 4,Cost Outlier Threshold $233797,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 006 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 006 SOI 1,Cost Outlier Threshold $1870981,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 006 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 006 SOI 2,Cost Outlier Threshold $1870981,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 006 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 006 SOI 3,Cost Outlier Threshold $1870981,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 006 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 006 SOI 4,Cost Outlier Threshold $1870981,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 007 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 007 SOI 1,Cost Outlier Threshold $582314,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 007 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 007 SOI 2,Cost Outlier Threshold $582314,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 007 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 007 SOI 3,Cost Outlier Threshold $582314,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 007 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 007 SOI 4,Cost Outlier Threshold $582314,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 008 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 008 SOI 1,Cost Outlier Threshold $503227,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 008 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 008 SOI 2,Cost Outlier Threshold $503227,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 008 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 008 SOI 3,Cost Outlier Threshold $503227,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 008 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 008 SOI 4,Cost Outlier Threshold $503227,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 009 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 009 SOI 1,Cost Outlier Threshold $1216450,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 009 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 009 SOI 2,Cost Outlier Threshold $1216450,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 009 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 009 SOI 3,Cost Outlier Threshold $1216450,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 009 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 009 SOI 4,Cost Outlier Threshold $1216450,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 020 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 020 SOI 1,Cost Outlier Threshold $270221,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 020 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 020 SOI 2,Cost Outlier Threshold $270221,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 020 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 020 SOI 3,Cost Outlier Threshold $270221,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 020 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 020 SOI 4,Cost Outlier Threshold $270221,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 021 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 021 SOI 1,Cost Outlier Threshold $240931,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 021 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 021 SOI 2,Cost Outlier Threshold $240931,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 021 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 021 SOI 3,Cost Outlier Threshold $240931,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 021 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 021 SOI 4,Cost Outlier Threshold $240931,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 022 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 022 SOI 1,Cost Outlier Threshold $33429,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 022 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 022 SOI 2,Cost Outlier Threshold $33429,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 022 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 022 SOI 3,Cost Outlier Threshold $33429,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 022 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 022 SOI 4,Cost Outlier Threshold $33429,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 023 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 023 SOI 1,Cost Outlier Threshold $142722,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 023 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 023 SOI 2,Cost Outlier Threshold $142722,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 023 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 023 SOI 3,Cost Outlier Threshold $142722,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 023 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 023 SOI 4,Cost Outlier Threshold $142722,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 024 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 024 SOI 1,Cost Outlier Threshold $31094,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 024 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 024 SOI 2,Cost Outlier Threshold $31094,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 024 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 024 SOI 3,Cost Outlier Threshold $31094,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 024 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 024 SOI 4,Cost Outlier Threshold $31094,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 026 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 026 SOI 1,Cost Outlier Threshold $67055,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 026 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 026 SOI 2,Cost Outlier Threshold $67055,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 026 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 026 SOI 3,Cost Outlier Threshold $67055,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 026 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 026 SOI 4,Cost Outlier Threshold $67055,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 027 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 027 SOI 1,Cost Outlier Threshold $96770,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 027 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 027 SOI 2,Cost Outlier Threshold $96770,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 027 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 027 SOI 3,Cost Outlier Threshold $96770,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 027 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 027 SOI 4,Cost Outlier Threshold $96770,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 029 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 029 SOI 1,Cost Outlier Threshold $89789,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 029 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 029 SOI 2,Cost Outlier Threshold $89789,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 029 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 029 SOI 3,Cost Outlier Threshold $89789,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 029 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 029 SOI 4,Cost Outlier Threshold $89789,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 030 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 030 SOI 1,Cost Outlier Threshold $138883,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 030 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 030 SOI 2,Cost Outlier Threshold $138883,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 030 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 030 SOI 3,Cost Outlier Threshold $138883,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 030 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 030 SOI 4,Cost Outlier Threshold $138883,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 040 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 040 SOI 1,Cost Outlier Threshold $340169,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 040 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 040 SOI 2,Cost Outlier Threshold $340169,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 040 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 040 SOI 3,Cost Outlier Threshold $340169,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 040 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 040 SOI 4,Cost Outlier Threshold $340169,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 041 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 041 SOI 1,Cost Outlier Threshold $77049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 041 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 041 SOI 2,Cost Outlier Threshold $77049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 041 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 041 SOI 3,Cost Outlier Threshold $77049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 041 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 041 SOI 4,Cost Outlier Threshold $77049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 042 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 042 SOI 1,Cost Outlier Threshold $155038,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 042 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 042 SOI 2,Cost Outlier Threshold $155038,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 042 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 042 SOI 3,Cost Outlier Threshold $155038,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 042 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 042 SOI 4,Cost Outlier Threshold $155038,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 043 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 043 SOI 1,Cost Outlier Threshold $88095,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 043 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 043 SOI 2,Cost Outlier Threshold $88095,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 043 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 043 SOI 3,Cost Outlier Threshold $88095,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 043 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 043 SOI 4,Cost Outlier Threshold $88095,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 044 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 044 SOI 1,Cost Outlier Threshold $128006,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 044 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 044 SOI 2,Cost Outlier Threshold $128006,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 044 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 044 SOI 3,Cost Outlier Threshold $128006,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 044 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 044 SOI 4,Cost Outlier Threshold $128006,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 045 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 045 SOI 1,Cost Outlier Threshold $76974,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 045 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 045 SOI 2,Cost Outlier Threshold $76974,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 045 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 045 SOI 3,Cost Outlier Threshold $76974,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 045 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 045 SOI 4,Cost Outlier Threshold $76974,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 046 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 046 SOI 1,Cost Outlier Threshold $33497,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 046 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 046 SOI 2,Cost Outlier Threshold $33497,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 046 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 046 SOI 3,Cost Outlier Threshold $33497,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 046 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 046 SOI 4,Cost Outlier Threshold $33497,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 047 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 047 SOI 1,Cost Outlier Threshold $30302,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 047 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 047 SOI 2,Cost Outlier Threshold $30302,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 047 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 047 SOI 3,Cost Outlier Threshold $30302,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 047 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 047 SOI 4,Cost Outlier Threshold $30302,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 048 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 048 SOI 1,Cost Outlier Threshold $75218,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 048 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 048 SOI 2,Cost Outlier Threshold $75218,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 048 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 048 SOI 3,Cost Outlier Threshold $75218,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 048 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 048 SOI 4,Cost Outlier Threshold $75218,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 049 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 049 SOI 1,Cost Outlier Threshold $137592,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 049 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 049 SOI 2,Cost Outlier Threshold $137592,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 049 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 049 SOI 3,Cost Outlier Threshold $137592,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 049 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 049 SOI 4,Cost Outlier Threshold $137592,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 050 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 050 SOI 1,Cost Outlier Threshold $80677,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 050 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 050 SOI 2,Cost Outlier Threshold $80677,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 050 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 050 SOI 3,Cost Outlier Threshold $80677,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 050 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 050 SOI 4,Cost Outlier Threshold $80677,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 051 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 051 SOI 1,Cost Outlier Threshold $16126,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 051 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 051 SOI 2,Cost Outlier Threshold $16126,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 051 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 051 SOI 3,Cost Outlier Threshold $16126,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 051 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 051 SOI 4,Cost Outlier Threshold $16126,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 052 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 052 SOI 1,Cost Outlier Threshold $44164,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 052 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 052 SOI 2,Cost Outlier Threshold $44164,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 052 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 052 SOI 3,Cost Outlier Threshold $44164,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 052 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 052 SOI 4,Cost Outlier Threshold $44164,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 053 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 053 SOI 1,Cost Outlier Threshold $29943,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 053 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 053 SOI 2,Cost Outlier Threshold $29943,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 053 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 053 SOI 3,Cost Outlier Threshold $29943,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 053 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 053 SOI 4,Cost Outlier Threshold $29943,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 054 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 054 SOI 1,Cost Outlier Threshold $37294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 054 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 054 SOI 2,Cost Outlier Threshold $37294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 054 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 054 SOI 3,Cost Outlier Threshold $37294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 054 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 054 SOI 4,Cost Outlier Threshold $37294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 055 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 055 SOI 1,Cost Outlier Threshold $64282,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 055 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 055 SOI 2,Cost Outlier Threshold $64282,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 055 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 055 SOI 3,Cost Outlier Threshold $64282,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 055 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 055 SOI 4,Cost Outlier Threshold $64282,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 056 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 056 SOI 1,Cost Outlier Threshold $18049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 056 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 056 SOI 2,Cost Outlier Threshold $18049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 056 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 056 SOI 3,Cost Outlier Threshold $18049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 056 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 056 SOI 4,Cost Outlier Threshold $18049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 057 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 057 SOI 1,Cost Outlier Threshold $31865,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 057 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 057 SOI 2,Cost Outlier Threshold $31865,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 057 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 057 SOI 3,Cost Outlier Threshold $31865,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 057 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 057 SOI 4,Cost Outlier Threshold $31865,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 058 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 058 SOI 1,Cost Outlier Threshold $141691,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 058 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 058 SOI 2,Cost Outlier Threshold $141691,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 058 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 058 SOI 3,Cost Outlier Threshold $141691,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 058 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 058 SOI 4,Cost Outlier Threshold $141691,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 059 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 059 SOI 1,Cost Outlier Threshold $127480,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 059 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 059 SOI 2,Cost Outlier Threshold $127480,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 059 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 059 SOI 3,Cost Outlier Threshold $127480,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 059 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 059 SOI 4,Cost Outlier Threshold $127480,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 073 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 073 SOI 1,Cost Outlier Threshold $52328,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 073 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 073 SOI 2,Cost Outlier Threshold $52328,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 073 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 073 SOI 3,Cost Outlier Threshold $52328,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 073 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 073 SOI 4,Cost Outlier Threshold $52328,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 082 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 082 SOI 1,Cost Outlier Threshold $27243,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 082 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 082 SOI 2,Cost Outlier Threshold $27243,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 082 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 082 SOI 3,Cost Outlier Threshold $27243,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 082 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 082 SOI 4,Cost Outlier Threshold $27243,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 089 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 089 SOI 1,Cost Outlier Threshold $110735,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 089 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 089 SOI 2,Cost Outlier Threshold $110735,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 089 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 089 SOI 3,Cost Outlier Threshold $110735,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 089 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 089 SOI 4,Cost Outlier Threshold $110735,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 091 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 091 SOI 1,Cost Outlier Threshold $75269,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 091 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 091 SOI 2,Cost Outlier Threshold $75269,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 091 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 091 SOI 3,Cost Outlier Threshold $75269,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 091 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 091 SOI 4,Cost Outlier Threshold $75269,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 092 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 092 SOI 1,Cost Outlier Threshold $60467,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 092 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 092 SOI 2,Cost Outlier Threshold $60467,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 092 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 092 SOI 3,Cost Outlier Threshold $60467,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 092 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 092 SOI 4,Cost Outlier Threshold $60467,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 095 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 095 SOI 1,Cost Outlier Threshold $26347,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 095 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 095 SOI 2,Cost Outlier Threshold $26347,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 095 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 095 SOI 3,Cost Outlier Threshold $26347,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 095 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 095 SOI 4,Cost Outlier Threshold $26347,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 097 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 097 SOI 1,Cost Outlier Threshold $42721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 097 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 097 SOI 2,Cost Outlier Threshold $42721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 097 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 097 SOI 3,Cost Outlier Threshold $42721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 097 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 097 SOI 4,Cost Outlier Threshold $42721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 098 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 098 SOI 1,Cost Outlier Threshold $70275,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 098 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 098 SOI 2,Cost Outlier Threshold $70275,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 098 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 098 SOI 3,Cost Outlier Threshold $70275,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 098 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 098 SOI 4,Cost Outlier Threshold $70275,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 110 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 110 SOI 1,Cost Outlier Threshold $67542,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 110 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 110 SOI 2,Cost Outlier Threshold $67542,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 110 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 110 SOI 3,Cost Outlier Threshold $67542,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 110 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 110 SOI 4,Cost Outlier Threshold $67542,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 111 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 111 SOI 1,Cost Outlier Threshold $31364,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 111 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 111 SOI 2,Cost Outlier Threshold $31364,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 111 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 111 SOI 3,Cost Outlier Threshold $31364,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 111 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 111 SOI 4,Cost Outlier Threshold $31364,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 113 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 113 SOI 1,Cost Outlier Threshold $25474,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 113 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 113 SOI 2,Cost Outlier Threshold $25474,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 113 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 113 SOI 3,Cost Outlier Threshold $25474,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 113 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 113 SOI 4,Cost Outlier Threshold $25474,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 114 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 114 SOI 1,Cost Outlier Threshold $13504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 114 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 114 SOI 2,Cost Outlier Threshold $13504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 114 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 114 SOI 3,Cost Outlier Threshold $13504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 114 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 114 SOI 4,Cost Outlier Threshold $13504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 115 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 115 SOI 1,Cost Outlier Threshold $33676,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 115 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 115 SOI 2,Cost Outlier Threshold $33676,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 115 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 115 SOI 3,Cost Outlier Threshold $33676,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 115 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 115 SOI 4,Cost Outlier Threshold $33676,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 120 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 120 SOI 1,Cost Outlier Threshold $80809,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 120 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 120 SOI 2,Cost Outlier Threshold $80809,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 120 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 120 SOI 3,Cost Outlier Threshold $80809,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 120 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 120 SOI 4,Cost Outlier Threshold $80809,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 121 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 121 SOI 1,Cost Outlier Threshold $65213,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 121 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 121 SOI 2,Cost Outlier Threshold $65213,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 121 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 121 SOI 3,Cost Outlier Threshold $65213,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 121 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 121 SOI 4,Cost Outlier Threshold $65213,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 130 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 130 SOI 1,Cost Outlier Threshold $212788,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 130 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 130 SOI 2,Cost Outlier Threshold $212788,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 130 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 130 SOI 3,Cost Outlier Threshold $212788,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 130 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 130 SOI 4,Cost Outlier Threshold $212788,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 131 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 131 SOI 1,Cost Outlier Threshold $111694,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 131 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 131 SOI 2,Cost Outlier Threshold $111694,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 131 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 131 SOI 3,Cost Outlier Threshold $111694,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 131 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 131 SOI 4,Cost Outlier Threshold $111694,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 132 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 132 SOI 1,Cost Outlier Threshold $35868,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 132 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 132 SOI 2,Cost Outlier Threshold $35868,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 132 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 132 SOI 3,Cost Outlier Threshold $35868,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 132 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 132 SOI 4,Cost Outlier Threshold $35868,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 133 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 133 SOI 1,Cost Outlier Threshold $69872,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 133 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 133 SOI 2,Cost Outlier Threshold $69872,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 133 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 133 SOI 3,Cost Outlier Threshold $69872,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 133 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 133 SOI 4,Cost Outlier Threshold $69872,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 134 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 134 SOI 1,Cost Outlier Threshold $45841,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 134 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 134 SOI 2,Cost Outlier Threshold $45841,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 134 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 134 SOI 3,Cost Outlier Threshold $45841,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 134 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 134 SOI 4,Cost Outlier Threshold $45841,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 135 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 135 SOI 1,Cost Outlier Threshold $41274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 135 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 135 SOI 2,Cost Outlier Threshold $41274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 135 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 135 SOI 3,Cost Outlier Threshold $41274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 135 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 135 SOI 4,Cost Outlier Threshold $41274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 136 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 136 SOI 1,Cost Outlier Threshold $111813,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 136 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 136 SOI 2,Cost Outlier Threshold $111813,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 136 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 136 SOI 3,Cost Outlier Threshold $111813,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 136 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 136 SOI 4,Cost Outlier Threshold $111813,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 137 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 137 SOI 1,Cost Outlier Threshold $71893,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 137 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 137 SOI 2,Cost Outlier Threshold $71893,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 137 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 137 SOI 3,Cost Outlier Threshold $71893,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 137 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 137 SOI 4,Cost Outlier Threshold $71893,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 138 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 138 SOI 1,Cost Outlier Threshold $27628,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 138 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 138 SOI 2,Cost Outlier Threshold $27628,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 138 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 138 SOI 3,Cost Outlier Threshold $27628,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 138 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 138 SOI 4,Cost Outlier Threshold $27628,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 139 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 139 SOI 1,Cost Outlier Threshold $35539,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 139 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 139 SOI 2,Cost Outlier Threshold $35539,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 139 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 139 SOI 3,Cost Outlier Threshold $35539,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 139 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 139 SOI 4,Cost Outlier Threshold $35539,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 140 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 140 SOI 1,Cost Outlier Threshold $38842,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 140 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 140 SOI 2,Cost Outlier Threshold $38842,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 140 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 140 SOI 3,Cost Outlier Threshold $38842,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 140 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 140 SOI 4,Cost Outlier Threshold $38842,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 141 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 141 SOI 1,Cost Outlier Threshold $27564,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 141 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 141 SOI 2,Cost Outlier Threshold $27564,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 141 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 141 SOI 3,Cost Outlier Threshold $27564,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 141 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 141 SOI 4,Cost Outlier Threshold $27564,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 142 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 142 SOI 1,Cost Outlier Threshold $56852,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 142 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 142 SOI 2,Cost Outlier Threshold $56852,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 142 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 142 SOI 3,Cost Outlier Threshold $56852,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 142 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 142 SOI 4,Cost Outlier Threshold $56852,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 143 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 143 SOI 1,Cost Outlier Threshold $40485,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 143 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 143 SOI 2,Cost Outlier Threshold $40485,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 143 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 143 SOI 3,Cost Outlier Threshold $40485,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 143 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 143 SOI 4,Cost Outlier Threshold $40485,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 144 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 144 SOI 1,Cost Outlier Threshold $31205,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 144 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 144 SOI 2,Cost Outlier Threshold $31205,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 144 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 144 SOI 3,Cost Outlier Threshold $31205,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 144 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 144 SOI 4,Cost Outlier Threshold $31205,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 145 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 145 SOI 1,Cost Outlier Threshold $29946,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 145 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 145 SOI 2,Cost Outlier Threshold $29946,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 145 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 145 SOI 3,Cost Outlier Threshold $29946,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 145 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 145 SOI 4,Cost Outlier Threshold $29946,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 160 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 160 SOI 1,Cost Outlier Threshold $269000,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 160 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 160 SOI 2,Cost Outlier Threshold $269000,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 160 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 160 SOI 3,Cost Outlier Threshold $269000,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 160 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 160 SOI 4,Cost Outlier Threshold $269000,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 161 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 161 SOI 1,Cost Outlier Threshold $913367,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 161 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 161 SOI 2,Cost Outlier Threshold $913367,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 161 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 161 SOI 3,Cost Outlier Threshold $913367,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 161 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 161 SOI 4,Cost Outlier Threshold $913367,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 162 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 162 SOI 1,Cost Outlier Threshold $175619,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 162 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 162 SOI 2,Cost Outlier Threshold $175619,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 162 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 162 SOI 3,Cost Outlier Threshold $175619,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 162 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 162 SOI 4,Cost Outlier Threshold $175619,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 163 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 163 SOI 1,Cost Outlier Threshold $124925,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 163 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 163 SOI 2,Cost Outlier Threshold $124925,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 163 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 163 SOI 3,Cost Outlier Threshold $124925,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 163 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 163 SOI 4,Cost Outlier Threshold $124925,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 165 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 165 SOI 1,Cost Outlier Threshold $106201,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 165 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 165 SOI 2,Cost Outlier Threshold $106201,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 165 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 165 SOI 3,Cost Outlier Threshold $106201,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 165 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 165 SOI 4,Cost Outlier Threshold $106201,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 166 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 166 SOI 1,Cost Outlier Threshold $101097,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 166 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 166 SOI 2,Cost Outlier Threshold $101097,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 166 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 166 SOI 3,Cost Outlier Threshold $101097,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 166 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 166 SOI 4,Cost Outlier Threshold $101097,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 167 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 167 SOI 1,Cost Outlier Threshold $98286,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 167 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 167 SOI 2,Cost Outlier Threshold $98286,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 167 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 167 SOI 3,Cost Outlier Threshold $98286,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 167 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 167 SOI 4,Cost Outlier Threshold $98286,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 169 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 169 SOI 1,Cost Outlier Threshold $180101,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 169 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 169 SOI 2,Cost Outlier Threshold $180101,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 169 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 169 SOI 3,Cost Outlier Threshold $180101,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 169 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 169 SOI 4,Cost Outlier Threshold $180101,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 170 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 170 SOI 1,Cost Outlier Threshold $91340,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 170 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 170 SOI 2,Cost Outlier Threshold $91340,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 170 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 170 SOI 3,Cost Outlier Threshold $91340,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 170 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 170 SOI 4,Cost Outlier Threshold $91340,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 171 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 171 SOI 1,Cost Outlier Threshold $49508,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 171 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 171 SOI 2,Cost Outlier Threshold $49508,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 171 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 171 SOI 3,Cost Outlier Threshold $49508,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 171 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 171 SOI 4,Cost Outlier Threshold $49508,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 174 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 174 SOI 1,Cost Outlier Threshold $45031,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 174 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 174 SOI 2,Cost Outlier Threshold $45031,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 174 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 174 SOI 3,Cost Outlier Threshold $45031,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 174 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 174 SOI 4,Cost Outlier Threshold $45031,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 175 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 175 SOI 1,Cost Outlier Threshold $48434,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 175 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 175 SOI 2,Cost Outlier Threshold $48434,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 175 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 175 SOI 3,Cost Outlier Threshold $48434,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 175 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 175 SOI 4,Cost Outlier Threshold $48434,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 176 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 176 SOI 1,Cost Outlier Threshold $136199,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 176 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 176 SOI 2,Cost Outlier Threshold $136199,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 176 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 176 SOI 3,Cost Outlier Threshold $136199,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 176 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 176 SOI 4,Cost Outlier Threshold $136199,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 177 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 177 SOI 1,Cost Outlier Threshold $55215,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 177 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 177 SOI 2,Cost Outlier Threshold $55215,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 177 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 177 SOI 3,Cost Outlier Threshold $55215,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 177 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 177 SOI 4,Cost Outlier Threshold $55215,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 178 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 178 SOI 1,Cost Outlier Threshold $223399,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 178 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 178 SOI 2,Cost Outlier Threshold $223399,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 178 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 178 SOI 3,Cost Outlier Threshold $223399,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 178 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 178 SOI 4,Cost Outlier Threshold $223399,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 179 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 179 SOI 1,Cost Outlier Threshold $197240,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 179 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 179 SOI 2,Cost Outlier Threshold $197240,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 179 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 179 SOI 3,Cost Outlier Threshold $197240,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 179 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 179 SOI 4,Cost Outlier Threshold $197240,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 180 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 180 SOI 1,Cost Outlier Threshold $157574,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 180 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 180 SOI 2,Cost Outlier Threshold $157574,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 180 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 180 SOI 3,Cost Outlier Threshold $157574,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 180 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 180 SOI 4,Cost Outlier Threshold $157574,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 181 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 181 SOI 1,Cost Outlier Threshold $60759,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 181 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 181 SOI 2,Cost Outlier Threshold $60759,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 181 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 181 SOI 3,Cost Outlier Threshold $60759,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 181 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 181 SOI 4,Cost Outlier Threshold $60759,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 182 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 182 SOI 1,Cost Outlier Threshold $136792,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 182 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 182 SOI 2,Cost Outlier Threshold $136792,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 182 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 182 SOI 3,Cost Outlier Threshold $136792,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 182 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 182 SOI 4,Cost Outlier Threshold $136792,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 183 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 183 SOI 1,Cost Outlier Threshold $88519,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 183 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 183 SOI 2,Cost Outlier Threshold $88519,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 183 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 183 SOI 3,Cost Outlier Threshold $88519,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 183 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 183 SOI 4,Cost Outlier Threshold $88519,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 190 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 190 SOI 1,Cost Outlier Threshold $22331,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 190 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 190 SOI 2,Cost Outlier Threshold $22331,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 190 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 190 SOI 3,Cost Outlier Threshold $22331,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 190 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 190 SOI 4,Cost Outlier Threshold $22331,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 191 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 191 SOI 1,Cost Outlier Threshold $19288,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 191 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 191 SOI 2,Cost Outlier Threshold $19288,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 191 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 191 SOI 3,Cost Outlier Threshold $19288,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 191 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 191 SOI 4,Cost Outlier Threshold $19288,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 192 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 192 SOI 1,Cost Outlier Threshold $39717,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 192 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 192 SOI 2,Cost Outlier Threshold $39717,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 192 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 192 SOI 3,Cost Outlier Threshold $39717,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 192 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 192 SOI 4,Cost Outlier Threshold $39717,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 193 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 193 SOI 1,Cost Outlier Threshold $83365,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 193 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 193 SOI 2,Cost Outlier Threshold $83365,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 193 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 193 SOI 3,Cost Outlier Threshold $83365,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 193 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 193 SOI 4,Cost Outlier Threshold $83365,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 194 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 194 SOI 1,Cost Outlier Threshold $41161,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 194 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 194 SOI 2,Cost Outlier Threshold $41161,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 194 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 194 SOI 3,Cost Outlier Threshold $41161,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 194 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 194 SOI 4,Cost Outlier Threshold $41161,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 196 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 196 SOI 1,Cost Outlier Threshold $74159,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 196 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 196 SOI 2,Cost Outlier Threshold $74159,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 196 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 196 SOI 3,Cost Outlier Threshold $74159,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 196 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 196 SOI 4,Cost Outlier Threshold $74159,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 197 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 197 SOI 1,Cost Outlier Threshold $66328,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 197 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 197 SOI 2,Cost Outlier Threshold $66328,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 197 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 197 SOI 3,Cost Outlier Threshold $66328,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 197 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 197 SOI 4,Cost Outlier Threshold $66328,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 198 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 198 SOI 1,Cost Outlier Threshold $29097,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 198 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 198 SOI 2,Cost Outlier Threshold $29097,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 198 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 198 SOI 3,Cost Outlier Threshold $29097,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 198 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 198 SOI 4,Cost Outlier Threshold $29097,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 199 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 199 SOI 1,Cost Outlier Threshold $26797,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 199 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 199 SOI 2,Cost Outlier Threshold $26797,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 199 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 199 SOI 3,Cost Outlier Threshold $26797,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 199 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 199 SOI 4,Cost Outlier Threshold $26797,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 200 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 200 SOI 1,Cost Outlier Threshold $41376,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 200 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 200 SOI 2,Cost Outlier Threshold $41376,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 200 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 200 SOI 3,Cost Outlier Threshold $41376,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 200 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 200 SOI 4,Cost Outlier Threshold $41376,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 201 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 201 SOI 1,Cost Outlier Threshold $23529,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 201 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 201 SOI 2,Cost Outlier Threshold $23529,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 201 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 201 SOI 3,Cost Outlier Threshold $23529,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 201 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 201 SOI 4,Cost Outlier Threshold $23529,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 203 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 203 SOI 1,Cost Outlier Threshold $29783,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 203 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 203 SOI 2,Cost Outlier Threshold $29783,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 203 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 203 SOI 3,Cost Outlier Threshold $29783,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 203 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 203 SOI 4,Cost Outlier Threshold $29783,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 204 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 204 SOI 1,Cost Outlier Threshold $44780,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 204 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 204 SOI 2,Cost Outlier Threshold $44780,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 204 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 204 SOI 3,Cost Outlier Threshold $44780,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 204 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 204 SOI 4,Cost Outlier Threshold $44780,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 205 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 205 SOI 1,Cost Outlier Threshold $45431,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 205 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 205 SOI 2,Cost Outlier Threshold $45431,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 205 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 205 SOI 3,Cost Outlier Threshold $45431,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 205 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 205 SOI 4,Cost Outlier Threshold $45431,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 206 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 206 SOI 1,Cost Outlier Threshold $61449,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 206 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 206 SOI 2,Cost Outlier Threshold $61449,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 206 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 206 SOI 3,Cost Outlier Threshold $61449,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 206 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 206 SOI 4,Cost Outlier Threshold $61449,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 207 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 207 SOI 1,Cost Outlier Threshold $36814,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 207 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 207 SOI 2,Cost Outlier Threshold $36814,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 207 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 207 SOI 3,Cost Outlier Threshold $36814,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 207 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 207 SOI 4,Cost Outlier Threshold $36814,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 220 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 220 SOI 1,Cost Outlier Threshold $55053,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 220 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 220 SOI 2,Cost Outlier Threshold $55053,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 220 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 220 SOI 3,Cost Outlier Threshold $55053,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 220 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 220 SOI 4,Cost Outlier Threshold $55053,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 222 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 222 SOI 1,Cost Outlier Threshold $74197,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 222 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 222 SOI 2,Cost Outlier Threshold $74197,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 222 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 222 SOI 3,Cost Outlier Threshold $74197,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 222 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 222 SOI 4,Cost Outlier Threshold $74197,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 223 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 223 SOI 1,Cost Outlier Threshold $43622,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 223 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 223 SOI 2,Cost Outlier Threshold $43622,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 223 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 223 SOI 3,Cost Outlier Threshold $43622,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 223 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 223 SOI 4,Cost Outlier Threshold $43622,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 224 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 224 SOI 1,Cost Outlier Threshold $65064,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 224 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 224 SOI 2,Cost Outlier Threshold $65064,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 224 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 224 SOI 3,Cost Outlier Threshold $65064,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 224 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 224 SOI 4,Cost Outlier Threshold $65064,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 226 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 226 SOI 1,Cost Outlier Threshold $33791,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 226 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 226 SOI 2,Cost Outlier Threshold $33791,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 226 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 226 SOI 3,Cost Outlier Threshold $33791,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 226 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 226 SOI 4,Cost Outlier Threshold $33791,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 227 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 227 SOI 1,Cost Outlier Threshold $54984,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 227 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 227 SOI 2,Cost Outlier Threshold $54984,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 227 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 227 SOI 3,Cost Outlier Threshold $54984,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 227 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 227 SOI 4,Cost Outlier Threshold $54984,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 228 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 228 SOI 1,Cost Outlier Threshold $199044,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 228 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 228 SOI 2,Cost Outlier Threshold $199044,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 228 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 228 SOI 3,Cost Outlier Threshold $199044,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 228 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 228 SOI 4,Cost Outlier Threshold $199044,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 229 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 229 SOI 1,Cost Outlier Threshold $86825,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 229 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 229 SOI 2,Cost Outlier Threshold $86825,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 229 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 229 SOI 3,Cost Outlier Threshold $86825,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 229 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 229 SOI 4,Cost Outlier Threshold $86825,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 230 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 230 SOI 1,Cost Outlier Threshold $82294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 230 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 230 SOI 2,Cost Outlier Threshold $82294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 230 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 230 SOI 3,Cost Outlier Threshold $82294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 230 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 230 SOI 4,Cost Outlier Threshold $82294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 231 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 231 SOI 1,Cost Outlier Threshold $53618,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 231 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 231 SOI 2,Cost Outlier Threshold $53618,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 231 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 231 SOI 3,Cost Outlier Threshold $53618,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 231 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 231 SOI 4,Cost Outlier Threshold $53618,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 232 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 232 SOI 1,Cost Outlier Threshold $27274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 232 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 232 SOI 2,Cost Outlier Threshold $27274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 232 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 232 SOI 3,Cost Outlier Threshold $27274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 232 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 232 SOI 4,Cost Outlier Threshold $27274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 233 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 233 SOI 1,Cost Outlier Threshold $49951,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 233 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 233 SOI 2,Cost Outlier Threshold $49951,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 233 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 233 SOI 3,Cost Outlier Threshold $49951,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 233 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 233 SOI 4,Cost Outlier Threshold $49951,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 234 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 234 SOI 1,Cost Outlier Threshold $28789,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 234 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 234 SOI 2,Cost Outlier Threshold $28789,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 234 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 234 SOI 3,Cost Outlier Threshold $28789,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 234 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 234 SOI 4,Cost Outlier Threshold $28789,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 240 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 240 SOI 1,Cost Outlier Threshold $35429,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 240 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 240 SOI 2,Cost Outlier Threshold $35429,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 240 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 240 SOI 3,Cost Outlier Threshold $35429,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 240 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 240 SOI 4,Cost Outlier Threshold $35429,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 241 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 241 SOI 1,Cost Outlier Threshold $29745,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 241 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 241 SOI 2,Cost Outlier Threshold $29745,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 241 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 241 SOI 3,Cost Outlier Threshold $29745,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 241 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 241 SOI 4,Cost Outlier Threshold $29745,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 242 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 242 SOI 1,Cost Outlier Threshold $42294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 242 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 242 SOI 2,Cost Outlier Threshold $42294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 242 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 242 SOI 3,Cost Outlier Threshold $42294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 242 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 242 SOI 4,Cost Outlier Threshold $42294,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 243 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 243 SOI 1,Cost Outlier Threshold $28926,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 243 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 243 SOI 2,Cost Outlier Threshold $28926,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 243 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 243 SOI 3,Cost Outlier Threshold $28926,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 243 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 243 SOI 4,Cost Outlier Threshold $28926,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 244 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 244 SOI 1,Cost Outlier Threshold $22651,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 244 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 244 SOI 2,Cost Outlier Threshold $22651,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 244 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 244 SOI 3,Cost Outlier Threshold $22651,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 244 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 244 SOI 4,Cost Outlier Threshold $22651,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 245 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 245 SOI 1,Cost Outlier Threshold $27031,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 245 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 245 SOI 2,Cost Outlier Threshold $27031,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 245 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 245 SOI 3,Cost Outlier Threshold $27031,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 245 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 245 SOI 4,Cost Outlier Threshold $27031,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 246 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 246 SOI 1,Cost Outlier Threshold $21349,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 246 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 246 SOI 2,Cost Outlier Threshold $21349,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 246 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 246 SOI 3,Cost Outlier Threshold $21349,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 246 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 246 SOI 4,Cost Outlier Threshold $21349,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 247 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 247 SOI 1,Cost Outlier Threshold $29287,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 247 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 247 SOI 2,Cost Outlier Threshold $29287,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 247 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 247 SOI 3,Cost Outlier Threshold $29287,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 247 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 247 SOI 4,Cost Outlier Threshold $29287,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 248 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 248 SOI 1,Cost Outlier Threshold $36976,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 248 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 248 SOI 2,Cost Outlier Threshold $36976,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 248 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 248 SOI 3,Cost Outlier Threshold $36976,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 248 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 248 SOI 4,Cost Outlier Threshold $36976,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 249 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 249 SOI 1,Cost Outlier Threshold $27307,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 249 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 249 SOI 2,Cost Outlier Threshold $27307,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 249 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 249 SOI 3,Cost Outlier Threshold $27307,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 249 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 249 SOI 4,Cost Outlier Threshold $27307,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 251 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 251 SOI 1,Cost Outlier Threshold $34634,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 251 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 251 SOI 2,Cost Outlier Threshold $34634,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 251 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 251 SOI 3,Cost Outlier Threshold $34634,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 251 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 251 SOI 4,Cost Outlier Threshold $34634,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 252 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 252 SOI 1,Cost Outlier Threshold $36664,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 252 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 252 SOI 2,Cost Outlier Threshold $36664,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 252 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 252 SOI 3,Cost Outlier Threshold $36664,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 252 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 252 SOI 4,Cost Outlier Threshold $36664,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 253 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 253 SOI 1,Cost Outlier Threshold $32726,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 253 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 253 SOI 2,Cost Outlier Threshold $32726,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 253 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 253 SOI 3,Cost Outlier Threshold $32726,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 253 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 253 SOI 4,Cost Outlier Threshold $32726,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 254 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 254 SOI 1,Cost Outlier Threshold $34730,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 254 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 254 SOI 2,Cost Outlier Threshold $34730,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 254 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 254 SOI 3,Cost Outlier Threshold $34730,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 254 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 254 SOI 4,Cost Outlier Threshold $34730,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 260 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 260 SOI 1,Cost Outlier Threshold $112014,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 260 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 260 SOI 2,Cost Outlier Threshold $112014,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 260 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 260 SOI 3,Cost Outlier Threshold $112014,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 260 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 260 SOI 4,Cost Outlier Threshold $112014,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 261 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 261 SOI 1,Cost Outlier Threshold $79910,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 261 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 261 SOI 2,Cost Outlier Threshold $79910,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 261 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 261 SOI 3,Cost Outlier Threshold $79910,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 261 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 261 SOI 4,Cost Outlier Threshold $79910,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 263 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 263 SOI 1,Cost Outlier Threshold $36073,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 263 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 263 SOI 2,Cost Outlier Threshold $36073,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 263 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 263 SOI 3,Cost Outlier Threshold $36073,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 263 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 263 SOI 4,Cost Outlier Threshold $36073,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 264 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 264 SOI 1,Cost Outlier Threshold $130142,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 264 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 264 SOI 2,Cost Outlier Threshold $130142,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 264 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 264 SOI 3,Cost Outlier Threshold $130142,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 264 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 264 SOI 4,Cost Outlier Threshold $130142,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 279 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 279 SOI 1,Cost Outlier Threshold $42942,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 279 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 279 SOI 2,Cost Outlier Threshold $42942,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 279 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 279 SOI 3,Cost Outlier Threshold $42942,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 279 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 279 SOI 4,Cost Outlier Threshold $42942,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 280 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 280 SOI 1,Cost Outlier Threshold $49226,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 280 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 280 SOI 2,Cost Outlier Threshold $49226,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 280 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 280 SOI 3,Cost Outlier Threshold $49226,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 280 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 280 SOI 4,Cost Outlier Threshold $49226,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 281 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 281 SOI 1,Cost Outlier Threshold $84903,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 281 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 281 SOI 2,Cost Outlier Threshold $84903,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 281 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 281 SOI 3,Cost Outlier Threshold $84903,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 281 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 281 SOI 4,Cost Outlier Threshold $84903,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 282 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 282 SOI 1,Cost Outlier Threshold $34336,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 282 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 282 SOI 2,Cost Outlier Threshold $34336,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 282 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 282 SOI 3,Cost Outlier Threshold $34336,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 282 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 282 SOI 4,Cost Outlier Threshold $34336,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 283 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 283 SOI 1,Cost Outlier Threshold $35027,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 283 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 283 SOI 2,Cost Outlier Threshold $35027,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 283 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 283 SOI 3,Cost Outlier Threshold $35027,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 283 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 283 SOI 4,Cost Outlier Threshold $35027,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 284 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 284 SOI 1,Cost Outlier Threshold $38741,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 284 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 284 SOI 2,Cost Outlier Threshold $38741,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 284 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 284 SOI 3,Cost Outlier Threshold $38741,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 284 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 284 SOI 4,Cost Outlier Threshold $38741,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 301 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 301 SOI 1,Cost Outlier Threshold $35322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 301 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 301 SOI 2,Cost Outlier Threshold $35322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 301 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 301 SOI 3,Cost Outlier Threshold $35322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 301 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 301 SOI 4,Cost Outlier Threshold $35322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 302 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 302 SOI 1,Cost Outlier Threshold $43068,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 302 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 302 SOI 2,Cost Outlier Threshold $43068,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 302 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 302 SOI 3,Cost Outlier Threshold $43068,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 302 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 302 SOI 4,Cost Outlier Threshold $43068,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 303 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 303 SOI 1,Cost Outlier Threshold $128030,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 303 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 303 SOI 2,Cost Outlier Threshold $128030,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 303 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 303 SOI 3,Cost Outlier Threshold $128030,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 303 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 303 SOI 4,Cost Outlier Threshold $128030,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 304 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 304 SOI 1,Cost Outlier Threshold $107022,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 304 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 304 SOI 2,Cost Outlier Threshold $107022,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 304 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 304 SOI 3,Cost Outlier Threshold $107022,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 304 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 304 SOI 4,Cost Outlier Threshold $107022,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 305 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 305 SOI 1,Cost Outlier Threshold $72549,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 305 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 305 SOI 2,Cost Outlier Threshold $72549,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 305 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 305 SOI 3,Cost Outlier Threshold $72549,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 305 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 305 SOI 4,Cost Outlier Threshold $72549,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 308 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 308 SOI 1,Cost Outlier Threshold $68090,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 308 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 308 SOI 2,Cost Outlier Threshold $68090,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 308 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 308 SOI 3,Cost Outlier Threshold $68090,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 308 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 308 SOI 4,Cost Outlier Threshold $68090,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 309 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 309 SOI 1,Cost Outlier Threshold $86862,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 309 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 309 SOI 2,Cost Outlier Threshold $86862,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 309 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 309 SOI 3,Cost Outlier Threshold $86862,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 309 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 309 SOI 4,Cost Outlier Threshold $86862,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 310 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 310 SOI 1,Cost Outlier Threshold $54658,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 310 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 310 SOI 2,Cost Outlier Threshold $54658,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 310 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 310 SOI 3,Cost Outlier Threshold $54658,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 310 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 310 SOI 4,Cost Outlier Threshold $54658,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 312 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 312 SOI 1,Cost Outlier Threshold $150787,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 312 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 312 SOI 2,Cost Outlier Threshold $150787,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 312 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 312 SOI 3,Cost Outlier Threshold $150787,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 312 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 312 SOI 4,Cost Outlier Threshold $150787,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 313 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 313 SOI 1,Cost Outlier Threshold $56005,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 313 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 313 SOI 2,Cost Outlier Threshold $56005,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 313 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 313 SOI 3,Cost Outlier Threshold $56005,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 313 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 313 SOI 4,Cost Outlier Threshold $56005,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 314 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 314 SOI 1,Cost Outlier Threshold $49380,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 314 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 314 SOI 2,Cost Outlier Threshold $49380,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 314 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 314 SOI 3,Cost Outlier Threshold $49380,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 314 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 314 SOI 4,Cost Outlier Threshold $49380,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 315 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 315 SOI 1,Cost Outlier Threshold $47149,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 315 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 315 SOI 2,Cost Outlier Threshold $47149,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 315 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 315 SOI 3,Cost Outlier Threshold $47149,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 315 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 315 SOI 4,Cost Outlier Threshold $47149,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 316 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 316 SOI 1,Cost Outlier Threshold $54673,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 316 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 316 SOI 2,Cost Outlier Threshold $54673,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 316 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 316 SOI 3,Cost Outlier Threshold $54673,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 316 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 316 SOI 4,Cost Outlier Threshold $54673,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 317 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 317 SOI 1,Cost Outlier Threshold $42555,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 317 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 317 SOI 2,Cost Outlier Threshold $42555,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 317 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 317 SOI 3,Cost Outlier Threshold $42555,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 317 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 317 SOI 4,Cost Outlier Threshold $42555,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 320 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 320 SOI 1,Cost Outlier Threshold $68007,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 320 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 320 SOI 2,Cost Outlier Threshold $68007,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 320 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 320 SOI 3,Cost Outlier Threshold $68007,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 320 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 320 SOI 4,Cost Outlier Threshold $68007,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 321 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 321 SOI 1,Cost Outlier Threshold $67786,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 321 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 321 SOI 2,Cost Outlier Threshold $67786,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 321 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 321 SOI 3,Cost Outlier Threshold $67786,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 321 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 321 SOI 4,Cost Outlier Threshold $67786,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 322 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 322 SOI 1,Cost Outlier Threshold $47563,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 322 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 322 SOI 2,Cost Outlier Threshold $47563,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 322 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 322 SOI 3,Cost Outlier Threshold $47563,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 322 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 322 SOI 4,Cost Outlier Threshold $47563,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 340 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 340 SOI 1,Cost Outlier Threshold $43939,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 340 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 340 SOI 2,Cost Outlier Threshold $43939,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 340 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 340 SOI 3,Cost Outlier Threshold $43939,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 340 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 340 SOI 4,Cost Outlier Threshold $43939,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 341 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 341 SOI 1,Cost Outlier Threshold $45504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 341 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 341 SOI 2,Cost Outlier Threshold $45504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 341 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 341 SOI 3,Cost Outlier Threshold $45504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 341 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 341 SOI 4,Cost Outlier Threshold $45504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 342 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 342 SOI 1,Cost Outlier Threshold $38315,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 342 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 342 SOI 2,Cost Outlier Threshold $38315,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 342 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 342 SOI 3,Cost Outlier Threshold $38315,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 342 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 342 SOI 4,Cost Outlier Threshold $38315,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 343 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 343 SOI 1,Cost Outlier Threshold $100712,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 343 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 343 SOI 2,Cost Outlier Threshold $100712,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 343 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 343 SOI 3,Cost Outlier Threshold $100712,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 343 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 343 SOI 4,Cost Outlier Threshold $100712,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 344 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 344 SOI 1,Cost Outlier Threshold $61256,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 344 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 344 SOI 2,Cost Outlier Threshold $61256,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 344 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 344 SOI 3,Cost Outlier Threshold $61256,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 344 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 344 SOI 4,Cost Outlier Threshold $61256,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 346 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 346 SOI 1,Cost Outlier Threshold $53316,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 346 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 346 SOI 2,Cost Outlier Threshold $53316,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 346 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 346 SOI 3,Cost Outlier Threshold $53316,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 346 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 346 SOI 4,Cost Outlier Threshold $53316,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 347 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 347 SOI 1,Cost Outlier Threshold $47138,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 347 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 347 SOI 2,Cost Outlier Threshold $47138,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 347 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 347 SOI 3,Cost Outlier Threshold $47138,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 347 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 347 SOI 4,Cost Outlier Threshold $47138,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 349 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 349 SOI 1,Cost Outlier Threshold $44403,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 349 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 349 SOI 2,Cost Outlier Threshold $44403,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 349 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 349 SOI 3,Cost Outlier Threshold $44403,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 349 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 349 SOI 4,Cost Outlier Threshold $44403,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 351 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 351 SOI 1,Cost Outlier Threshold $31562,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 351 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 351 SOI 2,Cost Outlier Threshold $31562,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 351 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 351 SOI 3,Cost Outlier Threshold $31562,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 351 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 351 SOI 4,Cost Outlier Threshold $31562,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 361 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 361 SOI 1,Cost Outlier Threshold $86272,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 361 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 361 SOI 2,Cost Outlier Threshold $86272,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 361 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 361 SOI 3,Cost Outlier Threshold $86272,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 361 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 361 SOI 4,Cost Outlier Threshold $86272,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 362 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 362 SOI 1,Cost Outlier Threshold $75636,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 362 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 362 SOI 2,Cost Outlier Threshold $75636,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 362 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 362 SOI 3,Cost Outlier Threshold $75636,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 362 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 362 SOI 4,Cost Outlier Threshold $75636,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 363 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 363 SOI 1,Cost Outlier Threshold $45999,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 363 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 363 SOI 2,Cost Outlier Threshold $45999,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 363 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 363 SOI 3,Cost Outlier Threshold $45999,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 363 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 363 SOI 4,Cost Outlier Threshold $45999,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 364 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 364 SOI 1,Cost Outlier Threshold $38769,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 364 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 364 SOI 2,Cost Outlier Threshold $38769,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 364 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 364 SOI 3,Cost Outlier Threshold $38769,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 364 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 364 SOI 4,Cost Outlier Threshold $38769,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 380 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 380 SOI 1,Cost Outlier Threshold $61944,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 380 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 380 SOI 2,Cost Outlier Threshold $61944,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 380 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 380 SOI 3,Cost Outlier Threshold $61944,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 380 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 380 SOI 4,Cost Outlier Threshold $61944,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 381 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 381 SOI 1,Cost Outlier Threshold $26237,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 381 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 381 SOI 2,Cost Outlier Threshold $26237,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 381 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 381 SOI 3,Cost Outlier Threshold $26237,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 381 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 381 SOI 4,Cost Outlier Threshold $26237,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 382 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 382 SOI 1,Cost Outlier Threshold $84520,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 382 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 382 SOI 2,Cost Outlier Threshold $84520,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 382 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 382 SOI 3,Cost Outlier Threshold $84520,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 382 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 382 SOI 4,Cost Outlier Threshold $84520,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 383 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 383 SOI 1,Cost Outlier Threshold $28735,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 383 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 383 SOI 2,Cost Outlier Threshold $28735,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 383 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 383 SOI 3,Cost Outlier Threshold $28735,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 383 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 383 SOI 4,Cost Outlier Threshold $28735,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 384 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 384 SOI 1,Cost Outlier Threshold $48860,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 384 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 384 SOI 2,Cost Outlier Threshold $48860,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 384 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 384 SOI 3,Cost Outlier Threshold $48860,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 384 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 384 SOI 4,Cost Outlier Threshold $48860,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 385 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 385 SOI 1,Cost Outlier Threshold $49622,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 385 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 385 SOI 2,Cost Outlier Threshold $49622,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 385 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 385 SOI 3,Cost Outlier Threshold $49622,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 385 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 385 SOI 4,Cost Outlier Threshold $49622,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 401 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 401 SOI 1,Cost Outlier Threshold $26471,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 401 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 401 SOI 2,Cost Outlier Threshold $26471,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 401 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 401 SOI 3,Cost Outlier Threshold $26471,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 401 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 401 SOI 4,Cost Outlier Threshold $26471,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 403 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 403 SOI 1,Cost Outlier Threshold $53309,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 403 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 403 SOI 2,Cost Outlier Threshold $53309,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 403 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 403 SOI 3,Cost Outlier Threshold $53309,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 403 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 403 SOI 4,Cost Outlier Threshold $53309,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 404 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 404 SOI 1,Cost Outlier Threshold $33901,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 404 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 404 SOI 2,Cost Outlier Threshold $33901,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 404 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 404 SOI 3,Cost Outlier Threshold $33901,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 404 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 404 SOI 4,Cost Outlier Threshold $33901,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 405 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 405 SOI 1,Cost Outlier Threshold $229460,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 405 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 405 SOI 2,Cost Outlier Threshold $229460,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 405 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 405 SOI 3,Cost Outlier Threshold $229460,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 405 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 405 SOI 4,Cost Outlier Threshold $229460,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 420 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 420 SOI 1,Cost Outlier Threshold $26305,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 420 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 420 SOI 2,Cost Outlier Threshold $26305,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 420 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 420 SOI 3,Cost Outlier Threshold $26305,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 420 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 420 SOI 4,Cost Outlier Threshold $26305,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 421 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 421 SOI 1,Cost Outlier Threshold $104880,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 421 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 421 SOI 2,Cost Outlier Threshold $104880,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 421 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 421 SOI 3,Cost Outlier Threshold $104880,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 421 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 421 SOI 4,Cost Outlier Threshold $104880,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 422 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 422 SOI 1,Cost Outlier Threshold $23861,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 422 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 422 SOI 2,Cost Outlier Threshold $23861,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 422 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 422 SOI 3,Cost Outlier Threshold $23861,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 422 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 422 SOI 4,Cost Outlier Threshold $23861,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 423 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 423 SOI 1,Cost Outlier Threshold $44396,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 423 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 423 SOI 2,Cost Outlier Threshold $44396,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 423 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 423 SOI 3,Cost Outlier Threshold $44396,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 423 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 423 SOI 4,Cost Outlier Threshold $44396,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 424 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 424 SOI 1,Cost Outlier Threshold $98570,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 424 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 424 SOI 2,Cost Outlier Threshold $98570,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 424 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 424 SOI 3,Cost Outlier Threshold $98570,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 424 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 424 SOI 4,Cost Outlier Threshold $98570,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 425 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 425 SOI 1,Cost Outlier Threshold $47052,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 425 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 425 SOI 2,Cost Outlier Threshold $47052,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 425 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 425 SOI 3,Cost Outlier Threshold $47052,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 425 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 425 SOI 4,Cost Outlier Threshold $47052,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 426 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 426 SOI 1,Cost Outlier Threshold $31519,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 426 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 426 SOI 2,Cost Outlier Threshold $31519,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 426 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 426 SOI 3,Cost Outlier Threshold $31519,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 426 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 426 SOI 4,Cost Outlier Threshold $31519,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 427 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 427 SOI 1,Cost Outlier Threshold $81094,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 427 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 427 SOI 2,Cost Outlier Threshold $81094,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 427 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 427 SOI 3,Cost Outlier Threshold $81094,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 427 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 427 SOI 4,Cost Outlier Threshold $81094,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 440 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 440 SOI 1,Cost Outlier Threshold $524452,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 440 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 440 SOI 2,Cost Outlier Threshold $524452,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 440 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 440 SOI 3,Cost Outlier Threshold $524452,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 440 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 440 SOI 4,Cost Outlier Threshold $524452,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 441 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 441 SOI 1,Cost Outlier Threshold $74969,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 441 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 441 SOI 2,Cost Outlier Threshold $74969,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 441 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 441 SOI 3,Cost Outlier Threshold $74969,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 441 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 441 SOI 4,Cost Outlier Threshold $74969,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 442 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 442 SOI 1,Cost Outlier Threshold $47837,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 442 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 442 SOI 2,Cost Outlier Threshold $47837,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 442 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 442 SOI 3,Cost Outlier Threshold $47837,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 442 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 442 SOI 4,Cost Outlier Threshold $47837,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 443 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 443 SOI 1,Cost Outlier Threshold $60721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 443 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 443 SOI 2,Cost Outlier Threshold $60721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 443 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 443 SOI 3,Cost Outlier Threshold $60721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 443 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 443 SOI 4,Cost Outlier Threshold $60721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 444 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 444 SOI 1,Cost Outlier Threshold $59273,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 444 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 444 SOI 2,Cost Outlier Threshold $59273,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 444 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 444 SOI 3,Cost Outlier Threshold $59273,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 444 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 444 SOI 4,Cost Outlier Threshold $59273,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 445 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 445 SOI 1,Cost Outlier Threshold $66973,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 445 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 445 SOI 2,Cost Outlier Threshold $66973,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 445 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 445 SOI 3,Cost Outlier Threshold $66973,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 445 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 445 SOI 4,Cost Outlier Threshold $66973,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 446 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 446 SOI 1,Cost Outlier Threshold $23091,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 446 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 446 SOI 2,Cost Outlier Threshold $23091,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 446 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 446 SOI 3,Cost Outlier Threshold $23091,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 446 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 446 SOI 4,Cost Outlier Threshold $23091,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 447 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 447 SOI 1,Cost Outlier Threshold $90520,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 447 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 447 SOI 2,Cost Outlier Threshold $90520,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 447 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 447 SOI 3,Cost Outlier Threshold $90520,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 447 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 447 SOI 4,Cost Outlier Threshold $90520,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 461 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 461 SOI 1,Cost Outlier Threshold $80473,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 461 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 461 SOI 2,Cost Outlier Threshold $80473,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 461 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 461 SOI 3,Cost Outlier Threshold $80473,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 461 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 461 SOI 4,Cost Outlier Threshold $80473,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 462 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 462 SOI 1,Cost Outlier Threshold $41617,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 462 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 462 SOI 2,Cost Outlier Threshold $41617,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 462 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 462 SOI 3,Cost Outlier Threshold $41617,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 462 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 462 SOI 4,Cost Outlier Threshold $41617,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 463 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 463 SOI 1,Cost Outlier Threshold $24173,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 463 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 463 SOI 2,Cost Outlier Threshold $24173,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 463 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 463 SOI 3,Cost Outlier Threshold $24173,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 463 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 463 SOI 4,Cost Outlier Threshold $24173,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 465 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 465 SOI 1,Cost Outlier Threshold $19077,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 465 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 465 SOI 2,Cost Outlier Threshold $19077,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 465 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 465 SOI 3,Cost Outlier Threshold $19077,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 465 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 465 SOI 4,Cost Outlier Threshold $19077,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 466 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 466 SOI 1,Cost Outlier Threshold $36651,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 466 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 466 SOI 2,Cost Outlier Threshold $36651,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 466 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 466 SOI 3,Cost Outlier Threshold $36651,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 466 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 466 SOI 4,Cost Outlier Threshold $36651,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 468 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 468 SOI 1,Cost Outlier Threshold $36684,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 468 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 468 SOI 2,Cost Outlier Threshold $36684,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 468 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 468 SOI 3,Cost Outlier Threshold $36684,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 468 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 468 SOI 4,Cost Outlier Threshold $36684,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 469 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 469 SOI 1,Cost Outlier Threshold $41987,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 469 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 469 SOI 2,Cost Outlier Threshold $41987,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 469 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 469 SOI 3,Cost Outlier Threshold $41987,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 469 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 469 SOI 4,Cost Outlier Threshold $41987,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 470 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 470 SOI 1,Cost Outlier Threshold $55759,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 470 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 470 SOI 2,Cost Outlier Threshold $55759,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 470 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 470 SOI 3,Cost Outlier Threshold $55759,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 470 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 470 SOI 4,Cost Outlier Threshold $55759,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 480 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 480 SOI 1,Cost Outlier Threshold $55600,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 480 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 480 SOI 2,Cost Outlier Threshold $55600,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 480 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 480 SOI 3,Cost Outlier Threshold $55600,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 480 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 480 SOI 4,Cost Outlier Threshold $55600,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 482 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 482 SOI 1,Cost Outlier Threshold $26847,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 482 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 482 SOI 2,Cost Outlier Threshold $26847,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 482 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 482 SOI 3,Cost Outlier Threshold $26847,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 482 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 482 SOI 4,Cost Outlier Threshold $26847,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 483 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 483 SOI 1,Cost Outlier Threshold $47280,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 483 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 483 SOI 2,Cost Outlier Threshold $47280,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 483 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 483 SOI 3,Cost Outlier Threshold $47280,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 483 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 483 SOI 4,Cost Outlier Threshold $47280,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 484 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 484 SOI 1,Cost Outlier Threshold $50352,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 484 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 484 SOI 2,Cost Outlier Threshold $50352,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 484 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 484 SOI 3,Cost Outlier Threshold $50352,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 484 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 484 SOI 4,Cost Outlier Threshold $50352,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 500 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 500 SOI 1,Cost Outlier Threshold $57764,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 500 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 500 SOI 2,Cost Outlier Threshold $57764,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 500 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 500 SOI 3,Cost Outlier Threshold $57764,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 500 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 500 SOI 4,Cost Outlier Threshold $57764,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 501 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 501 SOI 1,Cost Outlier Threshold $41119,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 501 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 501 SOI 2,Cost Outlier Threshold $41119,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 501 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 501 SOI 3,Cost Outlier Threshold $41119,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 501 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 501 SOI 4,Cost Outlier Threshold $41119,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 510 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 510 SOI 1,Cost Outlier Threshold $29049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 510 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 510 SOI 2,Cost Outlier Threshold $29049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 510 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 510 SOI 3,Cost Outlier Threshold $29049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 510 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 510 SOI 4,Cost Outlier Threshold $29049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 511 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 511 SOI 1,Cost Outlier Threshold $44329,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 511 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 511 SOI 2,Cost Outlier Threshold $44329,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 511 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 511 SOI 3,Cost Outlier Threshold $44329,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 511 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 511 SOI 4,Cost Outlier Threshold $44329,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 512 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 512 SOI 1,Cost Outlier Threshold $58958,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 512 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 512 SOI 2,Cost Outlier Threshold $58958,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 512 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 512 SOI 3,Cost Outlier Threshold $58958,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 512 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 512 SOI 4,Cost Outlier Threshold $58958,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 513 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 513 SOI 1,Cost Outlier Threshold $31192,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 513 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 513 SOI 2,Cost Outlier Threshold $31192,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 513 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 513 SOI 3,Cost Outlier Threshold $31192,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 513 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 513 SOI 4,Cost Outlier Threshold $31192,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 514 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 514 SOI 1,Cost Outlier Threshold $26385,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 514 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 514 SOI 2,Cost Outlier Threshold $26385,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 514 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 514 SOI 3,Cost Outlier Threshold $26385,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 514 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 514 SOI 4,Cost Outlier Threshold $26385,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 517 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 517 SOI 1,Cost Outlier Threshold $35193,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 517 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 517 SOI 2,Cost Outlier Threshold $35193,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 517 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 517 SOI 3,Cost Outlier Threshold $35193,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 517 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 517 SOI 4,Cost Outlier Threshold $35193,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 518 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 518 SOI 1,Cost Outlier Threshold $64667,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 518 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 518 SOI 2,Cost Outlier Threshold $64667,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 518 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 518 SOI 3,Cost Outlier Threshold $64667,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 518 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 518 SOI 4,Cost Outlier Threshold $64667,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 519 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 519 SOI 1,Cost Outlier Threshold $31400,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 519 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 519 SOI 2,Cost Outlier Threshold $31400,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 519 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 519 SOI 3,Cost Outlier Threshold $31400,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 519 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 519 SOI 4,Cost Outlier Threshold $31400,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 530 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 530 SOI 1,Cost Outlier Threshold $59827,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 530 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 530 SOI 2,Cost Outlier Threshold $59827,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 530 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 530 SOI 3,Cost Outlier Threshold $59827,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 530 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 530 SOI 4,Cost Outlier Threshold $59827,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 531 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 531 SOI 1,Cost Outlier Threshold $37300,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 531 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 531 SOI 2,Cost Outlier Threshold $37300,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 531 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 531 SOI 3,Cost Outlier Threshold $37300,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 531 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 531 SOI 4,Cost Outlier Threshold $37300,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 532 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 532 SOI 1,Cost Outlier Threshold $20492,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 532 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 532 SOI 2,Cost Outlier Threshold $20492,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 532 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 532 SOI 3,Cost Outlier Threshold $20492,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 532 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 532 SOI 4,Cost Outlier Threshold $20492,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 539 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 539 SOI 1,Cost Outlier Threshold $22436,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 539 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 539 SOI 2,Cost Outlier Threshold $22436,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 539 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 539 SOI 3,Cost Outlier Threshold $22436,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 539 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 539 SOI 4,Cost Outlier Threshold $22436,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 540 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 540 SOI 1,Cost Outlier Threshold $23536,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 540 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 540 SOI 2,Cost Outlier Threshold $23536,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 540 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 540 SOI 3,Cost Outlier Threshold $23536,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 540 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 540 SOI 4,Cost Outlier Threshold $23536,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 541 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 541 SOI 1,Cost Outlier Threshold $23936,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 541 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 541 SOI 2,Cost Outlier Threshold $23936,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 541 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 541 SOI 3,Cost Outlier Threshold $23936,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 541 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 541 SOI 4,Cost Outlier Threshold $23936,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 542 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 542 SOI 1,Cost Outlier Threshold $17322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 542 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 542 SOI 2,Cost Outlier Threshold $17322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 542 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 542 SOI 3,Cost Outlier Threshold $17322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 542 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 542 SOI 4,Cost Outlier Threshold $17322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 543 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 543 SOI 1,Cost Outlier Threshold $30803,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 543 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 543 SOI 2,Cost Outlier Threshold $30803,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 543 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 543 SOI 3,Cost Outlier Threshold $30803,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 543 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 543 SOI 4,Cost Outlier Threshold $30803,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 547 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 547 SOI 1,Cost Outlier Threshold $53120,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 547 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 547 SOI 2,Cost Outlier Threshold $53120,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 547 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 547 SOI 3,Cost Outlier Threshold $53120,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 547 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 547 SOI 4,Cost Outlier Threshold $53120,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 548 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 548 SOI 1,Cost Outlier Threshold $29323,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 548 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 548 SOI 2,Cost Outlier Threshold $29323,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 548 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 548 SOI 3,Cost Outlier Threshold $29323,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 548 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 548 SOI 4,Cost Outlier Threshold $29323,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 560 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 560 SOI 1,Cost Outlier Threshold $12954,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 560 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 560 SOI 2,Cost Outlier Threshold $12954,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 560 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 560 SOI 3,Cost Outlier Threshold $12954,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 560 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 560 SOI 4,Cost Outlier Threshold $12954,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 561 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 561 SOI 1,Cost Outlier Threshold $20071,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 561 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 561 SOI 2,Cost Outlier Threshold $20071,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 561 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 561 SOI 3,Cost Outlier Threshold $20071,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 561 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 561 SOI 4,Cost Outlier Threshold $20071,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 564 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 564 SOI 1,Cost Outlier Threshold $11272,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 564 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 564 SOI 2,Cost Outlier Threshold $11272,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 564 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 564 SOI 3,Cost Outlier Threshold $11272,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 564 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 564 SOI 4,Cost Outlier Threshold $11272,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 566 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 566 SOI 1,Cost Outlier Threshold $22051,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 566 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 566 SOI 2,Cost Outlier Threshold $22051,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 566 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 566 SOI 3,Cost Outlier Threshold $22051,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 566 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 566 SOI 4,Cost Outlier Threshold $22051,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 580 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 580 SOI 1,Cost Outlier Threshold $22575,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 580 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 580 SOI 2,Cost Outlier Threshold $22575,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 580 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 580 SOI 3,Cost Outlier Threshold $22575,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 580 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 580 SOI 4,Cost Outlier Threshold $22575,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 581 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 581 SOI 1,Cost Outlier Threshold $9726,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 581 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 581 SOI 2,Cost Outlier Threshold $9726,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 581 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 581 SOI 3,Cost Outlier Threshold $9726,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 581 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 581 SOI 4,Cost Outlier Threshold $9726,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 583 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 583 SOI 1,Cost Outlier Threshold $1585005,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 583 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 583 SOI 2,Cost Outlier Threshold $1585005,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 583 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 583 SOI 3,Cost Outlier Threshold $1585005,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 583 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 583 SOI 4,Cost Outlier Threshold $1585005,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 588 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 588 SOI 1,Cost Outlier Threshold $1376342,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 588 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 588 SOI 2,Cost Outlier Threshold $1376342,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 588 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 588 SOI 3,Cost Outlier Threshold $1376342,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 588 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 588 SOI 4,Cost Outlier Threshold $1376342,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 589 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 589 SOI 1,Cost Outlier Threshold $359559,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 589 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 589 SOI 2,Cost Outlier Threshold $359559,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 589 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 589 SOI 3,Cost Outlier Threshold $359559,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 589 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 589 SOI 4,Cost Outlier Threshold $359559,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 591 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 591 SOI 1,Cost Outlier Threshold $727588,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 591 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 591 SOI 2,Cost Outlier Threshold $727588,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 591 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 591 SOI 3,Cost Outlier Threshold $727588,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 591 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 591 SOI 4,Cost Outlier Threshold $727588,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 593 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 593 SOI 1,Cost Outlier Threshold $651787,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 593 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 593 SOI 2,Cost Outlier Threshold $651787,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 593 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 593 SOI 3,Cost Outlier Threshold $651787,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 593 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 593 SOI 4,Cost Outlier Threshold $651787,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 602 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 602 SOI 1,Cost Outlier Threshold $451368,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 602 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 602 SOI 2,Cost Outlier Threshold $451368,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 602 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 602 SOI 3,Cost Outlier Threshold $451368,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 602 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 602 SOI 4,Cost Outlier Threshold $451368,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 603 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 603 SOI 1,Cost Outlier Threshold $615714,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 603 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 603 SOI 2,Cost Outlier Threshold $615714,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 603 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 603 SOI 3,Cost Outlier Threshold $615714,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 603 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 603 SOI 4,Cost Outlier Threshold $615714,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 607 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 607 SOI 1,Cost Outlier Threshold $298191,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 607 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 607 SOI 2,Cost Outlier Threshold $298191,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 607 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 607 SOI 3,Cost Outlier Threshold $298191,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 607 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 607 SOI 4,Cost Outlier Threshold $298191,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 608 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 608 SOI 1,Cost Outlier Threshold $170980,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 608 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 608 SOI 2,Cost Outlier Threshold $170980,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 608 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 608 SOI 3,Cost Outlier Threshold $170980,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 608 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 608 SOI 4,Cost Outlier Threshold $170980,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 609 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 609 SOI 1,Cost Outlier Threshold $718274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 609 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 609 SOI 2,Cost Outlier Threshold $718274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 609 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 609 SOI 3,Cost Outlier Threshold $718274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 609 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 609 SOI 4,Cost Outlier Threshold $718274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 611 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 611 SOI 1,Cost Outlier Threshold $323639,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 611 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 611 SOI 2,Cost Outlier Threshold $323639,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 611 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 611 SOI 3,Cost Outlier Threshold $323639,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 611 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 611 SOI 4,Cost Outlier Threshold $323639,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 612 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 612 SOI 1,Cost Outlier Threshold $262230,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 612 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 612 SOI 2,Cost Outlier Threshold $262230,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 612 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 612 SOI 3,Cost Outlier Threshold $262230,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 612 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 612 SOI 4,Cost Outlier Threshold $262230,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 613 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 613 SOI 1,Cost Outlier Threshold $301262,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 613 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 613 SOI 2,Cost Outlier Threshold $301262,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 613 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 613 SOI 3,Cost Outlier Threshold $301262,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 613 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 613 SOI 4,Cost Outlier Threshold $301262,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 614 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 614 SOI 1,Cost Outlier Threshold $154099,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 614 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 614 SOI 2,Cost Outlier Threshold $154099,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 614 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 614 SOI 3,Cost Outlier Threshold $154099,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 614 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 614 SOI 4,Cost Outlier Threshold $154099,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 621 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 621 SOI 1,Cost Outlier Threshold $90332,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 621 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 621 SOI 2,Cost Outlier Threshold $90332,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 621 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 621 SOI 3,Cost Outlier Threshold $90332,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 621 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 621 SOI 4,Cost Outlier Threshold $90332,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 622 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 622 SOI 1,Cost Outlier Threshold $164095,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 622 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 622 SOI 2,Cost Outlier Threshold $164095,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 622 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 622 SOI 3,Cost Outlier Threshold $164095,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 622 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 622 SOI 4,Cost Outlier Threshold $164095,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 623 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 623 SOI 1,Cost Outlier Threshold $108023,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 623 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 623 SOI 2,Cost Outlier Threshold $108023,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 623 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 623 SOI 3,Cost Outlier Threshold $108023,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 623 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 623 SOI 4,Cost Outlier Threshold $108023,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 625 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 625 SOI 1,Cost Outlier Threshold $140785,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 625 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 625 SOI 2,Cost Outlier Threshold $140785,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 625 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 625 SOI 3,Cost Outlier Threshold $140785,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 625 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 625 SOI 4,Cost Outlier Threshold $140785,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 626 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 626 SOI 1,Cost Outlier Threshold $79374,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 626 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 626 SOI 2,Cost Outlier Threshold $79374,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 626 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 626 SOI 3,Cost Outlier Threshold $79374,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 626 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 626 SOI 4,Cost Outlier Threshold $79374,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 630 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 630 SOI 1,Cost Outlier Threshold $616274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 630 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 630 SOI 2,Cost Outlier Threshold $616274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 630 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 630 SOI 3,Cost Outlier Threshold $616274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 630 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 630 SOI 4,Cost Outlier Threshold $616274,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 631 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 631 SOI 1,Cost Outlier Threshold $189593,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 631 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 631 SOI 2,Cost Outlier Threshold $189593,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 631 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 631 SOI 3,Cost Outlier Threshold $189593,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 631 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 631 SOI 4,Cost Outlier Threshold $189593,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 633 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 633 SOI 1,Cost Outlier Threshold $63049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 633 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 633 SOI 2,Cost Outlier Threshold $63049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 633 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 633 SOI 3,Cost Outlier Threshold $63049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 633 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 633 SOI 4,Cost Outlier Threshold $63049,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 634 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 634 SOI 1,Cost Outlier Threshold $92152,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 634 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 634 SOI 2,Cost Outlier Threshold $92152,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 634 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 634 SOI 3,Cost Outlier Threshold $92152,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 634 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 634 SOI 4,Cost Outlier Threshold $92152,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 636 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 636 SOI 1,Cost Outlier Threshold $51017,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 636 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 636 SOI 2,Cost Outlier Threshold $51017,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 636 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 636 SOI 3,Cost Outlier Threshold $51017,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 636 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 636 SOI 4,Cost Outlier Threshold $51017,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 639 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 639 SOI 1,Cost Outlier Threshold $51908,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 639 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 639 SOI 2,Cost Outlier Threshold $51908,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 639 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 639 SOI 3,Cost Outlier Threshold $51908,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 639 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 639 SOI 4,Cost Outlier Threshold $51908,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 640 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 640 SOI 1,Cost Outlier Threshold $6763,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 640 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 640 SOI 2,Cost Outlier Threshold $6763,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 640 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 640 SOI 3,Cost Outlier Threshold $6763,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 640 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 640 SOI 4,Cost Outlier Threshold $6763,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 650 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 650 SOI 1,Cost Outlier Threshold $53125,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 650 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 650 SOI 2,Cost Outlier Threshold $53125,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 650 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 650 SOI 3,Cost Outlier Threshold $53125,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 650 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 650 SOI 4,Cost Outlier Threshold $53125,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 651 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 651 SOI 1,Cost Outlier Threshold $57518,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 651 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 651 SOI 2,Cost Outlier Threshold $57518,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 651 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 651 SOI 3,Cost Outlier Threshold $57518,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 651 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 651 SOI 4,Cost Outlier Threshold $57518,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 660 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 660 SOI 1,Cost Outlier Threshold $55367,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 660 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 660 SOI 2,Cost Outlier Threshold $55367,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 660 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 660 SOI 3,Cost Outlier Threshold $55367,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 660 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 660 SOI 4,Cost Outlier Threshold $55367,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 661 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 661 SOI 1,Cost Outlier Threshold $81199,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 661 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 661 SOI 2,Cost Outlier Threshold $81199,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 661 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 661 SOI 3,Cost Outlier Threshold $81199,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 661 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 661 SOI 4,Cost Outlier Threshold $81199,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 662 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 662 SOI 1,Cost Outlier Threshold $78297,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 662 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 662 SOI 2,Cost Outlier Threshold $78297,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 662 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 662 SOI 3,Cost Outlier Threshold $78297,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 662 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 662 SOI 4,Cost Outlier Threshold $78297,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 663 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 663 SOI 1,Cost Outlier Threshold $24189,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 663 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 663 SOI 2,Cost Outlier Threshold $24189,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 663 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 663 SOI 3,Cost Outlier Threshold $24189,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 663 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 663 SOI 4,Cost Outlier Threshold $24189,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 680 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 680 SOI 1,Cost Outlier Threshold $221259,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 680 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 680 SOI 2,Cost Outlier Threshold $221259,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 680 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 680 SOI 3,Cost Outlier Threshold $221259,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 680 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 680 SOI 4,Cost Outlier Threshold $221259,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 681 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 681 SOI 1,Cost Outlier Threshold $81955,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 681 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 681 SOI 2,Cost Outlier Threshold $81955,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 681 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 681 SOI 3,Cost Outlier Threshold $81955,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 681 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 681 SOI 4,Cost Outlier Threshold $81955,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 690 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 690 SOI 1,Cost Outlier Threshold $263129,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 690 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 690 SOI 2,Cost Outlier Threshold $263129,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 690 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 690 SOI 3,Cost Outlier Threshold $263129,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 690 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 690 SOI 4,Cost Outlier Threshold $263129,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 691 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 691 SOI 1,Cost Outlier Threshold $97556,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 691 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 691 SOI 2,Cost Outlier Threshold $97556,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 691 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 691 SOI 3,Cost Outlier Threshold $97556,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 691 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 691 SOI 4,Cost Outlier Threshold $97556,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 692 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 692 SOI 1,Cost Outlier Threshold $37322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 692 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 692 SOI 2,Cost Outlier Threshold $37322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 692 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 692 SOI 3,Cost Outlier Threshold $37322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 692 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 692 SOI 4,Cost Outlier Threshold $37322,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 694 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 694 SOI 1,Cost Outlier Threshold $76398,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 694 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 694 SOI 2,Cost Outlier Threshold $76398,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 694 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 694 SOI 3,Cost Outlier Threshold $76398,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 694 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 694 SOI 4,Cost Outlier Threshold $76398,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 695 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 695 SOI 1,Cost Outlier Threshold $89216,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 695 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 695 SOI 2,Cost Outlier Threshold $89216,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 695 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 695 SOI 3,Cost Outlier Threshold $89216,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 695 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 695 SOI 4,Cost Outlier Threshold $89216,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 696 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 696 SOI 1,Cost Outlier Threshold $43022,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 696 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 696 SOI 2,Cost Outlier Threshold $43022,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 696 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 696 SOI 3,Cost Outlier Threshold $43022,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 696 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 696 SOI 4,Cost Outlier Threshold $43022,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 710 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 710 SOI 1,Cost Outlier Threshold $158358,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 710 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 710 SOI 2,Cost Outlier Threshold $158358,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 710 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 710 SOI 3,Cost Outlier Threshold $158358,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 710 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 710 SOI 4,Cost Outlier Threshold $158358,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 711 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 711 SOI 1,Cost Outlier Threshold $94533,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 711 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 711 SOI 2,Cost Outlier Threshold $94533,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 711 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 711 SOI 3,Cost Outlier Threshold $94533,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 711 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 711 SOI 4,Cost Outlier Threshold $94533,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 720 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 720 SOI 1,Cost Outlier Threshold $59596,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 720 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 720 SOI 2,Cost Outlier Threshold $59596,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 720 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 720 SOI 3,Cost Outlier Threshold $59596,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 720 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 720 SOI 4,Cost Outlier Threshold $59596,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 721 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 721 SOI 1,Cost Outlier Threshold $54838,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 721 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 721 SOI 2,Cost Outlier Threshold $54838,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 721 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 721 SOI 3,Cost Outlier Threshold $54838,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 721 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 721 SOI 4,Cost Outlier Threshold $54838,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 722 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 722 SOI 1,Cost Outlier Threshold $26607,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 722 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 722 SOI 2,Cost Outlier Threshold $26607,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 722 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 722 SOI 3,Cost Outlier Threshold $26607,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 722 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 722 SOI 4,Cost Outlier Threshold $26607,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 723 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 723 SOI 1,Cost Outlier Threshold $17784,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 723 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 723 SOI 2,Cost Outlier Threshold $17784,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 723 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 723 SOI 3,Cost Outlier Threshold $17784,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 723 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 723 SOI 4,Cost Outlier Threshold $17784,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 724 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 724 SOI 1,Cost Outlier Threshold $60848,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 724 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 724 SOI 2,Cost Outlier Threshold $60848,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 724 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 724 SOI 3,Cost Outlier Threshold $60848,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 724 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 724 SOI 4,Cost Outlier Threshold $60848,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 740 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 740 SOI 1,Cost Outlier Threshold $148504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 740 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 740 SOI 2,Cost Outlier Threshold $148504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 740 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 740 SOI 3,Cost Outlier Threshold $148504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 740 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 740 SOI 4,Cost Outlier Threshold $148504,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 750 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 750 SOI 1,Cost Outlier Threshold $60275,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 750 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 750 SOI 2,Cost Outlier Threshold $60275,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 750 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 750 SOI 3,Cost Outlier Threshold $60275,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 750 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 750 SOI 4,Cost Outlier Threshold $60275,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 751 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 751 SOI 1,Cost Outlier Threshold $23439,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 751 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 751 SOI 2,Cost Outlier Threshold $23439,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 751 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 751 SOI 3,Cost Outlier Threshold $23439,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 751 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 751 SOI 4,Cost Outlier Threshold $23439,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 752 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 752 SOI 1,Cost Outlier Threshold $19548,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 752 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 752 SOI 2,Cost Outlier Threshold $19548,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 752 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 752 SOI 3,Cost Outlier Threshold $19548,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 752 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 752 SOI 4,Cost Outlier Threshold $19548,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 753 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 753 SOI 1,Cost Outlier Threshold $38361,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 753 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 753 SOI 2,Cost Outlier Threshold $38361,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 753 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 753 SOI 3,Cost Outlier Threshold $38361,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 753 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 753 SOI 4,Cost Outlier Threshold $38361,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 754 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 754 SOI 1,Cost Outlier Threshold $22962,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 754 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 754 SOI 2,Cost Outlier Threshold $22962,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 754 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 754 SOI 3,Cost Outlier Threshold $22962,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 754 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 754 SOI 4,Cost Outlier Threshold $22962,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 755 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 755 SOI 1,Cost Outlier Threshold $14655,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 755 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 755 SOI 2,Cost Outlier Threshold $14655,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 755 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 755 SOI 3,Cost Outlier Threshold $14655,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 755 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 755 SOI 4,Cost Outlier Threshold $14655,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 756 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 756 SOI 1,Cost Outlier Threshold $19419,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 756 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 756 SOI 2,Cost Outlier Threshold $19419,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 756 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 756 SOI 3,Cost Outlier Threshold $19419,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 756 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 756 SOI 4,Cost Outlier Threshold $19419,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 757 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 757 SOI 1,Cost Outlier Threshold $21077,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 757 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 757 SOI 2,Cost Outlier Threshold $21077,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 757 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 757 SOI 3,Cost Outlier Threshold $21077,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 757 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 757 SOI 4,Cost Outlier Threshold $21077,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 758 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 758 SOI 1,Cost Outlier Threshold $18776,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 758 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 758 SOI 2,Cost Outlier Threshold $18776,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 758 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 758 SOI 3,Cost Outlier Threshold $18776,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 758 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 758 SOI 4,Cost Outlier Threshold $18776,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 759 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 759 SOI 1,Cost Outlier Threshold $183385,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 759 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 759 SOI 2,Cost Outlier Threshold $183385,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 759 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 759 SOI 3,Cost Outlier Threshold $183385,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 759 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 759 SOI 4,Cost Outlier Threshold $183385,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 760 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 760 SOI 1,Cost Outlier Threshold $49822,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 760 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 760 SOI 2,Cost Outlier Threshold $49822,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 760 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 760 SOI 3,Cost Outlier Threshold $49822,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 760 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 760 SOI 4,Cost Outlier Threshold $49822,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 770 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 770 SOI 1,Cost Outlier Threshold $47327,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 770 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 770 SOI 2,Cost Outlier Threshold $47327,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 770 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 770 SOI 3,Cost Outlier Threshold $47327,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 770 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 770 SOI 4,Cost Outlier Threshold $47327,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 772 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 772 SOI 1,Cost Outlier Threshold $23673,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 772 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 772 SOI 2,Cost Outlier Threshold $23673,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 772 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 772 SOI 3,Cost Outlier Threshold $23673,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 772 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 772 SOI 4,Cost Outlier Threshold $23673,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 773 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 773 SOI 1,Cost Outlier Threshold $30090,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 773 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 773 SOI 2,Cost Outlier Threshold $30090,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 773 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 773 SOI 3,Cost Outlier Threshold $30090,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 773 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 773 SOI 4,Cost Outlier Threshold $30090,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 774 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 774 SOI 1,Cost Outlier Threshold $12837,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 774 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 774 SOI 2,Cost Outlier Threshold $12837,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 774 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 774 SOI 3,Cost Outlier Threshold $12837,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 774 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 774 SOI 4,Cost Outlier Threshold $12837,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 775 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 775 SOI 1,Cost Outlier Threshold $25616,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 775 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 775 SOI 2,Cost Outlier Threshold $25616,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 775 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 775 SOI 3,Cost Outlier Threshold $25616,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 775 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 775 SOI 4,Cost Outlier Threshold $25616,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 776 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 776 SOI 1,Cost Outlier Threshold $33076,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 776 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 776 SOI 2,Cost Outlier Threshold $33076,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 776 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 776 SOI 3,Cost Outlier Threshold $33076,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 776 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 776 SOI 4,Cost Outlier Threshold $33076,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 792 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 792 SOI 1,Cost Outlier Threshold $199415,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 792 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 792 SOI 2,Cost Outlier Threshold $199415,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 792 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 792 SOI 3,Cost Outlier Threshold $199415,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 792 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 792 SOI 4,Cost Outlier Threshold $199415,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 793 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 793 SOI 1,Cost Outlier Threshold $59338,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 793 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 793 SOI 2,Cost Outlier Threshold $59338,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 793 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 793 SOI 3,Cost Outlier Threshold $59338,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 793 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 793 SOI 4,Cost Outlier Threshold $59338,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 794 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 794 SOI 1,Cost Outlier Threshold $94845,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 794 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 794 SOI 2,Cost Outlier Threshold $94845,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 794 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 794 SOI 3,Cost Outlier Threshold $94845,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 794 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 794 SOI 4,Cost Outlier Threshold $94845,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 810 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 810 SOI 1,Cost Outlier Threshold $27434,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 810 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 810 SOI 2,Cost Outlier Threshold $27434,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 810 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 810 SOI 3,Cost Outlier Threshold $27434,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 810 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 810 SOI 4,Cost Outlier Threshold $27434,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 811 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 811 SOI 1,Cost Outlier Threshold $55911,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 811 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 811 SOI 2,Cost Outlier Threshold $55911,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 811 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 811 SOI 3,Cost Outlier Threshold $55911,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 811 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 811 SOI 4,Cost Outlier Threshold $55911,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 812 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 812 SOI 1,Cost Outlier Threshold $45772,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 812 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 812 SOI 2,Cost Outlier Threshold $45772,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 812 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 812 SOI 3,Cost Outlier Threshold $45772,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 812 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 812 SOI 4,Cost Outlier Threshold $45772,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 813 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 813 SOI 1,Cost Outlier Threshold $52335,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 813 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 813 SOI 2,Cost Outlier Threshold $52335,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 813 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 813 SOI 3,Cost Outlier Threshold $52335,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 813 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 813 SOI 4,Cost Outlier Threshold $52335,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 815 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 815 SOI 1,Cost Outlier Threshold $84731,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 815 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 815 SOI 2,Cost Outlier Threshold $84731,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 815 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 815 SOI 3,Cost Outlier Threshold $84731,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 815 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 815 SOI 4,Cost Outlier Threshold $84731,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 816 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 816 SOI 1,Cost Outlier Threshold $59873,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 816 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 816 SOI 2,Cost Outlier Threshold $59873,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 816 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 816 SOI 3,Cost Outlier Threshold $59873,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 816 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 816 SOI 4,Cost Outlier Threshold $59873,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 817 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 817 SOI 1,Cost Outlier Threshold $33027,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 817 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 817 SOI 2,Cost Outlier Threshold $33027,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 817 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 817 SOI 3,Cost Outlier Threshold $33027,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 817 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 817 SOI 4,Cost Outlier Threshold $33027,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 841 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 841 SOI 1,Cost Outlier Threshold $1628210,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 841 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 841 SOI 2,Cost Outlier Threshold $1628210,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 841 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 841 SOI 3,Cost Outlier Threshold $1628210,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 841 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 841 SOI 4,Cost Outlier Threshold $1628210,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 842 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 842 SOI 1,Cost Outlier Threshold $71889,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 842 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 842 SOI 2,Cost Outlier Threshold $71889,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 842 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 842 SOI 3,Cost Outlier Threshold $71889,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 842 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 842 SOI 4,Cost Outlier Threshold $71889,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 843 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 843 SOI 1,Cost Outlier Threshold $50573,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 843 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 843 SOI 2,Cost Outlier Threshold $50573,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 843 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 843 SOI 3,Cost Outlier Threshold $50573,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 843 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 843 SOI 4,Cost Outlier Threshold $50573,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 844 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 844 SOI 1,Cost Outlier Threshold $36278,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 844 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 844 SOI 2,Cost Outlier Threshold $36278,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 844 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 844 SOI 3,Cost Outlier Threshold $36278,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 844 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 844 SOI 4,Cost Outlier Threshold $36278,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 850 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 850 SOI 1,Cost Outlier Threshold $93313,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 850 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 850 SOI 2,Cost Outlier Threshold $93313,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 850 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 850 SOI 3,Cost Outlier Threshold $93313,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 850 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 850 SOI 4,Cost Outlier Threshold $93313,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 860 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 860 SOI 1,Cost Outlier Threshold $56981,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 860 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 860 SOI 2,Cost Outlier Threshold $56981,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 860 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 860 SOI 3,Cost Outlier Threshold $56981,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 860 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 860 SOI 4,Cost Outlier Threshold $56981,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 861 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 861 SOI 1,Cost Outlier Threshold $69809,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 861 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 861 SOI 2,Cost Outlier Threshold $69809,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 861 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 861 SOI 3,Cost Outlier Threshold $69809,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 861 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 861 SOI 4,Cost Outlier Threshold $69809,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 862 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 862 SOI 1,Cost Outlier Threshold $93305,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 862 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 862 SOI 2,Cost Outlier Threshold $93305,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 862 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 862 SOI 3,Cost Outlier Threshold $93305,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 862 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 862 SOI 4,Cost Outlier Threshold $93305,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 863 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 863 SOI 1,Cost Outlier Threshold $210553,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 863 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 863 SOI 2,Cost Outlier Threshold $210553,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 863 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 863 SOI 3,Cost Outlier Threshold $210553,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 863 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 863 SOI 4,Cost Outlier Threshold $210553,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 890 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 890 SOI 1,Cost Outlier Threshold $201172,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 890 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 890 SOI 2,Cost Outlier Threshold $201172,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 890 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 890 SOI 3,Cost Outlier Threshold $201172,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 890 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 890 SOI 4,Cost Outlier Threshold $201172,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 892 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 892 SOI 1,Cost Outlier Threshold $40145,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 892 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 892 SOI 2,Cost Outlier Threshold $40145,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 892 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 892 SOI 3,Cost Outlier Threshold $40145,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 892 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 892 SOI 4,Cost Outlier Threshold $40145,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 893 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 893 SOI 1,Cost Outlier Threshold $65381,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 893 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 893 SOI 2,Cost Outlier Threshold $65381,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 893 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 893 SOI 3,Cost Outlier Threshold $65381,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 893 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 893 SOI 4,Cost Outlier Threshold $65381,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 894 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 894 SOI 1,Cost Outlier Threshold $97915,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 894 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 894 SOI 2,Cost Outlier Threshold $97915,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 894 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 894 SOI 3,Cost Outlier Threshold $97915,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 894 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 894 SOI 4,Cost Outlier Threshold $97915,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 910 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 910 SOI 1,Cost Outlier Threshold $138572,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 910 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 910 SOI 2,Cost Outlier Threshold $138572,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 910 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 910 SOI 3,Cost Outlier Threshold $138572,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 910 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 910 SOI 4,Cost Outlier Threshold $138572,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 911 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 911 SOI 1,Cost Outlier Threshold $194635,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 911 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 911 SOI 2,Cost Outlier Threshold $194635,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 911 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 911 SOI 3,Cost Outlier Threshold $194635,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 911 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 911 SOI 4,Cost Outlier Threshold $194635,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 912 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 912 SOI 1,Cost Outlier Threshold $172900,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 912 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 912 SOI 2,Cost Outlier Threshold $172900,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 912 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 912 SOI 3,Cost Outlier Threshold $172900,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 912 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 912 SOI 4,Cost Outlier Threshold $172900,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 930 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 930 SOI 1,Cost Outlier Threshold $72721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 930 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 930 SOI 2,Cost Outlier Threshold $72721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 930 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 930 SOI 3,Cost Outlier Threshold $72721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 930 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 930 SOI 4,Cost Outlier Threshold $72721,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 950 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 950 SOI 1,Cost Outlier Threshold $157364,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 950 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 950 SOI 2,Cost Outlier Threshold $157364,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 950 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 950 SOI 3,Cost Outlier Threshold $157364,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 950 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 950 SOI 4,Cost Outlier Threshold $157364,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 951 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 951 SOI 1,Cost Outlier Threshold $140546,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 951 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 951 SOI 2,Cost Outlier Threshold $140546,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 951 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 951 SOI 3,Cost Outlier Threshold $140546,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 951 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 951 SOI 4,Cost Outlier Threshold $140546,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 952 SOI 1,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 952 SOI 1,Cost Outlier Threshold $147449,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 952 SOI 2,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 952 SOI 2,Cost Outlier Threshold $147449,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 952 SOI 3,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 952 SOI 3,Cost Outlier Threshold $147449,,,DRG,,,,,,,,0
unity,DRG,Outlier APR DRG 952 SOI 4,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,APR DRG 952 SOI 4,Cost Outlier Threshold $147449,,,DRG,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield Minnesota,,EAPG v3.13,,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0509T,Not in chargemaster,0509T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0509T,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,190.14,255,0
unity,Fee schedule,Facility 0509T mod 26,Not in chargemaster,0509T,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0509T mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,345.16,445,0
unity,Fee schedule,Facility 0509T mod TC,Not in chargemaster,0509T,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0509T mod TC,BCBS multispecialty AW base fee schedule,96.72,,Fee schedule,,,,,,194.78,325.83,0
unity,Fee schedule,Facility 10004,Not in chargemaster,10004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10004,BCBS multispecialty AW base fee schedule,82.81,,Fee schedule,,,,,,353.11,588.48,0
unity,Fee schedule,Facility 10005,Not in chargemaster,10005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10005,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,225.91,347.12,0
unity,Fee schedule,Facility 10006,Not in chargemaster,10006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10006,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,179.54,277.56,0
unity,Fee schedule,Facility 10007,Not in chargemaster,10007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10007,BCBS multispecialty AW base fee schedule,178.21,,Fee schedule,,,,,,338.54,405.82,0
unity,Fee schedule,Facility 10008,Not in chargemaster,10008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10008,BCBS multispecialty AW base fee schedule,116.6,,Fee schedule,,,,,,54.33,115.01,0
unity,Fee schedule,Facility 10009,Not in chargemaster,10009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10009,BCBS multispecialty AW base fee schedule,217.3,,Fee schedule,,,,,,115.94,265,0
unity,Fee schedule,Facility 10010,Not in chargemaster,10010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10010,BCBS multispecialty AW base fee schedule,157.68,,Fee schedule,,,,,,30.48,120,0
unity,Fee schedule,Facility 10021,Not in chargemaster,10021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10021,BCBS multispecialty AW base fee schedule,106,,Fee schedule,,,,,,74.2,210,0
unity,Fee schedule,Facility 10030,Not in chargemaster,10030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10030,BCBS multispecialty AW base fee schedule,263.68,,Fee schedule,,,,,,92.75,275,0
unity,Fee schedule,Facility 10035,Not in chargemaster,10035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10035,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,50.35,137.5,0
unity,Fee schedule,Facility 10036,Not in chargemaster,10036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10036,BCBS multispecialty AW base fee schedule,82.81,,Fee schedule,,,,,,139.13,186.7,0
unity,Fee schedule,Facility 10040,Not in chargemaster,10040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10040,BCBS multispecialty AW base fee schedule,101.36,,Fee schedule,,,,,,31.14,45,0
unity,Fee schedule,Facility 10060,10060,10060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10060,BCBS multispecialty AW base fee schedule,190.14,255,Fee schedule,,190.14,190.14,190.14,190.14,65.59,209.42,0
unity,Fee schedule,Facility 10061,10061,10061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10061,BCBS multispecialty AW base fee schedule,345.16,445,Fee schedule,,345.16,345.16,345.16,345.16,99.38,256.97,0
unity,Fee schedule,Facility 10080,Not in chargemaster,10080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10080,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,116.6,302.41,0
unity,Fee schedule,Facility 10081,Not in chargemaster,10081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10081,BCBS multispecialty AW base fee schedule,326.61,,Fee schedule,,,,,,137.14,333.64,0
unity,Fee schedule,Facility 10120,10120,10120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10120,BCBS multispecialty AW base fee schedule,194.78,325.83,Fee schedule,,194.78,194.78,194.78,194.78,74.86,220,0
unity,Fee schedule,Facility 10121,10121,10121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10121,BCBS multispecialty AW base fee schedule,353.11,588.48,Fee schedule,,353.11,353.11,353.11,353.11,96.06,259.11,0
unity,Fee schedule,Facility 10140,10140,10140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10140,BCBS multispecialty AW base fee schedule,225.91,347.12,Fee schedule,,225.91,225.91,225.91,225.91,123.89,307.38,0
unity,Fee schedule,Facility 10160,10160,10160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10160,BCBS multispecialty AW base fee schedule,179.54,277.56,Fee schedule,,179.54,179.54,179.54,179.54,88.78,243.5,0
unity,Fee schedule,Facility 10180,10180,10180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10180,BCBS multispecialty AW base fee schedule,338.54,405.82,Fee schedule,,338.54,338.54,338.54,338.54,121.24,290,0
unity,Fee schedule,Facility 11000,11000,11000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11000,BCBS multispecialty AW base fee schedule,54.33,115.01,Fee schedule,,54.33,54.33,54.33,54.33,143.76,345,0
unity,Fee schedule,Facility 11001,Not in chargemaster,11001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11001,BCBS multispecialty AW base fee schedule,27.16,,Fee schedule,,,,,,186.83,400,0
unity,Fee schedule,Facility 11004,Not in chargemaster,11004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11004,BCBS multispecialty AW base fee schedule,1105.05,,Fee schedule,,,,,,154.36,264.09,0
unity,Fee schedule,Facility 11005,Not in chargemaster,11005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11005,BCBS multispecialty AW base fee schedule,1505.2,,Fee schedule,,,,,,196.1,318.74,0
unity,Fee schedule,Facility 11006,Not in chargemaster,11006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11006,BCBS multispecialty AW base fee schedule,1357.46,,Fee schedule,,,,,,216.64,365,0
unity,Fee schedule,Facility 11008,Not in chargemaster,11008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11008,BCBS multispecialty AW base fee schedule,529.34,,Fee schedule,,,,,,280.24,420,0
unity,Fee schedule,Facility 11010,Not in chargemaster,11010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11010,BCBS multispecialty AW base fee schedule,527.35,,Fee schedule,,,,,,308.73,462.84,0
unity,Fee schedule,Facility 11011,Not in chargemaster,11011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11011,BCBS multispecialty AW base fee schedule,575.71,,Fee schedule,,,,,,469.71,685,0
unity,Fee schedule,Facility 11012,Not in chargemaster,11012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11012,BCBS multispecialty AW base fee schedule,800.96,,Fee schedule,,,,,,155.03,265,0
unity,Fee schedule,Facility 11042,11042,11042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11042,BCBS multispecialty AW base fee schedule,115.94,265,Fee schedule,,115.94,115.94,115.94,115.94,207.36,336.48,0
unity,Fee schedule,Facility 11043,Not in chargemaster,11043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11043,BCBS multispecialty AW base fee schedule,296.14,,Fee schedule,,,,,,257.05,380,0
unity,Fee schedule,Facility 11044,Not in chargemaster,11044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11044,BCBS multispecialty AW base fee schedule,434.6,,Fee schedule,,,,,,294.81,430.89,0
unity,Fee schedule,Facility 11045,Not in chargemaster,11045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11045,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,338.54,494.78,0
unity,Fee schedule,Facility 11046,Not in chargemaster,11046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11046,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,522.71,725,0
unity,Fee schedule,Facility 11047,Not in chargemaster,11047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11047,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,194.78,297,0
unity,Fee schedule,Facility 11055,11055,11055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11055,BCBS multispecialty AW base fee schedule,30.48,120,Fee schedule,,30.48,30.48,30.48,30.48,247.11,367,0
unity,Fee schedule,Facility 11056,Not in chargemaster,11056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11056,BCBS multispecialty AW base fee schedule,44.39,,Fee schedule,,,,,,274.28,410,0
unity,Fee schedule,Facility 11057,Not in chargemaster,11057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11057,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,336.55,476.32,0
unity,Fee schedule,Facility 11102,11102,11102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11102,BCBS multispecialty AW base fee schedule,74.2,210,Fee schedule,,74.2,74.2,74.2,74.2,429.96,594.87,0
unity,Fee schedule,Facility 11103,Not in chargemaster,11103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11103,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,229.23,420,0
unity,Fee schedule,Facility 11104,11104,11104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11104,BCBS multispecialty AW base fee schedule,92.75,275,Fee schedule,,92.75,92.75,92.75,92.75,280.9,495,0
unity,Fee schedule,Facility 11105,11105,11105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11105,BCBS multispecialty AW base fee schedule,50.35,137.5,Fee schedule,,50.35,50.35,50.35,50.35,306.74,535,0
unity,Fee schedule,Facility 11106,Not in chargemaster,11106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11106,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,367.03,601.26,0
unity,Fee schedule,Facility 11107,Not in chargemaster,11107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11107,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,405.45,670.12,0
unity,Fee schedule,Facility 11200,11200,11200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11200,BCBS multispecialty AW base fee schedule,139.13,186.7,Fee schedule,,139.13,139.13,139.13,139.13,606.19,975,0
unity,Fee schedule,Facility 11201,11201,11201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11201,BCBS multispecialty AW base fee schedule,31.14,45,Fee schedule,,31.14,31.14,31.14,31.14,282.89,490.52,0
unity,Fee schedule,Facility 11300,11300,11300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11300,BCBS multispecialty AW base fee schedule,65.59,209.42,Fee schedule,,65.59,65.59,65.59,65.59,321.31,547.31,0
unity,Fee schedule,Facility 11301,11301,11301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11301,BCBS multispecialty AW base fee schedule,99.38,256.97,Fee schedule,,99.38,99.38,99.38,99.38,399.49,639.6,0
unity,Fee schedule,Facility 11302,11302,11302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11302,BCBS multispecialty AW base fee schedule,116.6,302.41,Fee schedule,,116.6,116.6,116.6,116.6,453.81,719.09,0
unity,Fee schedule,Facility 11303,11303,11303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11303,BCBS multispecialty AW base fee schedule,137.14,333.64,Fee schedule,,137.14,137.14,137.14,137.14,559.15,866.04,0
unity,Fee schedule,Facility 11305,11305,11305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11305,BCBS multispecialty AW base fee schedule,74.86,220,Fee schedule,,74.86,74.86,74.86,74.86,237.84,430.18,0
unity,Fee schedule,Facility 11306,11306,11306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11306,BCBS multispecialty AW base fee schedule,96.06,259.11,Fee schedule,,96.06,96.06,96.06,96.06,294.81,508.28,0
unity,Fee schedule,Facility 11307,11307,11307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11307,BCBS multispecialty AW base fee schedule,123.89,307.38,Fee schedule,,123.89,123.89,123.89,123.89,345.83,577.84,0
unity,Fee schedule,Facility 11308,Not in chargemaster,11308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11308,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,433.94,680.05,0
unity,Fee schedule,Facility 11310,11310,11310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11310,BCBS multispecialty AW base fee schedule,88.78,243.5,Fee schedule,,88.78,88.78,88.78,88.78,539.28,837.64,0
unity,Fee schedule,Facility 11311,11311,11311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11311,BCBS multispecialty AW base fee schedule,121.24,290,Fee schedule,,121.24,121.24,121.24,121.24,747.3,1088.23,0
unity,Fee schedule,Facility 11312,11312,11312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11312,BCBS multispecialty AW base fee schedule,143.76,345,Fee schedule,,143.76,143.76,143.76,143.76,104.01,235,0
unity,Fee schedule,Facility 11313,11313,11313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11313,BCBS multispecialty AW base fee schedule,186.83,400,Fee schedule,,186.83,186.83,186.83,186.83,59.63,115,0
unity,Fee schedule,Facility 11400,11400,11400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11400,BCBS multispecialty AW base fee schedule,154.36,264.09,Fee schedule,,154.36,154.36,154.36,154.36,192.79,472.07,0
unity,Fee schedule,Facility 11401,11401,11401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11401,BCBS multispecialty AW base fee schedule,196.1,318.74,Fee schedule,,196.1,196.1,196.1,196.1,217.96,501.88,0
unity,Fee schedule,Facility 11402,11402,11402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11402,BCBS multispecialty AW base fee schedule,216.64,365,Fee schedule,,216.64,216.64,216.64,216.64,174.9,380,0
unity,Fee schedule,Facility 11403,11403,11403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11403,BCBS multispecialty AW base fee schedule,280.24,420,Fee schedule,,280.24,280.24,280.24,280.24,353.78,615,0
unity,Fee schedule,Facility 11404,11404,11404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11404,BCBS multispecialty AW base fee schedule,308.73,462.84,Fee schedule,,308.73,308.73,308.73,308.73,844.03,1216,0
unity,Fee schedule,Facility 11406,11406,11406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11406,BCBS multispecialty AW base fee schedule,469.71,685,Fee schedule,,469.71,469.71,469.71,469.71,57.64,117.83,0
unity,Fee schedule,Facility 11420,11420,11420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11420,BCBS multispecialty AW base fee schedule,155.03,265,Fee schedule,,155.03,155.03,155.03,155.03,180.86,306.67,0
unity,Fee schedule,Facility 11421,11421,11421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11421,BCBS multispecialty AW base fee schedule,207.36,336.48,Fee schedule,,207.36,207.36,207.36,207.36,123.23,308,0
unity,Fee schedule,Facility 11422,11422,11422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11422,BCBS multispecialty AW base fee schedule,257.05,380,Fee schedule,,257.05,257.05,257.05,257.05,199.41,522.5,0
unity,Fee schedule,Facility 11423,11423,11423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11423,BCBS multispecialty AW base fee schedule,294.81,430.89,Fee schedule,,294.81,294.81,294.81,294.81,86.13,193.09,0
unity,Fee schedule,Facility 11424,11424,11424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11424,BCBS multispecialty AW base fee schedule,338.54,494.78,Fee schedule,,338.54,338.54,338.54,338.54,114.61,233.55,0
unity,Fee schedule,Facility 11426,11426,11426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11426,BCBS multispecialty AW base fee schedule,522.71,725,Fee schedule,,522.71,522.71,522.71,522.71,142.44,274.01,0
unity,Fee schedule,Facility 11440,11440,11440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11440,BCBS multispecialty AW base fee schedule,194.78,297,Fee schedule,,194.78,194.78,194.78,194.78,185.5,354.23,0
unity,Fee schedule,Facility 11441,11441,11441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11441,BCBS multispecialty AW base fee schedule,247.11,367,Fee schedule,,247.11,247.11,247.11,247.11,107.99,235.69,0
unity,Fee schedule,Facility 11442,11442,11442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11442,BCBS multispecialty AW base fee schedule,274.28,410,Fee schedule,,274.28,274.28,274.28,274.28,113.95,257.69,0
unity,Fee schedule,Facility 11443,11443,11443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11443,BCBS multispecialty AW base fee schedule,336.55,476.32,Fee schedule,,336.55,336.55,336.55,336.55,145.75,300.99,0
unity,Fee schedule,Facility 11444,11444,11444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11444,BCBS multispecialty AW base fee schedule,429.96,594.87,Fee schedule,,429.96,429.96,429.96,429.96,184.18,367,0
unity,Fee schedule,Facility 11446,Not in chargemaster,11446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11446,BCBS multispecialty AW base fee schedule,613.48,,Fee schedule,,,,,,359.74,601.26,0
unity,Fee schedule,Facility 11450,Not in chargemaster,11450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11450,BCBS multispecialty AW base fee schedule,487.6,,Fee schedule,,,,,,288.85,508.98,0
unity,Fee schedule,Facility 11451,Not in chargemaster,11451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11451,BCBS multispecialty AW base fee schedule,623.41,,Fee schedule,,,,,,361.73,650.24,0
unity,Fee schedule,Facility 11462,Not in chargemaster,11462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11462,BCBS multispecialty AW base fee schedule,464.41,,Fee schedule,,,,,,391.54,690,0
unity,Fee schedule,Facility 11463,Not in chargemaster,11463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11463,BCBS multispecialty AW base fee schedule,628.71,,Fee schedule,,,,,,459.78,829.83,0
unity,Fee schedule,Facility 11470,Not in chargemaster,11470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11470,BCBS multispecialty AW base fee schedule,537.29,,Fee schedule,,,,,,279.58,530,0
unity,Fee schedule,Facility 11471,Not in chargemaster,11471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11471,BCBS multispecialty AW base fee schedule,663.83,,Fee schedule,,,,,,373.65,640,0
unity,Fee schedule,Facility 11600,11600,11600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11600,BCBS multispecialty AW base fee schedule,229.23,420,Fee schedule,,229.23,229.23,229.23,229.23,408.1,790,0
unity,Fee schedule,Facility 11601,11601,11601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11601,BCBS multispecialty AW base fee schedule,280.9,495,Fee schedule,,280.9,280.9,280.9,280.9,321.31,570,0
unity,Fee schedule,Facility 11602,11602,11602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11602,BCBS multispecialty AW base fee schedule,306.74,535,Fee schedule,,306.74,306.74,306.74,306.74,380.28,626.81,0
unity,Fee schedule,Facility 11603,11603,11603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11603,BCBS multispecialty AW base fee schedule,367.03,601.26,Fee schedule,,367.03,367.03,367.03,367.03,410.75,740.4,0
unity,Fee schedule,Facility 11604,11604,11604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11604,BCBS multispecialty AW base fee schedule,405.45,670.12,Fee schedule,,405.45,405.45,405.45,405.45,420.69,789.38,0
unity,Fee schedule,Facility 11606,11606,11606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11606,BCBS multispecialty AW base fee schedule,606.19,975,Fee schedule,,606.19,606.19,606.19,606.19,160.33,284.66,0
unity,Fee schedule,Facility 11620,Not in chargemaster,11620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11620,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,466.4,819.9,0
unity,Fee schedule,Facility 11621,11621,11621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11621,BCBS multispecialty AW base fee schedule,282.89,490.52,Fee schedule,,282.89,282.89,282.89,282.89,583.66,1040,0
unity,Fee schedule,Facility 11622,11622,11622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11622,BCBS multispecialty AW base fee schedule,321.31,547.31,Fee schedule,,321.31,321.31,321.31,321.31,1523.09,1707.23,0
unity,Fee schedule,Facility 11623,11623,11623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11623,BCBS multispecialty AW base fee schedule,399.49,639.6,Fee schedule,,399.49,399.49,399.49,399.49,88.11,155,0
unity,Fee schedule,Facility 11624,11624,11624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11624,BCBS multispecialty AW base fee schedule,453.81,719.09,Fee schedule,,453.81,453.81,453.81,453.81,103.35,173.92,0
unity,Fee schedule,Facility 11626,11626,11626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11626,BCBS multispecialty AW base fee schedule,559.15,866.04,Fee schedule,,559.15,559.15,559.15,559.15,210.68,313.06,0
unity,Fee schedule,Facility 11640,11640,11640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11640,BCBS multispecialty AW base fee schedule,237.84,430.18,Fee schedule,,237.84,237.84,237.84,237.84,101.36,173.92,0
unity,Fee schedule,Facility 11641,11641,11641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11641,BCBS multispecialty AW base fee schedule,294.81,508.28,Fee schedule,,294.81,294.81,294.81,294.81,3.98,14.2,0
unity,Fee schedule,Facility 11642,11642,11642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11642,BCBS multispecialty AW base fee schedule,345.83,577.84,Fee schedule,,345.83,345.83,345.83,345.83,184.84,330,0
unity,Fee schedule,Facility 11643,11643,11643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11643,BCBS multispecialty AW base fee schedule,433.94,680.05,Fee schedule,,433.94,433.94,433.94,433.94,126.54,230,0
unity,Fee schedule,Facility 11644,11644,11644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11644,BCBS multispecialty AW base fee schedule,539.28,837.64,Fee schedule,,539.28,539.28,539.28,539.28,155.03,281.83,0
unity,Fee schedule,Facility 11646,11646,11646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11646,BCBS multispecialty AW base fee schedule,747.3,1088.23,Fee schedule,,747.3,747.3,747.3,747.3,83.48,238.51,0
unity,Fee schedule,Facility 11719,Not in chargemaster,11719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11719,BCBS multispecialty AW base fee schedule,14.58,,Fee schedule,,,,,,294.15,357.5,0
unity,Fee schedule,Facility 11720,Not in chargemaster,11720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11720,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,74.86,122.1,0
unity,Fee schedule,Facility 11721,Not in chargemaster,11721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11721,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,76.19,126.36,0
unity,Fee schedule,Facility 11730,11730,11730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11730,BCBS multispecialty AW base fee schedule,104.01,235,Fee schedule,,104.01,104.01,104.01,104.01,73.54,120,0
unity,Fee schedule,Facility 11732,Not in chargemaster,11732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11732,BCBS multispecialty AW base fee schedule,33.13,,Fee schedule,,,,,,82.81,154,0
unity,Fee schedule,Facility 11740,11740,11740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11740,BCBS multispecialty AW base fee schedule,59.63,115,Fee schedule,,59.63,59.63,59.63,59.63,68.9,105,0
unity,Fee schedule,Facility 11750,11750,11750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11750,BCBS multispecialty AW base fee schedule,192.79,472.07,Fee schedule,,192.79,192.79,192.79,192.79,87.45,159,0
unity,Fee schedule,Facility 11755,Not in chargemaster,11755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11755,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,71.55,137.02,0
unity,Fee schedule,Facility 11760,11760,11760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11760,BCBS multispecialty AW base fee schedule,217.96,501.88,Fee schedule,,217.96,217.96,217.96,217.96,87.45,129.23,0
unity,Fee schedule,Facility 11762,Not in chargemaster,11762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11762,BCBS multispecialty AW base fee schedule,363.05,,Fee schedule,,,,,,296.14,565.05,0
unity,Fee schedule,Facility 11765,11765,11765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11765,BCBS multispecialty AW base fee schedule,174.9,380,Fee schedule,,174.9,174.9,174.9,174.9,853.96,946.25,0
unity,Fee schedule,Facility 11770,11770,11770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11770,BCBS multispecialty AW base fee schedule,353.78,615,Fee schedule,,353.78,353.78,353.78,353.78,427.31,467.8,0
unity,Fee schedule,Facility 11771,11771,11771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11771,BCBS multispecialty AW base fee schedule,844.03,1216,Fee schedule,,844.03,844.03,844.03,844.03,771.15,854.49,0
unity,Fee schedule,Facility 11772,Not in chargemaster,11772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11772,BCBS multispecialty AW base fee schedule,1105.05,,Fee schedule,,,,,,553.85,672.96,0
unity,Fee schedule,Facility 11900,11900,11900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11900,BCBS multispecialty AW base fee schedule,57.64,117.83,Fee schedule,,57.64,57.64,57.64,57.64,626.73,764.53,0
unity,Fee schedule,Facility 11901,Not in chargemaster,11901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11901,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,1332.95,1477.01,0
unity,Fee schedule,Facility 11920,Not in chargemaster,11920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11920,BCBS multispecialty AW base fee schedule,213.99,,Fee schedule,,,,,,149.73,305.95,0
unity,Fee schedule,Facility 11921,Not in chargemaster,11921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11921,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,461.1,560.79,0
unity,Fee schedule,Facility 11922,Not in chargemaster,11922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11922,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,612.15,678.63,0
unity,Fee schedule,Facility 11950,Not in chargemaster,11950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11950,BCBS multispecialty AW base fee schedule,100.04,,Fee schedule,,,,,,455.8,506.86,0
unity,Fee schedule,Facility 11951,Not in chargemaster,11951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11951,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,484.29,610,0
unity,Fee schedule,Facility 11952,Not in chargemaster,11952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11952,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,600.23,715,0
unity,Fee schedule,Facility 11954,Not in chargemaster,11954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11954,BCBS multispecialty AW base fee schedule,217.96,,Fee schedule,,,,,,534.64,653.08,0
unity,Fee schedule,Facility 11960,Not in chargemaster,11960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11960,BCBS multispecialty AW base fee schedule,1862.29,,Fee schedule,,,,,,263.01,569.61,0
unity,Fee schedule,Facility 11970,Not in chargemaster,11970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11970,BCBS multispecialty AW base fee schedule,1167.33,,Fee schedule,,,,,,975.86,1167.02,0
unity,Fee schedule,Facility 11971,Not in chargemaster,11971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11971,BCBS multispecialty AW base fee schedule,616.79,,Fee schedule,,,,,,533.98,640,0
unity,Fee schedule,Facility 11976,11976,11976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11976,BCBS multispecialty AW base fee schedule,180.86,306.67,Fee schedule,,180.86,180.86,180.86,180.86,559.81,700,0
unity,Fee schedule,Facility 11980,Not in chargemaster,11980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11980,BCBS multispecialty AW base fee schedule,106.66,,Fee schedule,,,,,,586.98,690.71,0
unity,Fee schedule,Facility 11981,11981,11981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11981,BCBS multispecialty AW base fee schedule,123.23,308,Fee schedule,,123.23,123.23,123.23,123.23,352.45,425.99,0
unity,Fee schedule,Facility 11982,Not in chargemaster,11982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11982,BCBS multispecialty AW base fee schedule,145.09,,Fee schedule,,,,,,578.36,719.09,0
unity,Fee schedule,Facility 11983,11983,11983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11983,BCBS multispecialty AW base fee schedule,199.41,522.5,Fee schedule,,199.41,199.41,199.41,199.41,354.44,394.68,0
unity,Fee schedule,Facility 12001,12001,12001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12001,BCBS multispecialty AW base fee schedule,86.13,193.09,Fee schedule,,86.13,86.13,86.13,86.13,521.39,671.53,0
unity,Fee schedule,Facility 12002,12002,12002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12002,BCBS multispecialty AW base fee schedule,114.61,233.55,Fee schedule,,114.61,114.61,114.61,114.61,490.91,591.33,0
unity,Fee schedule,Facility 12004,12004,12004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12004,BCBS multispecialty AW base fee schedule,142.44,274.01,Fee schedule,,142.44,142.44,142.44,142.44,963.94,1239.27,0
unity,Fee schedule,Facility 12005,12005,12005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12005,BCBS multispecialty AW base fee schedule,185.5,354.23,Fee schedule,,185.5,185.5,185.5,185.5,596.91,661.42,0
unity,Fee schedule,Facility 12006,Not in chargemaster,12006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12006,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,539.94,648.11,0
unity,Fee schedule,Facility 12007,Not in chargemaster,12007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12007,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,535.3,658.76,0
unity,Fee schedule,Facility 12011,12011,12011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12011,BCBS multispecialty AW base fee schedule,107.99,235.69,Fee schedule,,107.99,107.99,107.99,107.99,546.56,680,0
unity,Fee schedule,Facility 12013,12013,12013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12013,BCBS multispecialty AW base fee schedule,113.95,257.69,Fee schedule,,113.95,113.95,113.95,113.95,718.15,796.47,0
unity,Fee schedule,Facility 12014,12014,12014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12014,BCBS multispecialty AW base fee schedule,145.75,300.99,Fee schedule,,145.75,145.75,145.75,145.75,387.56,476.32,0
unity,Fee schedule,Facility 12015,12015,12015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12015,BCBS multispecialty AW base fee schedule,184.18,367,Fee schedule,,184.18,184.18,184.18,184.18,235.19,316.6,0
unity,Fee schedule,Facility 12016,Not in chargemaster,12016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12016,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,225.91,266.2,0
unity,Fee schedule,Facility 12017,Not in chargemaster,12017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12017,BCBS multispecialty AW base fee schedule,296.8,,Fee schedule,,,,,,270.3,355,0
unity,Fee schedule,Facility 12018,Not in chargemaster,12018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12018,BCBS multispecialty AW base fee schedule,336.55,,Fee schedule,,,,,,129.19,207.28,0
unity,Fee schedule,Facility 12020,12020,12020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12020,BCBS multispecialty AW base fee schedule,359.74,601.26,Fee schedule,,359.74,359.74,359.74,359.74,116.6,186.7,0
unity,Fee schedule,Facility 12021,Not in chargemaster,12021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12021,BCBS multispecialty AW base fee schedule,265.66,,Fee schedule,,,,,,80.16,188.84,0
unity,Fee schedule,Facility 12031,12031,12031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12031,BCBS multispecialty AW base fee schedule,288.85,508.98,Fee schedule,,288.85,288.85,288.85,288.85,74.86,140.56,0
unity,Fee schedule,Facility 12032,12032,12032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12032,BCBS multispecialty AW base fee schedule,361.73,650.24,Fee schedule,,361.73,361.73,361.73,361.73,56.31,87.32,0
unity,Fee schedule,Facility 12034,12034,12034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12034,BCBS multispecialty AW base fee schedule,391.54,690,Fee schedule,,391.54,391.54,391.54,391.54,35.78,122.1,0
unity,Fee schedule,Facility 12035,12035,12035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12035,BCBS multispecialty AW base fee schedule,459.78,829.83,Fee schedule,,459.78,459.78,459.78,459.78,111.96,175.34,0
unity,Fee schedule,Facility 12036,Not in chargemaster,12036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12036,BCBS multispecialty AW base fee schedule,539.94,,Fee schedule,,,,,,96.06,180.31,0
unity,Fee schedule,Facility 12037,Not in chargemaster,12037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12037,BCBS multispecialty AW base fee schedule,631.36,,Fee schedule,,,,,,94.08,154.76,0
unity,Fee schedule,Facility 12041,12041,12041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12041,BCBS multispecialty AW base fee schedule,279.58,530,Fee schedule,,279.58,279.58,279.58,279.58,53,185,0
unity,Fee schedule,Facility 12042,12042,12042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12042,BCBS multispecialty AW base fee schedule,373.65,640,Fee schedule,,373.65,373.65,373.65,373.65,213.99,276.13,0
unity,Fee schedule,Facility 12044,12044,12044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12044,BCBS multispecialty AW base fee schedule,408.1,790,Fee schedule,,408.1,408.1,408.1,408.1,108.65,280,0
unity,Fee schedule,Facility 12045,Not in chargemaster,12045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12045,BCBS multispecialty AW base fee schedule,514.1,,Fee schedule,,,,,,203.39,560.79,0
unity,Fee schedule,Facility 12046,Not in chargemaster,12046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12046,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,228.58,303.92,0
unity,Fee schedule,Facility 12047,Not in chargemaster,12047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12047,BCBS multispecialty AW base fee schedule,671.11,,Fee schedule,,,,,,302.1,407,0
unity,Fee schedule,Facility 12051,12051,12051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12051,BCBS multispecialty AW base fee schedule,321.31,570,Fee schedule,,321.31,321.31,321.31,321.31,171.59,220,0
unity,Fee schedule,Facility 12052,12052,12052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12052,BCBS multispecialty AW base fee schedule,380.28,626.81,Fee schedule,,380.28,380.28,380.28,380.28,488.93,541.77,0
unity,Fee schedule,Facility 12053,12053,12053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12053,BCBS multispecialty AW base fee schedule,410.75,740.4,Fee schedule,,410.75,410.75,410.75,410.75,841.38,932.31,0
unity,Fee schedule,Facility 12054,12054,12054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12054,BCBS multispecialty AW base fee schedule,420.69,789.38,Fee schedule,,420.69,420.69,420.69,420.69,800.96,887.53,0
unity,Fee schedule,Facility 12055,Not in chargemaster,12055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12055,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,665.81,742.5,0
unity,Fee schedule,Facility 12056,Not in chargemaster,12056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12056,BCBS multispecialty AW base fee schedule,735.38,,Fee schedule,,,,,,225.25,282.81,0
unity,Fee schedule,Facility 12057,Not in chargemaster,12057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12057,BCBS multispecialty AW base fee schedule,813.55,,Fee schedule,,,,,,234.53,315.35,0
unity,Fee schedule,Facility 13100,Not in chargemaster,13100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13100,BCBS multispecialty AW base fee schedule,384.91,,Fee schedule,,,,,,264.34,371.88,0
unity,Fee schedule,Facility 13101,Not in chargemaster,13101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13101,BCBS multispecialty AW base fee schedule,473.03,,Fee schedule,,,,,,338.54,412.5,0
unity,Fee schedule,Facility 13102,Not in chargemaster,13102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13102,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,292.83,387.2,0
unity,Fee schedule,Facility 13120,Not in chargemaster,13120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13120,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,374.98,440,0
unity,Fee schedule,Facility 13121,Not in chargemaster,13121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13121,BCBS multispecialty AW base fee schedule,496.88,,Fee schedule,,,,,,2085.55,2381,0
unity,Fee schedule,Facility 13122,13122,13122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13122,BCBS multispecialty AW base fee schedule,160.33,284.66,Fee schedule,,160.33,160.33,160.33,160.33,2110.06,2338.11,0
unity,Fee schedule,Facility 13131,13131,13131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13131,BCBS multispecialty AW base fee schedule,466.4,819.9,Fee schedule,,466.4,466.4,466.4,466.4,1895.41,2100.26,0
unity,Fee schedule,Facility 13132,13132,13132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13132,BCBS multispecialty AW base fee schedule,583.66,1040,Fee schedule,,583.66,583.66,583.66,583.66,1805.31,2000.42,0
unity,Fee schedule,Facility 13133,Not in chargemaster,13133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13133,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,2588.39,2868.13,0
unity,Fee schedule,Facility 13151,Not in chargemaster,13151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13151,BCBS multispecialty AW base fee schedule,535.96,,Fee schedule,,,,,,1625.78,1801.48,0
unity,Fee schedule,Facility 13152,Not in chargemaster,13152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13152,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,299.45,668.17,0
unity,Fee schedule,Facility 13153,Not in chargemaster,13153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13153,BCBS multispecialty AW base fee schedule,266.33,,Fee schedule,,,,,,1159.38,1284.68,0
unity,Fee schedule,Facility 13160,13160,13160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13160,BCBS multispecialty AW base fee schedule,1523.09,1707.23,Fee schedule,,1523.09,1523.09,1523.09,1523.09,1240.86,1374.97,0
unity,Fee schedule,Facility 14000,Not in chargemaster,14000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14000,BCBS multispecialty AW base fee schedule,947.38,,Fee schedule,,,,,,1158.71,1375,0
unity,Fee schedule,Facility 14001,Not in chargemaster,14001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14001,BCBS multispecialty AW base fee schedule,1231.59,,Fee schedule,,,,,,106.66,141.81,0
unity,Fee schedule,Facility 14020,Not in chargemaster,14020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14020,BCBS multispecialty AW base fee schedule,1063.31,,Fee schedule,,,,,,136.48,181.5,0
unity,Fee schedule,Facility 14021,Not in chargemaster,14021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14021,BCBS multispecialty AW base fee schedule,1344.21,,Fee schedule,,,,,,354.44,460,0
unity,Fee schedule,Facility 14040,Not in chargemaster,14040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14040,BCBS multispecialty AW base fee schedule,1181.24,,Fee schedule,,,,,,383.59,561.81,0
unity,Fee schedule,Facility 14041,Not in chargemaster,14041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14041,BCBS multispecialty AW base fee schedule,1448.23,,Fee schedule,,,,,,437.25,585.72,0
unity,Fee schedule,Facility 14060,Not in chargemaster,14060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14060,BCBS multispecialty AW base fee schedule,1258.75,,Fee schedule,,,,,,486.94,666.19,0
unity,Fee schedule,Facility 14061,Not in chargemaster,14061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14061,BCBS multispecialty AW base fee schedule,1550.91,,Fee schedule,,,,,,805.6,892.67,0
unity,Fee schedule,Facility 14302,Not in chargemaster,14302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14302,BCBS multispecialty AW base fee schedule,418.04,,Fee schedule,,,,,,188.81,210.84,0
unity,Fee schedule,Facility 14350,Not in chargemaster,14350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14350,BCBS multispecialty AW base fee schedule,1307.11,,Fee schedule,,,,,,207.36,229.77,0
unity,Fee schedule,Facility 15002,Not in chargemaster,15002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15002,BCBS multispecialty AW base fee schedule,427.31,,Fee schedule,,,,,,608.84,674.64,0
unity,Fee schedule,Facility 14301,Not in chargemaster,14301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14301,BCBS multispecialty AW base fee schedule,1656.91,,Fee schedule,,,,,,682.38,756.12,0
unity,Fee schedule,Facility 15003,Not in chargemaster,15003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15003,BCBS multispecialty AW base fee schedule,87.45,,Fee schedule,,,,,,757.24,865,0
unity,Fee schedule,Facility 15004,Not in chargemaster,15004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15004,BCBS multispecialty AW base fee schedule,506.81,,Fee schedule,,,,,,77.51,87.32,0
unity,Fee schedule,Facility 15005,Not in chargemaster,15005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15005,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,1271.34,1487.44,0
unity,Fee schedule,Facility 15040,Not in chargemaster,15040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15040,BCBS multispecialty AW base fee schedule,238.5,,Fee schedule,,,,,,2065.01,2355,0
unity,Fee schedule,Facility 15050,Not in chargemaster,15050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15050,BCBS multispecialty AW base fee schedule,867.21,,Fee schedule,,,,,,1482.68,1642.92,0
unity,Fee schedule,Facility 15100,Not in chargemaster,15100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15100,BCBS multispecialty AW base fee schedule,1364.09,,Fee schedule,,,,,,141.78,157.31,0
unity,Fee schedule,Facility 15101,Not in chargemaster,15101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15101,BCBS multispecialty AW base fee schedule,214.65,,Fee schedule,,,,,,206.04,280.32,0
unity,Fee schedule,Facility 15110,Not in chargemaster,15110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15110,BCBS multispecialty AW base fee schedule,1321.69,,Fee schedule,,,,,,1005.01,1145,0
unity,Fee schedule,Facility 15111,Not in chargemaster,15111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15111,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,1130.89,1253.11,0
unity,Fee schedule,Facility 15115,Not in chargemaster,15115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15115,BCBS multispecialty AW base fee schedule,1304.46,,Fee schedule,,,,,,1219,1350.74,0
unity,Fee schedule,Facility 15116,Not in chargemaster,15116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15116,BCBS multispecialty AW base fee schedule,290.84,,Fee schedule,,,,,,1424.38,1625,0
unity,Fee schedule,Facility 15120,Not in chargemaster,15120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15120,BCBS multispecialty AW base fee schedule,1321.69,,Fee schedule,,,,,,1794.71,1988.68,0
unity,Fee schedule,Facility 15121,Not in chargemaster,15121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15121,BCBS multispecialty AW base fee schedule,258.38,,Fee schedule,,,,,,1482.68,1642.92,0
unity,Fee schedule,Facility 15130,Not in chargemaster,15130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15130,BCBS multispecialty AW base fee schedule,1135.53,,Fee schedule,,,,,,1811.28,2007.03,0
unity,Fee schedule,Facility 15131,Not in chargemaster,15131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15131,BCBS multispecialty AW base fee schedule,175.56,,Fee schedule,,,,,,516.75,590,0
unity,Fee schedule,Facility 15135,Not in chargemaster,15135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15135,BCBS multispecialty AW base fee schedule,1440.28,,Fee schedule,,,,,,858.6,951.39,0
unity,Fee schedule,Facility 15136,Not in chargemaster,15136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15136,BCBS multispecialty AW base fee schedule,175.56,,Fee schedule,,,,,,918.23,1017.46,0
unity,Fee schedule,Facility 15150,Not in chargemaster,15150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15150,BCBS multispecialty AW base fee schedule,1221.65,,Fee schedule,,,,,,828.13,945,0
unity,Fee schedule,Facility 15151,Not in chargemaster,15151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15151,BCBS multispecialty AW base fee schedule,212.66,,Fee schedule,,,,,,1078.55,1225,0
unity,Fee schedule,Facility 15152,Not in chargemaster,15152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15152,BCBS multispecialty AW base fee schedule,279.58,,Fee schedule,,,,,,49.03,149.79,0
unity,Fee schedule,Facility 15155,Not in chargemaster,15155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15155,BCBS multispecialty AW base fee schedule,1403.18,,Fee schedule,,,,,,188.15,325.83,0
unity,Fee schedule,Facility 15156,Not in chargemaster,15156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15156,BCBS multispecialty AW base fee schedule,290.84,,Fee schedule,,,,,,409.43,453.67,0
unity,Fee schedule,Facility 15157,Not in chargemaster,15157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15157,BCBS multispecialty AW base fee schedule,319.33,,Fee schedule,,,,,,812.79,969.01,0
unity,Fee schedule,Facility 15200,Not in chargemaster,15200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15200,BCBS multispecialty AW base fee schedule,1277.96,,Fee schedule,,,,,,1937.81,2147.24,0
unity,Fee schedule,Facility 15201,Not in chargemaster,15201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15201,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,123.23,232.84,0
unity,Fee schedule,Facility 15220,Not in chargemaster,15220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15220,BCBS multispecialty AW base fee schedule,1158.05,,Fee schedule,,,,,,129.19,215,0
unity,Fee schedule,Facility 15221,Not in chargemaster,15221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15221,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,1558.86,1744.14,0
unity,Fee schedule,Facility 15240,Not in chargemaster,15240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15240,BCBS multispecialty AW base fee schedule,1506.53,,Fee schedule,,,,,,81.49,110,0
unity,Fee schedule,Facility 15241,Not in chargemaster,15241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15241,BCBS multispecialty AW base fee schedule,208.69,,Fee schedule,,,,,,54.99,120.68,0
unity,Fee schedule,Facility 15260,Not in chargemaster,15260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15260,BCBS multispecialty AW base fee schedule,1601.93,,Fee schedule,,,,,,68.9,149.08,0
unity,Fee schedule,Facility 15261,Not in chargemaster,15261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15261,BCBS multispecialty AW base fee schedule,262.35,,Fee schedule,,,,,,78.84,124.23,0
unity,Fee schedule,Facility 15271,Not in chargemaster,15271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15271,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,217.3,528.86,0
unity,Fee schedule,Facility 15272,Not in chargemaster,15272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15272,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,89.44,269.76,0
unity,Fee schedule,Facility 15273,Not in chargemaster,15273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15273,BCBS multispecialty AW base fee schedule,385.58,,Fee schedule,,,,,,26.5,30,0
unity,Fee schedule,Facility 15274,Not in chargemaster,15274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15274,BCBS multispecialty AW base fee schedule,87.45,,Fee schedule,,,,,,63.6,110.75,0
unity,Fee schedule,Facility 15275,Not in chargemaster,15275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15275,BCBS multispecialty AW base fee schedule,182.19,,Fee schedule,,,,,,23.85,27.93,0
unity,Fee schedule,Facility 15276,Not in chargemaster,15276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15276,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,25.18,29.48,0
unity,Fee schedule,Facility 15277,Not in chargemaster,15277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15277,BCBS multispecialty AW base fee schedule,437.25,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 15278,Not in chargemaster,15278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15278,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,21.2,27.93,0
unity,Fee schedule,Facility 15570,Not in chargemaster,15570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15570,BCBS multispecialty AW base fee schedule,1402.51,,Fee schedule,,,,,,19.21,27.93,0
unity,Fee schedule,Facility 15572,Not in chargemaster,15572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15572,BCBS multispecialty AW base fee schedule,1409.14,,Fee schedule,,,,,,27.16,38.01,0
unity,Fee schedule,Facility 15574,Not in chargemaster,15574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15574,BCBS multispecialty AW base fee schedule,1432.33,,Fee schedule,,,,,,17.23,19.09,0
unity,Fee schedule,Facility 15576,Not in chargemaster,15576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15576,BCBS multispecialty AW base fee schedule,1254.11,,Fee schedule,,,,,,80.16,93.07,0
unity,Fee schedule,Facility 15600,Not in chargemaster,15600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15600,BCBS multispecialty AW base fee schedule,394.85,,Fee schedule,,,,,,106,124.11,0
unity,Fee schedule,Facility 15610,Not in chargemaster,15610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15610,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,119.25,140.39,0
unity,Fee schedule,Facility 15620,Not in chargemaster,15620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15620,BCBS multispecialty AW base fee schedule,613.48,,Fee schedule,,,,,,119.91,141.94,0
unity,Fee schedule,Facility 15630,Not in chargemaster,15630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15630,BCBS multispecialty AW base fee schedule,647.26,,Fee schedule,,,,,,118.59,159.78,0
unity,Fee schedule,Facility 15650,Not in chargemaster,15650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15650,BCBS multispecialty AW base fee schedule,723.45,,Fee schedule,,,,,,80.83,125.65,0
unity,Fee schedule,Facility 15730,Not in chargemaster,15730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15730,BCBS multispecialty AW base fee schedule,1747.68,,Fee schedule,,,,,,129.85,152.02,0
unity,Fee schedule,Facility 15733,Not in chargemaster,15733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15733,BCBS multispecialty AW base fee schedule,1983.53,,Fee schedule,,,,,,153.04,169.58,0
unity,Fee schedule,Facility 15734,Not in chargemaster,15734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15734,BCBS multispecialty AW base fee schedule,2889.16,,Fee schedule,,,,,,200.74,236.57,0
unity,Fee schedule,Facility 15736,Not in chargemaster,15736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15736,BCBS multispecialty AW base fee schedule,2338.63,,Fee schedule,,,,,,112.63,132.64,0
unity,Fee schedule,Facility 15738,Not in chargemaster,15738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15738,BCBS multispecialty AW base fee schedule,2479.74,,Fee schedule,,,,,,139.79,162.89,0
unity,Fee schedule,Facility 15740,Not in chargemaster,15740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15740,BCBS multispecialty AW base fee schedule,1588.68,,Fee schedule,,,,,,215.31,260.62,0
unity,Fee schedule,Facility 15750,Not in chargemaster,15750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15750,BCBS multispecialty AW base fee schedule,1749.66,,Fee schedule,,,,,,17.23,20.17,0
unity,Fee schedule,Facility 15756,Not in chargemaster,15756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15756,BCBS multispecialty AW base fee schedule,4373.83,,Fee schedule,,,,,,20.54,24.05,0
unity,Fee schedule,Facility 15757,Not in chargemaster,15757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15757,BCBS multispecialty AW base fee schedule,4347.33,,Fee schedule,,,,,,25.84,30.25,0
unity,Fee schedule,Facility 15758,Not in chargemaster,15758,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15758,BCBS multispecialty AW base fee schedule,4375.15,,Fee schedule,,,,,,18.34,33.77,0
unity,Fee schedule,Facility 15760,Not in chargemaster,15760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15760,BCBS multispecialty AW base fee schedule,1330.3,,Fee schedule,,,,,,21.2,24.82,0
unity,Fee schedule,Facility 15769,Not in chargemaster,15769,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15769,BCBS multispecialty AW base fee schedule,918.23,,Fee schedule,,,,,,25.18,29.48,0
unity,Fee schedule,Facility 15770,Not in chargemaster,15770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15770,BCBS multispecialty AW base fee schedule,1262.06,,Fee schedule,,,,,,21.2,24.82,0
unity,Fee schedule,Facility 15771,Not in chargemaster,15771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15771,BCBS multispecialty AW base fee schedule,911.6,,Fee schedule,,,,,,108.65,120.39,0
unity,Fee schedule,Facility 15731,Not in chargemaster,15731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15731,BCBS multispecialty AW base fee schedule,1899.39,,Fee schedule,,,,,,117.26,137.29,0
unity,Fee schedule,Facility 15772,Not in chargemaster,15772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15772,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,129.19,151.25,0
unity,Fee schedule,Facility 15773,Not in chargemaster,15773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15773,BCBS multispecialty AW base fee schedule,921.54,,Fee schedule,,,,,,15.24,17.06,0
unity,Fee schedule,Facility 15774,Not in chargemaster,15774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15774,BCBS multispecialty AW base fee schedule,259.04,,Fee schedule,,,,,,21.2,31.41,0
unity,Fee schedule,Facility 15775,Not in chargemaster,15775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15775,BCBS multispecialty AW base fee schedule,492.9,,Fee schedule,,,,,,25.84,35.68,0
unity,Fee schedule,Facility 15776,Not in chargemaster,15776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15776,BCBS multispecialty AW base fee schedule,677.08,,Fee schedule,,,,,,19.21,24.82,0
unity,Fee schedule,Facility 15777,Not in chargemaster,15777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15777,BCBS multispecialty AW base fee schedule,414.06,,Fee schedule,,,,,,21.86,24.23,0
unity,Fee schedule,Facility 15780,Not in chargemaster,15780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15780,BCBS multispecialty AW base fee schedule,1281.28,,Fee schedule,,,,,,25.18,33,0
unity,Fee schedule,Facility 15781,Not in chargemaster,15781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15781,BCBS multispecialty AW base fee schedule,815.54,,Fee schedule,,,,,,30.48,40.13,0
unity,Fee schedule,Facility 15782,Not in chargemaster,15782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15782,BCBS multispecialty AW base fee schedule,745.31,,Fee schedule,,,,,,21.2,26.38,0
unity,Fee schedule,Facility 15783,Not in chargemaster,15783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15783,BCBS multispecialty AW base fee schedule,679.73,,Fee schedule,,,,,,24.51,35.68,0
unity,Fee schedule,Facility 15786,Not in chargemaster,15786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15786,BCBS multispecialty AW base fee schedule,255.06,,Fee schedule,,,,,,94.08,136.14,0
unity,Fee schedule,Facility 15787,Not in chargemaster,15787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15787,BCBS multispecialty AW base fee schedule,33.13,,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 15788,Not in chargemaster,15788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15788,BCBS multispecialty AW base fee schedule,433.94,,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 15789,Not in chargemaster,15789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15789,BCBS multispecialty AW base fee schedule,771.81,,Fee schedule,,,,,,139.79,177.63,0
unity,Fee schedule,Facility 15792,Not in chargemaster,15792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15792,BCBS multispecialty AW base fee schedule,437.91,,Fee schedule,,,,,,139.79,177.63,0
unity,Fee schedule,Facility 15793,Not in chargemaster,15793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15793,BCBS multispecialty AW base fee schedule,666.48,,Fee schedule,,,,,,139.79,203.5,0
unity,Fee schedule,Facility 15819,Not in chargemaster,15819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15819,BCBS multispecialty AW base fee schedule,1521.1,,Fee schedule,,,,,,215.31,284.66,0
unity,Fee schedule,Facility 15820,Not in chargemaster,15820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15820,BCBS multispecialty AW base fee schedule,961.29,,Fee schedule,,,,,,215.31,291.08,0
unity,Fee schedule,Facility 15821,Not in chargemaster,15821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15821,BCBS multispecialty AW base fee schedule,1028.86,,Fee schedule,,,,,,215.31,262.94,0
unity,Fee schedule,Facility 15830,Not in chargemaster,15830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15830,BCBS multispecialty AW base fee schedule,2251.18,,Fee schedule,,,,,,16.56,27.5,0
unity,Fee schedule,Facility 15832,Not in chargemaster,15832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15832,BCBS multispecialty AW base fee schedule,1760.26,,Fee schedule,,,,,,102.03,138.82,0
unity,Fee schedule,Facility 15833,Not in chargemaster,15833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15833,BCBS multispecialty AW base fee schedule,1671.49,,Fee schedule,,,,,,108.65,148.68,0
unity,Fee schedule,Facility 15834,Not in chargemaster,15834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15834,BCBS multispecialty AW base fee schedule,1704.61,,Fee schedule,,,,,,114.61,134.19,0
unity,Fee schedule,Facility 15835,Not in chargemaster,15835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15835,BCBS multispecialty AW base fee schedule,1787.43,,Fee schedule,,,,,,205.38,248.2,0
unity,Fee schedule,Facility 15836,Not in chargemaster,15836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15836,BCBS multispecialty AW base fee schedule,1435.64,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 15837,Not in chargemaster,15837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15837,BCBS multispecialty AW base fee schedule,1373.36,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 15852,Not in chargemaster,15852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15852,BCBS multispecialty AW base fee schedule,88.78,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 15860,Not in chargemaster,15860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15860,BCBS multispecialty AW base fee schedule,207.36,,Fee schedule,,,,,,17.23,21.71,0
unity,Fee schedule,Facility 15920,Not in chargemaster,15920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15920,BCBS multispecialty AW base fee schedule,1195.81,,Fee schedule,,,,,,14.58,17.06,0
unity,Fee schedule,Facility 15922,Not in chargemaster,15922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15922,BCBS multispecialty AW base fee schedule,1510.5,,Fee schedule,,,,,,17.89,22.5,0
unity,Fee schedule,Facility 15931,Not in chargemaster,15931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15931,BCBS multispecialty AW base fee schedule,1336.93,,Fee schedule,,,,,,15.9,19.39,0
unity,Fee schedule,Facility 15933,Not in chargemaster,15933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15933,BCBS multispecialty AW base fee schedule,1653.6,,Fee schedule,,,,,,15.9,17.83,0
unity,Fee schedule,Facility 15934,Not in chargemaster,15934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15934,BCBS multispecialty AW base fee schedule,1809.29,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 15935,Not in chargemaster,15935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15935,BCBS multispecialty AW base fee schedule,2200.83,,Fee schedule,,,,,,15.24,18.62,0
unity,Fee schedule,Facility 15936,Not in chargemaster,15936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15936,BCBS multispecialty AW base fee schedule,1724.49,,Fee schedule,,,,,,15.9,20.94,0
unity,Fee schedule,Facility 15937,Not in chargemaster,15937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15937,BCBS multispecialty AW base fee schedule,1996.11,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 15940,Not in chargemaster,15940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15940,BCBS multispecialty AW base fee schedule,1344.21,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 15941,Not in chargemaster,15941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15941,BCBS multispecialty AW base fee schedule,1750.99,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 15944,Not in chargemaster,15944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15944,BCBS multispecialty AW base fee schedule,1740.39,,Fee schedule,,,,,,13.25,17.91,0
unity,Fee schedule,Facility 15945,Not in chargemaster,15945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15945,BCBS multispecialty AW base fee schedule,1941.13,,Fee schedule,,,,,,94.08,111.69,0
unity,Fee schedule,Facility 15946,Not in chargemaster,15946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15946,BCBS multispecialty AW base fee schedule,3119.71,,Fee schedule,,,,,,129.19,152.02,0
unity,Fee schedule,Facility 15950,Not in chargemaster,15950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15950,BCBS multispecialty AW base fee schedule,1166.66,,Fee schedule,,,,,,15.9,21.71,0
unity,Fee schedule,Facility 15951,Not in chargemaster,15951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15951,BCBS multispecialty AW base fee schedule,1702.63,,Fee schedule,,,,,,17.89,22.5,0
unity,Fee schedule,Facility 15952,Not in chargemaster,15952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15952,BCBS multispecialty AW base fee schedule,1743.04,,Fee schedule,,,,,,21.2,27.15,0
unity,Fee schedule,Facility 15953,Not in chargemaster,15953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15953,BCBS multispecialty AW base fee schedule,1918.6,,Fee schedule,,,,,,16.56,21.71,0
unity,Fee schedule,Facility 15956,Not in chargemaster,15956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15956,BCBS multispecialty AW base fee schedule,2235.94,,Fee schedule,,,,,,15.24,19.39,0
unity,Fee schedule,Facility 15958,Not in chargemaster,15958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15958,BCBS multispecialty AW base fee schedule,2257.8,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 16000,16000,16000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16000,BCBS multispecialty AW base fee schedule,88.11,155,Fee schedule,,88.11,88.11,88.11,88.11,16.56,19.39,0
unity,Fee schedule,Facility 15822,Not in chargemaster,15822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15822,BCBS multispecialty AW base fee schedule,743.33,,Fee schedule,,,,,,14.58,17.06,0
unity,Fee schedule,Facility 15823,Not in chargemaster,15823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15823,BCBS multispecialty AW base fee schedule,1029.53,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 15840,Not in chargemaster,15840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15840,BCBS multispecialty AW base fee schedule,1916.61,,Fee schedule,,,,,,15.24,17.83,0
unity,Fee schedule,Facility 15841,Not in chargemaster,15841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15841,BCBS multispecialty AW base fee schedule,3416.51,,Fee schedule,,,,,,12.59,14.74,0
unity,Fee schedule,Facility 15842,Not in chargemaster,15842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15842,BCBS multispecialty AW base fee schedule,5203.94,,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 15845,Not in chargemaster,15845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15845,BCBS multispecialty AW base fee schedule,1919.26,,Fee schedule,,,,,,108.65,148.68,0
unity,Fee schedule,Facility 15850,Not in chargemaster,15850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15850,BCBS multispecialty AW base fee schedule,75.53,,Fee schedule,,,,,,126.54,148.93,0
unity,Fee schedule,Facility 15838,Not in chargemaster,15838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15838,BCBS multispecialty AW base fee schedule,1227.61,,Fee schedule,,,,,,200.74,236.57,0
unity,Fee schedule,Facility 15839,Not in chargemaster,15839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15839,BCBS multispecialty AW base fee schedule,1407.15,,Fee schedule,,,,,,127.2,152.02,0
unity,Fee schedule,Facility 15851,Not in chargemaster,15851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15851,BCBS multispecialty AW base fee schedule,86.79,,Fee schedule,,,,,,17.23,20.17,0
unity,Fee schedule,Facility 16020,16020,16020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16020,BCBS multispecialty AW base fee schedule,103.35,173.92,Fee schedule,,103.35,103.35,103.35,103.35,21.86,29.48,0
unity,Fee schedule,Facility 16025,16025,16025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16025,BCBS multispecialty AW base fee schedule,210.68,313.06,Fee schedule,,210.68,210.68,210.68,210.68,25.18,34.89,0
unity,Fee schedule,Facility 16035,Not in chargemaster,16035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16035,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,29.81,34.9,0
unity,Fee schedule,Facility 16036,Not in chargemaster,16036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16036,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,111.96,151.95,0
unity,Fee schedule,Facility 17000,17000,17000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17000,BCBS multispecialty AW base fee schedule,101.36,173.92,Fee schedule,,101.36,101.36,101.36,101.36,119.91,162.11,0
unity,Fee schedule,Facility 16030,Not in chargemaster,16030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16030,BCBS multispecialty AW base fee schedule,254.4,,Fee schedule,,,,,,131.84,179.12,0
unity,Fee schedule,Facility 17003,17003,17003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17003,BCBS multispecialty AW base fee schedule,3.98,14.2,Fee schedule,,3.98,3.98,3.98,3.98,163.64,222.11,0
unity,Fee schedule,Facility 17004,17004,17004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17004,BCBS multispecialty AW base fee schedule,184.84,330,Fee schedule,,184.84,184.84,184.84,184.84,171.59,232.86,0
unity,Fee schedule,Facility 17106,Not in chargemaster,17106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17106,BCBS multispecialty AW base fee schedule,519.4,,Fee schedule,,,,,,188.15,255.26,0
unity,Fee schedule,Facility 17107,Not in chargemaster,17107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17107,BCBS multispecialty AW base fee schedule,673.76,,Fee schedule,,,,,,137.8,160.56,0
unity,Fee schedule,Facility 17108,Not in chargemaster,17108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17108,BCBS multispecialty AW base fee schedule,994.41,,Fee schedule,,,,,,205.38,248.2,0
unity,Fee schedule,Facility 17110,17110,17110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17110,BCBS multispecialty AW base fee schedule,126.54,230,Fee schedule,,126.54,126.54,126.54,126.54,167.61,227.52,0
unity,Fee schedule,Facility 17111,17111,17111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17111,BCBS multispecialty AW base fee schedule,155.03,281.83,Fee schedule,,155.03,155.03,155.03,155.03,33.79,46.57,0
unity,Fee schedule,Facility 17250,Not in chargemaster,17250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17250,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,53,62.05,0
unity,Fee schedule,Facility 17260,Not in chargemaster,17260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17260,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,76.85,89.2,0
unity,Fee schedule,Facility 17261,Not in chargemaster,17261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17261,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,54.99,60.93,0
unity,Fee schedule,Facility 17262,Not in chargemaster,17262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17262,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,68.9,81.44,0
unity,Fee schedule,Facility 17263,Not in chargemaster,17263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17263,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,54.33,63.61,0
unity,Fee schedule,Facility 17264,Not in chargemaster,17264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17264,BCBS multispecialty AW base fee schedule,251.09,,Fee schedule,,,,,,93.41,109.37,0
unity,Fee schedule,Facility 17266,Not in chargemaster,17266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17266,BCBS multispecialty AW base fee schedule,296.14,,Fee schedule,,,,,,93.41,110.14,0
unity,Fee schedule,Facility 17270,Not in chargemaster,17270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17270,BCBS multispecialty AW base fee schedule,181.53,,Fee schedule,,,,,,92.75,108.58,0
unity,Fee schedule,Facility 17271,Not in chargemaster,17271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17271,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,60.95,70.58,0
unity,Fee schedule,Facility 17272,Not in chargemaster,17272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17272,BCBS multispecialty AW base fee schedule,233.2,,Fee schedule,,,,,,70.23,83.77,0
unity,Fee schedule,Facility 17273,Not in chargemaster,17273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17273,BCBS multispecialty AW base fee schedule,264.34,,Fee schedule,,,,,,64.93,76.79,0
unity,Fee schedule,Facility 17274,Not in chargemaster,17274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17274,BCBS multispecialty AW base fee schedule,323.3,,Fee schedule,,,,,,64.26,76.01,0
unity,Fee schedule,Facility 17276,Not in chargemaster,17276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17276,BCBS multispecialty AW base fee schedule,388.23,,Fee schedule,,,,,,59.63,70.58,0
unity,Fee schedule,Facility 17280,Not in chargemaster,17280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17280,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,27.16,33.38,0
unity,Fee schedule,Facility 17281,Not in chargemaster,17281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17281,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,59.63,74.91,0
unity,Fee schedule,Facility 17282,Not in chargemaster,17282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17282,BCBS multispecialty AW base fee schedule,263.01,,Fee schedule,,,,,,76.85,103.4,0
unity,Fee schedule,Facility 17283,Not in chargemaster,17283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17283,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,94.08,127.6,0
unity,Fee schedule,Facility 17284,Not in chargemaster,17284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17284,BCBS multispecialty AW base fee schedule,384.25,,Fee schedule,,,,,,72.21,91.21,0
unity,Fee schedule,Facility 17286,Not in chargemaster,17286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17286,BCBS multispecialty AW base fee schedule,520.73,,Fee schedule,,,,,,18.55,22.5,0
unity,Fee schedule,Facility 17311,Not in chargemaster,17311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17311,BCBS multispecialty AW base fee schedule,689.66,,Fee schedule,,,,,,58.3,79.71,0
unity,Fee schedule,Facility 17312,Not in chargemaster,17312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17312,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,77.51,104.8,0
unity,Fee schedule,Facility 17313,Not in chargemaster,17313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17313,BCBS multispecialty AW base fee schedule,618.78,,Fee schedule,,,,,,80.16,108.37,0
unity,Fee schedule,Facility 17314,Not in chargemaster,17314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17314,BCBS multispecialty AW base fee schedule,340.53,,Fee schedule,,,,,,68.24,93.14,0
unity,Fee schedule,Facility 17315,Not in chargemaster,17315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17315,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,24.8,33.57,0
unity,Fee schedule,Facility 17340,Not in chargemaster,17340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17340,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,21,26.43,0
unity,Fee schedule,Facility 17360,Not in chargemaster,17360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17360,BCBS multispecialty AW base fee schedule,176.89,,Fee schedule,,,,,,24.8,40.47,0
unity,Fee schedule,Facility 19000,19000,19000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19000,BCBS multispecialty AW base fee schedule,83.48,238.51,Fee schedule,,83.48,83.48,83.48,83.48,19.22,22.76,0
unity,Fee schedule,Facility 19001,Not in chargemaster,19001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19001,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,14.88,20,0
unity,Fee schedule,Facility 19020,Not in chargemaster,19020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19020,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,63.07,82.95,0
unity,Fee schedule,Facility 19030,Not in chargemaster,19030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19030,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,60.76,71.94,0
unity,Fee schedule,Facility 19081,Not in chargemaster,19081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19081,BCBS multispecialty AW base fee schedule,319.33,,Fee schedule,,,,,,39.06,47.12,0
unity,Fee schedule,Facility 19082,Not in chargemaster,19082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19082,BCBS multispecialty AW base fee schedule,160.33,,Fee schedule,,,,,,31,44,0
unity,Fee schedule,Facility 19083,Not in chargemaster,19083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19083,BCBS multispecialty AW base fee schedule,302.1,,Fee schedule,,,,,,332.32,393.48,0
unity,Fee schedule,Facility 19084,Not in chargemaster,19084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19084,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,16.12,19.88,0
unity,Fee schedule,Facility 19085,Not in chargemaster,19085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19085,BCBS multispecialty AW base fee schedule,349.8,,Fee schedule,,,,,,18.6,22.73,0
unity,Fee schedule,Facility 19086,Not in chargemaster,19086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19086,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,24.8,37,0
unity,Fee schedule,Facility 19100,Not in chargemaster,19100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19100,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,47.78,190,0
unity,Fee schedule,Facility 19101,Not in chargemaster,19101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19101,BCBS multispecialty AW base fee schedule,427.31,,Fee schedule,,,,,,46.5,98,0
unity,Fee schedule,Facility 19105,Not in chargemaster,19105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19105,BCBS multispecialty AW base fee schedule,406.78,,Fee schedule,,,,,,88.66,163,0
unity,Fee schedule,Facility 19110,Not in chargemaster,19110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19110,BCBS multispecialty AW base fee schedule,663.16,,Fee schedule,,,,,,132.68,230,0
unity,Fee schedule,Facility 19112,Not in chargemaster,19112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19112,BCBS multispecialty AW base fee schedule,604.2,,Fee schedule,,,,,,127.1,155,0
unity,Fee schedule,Facility 19120,Not in chargemaster,19120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19120,BCBS multispecialty AW base fee schedule,795,,Fee schedule,,,,,,174.84,214,0
unity,Fee schedule,Facility 19125,Not in chargemaster,19125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19125,BCBS multispecialty AW base fee schedule,883.11,,Fee schedule,,,,,,237.46,290,0
unity,Fee schedule,Facility 19126,Not in chargemaster,19126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19126,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,323.64,395,0
unity,Fee schedule,Facility 19281,Not in chargemaster,19281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19281,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,178.56,215,0
unity,Fee schedule,Facility 19282,Not in chargemaster,19282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19282,BCBS multispecialty AW base fee schedule,96.73,,Fee schedule,,,,,,241.18,290,0
unity,Fee schedule,Facility 19283,Not in chargemaster,19283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19283,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,354.02,430,0
unity,Fee schedule,Facility 19284,Not in chargemaster,19284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19284,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,69.44,85,0
unity,Fee schedule,Facility 19285,Not in chargemaster,19285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19285,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,127.1,155,0
unity,Fee schedule,Facility 19286,Not in chargemaster,19286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19286,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,182.9,225,0
unity,Fee schedule,Facility 19287,Not in chargemaster,19287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19287,BCBS multispecialty AW base fee schedule,246.45,,Fee schedule,,,,,,68.82,85,0
unity,Fee schedule,Facility 19288,Not in chargemaster,19288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19288,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,126.48,155,0
unity,Fee schedule,Facility 19294,Not in chargemaster,19294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19294,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,182.28,225,0
unity,Fee schedule,Facility 19296,Not in chargemaster,19296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19296,BCBS multispecialty AW base fee schedule,404.79,,Fee schedule,,,,,,233.74,285,0
unity,Fee schedule,Facility 19297,Not in chargemaster,19297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19297,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,295.74,360,0
unity,Fee schedule,Facility 19298,Not in chargemaster,19298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19298,BCBS multispecialty AW base fee schedule,610.83,,Fee schedule,,,,,,380.68,465,0
unity,Fee schedule,Facility 19300,Not in chargemaster,19300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19300,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,127.72,155,0
unity,Fee schedule,Facility 19301,Not in chargemaster,19301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19301,BCBS multispecialty AW base fee schedule,1262.73,,Fee schedule,,,,,,187.24,230,0
unity,Fee schedule,Facility 19302,Not in chargemaster,19302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19302,BCBS multispecialty AW base fee schedule,1735.75,,Fee schedule,,,,,,57.66,97.26,0
unity,Fee schedule,Facility 19303,Not in chargemaster,19303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19303,BCBS multispecialty AW base fee schedule,1844.4,,Fee schedule,,,,,,226.92,350,0
unity,Fee schedule,Facility 19305,Not in chargemaster,19305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19305,BCBS multispecialty AW base fee schedule,2189.56,,Fee schedule,,,,,,296.36,440,0
unity,Fee schedule,Facility 19306,Not in chargemaster,19306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19306,BCBS multispecialty AW base fee schedule,2324.71,,Fee schedule,,,,,,16.12,50,0
unity,Fee schedule,Facility 19307,Not in chargemaster,19307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19307,BCBS multispecialty AW base fee schedule,2317.43,,Fee schedule,,,,,,45.26,97,0
unity,Fee schedule,Facility 19316,Not in chargemaster,19316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19316,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,89.9,158,0
unity,Fee schedule,Facility 19318,Not in chargemaster,19318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19318,BCBS multispecialty AW base fee schedule,2101.45,,Fee schedule,,,,,,138.26,230,0
unity,Fee schedule,Facility 19324,Not in chargemaster,19324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19324,BCBS multispecialty AW base fee schedule,1020.91,,Fee schedule,,,,,,195.3,300,0
unity,Fee schedule,Facility 19325,Not in chargemaster,19325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19325,BCBS multispecialty AW base fee schedule,1238.21,,Fee schedule,,,,,,158.1,195,0
unity,Fee schedule,Facility 19328,Not in chargemaster,19328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19328,BCBS multispecialty AW base fee schedule,955.99,,Fee schedule,,,,,,226.3,267.95,0
unity,Fee schedule,Facility 19330,Not in chargemaster,19330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19330,BCBS multispecialty AW base fee schedule,1213.04,,Fee schedule,,,,,,76.88,95,0
unity,Fee schedule,Facility 19340,Not in chargemaster,19340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19340,BCBS multispecialty AW base fee schedule,1893.43,,Fee schedule,,,,,,120.9,145,0
unity,Fee schedule,Facility 19342,Not in chargemaster,19342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19342,BCBS multispecialty AW base fee schedule,1774.18,,Fee schedule,,,,,,159.34,195,0
unity,Fee schedule,Facility 19350,Not in chargemaster,19350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19350,BCBS multispecialty AW base fee schedule,1287.24,,Fee schedule,,,,,,128.34,151.96,0
unity,Fee schedule,Facility 19357,Not in chargemaster,19357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19357,BCBS multispecialty AW base fee schedule,2873.26,,Fee schedule,,,,,,184.14,218.03,0
unity,Fee schedule,Facility 19361,Not in chargemaster,19361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19361,BCBS multispecialty AW base fee schedule,3011.73,,Fee schedule,,,,,,39.68,50,0
unity,Fee schedule,Facility 19364,Not in chargemaster,19364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19364,BCBS multispecialty AW base fee schedule,5281.45,,Fee schedule,,,,,,76.26,90.29,0
unity,Fee schedule,Facility 19366,Not in chargemaster,19366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19366,BCBS multispecialty AW base fee schedule,2675.18,,Fee schedule,,,,,,114.08,135.07,0
unity,Fee schedule,Facility 19367,Not in chargemaster,19367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19367,BCBS multispecialty AW base fee schedule,3411.88,,Fee schedule,,,,,,209.56,250,0
unity,Fee schedule,Facility 19368,Not in chargemaster,19368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19368,BCBS multispecialty AW base fee schedule,4209.53,,Fee schedule,,,,,,304.42,370,0
unity,Fee schedule,Facility 19369,Not in chargemaster,19369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19369,BCBS multispecialty AW base fee schedule,3909.41,,Fee schedule,,,,,,389.36,480,0
unity,Fee schedule,Facility 19370,Not in chargemaster,19370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19370,BCBS multispecialty AW base fee schedule,1319.04,,Fee schedule,,,,,,195.92,262,0
unity,Fee schedule,Facility 19371,Not in chargemaster,19371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19371,BCBS multispecialty AW base fee schedule,1507.85,,Fee schedule,,,,,,135.78,238,0
unity,Fee schedule,Facility 19380,Not in chargemaster,19380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19380,BCBS multispecialty AW base fee schedule,1488.64,,Fee schedule,,,,,,145.08,238.51,0
unity,Fee schedule,Facility 19396,Not in chargemaster,19396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19396,BCBS multispecialty AW base fee schedule,276.93,,Fee schedule,,,,,,153.76,255,0
unity,Fee schedule,Facility 19355,Not in chargemaster,19355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19355,BCBS multispecialty AW base fee schedule,1185.21,,Fee schedule,,,,,,181.66,290,0
unity,Fee schedule,Facility 20100,Not in chargemaster,20100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20100,BCBS multispecialty AW base fee schedule,1157.39,,Fee schedule,,,,,,174.22,282,0
unity,Fee schedule,Facility 20101,Not in chargemaster,20101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20101,BCBS multispecialty AW base fee schedule,404.13,,Fee schedule,,,,,,211.42,325,0
unity,Fee schedule,Facility 20102,Not in chargemaster,20102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20102,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,227.54,342.17,0
unity,Fee schedule,Facility 20103,Not in chargemaster,20103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20103,BCBS multispecialty AW base fee schedule,663.16,,Fee schedule,,,,,,124.62,210,0
unity,Fee schedule,Facility 20150,Not in chargemaster,20150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20150,BCBS multispecialty AW base fee schedule,1925.23,,Fee schedule,,,,,,135.78,225,0
unity,Fee schedule,Facility 20200,Not in chargemaster,20200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20200,BCBS multispecialty AW base fee schedule,180.86,,Fee schedule,,,,,,135.78,225,0
unity,Fee schedule,Facility 20205,20205,20205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20205,BCBS multispecialty AW base fee schedule,294.15,357.5,Fee schedule,,294.15,294.15,294.15,294.15,153.76,250,0
unity,Fee schedule,Facility 20206,Not in chargemaster,20206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20206,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,158.1,250,0
unity,Fee schedule,Facility 20220,Not in chargemaster,20220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20220,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,172.36,270,0
unity,Fee schedule,Facility 20240,Not in chargemaster,20240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20240,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,181.66,290,0
unity,Fee schedule,Facility 20245,Not in chargemaster,20245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20245,BCBS multispecialty AW base fee schedule,667.14,,Fee schedule,,,,,,21.7,53.55,0
unity,Fee schedule,Facility 20250,Not in chargemaster,20250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20250,BCBS multispecialty AW base fee schedule,753.93,,Fee schedule,,,,,,45.88,101.14,0
unity,Fee schedule,Facility 20251,Not in chargemaster,20251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20251,BCBS multispecialty AW base fee schedule,818.85,,Fee schedule,,,,,,332.32,469.74,0
unity,Fee schedule,Facility 20500,Not in chargemaster,20500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20500,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,99.82,137.02,0
unity,Fee schedule,Facility 20225,Not in chargemaster,20225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20225,BCBS multispecialty AW base fee schedule,251.75,,Fee schedule,,,,,,331.08,469.74,0
unity,Fee schedule,Facility 20501,Not in chargemaster,20501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20501,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,33.48,200,0
unity,Fee schedule,Facility 20520,Not in chargemaster,20520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20520,BCBS multispecialty AW base fee schedule,279.58,,Fee schedule,,,,,,14.88,17.62,0
unity,Fee schedule,Facility 20525,Not in chargemaster,20525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20525,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,211.64,351.63,0
unity,Fee schedule,Facility 20526,Not in chargemaster,20526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20526,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,143,238.58,0
unity,Fee schedule,Facility 20527,Not in chargemaster,20527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20527,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,114.7,135.81,0
unity,Fee schedule,Facility 20550,20550,20550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20550,BCBS multispecialty AW base fee schedule,74.86,122.1,Fee schedule,,74.86,74.86,74.86,74.86,190.14,255,0
unity,Fee schedule,Facility 20551,20551,20551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20551,BCBS multispecialty AW base fee schedule,76.19,126.36,Fee schedule,,76.19,76.19,76.19,76.19,345.16,445,0
unity,Fee schedule,Facility 20552,20552,20552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20552,BCBS multispecialty AW base fee schedule,73.54,120,Fee schedule,,73.54,73.54,73.54,73.54,194.78,325.83,0
unity,Fee schedule,Facility 20553,20553,20553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20553,BCBS multispecialty AW base fee schedule,82.81,154,Fee schedule,,82.81,82.81,82.81,82.81,353.11,588.48,0
unity,Fee schedule,Facility 20555,Not in chargemaster,20555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20555,BCBS multispecialty AW base fee schedule,628.05,,Fee schedule,,,,,,225.91,347.12,0
unity,Fee schedule,Facility 20560,Not in chargemaster,20560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20560,BCBS multispecialty AW base fee schedule,31.14,,Fee schedule,,,,,,179.54,277.56,0
unity,Fee schedule,Facility 20561,Not in chargemaster,20561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20561,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,338.54,405.82,0
unity,Fee schedule,Facility 20600,20600,20600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20600,BCBS multispecialty AW base fee schedule,68.9,105,Fee schedule,,68.9,68.9,68.9,68.9,54.33,115.01,0
unity,Fee schedule,Facility 20604,20604,20604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20604,BCBS multispecialty AW base fee schedule,87.45,159,Fee schedule,,87.45,87.45,87.45,87.45,115.94,265,0
unity,Fee schedule,Facility 20605,20605,20605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20605,BCBS multispecialty AW base fee schedule,71.55,137.02,Fee schedule,,71.55,71.55,71.55,71.55,30.48,120,0
unity,Fee schedule,Facility 20606,Not in chargemaster,20606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20606,BCBS multispecialty AW base fee schedule,100.7,,Fee schedule,,,,,,74.2,210,0
unity,Fee schedule,Facility 20610,20610,20610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20610,BCBS multispecialty AW base fee schedule,87.45,129.23,Fee schedule,,87.45,87.45,87.45,87.45,92.75,275,0
unity,Fee schedule,Facility 20611,Not in chargemaster,20611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20611,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,50.35,137.5,0
unity,Fee schedule,Facility 20612,Not in chargemaster,20612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20612,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,139.13,186.7,0
unity,Fee schedule,Facility 20615,Not in chargemaster,20615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20615,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,31.14,45,0
unity,Fee schedule,Facility 20660,Not in chargemaster,20660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20660,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,65.59,209.42,0
unity,Fee schedule,Facility 20661,Not in chargemaster,20661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20661,BCBS multispecialty AW base fee schedule,955.99,,Fee schedule,,,,,,99.38,256.97,0
unity,Fee schedule,Facility 20662,Not in chargemaster,20662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20662,BCBS multispecialty AW base fee schedule,980.5,,Fee schedule,,,,,,116.6,302.41,0
unity,Fee schedule,Facility 20663,Not in chargemaster,20663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20663,BCBS multispecialty AW base fee schedule,901.66,,Fee schedule,,,,,,137.14,333.64,0
unity,Fee schedule,Facility 20664,Not in chargemaster,20664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20664,BCBS multispecialty AW base fee schedule,1658.24,,Fee schedule,,,,,,74.86,220,0
unity,Fee schedule,Facility 20665,Not in chargemaster,20665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20665,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,96.06,259.11,0
unity,Fee schedule,Facility 20650,Not in chargemaster,20650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20650,BCBS multispecialty AW base fee schedule,300.78,,Fee schedule,,,,,,123.89,307.38,0
unity,Fee schedule,Facility 20670,Not in chargemaster,20670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20670,BCBS multispecialty AW base fee schedule,276.93,,Fee schedule,,,,,,88.78,243.5,0
unity,Fee schedule,Facility 20690,Not in chargemaster,20690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20690,BCBS multispecialty AW base fee schedule,1140.83,,Fee schedule,,,,,,121.24,290,0
unity,Fee schedule,Facility 20692,Not in chargemaster,20692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20692,BCBS multispecialty AW base fee schedule,2138.55,,Fee schedule,,,,,,143.76,345,0
unity,Fee schedule,Facility 20693,Not in chargemaster,20693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20693,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,186.83,400,0
unity,Fee schedule,Facility 20694,Not in chargemaster,20694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20694,BCBS multispecialty AW base fee schedule,643.95,,Fee schedule,,,,,,154.36,264.09,0
unity,Fee schedule,Facility 20696,Not in chargemaster,20696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20696,BCBS multispecialty AW base fee schedule,2274.36,,Fee schedule,,,,,,196.1,318.74,0
unity,Fee schedule,Facility 20697,Not in chargemaster,20697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20697,BCBS multispecialty AW base fee schedule,3829.91,,Fee schedule,,,,,,216.64,365,0
unity,Fee schedule,Facility 20700,Not in chargemaster,20700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20700,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,280.24,420,0
unity,Fee schedule,Facility 20701,Not in chargemaster,20701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20701,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,308.73,462.84,0
unity,Fee schedule,Facility 20702,Not in chargemaster,20702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20702,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,469.71,685,0
unity,Fee schedule,Facility 20703,Not in chargemaster,20703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20703,BCBS multispecialty AW base fee schedule,192.79,,Fee schedule,,,,,,155.03,265,0
unity,Fee schedule,Facility 20704,Not in chargemaster,20704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20704,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,207.36,336.48,0
unity,Fee schedule,Facility 20705,Not in chargemaster,20705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20705,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,257.05,380,0
unity,Fee schedule,Facility 20802,Not in chargemaster,20802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20802,BCBS multispecialty AW base fee schedule,5269.53,,Fee schedule,,,,,,294.81,430.89,0
unity,Fee schedule,Facility 20805,Not in chargemaster,20805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20805,BCBS multispecialty AW base fee schedule,6274.54,,Fee schedule,,,,,,338.54,494.78,0
unity,Fee schedule,Facility 20808,Not in chargemaster,20808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20808,BCBS multispecialty AW base fee schedule,7586.95,,Fee schedule,,,,,,522.71,725,0
unity,Fee schedule,Facility 20816,Not in chargemaster,20816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20816,BCBS multispecialty AW base fee schedule,3947.18,,Fee schedule,,,,,,194.78,297,0
unity,Fee schedule,Facility 20822,Not in chargemaster,20822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20822,BCBS multispecialty AW base fee schedule,3394.65,,Fee schedule,,,,,,247.11,367,0
unity,Fee schedule,Facility 20824,Not in chargemaster,20824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20824,BCBS multispecialty AW base fee schedule,3953.8,,Fee schedule,,,,,,274.28,410,0
unity,Fee schedule,Facility 20827,Not in chargemaster,20827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20827,BCBS multispecialty AW base fee schedule,3487.4,,Fee schedule,,,,,,336.55,476.32,0
unity,Fee schedule,Facility 20838,Not in chargemaster,20838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20838,BCBS multispecialty AW base fee schedule,5342.4,,Fee schedule,,,,,,429.96,594.87,0
unity,Fee schedule,Facility 20900,Not in chargemaster,20900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20900,BCBS multispecialty AW base fee schedule,353.11,,Fee schedule,,,,,,229.23,420,0
unity,Fee schedule,Facility 20924,Not in chargemaster,20924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20924,BCBS multispecialty AW base fee schedule,967.25,,Fee schedule,,,,,,280.9,495,0
unity,Fee schedule,Facility 20931,Not in chargemaster,20931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20931,BCBS multispecialty AW base fee schedule,213.33,,Fee schedule,,,,,,306.74,535,0
unity,Fee schedule,Facility 20932,Not in chargemaster,20932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20932,BCBS multispecialty AW base fee schedule,1366.74,,Fee schedule,,,,,,367.03,601.26,0
unity,Fee schedule,Facility 20933,Not in chargemaster,20933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20933,BCBS multispecialty AW base fee schedule,1256.1,,Fee schedule,,,,,,405.45,670.12,0
unity,Fee schedule,Facility 20934,Not in chargemaster,20934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20934,BCBS multispecialty AW base fee schedule,1366.08,,Fee schedule,,,,,,606.19,975,0
unity,Fee schedule,Facility 20937,Not in chargemaster,20937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20937,BCBS multispecialty AW base fee schedule,321.31,,Fee schedule,,,,,,282.89,490.52,0
unity,Fee schedule,Facility 20938,Not in chargemaster,20938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20938,BCBS multispecialty AW base fee schedule,353.78,,Fee schedule,,,,,,321.31,547.31,0
unity,Fee schedule,Facility 20939,Not in chargemaster,20939,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20939,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,399.49,639.6,0
unity,Fee schedule,Facility 20950,Not in chargemaster,20950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20950,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,453.81,719.09,0
unity,Fee schedule,Facility 20955,Not in chargemaster,20955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20955,BCBS multispecialty AW base fee schedule,4703.09,,Fee schedule,,,,,,559.15,866.04,0
unity,Fee schedule,Facility 20956,Not in chargemaster,20956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20956,BCBS multispecialty AW base fee schedule,5069.45,,Fee schedule,,,,,,237.84,430.18,0
unity,Fee schedule,Facility 20957,Not in chargemaster,20957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20957,BCBS multispecialty AW base fee schedule,5274.83,,Fee schedule,,,,,,294.81,508.28,0
unity,Fee schedule,Facility 20962,Not in chargemaster,20962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20962,BCBS multispecialty AW base fee schedule,5094.63,,Fee schedule,,,,,,345.83,577.84,0
unity,Fee schedule,Facility 20969,Not in chargemaster,20969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20969,BCBS multispecialty AW base fee schedule,5207.91,,Fee schedule,,,,,,433.94,680.05,0
unity,Fee schedule,Facility 20970,Not in chargemaster,20970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20970,BCBS multispecialty AW base fee schedule,5476.89,,Fee schedule,,,,,,539.28,837.64,0
unity,Fee schedule,Facility 20972,Not in chargemaster,20972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20972,BCBS multispecialty AW base fee schedule,5462.31,,Fee schedule,,,,,,747.3,1088.23,0
unity,Fee schedule,Facility 20973,Not in chargemaster,20973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20973,BCBS multispecialty AW base fee schedule,5769.71,,Fee schedule,,,,,,104.01,235,0
unity,Fee schedule,Facility 20974,Not in chargemaster,20974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20974,BCBS multispecialty AW base fee schedule,96.06,,Fee schedule,,,,,,59.63,115,0
unity,Fee schedule,Facility 20902,Not in chargemaster,20902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20902,BCBS multispecialty AW base fee schedule,540.6,,Fee schedule,,,,,,192.79,472.07,0
unity,Fee schedule,Facility 20910,Not in chargemaster,20910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20910,BCBS multispecialty AW base fee schedule,894.38,,Fee schedule,,,,,,217.96,501.88,0
unity,Fee schedule,Facility 20912,Not in chargemaster,20912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20912,BCBS multispecialty AW base fee schedule,902.99,,Fee schedule,,,,,,174.9,380,0
unity,Fee schedule,Facility 20920,Not in chargemaster,20920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20920,BCBS multispecialty AW base fee schedule,743.33,,Fee schedule,,,,,,353.78,615,0
unity,Fee schedule,Facility 20922,Not in chargemaster,20922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20922,BCBS multispecialty AW base fee schedule,926.18,,Fee schedule,,,,,,844.03,1216,0
unity,Fee schedule,Facility 20680,Not in chargemaster,20680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20680,BCBS multispecialty AW base fee schedule,803.61,,Fee schedule,,,,,,57.64,117.83,0
unity,Fee schedule,Facility 20975,Not in chargemaster,20975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20975,BCBS multispecialty AW base fee schedule,339.2,,Fee schedule,,,,,,180.86,306.67,0
unity,Fee schedule,Facility 20979,Not in chargemaster,20979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20979,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,123.23,308,0
unity,Fee schedule,Facility 20982,Not in chargemaster,20982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20982,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,199.41,522.5,0
unity,Fee schedule,Facility 20983,Not in chargemaster,20983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20983,BCBS multispecialty AW base fee schedule,663.16,,Fee schedule,,,,,,86.13,193.09,0
unity,Fee schedule,Facility 20985,Not in chargemaster,20985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20985,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,114.61,233.55,0
unity,Fee schedule,Facility 21010,Not in chargemaster,21010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21010,BCBS multispecialty AW base fee schedule,1423.71,,Fee schedule,,,,,,142.44,274.01,0
unity,Fee schedule,Facility 21011,Not in chargemaster,21011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21011,BCBS multispecialty AW base fee schedule,488.93,,Fee schedule,,,,,,185.5,354.23,0
unity,Fee schedule,Facility 21014,Not in chargemaster,21014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21014,BCBS multispecialty AW base fee schedule,993.75,,Fee schedule,,,,,,107.99,235.69,0
unity,Fee schedule,Facility 21015,Not in chargemaster,21015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21015,BCBS multispecialty AW base fee schedule,1343.55,,Fee schedule,,,,,,113.95,257.69,0
unity,Fee schedule,Facility 21016,Not in chargemaster,21016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21016,BCBS multispecialty AW base fee schedule,1927.21,,Fee schedule,,,,,,145.75,300.99,0
unity,Fee schedule,Facility 21025,Not in chargemaster,21025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21025,BCBS multispecialty AW base fee schedule,1319.7,,Fee schedule,,,,,,184.18,367,0
unity,Fee schedule,Facility 21012,Not in chargemaster,21012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21012,BCBS multispecialty AW base fee schedule,643.95,,Fee schedule,,,,,,359.74,601.26,0
unity,Fee schedule,Facility 21013,Not in chargemaster,21013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21013,BCBS multispecialty AW base fee schedule,764.53,,Fee schedule,,,,,,288.85,508.98,0
unity,Fee schedule,Facility 21026,Not in chargemaster,21026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21026,BCBS multispecialty AW base fee schedule,859.93,,Fee schedule,,,,,,361.73,650.24,0
unity,Fee schedule,Facility 21029,Not in chargemaster,21029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21029,BCBS multispecialty AW base fee schedule,1185.88,,Fee schedule,,,,,,391.54,690,0
unity,Fee schedule,Facility 21030,Not in chargemaster,21030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21030,BCBS multispecialty AW base fee schedule,736.7,,Fee schedule,,,,,,459.78,829.83,0
unity,Fee schedule,Facility 21031,Not in chargemaster,21031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21031,BCBS multispecialty AW base fee schedule,531.99,,Fee schedule,,,,,,279.58,530,0
unity,Fee schedule,Facility 21032,Not in chargemaster,21032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21032,BCBS multispecialty AW base fee schedule,522.05,,Fee schedule,,,,,,373.65,640,0
unity,Fee schedule,Facility 21044,Not in chargemaster,21044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21044,BCBS multispecialty AW base fee schedule,1642.34,,Fee schedule,,,,,,408.1,790,0
unity,Fee schedule,Facility 21045,Not in chargemaster,21045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21045,BCBS multispecialty AW base fee schedule,2298.21,,Fee schedule,,,,,,321.31,570,0
unity,Fee schedule,Facility 21046,Not in chargemaster,21046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21046,BCBS multispecialty AW base fee schedule,1992.14,,Fee schedule,,,,,,380.28,626.81,0
unity,Fee schedule,Facility 21047,Not in chargemaster,21047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21047,BCBS multispecialty AW base fee schedule,2434.69,,Fee schedule,,,,,,410.75,740.4,0
unity,Fee schedule,Facility 21048,Not in chargemaster,21048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21048,BCBS multispecialty AW base fee schedule,2020.63,,Fee schedule,,,,,,420.69,789.38,0
unity,Fee schedule,Facility 21049,Not in chargemaster,21049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21049,BCBS multispecialty AW base fee schedule,2298.21,,Fee schedule,,,,,,160.33,284.66,0
unity,Fee schedule,Facility 21050,Not in chargemaster,21050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21050,BCBS multispecialty AW base fee schedule,1670.16,,Fee schedule,,,,,,466.4,819.9,0
unity,Fee schedule,Facility 21060,Not in chargemaster,21060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21060,BCBS multispecialty AW base fee schedule,1518.45,,Fee schedule,,,,,,583.66,1040,0
unity,Fee schedule,Facility 21070,Not in chargemaster,21070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21070,BCBS multispecialty AW base fee schedule,1193.83,,Fee schedule,,,,,,1523.09,1707.23,0
unity,Fee schedule,Facility 21073,Not in chargemaster,21073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21073,BCBS multispecialty AW base fee schedule,476.34,,Fee schedule,,,,,,88.11,155,0
unity,Fee schedule,Facility 21034,Not in chargemaster,21034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21034,BCBS multispecialty AW base fee schedule,2161.08,,Fee schedule,,,,,,103.35,173.92,0
unity,Fee schedule,Facility 21040,Not in chargemaster,21040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21040,BCBS multispecialty AW base fee schedule,738.69,,Fee schedule,,,,,,210.68,313.06,0
unity,Fee schedule,Facility 21076,Not in chargemaster,21076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21076,BCBS multispecialty AW base fee schedule,1427.03,,Fee schedule,,,,,,101.36,173.92,0
unity,Fee schedule,Facility 21077,Not in chargemaster,21077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21077,BCBS multispecialty AW base fee schedule,3540.4,,Fee schedule,,,,,,3.98,14.2,0
unity,Fee schedule,Facility 21079,Not in chargemaster,21079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21079,BCBS multispecialty AW base fee schedule,2377.71,,Fee schedule,,,,,,184.84,330,0
unity,Fee schedule,Facility 21080,Not in chargemaster,21080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21080,BCBS multispecialty AW base fee schedule,2681.8,,Fee schedule,,,,,,126.54,230,0
unity,Fee schedule,Facility 21081,Not in chargemaster,21081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21081,BCBS multispecialty AW base fee schedule,2451.91,,Fee schedule,,,,,,155.03,281.83,0
unity,Fee schedule,Facility 21082,Not in chargemaster,21082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21082,BCBS multispecialty AW base fee schedule,2255.15,,Fee schedule,,,,,,83.48,238.51,0
unity,Fee schedule,Facility 21083,Not in chargemaster,21083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21083,BCBS multispecialty AW base fee schedule,2093.5,,Fee schedule,,,,,,294.15,357.5,0
unity,Fee schedule,Facility 21084,Not in chargemaster,21084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21084,BCBS multispecialty AW base fee schedule,2422.76,,Fee schedule,,,,,,74.86,122.1,0
unity,Fee schedule,Facility 21085,Not in chargemaster,21085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21085,BCBS multispecialty AW base fee schedule,975.2,,Fee schedule,,,,,,76.19,126.36,0
unity,Fee schedule,Facility 21086,Not in chargemaster,21086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21086,BCBS multispecialty AW base fee schedule,2611.58,,Fee schedule,,,,,,73.54,120,0
unity,Fee schedule,Facility 21137,Not in chargemaster,21137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21137,BCBS multispecialty AW base fee schedule,1440.94,,Fee schedule,,,,,,82.81,154,0
unity,Fee schedule,Facility 21138,Not in chargemaster,21138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21138,BCBS multispecialty AW base fee schedule,1760.26,,Fee schedule,,,,,,68.9,105,0
unity,Fee schedule,Facility 21139,Not in chargemaster,21139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21139,BCBS multispecialty AW base fee schedule,2125.3,,Fee schedule,,,,,,87.45,159,0
unity,Fee schedule,Facility 21141,Not in chargemaster,21141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21141,BCBS multispecialty AW base fee schedule,2547.98,,Fee schedule,,,,,,71.55,137.02,0
unity,Fee schedule,Facility 21142,Not in chargemaster,21142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21142,BCBS multispecialty AW base fee schedule,2618.86,,Fee schedule,,,,,,87.45,129.23,0
unity,Fee schedule,Facility 21143,Not in chargemaster,21143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21143,BCBS multispecialty AW base fee schedule,2720.23,,Fee schedule,,,,,,296.14,565.05,0
unity,Fee schedule,Facility 21145,Not in chargemaster,21145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21145,BCBS multispecialty AW base fee schedule,2976.61,,Fee schedule,,,,,,853.96,946.25,0
unity,Fee schedule,Facility 21146,Not in chargemaster,21146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21146,BCBS multispecialty AW base fee schedule,3106.46,,Fee schedule,,,,,,427.31,467.8,0
unity,Fee schedule,Facility 21147,Not in chargemaster,21147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21147,BCBS multispecialty AW base fee schedule,3274.08,,Fee schedule,,,,,,553.85,672.96,0
unity,Fee schedule,Facility 21150,Not in chargemaster,21150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21150,BCBS multispecialty AW base fee schedule,3133.63,,Fee schedule,,,,,,771.15,854.49,0
unity,Fee schedule,Facility 21151,Not in chargemaster,21151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21151,BCBS multispecialty AW base fee schedule,3450.3,,Fee schedule,,,,,,1332.95,1477.01,0
unity,Fee schedule,Facility 21154,Not in chargemaster,21154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21154,BCBS multispecialty AW base fee schedule,3712.65,,Fee schedule,,,,,,626.73,764.53,0
unity,Fee schedule,Facility 21155,Not in chargemaster,21155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21155,BCBS multispecialty AW base fee schedule,4120.75,,Fee schedule,,,,,,149.73,305.95,0
unity,Fee schedule,Facility 21159,Not in chargemaster,21159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21159,BCBS multispecialty AW base fee schedule,4941.59,,Fee schedule,,,,,,461.1,560.79,0
unity,Fee schedule,Facility 21160,Not in chargemaster,21160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21160,BCBS multispecialty AW base fee schedule,5360.95,,Fee schedule,,,,,,612.15,678.63,0
unity,Fee schedule,Facility 21172,Not in chargemaster,21172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21172,BCBS multispecialty AW base fee schedule,3992.23,,Fee schedule,,,,,,455.8,506.86,0
unity,Fee schedule,Facility 21175,Not in chargemaster,21175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21175,BCBS multispecialty AW base fee schedule,4265.84,,Fee schedule,,,,,,484.29,610,0
unity,Fee schedule,Facility 21179,Not in chargemaster,21179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21179,BCBS multispecialty AW base fee schedule,2928.25,,Fee schedule,,,,,,600.23,715,0
unity,Fee schedule,Facility 21180,Not in chargemaster,21180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21180,BCBS multispecialty AW base fee schedule,3275.4,,Fee schedule,,,,,,975.86,1167.02,0
unity,Fee schedule,Facility 21181,Not in chargemaster,21181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21181,BCBS multispecialty AW base fee schedule,1421.06,,Fee schedule,,,,,,534.64,653.08,0
unity,Fee schedule,Facility 21182,Not in chargemaster,21182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21182,BCBS multispecialty AW base fee schedule,4086.96,,Fee schedule,,,,,,263.01,569.61,0
unity,Fee schedule,Facility 21183,Not in chargemaster,21183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21183,BCBS multispecialty AW base fee schedule,4451.34,,Fee schedule,,,,,,533.98,640,0
unity,Fee schedule,Facility 21184,Not in chargemaster,21184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21184,BCBS multispecialty AW base fee schedule,4791.2,,Fee schedule,,,,,,559.81,700,0
unity,Fee schedule,Facility 21188,Not in chargemaster,21188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21188,BCBS multispecialty AW base fee schedule,3085.26,,Fee schedule,,,,,,586.98,690.71,0
unity,Fee schedule,Facility 21193,Not in chargemaster,21193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21193,BCBS multispecialty AW base fee schedule,2370.43,,Fee schedule,,,,,,352.45,425.99,0
unity,Fee schedule,Facility 21194,Not in chargemaster,21194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21194,BCBS multispecialty AW base fee schedule,2732.15,,Fee schedule,,,,,,578.36,719.09,0
unity,Fee schedule,Facility 21195,Not in chargemaster,21195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21195,BCBS multispecialty AW base fee schedule,2619.53,,Fee schedule,,,,,,354.44,394.68,0
unity,Fee schedule,Facility 21196,Not in chargemaster,21196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21196,BCBS multispecialty AW base fee schedule,2712.28,,Fee schedule,,,,,,521.39,671.53,0
unity,Fee schedule,Facility 21198,Not in chargemaster,21198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21198,BCBS multispecialty AW base fee schedule,2110.73,,Fee schedule,,,,,,490.91,591.33,0
unity,Fee schedule,Facility 21199,Not in chargemaster,21199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21199,BCBS multispecialty AW base fee schedule,1979.55,,Fee schedule,,,,,,963.94,1239.27,0
unity,Fee schedule,Facility 21206,Not in chargemaster,21206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21206,BCBS multispecialty AW base fee schedule,2180.95,,Fee schedule,,,,,,596.91,661.42,0
unity,Fee schedule,Facility 21208,Not in chargemaster,21208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21208,BCBS multispecialty AW base fee schedule,1439.61,,Fee schedule,,,,,,539.94,648.11,0
unity,Fee schedule,Facility 21087,Not in chargemaster,21087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21087,BCBS multispecialty AW base fee schedule,2611.58,,Fee schedule,,,,,,535.3,658.76,0
unity,Fee schedule,Facility 21100,Not in chargemaster,21100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21100,BCBS multispecialty AW base fee schedule,704.9,,Fee schedule,,,,,,546.56,680,0
unity,Fee schedule,Facility 21110,Not in chargemaster,21110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21110,BCBS multispecialty AW base fee schedule,1303.14,,Fee schedule,,,,,,718.15,796.47,0
unity,Fee schedule,Facility 21116,Not in chargemaster,21116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21116,BCBS multispecialty AW base fee schedule,88.78,,Fee schedule,,,,,,387.56,476.32,0
unity,Fee schedule,Facility 21120,Not in chargemaster,21120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21120,BCBS multispecialty AW base fee schedule,994.41,,Fee schedule,,,,,,235.19,316.6,0
unity,Fee schedule,Facility 21121,Not in chargemaster,21121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21121,BCBS multispecialty AW base fee schedule,1087.83,,Fee schedule,,,,,,225.91,266.2,0
unity,Fee schedule,Facility 21122,Not in chargemaster,21122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21122,BCBS multispecialty AW base fee schedule,1466.78,,Fee schedule,,,,,,270.3,355,0
unity,Fee schedule,Facility 21123,Not in chargemaster,21123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21123,BCBS multispecialty AW base fee schedule,1666.85,,Fee schedule,,,,,,129.19,207.28,0
unity,Fee schedule,Facility 21125,Not in chargemaster,21125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21125,BCBS multispecialty AW base fee schedule,1317.05,,Fee schedule,,,,,,116.6,186.7,0
unity,Fee schedule,Facility 21127,Not in chargemaster,21127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21127,BCBS multispecialty AW base fee schedule,1515.8,,Fee schedule,,,,,,80.16,188.84,0
unity,Fee schedule,Facility 21209,Not in chargemaster,21209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21209,BCBS multispecialty AW base fee schedule,1155.4,,Fee schedule,,,,,,74.86,140.56,0
unity,Fee schedule,Facility 21210,Not in chargemaster,21210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21210,BCBS multispecialty AW base fee schedule,1481.35,,Fee schedule,,,,,,56.31,87.32,0
unity,Fee schedule,Facility 21215,Not in chargemaster,21215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21215,BCBS multispecialty AW base fee schedule,1538.99,,Fee schedule,,,,,,35.78,122.1,0
unity,Fee schedule,Facility 21240,Not in chargemaster,21240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21240,BCBS multispecialty AW base fee schedule,2043.81,,Fee schedule,,,,,,111.96,175.34,0
unity,Fee schedule,Facility 21242,Not in chargemaster,21242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21242,BCBS multispecialty AW base fee schedule,1934.5,,Fee schedule,,,,,,96.06,180.31,0
unity,Fee schedule,Facility 21243,Not in chargemaster,21243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21243,BCBS multispecialty AW base fee schedule,3117.73,,Fee schedule,,,,,,94.08,154.76,0
unity,Fee schedule,Facility 21244,Not in chargemaster,21244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21244,BCBS multispecialty AW base fee schedule,1942.45,,Fee schedule,,,,,,53,185,0
unity,Fee schedule,Facility 21245,Not in chargemaster,21245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21245,BCBS multispecialty AW base fee schedule,1776.16,,Fee schedule,,,,,,213.99,276.13,0
unity,Fee schedule,Facility 21246,Not in chargemaster,21246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21246,BCBS multispecialty AW base fee schedule,1635.05,,Fee schedule,,,,,,108.65,280,0
unity,Fee schedule,Facility 21247,Not in chargemaster,21247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21247,BCBS multispecialty AW base fee schedule,3042.86,,Fee schedule,,,,,,203.39,560.79,0
unity,Fee schedule,Facility 21248,Not in chargemaster,21248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21248,BCBS multispecialty AW base fee schedule,1567.48,,Fee schedule,,,,,,228.58,303.92,0
unity,Fee schedule,Facility 21255,Not in chargemaster,21255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21255,BCBS multispecialty AW base fee schedule,2602.96,,Fee schedule,,,,,,302.1,407,0
unity,Fee schedule,Facility 21256,Not in chargemaster,21256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21256,BCBS multispecialty AW base fee schedule,2383.68,,Fee schedule,,,,,,171.59,220,0
unity,Fee schedule,Facility 21260,Not in chargemaster,21260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21260,BCBS multispecialty AW base fee schedule,2656.63,,Fee schedule,,,,,,488.93,541.77,0
unity,Fee schedule,Facility 21261,Not in chargemaster,21261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21261,BCBS multispecialty AW base fee schedule,4711.7,,Fee schedule,,,,,,800.96,887.53,0
unity,Fee schedule,Facility 21263,Not in chargemaster,21263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21263,BCBS multispecialty AW base fee schedule,4357.26,,Fee schedule,,,,,,841.38,932.31,0
unity,Fee schedule,Facility 21267,Not in chargemaster,21267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21267,BCBS multispecialty AW base fee schedule,3106.46,,Fee schedule,,,,,,665.81,742.5,0
unity,Fee schedule,Facility 21268,Not in chargemaster,21268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21268,BCBS multispecialty AW base fee schedule,3897.49,,Fee schedule,,,,,,225.25,282.81,0
unity,Fee schedule,Facility 21270,Not in chargemaster,21270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21270,BCBS multispecialty AW base fee schedule,1441.6,,Fee schedule,,,,,,234.53,315.35,0
unity,Fee schedule,Facility 21230,Not in chargemaster,21230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21230,BCBS multispecialty AW base fee schedule,1416.43,,Fee schedule,,,,,,264.34,371.88,0
unity,Fee schedule,Facility 21235,Not in chargemaster,21235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21235,BCBS multispecialty AW base fee schedule,1067.95,,Fee schedule,,,,,,338.54,412.5,0
unity,Fee schedule,Facility 21249,Not in chargemaster,21249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21249,BCBS multispecialty AW base fee schedule,2215.4,,Fee schedule,,,,,,292.83,387.2,0
unity,Fee schedule,Facility 21275,Not in chargemaster,21275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21275,BCBS multispecialty AW base fee schedule,1616.5,,Fee schedule,,,,,,374.98,440,0
unity,Fee schedule,Facility 21280,Not in chargemaster,21280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21280,BCBS multispecialty AW base fee schedule,1089.15,,Fee schedule,,,,,,2085.55,2381,0
unity,Fee schedule,Facility 21282,Not in chargemaster,21282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21282,BCBS multispecialty AW base fee schedule,734.71,,Fee schedule,,,,,,2110.06,2338.11,0
unity,Fee schedule,Facility 21295,Not in chargemaster,21295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21295,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,1895.41,2100.26,0
unity,Fee schedule,Facility 21296,Not in chargemaster,21296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21296,BCBS multispecialty AW base fee schedule,769.16,,Fee schedule,,,,,,1805.31,2000.42,0
unity,Fee schedule,Facility 21310,Not in chargemaster,21310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21310,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,2588.39,2868.13,0
unity,Fee schedule,Facility 21315,Not in chargemaster,21315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21315,BCBS multispecialty AW base fee schedule,285.54,,Fee schedule,,,,,,1625.78,1801.48,0
unity,Fee schedule,Facility 21320,Not in chargemaster,21320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21320,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,299.45,668.17,0
unity,Fee schedule,Facility 21325,Not in chargemaster,21325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21325,BCBS multispecialty AW base fee schedule,824.81,,Fee schedule,,,,,,1240.86,1374.97,0
unity,Fee schedule,Facility 21330,Not in chargemaster,21330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21330,BCBS multispecialty AW base fee schedule,1060.66,,Fee schedule,,,,,,1158.71,1375,0
unity,Fee schedule,Facility 21335,Not in chargemaster,21335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21335,BCBS multispecialty AW base fee schedule,1348.19,,Fee schedule,,,,,,1159.38,1284.68,0
unity,Fee schedule,Facility 21336,Not in chargemaster,21336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21336,BCBS multispecialty AW base fee schedule,1205.75,,Fee schedule,,,,,,106.66,141.81,0
unity,Fee schedule,Facility 21337,Not in chargemaster,21337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21337,BCBS multispecialty AW base fee schedule,557.16,,Fee schedule,,,,,,136.48,181.5,0
unity,Fee schedule,Facility 21338,Not in chargemaster,21338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21338,BCBS multispecialty AW base fee schedule,1241.53,,Fee schedule,,,,,,354.44,460,0
unity,Fee schedule,Facility 21339,Not in chargemaster,21339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21339,BCBS multispecialty AW base fee schedule,1411.13,,Fee schedule,,,,,,383.59,561.81,0
unity,Fee schedule,Facility 21340,Not in chargemaster,21340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21340,BCBS multispecialty AW base fee schedule,1413.11,,Fee schedule,,,,,,437.25,585.72,0
unity,Fee schedule,Facility 21343,Not in chargemaster,21343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21343,BCBS multispecialty AW base fee schedule,2033.88,,Fee schedule,,,,,,486.94,666.19,0
unity,Fee schedule,Facility 21344,Not in chargemaster,21344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21344,BCBS multispecialty AW base fee schedule,2628.14,,Fee schedule,,,,,,805.6,892.67,0
unity,Fee schedule,Facility 21345,Not in chargemaster,21345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21345,BCBS multispecialty AW base fee schedule,1189.85,,Fee schedule,,,,,,188.81,210.84,0
unity,Fee schedule,Facility 21346,Not in chargemaster,21346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21346,BCBS multispecialty AW base fee schedule,1815.25,,Fee schedule,,,,,,207.36,229.77,0
unity,Fee schedule,Facility 21347,Not in chargemaster,21347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21347,BCBS multispecialty AW base fee schedule,1925.89,,Fee schedule,,,,,,608.84,674.64,0
unity,Fee schedule,Facility 21348,Not in chargemaster,21348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21348,BCBS multispecialty AW base fee schedule,2058.39,,Fee schedule,,,,,,682.38,756.12,0
unity,Fee schedule,Facility 21355,Not in chargemaster,21355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21355,BCBS multispecialty AW base fee schedule,608.18,,Fee schedule,,,,,,757.24,865,0
unity,Fee schedule,Facility 21360,Not in chargemaster,21360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21360,BCBS multispecialty AW base fee schedule,969.9,,Fee schedule,,,,,,77.51,87.32,0
unity,Fee schedule,Facility 21365,Not in chargemaster,21365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21365,BCBS multispecialty AW base fee schedule,2096.15,,Fee schedule,,,,,,211.64,351.63,0
unity,Fee schedule,Facility 21366,Not in chargemaster,21366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21366,BCBS multispecialty AW base fee schedule,2453.24,,Fee schedule,,,,,,143,238.58,0
unity,Fee schedule,Facility 21385,Not in chargemaster,21385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21385,BCBS multispecialty AW base fee schedule,1429.68,,Fee schedule,,,,,,114.7,135.81,0
unity,Fee schedule,Facility 21386,Not in chargemaster,21386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21386,BCBS multispecialty AW base fee schedule,1240.86,,Fee schedule,,,,,,45.26,97,0
unity,Fee schedule,Facility 21387,Not in chargemaster,21387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21387,BCBS multispecialty AW base fee schedule,1492.61,,Fee schedule,,,,,,89.9,158,0
unity,Fee schedule,Facility 21390,Not in chargemaster,21390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21390,BCBS multispecialty AW base fee schedule,1521.76,,Fee schedule,,,,,,138.26,230,0
unity,Fee schedule,Facility 21395,Not in chargemaster,21395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21395,BCBS multispecialty AW base fee schedule,1943.11,,Fee schedule,,,,,,195.3,300,0
unity,Fee schedule,Facility 21400,Not in chargemaster,21400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21400,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,127.1,155,0
unity,Fee schedule,Facility 21356,Not in chargemaster,21356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21356,BCBS multispecialty AW base fee schedule,712.85,,Fee schedule,,,,,,174.84,214,0
unity,Fee schedule,Facility 21401,Not in chargemaster,21401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21401,BCBS multispecialty AW base fee schedule,616.13,,Fee schedule,,,,,,237.46,290,0
unity,Fee schedule,Facility 21406,Not in chargemaster,21406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21406,BCBS multispecialty AW base fee schedule,1109.03,,Fee schedule,,,,,,323.64,395,0
unity,Fee schedule,Facility 21407,Not in chargemaster,21407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21407,BCBS multispecialty AW base fee schedule,1224.3,,Fee schedule,,,,,,178.56,215,0
unity,Fee schedule,Facility 21408,Not in chargemaster,21408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21408,BCBS multispecialty AW base fee schedule,1733.76,,Fee schedule,,,,,,241.18,290,0
unity,Fee schedule,Facility 21421,Not in chargemaster,21421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21421,BCBS multispecialty AW base fee schedule,1071.26,,Fee schedule,,,,,,354.02,430,0
unity,Fee schedule,Facility 21422,Not in chargemaster,21422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21422,BCBS multispecialty AW base fee schedule,1222.31,,Fee schedule,,,,,,69.44,85,0
unity,Fee schedule,Facility 21423,Not in chargemaster,21423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21423,BCBS multispecialty AW base fee schedule,1460.15,,Fee schedule,,,,,,127.1,155,0
unity,Fee schedule,Facility 21431,Not in chargemaster,21431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21431,BCBS multispecialty AW base fee schedule,1319.7,,Fee schedule,,,,,,182.9,225,0
unity,Fee schedule,Facility 21432,Not in chargemaster,21432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21432,BCBS multispecialty AW base fee schedule,1375.35,,Fee schedule,,,,,,68.82,85,0
unity,Fee schedule,Facility 21433,Not in chargemaster,21433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21433,BCBS multispecialty AW base fee schedule,3346.29,,Fee schedule,,,,,,126.48,155,0
unity,Fee schedule,Facility 21435,Not in chargemaster,21435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21435,BCBS multispecialty AW base fee schedule,2701.01,,Fee schedule,,,,,,182.28,225,0
unity,Fee schedule,Facility 21436,Not in chargemaster,21436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21436,BCBS multispecialty AW base fee schedule,3923.33,,Fee schedule,,,,,,233.74,285,0
unity,Fee schedule,Facility 21440,Not in chargemaster,21440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21440,BCBS multispecialty AW base fee schedule,957.31,,Fee schedule,,,,,,295.74,360,0
unity,Fee schedule,Facility 21445,Not in chargemaster,21445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21445,BCBS multispecialty AW base fee schedule,1188.53,,Fee schedule,,,,,,380.68,465,0
unity,Fee schedule,Facility 21450,Not in chargemaster,21450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21450,BCBS multispecialty AW base fee schedule,887.75,,Fee schedule,,,,,,127.72,155,0
unity,Fee schedule,Facility 21451,Not in chargemaster,21451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21451,BCBS multispecialty AW base fee schedule,1195.15,,Fee schedule,,,,,,187.24,230,0
unity,Fee schedule,Facility 21452,Not in chargemaster,21452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21452,BCBS multispecialty AW base fee schedule,798.98,,Fee schedule,,,,,,57.66,97.26,0
unity,Fee schedule,Facility 21453,Not in chargemaster,21453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21453,BCBS multispecialty AW base fee schedule,1624.45,,Fee schedule,,,,,,39.68,50,0
unity,Fee schedule,Facility 21454,Not in chargemaster,21454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21454,BCBS multispecialty AW base fee schedule,970.56,,Fee schedule,,,,,,76.26,90.29,0
unity,Fee schedule,Facility 21461,Not in chargemaster,21461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21461,BCBS multispecialty AW base fee schedule,1911.31,,Fee schedule,,,,,,114.08,135.07,0
unity,Fee schedule,Facility 21465,Not in chargemaster,21465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21465,BCBS multispecialty AW base fee schedule,1596.63,,Fee schedule,,,,,,209.56,250,0
unity,Fee schedule,Facility 21470,Not in chargemaster,21470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21470,BCBS multispecialty AW base fee schedule,2242.56,,Fee schedule,,,,,,304.42,370,0
unity,Fee schedule,Facility 21480,Not in chargemaster,21480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21480,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,389.36,480,0
unity,Fee schedule,Facility 21462,Not in chargemaster,21462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21462,BCBS multispecialty AW base fee schedule,2113.38,,Fee schedule,,,,,,195.92,262,0
unity,Fee schedule,Facility 21485,Not in chargemaster,21485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21485,BCBS multispecialty AW base fee schedule,1365.41,,Fee schedule,,,,,,158.1,195,0
unity,Fee schedule,Facility 21490,Not in chargemaster,21490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21490,BCBS multispecialty AW base fee schedule,1574.76,,Fee schedule,,,,,,226.3,267.95,0
unity,Fee schedule,Facility 21497,Not in chargemaster,21497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21497,BCBS multispecialty AW base fee schedule,1086.5,,Fee schedule,,,,,,76.88,95,0
unity,Fee schedule,Facility 21501,Not in chargemaster,21501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21501,BCBS multispecialty AW base fee schedule,620.76,,Fee schedule,,,,,,120.9,145,0
unity,Fee schedule,Facility 21556,Not in chargemaster,21556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21556,BCBS multispecialty AW base fee schedule,1008.33,,Fee schedule,,,,,,159.34,195,0
unity,Fee schedule,Facility 21557,Not in chargemaster,21557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21557,BCBS multispecialty AW base fee schedule,1826.51,,Fee schedule,,,,,,128.34,151.96,0
unity,Fee schedule,Facility 21558,Not in chargemaster,21558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21558,BCBS multispecialty AW base fee schedule,2574.48,,Fee schedule,,,,,,184.14,218.03,0
unity,Fee schedule,Facility 21600,Not in chargemaster,21600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21600,BCBS multispecialty AW base fee schedule,1056.03,,Fee schedule,,,,,,135.78,238,0
unity,Fee schedule,Facility 21601,Not in chargemaster,21601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21601,BCBS multispecialty AW base fee schedule,2263.76,,Fee schedule,,,,,,145.08,238.51,0
unity,Fee schedule,Facility 21602,Not in chargemaster,21602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21602,BCBS multispecialty AW base fee schedule,3036.24,,Fee schedule,,,,,,153.76,255,0
unity,Fee schedule,Facility 21603,Not in chargemaster,21603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21603,BCBS multispecialty AW base fee schedule,3360.2,,Fee schedule,,,,,,181.66,290,0
unity,Fee schedule,Facility 21610,Not in chargemaster,21610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21610,BCBS multispecialty AW base fee schedule,2285.63,,Fee schedule,,,,,,174.22,282,0
unity,Fee schedule,Facility 21615,Not in chargemaster,21615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21615,BCBS multispecialty AW base fee schedule,1183.89,,Fee schedule,,,,,,211.42,325,0
unity,Fee schedule,Facility 21616,Not in chargemaster,21616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21616,BCBS multispecialty AW base fee schedule,1372.04,,Fee schedule,,,,,,227.54,342.17,0
unity,Fee schedule,Facility 21620,Not in chargemaster,21620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21620,BCBS multispecialty AW base fee schedule,967.91,,Fee schedule,,,,,,124.62,210,0
unity,Fee schedule,Facility 21627,Not in chargemaster,21627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21627,BCBS multispecialty AW base fee schedule,1030.85,,Fee schedule,,,,,,135.78,225,0
unity,Fee schedule,Facility 21630,Not in chargemaster,21630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21630,BCBS multispecialty AW base fee schedule,2327.36,,Fee schedule,,,,,,135.78,225,0
unity,Fee schedule,Facility 21632,Not in chargemaster,21632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21632,BCBS multispecialty AW base fee schedule,2315.44,,Fee schedule,,,,,,153.76,250,0
unity,Fee schedule,Facility 21685,Not in chargemaster,21685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21685,BCBS multispecialty AW base fee schedule,1866.26,,Fee schedule,,,,,,158.1,250,0
unity,Fee schedule,Facility 21700,Not in chargemaster,21700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21700,BCBS multispecialty AW base fee schedule,686.35,,Fee schedule,,,,,,172.36,270,0
unity,Fee schedule,Facility 21705,Not in chargemaster,21705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21705,BCBS multispecialty AW base fee schedule,1029.53,,Fee schedule,,,,,,181.66,290,0
unity,Fee schedule,Facility 21720,Not in chargemaster,21720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21720,BCBS multispecialty AW base fee schedule,993.75,,Fee schedule,,,,,,21.7,53.55,0
unity,Fee schedule,Facility 21725,Not in chargemaster,21725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21725,BCBS multispecialty AW base fee schedule,1033.5,,Fee schedule,,,,,,45.88,101.14,0
unity,Fee schedule,Facility 21740,Not in chargemaster,21740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21740,BCBS multispecialty AW base fee schedule,1972.26,,Fee schedule,,,,,,99.82,137.02,0
unity,Fee schedule,Facility 21750,Not in chargemaster,21750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21750,BCBS multispecialty AW base fee schedule,1302.48,,Fee schedule,,,,,,331.08,469.74,0
unity,Fee schedule,Facility 21811,Not in chargemaster,21811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21811,BCBS multispecialty AW base fee schedule,1142.15,,Fee schedule,,,,,,332.32,469.74,0
unity,Fee schedule,Facility 21812,Not in chargemaster,21812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21812,BCBS multispecialty AW base fee schedule,1393.24,,Fee schedule,,,,,,33.48,200,0
unity,Fee schedule,Facility 21813,Not in chargemaster,21813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21813,BCBS multispecialty AW base fee schedule,1904.69,,Fee schedule,,,,,,14.88,17.62,0
unity,Fee schedule,Facility 21820,Not in chargemaster,21820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21820,BCBS multispecialty AW base fee schedule,274.94,,Fee schedule,,,,,,19.22,22.76,0
unity,Fee schedule,Facility 21825,Not in chargemaster,21825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21825,BCBS multispecialty AW base fee schedule,1036.15,,Fee schedule,,,,,,332.32,393.48,0
unity,Fee schedule,Facility 21920,Not in chargemaster,21920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21920,BCBS multispecialty AW base fee schedule,298.13,,Fee schedule,,,,,,14.88,20,0
unity,Fee schedule,Facility 21931,Not in chargemaster,21931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21931,BCBS multispecialty AW base fee schedule,902.33,,Fee schedule,,,,,,63.07,82.95,0
unity,Fee schedule,Facility 21932,Not in chargemaster,21932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21932,BCBS multispecialty AW base fee schedule,1270.68,,Fee schedule,,,,,,63.07,82.95,0
unity,Fee schedule,Facility 21933,Not in chargemaster,21933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21933,BCBS multispecialty AW base fee schedule,1416.43,,Fee schedule,,,,,,63.07,82.95,0
unity,Fee schedule,Facility 21935,Not in chargemaster,21935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21935,BCBS multispecialty AW base fee schedule,1969.61,,Fee schedule,,,,,,60.76,71.94,0
unity,Fee schedule,Facility 21936,Not in chargemaster,21936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21936,BCBS multispecialty AW base fee schedule,2716.25,,Fee schedule,,,,,,60.76,71.94,0
unity,Fee schedule,Facility 22010,Not in chargemaster,22010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22010,BCBS multispecialty AW base fee schedule,1836.45,,Fee schedule,,,,,,60.76,71.94,0
unity,Fee schedule,Facility 22015,Not in chargemaster,22015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22015,BCBS multispecialty AW base fee schedule,1807.3,,Fee schedule,,,,,,39.06,47.12,0
unity,Fee schedule,Facility 22100,Not in chargemaster,22100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22100,BCBS multispecialty AW base fee schedule,1635.05,,Fee schedule,,,,,,39.06,47.12,0
unity,Fee schedule,Facility 22101,Not in chargemaster,22101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22101,BCBS multispecialty AW base fee schedule,1665.53,,Fee schedule,,,,,,39.06,47.12,0
unity,Fee schedule,Facility 22102,Not in chargemaster,22102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22102,BCBS multispecialty AW base fee schedule,1566.81,,Fee schedule,,,,,,31,44,0
unity,Fee schedule,Facility 22103,Not in chargemaster,22103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22103,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,16.12,19.88,0
unity,Fee schedule,Facility 22110,Not in chargemaster,22110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22110,BCBS multispecialty AW base fee schedule,1994.13,,Fee schedule,,,,,,18.6,22.73,0
unity,Fee schedule,Facility 22112,Not in chargemaster,22112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22112,BCBS multispecialty AW base fee schedule,2139.88,,Fee schedule,,,,,,24.8,37,0
unity,Fee schedule,Facility 22114,Not in chargemaster,22114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22114,BCBS multispecialty AW base fee schedule,2139.88,,Fee schedule,,,,,,47.78,190,0
unity,Fee schedule,Facility 22116,Not in chargemaster,22116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22116,BCBS multispecialty AW base fee schedule,270.3,,Fee schedule,,,,,,46.5,98,0
unity,Fee schedule,Facility 22206,Not in chargemaster,22206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22206,BCBS multispecialty AW base fee schedule,4703.75,,Fee schedule,,,,,,88.66,163,0
unity,Fee schedule,Facility 22207,Not in chargemaster,22207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22207,BCBS multispecialty AW base fee schedule,4601.73,,Fee schedule,,,,,,132.68,230,0
unity,Fee schedule,Facility 22208,Not in chargemaster,22208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22208,BCBS multispecialty AW base fee schedule,1134.86,,Fee schedule,,,,,,226.92,350,0
unity,Fee schedule,Facility 22210,Not in chargemaster,22210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22210,BCBS multispecialty AW base fee schedule,3428.44,,Fee schedule,,,,,,296.36,440,0
unity,Fee schedule,Facility 22212,Not in chargemaster,22212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22212,BCBS multispecialty AW base fee schedule,2865.31,,Fee schedule,,,,,,16.12,50,0
unity,Fee schedule,Facility 22214,Not in chargemaster,22214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22214,BCBS multispecialty AW base fee schedule,2876.58,,Fee schedule,,,,,,1271.34,1487.44,0
unity,Fee schedule,Facility 22216,Not in chargemaster,22216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22216,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,2065.01,2355,0
unity,Fee schedule,Facility 22220,Not in chargemaster,22220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22220,BCBS multispecialty AW base fee schedule,3136.94,,Fee schedule,,,,,,1482.68,1642.92,0
unity,Fee schedule,Facility 22222,Not in chargemaster,22222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22222,BCBS multispecialty AW base fee schedule,3329.73,,Fee schedule,,,,,,141.78,157.31,0
unity,Fee schedule,Facility 22224,Not in chargemaster,22224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22224,BCBS multispecialty AW base fee schedule,3054.13,,Fee schedule,,,,,,206.04,280.32,0
unity,Fee schedule,Facility 22226,Not in chargemaster,22226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22226,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,1005.01,1145,0
unity,Fee schedule,Facility 22310,Not in chargemaster,22310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22310,BCBS multispecialty AW base fee schedule,555.18,,Fee schedule,,,,,,1130.89,1253.11,0
unity,Fee schedule,Facility 21502,Not in chargemaster,21502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21502,BCBS multispecialty AW base fee schedule,967.91,,Fee schedule,,,,,,1219,1350.74,0
unity,Fee schedule,Facility 21510,Not in chargemaster,21510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21510,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,1424.38,1625,0
unity,Fee schedule,Facility 21550,21550,21550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21550,BCBS multispecialty AW base fee schedule,296.14,565.05,Fee schedule,,296.14,296.14,296.14,296.14,1794.71,1988.68,0
unity,Fee schedule,Facility 21552,21552,21552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21552,BCBS multispecialty AW base fee schedule,853.96,941.29,Fee schedule,,853.96,853.96,853.96,853.96,1482.68,1642.92,0
unity,Fee schedule,Facility 21554,Not in chargemaster,21554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21554,BCBS multispecialty AW base fee schedule,1399.86,,Fee schedule,,,,,,1811.28,2007.03,0
unity,Fee schedule,Facility 21555,Not in chargemaster,21555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21555,BCBS multispecialty AW base fee schedule,582.34,,Fee schedule,,,,,,516.75,590,0
unity,Fee schedule,Facility 22318,Not in chargemaster,22318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22318,BCBS multispecialty AW base fee schedule,3135.61,,Fee schedule,,,,,,858.6,951.39,0
unity,Fee schedule,Facility 22319,Not in chargemaster,22319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22319,BCBS multispecialty AW base fee schedule,3488.06,,Fee schedule,,,,,,918.23,1017.46,0
unity,Fee schedule,Facility 22325,Not in chargemaster,22325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22325,BCBS multispecialty AW base fee schedule,2781.84,,Fee schedule,,,,,,828.13,945,0
unity,Fee schedule,Facility 22326,Not in chargemaster,22326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22326,BCBS multispecialty AW base fee schedule,2868.63,,Fee schedule,,,,,,1078.55,1225,0
unity,Fee schedule,Facility 22327,Not in chargemaster,22327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22327,BCBS multispecialty AW base fee schedule,2897.11,,Fee schedule,,,,,,49.03,149.79,0
unity,Fee schedule,Facility 22328,Not in chargemaster,22328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22328,BCBS multispecialty AW base fee schedule,541.26,,Fee schedule,,,,,,188.15,325.83,0
unity,Fee schedule,Facility 22505,Not in chargemaster,22505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22505,BCBS multispecialty AW base fee schedule,249.1,,Fee schedule,,,,,,409.43,453.67,0
unity,Fee schedule,Facility 22510,Not in chargemaster,22510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22510,BCBS multispecialty AW base fee schedule,828.13,,Fee schedule,,,,,,812.79,969.01,0
unity,Fee schedule,Facility 22532,Not in chargemaster,22532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22532,BCBS multispecialty AW base fee schedule,3452.29,,Fee schedule,,,,,,123.23,232.84,0
unity,Fee schedule,Facility 22533,Not in chargemaster,22533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22533,BCBS multispecialty AW base fee schedule,3182.65,,Fee schedule,,,,,,1937.81,2147.24,0
unity,Fee schedule,Facility 22534,Not in chargemaster,22534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22534,BCBS multispecialty AW base fee schedule,694.3,,Fee schedule,,,,,,129.19,215,0
unity,Fee schedule,Facility 22548,Not in chargemaster,22548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22548,BCBS multispecialty AW base fee schedule,3742.46,,Fee schedule,,,,,,1558.86,1744.14,0
unity,Fee schedule,Facility 22551,Not in chargemaster,22551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22551,BCBS multispecialty AW base fee schedule,3271.43,,Fee schedule,,,,,,81.49,110,0
unity,Fee schedule,Facility 22552,Not in chargemaster,22552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22552,BCBS multispecialty AW base fee schedule,765.19,,Fee schedule,,,,,,54.99,120.68,0
unity,Fee schedule,Facility 22554,Not in chargemaster,22554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22554,BCBS multispecialty AW base fee schedule,2406.86,,Fee schedule,,,,,,68.9,149.08,0
unity,Fee schedule,Facility 22556,Not in chargemaster,22556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22556,BCBS multispecialty AW base fee schedule,3191.93,,Fee schedule,,,,,,78.84,124.23,0
unity,Fee schedule,Facility 22558,Not in chargemaster,22558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22558,BCBS multispecialty AW base fee schedule,2940.84,,Fee schedule,,,,,,217.3,528.86,0
unity,Fee schedule,Facility 22585,Not in chargemaster,22585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22585,BCBS multispecialty AW base fee schedule,630.04,,Fee schedule,,,,,,89.44,269.76,0
unity,Fee schedule,Facility 22586,Not in chargemaster,22586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22586,BCBS multispecialty AW base fee schedule,3874.96,,Fee schedule,,,,,,26.5,30,0
unity,Fee schedule,Facility 22590,Not in chargemaster,22590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22590,BCBS multispecialty AW base fee schedule,3022.99,,Fee schedule,,,,,,63.6,110.75,0
unity,Fee schedule,Facility 22595,Not in chargemaster,22595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22595,BCBS multispecialty AW base fee schedule,2881.88,,Fee schedule,,,,,,23.85,27.93,0
unity,Fee schedule,Facility 22600,Not in chargemaster,22600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22600,BCBS multispecialty AW base fee schedule,2470.46,,Fee schedule,,,,,,25.18,29.48,0
unity,Fee schedule,Facility 22610,Not in chargemaster,22610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22610,BCBS multispecialty AW base fee schedule,2428.73,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 22612,Not in chargemaster,22612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22612,BCBS multispecialty AW base fee schedule,3047.5,,Fee schedule,,,,,,21.2,27.93,0
unity,Fee schedule,Facility 22614,Not in chargemaster,22614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22614,BCBS multispecialty AW base fee schedule,753.93,,Fee schedule,,,,,,19.21,27.93,0
unity,Fee schedule,Facility 22630,Not in chargemaster,22630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22630,BCBS multispecialty AW base fee schedule,3020.34,,Fee schedule,,,,,,27.16,38.01,0
unity,Fee schedule,Facility 22632,Not in chargemaster,22632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22632,BCBS multispecialty AW base fee schedule,620.1,,Fee schedule,,,,,,17.23,19.09,0
unity,Fee schedule,Facility 22633,Not in chargemaster,22633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22633,BCBS multispecialty AW base fee schedule,3555.64,,Fee schedule,,,,,,80.16,93.07,0
unity,Fee schedule,Facility 22634,Not in chargemaster,22634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22634,BCBS multispecialty AW base fee schedule,954.66,,Fee schedule,,,,,,106,124.11,0
unity,Fee schedule,Facility 22800,Not in chargemaster,22800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22800,BCBS multispecialty AW base fee schedule,2608.26,,Fee schedule,,,,,,119.25,140.39,0
unity,Fee schedule,Facility 22802,Not in chargemaster,22802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22802,BCBS multispecialty AW base fee schedule,4044.56,,Fee schedule,,,,,,119.91,141.94,0
unity,Fee schedule,Facility 22804,Not in chargemaster,22804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22804,BCBS multispecialty AW base fee schedule,4659.36,,Fee schedule,,,,,,118.59,159.78,0
unity,Fee schedule,Facility 22808,Not in chargemaster,22808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22808,BCBS multispecialty AW base fee schedule,3521.19,,Fee schedule,,,,,,80.83,125.65,0
unity,Fee schedule,Facility 22810,Not in chargemaster,22810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22810,BCBS multispecialty AW base fee schedule,3941.88,,Fee schedule,,,,,,129.85,152.02,0
unity,Fee schedule,Facility 22812,Not in chargemaster,22812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22812,BCBS multispecialty AW base fee schedule,4234.04,,Fee schedule,,,,,,153.04,169.58,0
unity,Fee schedule,Facility 22818,Not in chargemaster,22818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22818,BCBS multispecialty AW base fee schedule,4151.23,,Fee schedule,,,,,,200.74,236.57,0
unity,Fee schedule,Facility 22819,Not in chargemaster,22819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22819,BCBS multispecialty AW base fee schedule,4775.3,,Fee schedule,,,,,,112.63,132.64,0
unity,Fee schedule,Facility 22830,Not in chargemaster,22830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22830,BCBS multispecialty AW base fee schedule,1566.81,,Fee schedule,,,,,,139.79,162.89,0
unity,Fee schedule,Facility 22840,Not in chargemaster,22840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22840,BCBS multispecialty AW base fee schedule,1462.8,,Fee schedule,,,,,,215.31,260.62,0
unity,Fee schedule,Facility 22842,Not in chargemaster,22842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22842,BCBS multispecialty AW base fee schedule,1469.43,,Fee schedule,,,,,,17.23,20.17,0
unity,Fee schedule,Facility 22843,Not in chargemaster,22843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22843,BCBS multispecialty AW base fee schedule,1570.13,,Fee schedule,,,,,,20.54,24.05,0
unity,Fee schedule,Facility 22844,Not in chargemaster,22844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22844,BCBS multispecialty AW base fee schedule,1897.4,,Fee schedule,,,,,,25.84,30.25,0
unity,Fee schedule,Facility 22845,Not in chargemaster,22845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22845,BCBS multispecialty AW base fee schedule,1402.51,,Fee schedule,,,,,,18.34,33.77,0
unity,Fee schedule,Facility 22846,Not in chargemaster,22846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22846,BCBS multispecialty AW base fee schedule,1458.16,,Fee schedule,,,,,,21.2,24.82,0
unity,Fee schedule,Facility 22847,Not in chargemaster,22847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22847,BCBS multispecialty AW base fee schedule,1552.24,,Fee schedule,,,,,,25.18,29.48,0
unity,Fee schedule,Facility 22848,Not in chargemaster,22848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22848,BCBS multispecialty AW base fee schedule,693.64,,Fee schedule,,,,,,21.2,24.82,0
unity,Fee schedule,Facility 22849,Not in chargemaster,22849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22849,BCBS multispecialty AW base fee schedule,2500.94,,Fee schedule,,,,,,108.65,120.39,0
unity,Fee schedule,Facility 22850,Not in chargemaster,22850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22850,BCBS multispecialty AW base fee schedule,1397.21,,Fee schedule,,,,,,117.26,137.29,0
unity,Fee schedule,Facility 22852,Not in chargemaster,22852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22852,BCBS multispecialty AW base fee schedule,1341.56,,Fee schedule,,,,,,129.19,151.25,0
unity,Fee schedule,Facility 22853,Not in chargemaster,22853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22853,BCBS multispecialty AW base fee schedule,498.2,,Fee schedule,,,,,,15.24,17.06,0
unity,Fee schedule,Facility 22854,Not in chargemaster,22854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22854,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,21.2,31.41,0
unity,Fee schedule,Facility 22855,Not in chargemaster,22855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22855,BCBS multispecialty AW base fee schedule,2127.95,,Fee schedule,,,,,,25.84,35.68,0
unity,Fee schedule,Facility 22856,Not in chargemaster,22856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22856,BCBS multispecialty AW base fee schedule,3138.93,,Fee schedule,,,,,,19.21,24.82,0
unity,Fee schedule,Facility 22857,Not in chargemaster,22857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22857,BCBS multispecialty AW base fee schedule,3398.63,,Fee schedule,,,,,,21.86,24.23,0
unity,Fee schedule,Facility 22858,Not in chargemaster,22858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22858,BCBS multispecialty AW base fee schedule,984.48,,Fee schedule,,,,,,25.18,33,0
unity,Fee schedule,Facility 22859,Not in chargemaster,22859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22859,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,30.48,40.13,0
unity,Fee schedule,Facility 22861,Not in chargemaster,22861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22861,BCBS multispecialty AW base fee schedule,4438.09,,Fee schedule,,,,,,21.2,26.38,0
unity,Fee schedule,Facility 22862,Not in chargemaster,22862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22862,BCBS multispecialty AW base fee schedule,4425.5,,Fee schedule,,,,,,24.51,35.68,0
unity,Fee schedule,Facility 22864,Not in chargemaster,22864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22864,BCBS multispecialty AW base fee schedule,3957.78,,Fee schedule,,,,,,94.08,136.14,0
unity,Fee schedule,Facility 22865,Not in chargemaster,22865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22865,BCBS multispecialty AW base fee schedule,4318.18,,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 22867,Not in chargemaster,22867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22867,BCBS multispecialty AW base fee schedule,1873.55,,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 22868,Not in chargemaster,22868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22868,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,139.79,177.63,0
unity,Fee schedule,Facility 22869,Not in chargemaster,22869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22869,BCBS multispecialty AW base fee schedule,851.31,,Fee schedule,,,,,,139.79,177.63,0
unity,Fee schedule,Facility 22870,Not in chargemaster,22870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22870,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,139.79,203.5,0
unity,Fee schedule,Facility 22900,Not in chargemaster,22900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22900,BCBS multispecialty AW base fee schedule,1079.88,,Fee schedule,,,,,,215.31,284.66,0
unity,Fee schedule,Facility 22901,Not in chargemaster,22901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22901,BCBS multispecialty AW base fee schedule,1281.94,,Fee schedule,,,,,,215.31,291.08,0
unity,Fee schedule,Facility 22902,Not in chargemaster,22902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22902,BCBS multispecialty AW base fee schedule,634.01,,Fee schedule,,,,,,215.31,262.94,0
unity,Fee schedule,Facility 21925,Not in chargemaster,21925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21925,BCBS multispecialty AW base fee schedule,690.33,,Fee schedule,,,,,,16.56,27.5,0
unity,Fee schedule,Facility 21930,Not in chargemaster,21930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21930,BCBS multispecialty AW base fee schedule,694.3,,Fee schedule,,,,,,102.03,138.82,0
unity,Fee schedule,Facility 22315,Not in chargemaster,22315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22315,BCBS multispecialty AW base fee schedule,1471.41,,Fee schedule,,,,,,108.65,148.68,0
unity,Fee schedule,Facility 22511,Not in chargemaster,22511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22511,BCBS multispecialty AW base fee schedule,776.45,,Fee schedule,,,,,,114.61,134.19,0
unity,Fee schedule,Facility 22512,Not in chargemaster,22512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22512,BCBS multispecialty AW base fee schedule,394.85,,Fee schedule,,,,,,205.38,248.2,0
unity,Fee schedule,Facility 22513,Not in chargemaster,22513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22513,BCBS multispecialty AW base fee schedule,982.49,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 22514,Not in chargemaster,22514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22514,BCBS multispecialty AW base fee schedule,916.24,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 22515,Not in chargemaster,22515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22515,BCBS multispecialty AW base fee schedule,423.34,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 22526,Not in chargemaster,22526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22526,BCBS multispecialty AW base fee schedule,625.4,,Fee schedule,,,,,,17.23,21.71,0
unity,Fee schedule,Facility 22527,Not in chargemaster,22527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22527,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,14.58,17.06,0
unity,Fee schedule,Facility 22903,Not in chargemaster,22903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22903,BCBS multispecialty AW base fee schedule,842.7,,Fee schedule,,,,,,17.89,22.5,0
unity,Fee schedule,Facility 22904,Not in chargemaster,22904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22904,BCBS multispecialty AW base fee schedule,2022.61,,Fee schedule,,,,,,15.9,19.39,0
unity,Fee schedule,Facility 22905,Not in chargemaster,22905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22905,BCBS multispecialty AW base fee schedule,2555.93,,Fee schedule,,,,,,15.9,17.83,0
unity,Fee schedule,Facility 23000,Not in chargemaster,23000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23000,BCBS multispecialty AW base fee schedule,697.61,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 23020,Not in chargemaster,23020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23020,BCBS multispecialty AW base fee schedule,1319.7,,Fee schedule,,,,,,15.24,18.62,0
unity,Fee schedule,Facility 23030,Not in chargemaster,23030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23030,BCBS multispecialty AW base fee schedule,475.68,,Fee schedule,,,,,,15.9,20.94,0
unity,Fee schedule,Facility 23031,Not in chargemaster,23031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23031,BCBS multispecialty AW base fee schedule,398.16,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 23035,Not in chargemaster,23035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23035,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 23040,Not in chargemaster,23040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23040,BCBS multispecialty AW base fee schedule,1372.04,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 23044,Not in chargemaster,23044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23044,BCBS multispecialty AW base fee schedule,1081.86,,Fee schedule,,,,,,13.25,17.91,0
unity,Fee schedule,Facility 23065,Not in chargemaster,23065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23065,BCBS multispecialty AW base fee schedule,312.04,,Fee schedule,,,,,,94.08,111.69,0
unity,Fee schedule,Facility 23076,Not in chargemaster,23076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23076,BCBS multispecialty AW base fee schedule,1035.49,,Fee schedule,,,,,,129.19,152.02,0
unity,Fee schedule,Facility 23077,Not in chargemaster,23077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23077,BCBS multispecialty AW base fee schedule,2169.69,,Fee schedule,,,,,,15.9,21.71,0
unity,Fee schedule,Facility 23078,Not in chargemaster,23078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23078,BCBS multispecialty AW base fee schedule,2756.66,,Fee schedule,,,,,,17.89,22.5,0
unity,Fee schedule,Facility 23100,Not in chargemaster,23100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23100,BCBS multispecialty AW base fee schedule,960.63,,Fee schedule,,,,,,21.2,27.15,0
unity,Fee schedule,Facility 23101,Not in chargemaster,23101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23101,BCBS multispecialty AW base fee schedule,871.85,,Fee schedule,,,,,,16.56,21.71,0
unity,Fee schedule,Facility 23105,Not in chargemaster,23105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23105,BCBS multispecialty AW base fee schedule,1215.69,,Fee schedule,,,,,,15.24,19.39,0
unity,Fee schedule,Facility 23106,Not in chargemaster,23106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23106,BCBS multispecialty AW base fee schedule,952.68,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 23107,Not in chargemaster,23107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23107,BCBS multispecialty AW base fee schedule,1260.74,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 23120,Not in chargemaster,23120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23120,BCBS multispecialty AW base fee schedule,1116.98,,Fee schedule,,,,,,14.58,17.06,0
unity,Fee schedule,Facility 23125,Not in chargemaster,23125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23125,BCBS multispecialty AW base fee schedule,1356.8,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 23130,Not in chargemaster,23130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23130,BCBS multispecialty AW base fee schedule,1171.3,,Fee schedule,,,,,,15.24,17.83,0
unity,Fee schedule,Facility 23140,Not in chargemaster,23140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23140,BCBS multispecialty AW base fee schedule,1057.35,,Fee schedule,,,,,,12.59,14.74,0
unity,Fee schedule,Facility 23145,Not in chargemaster,23145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23145,BCBS multispecialty AW base fee schedule,1329.64,,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 23146,Not in chargemaster,23146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23146,BCBS multispecialty AW base fee schedule,1188.53,,Fee schedule,,,,,,108.65,148.68,0
unity,Fee schedule,Facility 23150,Not in chargemaster,23150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23150,BCBS multispecialty AW base fee schedule,1274.65,,Fee schedule,,,,,,126.54,148.93,0
unity,Fee schedule,Facility 23155,Not in chargemaster,23155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23155,BCBS multispecialty AW base fee schedule,1521.76,,Fee schedule,,,,,,200.74,236.57,0
unity,Fee schedule,Facility 23156,Not in chargemaster,23156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23156,BCBS multispecialty AW base fee schedule,1296.51,,Fee schedule,,,,,,127.2,152.02,0
unity,Fee schedule,Facility 23170,Not in chargemaster,23170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23170,BCBS multispecialty AW base fee schedule,1073.25,,Fee schedule,,,,,,17.23,20.17,0
unity,Fee schedule,Facility 23172,Not in chargemaster,23172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23172,BCBS multispecialty AW base fee schedule,1084.51,,Fee schedule,,,,,,21.86,29.48,0
unity,Fee schedule,Facility 23174,Not in chargemaster,23174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23174,BCBS multispecialty AW base fee schedule,1452.86,,Fee schedule,,,,,,25.18,34.89,0
unity,Fee schedule,Facility 23180,Not in chargemaster,23180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23180,BCBS multispecialty AW base fee schedule,1271.34,,Fee schedule,,,,,,29.81,34.9,0
unity,Fee schedule,Facility 23182,Not in chargemaster,23182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23182,BCBS multispecialty AW base fee schedule,1259.41,,Fee schedule,,,,,,111.96,151.95,0
unity,Fee schedule,Facility 23184,Not in chargemaster,23184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23184,BCBS multispecialty AW base fee schedule,1410.46,,Fee schedule,,,,,,119.91,162.11,0
unity,Fee schedule,Facility 23190,Not in chargemaster,23190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23190,BCBS multispecialty AW base fee schedule,1095.78,,Fee schedule,,,,,,131.84,179.12,0
unity,Fee schedule,Facility 23195,Not in chargemaster,23195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23195,BCBS multispecialty AW base fee schedule,1429.68,,Fee schedule,,,,,,163.64,222.11,0
unity,Fee schedule,Facility 23200,Not in chargemaster,23200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23200,BCBS multispecialty AW base fee schedule,2891.81,,Fee schedule,,,,,,171.59,232.86,0
unity,Fee schedule,Facility 23210,Not in chargemaster,23210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23210,BCBS multispecialty AW base fee schedule,3397.96,,Fee schedule,,,,,,188.15,255.26,0
unity,Fee schedule,Facility 23220,Not in chargemaster,23220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23220,BCBS multispecialty AW base fee schedule,3735.84,,Fee schedule,,,,,,137.8,160.56,0
unity,Fee schedule,Facility 23330,Not in chargemaster,23330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23330,BCBS multispecialty AW base fee schedule,316.68,,Fee schedule,,,,,,205.38,248.2,0
unity,Fee schedule,Facility 23395,Not in chargemaster,23395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23395,BCBS multispecialty AW base fee schedule,2456.55,,Fee schedule,,,,,,167.61,227.52,0
unity,Fee schedule,Facility 23397,Not in chargemaster,23397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23397,BCBS multispecialty AW base fee schedule,2185.59,,Fee schedule,,,,,,33.79,46.57,0
unity,Fee schedule,Facility 23400,Not in chargemaster,23400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23400,BCBS multispecialty AW base fee schedule,1860.3,,Fee schedule,,,,,,53,62.05,0
unity,Fee schedule,Facility 23405,Not in chargemaster,23405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23405,BCBS multispecialty AW base fee schedule,1184.55,,Fee schedule,,,,,,76.85,89.2,0
unity,Fee schedule,Facility 23406,Not in chargemaster,23406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23406,BCBS multispecialty AW base fee schedule,1470.75,,Fee schedule,,,,,,54.99,60.93,0
unity,Fee schedule,Facility 23410,Not in chargemaster,23410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23410,BCBS multispecialty AW base fee schedule,1568.8,,Fee schedule,,,,,,68.9,81.44,0
unity,Fee schedule,Facility 23412,Not in chargemaster,23412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23412,BCBS multispecialty AW base fee schedule,1631.08,,Fee schedule,,,,,,54.33,63.61,0
unity,Fee schedule,Facility 23415,Not in chargemaster,23415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23415,BCBS multispecialty AW base fee schedule,1332.29,,Fee schedule,,,,,,93.41,109.37,0
unity,Fee schedule,Facility 23420,Not in chargemaster,23420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23420,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,93.41,110.14,0
unity,Fee schedule,Facility 23430,Not in chargemaster,23430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23430,BCBS multispecialty AW base fee schedule,1423.71,,Fee schedule,,,,,,92.75,108.58,0
unity,Fee schedule,Facility 23440,Not in chargemaster,23440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23440,BCBS multispecialty AW base fee schedule,1446.24,,Fee schedule,,,,,,60.95,70.58,0
unity,Fee schedule,Facility 23450,Not in chargemaster,23450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23450,BCBS multispecialty AW base fee schedule,1814.59,,Fee schedule,,,,,,70.23,83.77,0
unity,Fee schedule,Facility 23455,Not in chargemaster,23455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23455,BCBS multispecialty AW base fee schedule,1902.7,,Fee schedule,,,,,,64.93,76.79,0
unity,Fee schedule,Facility 23460,Not in chargemaster,23460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23460,BCBS multispecialty AW base fee schedule,2085.55,,Fee schedule,,,,,,64.26,76.01,0
unity,Fee schedule,Facility 23462,Not in chargemaster,23462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23462,BCBS multispecialty AW base fee schedule,2047.13,,Fee schedule,,,,,,59.63,70.58,0
unity,Fee schedule,Facility 23465,Not in chargemaster,23465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23465,BCBS multispecialty AW base fee schedule,2141.86,,Fee schedule,,,,,,27.16,33.38,0
unity,Fee schedule,Facility 23466,Not in chargemaster,23466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23466,BCBS multispecialty AW base fee schedule,2122.65,,Fee schedule,,,,,,59.63,74.91,0
unity,Fee schedule,Facility 23470,Not in chargemaster,23470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23470,BCBS multispecialty AW base fee schedule,2300.2,,Fee schedule,,,,,,76.85,103.4,0
unity,Fee schedule,Facility 23472,Not in chargemaster,23472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23472,BCBS multispecialty AW base fee schedule,2781.18,,Fee schedule,,,,,,94.08,127.6,0
unity,Fee schedule,Facility 23473,Not in chargemaster,23473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23473,BCBS multispecialty AW base fee schedule,3102.49,,Fee schedule,,,,,,72.21,91.21,0
unity,Fee schedule,Facility 23474,Not in chargemaster,23474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23474,BCBS multispecialty AW base fee schedule,3352.25,,Fee schedule,,,,,,18.55,22.5,0
unity,Fee schedule,Facility 23480,Not in chargemaster,23480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23480,BCBS multispecialty AW base fee schedule,1570.13,,Fee schedule,,,,,,58.3,79.71,0
unity,Fee schedule,Facility 23485,Not in chargemaster,23485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23485,BCBS multispecialty AW base fee schedule,1831.15,,Fee schedule,,,,,,77.51,104.8,0
unity,Fee schedule,Facility 23490,Not in chargemaster,23490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23490,BCBS multispecialty AW base fee schedule,1648.3,,Fee schedule,,,,,,80.16,108.37,0
unity,Fee schedule,Facility 23491,Not in chargemaster,23491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23491,BCBS multispecialty AW base fee schedule,1943.78,,Fee schedule,,,,,,68.24,93.14,0
unity,Fee schedule,Facility 23500,23500,23500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23500,BCBS multispecialty AW base fee schedule,427.31,467.8,Fee schedule,,427.31,427.31,427.31,427.31,24.8,33.57,0
unity,Fee schedule,Facility 23505,Not in chargemaster,23505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23505,BCBS multispecialty AW base fee schedule,636.66,,Fee schedule,,,,,,21,26.43,0
unity,Fee schedule,Facility 23071,Not in chargemaster,23071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23071,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,24.8,40.47,0
unity,Fee schedule,Facility 23073,Not in chargemaster,23073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23073,BCBS multispecialty AW base fee schedule,1332.95,,Fee schedule,,,,,,182.71,243.61,0
unity,Fee schedule,Facility 23075,Not in chargemaster,23075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23075,BCBS multispecialty AW base fee schedule,625.4,,Fee schedule,,,,,,59.91,68,0
unity,Fee schedule,Facility 23333,Not in chargemaster,23333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23333,BCBS multispecialty AW base fee schedule,885.76,,Fee schedule,,,,,,35.42,48.56,0
unity,Fee schedule,Facility 23334,Not in chargemaster,23334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23334,BCBS multispecialty AW base fee schedule,2041.83,,Fee schedule,,,,,,17.36,17.72,0
unity,Fee schedule,Facility 23335,Not in chargemaster,23335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23335,BCBS multispecialty AW base fee schedule,2434.69,,Fee schedule,,,,,,232.36,336.48,0
unity,Fee schedule,Facility 23350,Not in chargemaster,23350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23350,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,60.98,63.8,0
unity,Fee schedule,Facility 23515,Not in chargemaster,23515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23515,BCBS multispecialty AW base fee schedule,1376.01,,Fee schedule,,,,,,214.62,299.22,0
unity,Fee schedule,Facility 23520,Not in chargemaster,23520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23520,BCBS multispecialty AW base fee schedule,448.51,,Fee schedule,,,,,,277.82,840.17,0
unity,Fee schedule,Facility 23525,Not in chargemaster,23525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23525,BCBS multispecialty AW base fee schedule,683.7,,Fee schedule,,,,,,86.09,125.58,0
unity,Fee schedule,Facility 23530,Not in chargemaster,23530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23530,BCBS multispecialty AW base fee schedule,1096.44,,Fee schedule,,,,,,21.13,25,0
unity,Fee schedule,Facility 23532,Not in chargemaster,23532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23532,BCBS multispecialty AW base fee schedule,1194.49,,Fee schedule,,,,,,19.58,25,0
unity,Fee schedule,Facility 23540,Not in chargemaster,23540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23540,BCBS multispecialty AW base fee schedule,439.9,,Fee schedule,,,,,,54.18,76.21,0
unity,Fee schedule,Facility 23545,Not in chargemaster,23545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23545,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,0.01,25.51,0
unity,Fee schedule,Facility 23550,Not in chargemaster,23550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23550,BCBS multispecialty AW base fee schedule,1094.45,,Fee schedule,,,,,,79.87,116.53,0
unity,Fee schedule,Facility 23552,Not in chargemaster,23552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23552,BCBS multispecialty AW base fee schedule,1248.15,,Fee schedule,,,,,,228.93,334.41,0
unity,Fee schedule,Facility 23570,Not in chargemaster,23570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23570,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,0.01,34.11,0
unity,Fee schedule,Facility 23575,Not in chargemaster,23575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23575,BCBS multispecialty AW base fee schedule,718.15,,Fee schedule,,,,,,25.11,49.68,0
unity,Fee schedule,Facility 23066,Not in chargemaster,23066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23066,BCBS multispecialty AW base fee schedule,689,,Fee schedule,,,,,,33.64,61.93,0
unity,Fee schedule,Facility 23585,Not in chargemaster,23585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23585,BCBS multispecialty AW base fee schedule,1874.21,,Fee schedule,,,,,,138.31,192.39,0
unity,Fee schedule,Facility 23600,Not in chargemaster,23600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23600,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,83.94,117.43,0
unity,Fee schedule,Facility 23615,Not in chargemaster,23615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23615,BCBS multispecialty AW base fee schedule,1689.38,,Fee schedule,,,,,,114.21,158.87,0
unity,Fee schedule,Facility 23616,Not in chargemaster,23616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23616,BCBS multispecialty AW base fee schedule,2369.1,,Fee schedule,,,,,,125.5,174.84,0
unity,Fee schedule,Facility 23620,Not in chargemaster,23620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23620,BCBS multispecialty AW base fee schedule,490.25,,Fee schedule,,,,,,26.9,28,0
unity,Fee schedule,Facility 23605,Not in chargemaster,23605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23605,BCBS multispecialty AW base fee schedule,812.23,,Fee schedule,,,,,,67.06,88.17,0
unity,Fee schedule,Facility 23625,Not in chargemaster,23625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23625,BCBS multispecialty AW base fee schedule,669.79,,Fee schedule,,,,,,154.44,224.43,0
unity,Fee schedule,Facility 23655,23655,23655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23655,BCBS multispecialty AW base fee schedule,771.15,839.77,Fee schedule,,771.15,771.15,771.15,771.15,3.05,3.05,0
unity,Fee schedule,Facility 23660,Not in chargemaster,23660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23660,BCBS multispecialty AW base fee schedule,1116.31,,Fee schedule,,,,,,0.82,1.14,0
unity,Fee schedule,Facility 23665,Not in chargemaster,23665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23665,BCBS multispecialty AW base fee schedule,755.91,,Fee schedule,,,,,,13.76,34.03,0
unity,Fee schedule,Facility 23630,Not in chargemaster,23630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23630,BCBS multispecialty AW base fee schedule,1489.96,,Fee schedule,,,,,,0.6,33,0
unity,Fee schedule,Facility 23650,23650,23650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23650,BCBS multispecialty AW base fee schedule,553.85,672.96,Fee schedule,,553.85,553.85,553.85,553.85,6.29,39.85,0
unity,Fee schedule,Facility 23670,Not in chargemaster,23670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23670,BCBS multispecialty AW base fee schedule,1670.83,,Fee schedule,,,,,,11.9,50.74,0
unity,Fee schedule,Facility 23675,Not in chargemaster,23675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23675,BCBS multispecialty AW base fee schedule,957.98,,Fee schedule,,,,,,0.51,0.56,0
unity,Fee schedule,Facility 23680,Not in chargemaster,23680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23680,BCBS multispecialty AW base fee schedule,1778.81,,Fee schedule,,,,,,0.03,0.11,0
unity,Fee schedule,Facility 23700,Not in chargemaster,23700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23700,BCBS multispecialty AW base fee schedule,372.99,,Fee schedule,,,,,,0.12,24.2,0
unity,Fee schedule,Facility 23800,Not in chargemaster,23800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23800,BCBS multispecialty AW base fee schedule,1964.98,,Fee schedule,,,,,,0.9,2.71,0
unity,Fee schedule,Facility 23802,Not in chargemaster,23802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23802,BCBS multispecialty AW base fee schedule,2453.24,,Fee schedule,,,,,,0.52,5.44,0
unity,Fee schedule,Facility 23900,Not in chargemaster,23900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23900,BCBS multispecialty AW base fee schedule,2655.96,,Fee schedule,,,,,,0.59,2.09,0
unity,Fee schedule,Facility 23920,Not in chargemaster,23920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23920,BCBS multispecialty AW base fee schedule,2151.14,,Fee schedule,,,,,,0.7,23.93,0
unity,Fee schedule,Facility 23921,Not in chargemaster,23921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23921,BCBS multispecialty AW base fee schedule,895.04,,Fee schedule,,,,,,0.09,1.14,0
unity,Fee schedule,Facility 23930,Not in chargemaster,23930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23930,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,1.2,3.41,0
unity,Fee schedule,Facility 24076,Not in chargemaster,24076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24076,BCBS multispecialty AW base fee schedule,1039.46,,Fee schedule,,,,,,4.76,192.5,0
unity,Fee schedule,Facility 24077,Not in chargemaster,24077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24077,BCBS multispecialty AW base fee schedule,1994.13,,Fee schedule,,,,,,4.58,5.5,0
unity,Fee schedule,Facility 24079,Not in chargemaster,24079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24079,BCBS multispecialty AW base fee schedule,2542.01,,Fee schedule,,,,,,6.32,7.25,0
unity,Fee schedule,Facility 24100,Not in chargemaster,24100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24100,BCBS multispecialty AW base fee schedule,798.31,,Fee schedule,,,,,,1.56,10.75,0
unity,Fee schedule,Facility 24101,Not in chargemaster,24101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24101,BCBS multispecialty AW base fee schedule,957.31,,Fee schedule,,,,,,1.65,13.72,0
unity,Fee schedule,Facility 24102,Not in chargemaster,24102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24102,BCBS multispecialty AW base fee schedule,1177.93,,Fee schedule,,,,,,2.21,10,0
unity,Fee schedule,Facility 24105,Not in chargemaster,24105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24105,BCBS multispecialty AW base fee schedule,674.43,,Fee schedule,,,,,,972.58,1200,0
unity,Fee schedule,Facility 24110,Not in chargemaster,24110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24110,BCBS multispecialty AW base fee schedule,1121.61,,Fee schedule,,,,,,902.19,2301.2,0
unity,Fee schedule,Facility 24115,Not in chargemaster,24115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24115,BCBS multispecialty AW base fee schedule,1409.8,,Fee schedule,,,,,,953.51,990,0
unity,Fee schedule,Facility 24116,Not in chargemaster,24116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24116,BCBS multispecialty AW base fee schedule,1647.64,,Fee schedule,,,,,,392.37,522.5,0
unity,Fee schedule,Facility 24120,Not in chargemaster,24120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24120,BCBS multispecialty AW base fee schedule,1016.28,,Fee schedule,,,,,,144.69,878.13,0
unity,Fee schedule,Facility 24125,Not in chargemaster,24125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24125,BCBS multispecialty AW base fee schedule,1187.2,,Fee schedule,,,,,,0.04,3.85,0
unity,Fee schedule,Facility 24126,Not in chargemaster,24126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24126,BCBS multispecialty AW base fee schedule,1240.2,,Fee schedule,,,,,,0.13,3.85,0
unity,Fee schedule,Facility 24130,Not in chargemaster,24130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24130,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,241.58,301.85,0
unity,Fee schedule,Facility 24134,Not in chargemaster,24134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24134,BCBS multispecialty AW base fee schedule,1429.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24136,Not in chargemaster,24136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24136,BCBS multispecialty AW base fee schedule,1207.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24138,Not in chargemaster,24138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24138,BCBS multispecialty AW base fee schedule,1299.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24140,Not in chargemaster,24140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24140,BCBS multispecialty AW base fee schedule,1343.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24145,Not in chargemaster,24145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24145,BCBS multispecialty AW base fee schedule,1134.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24147,Not in chargemaster,24147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24147,BCBS multispecialty AW base fee schedule,1191.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24149,Not in chargemaster,24149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24149,BCBS multispecialty AW base fee schedule,2244.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24150,Not in chargemaster,24150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24150,BCBS multispecialty AW base fee schedule,2968.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24152,Not in chargemaster,24152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24152,BCBS multispecialty AW base fee schedule,2578.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24155,Not in chargemaster,24155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24155,BCBS multispecialty AW base fee schedule,1630.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24160,Not in chargemaster,24160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24160,BCBS multispecialty AW base fee schedule,2407.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24164,Not in chargemaster,24164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24164,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24200,Not in chargemaster,24200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24200,BCBS multispecialty AW base fee schedule,268.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24300,Not in chargemaster,24300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24300,BCBS multispecialty AW base fee schedule,811.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24301,Not in chargemaster,24301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24301,BCBS multispecialty AW base fee schedule,1432.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24305,Not in chargemaster,24305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24305,BCBS multispecialty AW base fee schedule,1106.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24310,Not in chargemaster,24310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24310,BCBS multispecialty AW base fee schedule,900.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24320,Not in chargemaster,24320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24320,BCBS multispecialty AW base fee schedule,1493.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24330,Not in chargemaster,24330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24330,BCBS multispecialty AW base fee schedule,1372.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24331,Not in chargemaster,24331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24331,BCBS multispecialty AW base fee schedule,1503.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24332,Not in chargemaster,24332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24332,BCBS multispecialty AW base fee schedule,1171.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24340,Not in chargemaster,24340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24340,BCBS multispecialty AW base fee schedule,"$1,173.95 ",,Fee schedule,,,,,,24.8,40.47,0
unity,Fee schedule,Facility 24341,Not in chargemaster,24341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24341,BCBS multispecialty AW base fee schedule,"$1,422.39 ",,Fee schedule,,,,,,21,26.43,0
unity,Fee schedule,Facility 24342,Not in chargemaster,24342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24342,BCBS multispecialty AW base fee schedule,"$1,483.34 ",,Fee schedule,,,,,,24.8,33.57,0
unity,Fee schedule,Facility 24343,Not in chargemaster,24343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24343,BCBS multispecialty AW base fee schedule,"$1,352.83 ",,Fee schedule,,,,,,68.24,93.14,0
unity,Fee schedule,Facility 24344,Not in chargemaster,24344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24344,BCBS multispecialty AW base fee schedule,"$2,091.51 ",,Fee schedule,,,,,,80.16,108.37,0
unity,Fee schedule,Facility 24345,Not in chargemaster,24345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24345,BCBS multispecialty AW base fee schedule,"$1,340.90 ",,Fee schedule,,,,,,77.51,104.8,0
unity,Fee schedule,Facility 24346,Not in chargemaster,24346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24346,BCBS multispecialty AW base fee schedule,"$2,104.76 ",,Fee schedule,,,,,,58.3,79.71,0
unity,Fee schedule,Facility 24357,Not in chargemaster,24357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24357,BCBS multispecialty AW base fee schedule,$793.68 ,,Fee schedule,,,,,,18.55,22.5,0
unity,Fee schedule,Facility 24358,Not in chargemaster,24358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24358,BCBS multispecialty AW base fee schedule,"$1,005.01 ",,Fee schedule,,,,,,72.21,91.21,0
unity,Fee schedule,Facility 24359,Not in chargemaster,24359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24359,BCBS multispecialty AW base fee schedule,"$1,264.71 ",,Fee schedule,,,,,,94.08,127.6,0
unity,Fee schedule,Facility 24360,Not in chargemaster,24360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24360,BCBS multispecialty AW base fee schedule,"$1,724.49 ",,Fee schedule,,,,,,76.85,103.4,0
unity,Fee schedule,Facility 24361,Not in chargemaster,24361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24361,BCBS multispecialty AW base fee schedule,"$1,927.88 ",,Fee schedule,,,,,,59.63,74.91,0
unity,Fee schedule,Facility 24362,Not in chargemaster,24362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24362,BCBS multispecialty AW base fee schedule,"$2,029.90 ",,Fee schedule,,,,,,27.16,33.38,0
unity,Fee schedule,Facility 24363,Not in chargemaster,24363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24363,BCBS multispecialty AW base fee schedule,"$2,781.84 ",,Fee schedule,,,,,,59.63,70.58,0
unity,Fee schedule,Facility 24365,Not in chargemaster,24365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24365,BCBS multispecialty AW base fee schedule,"$1,222.98 ",,Fee schedule,,,,,,64.26,76.01,0
unity,Fee schedule,Facility 24366,Not in chargemaster,24366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24366,BCBS multispecialty AW base fee schedule,"$1,305.79 ",,Fee schedule,,,,,,64.93,76.79,0
unity,Fee schedule,Facility 24370,Not in chargemaster,24370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24370,BCBS multispecialty AW base fee schedule,"$2,957.40 ",,Fee schedule,,,,,,70.23,83.77,0
unity,Fee schedule,Facility 24371,Not in chargemaster,24371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24371,BCBS multispecialty AW base fee schedule,"$3,411.88 ",,Fee schedule,,,,,,60.95,70.58,0
unity,Fee schedule,Facility 24400,Not in chargemaster,24400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24400,BCBS multispecialty AW base fee schedule,"$1,574.10 ",,Fee schedule,,,,,,92.75,108.58,0
unity,Fee schedule,Facility 24410,Not in chargemaster,24410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24410,BCBS multispecialty AW base fee schedule,"$2,023.28 ",,Fee schedule,,,,,,93.41,110.14,0
unity,Fee schedule,Facility 24420,Not in chargemaster,24420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24420,BCBS multispecialty AW base fee schedule,"$1,960.34 ",,Fee schedule,,,,,,93.41,109.37,0
unity,Fee schedule,Facility 24430,Not in chargemaster,24430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24430,BCBS multispecialty AW base fee schedule,"$2,020.63 ",,Fee schedule,,,,,,54.33,63.61,0
unity,Fee schedule,Facility 24435,Not in chargemaster,24435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24435,BCBS multispecialty AW base fee schedule,"$2,056.40 ",,Fee schedule,,,,,,68.9,81.44,0
unity,Fee schedule,Facility 24470,Not in chargemaster,24470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24470,BCBS multispecialty AW base fee schedule,"$1,283.26 ",,Fee schedule,,,,,,54.99,60.93,0
unity,Fee schedule,Facility 24495,Not in chargemaster,24495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24495,BCBS multispecialty AW base fee schedule,"$1,551.58 ",,Fee schedule,,,,,,76.85,89.2,0
unity,Fee schedule,Facility 24498,Not in chargemaster,24498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24498,BCBS multispecialty AW base fee schedule,"$1,657.58 ",,Fee schedule,,,,,,53,62.05,0
unity,Fee schedule,Facility 24500,24500,24500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24500,BCBS multispecialty AW base fee schedule,$626.73 ,764.53,Fee schedule,,626.73,626.73,626.73,626.73,33.79,46.57,0
unity,Fee schedule,Facility 23935,Not in chargemaster,23935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23935,BCBS multispecialty AW base fee schedule,$976.53 ,,Fee schedule,,,,,,167.61,227.52,0
unity,Fee schedule,Facility 24000,Not in chargemaster,24000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24000,BCBS multispecialty AW base fee schedule,$912.93 ,,Fee schedule,,,,,,205.38,248.2,0
unity,Fee schedule,Facility 24006,Not in chargemaster,24006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24006,BCBS multispecialty AW base fee schedule,"$1,360.11 ",,Fee schedule,,,,,,137.8,160.56,0
unity,Fee schedule,Facility 24065,Not in chargemaster,24065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24065,BCBS multispecialty AW base fee schedule,$312.04 ,,Fee schedule,,,,,,188.15,255.26,0
unity,Fee schedule,Facility 23931,Not in chargemaster,23931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23931,BCBS multispecialty AW base fee schedule,$296.14 ,,Fee schedule,,,,,,171.59,232.86,0
unity,Fee schedule,Facility 24066,Not in chargemaster,24066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24066,BCBS multispecialty AW base fee schedule,$793.01 ,,Fee schedule,,,,,,163.64,222.11,0
unity,Fee schedule,Facility 24071,Not in chargemaster,24071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24071,BCBS multispecialty AW base fee schedule,$777.11 ,,Fee schedule,,,,,,131.84,179.12,0
unity,Fee schedule,Facility 24073,24073,24073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24073,BCBS multispecialty AW base fee schedule,"$1,332.95 ",1450.26,Fee schedule,,1332.95,1332.95,1332.95,1332.95,119.91,162.11,0
unity,Fee schedule,Facility 24075,Not in chargemaster,24075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24075,BCBS multispecialty AW base fee schedule,$627.39 ,,Fee schedule,,,,,,111.96,151.95,0
unity,Fee schedule,Facility 24201,Not in chargemaster,24201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24201,BCBS multispecialty AW base fee schedule,$692.31 ,,Fee schedule,,,,,,29.81,34.9,0
unity,Fee schedule,Facility 24220,Not in chargemaster,24220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24220,BCBS multispecialty AW base fee schedule,$129.19 ,,Fee schedule,,,,,,25.18,34.89,0
unity,Fee schedule,Facility 24515,Not in chargemaster,24515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24515,BCBS multispecialty AW base fee schedule,"$1,680.76 ",,Fee schedule,,,,,,21.86,29.48,0
unity,Fee schedule,Facility 24516,Not in chargemaster,24516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24516,BCBS multispecialty AW base fee schedule,"$1,643.00 ",,Fee schedule,,,,,,17.23,20.17,0
unity,Fee schedule,Facility 24530,Not in chargemaster,24530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24530,BCBS multispecialty AW base fee schedule,$659.85 ,,Fee schedule,,,,,,127.2,152.02,0
unity,Fee schedule,Facility 24505,Not in chargemaster,24505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24505,BCBS multispecialty AW base fee schedule,$857.28 ,,Fee schedule,,,,,,200.74,236.57,0
unity,Fee schedule,Facility 24535,Not in chargemaster,24535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24535,BCBS multispecialty AW base fee schedule,"$1,082.53 ",,Fee schedule,,,,,,126.54,148.93,0
unity,Fee schedule,Facility 24538,Not in chargemaster,24538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24538,BCBS multispecialty AW base fee schedule,"$1,458.16 ",,Fee schedule,,,,,,108.65,148.68,0
unity,Fee schedule,Facility 24545,Not in chargemaster,24545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24545,BCBS multispecialty AW base fee schedule,"$1,778.15 ",,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 24546,Not in chargemaster,24546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24546,BCBS multispecialty AW base fee schedule,"$1,986.18 ",,Fee schedule,,,,,,12.59,14.74,0
unity,Fee schedule,Facility 24560,Not in chargemaster,24560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24560,BCBS multispecialty AW base fee schedule,$557.16 ,,Fee schedule,,,,,,15.24,17.83,0
unity,Fee schedule,Facility 24566,Not in chargemaster,24566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24566,BCBS multispecialty AW base fee schedule,"$1,372.04 ",,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 24575,Not in chargemaster,24575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24575,BCBS multispecialty AW base fee schedule,"$1,399.86 ",,Fee schedule,,,,,,14.58,17.06,0
unity,Fee schedule,Facility 24576,Not in chargemaster,24576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24576,BCBS multispecialty AW base fee schedule,$588.30 ,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 24565,Not in chargemaster,24565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24565,BCBS multispecialty AW base fee schedule,$937.44 ,,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 24577,Not in chargemaster,24577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24577,BCBS multispecialty AW base fee schedule,$963.28 ,,Fee schedule,,,,,,15.24,19.39,0
unity,Fee schedule,Facility 24579,Not in chargemaster,24579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24579,BCBS multispecialty AW base fee schedule,"$1,590.00 ",,Fee schedule,,,,,,16.56,21.71,0
unity,Fee schedule,Facility 24582,Not in chargemaster,24582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24582,BCBS multispecialty AW base fee schedule,"$1,547.60 ",,Fee schedule,,,,,,21.2,27.15,0
unity,Fee schedule,Facility 24586,Not in chargemaster,24586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24586,BCBS multispecialty AW base fee schedule,"$2,080.91 ",,Fee schedule,,,,,,17.89,22.5,0
unity,Fee schedule,Facility 24587,Not in chargemaster,24587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24587,BCBS multispecialty AW base fee schedule,"$2,082.24 ",,Fee schedule,,,,,,15.9,21.71,0
unity,Fee schedule,Facility 24600,Not in chargemaster,24600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24600,BCBS multispecialty AW base fee schedule,$643.29 ,,Fee schedule,,,,,,129.19,152.02,0
unity,Fee schedule,Facility 24605,Not in chargemaster,24605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24605,BCBS multispecialty AW base fee schedule,$903.65 ,,Fee schedule,,,,,,94.08,111.69,0
unity,Fee schedule,Facility 24615,Not in chargemaster,24615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24615,BCBS multispecialty AW base fee schedule,"$1,364.75 ",,Fee schedule,,,,,,13.25,17.91,0
unity,Fee schedule,Facility 24620,Not in chargemaster,24620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24620,BCBS multispecialty AW base fee schedule,"$1,059.34 ",,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 24635,Not in chargemaster,24635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24635,BCBS multispecialty AW base fee schedule,"$1,287.24 ",,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 24640,24640,24640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24640,BCBS multispecialty AW base fee schedule,$149.73 ,305.95,Fee schedule,,149.73,149.73,149.73,149.73,16.56,19.39,0
unity,Fee schedule,Facility 24650,24650,24650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24650,BCBS multispecialty AW base fee schedule,$461.10 ,560.79,Fee schedule,,461.1,461.1,461.1,461.1,15.9,20.94,0
unity,Fee schedule,Facility 24655,Not in chargemaster,24655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24655,BCBS multispecialty AW base fee schedule,$760.55 ,,Fee schedule,,,,,,15.24,18.62,0
unity,Fee schedule,Facility 24685,Not in chargemaster,24685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24685,BCBS multispecialty AW base fee schedule,"$1,248.15 ",,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 24800,Not in chargemaster,24800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24800,BCBS multispecialty AW base fee schedule,"$1,589.34 ",,Fee schedule,,,,,,15.9,17.83,0
unity,Fee schedule,Facility 24802,Not in chargemaster,24802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24802,BCBS multispecialty AW base fee schedule,"$1,917.94 ",,Fee schedule,,,,,,15.9,19.39,0
unity,Fee schedule,Facility 24900,Not in chargemaster,24900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24900,BCBS multispecialty AW base fee schedule,"$1,411.13 ",,Fee schedule,,,,,,17.89,22.5,0
unity,Fee schedule,Facility 24920,Not in chargemaster,24920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24920,BCBS multispecialty AW base fee schedule,"$1,401.19 ",,Fee schedule,,,,,,14.58,17.06,0
unity,Fee schedule,Facility 24925,Not in chargemaster,24925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24925,BCBS multispecialty AW base fee schedule,"$1,083.19 ",,Fee schedule,,,,,,17.23,21.71,0
unity,Fee schedule,Facility 24930,Not in chargemaster,24930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24930,BCBS multispecialty AW base fee schedule,"$1,481.35 ",,Fee schedule,,,,,,15.9,18.62,0
unity,Fee schedule,Facility 24931,Not in chargemaster,24931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24931,BCBS multispecialty AW base fee schedule,"$1,784.11 ",,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 24935,Not in chargemaster,24935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24935,BCBS multispecialty AW base fee schedule,"$2,271.71 ",,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 25000,Not in chargemaster,25000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25000,BCBS multispecialty AW base fee schedule,$645.28 ,,Fee schedule,,,,,,205.38,248.2,0
unity,Fee schedule,Facility 25001,Not in chargemaster,25001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25001,BCBS multispecialty AW base fee schedule,$654.55 ,,Fee schedule,,,,,,114.61,134.19,0
unity,Fee schedule,Facility 25020,Not in chargemaster,25020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25020,BCBS multispecialty AW base fee schedule,"$1,216.35 ",,Fee schedule,,,,,,108.65,148.68,0
unity,Fee schedule,Facility 25023,Not in chargemaster,25023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25023,BCBS multispecialty AW base fee schedule,"$2,284.96 ",,Fee schedule,,,,,,102.03,138.82,0
unity,Fee schedule,Facility 25024,Not in chargemaster,25024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25024,BCBS multispecialty AW base fee schedule,"$1,495.26 ",,Fee schedule,,,,,,16.56,27.5,0
unity,Fee schedule,Facility 25025,Not in chargemaster,25025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25025,BCBS multispecialty AW base fee schedule,"$2,303.51 ",,Fee schedule,,,,,,215.31,262.94,0
unity,Fee schedule,Facility 25028,Not in chargemaster,25028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25028,BCBS multispecialty AW base fee schedule,"$1,130.89 ",,Fee schedule,,,,,,215.31,291.08,0
unity,Fee schedule,Facility 25031,Not in chargemaster,25031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25031,BCBS multispecialty AW base fee schedule,$668.46 ,,Fee schedule,,,,,,215.31,284.66,0
unity,Fee schedule,Facility 25035,Not in chargemaster,25035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25035,BCBS multispecialty AW base fee schedule,"$1,114.33 ",,Fee schedule,,,,,,139.79,203.5,0
unity,Fee schedule,Facility 25040,Not in chargemaster,25040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25040,BCBS multispecialty AW base fee schedule,"$1,071.93 ",,Fee schedule,,,,,,139.79,177.63,0
unity,Fee schedule,Facility 25065,Not in chargemaster,25065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25065,BCBS multispecialty AW base fee schedule,$304.09 ,,Fee schedule,,,,,,139.79,177.63,0
unity,Fee schedule,Facility 25076,Not in chargemaster,25076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25076,BCBS multispecialty AW base fee schedule,$987.79 ,,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 25077,Not in chargemaster,25077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25077,BCBS multispecialty AW base fee schedule,"$1,699.31 ",,Fee schedule,,,,,,94.08,128.07,0
unity,Fee schedule,Facility 25078,Not in chargemaster,25078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25078,BCBS multispecialty AW base fee schedule,"$2,228.65 ",,Fee schedule,,,,,,94.08,136.14,0
unity,Fee schedule,Facility 25085,Not in chargemaster,25085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25085,BCBS multispecialty AW base fee schedule,$856.61 ,,Fee schedule,,,,,,24.51,35.68,0
unity,Fee schedule,Facility 25100,Not in chargemaster,25100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25100,BCBS multispecialty AW base fee schedule,$662.50 ,,Fee schedule,,,,,,21.2,26.38,0
unity,Fee schedule,Facility 25101,Not in chargemaster,25101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25101,BCBS multispecialty AW base fee schedule,$770.49 ,,Fee schedule,,,,,,30.48,40.13,0
unity,Fee schedule,Facility 25105,Not in chargemaster,25105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25105,BCBS multispecialty AW base fee schedule,$925.51 ,,Fee schedule,,,,,,25.18,33,0
unity,Fee schedule,Facility 25107,Not in chargemaster,25107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25107,BCBS multispecialty AW base fee schedule,"$1,173.95 ",,Fee schedule,,,,,,21.86,24.23,0
unity,Fee schedule,Facility 25109,Not in chargemaster,25109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25109,BCBS multispecialty AW base fee schedule,"$1,025.55 ",,Fee schedule,,,,,,19.21,24.82,0
unity,Fee schedule,Facility 25110,Not in chargemaster,25110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25110,BCBS multispecialty AW base fee schedule,$651.90 ,,Fee schedule,,,,,,25.84,35.68,0
unity,Fee schedule,Facility 25111,25111,25111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25111,BCBS multispecialty AW base fee schedule,$612.15 ,678.63,Fee schedule,,612.15,612.15,612.15,612.15,21.2,31.41,0
unity,Fee schedule,Facility 25112,Not in chargemaster,25112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25112,BCBS multispecialty AW base fee schedule,$738.69 ,,Fee schedule,,,,,,15.24,17.06,0
unity,Fee schedule,Facility 25115,Not in chargemaster,25115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25115,BCBS multispecialty AW base fee schedule,"$1,444.91 ",,Fee schedule,,,,,,129.19,151.25,0
unity,Fee schedule,Facility 25116,Not in chargemaster,25116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25116,BCBS multispecialty AW base fee schedule,"$1,146.13 ",,Fee schedule,,,,,,117.26,137.29,0
unity,Fee schedule,Facility 25118,Not in chargemaster,25118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25118,BCBS multispecialty AW base fee schedule,$726.10 ,,Fee schedule,,,,,,108.65,120.39,0
unity,Fee schedule,Facility 25119,Not in chargemaster,25119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25119,BCBS multispecialty AW base fee schedule,$946.71 ,,Fee schedule,,,,,,21.2,24.82,0
unity,Fee schedule,Facility 25120,Not in chargemaster,25120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25120,BCBS multispecialty AW base fee schedule,$955.33 ,,Fee schedule,,,,,,25.18,29.48,0
unity,Fee schedule,Facility 25125,Not in chargemaster,25125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25125,BCBS multispecialty AW base fee schedule,"$1,133.54 ",,Fee schedule,,,,,,21.2,24.82,0
unity,Fee schedule,Facility 25126,Not in chargemaster,25126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25126,BCBS multispecialty AW base fee schedule,"$1,142.15 ",,Fee schedule,,,,,,18.34,33.77,0
unity,Fee schedule,Facility 25130,Not in chargemaster,25130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25130,BCBS multispecialty AW base fee schedule,$855.29 ,,Fee schedule,,,,,,25.84,30.25,0
unity,Fee schedule,Facility 25135,Not in chargemaster,25135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25135,BCBS multispecialty AW base fee schedule,"$1,067.95 ",,Fee schedule,,,,,,20.54,24.05,0
unity,Fee schedule,Facility 25136,Not in chargemaster,25136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25136,BCBS multispecialty AW base fee schedule,$947.38 ,,Fee schedule,,,,,,17.23,20.17,0
unity,Fee schedule,Facility 25145,Not in chargemaster,25145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25145,BCBS multispecialty AW base fee schedule,$991.10 ,,Fee schedule,,,,,,215.31,260.62,0
unity,Fee schedule,Facility 25150,Not in chargemaster,25150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25150,BCBS multispecialty AW base fee schedule,"$1,078.55 ",,Fee schedule,,,,,,139.79,162.89,0
unity,Fee schedule,Facility 25151,Not in chargemaster,25151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25151,BCBS multispecialty AW base fee schedule,"$1,113.66 ",,Fee schedule,,,,,,112.63,132.64,0
unity,Fee schedule,Facility 25170,Not in chargemaster,25170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25170,BCBS multispecialty AW base fee schedule,"$2,821.59 ",,Fee schedule,,,,,,200.74,236.57,0
unity,Fee schedule,Facility 25210,Not in chargemaster,25210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25210,BCBS multispecialty AW base fee schedule,$935.45 ,,Fee schedule,,,,,,153.04,169.58,0
unity,Fee schedule,Facility 25215,Not in chargemaster,25215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25215,BCBS multispecialty AW base fee schedule,"$1,179.91 ",,Fee schedule,,,,,,129.85,152.02,0
unity,Fee schedule,Facility 25230,Not in chargemaster,25230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25230,BCBS multispecialty AW base fee schedule,$824.15 ,,Fee schedule,,,,,,80.83,125.65,0
unity,Fee schedule,Facility 25240,Not in chargemaster,25240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25240,BCBS multispecialty AW base fee schedule,$818.19 ,,Fee schedule,,,,,,118.59,159.78,0
unity,Fee schedule,Facility 25246,Not in chargemaster,25246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25246,BCBS multispecialty AW base fee schedule,$141.78 ,,Fee schedule,,,,,,119.91,141.94,0
unity,Fee schedule,Facility 25248,Not in chargemaster,25248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25248,BCBS multispecialty AW base fee schedule,$793.01 ,,Fee schedule,,,,,,119.25,140.39,0
unity,Fee schedule,Facility 25250,Not in chargemaster,25250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25250,BCBS multispecialty AW base fee schedule,"$1,015.61 ",,Fee schedule,,,,,,106,124.11,0
unity,Fee schedule,Facility 25251,Not in chargemaster,25251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25251,BCBS multispecialty AW base fee schedule,"$1,376.01 ",,Fee schedule,,,,,,80.16,93.07,0
unity,Fee schedule,Facility 25259,Not in chargemaster,25259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25259,BCBS multispecialty AW base fee schedule,$805.60 ,,Fee schedule,,,,,,17.23,19.09,0
unity,Fee schedule,Facility 25260,Not in chargemaster,25260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25260,BCBS multispecialty AW base fee schedule,"$1,204.43 ",,Fee schedule,,,,,,27.16,38.01,0
unity,Fee schedule,Facility 25263,Not in chargemaster,25263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25263,BCBS multispecialty AW base fee schedule,"$1,205.09 ",,Fee schedule,,,,,,19.21,27.93,0
unity,Fee schedule,Facility 25265,Not in chargemaster,25265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25265,BCBS multispecialty AW base fee schedule,"$1,430.34 ",,Fee schedule,,,,,,21.2,27.93,0
unity,Fee schedule,Facility 25270,Not in chargemaster,25270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25270,BCBS multispecialty AW base fee schedule,$940.09 ,,Fee schedule,,,,,,16.56,19.39,0
unity,Fee schedule,Facility 25272,Not in chargemaster,25272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25272,BCBS multispecialty AW base fee schedule,"$1,065.96 ",,Fee schedule,,,,,,25.18,29.48,0
unity,Fee schedule,Facility 25274,Not in chargemaster,25274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25274,BCBS multispecialty AW base fee schedule,"$1,271.34 ",,Fee schedule,,,,,,23.85,27.93,0
unity,Fee schedule,Facility 25275,Not in chargemaster,25275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25275,BCBS multispecialty AW base fee schedule,"$1,283.26 ",,Fee schedule,,,,,,63.6,110.75,0
unity,Fee schedule,Facility 25280,Not in chargemaster,25280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25280,BCBS multispecialty AW base fee schedule,"$1,079.88 ",,Fee schedule,,,,,,26.5,30,0
unity,Fee schedule,Facility 25290,Not in chargemaster,25290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25290,BCBS multispecialty AW base fee schedule,$830.78 ,,Fee schedule,,,,,,89.44,269.76,0
unity,Fee schedule,Facility 25295,Not in chargemaster,25295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25295,BCBS multispecialty AW base fee schedule,"$1,003.69 ",,Fee schedule,,,,,,217.3,528.86,0
unity,Fee schedule,Facility 25300,Not in chargemaster,25300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25300,BCBS multispecialty AW base fee schedule,"$1,305.79 ",,Fee schedule,,,,,,78.84,124.23,0
unity,Fee schedule,Facility 25301,Not in chargemaster,25301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25301,BCBS multispecialty AW base fee schedule,"$1,228.28 ",,Fee schedule,,,,,,68.9,149.08,0
unity,Fee schedule,Facility 25310,Not in chargemaster,25310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25310,BCBS multispecialty AW base fee schedule,"$1,182.56 ",,Fee schedule,,,,,,54.99,120.68,0
unity,Fee schedule,Facility 25312,Not in chargemaster,25312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25312,BCBS multispecialty AW base fee schedule,"$1,372.04 ",,Fee schedule,,,,,,81.49,110,0
unity,Fee schedule,Facility 25315,Not in chargemaster,25315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25315,BCBS multispecialty AW base fee schedule,"$1,473.40 ",,Fee schedule,,,,,,1558.86,1744.14,0
unity,Fee schedule,Facility 25316,Not in chargemaster,25316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25316,BCBS multispecialty AW base fee schedule,"$1,750.99 ",,Fee schedule,,,,,,129.19,215,0
unity,Fee schedule,Facility 25320,Not in chargemaster,25320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25320,BCBS multispecialty AW base fee schedule,"$1,877.53 ",,Fee schedule,,,,,,1937.81,2147.24,0
unity,Fee schedule,Facility 25332,Not in chargemaster,25332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25332,BCBS multispecialty AW base fee schedule,"$1,610.54 ",,Fee schedule,,,,,,123.23,232.84,0
unity,Fee schedule,Facility 25335,Not in chargemaster,25335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25335,BCBS multispecialty AW base fee schedule,"$1,805.98 ",,Fee schedule,,,,,,812.79,969.01,0
unity,Fee schedule,Facility 25337,Not in chargemaster,25337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25337,BCBS multispecialty AW base fee schedule,"$1,690.70 ",,Fee schedule,,,,,,409.43,453.67,0
unity,Fee schedule,Facility 25350,Not in chargemaster,25350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25350,BCBS multispecialty AW base fee schedule,"$1,289.89 ",,Fee schedule,,,,,,188.15,325.83,0
unity,Fee schedule,Facility 25355,Not in chargemaster,25355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25355,BCBS multispecialty AW base fee schedule,"$1,462.80 ",,Fee schedule,,,,,,49.03,149.79,0
unity,Fee schedule,Facility 25360,Not in chargemaster,25360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25360,BCBS multispecialty AW base fee schedule,"$1,249.48 ",,Fee schedule,,,,,,1078.55,1225,0
unity,Fee schedule,Facility 25365,Not in chargemaster,25365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25365,BCBS multispecialty AW base fee schedule,"$1,752.31 ",,Fee schedule,,,,,,828.13,945,0
unity,Fee schedule,Facility 25370,Not in chargemaster,25370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25370,BCBS multispecialty AW base fee schedule,"$1,931.19 ",,Fee schedule,,,,,,918.23,1017.46,0
unity,Fee schedule,Facility 25375,Not in chargemaster,25375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25375,BCBS multispecialty AW base fee schedule,"$1,826.51 ",,Fee schedule,,,,,,858.6,951.39,0
unity,Fee schedule,Facility 25390,Not in chargemaster,25390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25390,BCBS multispecialty AW base fee schedule,"$1,469.43 ",,Fee schedule,,,,,,516.75,590,0
unity,Fee schedule,Facility 25391,Not in chargemaster,25391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25391,BCBS multispecialty AW base fee schedule,"$1,907.34 ",,Fee schedule,,,,,,1811.28,2007.03,0
unity,Fee schedule,Facility 25392,Not in chargemaster,25392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25392,BCBS multispecialty AW base fee schedule,"$1,941.79 ",,Fee schedule,,,,,,1482.68,1642.92,0
unity,Fee schedule,Facility 25393,Not in chargemaster,25393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25393,BCBS multispecialty AW base fee schedule,"$2,163.06 ",,Fee schedule,,,,,,1794.71,1988.68,0
unity,Fee schedule,Facility 25394,Not in chargemaster,25394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25394,BCBS multispecialty AW base fee schedule,"$1,500.56 ",,Fee schedule,,,,,,1424.38,1625,0
unity,Fee schedule,Facility 25400,Not in chargemaster,25400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25400,BCBS multispecialty AW base fee schedule,"$1,535.01 ",,Fee schedule,,,,,,1219,1350.74,0
unity,Fee schedule,Facility 25405,Not in chargemaster,25405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25405,BCBS multispecialty AW base fee schedule,"$1,984.19 ",,Fee schedule,,,,,,1130.89,1253.11,0
unity,Fee schedule,Facility 25415,Not in chargemaster,25415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25415,BCBS multispecialty AW base fee schedule,"$1,853.01 ",,Fee schedule,,,,,,1005.01,1145,0
unity,Fee schedule,Facility 25420,Not in chargemaster,25420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25420,BCBS multispecialty AW base fee schedule,"$2,233.29 ",,Fee schedule,,,,,,206.04,280.32,0
unity,Fee schedule,Facility 25425,Not in chargemaster,25425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25425,BCBS multispecialty AW base fee schedule,"$1,844.40 ",,Fee schedule,,,,,,141.78,157.31,0
unity,Fee schedule,Facility 25426,Not in chargemaster,25426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25426,BCBS multispecialty AW base fee schedule,"$2,151.14 ",,Fee schedule,,,,,,1482.68,1642.92,0
unity,Fee schedule,Facility 25430,Not in chargemaster,25430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25430,BCBS multispecialty AW base fee schedule,"$1,395.89 ",,Fee schedule,,,,,,2065.01,2355,0
unity,Fee schedule,Facility 25431,Not in chargemaster,25431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25431,BCBS multispecialty AW base fee schedule,"$1,508.51 ",,Fee schedule,,,,,,1271.34,1487.44,0
unity,Fee schedule,Facility 25440,Not in chargemaster,25440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25440,BCBS multispecialty AW base fee schedule,"$1,466.11 ",,Fee schedule,,,,,,114.7,135.81,0
unity,Fee schedule,Facility 25441,Not in chargemaster,25441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25441,BCBS multispecialty AW base fee schedule,"$1,793.39 ",,Fee schedule,,,,,,143,238.58,0
unity,Fee schedule,Facility 25442,Not in chargemaster,25442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25442,BCBS multispecialty AW base fee schedule,"$1,542.30 ",,Fee schedule,,,,,,211.64,351.63,0
unity,Fee schedule,Facility 25443,Not in chargemaster,25443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25443,BCBS multispecialty AW base fee schedule,"$1,497.91 ",,Fee schedule,,,,,,14.88,17.62,0
unity,Fee schedule,Facility 25444,Not in chargemaster,25444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25444,BCBS multispecialty AW base fee schedule,"$1,583.38 ",,Fee schedule,,,,,,33.48,200,0
unity,Fee schedule,Facility 25445,Not in chargemaster,25445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25445,BCBS multispecialty AW base fee schedule,"$1,379.33 ",,Fee schedule,,,,,,332.32,469.74,0
unity,Fee schedule,Facility 25446,Not in chargemaster,25446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25446,BCBS multispecialty AW base fee schedule,"$2,243.23 ",,Fee schedule,,,,,,331.08,469.74,0
unity,Fee schedule,Facility 25447,Not in chargemaster,25447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25447,BCBS multispecialty AW base fee schedule,"$1,582.05 ",,Fee schedule,,,,,,99.82,137.02,0
unity,Fee schedule,Facility 25449,Not in chargemaster,25449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25449,BCBS multispecialty AW base fee schedule,"$1,978.89 ",,Fee schedule,,,,,,45.88,101.14,0
unity,Fee schedule,Facility 25450,Not in chargemaster,25450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25450,BCBS multispecialty AW base fee schedule,"$1,178.59 ",,Fee schedule,,,,,,21.7,53.55,0
unity,Fee schedule,Facility 25455,Not in chargemaster,25455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25455,BCBS multispecialty AW base fee schedule,"$1,391.25 ",,Fee schedule,,,,,,181.66,290,0
unity,Fee schedule,Facility 25490,Not in chargemaster,25490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25490,BCBS multispecialty AW base fee schedule,"$1,374.03 ",,Fee schedule,,,,,,172.36,270,0
unity,Fee schedule,Facility 25491,Not in chargemaster,25491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25491,BCBS multispecialty AW base fee schedule,"$1,412.45 ",,Fee schedule,,,,,,158.1,250,0
unity,Fee schedule,Facility 25492,Not in chargemaster,25492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25492,BCBS multispecialty AW base fee schedule,"$1,732.44 ",,Fee schedule,,,,,,153.76,250,0
unity,Fee schedule,Facility 25500,Not in chargemaster,25500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25500,BCBS multispecialty AW base fee schedule,$480.31 ,,Fee schedule,,,,,,135.78,225,0
unity,Fee schedule,Facility 24665,Not in chargemaster,24665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24665,BCBS multispecialty AW base fee schedule,"$1,250.14 ",,Fee schedule,,,,,,135.78,225,0
unity,Fee schedule,Facility 24666,Not in chargemaster,24666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24666,BCBS multispecialty AW base fee schedule,"$1,401.19 ",,Fee schedule,,,,,,124.62,210,0
unity,Fee schedule,Facility 24670,Not in chargemaster,24670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24670,BCBS multispecialty AW base fee schedule,$504.83 ,,Fee schedule,,,,,,227.54,342.17,0
unity,Fee schedule,Facility 25066,Not in chargemaster,25066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25066,BCBS multispecialty AW base fee schedule,$682.38 ,,Fee schedule,,,,,,211.42,325,0
unity,Fee schedule,Facility 25071,Not in chargemaster,25071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25071,BCBS multispecialty AW base fee schedule,$811.56 ,,Fee schedule,,,,,,174.22,282,0
unity,Fee schedule,Facility 25073,Not in chargemaster,25073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25073,BCBS multispecialty AW base fee schedule,"$1,022.24 ",,Fee schedule,,,,,,181.66,290,0
unity,Fee schedule,Facility 25075,Not in chargemaster,25075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25075,BCBS multispecialty AW base fee schedule,$602.21 ,,Fee schedule,,,,,,153.76,255,0
unity,Fee schedule,Facility 24675,Not in chargemaster,24675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24675,BCBS multispecialty AW base fee schedule,$794.34 ,,Fee schedule,,,,,,145.08,238.51,0
unity,Fee schedule,Facility 25505,Not in chargemaster,25505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25505,BCBS multispecialty AW base fee schedule,$875.16 ,,Fee schedule,,,,,,135.78,238,0
unity,Fee schedule,Facility 25525,Not in chargemaster,25525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25525,BCBS multispecialty AW base fee schedule,"$1,506.53 ",,Fee schedule,,,,,,184.14,218.03,0
unity,Fee schedule,Facility 25526,Not in chargemaster,25526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25526,BCBS multispecialty AW base fee schedule,"$1,825.85 ",,Fee schedule,,,,,,128.34,151.96,0
unity,Fee schedule,Facility 25530,25530,25530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25530,BCBS multispecialty AW base fee schedule,$455.80 ,506.86,Fee schedule,,455.8,455.8,455.8,455.8,159.34,195,0
unity,Fee schedule,Facility 25515,Not in chargemaster,25515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25515,BCBS multispecialty AW base fee schedule,"$1,278.63 ",,Fee schedule,,,,,,120.9,145,0
unity,Fee schedule,Facility 25520,Not in chargemaster,25520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25520,BCBS multispecialty AW base fee schedule,"$1,031.51 ",,Fee schedule,,,,,,76.88,95,0
unity,Fee schedule,Facility 25535,Not in chargemaster,25535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25535,BCBS multispecialty AW base fee schedule,$863.90 ,,Fee schedule,,,,,,226.3,267.95,0
unity,Fee schedule,Facility 25545,Not in chargemaster,25545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25545,BCBS multispecialty AW base fee schedule,"$1,188.53 ",,Fee schedule,,,,,,158.1,195,0
unity,Fee schedule,Facility 25560,25560,25560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25560,BCBS multispecialty AW base fee schedule,$484.29 ,610,Fee schedule,,484.29,484.29,484.29,484.29,195.92,262,0
unity,Fee schedule,Facility 25565,Not in chargemaster,25565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25565,BCBS multispecialty AW base fee schedule,$886.43 ,,Fee schedule,,,,,,389.36,480,0
unity,Fee schedule,Facility 25574,Not in chargemaster,25574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25574,BCBS multispecialty AW base fee schedule,"$1,286.58 ",,Fee schedule,,,,,,304.42,370,0
unity,Fee schedule,Facility 25575,Not in chargemaster,25575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25575,BCBS multispecialty AW base fee schedule,"$1,722.50 ",,Fee schedule,,,,,,209.56,250,0
unity,Fee schedule,Facility 25600,25600,25600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25600,BCBS multispecialty AW base fee schedule,$600.23 ,715,Fee schedule,,600.23,600.23,600.23,600.23,114.08,135.07,0
unity,Fee schedule,Facility 25606,Not in chargemaster,25606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25606,BCBS multispecialty AW base fee schedule,"$1,266.04 ",,Fee schedule,,,,,,76.26,90.29,0
unity,Fee schedule,Facility 25607,Not in chargemaster,25607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25607,BCBS multispecialty AW base fee schedule,"$1,404.50 ",,Fee schedule,,,,,,39.68,50,0
unity,Fee schedule,Facility 25608,Not in chargemaster,25608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25608,BCBS multispecialty AW base fee schedule,"$1,575.43 ",,Fee schedule,,,,,,57.66,97.26,0
unity,Fee schedule,Facility 25609,Not in chargemaster,25609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25609,BCBS multispecialty AW base fee schedule,"$2,004.73 ",,Fee schedule,,,,,,187.24,230,0
unity,Fee schedule,Facility 25622,25622,25622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25622,BCBS multispecialty AW base fee schedule,$534.64 ,653.08,Fee schedule,,534.64,534.64,534.64,534.64,127.72,155,0
unity,Fee schedule,Facility 25676,Not in chargemaster,25676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25676,BCBS multispecialty AW base fee schedule,"$1,206.41 ",,Fee schedule,,,,,,380.68,465,0
unity,Fee schedule,Facility 25680,Not in chargemaster,25680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25680,BCBS multispecialty AW base fee schedule,"$1,001.04 ",,Fee schedule,,,,,,295.74,360,0
unity,Fee schedule,Facility 25685,Not in chargemaster,25685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25685,BCBS multispecialty AW base fee schedule,"$1,405.83 ",,Fee schedule,,,,,,233.74,285,0
unity,Fee schedule,Facility 25690,Not in chargemaster,25690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25690,BCBS multispecialty AW base fee schedule,$927.50 ,,Fee schedule,,,,,,182.28,225,0
unity,Fee schedule,Facility 25695,Not in chargemaster,25695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25695,BCBS multispecialty AW base fee schedule,"$1,212.38 ",,Fee schedule,,,,,,126.48,155,0
unity,Fee schedule,Facility 25800,Not in chargemaster,25800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25800,BCBS multispecialty AW base fee schedule,"$1,397.88 ",,Fee schedule,,,,,,68.82,85,0
unity,Fee schedule,Facility 25805,Not in chargemaster,25805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25805,BCBS multispecialty AW base fee schedule,"$1,619.81 ",,Fee schedule,,,,,,182.9,225,0
unity,Fee schedule,Facility 25810,Not in chargemaster,25810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25810,BCBS multispecialty AW base fee schedule,"$1,655.59 ",,Fee schedule,,,,,,127.1,155,0
unity,Fee schedule,Facility 25820,Not in chargemaster,25820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25820,BCBS multispecialty AW base fee schedule,"$1,205.09 ",,Fee schedule,,,,,,69.44,85,0
unity,Fee schedule,Facility 25825,Not in chargemaster,25825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25825,BCBS multispecialty AW base fee schedule,"$1,478.70 ",,Fee schedule,,,,,,354.02,430,0
unity,Fee schedule,Facility 25830,Not in chargemaster,25830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25830,BCBS multispecialty AW base fee schedule,"$1,864.28 ",,Fee schedule,,,,,,241.18,290,0
unity,Fee schedule,Facility 25900,Not in chargemaster,25900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25900,BCBS multispecialty AW base fee schedule,"$1,359.45 ",,Fee schedule,,,,,,178.56,215,0
unity,Fee schedule,Facility 25905,Not in chargemaster,25905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25905,BCBS multispecialty AW base fee schedule,"$1,341.56 ",,Fee schedule,,,,,,323.64,395,0
unity,Fee schedule,Facility 25907,Not in chargemaster,25907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25907,BCBS multispecialty AW base fee schedule,"$1,173.29 ",,Fee schedule,,,,,,237.46,290,0
unity,Fee schedule,Facility 25909,Not in chargemaster,25909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25909,BCBS multispecialty AW base fee schedule,"$1,310.43 ",,Fee schedule,,,,,,174.84,214,0
unity,Fee schedule,Facility 25915,Not in chargemaster,25915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25915,BCBS multispecialty AW base fee schedule,"$2,238.59 ",,Fee schedule,,,,,,127.1,155,0
unity,Fee schedule,Facility 25920,Not in chargemaster,25920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25920,BCBS multispecialty AW base fee schedule,"$1,364.09 ",,Fee schedule,,,,,,195.3,300,0
unity,Fee schedule,Facility 25922,Not in chargemaster,25922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25922,BCBS multispecialty AW base fee schedule,"$1,200.45 ",,Fee schedule,,,,,,138.26,230,0
unity,Fee schedule,Facility 25924,Not in chargemaster,25924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25924,BCBS multispecialty AW base fee schedule,"$1,330.96 ",,Fee schedule,,,,,,89.9,158,0
unity,Fee schedule,Facility 25927,Not in chargemaster,25927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25927,BCBS multispecialty AW base fee schedule,"$1,590.00 ",,Fee schedule,,,,,,45.26,97,0
unity,Fee schedule,Facility 25929,Not in chargemaster,25929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25929,BCBS multispecialty AW base fee schedule,"$1,141.49 ",,Fee schedule,,,,,,16.12,50,0
unity,Fee schedule,Facility 25931,Not in chargemaster,25931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25931,BCBS multispecialty AW base fee schedule,"$1,465.45 ",,Fee schedule,,,,,,296.36,440,0
unity,Fee schedule,Facility 26010,26010,26010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26010,BCBS multispecialty AW base fee schedule,$263.01 ,569.61,Fee schedule,,263.01,263.01,263.01,263.01,226.92,350,0
unity,Fee schedule,Facility 25605,25605,25605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25605,BCBS multispecialty AW base fee schedule,$975.86 ,1167.02,Fee schedule,,975.86,975.86,975.86,975.86,132.68,230,0
unity,Fee schedule,Facility 25624,Not in chargemaster,25624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25624,BCBS multispecialty AW base fee schedule,$836.74 ,,Fee schedule,,,,,,88.66,163,0
unity,Fee schedule,Facility 25628,Not in chargemaster,25628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25628,BCBS multispecialty AW base fee schedule,"$1,373.36 ",,Fee schedule,,,,,,46.5,98,0
unity,Fee schedule,Facility 25630,Not in chargemaster,25630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25630,BCBS multispecialty AW base fee schedule,$538.61 ,,Fee schedule,,,,,,47.78,190,0
unity,Fee schedule,Facility 25635,Not in chargemaster,25635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25635,BCBS multispecialty AW base fee schedule,$796.99 ,,Fee schedule,,,,,,24.8,37,0
unity,Fee schedule,Facility 25651,Not in chargemaster,25651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25651,BCBS multispecialty AW base fee schedule,$930.81 ,,Fee schedule,,,,,,18.6,22.73,0
unity,Fee schedule,Facility 25652,Not in chargemaster,25652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25652,BCBS multispecialty AW base fee schedule,"$1,187.86 ",,Fee schedule,,,,,,16.12,19.88,0
unity,Fee schedule,Facility 25660,Not in chargemaster,25660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25660,BCBS multispecialty AW base fee schedule,$791.03 ,,Fee schedule,,,,,,31,44,0
unity,Fee schedule,Facility 25670,Not in chargemaster,25670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25670,BCBS multispecialty AW base fee schedule,"$1,161.36 ",,Fee schedule,,,,,,39.06,47.12,0
unity,Fee schedule,Facility 25671,Not in chargemaster,25671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25671,BCBS multispecialty AW base fee schedule,"$1,013.63 ",,Fee schedule,,,,,,60.76,71.94,0
unity,Fee schedule,Facility 25675,Not in chargemaster,25675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25675,BCBS multispecialty AW base fee schedule,$764.53 ,,Fee schedule,,,,,,63.07,82.95,0
unity,Fee schedule,Facility 25645,Not in chargemaster,25645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25645,BCBS multispecialty AW base fee schedule,"$1,089.15 ",,Fee schedule,,,,,,14.88,20,0
unity,Fee schedule,Facility 25650,Not in chargemaster,25650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25650,BCBS multispecialty AW base fee schedule,$576.38 ,,Fee schedule,,,,,,332.32,393.48,0
unity,Fee schedule,Facility 26011,Not in chargemaster,26011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26011,BCBS multispecialty AW base fee schedule,$352.45 ,,Fee schedule,,,,,,19.22,22.76,0
unity,Fee schedule,Facility 26020,Not in chargemaster,26020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26020,BCBS multispecialty AW base fee schedule,"$1,057.35 ",,Fee schedule,,,,,,332.32,393.48,0
unity,Fee schedule,Facility 26025,Not in chargemaster,26025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26025,BCBS multispecialty AW base fee schedule,$802.95 ,,Fee schedule,,,,,,19.22,22.76,0
unity,Fee schedule,Facility 26030,Not in chargemaster,26030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26030,BCBS multispecialty AW base fee schedule,$937.44 ,,Fee schedule,,,,,,63.6,110.75,0
unity,Fee schedule,Facility 26034,Not in chargemaster,26034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26034,BCBS multispecialty AW base fee schedule,"$1,041.45 ",,Fee schedule,,,,,,89.44,269.76,0
unity,Fee schedule,Facility 26035,Not in chargemaster,26035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26035,BCBS multispecialty AW base fee schedule,"$1,639.69 ",,Fee schedule,,,,,,217.3,528.86,0
unity,Fee schedule,Facility 26037,Not in chargemaster,26037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26037,BCBS multispecialty AW base fee schedule,"$1,081.20 ",,Fee schedule,,,,,,78.84,124.23,0
unity,Fee schedule,Facility 26040,Not in chargemaster,26040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26040,BCBS multispecialty AW base fee schedule,$596.25 ,,Fee schedule,,,,,,68.9,149.08,0
unity,Fee schedule,Facility 26045,Not in chargemaster,26045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26045,BCBS multispecialty AW base fee schedule,$895.70 ,,Fee schedule,,,,,,54.99,120.68,0
unity,Fee schedule,Facility 26055,Not in chargemaster,26055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26055,BCBS multispecialty AW base fee schedule,$550.54 ,,Fee schedule,,,,,,81.49,110,0
unity,Fee schedule,Facility 26060,Not in chargemaster,26060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26060,BCBS multispecialty AW base fee schedule,$490.91 ,,Fee schedule,,,,,,129.19,215,0
unity,Fee schedule,Facility 26070,Not in chargemaster,26070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26070,BCBS multispecialty AW base fee schedule,$611.49 ,,Fee schedule,,,,,,123.23,232.84,0
unity,Fee schedule,Facility 26075,Not in chargemaster,26075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26075,BCBS multispecialty AW base fee schedule,$638.65 ,,Fee schedule,,,,,,188.15,325.83,0
unity,Fee schedule,Facility 26080,Not in chargemaster,26080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26080,BCBS multispecialty AW base fee schedule,$749.29 ,,Fee schedule,,,,,,49.03,149.79,0
unity,Fee schedule,Facility 26100,Not in chargemaster,26100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26100,BCBS multispecialty AW base fee schedule,$643.29 ,,Fee schedule,,,,,,206.04,280.32,0
unity,Fee schedule,Facility 26105,Not in chargemaster,26105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26105,BCBS multispecialty AW base fee schedule,$647.93 ,,Fee schedule,,,,,,141.78,157.31,0
unity,Fee schedule,Facility 26110,Not in chargemaster,26110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26110,BCBS multispecialty AW base fee schedule,$614.80 ,,Fee schedule,,,,,,77.51,87.32,0
unity,Fee schedule,Facility 26111,Not in chargemaster,26111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26111,BCBS multispecialty AW base fee schedule,$794.34 ,,Fee schedule,,,,,,757.24,865,0
unity,Fee schedule,Facility 26113,Not in chargemaster,26113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26113,BCBS multispecialty AW base fee schedule,"$1,044.10 ",,Fee schedule,,,,,,682.38,756.12,0
unity,Fee schedule,Facility 26115,Not in chargemaster,26115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26115,BCBS multispecialty AW base fee schedule,$630.04 ,,Fee schedule,,,,,,608.84,674.64,0
unity,Fee schedule,Facility 26170,Not in chargemaster,26170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26170,BCBS multispecialty AW base fee schedule,$775.79 ,,Fee schedule,,,,,,207.36,229.77,0
unity,Fee schedule,Facility 26180,Not in chargemaster,26180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26180,BCBS multispecialty AW base fee schedule,$851.31 ,,Fee schedule,,,,,,188.81,210.84,0
unity,Fee schedule,Facility 26185,Not in chargemaster,26185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26185,BCBS multispecialty AW base fee schedule,"$1,052.05 ",,Fee schedule,,,,,,805.6,892.67,0
unity,Fee schedule,Facility 26200,Not in chargemaster,26200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26200,BCBS multispecialty AW base fee schedule,$861.91 ,,Fee schedule,,,,,,486.94,666.19,0
unity,Fee schedule,Facility 26205,Not in chargemaster,26205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26205,BCBS multispecialty AW base fee schedule,"$1,154.74 ",,Fee schedule,,,,,,437.25,585.72,0
unity,Fee schedule,Facility 26210,Not in chargemaster,26210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26210,BCBS multispecialty AW base fee schedule,$846.68 ,,Fee schedule,,,,,,383.59,561.81,0
unity,Fee schedule,Facility 26215,Not in chargemaster,26215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26215,BCBS multispecialty AW base fee schedule,"$1,079.21 ",,Fee schedule,,,,,,354.44,460,0
unity,Fee schedule,Facility 26230,Not in chargemaster,26230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26230,BCBS multispecialty AW base fee schedule,$954.00 ,,Fee schedule,,,,,,136.48,181.5,0
unity,Fee schedule,Facility 26235,Not in chargemaster,26235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26235,BCBS multispecialty AW base fee schedule,$940.75 ,,Fee schedule,,,,,,106.66,141.81,0
unity,Fee schedule,Facility 26236,Not in chargemaster,26236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26236,BCBS multispecialty AW base fee schedule,$841.38 ,,Fee schedule,,,,,,299.45,668.17,0
unity,Fee schedule,Facility 26250,Not in chargemaster,26250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26250,BCBS multispecialty AW base fee schedule,"$2,040.50 ",,Fee schedule,,,,,,374.98,440,0
unity,Fee schedule,Facility 26260,Not in chargemaster,26260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26260,BCBS multispecialty AW base fee schedule,"$1,528.39 ",,Fee schedule,,,,,,292.83,387.2,0
unity,Fee schedule,Facility 26262,Not in chargemaster,26262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26262,BCBS multispecialty AW base fee schedule,"$1,205.09 ",,Fee schedule,,,,,,338.54,412.5,0
unity,Fee schedule,Facility 26320,Not in chargemaster,26320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26320,BCBS multispecialty AW base fee schedule,$663.16 ,,Fee schedule,,,,,,264.34,371.88,0
unity,Fee schedule,Facility 26340,Not in chargemaster,26340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26340,BCBS multispecialty AW base fee schedule,$648.59 ,,Fee schedule,,,,,,234.53,315.35,0
unity,Fee schedule,Facility 26341,Not in chargemaster,26341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26341,BCBS multispecialty AW base fee schedule,$145.09 ,,Fee schedule,,,,,,225.25,282.81,0
unity,Fee schedule,Facility 26350,Not in chargemaster,26350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26350,BCBS multispecialty AW base fee schedule,"$1,378.66 ",,Fee schedule,,,,,,665.81,742.5,0
unity,Fee schedule,Facility 26352,Not in chargemaster,26352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26352,BCBS multispecialty AW base fee schedule,"$1,544.95 ",,Fee schedule,,,,,,800.96,887.53,0
unity,Fee schedule,Facility 26356,Not in chargemaster,26356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26356,BCBS multispecialty AW base fee schedule,"$1,514.48 ",,Fee schedule,,,,,,488.93,541.77,0
unity,Fee schedule,Facility 26357,Not in chargemaster,26357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26357,BCBS multispecialty AW base fee schedule,"$1,697.33 ",,Fee schedule,,,,,,171.59,220,0
unity,Fee schedule,Facility 26358,Not in chargemaster,26358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26358,BCBS multispecialty AW base fee schedule,"$1,878.85 ",,Fee schedule,,,,,,77.51,87.32,0
unity,Fee schedule,Facility 26370,Not in chargemaster,26370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26370,BCBS multispecialty AW base fee schedule,"$1,456.18 ",,Fee schedule,,,,,,757.24,865,0
unity,Fee schedule,Facility 26372,Not in chargemaster,26372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26372,BCBS multispecialty AW base fee schedule,"$1,705.28 ",,Fee schedule,,,,,,682.38,756.12,0
unity,Fee schedule,Facility 26373,Not in chargemaster,26373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26373,BCBS multispecialty AW base fee schedule,"$1,637.04 ",,Fee schedule,,,,,,608.84,674.64,0
unity,Fee schedule,Facility 26390,Not in chargemaster,26390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26390,BCBS multispecialty AW base fee schedule,"$1,621.80 ",,Fee schedule,,,,,,207.36,229.77,0
unity,Fee schedule,Facility 26392,Not in chargemaster,26392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26392,BCBS multispecialty AW base fee schedule,"$1,871.56 ",,Fee schedule,,,,,,188.81,210.84,0
unity,Fee schedule,Facility 26410,Not in chargemaster,26410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26410,BCBS multispecialty AW base fee schedule,"$1,097.10 ",,Fee schedule,,,,,,805.6,892.67,0
unity,Fee schedule,Facility 26412,Not in chargemaster,26412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26412,BCBS multispecialty AW base fee schedule,"$1,308.44 ",,Fee schedule,,,,,,486.94,666.19,0
unity,Fee schedule,Facility 26415,Not in chargemaster,26415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26415,BCBS multispecialty AW base fee schedule,"$1,575.43 ",,Fee schedule,,,,,,437.25,585.72,0
unity,Fee schedule,Facility 26416,Not in chargemaster,26416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26416,BCBS multispecialty AW base fee schedule,"$1,708.59 ",,Fee schedule,,,,,,383.59,561.81,0
unity,Fee schedule,Facility 26418,Not in chargemaster,26418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26418,BCBS multispecialty AW base fee schedule,"$1,128.24 ",,Fee schedule,,,,,,354.44,460,0
unity,Fee schedule,Facility 26420,Not in chargemaster,26420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26420,BCBS multispecialty AW base fee schedule,"$1,369.39 ",,Fee schedule,,,,,,136.48,181.5,0
unity,Fee schedule,Facility 26426,Not in chargemaster,26426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26426,BCBS multispecialty AW base fee schedule,$957.98 ,,Fee schedule,,,,,,106.66,141.81,0
unity,Fee schedule,Facility 26428,Not in chargemaster,26428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26428,BCBS multispecialty AW base fee schedule,"$1,466.11 ",,Fee schedule,,,,,,1159.38,1284.68,0
unity,Fee schedule,Facility 26432,Not in chargemaster,26432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26432,BCBS multispecialty AW base fee schedule,$973.88 ,,Fee schedule,,,,,,1158.71,1375,0
unity,Fee schedule,Facility 26433,Not in chargemaster,26433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26433,BCBS multispecialty AW base fee schedule,"$1,034.83 ",,Fee schedule,,,,,,1240.86,1374.97,0
unity,Fee schedule,Facility 26434,Not in chargemaster,26434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26434,BCBS multispecialty AW base fee schedule,"$1,265.38 ",,Fee schedule,,,,,,299.45,668.17,0
unity,Fee schedule,Facility 26437,Not in chargemaster,26437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26437,BCBS multispecialty AW base fee schedule,"$1,212.38 ",,Fee schedule,,,,,,1625.78,1801.48,0
unity,Fee schedule,Facility 26440,Not in chargemaster,26440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26440,BCBS multispecialty AW base fee schedule,"$1,195.15 ",,Fee schedule,,,,,,2588.39,2868.13,0
unity,Fee schedule,Facility 26442,Not in chargemaster,26442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26442,BCBS multispecialty AW base fee schedule,"$1,839.76 ",,Fee schedule,,,,,,1805.31,2000.42,0
unity,Fee schedule,Facility 26445,Not in chargemaster,26445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26445,BCBS multispecialty AW base fee schedule,"$1,113.66 ",,Fee schedule,,,,,,1895.41,2100.26,0
unity,Fee schedule,Facility 26449,Not in chargemaster,26449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26449,BCBS multispecialty AW base fee schedule,"$1,323.01 ",,Fee schedule,,,,,,2110.06,2338.11,0
unity,Fee schedule,Facility 26450,Not in chargemaster,26450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26450,BCBS multispecialty AW base fee schedule,$809.58 ,,Fee schedule,,,,,,2085.55,2381,0
unity,Fee schedule,Facility 26455,Not in chargemaster,26455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26455,BCBS multispecialty AW base fee schedule,$803.61 ,,Fee schedule,,,,,,374.98,440,0
unity,Fee schedule,Facility 26460,Not in chargemaster,26460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26460,BCBS multispecialty AW base fee schedule,$785.06 ,,Fee schedule,,,,,,292.83,387.2,0
unity,Fee schedule,Facility 26471,Not in chargemaster,26471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26471,BCBS multispecialty AW base fee schedule,"$1,198.46 ",,Fee schedule,,,,,,338.54,412.5,0
unity,Fee schedule,Facility 26474,Not in chargemaster,26474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26474,BCBS multispecialty AW base fee schedule,"$1,177.26 ",,Fee schedule,,,,,,264.34,371.88,0
unity,Fee schedule,Facility 26476,Not in chargemaster,26476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26476,BCBS multispecialty AW base fee schedule,"$1,161.36 ",,Fee schedule,,,,,,234.53,315.35,0
unity,Fee schedule,Facility 26477,Not in chargemaster,26477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26477,BCBS multispecialty AW base fee schedule,"$1,131.55 ",,Fee schedule,,,,,,225.25,282.81,0
unity,Fee schedule,Facility 26478,Not in chargemaster,26478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26478,BCBS multispecialty AW base fee schedule,"$1,209.06 ",,Fee schedule,,,,,,665.81,742.5,0
unity,Fee schedule,Facility 26479,Not in chargemaster,26479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26479,BCBS multispecialty AW base fee schedule,"$1,224.96 ",,Fee schedule,,,,,,841.38,932.31,0
unity,Fee schedule,Facility 26480,Not in chargemaster,26480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26480,BCBS multispecialty AW base fee schedule,"$1,451.54 ",,Fee schedule,,,,,,800.96,887.53,0
unity,Fee schedule,Facility 26483,Not in chargemaster,26483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26483,BCBS multispecialty AW base fee schedule,"$1,619.81 ",,Fee schedule,,,,,,488.93,541.77,0
unity,Fee schedule,Facility 26485,Not in chargemaster,26485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26485,BCBS multispecialty AW base fee schedule,"$1,552.90 ",,Fee schedule,,,,,,171.59,220,0
unity,Fee schedule,Facility 26489,Not in chargemaster,26489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26489,BCBS multispecialty AW base fee schedule,"$1,800.01 ",,Fee schedule,,,,,,302.1,407,0
unity,Fee schedule,Facility 26490,Not in chargemaster,26490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26490,BCBS multispecialty AW base fee schedule,"$1,542.96 ",,Fee schedule,,,,,,228.58,303.92,0
unity,Fee schedule,Facility 26492,Not in chargemaster,26492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26492,BCBS multispecialty AW base fee schedule,"$1,711.90 ",,Fee schedule,,,,,,203.39,560.79,0
unity,Fee schedule,Facility 26494,Not in chargemaster,26494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26494,BCBS multispecialty AW base fee schedule,"$1,549.59 ",,Fee schedule,,,,,,108.65,280,0
unity,Fee schedule,Facility 26496,Not in chargemaster,26496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26496,BCBS multispecialty AW base fee schedule,"$1,652.28 ",,Fee schedule,,,,,,213.99,276.13,0
unity,Fee schedule,Facility 26497,Not in chargemaster,26497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26497,BCBS multispecialty AW base fee schedule,"$1,674.80 ",,Fee schedule,,,,,,53,185,0
unity,Fee schedule,Facility 26498,Not in chargemaster,26498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26498,BCBS multispecialty AW base fee schedule,"$2,204.14 ",,Fee schedule,,,,,,94.08,154.76,0
unity,Fee schedule,Facility 26499,Not in chargemaster,26499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26499,BCBS multispecialty AW base fee schedule,"$1,607.89 ",,Fee schedule,,,,,,96.06,180.31,0
unity,Fee schedule,Facility 26500,Not in chargemaster,26500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26500,BCBS multispecialty AW base fee schedule,"$1,209.73 ",,Fee schedule,,,,,,111.96,175.34,0
unity,Fee schedule,Facility 26502,Not in chargemaster,26502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26502,BCBS multispecialty AW base fee schedule,"$1,381.98 ",,Fee schedule,,,,,,35.78,122.1,0
unity,Fee schedule,Facility 26508,Not in chargemaster,26508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26508,BCBS multispecialty AW base fee schedule,"$1,232.91 ",,Fee schedule,,,,,,56.31,87.32,0
unity,Fee schedule,Facility 26510,Not in chargemaster,26510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26510,BCBS multispecialty AW base fee schedule,"$1,169.31 ",,Fee schedule,,,,,,74.86,140.56,0
unity,Fee schedule,Facility 26516,Not in chargemaster,26516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26516,BCBS multispecialty AW base fee schedule,"$1,364.09 ",,Fee schedule,,,,,,80.16,188.84,0
unity,Fee schedule,Facility 26517,Not in chargemaster,26517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26517,BCBS multispecialty AW base fee schedule,"$1,598.61 ",,Fee schedule,,,,,,116.6,186.7,0
unity,Fee schedule,Facility 26518,Not in chargemaster,26518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26518,BCBS multispecialty AW base fee schedule,"$1,619.81 ",,Fee schedule,,,,,,129.19,207.28,0
unity,Fee schedule,Facility 26520,Not in chargemaster,26520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26520,BCBS multispecialty AW base fee schedule,"$1,254.78 ",,Fee schedule,,,,,,270.3,355,0
unity,Fee schedule,Facility 26525,Not in chargemaster,26525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26525,BCBS multispecialty AW base fee schedule,"$1,258.09 ",,Fee schedule,,,,,,225.91,266.2,0
unity,Fee schedule,Facility 26530,Not in chargemaster,26530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26530,BCBS multispecialty AW base fee schedule,"$1,028.20 ",,Fee schedule,,,,,,235.19,316.6,0
unity,Fee schedule,Facility 26531,Not in chargemaster,26531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26531,BCBS multispecialty AW base fee schedule,"$1,197.14 ",,Fee schedule,,,,,,387.56,476.32,0
unity,Fee schedule,Facility 26535,Not in chargemaster,26535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26535,BCBS multispecialty AW base fee schedule,$826.80 ,,Fee schedule,,,,,,718.15,796.47,0
unity,Fee schedule,Facility 26536,Not in chargemaster,26536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26536,BCBS multispecialty AW base fee schedule,"$1,379.99 ",,Fee schedule,,,,,,546.56,680,0
unity,Fee schedule,Facility 26540,Not in chargemaster,26540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26540,BCBS multispecialty AW base fee schedule,"$1,279.95 ",,Fee schedule,,,,,,535.3,658.76,0
unity,Fee schedule,Facility 26541,Not in chargemaster,26541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26541,BCBS multispecialty AW base fee schedule,"$1,547.60 ",,Fee schedule,,,,,,539.94,648.11,0
unity,Fee schedule,Facility 26542,Not in chargemaster,26542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26542,BCBS multispecialty AW base fee schedule,"$1,320.36 ",,Fee schedule,,,,,,596.91,661.42,0
unity,Fee schedule,Facility 26545,Not in chargemaster,26545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26545,BCBS multispecialty AW base fee schedule,"$1,376.68 ",,Fee schedule,,,,,,963.94,1239.27,0
unity,Fee schedule,Facility 26546,Not in chargemaster,26546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26546,BCBS multispecialty AW base fee schedule,"$1,917.28 ",,Fee schedule,,,,,,490.91,591.33,0
unity,Fee schedule,Facility 26548,Not in chargemaster,26548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26548,BCBS multispecialty AW base fee schedule,"$1,472.08 ",,Fee schedule,,,,,,521.39,671.53,0
unity,Fee schedule,Facility 26550,Not in chargemaster,26550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26550,BCBS multispecialty AW base fee schedule,"$3,142.24 ",,Fee schedule,,,,,,354.44,394.68,0
unity,Fee schedule,Facility 26551,Not in chargemaster,26551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26551,BCBS multispecialty AW base fee schedule,"$6,305.68 ",,Fee schedule,,,,,,578.36,719.09,0
unity,Fee schedule,Facility 26553,Not in chargemaster,26553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26553,BCBS multispecialty AW base fee schedule,"$6,264.60 ",,Fee schedule,,,,,,352.45,425.99,0
unity,Fee schedule,Facility 26554,Not in chargemaster,26554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26554,BCBS multispecialty AW base fee schedule,"$7,306.05 ",,Fee schedule,,,,,,586.98,690.71,0
unity,Fee schedule,Facility 26555,Not in chargemaster,26555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26555,BCBS multispecialty AW base fee schedule,"$2,624.16 ",,Fee schedule,,,,,,559.81,700,0
unity,Fee schedule,Facility 26556,Not in chargemaster,26556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26556,BCBS multispecialty AW base fee schedule,"$6,507.74 ",,Fee schedule,,,,,,533.98,640,0
unity,Fee schedule,Facility 26560,Not in chargemaster,26560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26560,BCBS multispecialty AW base fee schedule,"$1,153.41 ",,Fee schedule,,,,,,263.01,569.61,0
unity,Fee schedule,Facility 26561,Not in chargemaster,26561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26561,BCBS multispecialty AW base fee schedule,"$1,825.19 ",,Fee schedule,,,,,,534.64,653.08,0
unity,Fee schedule,Facility 26562,Not in chargemaster,26562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26562,BCBS multispecialty AW base fee schedule,"$2,575.14 ",,Fee schedule,,,,,,975.86,1167.02,0
unity,Fee schedule,Facility 26565,Not in chargemaster,26565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26565,BCBS multispecialty AW base fee schedule,"$1,315.06 ",,Fee schedule,,,,,,600.23,715,0
unity,Fee schedule,Facility 26567,Not in chargemaster,26567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26567,BCBS multispecialty AW base fee schedule,"$1,323.01 ",,Fee schedule,,,,,,484.29,610,0
unity,Fee schedule,Facility 26568,Not in chargemaster,26568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26568,BCBS multispecialty AW base fee schedule,"$1,734.43 ",,Fee schedule,,,,,,455.8,506.86,0
unity,Fee schedule,Facility 26580,Not in chargemaster,26580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26580,BCBS multispecialty AW base fee schedule,"$2,900.43 ",,Fee schedule,,,,,,612.15,678.63,0
unity,Fee schedule,Facility 26587,Not in chargemaster,26587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26587,BCBS multispecialty AW base fee schedule,"$1,990.81 ",,Fee schedule,,,,,,461.1,560.79,0
unity,Fee schedule,Facility 26590,Not in chargemaster,26590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26590,BCBS multispecialty AW base fee schedule,"$2,701.68 ",,Fee schedule,,,,,,149.73,305.95,0
unity,Fee schedule,Facility 26591,Not in chargemaster,26591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26591,BCBS multispecialty AW base fee schedule,$863.90 ,,Fee schedule,,,,,,626.73,764.53,0
unity,Fee schedule,Facility 26593,Not in chargemaster,26593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26593,BCBS multispecialty AW base fee schedule,"$1,169.31 ",,Fee schedule,,,,,,1332.95,1477.01,0
unity,Fee schedule,Facility 26596,Not in chargemaster,26596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26596,BCBS multispecialty AW base fee schedule,"$1,490.63 ",,Fee schedule,,,,,,771.15,854.49,0
unity,Fee schedule,Facility 26600,26600,26600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26600,BCBS multispecialty AW base fee schedule,$533.98 ,640,Fee schedule,,533.98,533.98,533.98,533.98,553.85,672.96,0
unity,Fee schedule,Facility 26116,Not in chargemaster,26116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26116,BCBS multispecialty AW base fee schedule,"$1,002.36 ",,Fee schedule,,,,,,427.31,467.8,0
unity,Fee schedule,Facility 26117,Not in chargemaster,26117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26117,BCBS multispecialty AW base fee schedule,"$1,421.06 ",,Fee schedule,,,,,,853.96,946.25,0
unity,Fee schedule,Facility 26118,Not in chargemaster,26118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26118,BCBS multispecialty AW base fee schedule,"$2,013.34 ",,Fee schedule,,,,,,296.14,565.05,0
unity,Fee schedule,Facility 26121,Not in chargemaster,26121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26121,BCBS multispecialty AW base fee schedule,"$1,141.49 ",,Fee schedule,,,,,,87.45,129.23,0
unity,Fee schedule,Facility 26123,Not in chargemaster,26123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26123,BCBS multispecialty AW base fee schedule,"$1,592.65 ",,Fee schedule,,,,,,71.55,137.02,0
unity,Fee schedule,Facility 26125,Not in chargemaster,26125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26125,BCBS multispecialty AW base fee schedule,$521.39 ,,Fee schedule,,,,,,87.45,159,0
unity,Fee schedule,Facility 26130,Not in chargemaster,26130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26130,BCBS multispecialty AW base fee schedule,$888.41 ,,Fee schedule,,,,,,68.9,105,0
unity,Fee schedule,Facility 26135,Not in chargemaster,26135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26135,BCBS multispecialty AW base fee schedule,"$1,054.70 ",,Fee schedule,,,,,,82.81,154,0
unity,Fee schedule,Facility 26140,Not in chargemaster,26140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26140,BCBS multispecialty AW base fee schedule,$965.26 ,,Fee schedule,,,,,,73.54,120,0
unity,Fee schedule,Facility 26145,Not in chargemaster,26145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26145,BCBS multispecialty AW base fee schedule,$981.16 ,,Fee schedule,,,,,,76.19,126.36,0
unity,Fee schedule,Facility 26160,Not in chargemaster,26160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26160,BCBS multispecialty AW base fee schedule,$598.90 ,,Fee schedule,,,,,,74.86,122.1,0
unity,Fee schedule,Facility 26607,Not in chargemaster,26607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26607,BCBS multispecialty AW base fee schedule,$925.51 ,,Fee schedule,,,,,,294.15,357.5,0
unity,Fee schedule,Facility 26608,Not in chargemaster,26608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26608,BCBS multispecialty AW base fee schedule,$914.25 ,,Fee schedule,,,,,,83.48,238.51,0
unity,Fee schedule,Facility 26615,Not in chargemaster,26615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26615,BCBS multispecialty AW base fee schedule,"$1,096.44 ",,Fee schedule,,,,,,155.03,281.83,0
unity,Fee schedule,Facility 26641,Not in chargemaster,26641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26641,BCBS multispecialty AW base fee schedule,$660.51 ,,Fee schedule,,,,,,126.54,230,0
unity,Fee schedule,Facility 26605,26605,26605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26605,BCBS multispecialty AW base fee schedule,$559.81 ,700,Fee schedule,,559.81,559.81,559.81,559.81,184.84,330,0
unity,Fee schedule,Facility 26645,Not in chargemaster,26645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26645,BCBS multispecialty AW base fee schedule,$749.95 ,,Fee schedule,,,,,,3.98,14.2,0
unity,Fee schedule,Facility 26650,Not in chargemaster,26650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26650,BCBS multispecialty AW base fee schedule,$912.26 ,,Fee schedule,,,,,,101.36,173.92,0
unity,Fee schedule,Facility 26665,Not in chargemaster,26665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26665,BCBS multispecialty AW base fee schedule,"$1,193.16 ",,Fee schedule,,,,,,210.68,313.06,0
unity,Fee schedule,Facility 26670,Not in chargemaster,26670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26670,BCBS multispecialty AW base fee schedule,$587.64 ,,Fee schedule,,,,,,103.35,173.92,0
unity,Fee schedule,Facility 26676,Not in chargemaster,26676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26676,BCBS multispecialty AW base fee schedule,$963.28 ,,Fee schedule,,,,,,88.11,155,0
unity,Fee schedule,Facility 26685,Not in chargemaster,26685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26685,BCBS multispecialty AW base fee schedule,"$1,096.44 ",,Fee schedule,,,,,,1523.09,1707.23,0
unity,Fee schedule,Facility 26686,Not in chargemaster,26686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26686,BCBS multispecialty AW base fee schedule,"$1,192.50 ",,Fee schedule,,,,,,583.66,1040,0
unity,Fee schedule,Facility 26700,26700,26700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26700,BCBS multispecialty AW base fee schedule,$586.98 ,690.71,Fee schedule,,586.98,586.98,586.98,586.98,466.4,819.9,0
unity,Fee schedule,Facility 26675,Not in chargemaster,26675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26675,BCBS multispecialty AW base fee schedule,$800.30 ,,Fee schedule,,,,,,160.33,284.66,0
unity,Fee schedule,Facility 26705,Not in chargemaster,26705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26705,BCBS multispecialty AW base fee schedule,$730.08 ,,Fee schedule,,,,,,420.69,789.38,0
unity,Fee schedule,Facility 26706,Not in chargemaster,26706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26706,BCBS multispecialty AW base fee schedule,$842.04 ,,Fee schedule,,,,,,410.75,740.4,0
unity,Fee schedule,Facility 26715,Not in chargemaster,26715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26715,BCBS multispecialty AW base fee schedule,"$1,091.14 ",,Fee schedule,,,,,,380.28,626.81,0
unity,Fee schedule,Facility 26720,26720,26720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26720,BCBS multispecialty AW base fee schedule,$352.45 ,425.99,Fee schedule,,352.45,352.45,352.45,352.45,321.31,570,0
unity,Fee schedule,Facility 26727,Not in chargemaster,26727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26727,BCBS multispecialty AW base fee schedule,$898.35 ,,Fee schedule,,,,,,408.1,790,0
unity,Fee schedule,Facility 26735,Not in chargemaster,26735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26735,BCBS multispecialty AW base fee schedule,"$1,133.54 ",,Fee schedule,,,,,,373.65,640,0
unity,Fee schedule,Facility 26740,Not in chargemaster,26740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26740,BCBS multispecialty AW base fee schedule,$414.06 ,,Fee schedule,,,,,,279.58,530,0
unity,Fee schedule,Facility 26725,26725,26725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26725,BCBS multispecialty AW base fee schedule,$578.36 ,719.09,Fee schedule,,578.36,578.36,578.36,578.36,459.78,829.83,0
unity,Fee schedule,Facility 26742,Not in chargemaster,26742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26742,BCBS multispecialty AW base fee schedule,$638.65 ,,Fee schedule,,,,,,391.54,690,0
unity,Fee schedule,Facility 26746,Not in chargemaster,26746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26746,BCBS multispecialty AW base fee schedule,"$1,416.43 ",,Fee schedule,,,,,,361.73,650.24,0
unity,Fee schedule,Facility 26750,26750,26750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26750,BCBS multispecialty AW base fee schedule,$354.44 ,394.68,Fee schedule,,354.44,354.44,354.44,354.44,288.85,508.98,0
unity,Fee schedule,Facility 26755,26755,26755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26755,BCBS multispecialty AW base fee schedule,$521.39 ,671.53,Fee schedule,,521.39,521.39,521.39,521.39,359.74,601.26,0
unity,Fee schedule,Facility 26756,Not in chargemaster,26756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26756,BCBS multispecialty AW base fee schedule,$802.95 ,,Fee schedule,,,,,,184.18,367,0
unity,Fee schedule,Facility 26765,Not in chargemaster,26765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26765,BCBS multispecialty AW base fee schedule,$955.33 ,,Fee schedule,,,,,,145.75,300.99,0
unity,Fee schedule,Facility 26770,26770,26770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26770,BCBS multispecialty AW base fee schedule,$490.91 ,591.33,Fee schedule,,490.91,490.91,490.91,490.91,113.95,257.69,0
unity,Fee schedule,Facility 26776,Not in chargemaster,26776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26776,BCBS multispecialty AW base fee schedule,$850.65 ,,Fee schedule,,,,,,107.99,235.69,0
unity,Fee schedule,Facility 26785,Not in chargemaster,26785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26785,BCBS multispecialty AW base fee schedule,"$1,040.79 ",,Fee schedule,,,,,,185.5,354.23,0
unity,Fee schedule,Facility 26820,Not in chargemaster,26820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26820,BCBS multispecialty AW base fee schedule,"$1,527.73 ",,Fee schedule,,,,,,142.44,274.01,0
unity,Fee schedule,Facility 26841,Not in chargemaster,26841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26841,BCBS multispecialty AW base fee schedule,"$1,408.48 ",,Fee schedule,,,,,,114.61,233.55,0
unity,Fee schedule,Facility 26842,Not in chargemaster,26842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26842,BCBS multispecialty AW base fee schedule,"$1,514.48 ",,Fee schedule,,,,,,86.13,193.09,0
unity,Fee schedule,Facility 26843,Not in chargemaster,26843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26843,BCBS multispecialty AW base fee schedule,"$1,434.31 ",,Fee schedule,,,,,,199.41,522.5,0
unity,Fee schedule,Facility 26844,Not in chargemaster,26844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26844,BCBS multispecialty AW base fee schedule,"$1,587.35 ",,Fee schedule,,,,,,123.23,308,0
unity,Fee schedule,Facility 26850,Not in chargemaster,26850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26850,BCBS multispecialty AW base fee schedule,"$1,343.55 ",,Fee schedule,,,,,,180.86,306.67,0
unity,Fee schedule,Facility 26852,Not in chargemaster,26852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26852,BCBS multispecialty AW base fee schedule,"$1,537.66 ",,Fee schedule,,,,,,57.64,117.83,0
unity,Fee schedule,Facility 26860,Not in chargemaster,26860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26860,BCBS multispecialty AW base fee schedule,"$1,102.40 ",,Fee schedule,,,,,,844.03,1216,0
unity,Fee schedule,Facility 26861,Not in chargemaster,26861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26861,BCBS multispecialty AW base fee schedule,$197.43 ,,Fee schedule,,,,,,353.78,615,0
unity,Fee schedule,Facility 26862,Not in chargemaster,26862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26862,BCBS multispecialty AW base fee schedule,"$1,403.84 ",,Fee schedule,,,,,,174.9,380,0
unity,Fee schedule,Facility 26863,Not in chargemaster,26863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26863,BCBS multispecialty AW base fee schedule,$438.58 ,,Fee schedule,,,,,,217.96,501.88,0
unity,Fee schedule,Facility 26910,Not in chargemaster,26910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26910,BCBS multispecialty AW base fee schedule,"$1,400.53 ",,Fee schedule,,,,,,192.79,472.07,0
unity,Fee schedule,Facility 26951,Not in chargemaster,26951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26951,BCBS multispecialty AW base fee schedule,"$1,268.69 ",,Fee schedule,,,,,,59.63,115,0
unity,Fee schedule,Facility 26952,Not in chargemaster,26952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26952,BCBS multispecialty AW base fee schedule,"$1,252.79 ",,Fee schedule,,,,,,104.01,235,0
unity,Fee schedule,Facility 26990,Not in chargemaster,26990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26990,BCBS multispecialty AW base fee schedule,"$1,250.14 ",,Fee schedule,,,,,,747.3,1088.23,0
unity,Fee schedule,Facility 26991,Not in chargemaster,26991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26991,BCBS multispecialty AW base fee schedule,"$1,004.35 ",,Fee schedule,,,,,,539.28,837.64,0
unity,Fee schedule,Facility 27048,Not in chargemaster,27048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27048,BCBS multispecialty AW base fee schedule,"$1,167.33 ",,Fee schedule,,,,,,433.94,680.05,0
unity,Fee schedule,Facility 27049,Not in chargemaster,27049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27049,BCBS multispecialty AW base fee schedule,"$2,562.55 ",,Fee schedule,,,,,,345.83,577.84,0
unity,Fee schedule,Facility 27050,Not in chargemaster,27050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27050,BCBS multispecialty AW base fee schedule,$767.18 ,,Fee schedule,,,,,,294.81,508.28,0
unity,Fee schedule,Facility 27052,Not in chargemaster,27052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27052,BCBS multispecialty AW base fee schedule,"$1,103.06 ",,Fee schedule,,,,,,237.84,430.18,0
unity,Fee schedule,Facility 27054,Not in chargemaster,27054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27054,BCBS multispecialty AW base fee schedule,"$1,312.41 ",,Fee schedule,,,,,,559.15,866.04,0
unity,Fee schedule,Facility 27057,Not in chargemaster,27057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27057,BCBS multispecialty AW base fee schedule,"$1,939.80 ",,Fee schedule,,,,,,453.81,719.09,0
unity,Fee schedule,Facility 27059,Not in chargemaster,27059,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27059,BCBS multispecialty AW base fee schedule,"$3,474.81 ",,Fee schedule,,,,,,399.49,639.6,0
unity,Fee schedule,Facility 27060,Not in chargemaster,27060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27060,BCBS multispecialty AW base fee schedule,$887.75 ,,Fee schedule,,,,,,321.31,547.31,0
unity,Fee schedule,Facility 27062,Not in chargemaster,27062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27062,BCBS multispecialty AW base fee schedule,$867.21 ,,Fee schedule,,,,,,282.89,490.52,0
unity,Fee schedule,Facility 27065,Not in chargemaster,27065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27065,BCBS multispecialty AW base fee schedule,$993.75 ,,Fee schedule,,,,,,606.19,975,0
unity,Fee schedule,Facility 27066,Not in chargemaster,27066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27066,BCBS multispecialty AW base fee schedule,"$1,549.59 ",,Fee schedule,,,,,,405.45,670.12,0
unity,Fee schedule,Facility 27067,Not in chargemaster,27067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27067,BCBS multispecialty AW base fee schedule,"$1,980.21 ",,Fee schedule,,,,,,367.03,601.26,0
unity,Fee schedule,Facility 27070,Not in chargemaster,27070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27070,BCBS multispecialty AW base fee schedule,"$1,677.45 ",,Fee schedule,,,,,,306.74,535,0
unity,Fee schedule,Facility 27071,Not in chargemaster,27071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27071,BCBS multispecialty AW base fee schedule,"$1,807.30 ",,Fee schedule,,,,,,280.9,495,0
unity,Fee schedule,Facility 27075,Not in chargemaster,27075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27075,BCBS multispecialty AW base fee schedule,"$4,011.44 ",,Fee schedule,,,,,,229.23,420,0
unity,Fee schedule,Facility 27076,Not in chargemaster,27076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27076,BCBS multispecialty AW base fee schedule,"$4,856.13 ",,Fee schedule,,,,,,429.96,594.87,0
unity,Fee schedule,Facility 27077,Not in chargemaster,27077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27077,BCBS multispecialty AW base fee schedule,"$5,419.25 ",,Fee schedule,,,,,,336.55,476.32,0
unity,Fee schedule,Facility 27078,Not in chargemaster,27078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27078,BCBS multispecialty AW base fee schedule,"$3,953.80 ",,Fee schedule,,,,,,274.28,410,0
unity,Fee schedule,Facility 27080,Not in chargemaster,27080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27080,BCBS multispecialty AW base fee schedule,$979.84 ,,Fee schedule,,,,,,247.11,367,0
unity,Fee schedule,Facility 27086,Not in chargemaster,27086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27086,BCBS multispecialty AW base fee schedule,$319.33 ,,Fee schedule,,,,,,194.78,297,0
unity,Fee schedule,Facility 26992,Not in chargemaster,26992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26992,BCBS multispecialty AW base fee schedule,"$1,891.44 ",,Fee schedule,,,,,,522.71,725,0
unity,Fee schedule,Facility 27000,Not in chargemaster,27000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27000,BCBS multispecialty AW base fee schedule,$771.81 ,,Fee schedule,,,,,,338.54,494.78,0
unity,Fee schedule,Facility 27001,Not in chargemaster,27001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27001,BCBS multispecialty AW base fee schedule,"$1,034.83 ",,Fee schedule,,,,,,294.81,430.89,0
unity,Fee schedule,Facility 27003,Not in chargemaster,27003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27003,BCBS multispecialty AW base fee schedule,"$1,141.49 ",,Fee schedule,,,,,,257.05,380,0
unity,Fee schedule,Facility 27005,Not in chargemaster,27005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27005,BCBS multispecialty AW base fee schedule,"$1,382.64 ",,Fee schedule,,,,,,207.36,336.48,0
unity,Fee schedule,Facility 27006,Not in chargemaster,27006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27006,BCBS multispecialty AW base fee schedule,"$1,371.38 ",,Fee schedule,,,,,,155.03,265,0
unity,Fee schedule,Facility 27025,Not in chargemaster,27025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27025,BCBS multispecialty AW base fee schedule,"$1,756.95 ",,Fee schedule,,,,,,469.71,685,0
unity,Fee schedule,Facility 27027,Not in chargemaster,27027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27027,BCBS multispecialty AW base fee schedule,"$1,710.58 ",,Fee schedule,,,,,,308.73,462.84,0
unity,Fee schedule,Facility 27030,Not in chargemaster,27030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27030,BCBS multispecialty AW base fee schedule,"$1,796.70 ",,Fee schedule,,,,,,280.24,420,0
unity,Fee schedule,Facility 27033,Not in chargemaster,27033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27033,BCBS multispecialty AW base fee schedule,"$1,862.95 ",,Fee schedule,,,,,,216.64,365,0
unity,Fee schedule,Facility 27035,Not in chargemaster,27035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27035,BCBS multispecialty AW base fee schedule,"$2,187.58 ",,Fee schedule,,,,,,196.1,318.74,0
unity,Fee schedule,Facility 27036,Not in chargemaster,27036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27036,BCBS multispecialty AW base fee schedule,"$1,935.83 ",,Fee schedule,,,,,,154.36,264.09,0
unity,Fee schedule,Facility 27040,Not in chargemaster,27040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27040,BCBS multispecialty AW base fee schedule,$378.95 ,,Fee schedule,,,,,,186.83,400,0
unity,Fee schedule,Facility 27041,Not in chargemaster,27041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27041,BCBS multispecialty AW base fee schedule,"$1,335.60 ",,Fee schedule,,,,,,143.76,345,0
unity,Fee schedule,Facility 27043,Not in chargemaster,27043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27043,BCBS multispecialty AW base fee schedule,$899.01 ,,Fee schedule,,,,,,121.24,290,0
unity,Fee schedule,Facility 27045,Not in chargemaster,27045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27045,BCBS multispecialty AW base fee schedule,"$1,415.76 ",,Fee schedule,,,,,,88.78,243.5,0
unity,Fee schedule,Facility 27047,Not in chargemaster,27047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27047,BCBS multispecialty AW base fee schedule,$689.00 ,,Fee schedule,,,,,,123.89,307.38,0
unity,Fee schedule,Facility 27087,Not in chargemaster,27087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27087,BCBS multispecialty AW base fee schedule,"$1,178.59 ",,Fee schedule,,,,,,96.06,259.11,0
unity,Fee schedule,Facility 27090,Not in chargemaster,27090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27090,BCBS multispecialty AW base fee schedule,"$1,590.66 ",,Fee schedule,,,,,,74.86,220,0
unity,Fee schedule,Facility 27091,Not in chargemaster,27091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27091,BCBS multispecialty AW base fee schedule,"$3,058.76 ",,Fee schedule,,,,,,137.14,333.64,0
unity,Fee schedule,Facility 27093,Not in chargemaster,27093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27093,BCBS multispecialty AW base fee schedule,$132.50 ,,Fee schedule,,,,,,116.6,302.41,0
unity,Fee schedule,Facility 27097,Not in chargemaster,27097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27097,BCBS multispecialty AW base fee schedule,"$1,305.13 ",,Fee schedule,,,,,,99.38,256.97,0
unity,Fee schedule,Facility 27098,Not in chargemaster,27098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27098,BCBS multispecialty AW base fee schedule,"$1,327.65 ",,Fee schedule,,,,,,65.59,209.42,0
unity,Fee schedule,Facility 27100,Not in chargemaster,27100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27100,BCBS multispecialty AW base fee schedule,"$1,583.38 ",,Fee schedule,,,,,,31.14,45,0
unity,Fee schedule,Facility 27105,Not in chargemaster,27105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27105,BCBS multispecialty AW base fee schedule,"$1,660.23 ",,Fee schedule,,,,,,139.13,186.7,0
unity,Fee schedule,Facility 27110,Not in chargemaster,27110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27110,BCBS multispecialty AW base fee schedule,"$1,856.99 ",,Fee schedule,,,,,,50.35,137.5,0
unity,Fee schedule,Facility 27111,Not in chargemaster,27111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27111,BCBS multispecialty AW base fee schedule,"$1,724.49 ",,Fee schedule,,,,,,92.75,275,0
unity,Fee schedule,Facility 27120,Not in chargemaster,27120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27120,BCBS multispecialty AW base fee schedule,"$2,488.35 ",,Fee schedule,,,,,,74.2,210,0
unity,Fee schedule,Facility 27122,Not in chargemaster,27122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27122,BCBS multispecialty AW base fee schedule,"$2,108.08 ",,Fee schedule,,,,,,30.48,120,0
unity,Fee schedule,Facility 27125,Not in chargemaster,27125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27125,BCBS multispecialty AW base fee schedule,"$2,167.70 ",,Fee schedule,,,,,,115.94,265,0
unity,Fee schedule,Facility 27130,Not in chargemaster,27130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27130,BCBS multispecialty AW base fee schedule,"$2,597.66 ",,Fee schedule,,,,,,54.33,115.01,0
unity,Fee schedule,Facility 27132,Not in chargemaster,27132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27132,BCBS multispecialty AW base fee schedule,"$3,209.81 ",,Fee schedule,,,,,,338.54,405.82,0
unity,Fee schedule,Facility 27134,Not in chargemaster,27134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27134,BCBS multispecialty AW base fee schedule,"$3,669.59 ",,Fee schedule,,,,,,179.54,277.56,0
unity,Fee schedule,Facility 27137,Not in chargemaster,27137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27137,BCBS multispecialty AW base fee schedule,"$2,820.26 ",,Fee schedule,,,,,,225.91,347.12,0
unity,Fee schedule,Facility 27138,Not in chargemaster,27138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27138,BCBS multispecialty AW base fee schedule,"$2,931.56 ",,Fee schedule,,,,,,353.11,588.48,0
unity,Fee schedule,Facility 27140,Not in chargemaster,27140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27140,BCBS multispecialty AW base fee schedule,"$1,712.56 ",,Fee schedule,,,,,,194.78,325.83,0
unity,Fee schedule,Facility 27146,Not in chargemaster,27146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27146,BCBS multispecialty AW base fee schedule,"$2,447.28 ",,Fee schedule,,,,,,345.16,445,0
unity,Fee schedule,Facility 27147,Not in chargemaster,27147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27147,BCBS multispecialty AW base fee schedule,"$2,809.00 ",,Fee schedule,,,,,,190.14,255,0
unity,Fee schedule,Facility 27151,Not in chargemaster,27151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27151,BCBS multispecialty AW base fee schedule,"$3,039.55 ",,Fee schedule,,,,,,33.48,200,0
unity,Fee schedule,Facility 27156,Not in chargemaster,27156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27156,BCBS multispecialty AW base fee schedule,"$3,277.39 ",,Fee schedule,,,,,,331.08,469.74,0
unity,Fee schedule,Facility 27158,Not in chargemaster,27158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27158,BCBS multispecialty AW base fee schedule,"$2,683.79 ",,Fee schedule,,,,,,99.82,137.02,0
unity,Fee schedule,Facility 27161,Not in chargemaster,27161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27161,BCBS multispecialty AW base fee schedule,"$2,335.98 ",,Fee schedule,,,,,,332.32,469.74,0
unity,Fee schedule,Facility 27165,Not in chargemaster,27165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27165,BCBS multispecialty AW base fee schedule,"$2,628.80 ",,Fee schedule,,,,,,45.88,101.14,0
unity,Fee schedule,Facility 27170,Not in chargemaster,27170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27170,BCBS multispecialty AW base fee schedule,"$2,250.51 ",,Fee schedule,,,,,,21.7,53.55,0
unity,Fee schedule,Facility 27175,Not in chargemaster,27175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27175,BCBS multispecialty AW base fee schedule,"$1,274.65 ",,Fee schedule,,,,,,181.66,290,0
unity,Fee schedule,Facility 27176,Not in chargemaster,27176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27176,BCBS multispecialty AW base fee schedule,"$1,760.26 ",,Fee schedule,,,,,,172.36,270,0
unity,Fee schedule,Facility 27177,Not in chargemaster,27177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27177,BCBS multispecialty AW base fee schedule,"$2,132.59 ",,Fee schedule,,,,,,158.1,250,0
unity,Fee schedule,Facility 27178,Not in chargemaster,27178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27178,BCBS multispecialty AW base fee schedule,"$1,760.26 ",,Fee schedule,,,,,,153.76,250,0
unity,Fee schedule,Facility 27179,Not in chargemaster,27179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27179,BCBS multispecialty AW base fee schedule,"$1,871.56 ",,Fee schedule,,,,,,135.78,225,0
unity,Fee schedule,Facility 27181,Not in chargemaster,27181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27181,BCBS multispecialty AW base fee schedule,"$2,144.51 ",,Fee schedule,,,,,,135.78,225,0
unity,Fee schedule,Facility 27185,Not in chargemaster,27185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27185,BCBS multispecialty AW base fee schedule,"$1,372.70 ",,Fee schedule,,,,,,124.62,210,0
unity,Fee schedule,Facility 27187,Not in chargemaster,27187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27187,BCBS multispecialty AW base fee schedule,"$1,905.35 ",,Fee schedule,,,,,,227.54,342.17,0
unity,Fee schedule,Facility 27197,Not in chargemaster,27197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27197,BCBS multispecialty AW base fee schedule,$243.80 ,,Fee schedule,,,,,,211.42,325,0
unity,Fee schedule,Facility 27198,Not in chargemaster,27198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27198,BCBS multispecialty AW base fee schedule,$585.65 ,,Fee schedule,,,,,,174.22,282,0
unity,Fee schedule,Facility 27200,Not in chargemaster,27200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27200,BCBS multispecialty AW base fee schedule,$357.75 ,,Fee schedule,,,,,,181.66,290,0
unity,Fee schedule,Facility 27202,Not in chargemaster,27202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27202,BCBS multispecialty AW base fee schedule,"$1,012.96 ",,Fee schedule,,,,,,153.76,255,0
unity,Fee schedule,Facility 27215,Not in chargemaster,27215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27215,BCBS multispecialty AW base fee schedule,"$1,155.40 ",,Fee schedule,,,,,,145.08,238.51,0
unity,Fee schedule,Facility 27216,Not in chargemaster,27216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27216,BCBS multispecialty AW base fee schedule,"$1,713.23 ",,Fee schedule,,,,,,135.78,238,0
unity,Fee schedule,Facility 27217,Not in chargemaster,27217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27217,BCBS multispecialty AW base fee schedule,"$1,607.89 ",,Fee schedule,,,,,,195.92,262,0
unity,Fee schedule,Facility 27218,Not in chargemaster,27218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27218,BCBS multispecialty AW base fee schedule,"$2,217.39 ",,Fee schedule,,,,,,389.36,480,0
unity,Fee schedule,Facility 27220,Not in chargemaster,27220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27220,BCBS multispecialty AW base fee schedule,$810.24 ,,Fee schedule,,,,,,195.3,300,0
unity,Fee schedule,Facility 26775,Not in chargemaster,26775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26775,BCBS multispecialty AW base fee schedule,$659.85 ,,Fee schedule,,,,,,138.26,230,0
unity,Fee schedule,Facility 27095,Not in chargemaster,27095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27095,BCBS multispecialty AW base fee schedule,$160.99 ,,Fee schedule,,,,,,89.9,158,0
unity,Fee schedule,Facility 27222,Not in chargemaster,27222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27222,BCBS multispecialty AW base fee schedule,"$1,863.61 ",,Fee schedule,,,,,,45.26,97,0
unity,Fee schedule,Facility 27226,Not in chargemaster,27226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27226,BCBS multispecialty AW base fee schedule,"$2,022.61 ",,Fee schedule,,,,,,16.12,50,0
unity,Fee schedule,Facility 27227,Not in chargemaster,27227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27227,BCBS multispecialty AW base fee schedule,"$3,170.06 ",,Fee schedule,,,,,,296.36,440,0
unity,Fee schedule,Facility 27228,Not in chargemaster,27228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27228,BCBS multispecialty AW base fee schedule,"$3,601.35 ",,Fee schedule,,,,,,226.92,350,0
unity,Fee schedule,Facility 27230,Not in chargemaster,27230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27230,BCBS multispecialty AW base fee schedule,$906.30 ,,Fee schedule,,,,,,57.66,97.26,0
unity,Fee schedule,Facility 27232,Not in chargemaster,27232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27232,BCBS multispecialty AW base fee schedule,"$1,432.33 ",,Fee schedule,,,,,,132.68,230,0
unity,Fee schedule,Facility 27235,Not in chargemaster,27235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27235,BCBS multispecialty AW base fee schedule,"$1,737.74 ",,Fee schedule,,,,,,88.66,163,0
unity,Fee schedule,Facility 27236,Not in chargemaster,27236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27236,BCBS multispecialty AW base fee schedule,"$2,287.61 ",,Fee schedule,,,,,,46.5,98,0
unity,Fee schedule,Facility 27238,Not in chargemaster,27238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27238,BCBS multispecialty AW base fee schedule,$886.43 ,,Fee schedule,,,,,,47.78,190,0
unity,Fee schedule,Facility 27240,Not in chargemaster,27240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27240,BCBS multispecialty AW base fee schedule,"$1,824.53 ",,Fee schedule,,,,,,194.78,297,0
unity,Fee schedule,Facility 27244,Not in chargemaster,27244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27244,BCBS multispecialty AW base fee schedule,"$2,354.53 ",,Fee schedule,,,,,,522.71,725,0
unity,Fee schedule,Facility 27245,Not in chargemaster,27245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27245,BCBS multispecialty AW base fee schedule,"$2,351.88 ",,Fee schedule,,,,,,338.54,494.78,0
unity,Fee schedule,Facility 27246,Not in chargemaster,27246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27246,BCBS multispecialty AW base fee schedule,$736.70 ,,Fee schedule,,,,,,294.81,430.89,0
unity,Fee schedule,Facility 27248,Not in chargemaster,27248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27248,BCBS multispecialty AW base fee schedule,"$1,429.01 ",,Fee schedule,,,,,,257.05,380,0
unity,Fee schedule,Facility 27250,Not in chargemaster,27250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27250,BCBS multispecialty AW base fee schedule,$353.11 ,,Fee schedule,,,,,,207.36,336.48,0
unity,Fee schedule,Facility 27252,Not in chargemaster,27252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27252,BCBS multispecialty AW base fee schedule,"$1,445.58 ",,Fee schedule,,,,,,155.03,265,0
unity,Fee schedule,Facility 27253,Not in chargemaster,27253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27253,BCBS multispecialty AW base fee schedule,"$1,803.33 ",,Fee schedule,,,,,,469.71,685,0
unity,Fee schedule,Facility 27254,Not in chargemaster,27254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27254,BCBS multispecialty AW base fee schedule,"$2,438.66 ",,Fee schedule,,,,,,308.73,462.84,0
unity,Fee schedule,Facility 27256,Not in chargemaster,27256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27256,BCBS multispecialty AW base fee schedule,$457.13 ,,Fee schedule,,,,,,280.24,420,0
unity,Fee schedule,Facility 27257,Not in chargemaster,27257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27257,BCBS multispecialty AW base fee schedule,$691.65 ,,Fee schedule,,,,,,216.64,365,0
unity,Fee schedule,Facility 27258,Not in chargemaster,27258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27258,BCBS multispecialty AW base fee schedule,"$2,126.63 ",,Fee schedule,,,,,,196.1,318.74,0
unity,Fee schedule,Facility 27259,Not in chargemaster,27259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27259,BCBS multispecialty AW base fee schedule,"$2,964.03 ",,Fee schedule,,,,,,154.36,264.09,0
unity,Fee schedule,Facility 27265,Not in chargemaster,27265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27265,BCBS multispecialty AW base fee schedule,$772.48 ,,Fee schedule,,,,,,186.83,400,0
unity,Fee schedule,Facility 27266,Not in chargemaster,27266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27266,BCBS multispecialty AW base fee schedule,"$1,113.00 ",,Fee schedule,,,,,,143.76,345,0
unity,Fee schedule,Facility 27267,Not in chargemaster,27267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27267,BCBS multispecialty AW base fee schedule,$834.09 ,,Fee schedule,,,,,,121.24,290,0
unity,Fee schedule,Facility 27268,Not in chargemaster,27268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27268,BCBS multispecialty AW base fee schedule,"$1,034.83 ",,Fee schedule,,,,,,88.78,243.5,0
unity,Fee schedule,Facility 27269,Not in chargemaster,27269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27269,BCBS multispecialty AW base fee schedule,"$2,384.34 ",,Fee schedule,,,,,,123.89,307.38,0
unity,Fee schedule,Facility 27275,Not in chargemaster,27275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27275,BCBS multispecialty AW base fee schedule,$348.48 ,,Fee schedule,,,,,,96.06,259.11,0
unity,Fee schedule,Facility 27279,Not in chargemaster,27279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27279,BCBS multispecialty AW base fee schedule,"$1,678.78 ",,Fee schedule,,,,,,74.86,220,0
unity,Fee schedule,Facility 27280,Not in chargemaster,27280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27280,BCBS multispecialty AW base fee schedule,"$2,598.33 ",,Fee schedule,,,,,,137.14,333.64,0
unity,Fee schedule,Facility 27282,Not in chargemaster,27282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27282,BCBS multispecialty AW base fee schedule,"$1,639.69 ",,Fee schedule,,,,,,116.6,302.41,0
unity,Fee schedule,Facility 27284,Not in chargemaster,27284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27284,BCBS multispecialty AW base fee schedule,"$3,088.58 ",,Fee schedule,,,,,,99.38,256.97,0
unity,Fee schedule,Facility 27286,Not in chargemaster,27286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27286,BCBS multispecialty AW base fee schedule,"$3,158.14 ",,Fee schedule,,,,,,65.59,209.42,0
unity,Fee schedule,Facility 27290,Not in chargemaster,27290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27290,BCBS multispecialty AW base fee schedule,"$3,113.09 ",,Fee schedule,,,,,,31.14,45,0
unity,Fee schedule,Facility 27295,Not in chargemaster,27295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27295,BCBS multispecialty AW base fee schedule,"$2,413.49 ",,Fee schedule,,,,,,139.13,186.7,0
unity,Fee schedule,Facility 27301,27301,27301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27301,BCBS multispecialty AW base fee schedule,$963.94 ,1239.27,Fee schedule,,963.94,963.94,963.94,963.94,50.35,137.5,0
unity,Fee schedule,Facility 27380,Not in chargemaster,27380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27380,BCBS multispecialty AW base fee schedule,"$1,161.36 ",,Fee schedule,,,,,,92.75,275,0
unity,Fee schedule,Facility 27381,Not in chargemaster,27381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27381,BCBS multispecialty AW base fee schedule,"$1,546.94 ",,Fee schedule,,,,,,74.2,210,0
unity,Fee schedule,Facility 27385,Not in chargemaster,27385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27385,BCBS multispecialty AW base fee schedule,"$1,124.93 ",,Fee schedule,,,,,,30.48,120,0
unity,Fee schedule,Facility 27386,Not in chargemaster,27386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27386,BCBS multispecialty AW base fee schedule,"$1,615.84 ",,Fee schedule,,,,,,115.94,265,0
unity,Fee schedule,Facility 27390,Not in chargemaster,27390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27390,BCBS multispecialty AW base fee schedule,$855.95 ,,Fee schedule,,,,,,54.33,115.01,0
unity,Fee schedule,Facility 27391,Not in chargemaster,27391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27391,BCBS multispecialty AW base fee schedule,"$1,078.55 ",,Fee schedule,,,,,,338.54,405.82,0
unity,Fee schedule,Facility 27392,Not in chargemaster,27392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27392,BCBS multispecialty AW base fee schedule,"$1,362.10 ",,Fee schedule,,,,,,179.54,277.56,0
unity,Fee schedule,Facility 27393,Not in chargemaster,27393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27393,BCBS multispecialty AW base fee schedule,$973.21 ,,Fee schedule,,,,,,225.91,347.12,0
unity,Fee schedule,Facility 27394,Not in chargemaster,27394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27394,BCBS multispecialty AW base fee schedule,"$1,250.80 ",,Fee schedule,,,,,,353.11,588.48,0
unity,Fee schedule,Facility 27395,Not in chargemaster,27395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27395,BCBS multispecialty AW base fee schedule,"$1,683.41 ",,Fee schedule,,,,,,194.78,325.83,0
unity,Fee schedule,Facility 27396,Not in chargemaster,27396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27396,BCBS multispecialty AW base fee schedule,"$1,178.59 ",,Fee schedule,,,,,,345.16,445,0
unity,Fee schedule,Facility 27397,Not in chargemaster,27397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27397,BCBS multispecialty AW base fee schedule,"$1,749.66 ",,Fee schedule,,,,,,190.14,255,0
unity,Fee schedule,Facility 27400,Not in chargemaster,27400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27400,BCBS multispecialty AW base fee schedule,"$1,328.31 ",,Fee schedule,,,,,,583.66,1040,0
unity,Fee schedule,Facility 27403,Not in chargemaster,27403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27403,BCBS multispecialty AW base fee schedule,"$1,229.60 ",,Fee schedule,,,,,,466.4,819.9,0
unity,Fee schedule,Facility 27405,Not in chargemaster,27405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27405,BCBS multispecialty AW base fee schedule,"$1,291.88 ",,Fee schedule,,,,,,160.33,284.66,0
unity,Fee schedule,Facility 27407,Not in chargemaster,27407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27407,BCBS multispecialty AW base fee schedule,"$1,520.44 ",,Fee schedule,,,,,,420.69,789.38,0
unity,Fee schedule,Facility 27409,Not in chargemaster,27409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27409,BCBS multispecialty AW base fee schedule,"$1,850.36 ",,Fee schedule,,,,,,410.75,740.4,0
unity,Fee schedule,Facility 27412,Not in chargemaster,27412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27412,BCBS multispecialty AW base fee schedule,"$3,160.13 ",,Fee schedule,,,,,,380.28,626.81,0
unity,Fee schedule,Facility 27415,Not in chargemaster,27415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27415,BCBS multispecialty AW base fee schedule,"$2,628.14 ",,Fee schedule,,,,,,321.31,570,0
unity,Fee schedule,Facility 27416,Not in chargemaster,27416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27416,BCBS multispecialty AW base fee schedule,"$1,876.86 ",,Fee schedule,,,,,,408.1,790,0
unity,Fee schedule,Facility 27418,Not in chargemaster,27418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27418,BCBS multispecialty AW base fee schedule,"$1,584.70 ",,Fee schedule,,,,,,373.65,640,0
unity,Fee schedule,Facility 27420,Not in chargemaster,27420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27420,BCBS multispecialty AW base fee schedule,"$1,422.39 ",,Fee schedule,,,,,,279.58,530,0
unity,Fee schedule,Facility 27422,Not in chargemaster,27422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27422,BCBS multispecialty AW base fee schedule,"$1,423.05 ",,Fee schedule,,,,,,459.78,829.83,0
unity,Fee schedule,Facility 27424,Not in chargemaster,27424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27424,BCBS multispecialty AW base fee schedule,"$1,430.34 ",,Fee schedule,,,,,,391.54,690,0
unity,Fee schedule,Facility 27425,Not in chargemaster,27425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27425,BCBS multispecialty AW base fee schedule,$858.60 ,,Fee schedule,,,,,,361.73,650.24,0
unity,Fee schedule,Facility 27427,Not in chargemaster,27427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27427,BCBS multispecialty AW base fee schedule,"$1,360.11 ",,Fee schedule,,,,,,288.85,508.98,0
unity,Fee schedule,Facility 27428,Not in chargemaster,27428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27428,BCBS multispecialty AW base fee schedule,"$2,133.25 ",,Fee schedule,,,,,,359.74,601.26,0
unity,Fee schedule,Facility 27429,Not in chargemaster,27429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27429,BCBS multispecialty AW base fee schedule,"$2,399.58 ",,Fee schedule,,,,,,184.18,367,0
unity,Fee schedule,Facility 27430,Not in chargemaster,27430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27430,BCBS multispecialty AW base fee schedule,"$1,418.41 ",,Fee schedule,,,,,,145.75,300.99,0
unity,Fee schedule,Facility 27435,Not in chargemaster,27435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27435,BCBS multispecialty AW base fee schedule,"$1,547.60 ",,Fee schedule,,,,,,113.95,257.69,0
unity,Fee schedule,Facility 27437,Not in chargemaster,27437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27437,BCBS multispecialty AW base fee schedule,"$1,260.08 ",,Fee schedule,,,,,,107.99,235.69,0
unity,Fee schedule,Facility 27438,Not in chargemaster,27438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27438,BCBS multispecialty AW base fee schedule,"$1,610.54 ",,Fee schedule,,,,,,185.5,354.23,0
unity,Fee schedule,Facility 27440,Not in chargemaster,27440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27440,BCBS multispecialty AW base fee schedule,"$1,526.40 ",,Fee schedule,,,,,,142.44,274.01,0
unity,Fee schedule,Facility 27441,Not in chargemaster,27441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27441,BCBS multispecialty AW base fee schedule,"$1,576.75 ",,Fee schedule,,,,,,114.61,233.55,0
unity,Fee schedule,Facility 27442,Not in chargemaster,27442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27442,BCBS multispecialty AW base fee schedule,"$1,669.50 ",,Fee schedule,,,,,,86.13,193.09,0
unity,Fee schedule,Facility 27443,Not in chargemaster,27443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27443,BCBS multispecialty AW base fee schedule,"$1,554.89 ",,Fee schedule,,,,,,199.41,522.5,0
unity,Fee schedule,Facility 27445,Not in chargemaster,27445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27445,BCBS multispecialty AW base fee schedule,"$2,404.21 ",,Fee schedule,,,,,,123.23,308,0
unity,Fee schedule,Facility 27446,Not in chargemaster,27446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27446,BCBS multispecialty AW base fee schedule,"$2,218.71 ",,Fee schedule,,,,,,180.86,306.67,0
unity,Fee schedule,Facility 27447,Not in chargemaster,27447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27447,BCBS multispecialty AW base fee schedule,"$2,594.35 ",,Fee schedule,,,,,,57.64,117.83,0
unity,Fee schedule,Facility 27448,Not in chargemaster,27448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27448,BCBS multispecialty AW base fee schedule,"$1,571.45 ",,Fee schedule,,,,,,844.03,1216,0
unity,Fee schedule,Facility 27450,Not in chargemaster,27450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27450,BCBS multispecialty AW base fee schedule,"$1,943.11 ",,Fee schedule,,,,,,353.78,615,0
unity,Fee schedule,Facility 27454,Not in chargemaster,27454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27454,BCBS multispecialty AW base fee schedule,"$2,481.73 ",,Fee schedule,,,,,,174.9,380,0
unity,Fee schedule,Facility 27455,Not in chargemaster,27455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27455,BCBS multispecialty AW base fee schedule,"$1,821.88 ",,Fee schedule,,,,,,217.96,501.88,0
unity,Fee schedule,Facility 27457,Not in chargemaster,27457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27457,BCBS multispecialty AW base fee schedule,"$1,841.75 ",,Fee schedule,,,,,,192.79,472.07,0
unity,Fee schedule,Facility 27465,Not in chargemaster,27465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27465,BCBS multispecialty AW base fee schedule,"$2,396.26 ",,Fee schedule,,,,,,59.63,115,0
unity,Fee schedule,Facility 27466,Not in chargemaster,27466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27466,BCBS multispecialty AW base fee schedule,"$2,267.74 ",,Fee schedule,,,,,,104.01,235,0
unity,Fee schedule,Facility 27468,Not in chargemaster,27468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27468,BCBS multispecialty AW base fee schedule,"$2,570.50 ",,Fee schedule,,,,,,747.3,1088.23,0
unity,Fee schedule,Facility 27470,Not in chargemaster,27470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27470,BCBS multispecialty AW base fee schedule,"$2,255.15 ",,Fee schedule,,,,,,539.28,837.64,0
unity,Fee schedule,Facility 27472,Not in chargemaster,27472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27472,BCBS multispecialty AW base fee schedule,"$2,419.45 ",,Fee schedule,,,,,,433.94,680.05,0
unity,Fee schedule,Facility 27475,Not in chargemaster,27475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27475,BCBS multispecialty AW base fee schedule,"$1,266.70 ",,Fee schedule,,,,,,345.83,577.84,0
unity,Fee schedule,Facility 27477,Not in chargemaster,27477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27477,BCBS multispecialty AW base fee schedule,"$1,401.85 ",,Fee schedule,,,,,,294.81,508.28,0
unity,Fee schedule,Facility 27479,Not in chargemaster,27479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27479,BCBS multispecialty AW base fee schedule,"$1,758.94 ",,Fee schedule,,,,,,237.84,430.18,0
unity,Fee schedule,Facility 27485,Not in chargemaster,27485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27485,BCBS multispecialty AW base fee schedule,"$1,283.26 ",,Fee schedule,,,,,,559.15,866.04,0
unity,Fee schedule,Facility 27486,Not in chargemaster,27486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27486,BCBS multispecialty AW base fee schedule,"$2,695.05 ",,Fee schedule,,,,,,453.81,719.09,0
unity,Fee schedule,Facility 27487,Not in chargemaster,27487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27487,BCBS multispecialty AW base fee schedule,"$3,370.80 ",,Fee schedule,,,,,,399.49,639.6,0
unity,Fee schedule,Facility 27488,Not in chargemaster,27488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27488,BCBS multispecialty AW base fee schedule,"$2,298.88 ",,Fee schedule,,,,,,321.31,547.31,0
unity,Fee schedule,Facility 27495,Not in chargemaster,27495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27495,BCBS multispecialty AW base fee schedule,"$2,159.75 ",,Fee schedule,,,,,,282.89,490.52,0
unity,Fee schedule,Facility 27496,Not in chargemaster,27496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27496,BCBS multispecialty AW base fee schedule,"$1,040.79 ",,Fee schedule,,,,,,606.19,975,0
unity,Fee schedule,Facility 27497,Not in chargemaster,27497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27497,BCBS multispecialty AW base fee schedule,"$1,111.68 ",,Fee schedule,,,,,,405.45,670.12,0
unity,Fee schedule,Facility 27498,Not in chargemaster,27498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27498,BCBS multispecialty AW base fee schedule,"$1,251.46 ",,Fee schedule,,,,,,367.03,601.26,0
unity,Fee schedule,Facility 27499,Not in chargemaster,27499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27499,BCBS multispecialty AW base fee schedule,"$1,340.24 ",,Fee schedule,,,,,,306.74,535,0
unity,Fee schedule,Facility 27500,Not in chargemaster,27500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27500,BCBS multispecialty AW base fee schedule,$917.56 ,,Fee schedule,,,,,,280.9,495,0
unity,Fee schedule,Facility 27328,Not in chargemaster,27328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27328,BCBS multispecialty AW base fee schedule,"$1,193.83 ",,Fee schedule,,,,,,229.23,420,0
unity,Fee schedule,Facility 27329,Not in chargemaster,27329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27329,BCBS multispecialty AW base fee schedule,"$1,996.11 ",,Fee schedule,,,,,,429.96,594.87,0
unity,Fee schedule,Facility 27330,Not in chargemaster,27330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27330,BCBS multispecialty AW base fee schedule,$785.73 ,,Fee schedule,,,,,,336.55,476.32,0
unity,Fee schedule,Facility 27331,Not in chargemaster,27331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27331,BCBS multispecialty AW base fee schedule,$906.30 ,,Fee schedule,,,,,,274.28,410,0
unity,Fee schedule,Facility 27332,Not in chargemaster,27332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27332,BCBS multispecialty AW base fee schedule,"$1,230.93 ",,Fee schedule,,,,,,247.11,367,0
unity,Fee schedule,Facility 27333,Not in chargemaster,27333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27333,BCBS multispecialty AW base fee schedule,"$1,120.95 ",,Fee schedule,,,,,,87.45,129.23,0
unity,Fee schedule,Facility 27334,Not in chargemaster,27334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27334,BCBS multispecialty AW base fee schedule,"$1,309.10 ",,Fee schedule,,,,,,71.55,137.02,0
unity,Fee schedule,Facility 27335,Not in chargemaster,27335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27335,BCBS multispecialty AW base fee schedule,"$1,463.46 ",,Fee schedule,,,,,,87.45,159,0
unity,Fee schedule,Facility 27337,Not in chargemaster,27337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27337,BCBS multispecialty AW base fee schedule,$802.29 ,,Fee schedule,,,,,,68.9,105,0
unity,Fee schedule,Facility 27339,Not in chargemaster,27339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27339,BCBS multispecialty AW base fee schedule,"$1,446.90 ",,Fee schedule,,,,,,82.81,154,0
unity,Fee schedule,Facility 27340,Not in chargemaster,27340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27340,BCBS multispecialty AW base fee schedule,$708.88 ,,Fee schedule,,,,,,73.54,120,0
unity,Fee schedule,Facility 27345,Not in chargemaster,27345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27345,BCBS multispecialty AW base fee schedule,$923.53 ,,Fee schedule,,,,,,76.19,126.36,0
unity,Fee schedule,Facility 27347,Not in chargemaster,27347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27347,BCBS multispecialty AW base fee schedule,"$1,006.34 ",,Fee schedule,,,,,,74.86,122.1,0
unity,Fee schedule,Facility 27350,Not in chargemaster,27350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27350,BCBS multispecialty AW base fee schedule,"$1,247.49 ",,Fee schedule,,,,,,294.15,357.5,0
unity,Fee schedule,Facility 27355,Not in chargemaster,27355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27355,BCBS multispecialty AW base fee schedule,"$1,156.06 ",,Fee schedule,,,,,,83.48,238.51,0
unity,Fee schedule,Facility 27356,Not in chargemaster,27356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27356,BCBS multispecialty AW base fee schedule,"$1,413.11 ",,Fee schedule,,,,,,155.03,281.83,0
unity,Fee schedule,Facility 27357,Not in chargemaster,27357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27357,BCBS multispecialty AW base fee schedule,"$1,560.19 ",,Fee schedule,,,,,,126.54,230,0
unity,Fee schedule,Facility 27358,Not in chargemaster,27358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27358,BCBS multispecialty AW base fee schedule,$531.99 ,,Fee schedule,,,,,,184.84,330,0
unity,Fee schedule,Facility 27360,Not in chargemaster,27360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27360,BCBS multispecialty AW base fee schedule,"$1,678.11 ",,Fee schedule,,,,,,3.98,14.2,0
unity,Fee schedule,Facility 27364,Not in chargemaster,27364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27364,BCBS multispecialty AW base fee schedule,"$2,995.83 ",,Fee schedule,,,,,,101.36,173.92,0
unity,Fee schedule,Facility 27365,Not in chargemaster,27365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27365,BCBS multispecialty AW base fee schedule,"$3,952.48 ",,Fee schedule,,,,,,210.68,313.06,0
unity,Fee schedule,Facility 27369,Not in chargemaster,27369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27369,BCBS multispecialty AW base fee schedule,$78.18 ,,Fee schedule,,,,,,103.35,173.92,0
unity,Fee schedule,Facility 27303,Not in chargemaster,27303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27303,BCBS multispecialty AW base fee schedule,"$1,226.29 ",,Fee schedule,,,,,,88.11,155,0
unity,Fee schedule,Facility 27305,Not in chargemaster,27305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27305,BCBS multispecialty AW base fee schedule,$918.89 ,,Fee schedule,,,,,,203.39,560.79,0
unity,Fee schedule,Facility 27306,Not in chargemaster,27306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27306,BCBS multispecialty AW base fee schedule,$653.89 ,,Fee schedule,,,,,,108.65,280,0
unity,Fee schedule,Facility 27307,Not in chargemaster,27307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27307,BCBS multispecialty AW base fee schedule,$916.90 ,,Fee schedule,,,,,,213.99,276.13,0
unity,Fee schedule,Facility 27310,Not in chargemaster,27310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27310,BCBS multispecialty AW base fee schedule,"$1,398.54 ",,Fee schedule,,,,,,53,185,0
unity,Fee schedule,Facility 27323,Not in chargemaster,27323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27323,BCBS multispecialty AW base fee schedule,$336.55 ,,Fee schedule,,,,,,94.08,154.76,0
unity,Fee schedule,Facility 27324,Not in chargemaster,27324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27324,BCBS multispecialty AW base fee schedule,$771.81 ,,Fee schedule,,,,,,96.06,180.31,0
unity,Fee schedule,Facility 27325,Not in chargemaster,27325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27325,BCBS multispecialty AW base fee schedule,"$1,071.93 ",,Fee schedule,,,,,,111.96,175.34,0
unity,Fee schedule,Facility 27326,Not in chargemaster,27326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27326,BCBS multispecialty AW base fee schedule,$989.11 ,,Fee schedule,,,,,,35.78,122.1,0
unity,Fee schedule,Facility 27327,27327,27327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27327,BCBS multispecialty AW base fee schedule,$596.91 ,605,Fee schedule,,596.91,596.91,596.91,596.91,56.31,87.32,0
unity,Fee schedule,Facility 27096,Not in chargemaster,27096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27096,BCBS multispecialty AW base fee schedule,$158.34 ,,Fee schedule,,,,,,74.86,140.56,0
unity,Fee schedule,Facility 27372,Not in chargemaster,27372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27372,BCBS multispecialty AW base fee schedule,$767.84 ,,Fee schedule,,,,,,80.16,188.84,0
unity,Fee schedule,Facility 27502,Not in chargemaster,27502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27502,BCBS multispecialty AW base fee schedule,"$1,453.53 ",,Fee schedule,,,,,,116.6,186.7,0
unity,Fee schedule,Facility 27503,Not in chargemaster,27503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27503,BCBS multispecialty AW base fee schedule,"$1,531.70 ",,Fee schedule,,,,,,129.19,207.28,0
unity,Fee schedule,Facility 27506,Not in chargemaster,27506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27506,BCBS multispecialty AW base fee schedule,"$2,559.90 ",,Fee schedule,,,,,,270.3,355,0
unity,Fee schedule,Facility 27507,Not in chargemaster,27507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27507,BCBS multispecialty AW base fee schedule,"$1,859.64 ",,Fee schedule,,,,,,225.91,266.2,0
unity,Fee schedule,Facility 27508,Not in chargemaster,27508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27508,BCBS multispecialty AW base fee schedule,$947.38 ,,Fee schedule,,,,,,235.19,316.6,0
unity,Fee schedule,Facility 27509,Not in chargemaster,27509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27509,BCBS multispecialty AW base fee schedule,"$1,263.39 ",,Fee schedule,,,,,,387.56,476.32,0
unity,Fee schedule,Facility 27510,Not in chargemaster,27510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27510,BCBS multispecialty AW base fee schedule,"$1,301.15 ",,Fee schedule,,,,,,546.56,680,0
unity,Fee schedule,Facility 27511,Not in chargemaster,27511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27511,BCBS multispecialty AW base fee schedule,"$1,913.96 ",,Fee schedule,,,,,,535.3,658.76,0
unity,Fee schedule,Facility 27513,Not in chargemaster,27513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27513,BCBS multispecialty AW base fee schedule,"$2,379.04 ",,Fee schedule,,,,,,539.94,648.11,0
unity,Fee schedule,Facility 27514,Not in chargemaster,27514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27514,BCBS multispecialty AW base fee schedule,"$1,854.34 ",,Fee schedule,,,,,,596.91,661.42,0
unity,Fee schedule,Facility 27516,Not in chargemaster,27516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27516,BCBS multispecialty AW base fee schedule,$916.24 ,,Fee schedule,,,,,,963.94,1239.27,0
unity,Fee schedule,Facility 27517,Not in chargemaster,27517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27517,BCBS multispecialty AW base fee schedule,"$1,313.08 ",,Fee schedule,,,,,,490.91,591.33,0
unity,Fee schedule,Facility 27519,Not in chargemaster,27519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27519,BCBS multispecialty AW base fee schedule,"$1,708.59 ",,Fee schedule,,,,,,521.39,671.53,0
unity,Fee schedule,Facility 27520,Not in chargemaster,27520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27520,BCBS multispecialty AW base fee schedule,$565.78 ,,Fee schedule,,,,,,578.36,719.09,0
unity,Fee schedule,Facility 27501,Not in chargemaster,27501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27501,BCBS multispecialty AW base fee schedule,$950.03 ,,Fee schedule,,,,,,352.45,425.99,0
unity,Fee schedule,Facility 27524,Not in chargemaster,27524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27524,BCBS multispecialty AW base fee schedule,"$1,439.61 ",,Fee schedule,,,,,,586.98,690.71,0
unity,Fee schedule,Facility 27530,27530,27530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27530,BCBS multispecialty AW base fee schedule,$539.94 ,648.11,Fee schedule,,539.94,539.94,539.94,539.94,559.81,700,0
unity,Fee schedule,Facility 27535,Not in chargemaster,27535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27535,BCBS multispecialty AW base fee schedule,"$1,719.85 ",,Fee schedule,,,,,,533.98,640,0
unity,Fee schedule,Facility 27536,Not in chargemaster,27536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27536,BCBS multispecialty AW base fee schedule,"$2,275.03 ",,Fee schedule,,,,,,975.86,1167.02,0
unity,Fee schedule,Facility 27538,Not in chargemaster,27538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27538,BCBS multispecialty AW base fee schedule,$847.34 ,,Fee schedule,,,,,,263.01,569.61,0
unity,Fee schedule,Facility 27532,Not in chargemaster,27532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27532,BCBS multispecialty AW base fee schedule,"$1,101.74 ",,Fee schedule,,,,,,534.64,653.08,0
unity,Fee schedule,Facility 27540,Not in chargemaster,27540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27540,BCBS multispecialty AW base fee schedule,"$1,549.59 ",,Fee schedule,,,,,,600.23,715,0
unity,Fee schedule,Facility 27550,Not in chargemaster,27550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27550,BCBS multispecialty AW base fee schedule,$924.85 ,,Fee schedule,,,,,,484.29,610,0
unity,Fee schedule,Facility 27552,Not in chargemaster,27552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27552,BCBS multispecialty AW base fee schedule,"$1,201.78 ",,Fee schedule,,,,,,455.8,506.86,0
unity,Fee schedule,Facility 27556,Not in chargemaster,27556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27556,BCBS multispecialty AW base fee schedule,"$1,681.43 ",,Fee schedule,,,,,,461.1,560.79,0
unity,Fee schedule,Facility 27557,Not in chargemaster,27557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27557,BCBS multispecialty AW base fee schedule,"$2,006.71 ",,Fee schedule,,,,,,149.73,305.95,0
unity,Fee schedule,Facility 27558,Not in chargemaster,27558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27558,BCBS multispecialty AW base fee schedule,"$2,287.61 ",,Fee schedule,,,,,,626.73,764.53,0
unity,Fee schedule,Facility 27560,Not in chargemaster,27560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27560,BCBS multispecialty AW base fee schedule,$654.55 ,,Fee schedule,,,,,,553.85,672.96,0
unity,Fee schedule,Facility 27562,Not in chargemaster,27562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27562,BCBS multispecialty AW base fee schedule,$928.16 ,,Fee schedule,,,,,,296.14,565.05,0
unity,Fee schedule,Facility 27566,Not in chargemaster,27566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27566,BCBS multispecialty AW base fee schedule,1710.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27570,Not in chargemaster,27570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27570,BCBS multispecialty AW base fee schedule,287.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27580,Not in chargemaster,27580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27580,BCBS multispecialty AW base fee schedule,2794.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27590,Not in chargemaster,27590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27590,BCBS multispecialty AW base fee schedule,1525.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27591,Not in chargemaster,27591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27591,BCBS multispecialty AW base fee schedule,1848.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27592,Not in chargemaster,27592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27592,BCBS multispecialty AW base fee schedule,1297.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27594,Not in chargemaster,27594,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27594,BCBS multispecialty AW base fee schedule,979.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27596,Not in chargemaster,27596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27596,BCBS multispecialty AW base fee schedule,1370.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27598,Not in chargemaster,27598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27598,BCBS multispecialty AW base fee schedule,1364.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27600,Not in chargemaster,27600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27600,BCBS multispecialty AW base fee schedule,775.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27601,Not in chargemaster,27601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27601,BCBS multispecialty AW base fee schedule,853.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27602,Not in chargemaster,27602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27602,BCBS multispecialty AW base fee schedule,929.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27603,Not in chargemaster,27603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27603,BCBS multispecialty AW base fee schedule,743.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27604,Not in chargemaster,27604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27604,BCBS multispecialty AW base fee schedule,636.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27605,Not in chargemaster,27605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27605,BCBS multispecialty AW base fee schedule,353.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27606,Not in chargemaster,27606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27606,BCBS multispecialty AW base fee schedule,529.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27607,Not in chargemaster,27607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27607,BCBS multispecialty AW base fee schedule,1156.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27610,Not in chargemaster,27610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27610,BCBS multispecialty AW base fee schedule,1239.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27612,Not in chargemaster,27612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27612,BCBS multispecialty AW base fee schedule,1065.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27613,Not in chargemaster,27613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27613,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27615,Not in chargemaster,27615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27615,BCBS multispecialty AW base fee schedule,1964.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27616,Not in chargemaster,27616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27616,BCBS multispecialty AW base fee schedule,2439.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27618,Not in chargemaster,27618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27618,BCBS multispecialty AW base fee schedule,581.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27619,Not in chargemaster,27619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27619,BCBS multispecialty AW base fee schedule,881.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27620,Not in chargemaster,27620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27620,BCBS multispecialty AW base fee schedule,854.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27625,Not in chargemaster,27625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27625,BCBS multispecialty AW base fee schedule,1102.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27626,Not in chargemaster,27626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27626,BCBS multispecialty AW base fee schedule,1155.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27630,Not in chargemaster,27630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27630,BCBS multispecialty AW base fee schedule,686.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27632,Not in chargemaster,27632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27632,BCBS multispecialty AW base fee schedule,791.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27634,Not in chargemaster,27634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27634,BCBS multispecialty AW base fee schedule,1307.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27635,Not in chargemaster,27635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27635,BCBS multispecialty AW base fee schedule,1111.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27637,Not in chargemaster,27637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27637,BCBS multispecialty AW base fee schedule,1430.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27638,Not in chargemaster,27638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27638,BCBS multispecialty AW base fee schedule,1464.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27640,Not in chargemaster,27640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27640,BCBS multispecialty AW base fee schedule,1589.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27641,Not in chargemaster,27641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27641,BCBS multispecialty AW base fee schedule,1264.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27645,Not in chargemaster,27645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27645,BCBS multispecialty AW base fee schedule,3397.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27646,Not in chargemaster,27646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27646,BCBS multispecialty AW base fee schedule,2948.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27647,Not in chargemaster,27647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27647,BCBS multispecialty AW base fee schedule,1943.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27648,Not in chargemaster,27648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27648,BCBS multispecialty AW base fee schedule,100.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27658,Not in chargemaster,27658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27658,BCBS multispecialty AW base fee schedule,704.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27659,Not in chargemaster,27659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27659,BCBS multispecialty AW base fee schedule,897.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27664,Not in chargemaster,27664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27664,BCBS multispecialty AW base fee schedule,687.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27665,Not in chargemaster,27665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27665,BCBS multispecialty AW base fee schedule,791.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27675,Not in chargemaster,27675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27675,BCBS multispecialty AW base fee schedule,936.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27676,Not in chargemaster,27676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27676,BCBS multispecialty AW base fee schedule,1142.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27680,Not in chargemaster,27680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27680,BCBS multispecialty AW base fee schedule,809.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27681,Not in chargemaster,27681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27681,BCBS multispecialty AW base fee schedule,987.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27685,Not in chargemaster,27685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27685,BCBS multispecialty AW base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27686,Not in chargemaster,27686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27686,BCBS multispecialty AW base fee schedule,1034.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27687,Not in chargemaster,27687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27687,BCBS multispecialty AW base fee schedule,867.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27690,Not in chargemaster,27690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27690,BCBS multispecialty AW base fee schedule,1219.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27691,Not in chargemaster,27691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27691,BCBS multispecialty AW base fee schedule,1421.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27692,Not in chargemaster,27692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27692,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27695,Not in chargemaster,27695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27695,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27696,Not in chargemaster,27696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27696,BCBS multispecialty AW base fee schedule,1065.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27698,Not in chargemaster,27698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27698,BCBS multispecialty AW base fee schedule,1218.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27700,Not in chargemaster,27700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27700,BCBS multispecialty AW base fee schedule,1171.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27702,Not in chargemaster,27702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27702,BCBS multispecialty AW base fee schedule,1845.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27703,Not in chargemaster,27703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27703,BCBS multispecialty AW base fee schedule,2135.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27704,Not in chargemaster,27704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27704,BCBS multispecialty AW base fee schedule,1095.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27705,Not in chargemaster,27705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27705,BCBS multispecialty AW base fee schedule,1448.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27707,Not in chargemaster,27707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27707,BCBS multispecialty AW base fee schedule,761.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27709,Not in chargemaster,27709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27709,BCBS multispecialty AW base fee schedule,2233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27712,Not in chargemaster,27712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27712,BCBS multispecialty AW base fee schedule,2108.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27715,Not in chargemaster,27715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27715,BCBS multispecialty AW base fee schedule,2051.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27720,Not in chargemaster,27720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27720,BCBS multispecialty AW base fee schedule,1674.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27722,Not in chargemaster,27722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27722,BCBS multispecialty AW base fee schedule,1707.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27724,Not in chargemaster,27724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27724,BCBS multispecialty AW base fee schedule,2413.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27725,Not in chargemaster,27725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27725,BCBS multispecialty AW base fee schedule,2326.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27726,Not in chargemaster,27726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27726,BCBS multispecialty AW base fee schedule,1832.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27727,Not in chargemaster,27727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27727,BCBS multispecialty AW base fee schedule,1985.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27730,Not in chargemaster,27730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27730,BCBS multispecialty AW base fee schedule,1121.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27732,Not in chargemaster,27732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27732,BCBS multispecialty AW base fee schedule,859.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27734,Not in chargemaster,27734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27734,BCBS multispecialty AW base fee schedule,1255.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27740,Not in chargemaster,27740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27740,BCBS multispecialty AW base fee schedule,1353.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27742,Not in chargemaster,27742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27742,BCBS multispecialty AW base fee schedule,1486.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27745,Not in chargemaster,27745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27745,BCBS multispecialty AW base fee schedule,1454.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27750,Not in chargemaster,27750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27750,BCBS multispecialty AW base fee schedule,608.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27650,Not in chargemaster,27650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27650,BCBS multispecialty AW base fee schedule,1255.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27652,Not in chargemaster,27652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27652,BCBS multispecialty AW base fee schedule,1269.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27654,Not in chargemaster,27654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27654,BCBS multispecialty AW base fee schedule,1360.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27656,Not in chargemaster,27656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27656,BCBS multispecialty AW base fee schedule,756.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27614,Not in chargemaster,27614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27614,BCBS multispecialty AW base fee schedule,775.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27752,Not in chargemaster,27752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27752,BCBS multispecialty AW base fee schedule,940.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27756,Not in chargemaster,27756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27756,BCBS multispecialty AW base fee schedule,1097.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27758,Not in chargemaster,27758,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27758,BCBS multispecialty AW base fee schedule,1711.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27759,Not in chargemaster,27759,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27759,BCBS multispecialty AW base fee schedule,1911.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27760,Not in chargemaster,27760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27760,BCBS multispecialty AW base fee schedule,583.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27766,Not in chargemaster,27766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27766,BCBS multispecialty AW base fee schedule,1153.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27767,Not in chargemaster,27767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27767,BCBS multispecialty AW base fee schedule,543.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27768,Not in chargemaster,27768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27768,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27769,Not in chargemaster,27769,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27769,BCBS multispecialty AW base fee schedule,1394.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27780,27780,27780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27780,BCBS multispecialty AW base fee schedule,535.3,658.76,Fee schedule,,535.3,535.3,535.3,535.3,,,0
unity,Fee schedule,Facility 27762,Not in chargemaster,27762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27762,BCBS multispecialty AW base fee schedule,827.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27781,Not in chargemaster,27781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27781,BCBS multispecialty AW base fee schedule,759.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27784,Not in chargemaster,27784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27784,BCBS multispecialty AW base fee schedule,1358.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27786,27786,27786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27786,BCBS multispecialty AW base fee schedule,546.56,680,Fee schedule,,546.56,546.56,546.56,546.56,,,0
unity,Fee schedule,Facility 27788,Not in chargemaster,27788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27788,BCBS multispecialty AW base fee schedule,735.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27792,Not in chargemaster,27792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27792,BCBS multispecialty AW base fee schedule,1236.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27808,Not in chargemaster,27808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27808,BCBS multispecialty AW base fee schedule,576.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27810,Not in chargemaster,27810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27810,BCBS multispecialty AW base fee schedule,808.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27814,Not in chargemaster,27814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27814,BCBS multispecialty AW base fee schedule,1466.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27816,Not in chargemaster,27816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27816,BCBS multispecialty AW base fee schedule,553.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27818,Not in chargemaster,27818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27818,BCBS multispecialty AW base fee schedule,830.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27831,Not in chargemaster,27831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27831,BCBS multispecialty AW base fee schedule,770.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27832,Not in chargemaster,27832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27832,BCBS multispecialty AW base fee schedule,1445.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27840,27840,27840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27840,BCBS multispecialty AW base fee schedule,718.15,796.47,Fee schedule,,718.15,718.15,718.15,718.15,,,0
unity,Fee schedule,Facility 27842,Not in chargemaster,27842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27842,BCBS multispecialty AW base fee schedule,940.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27846,Not in chargemaster,27846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27846,BCBS multispecialty AW base fee schedule,1365.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27848,Not in chargemaster,27848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27848,BCBS multispecialty AW base fee schedule,1528.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27860,Not in chargemaster,27860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27860,BCBS multispecialty AW base fee schedule,325.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27870,Not in chargemaster,27870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27870,BCBS multispecialty AW base fee schedule,1955.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27871,Not in chargemaster,27871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27871,BCBS multispecialty AW base fee schedule,1317.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27880,Not in chargemaster,27880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27880,BCBS multispecialty AW base fee schedule,1745.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27881,Not in chargemaster,27881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27881,BCBS multispecialty AW base fee schedule,1645.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27882,Not in chargemaster,27882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27882,BCBS multispecialty AW base fee schedule,1146.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27884,Not in chargemaster,27884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27884,BCBS multispecialty AW base fee schedule,1097.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27886,Not in chargemaster,27886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27886,BCBS multispecialty AW base fee schedule,1256.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27888,Not in chargemaster,27888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27888,BCBS multispecialty AW base fee schedule,1255.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27889,Not in chargemaster,27889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27889,BCBS multispecialty AW base fee schedule,1232.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27892,Not in chargemaster,27892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27892,BCBS multispecialty AW base fee schedule,1052.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27893,Not in chargemaster,27893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27893,BCBS multispecialty AW base fee schedule,1167.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27894,Not in chargemaster,27894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27894,BCBS multispecialty AW base fee schedule,1611.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28001,Not in chargemaster,28001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28001,BCBS multispecialty AW base fee schedule,327.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27822,Not in chargemaster,27822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27822,BCBS multispecialty AW base fee schedule,1654.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27823,Not in chargemaster,27823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27823,BCBS multispecialty AW base fee schedule,1872.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27824,Not in chargemaster,27824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27824,BCBS multispecialty AW base fee schedule,579.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27826,Not in chargemaster,27826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27826,BCBS multispecialty AW base fee schedule,1626.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27827,Not in chargemaster,27827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27827,BCBS multispecialty AW base fee schedule,2123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27828,Not in chargemaster,27828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27828,BCBS multispecialty AW base fee schedule,2524.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27829,Not in chargemaster,27829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27829,BCBS multispecialty AW base fee schedule,1338.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27830,Not in chargemaster,27830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27830,BCBS multispecialty AW base fee schedule,681.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27825,Not in chargemaster,27825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27825,BCBS multispecialty AW base fee schedule,944.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28002,Not in chargemaster,28002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28002,BCBS multispecialty AW base fee schedule,610.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28003,Not in chargemaster,28003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28003,BCBS multispecialty AW base fee schedule,1069.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28005,Not in chargemaster,28005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28005,BCBS multispecialty AW base fee schedule,1102.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28008,Not in chargemaster,28008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28008,BCBS multispecialty AW base fee schedule,562.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28010,Not in chargemaster,28010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28010,BCBS multispecialty AW base fee schedule,396.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28011,Not in chargemaster,28011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28011,BCBS multispecialty AW base fee schedule,536.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28020,Not in chargemaster,28020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28020,BCBS multispecialty AW base fee schedule,686.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28022,Not in chargemaster,28022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28022,BCBS multispecialty AW base fee schedule,620.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28024,Not in chargemaster,28024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28024,BCBS multispecialty AW base fee schedule,577.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28035,Not in chargemaster,28035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28035,BCBS multispecialty AW base fee schedule,676.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28039,Not in chargemaster,28039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28039,BCBS multispecialty AW base fee schedule,658.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28041,Not in chargemaster,28041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28041,BCBS multispecialty AW base fee schedule,865.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28043,Not in chargemaster,28043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28043,BCBS multispecialty AW base fee schedule,498.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28046,Not in chargemaster,28046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28046,BCBS multispecialty AW base fee schedule,1369.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28047,Not in chargemaster,28047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28047,BCBS multispecialty AW base fee schedule,1992.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28050,Not in chargemaster,28050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28050,BCBS multispecialty AW base fee schedule,531.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28045,Not in chargemaster,28045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28045,BCBS multispecialty AW base fee schedule,660.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28052,Not in chargemaster,28052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28052,BCBS multispecialty AW base fee schedule,541.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28054,Not in chargemaster,28054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28054,BCBS multispecialty AW base fee schedule,447.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28055,Not in chargemaster,28055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28055,BCBS multispecialty AW base fee schedule,738.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28060,Not in chargemaster,28060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28060,BCBS multispecialty AW base fee schedule,686.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28062,Not in chargemaster,28062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28062,BCBS multispecialty AW base fee schedule,775.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28070,Not in chargemaster,28070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28070,BCBS multispecialty AW base fee schedule,675.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28072,Not in chargemaster,28072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28072,BCBS multispecialty AW base fee schedule,611.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28080,Not in chargemaster,28080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28080,BCBS multispecialty AW base fee schedule,703.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28086,Not in chargemaster,28086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28086,BCBS multispecialty AW base fee schedule,676.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28088,Not in chargemaster,28088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28088,BCBS multispecialty AW base fee schedule,524.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28090,Not in chargemaster,28090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28090,BCBS multispecialty AW base fee schedule,584.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28092,Not in chargemaster,28092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28092,BCBS multispecialty AW base fee schedule,513.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28102,Not in chargemaster,28102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28102,BCBS multispecialty AW base fee schedule,1162.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28103,Not in chargemaster,28103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28103,BCBS multispecialty AW base fee schedule,744.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28104,Not in chargemaster,28104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28104,BCBS multispecialty AW base fee schedule,675.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28100,Not in chargemaster,28100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28100,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28106,Not in chargemaster,28106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28106,BCBS multispecialty AW base fee schedule,817.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28107,Not in chargemaster,28107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28107,BCBS multispecialty AW base fee schedule,663.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28108,Not in chargemaster,28108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28108,BCBS multispecialty AW base fee schedule,549.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28110,Not in chargemaster,28110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28110,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28111,Not in chargemaster,28111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28111,BCBS multispecialty AW base fee schedule,618.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28112,Not in chargemaster,28112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28112,BCBS multispecialty AW base fee schedule,596.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28113,Not in chargemaster,28113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28113,BCBS multispecialty AW base fee schedule,806.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28114,Not in chargemaster,28114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28114,BCBS multispecialty AW base fee schedule,1578.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28116,Not in chargemaster,28116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28116,BCBS multispecialty AW base fee schedule,1101.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28118,Not in chargemaster,28118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28118,BCBS multispecialty AW base fee schedule,797.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28119,Not in chargemaster,28119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28119,BCBS multispecialty AW base fee schedule,688.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28120,Not in chargemaster,28120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28120,BCBS multispecialty AW base fee schedule,949.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28122,Not in chargemaster,28122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28122,BCBS multispecialty AW base fee schedule,836.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28124,Not in chargemaster,28124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28124,BCBS multispecialty AW base fee schedule,632.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28126,Not in chargemaster,28126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28126,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28130,Not in chargemaster,28130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28130,BCBS multispecialty AW base fee schedule,1206.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28140,Not in chargemaster,28140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28140,BCBS multispecialty AW base fee schedule,832.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28150,Not in chargemaster,28150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28150,BCBS multispecialty AW base fee schedule,530.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28153,Not in chargemaster,28153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28153,BCBS multispecialty AW base fee schedule,506.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28171,Not in chargemaster,28171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28171,BCBS multispecialty AW base fee schedule,2127.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28173,Not in chargemaster,28173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28173,BCBS multispecialty AW base fee schedule,1407.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28175,Not in chargemaster,28175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28175,BCBS multispecialty AW base fee schedule,903.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28190,Not in chargemaster,28190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28190,BCBS multispecialty AW base fee schedule,255.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28160,Not in chargemaster,28160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28160,BCBS multispecialty AW base fee schedule,509.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28192,Not in chargemaster,28192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28192,BCBS multispecialty AW base fee schedule,596.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28193,Not in chargemaster,28193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28193,BCBS multispecialty AW base fee schedule,704.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28200,Not in chargemaster,28200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28200,BCBS multispecialty AW base fee schedule,618.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28202,Not in chargemaster,28202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28202,BCBS multispecialty AW base fee schedule,824.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28208,Not in chargemaster,28208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28208,BCBS multispecialty AW base fee schedule,603.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28210,Not in chargemaster,28210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28210,BCBS multispecialty AW base fee schedule,799.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28220,Not in chargemaster,28220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28220,BCBS multispecialty AW base fee schedule,577.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28222,Not in chargemaster,28222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28222,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28225,Not in chargemaster,28225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28225,BCBS multispecialty AW base fee schedule,502.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28226,Not in chargemaster,28226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28226,BCBS multispecialty AW base fee schedule,751.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28230,Not in chargemaster,28230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28230,BCBS multispecialty AW base fee schedule,540.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28232,Not in chargemaster,28232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28232,BCBS multispecialty AW base fee schedule,460.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28234,Not in chargemaster,28234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28234,BCBS multispecialty AW base fee schedule,504.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28238,Not in chargemaster,28238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28238,BCBS multispecialty AW base fee schedule,925.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28240,Not in chargemaster,28240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28240,BCBS multispecialty AW base fee schedule,560.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28250,Not in chargemaster,28250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28250,BCBS multispecialty AW base fee schedule,772.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28260,Not in chargemaster,28260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28260,BCBS multispecialty AW base fee schedule,991.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28261,Not in chargemaster,28261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28261,BCBS multispecialty AW base fee schedule,1793.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28262,Not in chargemaster,28262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28262,BCBS multispecialty AW base fee schedule,2162.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28264,Not in chargemaster,28264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28264,BCBS multispecialty AW base fee schedule,1472.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28270,Not in chargemaster,28270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28270,BCBS multispecialty AW base fee schedule,638.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28272,Not in chargemaster,28272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28272,BCBS multispecialty AW base fee schedule,480.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28280,Not in chargemaster,28280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28280,BCBS multispecialty AW base fee schedule,664.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28285,Not in chargemaster,28285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28285,BCBS multispecialty AW base fee schedule,724.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28286,Not in chargemaster,28286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28286,BCBS multispecialty AW base fee schedule,567.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28288,Not in chargemaster,28288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28288,BCBS multispecialty AW base fee schedule,825.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28289,Not in chargemaster,28289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28289,BCBS multispecialty AW base fee schedule,875.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28291,Not in chargemaster,28291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28291,BCBS multispecialty AW base fee schedule,934.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28292,Not in chargemaster,28292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28292,BCBS multispecialty AW base fee schedule,922.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28295,Not in chargemaster,28295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28295,BCBS multispecialty AW base fee schedule,1070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28296,Not in chargemaster,28296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28296,BCBS multispecialty AW base fee schedule,981.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28297,Not in chargemaster,28297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28297,BCBS multispecialty AW base fee schedule,1152.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28298,Not in chargemaster,28298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28298,BCBS multispecialty AW base fee schedule,950.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28300,Not in chargemaster,28300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28300,BCBS multispecialty AW base fee schedule,1244.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28302,Not in chargemaster,28302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28302,BCBS multispecialty AW base fee schedule,1368.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28304,Not in chargemaster,28304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28304,BCBS multispecialty AW base fee schedule,1152.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28299,Not in chargemaster,28299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28299,BCBS multispecialty AW base fee schedule,1113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28305,Not in chargemaster,28305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28305,BCBS multispecialty AW base fee schedule,1278.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28306,Not in chargemaster,28306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28306,BCBS multispecialty AW base fee schedule,765.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28307,Not in chargemaster,28307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28307,BCBS multispecialty AW base fee schedule,793.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28308,Not in chargemaster,28308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28308,BCBS multispecialty AW base fee schedule,726.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28309,Not in chargemaster,28309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28309,BCBS multispecialty AW base fee schedule,1688.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28310,Not in chargemaster,28310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28310,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28312,Not in chargemaster,28312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28312,BCBS multispecialty AW base fee schedule,604.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28313,Not in chargemaster,28313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28313,BCBS multispecialty AW base fee schedule,677.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28315,Not in chargemaster,28315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28315,BCBS multispecialty AW base fee schedule,621.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28320,Not in chargemaster,28320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28320,BCBS multispecialty AW base fee schedule,1169.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28322,Not in chargemaster,28322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28322,BCBS multispecialty AW base fee schedule,1097.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28340,Not in chargemaster,28340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28340,BCBS multispecialty AW base fee schedule,785.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28341,Not in chargemaster,28341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28341,BCBS multispecialty AW base fee schedule,936.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28344,Not in chargemaster,28344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28344,BCBS multispecialty AW base fee schedule,532.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28345,Not in chargemaster,28345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28345,BCBS multispecialty AW base fee schedule,695.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28360,Not in chargemaster,28360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28360,BCBS multispecialty AW base fee schedule,2088.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28400,Not in chargemaster,28400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28400,BCBS multispecialty AW base fee schedule,433.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28406,Not in chargemaster,28406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28406,BCBS multispecialty AW base fee schedule,1032.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28415,Not in chargemaster,28415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28415,BCBS multispecialty AW base fee schedule,2138.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28420,Not in chargemaster,28420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28420,BCBS multispecialty AW base fee schedule,2457.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28430,Not in chargemaster,28430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28430,BCBS multispecialty AW base fee schedule,399.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28405,Not in chargemaster,28405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28405,BCBS multispecialty AW base fee schedule,667.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28435,Not in chargemaster,28435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28435,BCBS multispecialty AW base fee schedule,616.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28436,Not in chargemaster,28436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28436,BCBS multispecialty AW base fee schedule,891.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28445,Not in chargemaster,28445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28445,BCBS multispecialty AW base fee schedule,1981.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28446,Not in chargemaster,28446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28446,BCBS multispecialty AW base fee schedule,2341.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28450,Not in chargemaster,28450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28450,BCBS multispecialty AW base fee schedule,362.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28456,Not in chargemaster,28456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28456,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28465,Not in chargemaster,28465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28465,BCBS multispecialty AW base fee schedule,1204.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28470,28470,28470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28470,BCBS multispecialty AW base fee schedule,387.56,476.32,Fee schedule,,387.56,387.56,387.56,387.56,,,0
unity,Fee schedule,Facility 28455,Not in chargemaster,28455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28455,BCBS multispecialty AW base fee schedule,490.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28475,Not in chargemaster,28475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28475,BCBS multispecialty AW base fee schedule,431.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28476,Not in chargemaster,28476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28476,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28485,Not in chargemaster,28485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28485,BCBS multispecialty AW base fee schedule,1052.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28490,28490,28490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28490,BCBS multispecialty AW base fee schedule,235.19,316.6,Fee schedule,,235.19,235.19,235.19,235.19,,,0
unity,Fee schedule,Facility 28495,Not in chargemaster,28495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28495,BCBS multispecialty AW base fee schedule,281.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28496,Not in chargemaster,28496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28496,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28505,Not in chargemaster,28505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28505,BCBS multispecialty AW base fee schedule,948.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28510,28510,28510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28510,BCBS multispecialty AW base fee schedule,225.91,266.2,Fee schedule,,225.91,225.91,225.91,225.91,,,0
unity,Fee schedule,Facility 28515,28515,28515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28515,BCBS multispecialty AW base fee schedule,270.3,355,Fee schedule,,270.3,270.3,270.3,270.3,,,0
unity,Fee schedule,Facility 28525,Not in chargemaster,28525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28525,BCBS multispecialty AW base fee schedule,769.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28530,Not in chargemaster,28530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28530,BCBS multispecialty AW base fee schedule,190.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28531,Not in chargemaster,28531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28531,BCBS multispecialty AW base fee schedule,345.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28540,Not in chargemaster,28540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28540,BCBS multispecialty AW base fee schedule,331.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28545,Not in chargemaster,28545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28545,BCBS multispecialty AW base fee schedule,504.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28546,Not in chargemaster,28546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28546,BCBS multispecialty AW base fee schedule,652.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28555,Not in chargemaster,28555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28555,BCBS multispecialty AW base fee schedule,1242.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28570,Not in chargemaster,28570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28570,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28575,Not in chargemaster,28575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28575,BCBS multispecialty AW base fee schedule,634.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28576,Not in chargemaster,28576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28576,BCBS multispecialty AW base fee schedule,738.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28585,Not in chargemaster,28585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28585,BCBS multispecialty AW base fee schedule,1299.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28600,Not in chargemaster,28600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28600,BCBS multispecialty AW base fee schedule,351.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28606,Not in chargemaster,28606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28606,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28615,Not in chargemaster,28615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28615,BCBS multispecialty AW base fee schedule,1552.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28630,Not in chargemaster,28630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28630,BCBS multispecialty AW base fee schedule,212,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28605,Not in chargemaster,28605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28605,BCBS multispecialty AW base fee schedule,567.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28635,Not in chargemaster,28635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28635,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28636,Not in chargemaster,28636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28636,BCBS multispecialty AW base fee schedule,380.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28645,Not in chargemaster,28645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28645,BCBS multispecialty AW base fee schedule,927.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28705,Not in chargemaster,28705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28705,BCBS multispecialty AW base fee schedule,2349.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28715,Not in chargemaster,28715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28715,BCBS multispecialty AW base fee schedule,1796.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28725,Not in chargemaster,28725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28725,BCBS multispecialty AW base fee schedule,1488.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28730,Not in chargemaster,28730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28730,BCBS multispecialty AW base fee schedule,1405.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28735,Not in chargemaster,28735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28735,BCBS multispecialty AW base fee schedule,1482.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28737,Not in chargemaster,28737,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28737,BCBS multispecialty AW base fee schedule,1317.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28740,Not in chargemaster,28740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28740,BCBS multispecialty AW base fee schedule,1185.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28660,Not in chargemaster,28660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28660,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28665,Not in chargemaster,28665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28665,BCBS multispecialty AW base fee schedule,246.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28666,Not in chargemaster,28666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28666,BCBS multispecialty AW base fee schedule,317.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28675,Not in chargemaster,28675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28675,BCBS multispecialty AW base fee schedule,769.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28750,Not in chargemaster,28750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28750,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28755,Not in chargemaster,28755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28755,BCBS multispecialty AW base fee schedule,634.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28760,Not in chargemaster,28760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28760,BCBS multispecialty AW base fee schedule,1099.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28800,Not in chargemaster,28800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28800,BCBS multispecialty AW base fee schedule,1021.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28805,Not in chargemaster,28805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28805,BCBS multispecialty AW base fee schedule,1381.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28810,Not in chargemaster,28810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28810,BCBS multispecialty AW base fee schedule,819.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28820,Not in chargemaster,28820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28820,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28825,Not in chargemaster,28825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28825,BCBS multispecialty AW base fee schedule,702.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28890,Not in chargemaster,28890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28890,BCBS multispecialty AW base fee schedule,422.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29000,Not in chargemaster,29000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29000,BCBS multispecialty AW base fee schedule,369.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29010,Not in chargemaster,29010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29010,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29015,Not in chargemaster,29015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29015,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29035,Not in chargemaster,29035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29035,BCBS multispecialty AW base fee schedule,270.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29040,Not in chargemaster,29040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29040,BCBS multispecialty AW base fee schedule,327.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29044,Not in chargemaster,29044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29044,BCBS multispecialty AW base fee schedule,316.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29046,Not in chargemaster,29046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29046,BCBS multispecialty AW base fee schedule,355.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29049,Not in chargemaster,29049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29049,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29055,Not in chargemaster,29055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29055,BCBS multispecialty AW base fee schedule,260.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29058,Not in chargemaster,29058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29058,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29065,29065,29065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29065,BCBS multispecialty AW base fee schedule,129.19,207.28,Fee schedule,,129.19,129.19,129.19,129.19,,,0
unity,Fee schedule,Facility 29075,29075,29075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29075,BCBS multispecialty AW base fee schedule,116.6,186.7,Fee schedule,,116.6,116.6,116.6,116.6,,,0
unity,Fee schedule,Facility 29085,Not in chargemaster,29085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29085,BCBS multispecialty AW base fee schedule,127.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29086,Not in chargemaster,29086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29086,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29105,29105,29105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29105,BCBS multispecialty AW base fee schedule,80.16,188.84,Fee schedule,,80.16,80.16,80.16,80.16,,,0
unity,Fee schedule,Facility 29125,29125,29125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29125,BCBS multispecialty AW base fee schedule,74.86,140.56,Fee schedule,,74.86,74.86,74.86,74.86,,,0
unity,Fee schedule,Facility 29126,Not in chargemaster,29126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29126,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29130,29130,29130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29130,BCBS multispecialty AW base fee schedule,56.31,87.32,Fee schedule,,56.31,56.31,56.31,56.31,,,0
unity,Fee schedule,Facility 29131,Not in chargemaster,29131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29131,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29200,Not in chargemaster,29200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29200,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29240,29240,29240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29240,BCBS multispecialty AW base fee schedule,35.78,122.1,Fee schedule,,35.78,35.78,35.78,35.78,,,0
unity,Fee schedule,Facility 29260,Not in chargemaster,29260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29260,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29280,Not in chargemaster,29280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29280,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29305,Not in chargemaster,29305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29305,BCBS multispecialty AW base fee schedule,300.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29325,Not in chargemaster,29325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29325,BCBS multispecialty AW base fee schedule,337.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29345,Not in chargemaster,29345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29345,BCBS multispecialty AW base fee schedule,190.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29355,Not in chargemaster,29355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29355,BCBS multispecialty AW base fee schedule,203.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29358,Not in chargemaster,29358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29358,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29365,Not in chargemaster,29365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29365,BCBS multispecialty AW base fee schedule,165.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29405,29405,29405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29405,BCBS multispecialty AW base fee schedule,111.96,175.34,Fee schedule,,111.96,111.96,111.96,111.96,,,0
unity,Fee schedule,Facility 29425,Not in chargemaster,29425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29425,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29435,Not in chargemaster,29435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29435,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29440,Not in chargemaster,29440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29440,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29445,Not in chargemaster,29445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29445,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29450,Not in chargemaster,29450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29450,BCBS multispecialty AW base fee schedule,215.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29505,29505,29505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29505,BCBS multispecialty AW base fee schedule,96.06,180.31,Fee schedule,,96.06,96.06,96.06,96.06,,,0
unity,Fee schedule,Facility 29515,29515,29515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29515,BCBS multispecialty AW base fee schedule,94.08,154.76,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Facility 29520,Not in chargemaster,29520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29520,BCBS multispecialty AW base fee schedule,36.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29530,Not in chargemaster,29530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29530,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29540,Not in chargemaster,29540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29540,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29550,Not in chargemaster,29550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29550,BCBS multispecialty AW base fee schedule,21.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29580,Not in chargemaster,29580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29580,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29800,Not in chargemaster,29800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29800,BCBS multispecialty AW base fee schedule,1008.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29804,Not in chargemaster,29804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29804,BCBS multispecialty AW base fee schedule,1176.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29805,Not in chargemaster,29805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29805,BCBS multispecialty AW base fee schedule,897.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29806,Not in chargemaster,29806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29806,BCBS multispecialty AW base fee schedule,2023.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29807,Not in chargemaster,29807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29807,BCBS multispecialty AW base fee schedule,1978.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29819,Not in chargemaster,29819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29819,BCBS multispecialty AW base fee schedule,1120.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29820,Not in chargemaster,29820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29820,BCBS multispecialty AW base fee schedule,1025.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29821,Not in chargemaster,29821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29821,BCBS multispecialty AW base fee schedule,1132.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29822,Not in chargemaster,29822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29822,BCBS multispecialty AW base fee schedule,1101.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29823,Not in chargemaster,29823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29823,BCBS multispecialty AW base fee schedule,1199.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29824,Not in chargemaster,29824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29824,BCBS multispecialty AW base fee schedule,1289.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29825,Not in chargemaster,29825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29825,BCBS multispecialty AW base fee schedule,1120.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29826,Not in chargemaster,29826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29826,BCBS multispecialty AW base fee schedule,334.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29827,Not in chargemaster,29827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29827,BCBS multispecialty AW base fee schedule,2047.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29828,Not in chargemaster,29828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29828,BCBS multispecialty AW base fee schedule,1756.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29830,Not in chargemaster,29830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29830,BCBS multispecialty AW base fee schedule,871.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29834,Not in chargemaster,29834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29834,BCBS multispecialty AW base fee schedule,940.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29835,Not in chargemaster,29835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29835,BCBS multispecialty AW base fee schedule,971.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29836,Not in chargemaster,29836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29836,BCBS multispecialty AW base fee schedule,1115.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29837,Not in chargemaster,29837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29837,BCBS multispecialty AW base fee schedule,1007,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29838,Not in chargemaster,29838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29838,BCBS multispecialty AW base fee schedule,1130.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29840,Not in chargemaster,29840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29840,BCBS multispecialty AW base fee schedule,860.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29843,Not in chargemaster,29843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29843,BCBS multispecialty AW base fee schedule,927.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29844,Not in chargemaster,29844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29844,BCBS multispecialty AW base fee schedule,954,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29845,Not in chargemaster,29845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29845,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29846,Not in chargemaster,29846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29846,BCBS multispecialty AW base fee schedule,997.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29847,Not in chargemaster,29847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29847,BCBS multispecialty AW base fee schedule,1038.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29848,Not in chargemaster,29848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29848,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29850,Not in chargemaster,29850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29850,BCBS multispecialty AW base fee schedule,1191.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29851,Not in chargemaster,29851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29851,BCBS multispecialty AW base fee schedule,1780.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29855,Not in chargemaster,29855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29855,BCBS multispecialty AW base fee schedule,1495.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29856,Not in chargemaster,29856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29856,BCBS multispecialty AW base fee schedule,1894.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29860,Not in chargemaster,29860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29860,BCBS multispecialty AW base fee schedule,1274.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29861,Not in chargemaster,29861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29861,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29862,Not in chargemaster,29862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29862,BCBS multispecialty AW base fee schedule,1553.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29863,Not in chargemaster,29863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29863,BCBS multispecialty AW base fee schedule,1558.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29866,Not in chargemaster,29866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29866,BCBS multispecialty AW base fee schedule,2009.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29867,Not in chargemaster,29867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29867,BCBS multispecialty AW base fee schedule,2445.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29868,Not in chargemaster,29868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29868,BCBS multispecialty AW base fee schedule,3202.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29870,Not in chargemaster,29870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29870,BCBS multispecialty AW base fee schedule,782.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29581,29581,29581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29581,BCBS multispecialty AW base fee schedule,53,185,Fee schedule,,53,53,53,53,,,0
unity,Fee schedule,Facility 29584,Not in chargemaster,29584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29584,BCBS multispecialty AW base fee schedule,31.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29700,Not in chargemaster,29700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29700,BCBS multispecialty AW base fee schedule,63.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29705,Not in chargemaster,29705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29705,BCBS multispecialty AW base fee schedule,86.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29710,Not in chargemaster,29710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29710,BCBS multispecialty AW base fee schedule,159.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29720,Not in chargemaster,29720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29720,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29730,Not in chargemaster,29730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29730,BCBS multispecialty AW base fee schedule,82.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29740,Not in chargemaster,29740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29740,BCBS multispecialty AW base fee schedule,133.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29871,Not in chargemaster,29871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29871,BCBS multispecialty AW base fee schedule,981.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29873,Not in chargemaster,29873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29873,BCBS multispecialty AW base fee schedule,1009.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29874,Not in chargemaster,29874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29874,BCBS multispecialty AW base fee schedule,1027.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29875,Not in chargemaster,29875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29875,BCBS multispecialty AW base fee schedule,948.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29876,Not in chargemaster,29876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29876,BCBS multispecialty AW base fee schedule,1248.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29877,Not in chargemaster,29877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29877,BCBS multispecialty AW base fee schedule,1186.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29879,Not in chargemaster,29879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29879,BCBS multispecialty AW base fee schedule,1264.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29880,Not in chargemaster,29880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29880,BCBS multispecialty AW base fee schedule,1072.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29881,Not in chargemaster,29881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29881,BCBS multispecialty AW base fee schedule,1033.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29882,Not in chargemaster,29882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29882,BCBS multispecialty AW base fee schedule,1323.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29883,Not in chargemaster,29883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29883,BCBS multispecialty AW base fee schedule,1608.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29884,Not in chargemaster,29884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29884,BCBS multispecialty AW base fee schedule,1182.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29885,Not in chargemaster,29885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29885,BCBS multispecialty AW base fee schedule,1442.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29886,Not in chargemaster,29886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29886,BCBS multispecialty AW base fee schedule,1215.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29887,Not in chargemaster,29887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29887,BCBS multispecialty AW base fee schedule,1435.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29888,Not in chargemaster,29888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29888,BCBS multispecialty AW base fee schedule,1876.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29889,Not in chargemaster,29889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29889,BCBS multispecialty AW base fee schedule,2339.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29891,Not in chargemaster,29891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29891,BCBS multispecialty AW base fee schedule,1279.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29892,Not in chargemaster,29892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29892,BCBS multispecialty AW base fee schedule,1244.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29893,Not in chargemaster,29893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29893,BCBS multispecialty AW base fee schedule,820.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29894,Not in chargemaster,29894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29894,BCBS multispecialty AW base fee schedule,953.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29895,Not in chargemaster,29895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29895,BCBS multispecialty AW base fee schedule,887.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29897,Not in chargemaster,29897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29897,BCBS multispecialty AW base fee schedule,954.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29898,Not in chargemaster,29898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29898,BCBS multispecialty AW base fee schedule,1075.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29899,Not in chargemaster,29899,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29899,BCBS multispecialty AW base fee schedule,1972.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29900,Not in chargemaster,29900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29900,BCBS multispecialty AW base fee schedule,950.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29901,Not in chargemaster,29901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29901,BCBS multispecialty AW base fee schedule,1023.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29902,Not in chargemaster,29902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29902,BCBS multispecialty AW base fee schedule,1087.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29904,Not in chargemaster,29904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29904,BCBS multispecialty AW base fee schedule,1217.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29905,Not in chargemaster,29905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29905,BCBS multispecialty AW base fee schedule,988.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29906,Not in chargemaster,29906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29906,BCBS multispecialty AW base fee schedule,1268.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29907,Not in chargemaster,29907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29907,BCBS multispecialty AW base fee schedule,1676.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29914,Not in chargemaster,29914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29914,BCBS multispecialty AW base fee schedule,1902.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29915,Not in chargemaster,29915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29915,BCBS multispecialty AW base fee schedule,1959.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29916,Not in chargemaster,29916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29916,BCBS multispecialty AW base fee schedule,1959.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30000,Not in chargemaster,30000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30000,BCBS multispecialty AW base fee schedule,223.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29750,Not in chargemaster,29750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29750,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30020,Not in chargemaster,30020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30020,BCBS multispecialty AW base fee schedule,225.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30100,Not in chargemaster,30100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30100,BCBS multispecialty AW base fee schedule,126.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30110,Not in chargemaster,30110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30110,BCBS multispecialty AW base fee schedule,245.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30115,Not in chargemaster,30115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30115,BCBS multispecialty AW base fee schedule,841.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30117,Not in chargemaster,30117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30117,BCBS multispecialty AW base fee schedule,627.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30118,Not in chargemaster,30118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30118,BCBS multispecialty AW base fee schedule,1463.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30120,Not in chargemaster,30120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30120,BCBS multispecialty AW base fee schedule,808.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30124,Not in chargemaster,30124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30124,BCBS multispecialty AW base fee schedule,551.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30125,Not in chargemaster,30125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30125,BCBS multispecialty AW base fee schedule,1189.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30130,Not in chargemaster,30130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30130,BCBS multispecialty AW base fee schedule,747.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30140,Not in chargemaster,30140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30140,BCBS multispecialty AW base fee schedule,338.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30310,Not in chargemaster,30310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30310,BCBS multispecialty AW base fee schedule,384.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30320,Not in chargemaster,30320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30320,BCBS multispecialty AW base fee schedule,879.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30400,Not in chargemaster,30400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30400,BCBS multispecialty AW base fee schedule,2275.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30410,Not in chargemaster,30410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30410,BCBS multispecialty AW base fee schedule,2640.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30420,Not in chargemaster,30420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30420,BCBS multispecialty AW base fee schedule,2671.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30430,Not in chargemaster,30430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30430,BCBS multispecialty AW base fee schedule,1969.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30435,Not in chargemaster,30435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30435,BCBS multispecialty AW base fee schedule,2492.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30450,Not in chargemaster,30450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30450,BCBS multispecialty AW base fee schedule,3299.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30460,Not in chargemaster,30460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30460,BCBS multispecialty AW base fee schedule,1582.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30462,Not in chargemaster,30462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30462,BCBS multispecialty AW base fee schedule,3042.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30465,Not in chargemaster,30465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30465,BCBS multispecialty AW base fee schedule,1890.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30520,Not in chargemaster,30520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30520,BCBS multispecialty AW base fee schedule,1221.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30540,Not in chargemaster,30540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30540,BCBS multispecialty AW base fee schedule,1340.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30545,Not in chargemaster,30545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30545,BCBS multispecialty AW base fee schedule,1831.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30560,Not in chargemaster,30560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30560,BCBS multispecialty AW base fee schedule,266.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30150,Not in chargemaster,30150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30150,BCBS multispecialty AW base fee schedule,1488.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30160,Not in chargemaster,30160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30160,BCBS multispecialty AW base fee schedule,1497.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30200,Not in chargemaster,30200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30200,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30210,Not in chargemaster,30210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30210,BCBS multispecialty AW base fee schedule,186.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30220,Not in chargemaster,30220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30220,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30300,30300,30300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30300,BCBS multispecialty AW base fee schedule,213.99,276.13,Fee schedule,,213.99,213.99,213.99,213.99,,,0
unity,Fee schedule,Facility 30580,Not in chargemaster,30580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30580,BCBS multispecialty AW base fee schedule,902.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30620,Not in chargemaster,30620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30620,BCBS multispecialty AW base fee schedule,1209.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30630,Not in chargemaster,30630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30630,BCBS multispecialty AW base fee schedule,1222.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30801,Not in chargemaster,30801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30801,BCBS multispecialty AW base fee schedule,271.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30600,Not in chargemaster,30600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30600,BCBS multispecialty AW base fee schedule,817.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30802,Not in chargemaster,30802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30802,BCBS multispecialty AW base fee schedule,369.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30901,30901,30901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30901,BCBS multispecialty AW base fee schedule,108.65,280,Fee schedule,,108.65,108.65,108.65,108.65,,,0
unity,Fee schedule,Facility 30903,Not in chargemaster,30903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30903,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30905,30905,30905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30905,BCBS multispecialty AW base fee schedule,203.39,560.79,Fee schedule,,203.39,203.39,203.39,203.39,,,0
unity,Fee schedule,Facility 30906,Not in chargemaster,30906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30906,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30915,Not in chargemaster,30915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30915,BCBS multispecialty AW base fee schedule,1111.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30920,Not in chargemaster,30920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30920,BCBS multispecialty AW base fee schedule,1611.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30930,Not in chargemaster,30930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30930,BCBS multispecialty AW base fee schedule,223.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31000,Not in chargemaster,31000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31000,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31032,Not in chargemaster,31032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31032,BCBS multispecialty AW base fee schedule,1095.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31040,Not in chargemaster,31040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31040,BCBS multispecialty AW base fee schedule,1487.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31050,Not in chargemaster,31050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31050,BCBS multispecialty AW base fee schedule,939.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31051,Not in chargemaster,31051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31051,BCBS multispecialty AW base fee schedule,1258.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31070,Not in chargemaster,31070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31070,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31075,Not in chargemaster,31075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31075,BCBS multispecialty AW base fee schedule,1513.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31080,Not in chargemaster,31080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31080,BCBS multispecialty AW base fee schedule,1993.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31081,Not in chargemaster,31081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31081,BCBS multispecialty AW base fee schedule,2144.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31084,Not in chargemaster,31084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31084,BCBS multispecialty AW base fee schedule,2221.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31085,Not in chargemaster,31085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31085,BCBS multispecialty AW base fee schedule,2294.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31086,Not in chargemaster,31086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31086,BCBS multispecialty AW base fee schedule,2162.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31087,Not in chargemaster,31087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31087,BCBS multispecialty AW base fee schedule,2070.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31090,Not in chargemaster,31090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31090,BCBS multispecialty AW base fee schedule,2010.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31200,Not in chargemaster,31200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31200,BCBS multispecialty AW base fee schedule,1129.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31201,Not in chargemaster,31201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31201,BCBS multispecialty AW base fee schedule,1456.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31205,Not in chargemaster,31205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31205,BCBS multispecialty AW base fee schedule,1745.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31225,Not in chargemaster,31225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31225,BCBS multispecialty AW base fee schedule,3455.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31230,Not in chargemaster,31230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31230,BCBS multispecialty AW base fee schedule,3835.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31231,Not in chargemaster,31231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31231,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31002,Not in chargemaster,31002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31002,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31020,Not in chargemaster,31020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31020,BCBS multispecialty AW base fee schedule,702.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31030,Not in chargemaster,31030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31030,BCBS multispecialty AW base fee schedule,973.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31233,Not in chargemaster,31233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31233,BCBS multispecialty AW base fee schedule,254.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31235,Not in chargemaster,31235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31235,BCBS multispecialty AW base fee schedule,300.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31237,Not in chargemaster,31237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31237,BCBS multispecialty AW base fee schedule,300.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31238,Not in chargemaster,31238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31238,BCBS multispecialty AW base fee schedule,316.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31239,Not in chargemaster,31239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31239,BCBS multispecialty AW base fee schedule,1153.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31240,Not in chargemaster,31240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31240,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31241,Not in chargemaster,31241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31241,BCBS multispecialty AW base fee schedule,846.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31253,Not in chargemaster,31253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31253,BCBS multispecialty AW base fee schedule,954,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31254,Not in chargemaster,31254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31254,BCBS multispecialty AW base fee schedule,462.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31300,Not in chargemaster,31300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31300,BCBS multispecialty AW base fee schedule,2393.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31360,Not in chargemaster,31360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31360,BCBS multispecialty AW base fee schedule,3923.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31365,Not in chargemaster,31365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31365,BCBS multispecialty AW base fee schedule,4855.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31367,Not in chargemaster,31367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31367,BCBS multispecialty AW base fee schedule,4148.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31368,Not in chargemaster,31368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31368,BCBS multispecialty AW base fee schedule,4601.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31370,Not in chargemaster,31370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31370,BCBS multispecialty AW base fee schedule,3897.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31375,Not in chargemaster,31375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31375,BCBS multispecialty AW base fee schedule,3699.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31380,Not in chargemaster,31380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31380,BCBS multispecialty AW base fee schedule,3647.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31382,Not in chargemaster,31382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31382,BCBS multispecialty AW base fee schedule,4000.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31390,Not in chargemaster,31390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31390,BCBS multispecialty AW base fee schedule,5371.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31395,Not in chargemaster,31395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31395,BCBS multispecialty AW base fee schedule,5661.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31400,Not in chargemaster,31400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31400,BCBS multispecialty AW base fee schedule,1856.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31420,Not in chargemaster,31420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31420,BCBS multispecialty AW base fee schedule,1556.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31500,31500,31500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31500,BCBS multispecialty AW base fee schedule,274.28,228.58,Fee schedule,,228.58,228.58,228.58,228.58,,,0
unity,Fee schedule,Facility 31502,Not in chargemaster,31502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31502,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31505,Not in chargemaster,31505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31505,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31255,Not in chargemaster,31255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31255,BCBS multispecialty AW base fee schedule,616.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31256,Not in chargemaster,31256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31256,BCBS multispecialty AW base fee schedule,342.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31257,Not in chargemaster,31257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31257,BCBS multispecialty AW base fee schedule,849.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31259,Not in chargemaster,31259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31259,BCBS multispecialty AW base fee schedule,899.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31267,Not in chargemaster,31267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31267,BCBS multispecialty AW base fee schedule,504.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31276,Not in chargemaster,31276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31276,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31287,Not in chargemaster,31287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31287,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31288,Not in chargemaster,31288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31288,BCBS multispecialty AW base fee schedule,444.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31290,Not in chargemaster,31290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31290,BCBS multispecialty AW base fee schedule,2167.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31291,Not in chargemaster,31291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31291,BCBS multispecialty AW base fee schedule,2315.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31292,Not in chargemaster,31292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31292,BCBS multispecialty AW base fee schedule,1882.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31293,Not in chargemaster,31293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31293,BCBS multispecialty AW base fee schedule,2034.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31294,Not in chargemaster,31294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31294,BCBS multispecialty AW base fee schedule,2330.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31295,Not in chargemaster,31295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31295,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31296,Not in chargemaster,31296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31296,BCBS multispecialty AW base fee schedule,341.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31297,Not in chargemaster,31297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31297,BCBS multispecialty AW base fee schedule,272.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31298,Not in chargemaster,31298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31298,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31510,Not in chargemaster,31510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31510,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31526,Not in chargemaster,31526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31526,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31527,Not in chargemaster,31527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31527,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31528,Not in chargemaster,31528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31528,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31529,Not in chargemaster,31529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31529,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31530,Not in chargemaster,31530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31530,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31531,Not in chargemaster,31531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31531,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31535,Not in chargemaster,31535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31535,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31536,Not in chargemaster,31536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31536,BCBS multispecialty AW base fee schedule,397.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31540,Not in chargemaster,31540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31540,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31541,Not in chargemaster,31541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31541,BCBS multispecialty AW base fee schedule,498.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31545,Not in chargemaster,31545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31545,BCBS multispecialty AW base fee schedule,684.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31546,Not in chargemaster,31546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31546,BCBS multispecialty AW base fee schedule,1040.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31551,Not in chargemaster,31551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31551,BCBS multispecialty AW base fee schedule,2887.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31552,Not in chargemaster,31552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31552,BCBS multispecialty AW base fee schedule,2785.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31553,Not in chargemaster,31553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31553,BCBS multispecialty AW base fee schedule,3170.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31554,Not in chargemaster,31554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31554,BCBS multispecialty AW base fee schedule,3171.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31560,Not in chargemaster,31560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31560,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31561,Not in chargemaster,31561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31561,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31570,Not in chargemaster,31570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31570,BCBS multispecialty AW base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31511,Not in chargemaster,31511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31511,BCBS multispecialty AW base fee schedule,251.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31512,Not in chargemaster,31512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31512,BCBS multispecialty AW base fee schedule,243.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31513,Not in chargemaster,31513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31513,BCBS multispecialty AW base fee schedule,246.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31515,Not in chargemaster,31515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31515,BCBS multispecialty AW base fee schedule,208.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31520,Not in chargemaster,31520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31520,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31525,Not in chargemaster,31525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31525,BCBS multispecialty AW base fee schedule,302.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31571,Not in chargemaster,31571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31571,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31572,Not in chargemaster,31572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31572,BCBS multispecialty AW base fee schedule,341.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31573,Not in chargemaster,31573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31573,BCBS multispecialty AW base fee schedule,279.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31574,Not in chargemaster,31574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31574,BCBS multispecialty AW base fee schedule,279.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31575,Not in chargemaster,31575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31575,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31576,Not in chargemaster,31576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31576,BCBS multispecialty AW base fee schedule,223.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31577,Not in chargemaster,31577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31577,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31578,Not in chargemaster,31578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31578,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31579,Not in chargemaster,31579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31579,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31580,Not in chargemaster,31580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31580,BCBS multispecialty AW base fee schedule,2402.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31584,Not in chargemaster,31584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31584,BCBS multispecialty AW base fee schedule,2660.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31587,Not in chargemaster,31587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31587,BCBS multispecialty AW base fee schedule,2241.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31590,Not in chargemaster,31590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31590,BCBS multispecialty AW base fee schedule,1652.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31591,Not in chargemaster,31591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31591,BCBS multispecialty AW base fee schedule,2037.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31592,Not in chargemaster,31592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31592,BCBS multispecialty AW base fee schedule,3251.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31600,Not in chargemaster,31600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31600,BCBS multispecialty AW base fee schedule,588.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31601,Not in chargemaster,31601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31601,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31603,Not in chargemaster,31603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31603,BCBS multispecialty AW base fee schedule,616.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31605,Not in chargemaster,31605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31605,BCBS multispecialty AW base fee schedule,642.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31610,Not in chargemaster,31610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31610,BCBS multispecialty AW base fee schedule,1807.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31611,Not in chargemaster,31611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31611,BCBS multispecialty AW base fee schedule,1001.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31612,Not in chargemaster,31612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31612,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31613,Not in chargemaster,31613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31613,BCBS multispecialty AW base fee schedule,824.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31614,Not in chargemaster,31614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31614,BCBS multispecialty AW base fee schedule,1374.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31615,Not in chargemaster,31615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31615,BCBS multispecialty AW base fee schedule,217.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31622,Not in chargemaster,31622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31622,BCBS multispecialty AW base fee schedule,251.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31623,Not in chargemaster,31623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31623,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31624,Not in chargemaster,31624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31624,BCBS multispecialty AW base fee schedule,256.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31625,Not in chargemaster,31625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31625,BCBS multispecialty AW base fee schedule,298.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31626,Not in chargemaster,31626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31626,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31627,Not in chargemaster,31627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31627,BCBS multispecialty AW base fee schedule,184.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31628,Not in chargemaster,31628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31628,BCBS multispecialty AW base fee schedule,335.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31629,Not in chargemaster,31629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31629,BCBS multispecialty AW base fee schedule,355.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31630,Not in chargemaster,31630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31630,BCBS multispecialty AW base fee schedule,378.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31631,Not in chargemaster,31631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31631,BCBS multispecialty AW base fee schedule,434.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31632,Not in chargemaster,31632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31632,BCBS multispecialty AW base fee schedule,94.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31636,Not in chargemaster,31636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31636,BCBS multispecialty AW base fee schedule,419.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31637,Not in chargemaster,31637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31637,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31638,Not in chargemaster,31638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31638,BCBS multispecialty AW base fee schedule,475.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31640,Not in chargemaster,31640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31640,BCBS multispecialty AW base fee schedule,477.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31641,Not in chargemaster,31641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31641,BCBS multispecialty AW base fee schedule,488.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31643,Not in chargemaster,31643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31643,BCBS multispecialty AW base fee schedule,333.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31645,Not in chargemaster,31645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31645,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31633,Not in chargemaster,31633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31633,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31634,Not in chargemaster,31634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31634,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31646,Not in chargemaster,31646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31646,BCBS multispecialty AW base fee schedule,270.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31647,Not in chargemaster,31647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31647,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31648,Not in chargemaster,31648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31648,BCBS multispecialty AW base fee schedule,382.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31649,Not in chargemaster,31649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31649,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31651,Not in chargemaster,31651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31651,BCBS multispecialty AW base fee schedule,141.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31652,Not in chargemaster,31652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31652,BCBS multispecialty AW base fee schedule,422.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31635,Not in chargemaster,31635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31635,BCBS multispecialty AW base fee schedule,335.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31653,Not in chargemaster,31653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31653,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31660,Not in chargemaster,31660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31660,BCBS multispecialty AW base fee schedule,371.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31661,Not in chargemaster,31661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31661,BCBS multispecialty AW base fee schedule,394.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31717,Not in chargemaster,31717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31717,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31750,Not in chargemaster,31750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31750,BCBS multispecialty AW base fee schedule,2592.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31755,Not in chargemaster,31755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31755,BCBS multispecialty AW base fee schedule,3258.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31760,Not in chargemaster,31760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31760,BCBS multispecialty AW base fee schedule,2626.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31766,Not in chargemaster,31766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31766,BCBS multispecialty AW base fee schedule,3403.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31770,Not in chargemaster,31770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31770,BCBS multispecialty AW base fee schedule,2546.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31775,Not in chargemaster,31775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31775,BCBS multispecialty AW base fee schedule,2675.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31780,Not in chargemaster,31780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31780,BCBS multispecialty AW base fee schedule,2267.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31781,Not in chargemaster,31781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31781,BCBS multispecialty AW base fee schedule,2653.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31785,Not in chargemaster,31785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31785,BCBS multispecialty AW base fee schedule,2042.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31786,Not in chargemaster,31786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31786,BCBS multispecialty AW base fee schedule,2759.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31800,Not in chargemaster,31800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31800,BCBS multispecialty AW base fee schedule,1348.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31805,Not in chargemaster,31805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31805,BCBS multispecialty AW base fee schedule,1560.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31820,Not in chargemaster,31820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31820,BCBS multispecialty AW base fee schedule,618.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31720,Not in chargemaster,31720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31720,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31725,Not in chargemaster,31725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31725,BCBS multispecialty AW base fee schedule,150.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31730,Not in chargemaster,31730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31730,BCBS multispecialty AW base fee schedule,286.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31654,Not in chargemaster,31654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31654,BCBS multispecialty AW base fee schedule,128.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31825,Not in chargemaster,31825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31825,BCBS multispecialty AW base fee schedule,906.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32035,Not in chargemaster,32035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32035,BCBS multispecialty AW base fee schedule,1391.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32036,Not in chargemaster,32036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32036,BCBS multispecialty AW base fee schedule,1490.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32096,Not in chargemaster,32096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32096,BCBS multispecialty AW base fee schedule,1533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32097,Not in chargemaster,32097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32097,BCBS multispecialty AW base fee schedule,1535.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32098,Not in chargemaster,32098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32098,BCBS multispecialty AW base fee schedule,1454.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32100,Not in chargemaster,32100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32100,BCBS multispecialty AW base fee schedule,1549.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32110,Not in chargemaster,32110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32110,BCBS multispecialty AW base fee schedule,2809,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32120,Not in chargemaster,32120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32120,BCBS multispecialty AW base fee schedule,1669.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32124,Not in chargemaster,32124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32124,BCBS multispecialty AW base fee schedule,1772.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32140,Not in chargemaster,32140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32140,BCBS multispecialty AW base fee schedule,1894.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32141,Not in chargemaster,32141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32141,BCBS multispecialty AW base fee schedule,2917.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32150,Not in chargemaster,32150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32150,BCBS multispecialty AW base fee schedule,1919.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32151,Not in chargemaster,32151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32151,BCBS multispecialty AW base fee schedule,1921.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32160,Not in chargemaster,32160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32160,BCBS multispecialty AW base fee schedule,1521.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32200,Not in chargemaster,32200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32200,BCBS multispecialty AW base fee schedule,2172.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32215,Not in chargemaster,32215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32215,BCBS multispecialty AW base fee schedule,1525.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32220,Not in chargemaster,32220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32220,BCBS multispecialty AW base fee schedule,3040.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32225,Not in chargemaster,32225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32225,BCBS multispecialty AW base fee schedule,1902.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32310,Not in chargemaster,32310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32310,BCBS multispecialty AW base fee schedule,1745.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32320,Not in chargemaster,32320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32320,BCBS multispecialty AW base fee schedule,3057.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32400,Not in chargemaster,32400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32400,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32440,Not in chargemaster,32440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32440,BCBS multispecialty AW base fee schedule,2997.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32442,Not in chargemaster,32442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32442,BCBS multispecialty AW base fee schedule,5871.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32445,Not in chargemaster,32445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32445,BCBS multispecialty AW base fee schedule,6776.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32480,Not in chargemaster,32480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32480,BCBS multispecialty AW base fee schedule,2831.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32482,Not in chargemaster,32482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32482,BCBS multispecialty AW base fee schedule,3034.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32484,Not in chargemaster,32484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32484,BCBS multispecialty AW base fee schedule,2744.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32486,Not in chargemaster,32486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32486,BCBS multispecialty AW base fee schedule,4510.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32488,Not in chargemaster,32488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32488,BCBS multispecialty AW base fee schedule,4583.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32491,Not in chargemaster,32491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32491,BCBS multispecialty AW base fee schedule,2814.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32501,Not in chargemaster,32501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32501,BCBS multispecialty AW base fee schedule,466.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32503,Not in chargemaster,32503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32503,BCBS multispecialty AW base fee schedule,3439.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32504,Not in chargemaster,32504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32504,BCBS multispecialty AW base fee schedule,3919.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32505,Not in chargemaster,32505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32505,BCBS multispecialty AW base fee schedule,1782.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32506,Not in chargemaster,32506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32506,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32507,Not in chargemaster,32507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32507,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32540,Not in chargemaster,32540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32540,BCBS multispecialty AW base fee schedule,3319.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32550,Not in chargemaster,32550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32550,BCBS multispecialty AW base fee schedule,395.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33016,Not in chargemaster,33016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33016,BCBS multispecialty AW base fee schedule,453.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33017,Not in chargemaster,33017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33017,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33018,Not in chargemaster,33018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33018,BCBS multispecialty AW base fee schedule,535.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33019,Not in chargemaster,33019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33019,BCBS multispecialty AW base fee schedule,435.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33020,Not in chargemaster,33020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33020,BCBS multispecialty AW base fee schedule,1582.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33025,Not in chargemaster,33025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33025,BCBS multispecialty AW base fee schedule,1474.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33030,Not in chargemaster,33030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33030,BCBS multispecialty AW base fee schedule,3833.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33031,Not in chargemaster,33031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33031,BCBS multispecialty AW base fee schedule,4750.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33050,Not in chargemaster,33050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33050,BCBS multispecialty AW base fee schedule,1921.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33120,Not in chargemaster,33120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33120,BCBS multispecialty AW base fee schedule,4020.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33130,Not in chargemaster,33130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33130,BCBS multispecialty AW base fee schedule,2619.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33140,Not in chargemaster,33140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33140,BCBS multispecialty AW base fee schedule,2990.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33141,Not in chargemaster,33141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33141,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33202,Not in chargemaster,33202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33202,BCBS multispecialty AW base fee schedule,1476.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33203,Not in chargemaster,33203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33203,BCBS multispecialty AW base fee schedule,1544.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33206,Not in chargemaster,33206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33206,BCBS multispecialty AW base fee schedule,873.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33207,Not in chargemaster,33207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33207,BCBS multispecialty AW base fee schedule,922.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33208,Not in chargemaster,33208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33208,BCBS multispecialty AW base fee schedule,1002.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33210,Not in chargemaster,33210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33210,BCBS multispecialty AW base fee schedule,314.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33211,Not in chargemaster,33211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33211,BCBS multispecialty AW base fee schedule,324.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33212,Not in chargemaster,33212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33212,BCBS multispecialty AW base fee schedule,617.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33213,Not in chargemaster,33213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33213,BCBS multispecialty AW base fee schedule,644.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33214,Not in chargemaster,33214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33214,BCBS multispecialty AW base fee schedule,920.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33215,Not in chargemaster,33215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33215,BCBS multispecialty AW base fee schedule,596.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33216,Not in chargemaster,33216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33216,BCBS multispecialty AW base fee schedule,714.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33217,Not in chargemaster,33217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33217,BCBS multispecialty AW base fee schedule,704.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33218,Not in chargemaster,33218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33218,BCBS multispecialty AW base fee schedule,742,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33220,Not in chargemaster,33220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33220,BCBS multispecialty AW base fee schedule,722.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33221,Not in chargemaster,33221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33221,BCBS multispecialty AW base fee schedule,694.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33222,Not in chargemaster,33222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33222,BCBS multispecialty AW base fee schedule,651.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33223,Not in chargemaster,33223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33223,BCBS multispecialty AW base fee schedule,787.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33224,Not in chargemaster,33224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33224,BCBS multispecialty AW base fee schedule,992.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33225,Not in chargemaster,33225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33225,BCBS multispecialty AW base fee schedule,904.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33226,Not in chargemaster,33226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33226,BCBS multispecialty AW base fee schedule,954,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33227,Not in chargemaster,33227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33227,BCBS multispecialty AW base fee schedule,650.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33228,Not in chargemaster,33228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33228,BCBS multispecialty AW base fee schedule,681.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33229,Not in chargemaster,33229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33229,BCBS multispecialty AW base fee schedule,720.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33230,Not in chargemaster,33230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33230,BCBS multispecialty AW base fee schedule,734.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33231,Not in chargemaster,33231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33231,BCBS multispecialty AW base fee schedule,772.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33233,Not in chargemaster,33233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33233,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33234,Not in chargemaster,33234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33234,BCBS multispecialty AW base fee schedule,933.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33235,Not in chargemaster,33235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33235,BCBS multispecialty AW base fee schedule,1225.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33236,Not in chargemaster,33236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33236,BCBS multispecialty AW base fee schedule,1493.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33237,Not in chargemaster,33237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33237,BCBS multispecialty AW base fee schedule,1602.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33238,Not in chargemaster,33238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33238,BCBS multispecialty AW base fee schedule,1799.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33240,Not in chargemaster,33240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33240,BCBS multispecialty AW base fee schedule,701.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33241,Not in chargemaster,33241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33241,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33243,Not in chargemaster,33243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33243,BCBS multispecialty AW base fee schedule,2625.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33244,Not in chargemaster,33244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33244,BCBS multispecialty AW base fee schedule,1663.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33249,Not in chargemaster,33249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33249,BCBS multispecialty AW base fee schedule,1763.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33250,Not in chargemaster,33250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33250,BCBS multispecialty AW base fee schedule,2790.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33251,Not in chargemaster,33251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33251,BCBS multispecialty AW base fee schedule,3118.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33254,Not in chargemaster,33254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33254,BCBS multispecialty AW base fee schedule,2589.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33255,Not in chargemaster,33255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33255,BCBS multispecialty AW base fee schedule,3119.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33256,Not in chargemaster,33256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33256,BCBS multispecialty AW base fee schedule,3715.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33257,Not in chargemaster,33257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33257,BCBS multispecialty AW base fee schedule,1113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33258,Not in chargemaster,33258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33258,BCBS multispecialty AW base fee schedule,1244.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33259,Not in chargemaster,33259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33259,BCBS multispecialty AW base fee schedule,1615.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33261,Not in chargemaster,33261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33261,BCBS multispecialty AW base fee schedule,3090.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33262,Not in chargemaster,33262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33262,BCBS multispecialty AW base fee schedule,717.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33263,Not in chargemaster,33263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33263,BCBS multispecialty AW base fee schedule,745.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33264,Not in chargemaster,33264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33264,BCBS multispecialty AW base fee schedule,779.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33265,Not in chargemaster,33265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33265,BCBS multispecialty AW base fee schedule,2603.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33266,Not in chargemaster,33266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33266,BCBS multispecialty AW base fee schedule,3539.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33270,Not in chargemaster,33270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33270,BCBS multispecialty AW base fee schedule,1088.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33271,Not in chargemaster,33271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33271,BCBS multispecialty AW base fee schedule,872.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33272,Not in chargemaster,33272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33272,BCBS multispecialty AW base fee schedule,667.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33273,Not in chargemaster,33273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33273,BCBS multispecialty AW base fee schedule,767.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33274,Not in chargemaster,33274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33274,BCBS multispecialty AW base fee schedule,935.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33275,Not in chargemaster,33275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33275,BCBS multispecialty AW base fee schedule,1023.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33285,Not in chargemaster,33285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33285,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33289,Not in chargemaster,33289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33289,BCBS multispecialty AW base fee schedule,632.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33300,Not in chargemaster,33300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33300,BCBS multispecialty AW base fee schedule,4707.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33305,Not in chargemaster,33305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33305,BCBS multispecialty AW base fee schedule,7881.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33310,Not in chargemaster,33310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33310,BCBS multispecialty AW base fee schedule,2238.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33315,Not in chargemaster,33315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33315,BCBS multispecialty AW base fee schedule,3670.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33320,Not in chargemaster,33320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33320,BCBS multispecialty AW base fee schedule,2017.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33321,Not in chargemaster,33321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33321,BCBS multispecialty AW base fee schedule,2275.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33322,Not in chargemaster,33322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33322,BCBS multispecialty AW base fee schedule,2663.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33330,Not in chargemaster,33330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33330,BCBS multispecialty AW base fee schedule,2730.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33335,Not in chargemaster,33335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33335,BCBS multispecialty AW base fee schedule,3586.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33340,Not in chargemaster,33340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33340,BCBS multispecialty AW base fee schedule,1519.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33361,Not in chargemaster,33361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33361,BCBS multispecialty AW base fee schedule,2329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33362,Not in chargemaster,33362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33362,BCBS multispecialty AW base fee schedule,2538.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33363,Not in chargemaster,33363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33363,BCBS multispecialty AW base fee schedule,2631.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33364,Not in chargemaster,33364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33364,BCBS multispecialty AW base fee schedule,2632.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33365,Not in chargemaster,33365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33365,BCBS multispecialty AW base fee schedule,2781.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33366,Not in chargemaster,33366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33366,BCBS multispecialty AW base fee schedule,3028.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33367,Not in chargemaster,33367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33367,BCBS multispecialty AW base fee schedule,1211.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33368,Not in chargemaster,33368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33368,BCBS multispecialty AW base fee schedule,1429.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33369,Not in chargemaster,33369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33369,BCBS multispecialty AW base fee schedule,1886.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33390,Not in chargemaster,33390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33390,BCBS multispecialty AW base fee schedule,3704.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33391,Not in chargemaster,33391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33391,BCBS multispecialty AW base fee schedule,4401.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33404,Not in chargemaster,33404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33404,BCBS multispecialty AW base fee schedule,3353.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33405,Not in chargemaster,33405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33405,BCBS multispecialty AW base fee schedule,4356.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33406,Not in chargemaster,33406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33406,BCBS multispecialty AW base fee schedule,5529.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33410,Not in chargemaster,33410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33410,BCBS multispecialty AW base fee schedule,4881.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33411,Not in chargemaster,33411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33411,BCBS multispecialty AW base fee schedule,6452.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33412,Not in chargemaster,33412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33412,BCBS multispecialty AW base fee schedule,6059.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33413,Not in chargemaster,33413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33413,BCBS multispecialty AW base fee schedule,6202.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33414,Not in chargemaster,33414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33414,BCBS multispecialty AW base fee schedule,4123.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33415,Not in chargemaster,33415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33415,BCBS multispecialty AW base fee schedule,3897.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33416,Not in chargemaster,33416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33416,BCBS multispecialty AW base fee schedule,3878.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33417,Not in chargemaster,33417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33417,BCBS multispecialty AW base fee schedule,3195.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33418,Not in chargemaster,33418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33418,BCBS multispecialty AW base fee schedule,3455.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33419,Not in chargemaster,33419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33419,BCBS multispecialty AW base fee schedule,816.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33420,Not in chargemaster,33420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33420,BCBS multispecialty AW base fee schedule,2780.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33422,Not in chargemaster,33422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33422,BCBS multispecialty AW base fee schedule,3191.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33425,Not in chargemaster,33425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33425,BCBS multispecialty AW base fee schedule,5244.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33426,Not in chargemaster,33426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33426,BCBS multispecialty AW base fee schedule,4571.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33427,Not in chargemaster,33427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33427,BCBS multispecialty AW base fee schedule,4688.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33430,Not in chargemaster,33430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33430,BCBS multispecialty AW base fee schedule,5376.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33440,Not in chargemaster,33440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33440,BCBS multispecialty AW base fee schedule,6587.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33460,Not in chargemaster,33460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33460,BCBS multispecialty AW base fee schedule,4616.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33463,Not in chargemaster,33463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33463,BCBS multispecialty AW base fee schedule,5927.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33464,Not in chargemaster,33464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33464,BCBS multispecialty AW base fee schedule,4685.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33465,Not in chargemaster,33465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33465,BCBS multispecialty AW base fee schedule,5292.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33468,Not in chargemaster,33468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33468,BCBS multispecialty AW base fee schedule,4706.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33470,Not in chargemaster,33470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33470,BCBS multispecialty AW base fee schedule,2372.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33471,Not in chargemaster,33471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33471,BCBS multispecialty AW base fee schedule,2536.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33474,Not in chargemaster,33474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33474,BCBS multispecialty AW base fee schedule,4178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33475,Not in chargemaster,33475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33475,BCBS multispecialty AW base fee schedule,4475.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33476,Not in chargemaster,33476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33476,BCBS multispecialty AW base fee schedule,2916.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33477,Not in chargemaster,33477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33477,BCBS multispecialty AW base fee schedule,2611.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33478,Not in chargemaster,33478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33478,BCBS multispecialty AW base fee schedule,3013.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33496,Not in chargemaster,33496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33496,BCBS multispecialty AW base fee schedule,3192.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33500,Not in chargemaster,33500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33500,BCBS multispecialty AW base fee schedule,2994.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33501,Not in chargemaster,33501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33501,BCBS multispecialty AW base fee schedule,2138.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33502,Not in chargemaster,33502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33502,BCBS multispecialty AW base fee schedule,2444.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33503,Not in chargemaster,33503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33503,BCBS multispecialty AW base fee schedule,2539.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33504,Not in chargemaster,33504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33504,BCBS multispecialty AW base fee schedule,2807.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33505,Not in chargemaster,33505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33505,BCBS multispecialty AW base fee schedule,3961.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33506,Not in chargemaster,33506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33506,BCBS multispecialty AW base fee schedule,3942.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33507,Not in chargemaster,33507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33507,BCBS multispecialty AW base fee schedule,3305.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33508,Not in chargemaster,33508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33508,BCBS multispecialty AW base fee schedule,31.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33510,Not in chargemaster,33510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33510,BCBS multispecialty AW base fee schedule,3712.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33511,Not in chargemaster,33511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33511,BCBS multispecialty AW base fee schedule,4075.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33512,Not in chargemaster,33512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33512,BCBS multispecialty AW base fee schedule,4641.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33513,Not in chargemaster,33513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33513,BCBS multispecialty AW base fee schedule,4764.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33514,Not in chargemaster,33514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33514,BCBS multispecialty AW base fee schedule,5013.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33516,Not in chargemaster,33516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33516,BCBS multispecialty AW base fee schedule,5194.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33517,Not in chargemaster,33517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33517,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33518,Not in chargemaster,33518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33518,BCBS multispecialty AW base fee schedule,791.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33519,Not in chargemaster,33519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33519,BCBS multispecialty AW base fee schedule,1046.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33521,Not in chargemaster,33521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33521,BCBS multispecialty AW base fee schedule,1256.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33522,Not in chargemaster,33522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33522,BCBS multispecialty AW base fee schedule,1408.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33523,Not in chargemaster,33523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33523,BCBS multispecialty AW base fee schedule,1600.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33530,Not in chargemaster,33530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33530,BCBS multispecialty AW base fee schedule,1010.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33533,Not in chargemaster,33533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33533,BCBS multispecialty AW base fee schedule,3590.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33534,Not in chargemaster,33534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33534,BCBS multispecialty AW base fee schedule,4218.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33535,Not in chargemaster,33535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33535,BCBS multispecialty AW base fee schedule,4705.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33536,Not in chargemaster,33536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33536,BCBS multispecialty AW base fee schedule,5070.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33542,Not in chargemaster,33542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33542,BCBS multispecialty AW base fee schedule,5044.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33545,Not in chargemaster,33545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33545,BCBS multispecialty AW base fee schedule,5902.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33548,Not in chargemaster,33548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33548,BCBS multispecialty AW base fee schedule,5684.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33572,Not in chargemaster,33572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33572,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33600,Not in chargemaster,33600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33600,BCBS multispecialty AW base fee schedule,3292.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33602,Not in chargemaster,33602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33602,BCBS multispecialty AW base fee schedule,3196.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33606,Not in chargemaster,33606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33606,BCBS multispecialty AW base fee schedule,3408.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33608,Not in chargemaster,33608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33608,BCBS multispecialty AW base fee schedule,3451.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33610,Not in chargemaster,33610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33610,BCBS multispecialty AW base fee schedule,3402.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33611,Not in chargemaster,33611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33611,BCBS multispecialty AW base fee schedule,3743.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33612,Not in chargemaster,33612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33612,BCBS multispecialty AW base fee schedule,3843.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33615,Not in chargemaster,33615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33615,BCBS multispecialty AW base fee schedule,3829.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33617,Not in chargemaster,33617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33617,BCBS multispecialty AW base fee schedule,4150.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33619,Not in chargemaster,33619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33619,BCBS multispecialty AW base fee schedule,5252.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33620,Not in chargemaster,33620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33620,BCBS multispecialty AW base fee schedule,3164.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33621,Not in chargemaster,33621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33621,BCBS multispecialty AW base fee schedule,1782.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33622,Not in chargemaster,33622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33622,BCBS multispecialty AW base fee schedule,6600.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33641,Not in chargemaster,33641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33641,BCBS multispecialty AW base fee schedule,3144.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33645,Not in chargemaster,33645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33645,BCBS multispecialty AW base fee schedule,3321.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33647,Not in chargemaster,33647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33647,BCBS multispecialty AW base fee schedule,3486.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33660,Not in chargemaster,33660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33660,BCBS multispecialty AW base fee schedule,3370.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33665,Not in chargemaster,33665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33665,BCBS multispecialty AW base fee schedule,3671.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33670,Not in chargemaster,33670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33670,BCBS multispecialty AW base fee schedule,3788.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33675,Not in chargemaster,33675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33675,BCBS multispecialty AW base fee schedule,3782.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33676,Not in chargemaster,33676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33676,BCBS multispecialty AW base fee schedule,3882.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33677,Not in chargemaster,33677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33677,BCBS multispecialty AW base fee schedule,4034.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33681,Not in chargemaster,33681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33681,BCBS multispecialty AW base fee schedule,3529.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33684,Not in chargemaster,33684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33684,BCBS multispecialty AW base fee schedule,3623.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33688,Not in chargemaster,33688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33688,BCBS multispecialty AW base fee schedule,3617.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33690,Not in chargemaster,33690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33690,BCBS multispecialty AW base fee schedule,2298.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33692,Not in chargemaster,33692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33692,BCBS multispecialty AW base fee schedule,3755.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33694,Not in chargemaster,33694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33694,BCBS multispecialty AW base fee schedule,3743.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33697,Not in chargemaster,33697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33697,BCBS multispecialty AW base fee schedule,3943.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33702,Not in chargemaster,33702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33702,BCBS multispecialty AW base fee schedule,2964.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33710,Not in chargemaster,33710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33710,BCBS multispecialty AW base fee schedule,3935.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33720,Not in chargemaster,33720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33720,BCBS multispecialty AW base fee schedule,2966.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33722,Not in chargemaster,33722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33722,BCBS multispecialty AW base fee schedule,3121.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33724,Not in chargemaster,33724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33724,BCBS multispecialty AW base fee schedule,2950.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33726,Not in chargemaster,33726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33726,BCBS multispecialty AW base fee schedule,3899.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33730,Not in chargemaster,33730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33730,BCBS multispecialty AW base fee schedule,3846.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33732,Not in chargemaster,33732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33732,BCBS multispecialty AW base fee schedule,3159.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33735,Not in chargemaster,33735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33735,BCBS multispecialty AW base fee schedule,2481.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33736,Not in chargemaster,33736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33736,BCBS multispecialty AW base fee schedule,2694.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33737,Not in chargemaster,33737,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33737,BCBS multispecialty AW base fee schedule,2486.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33750,Not in chargemaster,33750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33750,BCBS multispecialty AW base fee schedule,2421.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33755,Not in chargemaster,33755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33755,BCBS multispecialty AW base fee schedule,2522.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33762,Not in chargemaster,33762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33762,BCBS multispecialty AW base fee schedule,2459.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33764,Not in chargemaster,33764,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33764,BCBS multispecialty AW base fee schedule,2522.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33766,Not in chargemaster,33766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33766,BCBS multispecialty AW base fee schedule,2557.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33767,Not in chargemaster,33767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33767,BCBS multispecialty AW base fee schedule,2727.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33768,Not in chargemaster,33768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33768,BCBS multispecialty AW base fee schedule,800.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33770,Not in chargemaster,33770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33770,BCBS multispecialty AW base fee schedule,4065.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33771,Not in chargemaster,33771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33771,BCBS multispecialty AW base fee schedule,4184.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33774,Not in chargemaster,33774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33774,BCBS multispecialty AW base fee schedule,3448.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33775,Not in chargemaster,33775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33775,BCBS multispecialty AW base fee schedule,3553.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33776,Not in chargemaster,33776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33776,BCBS multispecialty AW base fee schedule,3757.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33777,Not in chargemaster,33777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33777,BCBS multispecialty AW base fee schedule,3630.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33778,Not in chargemaster,33778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33778,BCBS multispecialty AW base fee schedule,4508.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33779,Not in chargemaster,33779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33779,BCBS multispecialty AW base fee schedule,4465.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33780,Not in chargemaster,33780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33780,BCBS multispecialty AW base fee schedule,4546.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33781,Not in chargemaster,33781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33781,BCBS multispecialty AW base fee schedule,4442.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33782,Not in chargemaster,33782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33782,BCBS multispecialty AW base fee schedule,6204.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33783,Not in chargemaster,33783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33783,BCBS multispecialty AW base fee schedule,6709.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33786,Not in chargemaster,33786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33786,BCBS multispecialty AW base fee schedule,4372.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33788,Not in chargemaster,33788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33788,BCBS multispecialty AW base fee schedule,2940.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33800,Not in chargemaster,33800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33800,BCBS multispecialty AW base fee schedule,1891.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33802,Not in chargemaster,33802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33802,BCBS multispecialty AW base fee schedule,2076.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33803,Not in chargemaster,33803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33803,BCBS multispecialty AW base fee schedule,2208.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33813,Not in chargemaster,33813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33813,BCBS multispecialty AW base fee schedule,2375.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33814,Not in chargemaster,33814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33814,BCBS multispecialty AW base fee schedule,2918.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33820,Not in chargemaster,33820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33820,BCBS multispecialty AW base fee schedule,1854.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33822,Not in chargemaster,33822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33822,BCBS multispecialty AW base fee schedule,1955.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33824,Not in chargemaster,33824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33824,BCBS multispecialty AW base fee schedule,2261.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33840,Not in chargemaster,33840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33840,BCBS multispecialty AW base fee schedule,2373.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33845,Not in chargemaster,33845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33845,BCBS multispecialty AW base fee schedule,2554.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33851,Not in chargemaster,33851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33851,BCBS multispecialty AW base fee schedule,2438,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33852,Not in chargemaster,33852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33852,BCBS multispecialty AW base fee schedule,2681.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33853,Not in chargemaster,33853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33853,BCBS multispecialty AW base fee schedule,3513.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33858,Not in chargemaster,33858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33858,BCBS multispecialty AW base fee schedule,6528.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33859,Not in chargemaster,33859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33859,BCBS multispecialty AW base fee schedule,4686.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33863,Not in chargemaster,33863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33863,BCBS multispecialty AW base fee schedule,6055.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33864,Not in chargemaster,33864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33864,BCBS multispecialty AW base fee schedule,6187.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33866,Not in chargemaster,33866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33866,BCBS multispecialty AW base fee schedule,1774.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33871,Not in chargemaster,33871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33871,BCBS multispecialty AW base fee schedule,6276.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33875,Not in chargemaster,33875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33875,BCBS multispecialty AW base fee schedule,5267.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33877,Not in chargemaster,33877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33877,BCBS multispecialty AW base fee schedule,6966.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33880,Not in chargemaster,33880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33880,BCBS multispecialty AW base fee schedule,3448.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33881,Not in chargemaster,33881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33881,BCBS multispecialty AW base fee schedule,2960.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33883,Not in chargemaster,33883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33883,BCBS multispecialty AW base fee schedule,2143.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33884,Not in chargemaster,33884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33884,BCBS multispecialty AW base fee schedule,761.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33886,Not in chargemaster,33886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33886,BCBS multispecialty AW base fee schedule,1838.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33889,Not in chargemaster,33889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33889,BCBS multispecialty AW base fee schedule,1520.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33891,Not in chargemaster,33891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33891,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33910,Not in chargemaster,33910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33910,BCBS multispecialty AW base fee schedule,5113.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33915,Not in chargemaster,33915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33915,BCBS multispecialty AW base fee schedule,2642.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33916,Not in chargemaster,33916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33916,BCBS multispecialty AW base fee schedule,8111.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33917,Not in chargemaster,33917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33917,BCBS multispecialty AW base fee schedule,2790.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33920,Not in chargemaster,33920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33920,BCBS multispecialty AW base fee schedule,3474.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33922,Not in chargemaster,33922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33922,BCBS multispecialty AW base fee schedule,2662.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33924,Not in chargemaster,33924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33924,BCBS multispecialty AW base fee schedule,549.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33925,Not in chargemaster,33925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33925,BCBS multispecialty AW base fee schedule,3295.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33926,Not in chargemaster,33926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33926,BCBS multispecialty AW base fee schedule,4640.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33927,Not in chargemaster,33927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33927,BCBS multispecialty AW base fee schedule,4906.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33935,Not in chargemaster,33935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33935,BCBS multispecialty AW base fee schedule,9518.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33945,Not in chargemaster,33945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33945,BCBS multispecialty AW base fee schedule,9349.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33946,Not in chargemaster,33946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33946,BCBS multispecialty AW base fee schedule,592.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33947,Not in chargemaster,33947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33947,BCBS multispecialty AW base fee schedule,659.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33948,Not in chargemaster,33948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33948,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33949,Not in chargemaster,33949,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33949,BCBS multispecialty AW base fee schedule,445.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33951,Not in chargemaster,33951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33951,BCBS multispecialty AW base fee schedule,815.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33952,Not in chargemaster,33952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33952,BCBS multispecialty AW base fee schedule,822.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33953,Not in chargemaster,33953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33953,BCBS multispecialty AW base fee schedule,908.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33954,Not in chargemaster,33954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33954,BCBS multispecialty AW base fee schedule,915.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33955,Not in chargemaster,33955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33955,BCBS multispecialty AW base fee schedule,1594.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33956,Not in chargemaster,33956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33956,BCBS multispecialty AW base fee schedule,1605.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33957,Not in chargemaster,33957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33957,BCBS multispecialty AW base fee schedule,355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33958,Not in chargemaster,33958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33958,BCBS multispecialty AW base fee schedule,355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33959,Not in chargemaster,33959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33959,BCBS multispecialty AW base fee schedule,449.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33962,Not in chargemaster,33962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33962,BCBS multispecialty AW base fee schedule,449.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33963,Not in chargemaster,33963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33963,BCBS multispecialty AW base fee schedule,899.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33964,Not in chargemaster,33964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33964,BCBS multispecialty AW base fee schedule,948.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33965,Not in chargemaster,33965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33965,BCBS multispecialty AW base fee schedule,355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33966,Not in chargemaster,33966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33966,BCBS multispecialty AW base fee schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33967,Not in chargemaster,33967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33967,BCBS multispecialty AW base fee schedule,497.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33968,Not in chargemaster,33968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33968,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33969,Not in chargemaster,33969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33969,BCBS multispecialty AW base fee schedule,524.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33970,Not in chargemaster,33970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33970,BCBS multispecialty AW base fee schedule,680.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33971,Not in chargemaster,33971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33971,BCBS multispecialty AW base fee schedule,1349.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33973,Not in chargemaster,33973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33973,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33974,Not in chargemaster,33974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33974,BCBS multispecialty AW base fee schedule,1702.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33975,Not in chargemaster,33975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33975,BCBS multispecialty AW base fee schedule,2509.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33976,Not in chargemaster,33976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33976,BCBS multispecialty AW base fee schedule,3051.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33977,Not in chargemaster,33977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33977,BCBS multispecialty AW base fee schedule,2161.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33978,Not in chargemaster,33978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33978,BCBS multispecialty AW base fee schedule,2554.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33979,Not in chargemaster,33979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33979,BCBS multispecialty AW base fee schedule,3743.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33980,Not in chargemaster,33980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33980,BCBS multispecialty AW base fee schedule,3415.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33981,Not in chargemaster,33981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33981,BCBS multispecialty AW base fee schedule,1599.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33982,Not in chargemaster,33982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33982,BCBS multispecialty AW base fee schedule,3757.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33983,Not in chargemaster,33983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33983,BCBS multispecialty AW base fee schedule,4442.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33984,Not in chargemaster,33984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33984,BCBS multispecialty AW base fee schedule,546.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33985,Not in chargemaster,33985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33985,BCBS multispecialty AW base fee schedule,987.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33986,Not in chargemaster,33986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33986,BCBS multispecialty AW base fee schedule,1006.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33987,Not in chargemaster,33987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33987,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33988,Not in chargemaster,33988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33988,BCBS multispecialty AW base fee schedule,1494.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33989,Not in chargemaster,33989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33989,BCBS multispecialty AW base fee schedule,948.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33990,Not in chargemaster,33990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33990,BCBS multispecialty AW base fee schedule,816.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33991,Not in chargemaster,33991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33991,BCBS multispecialty AW base fee schedule,1197.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33992,Not in chargemaster,33992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33992,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33993,Not in chargemaster,33993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33993,BCBS multispecialty AW base fee schedule,333.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34001,Not in chargemaster,34001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34001,BCBS multispecialty AW base fee schedule,1759.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34051,Not in chargemaster,34051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34051,BCBS multispecialty AW base fee schedule,1898.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34101,Not in chargemaster,34101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34101,BCBS multispecialty AW base fee schedule,1151.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34111,Not in chargemaster,34111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34111,BCBS multispecialty AW base fee schedule,1157.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34151,Not in chargemaster,34151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34151,BCBS multispecialty AW base fee schedule,2677.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34201,Not in chargemaster,34201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34201,BCBS multispecialty AW base fee schedule,1975.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34203,Not in chargemaster,34203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34203,BCBS multispecialty AW base fee schedule,1829.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34401,Not in chargemaster,34401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34401,BCBS multispecialty AW base fee schedule,2795.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34421,Not in chargemaster,34421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34421,BCBS multispecialty AW base fee schedule,1428.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34451,Not in chargemaster,34451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34451,BCBS multispecialty AW base fee schedule,2763.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34471,Not in chargemaster,34471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34471,BCBS multispecialty AW base fee schedule,2074.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34490,Not in chargemaster,34490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34490,BCBS multispecialty AW base fee schedule,1226.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34501,Not in chargemaster,34501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34501,BCBS multispecialty AW base fee schedule,1713.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34502,Not in chargemaster,34502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34502,BCBS multispecialty AW base fee schedule,2965.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34510,Not in chargemaster,34510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34510,BCBS multispecialty AW base fee schedule,1963.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34520,Not in chargemaster,34520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34520,BCBS multispecialty AW base fee schedule,1902.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34530,Not in chargemaster,34530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34530,BCBS multispecialty AW base fee schedule,1805.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34701,Not in chargemaster,34701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34701,BCBS multispecialty AW base fee schedule,2395.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34702,Not in chargemaster,34702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34702,BCBS multispecialty AW base fee schedule,3575.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34703,Not in chargemaster,34703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34703,BCBS multispecialty AW base fee schedule,2642.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34704,Not in chargemaster,34704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34704,BCBS multispecialty AW base fee schedule,4401.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34705,Not in chargemaster,34705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34705,BCBS multispecialty AW base fee schedule,2950.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34706,Not in chargemaster,34706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34706,BCBS multispecialty AW base fee schedule,4448.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34707,Not in chargemaster,34707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34707,BCBS multispecialty AW base fee schedule,2235.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34708,Not in chargemaster,34708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34708,BCBS multispecialty AW base fee schedule,3568.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34709,Not in chargemaster,34709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34709,BCBS multispecialty AW base fee schedule,624.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34710,Not in chargemaster,34710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34710,BCBS multispecialty AW base fee schedule,1544.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34711,Not in chargemaster,34711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34711,BCBS multispecialty AW base fee schedule,575.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34712,Not in chargemaster,34712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34712,BCBS multispecialty AW base fee schedule,1272,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34713,Not in chargemaster,34713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34713,BCBS multispecialty AW base fee schedule,240.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34714,Not in chargemaster,34714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34714,BCBS multispecialty AW base fee schedule,521.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34715,Not in chargemaster,34715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34715,BCBS multispecialty AW base fee schedule,577.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34716,Not in chargemaster,34716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34716,BCBS multispecialty AW base fee schedule,715.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34717,Not in chargemaster,34717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34717,BCBS multispecialty AW base fee schedule,857.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34718,Not in chargemaster,34718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34718,BCBS multispecialty AW base fee schedule,2390.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34808,Not in chargemaster,34808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34808,BCBS multispecialty AW base fee schedule,384.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34812,Not in chargemaster,34812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34812,BCBS multispecialty AW base fee schedule,398.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34813,Not in chargemaster,34813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34813,BCBS multispecialty AW base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34820,Not in chargemaster,34820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34820,BCBS multispecialty AW base fee schedule,674.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34830,Not in chargemaster,34830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34830,BCBS multispecialty AW base fee schedule,3392.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34831,Not in chargemaster,34831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34831,BCBS multispecialty AW base fee schedule,3712.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34832,Not in chargemaster,34832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34832,BCBS multispecialty AW base fee schedule,3649.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34833,Not in chargemaster,34833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34833,BCBS multispecialty AW base fee schedule,777.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 34834,Not in chargemaster,34834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34834,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35001,Not in chargemaster,35001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35001,BCBS multispecialty AW base fee schedule,2159.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35002,Not in chargemaster,35002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35002,BCBS multispecialty AW base fee schedule,2186.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35005,Not in chargemaster,35005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35005,BCBS multispecialty AW base fee schedule,1913.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35011,Not in chargemaster,35011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35011,BCBS multispecialty AW base fee schedule,1930.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35013,Not in chargemaster,35013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35013,BCBS multispecialty AW base fee schedule,2428.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35021,Not in chargemaster,35021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35021,BCBS multispecialty AW base fee schedule,2414.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35022,Not in chargemaster,35022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35022,BCBS multispecialty AW base fee schedule,2762.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35045,Not in chargemaster,35045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35045,BCBS multispecialty AW base fee schedule,1884.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35081,Not in chargemaster,35081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35081,BCBS multispecialty AW base fee schedule,3334.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35082,Not in chargemaster,35082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35082,BCBS multispecialty AW base fee schedule,4206.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35091,Not in chargemaster,35091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35091,BCBS multispecialty AW base fee schedule,3446.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35092,Not in chargemaster,35092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35092,BCBS multispecialty AW base fee schedule,5019.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35102,Not in chargemaster,35102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35102,BCBS multispecialty AW base fee schedule,3619.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35103,Not in chargemaster,35103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35103,BCBS multispecialty AW base fee schedule,4308.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35111,Not in chargemaster,35111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35111,BCBS multispecialty AW base fee schedule,2556.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35112,Not in chargemaster,35112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35112,BCBS multispecialty AW base fee schedule,3146.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35121,Not in chargemaster,35121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35121,BCBS multispecialty AW base fee schedule,3043.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35122,Not in chargemaster,35122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35122,BCBS multispecialty AW base fee schedule,3640.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35131,Not in chargemaster,35131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35131,BCBS multispecialty AW base fee schedule,2651.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35132,Not in chargemaster,35132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35132,BCBS multispecialty AW base fee schedule,3146.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35141,Not in chargemaster,35141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35141,BCBS multispecialty AW base fee schedule,2122.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35142,Not in chargemaster,35142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35142,BCBS multispecialty AW base fee schedule,2560.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35151,Not in chargemaster,35151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35151,BCBS multispecialty AW base fee schedule,2383.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35152,Not in chargemaster,35152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35152,BCBS multispecialty AW base fee schedule,2689.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35180,Not in chargemaster,35180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35180,BCBS multispecialty AW base fee schedule,1684.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35182,Not in chargemaster,35182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35182,BCBS multispecialty AW base fee schedule,3431.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35184,Not in chargemaster,35184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35184,BCBS multispecialty AW base fee schedule,1854.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35188,Not in chargemaster,35188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35188,BCBS multispecialty AW base fee schedule,2449.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35189,Not in chargemaster,35189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35189,BCBS multispecialty AW base fee schedule,2905.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35190,Not in chargemaster,35190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35190,BCBS multispecialty AW base fee schedule,1466.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35201,Not in chargemaster,35201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35201,BCBS multispecialty AW base fee schedule,1811.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35206,Not in chargemaster,35206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35206,BCBS multispecialty AW base fee schedule,1502.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35207,Not in chargemaster,35207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35207,BCBS multispecialty AW base fee schedule,1441.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35211,Not in chargemaster,35211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35211,BCBS multispecialty AW base fee schedule,2665.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35216,Not in chargemaster,35216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35216,BCBS multispecialty AW base fee schedule,3980.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35221,Not in chargemaster,35221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35221,BCBS multispecialty AW base fee schedule,2824.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35226,Not in chargemaster,35226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35226,BCBS multispecialty AW base fee schedule,1601.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35231,Not in chargemaster,35231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35231,BCBS multispecialty AW base fee schedule,2410.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35236,Not in chargemaster,35236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35236,BCBS multispecialty AW base fee schedule,1933.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35241,Not in chargemaster,35241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35241,BCBS multispecialty AW base fee schedule,2750.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35246,Not in chargemaster,35246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35246,BCBS multispecialty AW base fee schedule,3000.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35251,Not in chargemaster,35251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35251,BCBS multispecialty AW base fee schedule,3359.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35256,Not in chargemaster,35256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35256,BCBS multispecialty AW base fee schedule,1972.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35261,Not in chargemaster,35261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35261,BCBS multispecialty AW base fee schedule,1883.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35266,Not in chargemaster,35266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35266,BCBS multispecialty AW base fee schedule,1664.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35271,Not in chargemaster,35271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35271,BCBS multispecialty AW base fee schedule,2647.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35276,Not in chargemaster,35276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35276,BCBS multispecialty AW base fee schedule,2792.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35281,Not in chargemaster,35281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35281,BCBS multispecialty AW base fee schedule,3134.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35286,Not in chargemaster,35286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35286,BCBS multispecialty AW base fee schedule,1799.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35301,Not in chargemaster,35301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35301,BCBS multispecialty AW base fee schedule,2179.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35302,Not in chargemaster,35302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35302,BCBS multispecialty AW base fee schedule,2159.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35303,Not in chargemaster,35303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35303,BCBS multispecialty AW base fee schedule,2385,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35304,Not in chargemaster,35304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35304,BCBS multispecialty AW base fee schedule,2455.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35305,Not in chargemaster,35305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35305,BCBS multispecialty AW base fee schedule,2359.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35306,Not in chargemaster,35306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35306,BCBS multispecialty AW base fee schedule,858.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35311,Not in chargemaster,35311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35311,BCBS multispecialty AW base fee schedule,2989.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35321,Not in chargemaster,35321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35321,BCBS multispecialty AW base fee schedule,1718.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35331,Not in chargemaster,35331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35331,BCBS multispecialty AW base fee schedule,2797.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35341,Not in chargemaster,35341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35341,BCBS multispecialty AW base fee schedule,2648.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35351,Not in chargemaster,35351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35351,BCBS multispecialty AW base fee schedule,2471.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35355,Not in chargemaster,35355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35355,BCBS multispecialty AW base fee schedule,1986.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35361,Not in chargemaster,35361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35361,BCBS multispecialty AW base fee schedule,2930.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35363,Not in chargemaster,35363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35363,BCBS multispecialty AW base fee schedule,3126.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35371,Not in chargemaster,35371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35371,BCBS multispecialty AW base fee schedule,1573.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35372,Not in chargemaster,35372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35372,BCBS multispecialty AW base fee schedule,1884.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35390,Not in chargemaster,35390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35390,BCBS multispecialty AW base fee schedule,308.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35400,Not in chargemaster,35400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35400,BCBS multispecialty AW base fee schedule,286.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35500,Not in chargemaster,35500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35500,BCBS multispecialty AW base fee schedule,615.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35501,Not in chargemaster,35501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35501,BCBS multispecialty AW base fee schedule,2810.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35506,Not in chargemaster,35506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35506,BCBS multispecialty AW base fee schedule,2451.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35508,Not in chargemaster,35508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35508,BCBS multispecialty AW base fee schedule,2552.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35509,Not in chargemaster,35509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35509,BCBS multispecialty AW base fee schedule,2720.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35510,Not in chargemaster,35510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35510,BCBS multispecialty AW base fee schedule,2365.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35511,Not in chargemaster,35511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35511,BCBS multispecialty AW base fee schedule,2156.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35512,Not in chargemaster,35512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35512,BCBS multispecialty AW base fee schedule,2320.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35515,Not in chargemaster,35515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35515,BCBS multispecialty AW base fee schedule,2552.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35516,Not in chargemaster,35516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35516,BCBS multispecialty AW base fee schedule,2347.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35518,Not in chargemaster,35518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35518,BCBS multispecialty AW base fee schedule,2198.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35521,Not in chargemaster,35521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35521,BCBS multispecialty AW base fee schedule,2359.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35522,Not in chargemaster,35522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35522,BCBS multispecialty AW base fee schedule,2343.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35523,Not in chargemaster,35523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35523,BCBS multispecialty AW base fee schedule,2467.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35525,Not in chargemaster,35525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35525,BCBS multispecialty AW base fee schedule,2186.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35526,Not in chargemaster,35526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35526,BCBS multispecialty AW base fee schedule,3322.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35531,Not in chargemaster,35531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35531,BCBS multispecialty AW base fee schedule,3752.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35533,Not in chargemaster,35533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35533,BCBS multispecialty AW base fee schedule,2899.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35535,Not in chargemaster,35535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35535,BCBS multispecialty AW base fee schedule,3665.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35536,Not in chargemaster,35536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35536,BCBS multispecialty AW base fee schedule,3254.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35537,Not in chargemaster,35537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35537,BCBS multispecialty AW base fee schedule,4016.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35538,Not in chargemaster,35538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35538,BCBS multispecialty AW base fee schedule,4501.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35539,Not in chargemaster,35539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35539,BCBS multispecialty AW base fee schedule,4224.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35540,Not in chargemaster,35540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35540,BCBS multispecialty AW base fee schedule,4709.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35556,Not in chargemaster,35556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35556,BCBS multispecialty AW base fee schedule,2698.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35558,Not in chargemaster,35558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35558,BCBS multispecialty AW base fee schedule,2368.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35560,Not in chargemaster,35560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35560,BCBS multispecialty AW base fee schedule,3281.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35563,Not in chargemaster,35563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35563,BCBS multispecialty AW base fee schedule,2545.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35565,Not in chargemaster,35565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35565,BCBS multispecialty AW base fee schedule,2520.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35566,Not in chargemaster,35566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35566,BCBS multispecialty AW base fee schedule,3219.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35570,Not in chargemaster,35570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35570,BCBS multispecialty AW base fee schedule,2835.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35571,Not in chargemaster,35571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35571,BCBS multispecialty AW base fee schedule,2553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35572,Not in chargemaster,35572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35572,BCBS multispecialty AW base fee schedule,665.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35583,Not in chargemaster,35583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35583,BCBS multispecialty AW base fee schedule,2782.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35585,Not in chargemaster,35585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35585,BCBS multispecialty AW base fee schedule,3225.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35587,Not in chargemaster,35587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35587,BCBS multispecialty AW base fee schedule,2626.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35600,Not in chargemaster,35600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35600,BCBS multispecialty AW base fee schedule,492.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35601,Not in chargemaster,35601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35601,BCBS multispecialty AW base fee schedule,2693.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35606,Not in chargemaster,35606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35606,BCBS multispecialty AW base fee schedule,2258.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35612,Not in chargemaster,35612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35612,BCBS multispecialty AW base fee schedule,2007.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35616,Not in chargemaster,35616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35616,BCBS multispecialty AW base fee schedule,2121.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35621,Not in chargemaster,35621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35621,BCBS multispecialty AW base fee schedule,2112.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35623,Not in chargemaster,35623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35623,BCBS multispecialty AW base fee schedule,2526.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35626,Not in chargemaster,35626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35626,BCBS multispecialty AW base fee schedule,3055.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35631,Not in chargemaster,35631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35631,BCBS multispecialty AW base fee schedule,3566.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35632,Not in chargemaster,35632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35632,BCBS multispecialty AW base fee schedule,3479.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35633,Not in chargemaster,35633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35633,BCBS multispecialty AW base fee schedule,3819.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35634,Not in chargemaster,35634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35634,BCBS multispecialty AW base fee schedule,3405.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35636,Not in chargemaster,35636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35636,BCBS multispecialty AW base fee schedule,3069.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35637,Not in chargemaster,35637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35637,BCBS multispecialty AW base fee schedule,3194.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35638,Not in chargemaster,35638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35638,BCBS multispecialty AW base fee schedule,3358.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35642,Not in chargemaster,35642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35642,BCBS multispecialty AW base fee schedule,1895.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35645,Not in chargemaster,35645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35645,BCBS multispecialty AW base fee schedule,1820.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35646,Not in chargemaster,35646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35646,BCBS multispecialty AW base fee schedule,3305.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35647,Not in chargemaster,35647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35647,BCBS multispecialty AW base fee schedule,2980.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35650,Not in chargemaster,35650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35650,BCBS multispecialty AW base fee schedule,1965.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35654,Not in chargemaster,35654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35654,BCBS multispecialty AW base fee schedule,2638.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35656,Not in chargemaster,35656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35656,BCBS multispecialty AW base fee schedule,2080.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35661,Not in chargemaster,35661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35661,BCBS multispecialty AW base fee schedule,2087.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35663,Not in chargemaster,35663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35663,BCBS multispecialty AW base fee schedule,2341.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35665,Not in chargemaster,35665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35665,BCBS multispecialty AW base fee schedule,2261.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35666,Not in chargemaster,35666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35666,BCBS multispecialty AW base fee schedule,2452.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35671,Not in chargemaster,35671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35671,BCBS multispecialty AW base fee schedule,2163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35681,Not in chargemaster,35681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35681,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35682,Not in chargemaster,35682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35682,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35683,Not in chargemaster,35683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35683,BCBS multispecialty AW base fee schedule,787.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35685,Not in chargemaster,35685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35685,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35686,Not in chargemaster,35686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35686,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35691,Not in chargemaster,35691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35691,BCBS multispecialty AW base fee schedule,1818.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35693,Not in chargemaster,35693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35693,BCBS multispecialty AW base fee schedule,1602.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35694,Not in chargemaster,35694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35694,BCBS multispecialty AW base fee schedule,1900.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35695,Not in chargemaster,35695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35695,BCBS multispecialty AW base fee schedule,1972.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35697,Not in chargemaster,35697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35697,BCBS multispecialty AW base fee schedule,284.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35700,Not in chargemaster,35700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35700,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35701,Not in chargemaster,35701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35701,BCBS multispecialty AW base fee schedule,838.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35702,Not in chargemaster,35702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35702,BCBS multispecialty AW base fee schedule,788.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35703,Not in chargemaster,35703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35703,BCBS multispecialty AW base fee schedule,800.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35800,Not in chargemaster,35800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35800,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35820,Not in chargemaster,35820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35820,BCBS multispecialty AW base fee schedule,3861.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35840,Not in chargemaster,35840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35840,BCBS multispecialty AW base fee schedule,2309.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35860,Not in chargemaster,35860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35860,BCBS multispecialty AW base fee schedule,1610.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35870,Not in chargemaster,35870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35870,BCBS multispecialty AW base fee schedule,2396.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35875,Not in chargemaster,35875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35875,BCBS multispecialty AW base fee schedule,1146.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35876,Not in chargemaster,35876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35876,BCBS multispecialty AW base fee schedule,1823.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35879,Not in chargemaster,35879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35879,BCBS multispecialty AW base fee schedule,1782.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35881,Not in chargemaster,35881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35881,BCBS multispecialty AW base fee schedule,1966.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35883,Not in chargemaster,35883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35883,BCBS multispecialty AW base fee schedule,2314.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35884,Not in chargemaster,35884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35884,BCBS multispecialty AW base fee schedule,2386.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35901,Not in chargemaster,35901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35901,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35903,Not in chargemaster,35903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35903,BCBS multispecialty AW base fee schedule,1087.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35905,Not in chargemaster,35905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35905,BCBS multispecialty AW base fee schedule,3409.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 35907,Not in chargemaster,35907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35907,BCBS multispecialty AW base fee schedule,3666.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36000,Not in chargemaster,36000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36000,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32601,Not in chargemaster,32601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32601,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32604,Not in chargemaster,32604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32604,BCBS multispecialty AW base fee schedule,918.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32606,Not in chargemaster,32606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32606,BCBS multispecialty AW base fee schedule,886.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32607,Not in chargemaster,32607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32607,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32608,Not in chargemaster,32608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32608,BCBS multispecialty AW base fee schedule,726.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32609,Not in chargemaster,32609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32609,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32650,Not in chargemaster,32650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32650,BCBS multispecialty AW base fee schedule,1272.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32651,Not in chargemaster,32651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32651,BCBS multispecialty AW base fee schedule,2095.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32652,Not in chargemaster,32652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32652,BCBS multispecialty AW base fee schedule,3180,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32653,Not in chargemaster,32653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32653,BCBS multispecialty AW base fee schedule,2031.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32654,Not in chargemaster,32654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32654,BCBS multispecialty AW base fee schedule,2223.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32655,Not in chargemaster,32655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32655,BCBS multispecialty AW base fee schedule,1827.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32656,Not in chargemaster,32656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32656,BCBS multispecialty AW base fee schedule,1533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32658,Not in chargemaster,32658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32658,BCBS multispecialty AW base fee schedule,1364.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32659,Not in chargemaster,32659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32659,BCBS multispecialty AW base fee schedule,1398.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32661,Not in chargemaster,32661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32661,BCBS multispecialty AW base fee schedule,1525.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32662,Not in chargemaster,32662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32662,BCBS multispecialty AW base fee schedule,1705.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32663,Not in chargemaster,32663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32663,BCBS multispecialty AW base fee schedule,2678.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32664,Not in chargemaster,32664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32664,BCBS multispecialty AW base fee schedule,1620.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32665,Not in chargemaster,32665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32665,BCBS multispecialty AW base fee schedule,2357.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32666,Not in chargemaster,32666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32666,BCBS multispecialty AW base fee schedule,1661.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32667,Not in chargemaster,32667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32667,BCBS multispecialty AW base fee schedule,300.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32668,Not in chargemaster,32668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32668,BCBS multispecialty AW base fee schedule,300.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32669,Not in chargemaster,32669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32669,BCBS multispecialty AW base fee schedule,2572.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32670,Not in chargemaster,32670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32670,BCBS multispecialty AW base fee schedule,3072.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32671,Not in chargemaster,32671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32671,BCBS multispecialty AW base fee schedule,3401.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32672,Not in chargemaster,32672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32672,BCBS multispecialty AW base fee schedule,2916.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32673,Not in chargemaster,32673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32673,BCBS multispecialty AW base fee schedule,2330.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32674,Not in chargemaster,32674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32674,BCBS multispecialty AW base fee schedule,412.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32701,Not in chargemaster,32701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32701,BCBS multispecialty AW base fee schedule,410.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32800,Not in chargemaster,32800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32800,BCBS multispecialty AW base fee schedule,1807.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32810,Not in chargemaster,32810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32810,BCBS multispecialty AW base fee schedule,1721.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32815,Not in chargemaster,32815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32815,BCBS multispecialty AW base fee schedule,5360.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32820,Not in chargemaster,32820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32820,BCBS multispecialty AW base fee schedule,2543.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32851,Not in chargemaster,32851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32851,BCBS multispecialty AW base fee schedule,6283.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32852,Not in chargemaster,32852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32852,BCBS multispecialty AW base fee schedule,6826.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32853,Not in chargemaster,32853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32853,BCBS multispecialty AW base fee schedule,8807.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32854,Not in chargemaster,32854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32854,BCBS multispecialty AW base fee schedule,9354.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32900,Not in chargemaster,32900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32900,BCBS multispecialty AW base fee schedule,2718.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32905,Not in chargemaster,32905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32905,BCBS multispecialty AW base fee schedule,2554.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32906,Not in chargemaster,32906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32906,BCBS multispecialty AW base fee schedule,3157.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32940,Not in chargemaster,32940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32940,BCBS multispecialty AW base fee schedule,2359.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32960,Not in chargemaster,32960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32960,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31830,Not in chargemaster,31830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31830,BCBS multispecialty AW base fee schedule,668.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32405,Not in chargemaster,32405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32405,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32551,32551,32551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32551,BCBS multispecialty AW base fee schedule,302.1,407,Fee schedule,,302.1,302.1,302.1,302.1,,,0
unity,Fee schedule,Facility 32552,Not in chargemaster,32552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32552,BCBS multispecialty AW base fee schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32553,Not in chargemaster,32553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32553,BCBS multispecialty AW base fee schedule,342.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32554,32554,32554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32554,BCBS multispecialty AW base fee schedule,171.59,220,Fee schedule,,171.59,171.59,171.59,171.59,,,0
unity,Fee schedule,Facility 32555,Not in chargemaster,32555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32555,BCBS multispecialty AW base fee schedule,213.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32556,Not in chargemaster,32556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32556,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32557,Not in chargemaster,32557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32557,BCBS multispecialty AW base fee schedule,291.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32560,Not in chargemaster,32560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32560,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32561,Not in chargemaster,32561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32561,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32562,Not in chargemaster,32562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32562,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32994,Not in chargemaster,32994,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32994,BCBS multispecialty AW base fee schedule,848,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32997,Not in chargemaster,32997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32997,BCBS multispecialty AW base fee schedule,651.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32998,Not in chargemaster,32998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32998,BCBS multispecialty AW base fee schedule,846.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33286,Not in chargemaster,33286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33286,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36002,Not in chargemaster,36002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36002,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36005,Not in chargemaster,36005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36005,BCBS multispecialty AW base fee schedule,91.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36010,Not in chargemaster,36010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36010,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36011,Not in chargemaster,36011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36011,BCBS multispecialty AW base fee schedule,302.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36012,Not in chargemaster,36012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36012,BCBS multispecialty AW base fee schedule,333.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36013,Not in chargemaster,36013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36013,BCBS multispecialty AW base fee schedule,233.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36014,Not in chargemaster,36014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36014,BCBS multispecialty AW base fee schedule,292.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36015,Not in chargemaster,36015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36015,BCBS multispecialty AW base fee schedule,331.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36100,Not in chargemaster,36100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36100,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36140,Not in chargemaster,36140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36140,BCBS multispecialty AW base fee schedule,172.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36160,Not in chargemaster,36160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36160,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36200,Not in chargemaster,36200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36200,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36215,Not in chargemaster,36215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36215,BCBS multispecialty AW base fee schedule,406.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36216,Not in chargemaster,36216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36216,BCBS multispecialty AW base fee schedule,523.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36217,Not in chargemaster,36217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36217,BCBS multispecialty AW base fee schedule,630.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36218,Not in chargemaster,36218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36218,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36221,Not in chargemaster,36221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36221,BCBS multispecialty AW base fee schedule,386.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36222,Not in chargemaster,36222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36222,BCBS multispecialty AW base fee schedule,542.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36223,Not in chargemaster,36223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36223,BCBS multispecialty AW base fee schedule,608.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36224,Not in chargemaster,36224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36224,BCBS multispecialty AW base fee schedule,690.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36225,Not in chargemaster,36225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36225,BCBS multispecialty AW base fee schedule,606.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36226,Not in chargemaster,36226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36226,BCBS multispecialty AW base fee schedule,681.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36227,Not in chargemaster,36227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36227,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36228,Not in chargemaster,36228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36228,BCBS multispecialty AW base fee schedule,462.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36245,Not in chargemaster,36245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36245,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36246,Not in chargemaster,36246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36246,BCBS multispecialty AW base fee schedule,486.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36247,Not in chargemaster,36247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36247,BCBS multispecialty AW base fee schedule,579.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36248,Not in chargemaster,36248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36248,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36251,Not in chargemaster,36251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36251,BCBS multispecialty AW base fee schedule,497.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36252,Not in chargemaster,36252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36252,BCBS multispecialty AW base fee schedule,690.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36253,Not in chargemaster,36253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36253,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36254,Not in chargemaster,36254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36254,BCBS multispecialty AW base fee schedule,796.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36260,Not in chargemaster,36260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36260,BCBS multispecialty AW base fee schedule,1254.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36261,Not in chargemaster,36261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36261,BCBS multispecialty AW base fee schedule,778.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36262,Not in chargemaster,36262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36262,BCBS multispecialty AW base fee schedule,593.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36400,Not in chargemaster,36400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36400,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36420,Not in chargemaster,36420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36420,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36425,Not in chargemaster,36425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36425,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36430,Not in chargemaster,36430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36430,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36440,Not in chargemaster,36440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36440,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36450,Not in chargemaster,36450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36450,BCBS multispecialty AW base fee schedule,326.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36455,Not in chargemaster,36455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36455,BCBS multispecialty AW base fee schedule,243.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36456,Not in chargemaster,36456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36456,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36460,Not in chargemaster,36460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36460,BCBS multispecialty AW base fee schedule,669.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36465,Not in chargemaster,36465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36465,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36405,Not in chargemaster,36405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36405,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36406,Not in chargemaster,36406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36406,BCBS multispecialty AW base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36410,Not in chargemaster,36410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36410,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36466,Not in chargemaster,36466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36466,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36470,Not in chargemaster,36470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36470,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36471,Not in chargemaster,36471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36471,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36473,Not in chargemaster,36473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36473,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36474,Not in chargemaster,36474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36474,BCBS multispecialty AW base fee schedule,172.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36475,Not in chargemaster,36475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36475,BCBS multispecialty AW base fee schedule,535.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36476,Not in chargemaster,36476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36476,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36478,Not in chargemaster,36478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36478,BCBS multispecialty AW base fee schedule,533.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36479,Not in chargemaster,36479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36479,BCBS multispecialty AW base fee schedule,262.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36481,Not in chargemaster,36481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36481,BCBS multispecialty AW base fee schedule,633.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36482,Not in chargemaster,36482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36482,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36483,Not in chargemaster,36483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36483,BCBS multispecialty AW base fee schedule,172.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36500,Not in chargemaster,36500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36500,BCBS multispecialty AW base fee schedule,350.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36510,Not in chargemaster,36510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36510,BCBS multispecialty AW base fee schedule,102.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36511,Not in chargemaster,36511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36511,BCBS multispecialty AW base fee schedule,208.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36512,Not in chargemaster,36512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36512,BCBS multispecialty AW base fee schedule,206.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36513,Not in chargemaster,36513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36513,BCBS multispecialty AW base fee schedule,208.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36514,Not in chargemaster,36514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36514,BCBS multispecialty AW base fee schedule,182.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36516,Not in chargemaster,36516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36516,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36522,Not in chargemaster,36522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36522,BCBS multispecialty AW base fee schedule,186.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36555,Not in chargemaster,36555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36555,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36556,Not in chargemaster,36556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36556,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36557,Not in chargemaster,36557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36557,BCBS multispecialty AW base fee schedule,612.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36558,Not in chargemaster,36558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36558,BCBS multispecialty AW base fee schedule,500.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36560,Not in chargemaster,36560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36560,BCBS multispecialty AW base fee schedule,734.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36561,Not in chargemaster,36561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36561,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36563,Not in chargemaster,36563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36563,BCBS multispecialty AW base fee schedule,702.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36565,Not in chargemaster,36565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36565,BCBS multispecialty AW base fee schedule,643.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36568,Not in chargemaster,36568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36568,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36569,Not in chargemaster,36569,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36569,BCBS multispecialty AW base fee schedule,180.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36570,Not in chargemaster,36570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36570,BCBS multispecialty AW base fee schedule,636.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36566,Not in chargemaster,36566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36566,BCBS multispecialty AW base fee schedule,692.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36571,Not in chargemaster,36571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36571,BCBS multispecialty AW base fee schedule,598.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36572,Not in chargemaster,36572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36572,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36573,Not in chargemaster,36573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36573,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36575,Not in chargemaster,36575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36575,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36576,Not in chargemaster,36576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36576,BCBS multispecialty AW base fee schedule,354.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36578,Not in chargemaster,36578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36578,BCBS multispecialty AW base fee schedule,390.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36580,Not in chargemaster,36580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36580,BCBS multispecialty AW base fee schedule,126.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36581,Not in chargemaster,36581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36581,BCBS multispecialty AW base fee schedule,351.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36582,Not in chargemaster,36582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36582,BCBS multispecialty AW base fee schedule,556.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36583,Not in chargemaster,36583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36583,BCBS multispecialty AW base fee schedule,630.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36584,Not in chargemaster,36584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36584,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36585,Not in chargemaster,36585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36585,BCBS multispecialty AW base fee schedule,520.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36589,Not in chargemaster,36589,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36589,BCBS multispecialty AW base fee schedule,263.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36620,Not in chargemaster,36620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36620,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36625,Not in chargemaster,36625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36625,BCBS multispecialty AW base fee schedule,202.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36640,Not in chargemaster,36640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36640,BCBS multispecialty AW base fee schedule,219.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36660,Not in chargemaster,36660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36660,BCBS multispecialty AW base fee schedule,130.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36680,Not in chargemaster,36680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36680,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36800,Not in chargemaster,36800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36800,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36810,Not in chargemaster,36810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36810,BCBS multispecialty AW base fee schedule,404.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36815,Not in chargemaster,36815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36815,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36818,Not in chargemaster,36818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36818,BCBS multispecialty AW base fee schedule,1332.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36819,Not in chargemaster,36819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36819,BCBS multispecialty AW base fee schedule,1409.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36820,Not in chargemaster,36820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36820,BCBS multispecialty AW base fee schedule,1404.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36821,Not in chargemaster,36821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36821,BCBS multispecialty AW base fee schedule,1279.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36823,Not in chargemaster,36823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36823,BCBS multispecialty AW base fee schedule,2697.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36825,Not in chargemaster,36825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36825,BCBS multispecialty AW base fee schedule,1531.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36830,Not in chargemaster,36830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36830,BCBS multispecialty AW base fee schedule,1285.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36831,Not in chargemaster,36831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36831,BCBS multispecialty AW base fee schedule,1185.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36832,Not in chargemaster,36832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36832,BCBS multispecialty AW base fee schedule,1455.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36833,Not in chargemaster,36833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36833,BCBS multispecialty AW base fee schedule,1560.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36835,Not in chargemaster,36835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36835,BCBS multispecialty AW base fee schedule,918.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36838,Not in chargemaster,36838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36838,BCBS multispecialty AW base fee schedule,2206.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36860,Not in chargemaster,36860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36860,BCBS multispecialty AW base fee schedule,213.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36591,Not in chargemaster,36591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36591,BCBS multispecialty AW base fee schedule,46.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36592,Not in chargemaster,36592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36592,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36593,Not in chargemaster,36593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36593,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36595,Not in chargemaster,36595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36595,BCBS multispecialty AW base fee schedule,349.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36590,Not in chargemaster,36590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36590,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36596,Not in chargemaster,36596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36596,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36597,Not in chargemaster,36597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36597,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36598,Not in chargemaster,36598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36598,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36600,Not in chargemaster,36600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36600,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36861,Not in chargemaster,36861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36861,BCBS multispecialty AW base fee schedule,268.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36901,Not in chargemaster,36901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36901,BCBS multispecialty AW base fee schedule,324.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36902,Not in chargemaster,36902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36902,BCBS multispecialty AW base fee schedule,459.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36903,Not in chargemaster,36903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36903,BCBS multispecialty AW base fee schedule,609.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36904,Not in chargemaster,36904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36904,BCBS multispecialty AW base fee schedule,711.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36905,Not in chargemaster,36905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36905,BCBS multispecialty AW base fee schedule,853.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36906,Not in chargemaster,36906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36906,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36907,Not in chargemaster,36907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36907,BCBS multispecialty AW base fee schedule,281.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36908,Not in chargemaster,36908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36908,BCBS multispecialty AW base fee schedule,398.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36909,Not in chargemaster,36909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36909,BCBS multispecialty AW base fee schedule,386.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37140,Not in chargemaster,37140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37140,BCBS multispecialty AW base fee schedule,4485.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37145,Not in chargemaster,37145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37145,BCBS multispecialty AW base fee schedule,4158.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37160,Not in chargemaster,37160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37160,BCBS multispecialty AW base fee schedule,4271.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37180,Not in chargemaster,37180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37180,BCBS multispecialty AW base fee schedule,4106.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37181,Not in chargemaster,37181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37181,BCBS multispecialty AW base fee schedule,4485.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37182,Not in chargemaster,37182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37182,BCBS multispecialty AW base fee schedule,1572.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37183,Not in chargemaster,37183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37183,BCBS multispecialty AW base fee schedule,716.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37184,Not in chargemaster,37184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37184,BCBS multispecialty AW base fee schedule,837.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37185,Not in chargemaster,37185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37185,BCBS multispecialty AW base fee schedule,316.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37186,Not in chargemaster,37186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37186,BCBS multispecialty AW base fee schedule,469.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37187,Not in chargemaster,37187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37187,BCBS multispecialty AW base fee schedule,755.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37188,Not in chargemaster,37188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37188,BCBS multispecialty AW base fee schedule,536.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37191,Not in chargemaster,37191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37191,BCBS multispecialty AW base fee schedule,429.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37192,Not in chargemaster,37192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37192,BCBS multispecialty AW base fee schedule,663.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37193,Not in chargemaster,37193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37193,BCBS multispecialty AW base fee schedule,671.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37200,Not in chargemaster,37200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37200,BCBS multispecialty AW base fee schedule,417.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37211,Not in chargemaster,37211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37211,BCBS multispecialty AW base fee schedule,743.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37212,Not in chargemaster,37212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37212,BCBS multispecialty AW base fee schedule,649.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37213,Not in chargemaster,37213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37213,BCBS multispecialty AW base fee schedule,447.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37214,Not in chargemaster,37214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37214,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37215,Not in chargemaster,37215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37215,BCBS multispecialty AW base fee schedule,1923.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37216,Not in chargemaster,37216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37216,BCBS multispecialty AW base fee schedule,1872.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37217,Not in chargemaster,37217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37217,BCBS multispecialty AW base fee schedule,2078.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37218,Not in chargemaster,37218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37218,BCBS multispecialty AW base fee schedule,1574.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37220,Not in chargemaster,37220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37220,BCBS multispecialty AW base fee schedule,772.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37197,Not in chargemaster,37197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37197,BCBS multispecialty AW base fee schedule,579.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37221,Not in chargemaster,37221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37221,BCBS multispecialty AW base fee schedule,953.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37222,Not in chargemaster,37222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37222,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37223,Not in chargemaster,37223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37223,BCBS multispecialty AW base fee schedule,410.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37224,Not in chargemaster,37224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37224,BCBS multispecialty AW base fee schedule,857.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37225,Not in chargemaster,37225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37225,BCBS multispecialty AW base fee schedule,1162.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37226,Not in chargemaster,37226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37226,BCBS multispecialty AW base fee schedule,1003.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37227,Not in chargemaster,37227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37227,BCBS multispecialty AW base fee schedule,1397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37228,Not in chargemaster,37228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37228,BCBS multispecialty AW base fee schedule,1046.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37229,Not in chargemaster,37229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37229,BCBS multispecialty AW base fee schedule,1354.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37230,Not in chargemaster,37230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37230,BCBS multispecialty AW base fee schedule,1346.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37231,Not in chargemaster,37231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37231,BCBS multispecialty AW base fee schedule,1460.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37232,Not in chargemaster,37232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37232,BCBS multispecialty AW base fee schedule,386.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37233,Not in chargemaster,37233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37233,BCBS multispecialty AW base fee schedule,628.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37234,Not in chargemaster,37234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37234,BCBS multispecialty AW base fee schedule,549.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37235,Not in chargemaster,37235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37235,BCBS multispecialty AW base fee schedule,775.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37236,Not in chargemaster,37236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37236,BCBS multispecialty AW base fee schedule,856.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37237,Not in chargemaster,37237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37237,BCBS multispecialty AW base fee schedule,409.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37238,Not in chargemaster,37238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37238,BCBS multispecialty AW base fee schedule,588.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37239,Not in chargemaster,37239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37239,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37241,Not in chargemaster,37241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37241,BCBS multispecialty AW base fee schedule,841.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37242,Not in chargemaster,37242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37242,BCBS multispecialty AW base fee schedule,917.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37243,Not in chargemaster,37243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37243,BCBS multispecialty AW base fee schedule,1079.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37244,Not in chargemaster,37244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37244,BCBS multispecialty AW base fee schedule,1278.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37246,Not in chargemaster,37246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37246,BCBS multispecialty AW base fee schedule,670.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37247,Not in chargemaster,37247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37247,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37248,Not in chargemaster,37248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37248,BCBS multispecialty AW base fee schedule,572.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37249,Not in chargemaster,37249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37249,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37500,Not in chargemaster,37500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37500,BCBS multispecialty AW base fee schedule,1217.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37565,Not in chargemaster,37565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37565,BCBS multispecialty AW base fee schedule,1386.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37600,Not in chargemaster,37600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37600,BCBS multispecialty AW base fee schedule,1405.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37605,Not in chargemaster,37605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37605,BCBS multispecialty AW base fee schedule,1419.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37606,Not in chargemaster,37606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37606,BCBS multispecialty AW base fee schedule,1371.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37607,Not in chargemaster,37607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37607,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37609,Not in chargemaster,37609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37609,BCBS multispecialty AW base fee schedule,393.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37615,Not in chargemaster,37615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37615,BCBS multispecialty AW base fee schedule,1014.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37616,Not in chargemaster,37616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37616,BCBS multispecialty AW base fee schedule,2121.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37617,Not in chargemaster,37617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37617,BCBS multispecialty AW base fee schedule,2558.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37618,Not in chargemaster,37618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37618,BCBS multispecialty AW base fee schedule,743.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37619,Not in chargemaster,37619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37619,BCBS multispecialty AW base fee schedule,3337.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37650,Not in chargemaster,37650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37650,BCBS multispecialty AW base fee schedule,880.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37660,Not in chargemaster,37660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37660,BCBS multispecialty AW base fee schedule,2539.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37700,Not in chargemaster,37700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37700,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37718,Not in chargemaster,37718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37718,BCBS multispecialty AW base fee schedule,808.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37722,Not in chargemaster,37722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37722,BCBS multispecialty AW base fee schedule,906.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37735,Not in chargemaster,37735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37735,BCBS multispecialty AW base fee schedule,1116.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37760,Not in chargemaster,37760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37760,BCBS multispecialty AW base fee schedule,1199.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37761,Not in chargemaster,37761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37761,BCBS multispecialty AW base fee schedule,1040.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37765,Not in chargemaster,37765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37765,BCBS multispecialty AW base fee schedule,522.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37252,Not in chargemaster,37252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37252,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37253,Not in chargemaster,37253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37253,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37766,Not in chargemaster,37766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37766,BCBS multispecialty AW base fee schedule,639.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37780,Not in chargemaster,37780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37780,BCBS multispecialty AW base fee schedule,448.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37785,Not in chargemaster,37785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37785,BCBS multispecialty AW base fee schedule,494.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37788,Not in chargemaster,37788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37788,BCBS multispecialty AW base fee schedule,2419.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37790,Not in chargemaster,37790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37790,BCBS multispecialty AW base fee schedule,929.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38100,Not in chargemaster,38100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38100,BCBS multispecialty AW base fee schedule,2225.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38101,Not in chargemaster,38101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38101,BCBS multispecialty AW base fee schedule,2249.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38102,Not in chargemaster,38102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38102,BCBS multispecialty AW base fee schedule,505.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38115,Not in chargemaster,38115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38115,BCBS multispecialty AW base fee schedule,2463.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38120,Not in chargemaster,38120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38120,BCBS multispecialty AW base fee schedule,2031.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38200,Not in chargemaster,38200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38200,BCBS multispecialty AW base fee schedule,255.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38204,Not in chargemaster,38204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38204,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38205,Not in chargemaster,38205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38205,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38206,Not in chargemaster,38206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38206,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38207,Not in chargemaster,38207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38207,BCBS multispecialty AW base fee schedule,86.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38208,Not in chargemaster,38208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38208,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38209,Not in chargemaster,38209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38209,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38210,Not in chargemaster,38210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38210,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38211,Not in chargemaster,38211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38211,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38212,Not in chargemaster,38212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38212,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38213,Not in chargemaster,38213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38213,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38214,Not in chargemaster,38214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38214,BCBS multispecialty AW base fee schedule,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38215,Not in chargemaster,38215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38215,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38220,Not in chargemaster,38220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38220,BCBS multispecialty AW base fee schedule,133.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38230,Not in chargemaster,38230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38230,BCBS multispecialty AW base fee schedule,392.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38232,Not in chargemaster,38232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38232,BCBS multispecialty AW base fee schedule,381.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38240,Not in chargemaster,38240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38240,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38241,Not in chargemaster,38241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38241,BCBS multispecialty AW base fee schedule,332.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38242,Not in chargemaster,38242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38242,BCBS multispecialty AW base fee schedule,240.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38243,Not in chargemaster,38243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38243,BCBS multispecialty AW base fee schedule,231.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38300,Not in chargemaster,38300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38300,BCBS multispecialty AW base fee schedule,391.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38221,Not in chargemaster,38221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38221,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38222,Not in chargemaster,38222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38222,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38305,Not in chargemaster,38305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38305,BCBS multispecialty AW base fee schedule,936.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38308,Not in chargemaster,38308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38308,BCBS multispecialty AW base fee schedule,872.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38380,Not in chargemaster,38380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38380,BCBS multispecialty AW base fee schedule,1083.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38381,Not in chargemaster,38381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38381,BCBS multispecialty AW base fee schedule,1538.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38382,Not in chargemaster,38382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38382,BCBS multispecialty AW base fee schedule,1300.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38500,38500,38500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38500,BCBS multispecialty AW base fee schedule,488.93,506,Fee schedule,,488.93,488.93,488.93,488.93,,,0
unity,Fee schedule,Facility 38520,Not in chargemaster,38520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38520,BCBS multispecialty AW base fee schedule,890.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38525,38525,38525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38525,BCBS multispecialty AW base fee schedule,841.38,921.4,Fee schedule,,841.38,841.38,841.38,841.38,,,0
unity,Fee schedule,Facility 38530,Not in chargemaster,38530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38530,BCBS multispecialty AW base fee schedule,1082.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38531,Not in chargemaster,38531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38531,BCBS multispecialty AW base fee schedule,829.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38542,Not in chargemaster,38542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38542,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38550,Not in chargemaster,38550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38550,BCBS multispecialty AW base fee schedule,987.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38555,Not in chargemaster,38555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38555,BCBS multispecialty AW base fee schedule,1957.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38562,Not in chargemaster,38562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38562,BCBS multispecialty AW base fee schedule,1352.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38564,Not in chargemaster,38564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38564,BCBS multispecialty AW base fee schedule,1353.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38570,Not in chargemaster,38570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38570,BCBS multispecialty AW base fee schedule,979.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38571,Not in chargemaster,38571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38571,BCBS multispecialty AW base fee schedule,1270.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38572,Not in chargemaster,38572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38572,BCBS multispecialty AW base fee schedule,1743.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38573,Not in chargemaster,38573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38573,BCBS multispecialty AW base fee schedule,2220.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38700,Not in chargemaster,38700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38700,BCBS multispecialty AW base fee schedule,1529.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38720,Not in chargemaster,38720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38720,BCBS multispecialty AW base fee schedule,2552.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38724,Not in chargemaster,38724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38724,BCBS multispecialty AW base fee schedule,2752.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38740,Not in chargemaster,38740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38740,BCBS multispecialty AW base fee schedule,1344.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38745,Not in chargemaster,38745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38745,BCBS multispecialty AW base fee schedule,1692.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38746,Not in chargemaster,38746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38746,BCBS multispecialty AW base fee schedule,412.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38747,Not in chargemaster,38747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38747,BCBS multispecialty AW base fee schedule,515.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38760,Not in chargemaster,38760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38760,BCBS multispecialty AW base fee schedule,1609.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38765,Not in chargemaster,38765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38765,BCBS multispecialty AW base fee schedule,2498.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38770,Not in chargemaster,38770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38770,BCBS multispecialty AW base fee schedule,1538.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38780,Not in chargemaster,38780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38780,BCBS multispecialty AW base fee schedule,1982.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38790,Not in chargemaster,38790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38790,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38792,Not in chargemaster,38792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38792,BCBS multispecialty AW base fee schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38794,Not in chargemaster,38794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38794,BCBS multispecialty AW base fee schedule,564.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38900,Not in chargemaster,38900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38900,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39000,Not in chargemaster,39000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39000,BCBS multispecialty AW base fee schedule,950.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39010,Not in chargemaster,39010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39010,BCBS multispecialty AW base fee schedule,1507.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39200,Not in chargemaster,39200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39200,BCBS multispecialty AW base fee schedule,1670.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39220,Not in chargemaster,39220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39220,BCBS multispecialty AW base fee schedule,2173,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39401,Not in chargemaster,39401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39401,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39402,Not in chargemaster,39402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39402,BCBS multispecialty AW base fee schedule,773.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39501,Not in chargemaster,39501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39501,BCBS multispecialty AW base fee schedule,1641.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39503,Not in chargemaster,39503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39503,BCBS multispecialty AW base fee schedule,11474.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39540,Not in chargemaster,39540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39540,BCBS multispecialty AW base fee schedule,1676.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39541,Not in chargemaster,39541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39541,BCBS multispecialty AW base fee schedule,1810.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39545,Not in chargemaster,39545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39545,BCBS multispecialty AW base fee schedule,1712.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39560,Not in chargemaster,39560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39560,BCBS multispecialty AW base fee schedule,1533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 39561,Not in chargemaster,39561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39561,BCBS multispecialty AW base fee schedule,2376.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40490,Not in chargemaster,40490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40490,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38505,Not in chargemaster,38505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38505,BCBS multispecialty AW base fee schedule,133.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38510,38510,38510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38510,BCBS multispecialty AW base fee schedule,800.96,880,Fee schedule,,800.96,800.96,800.96,800.96,,,0
unity,Fee schedule,Facility 40500,Not in chargemaster,40500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40500,BCBS multispecialty AW base fee schedule,689,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40510,40510,40510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40510,BCBS multispecialty AW base fee schedule,665.81,742.5,Fee schedule,,665.81,665.81,665.81,665.81,,,0
unity,Fee schedule,Facility 40525,Not in chargemaster,40525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40525,BCBS multispecialty AW base fee schedule,1052.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40527,Not in chargemaster,40527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40527,BCBS multispecialty AW base fee schedule,1174.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40530,Not in chargemaster,40530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40530,BCBS multispecialty AW base fee schedule,761.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40520,Not in chargemaster,40520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40520,BCBS multispecialty AW base fee schedule,675.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40650,Not in chargemaster,40650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40650,BCBS multispecialty AW base fee schedule,582.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40652,Not in chargemaster,40652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40652,BCBS multispecialty AW base fee schedule,677.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40654,Not in chargemaster,40654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40654,BCBS multispecialty AW base fee schedule,805.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40700,Not in chargemaster,40700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40700,BCBS multispecialty AW base fee schedule,1936.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40701,Not in chargemaster,40701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40701,BCBS multispecialty AW base fee schedule,2293.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40702,Not in chargemaster,40702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40702,BCBS multispecialty AW base fee schedule,1924.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40720,Not in chargemaster,40720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40720,BCBS multispecialty AW base fee schedule,1976.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40761,Not in chargemaster,40761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40761,BCBS multispecialty AW base fee schedule,2084.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40800,Not in chargemaster,40800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40800,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40801,Not in chargemaster,40801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40801,BCBS multispecialty AW base fee schedule,394.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40804,Not in chargemaster,40804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40804,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40805,Not in chargemaster,40805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40805,BCBS multispecialty AW base fee schedule,397.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40806,Not in chargemaster,40806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40806,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40808,Not in chargemaster,40808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40808,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40810,Not in chargemaster,40810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40810,BCBS multispecialty AW base fee schedule,234.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40812,Not in chargemaster,40812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40812,BCBS multispecialty AW base fee schedule,361.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40814,Not in chargemaster,40814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40814,BCBS multispecialty AW base fee schedule,557.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40816,Not in chargemaster,40816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40816,BCBS multispecialty AW base fee schedule,583.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40818,Not in chargemaster,40818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40818,BCBS multispecialty AW base fee schedule,515.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40819,Not in chargemaster,40819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40819,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40820,Not in chargemaster,40820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40820,BCBS multispecialty AW base fee schedule,316.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40830,Not in chargemaster,40830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40830,BCBS multispecialty AW base fee schedule,320.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40831,Not in chargemaster,40831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40831,BCBS multispecialty AW base fee schedule,439.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40840,Not in chargemaster,40840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40840,BCBS multispecialty AW base fee schedule,1193.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40842,Not in chargemaster,40842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40842,BCBS multispecialty AW base fee schedule,1297.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40843,Not in chargemaster,40843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40843,BCBS multispecialty AW base fee schedule,1682.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40844,Not in chargemaster,40844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40844,BCBS multispecialty AW base fee schedule,2265.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40845,Not in chargemaster,40845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40845,BCBS multispecialty AW base fee schedule,2308.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41000,Not in chargemaster,41000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41000,BCBS multispecialty AW base fee schedule,207.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41005,Not in chargemaster,41005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41005,BCBS multispecialty AW base fee schedule,218.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41006,Not in chargemaster,41006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41006,BCBS multispecialty AW base fee schedule,453.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41007,Not in chargemaster,41007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41007,BCBS multispecialty AW base fee schedule,439.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41008,Not in chargemaster,41008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41008,BCBS multispecialty AW base fee schedule,493.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41009,Not in chargemaster,41009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41009,BCBS multispecialty AW base fee schedule,542.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41010,Not in chargemaster,41010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41010,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41015,Not in chargemaster,41015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41015,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41016,Not in chargemaster,41016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41016,BCBS multispecialty AW base fee schedule,657.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41017,Not in chargemaster,41017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41017,BCBS multispecialty AW base fee schedule,653.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41018,Not in chargemaster,41018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41018,BCBS multispecialty AW base fee schedule,759.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41019,Not in chargemaster,41019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41019,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41100,Not in chargemaster,41100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41100,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41105,Not in chargemaster,41105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41105,BCBS multispecialty AW base fee schedule,206.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41108,Not in chargemaster,41108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41108,BCBS multispecialty AW base fee schedule,166.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41110,Not in chargemaster,41110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41110,BCBS multispecialty AW base fee schedule,247.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41112,Not in chargemaster,41112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41112,BCBS multispecialty AW base fee schedule,465.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41113,Not in chargemaster,41113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41113,BCBS multispecialty AW base fee schedule,514.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41120,Not in chargemaster,41120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41120,BCBS multispecialty AW base fee schedule,2013.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41130,Not in chargemaster,41130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41130,BCBS multispecialty AW base fee schedule,2489.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41135,Not in chargemaster,41135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41135,BCBS multispecialty AW base fee schedule,4112.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41140,Not in chargemaster,41140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41140,BCBS multispecialty AW base fee schedule,4132.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41145,Not in chargemaster,41145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41145,BCBS multispecialty AW base fee schedule,5229.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41150,Not in chargemaster,41150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41150,BCBS multispecialty AW base fee schedule,4161.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41153,Not in chargemaster,41153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41153,BCBS multispecialty AW base fee schedule,4532.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41155,Not in chargemaster,41155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41155,BCBS multispecialty AW base fee schedule,5709.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41250,Not in chargemaster,41250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41250,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41114,Not in chargemaster,41114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41114,BCBS multispecialty AW base fee schedule,1175.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41115,Not in chargemaster,41115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41115,BCBS multispecialty AW base fee schedule,275.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41116,Not in chargemaster,41116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41116,BCBS multispecialty AW base fee schedule,409.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41251,Not in chargemaster,41251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41251,BCBS multispecialty AW base fee schedule,349.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41252,Not in chargemaster,41252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41252,BCBS multispecialty AW base fee schedule,398.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41510,Not in chargemaster,41510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41510,BCBS multispecialty AW base fee schedule,846.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41512,Not in chargemaster,41512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41512,BCBS multispecialty AW base fee schedule,1246.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41520,Not in chargemaster,41520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41520,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41530,Not in chargemaster,41530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41530,BCBS multispecialty AW base fee schedule,706.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41800,Not in chargemaster,41800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41800,BCBS multispecialty AW base fee schedule,289.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41805,Not in chargemaster,41805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41805,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41806,Not in chargemaster,41806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41806,BCBS multispecialty AW base fee schedule,520.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41822,Not in chargemaster,41822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41822,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41823,Not in chargemaster,41823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41823,BCBS multispecialty AW base fee schedule,680.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41825,Not in chargemaster,41825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41825,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41826,Not in chargemaster,41826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41826,BCBS multispecialty AW base fee schedule,389.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41827,Not in chargemaster,41827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41827,BCBS multispecialty AW base fee schedule,569.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41828,Not in chargemaster,41828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41828,BCBS multispecialty AW base fee schedule,425.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41830,Not in chargemaster,41830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41830,BCBS multispecialty AW base fee schedule,590.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41872,Not in chargemaster,41872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41872,BCBS multispecialty AW base fee schedule,565.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41874,Not in chargemaster,41874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41874,BCBS multispecialty AW base fee schedule,477.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42000,Not in chargemaster,42000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42000,BCBS multispecialty AW base fee schedule,197.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42100,Not in chargemaster,42100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42100,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42104,Not in chargemaster,42104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42104,BCBS multispecialty AW base fee schedule,258.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42106,Not in chargemaster,42106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42106,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42107,Not in chargemaster,42107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42107,BCBS multispecialty AW base fee schedule,644.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42120,Not in chargemaster,42120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42120,BCBS multispecialty AW base fee schedule,1904.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42140,Not in chargemaster,42140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42140,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42145,Not in chargemaster,42145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42145,BCBS multispecialty AW base fee schedule,1311.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42160,Not in chargemaster,42160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42160,BCBS multispecialty AW base fee schedule,274.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42180,Not in chargemaster,42180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42180,BCBS multispecialty AW base fee schedule,349.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42182,Not in chargemaster,42182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42182,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42200,Not in chargemaster,42200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42200,BCBS multispecialty AW base fee schedule,1805.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42205,Not in chargemaster,42205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42205,BCBS multispecialty AW base fee schedule,1882.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42210,Not in chargemaster,42210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42210,BCBS multispecialty AW base fee schedule,2100.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42215,Not in chargemaster,42215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42215,BCBS multispecialty AW base fee schedule,1368.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42220,Not in chargemaster,42220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42220,BCBS multispecialty AW base fee schedule,1125.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42225,Not in chargemaster,42225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42225,BCBS multispecialty AW base fee schedule,1870.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42226,Not in chargemaster,42226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42226,BCBS multispecialty AW base fee schedule,1675.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42227,Not in chargemaster,42227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42227,BCBS multispecialty AW base fee schedule,1566.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42235,Not in chargemaster,42235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42235,BCBS multispecialty AW base fee schedule,1371.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42260,Not in chargemaster,42260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42260,BCBS multispecialty AW base fee schedule,1257.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42280,Not in chargemaster,42280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42280,BCBS multispecialty AW base fee schedule,206.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42281,Not in chargemaster,42281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42281,BCBS multispecialty AW base fee schedule,307.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42300,Not in chargemaster,42300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42300,BCBS multispecialty AW base fee schedule,290.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42305,Not in chargemaster,42305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42305,BCBS multispecialty AW base fee schedule,811.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42310,Not in chargemaster,42310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42310,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42320,Not in chargemaster,42320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42320,BCBS multispecialty AW base fee schedule,333.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42330,Not in chargemaster,42330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42330,BCBS multispecialty AW base fee schedule,310.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42335,Not in chargemaster,42335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42335,BCBS multispecialty AW base fee schedule,488.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42340,Not in chargemaster,42340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42340,BCBS multispecialty AW base fee schedule,639.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42400,Not in chargemaster,42400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42400,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42405,Not in chargemaster,42405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42405,BCBS multispecialty AW base fee schedule,429.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42408,Not in chargemaster,42408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42408,BCBS multispecialty AW base fee schedule,663.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42409,Not in chargemaster,42409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42409,BCBS multispecialty AW base fee schedule,425.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42410,Not in chargemaster,42410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42410,BCBS multispecialty AW base fee schedule,1186.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42415,Not in chargemaster,42415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42415,BCBS multispecialty AW base fee schedule,2004.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42420,Not in chargemaster,42420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42420,BCBS multispecialty AW base fee schedule,2251.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42425,Not in chargemaster,42425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42425,BCBS multispecialty AW base fee schedule,1588.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42426,Not in chargemaster,42426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42426,BCBS multispecialty AW base fee schedule,2568.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42440,Not in chargemaster,42440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42440,BCBS multispecialty AW base fee schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42450,Not in chargemaster,42450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42450,BCBS multispecialty AW base fee schedule,682.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42500,Not in chargemaster,42500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42500,BCBS multispecialty AW base fee schedule,643.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42505,Not in chargemaster,42505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42505,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42507,Not in chargemaster,42507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42507,BCBS multispecialty AW base fee schedule,944.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42509,Not in chargemaster,42509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42509,BCBS multispecialty AW base fee schedule,1568.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42510,Not in chargemaster,42510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42510,BCBS multispecialty AW base fee schedule,1162.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42550,Not in chargemaster,42550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42550,BCBS multispecialty AW base fee schedule,121.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42600,Not in chargemaster,42600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42600,BCBS multispecialty AW base fee schedule,661.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42650,Not in chargemaster,42650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42650,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42660,Not in chargemaster,42660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42660,BCBS multispecialty AW base fee schedule,166.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42665,Not in chargemaster,42665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42665,BCBS multispecialty AW base fee schedule,395.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42700,Not in chargemaster,42700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42700,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42720,Not in chargemaster,42720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42720,BCBS multispecialty AW base fee schedule,738.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42725,Not in chargemaster,42725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42725,BCBS multispecialty AW base fee schedule,1527.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42800,Not in chargemaster,42800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42800,BCBS multispecialty AW base fee schedule,213.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42804,Not in chargemaster,42804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42804,BCBS multispecialty AW base fee schedule,216.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42815,Not in chargemaster,42815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42815,BCBS multispecialty AW base fee schedule,1034.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42820,Not in chargemaster,42820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42820,BCBS multispecialty AW base fee schedule,547.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42821,Not in chargemaster,42821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42821,BCBS multispecialty AW base fee schedule,571.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42825,Not in chargemaster,42825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42825,BCBS multispecialty AW base fee schedule,498.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42826,Not in chargemaster,42826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42826,BCBS multispecialty AW base fee schedule,477,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42830,Not in chargemaster,42830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42830,BCBS multispecialty AW base fee schedule,394.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42831,Not in chargemaster,42831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42831,BCBS multispecialty AW base fee schedule,426.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42835,Not in chargemaster,42835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42835,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42836,Not in chargemaster,42836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42836,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42842,Not in chargemaster,42842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42842,BCBS multispecialty AW base fee schedule,1906.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42844,Not in chargemaster,42844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42844,BCBS multispecialty AW base fee schedule,2628.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42845,Not in chargemaster,42845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42845,BCBS multispecialty AW base fee schedule,4233.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42860,Not in chargemaster,42860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42860,BCBS multispecialty AW base fee schedule,357.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42870,Not in chargemaster,42870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42870,BCBS multispecialty AW base fee schedule,1111.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42890,Not in chargemaster,42890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42890,BCBS multispecialty AW base fee schedule,2701.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42892,Not in chargemaster,42892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42892,BCBS multispecialty AW base fee schedule,3551,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42894,Not in chargemaster,42894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42894,BCBS multispecialty AW base fee schedule,4487.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42900,Not in chargemaster,42900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42900,BCBS multispecialty AW base fee schedule,633.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42950,Not in chargemaster,42950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42950,BCBS multispecialty AW base fee schedule,1514.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42953,Not in chargemaster,42953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42953,BCBS multispecialty AW base fee schedule,1812.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42955,Not in chargemaster,42955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42955,BCBS multispecialty AW base fee schedule,1437.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42960,Not in chargemaster,42960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42960,BCBS multispecialty AW base fee schedule,313.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42961,Not in chargemaster,42961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42961,BCBS multispecialty AW base fee schedule,789.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42962,Not in chargemaster,42962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42962,BCBS multispecialty AW base fee schedule,973.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42970,Not in chargemaster,42970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42970,BCBS multispecialty AW base fee schedule,777.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42971,Not in chargemaster,42971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42971,BCBS multispecialty AW base fee schedule,857.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42972,Not in chargemaster,42972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42972,BCBS multispecialty AW base fee schedule,961.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43020,Not in chargemaster,43020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43020,BCBS multispecialty AW base fee schedule,1077.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43030,Not in chargemaster,43030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43030,BCBS multispecialty AW base fee schedule,986.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43045,Not in chargemaster,43045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43045,BCBS multispecialty AW base fee schedule,2493.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43100,Not in chargemaster,43100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43100,BCBS multispecialty AW base fee schedule,1193.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43101,Not in chargemaster,43101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43101,BCBS multispecialty AW base fee schedule,1927.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43107,Not in chargemaster,43107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43107,BCBS multispecialty AW base fee schedule,5735.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43108,Not in chargemaster,43108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43108,BCBS multispecialty AW base fee schedule,8584.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43112,Not in chargemaster,43112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43112,BCBS multispecialty AW base fee schedule,6709.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43113,Not in chargemaster,43113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43113,BCBS multispecialty AW base fee schedule,8378.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43116,Not in chargemaster,43116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43116,BCBS multispecialty AW base fee schedule,9610.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43117,Not in chargemaster,43117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43117,BCBS multispecialty AW base fee schedule,6251.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43118,Not in chargemaster,43118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43118,BCBS multispecialty AW base fee schedule,6984.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43121,Not in chargemaster,43121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43121,BCBS multispecialty AW base fee schedule,5486.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43122,Not in chargemaster,43122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43122,BCBS multispecialty AW base fee schedule,4927.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43123,Not in chargemaster,43123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43123,BCBS multispecialty AW base fee schedule,8690.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43124,Not in chargemaster,43124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43124,BCBS multispecialty AW base fee schedule,7323.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43130,Not in chargemaster,43130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43130,BCBS multispecialty AW base fee schedule,1501.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43135,Not in chargemaster,43135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43135,BCBS multispecialty AW base fee schedule,2822.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43180,Not in chargemaster,43180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43180,BCBS multispecialty AW base fee schedule,1038.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43191,Not in chargemaster,43191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43191,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43192,Not in chargemaster,43192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43192,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43193,Not in chargemaster,43193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43193,BCBS multispecialty AW base fee schedule,321.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43194,Not in chargemaster,43194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43194,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43195,Not in chargemaster,43195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43195,BCBS multispecialty AW base fee schedule,349.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43196,Not in chargemaster,43196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43196,BCBS multispecialty AW base fee schedule,372.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43197,Not in chargemaster,43197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43197,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42806,Not in chargemaster,42806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42806,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42808,Not in chargemaster,42808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42808,BCBS multispecialty AW base fee schedule,308.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42809,Not in chargemaster,42809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42809,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42810,Not in chargemaster,42810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42810,BCBS multispecialty AW base fee schedule,536.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43198,Not in chargemaster,43198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43198,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43200,Not in chargemaster,43200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43200,BCBS multispecialty AW base fee schedule,166.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43201,Not in chargemaster,43201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43201,BCBS multispecialty AW base fee schedule,197.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43202,Not in chargemaster,43202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43202,BCBS multispecialty AW base fee schedule,196.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43204,Not in chargemaster,43204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43204,BCBS multispecialty AW base fee schedule,258.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43205,Not in chargemaster,43205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43205,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43206,Not in chargemaster,43206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43206,BCBS multispecialty AW base fee schedule,253.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43210,Not in chargemaster,43210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43210,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43211,Not in chargemaster,43211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43211,BCBS multispecialty AW base fee schedule,448.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43212,Not in chargemaster,43212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43212,BCBS multispecialty AW base fee schedule,363.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43213,Not in chargemaster,43213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43213,BCBS multispecialty AW base fee schedule,495.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43214,Not in chargemaster,43214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43214,BCBS multispecialty AW base fee schedule,368.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43215,Not in chargemaster,43215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43215,BCBS multispecialty AW base fee schedule,270.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43216,Not in chargemaster,43216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43216,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43217,Not in chargemaster,43217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43217,BCBS multispecialty AW base fee schedule,306.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43220,43220,43220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43220,BCBS multispecialty AW base fee schedule,225.25,282.81,Fee schedule,,225.25,225.25,225.25,225.25,,,0
unity,Fee schedule,Facility 43226,Not in chargemaster,43226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43226,BCBS multispecialty AW base fee schedule,248.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43227,Not in chargemaster,43227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43227,BCBS multispecialty AW base fee schedule,314.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43231,Not in chargemaster,43231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43231,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43232,Not in chargemaster,43232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43232,BCBS multispecialty AW base fee schedule,380.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43233,Not in chargemaster,43233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43233,BCBS multispecialty AW base fee schedule,438.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43235,43235,43235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43235,BCBS multispecialty AW base fee schedule,234.53,315.35,Fee schedule,,234.53,234.53,234.53,234.53,,,0
unity,Fee schedule,Facility 43229,Not in chargemaster,43229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43229,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43236,Not in chargemaster,43236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43236,BCBS multispecialty AW base fee schedule,264.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43237,Not in chargemaster,43237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43237,BCBS multispecialty AW base fee schedule,373.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43238,Not in chargemaster,43238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43238,BCBS multispecialty AW base fee schedule,443.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43239,43239,43239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43239,BCBS multispecialty AW base fee schedule,264.34,371.88,Fee schedule,,264.34,264.34,264.34,264.34,,,0
unity,Fee schedule,Facility 43240,Not in chargemaster,43240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43240,BCBS multispecialty AW base fee schedule,750.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43241,Not in chargemaster,43241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43241,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43242,Not in chargemaster,43242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43242,BCBS multispecialty AW base fee schedule,502.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43243,Not in chargemaster,43243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43243,BCBS multispecialty AW base fee schedule,453.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43244,Not in chargemaster,43244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43244,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43245,Not in chargemaster,43245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43245,BCBS multispecialty AW base fee schedule,336.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43246,Not in chargemaster,43246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43246,BCBS multispecialty AW base fee schedule,384.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43247,43247,43247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43247,BCBS multispecialty AW base fee schedule,338.54,412.5,Fee schedule,,338.54,338.54,338.54,338.54,,,0
unity,Fee schedule,Facility 43248,Not in chargemaster,43248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43248,BCBS multispecialty AW base fee schedule,316.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43249,43249,43249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43249,BCBS multispecialty AW base fee schedule,292.83,387.2,Fee schedule,,292.83,292.83,292.83,292.83,,,0
unity,Fee schedule,Facility 43250,Not in chargemaster,43250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43250,BCBS multispecialty AW base fee schedule,327.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43251,43251,43251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43251,BCBS multispecialty AW base fee schedule,374.98,440,Fee schedule,,374.98,374.98,374.98,374.98,,,0
unity,Fee schedule,Facility 43252,Not in chargemaster,43252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43252,BCBS multispecialty AW base fee schedule,323.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43273,Not in chargemaster,43273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43273,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43274,Not in chargemaster,43274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43274,BCBS multispecialty AW base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43275,Not in chargemaster,43275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43275,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43276,Not in chargemaster,43276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43276,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43277,Not in chargemaster,43277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43277,BCBS multispecialty AW base fee schedule,723.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43278,Not in chargemaster,43278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43278,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43279,Not in chargemaster,43279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43279,BCBS multispecialty AW base fee schedule,2487.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43280,43280,43280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43280,BCBS multispecialty AW base fee schedule,2085.55,2381,Fee schedule,,2085.55,2085.55,2085.55,2085.55,,,0
unity,Fee schedule,Facility 43281,Not in chargemaster,43281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43281,BCBS multispecialty AW base fee schedule,2982.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43282,Not in chargemaster,43282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43282,BCBS multispecialty AW base fee schedule,3353.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43283,Not in chargemaster,43283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43283,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43284,Not in chargemaster,43284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43284,BCBS multispecialty AW base fee schedule,1254.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43285,Not in chargemaster,43285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43285,BCBS multispecialty AW base fee schedule,1292.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43286,Not in chargemaster,43286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43286,BCBS multispecialty AW base fee schedule,6114.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43287,Not in chargemaster,43287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43287,BCBS multispecialty AW base fee schedule,6920.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43288,Not in chargemaster,43288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43288,BCBS multispecialty AW base fee schedule,7274.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43300,Not in chargemaster,43300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43300,BCBS multispecialty AW base fee schedule,1171.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43305,Not in chargemaster,43305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43305,BCBS multispecialty AW base fee schedule,2072.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43310,Not in chargemaster,43310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43310,BCBS multispecialty AW base fee schedule,2843.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43312,Not in chargemaster,43312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43312,BCBS multispecialty AW base fee schedule,3058.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43313,Not in chargemaster,43313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43313,BCBS multispecialty AW base fee schedule,5243.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43314,Not in chargemaster,43314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43314,BCBS multispecialty AW base fee schedule,5650.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43320,Not in chargemaster,43320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43320,BCBS multispecialty AW base fee schedule,2699.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43325,Not in chargemaster,43325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43325,BCBS multispecialty AW base fee schedule,2624.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43327,Not in chargemaster,43327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43327,BCBS multispecialty AW base fee schedule,1583.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43328,Not in chargemaster,43328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43328,BCBS multispecialty AW base fee schedule,2159.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43330,Not in chargemaster,43330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43330,BCBS multispecialty AW base fee schedule,2581.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43331,Not in chargemaster,43331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43331,BCBS multispecialty AW base fee schedule,2567.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43332,Not in chargemaster,43332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43332,BCBS multispecialty AW base fee schedule,2233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43333,Not in chargemaster,43333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43333,BCBS multispecialty AW base fee schedule,2439.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43334,Not in chargemaster,43334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43334,BCBS multispecialty AW base fee schedule,2399.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43335,Not in chargemaster,43335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43335,BCBS multispecialty AW base fee schedule,2567.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43336,Not in chargemaster,43336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43336,BCBS multispecialty AW base fee schedule,2784.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43337,Not in chargemaster,43337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43337,BCBS multispecialty AW base fee schedule,2971.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43338,Not in chargemaster,43338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43338,BCBS multispecialty AW base fee schedule,223.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43340,Not in chargemaster,43340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43340,BCBS multispecialty AW base fee schedule,2665.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43341,Not in chargemaster,43341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43341,BCBS multispecialty AW base fee schedule,2685.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43351,Not in chargemaster,43351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43351,BCBS multispecialty AW base fee schedule,2522.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43352,Not in chargemaster,43352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43352,BCBS multispecialty AW base fee schedule,2041.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43360,Not in chargemaster,43360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43360,BCBS multispecialty AW base fee schedule,4320.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43361,Not in chargemaster,43361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43361,BCBS multispecialty AW base fee schedule,5208.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43400,Not in chargemaster,43400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43400,BCBS multispecialty AW base fee schedule,2942.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43405,Not in chargemaster,43405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43405,BCBS multispecialty AW base fee schedule,2789.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43410,Not in chargemaster,43410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43410,BCBS multispecialty AW base fee schedule,1945.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43415,Not in chargemaster,43415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43415,BCBS multispecialty AW base fee schedule,4938.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43420,Not in chargemaster,43420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43420,BCBS multispecialty AW base fee schedule,1927.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43425,Not in chargemaster,43425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43425,BCBS multispecialty AW base fee schedule,2765.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43450,Not in chargemaster,43450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43450,BCBS multispecialty AW base fee schedule,150.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43460,Not in chargemaster,43460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43460,BCBS multispecialty AW base fee schedule,406.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43500,Not in chargemaster,43500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43500,BCBS multispecialty AW base fee schedule,1512.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43501,Not in chargemaster,43501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43501,BCBS multispecialty AW base fee schedule,2602.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43502,Not in chargemaster,43502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43502,BCBS multispecialty AW base fee schedule,2948.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43510,Not in chargemaster,43510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43510,BCBS multispecialty AW base fee schedule,1831.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43520,Not in chargemaster,43520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43520,BCBS multispecialty AW base fee schedule,1320.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43605,Not in chargemaster,43605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43605,BCBS multispecialty AW base fee schedule,1619.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43610,Not in chargemaster,43610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43610,BCBS multispecialty AW base fee schedule,1893.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43611,Not in chargemaster,43611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43611,BCBS multispecialty AW base fee schedule,2360.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43620,Not in chargemaster,43620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43620,BCBS multispecialty AW base fee schedule,3835.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43621,Not in chargemaster,43621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43621,BCBS multispecialty AW base fee schedule,4387.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43622,Not in chargemaster,43622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43622,BCBS multispecialty AW base fee schedule,4473.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43631,Not in chargemaster,43631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43631,BCBS multispecialty AW base fee schedule,2802.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43632,Not in chargemaster,43632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43632,BCBS multispecialty AW base fee schedule,3931.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43633,Not in chargemaster,43633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43633,BCBS multispecialty AW base fee schedule,3718.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43634,Not in chargemaster,43634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43634,BCBS multispecialty AW base fee schedule,4113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43635,Not in chargemaster,43635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43635,BCBS multispecialty AW base fee schedule,217.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43640,Not in chargemaster,43640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43640,BCBS multispecialty AW base fee schedule,2275.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43641,Not in chargemaster,43641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43641,BCBS multispecialty AW base fee schedule,2326.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43644,Not in chargemaster,43644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43644,BCBS multispecialty AW base fee schedule,3356.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43645,Not in chargemaster,43645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43645,BCBS multispecialty AW base fee schedule,3574.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43651,Not in chargemaster,43651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43651,BCBS multispecialty AW base fee schedule,1264.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43652,Not in chargemaster,43652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43652,BCBS multispecialty AW base fee schedule,1476.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43653,Not in chargemaster,43653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43653,BCBS multispecialty AW base fee schedule,1107.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43752,Not in chargemaster,43752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43752,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43753,Not in chargemaster,43753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43753,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43754,Not in chargemaster,43754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43754,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43257,Not in chargemaster,43257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43257,BCBS multispecialty AW base fee schedule,446.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43259,Not in chargemaster,43259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43259,BCBS multispecialty AW base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43260,Not in chargemaster,43260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43260,BCBS multispecialty AW base fee schedule,616.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43261,Not in chargemaster,43261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43261,BCBS multispecialty AW base fee schedule,646.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43262,Not in chargemaster,43262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43262,BCBS multispecialty AW base fee schedule,682.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43263,Not in chargemaster,43263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43263,BCBS multispecialty AW base fee schedule,682.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43264,Not in chargemaster,43264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43264,BCBS multispecialty AW base fee schedule,694.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43265,Not in chargemaster,43265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43265,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43266,Not in chargemaster,43266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43266,BCBS multispecialty AW base fee schedule,416.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43270,Not in chargemaster,43270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43270,BCBS multispecialty AW base fee schedule,429.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43253,Not in chargemaster,43253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43253,BCBS multispecialty AW base fee schedule,503.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43254,Not in chargemaster,43254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43254,BCBS multispecialty AW base fee schedule,516.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43255,Not in chargemaster,43255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43255,BCBS multispecialty AW base fee schedule,383.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43453,Not in chargemaster,43453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43453,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43755,Not in chargemaster,43755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43755,BCBS multispecialty AW base fee schedule,112.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43770,Not in chargemaster,43770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43770,BCBS multispecialty AW base fee schedule,2173.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43771,Not in chargemaster,43771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43771,BCBS multispecialty AW base fee schedule,2469.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43772,Not in chargemaster,43772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43772,BCBS multispecialty AW base fee schedule,1838.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43773,Not in chargemaster,43773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43773,BCBS multispecialty AW base fee schedule,2469.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43774,Not in chargemaster,43774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43774,BCBS multispecialty AW base fee schedule,1855.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43775,Not in chargemaster,43775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43775,BCBS multispecialty AW base fee schedule,2157.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43800,Not in chargemaster,43800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43800,BCBS multispecialty AW base fee schedule,1802,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43810,Not in chargemaster,43810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43810,BCBS multispecialty AW base fee schedule,1967.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43820,Not in chargemaster,43820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43820,BCBS multispecialty AW base fee schedule,2595.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43825,Not in chargemaster,43825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43825,BCBS multispecialty AW base fee schedule,2532.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43830,Not in chargemaster,43830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43830,BCBS multispecialty AW base fee schedule,1354.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43831,Not in chargemaster,43831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43831,BCBS multispecialty AW base fee schedule,1160.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43832,Not in chargemaster,43832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43832,BCBS multispecialty AW base fee schedule,2009.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43840,Not in chargemaster,43840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43840,BCBS multispecialty AW base fee schedule,2628.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43842,Not in chargemaster,43842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43842,BCBS multispecialty AW base fee schedule,2213.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43843,Not in chargemaster,43843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43843,BCBS multispecialty AW base fee schedule,2479.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43845,Not in chargemaster,43845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43845,BCBS multispecialty AW base fee schedule,3763,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43846,Not in chargemaster,43846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43846,BCBS multispecialty AW base fee schedule,3139.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43847,Not in chargemaster,43847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43847,BCBS multispecialty AW base fee schedule,3491.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43848,Not in chargemaster,43848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43848,BCBS multispecialty AW base fee schedule,3742.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43850,Not in chargemaster,43850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43850,BCBS multispecialty AW base fee schedule,3150.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43855,Not in chargemaster,43855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43855,BCBS multispecialty AW base fee schedule,3268.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43860,Not in chargemaster,43860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43860,BCBS multispecialty AW base fee schedule,3161.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43865,Not in chargemaster,43865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43865,BCBS multispecialty AW base fee schedule,3307.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43870,Not in chargemaster,43870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43870,BCBS multispecialty AW base fee schedule,1370.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43880,Not in chargemaster,43880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43880,BCBS multispecialty AW base fee schedule,3074.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43886,Not in chargemaster,43886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43886,BCBS multispecialty AW base fee schedule,700.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43887,Not in chargemaster,43887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43887,BCBS multispecialty AW base fee schedule,630.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43888,Not in chargemaster,43888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43888,BCBS multispecialty AW base fee schedule,891.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44005,44005,44005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44005,BCBS multispecialty AW base fee schedule,2110.06,2282.5,Fee schedule,,2110.06,2110.06,2110.06,2110.06,,,0
unity,Fee schedule,Facility 44010,Not in chargemaster,44010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44010,BCBS multispecialty AW base fee schedule,1648.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44015,Not in chargemaster,44015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44015,BCBS multispecialty AW base fee schedule,274.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44020,Not in chargemaster,44020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44020,BCBS multispecialty AW base fee schedule,1880.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44021,Not in chargemaster,44021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44021,BCBS multispecialty AW base fee schedule,1880.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44025,44025,44025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44025,BCBS multispecialty AW base fee schedule,1895.41,2077.77,Fee schedule,,1895.41,1895.41,1895.41,1895.41,,,0
unity,Fee schedule,Facility 44050,44050,44050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44050,BCBS multispecialty AW base fee schedule,1805.31,1962.77,Fee schedule,,1805.31,1805.31,1805.31,1805.31,,,0
unity,Fee schedule,Facility 44055,Not in chargemaster,44055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44055,BCBS multispecialty AW base fee schedule,2877.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44100,Not in chargemaster,44100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44100,BCBS multispecialty AW base fee schedule,206.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44110,Not in chargemaster,44110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44110,BCBS multispecialty AW base fee schedule,1625.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44111,Not in chargemaster,44111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44111,BCBS multispecialty AW base fee schedule,1884.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44120,Not in chargemaster,44120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44120,BCBS multispecialty AW base fee schedule,2360.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44121,Not in chargemaster,44121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44121,BCBS multispecialty AW base fee schedule,466.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44125,Not in chargemaster,44125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44125,BCBS multispecialty AW base fee schedule,2274.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44126,Not in chargemaster,44126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44126,BCBS multispecialty AW base fee schedule,4775.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44127,Not in chargemaster,44127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44127,BCBS multispecialty AW base fee schedule,5521.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44128,Not in chargemaster,44128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44128,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44130,Not in chargemaster,44130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44130,BCBS multispecialty AW base fee schedule,2536.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44139,Not in chargemaster,44139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44139,BCBS multispecialty AW base fee schedule,233.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44140,44140,44140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44140,BCBS multispecialty AW base fee schedule,2588.39,2813.2,Fee schedule,,2588.39,2588.39,2588.39,2588.39,,,0
unity,Fee schedule,Facility 44141,Not in chargemaster,44141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44141,BCBS multispecialty AW base fee schedule,3513.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44143,Not in chargemaster,44143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44143,BCBS multispecialty AW base fee schedule,3207.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44144,Not in chargemaster,44144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44144,BCBS multispecialty AW base fee schedule,3407.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44145,Not in chargemaster,44145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44145,BCBS multispecialty AW base fee schedule,3183.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44146,Not in chargemaster,44146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44146,BCBS multispecialty AW base fee schedule,4059.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44147,Not in chargemaster,44147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44147,BCBS multispecialty AW base fee schedule,3736.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44150,Not in chargemaster,44150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44150,BCBS multispecialty AW base fee schedule,3588.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44151,Not in chargemaster,44151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44151,BCBS multispecialty AW base fee schedule,4170.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44155,Not in chargemaster,44155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44155,BCBS multispecialty AW base fee schedule,3979.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44156,Not in chargemaster,44156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44156,BCBS multispecialty AW base fee schedule,4465.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44157,Not in chargemaster,44157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44157,BCBS multispecialty AW base fee schedule,4234.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44158,Not in chargemaster,44158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44158,BCBS multispecialty AW base fee schedule,4340.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44160,Not in chargemaster,44160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44160,BCBS multispecialty AW base fee schedule,2394.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44180,Not in chargemaster,44180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44180,BCBS multispecialty AW base fee schedule,1774.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44186,Not in chargemaster,44186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44186,BCBS multispecialty AW base fee schedule,1257.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44187,Not in chargemaster,44187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44187,BCBS multispecialty AW base fee schedule,2107.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44188,Not in chargemaster,44188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44188,BCBS multispecialty AW base fee schedule,2347.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44202,Not in chargemaster,44202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44202,BCBS multispecialty AW base fee schedule,2672.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44203,Not in chargemaster,44203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44203,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44204,Not in chargemaster,44204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44204,BCBS multispecialty AW base fee schedule,2961.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44205,Not in chargemaster,44205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44205,BCBS multispecialty AW base fee schedule,2571.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44206,Not in chargemaster,44206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44206,BCBS multispecialty AW base fee schedule,3364.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44207,Not in chargemaster,44207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44207,BCBS multispecialty AW base fee schedule,3490.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44208,Not in chargemaster,44208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44208,BCBS multispecialty AW base fee schedule,3801.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44210,Not in chargemaster,44210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44210,BCBS multispecialty AW base fee schedule,3401.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44211,Not in chargemaster,44211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44211,BCBS multispecialty AW base fee schedule,4055.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44212,Not in chargemaster,44212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44212,BCBS multispecialty AW base fee schedule,3910.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44213,Not in chargemaster,44213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44213,BCBS multispecialty AW base fee schedule,359.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44227,Not in chargemaster,44227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44227,BCBS multispecialty AW base fee schedule,3206.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44300,44300,44300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44300,BCBS multispecialty AW base fee schedule,1625.78,1772.54,Fee schedule,,1625.78,1625.78,1625.78,1625.78,,,0
unity,Fee schedule,Facility 44310,Not in chargemaster,44310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44310,BCBS multispecialty AW base fee schedule,2004.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44312,Not in chargemaster,44312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44312,BCBS multispecialty AW base fee schedule,1140.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44314,Not in chargemaster,44314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44314,BCBS multispecialty AW base fee schedule,1933.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44316,Not in chargemaster,44316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44316,BCBS multispecialty AW base fee schedule,2733.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44320,Not in chargemaster,44320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44320,BCBS multispecialty AW base fee schedule,2312.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44322,Not in chargemaster,44322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44322,BCBS multispecialty AW base fee schedule,1937.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44340,Not in chargemaster,44340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44340,BCBS multispecialty AW base fee schedule,1196.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44345,Not in chargemaster,44345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44345,BCBS multispecialty AW base fee schedule,2019.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44346,Not in chargemaster,44346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44346,BCBS multispecialty AW base fee schedule,2276.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44360,Not in chargemaster,44360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44360,BCBS multispecialty AW base fee schedule,274.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44361,Not in chargemaster,44361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44361,BCBS multispecialty AW base fee schedule,302.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44363,Not in chargemaster,44363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44363,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44364,Not in chargemaster,44364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44364,BCBS multispecialty AW base fee schedule,390.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44365,Not in chargemaster,44365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44365,BCBS multispecialty AW base fee schedule,347.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44366,Not in chargemaster,44366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44366,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44369,Not in chargemaster,44369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44369,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44370,Not in chargemaster,44370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44370,BCBS multispecialty AW base fee schedule,509.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44372,Not in chargemaster,44372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44372,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44373,Not in chargemaster,44373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44373,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44376,Not in chargemaster,44376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44376,BCBS multispecialty AW base fee schedule,543.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44377,Not in chargemaster,44377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44377,BCBS multispecialty AW base fee schedule,571.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44378,Not in chargemaster,44378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44378,BCBS multispecialty AW base fee schedule,735.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44379,Not in chargemaster,44379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44379,BCBS multispecialty AW base fee schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44380,Not in chargemaster,44380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44380,BCBS multispecialty AW base fee schedule,106.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43756,Not in chargemaster,43756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43756,BCBS multispecialty AW base fee schedule,96.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43757,Not in chargemaster,43757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43757,BCBS multispecialty AW base fee schedule,145.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43761,Not in chargemaster,43761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43761,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43762,Not in chargemaster,43762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43762,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43763,Not in chargemaster,43763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43763,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44381,Not in chargemaster,44381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44381,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44382,Not in chargemaster,44382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44382,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44384,Not in chargemaster,44384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44384,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44385,Not in chargemaster,44385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44385,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44386,Not in chargemaster,44386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44386,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44388,44388,44388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44388,BCBS multispecialty AW base fee schedule,299.45,668.17,Fee schedule,,299.45,299.45,299.45,299.45,,,0
unity,Fee schedule,Facility 44389,Not in chargemaster,44389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44389,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44390,Not in chargemaster,44390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44390,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44391,Not in chargemaster,44391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44391,BCBS multispecialty AW base fee schedule,440.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44392,Not in chargemaster,44392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44392,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44394,Not in chargemaster,44394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44394,BCBS multispecialty AW base fee schedule,431.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44401,Not in chargemaster,44401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44401,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44406,Not in chargemaster,44406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44406,BCBS multispecialty AW base fee schedule,438.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44407,Not in chargemaster,44407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44407,BCBS multispecialty AW base fee schedule,526.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44408,Not in chargemaster,44408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44408,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44500,Not in chargemaster,44500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44500,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44602,Not in chargemaster,44602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44602,BCBS multispecialty AW base fee schedule,2722.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44603,Not in chargemaster,44603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44603,BCBS multispecialty AW base fee schedule,3123.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44604,Not in chargemaster,44604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44604,BCBS multispecialty AW base fee schedule,2039.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44605,Not in chargemaster,44605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44605,BCBS multispecialty AW base fee schedule,2512.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44615,Not in chargemaster,44615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44615,BCBS multispecialty AW base fee schedule,2077.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44620,Not in chargemaster,44620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44620,BCBS multispecialty AW base fee schedule,1666.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44625,Not in chargemaster,44625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44625,BCBS multispecialty AW base fee schedule,1946.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44626,Not in chargemaster,44626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44626,BCBS multispecialty AW base fee schedule,3082.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44640,Not in chargemaster,44640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44640,BCBS multispecialty AW base fee schedule,2695.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44650,Not in chargemaster,44650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44650,BCBS multispecialty AW base fee schedule,2786.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44660,Not in chargemaster,44660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44660,BCBS multispecialty AW base fee schedule,2565.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44661,Not in chargemaster,44661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44661,BCBS multispecialty AW base fee schedule,2985.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44680,Not in chargemaster,44680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44680,BCBS multispecialty AW base fee schedule,2045.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44700,Not in chargemaster,44700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44700,BCBS multispecialty AW base fee schedule,1925.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44701,Not in chargemaster,44701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44701,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44705,Not in chargemaster,44705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44705,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45020,Not in chargemaster,45020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45020,BCBS multispecialty AW base fee schedule,1098.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45100,Not in chargemaster,45100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45100,BCBS multispecialty AW base fee schedule,573.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45108,Not in chargemaster,45108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45108,BCBS multispecialty AW base fee schedule,713.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45110,Not in chargemaster,45110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45110,BCBS multispecialty AW base fee schedule,3519.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45111,Not in chargemaster,45111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45111,BCBS multispecialty AW base fee schedule,2086.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45112,Not in chargemaster,45112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45112,BCBS multispecialty AW base fee schedule,3574.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45113,Not in chargemaster,45113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45113,BCBS multispecialty AW base fee schedule,3591.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45114,Not in chargemaster,45114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45114,BCBS multispecialty AW base fee schedule,3513.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45116,Not in chargemaster,45116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45116,BCBS multispecialty AW base fee schedule,2960.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45119,Not in chargemaster,45119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45119,BCBS multispecialty AW base fee schedule,3693.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45120,Not in chargemaster,45120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45120,BCBS multispecialty AW base fee schedule,3083.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45121,Not in chargemaster,45121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45121,BCBS multispecialty AW base fee schedule,3369.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45123,Not in chargemaster,45123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45123,BCBS multispecialty AW base fee schedule,2135.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45126,Not in chargemaster,45126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45126,BCBS multispecialty AW base fee schedule,5310.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45130,Not in chargemaster,45130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45130,BCBS multispecialty AW base fee schedule,2078.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45135,Not in chargemaster,45135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45135,BCBS multispecialty AW base fee schedule,2477.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45136,Not in chargemaster,45136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45136,BCBS multispecialty AW base fee schedule,3433.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45150,Not in chargemaster,45150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45150,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45160,Not in chargemaster,45160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45160,BCBS multispecialty AW base fee schedule,1976.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45171,45171,45171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45171,BCBS multispecialty AW base fee schedule,1159.38,1283.44,Fee schedule,,1159.38,1159.38,1159.38,1159.38,,,0
unity,Fee schedule,Facility 45172,Not in chargemaster,45172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45172,BCBS multispecialty AW base fee schedule,1557.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45190,Not in chargemaster,45190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45190,BCBS multispecialty AW base fee schedule,1339.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45300,Not in chargemaster,45300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45300,BCBS multispecialty AW base fee schedule,91.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44720,Not in chargemaster,44720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44720,BCBS multispecialty AW base fee schedule,531.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44721,Not in chargemaster,44721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44721,BCBS multispecialty AW base fee schedule,742.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44800,Not in chargemaster,44800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44800,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44820,Not in chargemaster,44820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44820,BCBS multispecialty AW base fee schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44850,Not in chargemaster,44850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44850,BCBS multispecialty AW base fee schedule,1436.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44900,Not in chargemaster,44900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44900,BCBS multispecialty AW base fee schedule,1512.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44950,44950,44950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44950,BCBS multispecialty AW base fee schedule,1240.86,1346.62,Fee schedule,,1240.86,1240.86,1240.86,1240.86,,,0
unity,Fee schedule,Facility 44955,Not in chargemaster,44955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44955,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44960,Not in chargemaster,44960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44960,BCBS multispecialty AW base fee schedule,1693.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44970,44970,44970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44970,BCBS multispecialty AW base fee schedule,1158.71,1375,Fee schedule,,1158.71,1158.71,1158.71,1158.71,,,0
unity,Fee schedule,Facility 45000,Not in chargemaster,45000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45000,BCBS multispecialty AW base fee schedule,818.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45005,Not in chargemaster,45005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45005,BCBS multispecialty AW base fee schedule,310.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44402,Not in chargemaster,44402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44402,BCBS multispecialty AW base fee schedule,500.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44403,Not in chargemaster,44403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44403,BCBS multispecialty AW base fee schedule,581.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44404,Not in chargemaster,44404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44404,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44405,Not in chargemaster,44405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44405,BCBS multispecialty AW base fee schedule,349.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45303,Not in chargemaster,45303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45303,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45305,Not in chargemaster,45305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45305,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45307,Not in chargemaster,45307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45307,BCBS multispecialty AW base fee schedule,186.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45308,Not in chargemaster,45308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45308,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45309,Not in chargemaster,45309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45309,BCBS multispecialty AW base fee schedule,172.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45315,Not in chargemaster,45315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45315,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45317,Not in chargemaster,45317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45317,BCBS multispecialty AW base fee schedule,212.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45321,Not in chargemaster,45321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45321,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45327,Not in chargemaster,45327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45327,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45330,45330,45330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45330,BCBS multispecialty AW base fee schedule,106.66,141.81,Fee schedule,,106.66,106.66,106.66,106.66,,,0
unity,Fee schedule,Facility 45320,Not in chargemaster,45320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45320,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45331,45331,45331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45331,BCBS multispecialty AW base fee schedule,136.48,181.5,Fee schedule,,136.48,136.48,136.48,136.48,,,0
unity,Fee schedule,Facility 45332,Not in chargemaster,45332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45332,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45333,Not in chargemaster,45333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45333,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45334,Not in chargemaster,45334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45334,BCBS multispecialty AW base fee schedule,223.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45335,Not in chargemaster,45335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45335,BCBS multispecialty AW base fee schedule,126.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45337,Not in chargemaster,45337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45337,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45338,Not in chargemaster,45338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45338,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45340,Not in chargemaster,45340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45340,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45341,Not in chargemaster,45341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45341,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45342,Not in chargemaster,45342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45342,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45346,Not in chargemaster,45346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45346,BCBS multispecialty AW base fee schedule,306.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45347,Not in chargemaster,45347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45347,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45349,Not in chargemaster,45349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45349,BCBS multispecialty AW base fee schedule,379.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45350,Not in chargemaster,45350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45350,BCBS multispecialty AW base fee schedule,193.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45378,45378,45378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45378,BCBS multispecialty AW base fee schedule,354.44,460,Fee schedule,,354.44,354.44,354.44,354.44,,,0
unity,Fee schedule,Facility 45379,Not in chargemaster,45379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45379,BCBS multispecialty AW base fee schedule,457.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45380,45380,45380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45380,BCBS multispecialty AW base fee schedule,383.59,561.81,Fee schedule,,383.59,383.59,383.59,383.59,,,0
unity,Fee schedule,Facility 45381,Not in chargemaster,45381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45381,BCBS multispecialty AW base fee schedule,383.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45382,Not in chargemaster,45382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45382,BCBS multispecialty AW base fee schedule,495.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45384,45384,45384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45384,BCBS multispecialty AW base fee schedule,437.25,585.72,Fee schedule,,437.25,437.25,437.25,437.25,,,0
unity,Fee schedule,Facility 45385,45385,45385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45385,BCBS multispecialty AW base fee schedule,486.94,666.19,Fee schedule,,486.94,486.94,486.94,486.94,,,0
unity,Fee schedule,Facility 45386,Not in chargemaster,45386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45386,BCBS multispecialty AW base fee schedule,404.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45389,Not in chargemaster,45389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45389,BCBS multispecialty AW base fee schedule,554.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45390,Not in chargemaster,45390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45390,BCBS multispecialty AW base fee schedule,635.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45391,Not in chargemaster,45391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45391,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45392,Not in chargemaster,45392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45392,BCBS multispecialty AW base fee schedule,581.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45393,Not in chargemaster,45393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45393,BCBS multispecialty AW base fee schedule,484.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45395,Not in chargemaster,45395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45395,BCBS multispecialty AW base fee schedule,3768.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45397,Not in chargemaster,45397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45397,BCBS multispecialty AW base fee schedule,4098.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45398,Not in chargemaster,45398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45398,BCBS multispecialty AW base fee schedule,452.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45540,Not in chargemaster,45540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45540,BCBS multispecialty AW base fee schedule,2031.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45541,Not in chargemaster,45541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45541,BCBS multispecialty AW base fee schedule,1811.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45550,Not in chargemaster,45550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45550,BCBS multispecialty AW base fee schedule,2807.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45560,Not in chargemaster,45560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45560,BCBS multispecialty AW base fee schedule,1326.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45562,Not in chargemaster,45562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45562,BCBS multispecialty AW base fee schedule,2167.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45563,Not in chargemaster,45563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45563,BCBS multispecialty AW base fee schedule,3199.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45800,Not in chargemaster,45800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45800,BCBS multispecialty AW base fee schedule,2447.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45805,Not in chargemaster,45805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45805,BCBS multispecialty AW base fee schedule,2836.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45820,Not in chargemaster,45820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45820,BCBS multispecialty AW base fee schedule,2454.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45825,Not in chargemaster,45825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45825,BCBS multispecialty AW base fee schedule,2964.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45900,Not in chargemaster,45900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45900,BCBS multispecialty AW base fee schedule,406.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45905,Not in chargemaster,45905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45905,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45910,Not in chargemaster,45910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45910,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45915,Not in chargemaster,45915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45915,BCBS multispecialty AW base fee schedule,440.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45400,Not in chargemaster,45400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45400,BCBS multispecialty AW base fee schedule,2177.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45402,Not in chargemaster,45402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45402,BCBS multispecialty AW base fee schedule,2907.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45500,Not in chargemaster,45500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45500,BCBS multispecialty AW base fee schedule,1084.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45505,Not in chargemaster,45505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45505,BCBS multispecialty AW base fee schedule,1142.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45520,Not in chargemaster,45520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45520,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45388,Not in chargemaster,45388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45388,BCBS multispecialty AW base fee schedule,518.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45990,Not in chargemaster,45990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45990,BCBS multispecialty AW base fee schedule,203.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46020,Not in chargemaster,46020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46020,BCBS multispecialty AW base fee schedule,451.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46030,Not in chargemaster,46030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46030,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46040,46040,46040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46040,BCBS multispecialty AW base fee schedule,805.6,882.38,Fee schedule,,805.6,805.6,805.6,805.6,,,0
unity,Fee schedule,Facility 46060,Not in chargemaster,46060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46060,BCBS multispecialty AW base fee schedule,921.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46070,Not in chargemaster,46070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46070,BCBS multispecialty AW base fee schedule,506.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46080,Not in chargemaster,46080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46080,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46045,Not in chargemaster,46045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46045,BCBS multispecialty AW base fee schedule,838.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46050,46050,46050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46050,BCBS multispecialty AW base fee schedule,188.81,210.84,Fee schedule,,188.81,188.81,188.81,188.81,,,0
unity,Fee schedule,Facility 46083,46083,46083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46083,BCBS multispecialty AW base fee schedule,207.36,227.16,Fee schedule,,207.36,207.36,207.36,207.36,,,0
unity,Fee schedule,Facility 46200,Not in chargemaster,46200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46200,BCBS multispecialty AW base fee schedule,632.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46220,Not in chargemaster,46220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46220,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46221,Not in chargemaster,46221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46221,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46230,Not in chargemaster,46230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46230,BCBS multispecialty AW base fee schedule,331.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46250,46250,46250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46250,BCBS multispecialty AW base fee schedule,608.84,669.42,Fee schedule,,608.84,608.84,608.84,608.84,,,0
unity,Fee schedule,Facility 46255,46255,46255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46255,BCBS multispecialty AW base fee schedule,682.38,751.04,Fee schedule,,682.38,682.38,682.38,682.38,,,0
unity,Fee schedule,Facility 46257,Not in chargemaster,46257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46257,BCBS multispecialty AW base fee schedule,818.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46258,Not in chargemaster,46258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46258,BCBS multispecialty AW base fee schedule,908.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46260,Not in chargemaster,46260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46260,BCBS multispecialty AW base fee schedule,918.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46261,Not in chargemaster,46261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46261,BCBS multispecialty AW base fee schedule,1004.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46262,Not in chargemaster,46262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46262,BCBS multispecialty AW base fee schedule,1065.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46270,46270,46270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46270,BCBS multispecialty AW base fee schedule,757.24,865,Fee schedule,,757.24,757.24,757.24,757.24,,,0
unity,Fee schedule,Facility 46275,Not in chargemaster,46275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46275,BCBS multispecialty AW base fee schedule,796.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46280,Not in chargemaster,46280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46280,BCBS multispecialty AW base fee schedule,908.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46285,Not in chargemaster,46285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46285,BCBS multispecialty AW base fee schedule,796.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46288,Not in chargemaster,46288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46288,BCBS multispecialty AW base fee schedule,1056.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46320,Not in chargemaster,46320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46320,BCBS multispecialty AW base fee schedule,213.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46500,Not in chargemaster,46500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46500,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46505,Not in chargemaster,46505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46505,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46600,46600,46600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46600,BCBS multispecialty AW base fee schedule,77.51,87.32,Fee schedule,,77.51,77.51,77.51,77.51,,,0
unity,Fee schedule,Facility 46601,Not in chargemaster,46601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46601,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46604,Not in chargemaster,46604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46604,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46606,Not in chargemaster,46606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46606,BCBS multispecialty AW base fee schedule,143.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46607,Not in chargemaster,46607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46607,BCBS multispecialty AW base fee schedule,241.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46700,Not in chargemaster,46700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46700,BCBS multispecialty AW base fee schedule,1256.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46705,Not in chargemaster,46705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46705,BCBS multispecialty AW base fee schedule,1082.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46706,Not in chargemaster,46706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46706,BCBS multispecialty AW base fee schedule,340.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46707,Not in chargemaster,46707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46707,BCBS multispecialty AW base fee schedule,954.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46710,Not in chargemaster,46710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46710,BCBS multispecialty AW base fee schedule,2141.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46712,Not in chargemaster,46712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46712,BCBS multispecialty AW base fee schedule,4306.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46715,Not in chargemaster,46715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46715,BCBS multispecialty AW base fee schedule,1059.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46716,Not in chargemaster,46716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46716,BCBS multispecialty AW base fee schedule,2347.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46730,Not in chargemaster,46730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46730,BCBS multispecialty AW base fee schedule,3808.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46735,Not in chargemaster,46735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46735,BCBS multispecialty AW base fee schedule,4391.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46740,Not in chargemaster,46740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46740,BCBS multispecialty AW base fee schedule,4157.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46742,Not in chargemaster,46742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46742,BCBS multispecialty AW base fee schedule,4816.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46744,Not in chargemaster,46744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46744,BCBS multispecialty AW base fee schedule,6827.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46746,Not in chargemaster,46746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46746,BCBS multispecialty AW base fee schedule,7533.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46748,Not in chargemaster,46748,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46748,BCBS multispecialty AW base fee schedule,8176.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46750,Not in chargemaster,46750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46750,BCBS multispecialty AW base fee schedule,1440.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46751,Not in chargemaster,46751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46751,BCBS multispecialty AW base fee schedule,1273.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46753,Not in chargemaster,46753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46753,BCBS multispecialty AW base fee schedule,1188.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46754,Not in chargemaster,46754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46754,BCBS multispecialty AW base fee schedule,447.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46608,Not in chargemaster,46608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46608,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46610,Not in chargemaster,46610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46610,BCBS multispecialty AW base fee schedule,155.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46611,Not in chargemaster,46611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46611,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46612,Not in chargemaster,46612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46612,BCBS multispecialty AW base fee schedule,182.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46614,Not in chargemaster,46614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46614,BCBS multispecialty AW base fee schedule,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46615,Not in chargemaster,46615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46615,BCBS multispecialty AW base fee schedule,174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46760,Not in chargemaster,46760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46760,BCBS multispecialty AW base fee schedule,2093.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46761,Not in chargemaster,46761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46761,BCBS multispecialty AW base fee schedule,1766.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46900,Not in chargemaster,46900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46900,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46910,Not in chargemaster,46910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46910,BCBS multispecialty AW base fee schedule,254.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46916,Not in chargemaster,46916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46916,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46917,Not in chargemaster,46917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46917,BCBS multispecialty AW base fee schedule,243.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46922,Not in chargemaster,46922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46922,BCBS multispecialty AW base fee schedule,260.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46924,Not in chargemaster,46924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46924,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46930,Not in chargemaster,46930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46930,BCBS multispecialty AW base fee schedule,286.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46940,Not in chargemaster,46940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46940,BCBS multispecialty AW base fee schedule,275.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46942,Not in chargemaster,46942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46942,BCBS multispecialty AW base fee schedule,247.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47001,Not in chargemaster,47001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47001,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47010,Not in chargemaster,47010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47010,BCBS multispecialty AW base fee schedule,2334.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47015,Not in chargemaster,47015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47015,BCBS multispecialty AW base fee schedule,2250.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47100,Not in chargemaster,47100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47100,BCBS multispecialty AW base fee schedule,1632.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47120,Not in chargemaster,47120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47120,BCBS multispecialty AW base fee schedule,4505.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47122,Not in chargemaster,47122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47122,BCBS multispecialty AW base fee schedule,6631.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47125,Not in chargemaster,47125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47125,BCBS multispecialty AW base fee schedule,5949.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47130,Not in chargemaster,47130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47130,BCBS multispecialty AW base fee schedule,6389.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47135,Not in chargemaster,47135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47135,BCBS multispecialty AW base fee schedule,10404.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47140,Not in chargemaster,47140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47140,BCBS multispecialty AW base fee schedule,6888.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47141,Not in chargemaster,47141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47141,BCBS multispecialty AW base fee schedule,8251.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47142,Not in chargemaster,47142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47142,BCBS multispecialty AW base fee schedule,9104.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47146,Not in chargemaster,47146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47146,BCBS multispecialty AW base fee schedule,634.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47147,Not in chargemaster,47147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47147,BCBS multispecialty AW base fee schedule,739.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47300,Not in chargemaster,47300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47300,BCBS multispecialty AW base fee schedule,2180.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47350,Not in chargemaster,47350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47350,BCBS multispecialty AW base fee schedule,2642.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47360,Not in chargemaster,47360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47360,BCBS multispecialty AW base fee schedule,3630.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47361,Not in chargemaster,47361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47361,BCBS multispecialty AW base fee schedule,5851.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47362,Not in chargemaster,47362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47362,BCBS multispecialty AW base fee schedule,2804.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47370,Not in chargemaster,47370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47370,BCBS multispecialty AW base fee schedule,2412.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47371,Not in chargemaster,47371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47371,BCBS multispecialty AW base fee schedule,2429.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47380,Not in chargemaster,47380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47380,BCBS multispecialty AW base fee schedule,2789.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47381,Not in chargemaster,47381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47381,BCBS multispecialty AW base fee schedule,2862.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47382,Not in chargemaster,47382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47382,BCBS multispecialty AW base fee schedule,1423.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47400,Not in chargemaster,47400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47400,BCBS multispecialty AW base fee schedule,4167.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47420,Not in chargemaster,47420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47420,BCBS multispecialty AW base fee schedule,2590.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47425,Not in chargemaster,47425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47425,BCBS multispecialty AW base fee schedule,2644.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47460,Not in chargemaster,47460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47460,BCBS multispecialty AW base fee schedule,2455.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47480,Not in chargemaster,47480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47480,BCBS multispecialty AW base fee schedule,1697.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47490,Not in chargemaster,47490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47490,BCBS multispecialty AW base fee schedule,635.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47531,Not in chargemaster,47531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47531,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46945,Not in chargemaster,46945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46945,BCBS multispecialty AW base fee schedule,637.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46946,Not in chargemaster,46946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46946,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46947,Not in chargemaster,46947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46947,BCBS multispecialty AW base fee schedule,738.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46948,Not in chargemaster,46948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46948,BCBS multispecialty AW base fee schedule,842.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47000,Not in chargemaster,47000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47000,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47383,Not in chargemaster,47383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47383,BCBS multispecialty AW base fee schedule,873.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47532,Not in chargemaster,47532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47532,BCBS multispecialty AW base fee schedule,408.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47550,Not in chargemaster,47550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47550,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47552,Not in chargemaster,47552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47552,BCBS multispecialty AW base fee schedule,527.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47553,Not in chargemaster,47553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47553,BCBS multispecialty AW base fee schedule,532.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47554,Not in chargemaster,47554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47554,BCBS multispecialty AW base fee schedule,995.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47555,Not in chargemaster,47555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47555,BCBS multispecialty AW base fee schedule,633.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47556,Not in chargemaster,47556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47556,BCBS multispecialty AW base fee schedule,717.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47562,47562,47562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47562,BCBS multispecialty AW base fee schedule,1271.34,1487.44,Fee schedule,,1271.34,1271.34,1271.34,1271.34,,,0
unity,Fee schedule,Facility 47563,Not in chargemaster,47563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47563,BCBS multispecialty AW base fee schedule,1383.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47564,Not in chargemaster,47564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47564,BCBS multispecialty AW base fee schedule,2151.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47570,Not in chargemaster,47570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47570,BCBS multispecialty AW base fee schedule,1498.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47600,47600,47600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47600,BCBS multispecialty AW base fee schedule,2065.01,2355,Fee schedule,,2065.01,2065.01,2065.01,2065.01,,,0
unity,Fee schedule,Facility 47605,Not in chargemaster,47605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47605,BCBS multispecialty AW base fee schedule,2173,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47610,Not in chargemaster,47610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47610,BCBS multispecialty AW base fee schedule,2426.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47612,Not in chargemaster,47612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47612,BCBS multispecialty AW base fee schedule,2467.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47620,Not in chargemaster,47620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47620,BCBS multispecialty AW base fee schedule,2663.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47700,Not in chargemaster,47700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47700,BCBS multispecialty AW base fee schedule,2041.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47701,Not in chargemaster,47701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47701,BCBS multispecialty AW base fee schedule,3360.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47711,Not in chargemaster,47711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47711,BCBS multispecialty AW base fee schedule,3010.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47712,Not in chargemaster,47712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47712,BCBS multispecialty AW base fee schedule,3865.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47715,Not in chargemaster,47715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47715,BCBS multispecialty AW base fee schedule,2574.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47720,Not in chargemaster,47720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47720,BCBS multispecialty AW base fee schedule,2233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47721,Not in chargemaster,47721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47721,BCBS multispecialty AW base fee schedule,2620.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47740,Not in chargemaster,47740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47740,BCBS multispecialty AW base fee schedule,2540.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47741,Not in chargemaster,47741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47741,BCBS multispecialty AW base fee schedule,2855.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47760,Not in chargemaster,47760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47760,BCBS multispecialty AW base fee schedule,4351.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47765,Not in chargemaster,47765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47765,BCBS multispecialty AW base fee schedule,5881.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47780,Not in chargemaster,47780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47780,BCBS multispecialty AW base fee schedule,4779.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47785,Not in chargemaster,47785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47785,BCBS multispecialty AW base fee schedule,6283.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47800,Not in chargemaster,47800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47800,BCBS multispecialty AW base fee schedule,3046.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47801,Not in chargemaster,47801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47801,BCBS multispecialty AW base fee schedule,2154.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47802,Not in chargemaster,47802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47802,BCBS multispecialty AW base fee schedule,2952.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47900,Not in chargemaster,47900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47900,BCBS multispecialty AW base fee schedule,2635.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48000,Not in chargemaster,48000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48000,BCBS multispecialty AW base fee schedule,3645.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48001,Not in chargemaster,48001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48001,BCBS multispecialty AW base fee schedule,4466.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48020,Not in chargemaster,48020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48020,BCBS multispecialty AW base fee schedule,2277.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48100,Not in chargemaster,48100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48100,BCBS multispecialty AW base fee schedule,1707.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48102,Not in chargemaster,48102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48102,BCBS multispecialty AW base fee schedule,458.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48105,Not in chargemaster,48105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48105,BCBS multispecialty AW base fee schedule,5484.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48120,Not in chargemaster,48120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48120,BCBS multispecialty AW base fee schedule,2133.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48140,Not in chargemaster,48140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48140,BCBS multispecialty AW base fee schedule,3019.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48145,Not in chargemaster,48145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48145,BCBS multispecialty AW base fee schedule,3159.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48146,Not in chargemaster,48146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48146,BCBS multispecialty AW base fee schedule,3641.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48148,Not in chargemaster,48148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48148,BCBS multispecialty AW base fee schedule,2415.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48150,Not in chargemaster,48150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48150,BCBS multispecialty AW base fee schedule,6021.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48152,Not in chargemaster,48152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48152,BCBS multispecialty AW base fee schedule,5594.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48153,Not in chargemaster,48153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48153,BCBS multispecialty AW base fee schedule,5997.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48154,Not in chargemaster,48154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48154,BCBS multispecialty AW base fee schedule,5618.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48155,Not in chargemaster,48155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48155,BCBS multispecialty AW base fee schedule,3498.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48400,Not in chargemaster,48400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48400,BCBS multispecialty AW base fee schedule,208.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48500,Not in chargemaster,48500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48500,BCBS multispecialty AW base fee schedule,2224.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48510,Not in chargemaster,48510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48510,BCBS multispecialty AW base fee schedule,2120.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48520,Not in chargemaster,48520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48520,BCBS multispecialty AW base fee schedule,2111.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48540,Not in chargemaster,48540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48540,BCBS multispecialty AW base fee schedule,2533.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48545,Not in chargemaster,48545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48545,BCBS multispecialty AW base fee schedule,2602.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48547,Not in chargemaster,48547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48547,BCBS multispecialty AW base fee schedule,3468.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48548,Not in chargemaster,48548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48548,BCBS multispecialty AW base fee schedule,3217.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48552,Not in chargemaster,48552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48552,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48554,Not in chargemaster,48554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48554,BCBS multispecialty AW base fee schedule,4932.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 48556,Not in chargemaster,48556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48556,BCBS multispecialty AW base fee schedule,2459.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49000,49000,49000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49000,BCBS multispecialty AW base fee schedule,1482.68,1618.51,Fee schedule,,1482.68,1482.68,1482.68,1482.68,,,0
unity,Fee schedule,Facility 49002,Not in chargemaster,49002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49002,BCBS multispecialty AW base fee schedule,2016.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49010,Not in chargemaster,49010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49010,BCBS multispecialty AW base fee schedule,1781.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49013,Not in chargemaster,49013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49013,BCBS multispecialty AW base fee schedule,842.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49014,Not in chargemaster,49014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49014,BCBS multispecialty AW base fee schedule,696.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49020,Not in chargemaster,49020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49020,BCBS multispecialty AW base fee schedule,3071.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49040,Not in chargemaster,49040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49040,BCBS multispecialty AW base fee schedule,1931.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49060,Not in chargemaster,49060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49060,BCBS multispecialty AW base fee schedule,2121.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49062,Not in chargemaster,49062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49062,BCBS multispecialty AW base fee schedule,1482.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49082,49082,49082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49082,BCBS multispecialty AW base fee schedule,141.78,157.31,Fee schedule,,141.78,141.78,141.78,141.78,,,0
unity,Fee schedule,Facility 47533,Not in chargemaster,47533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47533,BCBS multispecialty AW base fee schedule,511.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47534,Not in chargemaster,47534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47534,BCBS multispecialty AW base fee schedule,713.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47535,Not in chargemaster,47535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47535,BCBS multispecialty AW base fee schedule,376.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47536,Not in chargemaster,47536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47536,BCBS multispecialty AW base fee schedule,254.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47537,Not in chargemaster,47537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47537,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47538,Not in chargemaster,47538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47538,BCBS multispecialty AW base fee schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47539,Not in chargemaster,47539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47539,BCBS multispecialty AW base fee schedule,816.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47540,Not in chargemaster,47540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47540,BCBS multispecialty AW base fee schedule,848,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49203,Not in chargemaster,49203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49203,BCBS multispecialty AW base fee schedule,2297.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49204,Not in chargemaster,49204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49204,BCBS multispecialty AW base fee schedule,2928.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49205,Not in chargemaster,49205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49205,BCBS multispecialty AW base fee schedule,3354.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49215,Not in chargemaster,49215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49215,BCBS multispecialty AW base fee schedule,4271.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49220,Not in chargemaster,49220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49220,BCBS multispecialty AW base fee schedule,1878.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49250,Not in chargemaster,49250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49250,BCBS multispecialty AW base fee schedule,1132.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49255,Not in chargemaster,49255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49255,BCBS multispecialty AW base fee schedule,1514.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49320,Not in chargemaster,49320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49320,BCBS multispecialty AW base fee schedule,632.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49321,Not in chargemaster,49321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49321,BCBS multispecialty AW base fee schedule,663.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49322,Not in chargemaster,49322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49322,BCBS multispecialty AW base fee schedule,718.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49323,Not in chargemaster,49323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49323,BCBS multispecialty AW base fee schedule,1234.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49324,Not in chargemaster,49324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49324,BCBS multispecialty AW base fee schedule,751.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49325,Not in chargemaster,49325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49325,BCBS multispecialty AW base fee schedule,801.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49326,Not in chargemaster,49326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49326,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49327,Not in chargemaster,49327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49327,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49400,Not in chargemaster,49400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49400,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47541,Not in chargemaster,47541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47541,BCBS multispecialty AW base fee schedule,638.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47542,Not in chargemaster,47542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47542,BCBS multispecialty AW base fee schedule,262.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47543,Not in chargemaster,47543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47543,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47544,Not in chargemaster,47544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47544,BCBS multispecialty AW base fee schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49083,49083,49083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49083,BCBS multispecialty AW base fee schedule,206.04,280.32,Fee schedule,,206.04,206.04,206.04,206.04,,,0
unity,Fee schedule,Facility 49084,Not in chargemaster,49084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49084,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49180,Not in chargemaster,49180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49180,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49185,Not in chargemaster,49185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49185,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49402,Not in chargemaster,49402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49402,BCBS multispecialty AW base fee schedule,1651.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49405,Not in chargemaster,49405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49405,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49406,Not in chargemaster,49406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49406,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49407,Not in chargemaster,49407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49407,BCBS multispecialty AW base fee schedule,400.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49411,Not in chargemaster,49411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49411,BCBS multispecialty AW base fee schedule,353.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49412,Not in chargemaster,49412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49412,BCBS multispecialty AW base fee schedule,159.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49418,Not in chargemaster,49418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49418,BCBS multispecialty AW base fee schedule,389.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49425,Not in chargemaster,49425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49425,BCBS multispecialty AW base fee schedule,1374.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49426,Not in chargemaster,49426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49426,BCBS multispecialty AW base fee schedule,1288.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49427,Not in chargemaster,49427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49427,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49428,Not in chargemaster,49428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49428,BCBS multispecialty AW base fee schedule,833.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49429,Not in chargemaster,49429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49429,BCBS multispecialty AW base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49435,Not in chargemaster,49435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49435,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49436,Not in chargemaster,49436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49436,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49440,Not in chargemaster,49440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49440,BCBS multispecialty AW base fee schedule,392.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49491,Not in chargemaster,49491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49491,BCBS multispecialty AW base fee schedule,1537,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49492,Not in chargemaster,49492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49492,BCBS multispecialty AW base fee schedule,1850.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49495,Not in chargemaster,49495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49495,BCBS multispecialty AW base fee schedule,787.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49496,Not in chargemaster,49496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49496,BCBS multispecialty AW base fee schedule,1184.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49500,Not in chargemaster,49500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49500,BCBS multispecialty AW base fee schedule,794.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49501,Not in chargemaster,49501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49501,BCBS multispecialty AW base fee schedule,1167.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49505,49505,49505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49505,BCBS multispecialty AW base fee schedule,1005.01,1145,Fee schedule,,1005.01,1005.01,1005.01,1005.01,,,0
unity,Fee schedule,Facility 49507,49507,49507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49507,BCBS multispecialty AW base fee schedule,1130.89,1232.8,Fee schedule,,1130.89,1130.89,1130.89,1130.89,,,0
unity,Fee schedule,Facility 49520,49520,49520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49520,BCBS multispecialty AW base fee schedule,1219,1327.46,Fee schedule,,1219,1219,1219,1219,,,0
unity,Fee schedule,Facility 49521,Not in chargemaster,49521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49521,BCBS multispecialty AW base fee schedule,1383.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49525,Not in chargemaster,49525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49525,BCBS multispecialty AW base fee schedule,1107.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49540,Not in chargemaster,49540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49540,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49550,Not in chargemaster,49550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49550,BCBS multispecialty AW base fee schedule,1111.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49553,Not in chargemaster,49553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49553,BCBS multispecialty AW base fee schedule,1217.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49555,Not in chargemaster,49555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49555,BCBS multispecialty AW base fee schedule,1162.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49557,Not in chargemaster,49557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49557,BCBS multispecialty AW base fee schedule,1396.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49560,49560,49560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49560,BCBS multispecialty AW base fee schedule,1424.38,1625,Fee schedule,,1424.38,1424.38,1424.38,1424.38,,,0
unity,Fee schedule,Facility 49561,49561,49561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49561,BCBS multispecialty AW base fee schedule,1794.71,1949.29,Fee schedule,,1794.71,1794.71,1794.71,1794.71,,,0
unity,Fee schedule,Facility 49565,49565,49565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49565,BCBS multispecialty AW base fee schedule,1482.68,1612.11,Fee schedule,,1482.68,1482.68,1482.68,1482.68,,,0
unity,Fee schedule,Facility 49566,49566,49566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49566,BCBS multispecialty AW base fee schedule,1811.28,1969.88,Fee schedule,,1811.28,1811.28,1811.28,1811.28,,,0
unity,Fee schedule,Facility 49568,49568,49568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49568,BCBS multispecialty AW base fee schedule,516.75,590,Fee schedule,,516.75,516.75,516.75,516.75,,,0
unity,Fee schedule,Facility 49570,Not in chargemaster,49570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49570,BCBS multispecialty AW base fee schedule,802.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49572,Not in chargemaster,49572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49572,BCBS multispecialty AW base fee schedule,997.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49580,Not in chargemaster,49580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49580,BCBS multispecialty AW base fee schedule,641.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49582,Not in chargemaster,49582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49582,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49585,49585,49585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49585,BCBS multispecialty AW base fee schedule,858.6,937.74,Fee schedule,,858.6,858.6,858.6,858.6,,,0
unity,Fee schedule,Facility 49587,49587,49587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49587,BCBS multispecialty AW base fee schedule,918.23,1004.47,Fee schedule,,918.23,918.23,918.23,918.23,,,0
unity,Fee schedule,Facility 49590,Not in chargemaster,49590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49590,BCBS multispecialty AW base fee schedule,1105.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49600,Not in chargemaster,49600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49600,BCBS multispecialty AW base fee schedule,1415.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49605,Not in chargemaster,49605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49605,BCBS multispecialty AW base fee schedule,9580.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49606,Not in chargemaster,49606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49606,BCBS multispecialty AW base fee schedule,2192.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49610,Not in chargemaster,49610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49610,BCBS multispecialty AW base fee schedule,1333.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49611,Not in chargemaster,49611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49611,BCBS multispecialty AW base fee schedule,1173.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49650,49650,49650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49650,BCBS multispecialty AW base fee schedule,828.13,945,Fee schedule,,828.13,828.13,828.13,828.13,,,0
unity,Fee schedule,Facility 49651,49651,49651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49651,BCBS multispecialty AW base fee schedule,1078.55,1225,Fee schedule,,1078.55,1078.55,1078.55,1078.55,,,0
unity,Fee schedule,Facility 49652,Not in chargemaster,49652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49652,BCBS multispecialty AW base fee schedule,1436.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49653,Not in chargemaster,49653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49653,BCBS multispecialty AW base fee schedule,1794.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49654,Not in chargemaster,49654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49654,BCBS multispecialty AW base fee schedule,1631.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49655,Not in chargemaster,49655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49655,BCBS multispecialty AW base fee schedule,1995.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49656,Not in chargemaster,49656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49656,BCBS multispecialty AW base fee schedule,1770.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49657,Not in chargemaster,49657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49657,BCBS multispecialty AW base fee schedule,2551.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49900,Not in chargemaster,49900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49900,BCBS multispecialty AW base fee schedule,1573.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49904,Not in chargemaster,49904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49904,BCBS multispecialty AW base fee schedule,2688.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49905,Not in chargemaster,49905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49905,BCBS multispecialty AW base fee schedule,682.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50010,Not in chargemaster,50010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50010,BCBS multispecialty AW base fee schedule,1407.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50020,Not in chargemaster,50020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50020,BCBS multispecialty AW base fee schedule,1937.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50040,Not in chargemaster,50040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50040,BCBS multispecialty AW base fee schedule,1764.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50045,Not in chargemaster,50045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50045,BCBS multispecialty AW base fee schedule,1782.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50060,Not in chargemaster,50060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50060,BCBS multispecialty AW base fee schedule,2180.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50065,Not in chargemaster,50065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50065,BCBS multispecialty AW base fee schedule,2312.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50070,Not in chargemaster,50070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50070,BCBS multispecialty AW base fee schedule,2267.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50075,Not in chargemaster,50075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50075,BCBS multispecialty AW base fee schedule,2789.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50080,Not in chargemaster,50080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50080,BCBS multispecialty AW base fee schedule,1662.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50081,Not in chargemaster,50081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50081,BCBS multispecialty AW base fee schedule,2444.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50100,Not in chargemaster,50100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50100,BCBS multispecialty AW base fee schedule,2084.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50120,Not in chargemaster,50120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50120,BCBS multispecialty AW base fee schedule,1815.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50125,Not in chargemaster,50125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50125,BCBS multispecialty AW base fee schedule,1878.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50130,Not in chargemaster,50130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50130,BCBS multispecialty AW base fee schedule,1976.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50135,Not in chargemaster,50135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50135,BCBS multispecialty AW base fee schedule,2145.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50200,Not in chargemaster,50200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50200,BCBS multispecialty AW base fee schedule,245.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49419,Not in chargemaster,49419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49419,BCBS multispecialty AW base fee schedule,829.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49421,Not in chargemaster,49421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49421,BCBS multispecialty AW base fee schedule,440.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49422,Not in chargemaster,49422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49422,BCBS multispecialty AW base fee schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49423,Not in chargemaster,49423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49423,BCBS multispecialty AW base fee schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49424,Not in chargemaster,49424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49424,BCBS multispecialty AW base fee schedule,73.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49441,Not in chargemaster,49441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49441,BCBS multispecialty AW base fee schedule,463.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49442,Not in chargemaster,49442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49442,BCBS multispecialty AW base fee schedule,397.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49446,Not in chargemaster,49446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49446,BCBS multispecialty AW base fee schedule,284.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49450,Not in chargemaster,49450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49450,BCBS multispecialty AW base fee schedule,126.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49451,Not in chargemaster,49451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49451,BCBS multispecialty AW base fee schedule,172.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50205,Not in chargemaster,50205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50205,BCBS multispecialty AW base fee schedule,1453.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50220,Not in chargemaster,50220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50220,BCBS multispecialty AW base fee schedule,2008.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50225,Not in chargemaster,50225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50225,BCBS multispecialty AW base fee schedule,2300.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50230,Not in chargemaster,50230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50230,BCBS multispecialty AW base fee schedule,2453.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50234,Not in chargemaster,50234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50234,BCBS multispecialty AW base fee schedule,2492.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50236,Not in chargemaster,50236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50236,BCBS multispecialty AW base fee schedule,2802.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50240,Not in chargemaster,50240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50240,BCBS multispecialty AW base fee schedule,2536.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50250,Not in chargemaster,50250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50250,BCBS multispecialty AW base fee schedule,2328.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50280,Not in chargemaster,50280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50280,BCBS multispecialty AW base fee schedule,1834.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50290,Not in chargemaster,50290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50290,BCBS multispecialty AW base fee schedule,1718.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50320,Not in chargemaster,50320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50320,BCBS multispecialty AW base fee schedule,2896.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50327,Not in chargemaster,50327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50327,BCBS multispecialty AW base fee schedule,418.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50328,Not in chargemaster,50328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50328,BCBS multispecialty AW base fee schedule,366.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50329,Not in chargemaster,50329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50329,BCBS multispecialty AW base fee schedule,348.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50340,Not in chargemaster,50340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50340,BCBS multispecialty AW base fee schedule,1827.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50360,Not in chargemaster,50360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50360,BCBS multispecialty AW base fee schedule,4660.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50365,Not in chargemaster,50365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50365,BCBS multispecialty AW base fee schedule,5535.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50370,Not in chargemaster,50370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50370,BCBS multispecialty AW base fee schedule,2322.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50380,Not in chargemaster,50380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50380,BCBS multispecialty AW base fee schedule,3873.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50382,Not in chargemaster,50382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50382,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49452,Not in chargemaster,49452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49452,BCBS multispecialty AW base fee schedule,266.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49460,Not in chargemaster,49460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49460,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49465,Not in chargemaster,49465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49465,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50384,Not in chargemaster,50384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50384,BCBS multispecialty AW base fee schedule,440.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50385,Not in chargemaster,50385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50385,BCBS multispecialty AW base fee schedule,418.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50386,Not in chargemaster,50386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50386,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50387,Not in chargemaster,50387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50387,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50389,Not in chargemaster,50389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50389,BCBS multispecialty AW base fee schedule,102.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50396,Not in chargemaster,50396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50396,BCBS multispecialty AW base fee schedule,222.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50400,Not in chargemaster,50400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50400,BCBS multispecialty AW base fee schedule,2226.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50405,Not in chargemaster,50405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50405,BCBS multispecialty AW base fee schedule,2670.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50430,Not in chargemaster,50430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50430,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50390,Not in chargemaster,50390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50390,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50391,Not in chargemaster,50391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50391,BCBS multispecialty AW base fee schedule,188.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50431,Not in chargemaster,50431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50431,BCBS multispecialty AW base fee schedule,124.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50432,Not in chargemaster,50432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50432,BCBS multispecialty AW base fee schedule,394.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50433,Not in chargemaster,50433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50433,BCBS multispecialty AW base fee schedule,490.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50434,Not in chargemaster,50434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50434,BCBS multispecialty AW base fee schedule,368.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50435,Not in chargemaster,50435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50435,BCBS multispecialty AW base fee schedule,190.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50436,Not in chargemaster,50436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50436,BCBS multispecialty AW base fee schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50437,Not in chargemaster,50437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50437,BCBS multispecialty AW base fee schedule,482.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50500,Not in chargemaster,50500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50500,BCBS multispecialty AW base fee schedule,2379.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50520,Not in chargemaster,50520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50520,BCBS multispecialty AW base fee schedule,2235.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50525,Not in chargemaster,50525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50525,BCBS multispecialty AW base fee schedule,2838.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50526,Not in chargemaster,50526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50526,BCBS multispecialty AW base fee schedule,3042.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50540,Not in chargemaster,50540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50540,BCBS multispecialty AW base fee schedule,2194.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50541,Not in chargemaster,50541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50541,BCBS multispecialty AW base fee schedule,1755.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50542,Not in chargemaster,50542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50542,BCBS multispecialty AW base fee schedule,2229.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50543,Not in chargemaster,50543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50543,BCBS multispecialty AW base fee schedule,2848.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50544,Not in chargemaster,50544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50544,BCBS multispecialty AW base fee schedule,2382.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50545,Not in chargemaster,50545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50545,BCBS multispecialty AW base fee schedule,2561.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50546,Not in chargemaster,50546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50546,BCBS multispecialty AW base fee schedule,2304.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50547,Not in chargemaster,50547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50547,BCBS multispecialty AW base fee schedule,3089.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50548,Not in chargemaster,50548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50548,BCBS multispecialty AW base fee schedule,2575.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50551,Not in chargemaster,50551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50551,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50553,Not in chargemaster,50553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50553,BCBS multispecialty AW base fee schedule,598.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50555,Not in chargemaster,50555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50555,BCBS multispecialty AW base fee schedule,653.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50557,Not in chargemaster,50557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50557,BCBS multispecialty AW base fee schedule,661.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50561,Not in chargemaster,50561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50561,BCBS multispecialty AW base fee schedule,752.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50562,Not in chargemaster,50562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50562,BCBS multispecialty AW base fee schedule,1108.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50570,Not in chargemaster,50570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50570,BCBS multispecialty AW base fee schedule,939.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50572,Not in chargemaster,50572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50572,BCBS multispecialty AW base fee schedule,1016.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50574,Not in chargemaster,50574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50574,BCBS multispecialty AW base fee schedule,1080.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50575,Not in chargemaster,50575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50575,BCBS multispecialty AW base fee schedule,1367.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50576,Not in chargemaster,50576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50576,BCBS multispecialty AW base fee schedule,1077.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50580,Not in chargemaster,50580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50580,BCBS multispecialty AW base fee schedule,1161.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50590,Not in chargemaster,50590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50590,BCBS multispecialty AW base fee schedule,1087.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50592,Not in chargemaster,50592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50592,BCBS multispecialty AW base fee schedule,657.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50593,Not in chargemaster,50593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50593,BCBS multispecialty AW base fee schedule,881.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50600,Not in chargemaster,50600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50600,BCBS multispecialty AW base fee schedule,1795.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50605,Not in chargemaster,50605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50605,BCBS multispecialty AW base fee schedule,1912.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50606,Not in chargemaster,50606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50606,BCBS multispecialty AW base fee schedule,292.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50610,Not in chargemaster,50610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50610,BCBS multispecialty AW base fee schedule,1807.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50620,Not in chargemaster,50620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50620,BCBS multispecialty AW base fee schedule,1729.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50630,Not in chargemaster,50630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50630,BCBS multispecialty AW base fee schedule,1707.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50650,Not in chargemaster,50650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50650,BCBS multispecialty AW base fee schedule,1987.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50660,Not in chargemaster,50660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50660,BCBS multispecialty AW base fee schedule,2187.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50684,Not in chargemaster,50684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50684,BCBS multispecialty AW base fee schedule,96.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50686,Not in chargemaster,50686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50686,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50688,Not in chargemaster,50688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50688,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50690,Not in chargemaster,50690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50690,BCBS multispecialty AW base fee schedule,133.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50715,Not in chargemaster,50715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50715,BCBS multispecialty AW base fee schedule,2302.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50722,Not in chargemaster,50722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50722,BCBS multispecialty AW base fee schedule,1975.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50725,Not in chargemaster,50725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50725,BCBS multispecialty AW base fee schedule,2110.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50727,Not in chargemaster,50727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50727,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50728,Not in chargemaster,50728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50728,BCBS multispecialty AW base fee schedule,1409.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50740,Not in chargemaster,50740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50740,BCBS multispecialty AW base fee schedule,2361.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50750,Not in chargemaster,50750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50750,BCBS multispecialty AW base fee schedule,2206.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50760,Not in chargemaster,50760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50760,BCBS multispecialty AW base fee schedule,2165.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50770,Not in chargemaster,50770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50770,BCBS multispecialty AW base fee schedule,2206.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50780,Not in chargemaster,50780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50780,BCBS multispecialty AW base fee schedule,2120,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50782,Not in chargemaster,50782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50782,BCBS multispecialty AW base fee schedule,2056.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50783,Not in chargemaster,50783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50783,BCBS multispecialty AW base fee schedule,2156.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50785,Not in chargemaster,50785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50785,BCBS multispecialty AW base fee schedule,2322.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50800,Not in chargemaster,50800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50800,BCBS multispecialty AW base fee schedule,1772.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50810,Not in chargemaster,50810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50810,BCBS multispecialty AW base fee schedule,2703,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50815,Not in chargemaster,50815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50815,BCBS multispecialty AW base fee schedule,2341.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50820,Not in chargemaster,50820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50820,BCBS multispecialty AW base fee schedule,2514.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50825,Not in chargemaster,50825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50825,BCBS multispecialty AW base fee schedule,3170.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50830,Not in chargemaster,50830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50830,BCBS multispecialty AW base fee schedule,3448.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50840,Not in chargemaster,50840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50840,BCBS multispecialty AW base fee schedule,2352.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50845,Not in chargemaster,50845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50845,BCBS multispecialty AW base fee schedule,2393.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50860,Not in chargemaster,50860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50860,BCBS multispecialty AW base fee schedule,1808.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50900,Not in chargemaster,50900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50900,BCBS multispecialty AW base fee schedule,1610.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50920,Not in chargemaster,50920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50920,BCBS multispecialty AW base fee schedule,1684.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50930,Not in chargemaster,50930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50930,BCBS multispecialty AW base fee schedule,2108.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50940,Not in chargemaster,50940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50940,BCBS multispecialty AW base fee schedule,1696.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50945,Not in chargemaster,50945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50945,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50947,Not in chargemaster,50947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50947,BCBS multispecialty AW base fee schedule,2653.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50948,Not in chargemaster,50948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50948,BCBS multispecialty AW base fee schedule,2437.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50951,Not in chargemaster,50951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50951,BCBS multispecialty AW base fee schedule,584.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50693,Not in chargemaster,50693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50693,BCBS multispecialty AW base fee schedule,392.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50694,Not in chargemaster,50694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50694,BCBS multispecialty AW base fee schedule,515.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50695,Not in chargemaster,50695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50695,BCBS multispecialty AW base fee schedule,660.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50700,Not in chargemaster,50700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50700,BCBS multispecialty AW base fee schedule,1770.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50705,Not in chargemaster,50705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50705,BCBS multispecialty AW base fee schedule,338.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50706,Not in chargemaster,50706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50706,BCBS multispecialty AW base fee schedule,351.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50953,Not in chargemaster,50953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50953,BCBS multispecialty AW base fee schedule,623.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50955,Not in chargemaster,50955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50955,BCBS multispecialty AW base fee schedule,674.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50957,Not in chargemaster,50957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50957,BCBS multispecialty AW base fee schedule,678.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51500,Not in chargemaster,51500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51500,BCBS multispecialty AW base fee schedule,1217.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51520,Not in chargemaster,51520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51520,BCBS multispecialty AW base fee schedule,1137.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51525,Not in chargemaster,51525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51525,BCBS multispecialty AW base fee schedule,1643.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51530,Not in chargemaster,51530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51530,BCBS multispecialty AW base fee schedule,1473.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51535,Not in chargemaster,51535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51535,BCBS multispecialty AW base fee schedule,1493.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51550,Not in chargemaster,51550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51550,BCBS multispecialty AW base fee schedule,1843.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51555,Not in chargemaster,51555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51555,BCBS multispecialty AW base fee schedule,2423.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51565,Not in chargemaster,51565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51565,BCBS multispecialty AW base fee schedule,2490.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51570,Not in chargemaster,51570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51570,BCBS multispecialty AW base fee schedule,2822.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51575,Not in chargemaster,51575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51575,BCBS multispecialty AW base fee schedule,3488.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51580,Not in chargemaster,51580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51580,BCBS multispecialty AW base fee schedule,3627.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51585,Not in chargemaster,51585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51585,BCBS multispecialty AW base fee schedule,4038.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51590,Not in chargemaster,51590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51590,BCBS multispecialty AW base fee schedule,3702.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51595,Not in chargemaster,51595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51595,BCBS multispecialty AW base fee schedule,4187.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51596,Not in chargemaster,51596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51596,BCBS multispecialty AW base fee schedule,4503.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51597,Not in chargemaster,51597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51597,BCBS multispecialty AW base fee schedule,4391.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51600,Not in chargemaster,51600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51600,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50970,Not in chargemaster,50970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50970,BCBS multispecialty AW base fee schedule,708.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50972,Not in chargemaster,50972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50972,BCBS multispecialty AW base fee schedule,685.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50974,Not in chargemaster,50974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50974,BCBS multispecialty AW base fee schedule,903.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50976,Not in chargemaster,50976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50976,BCBS multispecialty AW base fee schedule,891.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50980,Not in chargemaster,50980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50980,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51020,Not in chargemaster,51020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51020,BCBS multispecialty AW base fee schedule,895.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51030,Not in chargemaster,51030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51030,BCBS multispecialty AW base fee schedule,901.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51040,Not in chargemaster,51040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51040,BCBS multispecialty AW base fee schedule,552.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51045,Not in chargemaster,51045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51045,BCBS multispecialty AW base fee schedule,955.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51050,Not in chargemaster,51050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51050,BCBS multispecialty AW base fee schedule,901,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51060,Not in chargemaster,51060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51060,BCBS multispecialty AW base fee schedule,1113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51065,Not in chargemaster,51065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51065,BCBS multispecialty AW base fee schedule,1107.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51080,Not in chargemaster,51080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51080,BCBS multispecialty AW base fee schedule,781.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51100,Not in chargemaster,51100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51100,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50961,Not in chargemaster,50961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50961,BCBS multispecialty AW base fee schedule,605.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51101,Not in chargemaster,51101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51101,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51102,Not in chargemaster,51102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51102,BCBS multispecialty AW base fee schedule,278.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51605,Not in chargemaster,51605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51605,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51610,Not in chargemaster,51610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51610,BCBS multispecialty AW base fee schedule,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51700,Not in chargemaster,51700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51700,BCBS multispecialty AW base fee schedule,59.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51701,Not in chargemaster,51701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51701,BCBS multispecialty AW base fee schedule,50.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51702,51702,51702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51702,BCBS multispecialty AW base fee schedule,49.03,149.79,Fee schedule,,49.03,49.03,49.03,49.03,,,0
unity,Fee schedule,Facility 51703,Not in chargemaster,51703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51703,BCBS multispecialty AW base fee schedule,147.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51705,Not in chargemaster,51705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51705,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51710,Not in chargemaster,51710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51710,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51715,Not in chargemaster,51715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51715,BCBS multispecialty AW base fee schedule,383.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51720,Not in chargemaster,51720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51720,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51725,Not in chargemaster,51725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51725,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51725 mod 26,Not in chargemaster,51725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51725 mod 26,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51725 mod TC,Not in chargemaster,51725,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51725 mod TC,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51726,Not in chargemaster,51726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51726,BCBS multispecialty AW base fee schedule,545.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51726 mod 26,Not in chargemaster,51726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51726 mod 26,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51726 mod TC,Not in chargemaster,51726,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51726 mod TC,BCBS multispecialty AW base fee schedule,384.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51727,Not in chargemaster,51727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51727,BCBS multispecialty AW base fee schedule,654.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51727 mod 26,Not in chargemaster,51727,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51727 mod 26,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51727 mod TC,Not in chargemaster,51727,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51727 mod TC,BCBS multispecialty AW base fee schedule,450.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51728,Not in chargemaster,51728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51728,BCBS multispecialty AW base fee schedule,662.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51728 mod 26,Not in chargemaster,51728,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51728 mod 26,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51728 mod TC,Not in chargemaster,51728,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51728 mod TC,BCBS multispecialty AW base fee schedule,462.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51729,Not in chargemaster,51729,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51729,BCBS multispecialty AW base fee schedule,706.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51729 mod 26,Not in chargemaster,51729,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51729 mod 26,BCBS multispecialty AW base fee schedule,242.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51729 mod TC,Not in chargemaster,51729,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51729 mod TC,BCBS multispecialty AW base fee schedule,464.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51736,Not in chargemaster,51736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51736,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51736 mod 26,Not in chargemaster,51736,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51736 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51736 mod TC,Not in chargemaster,51736,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51736 mod TC,BCBS multispecialty AW base fee schedule,9.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51741,Not in chargemaster,51741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51741,BCBS multispecialty AW base fee schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51741 mod 26,Not in chargemaster,51741,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51741 mod 26,BCBS multispecialty AW base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51741 mod TC,Not in chargemaster,51741,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51741 mod TC,BCBS multispecialty AW base fee schedule,10.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51784,Not in chargemaster,51784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51784,BCBS multispecialty AW base fee schedule,127.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51784 mod 26,Not in chargemaster,51784,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51784 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51784 mod TC,Not in chargemaster,51784,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51784 mod TC,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51785,Not in chargemaster,51785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51785,BCBS multispecialty AW base fee schedule,704.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51785 mod 26,Not in chargemaster,51785,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51785 mod 26,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51785 mod TC,Not in chargemaster,51785,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51785 mod TC,BCBS multispecialty AW base fee schedule,528.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51792,Not in chargemaster,51792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51792,BCBS multispecialty AW base fee schedule,466.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51792 mod 26,Not in chargemaster,51792,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51792 mod 26,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51792 mod TC,Not in chargemaster,51792,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51792 mod TC,BCBS multispecialty AW base fee schedule,361.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51797,Not in chargemaster,51797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51797,BCBS multispecialty AW base fee schedule,305.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51797 mod 26,Not in chargemaster,51797,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51797 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51797 mod TC,Not in chargemaster,51797,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51797 mod TC,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51798,Not in chargemaster,51798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51798,BCBS multispecialty AW base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51800,Not in chargemaster,51800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51800,BCBS multispecialty AW base fee schedule,1995.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51820,Not in chargemaster,51820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51820,BCBS multispecialty AW base fee schedule,2073.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51840,Not in chargemaster,51840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51840,BCBS multispecialty AW base fee schedule,1305.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51841,Not in chargemaster,51841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51841,BCBS multispecialty AW base fee schedule,1511.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51845,Not in chargemaster,51845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51845,BCBS multispecialty AW base fee schedule,1113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51860,Not in chargemaster,51860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51860,BCBS multispecialty AW base fee schedule,1427.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51865,Not in chargemaster,51865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51865,BCBS multispecialty AW base fee schedule,1720.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51880,Not in chargemaster,51880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51880,BCBS multispecialty AW base fee schedule,891.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51900,Not in chargemaster,51900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51900,BCBS multispecialty AW base fee schedule,1576.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51920,Not in chargemaster,51920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51920,BCBS multispecialty AW base fee schedule,1459.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51925,Not in chargemaster,51925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51925,BCBS multispecialty AW base fee schedule,2035.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51940,Not in chargemaster,51940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51940,BCBS multispecialty AW base fee schedule,3140.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51960,Not in chargemaster,51960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51960,BCBS multispecialty AW base fee schedule,2650,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51980,Not in chargemaster,51980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51980,BCBS multispecialty AW base fee schedule,1364.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51990,Not in chargemaster,51990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51990,BCBS multispecialty AW base fee schedule,1430.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51992,Not in chargemaster,51992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51992,BCBS multispecialty AW base fee schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52000,Not in chargemaster,52000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52000,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52001,Not in chargemaster,52001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52001,BCBS multispecialty AW base fee schedule,547.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52005,Not in chargemaster,52005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52005,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52007,Not in chargemaster,52007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52007,BCBS multispecialty AW base fee schedule,315.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52010,Not in chargemaster,52010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52010,BCBS multispecialty AW base fee schedule,315.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52204,Not in chargemaster,52204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52204,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52214,Not in chargemaster,52214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52214,BCBS multispecialty AW base fee schedule,337.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52234,Not in chargemaster,52234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52234,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52235,Not in chargemaster,52235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52235,BCBS multispecialty AW base fee schedule,550.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52240,Not in chargemaster,52240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52240,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52250,Not in chargemaster,52250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52250,BCBS multispecialty AW base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52260,Not in chargemaster,52260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52260,BCBS multispecialty AW base fee schedule,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52265,Not in chargemaster,52265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52265,BCBS multispecialty AW base fee schedule,311.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52224,Not in chargemaster,52224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52224,BCBS multispecialty AW base fee schedule,390.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52270,Not in chargemaster,52270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52270,BCBS multispecialty AW base fee schedule,346.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52276,Not in chargemaster,52276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52276,BCBS multispecialty AW base fee schedule,504.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52277,Not in chargemaster,52277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52277,BCBS multispecialty AW base fee schedule,616.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52281,Not in chargemaster,52281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52281,BCBS multispecialty AW base fee schedule,289.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52275,Not in chargemaster,52275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52275,BCBS multispecialty AW base fee schedule,474.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52282,Not in chargemaster,52282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52282,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52283,Not in chargemaster,52283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52283,BCBS multispecialty AW base fee schedule,384.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52285,Not in chargemaster,52285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52285,BCBS multispecialty AW base fee schedule,373.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52287,Not in chargemaster,52287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52287,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52334,Not in chargemaster,52334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52334,BCBS multispecialty AW base fee schedule,349.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52341,Not in chargemaster,52341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52341,BCBS multispecialty AW base fee schedule,542.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52342,Not in chargemaster,52342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52342,BCBS multispecialty AW base fee schedule,588.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52343,Not in chargemaster,52343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52343,BCBS multispecialty AW base fee schedule,657.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52344,Not in chargemaster,52344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52344,BCBS multispecialty AW base fee schedule,704.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52345,Not in chargemaster,52345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52345,BCBS multispecialty AW base fee schedule,753.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52346,Not in chargemaster,52346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52346,BCBS multispecialty AW base fee schedule,851.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52351,Not in chargemaster,52351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52351,BCBS multispecialty AW base fee schedule,577.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52352,Not in chargemaster,52352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52352,BCBS multispecialty AW base fee schedule,677.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52353,Not in chargemaster,52353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52353,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52354,Not in chargemaster,52354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52354,BCBS multispecialty AW base fee schedule,796.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52355,Not in chargemaster,52355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52355,BCBS multispecialty AW base fee schedule,893.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52356,Not in chargemaster,52356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52356,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52400,Not in chargemaster,52400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52400,BCBS multispecialty AW base fee schedule,912.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52402,Not in chargemaster,52402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52402,BCBS multispecialty AW base fee schedule,510.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52441,Not in chargemaster,52441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52441,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52290,Not in chargemaster,52290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52290,BCBS multispecialty AW base fee schedule,465.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52300,Not in chargemaster,52300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52300,BCBS multispecialty AW base fee schedule,533.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52301,Not in chargemaster,52301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52301,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52305,Not in chargemaster,52305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52305,BCBS multispecialty AW base fee schedule,532.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52310,Not in chargemaster,52310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52310,BCBS multispecialty AW base fee schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52315,Not in chargemaster,52315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52315,BCBS multispecialty AW base fee schedule,524.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52317,Not in chargemaster,52317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52317,BCBS multispecialty AW base fee schedule,665.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52318,Not in chargemaster,52318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52318,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52320,Not in chargemaster,52320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52320,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52325,Not in chargemaster,52325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52325,BCBS multispecialty AW base fee schedule,610.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52327,Not in chargemaster,52327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52327,BCBS multispecialty AW base fee schedule,502.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52330,Not in chargemaster,52330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52330,BCBS multispecialty AW base fee schedule,503.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52332,Not in chargemaster,52332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52332,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52442,Not in chargemaster,52442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52442,BCBS multispecialty AW base fee schedule,96.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52649,Not in chargemaster,52649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52649,BCBS multispecialty AW base fee schedule,1578.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52700,Not in chargemaster,52700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52700,BCBS multispecialty AW base fee schedule,843.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53000,Not in chargemaster,53000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53000,BCBS multispecialty AW base fee schedule,282.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53010,Not in chargemaster,53010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53010,BCBS multispecialty AW base fee schedule,562.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53020,Not in chargemaster,53020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53020,BCBS multispecialty AW base fee schedule,185.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53025,Not in chargemaster,53025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53025,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53040,Not in chargemaster,53040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53040,BCBS multispecialty AW base fee schedule,749.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53060,Not in chargemaster,53060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53060,BCBS multispecialty AW base fee schedule,318,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52450,Not in chargemaster,52450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52450,BCBS multispecialty AW base fee schedule,900.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52500,Not in chargemaster,52500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52500,BCBS multispecialty AW base fee schedule,934.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52601,Not in chargemaster,52601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52601,BCBS multispecialty AW base fee schedule,1394.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52630,Not in chargemaster,52630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52630,BCBS multispecialty AW base fee schedule,768.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52640,Not in chargemaster,52640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52640,BCBS multispecialty AW base fee schedule,604.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52647,Not in chargemaster,52647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52647,BCBS multispecialty AW base fee schedule,1238.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53080,Not in chargemaster,53080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53080,BCBS multispecialty AW base fee schedule,802.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53085,Not in chargemaster,53085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53085,BCBS multispecialty AW base fee schedule,1240.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53200,Not in chargemaster,53200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53200,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53275,Not in chargemaster,53275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53275,BCBS multispecialty AW base fee schedule,502.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53400,Not in chargemaster,53400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53400,BCBS multispecialty AW base fee schedule,1534.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53405,Not in chargemaster,53405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53405,BCBS multispecialty AW base fee schedule,1670.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53410,Not in chargemaster,53410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53410,BCBS multispecialty AW base fee schedule,1872.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53415,Not in chargemaster,53415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53415,BCBS multispecialty AW base fee schedule,2162.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53420,Not in chargemaster,53420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53420,BCBS multispecialty AW base fee schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53425,Not in chargemaster,53425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53425,BCBS multispecialty AW base fee schedule,1792.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53430,Not in chargemaster,53430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53430,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53431,Not in chargemaster,53431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53431,BCBS multispecialty AW base fee schedule,2207.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53440,Not in chargemaster,53440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53440,BCBS multispecialty AW base fee schedule,1440.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53442,Not in chargemaster,53442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53442,BCBS multispecialty AW base fee schedule,1498.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53444,Not in chargemaster,53444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53444,BCBS multispecialty AW base fee schedule,1518.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53445,Not in chargemaster,53445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53445,BCBS multispecialty AW base fee schedule,1442.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53446,Not in chargemaster,53446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53446,BCBS multispecialty AW base fee schedule,1227.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53447,Not in chargemaster,53447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53447,BCBS multispecialty AW base fee schedule,1545.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53448,Not in chargemaster,53448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53448,BCBS multispecialty AW base fee schedule,2447.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53449,Not in chargemaster,53449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53449,BCBS multispecialty AW base fee schedule,1170.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53450,Not in chargemaster,53450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53450,BCBS multispecialty AW base fee schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53460,Not in chargemaster,53460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53460,BCBS multispecialty AW base fee schedule,874.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53500,Not in chargemaster,53500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53500,BCBS multispecialty AW base fee schedule,1434.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53502,Not in chargemaster,53502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53502,BCBS multispecialty AW base fee schedule,928.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53505,Not in chargemaster,53505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53505,BCBS multispecialty AW base fee schedule,927.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53510,Not in chargemaster,53510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53510,BCBS multispecialty AW base fee schedule,1207.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53515,Not in chargemaster,53515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53515,BCBS multispecialty AW base fee schedule,1522.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53520,Not in chargemaster,53520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53520,BCBS multispecialty AW base fee schedule,1065.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53600,Not in chargemaster,53600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53600,BCBS multispecialty AW base fee schedule,121.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53210,Not in chargemaster,53210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53210,BCBS multispecialty AW base fee schedule,1493.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53215,Not in chargemaster,53215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53215,BCBS multispecialty AW base fee schedule,1776.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53220,Not in chargemaster,53220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53220,BCBS multispecialty AW base fee schedule,863.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53230,Not in chargemaster,53230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53230,BCBS multispecialty AW base fee schedule,1164.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53235,Not in chargemaster,53235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53235,BCBS multispecialty AW base fee schedule,1210.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53240,Not in chargemaster,53240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53240,BCBS multispecialty AW base fee schedule,809.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53250,Not in chargemaster,53250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53250,BCBS multispecialty AW base fee schedule,756.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53260,Not in chargemaster,53260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53260,BCBS multispecialty AW base fee schedule,345.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52648,Not in chargemaster,52648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52648,BCBS multispecialty AW base fee schedule,1321.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53265,Not in chargemaster,53265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53265,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53270,Not in chargemaster,53270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53270,BCBS multispecialty AW base fee schedule,351.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53601,Not in chargemaster,53601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53601,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53605,Not in chargemaster,53605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53605,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53620,Not in chargemaster,53620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53620,BCBS multispecialty AW base fee schedule,166.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53621,Not in chargemaster,53621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53621,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53660,Not in chargemaster,53660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53660,BCBS multispecialty AW base fee schedule,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53661,Not in chargemaster,53661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53661,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53665,Not in chargemaster,53665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53665,BCBS multispecialty AW base fee schedule,73.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53850,Not in chargemaster,53850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53850,BCBS multispecialty AW base fee schedule,669.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53852,Not in chargemaster,53852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53852,BCBS multispecialty AW base fee schedule,716.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53854,Not in chargemaster,53854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53854,BCBS multispecialty AW base fee schedule,716.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53855,Not in chargemaster,53855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53855,BCBS multispecialty AW base fee schedule,158.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53860,Not in chargemaster,53860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53860,BCBS multispecialty AW base fee schedule,427.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54000,Not in chargemaster,54000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54000,BCBS multispecialty AW base fee schedule,206.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54001,Not in chargemaster,54001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54001,BCBS multispecialty AW base fee schedule,266.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54015,Not in chargemaster,54015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54015,BCBS multispecialty AW base fee schedule,584.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54050,Not in chargemaster,54050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54050,BCBS multispecialty AW base fee schedule,198.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54055,Not in chargemaster,54055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54055,BCBS multispecialty AW base fee schedule,176.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54056,Not in chargemaster,54056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54056,BCBS multispecialty AW base fee schedule,206.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54057,Not in chargemaster,54057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54057,BCBS multispecialty AW base fee schedule,180.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54060,Not in chargemaster,54060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54060,BCBS multispecialty AW base fee schedule,247.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54065,Not in chargemaster,54065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54065,BCBS multispecialty AW base fee schedule,324.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54100,Not in chargemaster,54100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54100,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54110,Not in chargemaster,54110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54110,BCBS multispecialty AW base fee schedule,1193.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54111,Not in chargemaster,54111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54111,BCBS multispecialty AW base fee schedule,1531.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54112,Not in chargemaster,54112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54112,BCBS multispecialty AW base fee schedule,1793.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54115,Not in chargemaster,54115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54115,BCBS multispecialty AW base fee schedule,810.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54120,Not in chargemaster,54120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54120,BCBS multispecialty AW base fee schedule,1207.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54125,Not in chargemaster,54125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54125,BCBS multispecialty AW base fee schedule,1558.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54130,Not in chargemaster,54130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54130,BCBS multispecialty AW base fee schedule,2282.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54135,Not in chargemaster,54135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54135,BCBS multispecialty AW base fee schedule,2893.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54150,54150,54150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54150,BCBS multispecialty AW base fee schedule,188.15,325.83,Fee schedule,,188.15,188.15,188.15,188.15,,,0
unity,Fee schedule,Facility 54105,Not in chargemaster,54105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54105,BCBS multispecialty AW base fee schedule,406.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54160,Not in chargemaster,54160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54160,BCBS multispecialty AW base fee schedule,276.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54240,Not in chargemaster,54240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54240,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54240 mod 26,Not in chargemaster,54240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54240 mod 26,BCBS multispecialty AW base fee schedule,124.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54240 mod TC,Not in chargemaster,54240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54240 mod TC,BCBS multispecialty AW base fee schedule,70.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54250,Not in chargemaster,54250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54250,BCBS multispecialty AW base fee schedule,232.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54250 mod 26,Not in chargemaster,54250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54250 mod 26,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54250 mod TC,Not in chargemaster,54250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54250 mod TC,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54300,Not in chargemaster,54300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54300,BCBS multispecialty AW base fee schedule,1233.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54304,Not in chargemaster,54304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54304,BCBS multispecialty AW base fee schedule,1432.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54308,Not in chargemaster,54308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54308,BCBS multispecialty AW base fee schedule,1368.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54312,Not in chargemaster,54312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54312,BCBS multispecialty AW base fee schedule,1566.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54316,Not in chargemaster,54316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54316,BCBS multispecialty AW base fee schedule,1906.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54318,Not in chargemaster,54318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54318,BCBS multispecialty AW base fee schedule,1360.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54322,Not in chargemaster,54322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54322,BCBS multispecialty AW base fee schedule,1495.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54324,Not in chargemaster,54324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54324,BCBS multispecialty AW base fee schedule,1852.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54326,Not in chargemaster,54326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54326,BCBS multispecialty AW base fee schedule,1806.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54328,Not in chargemaster,54328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54328,BCBS multispecialty AW base fee schedule,1794.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54332,Not in chargemaster,54332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54332,BCBS multispecialty AW base fee schedule,1937.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54336,Not in chargemaster,54336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54336,BCBS multispecialty AW base fee schedule,2275.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54340,Not in chargemaster,54340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54340,BCBS multispecialty AW base fee schedule,1089.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54344,Not in chargemaster,54344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54344,BCBS multispecialty AW base fee schedule,1810.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54348,Not in chargemaster,54348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54348,BCBS multispecialty AW base fee schedule,1935.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54352,Not in chargemaster,54352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54352,BCBS multispecialty AW base fee schedule,2710.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54360,Not in chargemaster,54360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54360,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54380,Not in chargemaster,54380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54380,BCBS multispecialty AW base fee schedule,1529.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54385,Not in chargemaster,54385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54385,BCBS multispecialty AW base fee schedule,1778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54390,Not in chargemaster,54390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54390,BCBS multispecialty AW base fee schedule,2375.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54400,Not in chargemaster,54400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54400,BCBS multispecialty AW base fee schedule,1016.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54401,Not in chargemaster,54401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54401,BCBS multispecialty AW base fee schedule,1257.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54405,Not in chargemaster,54405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54405,BCBS multispecialty AW base fee schedule,1548.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54406,Not in chargemaster,54406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54406,BCBS multispecialty AW base fee schedule,1398.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54408,Not in chargemaster,54408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54408,BCBS multispecialty AW base fee schedule,1512.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54410,Not in chargemaster,54410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54410,BCBS multispecialty AW base fee schedule,1646.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54411,Not in chargemaster,54411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54411,BCBS multispecialty AW base fee schedule,1968.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54415,Not in chargemaster,54415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54415,BCBS multispecialty AW base fee schedule,1011.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54416,Not in chargemaster,54416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54416,BCBS multispecialty AW base fee schedule,1360.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54417,Not in chargemaster,54417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54417,BCBS multispecialty AW base fee schedule,1719.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54420,Not in chargemaster,54420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54420,BCBS multispecialty AW base fee schedule,1346.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54430,Not in chargemaster,54430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54430,BCBS multispecialty AW base fee schedule,1222.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54435,Not in chargemaster,54435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54435,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54437,Not in chargemaster,54437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54437,BCBS multispecialty AW base fee schedule,1289.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54438,Not in chargemaster,54438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54438,BCBS multispecialty AW base fee schedule,2559.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54450,Not in chargemaster,54450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54450,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54500,Not in chargemaster,54500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54500,BCBS multispecialty AW base fee schedule,141.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54505,Not in chargemaster,54505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54505,BCBS multispecialty AW base fee schedule,401.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54512,Not in chargemaster,54512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54512,BCBS multispecialty AW base fee schedule,1030.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54520,Not in chargemaster,54520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54520,BCBS multispecialty AW base fee schedule,622.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54522,Not in chargemaster,54522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54522,BCBS multispecialty AW base fee schedule,1126.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54530,Not in chargemaster,54530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54530,BCBS multispecialty AW base fee schedule,969.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54535,Not in chargemaster,54535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54535,BCBS multispecialty AW base fee schedule,1423.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54550,Not in chargemaster,54550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54550,BCBS multispecialty AW base fee schedule,940.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54560,Not in chargemaster,54560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54560,BCBS multispecialty AW base fee schedule,1314.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54600,Not in chargemaster,54600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54600,BCBS multispecialty AW base fee schedule,865.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54620,Not in chargemaster,54620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54620,BCBS multispecialty AW base fee schedule,572.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54640,Not in chargemaster,54640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54640,BCBS multispecialty AW base fee schedule,831.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54650,Not in chargemaster,54650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54650,BCBS multispecialty AW base fee schedule,1361.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54660,Not in chargemaster,54660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54660,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54670,Not in chargemaster,54670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54670,BCBS multispecialty AW base fee schedule,778.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54680,Not in chargemaster,54680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54680,BCBS multispecialty AW base fee schedule,1507.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54690,Not in chargemaster,54690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54690,BCBS multispecialty AW base fee schedule,1254.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54692,Not in chargemaster,54692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54692,BCBS multispecialty AW base fee schedule,1450.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54700,54700,54700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54700,BCBS multispecialty AW base fee schedule,409.43,440,Fee schedule,,409.43,409.43,409.43,409.43,,,0
unity,Fee schedule,Facility 54800,Not in chargemaster,54800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54800,BCBS multispecialty AW base fee schedule,240.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54830,Not in chargemaster,54830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54830,BCBS multispecialty AW base fee schedule,710.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54840,Not in chargemaster,54840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54840,BCBS multispecialty AW base fee schedule,614.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54860,Not in chargemaster,54860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54860,BCBS multispecialty AW base fee schedule,799.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54861,Not in chargemaster,54861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54861,BCBS multispecialty AW base fee schedule,1085.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54865,Not in chargemaster,54865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54865,BCBS multispecialty AW base fee schedule,684.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54900,Not in chargemaster,54900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54900,BCBS multispecialty AW base fee schedule,1532.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54901,Not in chargemaster,54901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54901,BCBS multispecialty AW base fee schedule,2023.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55000,Not in chargemaster,55000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55000,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54163,Not in chargemaster,54163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54163,BCBS multispecialty AW base fee schedule,415.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54164,Not in chargemaster,54164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54164,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54200,Not in chargemaster,54200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54200,BCBS multispecialty AW base fee schedule,159.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54161,Not in chargemaster,54161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54161,BCBS multispecialty AW base fee schedule,376.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54162,Not in chargemaster,54162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54162,BCBS multispecialty AW base fee schedule,380.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54205,Not in chargemaster,54205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54205,BCBS multispecialty AW base fee schedule,1017.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54220,Not in chargemaster,54220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54220,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54230,Not in chargemaster,54230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54230,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54231,Not in chargemaster,54231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54231,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55040,Not in chargemaster,55040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55040,BCBS multispecialty AW base fee schedule,643.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55041,Not in chargemaster,55041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55041,BCBS multispecialty AW base fee schedule,977.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55060,Not in chargemaster,55060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55060,BCBS multispecialty AW base fee schedule,726.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55100,Not in chargemaster,55100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55100,BCBS multispecialty AW base fee schedule,318,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55110,Not in chargemaster,55110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55110,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55120,Not in chargemaster,55120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55120,BCBS multispecialty AW base fee schedule,675.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55150,Not in chargemaster,55150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55150,BCBS multispecialty AW base fee schedule,940.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55175,Not in chargemaster,55175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55175,BCBS multispecialty AW base fee schedule,692.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55180,Not in chargemaster,55180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55180,BCBS multispecialty AW base fee schedule,1325,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55200,Not in chargemaster,55200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55200,BCBS multispecialty AW base fee schedule,530,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54235,Not in chargemaster,54235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54235,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55250,Not in chargemaster,55250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55250,BCBS multispecialty AW base fee schedule,433.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55300,Not in chargemaster,55300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55300,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55400,Not in chargemaster,55400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55400,BCBS multispecialty AW base fee schedule,955.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55500,Not in chargemaster,55500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55500,BCBS multispecialty AW base fee schedule,751.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55520,55520,55520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55520,BCBS multispecialty AW base fee schedule,874.5,812.79,Fee schedule,,812.79,812.79,812.79,812.79,,,0
unity,Fee schedule,Facility 55530,Not in chargemaster,55530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55530,BCBS multispecialty AW base fee schedule,671.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55535,Not in chargemaster,55535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55535,BCBS multispecialty AW base fee schedule,822.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55540,Not in chargemaster,55540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55540,BCBS multispecialty AW base fee schedule,1063.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55550,Not in chargemaster,55550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55550,BCBS multispecialty AW base fee schedule,819.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55600,Not in chargemaster,55600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55600,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55605,Not in chargemaster,55605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55605,BCBS multispecialty AW base fee schedule,998.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55650,Not in chargemaster,55650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55650,BCBS multispecialty AW base fee schedule,1372.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55680,Not in chargemaster,55680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55680,BCBS multispecialty AW base fee schedule,661.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55700,Not in chargemaster,55700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55700,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55705,Not in chargemaster,55705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55705,BCBS multispecialty AW base fee schedule,508.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55706,Not in chargemaster,55706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55706,BCBS multispecialty AW base fee schedule,712.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55720,Not in chargemaster,55720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55720,BCBS multispecialty AW base fee schedule,864.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55725,Not in chargemaster,55725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55725,BCBS multispecialty AW base fee schedule,1135.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55801,Not in chargemaster,55801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55801,BCBS multispecialty AW base fee schedule,2094.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55810,Not in chargemaster,55810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55810,BCBS multispecialty AW base fee schedule,2508.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55812,Not in chargemaster,55812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55812,BCBS multispecialty AW base fee schedule,3079.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55815,Not in chargemaster,55815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55815,BCBS multispecialty AW base fee schedule,3373.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55821,Not in chargemaster,55821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55821,BCBS multispecialty AW base fee schedule,1672.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55831,Not in chargemaster,55831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55831,BCBS multispecialty AW base fee schedule,1809.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55840,Not in chargemaster,55840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55840,BCBS multispecialty AW base fee schedule,2239.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55842,Not in chargemaster,55842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55842,BCBS multispecialty AW base fee schedule,2241.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55845,Not in chargemaster,55845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55845,BCBS multispecialty AW base fee schedule,2608.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55860,Not in chargemaster,55860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55860,BCBS multispecialty AW base fee schedule,1674.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55862,Not in chargemaster,55862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55862,BCBS multispecialty AW base fee schedule,2098.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55865,Not in chargemaster,55865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55865,BCBS multispecialty AW base fee schedule,2555.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55866,Not in chargemaster,55866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55866,BCBS multispecialty AW base fee schedule,2761.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55870,Not in chargemaster,55870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55870,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55873,Not in chargemaster,55873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55873,BCBS multispecialty AW base fee schedule,1461.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55874,Not in chargemaster,55874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55874,BCBS multispecialty AW base fee schedule,316.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55875,Not in chargemaster,55875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55875,BCBS multispecialty AW base fee schedule,1470.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55876,Not in chargemaster,55876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55876,BCBS multispecialty AW base fee schedule,192.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55920,Not in chargemaster,55920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55920,BCBS multispecialty AW base fee schedule,867.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56405,Not in chargemaster,56405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56405,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56420,Not in chargemaster,56420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56420,BCBS multispecialty AW base fee schedule,196.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56440,Not in chargemaster,56440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56440,BCBS multispecialty AW base fee schedule,347.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56441,Not in chargemaster,56441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56441,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56442,Not in chargemaster,56442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56442,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56501,Not in chargemaster,56501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56501,BCBS multispecialty AW base fee schedule,238.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56515,Not in chargemaster,56515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56515,BCBS multispecialty AW base fee schedule,395.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56620,Not in chargemaster,56620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56620,BCBS multispecialty AW base fee schedule,1054.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56625,Not in chargemaster,56625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56625,BCBS multispecialty AW base fee schedule,1232.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56630,Not in chargemaster,56630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56630,BCBS multispecialty AW base fee schedule,1794.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56631,Not in chargemaster,56631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56631,BCBS multispecialty AW base fee schedule,2241.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56632,Not in chargemaster,56632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56632,BCBS multispecialty AW base fee schedule,2668.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56633,Not in chargemaster,56633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56633,BCBS multispecialty AW base fee schedule,2316.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56634,Not in chargemaster,56634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56634,BCBS multispecialty AW base fee schedule,2443.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56637,Not in chargemaster,56637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56637,BCBS multispecialty AW base fee schedule,2838.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56640,Not in chargemaster,56640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56640,BCBS multispecialty AW base fee schedule,2873.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56700,Not in chargemaster,56700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56700,BCBS multispecialty AW base fee schedule,376.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56740,Not in chargemaster,56740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56740,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56800,Not in chargemaster,56800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56800,BCBS multispecialty AW base fee schedule,475.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56805,Not in chargemaster,56805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56805,BCBS multispecialty AW base fee schedule,2227.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56810,Not in chargemaster,56810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56810,BCBS multispecialty AW base fee schedule,511.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56820,Not in chargemaster,56820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56820,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56605,Not in chargemaster,56605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56605,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56606,Not in chargemaster,56606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56606,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57000,Not in chargemaster,57000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57000,BCBS multispecialty AW base fee schedule,376.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57010,Not in chargemaster,57010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57010,BCBS multispecialty AW base fee schedule,857.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57020,Not in chargemaster,57020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57020,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57022,Not in chargemaster,57022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57022,BCBS multispecialty AW base fee schedule,337.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57023,Not in chargemaster,57023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57023,BCBS multispecialty AW base fee schedule,606.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57061,Not in chargemaster,57061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57061,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56821,Not in chargemaster,56821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56821,BCBS multispecialty AW base fee schedule,218.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57065,Not in chargemaster,57065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57065,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57106,Not in chargemaster,57106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57106,BCBS multispecialty AW base fee schedule,986.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57107,Not in chargemaster,57107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57107,BCBS multispecialty AW base fee schedule,2751.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57109,Not in chargemaster,57109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57109,BCBS multispecialty AW base fee schedule,3268.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57110,Not in chargemaster,57110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57110,BCBS multispecialty AW base fee schedule,1731.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57111,Not in chargemaster,57111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57111,BCBS multispecialty AW base fee schedule,3268.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57112,Not in chargemaster,57112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57112,BCBS multispecialty AW base fee schedule,3496.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57120,Not in chargemaster,57120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57120,BCBS multispecialty AW base fee schedule,1001.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57130,Not in chargemaster,57130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57130,BCBS multispecialty AW base fee schedule,319.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57100,Not in chargemaster,57100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57100,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57105,Not in chargemaster,57105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57105,BCBS multispecialty AW base fee schedule,260.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57135,Not in chargemaster,57135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57135,BCBS multispecialty AW base fee schedule,347.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57150,Not in chargemaster,57150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57150,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57200,Not in chargemaster,57200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57200,BCBS multispecialty AW base fee schedule,607.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57210,Not in chargemaster,57210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57210,BCBS multispecialty AW base fee schedule,733.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57220,Not in chargemaster,57220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57220,BCBS multispecialty AW base fee schedule,640.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57230,Not in chargemaster,57230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57230,BCBS multispecialty AW base fee schedule,785.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57240,Not in chargemaster,57240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57240,BCBS multispecialty AW base fee schedule,1158.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57250,Not in chargemaster,57250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57250,BCBS multispecialty AW base fee schedule,1166,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57260,Not in chargemaster,57260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57260,BCBS multispecialty AW base fee schedule,1485.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57265,Not in chargemaster,57265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57265,BCBS multispecialty AW base fee schedule,1668.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57267,Not in chargemaster,57267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57267,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57268,Not in chargemaster,57268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57268,BCBS multispecialty AW base fee schedule,951.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57270,Not in chargemaster,57270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57270,BCBS multispecialty AW base fee schedule,1552.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57280,Not in chargemaster,57280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57280,BCBS multispecialty AW base fee schedule,1846.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57282,Not in chargemaster,57282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57282,BCBS multispecialty AW base fee schedule,1005.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57283,Not in chargemaster,57283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57283,BCBS multispecialty AW base fee schedule,1341.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57284,Not in chargemaster,57284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57284,BCBS multispecialty AW base fee schedule,1582.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57285,Not in chargemaster,57285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57285,BCBS multispecialty AW base fee schedule,1317.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57287,Not in chargemaster,57287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57287,BCBS multispecialty AW base fee schedule,1370.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57288,Not in chargemaster,57288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57288,BCBS multispecialty AW base fee schedule,1403.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57289,Not in chargemaster,57289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57289,BCBS multispecialty AW base fee schedule,1500.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57291,Not in chargemaster,57291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57291,BCBS multispecialty AW base fee schedule,1038.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57292,Not in chargemaster,57292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57292,BCBS multispecialty AW base fee schedule,1585.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57295,Not in chargemaster,57295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57295,BCBS multispecialty AW base fee schedule,942.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57296,Not in chargemaster,57296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57296,BCBS multispecialty AW base fee schedule,1815.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57300,Not in chargemaster,57300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57300,BCBS multispecialty AW base fee schedule,1129.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57305,Not in chargemaster,57305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57305,BCBS multispecialty AW base fee schedule,1852.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57307,Not in chargemaster,57307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57307,BCBS multispecialty AW base fee schedule,2013.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57308,Not in chargemaster,57308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57308,BCBS multispecialty AW base fee schedule,1258.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57310,Not in chargemaster,57310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57310,BCBS multispecialty AW base fee schedule,917.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57311,Not in chargemaster,57311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57311,BCBS multispecialty AW base fee schedule,1038.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57320,Not in chargemaster,57320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57320,BCBS multispecialty AW base fee schedule,1050.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57330,Not in chargemaster,57330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57330,BCBS multispecialty AW base fee schedule,1448.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57335,Not in chargemaster,57335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57335,BCBS multispecialty AW base fee schedule,2249.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57400,Not in chargemaster,57400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57400,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57410,Not in chargemaster,57410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57410,BCBS multispecialty AW base fee schedule,203.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57415,Not in chargemaster,57415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57415,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57420,Not in chargemaster,57420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57420,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57155,Not in chargemaster,57155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57155,BCBS multispecialty AW base fee schedule,538.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57156,Not in chargemaster,57156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57156,BCBS multispecialty AW base fee schedule,284.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57160,Not in chargemaster,57160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57160,BCBS multispecialty AW base fee schedule,89.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57170,Not in chargemaster,57170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57170,BCBS multispecialty AW base fee schedule,91.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57180,Not in chargemaster,57180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57180,BCBS multispecialty AW base fee schedule,219.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57421,Not in chargemaster,57421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57421,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57423,Not in chargemaster,57423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57423,BCBS multispecialty AW base fee schedule,1777.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57425,Not in chargemaster,57425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57425,BCBS multispecialty AW base fee schedule,1875.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57426,Not in chargemaster,57426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57426,BCBS multispecialty AW base fee schedule,1647.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57452,Not in chargemaster,57452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57452,BCBS multispecialty AW base fee schedule,174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57454,Not in chargemaster,57454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57454,BCBS multispecialty AW base fee schedule,257.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57455,Not in chargemaster,57455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57455,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57456,Not in chargemaster,57456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57456,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57460,Not in chargemaster,57460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57460,BCBS multispecialty AW base fee schedule,308.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57461,Not in chargemaster,57461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57461,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57500,Not in chargemaster,57500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57500,BCBS multispecialty AW base fee schedule,143.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57505,Not in chargemaster,57505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57505,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57510,Not in chargemaster,57510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57510,BCBS multispecialty AW base fee schedule,217.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57511,Not in chargemaster,57511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57511,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57513,Not in chargemaster,57513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57513,BCBS multispecialty AW base fee schedule,268.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57520,Not in chargemaster,57520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57520,BCBS multispecialty AW base fee schedule,545.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57522,Not in chargemaster,57522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57522,BCBS multispecialty AW base fee schedule,477.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57530,Not in chargemaster,57530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57530,BCBS multispecialty AW base fee schedule,690.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57531,Not in chargemaster,57531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57531,BCBS multispecialty AW base fee schedule,3506.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57540,Not in chargemaster,57540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57540,BCBS multispecialty AW base fee schedule,1513.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57545,Not in chargemaster,57545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57545,BCBS multispecialty AW base fee schedule,1595.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57550,Not in chargemaster,57550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57550,BCBS multispecialty AW base fee schedule,807.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57555,Not in chargemaster,57555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57555,BCBS multispecialty AW base fee schedule,1175.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57556,Not in chargemaster,57556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57556,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57558,Not in chargemaster,57558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57558,BCBS multispecialty AW base fee schedule,233.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58140,Not in chargemaster,58140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58140,BCBS multispecialty AW base fee schedule,1783.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58145,Not in chargemaster,58145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58145,BCBS multispecialty AW base fee schedule,1075.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58146,Not in chargemaster,58146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58146,BCBS multispecialty AW base fee schedule,2224.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58150,58150,58150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58150,BCBS multispecialty AW base fee schedule,1937.81,2120.37,Fee schedule,,1937.81,1937.81,1937.81,1937.81,,,0
unity,Fee schedule,Facility 58152,Not in chargemaster,58152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58152,BCBS multispecialty AW base fee schedule,2407.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58180,Not in chargemaster,58180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58180,BCBS multispecialty AW base fee schedule,1844.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58200,Not in chargemaster,58200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58200,BCBS multispecialty AW base fee schedule,2585.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58210,Not in chargemaster,58210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58210,BCBS multispecialty AW base fee schedule,3469.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58240,Not in chargemaster,58240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58240,BCBS multispecialty AW base fee schedule,5552.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58260,Not in chargemaster,58260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58260,BCBS multispecialty AW base fee schedule,1603.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58262,Not in chargemaster,58262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58262,BCBS multispecialty AW base fee schedule,1780.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58263,Not in chargemaster,58263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58263,BCBS multispecialty AW base fee schedule,1912.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58267,Not in chargemaster,58267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58267,BCBS multispecialty AW base fee schedule,2047.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58270,Not in chargemaster,58270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58270,BCBS multispecialty AW base fee schedule,1711.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58275,Not in chargemaster,58275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58275,BCBS multispecialty AW base fee schedule,1898.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58280,Not in chargemaster,58280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58280,BCBS multispecialty AW base fee schedule,2035.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58285,Not in chargemaster,58285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58285,BCBS multispecialty AW base fee schedule,2681.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58290,Not in chargemaster,58290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58290,BCBS multispecialty AW base fee schedule,2216.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58291,Not in chargemaster,58291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58291,BCBS multispecialty AW base fee schedule,2401.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58292,Not in chargemaster,58292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58292,BCBS multispecialty AW base fee schedule,2531.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58293,Not in chargemaster,58293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58293,BCBS multispecialty AW base fee schedule,2630.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58294,Not in chargemaster,58294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58294,BCBS multispecialty AW base fee schedule,2347.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58300,Not in chargemaster,58300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58300,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57700,Not in chargemaster,57700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57700,BCBS multispecialty AW base fee schedule,641.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57720,Not in chargemaster,57720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57720,BCBS multispecialty AW base fee schedule,618.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57800,Not in chargemaster,57800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57800,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58100,58100,58100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58100,BCBS multispecialty AW base fee schedule,123.23,232.84,Fee schedule,,123.23,123.23,123.23,123.23,,,0
unity,Fee schedule,Facility 58110,Not in chargemaster,58110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58110,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58120,Not in chargemaster,58120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58120,BCBS multispecialty AW base fee schedule,434.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58301,58301,58301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58301,BCBS multispecialty AW base fee schedule,129.19,215,Fee schedule,,129.19,129.19,129.19,129.19,,,0
unity,Fee schedule,Facility 58321,Not in chargemaster,58321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58321,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58322,Not in chargemaster,58322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58322,BCBS multispecialty AW base fee schedule,112.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58400,Not in chargemaster,58400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58400,BCBS multispecialty AW base fee schedule,870.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58410,Not in chargemaster,58410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58410,BCBS multispecialty AW base fee schedule,1562.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58520,Not in chargemaster,58520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58520,BCBS multispecialty AW base fee schedule,1529.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58540,Not in chargemaster,58540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58540,BCBS multispecialty AW base fee schedule,1759.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58541,Not in chargemaster,58541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58541,BCBS multispecialty AW base fee schedule,1395.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58542,Not in chargemaster,58542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58542,BCBS multispecialty AW base fee schedule,1588.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58543,Not in chargemaster,58543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58543,BCBS multispecialty AW base fee schedule,1613.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58544,Not in chargemaster,58544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58544,BCBS multispecialty AW base fee schedule,1737.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58545,Not in chargemaster,58545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58545,BCBS multispecialty AW base fee schedule,1727.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58546,Not in chargemaster,58546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58546,BCBS multispecialty AW base fee schedule,2153.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58548,Not in chargemaster,58548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58548,BCBS multispecialty AW base fee schedule,3576.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58550,Not in chargemaster,58550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58550,BCBS multispecialty AW base fee schedule,1695.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58552,Not in chargemaster,58552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58552,BCBS multispecialty AW base fee schedule,1889.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58553,Not in chargemaster,58553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58553,BCBS multispecialty AW base fee schedule,2166.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58554,Not in chargemaster,58554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58554,BCBS multispecialty AW base fee schedule,2526.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58555,Not in chargemaster,58555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58555,BCBS multispecialty AW base fee schedule,292.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58323,Not in chargemaster,58323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58323,BCBS multispecialty AW base fee schedule,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58340,Not in chargemaster,58340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58340,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58345,Not in chargemaster,58345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58345,BCBS multispecialty AW base fee schedule,547.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58346,Not in chargemaster,58346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58346,BCBS multispecialty AW base fee schedule,904.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58350,Not in chargemaster,58350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58350,BCBS multispecialty AW base fee schedule,166.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58353,Not in chargemaster,58353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58353,BCBS multispecialty AW base fee schedule,433.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58356,Not in chargemaster,58356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58356,BCBS multispecialty AW base fee schedule,679.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58559,Not in chargemaster,58559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58559,BCBS multispecialty AW base fee schedule,551.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58560,Not in chargemaster,58560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58560,BCBS multispecialty AW base fee schedule,606.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58561,Not in chargemaster,58561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58561,BCBS multispecialty AW base fee schedule,694.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58562,Not in chargemaster,58562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58562,BCBS multispecialty AW base fee schedule,428.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58570,Not in chargemaster,58570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58570,BCBS multispecialty AW base fee schedule,1523.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58571,Not in chargemaster,58571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58571,BCBS multispecialty AW base fee schedule,1717.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58572,Not in chargemaster,58572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58572,BCBS multispecialty AW base fee schedule,1978.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58573,Not in chargemaster,58573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58573,BCBS multispecialty AW base fee schedule,2320.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58575,Not in chargemaster,58575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58575,BCBS multispecialty AW base fee schedule,3637.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58600,Not in chargemaster,58600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58600,BCBS multispecialty AW base fee schedule,706.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58605,Not in chargemaster,58605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58605,BCBS multispecialty AW base fee schedule,639.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58611,Not in chargemaster,58611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58611,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58615,Not in chargemaster,58615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58615,BCBS multispecialty AW base fee schedule,479.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58660,Not in chargemaster,58660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58660,BCBS multispecialty AW base fee schedule,1301.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58661,Not in chargemaster,58661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58661,BCBS multispecialty AW base fee schedule,1249.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58662,Not in chargemaster,58662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58662,BCBS multispecialty AW base fee schedule,1366.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58670,Not in chargemaster,58670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58670,BCBS multispecialty AW base fee schedule,708.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58671,Not in chargemaster,58671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58671,BCBS multispecialty AW base fee schedule,706.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58672,Not in chargemaster,58672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58672,BCBS multispecialty AW base fee schedule,1411.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58673,Not in chargemaster,58673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58673,BCBS multispecialty AW base fee schedule,1533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58674,Not in chargemaster,58674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58674,BCBS multispecialty AW base fee schedule,1568.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58700,Not in chargemaster,58700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58700,BCBS multispecialty AW base fee schedule,1517.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58720,Not in chargemaster,58720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58720,BCBS multispecialty AW base fee schedule,1429.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58740,Not in chargemaster,58740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58740,BCBS multispecialty AW base fee schedule,1719.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58750,Not in chargemaster,58750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58750,BCBS multispecialty AW base fee schedule,1746.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58752,Not in chargemaster,58752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58752,BCBS multispecialty AW base fee schedule,1741.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58760,Not in chargemaster,58760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58760,BCBS multispecialty AW base fee schedule,1572.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58770,Not in chargemaster,58770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58770,BCBS multispecialty AW base fee schedule,1654.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58800,Not in chargemaster,58800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58800,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60500,Not in chargemaster,60500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60500,BCBS multispecialty AW base fee schedule,1853.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60502,Not in chargemaster,60502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60502,BCBS multispecialty AW base fee schedule,2484.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60505,Not in chargemaster,60505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60505,BCBS multispecialty AW base fee schedule,2657.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60512,Not in chargemaster,60512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60512,BCBS multispecialty AW base fee schedule,465.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60520,Not in chargemaster,60520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60520,BCBS multispecialty AW base fee schedule,2014,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60521,Not in chargemaster,60521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60521,BCBS multispecialty AW base fee schedule,2148.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60522,Not in chargemaster,60522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60522,BCBS multispecialty AW base fee schedule,2614.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60540,Not in chargemaster,60540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60540,BCBS multispecialty AW base fee schedule,2055.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60545,Not in chargemaster,60545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60545,BCBS multispecialty AW base fee schedule,2369.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60600,Not in chargemaster,60600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60600,BCBS multispecialty AW base fee schedule,2630.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60605,Not in chargemaster,60605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60605,BCBS multispecialty AW base fee schedule,3194.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60650,Not in chargemaster,60650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60650,BCBS multispecialty AW base fee schedule,2293.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61000,Not in chargemaster,61000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61000,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61001,Not in chargemaster,61001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61001,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61020,Not in chargemaster,61020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61020,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61026,Not in chargemaster,61026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61026,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61050,Not in chargemaster,61050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61050,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61055,Not in chargemaster,61055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61055,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61070,Not in chargemaster,61070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61070,BCBS multispecialty AW base fee schedule,107.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61105,Not in chargemaster,61105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61105,BCBS multispecialty AW base fee schedule,877.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61107,Not in chargemaster,61107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61107,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61108,Not in chargemaster,61108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61108,BCBS multispecialty AW base fee schedule,1711.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61120,Not in chargemaster,61120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61120,BCBS multispecialty AW base fee schedule,1425.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61140,Not in chargemaster,61140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61140,BCBS multispecialty AW base fee schedule,2420.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61150,Not in chargemaster,61150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61150,BCBS multispecialty AW base fee schedule,2584.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61151,Not in chargemaster,61151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61151,BCBS multispecialty AW base fee schedule,1896.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61154,Not in chargemaster,61154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61154,BCBS multispecialty AW base fee schedule,2430.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61156,Not in chargemaster,61156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61156,BCBS multispecialty AW base fee schedule,2374.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61210,Not in chargemaster,61210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61210,BCBS multispecialty AW base fee schedule,705.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61215,Not in chargemaster,61215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61215,BCBS multispecialty AW base fee schedule,965.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61250,Not in chargemaster,61250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61250,BCBS multispecialty AW base fee schedule,1655.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61253,Not in chargemaster,61253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61253,BCBS multispecialty AW base fee schedule,1896.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61304,Not in chargemaster,61304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61304,BCBS multispecialty AW base fee schedule,3141.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61305,Not in chargemaster,61305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61305,BCBS multispecialty AW base fee schedule,3839.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61312,Not in chargemaster,61312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61312,BCBS multispecialty AW base fee schedule,3973.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61313,Not in chargemaster,61313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61313,BCBS multispecialty AW base fee schedule,3792.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61314,Not in chargemaster,61314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61314,BCBS multispecialty AW base fee schedule,3495.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61315,Not in chargemaster,61315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61315,BCBS multispecialty AW base fee schedule,3953.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61316,Not in chargemaster,61316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61316,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61320,Not in chargemaster,61320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61320,BCBS multispecialty AW base fee schedule,3633.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61321,Not in chargemaster,61321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61321,BCBS multispecialty AW base fee schedule,4070.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61322,Not in chargemaster,61322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61322,BCBS multispecialty AW base fee schedule,4552.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61323,Not in chargemaster,61323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61323,BCBS multispecialty AW base fee schedule,4587.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61330,Not in chargemaster,61330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61330,BCBS multispecialty AW base fee schedule,3429.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61333,Not in chargemaster,61333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61333,BCBS multispecialty AW base fee schedule,3869,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61340,Not in chargemaster,61340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61340,BCBS multispecialty AW base fee schedule,2755.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61343,Not in chargemaster,61343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61343,BCBS multispecialty AW base fee schedule,4202.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61345,Not in chargemaster,61345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61345,BCBS multispecialty AW base fee schedule,3905.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61450,Not in chargemaster,61450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61450,BCBS multispecialty AW base fee schedule,3675.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61458,Not in chargemaster,61458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61458,BCBS multispecialty AW base fee schedule,3847.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61460,Not in chargemaster,61460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61460,BCBS multispecialty AW base fee schedule,4029.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61500,Not in chargemaster,61500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61500,BCBS multispecialty AW base fee schedule,2510.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61501,Not in chargemaster,61501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61501,BCBS multispecialty AW base fee schedule,2178.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61510,Not in chargemaster,61510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61510,BCBS multispecialty AW base fee schedule,4197.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61512,Not in chargemaster,61512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61512,BCBS multispecialty AW base fee schedule,4890.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61514,Not in chargemaster,61514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61514,BCBS multispecialty AW base fee schedule,3653.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61516,Not in chargemaster,61516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61516,BCBS multispecialty AW base fee schedule,3580.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61517,Not in chargemaster,61517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61517,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61518,Not in chargemaster,61518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61518,BCBS multispecialty AW base fee schedule,5296.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61519,Not in chargemaster,61519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61519,BCBS multispecialty AW base fee schedule,5661.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61520,Not in chargemaster,61520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61520,BCBS multispecialty AW base fee schedule,7186.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61521,Not in chargemaster,61521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61521,BCBS multispecialty AW base fee schedule,6111.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61522,Not in chargemaster,61522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61522,BCBS multispecialty AW base fee schedule,4187.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61524,Not in chargemaster,61524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61524,BCBS multispecialty AW base fee schedule,3986.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61526,Not in chargemaster,61526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61526,BCBS multispecialty AW base fee schedule,6422.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61530,Not in chargemaster,61530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61530,BCBS multispecialty AW base fee schedule,5906.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61531,Not in chargemaster,61531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61531,BCBS multispecialty AW base fee schedule,2333.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61533,Not in chargemaster,61533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61533,BCBS multispecialty AW base fee schedule,2918.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61534,Not in chargemaster,61534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61534,BCBS multispecialty AW base fee schedule,3148.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61535,Not in chargemaster,61535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61535,BCBS multispecialty AW base fee schedule,1909.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61536,Not in chargemaster,61536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61536,BCBS multispecialty AW base fee schedule,4942.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61537,Not in chargemaster,61537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61537,BCBS multispecialty AW base fee schedule,4725.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61538,Not in chargemaster,61538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61538,BCBS multispecialty AW base fee schedule,5109.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61539,Not in chargemaster,61539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61539,BCBS multispecialty AW base fee schedule,4521.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61540,Not in chargemaster,61540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61540,BCBS multispecialty AW base fee schedule,4171.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61541,Not in chargemaster,61541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61541,BCBS multispecialty AW base fee schedule,4114.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61543,Not in chargemaster,61543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61543,BCBS multispecialty AW base fee schedule,4159.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61544,Not in chargemaster,61544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61544,BCBS multispecialty AW base fee schedule,3635.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61545,Not in chargemaster,61545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61545,BCBS multispecialty AW base fee schedule,6115.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61546,Not in chargemaster,61546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61546,BCBS multispecialty AW base fee schedule,4418.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61548,Not in chargemaster,61548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61548,BCBS multispecialty AW base fee schedule,2994.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61550,Not in chargemaster,61550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61550,BCBS multispecialty AW base fee schedule,2269.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61552,Not in chargemaster,61552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61552,BCBS multispecialty AW base fee schedule,2832.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61556,Not in chargemaster,61556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61556,BCBS multispecialty AW base fee schedule,3264.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61557,Not in chargemaster,61557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61557,BCBS multispecialty AW base fee schedule,3216.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61558,Not in chargemaster,61558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61558,BCBS multispecialty AW base fee schedule,3593.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61559,Not in chargemaster,61559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61559,BCBS multispecialty AW base fee schedule,4583.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61563,Not in chargemaster,61563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61563,BCBS multispecialty AW base fee schedule,3792.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61564,Not in chargemaster,61564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61564,BCBS multispecialty AW base fee schedule,4607.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61566,Not in chargemaster,61566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61566,BCBS multispecialty AW base fee schedule,4296.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61567,Not in chargemaster,61567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61567,BCBS multispecialty AW base fee schedule,4898.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61570,Not in chargemaster,61570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61570,BCBS multispecialty AW base fee schedule,3574.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61571,Not in chargemaster,61571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61571,BCBS multispecialty AW base fee schedule,3808.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61575,Not in chargemaster,61575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61575,BCBS multispecialty AW base fee schedule,4799.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61576,Not in chargemaster,61576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61576,BCBS multispecialty AW base fee schedule,8040.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61580,Not in chargemaster,61580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61580,BCBS multispecialty AW base fee schedule,4673.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61581,Not in chargemaster,61581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61581,BCBS multispecialty AW base fee schedule,5075.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61582,Not in chargemaster,61582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61582,BCBS multispecialty AW base fee schedule,5878.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61583,Not in chargemaster,61583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61583,BCBS multispecialty AW base fee schedule,5521.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61584,Not in chargemaster,61584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61584,BCBS multispecialty AW base fee schedule,5490.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61585,Not in chargemaster,61585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61585,BCBS multispecialty AW base fee schedule,6231.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61586,Not in chargemaster,61586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61586,BCBS multispecialty AW base fee schedule,4718.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61590,Not in chargemaster,61590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61590,BCBS multispecialty AW base fee schedule,5808.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61591,Not in chargemaster,61591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61591,BCBS multispecialty AW base fee schedule,5873.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61592,Not in chargemaster,61592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61592,BCBS multispecialty AW base fee schedule,6079.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61595,Not in chargemaster,61595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61595,BCBS multispecialty AW base fee schedule,4522.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61596,Not in chargemaster,61596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61596,BCBS multispecialty AW base fee schedule,4643.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61597,Not in chargemaster,61597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61597,BCBS multispecialty AW base fee schedule,5630.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61598,Not in chargemaster,61598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61598,BCBS multispecialty AW base fee schedule,5461.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61600,Not in chargemaster,61600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61600,BCBS multispecialty AW base fee schedule,4065.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61601,Not in chargemaster,61601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61601,BCBS multispecialty AW base fee schedule,4611.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61605,Not in chargemaster,61605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61605,BCBS multispecialty AW base fee schedule,4123.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61606,Not in chargemaster,61606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61606,BCBS multispecialty AW base fee schedule,5618,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61607,Not in chargemaster,61607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61607,BCBS multispecialty AW base fee schedule,5121.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61608,Not in chargemaster,61608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61608,BCBS multispecialty AW base fee schedule,6240.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61611,Not in chargemaster,61611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61611,BCBS multispecialty AW base fee schedule,898.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61613,Not in chargemaster,61613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61613,BCBS multispecialty AW base fee schedule,6318.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61615,Not in chargemaster,61615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61615,BCBS multispecialty AW base fee schedule,5386.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61616,Not in chargemaster,61616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61616,BCBS multispecialty AW base fee schedule,6363.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61618,Not in chargemaster,61618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61618,BCBS multispecialty AW base fee schedule,2441.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61619,Not in chargemaster,61619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61619,BCBS multispecialty AW base fee schedule,2691.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61623,Not in chargemaster,61623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61623,BCBS multispecialty AW base fee schedule,1097.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61624,Not in chargemaster,61624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61624,BCBS multispecialty AW base fee schedule,2208.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61626,Not in chargemaster,61626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61626,BCBS multispecialty AW base fee schedule,1696.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61630,Not in chargemaster,61630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61630,BCBS multispecialty AW base fee schedule,2618.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61635,Not in chargemaster,61635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61635,BCBS multispecialty AW base fee schedule,2783.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61640,Not in chargemaster,61640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61640,BCBS multispecialty AW base fee schedule,928.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61641,Not in chargemaster,61641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61641,BCBS multispecialty AW base fee schedule,325.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61642,Not in chargemaster,61642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61642,BCBS multispecialty AW base fee schedule,651.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61645,Not in chargemaster,61645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61645,BCBS multispecialty AW base fee schedule,1602.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61650,Not in chargemaster,61650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61650,BCBS multispecialty AW base fee schedule,1093.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61651,Not in chargemaster,61651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61651,BCBS multispecialty AW base fee schedule,468.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61680,Not in chargemaster,61680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61680,BCBS multispecialty AW base fee schedule,4314.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61682,Not in chargemaster,61682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61682,BCBS multispecialty AW base fee schedule,8197.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61684,Not in chargemaster,61684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61684,BCBS multispecialty AW base fee schedule,5453.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61686,Not in chargemaster,61686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61686,BCBS multispecialty AW base fee schedule,8888.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61690,Not in chargemaster,61690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61690,BCBS multispecialty AW base fee schedule,4176.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61692,Not in chargemaster,61692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61692,BCBS multispecialty AW base fee schedule,7029.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61697,Not in chargemaster,61697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61697,BCBS multispecialty AW base fee schedule,8126.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61698,Not in chargemaster,61698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61698,BCBS multispecialty AW base fee schedule,9145.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61700,Not in chargemaster,61700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61700,BCBS multispecialty AW base fee schedule,6543.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61702,Not in chargemaster,61702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61702,BCBS multispecialty AW base fee schedule,7757.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61703,Not in chargemaster,61703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61703,BCBS multispecialty AW base fee schedule,2596.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61705,Not in chargemaster,61705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61705,BCBS multispecialty AW base fee schedule,4987.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61708,Not in chargemaster,61708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61708,BCBS multispecialty AW base fee schedule,4877.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61710,Not in chargemaster,61710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61710,BCBS multispecialty AW base fee schedule,4113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61711,Not in chargemaster,61711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61711,BCBS multispecialty AW base fee schedule,4964.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61720,Not in chargemaster,61720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61720,BCBS multispecialty AW base fee schedule,2428.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61735,Not in chargemaster,61735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61735,BCBS multispecialty AW base fee schedule,3044.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61750,Not in chargemaster,61750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61750,BCBS multispecialty AW base fee schedule,2692.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61751,Not in chargemaster,61751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61751,BCBS multispecialty AW base fee schedule,2634.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61760,Not in chargemaster,61760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61760,BCBS multispecialty AW base fee schedule,3021.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61770,Not in chargemaster,61770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61770,BCBS multispecialty AW base fee schedule,3103.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61781,Not in chargemaster,61781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61781,BCBS multispecialty AW base fee schedule,451.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61782,Not in chargemaster,61782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61782,BCBS multispecialty AW base fee schedule,331.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61783,Not in chargemaster,61783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61783,BCBS multispecialty AW base fee schedule,447.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61790,Not in chargemaster,61790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61790,BCBS multispecialty AW base fee schedule,1676.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61791,Not in chargemaster,61791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61791,BCBS multispecialty AW base fee schedule,2149.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61796,Not in chargemaster,61796,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61796,BCBS multispecialty AW base fee schedule,1937.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61797,Not in chargemaster,61797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61797,BCBS multispecialty AW base fee schedule,420.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61798,Not in chargemaster,61798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61798,BCBS multispecialty AW base fee schedule,2636.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61799,Not in chargemaster,61799,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61799,BCBS multispecialty AW base fee schedule,581.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61800,Not in chargemaster,61800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61800,BCBS multispecialty AW base fee schedule,291.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61850,Not in chargemaster,61850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61850,BCBS multispecialty AW base fee schedule,1879.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61860,Not in chargemaster,61860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61860,BCBS multispecialty AW base fee schedule,2991.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61863,Not in chargemaster,61863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61863,BCBS multispecialty AW base fee schedule,2871.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61864,Not in chargemaster,61864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61864,BCBS multispecialty AW base fee schedule,543.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61867,Not in chargemaster,61867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61867,BCBS multispecialty AW base fee schedule,4366.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61868,Not in chargemaster,61868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61868,BCBS multispecialty AW base fee schedule,957.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61870,Not in chargemaster,61870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61870,BCBS multispecialty AW base fee schedule,2263.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61880,Not in chargemaster,61880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61880,BCBS multispecialty AW base fee schedule,1101.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61885,Not in chargemaster,61885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61885,BCBS multispecialty AW base fee schedule,989.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61886,Not in chargemaster,61886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61886,BCBS multispecialty AW base fee schedule,1635.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 61888,Not in chargemaster,61888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61888,BCBS multispecialty AW base fee schedule,754.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62000,Not in chargemaster,62000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62000,BCBS multispecialty AW base fee schedule,1970.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62005,Not in chargemaster,62005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62005,BCBS multispecialty AW base fee schedule,2428.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62010,Not in chargemaster,62010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62010,BCBS multispecialty AW base fee schedule,2933.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62100,Not in chargemaster,62100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62100,BCBS multispecialty AW base fee schedule,3022.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62115,Not in chargemaster,62115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62115,BCBS multispecialty AW base fee schedule,3206.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62117,Not in chargemaster,62117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62117,BCBS multispecialty AW base fee schedule,3761.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62120,Not in chargemaster,62120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62120,BCBS multispecialty AW base fee schedule,4016.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62121,Not in chargemaster,62121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62121,BCBS multispecialty AW base fee schedule,2983.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62140,Not in chargemaster,62140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62140,BCBS multispecialty AW base fee schedule,1959.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62141,Not in chargemaster,62141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62141,BCBS multispecialty AW base fee schedule,2181.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62142,Not in chargemaster,62142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62142,BCBS multispecialty AW base fee schedule,1691.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62143,Not in chargemaster,62143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62143,BCBS multispecialty AW base fee schedule,1989.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62145,Not in chargemaster,62145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62145,BCBS multispecialty AW base fee schedule,2721.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62146,Not in chargemaster,62146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62146,BCBS multispecialty AW base fee schedule,2161.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62147,Not in chargemaster,62147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62147,BCBS multispecialty AW base fee schedule,2718.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62148,Not in chargemaster,62148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62148,BCBS multispecialty AW base fee schedule,243.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62160,Not in chargemaster,62160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62160,BCBS multispecialty AW base fee schedule,362.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62161,Not in chargemaster,62161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62161,BCBS multispecialty AW base fee schedule,2891.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62162,Not in chargemaster,62162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62162,BCBS multispecialty AW base fee schedule,3612.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62163,Not in chargemaster,62163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62163,BCBS multispecialty AW base fee schedule,2341.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62164,Not in chargemaster,62164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62164,BCBS multispecialty AW base fee schedule,4000.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62165,Not in chargemaster,62165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62165,BCBS multispecialty AW base fee schedule,2908.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62180,Not in chargemaster,62180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62180,BCBS multispecialty AW base fee schedule,3058.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62190,Not in chargemaster,62190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62190,BCBS multispecialty AW base fee schedule,1767.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62192,Not in chargemaster,62192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62192,BCBS multispecialty AW base fee schedule,1876.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62194,Not in chargemaster,62194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62194,BCBS multispecialty AW base fee schedule,931.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62200,Not in chargemaster,62200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62200,BCBS multispecialty AW base fee schedule,2631.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62201,Not in chargemaster,62201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62201,BCBS multispecialty AW base fee schedule,2305.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62220,Not in chargemaster,62220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62220,BCBS multispecialty AW base fee schedule,1886.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62223,Not in chargemaster,62223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62223,BCBS multispecialty AW base fee schedule,1988.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62225,Not in chargemaster,62225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62225,BCBS multispecialty AW base fee schedule,1005.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62230,Not in chargemaster,62230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62230,BCBS multispecialty AW base fee schedule,1607.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62252,Not in chargemaster,62252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62252,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62252 mod 26,Not in chargemaster,62252,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62252 mod 26,BCBS multispecialty AW base fee schedule,88.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62252 mod TC,Not in chargemaster,62252,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62252 mod TC,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62256,Not in chargemaster,62256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62256,BCBS multispecialty AW base fee schedule,1150.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62258,Not in chargemaster,62258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62258,BCBS multispecialty AW base fee schedule,2122.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62263,Not in chargemaster,62263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62263,BCBS multispecialty AW base fee schedule,589.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58805,Not in chargemaster,58805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58805,BCBS multispecialty AW base fee schedule,802.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58820,Not in chargemaster,58820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58820,BCBS multispecialty AW base fee schedule,627.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58822,Not in chargemaster,58822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58822,BCBS multispecialty AW base fee schedule,1363.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58825,Not in chargemaster,58825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58825,BCBS multispecialty AW base fee schedule,1354.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58900,Not in chargemaster,58900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58900,BCBS multispecialty AW base fee schedule,820.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58920,Not in chargemaster,58920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58920,BCBS multispecialty AW base fee schedule,1365.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58925,Not in chargemaster,58925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58925,BCBS multispecialty AW base fee schedule,1456.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58940,Not in chargemaster,58940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58940,BCBS multispecialty AW base fee schedule,1036.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58943,Not in chargemaster,58943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58943,BCBS multispecialty AW base fee schedule,2231.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58950,Not in chargemaster,58950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58950,BCBS multispecialty AW base fee schedule,2165.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58951,Not in chargemaster,58951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58951,BCBS multispecialty AW base fee schedule,2740.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58952,Not in chargemaster,58952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58952,BCBS multispecialty AW base fee schedule,3111.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58953,Not in chargemaster,58953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58953,BCBS multispecialty AW base fee schedule,3816.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58954,Not in chargemaster,58954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58954,BCBS multispecialty AW base fee schedule,4135.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58956,Not in chargemaster,58956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58956,BCBS multispecialty AW base fee schedule,2593.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58957,Not in chargemaster,58957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58957,BCBS multispecialty AW base fee schedule,3011.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58958,Not in chargemaster,58958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58958,BCBS multispecialty AW base fee schedule,3334.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58960,Not in chargemaster,58960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58960,BCBS multispecialty AW base fee schedule,1854.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58970,Not in chargemaster,58970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58970,BCBS multispecialty AW base fee schedule,380.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58558,Not in chargemaster,58558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58558,BCBS multispecialty AW base fee schedule,446.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58563,Not in chargemaster,58563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58563,BCBS multispecialty AW base fee schedule,475.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58565,Not in chargemaster,58565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58565,BCBS multispecialty AW base fee schedule,859.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58976,Not in chargemaster,58976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58976,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59020,Not in chargemaster,59020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59020,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59020 mod 26,Not in chargemaster,59020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59020 mod 26,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59020 mod TC,Not in chargemaster,59020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59020 mod TC,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59025,Not in chargemaster,59025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59025,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59025 mod 26,Not in chargemaster,59025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59025 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59025 mod TC,Not in chargemaster,59025,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59025 mod TC,BCBS multispecialty AW base fee schedule,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59030,Not in chargemaster,59030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59030,BCBS multispecialty AW base fee schedule,217.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59050,Not in chargemaster,59050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59050,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59051,Not in chargemaster,59051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59051,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59070,Not in chargemaster,59070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59070,BCBS multispecialty AW base fee schedule,595.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59001,Not in chargemaster,59001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59001,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59012,Not in chargemaster,59012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59012,BCBS multispecialty AW base fee schedule,388.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59015,Not in chargemaster,59015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59015,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59000,Not in chargemaster,59000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59000,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59072,Not in chargemaster,59072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59072,BCBS multispecialty AW base fee schedule,1007,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59074,Not in chargemaster,59074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59074,BCBS multispecialty AW base fee schedule,595.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59076,Not in chargemaster,59076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59076,BCBS multispecialty AW base fee schedule,1007,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59100,Not in chargemaster,59100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59100,BCBS multispecialty AW base fee schedule,1633.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59120,Not in chargemaster,59120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59120,BCBS multispecialty AW base fee schedule,1556.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59121,Not in chargemaster,59121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59121,BCBS multispecialty AW base fee schedule,1558.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59130,Not in chargemaster,59130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59130,BCBS multispecialty AW base fee schedule,1813.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59135,Not in chargemaster,59135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59135,BCBS multispecialty AW base fee schedule,1793.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59136,Not in chargemaster,59136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59136,BCBS multispecialty AW base fee schedule,1719.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59140,Not in chargemaster,59140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59140,BCBS multispecialty AW base fee schedule,790.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59150,Not in chargemaster,59150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59150,BCBS multispecialty AW base fee schedule,1509.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59151,Not in chargemaster,59151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59151,BCBS multispecialty AW base fee schedule,1474.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59160,Not in chargemaster,59160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59160,BCBS multispecialty AW base fee schedule,350.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59320,Not in chargemaster,59320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59320,BCBS multispecialty AW base fee schedule,290.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59325,Not in chargemaster,59325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59325,BCBS multispecialty AW base fee schedule,465.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59350,Not in chargemaster,59350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59350,BCBS multispecialty AW base fee schedule,540.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59400,Not in chargemaster,59400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59400,BCBS multispecialty AW base fee schedule,4076.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59409,59409,59409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59409,BCBS multispecialty AW base fee schedule,1558.86,1744.14,Fee schedule,,1558.86,1558.86,1558.86,1558.86,,,0
unity,Fee schedule,Facility 59410,Not in chargemaster,59410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59410,BCBS multispecialty AW base fee schedule,2006.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59412,Not in chargemaster,59412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59412,BCBS multispecialty AW base fee schedule,198.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59414,Not in chargemaster,59414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59414,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59425,Not in chargemaster,59425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59425,BCBS multispecialty AW base fee schedule,684.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59200,Not in chargemaster,59200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59200,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59300,Not in chargemaster,59300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59300,BCBS multispecialty AW base fee schedule,282.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59426,Not in chargemaster,59426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59426,BCBS multispecialty AW base fee schedule,1206.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59430,Not in chargemaster,59430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59430,BCBS multispecialty AW base fee schedule,268.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59510,Not in chargemaster,59510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59510,BCBS multispecialty AW base fee schedule,4520.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59514,Not in chargemaster,59514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59514,BCBS multispecialty AW base fee schedule,1761.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59515,Not in chargemaster,59515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59515,BCBS multispecialty AW base fee schedule,2443.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59525,Not in chargemaster,59525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59525,BCBS multispecialty AW base fee schedule,934.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59610,Not in chargemaster,59610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59610,BCBS multispecialty AW base fee schedule,4289.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59612,Not in chargemaster,59612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59612,BCBS multispecialty AW base fee schedule,1761.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59614,Not in chargemaster,59614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59614,BCBS multispecialty AW base fee schedule,2189.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59618,Not in chargemaster,59618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59618,BCBS multispecialty AW base fee schedule,4579.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59620,Not in chargemaster,59620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59620,BCBS multispecialty AW base fee schedule,1825.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59622,Not in chargemaster,59622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59622,BCBS multispecialty AW base fee schedule,2525.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59812,Not in chargemaster,59812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59812,BCBS multispecialty AW base fee schedule,582.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59820,Not in chargemaster,59820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59820,BCBS multispecialty AW base fee schedule,712.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59821,Not in chargemaster,59821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59821,BCBS multispecialty AW base fee schedule,706.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59830,Not in chargemaster,59830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59830,BCBS multispecialty AW base fee schedule,869.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59840,Not in chargemaster,59840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59840,BCBS multispecialty AW base fee schedule,415.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59841,Not in chargemaster,59841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59841,BCBS multispecialty AW base fee schedule,707.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59850,Not in chargemaster,59850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59850,BCBS multispecialty AW base fee schedule,743.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59851,Not in chargemaster,59851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59851,BCBS multispecialty AW base fee schedule,797.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59852,Not in chargemaster,59852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59852,BCBS multispecialty AW base fee schedule,1098.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59855,Not in chargemaster,59855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59855,BCBS multispecialty AW base fee schedule,810.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59856,Not in chargemaster,59856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59856,BCBS multispecialty AW base fee schedule,951.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59857,Not in chargemaster,59857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59857,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59866,Not in chargemaster,59866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59866,BCBS multispecialty AW base fee schedule,459.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59870,Not in chargemaster,59870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59870,BCBS multispecialty AW base fee schedule,974.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59871,Not in chargemaster,59871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59871,BCBS multispecialty AW base fee schedule,255.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60000,Not in chargemaster,60000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60000,BCBS multispecialty AW base fee schedule,289.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60200,Not in chargemaster,60200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60200,BCBS multispecialty AW base fee schedule,1268.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60210,Not in chargemaster,60210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60210,BCBS multispecialty AW base fee schedule,1351.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60212,Not in chargemaster,60212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60212,BCBS multispecialty AW base fee schedule,1977.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60220,Not in chargemaster,60220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60220,BCBS multispecialty AW base fee schedule,1347.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60225,Not in chargemaster,60225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60225,BCBS multispecialty AW base fee schedule,1780.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60240,Not in chargemaster,60240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60240,BCBS multispecialty AW base fee schedule,1757.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60252,Not in chargemaster,60252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60252,BCBS multispecialty AW base fee schedule,2526.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60254,Not in chargemaster,60254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60254,BCBS multispecialty AW base fee schedule,3193.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60260,Not in chargemaster,60260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60260,BCBS multispecialty AW base fee schedule,2083.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60270,Not in chargemaster,60270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60270,BCBS multispecialty AW base fee schedule,2615.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60271,Not in chargemaster,60271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60271,BCBS multispecialty AW base fee schedule,2019.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60280,Not in chargemaster,60280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60280,BCBS multispecialty AW base fee schedule,844.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60281,Not in chargemaster,60281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60281,BCBS multispecialty AW base fee schedule,1116.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60300,Not in chargemaster,60300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60300,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60100,Not in chargemaster,60100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60100,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62264,Not in chargemaster,62264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62264,BCBS multispecialty AW base fee schedule,464.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62268,Not in chargemaster,62268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62268,BCBS multispecialty AW base fee schedule,492.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62269,Not in chargemaster,62269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62269,BCBS multispecialty AW base fee schedule,506.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62270,Not in chargemaster,62270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62270,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62267,Not in chargemaster,62267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62267,BCBS multispecialty AW base fee schedule,300.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62272,Not in chargemaster,62272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62272,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62273,Not in chargemaster,62273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62273,BCBS multispecialty AW base fee schedule,215.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62280,Not in chargemaster,62280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62280,BCBS multispecialty AW base fee schedule,324.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62281,Not in chargemaster,62281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62281,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62282,Not in chargemaster,62282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62282,BCBS multispecialty AW base fee schedule,273.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62284,Not in chargemaster,62284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62284,BCBS multispecialty AW base fee schedule,165.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62287,Not in chargemaster,62287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62287,BCBS multispecialty AW base fee schedule,1110.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62290,Not in chargemaster,62290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62290,BCBS multispecialty AW base fee schedule,317.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62292,Not in chargemaster,62292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62292,BCBS multispecialty AW base fee schedule,1105.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62294,Not in chargemaster,62294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62294,BCBS multispecialty AW base fee schedule,1813.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62302,Not in chargemaster,62302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62302,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62291,Not in chargemaster,62291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62291,BCBS multispecialty AW base fee schedule,302.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62303,Not in chargemaster,62303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62303,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63001,Not in chargemaster,63001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63001,BCBS multispecialty AW base fee schedule,2366.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63003,Not in chargemaster,63003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63003,BCBS multispecialty AW base fee schedule,2368.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63005,Not in chargemaster,63005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63005,BCBS multispecialty AW base fee schedule,2281.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63011,Not in chargemaster,63011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63011,BCBS multispecialty AW base fee schedule,2081.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63012,Not in chargemaster,63012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63012,BCBS multispecialty AW base fee schedule,2288.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63015,Not in chargemaster,63015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63015,BCBS multispecialty AW base fee schedule,2833.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63016,Not in chargemaster,63016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63016,BCBS multispecialty AW base fee schedule,2915.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63017,Not in chargemaster,63017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63017,BCBS multispecialty AW base fee schedule,2410.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63020,Not in chargemaster,63020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63020,BCBS multispecialty AW base fee schedule,2218.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63030,Not in chargemaster,63030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63030,BCBS multispecialty AW base fee schedule,1862.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63035,Not in chargemaster,63035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63035,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63040,Not in chargemaster,63040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63040,BCBS multispecialty AW base fee schedule,2669.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63042,Not in chargemaster,63042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63042,BCBS multispecialty AW base fee schedule,2487.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63045,Not in chargemaster,63045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63045,BCBS multispecialty AW base fee schedule,2463.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63046,Not in chargemaster,63046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63046,BCBS multispecialty AW base fee schedule,2351.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63047,Not in chargemaster,63047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63047,BCBS multispecialty AW base fee schedule,2113.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63048,Not in chargemaster,63048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63048,BCBS multispecialty AW base fee schedule,406.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63050,Not in chargemaster,63050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63050,BCBS multispecialty AW base fee schedule,2883.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63051,Not in chargemaster,63051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63051,BCBS multispecialty AW base fee schedule,3270.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63055,Not in chargemaster,63055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63055,BCBS multispecialty AW base fee schedule,3115.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63056,Not in chargemaster,63056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63056,BCBS multispecialty AW base fee schedule,2854.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63057,Not in chargemaster,63057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63057,BCBS multispecialty AW base fee schedule,614.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63064,Not in chargemaster,63064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63064,BCBS multispecialty AW base fee schedule,3413.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63066,Not in chargemaster,63066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63066,BCBS multispecialty AW base fee schedule,395.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63075,Not in chargemaster,63075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63075,BCBS multispecialty AW base fee schedule,2590.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63076,Not in chargemaster,63076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63076,BCBS multispecialty AW base fee schedule,473.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63077,Not in chargemaster,63077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63077,BCBS multispecialty AW base fee schedule,2889.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63078,Not in chargemaster,63078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63078,BCBS multispecialty AW base fee schedule,398.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63081,Not in chargemaster,63081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63081,BCBS multispecialty AW base fee schedule,3375.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63082,Not in chargemaster,63082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63082,BCBS multispecialty AW base fee schedule,511.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63085,Not in chargemaster,63085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63085,BCBS multispecialty AW base fee schedule,3692.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63086,Not in chargemaster,63086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63086,BCBS multispecialty AW base fee schedule,366.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63087,Not in chargemaster,63087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63087,BCBS multispecialty AW base fee schedule,4624.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63088,Not in chargemaster,63088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63088,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63090,Not in chargemaster,63090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63090,BCBS multispecialty AW base fee schedule,3768.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63091,Not in chargemaster,63091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63091,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63101,Not in chargemaster,63101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63101,BCBS multispecialty AW base fee schedule,4456.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63102,Not in chargemaster,63102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63102,BCBS multispecialty AW base fee schedule,4341.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63103,Not in chargemaster,63103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63103,BCBS multispecialty AW base fee schedule,565.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63170,Not in chargemaster,63170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63170,BCBS multispecialty AW base fee schedule,3044.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63172,Not in chargemaster,63172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63172,BCBS multispecialty AW base fee schedule,2650.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63173,Not in chargemaster,63173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63173,BCBS multispecialty AW base fee schedule,3298.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63180,Not in chargemaster,63180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63180,BCBS multispecialty AW base fee schedule,2839.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63182,Not in chargemaster,63182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63182,BCBS multispecialty AW base fee schedule,3117.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63185,Not in chargemaster,63185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63185,BCBS multispecialty AW base fee schedule,2196.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63190,Not in chargemaster,63190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63190,BCBS multispecialty AW base fee schedule,2386.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63191,Not in chargemaster,63191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63191,BCBS multispecialty AW base fee schedule,2634.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63194,Not in chargemaster,63194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63194,BCBS multispecialty AW base fee schedule,3051.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63195,Not in chargemaster,63195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63195,BCBS multispecialty AW base fee schedule,2932.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63196,Not in chargemaster,63196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63196,BCBS multispecialty AW base fee schedule,3404.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63197,Not in chargemaster,63197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63197,BCBS multispecialty AW base fee schedule,3270.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63198,Not in chargemaster,63198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63198,BCBS multispecialty AW base fee schedule,3998.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63199,Not in chargemaster,63199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63199,BCBS multispecialty AW base fee schedule,4190.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63200,Not in chargemaster,63200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63200,BCBS multispecialty AW base fee schedule,2927.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63250,Not in chargemaster,63250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63250,BCBS multispecialty AW base fee schedule,5696.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63251,Not in chargemaster,63251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63251,BCBS multispecialty AW base fee schedule,5822.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63252,Not in chargemaster,63252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63252,BCBS multispecialty AW base fee schedule,5821.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63265,Not in chargemaster,63265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63265,BCBS multispecialty AW base fee schedule,3198.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63266,Not in chargemaster,63266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63266,BCBS multispecialty AW base fee schedule,3295.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63267,Not in chargemaster,63267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63267,BCBS multispecialty AW base fee schedule,2628.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63268,Not in chargemaster,63268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63268,BCBS multispecialty AW base fee schedule,2711.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63270,Not in chargemaster,63270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63270,BCBS multispecialty AW base fee schedule,3975.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63271,Not in chargemaster,63271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63271,BCBS multispecialty AW base fee schedule,3964.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63272,Not in chargemaster,63272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63272,BCBS multispecialty AW base fee schedule,3616.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63273,Not in chargemaster,63273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63273,BCBS multispecialty AW base fee schedule,3569.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63275,Not in chargemaster,63275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63275,BCBS multispecialty AW base fee schedule,3454.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63276,Not in chargemaster,63276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63276,BCBS multispecialty AW base fee schedule,3427.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63277,Not in chargemaster,63277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63277,BCBS multispecialty AW base fee schedule,2987.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63278,Not in chargemaster,63278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63278,BCBS multispecialty AW base fee schedule,3041.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63280,Not in chargemaster,63280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63280,BCBS multispecialty AW base fee schedule,4056.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63281,Not in chargemaster,63281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63281,BCBS multispecialty AW base fee schedule,4009.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63282,Not in chargemaster,63282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63282,BCBS multispecialty AW base fee schedule,3781.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63283,Not in chargemaster,63283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63283,BCBS multispecialty AW base fee schedule,3635.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63285,Not in chargemaster,63285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63285,BCBS multispecialty AW base fee schedule,5011.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63286,Not in chargemaster,63286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63286,BCBS multispecialty AW base fee schedule,4952.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63287,Not in chargemaster,63287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63287,BCBS multispecialty AW base fee schedule,5260.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63290,Not in chargemaster,63290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63290,BCBS multispecialty AW base fee schedule,5351.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63295,Not in chargemaster,63295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63295,BCBS multispecialty AW base fee schedule,632.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63300,Not in chargemaster,63300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63300,BCBS multispecialty AW base fee schedule,3521.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63301,Not in chargemaster,63301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63301,BCBS multispecialty AW base fee schedule,4220.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63302,Not in chargemaster,63302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63302,BCBS multispecialty AW base fee schedule,4169.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63303,Not in chargemaster,63303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63303,BCBS multispecialty AW base fee schedule,4432.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63304,Not in chargemaster,63304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63304,BCBS multispecialty AW base fee schedule,4497.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63305,Not in chargemaster,63305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63305,BCBS multispecialty AW base fee schedule,4789.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63306,Not in chargemaster,63306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63306,BCBS multispecialty AW base fee schedule,4707.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63307,Not in chargemaster,63307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63307,BCBS multispecialty AW base fee schedule,4609.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63308,Not in chargemaster,63308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63308,BCBS multispecialty AW base fee schedule,620.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63600,Not in chargemaster,63600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63600,BCBS multispecialty AW base fee schedule,2085.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63610,Not in chargemaster,63610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63610,BCBS multispecialty AW base fee schedule,1109.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63620,Not in chargemaster,63620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63620,BCBS multispecialty AW base fee schedule,2139.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63621,Not in chargemaster,63621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63621,BCBS multispecialty AW base fee schedule,483.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63650,Not in chargemaster,63650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63650,BCBS multispecialty AW base fee schedule,790.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62304,Not in chargemaster,62304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62304,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62305,Not in chargemaster,62305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62305,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62320,Not in chargemaster,62320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62320,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62321,Not in chargemaster,62321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62321,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62322,Not in chargemaster,62322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62322,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62323,Not in chargemaster,62323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62323,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62324,Not in chargemaster,62324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62324,BCBS multispecialty AW base fee schedule,170.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62325,Not in chargemaster,62325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62325,BCBS multispecialty AW base fee schedule,207.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62326,Not in chargemaster,62326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62326,BCBS multispecialty AW base fee schedule,166.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62327,Not in chargemaster,62327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62327,BCBS multispecialty AW base fee schedule,191.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62328,Not in chargemaster,62328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62328,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62329,Not in chargemaster,62329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62329,BCBS multispecialty AW base fee schedule,215.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62350,Not in chargemaster,62350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62350,BCBS multispecialty AW base fee schedule,758.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62351,Not in chargemaster,62351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62351,BCBS multispecialty AW base fee schedule,1664.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62355,Not in chargemaster,62355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62355,BCBS multispecialty AW base fee schedule,516.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62360,Not in chargemaster,62360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62360,BCBS multispecialty AW base fee schedule,598.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62361,Not in chargemaster,62361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62361,BCBS multispecialty AW base fee schedule,816.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62362,Not in chargemaster,62362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62362,BCBS multispecialty AW base fee schedule,730.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62365,Not in chargemaster,62365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62365,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62367,Not in chargemaster,62367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62367,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63664,Not in chargemaster,63664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63664,BCBS multispecialty AW base fee schedule,1675.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63685,Not in chargemaster,63685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63685,BCBS multispecialty AW base fee schedule,687.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63688,Not in chargemaster,63688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63688,BCBS multispecialty AW base fee schedule,708.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63700,Not in chargemaster,63700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63700,BCBS multispecialty AW base fee schedule,2492.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63702,Not in chargemaster,63702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63702,BCBS multispecialty AW base fee schedule,2726.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63704,Not in chargemaster,63704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63704,BCBS multispecialty AW base fee schedule,3164.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63706,Not in chargemaster,63706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63706,BCBS multispecialty AW base fee schedule,3521.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63707,Not in chargemaster,63707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63707,BCBS multispecialty AW base fee schedule,1776.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63709,Not in chargemaster,63709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63709,BCBS multispecialty AW base fee schedule,2122.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63710,Not in chargemaster,63710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63710,BCBS multispecialty AW base fee schedule,2080.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63740,Not in chargemaster,63740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63740,BCBS multispecialty AW base fee schedule,1865.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63741,Not in chargemaster,63741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63741,BCBS multispecialty AW base fee schedule,1291.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63744,Not in chargemaster,63744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63744,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63746,Not in chargemaster,63746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63746,BCBS multispecialty AW base fee schedule,1152.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64400,Not in chargemaster,64400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64400,BCBS multispecialty AW base fee schedule,95.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62368,Not in chargemaster,62368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62368,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62369,Not in chargemaster,62369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62369,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62370,Not in chargemaster,62370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62370,BCBS multispecialty AW base fee schedule,88.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63655,Not in chargemaster,63655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63655,BCBS multispecialty AW base fee schedule,1590.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63661,Not in chargemaster,63661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63661,BCBS multispecialty AW base fee schedule,618.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63662,Not in chargemaster,63662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63662,BCBS multispecialty AW base fee schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63663,Not in chargemaster,63663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63663,BCBS multispecialty AW base fee schedule,861.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64405,Not in chargemaster,64405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64405,BCBS multispecialty AW base fee schedule,102.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64408,Not in chargemaster,64408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64408,BCBS multispecialty AW base fee schedule,82.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64415,Not in chargemaster,64415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64415,BCBS multispecialty AW base fee schedule,121.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64416,Not in chargemaster,64416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64416,BCBS multispecialty AW base fee schedule,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64417,Not in chargemaster,64417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64417,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64418,Not in chargemaster,64418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64418,BCBS multispecialty AW base fee schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64420,Not in chargemaster,64420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64420,BCBS multispecialty AW base fee schedule,113.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64421,Not in chargemaster,64421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64421,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64425,Not in chargemaster,64425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64425,BCBS multispecialty AW base fee schedule,106,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64430,Not in chargemaster,64430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64430,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64435,Not in chargemaster,64435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64435,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64445,Not in chargemaster,64445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64445,BCBS multispecialty AW base fee schedule,102.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64448,Not in chargemaster,64448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64448,BCBS multispecialty AW base fee schedule,117.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64449,Not in chargemaster,64449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64449,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64450,64450,64450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64450,BCBS multispecialty AW base fee schedule,81.49,110,Fee schedule,,81.49,81.49,81.49,81.49,,,0
unity,Fee schedule,Facility 64446,Not in chargemaster,64446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64446,BCBS multispecialty AW base fee schedule,113.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64447,Not in chargemaster,64447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64447,BCBS multispecialty AW base fee schedule,101.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64451,Not in chargemaster,64451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64451,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64454,Not in chargemaster,64454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64454,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64455,Not in chargemaster,64455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64455,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64461,Not in chargemaster,64461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64461,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64462,Not in chargemaster,64462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64462,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64463,Not in chargemaster,64463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64463,BCBS multispecialty AW base fee schedule,158.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64479,Not in chargemaster,64479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64479,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64480,Not in chargemaster,64480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64480,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64483,Not in chargemaster,64483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64483,BCBS multispecialty AW base fee schedule,212.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64484,Not in chargemaster,64484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64484,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64486,Not in chargemaster,64486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64486,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64487,Not in chargemaster,64487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64487,BCBS multispecialty AW base fee schedule,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64488,Not in chargemaster,64488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64488,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64489,Not in chargemaster,64489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64489,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64490,Not in chargemaster,64490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64490,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64491,Not in chargemaster,64491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64491,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64492,Not in chargemaster,64492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64492,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64493,Not in chargemaster,64493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64493,BCBS multispecialty AW base fee schedule,170.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64494,Not in chargemaster,64494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64494,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64495,Not in chargemaster,64495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64495,BCBS multispecialty AW base fee schedule,100.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64505,Not in chargemaster,64505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64505,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64510,Not in chargemaster,64510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64510,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64517,Not in chargemaster,64517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64517,BCBS multispecialty AW base fee schedule,238.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64520,Not in chargemaster,64520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64520,BCBS multispecialty AW base fee schedule,157.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64530,Not in chargemaster,64530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64530,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64553,Not in chargemaster,64553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64553,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64555,Not in chargemaster,64555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64555,BCBS multispecialty AW base fee schedule,653.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64561,Not in chargemaster,64561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64561,BCBS multispecialty AW base fee schedule,581.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64566,Not in chargemaster,64566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64566,BCBS multispecialty AW base fee schedule,59.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64568,Not in chargemaster,64568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64568,BCBS multispecialty AW base fee schedule,1196.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64569,Not in chargemaster,64569,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64569,BCBS multispecialty AW base fee schedule,1450.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64570,Not in chargemaster,64570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64570,BCBS multispecialty AW base fee schedule,1396.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64575,Not in chargemaster,64575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64575,BCBS multispecialty AW base fee schedule,649.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64580,Not in chargemaster,64580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64580,BCBS multispecialty AW base fee schedule,594.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64581,Not in chargemaster,64581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64581,BCBS multispecialty AW base fee schedule,1270.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64585,Not in chargemaster,64585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64585,BCBS multispecialty AW base fee schedule,274.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64590,Not in chargemaster,64590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64590,BCBS multispecialty AW base fee schedule,306.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64595,Not in chargemaster,64595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64595,BCBS multispecialty AW base fee schedule,241.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64600,Not in chargemaster,64600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64600,BCBS multispecialty AW base fee schedule,436.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64605,Not in chargemaster,64605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64605,BCBS multispecialty AW base fee schedule,675.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64610,Not in chargemaster,64610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64610,BCBS multispecialty AW base fee schedule,926.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64611,Not in chargemaster,64611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64611,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64612,Not in chargemaster,64612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64612,BCBS multispecialty AW base fee schedule,221.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64615,Not in chargemaster,64615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64615,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64616,Not in chargemaster,64616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64616,BCBS multispecialty AW base fee schedule,208.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64617,Not in chargemaster,64617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64617,BCBS multispecialty AW base fee schedule,207.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64620,Not in chargemaster,64620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64620,BCBS multispecialty AW base fee schedule,333.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64624,Not in chargemaster,64624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64624,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64625,Not in chargemaster,64625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64625,BCBS multispecialty AW base fee schedule,370.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64630,Not in chargemaster,64630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64630,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64632,Not in chargemaster,64632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64632,BCBS multispecialty AW base fee schedule,128.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64633,Not in chargemaster,64633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64633,BCBS multispecialty AW base fee schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64634,Not in chargemaster,64634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64634,BCBS multispecialty AW base fee schedule,129.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64635,Not in chargemaster,64635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64635,BCBS multispecialty AW base fee schedule,422.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64636,Not in chargemaster,64636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64636,BCBS multispecialty AW base fee schedule,113.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64640,Not in chargemaster,64640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64640,BCBS multispecialty AW base fee schedule,223.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64722,Not in chargemaster,64722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64722,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64726,Not in chargemaster,64726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64726,BCBS multispecialty AW base fee schedule,512.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64727,Not in chargemaster,64727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64727,BCBS multispecialty AW base fee schedule,349.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64732,Not in chargemaster,64732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64732,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64734,Not in chargemaster,64734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64734,BCBS multispecialty AW base fee schedule,954.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64736,Not in chargemaster,64736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64736,BCBS multispecialty AW base fee schedule,663.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64738,Not in chargemaster,64738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64738,BCBS multispecialty AW base fee schedule,861.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64740,Not in chargemaster,64740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64740,BCBS multispecialty AW base fee schedule,894.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64742,Not in chargemaster,64742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64742,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64744,Not in chargemaster,64744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64744,BCBS multispecialty AW base fee schedule,946.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64746,Not in chargemaster,64746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64746,BCBS multispecialty AW base fee schedule,824.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64755,Not in chargemaster,64755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64755,BCBS multispecialty AW base fee schedule,1776.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64760,Not in chargemaster,64760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64760,BCBS multispecialty AW base fee schedule,995.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64763,Not in chargemaster,64763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64763,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64766,Not in chargemaster,64766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64766,BCBS multispecialty AW base fee schedule,1215.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64771,Not in chargemaster,64771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64771,BCBS multispecialty AW base fee schedule,1160.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64772,Not in chargemaster,64772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64772,BCBS multispecialty AW base fee schedule,1077.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64774,Not in chargemaster,64774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64774,BCBS multispecialty AW base fee schedule,782.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64776,Not in chargemaster,64776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64776,BCBS multispecialty AW base fee schedule,743.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64778,Not in chargemaster,64778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64778,BCBS multispecialty AW base fee schedule,350.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64782,Not in chargemaster,64782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64782,BCBS multispecialty AW base fee schedule,869.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64783,Not in chargemaster,64783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64783,BCBS multispecialty AW base fee schedule,418.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64784,Not in chargemaster,64784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64784,BCBS multispecialty AW base fee schedule,1395.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64786,Not in chargemaster,64786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64786,BCBS multispecialty AW base fee schedule,1935.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64787,Not in chargemaster,64787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64787,BCBS multispecialty AW base fee schedule,461.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64788,Not in chargemaster,64788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64788,BCBS multispecialty AW base fee schedule,768.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64790,Not in chargemaster,64790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64790,BCBS multispecialty AW base fee schedule,1598.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64792,Not in chargemaster,64792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64792,BCBS multispecialty AW base fee schedule,2023.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64795,Not in chargemaster,64795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64795,BCBS multispecialty AW base fee schedule,369.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64802,Not in chargemaster,64802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64802,BCBS multispecialty AW base fee schedule,1592.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64804,Not in chargemaster,64804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64804,BCBS multispecialty AW base fee schedule,2263.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64809,Not in chargemaster,64809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64809,BCBS multispecialty AW base fee schedule,2074.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64818,Not in chargemaster,64818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64818,BCBS multispecialty AW base fee schedule,1493.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64820,Not in chargemaster,64820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64820,BCBS multispecialty AW base fee schedule,1393.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64821,Not in chargemaster,64821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64821,BCBS multispecialty AW base fee schedule,1328.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64822,Not in chargemaster,64822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64822,BCBS multispecialty AW base fee schedule,1328.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64823,Not in chargemaster,64823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64823,BCBS multispecialty AW base fee schedule,1509.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64831,Not in chargemaster,64831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64831,BCBS multispecialty AW base fee schedule,1315.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64832,Not in chargemaster,64832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64832,BCBS multispecialty AW base fee schedule,644.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64834,Not in chargemaster,64834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64834,BCBS multispecialty AW base fee schedule,1416.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64835,Not in chargemaster,64835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64835,BCBS multispecialty AW base fee schedule,1562.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64836,Not in chargemaster,64836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64836,BCBS multispecialty AW base fee schedule,1562.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64837,Not in chargemaster,64837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64837,BCBS multispecialty AW base fee schedule,704.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64840,Not in chargemaster,64840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64840,BCBS multispecialty AW base fee schedule,1841.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64856,Not in chargemaster,64856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64856,BCBS multispecialty AW base fee schedule,1936.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64857,Not in chargemaster,64857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64857,BCBS multispecialty AW base fee schedule,2016.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64858,Not in chargemaster,64858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64858,BCBS multispecialty AW base fee schedule,2254.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64859,Not in chargemaster,64859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64859,BCBS multispecialty AW base fee schedule,478.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64861,Not in chargemaster,64861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64861,BCBS multispecialty AW base fee schedule,2897.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64862,Not in chargemaster,64862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64862,BCBS multispecialty AW base fee schedule,2636.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64864,Not in chargemaster,64864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64864,BCBS multispecialty AW base fee schedule,1644.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64865,Not in chargemaster,64865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64865,BCBS multispecialty AW base fee schedule,2072.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64866,Not in chargemaster,64866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64866,BCBS multispecialty AW base fee schedule,2433.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64868,Not in chargemaster,64868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64868,BCBS multispecialty AW base fee schedule,1898.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64872,Not in chargemaster,64872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64872,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64874,Not in chargemaster,64874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64874,BCBS multispecialty AW base fee schedule,334.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64876,Not in chargemaster,64876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64876,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64885,Not in chargemaster,64885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64885,BCBS multispecialty AW base fee schedule,2110.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64886,Not in chargemaster,64886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64886,BCBS multispecialty AW base fee schedule,2434.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64890,Not in chargemaster,64890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64890,BCBS multispecialty AW base fee schedule,2069.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64891,Not in chargemaster,64891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64891,BCBS multispecialty AW base fee schedule,2201.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64892,Not in chargemaster,64892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64892,BCBS multispecialty AW base fee schedule,2012.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64893,Not in chargemaster,64893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64893,BCBS multispecialty AW base fee schedule,2147.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64895,Not in chargemaster,64895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64895,BCBS multispecialty AW base fee schedule,2544,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64896,Not in chargemaster,64896,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64896,BCBS multispecialty AW base fee schedule,2743.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64897,Not in chargemaster,64897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64897,BCBS multispecialty AW base fee schedule,2430.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64898,Not in chargemaster,64898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64898,BCBS multispecialty AW base fee schedule,2631.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64901,Not in chargemaster,64901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64901,BCBS multispecialty AW base fee schedule,1147.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64902,Not in chargemaster,64902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64902,BCBS multispecialty AW base fee schedule,1330.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64905,Not in chargemaster,64905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64905,BCBS multispecialty AW base fee schedule,1955.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64907,Not in chargemaster,64907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64907,BCBS multispecialty AW base fee schedule,2496.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64910,Not in chargemaster,64910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64910,BCBS multispecialty AW base fee schedule,1505.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64911,Not in chargemaster,64911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64911,BCBS multispecialty AW base fee schedule,1959.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64912,Not in chargemaster,64912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64912,BCBS multispecialty AW base fee schedule,1745.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64913,Not in chargemaster,64913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64913,BCBS multispecialty AW base fee schedule,341.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65091,Not in chargemaster,65091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65091,BCBS multispecialty AW base fee schedule,1293.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65093,Not in chargemaster,65093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65093,BCBS multispecialty AW base fee schedule,1280.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65101,Not in chargemaster,65101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65101,BCBS multispecialty AW base fee schedule,1489.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65103,Not in chargemaster,65103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65103,BCBS multispecialty AW base fee schedule,1544.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65105,Not in chargemaster,65105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65105,BCBS multispecialty AW base fee schedule,1693.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65110,Not in chargemaster,65110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65110,BCBS multispecialty AW base fee schedule,2386.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65112,Not in chargemaster,65112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65112,BCBS multispecialty AW base fee schedule,2752.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65114,Not in chargemaster,65114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65114,BCBS multispecialty AW base fee schedule,2879.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65125,Not in chargemaster,65125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65125,BCBS multispecialty AW base fee schedule,547.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64642,Not in chargemaster,64642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64642,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64643,Not in chargemaster,64643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64643,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64644,Not in chargemaster,64644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64644,BCBS multispecialty AW base fee schedule,223.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64645,Not in chargemaster,64645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64645,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64646,Not in chargemaster,64646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64646,BCBS multispecialty AW base fee schedule,219.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64647,Not in chargemaster,64647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64647,BCBS multispecialty AW base fee schedule,257.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64650,Not in chargemaster,64650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64650,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64653,Not in chargemaster,64653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64653,BCBS multispecialty AW base fee schedule,101.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64702,Not in chargemaster,64702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64702,BCBS multispecialty AW base fee schedule,959.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64704,Not in chargemaster,64704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64704,BCBS multispecialty AW base fee schedule,613.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64708,Not in chargemaster,64708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64708,BCBS multispecialty AW base fee schedule,961.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64712,Not in chargemaster,64712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64712,BCBS multispecialty AW base fee schedule,1122.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64713,Not in chargemaster,64713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64713,BCBS multispecialty AW base fee schedule,1495.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64714,Not in chargemaster,64714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64714,BCBS multispecialty AW base fee schedule,1399.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64716,Not in chargemaster,64716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64716,BCBS multispecialty AW base fee schedule,981.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64718,Not in chargemaster,64718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64718,BCBS multispecialty AW base fee schedule,1135.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64719,Not in chargemaster,64719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64719,BCBS multispecialty AW base fee schedule,767.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64721,Not in chargemaster,64721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64721,BCBS multispecialty AW base fee schedule,819.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65130,Not in chargemaster,65130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65130,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65135,Not in chargemaster,65135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65135,BCBS multispecialty AW base fee schedule,1501.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65140,Not in chargemaster,65140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65140,BCBS multispecialty AW base fee schedule,1622.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65150,Not in chargemaster,65150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65150,BCBS multispecialty AW base fee schedule,1195.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65155,Not in chargemaster,65155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65155,BCBS multispecialty AW base fee schedule,1696,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65175,Not in chargemaster,65175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65175,BCBS multispecialty AW base fee schedule,1342.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65205,65205,65205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65205,BCBS multispecialty AW base fee schedule,54.99,120.68,Fee schedule,,54.99,54.99,54.99,54.99,,,0
unity,Fee schedule,Facility 64680,Not in chargemaster,64680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64680,BCBS multispecialty AW base fee schedule,308.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64681,Not in chargemaster,64681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64681,BCBS multispecialty AW base fee schedule,496.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65210,65210,65210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65210,BCBS multispecialty AW base fee schedule,68.9,149.08,Fee schedule,,68.9,68.9,68.9,68.9,,,0
unity,Fee schedule,Facility 65220,65220,65220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65220,BCBS multispecialty AW base fee schedule,78.84,124.23,Fee schedule,,78.84,78.84,78.84,78.84,,,0
unity,Fee schedule,Facility 65235,Not in chargemaster,65235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65235,BCBS multispecialty AW base fee schedule,1347.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65260,Not in chargemaster,65260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65260,BCBS multispecialty AW base fee schedule,1823.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65265,Not in chargemaster,65265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65265,BCBS multispecialty AW base fee schedule,2047.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65270,Not in chargemaster,65270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65270,BCBS multispecialty AW base fee schedule,264.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65222,Not in chargemaster,65222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65222,BCBS multispecialty AW base fee schedule,96.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65272,Not in chargemaster,65272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65272,BCBS multispecialty AW base fee schedule,662.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65280,Not in chargemaster,65280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65280,BCBS multispecialty AW base fee schedule,1258.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65285,Not in chargemaster,65285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65285,BCBS multispecialty AW base fee schedule,2081.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65286,Not in chargemaster,65286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65286,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65273,Not in chargemaster,65273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65273,BCBS multispecialty AW base fee schedule,715.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65275,Not in chargemaster,65275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65275,BCBS multispecialty AW base fee schedule,868.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65290,Not in chargemaster,65290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65290,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65400,Not in chargemaster,65400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65400,BCBS multispecialty AW base fee schedule,1128.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65410,Not in chargemaster,65410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65410,BCBS multispecialty AW base fee schedule,193.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65420,Not in chargemaster,65420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65420,BCBS multispecialty AW base fee schedule,706.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65426,Not in chargemaster,65426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65426,BCBS multispecialty AW base fee schedule,896.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65430,Not in chargemaster,65430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65430,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65435,Not in chargemaster,65435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65435,BCBS multispecialty AW base fee schedule,131.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65436,Not in chargemaster,65436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65436,BCBS multispecialty AW base fee schedule,692.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65450,Not in chargemaster,65450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65450,BCBS multispecialty AW base fee schedule,600.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65600,Not in chargemaster,65600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65600,BCBS multispecialty AW base fee schedule,636.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65710,Not in chargemaster,65710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65710,BCBS multispecialty AW base fee schedule,2110.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65730,Not in chargemaster,65730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65730,BCBS multispecialty AW base fee schedule,2333.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65750,Not in chargemaster,65750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65750,BCBS multispecialty AW base fee schedule,2346.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65755,Not in chargemaster,65755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65755,BCBS multispecialty AW base fee schedule,2335.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65756,Not in chargemaster,65756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65756,BCBS multispecialty AW base fee schedule,2215.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65770,Not in chargemaster,65770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65770,BCBS multispecialty AW base fee schedule,2620.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65772,Not in chargemaster,65772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65772,BCBS multispecialty AW base fee schedule,758.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65775,Not in chargemaster,65775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65775,BCBS multispecialty AW base fee schedule,1055.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65778,Not in chargemaster,65778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65778,BCBS multispecialty AW base fee schedule,102.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65779,Not in chargemaster,65779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65779,BCBS multispecialty AW base fee schedule,282.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65780,Not in chargemaster,65780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65780,BCBS multispecialty AW base fee schedule,1248.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65781,Not in chargemaster,65781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65781,BCBS multispecialty AW base fee schedule,2495.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65782,Not in chargemaster,65782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65782,BCBS multispecialty AW base fee schedule,2154.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65785,Not in chargemaster,65785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65785,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65800,Not in chargemaster,65800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65800,BCBS multispecialty AW base fee schedule,170.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65810,Not in chargemaster,65810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65810,BCBS multispecialty AW base fee schedule,870.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65815,Not in chargemaster,65815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65815,BCBS multispecialty AW base fee schedule,893.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65820,Not in chargemaster,65820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65820,BCBS multispecialty AW base fee schedule,1471.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65850,Not in chargemaster,65850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65850,BCBS multispecialty AW base fee schedule,1580.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65855,Not in chargemaster,65855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65855,BCBS multispecialty AW base fee schedule,388.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65865,Not in chargemaster,65865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65865,BCBS multispecialty AW base fee schedule,891.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65870,Not in chargemaster,65870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65870,BCBS multispecialty AW base fee schedule,1111.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65875,Not in chargemaster,65875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65875,BCBS multispecialty AW base fee schedule,1183.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65880,Not in chargemaster,65880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65880,BCBS multispecialty AW base fee schedule,1246.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65900,Not in chargemaster,65900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65900,BCBS multispecialty AW base fee schedule,1838.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65920,Not in chargemaster,65920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65920,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65930,Not in chargemaster,65930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65930,BCBS multispecialty AW base fee schedule,1199.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66020,Not in chargemaster,66020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66020,BCBS multispecialty AW base fee schedule,245.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66150,Not in chargemaster,66150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66150,BCBS multispecialty AW base fee schedule,1644.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66155,Not in chargemaster,66155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66155,BCBS multispecialty AW base fee schedule,1643,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66160,Not in chargemaster,66160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66160,BCBS multispecialty AW base fee schedule,1850.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66170,Not in chargemaster,66170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66170,BCBS multispecialty AW base fee schedule,2049.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66172,Not in chargemaster,66172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66172,BCBS multispecialty AW base fee schedule,2232.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66174,Not in chargemaster,66174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66174,BCBS multispecialty AW base fee schedule,1773.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66175,Not in chargemaster,66175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66175,BCBS multispecialty AW base fee schedule,1857.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66179,Not in chargemaster,66179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66179,BCBS multispecialty AW base fee schedule,2022.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66180,Not in chargemaster,66180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66180,BCBS multispecialty AW base fee schedule,2135.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66183,Not in chargemaster,66183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66183,BCBS multispecialty AW base fee schedule,1929.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66184,Not in chargemaster,66184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66184,BCBS multispecialty AW base fee schedule,1474.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66185,Not in chargemaster,66185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66185,BCBS multispecialty AW base fee schedule,1587.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66225,Not in chargemaster,66225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66225,BCBS multispecialty AW base fee schedule,1749,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66250,Not in chargemaster,66250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66250,BCBS multispecialty AW base fee schedule,1042.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66500,Not in chargemaster,66500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66500,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66505,Not in chargemaster,66505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66505,BCBS multispecialty AW base fee schedule,763.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66600,Not in chargemaster,66600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66600,BCBS multispecialty AW base fee schedule,1630.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66605,Not in chargemaster,66605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66605,BCBS multispecialty AW base fee schedule,2023.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66625,Not in chargemaster,66625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66625,BCBS multispecialty AW base fee schedule,803.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66630,Not in chargemaster,66630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66630,BCBS multispecialty AW base fee schedule,1063.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66635,Not in chargemaster,66635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66635,BCBS multispecialty AW base fee schedule,1073.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66680,Not in chargemaster,66680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66680,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66682,Not in chargemaster,66682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66682,BCBS multispecialty AW base fee schedule,1264.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66700,Not in chargemaster,66700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66700,BCBS multispecialty AW base fee schedule,734.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65860,Not in chargemaster,65860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65860,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66030,Not in chargemaster,66030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66030,BCBS multispecialty AW base fee schedule,206.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66130,Not in chargemaster,66130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66130,BCBS multispecialty AW base fee schedule,1061.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66710,Not in chargemaster,66710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66710,BCBS multispecialty AW base fee schedule,734.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66825,Not in chargemaster,66825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66825,BCBS multispecialty AW base fee schedule,1489.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66830,Not in chargemaster,66830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66830,BCBS multispecialty AW base fee schedule,1330.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66840,Not in chargemaster,66840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66840,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66850,Not in chargemaster,66850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66850,BCBS multispecialty AW base fee schedule,1482.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66852,Not in chargemaster,66852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66852,BCBS multispecialty AW base fee schedule,1579.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66920,Not in chargemaster,66920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66920,BCBS multispecialty AW base fee schedule,1409.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66930,Not in chargemaster,66930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66930,BCBS multispecialty AW base fee schedule,1606.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66940,Not in chargemaster,66940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66940,BCBS multispecialty AW base fee schedule,1468.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66982,Not in chargemaster,66982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66982,BCBS multispecialty AW base fee schedule,1404.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66984,Not in chargemaster,66984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66984,BCBS multispecialty AW base fee schedule,1023.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66985,Not in chargemaster,66985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66985,BCBS multispecialty AW base fee schedule,1438.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66986,Not in chargemaster,66986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66986,BCBS multispecialty AW base fee schedule,1698.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66990,Not in chargemaster,66990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66990,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67005,Not in chargemaster,67005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67005,BCBS multispecialty AW base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67010,Not in chargemaster,67010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67010,BCBS multispecialty AW base fee schedule,1014.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67015,Not in chargemaster,67015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67015,BCBS multispecialty AW base fee schedule,1109.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67025,Not in chargemaster,67025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67025,BCBS multispecialty AW base fee schedule,1183.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66711,Not in chargemaster,66711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66711,BCBS multispecialty AW base fee schedule,942.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66720,Not in chargemaster,66720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66720,BCBS multispecialty AW base fee schedule,763.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66740,Not in chargemaster,66740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66740,BCBS multispecialty AW base fee schedule,734.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66761,Not in chargemaster,66761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66761,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66762,Not in chargemaster,66762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66762,BCBS multispecialty AW base fee schedule,795.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66770,Not in chargemaster,66770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66770,BCBS multispecialty AW base fee schedule,902.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66820,Not in chargemaster,66820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66820,BCBS multispecialty AW base fee schedule,806.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66821,Not in chargemaster,66821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66821,BCBS multispecialty AW base fee schedule,583.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67027,Not in chargemaster,67027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67027,BCBS multispecialty AW base fee schedule,1594.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67028,Not in chargemaster,67028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67028,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67030,Not in chargemaster,67030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67030,BCBS multispecialty AW base fee schedule,1018.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67031,Not in chargemaster,67031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67031,BCBS multispecialty AW base fee schedule,666.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67036,Not in chargemaster,67036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67036,BCBS multispecialty AW base fee schedule,1685.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67039,Not in chargemaster,67039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67039,BCBS multispecialty AW base fee schedule,1804.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67040,Not in chargemaster,67040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67040,BCBS multispecialty AW base fee schedule,1950.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67041,Not in chargemaster,67041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67041,BCBS multispecialty AW base fee schedule,2155.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67042,Not in chargemaster,67042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67042,BCBS multispecialty AW base fee schedule,2155.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67043,Not in chargemaster,67043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67043,BCBS multispecialty AW base fee schedule,2274.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67101,Not in chargemaster,67101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67101,BCBS multispecialty AW base fee schedule,533.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67107,Not in chargemaster,67107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67107,BCBS multispecialty AW base fee schedule,2118.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67108,Not in chargemaster,67108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67108,BCBS multispecialty AW base fee schedule,2243.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67110,Not in chargemaster,67110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67110,BCBS multispecialty AW base fee schedule,1523.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67113,Not in chargemaster,67113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67113,BCBS multispecialty AW base fee schedule,2507.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67115,Not in chargemaster,67115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67115,BCBS multispecialty AW base fee schedule,934.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67120,Not in chargemaster,67120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67120,BCBS multispecialty AW base fee schedule,1040.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67105,Not in chargemaster,67105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67105,BCBS multispecialty AW base fee schedule,514.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67121,Not in chargemaster,67121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67121,BCBS multispecialty AW base fee schedule,1697.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67141,Not in chargemaster,67141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67141,BCBS multispecialty AW base fee schedule,910.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67145,Not in chargemaster,67145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67145,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67208,Not in chargemaster,67208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67208,BCBS multispecialty AW base fee schedule,1080.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67210,Not in chargemaster,67210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67210,BCBS multispecialty AW base fee schedule,935.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67218,Not in chargemaster,67218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67218,BCBS multispecialty AW base fee schedule,2610.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67220,Not in chargemaster,67220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67220,BCBS multispecialty AW base fee schedule,935.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67221,Not in chargemaster,67221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67221,BCBS multispecialty AW base fee schedule,398.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67225,Not in chargemaster,67225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67225,BCBS multispecialty AW base fee schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67229,Not in chargemaster,67229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67229,BCBS multispecialty AW base fee schedule,2182.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67250,Not in chargemaster,67250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67250,BCBS multispecialty AW base fee schedule,1578.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67255,Not in chargemaster,67255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67255,BCBS multispecialty AW base fee schedule,1281.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67311,Not in chargemaster,67311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67311,BCBS multispecialty AW base fee schedule,1118.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67312,Not in chargemaster,67312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67312,BCBS multispecialty AW base fee schedule,1344.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67314,Not in chargemaster,67314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67314,BCBS multispecialty AW base fee schedule,1270.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67316,Not in chargemaster,67316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67316,BCBS multispecialty AW base fee schedule,1507.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67318,Not in chargemaster,67318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67318,BCBS multispecialty AW base fee schedule,1326.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67320,Not in chargemaster,67320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67320,BCBS multispecialty AW base fee schedule,602.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67331,Not in chargemaster,67331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67331,BCBS multispecialty AW base fee schedule,573.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67332,Not in chargemaster,67332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67332,BCBS multispecialty AW base fee schedule,620.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67334,Not in chargemaster,67334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67334,BCBS multispecialty AW base fee schedule,564.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67335,Not in chargemaster,67335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67335,BCBS multispecialty AW base fee schedule,276.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67340,Not in chargemaster,67340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67340,BCBS multispecialty AW base fee schedule,670.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67343,Not in chargemaster,67343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67343,BCBS multispecialty AW base fee schedule,1232.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67345,Not in chargemaster,67345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67345,BCBS multispecialty AW base fee schedule,409.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67346,Not in chargemaster,67346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67346,BCBS multispecialty AW base fee schedule,361.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67400,Not in chargemaster,67400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67400,BCBS multispecialty AW base fee schedule,1846.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67405,Not in chargemaster,67405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67405,BCBS multispecialty AW base fee schedule,1587.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67412,Not in chargemaster,67412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67412,BCBS multispecialty AW base fee schedule,1729.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67413,Not in chargemaster,67413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67413,BCBS multispecialty AW base fee schedule,1709.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67414,Not in chargemaster,67414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67414,BCBS multispecialty AW base fee schedule,2622.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67415,Not in chargemaster,67415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67415,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67420,Not in chargemaster,67420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67420,BCBS multispecialty AW base fee schedule,3151.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67430,Not in chargemaster,67430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67430,BCBS multispecialty AW base fee schedule,2472.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67440,Not in chargemaster,67440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67440,BCBS multispecialty AW base fee schedule,2394.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67445,Not in chargemaster,67445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67445,BCBS multispecialty AW base fee schedule,2761.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67450,Not in chargemaster,67450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67450,BCBS multispecialty AW base fee schedule,2485.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67500,Not in chargemaster,67500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67500,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67227,Not in chargemaster,67227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67227,BCBS multispecialty AW base fee schedule,479.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67228,Not in chargemaster,67228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67228,BCBS multispecialty AW base fee schedule,572.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67505,Not in chargemaster,67505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67505,BCBS multispecialty AW base fee schedule,131.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67515,Not in chargemaster,67515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67515,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67550,Not in chargemaster,67550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67550,BCBS multispecialty AW base fee schedule,1922.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67560,Not in chargemaster,67560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67560,BCBS multispecialty AW base fee schedule,1969.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67570,Not in chargemaster,67570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67570,BCBS multispecialty AW base fee schedule,2363.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67700,Not in chargemaster,67700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67700,BCBS multispecialty AW base fee schedule,217.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67710,Not in chargemaster,67710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67710,BCBS multispecialty AW base fee schedule,182.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67715,Not in chargemaster,67715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67715,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67800,Not in chargemaster,67800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67800,BCBS multispecialty AW base fee schedule,192.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67801,Not in chargemaster,67801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67801,BCBS multispecialty AW base fee schedule,247.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67805,Not in chargemaster,67805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67805,BCBS multispecialty AW base fee schedule,306.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67808,Not in chargemaster,67808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67808,BCBS multispecialty AW base fee schedule,690.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67810,Not in chargemaster,67810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67810,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67820,Not in chargemaster,67820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67820,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67825,Not in chargemaster,67825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67825,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67830,Not in chargemaster,67830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67830,BCBS multispecialty AW base fee schedule,257.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67835,Not in chargemaster,67835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67835,BCBS multispecialty AW base fee schedule,823.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67840,Not in chargemaster,67840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67840,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67850,Not in chargemaster,67850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67850,BCBS multispecialty AW base fee schedule,248.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67875,Not in chargemaster,67875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67875,BCBS multispecialty AW base fee schedule,180.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67880,Not in chargemaster,67880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67880,BCBS multispecialty AW base fee schedule,688.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67882,Not in chargemaster,67882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67882,BCBS multispecialty AW base fee schedule,883.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67900,Not in chargemaster,67900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67900,BCBS multispecialty AW base fee schedule,952.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67901,Not in chargemaster,67901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67901,BCBS multispecialty AW base fee schedule,1095.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67902,Not in chargemaster,67902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67902,BCBS multispecialty AW base fee schedule,1358.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67903,Not in chargemaster,67903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67903,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67904,Not in chargemaster,67904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67904,BCBS multispecialty AW base fee schedule,1118.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67906,Not in chargemaster,67906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67906,BCBS multispecialty AW base fee schedule,949.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67908,Not in chargemaster,67908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67908,BCBS multispecialty AW base fee schedule,802.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67909,Not in chargemaster,67909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67909,BCBS multispecialty AW base fee schedule,822.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67911,Not in chargemaster,67911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67911,BCBS multispecialty AW base fee schedule,1050.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67912,Not in chargemaster,67912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67912,BCBS multispecialty AW base fee schedule,912.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67914,Not in chargemaster,67914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67914,BCBS multispecialty AW base fee schedule,612.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67915,Not in chargemaster,67915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67915,BCBS multispecialty AW base fee schedule,368.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67916,Not in chargemaster,67916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67916,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67917,Not in chargemaster,67917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67917,BCBS multispecialty AW base fee schedule,856.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67921,Not in chargemaster,67921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67921,BCBS multispecialty AW base fee schedule,580.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67922,Not in chargemaster,67922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67922,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67923,Not in chargemaster,67923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67923,BCBS multispecialty AW base fee schedule,806.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67924,Not in chargemaster,67924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67924,BCBS multispecialty AW base fee schedule,856.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67930,Not in chargemaster,67930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67930,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67935,Not in chargemaster,67935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67935,BCBS multispecialty AW base fee schedule,829.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67938,67938,67938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67938,BCBS multispecialty AW base fee schedule,217.3,528.86,Fee schedule,,217.3,217.3,217.3,217.3,,,0
unity,Fee schedule,Facility 67950,Not in chargemaster,67950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67950,BCBS multispecialty AW base fee schedule,867.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67961,Not in chargemaster,67961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67961,BCBS multispecialty AW base fee schedule,851.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67966,Not in chargemaster,67966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67966,BCBS multispecialty AW base fee schedule,1230.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67971,Not in chargemaster,67971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67971,BCBS multispecialty AW base fee schedule,1354.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67973,Not in chargemaster,67973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67973,BCBS multispecialty AW base fee schedule,1743.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67974,Not in chargemaster,67974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67974,BCBS multispecialty AW base fee schedule,1739.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67975,Not in chargemaster,67975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67975,BCBS multispecialty AW base fee schedule,1283.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68020,Not in chargemaster,68020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68020,BCBS multispecialty AW base fee schedule,206.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68040,Not in chargemaster,68040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68040,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68100,Not in chargemaster,68100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68100,BCBS multispecialty AW base fee schedule,180.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68110,Not in chargemaster,68110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68110,BCBS multispecialty AW base fee schedule,276.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68115,Not in chargemaster,68115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68115,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68130,Not in chargemaster,68130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68130,BCBS multispecialty AW base fee schedule,771.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68135,Not in chargemaster,68135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68135,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68200,Not in chargemaster,68200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68200,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68320,Not in chargemaster,68320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68320,BCBS multispecialty AW base fee schedule,1009.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68325,Not in chargemaster,68325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68325,BCBS multispecialty AW base fee schedule,1229.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68326,Not in chargemaster,68326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68326,BCBS multispecialty AW base fee schedule,1207.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68328,Not in chargemaster,68328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68328,BCBS multispecialty AW base fee schedule,1327.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68330,Not in chargemaster,68330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68330,BCBS multispecialty AW base fee schedule,861.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68335,Not in chargemaster,68335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68335,BCBS multispecialty AW base fee schedule,1211.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68340,Not in chargemaster,68340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68340,BCBS multispecialty AW base fee schedule,745.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68360,Not in chargemaster,68360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68360,BCBS multispecialty AW base fee schedule,767.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68362,Not in chargemaster,68362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68362,BCBS multispecialty AW base fee schedule,1226.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68371,Not in chargemaster,68371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68371,BCBS multispecialty AW base fee schedule,773.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68400,Not in chargemaster,68400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68400,BCBS multispecialty AW base fee schedule,245.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68420,Not in chargemaster,68420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68420,BCBS multispecialty AW base fee schedule,314.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68440,Not in chargemaster,68440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68440,BCBS multispecialty AW base fee schedule,185.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68500,Not in chargemaster,68500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68500,BCBS multispecialty AW base fee schedule,1900.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68505,Not in chargemaster,68505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68505,BCBS multispecialty AW base fee schedule,1891.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68510,Not in chargemaster,68510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68510,BCBS multispecialty AW base fee schedule,547.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68520,Not in chargemaster,68520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68520,BCBS multispecialty AW base fee schedule,1330.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68525,Not in chargemaster,68525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68525,BCBS multispecialty AW base fee schedule,494.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68530,Not in chargemaster,68530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68530,BCBS multispecialty AW base fee schedule,478.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68540,Not in chargemaster,68540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68540,BCBS multispecialty AW base fee schedule,1789.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68550,Not in chargemaster,68550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68550,BCBS multispecialty AW base fee schedule,2209.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68700,Not in chargemaster,68700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68700,BCBS multispecialty AW base fee schedule,1130.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68705,Not in chargemaster,68705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68705,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68720,Not in chargemaster,68720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68720,BCBS multispecialty AW base fee schedule,1466.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68745,Not in chargemaster,68745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68745,BCBS multispecialty AW base fee schedule,1471.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68750,Not in chargemaster,68750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68750,BCBS multispecialty AW base fee schedule,1535.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68760,Not in chargemaster,68760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68760,BCBS multispecialty AW base fee schedule,272.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68761,Not in chargemaster,68761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68761,BCBS multispecialty AW base fee schedule,219.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68770,Not in chargemaster,68770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68770,BCBS multispecialty AW base fee schedule,1176.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68801,Not in chargemaster,68801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68801,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68810,Not in chargemaster,68810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68810,BCBS multispecialty AW base fee schedule,238.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68811,Not in chargemaster,68811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68811,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68815,Not in chargemaster,68815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68815,BCBS multispecialty AW base fee schedule,415.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68816,Not in chargemaster,68816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68816,BCBS multispecialty AW base fee schedule,294.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68840,Not in chargemaster,68840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68840,BCBS multispecialty AW base fee schedule,216.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68850,Not in chargemaster,68850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68850,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69000,Not in chargemaster,69000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69000,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69005,Not in chargemaster,69005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69005,BCBS multispecialty AW base fee schedule,298.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69020,Not in chargemaster,69020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69020,BCBS multispecialty AW base fee schedule,265.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69100,Not in chargemaster,69100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69100,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69105,Not in chargemaster,69105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69105,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69120,Not in chargemaster,69120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69120,BCBS multispecialty AW base fee schedule,739.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69140,Not in chargemaster,69140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69140,BCBS multispecialty AW base fee schedule,1647.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69145,Not in chargemaster,69145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69145,BCBS multispecialty AW base fee schedule,473.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69150,Not in chargemaster,69150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69150,BCBS multispecialty AW base fee schedule,1937.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69155,Not in chargemaster,69155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69155,BCBS multispecialty AW base fee schedule,3090.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69200,69200,69200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69200,BCBS multispecialty AW base fee schedule,89.44,269.76,Fee schedule,,89.44,89.44,89.44,89.44,,,0
unity,Fee schedule,Facility 69205,Not in chargemaster,69205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69205,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69209,69209,69209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69209,BCBS multispecialty AW base fee schedule,26.5,30,Fee schedule,,26.5,26.5,26.5,26.5,,,0
unity,Fee schedule,Facility 69210,69210,69210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69210,BCBS multispecialty AW base fee schedule,63.6,110.75,Fee schedule,,63.6,63.6,63.6,63.6,,,0
unity,Fee schedule,Facility 69110,Not in chargemaster,69110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69110,BCBS multispecialty AW base fee schedule,614.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69220,Not in chargemaster,69220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69220,BCBS multispecialty AW base fee schedule,96.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69222,Not in chargemaster,69222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69222,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69300,Not in chargemaster,69300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69300,BCBS multispecialty AW base fee schedule,869.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69310,Not in chargemaster,69310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69310,BCBS multispecialty AW base fee schedule,2053.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69320,Not in chargemaster,69320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69320,BCBS multispecialty AW base fee schedule,2879.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69420,Not in chargemaster,69420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69420,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69421,Not in chargemaster,69421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69421,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69424,Not in chargemaster,69424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69424,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69433,Not in chargemaster,69433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69433,BCBS multispecialty AW base fee schedule,246.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69436,Not in chargemaster,69436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69436,BCBS multispecialty AW base fee schedule,296.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69440,Not in chargemaster,69440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69440,BCBS multispecialty AW base fee schedule,1292.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69450,Not in chargemaster,69450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69450,BCBS multispecialty AW base fee schedule,1022.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69501,Not in chargemaster,69501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69501,BCBS multispecialty AW base fee schedule,1350.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69502,Not in chargemaster,69502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69502,BCBS multispecialty AW base fee schedule,1796.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69505,Not in chargemaster,69505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69505,BCBS multispecialty AW base fee schedule,2267.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69511,Not in chargemaster,69511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69511,BCBS multispecialty AW base fee schedule,2322.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69530,Not in chargemaster,69530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69530,BCBS multispecialty AW base fee schedule,3115.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69535,Not in chargemaster,69535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69535,BCBS multispecialty AW base fee schedule,4998.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69540,Not in chargemaster,69540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69540,BCBS multispecialty AW base fee schedule,237.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69550,Not in chargemaster,69550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69550,BCBS multispecialty AW base fee schedule,1959.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69552,Not in chargemaster,69552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69552,BCBS multispecialty AW base fee schedule,2957.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69554,Not in chargemaster,69554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69554,BCBS multispecialty AW base fee schedule,4742.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69601,Not in chargemaster,69601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69601,BCBS multispecialty AW base fee schedule,1935.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69602,Not in chargemaster,69602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69602,BCBS multispecialty AW base fee schedule,2046.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69603,Not in chargemaster,69603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69603,BCBS multispecialty AW base fee schedule,2373.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69604,Not in chargemaster,69604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69604,BCBS multispecialty AW base fee schedule,2091.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69605,Not in chargemaster,69605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69605,BCBS multispecialty AW base fee schedule,2938.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69610,Not in chargemaster,69610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69610,BCBS multispecialty AW base fee schedule,545.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69631,Not in chargemaster,69631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69631,BCBS multispecialty AW base fee schedule,1662.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69632,Not in chargemaster,69632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69632,BCBS multispecialty AW base fee schedule,2025.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69633,Not in chargemaster,69633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69633,BCBS multispecialty AW base fee schedule,1962.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69635,Not in chargemaster,69635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69635,BCBS multispecialty AW base fee schedule,2324.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69636,Not in chargemaster,69636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69636,BCBS multispecialty AW base fee schedule,2600.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69637,Not in chargemaster,69637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69637,BCBS multispecialty AW base fee schedule,2588.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69641,Not in chargemaster,69641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69641,BCBS multispecialty AW base fee schedule,1957.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69642,Not in chargemaster,69642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69642,BCBS multispecialty AW base fee schedule,2515.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69643,Not in chargemaster,69643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69643,BCBS multispecialty AW base fee schedule,2298.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69644,Not in chargemaster,69644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69644,BCBS multispecialty AW base fee schedule,2784.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69645,Not in chargemaster,69645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69645,BCBS multispecialty AW base fee schedule,2740.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69646,Not in chargemaster,69646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69646,BCBS multispecialty AW base fee schedule,2904.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69650,Not in chargemaster,69650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69650,BCBS multispecialty AW base fee schedule,1507.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69660,Not in chargemaster,69660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69660,BCBS multispecialty AW base fee schedule,1740.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69661,Not in chargemaster,69661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69661,BCBS multispecialty AW base fee schedule,2271.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69662,Not in chargemaster,69662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69662,BCBS multispecialty AW base fee schedule,2167.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69666,Not in chargemaster,69666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69666,BCBS multispecialty AW base fee schedule,1520.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69667,Not in chargemaster,69667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69667,BCBS multispecialty AW base fee schedule,1519.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69670,Not in chargemaster,69670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69670,BCBS multispecialty AW base fee schedule,1778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69676,Not in chargemaster,69676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69676,BCBS multispecialty AW base fee schedule,1560.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69700,Not in chargemaster,69700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69700,BCBS multispecialty AW base fee schedule,1265.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69711,Not in chargemaster,69711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69711,BCBS multispecialty AW base fee schedule,1591.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69714,Not in chargemaster,69714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69714,BCBS multispecialty AW base fee schedule,1995.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69715,Not in chargemaster,69715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69715,BCBS multispecialty AW base fee schedule,2469.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69717,Not in chargemaster,69717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69717,BCBS multispecialty AW base fee schedule,2094.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69718,Not in chargemaster,69718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69718,BCBS multispecialty AW base fee schedule,2495.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69720,Not in chargemaster,69720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69720,BCBS multispecialty AW base fee schedule,2235.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69725,Not in chargemaster,69725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69725,BCBS multispecialty AW base fee schedule,3536.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69740,Not in chargemaster,69740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69740,BCBS multispecialty AW base fee schedule,2192.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69745,Not in chargemaster,69745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69745,BCBS multispecialty AW base fee schedule,2335.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69801,Not in chargemaster,69801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69801,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69805,Not in chargemaster,69805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69805,BCBS multispecialty AW base fee schedule,1956.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69806,Not in chargemaster,69806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69806,BCBS multispecialty AW base fee schedule,1752.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69905,Not in chargemaster,69905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69905,BCBS multispecialty AW base fee schedule,1723.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69910,Not in chargemaster,69910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69910,BCBS multispecialty AW base fee schedule,1886.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69915,Not in chargemaster,69915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69915,BCBS multispecialty AW base fee schedule,2864.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69930,Not in chargemaster,69930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69930,BCBS multispecialty AW base fee schedule,2302.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69950,Not in chargemaster,69950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69950,BCBS multispecialty AW base fee schedule,3328.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69955,Not in chargemaster,69955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69955,BCBS multispecialty AW base fee schedule,3721.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69960,Not in chargemaster,69960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69960,BCBS multispecialty AW base fee schedule,3590.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69970,Not in chargemaster,69970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69970,BCBS multispecialty AW base fee schedule,4031.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69990,Not in chargemaster,69990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69990,BCBS multispecialty AW base fee schedule,417.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70010,Not in chargemaster,70010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70010,BCBS multispecialty AW base fee schedule,113.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70015,Not in chargemaster,70015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70015,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70015 mod 26,Not in chargemaster,70015,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70015 mod 26,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70015 mod TC,Not in chargemaster,70015,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70015 mod TC,BCBS multispecialty AW base fee schedule,192.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70030,Not in chargemaster,70030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70030,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70030 mod 26,Not in chargemaster,70030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70030 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70030 mod TC,Not in chargemaster,70030,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70030 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70100,Not in chargemaster,70100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70100,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70100 mod 26,Not in chargemaster,70100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70100 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70100 mod TC,Not in chargemaster,70100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70100 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70110,Not in chargemaster,70110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70110,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70110 mod 26,70110,70110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70110 mod 26,BCBS multispecialty AW base fee schedule,23.85,27.93,Fee schedule,,23.85,23.85,23.85,23.85,,,0
unity,Fee schedule,Facility 70110 mod TC,Not in chargemaster,70110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70110 mod TC,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70120,Not in chargemaster,70120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70120,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70120 mod 26,Not in chargemaster,70120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70120 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70120 mod TC,Not in chargemaster,70120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70120 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70130,Not in chargemaster,70130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70130,BCBS multispecialty AW base fee schedule,111.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70130 mod 26,Not in chargemaster,70130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70130 mod 26,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70130 mod TC,Not in chargemaster,70130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70130 mod TC,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70134,Not in chargemaster,70134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70134,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70134 mod 26,Not in chargemaster,70134,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70134 mod 26,BCBS multispecialty AW base fee schedule,33.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70134 mod TC,Not in chargemaster,70134,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70134 mod TC,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70140,Not in chargemaster,70140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70140,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70140 mod 26,Not in chargemaster,70140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70140 mod 26,BCBS multispecialty AW base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70140 mod TC,Not in chargemaster,70140,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70140 mod TC,BCBS multispecialty AW base fee schedule,39.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70150,Not in chargemaster,70150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70150,BCBS multispecialty AW base fee schedule,85.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70150 mod 26,70150,70150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70150 mod 26,BCBS multispecialty AW base fee schedule,25.18,29.48,Fee schedule,,25.18,25.18,25.18,25.18,,,0
unity,Fee schedule,Facility 70150 mod TC,Not in chargemaster,70150,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70150 mod TC,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70160,Not in chargemaster,70160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70160,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70160 mod 26,70160,70160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70160 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Facility 70160 mod TC,Not in chargemaster,70160,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70160 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70170,Not in chargemaster,70170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70170,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70170 mod 26,Not in chargemaster,70170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70170 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70190,Not in chargemaster,70190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70190,BCBS multispecialty AW base fee schedule,71.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70190 mod 26,Not in chargemaster,70190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70190 mod 26,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70190 mod TC,Not in chargemaster,70190,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70190 mod TC,BCBS multispecialty AW base fee schedule,50.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70200,Not in chargemaster,70200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70200,BCBS multispecialty AW base fee schedule,86.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70200 mod 26,Not in chargemaster,70200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70200 mod 26,BCBS multispecialty AW base fee schedule,26.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70200 mod TC,Not in chargemaster,70200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70200 mod TC,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70210,Not in chargemaster,70210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70210,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70210 mod 26,Not in chargemaster,70210,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70210 mod 26,BCBS multispecialty AW base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70210 mod TC,Not in chargemaster,70210,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70210 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70220,Not in chargemaster,70220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70220,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70220 mod 26,70220,70220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70220 mod 26,BCBS multispecialty AW base fee schedule,21.2,27.93,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Facility 70220 mod TC,Not in chargemaster,70220,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70220 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70240,Not in chargemaster,70240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70240,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70240 mod 26,Not in chargemaster,70240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70240 mod 26,BCBS multispecialty AW base fee schedule,18.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70240 mod TC,Not in chargemaster,70240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70240 mod TC,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70250,Not in chargemaster,70250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70250,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70250 mod 26,70250,70250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70250 mod 26,BCBS multispecialty AW base fee schedule,19.21,27.93,Fee schedule,,19.21,19.21,19.21,19.21,,,0
unity,Fee schedule,Facility 70250 mod TC,Not in chargemaster,70250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70250 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70260,Not in chargemaster,70260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70260,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70260 mod 26,70260,70260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70260 mod 26,BCBS multispecialty AW base fee schedule,27.16,38.01,Fee schedule,,27.16,27.16,27.16,27.16,,,0
unity,Fee schedule,Facility 70260 mod TC,Not in chargemaster,70260,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70260 mod TC,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70300,Not in chargemaster,70300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70300,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70300 mod 26,Not in chargemaster,70300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70300 mod 26,BCBS multispecialty AW base fee schedule,10.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70300 mod TC,Not in chargemaster,70300,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70300 mod TC,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70310,Not in chargemaster,70310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70310,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70310 mod 26,Not in chargemaster,70310,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70310 mod 26,BCBS multispecialty AW base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70310 mod TC,Not in chargemaster,70310,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70310 mod TC,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70320,Not in chargemaster,70320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70320,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70320 mod 26,Not in chargemaster,70320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70320 mod 26,BCBS multispecialty AW base fee schedule,21.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70320 mod TC,Not in chargemaster,70320,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70320 mod TC,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70328,Not in chargemaster,70328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70328,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70328 mod 26,Not in chargemaster,70328,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70328 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70328 mod TC,Not in chargemaster,70328,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70328 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70330,Not in chargemaster,70330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70330,BCBS multispecialty AW base fee schedule,96.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70330 mod 26,Not in chargemaster,70330,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70330 mod 26,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70330 mod TC,Not in chargemaster,70330,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70330 mod TC,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70332,Not in chargemaster,70332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70332,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70332 mod 26,Not in chargemaster,70332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70332 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70332 mod TC,Not in chargemaster,70332,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70332 mod TC,BCBS multispecialty AW base fee schedule,100.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70336,Not in chargemaster,70336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70336,BCBS multispecialty AW base fee schedule,575.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70336 mod 26,Not in chargemaster,70336,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70336 mod 26,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70336 mod TC,Not in chargemaster,70336,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70336 mod TC,BCBS multispecialty AW base fee schedule,435.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70350,Not in chargemaster,70350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70350,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70350 mod 26,Not in chargemaster,70350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70350 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70350 mod TC,Not in chargemaster,70350,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70350 mod TC,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70355,Not in chargemaster,70355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70355,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70355 mod 26,Not in chargemaster,70355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70355 mod 26,BCBS multispecialty AW base fee schedule,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70355 mod TC,Not in chargemaster,70355,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70355 mod TC,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70360,Not in chargemaster,70360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70360,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70360 mod 26,70360,70360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70360 mod 26,BCBS multispecialty AW base fee schedule,17.23,18.62,Fee schedule,,17.23,17.23,17.23,17.23,,,0
unity,Fee schedule,Facility 70360 mod TC,Not in chargemaster,70360,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70360 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70370,Not in chargemaster,70370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70370,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70370 mod 26,Not in chargemaster,70370,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70370 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70370 mod TC,Not in chargemaster,70370,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70370 mod TC,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70371,Not in chargemaster,70371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70371,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70371 mod 26,Not in chargemaster,70371,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70371 mod 26,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70371 mod TC,Not in chargemaster,70371,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70371 mod TC,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70380,Not in chargemaster,70380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70380,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70380 mod 26,Not in chargemaster,70380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70380 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70380 mod TC,Not in chargemaster,70380,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70380 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70390,Not in chargemaster,70390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70390,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70390 mod 26,Not in chargemaster,70390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70390 mod 26,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70390 mod TC,Not in chargemaster,70390,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70390 mod TC,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70450,Not in chargemaster,70450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70450,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70450 mod 26,70450,70450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70450 mod 26,BCBS multispecialty AW base fee schedule,80.16,93.07,Fee schedule,,80.16,80.16,80.16,80.16,,,0
unity,Fee schedule,Facility 70450 mod TC,Not in chargemaster,70450,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70450 mod TC,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70460,Not in chargemaster,70460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70460,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70460 mod 26,70460,70460,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70460 mod 26,BCBS multispecialty AW base fee schedule,106,124.11,Fee schedule,,106,106,106,106,,,0
unity,Fee schedule,Facility 70460 mod TC,Not in chargemaster,70460,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70460 mod TC,BCBS multispecialty AW base fee schedule,198.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70470,Not in chargemaster,70470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70470,BCBS multispecialty AW base fee schedule,356.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70470 mod 26,70470,70470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70470 mod 26,BCBS multispecialty AW base fee schedule,119.25,140.39,Fee schedule,,119.25,119.25,119.25,119.25,,,0
unity,Fee schedule,Facility 70470 mod TC,Not in chargemaster,70470,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70470 mod TC,BCBS multispecialty AW base fee schedule,237.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70480,Not in chargemaster,70480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70480,BCBS multispecialty AW base fee schedule,373.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70480 mod 26,70480,70480,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70480 mod 26,BCBS multispecialty AW base fee schedule,119.91,141.94,Fee schedule,,119.91,119.91,119.91,119.91,,,0
unity,Fee schedule,Facility 70480 mod TC,Not in chargemaster,70480,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70480 mod TC,BCBS multispecialty AW base fee schedule,253.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70481,Not in chargemaster,70481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70481,BCBS multispecialty AW base fee schedule,416.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70481 mod 26,Not in chargemaster,70481,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70481 mod 26,BCBS multispecialty AW base fee schedule,106,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70481 mod TC,Not in chargemaster,70481,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70481 mod TC,BCBS multispecialty AW base fee schedule,310.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70482,Not in chargemaster,70482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70482,BCBS multispecialty AW base fee schedule,461.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70482 mod 26,70482,70482,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70482 mod 26,BCBS multispecialty AW base fee schedule,118.59,159.78,Fee schedule,,118.59,118.59,118.59,118.59,,,0
unity,Fee schedule,Facility 70482 mod TC,Not in chargemaster,70482,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70482 mod TC,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70486,Not in chargemaster,70486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70486,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70486 mod 26,70486,70486,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70486 mod 26,BCBS multispecialty AW base fee schedule,80.83,125.65,Fee schedule,,80.83,80.83,80.83,80.83,,,0
unity,Fee schedule,Facility 70486 mod TC,Not in chargemaster,70486,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70486 mod TC,BCBS multispecialty AW base fee schedule,178.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70487,Not in chargemaster,70487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70487,BCBS multispecialty AW base fee schedule,311.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70487 mod 26,Not in chargemaster,70487,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70487 mod 26,BCBS multispecialty AW base fee schedule,106,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70487 mod TC,Not in chargemaster,70487,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70487 mod TC,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70488,Not in chargemaster,70488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70488,BCBS multispecialty AW base fee schedule,379.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70488 mod 26,Not in chargemaster,70488,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70488 mod 26,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70488 mod TC,Not in chargemaster,70488,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70488 mod TC,BCBS multispecialty AW base fee schedule,260.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70490,Not in chargemaster,70490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70490,BCBS multispecialty AW base fee schedule,306.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70490 mod 26,Not in chargemaster,70490,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70490 mod 26,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70490 mod TC,Not in chargemaster,70490,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70490 mod TC,BCBS multispecialty AW base fee schedule,186.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70491,Not in chargemaster,70491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70491,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70491 mod 26,70491,70491,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70491 mod 26,BCBS multispecialty AW base fee schedule,129.85,152.02,Fee schedule,,129.85,129.85,129.85,129.85,,,0
unity,Fee schedule,Facility 70491 mod TC,Not in chargemaster,70491,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70491 mod TC,BCBS multispecialty AW base fee schedule,247.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70492,Not in chargemaster,70492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70492,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70492 mod 26,70492,70492,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70492 mod 26,BCBS multispecialty AW base fee schedule,153.04,159.78,Fee schedule,,153.04,153.04,153.04,153.04,,,0
unity,Fee schedule,Facility 70492 mod TC,Not in chargemaster,70492,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70492 mod TC,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70496,Not in chargemaster,70496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70496,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70496 mod 26,Not in chargemaster,70496,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70496 mod 26,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70496 mod TC,Not in chargemaster,70496,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70496 mod TC,BCBS multispecialty AW base fee schedule,388.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70498,Not in chargemaster,70498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70498,BCBS multispecialty AW base fee schedule,552.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70498 mod 26,Not in chargemaster,70498,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70498 mod 26,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70498 mod TC,Not in chargemaster,70498,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70498 mod TC,BCBS multispecialty AW base fee schedule,388.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70540,Not in chargemaster,70540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70540,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70540 mod 26,Not in chargemaster,70540,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70540 mod 26,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70540 mod TC,Not in chargemaster,70540,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70540 mod TC,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70542,Not in chargemaster,70542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70542,BCBS multispecialty AW base fee schedule,577.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70542 mod 26,Not in chargemaster,70542,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70542 mod 26,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70542 mod TC,Not in chargemaster,70542,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70542 mod TC,BCBS multispecialty AW base fee schedule,424.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70543,Not in chargemaster,70543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70543,BCBS multispecialty AW base fee schedule,726.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70543 mod 26,70543,70543,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70543 mod 26,BCBS multispecialty AW base fee schedule,200.74,236.57,Fee schedule,,200.74,200.74,200.74,200.74,,,0
unity,Fee schedule,Facility 70543 mod TC,Not in chargemaster,70543,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70543 mod TC,BCBS multispecialty AW base fee schedule,525.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70544,Not in chargemaster,70544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70544,BCBS multispecialty AW base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70544 mod 26,70544,70544,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70544 mod 26,BCBS multispecialty AW base fee schedule,112.63,132.64,Fee schedule,,112.63,112.63,112.63,112.63,,,0
unity,Fee schedule,Facility 70544 mod TC,Not in chargemaster,70544,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70544 mod TC,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70545,Not in chargemaster,70545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70545,BCBS multispecialty AW base fee schedule,477.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70545 mod 26,Not in chargemaster,70545,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70545 mod 26,BCBS multispecialty AW base fee schedule,112.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70545 mod TC,Not in chargemaster,70545,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70545 mod TC,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70546,Not in chargemaster,70546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70546,BCBS multispecialty AW base fee schedule,692.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70546 mod 26,Not in chargemaster,70546,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70546 mod 26,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70546 mod TC,Not in chargemaster,70546,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70546 mod TC,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70547,Not in chargemaster,70547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70547,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70547 mod 26,Not in chargemaster,70547,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70547 mod 26,BCBS multispecialty AW base fee schedule,113.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70547 mod TC,Not in chargemaster,70547,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70547 mod TC,BCBS multispecialty AW base fee schedule,345.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70548,Not in chargemaster,70548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70548,BCBS multispecialty AW base fee schedule,512.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70548 mod 26,Not in chargemaster,70548,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70548 mod 26,BCBS multispecialty AW base fee schedule,141.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70548 mod TC,Not in chargemaster,70548,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70548 mod TC,BCBS multispecialty AW base fee schedule,371.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70549,Not in chargemaster,70549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70549,BCBS multispecialty AW base fee schedule,726.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70549 mod 26,Not in chargemaster,70549,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70549 mod 26,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70549 mod TC,Not in chargemaster,70549,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70549 mod TC,BCBS multispecialty AW base fee schedule,557.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70551,Not in chargemaster,70551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70551,BCBS multispecialty AW base fee schedule,416.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70551 mod 26,70551,70551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70551 mod 26,BCBS multispecialty AW base fee schedule,139.79,162.89,Fee schedule,,139.79,139.79,139.79,139.79,,,0
unity,Fee schedule,Facility 70551 mod TC,Not in chargemaster,70551,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70551 mod TC,BCBS multispecialty AW base fee schedule,276.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70552,Not in chargemaster,70552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70552,BCBS multispecialty AW base fee schedule,575.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70552 mod 26,Not in chargemaster,70552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70552 mod 26,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70552 mod TC,Not in chargemaster,70552,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70552 mod TC,BCBS multispecialty AW base fee schedule,408.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70553,Not in chargemaster,70553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70553,BCBS multispecialty AW base fee schedule,680.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70553 mod 26,70553,70553,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70553 mod 26,BCBS multispecialty AW base fee schedule,215.31,260.62,Fee schedule,,215.31,215.31,215.31,215.31,,,0
unity,Fee schedule,Facility 70553 mod TC,Not in chargemaster,70553,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70553 mod TC,BCBS multispecialty AW base fee schedule,465.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70554,Not in chargemaster,70554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70554,BCBS multispecialty AW base fee schedule,805.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70554 mod 26,Not in chargemaster,70554,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70554 mod 26,BCBS multispecialty AW base fee schedule,198.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70554 mod TC,Not in chargemaster,70554,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70554 mod TC,BCBS multispecialty AW base fee schedule,607.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70555,Not in chargemaster,70555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70555,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70555 mod 26,Not in chargemaster,70555,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70555 mod 26,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70557,Not in chargemaster,70557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70557,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70557 mod 26,Not in chargemaster,70557,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70557 mod 26,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70558,Not in chargemaster,70558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70558,BCBS multispecialty AW base fee schedule,322.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70558 mod 26,Not in chargemaster,70558,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70558 mod 26,BCBS multispecialty AW base fee schedule,322.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70559,Not in chargemaster,70559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70559,BCBS multispecialty AW base fee schedule,309.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 70559 mod 26,Not in chargemaster,70559,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70559 mod 26,BCBS multispecialty AW base fee schedule,309.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71045,Not in chargemaster,71045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71045,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71045 mod 26,71045,71045,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71045 mod 26,BCBS multispecialty AW base fee schedule,17.23,20.17,Fee schedule,,17.23,17.23,17.23,17.23,,,0
unity,Fee schedule,Facility 71045 mod TC,Not in chargemaster,71045,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71045 mod TC,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71046,Not in chargemaster,71046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71046,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71046 mod 26,71046,71046,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71046 mod 26,BCBS multispecialty AW base fee schedule,20.54,24.05,Fee schedule,,20.54,20.54,20.54,20.54,,,0
unity,Fee schedule,Facility 71046 mod TC,Not in chargemaster,71046,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71046 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71047,Not in chargemaster,71047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71047,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71047 mod 26,71047,71047,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71047 mod 26,BCBS multispecialty AW base fee schedule,25.84,30.25,Fee schedule,,25.84,25.84,25.84,25.84,,,0
unity,Fee schedule,Facility 71047 mod TC,Not in chargemaster,71047,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71047 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71048,Not in chargemaster,71048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71048,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71048 mod 26,71048,71048,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71048 mod 26,BCBS multispecialty AW base fee schedule,30.48,18.34,Fee schedule,,18.34,18.34,18.34,18.34,,,0
unity,Fee schedule,Facility 71048 mod TC,Not in chargemaster,71048,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71048 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71100,Not in chargemaster,71100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71100,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71100 mod 26,71100,71100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71100 mod 26,BCBS multispecialty AW base fee schedule,21.2,24.82,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Facility 71100 mod TC,Not in chargemaster,71100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71100 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71101,Not in chargemaster,71101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71101,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71101 mod 26,71101,71101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71101 mod 26,BCBS multispecialty AW base fee schedule,25.18,29.48,Fee schedule,,25.18,25.18,25.18,25.18,,,0
unity,Fee schedule,Facility 71101 mod TC,Not in chargemaster,71101,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71101 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71110,Not in chargemaster,71110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71110,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71110 mod 26,Not in chargemaster,71110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71110 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71110 mod TC,Not in chargemaster,71110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71110 mod TC,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71111,Not in chargemaster,71111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71111,BCBS multispecialty AW base fee schedule,95.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71111 mod 26,Not in chargemaster,71111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71111 mod 26,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71111 mod TC,Not in chargemaster,71111,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71111 mod TC,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71120,Not in chargemaster,71120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71120,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71120 mod 26,Not in chargemaster,71120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71120 mod 26,BCBS multispecialty AW base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71120 mod TC,Not in chargemaster,71120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71120 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71130,Not in chargemaster,71130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71130,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71130 mod 26,71130,71130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71130 mod 26,BCBS multispecialty AW base fee schedule,21.2,24.82,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Facility 71130 mod TC,Not in chargemaster,71130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71130 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71250,Not in chargemaster,71250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71250,BCBS multispecialty AW base fee schedule,294.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71250 mod 26,71250,71250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71250 mod 26,BCBS multispecialty AW base fee schedule,108.65,111.69,Fee schedule,,108.65,108.65,108.65,108.65,,,0
unity,Fee schedule,Facility 71250 mod TC,Not in chargemaster,71250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71250 mod TC,BCBS multispecialty AW base fee schedule,186.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71260,Not in chargemaster,71260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71260,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71260 mod 26,71260,71260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71260 mod 26,BCBS multispecialty AW base fee schedule,117.26,137.29,Fee schedule,,117.26,117.26,117.26,117.26,,,0
unity,Fee schedule,Facility 71260 mod TC,Not in chargemaster,71260,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71260 mod TC,BCBS multispecialty AW base fee schedule,248.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71270,Not in chargemaster,71270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71270,BCBS multispecialty AW base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71270 mod 26,71270,71270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71270 mod 26,BCBS multispecialty AW base fee schedule,129.19,151.25,Fee schedule,,129.19,129.19,129.19,129.19,,,0
unity,Fee schedule,Facility 71270 mod TC,Not in chargemaster,71270,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71270 mod TC,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71275,Not in chargemaster,71275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71275,BCBS multispecialty AW base fee schedule,565.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71275 mod 26,Not in chargemaster,71275,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71275 mod 26,BCBS multispecialty AW base fee schedule,170.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71275 mod TC,Not in chargemaster,71275,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71275 mod TC,BCBS multispecialty AW base fee schedule,394.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71550,Not in chargemaster,71550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71550,BCBS multispecialty AW base fee schedule,739.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71550 mod 26,Not in chargemaster,71550,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71550 mod 26,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71550 mod TC,Not in chargemaster,71550,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71550 mod TC,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71551,Not in chargemaster,71551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71551,BCBS multispecialty AW base fee schedule,815.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71551 mod 26,Not in chargemaster,71551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71551 mod 26,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71551 mod TC,Not in chargemaster,71551,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71551 mod TC,BCBS multispecialty AW base fee schedule,653.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71552,Not in chargemaster,71552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71552,BCBS multispecialty AW base fee schedule,1032.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71552 mod 26,Not in chargemaster,71552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71552 mod 26,BCBS multispecialty AW base fee schedule,210.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71552 mod TC,Not in chargemaster,71552,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71552 mod TC,BCBS multispecialty AW base fee schedule,821.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71555,Not in chargemaster,71555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71555,BCBS multispecialty AW base fee schedule,716.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71555 mod 26,Not in chargemaster,71555,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71555 mod 26,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 71555 mod TC,Not in chargemaster,71555,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71555 mod TC,BCBS multispecialty AW base fee schedule,547.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72020,Not in chargemaster,72020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72020,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72020 mod 26,72020,72020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72020 mod 26,BCBS multispecialty AW base fee schedule,15.24,17.06,Fee schedule,,15.24,15.24,15.24,15.24,,,0
unity,Fee schedule,Facility 72020 mod TC,Not in chargemaster,72020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72020 mod TC,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72040,Not in chargemaster,72040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72040,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72040 mod 26,72040,72040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72040 mod 26,BCBS multispecialty AW base fee schedule,21.2,31.41,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Facility 72040 mod TC,Not in chargemaster,72040,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72040 mod TC,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72050,Not in chargemaster,72050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72050,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72050 mod 26,72050,72050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72050 mod 26,BCBS multispecialty AW base fee schedule,25.84,35.68,Fee schedule,,25.84,25.84,25.84,25.84,,,0
unity,Fee schedule,Facility 72050 mod TC,Not in chargemaster,72050,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72050 mod TC,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72052,Not in chargemaster,72052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72052,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72052 mod 26,Not in chargemaster,72052,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72052 mod 26,BCBS multispecialty AW base fee schedule,28.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72052 mod TC,Not in chargemaster,72052,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72052 mod TC,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72070,Not in chargemaster,72070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72070,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72070 mod 26,72070,72070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72070 mod 26,BCBS multispecialty AW base fee schedule,19.21,24.82,Fee schedule,,19.21,19.21,19.21,19.21,,,0
unity,Fee schedule,Facility 72070 mod TC,Not in chargemaster,72070,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72070 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72072,Not in chargemaster,72072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72072,BCBS multispecialty AW base fee schedule,71.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72072 mod 26,72072,72072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72072 mod 26,BCBS multispecialty AW base fee schedule,21.86,24.05,Fee schedule,,21.86,21.86,21.86,21.86,,,0
unity,Fee schedule,Facility 72072 mod TC,Not in chargemaster,72072,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72072 mod TC,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72074,Not in chargemaster,72074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72074,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72074 mod 26,Not in chargemaster,72074,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72074 mod 26,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72074 mod TC,Not in chargemaster,72074,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72074 mod TC,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72080,Not in chargemaster,72080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72080,BCBS multispecialty AW base fee schedule,63.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72080 mod 26,Not in chargemaster,72080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72080 mod 26,BCBS multispecialty AW base fee schedule,20.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72080 mod TC,Not in chargemaster,72080,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72080 mod TC,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72081,Not in chargemaster,72081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72081,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72081 mod 26,72081,72081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72081 mod 26,BCBS multispecialty AW base fee schedule,25.18,33,Fee schedule,,25.18,25.18,25.18,25.18,,,0
unity,Fee schedule,Facility 72081 mod TC,Not in chargemaster,72081,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72081 mod TC,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72082,Not in chargemaster,72082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72082,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72082 mod 26,72082,72082,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72082 mod 26,BCBS multispecialty AW base fee schedule,30.48,40.13,Fee schedule,,30.48,30.48,30.48,30.48,,,0
unity,Fee schedule,Facility 72082 mod TC,Not in chargemaster,72082,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72082 mod TC,BCBS multispecialty AW base fee schedule,95.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72083,Not in chargemaster,72083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72083,BCBS multispecialty AW base fee schedule,146.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72083 mod 26,Not in chargemaster,72083,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72083 mod 26,BCBS multispecialty AW base fee schedule,34.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72083 mod TC,Not in chargemaster,72083,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72083 mod TC,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72084,Not in chargemaster,72084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72084,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72084 mod 26,Not in chargemaster,72084,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72084 mod 26,BCBS multispecialty AW base fee schedule,39.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72084 mod TC,Not in chargemaster,72084,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72084 mod TC,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72100,Not in chargemaster,72100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72100,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72100 mod 26,72100,72100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72100 mod 26,BCBS multispecialty AW base fee schedule,21.2,26.38,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Facility 72100 mod TC,Not in chargemaster,72100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72100 mod TC,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72110,Not in chargemaster,72110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72110,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72110 mod 26,72110,72110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72110 mod 26,BCBS multispecialty AW base fee schedule,24.51,35.68,Fee schedule,,24.51,24.51,24.51,24.51,,,0
unity,Fee schedule,Facility 72110 mod TC,Not in chargemaster,72110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72110 mod TC,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72114,Not in chargemaster,72114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72114,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72114 mod 26,Not in chargemaster,72114,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72114 mod 26,BCBS multispecialty AW base fee schedule,28.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72114 mod TC,Not in chargemaster,72114,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72114 mod TC,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72120,Not in chargemaster,72120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72120,BCBS multispecialty AW base fee schedule,73.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72120 mod 26,Not in chargemaster,72120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72120 mod 26,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72120 mod TC,Not in chargemaster,72120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72120 mod TC,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72125,Not in chargemaster,72125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72125,BCBS multispecialty AW base fee schedule,290.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72125 mod 26,72125,72125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72125 mod 26,BCBS multispecialty AW base fee schedule,94.08,136.14,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Facility 72125 mod TC,Not in chargemaster,72125,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72125 mod TC,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72126,Not in chargemaster,72126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72126,BCBS multispecialty AW base fee schedule,364.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72126 mod 26,Not in chargemaster,72126,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72126 mod 26,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72126 mod TC,Not in chargemaster,72126,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72126 mod TC,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72127,Not in chargemaster,72127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72127,BCBS multispecialty AW base fee schedule,429.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72127 mod 26,Not in chargemaster,72127,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72127 mod 26,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72127 mod TC,Not in chargemaster,72127,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72127 mod TC,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72128,Not in chargemaster,72128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72128,BCBS multispecialty AW base fee schedule,290.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72128 mod 26,72128,72128,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72128 mod 26,BCBS multispecialty AW base fee schedule,94.08,128.07,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Facility 72128 mod TC,Not in chargemaster,72128,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72128 mod TC,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72129,Not in chargemaster,72129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72129,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72129 mod 26,Not in chargemaster,72129,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72129 mod 26,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72129 mod TC,Not in chargemaster,72129,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72129 mod TC,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72130,Not in chargemaster,72130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72130,BCBS multispecialty AW base fee schedule,429.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72130 mod 26,Not in chargemaster,72130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72130 mod 26,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72130 mod TC,Not in chargemaster,72130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72130 mod TC,BCBS multispecialty AW base fee schedule,310.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72131,Not in chargemaster,72131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72131,BCBS multispecialty AW base fee schedule,288.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72131 mod 26,72131,72131,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72131 mod 26,BCBS multispecialty AW base fee schedule,94.08,128.07,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Facility 72131 mod TC,Not in chargemaster,72131,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72131 mod TC,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72132,Not in chargemaster,72132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72132,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72132 mod 26,Not in chargemaster,72132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72132 mod 26,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72132 mod TC,Not in chargemaster,72132,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72132 mod TC,BCBS multispecialty AW base fee schedule,250.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72133,Not in chargemaster,72133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72133,BCBS multispecialty AW base fee schedule,427.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72133 mod 26,Not in chargemaster,72133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72133 mod 26,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72133 mod TC,Not in chargemaster,72133,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72133 mod TC,BCBS multispecialty AW base fee schedule,308.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72141,Not in chargemaster,72141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72141,BCBS multispecialty AW base fee schedule,404.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72141 mod 26,72141,72141,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72141 mod 26,BCBS multispecialty AW base fee schedule,139.79,177.63,Fee schedule,,139.79,139.79,139.79,139.79,,,0
unity,Fee schedule,Facility 72141 mod TC,Not in chargemaster,72141,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72141 mod TC,BCBS multispecialty AW base fee schedule,265,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72142,Not in chargemaster,72142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72142,BCBS multispecialty AW base fee schedule,588.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72142 mod 26,Not in chargemaster,72142,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72142 mod 26,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72142 mod TC,Not in chargemaster,72142,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72142 mod TC,BCBS multispecialty AW base fee schedule,420.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72146,Not in chargemaster,72146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72146,BCBS multispecialty AW base fee schedule,404.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72146 mod 26,72146,72146,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72146 mod 26,BCBS multispecialty AW base fee schedule,139.79,177.63,Fee schedule,,139.79,139.79,139.79,139.79,,,0
unity,Fee schedule,Facility 72146 mod TC,Not in chargemaster,72146,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72146 mod TC,BCBS multispecialty AW base fee schedule,265,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72147,Not in chargemaster,72147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72147,BCBS multispecialty AW base fee schedule,584.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72147 mod 26,Not in chargemaster,72147,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72147 mod 26,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72147 mod TC,Not in chargemaster,72147,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72147 mod TC,BCBS multispecialty AW base fee schedule,416.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72148,Not in chargemaster,72148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72148,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72148 mod 26,72148,72148,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72148 mod 26,BCBS multispecialty AW base fee schedule,139.79,203.5,Fee schedule,,139.79,139.79,139.79,139.79,,,0
unity,Fee schedule,Facility 72148 mod TC,Not in chargemaster,72148,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72148 mod TC,BCBS multispecialty AW base fee schedule,265.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72149,Not in chargemaster,72149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72149,BCBS multispecialty AW base fee schedule,579.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72149 mod 26,Not in chargemaster,72149,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72149 mod 26,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72149 mod TC,Not in chargemaster,72149,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72149 mod TC,BCBS multispecialty AW base fee schedule,411.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72156,Not in chargemaster,72156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72156,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72156 mod 26,72156,72156,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72156 mod 26,BCBS multispecialty AW base fee schedule,215.31,284.66,Fee schedule,,215.31,215.31,215.31,215.31,,,0
unity,Fee schedule,Facility 72156 mod TC,Not in chargemaster,72156,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72156 mod TC,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72157,Not in chargemaster,72157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72157,BCBS multispecialty AW base fee schedule,687.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72157 mod 26,72157,72157,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72157 mod 26,BCBS multispecialty AW base fee schedule,215.31,291.08,Fee schedule,,215.31,215.31,215.31,215.31,,,0
unity,Fee schedule,Facility 72157 mod TC,Not in chargemaster,72157,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72157 mod TC,BCBS multispecialty AW base fee schedule,471.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72158,Not in chargemaster,72158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72158,BCBS multispecialty AW base fee schedule,684.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72158 mod 26,72158,72158,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72158 mod 26,BCBS multispecialty AW base fee schedule,215.31,262.94,Fee schedule,,215.31,215.31,215.31,215.31,,,0
unity,Fee schedule,Facility 72158 mod TC,Not in chargemaster,72158,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72158 mod TC,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72159,Not in chargemaster,72159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72159,BCBS multispecialty AW base fee schedule,743.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72159 mod 26,Not in chargemaster,72159,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72159 mod 26,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72159 mod TC,Not in chargemaster,72159,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72159 mod TC,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72170,Not in chargemaster,72170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72170,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72170 mod 26,72170,72170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72170 mod 26,BCBS multispecialty AW base fee schedule,16.56,27.5,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Facility 72170 mod TC,Not in chargemaster,72170,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72170 mod TC,BCBS multispecialty AW base fee schedule,36.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72190,Not in chargemaster,72190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72190,BCBS multispecialty AW base fee schedule,75.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72190 mod 26,Not in chargemaster,72190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72190 mod 26,BCBS multispecialty AW base fee schedule,23.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72190 mod TC,Not in chargemaster,72190,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72190 mod TC,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72191,Not in chargemaster,72191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72191,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72191 mod 26,Not in chargemaster,72191,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72191 mod 26,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72191 mod TC,Not in chargemaster,72191,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72191 mod TC,BCBS multispecialty AW base fee schedule,433.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72192,Not in chargemaster,72192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72192,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72192 mod 26,72192,72192,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72192 mod 26,BCBS multispecialty AW base fee schedule,102.03,138.82,Fee schedule,,102.03,102.03,102.03,102.03,,,0
unity,Fee schedule,Facility 72192 mod TC,Not in chargemaster,72192,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72192 mod TC,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72193,Not in chargemaster,72193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72193,BCBS multispecialty AW base fee schedule,451.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72193 mod 26,72193,72193,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72193 mod 26,BCBS multispecialty AW base fee schedule,108.65,148.68,Fee schedule,,108.65,108.65,108.65,108.65,,,0
unity,Fee schedule,Facility 72193 mod TC,Not in chargemaster,72193,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72193 mod TC,BCBS multispecialty AW base fee schedule,342.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72194,Not in chargemaster,72194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72194,BCBS multispecialty AW base fee schedule,507.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72194 mod 26,72194,72194,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72194 mod 26,BCBS multispecialty AW base fee schedule,114.61,134.19,Fee schedule,,114.61,114.61,114.61,114.61,,,0
unity,Fee schedule,Facility 72194 mod TC,Not in chargemaster,72194,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72194 mod TC,BCBS multispecialty AW base fee schedule,392.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72195,Not in chargemaster,72195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72195,BCBS multispecialty AW base fee schedule,496.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72195 mod 26,Not in chargemaster,72195,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72195 mod 26,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72195 mod TC,Not in chargemaster,72195,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72195 mod TC,BCBS multispecialty AW base fee schedule,358.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72196,Not in chargemaster,72196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72196,BCBS multispecialty AW base fee schedule,579.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72196 mod 26,Not in chargemaster,72196,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72196 mod 26,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72196 mod TC,Not in chargemaster,72196,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72196 mod TC,BCBS multispecialty AW base fee schedule,416.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72197,Not in chargemaster,72197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72197,BCBS multispecialty AW base fee schedule,728.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72197 mod 26,72197,72197,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72197 mod 26,BCBS multispecialty AW base fee schedule,205.38,248.2,Fee schedule,,205.38,205.38,205.38,205.38,,,0
unity,Fee schedule,Facility 72197 mod TC,Not in chargemaster,72197,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72197 mod TC,BCBS multispecialty AW base fee schedule,522.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72198,Not in chargemaster,72198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72198,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72198 mod 26,Not in chargemaster,72198,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72198 mod 26,BCBS multispecialty AW base fee schedule,166.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72198 mod TC,Not in chargemaster,72198,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72198 mod TC,BCBS multispecialty AW base fee schedule,552.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72200,Not in chargemaster,72200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72200,BCBS multispecialty AW base fee schedule,59.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72200 mod 26,72200,72200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72200 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Facility 72200 mod TC,Not in chargemaster,72200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72200 mod TC,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72202,Not in chargemaster,72202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72202,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72202 mod 26,Not in chargemaster,72202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72202 mod 26,BCBS multispecialty AW base fee schedule,21.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72202 mod TC,Not in chargemaster,72202,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72202 mod TC,BCBS multispecialty AW base fee schedule,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72220,Not in chargemaster,72220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72220,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72220 mod 26,72220,72220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72220 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Facility 72220 mod TC,Not in chargemaster,72220,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72220 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72240,Not in chargemaster,72240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72240,BCBS multispecialty AW base fee schedule,208.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72240 mod 26,Not in chargemaster,72240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72240 mod 26,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72240 mod TC,Not in chargemaster,72240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72240 mod TC,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72255,Not in chargemaster,72255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72255,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72255 mod 26,Not in chargemaster,72255,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72255 mod 26,BCBS multispecialty AW base fee schedule,89.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72255 mod TC,Not in chargemaster,72255,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72255 mod TC,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72265,Not in chargemaster,72265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72265,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72265 mod 26,Not in chargemaster,72265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72265 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72265 mod TC,Not in chargemaster,72265,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72265 mod TC,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72270,Not in chargemaster,72270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72270,BCBS multispecialty AW base fee schedule,265,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72270 mod 26,Not in chargemaster,72270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72270 mod 26,BCBS multispecialty AW base fee schedule,126.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72270 mod TC,Not in chargemaster,72270,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72270 mod TC,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72275,Not in chargemaster,72275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72275,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72275 mod 26,Not in chargemaster,72275,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72275 mod 26,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72275 mod TC,Not in chargemaster,72275,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72275 mod TC,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72285,Not in chargemaster,72285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72285,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72285 mod 26,Not in chargemaster,72285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72285 mod 26,BCBS multispecialty AW base fee schedule,111.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72285 mod TC,Not in chargemaster,72285,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72285 mod TC,BCBS multispecialty AW base fee schedule,117.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72295,Not in chargemaster,72295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72295,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72295 mod 26,Not in chargemaster,72295,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72295 mod 26,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 72295 mod TC,Not in chargemaster,72295,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72295 mod TC,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73000,Not in chargemaster,73000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73000,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73000 mod 26,73000,73000,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73000 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73000 mod TC,Not in chargemaster,73000,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73000 mod TC,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73010,Not in chargemaster,73010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73010,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73010 mod 26,73010,73010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73010 mod 26,BCBS multispecialty AW base fee schedule,17.23,21.71,Fee schedule,,17.23,17.23,17.23,17.23,,,0
unity,Fee schedule,Facility 73010 mod TC,Not in chargemaster,73010,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73010 mod TC,BCBS multispecialty AW base fee schedule,34.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73020,Not in chargemaster,73020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73020,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73020 mod 26,73020,73020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73020 mod 26,BCBS multispecialty AW base fee schedule,14.58,17.06,Fee schedule,,14.58,14.58,14.58,14.58,,,0
unity,Fee schedule,Facility 73020 mod TC,Not in chargemaster,73020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73020 mod TC,BCBS multispecialty AW base fee schedule,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73030,Not in chargemaster,73030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73030,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73030 mod 26,73030,73030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73030 mod 26,BCBS multispecialty AW base fee schedule,17.89,22.5,Fee schedule,,17.89,17.89,17.89,17.89,,,0
unity,Fee schedule,Facility 73030 mod TC,Not in chargemaster,73030,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73030 mod TC,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73040,Not in chargemaster,73040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73040,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73040 mod 26,Not in chargemaster,73040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73040 mod 26,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73040 mod TC,Not in chargemaster,73040,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73040 mod TC,BCBS multispecialty AW base fee schedule,172.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73050,Not in chargemaster,73050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73050,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73050 mod 26,Not in chargemaster,73050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73050 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73050 mod TC,Not in chargemaster,73050,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73050 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73060,Not in chargemaster,73060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73060,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73060 mod 26,73060,73060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73060 mod 26,BCBS multispecialty AW base fee schedule,15.9,19.39,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73060 mod TC,Not in chargemaster,73060,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73060 mod TC,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73070,Not in chargemaster,73070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73070,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73070 mod 26,73070,73070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73070 mod 26,BCBS multispecialty AW base fee schedule,15.9,17.83,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73070 mod TC,Not in chargemaster,73070,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73070 mod TC,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73080,Not in chargemaster,73080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73080,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73080 mod 26,Not in chargemaster,73080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73080 mod 26,BCBS multispecialty AW base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73080 mod TC,Not in chargemaster,73080,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73080 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73085,Not in chargemaster,73085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73085,BCBS multispecialty AW base fee schedule,210.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73085 mod 26,Not in chargemaster,73085,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73085 mod 26,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73085 mod TC,Not in chargemaster,73085,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73085 mod TC,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73090,Not in chargemaster,73090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73090,BCBS multispecialty AW base fee schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73090 mod 26,73090,73090,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73090 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73090 mod TC,Not in chargemaster,73090,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73090 mod TC,BCBS multispecialty AW base fee schedule,37.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73092,Not in chargemaster,73092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73092,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73092 mod 26,73092,73092,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73092 mod 26,BCBS multispecialty AW base fee schedule,15.24,18.62,Fee schedule,,15.24,15.24,15.24,15.24,,,0
unity,Fee schedule,Facility 73092 mod TC,Not in chargemaster,73092,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73092 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73100,Not in chargemaster,73100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73100,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73100 mod 26,73100,73100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73100 mod 26,BCBS multispecialty AW base fee schedule,15.9,20.94,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73100 mod TC,Not in chargemaster,73100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73100 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73110,Not in chargemaster,73110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73110,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73110 mod 26,73110,73110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73110 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Facility 73110 mod TC,Not in chargemaster,73110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73110 mod TC,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73115,Not in chargemaster,73115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73115,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73115 mod 26,Not in chargemaster,73115,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73115 mod 26,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73115 mod TC,Not in chargemaster,73115,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73115 mod TC,BCBS multispecialty AW base fee schedule,182.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73120,Not in chargemaster,73120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73120,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73120 mod 26,73120,73120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73120 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73120 mod TC,Not in chargemaster,73120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73120 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73130,Not in chargemaster,73130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73130,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73130 mod 26,73130,73130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73130 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Facility 73130 mod TC,Not in chargemaster,73130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73130 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73140,Not in chargemaster,73140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73140,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73140 mod 26,73140,73140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73140 mod 26,BCBS multispecialty AW base fee schedule,13.25,17.91,Fee schedule,,13.25,13.25,13.25,13.25,,,0
unity,Fee schedule,Facility 73140 mod TC,Not in chargemaster,73140,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73140 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73200,Not in chargemaster,73200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73200,BCBS multispecialty AW base fee schedule,333.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73200 mod 26,73200,73200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73200 mod 26,BCBS multispecialty AW base fee schedule,94.08,111.69,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Facility 73200 mod TC,Not in chargemaster,73200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73200 mod TC,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73201,Not in chargemaster,73201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73201,BCBS multispecialty AW base fee schedule,414.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73201 mod 26,Not in chargemaster,73201,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73201 mod 26,BCBS multispecialty AW base fee schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73201 mod TC,Not in chargemaster,73201,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73201 mod TC,BCBS multispecialty AW base fee schedule,306.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73202,Not in chargemaster,73202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73202,BCBS multispecialty AW base fee schedule,518.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73202 mod 26,Not in chargemaster,73202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73202 mod 26,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73202 mod TC,Not in chargemaster,73202,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73202 mod TC,BCBS multispecialty AW base fee schedule,403.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73206,Not in chargemaster,73206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73206,BCBS multispecialty AW base fee schedule,612.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73206 mod 26,Not in chargemaster,73206,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73206 mod 26,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73206 mod TC,Not in chargemaster,73206,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73206 mod TC,BCBS multispecialty AW base fee schedule,443.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73218,Not in chargemaster,73218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73218,BCBS multispecialty AW base fee schedule,657.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73218 mod 26,Not in chargemaster,73218,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73218 mod 26,BCBS multispecialty AW base fee schedule,127.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73218 mod TC,Not in chargemaster,73218,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73218 mod TC,BCBS multispecialty AW base fee schedule,530.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73219,Not in chargemaster,73219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73219,BCBS multispecialty AW base fee schedule,727.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73219 mod 26,Not in chargemaster,73219,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73219 mod 26,BCBS multispecialty AW base fee schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73219 mod TC,Not in chargemaster,73219,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73219 mod TC,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73220,Not in chargemaster,73220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73220,BCBS multispecialty AW base fee schedule,893.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73220 mod 26,Not in chargemaster,73220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73220 mod 26,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73220 mod TC,Not in chargemaster,73220,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73220 mod TC,BCBS multispecialty AW base fee schedule,691.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73221,Not in chargemaster,73221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73221,BCBS multispecialty AW base fee schedule,428.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73221 mod 26,73221,73221,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73221 mod 26,BCBS multispecialty AW base fee schedule,129.19,152.02,Fee schedule,,129.19,129.19,129.19,129.19,,,0
unity,Fee schedule,Facility 73221 mod TC,Not in chargemaster,73221,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73221 mod TC,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73222,Not in chargemaster,73222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73222,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73222 mod 26,Not in chargemaster,73222,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73222 mod 26,BCBS multispecialty AW base fee schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73222 mod TC,Not in chargemaster,73222,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73222 mod TC,BCBS multispecialty AW base fee schedule,528.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73223,Not in chargemaster,73223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73223,BCBS multispecialty AW base fee schedule,842.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73223 mod 26,Not in chargemaster,73223,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73223 mod 26,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73223 mod TC,Not in chargemaster,73223,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73223 mod TC,BCBS multispecialty AW base fee schedule,641.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73225,Not in chargemaster,73225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73225,BCBS multispecialty AW base fee schedule,737.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73225 mod 26,Not in chargemaster,73225,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73225 mod 26,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73225 mod TC,Not in chargemaster,73225,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73225 mod TC,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73501,Not in chargemaster,73501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73501,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73501 mod 26,Not in chargemaster,73501,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73501 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73501 mod TC,Not in chargemaster,73501,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73501 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73502,Not in chargemaster,73502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73502,BCBS multispecialty AW base fee schedule,84.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73502 mod 26,Not in chargemaster,73502,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73502 mod 26,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73502 mod TC,Not in chargemaster,73502,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73502 mod TC,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73503,Not in chargemaster,73503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73503,BCBS multispecialty AW base fee schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73503 mod 26,Not in chargemaster,73503,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73503 mod 26,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73503 mod TC,Not in chargemaster,73503,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73503 mod TC,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73521,Not in chargemaster,73521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73521,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73521 mod 26,Not in chargemaster,73521,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73521 mod 26,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73521 mod TC,Not in chargemaster,73521,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73521 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73522,Not in chargemaster,73522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73522,BCBS multispecialty AW base fee schedule,96.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73522 mod 26,Not in chargemaster,73522,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73522 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73522 mod TC,Not in chargemaster,73522,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73522 mod TC,BCBS multispecialty AW base fee schedule,68.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73523,Not in chargemaster,73523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73523,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73523 mod 26,Not in chargemaster,73523,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73523 mod 26,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73523 mod TC,Not in chargemaster,73523,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73523 mod TC,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73525,Not in chargemaster,73525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73525,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73525 mod 26,Not in chargemaster,73525,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73525 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73525 mod TC,Not in chargemaster,73525,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73525 mod TC,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73551,Not in chargemaster,73551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73551,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73551 mod 26,Not in chargemaster,73551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73551 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73551 mod TC,Not in chargemaster,73551,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73551 mod TC,BCBS multispecialty AW base fee schedule,38.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73552,Not in chargemaster,73552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73552,BCBS multispecialty AW base fee schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73552 mod 26,Not in chargemaster,73552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73552 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73552 mod TC,Not in chargemaster,73552,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73552 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73560,Not in chargemaster,73560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73560,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73560 mod 26,73560,73560,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73560 mod 26,BCBS multispecialty AW base fee schedule,15.9,21.71,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73560 mod TC,Not in chargemaster,73560,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73560 mod TC,BCBS multispecialty AW base fee schedule,46.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73562,Not in chargemaster,73562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73562,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73562 mod 26,73562,73562,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73562 mod 26,BCBS multispecialty AW base fee schedule,17.89,22.5,Fee schedule,,17.89,17.89,17.89,17.89,,,0
unity,Fee schedule,Facility 73562 mod TC,Not in chargemaster,73562,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73562 mod TC,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73564,Not in chargemaster,73564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73564,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73564 mod 26,73564,73564,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73564 mod 26,BCBS multispecialty AW base fee schedule,21.2,27.15,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Facility 73564 mod TC,Not in chargemaster,73564,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73564 mod TC,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73565,Not in chargemaster,73565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73565,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73565 mod 26,73565,73565,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73565 mod 26,BCBS multispecialty AW base fee schedule,16.56,21.71,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Facility 73565 mod TC,Not in chargemaster,73565,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73565 mod TC,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73580,Not in chargemaster,73580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73580,BCBS multispecialty AW base fee schedule,254.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73580 mod 26,Not in chargemaster,73580,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73580 mod 26,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73580 mod TC,Not in chargemaster,73580,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73580 mod TC,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73590,Not in chargemaster,73590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73590,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73590 mod 26,73590,73590,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73590 mod 26,BCBS multispecialty AW base fee schedule,15.24,19.39,Fee schedule,,15.24,15.24,15.24,15.24,,,0
unity,Fee schedule,Facility 73590 mod TC,Not in chargemaster,73590,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73590 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73592,Not in chargemaster,73592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73592,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73592 mod 26,Not in chargemaster,73592,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73592 mod 26,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73592 mod TC,Not in chargemaster,73592,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73592 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73600,Not in chargemaster,73600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73600,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73600 mod 26,73600,73600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73600 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73600 mod TC,Not in chargemaster,73600,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73600 mod TC,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73610,Not in chargemaster,73610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73610,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73610 mod 26,73610,73610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73610 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Facility 73610 mod TC,Not in chargemaster,73610,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73610 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73615,Not in chargemaster,73615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73615,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73615 mod 26,Not in chargemaster,73615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73615 mod 26,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73615 mod TC,Not in chargemaster,73615,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73615 mod TC,BCBS multispecialty AW base fee schedule,184.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73620,Not in chargemaster,73620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73620,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73620 mod 26,73620,73620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73620 mod 26,BCBS multispecialty AW base fee schedule,14.58,17.06,Fee schedule,,14.58,14.58,14.58,14.58,,,0
unity,Fee schedule,Facility 73620 mod TC,Not in chargemaster,73620,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73620 mod TC,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73630,Not in chargemaster,73630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73630,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73630 mod 26,73630,73630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73630 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Facility 73630 mod TC,Not in chargemaster,73630,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73630 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73650,Not in chargemaster,73650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73650,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73650 mod 26,73650,73650,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73650 mod 26,BCBS multispecialty AW base fee schedule,15.24,17.83,Fee schedule,,15.24,15.24,15.24,15.24,,,0
unity,Fee schedule,Facility 73650 mod TC,Not in chargemaster,73650,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73650 mod TC,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73660,Not in chargemaster,73660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73660,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73660 mod 26,73660,73660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73660 mod 26,BCBS multispecialty AW base fee schedule,12.59,14.74,Fee schedule,,12.59,12.59,12.59,12.59,,,0
unity,Fee schedule,Facility 73660 mod TC,Not in chargemaster,73660,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73660 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73700,Not in chargemaster,73700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73700,BCBS multispecialty AW base fee schedule,288.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73700 mod 26,73700,73700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73700 mod 26,BCBS multispecialty AW base fee schedule,94.08,128.07,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Facility 73700 mod TC,Not in chargemaster,73700,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73700 mod TC,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73701,Not in chargemaster,73701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73701,BCBS multispecialty AW base fee schedule,361.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73701 mod 26,73701,73701,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73701 mod 26,BCBS multispecialty AW base fee schedule,108.65,148.68,Fee schedule,,108.65,108.65,108.65,108.65,,,0
unity,Fee schedule,Facility 73701 mod TC,Not in chargemaster,73701,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73701 mod TC,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73702,Not in chargemaster,73702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73702,BCBS multispecialty AW base fee schedule,434.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73702 mod 26,Not in chargemaster,73702,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73702 mod 26,BCBS multispecialty AW base fee schedule,113.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73702 mod TC,Not in chargemaster,73702,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73702 mod TC,BCBS multispecialty AW base fee schedule,320.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73706,Not in chargemaster,73706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73706,BCBS multispecialty AW base fee schedule,662.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73706 mod 26,Not in chargemaster,73706,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73706 mod 26,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73706 mod TC,Not in chargemaster,73706,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73706 mod TC,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73718,Not in chargemaster,73718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73718,BCBS multispecialty AW base fee schedule,480.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73718 mod 26,73718,73718,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73718 mod 26,BCBS multispecialty AW base fee schedule,126.54,148.93,Fee schedule,,126.54,126.54,126.54,126.54,,,0
unity,Fee schedule,Facility 73718 mod TC,Not in chargemaster,73718,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73718 mod TC,BCBS multispecialty AW base fee schedule,353.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73719,Not in chargemaster,73719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73719,BCBS multispecialty AW base fee schedule,568.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73719 mod 26,Not in chargemaster,73719,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73719 mod 26,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73719 mod TC,Not in chargemaster,73719,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73719 mod TC,BCBS multispecialty AW base fee schedule,415.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73720,Not in chargemaster,73720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73720,BCBS multispecialty AW base fee schedule,727.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73720 mod 26,73720,73720,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73720 mod 26,BCBS multispecialty AW base fee schedule,200.74,236.57,Fee schedule,,200.74,200.74,200.74,200.74,,,0
unity,Fee schedule,Facility 73720 mod TC,Not in chargemaster,73720,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73720 mod TC,BCBS multispecialty AW base fee schedule,526.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73721,Not in chargemaster,73721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73721,BCBS multispecialty AW base fee schedule,426.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73721 mod 26,73721,73721,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73721 mod 26,BCBS multispecialty AW base fee schedule,127.2,152.02,Fee schedule,,127.2,127.2,127.2,127.2,,,0
unity,Fee schedule,Facility 73721 mod TC,Not in chargemaster,73721,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73721 mod TC,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73722,Not in chargemaster,73722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73722,BCBS multispecialty AW base fee schedule,683.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73722 mod 26,Not in chargemaster,73722,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73722 mod 26,BCBS multispecialty AW base fee schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73722 mod TC,Not in chargemaster,73722,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73722 mod TC,BCBS multispecialty AW base fee schedule,529.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73723,Not in chargemaster,73723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73723,BCBS multispecialty AW base fee schedule,841.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73723 mod 26,Not in chargemaster,73723,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73723 mod 26,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73723 mod TC,Not in chargemaster,73723,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73723 mod TC,BCBS multispecialty AW base fee schedule,639.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73725,Not in chargemaster,73725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73725,BCBS multispecialty AW base fee schedule,720.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73725 mod 26,Not in chargemaster,73725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73725 mod 26,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 73725 mod TC,Not in chargemaster,73725,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73725 mod TC,BCBS multispecialty AW base fee schedule,551.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74018,Not in chargemaster,74018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74018,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74018 mod 26,74018,74018,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74018 mod 26,BCBS multispecialty AW base fee schedule,17.23,20.17,Fee schedule,,17.23,17.23,17.23,17.23,,,0
unity,Fee schedule,Facility 74018 mod TC,Not in chargemaster,74018,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74018 mod TC,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74019,Not in chargemaster,74019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74019,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74019 mod 26,74019,74019,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74019 mod 26,BCBS multispecialty AW base fee schedule,21.86,29.48,Fee schedule,,21.86,21.86,21.86,21.86,,,0
unity,Fee schedule,Facility 74019 mod TC,Not in chargemaster,74019,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74019 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74021,Not in chargemaster,74021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74021,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74021 mod 26,74021,74021,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74021 mod 26,BCBS multispecialty AW base fee schedule,25.18,34.89,Fee schedule,,25.18,25.18,25.18,25.18,,,0
unity,Fee schedule,Facility 74021 mod TC,Not in chargemaster,74021,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74021 mod TC,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74022,Not in chargemaster,74022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74022,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74022 mod 26,74022,74022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74022 mod 26,BCBS multispecialty AW base fee schedule,29.81,34.9,Fee schedule,,29.81,29.81,29.81,29.81,,,0
unity,Fee schedule,Facility 74022 mod TC,Not in chargemaster,74022,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74022 mod TC,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74150,Not in chargemaster,74150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74150,BCBS multispecialty AW base fee schedule,278.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74150 mod 26,74150,74150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74150 mod 26,BCBS multispecialty AW base fee schedule,111.96,151.95,Fee schedule,,111.96,111.96,111.96,111.96,,,0
unity,Fee schedule,Facility 74150 mod TC,Not in chargemaster,74150,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74150 mod TC,BCBS multispecialty AW base fee schedule,166.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74160,Not in chargemaster,74160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74160,BCBS multispecialty AW base fee schedule,461.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74160 mod 26,74160,74160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74160 mod 26,BCBS multispecialty AW base fee schedule,119.91,162.11,Fee schedule,,119.91,119.91,119.91,119.91,,,0
unity,Fee schedule,Facility 74160 mod TC,Not in chargemaster,74160,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74160 mod TC,BCBS multispecialty AW base fee schedule,341.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74170,Not in chargemaster,74170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74170,BCBS multispecialty AW base fee schedule,520.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74170 mod 26,74170,74170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74170 mod 26,BCBS multispecialty AW base fee schedule,131.84,179.12,Fee schedule,,131.84,131.84,131.84,131.84,,,0
unity,Fee schedule,Facility 74170 mod TC,Not in chargemaster,74170,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74170 mod TC,BCBS multispecialty AW base fee schedule,388.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74174,Not in chargemaster,74174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74174,BCBS multispecialty AW base fee schedule,755.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74174 mod 26,Not in chargemaster,74174,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74174 mod 26,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74174 mod TC,Not in chargemaster,74174,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74174 mod TC,BCBS multispecialty AW base fee schedule,549.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74175,Not in chargemaster,74175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74175,BCBS multispecialty AW base fee schedule,602.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74175 mod 26,Not in chargemaster,74175,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74175 mod 26,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74175 mod TC,Not in chargemaster,74175,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74175 mod TC,BCBS multispecialty AW base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74176,Not in chargemaster,74176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74176,BCBS multispecialty AW base fee schedule,372.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74176 mod 26,74176,74176,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74176 mod 26,BCBS multispecialty AW base fee schedule,163.64,222.11,Fee schedule,,163.64,163.64,163.64,163.64,,,0
unity,Fee schedule,Facility 74176 mod TC,Not in chargemaster,74176,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74176 mod TC,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74177,Not in chargemaster,74177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74177,BCBS multispecialty AW base fee schedule,610.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74177 mod 26,74177,74177,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74177 mod 26,BCBS multispecialty AW base fee schedule,171.59,232.86,Fee schedule,,171.59,171.59,171.59,171.59,,,0
unity,Fee schedule,Facility 74177 mod TC,Not in chargemaster,74177,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74177 mod TC,BCBS multispecialty AW base fee schedule,438.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74178,Not in chargemaster,74178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74178,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74178 mod 26,74178,74178,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74178 mod 26,BCBS multispecialty AW base fee schedule,188.15,255.26,Fee schedule,,188.15,188.15,188.15,188.15,,,0
unity,Fee schedule,Facility 74178 mod TC,Not in chargemaster,74178,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74178 mod TC,BCBS multispecialty AW base fee schedule,497.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74181,Not in chargemaster,74181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74181,BCBS multispecialty AW base fee schedule,420.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74181 mod 26,74181,74181,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74181 mod 26,BCBS multispecialty AW base fee schedule,137.8,160.56,Fee schedule,,137.8,137.8,137.8,137.8,,,0
unity,Fee schedule,Facility 74181 mod TC,Not in chargemaster,74181,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74181 mod TC,BCBS multispecialty AW base fee schedule,282.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74182,Not in chargemaster,74182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74182,BCBS multispecialty AW base fee schedule,655.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74182 mod 26,Not in chargemaster,74182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74182 mod 26,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74182 mod TC,Not in chargemaster,74182,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74182 mod TC,BCBS multispecialty AW base fee schedule,492.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74183,Not in chargemaster,74183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74183,BCBS multispecialty AW base fee schedule,729.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74183 mod 26,74183,74183,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74183 mod 26,BCBS multispecialty AW base fee schedule,205.38,248.2,Fee schedule,,205.38,205.38,205.38,205.38,,,0
unity,Fee schedule,Facility 74183 mod TC,Not in chargemaster,74183,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74183 mod TC,BCBS multispecialty AW base fee schedule,524.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74185,Not in chargemaster,74185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74185,BCBS multispecialty AW base fee schedule,722.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74185 mod 26,74185,74185,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74185 mod 26,BCBS multispecialty AW base fee schedule,167.61,227.52,Fee schedule,,167.61,167.61,167.61,167.61,,,0
unity,Fee schedule,Facility 74185 mod TC,Not in chargemaster,74185,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74185 mod TC,BCBS multispecialty AW base fee schedule,555.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74190,Not in chargemaster,74190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74190,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74190 mod 26,Not in chargemaster,74190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74190 mod 26,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74210,Not in chargemaster,74210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74210,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74210 mod 26,Not in chargemaster,74210,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74210 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74210 mod TC,Not in chargemaster,74210,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74210 mod TC,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74220,Not in chargemaster,74220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74220,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74220 mod 26,Not in chargemaster,74220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74220 mod 26,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74220 mod TC,Not in chargemaster,74220,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74220 mod TC,BCBS multispecialty AW base fee schedule,123.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74221,Not in chargemaster,74221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74221,BCBS multispecialty AW base fee schedule,202.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74221 mod 26,Not in chargemaster,74221,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74221 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74221 mod TC,Not in chargemaster,74221,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74221 mod TC,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74230,Not in chargemaster,74230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74230,BCBS multispecialty AW base fee schedule,241.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74230 mod 26,Not in chargemaster,74230,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74230 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74230 mod TC,Not in chargemaster,74230,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74230 mod TC,BCBS multispecialty AW base fee schedule,191.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74235,Not in chargemaster,74235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74235,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74235 mod 26,Not in chargemaster,74235,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74235 mod 26,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74240,Not in chargemaster,74240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74240,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74240 mod 26,Not in chargemaster,74240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74240 mod 26,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74240 mod TC,Not in chargemaster,74240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74240 mod TC,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74246,Not in chargemaster,74246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74246,BCBS multispecialty AW base fee schedule,258.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74246 mod 26,Not in chargemaster,74246,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74246 mod 26,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74246 mod TC,Not in chargemaster,74246,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74246 mod TC,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74248,Not in chargemaster,74248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74248,BCBS multispecialty AW base fee schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74248 mod 26,Not in chargemaster,74248,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74248 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74248 mod TC,Not in chargemaster,74248,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74248 mod TC,BCBS multispecialty AW base fee schedule,88.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74250,Not in chargemaster,74250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74250,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74250 mod 26,Not in chargemaster,74250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74250 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74250 mod TC,Not in chargemaster,74250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74250 mod TC,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74251,Not in chargemaster,74251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74251,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74251 mod 26,Not in chargemaster,74251,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74251 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74251 mod TC,Not in chargemaster,74251,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74251 mod TC,BCBS multispecialty AW base fee schedule,639.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74261,Not in chargemaster,74261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74261,BCBS multispecialty AW base fee schedule,890.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74261 mod 26,Not in chargemaster,74261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74261 mod 26,BCBS multispecialty AW base fee schedule,225.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74261 mod TC,Not in chargemaster,74261,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74261 mod TC,BCBS multispecialty AW base fee schedule,665.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74262,Not in chargemaster,74262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74262,BCBS multispecialty AW base fee schedule,1001.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74262 mod 26,Not in chargemaster,74262,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74262 mod 26,BCBS multispecialty AW base fee schedule,234.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74262 mod TC,Not in chargemaster,74262,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74262 mod TC,BCBS multispecialty AW base fee schedule,766.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74263,Not in chargemaster,74263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74263,BCBS multispecialty AW base fee schedule,1401.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74263 mod 26,Not in chargemaster,74263,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74263 mod 26,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74263 mod TC,Not in chargemaster,74263,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74263 mod TC,BCBS multispecialty AW base fee schedule,1185.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74270,Not in chargemaster,74270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74270,BCBS multispecialty AW base fee schedule,287.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74270 mod 26,Not in chargemaster,74270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74270 mod 26,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74270 mod TC,Not in chargemaster,74270,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74270 mod TC,BCBS multispecialty AW base fee schedule,190.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74280,Not in chargemaster,74280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74280,BCBS multispecialty AW base fee schedule,413.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74280 mod 26,Not in chargemaster,74280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74280 mod 26,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74280 mod TC,Not in chargemaster,74280,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74280 mod TC,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74283,Not in chargemaster,74283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74283,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74283 mod 26,Not in chargemaster,74283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74283 mod 26,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74283 mod TC,Not in chargemaster,74283,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74283 mod TC,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74290,Not in chargemaster,74290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74290,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74290 mod 26,Not in chargemaster,74290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74290 mod 26,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74290 mod TC,Not in chargemaster,74290,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74290 mod TC,BCBS multispecialty AW base fee schedule,123.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74300,Not in chargemaster,74300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74300,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74300 mod 26,74300,74300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74300 mod 26,BCBS multispecialty AW base fee schedule,33.79,46.57,Fee schedule,,33.79,33.79,33.79,33.79,,,0
unity,Fee schedule,Facility 74301,Not in chargemaster,74301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74301,BCBS multispecialty AW base fee schedule,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74301 mod 26,Not in chargemaster,74301,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74301 mod 26,BCBS multispecialty AW base fee schedule,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74328,Not in chargemaster,74328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74328,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74328 mod 26,Not in chargemaster,74328,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74328 mod 26,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74329,Not in chargemaster,74329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74329,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74329 mod 26,Not in chargemaster,74329,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74329 mod 26,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74330,Not in chargemaster,74330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74330,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74330 mod 26,Not in chargemaster,74330,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74330 mod 26,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74340,Not in chargemaster,74340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74340,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74340 mod 26,Not in chargemaster,74340,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74340 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74355,Not in chargemaster,74355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74355,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74355 mod 26,Not in chargemaster,74355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74355 mod 26,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74360,Not in chargemaster,74360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74360,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74360 mod 26,Not in chargemaster,74360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74360 mod 26,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74363,Not in chargemaster,74363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74363,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74363 mod 26,Not in chargemaster,74363,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74363 mod 26,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74400,Not in chargemaster,74400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74400,BCBS multispecialty AW base fee schedule,238.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74400 mod 26,Not in chargemaster,74400,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74400 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74400 mod TC,Not in chargemaster,74400,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74400 mod TC,BCBS multispecialty AW base fee schedule,192.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74410,Not in chargemaster,74410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74410,BCBS multispecialty AW base fee schedule,242.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74410 mod 26,Not in chargemaster,74410,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74410 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74410 mod TC,Not in chargemaster,74410,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74410 mod TC,BCBS multispecialty AW base fee schedule,197.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74415,Not in chargemaster,74415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74415,BCBS multispecialty AW base fee schedule,283.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74415 mod 26,Not in chargemaster,74415,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74415 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74415 mod TC,Not in chargemaster,74415,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74415 mod TC,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74420,Not in chargemaster,74420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74420,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74420 mod 26,Not in chargemaster,74420,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74420 mod 26,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74420 mod TC,Not in chargemaster,74420,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74420 mod TC,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74425,Not in chargemaster,74425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74425,BCBS multispecialty AW base fee schedule,242.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74425 mod 26,Not in chargemaster,74425,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74425 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74425 mod TC,Not in chargemaster,74425,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74425 mod TC,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74430,Not in chargemaster,74430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74430,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74430 mod 26,Not in chargemaster,74430,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74430 mod 26,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74430 mod TC,Not in chargemaster,74430,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74430 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74440,Not in chargemaster,74440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74440,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74440 mod 26,Not in chargemaster,74440,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74440 mod 26,BCBS multispecialty AW base fee schedule,34.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74440 mod TC,Not in chargemaster,74440,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74440 mod TC,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74445,Not in chargemaster,74445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74445,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74445 mod 26,Not in chargemaster,74445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74445 mod 26,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74450,Not in chargemaster,74450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74450,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74450 mod 26,Not in chargemaster,74450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74450 mod 26,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74455,Not in chargemaster,74455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74455,BCBS multispecialty AW base fee schedule,181.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74455 mod 26,Not in chargemaster,74455,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74455 mod 26,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74455 mod TC,Not in chargemaster,74455,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74455 mod TC,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74470,Not in chargemaster,74470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74470,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74470 mod 26,Not in chargemaster,74470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74470 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74485,Not in chargemaster,74485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74485,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74485 mod 26,Not in chargemaster,74485,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74485 mod 26,BCBS multispecialty AW base fee schedule,75.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74485 mod TC,Not in chargemaster,74485,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74485 mod TC,BCBS multispecialty AW base fee schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74710,Not in chargemaster,74710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74710,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74710 mod 26,Not in chargemaster,74710,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74710 mod 26,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74710 mod TC,Not in chargemaster,74710,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74710 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74712,Not in chargemaster,74712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74712,BCBS multispecialty AW base fee schedule,882.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74712 mod 26,Not in chargemaster,74712,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74712 mod 26,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74712 mod TC,Not in chargemaster,74712,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74712 mod TC,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74713,Not in chargemaster,74713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74713,BCBS multispecialty AW base fee schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74713 mod 26,Not in chargemaster,74713,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74713 mod 26,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74713 mod TC,Not in chargemaster,74713,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74713 mod TC,BCBS multispecialty AW base fee schedule,253.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74740,Not in chargemaster,74740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74740,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74740 mod 26,Not in chargemaster,74740,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74740 mod 26,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74740 mod TC,Not in chargemaster,74740,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74740 mod TC,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74742,Not in chargemaster,74742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74742,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74742 mod 26,Not in chargemaster,74742,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74742 mod 26,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74775,Not in chargemaster,74775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74775,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 74775 mod 26,Not in chargemaster,74775,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74775 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75557,Not in chargemaster,75557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75557,BCBS multispecialty AW base fee schedule,596.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75557 mod 26,Not in chargemaster,75557,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75557 mod 26,BCBS multispecialty AW base fee schedule,217.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75557 mod TC,Not in chargemaster,75557,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75557 mod TC,BCBS multispecialty AW base fee schedule,379.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75559,Not in chargemaster,75559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75559,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75559 mod 26,Not in chargemaster,75559,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75559 mod 26,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75559 mod TC,Not in chargemaster,75559,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75559 mod TC,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75561,Not in chargemaster,75561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75561,BCBS multispecialty AW base fee schedule,783.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75561 mod 26,Not in chargemaster,75561,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75561 mod 26,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75561 mod TC,Not in chargemaster,75561,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75561 mod TC,BCBS multispecialty AW base fee schedule,543.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75563,Not in chargemaster,75563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75563,BCBS multispecialty AW base fee schedule,927.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75563 mod 26,Not in chargemaster,75563,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75563 mod 26,BCBS multispecialty AW base fee schedule,276.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75563 mod TC,Not in chargemaster,75563,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75563 mod TC,BCBS multispecialty AW base fee schedule,651.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75565,Not in chargemaster,75565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75565,BCBS multispecialty AW base fee schedule,98.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75565 mod 26,Not in chargemaster,75565,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75565 mod 26,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75565 mod TC,Not in chargemaster,75565,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75565 mod TC,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75571,Not in chargemaster,75571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75571,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75571 mod 26,Not in chargemaster,75571,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75571 mod 26,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75571 mod TC,Not in chargemaster,75571,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75571 mod TC,BCBS multispecialty AW base fee schedule,141.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75572,Not in chargemaster,75572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75572,BCBS multispecialty AW base fee schedule,464.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75572 mod 26,Not in chargemaster,75572,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75572 mod 26,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75572 mod TC,Not in chargemaster,75572,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75572 mod TC,BCBS multispecialty AW base fee schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75573,Not in chargemaster,75573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75573,BCBS multispecialty AW base fee schedule,624.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75573 mod 26,Not in chargemaster,75573,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75573 mod 26,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75573 mod TC,Not in chargemaster,75573,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75573 mod TC,BCBS multispecialty AW base fee schedule,386.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75574,Not in chargemaster,75574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75574,BCBS multispecialty AW base fee schedule,671.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75574 mod 26,Not in chargemaster,75574,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75574 mod 26,BCBS multispecialty AW base fee schedule,221.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75574 mod TC,Not in chargemaster,75574,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75574 mod TC,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75600,Not in chargemaster,75600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75600,BCBS multispecialty AW base fee schedule,374.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75600 mod 26,Not in chargemaster,75600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75600 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75600 mod TC,Not in chargemaster,75600,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75600 mod TC,BCBS multispecialty AW base fee schedule,327.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75605,Not in chargemaster,75605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75605,BCBS multispecialty AW base fee schedule,243.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75605 mod 26,Not in chargemaster,75605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75605 mod 26,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75605 mod TC,Not in chargemaster,75605,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75605 mod TC,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75625,Not in chargemaster,75625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75625,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75625 mod 26,Not in chargemaster,75625,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75625 mod 26,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75625 mod TC,Not in chargemaster,75625,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75625 mod TC,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75630,Not in chargemaster,75630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75630,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75630 mod 26,Not in chargemaster,75630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75630 mod 26,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75630 mod TC,Not in chargemaster,75630,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75630 mod TC,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75635,Not in chargemaster,75635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75635,BCBS multispecialty AW base fee schedule,827.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75635 mod 26,Not in chargemaster,75635,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75635 mod 26,BCBS multispecialty AW base fee schedule,221.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75635 mod TC,Not in chargemaster,75635,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75635 mod TC,BCBS multispecialty AW base fee schedule,605.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75705,Not in chargemaster,75705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75705,BCBS multispecialty AW base fee schedule,469.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75705 mod 26,Not in chargemaster,75705,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75705 mod 26,BCBS multispecialty AW base fee schedule,219.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75705 mod TC,Not in chargemaster,75705,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75705 mod TC,BCBS multispecialty AW base fee schedule,250.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75710,Not in chargemaster,75710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75710,BCBS multispecialty AW base fee schedule,306.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75710 mod 26,Not in chargemaster,75710,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75710 mod 26,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75710 mod TC,Not in chargemaster,75710,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75710 mod TC,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75716,Not in chargemaster,75716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75716,BCBS multispecialty AW base fee schedule,327.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75716 mod 26,Not in chargemaster,75716,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75716 mod 26,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75716 mod TC,Not in chargemaster,75716,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75716 mod TC,BCBS multispecialty AW base fee schedule,147.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75726,Not in chargemaster,75726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75726,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75726 mod 26,Not in chargemaster,75726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75726 mod 26,BCBS multispecialty AW base fee schedule,184.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75726 mod TC,Not in chargemaster,75726,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75726 mod TC,BCBS multispecialty AW base fee schedule,160.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75731,Not in chargemaster,75731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75731,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75731 mod 26,Not in chargemaster,75731,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75731 mod 26,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75731 mod TC,Not in chargemaster,75731,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75731 mod TC,BCBS multispecialty AW base fee schedule,197.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75733,Not in chargemaster,75733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75733,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75733 mod 26,Not in chargemaster,75733,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75733 mod 26,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75733 mod TC,Not in chargemaster,75733,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75733 mod TC,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75736,Not in chargemaster,75736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75736,BCBS multispecialty AW base fee schedule,281.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75736 mod 26,Not in chargemaster,75736,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75736 mod 26,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75736 mod TC,Not in chargemaster,75736,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75736 mod TC,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75741,Not in chargemaster,75741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75741,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75741 mod 26,Not in chargemaster,75741,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75741 mod 26,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75741 mod TC,Not in chargemaster,75741,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75741 mod TC,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75743,Not in chargemaster,75743,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75743,BCBS multispecialty AW base fee schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75743 mod 26,Not in chargemaster,75743,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75743 mod 26,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75743 mod TC,Not in chargemaster,75743,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75743 mod TC,BCBS multispecialty AW base fee schedule,150.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75746,Not in chargemaster,75746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75746,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75746 mod 26,Not in chargemaster,75746,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75746 mod 26,BCBS multispecialty AW base fee schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75746 mod TC,Not in chargemaster,75746,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75746 mod TC,BCBS multispecialty AW base fee schedule,165.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75756,Not in chargemaster,75756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75756,BCBS multispecialty AW base fee schedule,306.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75756 mod 26,Not in chargemaster,75756,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75756 mod 26,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75756 mod TC,Not in chargemaster,75756,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75756 mod TC,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75774,Not in chargemaster,75774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75774,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75774 mod 26,Not in chargemaster,75774,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75774 mod 26,BCBS multispecialty AW base fee schedule,91.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75774 mod TC,Not in chargemaster,75774,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75774 mod TC,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75801,Not in chargemaster,75801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75801,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75801 mod 26,Not in chargemaster,75801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75801 mod 26,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75803,Not in chargemaster,75803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75803,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75803 mod 26,Not in chargemaster,75803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75803 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75805,Not in chargemaster,75805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75805,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75805 mod 26,Not in chargemaster,75805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75805 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75807,Not in chargemaster,75807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75807,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75807 mod 26,Not in chargemaster,75807,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75807 mod 26,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75809,Not in chargemaster,75809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75809,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75809 mod 26,Not in chargemaster,75809,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75809 mod 26,BCBS multispecialty AW base fee schedule,44.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75809 mod TC,Not in chargemaster,75809,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75809 mod TC,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75810,Not in chargemaster,75810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75810,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75810 mod 26,Not in chargemaster,75810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75810 mod 26,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75820,Not in chargemaster,75820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75820,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75820 mod 26,Not in chargemaster,75820,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75820 mod 26,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75820 mod TC,Not in chargemaster,75820,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75820 mod TC,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75822,Not in chargemaster,75822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75822,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75822 mod 26,Not in chargemaster,75822,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75822 mod 26,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75822 mod TC,Not in chargemaster,75822,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75822 mod TC,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75825,Not in chargemaster,75825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75825,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75825 mod 26,Not in chargemaster,75825,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75825 mod 26,BCBS multispecialty AW base fee schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75825 mod TC,Not in chargemaster,75825,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75825 mod TC,BCBS multispecialty AW base fee schedule,131.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75827,Not in chargemaster,75827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75827,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75827 mod 26,Not in chargemaster,75827,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75827 mod 26,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75827 mod TC,Not in chargemaster,75827,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75827 mod TC,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75831,Not in chargemaster,75831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75831,BCBS multispecialty AW base fee schedule,245.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75831 mod 26,Not in chargemaster,75831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75831 mod 26,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75831 mod TC,Not in chargemaster,75831,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75831 mod TC,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75833,Not in chargemaster,75833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75833,BCBS multispecialty AW base fee schedule,294.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75833 mod 26,Not in chargemaster,75833,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75833 mod 26,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75833 mod TC,Not in chargemaster,75833,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75833 mod TC,BCBS multispecialty AW base fee schedule,158.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75840,Not in chargemaster,75840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75840,BCBS multispecialty AW base fee schedule,263.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75840 mod 26,Not in chargemaster,75840,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75840 mod 26,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75840 mod TC,Not in chargemaster,75840,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75840 mod TC,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75842,Not in chargemaster,75842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75842,BCBS multispecialty AW base fee schedule,320.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75842 mod 26,Not in chargemaster,75842,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75842 mod 26,BCBS multispecialty AW base fee schedule,141.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75842 mod TC,Not in chargemaster,75842,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75842 mod TC,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75860,Not in chargemaster,75860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75860,BCBS multispecialty AW base fee schedule,257.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75860 mod 26,Not in chargemaster,75860,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75860 mod 26,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75860 mod TC,Not in chargemaster,75860,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75860 mod TC,BCBS multispecialty AW base fee schedule,152.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75870,Not in chargemaster,75870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75870,BCBS multispecialty AW base fee schedule,342.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75870 mod 26,Not in chargemaster,75870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75870 mod 26,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75870 mod TC,Not in chargemaster,75870,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75870 mod TC,BCBS multispecialty AW base fee schedule,222.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75872,Not in chargemaster,75872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75872,BCBS multispecialty AW base fee schedule,263.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75872 mod 26,Not in chargemaster,75872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75872 mod 26,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75872 mod TC,Not in chargemaster,75872,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75872 mod TC,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75880,Not in chargemaster,75880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75880,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75880 mod 26,Not in chargemaster,75880,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75880 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75880 mod TC,Not in chargemaster,75880,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75880 mod TC,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75885,Not in chargemaster,75885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75885,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75885 mod 26,Not in chargemaster,75885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75885 mod 26,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75885 mod TC,Not in chargemaster,75885,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75885 mod TC,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75887,Not in chargemaster,75887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75887,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75887 mod 26,Not in chargemaster,75887,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75887 mod 26,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75887 mod TC,Not in chargemaster,75887,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75887 mod TC,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75889,Not in chargemaster,75889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75889,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75889 mod 26,Not in chargemaster,75889,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75889 mod 26,BCBS multispecialty AW base fee schedule,101.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75889 mod TC,Not in chargemaster,75889,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75889 mod TC,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75891,Not in chargemaster,75891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75891,BCBS multispecialty AW base fee schedule,256.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75891 mod 26,Not in chargemaster,75891,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75891 mod 26,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75891 mod TC,Not in chargemaster,75891,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75891 mod TC,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75893,Not in chargemaster,75893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75893,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75893 mod 26,Not in chargemaster,75893,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75893 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75893 mod TC,Not in chargemaster,75893,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75893 mod TC,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75894,Not in chargemaster,75894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75894,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75894 mod 26,Not in chargemaster,75894,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75894 mod 26,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75898,Not in chargemaster,75898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75898,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75898 mod 26,Not in chargemaster,75898,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75898 mod 26,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75901,Not in chargemaster,75901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75901,BCBS multispecialty AW base fee schedule,407.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75901 mod 26,Not in chargemaster,75901,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75901 mod 26,BCBS multispecialty AW base fee schedule,44.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75901 mod TC,Not in chargemaster,75901,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75901 mod TC,BCBS multispecialty AW base fee schedule,363.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75902,Not in chargemaster,75902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75902,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75902 mod 26,Not in chargemaster,75902,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75902 mod 26,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75902 mod TC,Not in chargemaster,75902,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75902 mod TC,BCBS multispecialty AW base fee schedule,123.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75956,Not in chargemaster,75956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75956,BCBS multispecialty AW base fee schedule,649.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75956 mod 26,Not in chargemaster,75956,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75956 mod 26,BCBS multispecialty AW base fee schedule,649.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75957,Not in chargemaster,75957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75957,BCBS multispecialty AW base fee schedule,555.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75957 mod 26,Not in chargemaster,75957,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75957 mod 26,BCBS multispecialty AW base fee schedule,555.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75958,Not in chargemaster,75958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75958,BCBS multispecialty AW base fee schedule,368.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75958 mod 26,Not in chargemaster,75958,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75958 mod 26,BCBS multispecialty AW base fee schedule,368.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75959,Not in chargemaster,75959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75959,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75959 mod 26,Not in chargemaster,75959,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75959 mod 26,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75970,Not in chargemaster,75970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75970,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75970 mod 26,Not in chargemaster,75970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75970 mod 26,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75984,Not in chargemaster,75984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75984,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75984 mod 26,Not in chargemaster,75984,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75984 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75984 mod TC,Not in chargemaster,75984,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75984 mod TC,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75989,Not in chargemaster,75989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75989,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75989 mod 26,Not in chargemaster,75989,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75989 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 75989 mod TC,Not in chargemaster,75989,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75989 mod TC,BCBS multispecialty AW base fee schedule,117.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76000,Not in chargemaster,76000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76000,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76000 mod 26,Not in chargemaster,76000,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76000 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76000 mod TC,Not in chargemaster,76000,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76000 mod TC,BCBS multispecialty AW base fee schedule,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76010,Not in chargemaster,76010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76010,BCBS multispecialty AW base fee schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76010 mod 26,Not in chargemaster,76010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76010 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76010 mod TC,Not in chargemaster,76010,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76010 mod TC,BCBS multispecialty AW base fee schedule,36.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76080,Not in chargemaster,76080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76080,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76080 mod 26,Not in chargemaster,76080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76080 mod 26,BCBS multispecialty AW base fee schedule,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76080 mod TC,Not in chargemaster,76080,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76080 mod TC,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76098,Not in chargemaster,76098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76098,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76098 mod 26,Not in chargemaster,76098,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76098 mod 26,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76098 mod TC,Not in chargemaster,76098,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76098 mod TC,BCBS multispecialty AW base fee schedule,50.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76100,Not in chargemaster,76100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76100,BCBS multispecialty AW base fee schedule,182.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76100 mod 26,Not in chargemaster,76100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76100 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76100 mod TC,Not in chargemaster,76100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76100 mod TC,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76101,Not in chargemaster,76101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76101,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76101 mod 26,Not in chargemaster,76101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76101 mod 26,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76101 mod TC,Not in chargemaster,76101,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76101 mod TC,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76102,Not in chargemaster,76102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76102,BCBS multispecialty AW base fee schedule,328.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76102 mod 26,Not in chargemaster,76102,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76102 mod 26,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76102 mod TC,Not in chargemaster,76102,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76102 mod TC,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76120,Not in chargemaster,76120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76120,BCBS multispecialty AW base fee schedule,202.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76120 mod 26,Not in chargemaster,76120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76120 mod 26,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76120 mod TC,Not in chargemaster,76120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76120 mod TC,BCBS multispecialty AW base fee schedule,166.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76125,Not in chargemaster,76125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76125,BCBS multispecialty AW base fee schedule,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76125 mod 26,Not in chargemaster,76125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76125 mod 26,BCBS multispecialty AW base fee schedule,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76376,Not in chargemaster,76376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76376,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76376 mod 26,Not in chargemaster,76376,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76376 mod 26,BCBS multispecialty AW base fee schedule,18.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76376 mod TC,Not in chargemaster,76376,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76376 mod TC,BCBS multispecialty AW base fee schedule,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76377,Not in chargemaster,76377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76377,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76377 mod 26,Not in chargemaster,76377,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76377 mod 26,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76377 mod TC,Not in chargemaster,76377,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76377 mod TC,BCBS multispecialty AW base fee schedule,59.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76380,Not in chargemaster,76380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76380,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76380 mod 26,Not in chargemaster,76380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76380 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76380 mod TC,Not in chargemaster,76380,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76380 mod TC,BCBS multispecialty AW base fee schedule,178.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76390,Not in chargemaster,76390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76390,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76390 mod 26,Not in chargemaster,76390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76390 mod 26,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76390 mod TC,Not in chargemaster,76390,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76390 mod TC,BCBS multispecialty AW base fee schedule,661.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76391,Not in chargemaster,76391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76391,BCBS multispecialty AW base fee schedule,433.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76391 mod 26,Not in chargemaster,76391,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76391 mod 26,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76391 mod TC,Not in chargemaster,76391,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76391 mod TC,BCBS multispecialty AW base fee schedule,328.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76506,Not in chargemaster,76506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76506,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76506 mod 26,Not in chargemaster,76506,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76506 mod 26,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76506 mod TC,Not in chargemaster,76506,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76506 mod TC,BCBS multispecialty AW base fee schedule,155.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76510,Not in chargemaster,76510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76510,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76510 mod 26,Not in chargemaster,76510,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76510 mod 26,BCBS multispecialty AW base fee schedule,88.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76510 mod TC,Not in chargemaster,76510,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76510 mod TC,BCBS multispecialty AW base fee schedule,80.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76511,Not in chargemaster,76511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76511,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76511 mod 26,Not in chargemaster,76511,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76511 mod 26,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76511 mod TC,Not in chargemaster,76511,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76511 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76512,Not in chargemaster,76512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76512,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76512 mod 26,Not in chargemaster,76512,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76512 mod 26,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76512 mod TC,Not in chargemaster,76512,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76512 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76513,Not in chargemaster,76513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76513,BCBS multispecialty AW base fee schedule,186.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76513 mod 26,Not in chargemaster,76513,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76513 mod 26,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76513 mod TC,Not in chargemaster,76513,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76513 mod TC,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76514,Not in chargemaster,76514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76514,BCBS multispecialty AW base fee schedule,22.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76514 mod 26,Not in chargemaster,76514,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76514 mod 26,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76514 mod TC,Not in chargemaster,76514,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76514 mod TC,BCBS multispecialty AW base fee schedule,7.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76516,Not in chargemaster,76516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76516,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76516 mod 26,Not in chargemaster,76516,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76516 mod 26,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76516 mod TC,Not in chargemaster,76516,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76516 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76519,Not in chargemaster,76519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76519,BCBS multispecialty AW base fee schedule,124.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76519 mod 26,Not in chargemaster,76519,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76519 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76519 mod TC,Not in chargemaster,76519,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76519 mod TC,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76529,Not in chargemaster,76529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76529,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76529 mod 26,Not in chargemaster,76529,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76529 mod 26,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76529 mod TC,Not in chargemaster,76529,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76529 mod TC,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76536,Not in chargemaster,76536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76536,BCBS multispecialty AW base fee schedule,216.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76536 mod 26,76536,76536,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76536 mod 26,BCBS multispecialty AW base fee schedule,53,62.05,Fee schedule,,53,53,53,53,,,0
unity,Fee schedule,Facility 76536 mod TC,Not in chargemaster,76536,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76536 mod TC,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76604,Not in chargemaster,76604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76604,BCBS multispecialty AW base fee schedule,147.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76604 mod 26,Not in chargemaster,76604,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76604 mod 26,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76604 mod TC,Not in chargemaster,76604,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76604 mod TC,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76641,Not in chargemaster,76641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76641,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76641 mod 26,Not in chargemaster,76641,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76641 mod 26,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76641 mod TC,Not in chargemaster,76641,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76641 mod TC,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76642,Not in chargemaster,76642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76642,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76642 mod 26,Not in chargemaster,76642,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76642 mod 26,BCBS multispecialty AW base fee schedule,63.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76642 mod TC,Not in chargemaster,76642,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76642 mod TC,BCBS multispecialty AW base fee schedule,100.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76700,Not in chargemaster,76700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76700,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76700 mod 26,76700,76700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76700 mod 26,BCBS multispecialty AW base fee schedule,76.85,89.2,Fee schedule,,76.85,76.85,76.85,76.85,,,0
unity,Fee schedule,Facility 76700 mod TC,Not in chargemaster,76700,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76700 mod TC,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76705,Not in chargemaster,76705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76705,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76705 mod 26,76705,76705,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76705 mod 26,BCBS multispecialty AW base fee schedule,54.99,59.23,Fee schedule,,54.99,54.99,54.99,54.99,,,0
unity,Fee schedule,Facility 76705 mod TC,Not in chargemaster,76705,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76705 mod TC,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76706,Not in chargemaster,76706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76706,BCBS multispecialty AW base fee schedule,212.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76706 mod 26,Not in chargemaster,76706,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76706 mod 26,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76706 mod TC,Not in chargemaster,76706,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76706 mod TC,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76770,Not in chargemaster,76770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76770,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76770 mod 26,76770,76770,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76770 mod 26,BCBS multispecialty AW base fee schedule,68.9,81.44,Fee schedule,,68.9,68.9,68.9,68.9,,,0
unity,Fee schedule,Facility 76770 mod TC,Not in chargemaster,76770,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76770 mod TC,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76775,Not in chargemaster,76775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76775,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76775 mod 26,76775,76775,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76775 mod 26,BCBS multispecialty AW base fee schedule,54.33,63.61,Fee schedule,,54.33,54.33,54.33,54.33,,,0
unity,Fee schedule,Facility 76775 mod TC,Not in chargemaster,76775,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76775 mod TC,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76776,Not in chargemaster,76776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76776,BCBS multispecialty AW base fee schedule,292.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76776 mod 26,Not in chargemaster,76776,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76776 mod 26,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76776 mod TC,Not in chargemaster,76776,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76776 mod TC,BCBS multispecialty AW base fee schedule,219.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76800,Not in chargemaster,76800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76800,BCBS multispecialty AW base fee schedule,267.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76800 mod 26,Not in chargemaster,76800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76800 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76800 mod TC,Not in chargemaster,76800,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76800 mod TC,BCBS multispecialty AW base fee schedule,157.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76801,Not in chargemaster,76801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76801,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76801 mod 26,76801,76801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76801 mod 26,BCBS multispecialty AW base fee schedule,93.41,109.37,Fee schedule,,93.41,93.41,93.41,93.41,,,0
unity,Fee schedule,Facility 76801 mod TC,Not in chargemaster,76801,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76801 mod TC,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76802,Not in chargemaster,76802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76802,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76802 mod 26,Not in chargemaster,76802,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76802 mod 26,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76802 mod TC,Not in chargemaster,76802,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76802 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76805,Not in chargemaster,76805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76805,BCBS multispecialty AW base fee schedule,261.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76805 mod 26,76805,76805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76805 mod 26,BCBS multispecialty AW base fee schedule,93.41,110.14,Fee schedule,,93.41,93.41,93.41,93.41,,,0
unity,Fee schedule,Facility 76805 mod TC,Not in chargemaster,76805,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76805 mod TC,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76810,Not in chargemaster,76810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76810,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76810 mod 26,76810,76810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76810 mod 26,BCBS multispecialty AW base fee schedule,92.75,108.58,Fee schedule,,92.75,92.75,92.75,92.75,,,0
unity,Fee schedule,Facility 76810 mod TC,Not in chargemaster,76810,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76810 mod TC,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76811,Not in chargemaster,76811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76811,BCBS multispecialty AW base fee schedule,331.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76811 mod 26,Not in chargemaster,76811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76811 mod 26,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76811 mod TC,Not in chargemaster,76811,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76811 mod TC,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76812,Not in chargemaster,76812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76812,BCBS multispecialty AW base fee schedule,371.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76812 mod 26,Not in chargemaster,76812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76812 mod 26,BCBS multispecialty AW base fee schedule,166.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76812 mod TC,Not in chargemaster,76812,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76812 mod TC,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76813,Not in chargemaster,76813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76813,BCBS multispecialty AW base fee schedule,226.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76813 mod 26,Not in chargemaster,76813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76813 mod 26,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76813 mod TC,Not in chargemaster,76813,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76813 mod TC,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76814,Not in chargemaster,76814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76814,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76814 mod 26,Not in chargemaster,76814,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76814 mod 26,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76814 mod TC,Not in chargemaster,76814,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76814 mod TC,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76815,Not in chargemaster,76815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76815,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76815 mod 26,76815,76815,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76815 mod 26,BCBS multispecialty AW base fee schedule,60.95,70.58,Fee schedule,,60.95,60.95,60.95,60.95,,,0
unity,Fee schedule,Facility 76815 mod TC,Not in chargemaster,76815,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76815 mod TC,BCBS multispecialty AW base fee schedule,96.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76816,Not in chargemaster,76816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76816,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76816 mod 26,Not in chargemaster,76816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76816 mod 26,BCBS multispecialty AW base fee schedule,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76816 mod TC,Not in chargemaster,76816,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76816 mod TC,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76817,Not in chargemaster,76817,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76817,BCBS multispecialty AW base fee schedule,178.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76817 mod 26,76817,76817,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76817 mod 26,BCBS multispecialty AW base fee schedule,70.23,83.77,Fee schedule,,70.23,70.23,70.23,70.23,,,0
unity,Fee schedule,Facility 76817 mod TC,Not in chargemaster,76817,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76817 mod TC,BCBS multispecialty AW base fee schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76818,Not in chargemaster,76818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76818,BCBS multispecialty AW base fee schedule,220.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76818 mod 26,Not in chargemaster,76818,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76818 mod 26,BCBS multispecialty AW base fee schedule,98.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76818 mod TC,Not in chargemaster,76818,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76818 mod TC,BCBS multispecialty AW base fee schedule,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76819,Not in chargemaster,76819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76819,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76819 mod 26,Not in chargemaster,76819,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76819 mod 26,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76819 mod TC,Not in chargemaster,76819,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76819 mod TC,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76820,Not in chargemaster,76820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76820,BCBS multispecialty AW base fee schedule,87.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76820 mod 26,Not in chargemaster,76820,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76820 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76820 mod TC,Not in chargemaster,76820,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76820 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76821,Not in chargemaster,76821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76821,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76821 mod 26,Not in chargemaster,76821,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76821 mod 26,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76821 mod TC,Not in chargemaster,76821,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76821 mod TC,BCBS multispecialty AW base fee schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76825,Not in chargemaster,76825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76825,BCBS multispecialty AW base fee schedule,510.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76825 mod 26,Not in chargemaster,76825,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76825 mod 26,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76825 mod TC,Not in chargemaster,76825,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76825 mod TC,BCBS multispecialty AW base fee schedule,356.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76826,Not in chargemaster,76826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76826,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76826 mod 26,Not in chargemaster,76826,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76826 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76826 mod TC,Not in chargemaster,76826,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76826 mod TC,BCBS multispecialty AW base fee schedule,226.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76827,Not in chargemaster,76827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76827,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76827 mod 26,Not in chargemaster,76827,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76827 mod 26,BCBS multispecialty AW base fee schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76827 mod TC,Not in chargemaster,76827,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76827 mod TC,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76828,Not in chargemaster,76828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76828,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76828 mod 26,Not in chargemaster,76828,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76828 mod 26,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76828 mod TC,Not in chargemaster,76828,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76828 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76830,Not in chargemaster,76830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76830,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76830 mod 26,76830,76830,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76830 mod 26,BCBS multispecialty AW base fee schedule,64.93,76.79,Fee schedule,,64.93,64.93,64.93,64.93,,,0
unity,Fee schedule,Facility 76830 mod TC,Not in chargemaster,76830,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76830 mod TC,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76831,Not in chargemaster,76831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76831,BCBS multispecialty AW base fee schedule,222.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76831 mod 26,Not in chargemaster,76831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76831 mod 26,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76831 mod TC,Not in chargemaster,76831,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76831 mod TC,BCBS multispecialty AW base fee schedule,155.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76856,Not in chargemaster,76856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76856,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76856 mod 26,76856,76856,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76856 mod 26,BCBS multispecialty AW base fee schedule,64.26,76.01,Fee schedule,,64.26,64.26,64.26,64.26,,,0
unity,Fee schedule,Facility 76856 mod TC,Not in chargemaster,76856,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76856 mod TC,BCBS multispecialty AW base fee schedule,140.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76857,Not in chargemaster,76857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76857,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76857 mod 26,Not in chargemaster,76857,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76857 mod 26,BCBS multispecialty AW base fee schedule,46.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76857 mod TC,Not in chargemaster,76857,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76857 mod TC,BCBS multispecialty AW base fee schedule,44.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76870,Not in chargemaster,76870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76870,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76870 mod 26,76870,76870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76870 mod 26,BCBS multispecialty AW base fee schedule,59.63,70.58,Fee schedule,,59.63,59.63,59.63,59.63,,,0
unity,Fee schedule,Facility 76870 mod TC,Not in chargemaster,76870,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76870 mod TC,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76872,Not in chargemaster,76872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76872,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76872 mod 26,Not in chargemaster,76872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76872 mod 26,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76872 mod TC,Not in chargemaster,76872,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76872 mod TC,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76873,Not in chargemaster,76873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76873,BCBS multispecialty AW base fee schedule,328.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76873 mod 26,Not in chargemaster,76873,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76873 mod 26,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76873 mod TC,Not in chargemaster,76873,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76873 mod TC,BCBS multispecialty AW base fee schedule,181.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76881,Not in chargemaster,76881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76881,BCBS multispecialty AW base fee schedule,145.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76881 mod 26,Not in chargemaster,76881,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76881 mod 26,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76881 mod TC,Not in chargemaster,76881,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76881 mod TC,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76882,Not in chargemaster,76882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76882,BCBS multispecialty AW base fee schedule,106.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76882 mod 26,Not in chargemaster,76882,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76882 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76882 mod TC,Not in chargemaster,76882,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76882 mod TC,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76885,Not in chargemaster,76885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76885,BCBS multispecialty AW base fee schedule,268.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76885 mod 26,Not in chargemaster,76885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76885 mod 26,BCBS multispecialty AW base fee schedule,69.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76885 mod TC,Not in chargemaster,76885,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76885 mod TC,BCBS multispecialty AW base fee schedule,198.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76886,Not in chargemaster,76886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76886,BCBS multispecialty AW base fee schedule,196.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76886 mod 26,Not in chargemaster,76886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76886 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76886 mod TC,Not in chargemaster,76886,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76886 mod TC,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76932,Not in chargemaster,76932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76932,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76932 mod 26,Not in chargemaster,76932,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76932 mod 26,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76936,Not in chargemaster,76936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76936,BCBS multispecialty AW base fee schedule,504.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76936 mod 26,Not in chargemaster,76936,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76936 mod 26,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76936 mod TC,Not in chargemaster,76936,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76936 mod TC,BCBS multispecialty AW base fee schedule,321.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76937,Not in chargemaster,76937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76937,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76937 mod 26,76937,76937,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76937 mod 26,BCBS multispecialty AW base fee schedule,27.16,33.38,Fee schedule,,27.16,27.16,27.16,27.16,,,0
unity,Fee schedule,Facility 76937 mod TC,Not in chargemaster,76937,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76937 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76940,Not in chargemaster,76940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76940,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76940 mod 26,Not in chargemaster,76940,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76940 mod 26,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76941,Not in chargemaster,76941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76941,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76941 mod 26,Not in chargemaster,76941,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76941 mod 26,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76942,Not in chargemaster,76942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76942,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76942 mod 26,76942,76942,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76942 mod 26,BCBS multispecialty AW base fee schedule,59.63,74.91,Fee schedule,,59.63,59.63,59.63,59.63,,,0
unity,Fee schedule,Facility 76942 mod TC,Not in chargemaster,76942,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76942 mod TC,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76945,Not in chargemaster,76945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76945,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76945 mod 26,Not in chargemaster,76945,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76945 mod 26,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76946,Not in chargemaster,76946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76946,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76946 mod 26,Not in chargemaster,76946,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76946 mod 26,BCBS multispecialty AW base fee schedule,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76946 mod TC,Not in chargemaster,76946,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76946 mod TC,BCBS multispecialty AW base fee schedule,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76948,Not in chargemaster,76948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76948,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76948 mod 26,Not in chargemaster,76948,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76948 mod 26,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76948 mod TC,Not in chargemaster,76948,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76948 mod TC,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76965,Not in chargemaster,76965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76965,BCBS multispecialty AW base fee schedule,174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76965 mod 26,Not in chargemaster,76965,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76965 mod 26,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76965 mod TC,Not in chargemaster,76965,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76965 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76970,Not in chargemaster,76970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76970,BCBS multispecialty AW base fee schedule,166.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76970 mod 26,Not in chargemaster,76970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76970 mod 26,BCBS multispecialty AW base fee schedule,36.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76970 mod TC,Not in chargemaster,76970,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76970 mod TC,BCBS multispecialty AW base fee schedule,129.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76975,Not in chargemaster,76975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76975,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76975 mod 26,Not in chargemaster,76975,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76975 mod 26,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76977,Not in chargemaster,76977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76977,BCBS multispecialty AW base fee schedule,13.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76977 mod 26,Not in chargemaster,76977,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76977 mod 26,BCBS multispecialty AW base fee schedule,5.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76977 mod TC,Not in chargemaster,76977,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76977 mod TC,BCBS multispecialty AW base fee schedule,7.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76978,Not in chargemaster,76978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76978,BCBS multispecialty AW base fee schedule,610.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76978 mod 26,Not in chargemaster,76978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76978 mod 26,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76978 mod TC,Not in chargemaster,76978,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76978 mod TC,BCBS multispecialty AW base fee schedule,458.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76979,Not in chargemaster,76979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76979,BCBS multispecialty AW base fee schedule,414.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76979 mod 26,Not in chargemaster,76979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76979 mod 26,BCBS multispecialty AW base fee schedule,80.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76979 mod TC,Not in chargemaster,76979,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76979 mod TC,BCBS multispecialty AW base fee schedule,333.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76981,Not in chargemaster,76981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76981,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76981 mod 26,Not in chargemaster,76981,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76981 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76981 mod TC,Not in chargemaster,76981,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76981 mod TC,BCBS multispecialty AW base fee schedule,145.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76982,Not in chargemaster,76982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76982,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76982 mod 26,Not in chargemaster,76982,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76982 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76982 mod TC,Not in chargemaster,76982,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76982 mod TC,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76983,Not in chargemaster,76983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76983,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76983 mod 26,Not in chargemaster,76983,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76983 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76983 mod TC,Not in chargemaster,76983,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76983 mod TC,BCBS multispecialty AW base fee schedule,63.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76998,Not in chargemaster,76998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76998,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 76998 mod 26,Not in chargemaster,76998,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76998 mod 26,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77001,Not in chargemaster,77001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77001,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77001 mod 26,Not in chargemaster,77001,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77001 mod 26,BCBS multispecialty AW base fee schedule,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77001 mod TC,Not in chargemaster,77001,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77001 mod TC,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77002,Not in chargemaster,77002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77002,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77002 mod 26,Not in chargemaster,77002,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77002 mod 26,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77002 mod TC,Not in chargemaster,77002,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77002 mod TC,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77003,Not in chargemaster,77003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77003,BCBS multispecialty AW base fee schedule,188.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77003 mod 26,Not in chargemaster,77003,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77003 mod 26,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77003 mod TC,Not in chargemaster,77003,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77003 mod TC,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77011,Not in chargemaster,77011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77011,BCBS multispecialty AW base fee schedule,435.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77011 mod 26,Not in chargemaster,77011,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77011 mod 26,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77011 mod TC,Not in chargemaster,77011,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77011 mod TC,BCBS multispecialty AW base fee schedule,315.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77012,Not in chargemaster,77012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77012,BCBS multispecialty AW base fee schedule,282.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77012 mod 26,Not in chargemaster,77012,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77012 mod 26,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77012 mod TC,Not in chargemaster,77012,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77012 mod TC,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77013,Not in chargemaster,77013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77013,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77013 mod 26,Not in chargemaster,77013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77013 mod 26,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77014,Not in chargemaster,77014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77014,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77014 mod 26,Not in chargemaster,77014,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77014 mod 26,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77014 mod TC,Not in chargemaster,77014,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77014 mod TC,BCBS multispecialty AW base fee schedule,143.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77021,Not in chargemaster,77021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77021,BCBS multispecialty AW base fee schedule,867.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77021 mod 26,Not in chargemaster,77021,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77021 mod 26,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77021 mod TC,Not in chargemaster,77021,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77021 mod TC,BCBS multispecialty AW base fee schedule,730.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77022,Not in chargemaster,77022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77022,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77022 mod 26,Not in chargemaster,77022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77022 mod 26,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77046,Not in chargemaster,77046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77046,BCBS multispecialty AW base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77046 mod 26,Not in chargemaster,77046,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77046 mod 26,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77046 mod TC,Not in chargemaster,77046,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77046 mod TC,BCBS multispecialty AW base fee schedule,320.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77047,Not in chargemaster,77047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77047,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77047 mod 26,Not in chargemaster,77047,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77047 mod 26,BCBS multispecialty AW base fee schedule,150.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77047 mod TC,Not in chargemaster,77047,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77047 mod TC,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77048,Not in chargemaster,77048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77048,BCBS multispecialty AW base fee schedule,724.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77048 mod 26,Not in chargemaster,77048,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77048 mod 26,BCBS multispecialty AW base fee schedule,196.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77048 mod TC,Not in chargemaster,77048,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77048 mod TC,BCBS multispecialty AW base fee schedule,527.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77049,Not in chargemaster,77049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77049,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77049 mod 26,Not in chargemaster,77049,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77049 mod 26,BCBS multispecialty AW base fee schedule,215.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77049 mod TC,Not in chargemaster,77049,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77049 mod TC,BCBS multispecialty AW base fee schedule,525.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77053,Not in chargemaster,77053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77053,BCBS multispecialty AW base fee schedule,106,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77053 mod 26,Not in chargemaster,77053,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77053 mod 26,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77053 mod TC,Not in chargemaster,77053,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77053 mod TC,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77054,Not in chargemaster,77054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77054,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77054 mod 26,Not in chargemaster,77054,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77054 mod 26,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77054 mod TC,Not in chargemaster,77054,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77054 mod TC,BCBS multispecialty AW base fee schedule,94.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77063,Not in chargemaster,77063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77063,BCBS multispecialty AW base fee schedule,102.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77063 mod 26,Not in chargemaster,77063,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77063 mod 26,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77063 mod TC,Not in chargemaster,77063,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77063 mod TC,BCBS multispecialty AW base fee schedule,46.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77065,Not in chargemaster,77065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77065,BCBS multispecialty AW base fee schedule,250.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77065 mod 26,77065,77065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77065 mod 26,BCBS multispecialty AW base fee schedule,76.85,103.4,Fee schedule,,76.85,76.85,76.85,76.85,,,0
unity,Fee schedule,Facility 77065 mod TC,Not in chargemaster,77065,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77065 mod TC,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77066,Not in chargemaster,77066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77066,BCBS multispecialty AW base fee schedule,315.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77066 mod 26,77066,77066,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77066 mod 26,BCBS multispecialty AW base fee schedule,94.08,127.6,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Facility 77066 mod TC,Not in chargemaster,77066,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77066 mod TC,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77067,Not in chargemaster,77067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77067,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77067 mod 26,77067,77067,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77067 mod 26,BCBS multispecialty AW base fee schedule,72.21,91.21,Fee schedule,,72.21,72.21,72.21,72.21,,,0
unity,Fee schedule,Facility 77067 mod TC,Not in chargemaster,77067,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77067 mod TC,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77071,Not in chargemaster,77071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77071,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77072,Not in chargemaster,77072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77072,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77072 mod 26,Not in chargemaster,77072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77072 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77072 mod TC,Not in chargemaster,77072,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77072 mod TC,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77073,Not in chargemaster,77073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77073,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77073 mod 26,Not in chargemaster,77073,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77073 mod 26,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77073 mod TC,Not in chargemaster,77073,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77073 mod TC,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77074,Not in chargemaster,77074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77074,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77074 mod 26,Not in chargemaster,77074,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77074 mod 26,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77074 mod TC,Not in chargemaster,77074,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77074 mod TC,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77075,Not in chargemaster,77075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77075,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77075 mod 26,Not in chargemaster,77075,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77075 mod 26,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77075 mod TC,Not in chargemaster,77075,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77075 mod TC,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77076,Not in chargemaster,77076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77076,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77076 mod 26,Not in chargemaster,77076,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77076 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77076 mod TC,Not in chargemaster,77076,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77076 mod TC,BCBS multispecialty AW base fee schedule,126.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77077,Not in chargemaster,77077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77077,BCBS multispecialty AW base fee schedule,85.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77077 mod 26,Not in chargemaster,77077,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77077 mod 26,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77077 mod TC,Not in chargemaster,77077,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77077 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77078,Not in chargemaster,77078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77078,BCBS multispecialty AW base fee schedule,213.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77078 mod 26,Not in chargemaster,77078,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77078 mod 26,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77078 mod TC,Not in chargemaster,77078,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77078 mod TC,BCBS multispecialty AW base fee schedule,190.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77080,Not in chargemaster,77080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77080,BCBS multispecialty AW base fee schedule,73.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77080 mod 26,77080,77080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77080 mod 26,BCBS multispecialty AW base fee schedule,18.55,22.5,Fee schedule,,18.55,18.55,18.55,18.55,,,0
unity,Fee schedule,Facility 77080 mod TC,Not in chargemaster,77080,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77080 mod TC,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77081,Not in chargemaster,77081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77081,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77081 mod 26,Not in chargemaster,77081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77081 mod 26,BCBS multispecialty AW base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77081 mod TC,Not in chargemaster,77081,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77081 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77084,Not in chargemaster,77084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77084,BCBS multispecialty AW base fee schedule,692.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77084 mod 26,Not in chargemaster,77084,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77084 mod 26,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77084 mod TC,Not in chargemaster,77084,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77084 mod TC,BCBS multispecialty AW base fee schedule,541.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77085,Not in chargemaster,77085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77085,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77085 mod 26,Not in chargemaster,77085,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77085 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77085 mod TC,Not in chargemaster,77085,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77085 mod TC,BCBS multispecialty AW base fee schedule,71.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77086,Not in chargemaster,77086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77086,BCBS multispecialty AW base fee schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77086 mod 26,Not in chargemaster,77086,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77086 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77086 mod TC,Not in chargemaster,77086,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77086 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77261,Not in chargemaster,77261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77261,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77262,Not in chargemaster,77262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77262,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77263,Not in chargemaster,77263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77263,BCBS multispecialty AW base fee schedule,319.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77280,Not in chargemaster,77280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77280,BCBS multispecialty AW base fee schedule,520.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77280 mod 26,Not in chargemaster,77280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77280 mod 26,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77280 mod TC,Not in chargemaster,77280,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77280 mod TC,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77285,Not in chargemaster,77285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77285,BCBS multispecialty AW base fee schedule,871.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77285 mod 26,Not in chargemaster,77285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77285 mod 26,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77285 mod TC,Not in chargemaster,77285,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77285 mod TC,BCBS multispecialty AW base fee schedule,761.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77290,Not in chargemaster,77290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77290,BCBS multispecialty AW base fee schedule,932.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77290 mod 26,Not in chargemaster,77290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77290 mod 26,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77290 mod TC,Not in chargemaster,77290,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77290 mod TC,BCBS multispecialty AW base fee schedule,776.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77293,Not in chargemaster,77293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77293,BCBS multispecialty AW base fee schedule,846.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77293 mod 26,Not in chargemaster,77293,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77293 mod 26,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77293 mod TC,Not in chargemaster,77293,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77293 mod TC,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77295,Not in chargemaster,77295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77295,BCBS multispecialty AW base fee schedule,914.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77295 mod 26,Not in chargemaster,77295,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77295 mod 26,BCBS multispecialty AW base fee schedule,426.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77295 mod TC,Not in chargemaster,77295,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77295 mod TC,BCBS multispecialty AW base fee schedule,487.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77300,Not in chargemaster,77300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77300,BCBS multispecialty AW base fee schedule,124.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77300 mod 26,Not in chargemaster,77300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77300 mod 26,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77300 mod TC,Not in chargemaster,77300,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77300 mod TC,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77301,Not in chargemaster,77301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77301,BCBS multispecialty AW base fee schedule,3578.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77301 mod 26,Not in chargemaster,77301,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77301 mod 26,BCBS multispecialty AW base fee schedule,794.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77301 mod TC,Not in chargemaster,77301,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77301 mod TC,BCBS multispecialty AW base fee schedule,2783.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77306,Not in chargemaster,77306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77306,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77306 mod 26,Not in chargemaster,77306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77306 mod 26,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77306 mod TC,Not in chargemaster,77306,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77306 mod TC,BCBS multispecialty AW base fee schedule,140.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77307,Not in chargemaster,77307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77307,BCBS multispecialty AW base fee schedule,543.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77307 mod 26,Not in chargemaster,77307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77307 mod 26,BCBS multispecialty AW base fee schedule,288.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77307 mod TC,Not in chargemaster,77307,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77307 mod TC,BCBS multispecialty AW base fee schedule,254.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77316,Not in chargemaster,77316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77316,BCBS multispecialty AW base fee schedule,408.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77316 mod 26,Not in chargemaster,77316,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77316 mod 26,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77316 mod TC,Not in chargemaster,77316,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77316 mod TC,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77317,Not in chargemaster,77317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77317,BCBS multispecialty AW base fee schedule,535.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77317 mod 26,Not in chargemaster,77317,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77317 mod 26,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77317 mod TC,Not in chargemaster,77317,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77317 mod TC,BCBS multispecialty AW base fee schedule,352.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77318,Not in chargemaster,77318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77318,BCBS multispecialty AW base fee schedule,766.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77318 mod 26,Not in chargemaster,77318,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77318 mod 26,BCBS multispecialty AW base fee schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77318 mod TC,Not in chargemaster,77318,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77318 mod TC,BCBS multispecialty AW base fee schedule,478.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77321,Not in chargemaster,77321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77321,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77321 mod 26,Not in chargemaster,77321,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77321 mod 26,BCBS multispecialty AW base fee schedule,96.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77321 mod TC,Not in chargemaster,77321,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77321 mod TC,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77331,Not in chargemaster,77331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77331,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77331 mod 26,Not in chargemaster,77331,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77331 mod 26,BCBS multispecialty AW base fee schedule,86.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77331 mod TC,Not in chargemaster,77331,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77331 mod TC,BCBS multispecialty AW base fee schedule,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77332,Not in chargemaster,77332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77332,BCBS multispecialty AW base fee schedule,88.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77332 mod 26,Not in chargemaster,77332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77332 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77332 mod TC,Not in chargemaster,77332,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77332 mod TC,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77333,Not in chargemaster,77333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77333,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77333 mod 26,Not in chargemaster,77333,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77333 mod 26,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77333 mod TC,Not in chargemaster,77333,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77333 mod TC,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77334,Not in chargemaster,77334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77334,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77334 mod 26,Not in chargemaster,77334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77334 mod 26,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77334 mod TC,Not in chargemaster,77334,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77334 mod TC,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77336,Not in chargemaster,77336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77336,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77338,Not in chargemaster,77338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77338,BCBS multispecialty AW base fee schedule,912.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77338 mod 26,Not in chargemaster,77338,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77338 mod 26,BCBS multispecialty AW base fee schedule,426.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77338 mod TC,Not in chargemaster,77338,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77338 mod TC,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77370,Not in chargemaster,77370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77370,BCBS multispecialty AW base fee schedule,232.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77372,Not in chargemaster,77372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77372,BCBS multispecialty AW base fee schedule,1962.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77373,Not in chargemaster,77373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77373,BCBS multispecialty AW base fee schedule,2259.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77401,Not in chargemaster,77401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77401,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77417,Not in chargemaster,77417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77417,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77427,Not in chargemaster,77427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77427,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77431,Not in chargemaster,77431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77431,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77432,Not in chargemaster,77432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77432,BCBS multispecialty AW base fee schedule,805.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77435,Not in chargemaster,77435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77435,BCBS multispecialty AW base fee schedule,1216.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77469,Not in chargemaster,77469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77469,BCBS multispecialty AW base fee schedule,602.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77470,Not in chargemaster,77470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77470,BCBS multispecialty AW base fee schedule,251.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77470 mod 26,Not in chargemaster,77470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77470 mod 26,BCBS multispecialty AW base fee schedule,203.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77470 mod TC,Not in chargemaster,77470,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77470 mod TC,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77600,Not in chargemaster,77600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77600,BCBS multispecialty AW base fee schedule,872.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77600 mod 26,Not in chargemaster,77600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77600 mod 26,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77600 mod TC,Not in chargemaster,77600,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77600 mod TC,BCBS multispecialty AW base fee schedule,738.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77605,Not in chargemaster,77605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77605,BCBS multispecialty AW base fee schedule,1590,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77605 mod 26,Not in chargemaster,77605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77605 mod 26,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77605 mod TC,Not in chargemaster,77605,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77605 mod TC,BCBS multispecialty AW base fee schedule,1395.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77610,Not in chargemaster,77610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77610,BCBS multispecialty AW base fee schedule,1277.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77610 mod 26,Not in chargemaster,77610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77610 mod 26,BCBS multispecialty AW base fee schedule,130.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77610 mod TC,Not in chargemaster,77610,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77610 mod TC,BCBS multispecialty AW base fee schedule,1147.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77615,Not in chargemaster,77615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77615,BCBS multispecialty AW base fee schedule,1999.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77615 mod 26,Not in chargemaster,77615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77615 mod 26,BCBS multispecialty AW base fee schedule,184.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77615 mod TC,Not in chargemaster,77615,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77615 mod TC,BCBS multispecialty AW base fee schedule,1815.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77620,Not in chargemaster,77620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77620,BCBS multispecialty AW base fee schedule,1146.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77620 mod 26,Not in chargemaster,77620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77620 mod 26,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77620 mod TC,Not in chargemaster,77620,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77620 mod TC,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77750,Not in chargemaster,77750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77750,BCBS multispecialty AW base fee schedule,722.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77750 mod 26,Not in chargemaster,77750,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77750 mod 26,BCBS multispecialty AW base fee schedule,496.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77750 mod TC,Not in chargemaster,77750,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77750 mod TC,BCBS multispecialty AW base fee schedule,225.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77761,Not in chargemaster,77761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77761,BCBS multispecialty AW base fee schedule,757.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77761 mod 26,Not in chargemaster,77761,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77761 mod 26,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77761 mod TC,Not in chargemaster,77761,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77761 mod TC,BCBS multispecialty AW base fee schedule,374.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77762,Not in chargemaster,77762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77762,BCBS multispecialty AW base fee schedule,1004.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77762 mod 26,Not in chargemaster,77762,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77762 mod 26,BCBS multispecialty AW base fee schedule,574.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77762 mod TC,Not in chargemaster,77762,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77762 mod TC,BCBS multispecialty AW base fee schedule,429.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77763,Not in chargemaster,77763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77763,BCBS multispecialty AW base fee schedule,1417.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77763 mod 26,Not in chargemaster,77763,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77763 mod 26,BCBS multispecialty AW base fee schedule,862.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77763 mod TC,Not in chargemaster,77763,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77763 mod TC,BCBS multispecialty AW base fee schedule,555.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77767,Not in chargemaster,77767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77767,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77767 mod 26,Not in chargemaster,77767,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77767 mod 26,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77767 mod TC,Not in chargemaster,77767,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77767 mod TC,BCBS multispecialty AW base fee schedule,343.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77768,Not in chargemaster,77768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77768,BCBS multispecialty AW base fee schedule,673.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77768 mod 26,Not in chargemaster,77768,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77768 mod 26,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77768 mod TC,Not in chargemaster,77768,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77768 mod TC,BCBS multispecialty AW base fee schedule,533.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77770,Not in chargemaster,77770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77770,BCBS multispecialty AW base fee schedule,630.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77770 mod 26,Not in chargemaster,77770,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77770 mod 26,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77770 mod TC,Not in chargemaster,77770,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77770 mod TC,BCBS multispecialty AW base fee schedule,435.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77771,Not in chargemaster,77771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77771,BCBS multispecialty AW base fee schedule,1124.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77771 mod 26,Not in chargemaster,77771,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77771 mod 26,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77771 mod TC,Not in chargemaster,77771,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77771 mod TC,BCBS multispecialty AW base fee schedule,746.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77772,Not in chargemaster,77772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77772,BCBS multispecialty AW base fee schedule,1693.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77772 mod 26,Not in chargemaster,77772,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77772 mod 26,BCBS multispecialty AW base fee schedule,533.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77772 mod TC,Not in chargemaster,77772,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77772 mod TC,BCBS multispecialty AW base fee schedule,1159.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77778,Not in chargemaster,77778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77778,BCBS multispecialty AW base fee schedule,1627.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77778 mod 26,Not in chargemaster,77778,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77778 mod 26,BCBS multispecialty AW base fee schedule,871.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77778 mod TC,Not in chargemaster,77778,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77778 mod TC,BCBS multispecialty AW base fee schedule,755.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77789,Not in chargemaster,77789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77789,BCBS multispecialty AW base fee schedule,240.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77789 mod 26,Not in chargemaster,77789,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77789 mod 26,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77789 mod TC,Not in chargemaster,77789,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77789 mod TC,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 77790,Not in chargemaster,77790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77790,BCBS multispecialty AW base fee schedule,28.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78012,Not in chargemaster,78012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78012,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78012 mod 26,Not in chargemaster,78012,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78012 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78012 mod TC,Not in chargemaster,78012,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78012 mod TC,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78013,Not in chargemaster,78013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78013,BCBS multispecialty AW base fee schedule,363.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78013 mod 26,Not in chargemaster,78013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78013 mod 26,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78013 mod TC,Not in chargemaster,78013,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78013 mod TC,BCBS multispecialty AW base fee schedule,329.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78014,Not in chargemaster,78014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78014,BCBS multispecialty AW base fee schedule,454.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78014 mod 26,Not in chargemaster,78014,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78014 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78014 mod TC,Not in chargemaster,78014,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78014 mod TC,BCBS multispecialty AW base fee schedule,408.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78015,Not in chargemaster,78015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78015,BCBS multispecialty AW base fee schedule,425.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78015 mod 26,Not in chargemaster,78015,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78015 mod 26,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78015 mod TC,Not in chargemaster,78015,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78015 mod TC,BCBS multispecialty AW base fee schedule,363.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78016,Not in chargemaster,78016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78016,BCBS multispecialty AW base fee schedule,535.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78016 mod 26,Not in chargemaster,78016,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78016 mod 26,BCBS multispecialty AW base fee schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78016 mod TC,Not in chargemaster,78016,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78016 mod TC,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78018,Not in chargemaster,78018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78018,BCBS multispecialty AW base fee schedule,593.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78018 mod 26,Not in chargemaster,78018,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78018 mod 26,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78018 mod TC,Not in chargemaster,78018,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78018 mod TC,BCBS multispecialty AW base fee schedule,516.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78020,Not in chargemaster,78020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78020,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78020 mod 26,Not in chargemaster,78020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78020 mod 26,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78020 mod TC,Not in chargemaster,78020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78020 mod TC,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78070,Not in chargemaster,78070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78070,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78070 mod 26,Not in chargemaster,78070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78070 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78070 mod TC,Not in chargemaster,78070,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78070 mod TC,BCBS multispecialty AW base fee schedule,488.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78071,Not in chargemaster,78071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78071,BCBS multispecialty AW base fee schedule,670.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78071 mod 26,Not in chargemaster,78071,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78071 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78071 mod TC,Not in chargemaster,78071,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78071 mod TC,BCBS multispecialty AW base fee schedule,560.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78072,Not in chargemaster,78072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78072,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78072 mod 26,Not in chargemaster,78072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78072 mod 26,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78072 mod TC,Not in chargemaster,78072,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78072 mod TC,BCBS multispecialty AW base fee schedule,700.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78075,Not in chargemaster,78075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78075,BCBS multispecialty AW base fee schedule,849.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78075 mod 26,Not in chargemaster,78075,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78075 mod 26,BCBS multispecialty AW base fee schedule,69.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78075 mod TC,Not in chargemaster,78075,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78075 mod TC,BCBS multispecialty AW base fee schedule,779.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78102,Not in chargemaster,78102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78102,BCBS multispecialty AW base fee schedule,322.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78102 mod 26,Not in chargemaster,78102,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78102 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78102 mod TC,Not in chargemaster,78102,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78102 mod TC,BCBS multispecialty AW base fee schedule,272.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78103,Not in chargemaster,78103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78103,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78103 mod 26,Not in chargemaster,78103,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78103 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78103 mod TC,Not in chargemaster,78103,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78103 mod TC,BCBS multispecialty AW base fee schedule,345.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78104,Not in chargemaster,78104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78104,BCBS multispecialty AW base fee schedule,473.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78104 mod 26,Not in chargemaster,78104,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78104 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78104 mod TC,Not in chargemaster,78104,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78104 mod TC,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78110,Not in chargemaster,78110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78110,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78110 mod 26,Not in chargemaster,78110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78110 mod 26,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78110 mod TC,Not in chargemaster,78110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78110 mod TC,BCBS multispecialty AW base fee schedule,116.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78111,Not in chargemaster,78111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78111,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78111 mod 26,Not in chargemaster,78111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78111 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78111 mod TC,Not in chargemaster,78111,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78111 mod TC,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78120,Not in chargemaster,78120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78120,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78120 mod 26,Not in chargemaster,78120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78120 mod 26,BCBS multispecialty AW base fee schedule,18.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78120 mod TC,Not in chargemaster,78120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78120 mod TC,BCBS multispecialty AW base fee schedule,116.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78121,Not in chargemaster,78121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78121,BCBS multispecialty AW base fee schedule,147.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78121 mod 26,Not in chargemaster,78121,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78121 mod 26,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78121 mod TC,Not in chargemaster,78121,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78121 mod TC,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78122,Not in chargemaster,78122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78122,BCBS multispecialty AW base fee schedule,182.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78122 mod 26,Not in chargemaster,78122,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78122 mod 26,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78122 mod TC,Not in chargemaster,78122,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78122 mod TC,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78130,Not in chargemaster,78130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78130,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78130 mod 26,Not in chargemaster,78130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78130 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78130 mod TC,Not in chargemaster,78130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78130 mod TC,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78135,Not in chargemaster,78135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78135,BCBS multispecialty AW base fee schedule,530,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78135 mod 26,Not in chargemaster,78135,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78135 mod 26,BCBS multispecialty AW base fee schedule,50.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78135 mod TC,Not in chargemaster,78135,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78135 mod TC,BCBS multispecialty AW base fee schedule,479.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78140,Not in chargemaster,78140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78140,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78140 mod 26,Not in chargemaster,78140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78140 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78140 mod TC,Not in chargemaster,78140,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78140 mod TC,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78185,Not in chargemaster,78185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78185,BCBS multispecialty AW base fee schedule,323.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78185 mod 26,Not in chargemaster,78185,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78185 mod 26,BCBS multispecialty AW base fee schedule,31.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78185 mod TC,Not in chargemaster,78185,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78185 mod TC,BCBS multispecialty AW base fee schedule,291.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78191,Not in chargemaster,78191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78191,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78191 mod 26,Not in chargemaster,78191,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78191 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78191 mod TC,Not in chargemaster,78191,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78191 mod TC,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78195,Not in chargemaster,78195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78195,BCBS multispecialty AW base fee schedule,672.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78195 mod 26,Not in chargemaster,78195,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78195 mod 26,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78195 mod TC,Not in chargemaster,78195,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78195 mod TC,BCBS multispecialty AW base fee schedule,563.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78201,Not in chargemaster,78201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78201,BCBS multispecialty AW base fee schedule,361.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78201 mod 26,Not in chargemaster,78201,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78201 mod 26,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78201 mod TC,Not in chargemaster,78201,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78201 mod TC,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78202,Not in chargemaster,78202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78202,BCBS multispecialty AW base fee schedule,389.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78202 mod 26,Not in chargemaster,78202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78202 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78202 mod TC,Not in chargemaster,78202,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78202 mod TC,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78215,Not in chargemaster,78215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78215,BCBS multispecialty AW base fee schedule,370.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78215 mod 26,Not in chargemaster,78215,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78215 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78215 mod TC,Not in chargemaster,78215,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78215 mod TC,BCBS multispecialty AW base fee schedule,325.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78216,Not in chargemaster,78216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78216,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78216 mod 26,Not in chargemaster,78216,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78216 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78216 mod TC,Not in chargemaster,78216,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78216 mod TC,BCBS multispecialty AW base fee schedule,193.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78226,Not in chargemaster,78226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78226,BCBS multispecialty AW base fee schedule,621.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78226 mod 26,Not in chargemaster,78226,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78226 mod 26,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78226 mod TC,Not in chargemaster,78226,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78226 mod TC,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78227,Not in chargemaster,78227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78227,BCBS multispecialty AW base fee schedule,839.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78227 mod 26,Not in chargemaster,78227,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78227 mod 26,BCBS multispecialty AW base fee schedule,84.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78227 mod TC,Not in chargemaster,78227,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78227 mod TC,BCBS multispecialty AW base fee schedule,755.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78230,Not in chargemaster,78230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78230,BCBS multispecialty AW base fee schedule,330.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78230 mod 26,Not in chargemaster,78230,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78230 mod 26,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78230 mod TC,Not in chargemaster,78230,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78230 mod TC,BCBS multispecialty AW base fee schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78231,Not in chargemaster,78231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78231,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78231 mod 26,Not in chargemaster,78231,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78231 mod 26,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78231 mod TC,Not in chargemaster,78231,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78231 mod TC,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78232,Not in chargemaster,78232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78232,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78232 mod 26,Not in chargemaster,78232,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78232 mod 26,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78232 mod TC,Not in chargemaster,78232,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78232 mod TC,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78258,Not in chargemaster,78258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78258,BCBS multispecialty AW base fee schedule,410.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78258 mod 26,Not in chargemaster,78258,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78258 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78258 mod TC,Not in chargemaster,78258,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78258 mod TC,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78261,Not in chargemaster,78261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78261,BCBS multispecialty AW base fee schedule,386.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78261 mod 26,Not in chargemaster,78261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78261 mod 26,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78261 mod TC,Not in chargemaster,78261,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78261 mod TC,BCBS multispecialty AW base fee schedule,332.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78262,Not in chargemaster,78262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78262,BCBS multispecialty AW base fee schedule,454.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78262 mod 26,Not in chargemaster,78262,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78262 mod 26,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78262 mod TC,Not in chargemaster,78262,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78262 mod TC,BCBS multispecialty AW base fee schedule,391.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78264,Not in chargemaster,78264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78264,BCBS multispecialty AW base fee schedule,630.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78264 mod 26,Not in chargemaster,78264,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78264 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78264 mod TC,Not in chargemaster,78264,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78264 mod TC,BCBS multispecialty AW base fee schedule,557.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78265,Not in chargemaster,78265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78265,BCBS multispecialty AW base fee schedule,745.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78265 mod 26,Not in chargemaster,78265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78265 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78265 mod TC,Not in chargemaster,78265,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78265 mod TC,BCBS multispecialty AW base fee schedule,655.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78266,Not in chargemaster,78266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78266,BCBS multispecialty AW base fee schedule,815.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78266 mod 26,Not in chargemaster,78266,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78266 mod 26,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78266 mod TC,Not in chargemaster,78266,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78266 mod TC,BCBS multispecialty AW base fee schedule,722.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78278,Not in chargemaster,78278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78278,BCBS multispecialty AW base fee schedule,660.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78278 mod 26,Not in chargemaster,78278,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78278 mod 26,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78278 mod TC,Not in chargemaster,78278,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78278 mod TC,BCBS multispecialty AW base fee schedule,568.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78282,Not in chargemaster,78282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78282,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78282 mod 26,Not in chargemaster,78282,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78282 mod 26,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78290,Not in chargemaster,78290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78290,BCBS multispecialty AW base fee schedule,625.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78290 mod 26,Not in chargemaster,78290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78290 mod 26,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78290 mod TC,Not in chargemaster,78290,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78290 mod TC,BCBS multispecialty AW base fee schedule,563.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78291,Not in chargemaster,78291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78291,BCBS multispecialty AW base fee schedule,483.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78291 mod 26,Not in chargemaster,78291,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78291 mod 26,BCBS multispecialty AW base fee schedule,80.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78291 mod TC,Not in chargemaster,78291,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78291 mod TC,BCBS multispecialty AW base fee schedule,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78300,Not in chargemaster,78300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78300,BCBS multispecialty AW base fee schedule,434.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78300 mod 26,78300,78300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78300 mod 26,BCBS multispecialty AW base fee schedule,58.3,79.71,Fee schedule,,58.3,58.3,58.3,58.3,,,0
unity,Fee schedule,Facility 78300 mod TC,Not in chargemaster,78300,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78300 mod TC,BCBS multispecialty AW base fee schedule,376.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78305,Not in chargemaster,78305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78305,BCBS multispecialty AW base fee schedule,526.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78305 mod 26,78305,78305,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78305 mod 26,BCBS multispecialty AW base fee schedule,77.51,104.8,Fee schedule,,77.51,77.51,77.51,77.51,,,0
unity,Fee schedule,Facility 78305 mod TC,Not in chargemaster,78305,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78305 mod TC,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78306,Not in chargemaster,78306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78306,BCBS multispecialty AW base fee schedule,571.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78306 mod 26,78306,78306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78306 mod 26,BCBS multispecialty AW base fee schedule,80.16,108.37,Fee schedule,,80.16,80.16,80.16,80.16,,,0
unity,Fee schedule,Facility 78306 mod TC,Not in chargemaster,78306,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78306 mod TC,BCBS multispecialty AW base fee schedule,490.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78315,Not in chargemaster,78315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78315,BCBS multispecialty AW base fee schedule,656.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78315 mod 26,Not in chargemaster,78315,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78315 mod 26,BCBS multispecialty AW base fee schedule,94.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78315 mod TC,Not in chargemaster,78315,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78315 mod TC,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78350,Not in chargemaster,78350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78350,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78350 mod 26,Not in chargemaster,78350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78350 mod 26,BCBS multispecialty AW base fee schedule,20.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78350 mod TC,Not in chargemaster,78350,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78350 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78351,Not in chargemaster,78351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78351,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78414,Not in chargemaster,78414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78414,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78414 mod 26,Not in chargemaster,78414,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78414 mod 26,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78428,Not in chargemaster,78428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78428,BCBS multispecialty AW base fee schedule,351.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78428 mod 26,Not in chargemaster,78428,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78428 mod 26,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78428 mod TC,Not in chargemaster,78428,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78428 mod TC,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78429,Not in chargemaster,78429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78429,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78429 mod 26,Not in chargemaster,78429,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78429 mod 26,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78430,Not in chargemaster,78430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78430,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78430 mod 26,Not in chargemaster,78430,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78430 mod 26,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78431,Not in chargemaster,78431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78431,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78431 mod 26,Not in chargemaster,78431,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78431 mod 26,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78432,Not in chargemaster,78432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78432,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78432 mod 26,Not in chargemaster,78432,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78432 mod 26,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78433,Not in chargemaster,78433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78433,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78433 mod 26,Not in chargemaster,78433,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78433 mod 26,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78434,Not in chargemaster,78434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78434,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78434 mod 26,Not in chargemaster,78434,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78434 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78445,Not in chargemaster,78445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78445,BCBS multispecialty AW base fee schedule,371,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78445 mod 26,Not in chargemaster,78445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78445 mod 26,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78445 mod TC,Not in chargemaster,78445,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78445 mod TC,BCBS multispecialty AW base fee schedule,323.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78451,Not in chargemaster,78451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78451,BCBS multispecialty AW base fee schedule,637.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78451 mod 26,Not in chargemaster,78451,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78451 mod 26,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78451 mod TC,Not in chargemaster,78451,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78451 mod TC,BCBS multispecialty AW base fee schedule,512.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78452,Not in chargemaster,78452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78452,BCBS multispecialty AW base fee schedule,889.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78452 mod 26,Not in chargemaster,78452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78452 mod 26,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78452 mod TC,Not in chargemaster,78452,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78452 mod TC,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78453,Not in chargemaster,78453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78453,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78453 mod 26,Not in chargemaster,78453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78453 mod 26,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78453 mod TC,Not in chargemaster,78453,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78453 mod TC,BCBS multispecialty AW base fee schedule,480.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78454,Not in chargemaster,78454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78454,BCBS multispecialty AW base fee schedule,822.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78454 mod 26,Not in chargemaster,78454,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78454 mod 26,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78454 mod TC,Not in chargemaster,78454,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78454 mod TC,BCBS multispecialty AW base fee schedule,697.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78456,Not in chargemaster,78456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78456,BCBS multispecialty AW base fee schedule,584.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78456 mod 26,Not in chargemaster,78456,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78456 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78456 mod TC,Not in chargemaster,78456,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78456 mod TC,BCBS multispecialty AW base fee schedule,493.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78457,Not in chargemaster,78457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78457,BCBS multispecialty AW base fee schedule,332.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78457 mod 26,Not in chargemaster,78457,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78457 mod 26,BCBS multispecialty AW base fee schedule,70.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78457 mod TC,Not in chargemaster,78457,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78457 mod TC,BCBS multispecialty AW base fee schedule,262.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78458,Not in chargemaster,78458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78458,BCBS multispecialty AW base fee schedule,389.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78458 mod 26,Not in chargemaster,78458,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78458 mod 26,BCBS multispecialty AW base fee schedule,85.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78458 mod TC,Not in chargemaster,78458,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78458 mod TC,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78459,Not in chargemaster,78459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78459,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78459 mod 26,Not in chargemaster,78459,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78459 mod 26,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78466,Not in chargemaster,78466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78466,BCBS multispecialty AW base fee schedule,378.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78466 mod 26,Not in chargemaster,78466,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78466 mod 26,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78466 mod TC,Not in chargemaster,78466,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78466 mod TC,BCBS multispecialty AW base fee schedule,312.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78468,Not in chargemaster,78468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78468,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78468 mod 26,Not in chargemaster,78468,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78468 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78468 mod TC,Not in chargemaster,78468,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78468 mod TC,BCBS multispecialty AW base fee schedule,292.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78469,Not in chargemaster,78469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78469,BCBS multispecialty AW base fee schedule,423.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78469 mod 26,Not in chargemaster,78469,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78469 mod 26,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78469 mod TC,Not in chargemaster,78469,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78469 mod TC,BCBS multispecialty AW base fee schedule,338.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78472,Not in chargemaster,78472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78472,BCBS multispecialty AW base fee schedule,431.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78472 mod 26,Not in chargemaster,78472,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78472 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78472 mod TC,Not in chargemaster,78472,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78472 mod TC,BCBS multispecialty AW base fee schedule,340.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78473,Not in chargemaster,78473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78473,BCBS multispecialty AW base fee schedule,547.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78473 mod 26,Not in chargemaster,78473,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78473 mod 26,BCBS multispecialty AW base fee schedule,133.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78473 mod TC,Not in chargemaster,78473,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78473 mod TC,BCBS multispecialty AW base fee schedule,414.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78481,Not in chargemaster,78481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78481,BCBS multispecialty AW base fee schedule,333.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78481 mod 26,Not in chargemaster,78481,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78481 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78481 mod TC,Not in chargemaster,78481,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78481 mod TC,BCBS multispecialty AW base fee schedule,242.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78483,Not in chargemaster,78483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78483,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78483 mod 26,Not in chargemaster,78483,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78483 mod 26,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78483 mod TC,Not in chargemaster,78483,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78483 mod TC,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78491,Not in chargemaster,78491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78491,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78491 mod 26,Not in chargemaster,78491,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78491 mod 26,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78492,Not in chargemaster,78492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78492,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78492 mod 26,Not in chargemaster,78492,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78492 mod 26,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78494,Not in chargemaster,78494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78494,BCBS multispecialty AW base fee schedule,428.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78494 mod 26,Not in chargemaster,78494,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78494 mod 26,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78494 mod TC,Not in chargemaster,78494,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78494 mod TC,BCBS multispecialty AW base fee schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78496,Not in chargemaster,78496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78496,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78496 mod 26,Not in chargemaster,78496,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78496 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78496 mod TC,Not in chargemaster,78496,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78496 mod TC,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78579,Not in chargemaster,78579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78579,BCBS multispecialty AW base fee schedule,355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78579 mod 26,Not in chargemaster,78579,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78579 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78579 mod TC,Not in chargemaster,78579,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78579 mod TC,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78580,Not in chargemaster,78580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78580,BCBS multispecialty AW base fee schedule,448.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78580 mod 26,78580,78580,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78580 mod 26,BCBS multispecialty AW base fee schedule,68.24,93.14,Fee schedule,,68.24,68.24,68.24,68.24,,,0
unity,Fee schedule,Facility 78580 mod TC,Not in chargemaster,78580,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78580 mod TC,BCBS multispecialty AW base fee schedule,380.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78582,Not in chargemaster,78582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78582,BCBS multispecialty AW base fee schedule,632.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78582 mod 26,Not in chargemaster,78582,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78582 mod 26,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78582 mod TC,Not in chargemaster,78582,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78582 mod TC,BCBS multispecialty AW base fee schedule,533.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78597,Not in chargemaster,78597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78597,BCBS multispecialty AW base fee schedule,380.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78597 mod 26,Not in chargemaster,78597,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78597 mod 26,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78597 mod TC,Not in chargemaster,78597,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78597 mod TC,BCBS multispecialty AW base fee schedule,314.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78598,Not in chargemaster,78598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78598,BCBS multispecialty AW base fee schedule,576.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78598 mod 26,Not in chargemaster,78598,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78598 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78598 mod TC,Not in chargemaster,78598,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78598 mod TC,BCBS multispecialty AW base fee schedule,499.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78600,Not in chargemaster,78600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78600,BCBS multispecialty AW base fee schedule,348.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78600 mod 26,Not in chargemaster,78600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78600 mod 26,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78600 mod TC,Not in chargemaster,78600,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78600 mod TC,BCBS multispecialty AW base fee schedule,307.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78601,Not in chargemaster,78601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78601,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78601 mod 26,Not in chargemaster,78601,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78601 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78601 mod TC,Not in chargemaster,78601,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78601 mod TC,BCBS multispecialty AW base fee schedule,363.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78605,Not in chargemaster,78605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78605,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78605 mod 26,Not in chargemaster,78605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78605 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78605 mod TC,Not in chargemaster,78605,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78605 mod TC,BCBS multispecialty AW base fee schedule,328.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78606,Not in chargemaster,78606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78606,BCBS multispecialty AW base fee schedule,626.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78606 mod 26,Not in chargemaster,78606,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78606 mod 26,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78606 mod TC,Not in chargemaster,78606,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78606 mod TC,BCBS multispecialty AW base fee schedule,567.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78608,Not in chargemaster,78608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78608,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78608 mod 26,Not in chargemaster,78608,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78608 mod 26,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78609,Not in chargemaster,78609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78609,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78609 mod 26,Not in chargemaster,78609,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78609 mod 26,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78610,Not in chargemaster,78610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78610,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78610 mod 26,Not in chargemaster,78610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78610 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78610 mod TC,Not in chargemaster,78610,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78610 mod TC,BCBS multispecialty AW base fee schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78630,Not in chargemaster,78630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78630,BCBS multispecialty AW base fee schedule,639.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78630 mod 26,Not in chargemaster,78630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78630 mod 26,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78630 mod TC,Not in chargemaster,78630,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78630 mod TC,BCBS multispecialty AW base fee schedule,577.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78635,Not in chargemaster,78635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78635,BCBS multispecialty AW base fee schedule,639.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78635 mod 26,Not in chargemaster,78635,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78635 mod 26,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78635 mod TC,Not in chargemaster,78635,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78635 mod TC,BCBS multispecialty AW base fee schedule,582.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78645,Not in chargemaster,78645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78645,BCBS multispecialty AW base fee schedule,614.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78645 mod 26,Not in chargemaster,78645,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78645 mod 26,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78645 mod TC,Not in chargemaster,78645,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78645 mod TC,BCBS multispecialty AW base fee schedule,563.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78650,Not in chargemaster,78650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78650,BCBS multispecialty AW base fee schedule,522.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78650 mod 26,Not in chargemaster,78650,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78650 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78650 mod TC,Not in chargemaster,78650,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78650 mod TC,BCBS multispecialty AW base fee schedule,474.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78660,Not in chargemaster,78660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78660,BCBS multispecialty AW base fee schedule,349.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78660 mod 26,Not in chargemaster,78660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78660 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78660 mod TC,Not in chargemaster,78660,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78660 mod TC,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78700,Not in chargemaster,78700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78700,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78700 mod 26,Not in chargemaster,78700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78700 mod 26,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78700 mod TC,Not in chargemaster,78700,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78700 mod TC,BCBS multispecialty AW base fee schedule,282.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78701,Not in chargemaster,78701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78701,BCBS multispecialty AW base fee schedule,414.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78701 mod 26,Not in chargemaster,78701,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78701 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78701 mod TC,Not in chargemaster,78701,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78701 mod TC,BCBS multispecialty AW base fee schedule,369.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78707,Not in chargemaster,78707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78707,BCBS multispecialty AW base fee schedule,441.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78707 mod 26,Not in chargemaster,78707,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78707 mod 26,BCBS multispecialty AW base fee schedule,88.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78707 mod TC,Not in chargemaster,78707,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78707 mod TC,BCBS multispecialty AW base fee schedule,353.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78708,Not in chargemaster,78708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78708,BCBS multispecialty AW base fee schedule,335.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78708 mod 26,Not in chargemaster,78708,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78708 mod 26,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78708 mod TC,Not in chargemaster,78708,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78708 mod TC,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78709,Not in chargemaster,78709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78709,BCBS multispecialty AW base fee schedule,695.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78709 mod 26,Not in chargemaster,78709,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78709 mod 26,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78709 mod TC,Not in chargemaster,78709,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78709 mod TC,BCBS multispecialty AW base fee schedule,567.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78725,Not in chargemaster,78725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78725,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78725 mod 26,Not in chargemaster,78725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78725 mod 26,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78725 mod TC,Not in chargemaster,78725,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78725 mod TC,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78730,Not in chargemaster,78730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78730,BCBS multispecialty AW base fee schedule,143.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78730 mod 26,Not in chargemaster,78730,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78730 mod 26,BCBS multispecialty AW base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78730 mod TC,Not in chargemaster,78730,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78730 mod TC,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78740,Not in chargemaster,78740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78740,BCBS multispecialty AW base fee schedule,411.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78740 mod 26,Not in chargemaster,78740,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78740 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78740 mod TC,Not in chargemaster,78740,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78740 mod TC,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78761,Not in chargemaster,78761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78761,BCBS multispecialty AW base fee schedule,401.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78761 mod 26,Not in chargemaster,78761,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78761 mod 26,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78761 mod TC,Not in chargemaster,78761,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78761 mod TC,BCBS multispecialty AW base fee schedule,334.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78800,Not in chargemaster,78800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78800,BCBS multispecialty AW base fee schedule,490.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78800 mod 26,Not in chargemaster,78800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78800 mod 26,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78800 mod TC,Not in chargemaster,78800,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78800 mod TC,BCBS multispecialty AW base fee schedule,429.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78801,Not in chargemaster,78801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78801,BCBS multispecialty AW base fee schedule,538.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78801 mod 26,Not in chargemaster,78801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78801 mod 26,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78801 mod TC,Not in chargemaster,78801,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78801 mod TC,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78802,Not in chargemaster,78802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78802,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78802 mod 26,Not in chargemaster,78802,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78802 mod 26,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78802 mod TC,Not in chargemaster,78802,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78802 mod TC,BCBS multispecialty AW base fee schedule,519.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78803,Not in chargemaster,78803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78803,BCBS multispecialty AW base fee schedule,736.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78803 mod 26,Not in chargemaster,78803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78803 mod 26,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78803 mod TC,Not in chargemaster,78803,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78803 mod TC,BCBS multispecialty AW base fee schedule,637.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78804,Not in chargemaster,78804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78804,BCBS multispecialty AW base fee schedule,1250.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78804 mod 26,Not in chargemaster,78804,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78804 mod 26,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78804 mod TC,Not in chargemaster,78804,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78804 mod TC,BCBS multispecialty AW base fee schedule,1157.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78808,Not in chargemaster,78808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78808,BCBS multispecialty AW base fee schedule,75.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78811,Not in chargemaster,78811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78811,BCBS multispecialty AW base fee schedule,141.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78811 mod 26,Not in chargemaster,78811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78811 mod 26,BCBS multispecialty AW base fee schedule,141.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78812,Not in chargemaster,78812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78812,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78812 mod 26,Not in chargemaster,78812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78812 mod 26,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78813,Not in chargemaster,78813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78813,BCBS multispecialty AW base fee schedule,174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78813 mod 26,Not in chargemaster,78813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78813 mod 26,BCBS multispecialty AW base fee schedule,174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78814,Not in chargemaster,78814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78814,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78814 mod 26,Not in chargemaster,78814,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78814 mod 26,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78815,Not in chargemaster,78815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78815,BCBS multispecialty AW base fee schedule,5237.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78815 mod 26,Not in chargemaster,78815,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78815 mod 26,BCBS multispecialty AW base fee schedule,223.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78815 mod TC,Not in chargemaster,78815,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78815 mod TC,BCBS multispecialty AW base fee schedule,5014.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78816,Not in chargemaster,78816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78816,BCBS multispecialty AW base fee schedule,5210.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78816 mod 26,Not in chargemaster,78816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78816 mod 26,BCBS multispecialty AW base fee schedule,225.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78816 mod TC,Not in chargemaster,78816,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78816 mod TC,BCBS multispecialty AW base fee schedule,4985.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78830,Not in chargemaster,78830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78830,BCBS multispecialty AW base fee schedule,932.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78830 mod 26,Not in chargemaster,78830,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78830 mod 26,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78830 mod TC,Not in chargemaster,78830,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78830 mod TC,BCBS multispecialty AW base fee schedule,796.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78831,Not in chargemaster,78831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78831,BCBS multispecialty AW base fee schedule,1348.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78831 mod 26,Not in chargemaster,78831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78831 mod 26,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78831 mod TC,Not in chargemaster,78831,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78831 mod TC,BCBS multispecialty AW base fee schedule,1183.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78832,Not in chargemaster,78832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78832,BCBS multispecialty AW base fee schedule,1754.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78832 mod 26,Not in chargemaster,78832,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78832 mod 26,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78832 mod TC,Not in chargemaster,78832,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78832 mod TC,BCBS multispecialty AW base fee schedule,1562.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78835,Not in chargemaster,78835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78835,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78835 mod 26,Not in chargemaster,78835,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78835 mod 26,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 78835 mod TC,Not in chargemaster,78835,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78835 mod TC,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79005,Not in chargemaster,79005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79005,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79005 mod 26,Not in chargemaster,79005,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79005 mod 26,BCBS multispecialty AW base fee schedule,165.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79005 mod TC,Not in chargemaster,79005,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79005 mod TC,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79101,Not in chargemaster,79101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79101,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79101 mod 26,Not in chargemaster,79101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79101 mod 26,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79101 mod TC,Not in chargemaster,79101,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79101 mod TC,BCBS multispecialty AW base fee schedule,95.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79200,Not in chargemaster,79200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79200,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79200 mod 26,Not in chargemaster,79200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79200 mod 26,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79200 mod TC,Not in chargemaster,79200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79200 mod TC,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79300,Not in chargemaster,79300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79300,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79300 mod 26,Not in chargemaster,79300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79300 mod 26,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79403,Not in chargemaster,79403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79403,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79403 mod 26,Not in chargemaster,79403,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79403 mod 26,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79403 mod TC,Not in chargemaster,79403,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79403 mod TC,BCBS multispecialty AW base fee schedule,152.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79440,Not in chargemaster,79440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79440,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79440 mod 26,Not in chargemaster,79440,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79440 mod 26,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79440 mod TC,Not in chargemaster,79440,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79440 mod TC,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79445,Not in chargemaster,79445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79445,BCBS multispecialty AW base fee schedule,214.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 79445 mod 26,Not in chargemaster,79445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79445 mod 26,BCBS multispecialty AW base fee schedule,214.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 80500,Not in chargemaster,80500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80500,BCBS multispecialty AW base fee schedule,30.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86153,Not in chargemaster,86153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86153,BCBS multispecialty AW base fee schedule,54.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86153 mod 26,Not in chargemaster,86153,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86153 mod 26,BCBS multispecialty AW base fee schedule,54.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86255,Not in chargemaster,86255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86255,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86255 mod 26,Not in chargemaster,86255,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86255 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86256,Not in chargemaster,86256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86256,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86256 mod 26,Not in chargemaster,86256,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86256 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86320,Not in chargemaster,86320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86320,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86320 mod 26,Not in chargemaster,86320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86320 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86325,Not in chargemaster,86325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86325,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86325 mod 26,Not in chargemaster,86325,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86325 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86327,Not in chargemaster,86327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86327,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86327 mod 26,Not in chargemaster,86327,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86327 mod 26,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86334,Not in chargemaster,86334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86334,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86334 mod 26,Not in chargemaster,86334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86334 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86335,Not in chargemaster,86335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86335,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86335 mod 26,Not in chargemaster,86335,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86335 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86486,Not in chargemaster,86486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86486,BCBS multispecialty AW base fee schedule,8.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86490,Not in chargemaster,86490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86490,BCBS multispecialty AW base fee schedule,136.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86510,Not in chargemaster,86510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86510,BCBS multispecialty AW base fee schedule,10.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86580,Not in chargemaster,86580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86580,BCBS multispecialty AW base fee schedule,14.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 87164,Not in chargemaster,87164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87164,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 87164 mod 26,Not in chargemaster,87164,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87164 mod 26,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 87207,Not in chargemaster,87207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87207,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 87207 mod 26,Not in chargemaster,87207,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87207 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88104,Not in chargemaster,88104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88104,BCBS multispecialty AW base fee schedule,106.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88104 mod 26,Not in chargemaster,88104,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88104 mod 26,BCBS multispecialty AW base fee schedule,44.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88104 mod TC,Not in chargemaster,88104,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88104 mod TC,BCBS multispecialty AW base fee schedule,61.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88106,Not in chargemaster,88106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88106,BCBS multispecialty AW base fee schedule,100.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88106 mod 26,Not in chargemaster,88106,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88106 mod 26,BCBS multispecialty AW base fee schedule,30.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88106 mod TC,Not in chargemaster,88106,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88106 mod TC,BCBS multispecialty AW base fee schedule,69.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88108,Not in chargemaster,88108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88108,BCBS multispecialty AW base fee schedule,96.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88108 mod 26,Not in chargemaster,88108,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88108 mod 26,BCBS multispecialty AW base fee schedule,35.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88108 mod TC,Not in chargemaster,88108,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88108 mod TC,BCBS multispecialty AW base fee schedule,60.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88112,Not in chargemaster,88112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88112,BCBS multispecialty AW base fee schedule,104.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88112 mod 26,Not in chargemaster,88112,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88112 mod 26,BCBS multispecialty AW base fee schedule,44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88112 mod TC,Not in chargemaster,88112,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88112 mod TC,BCBS multispecialty AW base fee schedule,60.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88120,Not in chargemaster,88120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88120,BCBS multispecialty AW base fee schedule,898.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88120 mod 26,Not in chargemaster,88120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88120 mod 26,BCBS multispecialty AW base fee schedule,91.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88120 mod TC,Not in chargemaster,88120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88120 mod TC,BCBS multispecialty AW base fee schedule,806.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88121,Not in chargemaster,88121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88121,BCBS multispecialty AW base fee schedule,686.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88121 mod 26,Not in chargemaster,88121,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88121 mod 26,BCBS multispecialty AW base fee schedule,77.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88121 mod TC,Not in chargemaster,88121,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88121 mod TC,BCBS multispecialty AW base fee schedule,608.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88125,Not in chargemaster,88125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88125,BCBS multispecialty AW base fee schedule,41.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88125 mod 26,Not in chargemaster,88125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88125 mod 26,BCBS multispecialty AW base fee schedule,22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88125 mod TC,Not in chargemaster,88125,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88125 mod TC,BCBS multispecialty AW base fee schedule,19.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88141,Not in chargemaster,88141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88141,BCBS multispecialty AW base fee schedule,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88160,Not in chargemaster,88160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88160,BCBS multispecialty AW base fee schedule,110.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88160 mod 26,Not in chargemaster,88160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88160 mod 26,BCBS multispecialty AW base fee schedule,41.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88160 mod TC,Not in chargemaster,88160,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88160 mod TC,BCBS multispecialty AW base fee schedule,69.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88161,Not in chargemaster,88161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88161,BCBS multispecialty AW base fee schedule,106.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88161 mod 26,Not in chargemaster,88161,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88161 mod 26,BCBS multispecialty AW base fee schedule,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88161 mod TC,Not in chargemaster,88161,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88161 mod TC,BCBS multispecialty AW base fee schedule,66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88162,Not in chargemaster,88162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88162,BCBS multispecialty AW base fee schedule,154,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88162 mod 26,Not in chargemaster,88162,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88162 mod 26,BCBS multispecialty AW base fee schedule,61.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88162 mod TC,Not in chargemaster,88162,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88162 mod TC,BCBS multispecialty AW base fee schedule,92.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88172,Not in chargemaster,88172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88172,BCBS multispecialty AW base fee schedule,86.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88172 mod 26,Not in chargemaster,88172,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88172 mod 26,BCBS multispecialty AW base fee schedule,57.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88172 mod TC,Not in chargemaster,88172,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88172 mod TC,BCBS multispecialty AW base fee schedule,29.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88173,Not in chargemaster,88173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88173,BCBS multispecialty AW base fee schedule,239.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88173 mod 26,Not in chargemaster,88173,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88173 mod 26,BCBS multispecialty AW base fee schedule,112.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88173 mod TC,Not in chargemaster,88173,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88173 mod TC,BCBS multispecialty AW base fee schedule,127.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88177,Not in chargemaster,88177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88177,BCBS multispecialty AW base fee schedule,46.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88177 mod 26,Not in chargemaster,88177,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88177 mod 26,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88177 mod TC,Not in chargemaster,88177,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88177 mod TC,BCBS multispecialty AW base fee schedule,11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88182,Not in chargemaster,88182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88182,BCBS multispecialty AW base fee schedule,213.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88182 mod 26,Not in chargemaster,88182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88182 mod 26,BCBS multispecialty AW base fee schedule,61.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88182 mod TC,Not in chargemaster,88182,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88182 mod TC,BCBS multispecialty AW base fee schedule,152.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88184,Not in chargemaster,88184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88184,BCBS multispecialty AW base fee schedule,103.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88185,Not in chargemaster,88185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88185,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88187,Not in chargemaster,88187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88187,BCBS multispecialty AW base fee schedule,59.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88188,Not in chargemaster,88188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88188,BCBS multispecialty AW base fee schedule,100.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88189,Not in chargemaster,88189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88189,BCBS multispecialty AW base fee schedule,135.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88291,Not in chargemaster,88291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88291,BCBS multispecialty AW base fee schedule,52.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88300,Not in chargemaster,88300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88300,BCBS multispecialty AW base fee schedule,24.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88300 mod 26,Not in chargemaster,88300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88300 mod 26,BCBS multispecialty AW base fee schedule,7.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88300 mod TC,Not in chargemaster,88300,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88300 mod TC,BCBS multispecialty AW base fee schedule,17.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88302,Not in chargemaster,88302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88302,BCBS multispecialty AW base fee schedule,47.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88302 mod 26,Not in chargemaster,88302,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88302 mod 26,BCBS multispecialty AW base fee schedule,11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88302 mod TC,Not in chargemaster,88302,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88302 mod TC,BCBS multispecialty AW base fee schedule,36.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88304,Not in chargemaster,88304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88304,BCBS multispecialty AW base fee schedule,63.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88304 mod 26,Not in chargemaster,88304,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88304 mod 26,BCBS multispecialty AW base fee schedule,18.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88304 mod TC,Not in chargemaster,88304,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88304 mod TC,BCBS multispecialty AW base fee schedule,45.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88305,Not in chargemaster,88305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88305,BCBS multispecialty AW base fee schedule,108.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88305 mod 26,Not in chargemaster,88305,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88305 mod 26,BCBS multispecialty AW base fee schedule,59.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88305 mod TC,Not in chargemaster,88305,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88305 mod TC,BCBS multispecialty AW base fee schedule,48.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88307,Not in chargemaster,88307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88307,BCBS multispecialty AW base fee schedule,429,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88307 mod 26,Not in chargemaster,88307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88307 mod 26,BCBS multispecialty AW base fee schedule,132,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88307 mod TC,Not in chargemaster,88307,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88307 mod TC,BCBS multispecialty AW base fee schedule,297,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88309,Not in chargemaster,88309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88309,BCBS multispecialty AW base fee schedule,651.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88309 mod 26,Not in chargemaster,88309,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88309 mod 26,BCBS multispecialty AW base fee schedule,232.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88309 mod TC,Not in chargemaster,88309,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88309 mod TC,BCBS multispecialty AW base fee schedule,419.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88311,Not in chargemaster,88311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88311,BCBS multispecialty AW base fee schedule,33.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88311 mod 26,Not in chargemaster,88311,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88311 mod 26,BCBS multispecialty AW base fee schedule,19.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88311 mod TC,Not in chargemaster,88311,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88311 mod TC,BCBS multispecialty AW base fee schedule,13.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88312,Not in chargemaster,88312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88312,BCBS multispecialty AW base fee schedule,163.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88312 mod 26,Not in chargemaster,88312,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88312 mod 26,BCBS multispecialty AW base fee schedule,42.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88312 mod TC,Not in chargemaster,88312,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88312 mod TC,BCBS multispecialty AW base fee schedule,121,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88313,Not in chargemaster,88313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88313,BCBS multispecialty AW base fee schedule,117.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88313 mod 26,Not in chargemaster,88313,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88313 mod 26,BCBS multispecialty AW base fee schedule,19.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88313 mod TC,Not in chargemaster,88313,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88313 mod TC,BCBS multispecialty AW base fee schedule,98.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88314,Not in chargemaster,88314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88314,BCBS multispecialty AW base fee schedule,150.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88314 mod 26,Not in chargemaster,88314,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88314 mod 26,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88314 mod TC,Not in chargemaster,88314,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88314 mod TC,BCBS multispecialty AW base fee schedule,114.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88319,Not in chargemaster,88319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88319,BCBS multispecialty AW base fee schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88319 mod 26,Not in chargemaster,88319,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88319 mod 26,BCBS multispecialty AW base fee schedule,42.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88319 mod TC,Not in chargemaster,88319,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88319 mod TC,BCBS multispecialty AW base fee schedule,130.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88321,Not in chargemaster,88321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88321,BCBS multispecialty AW base fee schedule,134.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88331,Not in chargemaster,88331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88331,BCBS multispecialty AW base fee schedule,152.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88331 mod 26,Not in chargemaster,88331,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88331 mod 26,BCBS multispecialty AW base fee schedule,99.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88331 mod TC,Not in chargemaster,88331,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88331 mod TC,BCBS multispecialty AW base fee schedule,53.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88332,Not in chargemaster,88332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88332,BCBS multispecialty AW base fee schedule,84.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88332 mod 26,Not in chargemaster,88332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88332 mod 26,BCBS multispecialty AW base fee schedule,49.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88332 mod TC,Not in chargemaster,88332,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88332 mod TC,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88333,Not in chargemaster,88333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88333,BCBS multispecialty AW base fee schedule,140.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88333 mod 26,Not in chargemaster,88333,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88333 mod 26,BCBS multispecialty AW base fee schedule,99.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88333 mod TC,Not in chargemaster,88333,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88333 mod TC,BCBS multispecialty AW base fee schedule,40.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88334,Not in chargemaster,88334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88334,BCBS multispecialty AW base fee schedule,88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88334 mod 26,Not in chargemaster,88334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88334 mod 26,BCBS multispecialty AW base fee schedule,60.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88334 mod TC,Not in chargemaster,88334,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88334 mod TC,BCBS multispecialty AW base fee schedule,27.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88341,Not in chargemaster,88341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88341,BCBS multispecialty AW base fee schedule,143.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88341 mod 26,Not in chargemaster,88341,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88341 mod 26,BCBS multispecialty AW base fee schedule,45.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88341 mod TC,Not in chargemaster,88341,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88341 mod TC,BCBS multispecialty AW base fee schedule,98.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88342,Not in chargemaster,88342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88342,BCBS multispecialty AW base fee schedule,163.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88342 mod 26,Not in chargemaster,88342,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88342 mod 26,BCBS multispecialty AW base fee schedule,56.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88342 mod TC,Not in chargemaster,88342,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88342 mod TC,BCBS multispecialty AW base fee schedule,107.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88344,Not in chargemaster,88344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88344,BCBS multispecialty AW base fee schedule,267.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88344 mod 26,Not in chargemaster,88344,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88344 mod 26,BCBS multispecialty AW base fee schedule,61.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88344 mod TC,Not in chargemaster,88344,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88344 mod TC,BCBS multispecialty AW base fee schedule,206.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88346,Not in chargemaster,88346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88346,BCBS multispecialty AW base fee schedule,195.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88346 mod 26,Not in chargemaster,88346,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88346 mod 26,BCBS multispecialty AW base fee schedule,57.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88346 mod TC,Not in chargemaster,88346,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88346 mod TC,BCBS multispecialty AW base fee schedule,138.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88348,Not in chargemaster,88348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88348,BCBS multispecialty AW base fee schedule,600.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88348 mod 26,Not in chargemaster,88348,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88348 mod 26,BCBS multispecialty AW base fee schedule,121.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88348 mod TC,Not in chargemaster,88348,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88348 mod TC,BCBS multispecialty AW base fee schedule,479.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88350,Not in chargemaster,88350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88350,BCBS multispecialty AW base fee schedule,143.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88350 mod 26,Not in chargemaster,88350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88350 mod 26,BCBS multispecialty AW base fee schedule,46.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88350 mod TC,Not in chargemaster,88350,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88350 mod TC,BCBS multispecialty AW base fee schedule,97.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88355,Not in chargemaster,88355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88355,BCBS multispecialty AW base fee schedule,213.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88355 mod 26,Not in chargemaster,88355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88355 mod 26,BCBS multispecialty AW base fee schedule,130.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88355 mod TC,Not in chargemaster,88355,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88355 mod TC,BCBS multispecialty AW base fee schedule,82.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88356,Not in chargemaster,88356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88356,BCBS multispecialty AW base fee schedule,366.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88356 mod 26,Not in chargemaster,88356,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88356 mod 26,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88356 mod TC,Not in chargemaster,88356,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88356 mod TC,BCBS multispecialty AW base fee schedule,162.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88358,Not in chargemaster,88358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88358,BCBS multispecialty AW base fee schedule,207.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88358 mod 26,Not in chargemaster,88358,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88358 mod 26,BCBS multispecialty AW base fee schedule,79.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88358 mod TC,Not in chargemaster,88358,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88358 mod TC,BCBS multispecialty AW base fee schedule,127.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88360,Not in chargemaster,88360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88360,BCBS multispecialty AW base fee schedule,194.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88360 mod 26,Not in chargemaster,88360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88360 mod 26,BCBS multispecialty AW base fee schedule,67.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88360 mod TC,Not in chargemaster,88360,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88360 mod TC,BCBS multispecialty AW base fee schedule,127.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88361,Not in chargemaster,88361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88361,BCBS multispecialty AW base fee schedule,196.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88361 mod 26,Not in chargemaster,88361,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88361 mod 26,BCBS multispecialty AW base fee schedule,70.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88361 mod TC,Not in chargemaster,88361,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88361 mod TC,BCBS multispecialty AW base fee schedule,125.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88362,Not in chargemaster,88362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88362,BCBS multispecialty AW base fee schedule,354.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88362 mod 26,Not in chargemaster,88362,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88362 mod 26,BCBS multispecialty AW base fee schedule,179.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88362 mod TC,Not in chargemaster,88362,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88362 mod TC,BCBS multispecialty AW base fee schedule,174.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88363,Not in chargemaster,88363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88363,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88364,Not in chargemaster,88364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88364,BCBS multispecialty AW base fee schedule,213.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88364 mod 26,Not in chargemaster,88364,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88364 mod 26,BCBS multispecialty AW base fee schedule,55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88364 mod TC,Not in chargemaster,88364,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88364 mod TC,BCBS multispecialty AW base fee schedule,158.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88365,Not in chargemaster,88365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88365,BCBS multispecialty AW base fee schedule,280.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88365 mod 26,Not in chargemaster,88365,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88365 mod 26,BCBS multispecialty AW base fee schedule,69.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88365 mod TC,Not in chargemaster,88365,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88365 mod TC,BCBS multispecialty AW base fee schedule,210.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88366,Not in chargemaster,88366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88366,BCBS multispecialty AW base fee schedule,429,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88366 mod 26,Not in chargemaster,88366,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88366 mod 26,BCBS multispecialty AW base fee schedule,99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88366 mod TC,Not in chargemaster,88366,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88366 mod TC,BCBS multispecialty AW base fee schedule,330,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88367,Not in chargemaster,88367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88367,BCBS multispecialty AW base fee schedule,175.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88367 mod 26,Not in chargemaster,88367,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88367 mod 26,BCBS multispecialty AW base fee schedule,54.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88367 mod TC,Not in chargemaster,88367,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88367 mod TC,BCBS multispecialty AW base fee schedule,121,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88368,Not in chargemaster,88368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88368,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88368 mod 26,Not in chargemaster,88368,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88368 mod 26,BCBS multispecialty AW base fee schedule,66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88368 mod TC,Not in chargemaster,88368,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88368 mod TC,BCBS multispecialty AW base fee schedule,138.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88369,Not in chargemaster,88369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88369,BCBS multispecialty AW base fee schedule,177.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88369 mod 26,Not in chargemaster,88369,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88369 mod 26,BCBS multispecialty AW base fee schedule,51.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88369 mod TC,Not in chargemaster,88369,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88369 mod TC,BCBS multispecialty AW base fee schedule,125.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88371,Not in chargemaster,88371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88371,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88371 mod 26,Not in chargemaster,88371,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88371 mod 26,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88372,Not in chargemaster,88372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88372,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88372 mod 26,Not in chargemaster,88372,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88372 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88373,Not in chargemaster,88373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88373,BCBS multispecialty AW base fee schedule,114.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88373 mod 26,Not in chargemaster,88373,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88373 mod 26,BCBS multispecialty AW base fee schedule,42.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88373 mod TC,Not in chargemaster,88373,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88373 mod TC,BCBS multispecialty AW base fee schedule,72.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88374,Not in chargemaster,88374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88374,BCBS multispecialty AW base fee schedule,530.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88374 mod 26,Not in chargemaster,88374,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88374 mod 26,BCBS multispecialty AW base fee schedule,70.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88374 mod TC,Not in chargemaster,88374,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88374 mod TC,BCBS multispecialty AW base fee schedule,460.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88375,Not in chargemaster,88375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88375,BCBS multispecialty AW base fee schedule,78.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88377,Not in chargemaster,88377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88377,BCBS multispecialty AW base fee schedule,627.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88377 mod 26,Not in chargemaster,88377,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88377 mod 26,BCBS multispecialty AW base fee schedule,102.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88377 mod TC,Not in chargemaster,88377,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88377 mod TC,BCBS multispecialty AW base fee schedule,524.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88380,Not in chargemaster,88380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88380,BCBS multispecialty AW base fee schedule,210.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88380 mod 26,Not in chargemaster,88380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88380 mod 26,BCBS multispecialty AW base fee schedule,88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88380 mod TC,Not in chargemaster,88380,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88380 mod TC,BCBS multispecialty AW base fee schedule,122.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88381,Not in chargemaster,88381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88381,BCBS multispecialty AW base fee schedule,278.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88381 mod 26,Not in chargemaster,88381,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88381 mod 26,BCBS multispecialty AW base fee schedule,39.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88381 mod TC,Not in chargemaster,88381,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88381 mod TC,BCBS multispecialty AW base fee schedule,239.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88387,Not in chargemaster,88387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88387,BCBS multispecialty AW base fee schedule,55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88387 mod 26,Not in chargemaster,88387,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88387 mod 26,BCBS multispecialty AW base fee schedule,44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88387 mod TC,Not in chargemaster,88387,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88387 mod TC,BCBS multispecialty AW base fee schedule,11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88388,Not in chargemaster,88388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88388,BCBS multispecialty AW base fee schedule,57.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88388 mod 26,Not in chargemaster,88388,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88388 mod 26,BCBS multispecialty AW base fee schedule,37.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88388 mod TC,Not in chargemaster,88388,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88388 mod TC,BCBS multispecialty AW base fee schedule,19.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 89049,Not in chargemaster,89049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89049,BCBS multispecialty AW base fee schedule,96.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 83020,Not in chargemaster,83020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83020,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 83020 mod 26,Not in chargemaster,83020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83020 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 84165,Not in chargemaster,84165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84165,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 84165 mod 26,Not in chargemaster,84165,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84165 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 84166,Not in chargemaster,84166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84166,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 84166 mod 26,Not in chargemaster,84166,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84166 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 84181,Not in chargemaster,84181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84181,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 84181 mod 26,Not in chargemaster,84181,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84181 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 84182,Not in chargemaster,84182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84182,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 84182 mod 26,Not in chargemaster,84182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84182 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 85060,Not in chargemaster,85060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85060,BCBS multispecialty AW base fee schedule,38.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 85097,Not in chargemaster,85097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85097,BCBS multispecialty AW base fee schedule,78.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69620,Not in chargemaster,69620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69620,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 80502,Not in chargemaster,80502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80502,BCBS multispecialty AW base fee schedule,111.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 85390,Not in chargemaster,85390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85390,BCBS multispecialty AW base fee schedule,58.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 85390 mod 26,Not in chargemaster,85390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85390 mod 26,BCBS multispecialty AW base fee schedule,58.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 85396,Not in chargemaster,85396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85396,BCBS multispecialty AW base fee schedule,31.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 85576,Not in chargemaster,85576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85576,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 85576 mod 26,Not in chargemaster,85576,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85576 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86077,Not in chargemaster,86077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86077,BCBS multispecialty AW base fee schedule,80.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86078,Not in chargemaster,86078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86078,BCBS multispecialty AW base fee schedule,80.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86079,Not in chargemaster,86079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86079,BCBS multispecialty AW base fee schedule,79.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88323,Not in chargemaster,88323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88323,BCBS multispecialty AW base fee schedule,179.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88323 mod 26,Not in chargemaster,88323,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88323 mod 26,BCBS multispecialty AW base fee schedule,138.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88323 mod TC,Not in chargemaster,88323,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88323 mod TC,BCBS multispecialty AW base fee schedule,40.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88325,Not in chargemaster,88325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88325,BCBS multispecialty AW base fee schedule,229.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 89060,Not in chargemaster,89060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89060,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 89060 mod 26,Not in chargemaster,89060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89060 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 89220,Not in chargemaster,89220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89220,BCBS multispecialty AW base fee schedule,25.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 89230,Not in chargemaster,89230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89230,BCBS multispecialty AW base fee schedule,3.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90460,Not in chargemaster,90460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90460,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90461,Not in chargemaster,90461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90461,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90471,90471,90471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90471,BCBS multispecialty AW base fee schedule,24.8,33.57,Fee schedule,,24.8,24.8,24.8,24.8,,,0
unity,Fee schedule,Facility 90472,90472,90472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90472,BCBS multispecialty AW base fee schedule,22.32,21,Fee schedule,,21,21,21,21,,,0
unity,Fee schedule,Facility 90473,90473,90473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90473,BCBS multispecialty AW base fee schedule,24.8,40.47,Fee schedule,,24.8,24.8,24.8,24.8,,,0
unity,Fee schedule,Facility 90474,Not in chargemaster,90474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90474,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90785,Not in chargemaster,90785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90785,BCBS multispecialty AW base fee schedule,24.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90791,Not in chargemaster,90791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90791,BCBS multispecialty AW base fee schedule,219.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90792,Not in chargemaster,90792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90792,BCBS multispecialty AW base fee schedule,245.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88329,Not in chargemaster,88329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88329,BCBS multispecialty AW base fee schedule,57.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90839,Not in chargemaster,90839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90839,BCBS multispecialty AW base fee schedule,228.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90840,Not in chargemaster,90840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90840,BCBS multispecialty AW base fee schedule,109.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90845,Not in chargemaster,90845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90845,BCBS multispecialty AW base fee schedule,156.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90846,Not in chargemaster,90846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90846,BCBS multispecialty AW base fee schedule,176.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90847,Not in chargemaster,90847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90847,BCBS multispecialty AW base fee schedule,183.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90849,Not in chargemaster,90849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90849,BCBS multispecialty AW base fee schedule,50.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90853,Not in chargemaster,90853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90853,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90863,Not in chargemaster,90863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90863,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90865,Not in chargemaster,90865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90865,BCBS multispecialty AW base fee schedule,223.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90870,Not in chargemaster,90870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90870,BCBS multispecialty AW base fee schedule,192.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90875,Not in chargemaster,90875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90875,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90876,Not in chargemaster,90876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90876,BCBS multispecialty AW base fee schedule,172.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90880,Not in chargemaster,90880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90880,BCBS multispecialty AW base fee schedule,161.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90935,Not in chargemaster,90935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90935,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90937,Not in chargemaster,90937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90937,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90945,Not in chargemaster,90945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90945,BCBS multispecialty AW base fee schedule,151.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90947,Not in chargemaster,90947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90947,BCBS multispecialty AW base fee schedule,219.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90951,Not in chargemaster,90951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90951,BCBS multispecialty AW base fee schedule,1649.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90954,Not in chargemaster,90954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90954,BCBS multispecialty AW base fee schedule,1430.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90955,Not in chargemaster,90955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90955,BCBS multispecialty AW base fee schedule,806,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90956,Not in chargemaster,90956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90956,BCBS multispecialty AW base fee schedule,561.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90957,Not in chargemaster,90957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90957,BCBS multispecialty AW base fee schedule,1134.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90958,Not in chargemaster,90958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90958,BCBS multispecialty AW base fee schedule,770.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90959,Not in chargemaster,90959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90959,BCBS multispecialty AW base fee schedule,521.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90960,Not in chargemaster,90960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90960,BCBS multispecialty AW base fee schedule,500.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90961,Not in chargemaster,90961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90961,BCBS multispecialty AW base fee schedule,420.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90962,Not in chargemaster,90962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90962,BCBS multispecialty AW base fee schedule,324.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90963,Not in chargemaster,90963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90963,BCBS multispecialty AW base fee schedule,958.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90964,Not in chargemaster,90964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90964,BCBS multispecialty AW base fee schedule,838.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90965,Not in chargemaster,90965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90965,BCBS multispecialty AW base fee schedule,801.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90966,Not in chargemaster,90966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90966,BCBS multispecialty AW base fee schedule,419.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90967,Not in chargemaster,90967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90967,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90968,Not in chargemaster,90968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90968,BCBS multispecialty AW base fee schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90969,Not in chargemaster,90969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90969,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90970,Not in chargemaster,90970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90970,BCBS multispecialty AW base fee schedule,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90997,Not in chargemaster,90997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90997,BCBS multispecialty AW base fee schedule,158.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91010,Not in chargemaster,91010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91010,BCBS multispecialty AW base fee schedule,353.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91010 mod 26,Not in chargemaster,91010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91010 mod 26,BCBS multispecialty AW base fee schedule,117.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91010 mod TC,Not in chargemaster,91010,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91010 mod TC,BCBS multispecialty AW base fee schedule,236.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91013,Not in chargemaster,91013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91013,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91013 mod 26,Not in chargemaster,91013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91013 mod 26,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91013 mod TC,Not in chargemaster,91013,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91013 mod TC,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91020,Not in chargemaster,91020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91020,BCBS multispecialty AW base fee schedule,455.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91020 mod 26,Not in chargemaster,91020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91020 mod 26,BCBS multispecialty AW base fee schedule,131.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91020 mod TC,Not in chargemaster,91020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91020 mod TC,BCBS multispecialty AW base fee schedule,324.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91022,Not in chargemaster,91022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91022,BCBS multispecialty AW base fee schedule,295.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91022 mod 26,Not in chargemaster,91022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91022 mod 26,BCBS multispecialty AW base fee schedule,131.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91022 mod TC,Not in chargemaster,91022,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91022 mod TC,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91030,Not in chargemaster,91030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91030,BCBS multispecialty AW base fee schedule,244.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91030 mod 26,Not in chargemaster,91030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91030 mod 26,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91030 mod TC,Not in chargemaster,91030,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91030 mod TC,BCBS multispecialty AW base fee schedule,161.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91034,Not in chargemaster,91034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91034,BCBS multispecialty AW base fee schedule,335.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91034 mod 26,Not in chargemaster,91034,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91034 mod 26,BCBS multispecialty AW base fee schedule,89.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91034 mod TC,Not in chargemaster,91034,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91034 mod TC,BCBS multispecialty AW base fee schedule,246.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91035,Not in chargemaster,91035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91035,BCBS multispecialty AW base fee schedule,850.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91035 mod 26,Not in chargemaster,91035,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91035 mod 26,BCBS multispecialty AW base fee schedule,146.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91035 mod TC,Not in chargemaster,91035,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91035 mod TC,BCBS multispecialty AW base fee schedule,703.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91037,Not in chargemaster,91037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91037,BCBS multispecialty AW base fee schedule,292.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91037 mod 26,Not in chargemaster,91037,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91037 mod 26,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91037 mod TC,Not in chargemaster,91037,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91037 mod TC,BCBS multispecialty AW base fee schedule,203.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91038,Not in chargemaster,91038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91038,BCBS multispecialty AW base fee schedule,771.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91038 mod 26,Not in chargemaster,91038,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91038 mod 26,BCBS multispecialty AW base fee schedule,100.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91038 mod TC,Not in chargemaster,91038,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91038 mod TC,BCBS multispecialty AW base fee schedule,671.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91040,Not in chargemaster,91040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91040,BCBS multispecialty AW base fee schedule,892.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91040 mod 26,Not in chargemaster,91040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91040 mod 26,BCBS multispecialty AW base fee schedule,90.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91040 mod TC,Not in chargemaster,91040,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91040 mod TC,BCBS multispecialty AW base fee schedule,802.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91065,Not in chargemaster,91065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91065,BCBS multispecialty AW base fee schedule,140.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91065 mod 26,Not in chargemaster,91065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91065 mod 26,BCBS multispecialty AW base fee schedule,17.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91065 mod TC,Not in chargemaster,91065,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91065 mod TC,BCBS multispecialty AW base fee schedule,122.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91110,Not in chargemaster,91110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91110,BCBS multispecialty AW base fee schedule,1510.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91110 mod 26,Not in chargemaster,91110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91110 mod 26,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91110 mod TC,Not in chargemaster,91110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91110 mod TC,BCBS multispecialty AW base fee schedule,1284.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91111,Not in chargemaster,91111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91111,BCBS multispecialty AW base fee schedule,1517.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91111 mod 26,Not in chargemaster,91111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91111 mod 26,BCBS multispecialty AW base fee schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91111 mod TC,Not in chargemaster,91111,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91111 mod TC,BCBS multispecialty AW base fee schedule,1426,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91112,Not in chargemaster,91112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91112,BCBS multispecialty AW base fee schedule,2541.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91112 mod 26,Not in chargemaster,91112,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91112 mod 26,BCBS multispecialty AW base fee schedule,191.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91112 mod TC,Not in chargemaster,91112,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91112 mod TC,BCBS multispecialty AW base fee schedule,2349.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91117,Not in chargemaster,91117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91117,BCBS multispecialty AW base fee schedule,243.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91120,Not in chargemaster,91120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91120,BCBS multispecialty AW base fee schedule,854.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91120 mod 26,Not in chargemaster,91120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91120 mod 26,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91120 mod TC,Not in chargemaster,91120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91120 mod TC,BCBS multispecialty AW base fee schedule,767.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91122,Not in chargemaster,91122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91122,BCBS multispecialty AW base fee schedule,442.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91122 mod 26,Not in chargemaster,91122,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91122 mod 26,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91122 mod TC,Not in chargemaster,91122,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91122 mod TC,BCBS multispecialty AW base fee schedule,283.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91132,Not in chargemaster,91132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91132,BCBS multispecialty AW base fee schedule,567.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91132 mod 26,Not in chargemaster,91132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91132 mod 26,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91132 mod TC,Not in chargemaster,91132,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91132 mod TC,BCBS multispecialty AW base fee schedule,520.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91133,Not in chargemaster,91133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91133,BCBS multispecialty AW base fee schedule,608.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91133 mod 26,Not in chargemaster,91133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91133 mod 26,BCBS multispecialty AW base fee schedule,60.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91133 mod TC,Not in chargemaster,91133,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91133 mod TC,BCBS multispecialty AW base fee schedule,548.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91200,Not in chargemaster,91200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91200,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91200 mod 26,Not in chargemaster,91200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91200 mod 26,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 91200 mod TC,Not in chargemaster,91200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91200 mod TC,BCBS multispecialty AW base fee schedule,40.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92002,Not in chargemaster,92002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92002,BCBS multispecialty AW base fee schedule,60.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90885,Not in chargemaster,90885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90885,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90887,Not in chargemaster,90887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90887,BCBS multispecialty AW base fee schedule,133.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90901,Not in chargemaster,90901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90901,BCBS multispecialty AW base fee schedule,35.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90912,Not in chargemaster,90912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90912,BCBS multispecialty AW base fee schedule,78.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90913,Not in chargemaster,90913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90913,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92004,Not in chargemaster,92004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92004,BCBS multispecialty AW base fee schedule,126.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92012,Not in chargemaster,92012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92012,BCBS multispecialty AW base fee schedule,66.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92014,Not in chargemaster,92014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92014,BCBS multispecialty AW base fee schedule,101.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92015,Not in chargemaster,92015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92015,BCBS multispecialty AW base fee schedule,25.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92025,Not in chargemaster,92025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92025,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92025 mod 26,Not in chargemaster,92025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92025 mod 26,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92025 mod TC,Not in chargemaster,92025,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92025 mod TC,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92060,Not in chargemaster,92060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92060,BCBS multispecialty AW base fee schedule,110.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92060 mod 26,Not in chargemaster,92060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92060 mod 26,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92060 mod TC,Not in chargemaster,92060,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92060 mod TC,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92065,Not in chargemaster,92065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92065,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92065 mod 26,Not in chargemaster,92065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92065 mod 26,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92065 mod TC,Not in chargemaster,92065,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92065 mod TC,BCBS multispecialty AW base fee schedule,60.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92071,Not in chargemaster,92071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92071,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92081,Not in chargemaster,92081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92081,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92081 mod 26,Not in chargemaster,92081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92081 mod 26,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92081 mod TC,Not in chargemaster,92081,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92081 mod TC,BCBS multispecialty AW base fee schedule,30.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92082,Not in chargemaster,92082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92082,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92082 mod 26,Not in chargemaster,92082,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92082 mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92082 mod TC,Not in chargemaster,92082,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92082 mod TC,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92083,Not in chargemaster,92083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92083,BCBS multispecialty AW base fee schedule,110.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92083 mod 26,Not in chargemaster,92083,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92083 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92083 mod TC,Not in chargemaster,92083,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92083 mod TC,BCBS multispecialty AW base fee schedule,62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92100,Not in chargemaster,92100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92100,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92132,Not in chargemaster,92132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92132,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92132 mod 26,Not in chargemaster,92132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92132 mod 26,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92132 mod TC,Not in chargemaster,92132,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92132 mod TC,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92133,Not in chargemaster,92133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92133,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92133 mod 26,Not in chargemaster,92133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92133 mod 26,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92133 mod TC,Not in chargemaster,92133,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92133 mod TC,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92134,Not in chargemaster,92134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92134,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92134 mod 26,Not in chargemaster,92134,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92134 mod 26,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92134 mod TC,Not in chargemaster,92134,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92134 mod TC,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92136,Not in chargemaster,92136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92136,BCBS multispecialty AW base fee schedule,109.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92136 mod 26,Not in chargemaster,92136,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92136 mod 26,BCBS multispecialty AW base fee schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92136 mod TC,Not in chargemaster,92136,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92136 mod TC,BCBS multispecialty AW base fee schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92145,Not in chargemaster,92145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92145,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92145 mod 26,Not in chargemaster,92145,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92145 mod 26,BCBS multispecialty AW base fee schedule,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92145 mod TC,Not in chargemaster,92145,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92145 mod TC,BCBS multispecialty AW base fee schedule,12.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92201,Not in chargemaster,92201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92201,BCBS multispecialty AW base fee schedule,40.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92018,Not in chargemaster,92018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92018,BCBS multispecialty AW base fee schedule,251.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92019,Not in chargemaster,92019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92019,BCBS multispecialty AW base fee schedule,128.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92020,Not in chargemaster,92020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92020,BCBS multispecialty AW base fee schedule,36.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92072,Not in chargemaster,92072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92072,BCBS multispecialty AW base fee schedule,171.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92202,Not in chargemaster,92202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92202,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92235,Not in chargemaster,92235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92235,BCBS multispecialty AW base fee schedule,181.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92235 mod 26,Not in chargemaster,92235,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92235 mod 26,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92235 mod TC,Not in chargemaster,92235,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92235 mod TC,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92240,Not in chargemaster,92240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92240,BCBS multispecialty AW base fee schedule,352.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92240 mod 26,Not in chargemaster,92240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92240 mod 26,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92240 mod TC,Not in chargemaster,92240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92240 mod TC,BCBS multispecialty AW base fee schedule,269.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92242,Not in chargemaster,92242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92242,BCBS multispecialty AW base fee schedule,416.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92242 mod 26,Not in chargemaster,92242,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92242 mod 26,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92242 mod TC,Not in chargemaster,92242,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92242 mod TC,BCBS multispecialty AW base fee schedule,320.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92250,Not in chargemaster,92250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92250,BCBS multispecialty AW base fee schedule,78.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92250 mod 26,Not in chargemaster,92250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92250 mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92250 mod TC,Not in chargemaster,92250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92250 mod TC,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92260,Not in chargemaster,92260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92260,BCBS multispecialty AW base fee schedule,19.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92265,Not in chargemaster,92265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92265,BCBS multispecialty AW base fee schedule,151.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92265 mod 26,Not in chargemaster,92265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92265 mod 26,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92265 mod TC,Not in chargemaster,92265,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92265 mod TC,BCBS multispecialty AW base fee schedule,70.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92270,Not in chargemaster,92270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92270,BCBS multispecialty AW base fee schedule,169.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92270 mod 26,Not in chargemaster,92270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92270 mod 26,BCBS multispecialty AW base fee schedule,75.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92270 mod TC,Not in chargemaster,92270,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92270 mod TC,BCBS multispecialty AW base fee schedule,94.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92273,Not in chargemaster,92273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92273,BCBS multispecialty AW base fee schedule,228.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92273 mod 26,Not in chargemaster,92273,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92273 mod 26,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92273 mod TC,Not in chargemaster,92273,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92273 mod TC,BCBS multispecialty AW base fee schedule,163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92274,Not in chargemaster,92274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92274,BCBS multispecialty AW base fee schedule,154.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92274 mod 26,Not in chargemaster,92274,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92274 mod 26,BCBS multispecialty AW base fee schedule,57.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92274 mod TC,Not in chargemaster,92274,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92274 mod TC,BCBS multispecialty AW base fee schedule,96.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92283,Not in chargemaster,92283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92283,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92283 mod 26,Not in chargemaster,92283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92283 mod 26,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92283 mod TC,Not in chargemaster,92283,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92283 mod TC,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92284,Not in chargemaster,92284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92284,BCBS multispecialty AW base fee schedule,104.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92284 mod 26,Not in chargemaster,92284,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92284 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92284 mod TC,Not in chargemaster,92284,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92284 mod TC,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92285,Not in chargemaster,92285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92285,BCBS multispecialty AW base fee schedule,38.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92285 mod 26,Not in chargemaster,92285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92285 mod 26,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92285 mod TC,Not in chargemaster,92285,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92285 mod TC,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92286,Not in chargemaster,92286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92286,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92286 mod 26,Not in chargemaster,92286,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92286 mod 26,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92286 mod TC,Not in chargemaster,92286,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92286 mod TC,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92287,Not in chargemaster,92287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92287,BCBS multispecialty AW base fee schedule,276.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92287 mod 26,Not in chargemaster,92287,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92287 mod 26,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92287 mod TC,Not in chargemaster,92287,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92287 mod TC,BCBS multispecialty AW base fee schedule,194.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92310,Not in chargemaster,92310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92310,BCBS multispecialty AW base fee schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92227,Not in chargemaster,92227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92227,BCBS multispecialty AW base fee schedule,23.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92228,Not in chargemaster,92228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92228,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92228 mod 26,Not in chargemaster,92228,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92228 mod 26,BCBS multispecialty AW base fee schedule,36.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92228 mod TC,Not in chargemaster,92228,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92228 mod TC,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92230,Not in chargemaster,92230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92230,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92311,Not in chargemaster,92311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92311,BCBS multispecialty AW base fee schedule,70.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92312,Not in chargemaster,92312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92312,BCBS multispecialty AW base fee schedule,80.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92313,Not in chargemaster,92313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92313,BCBS multispecialty AW base fee schedule,57.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92314,Not in chargemaster,92314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92314,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92315,Not in chargemaster,92315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92315,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92316,Not in chargemaster,92316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92316,BCBS multispecialty AW base fee schedule,57.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92325,Not in chargemaster,92325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92325,BCBS multispecialty AW base fee schedule,77.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92326,Not in chargemaster,92326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92326,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92340,Not in chargemaster,92340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92340,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92317,Not in chargemaster,92317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92317,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92341,Not in chargemaster,92341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92341,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92342,Not in chargemaster,92342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92342,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92352,Not in chargemaster,92352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92352,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92354,Not in chargemaster,92354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92354,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92355,Not in chargemaster,92355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92355,BCBS multispecialty AW base fee schedule,35.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92358,Not in chargemaster,92358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92358,BCBS multispecialty AW base fee schedule,19.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92370,Not in chargemaster,92370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92370,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92371,Not in chargemaster,92371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92371,BCBS multispecialty AW base fee schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92502,Not in chargemaster,92502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92502,BCBS multispecialty AW base fee schedule,166.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92504,Not in chargemaster,92504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92504,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92507,Not in chargemaster,92507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92507,BCBS multispecialty AW base fee schedule,139.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92508,Not in chargemaster,92508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92508,BCBS multispecialty AW base fee schedule,42.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92511,Not in chargemaster,92511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92511,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92353,Not in chargemaster,92353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92353,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92512,Not in chargemaster,92512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92512,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92516,Not in chargemaster,92516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92516,BCBS multispecialty AW base fee schedule,40.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92520,Not in chargemaster,92520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92520,BCBS multispecialty AW base fee schedule,72.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92521,Not in chargemaster,92521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92521,BCBS multispecialty AW base fee schedule,199.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92522,Not in chargemaster,92522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92522,BCBS multispecialty AW base fee schedule,162.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92523,Not in chargemaster,92523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92523,BCBS multispecialty AW base fee schedule,341,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92524,Not in chargemaster,92524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92524,BCBS multispecialty AW base fee schedule,158.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92526,Not in chargemaster,92526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92526,BCBS multispecialty AW base fee schedule,153.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92537,Not in chargemaster,92537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92537,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92537 mod 26,Not in chargemaster,92537,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92537 mod 26,BCBS multispecialty AW base fee schedule,55.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92537 mod TC,Not in chargemaster,92537,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92537 mod TC,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92538,Not in chargemaster,92538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92538,BCBS multispecialty AW base fee schedule,29.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92538 mod 26,Not in chargemaster,92538,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92538 mod 26,BCBS multispecialty AW base fee schedule,20.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92538 mod TC,Not in chargemaster,92538,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92538 mod TC,BCBS multispecialty AW base fee schedule,8.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92540,Not in chargemaster,92540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92540,BCBS multispecialty AW base fee schedule,188.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92540 mod 26,Not in chargemaster,92540,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92540 mod 26,BCBS multispecialty AW base fee schedule,140.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92540 mod TC,Not in chargemaster,92540,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92540 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92541,Not in chargemaster,92541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92541,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92541 mod 26,Not in chargemaster,92541,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92541 mod 26,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92541 mod TC,Not in chargemaster,92541,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92541 mod TC,BCBS multispecialty AW base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92542,Not in chargemaster,92542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92542,BCBS multispecialty AW base fee schedule,52.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92542 mod 26,Not in chargemaster,92542,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92542 mod 26,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92542 mod TC,Not in chargemaster,92542,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92542 mod TC,BCBS multispecialty AW base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92544,Not in chargemaster,92544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92544,BCBS multispecialty AW base fee schedule,31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92544 mod 26,Not in chargemaster,92544,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92544 mod 26,BCBS multispecialty AW base fee schedule,25.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92544 mod TC,Not in chargemaster,92544,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92544 mod TC,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92545,Not in chargemaster,92545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92545,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92545 mod 26,Not in chargemaster,92545,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92545 mod 26,BCBS multispecialty AW base fee schedule,23.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92545 mod TC,Not in chargemaster,92545,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92545 mod TC,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92546,Not in chargemaster,92546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92546,BCBS multispecialty AW base fee schedule,195.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92546 mod 26,Not in chargemaster,92546,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92546 mod 26,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92546 mod TC,Not in chargemaster,92546,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92546 mod TC,BCBS multispecialty AW base fee schedule,168.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92547,Not in chargemaster,92547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92547,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92548,Not in chargemaster,92548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92548,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92548 mod 26,Not in chargemaster,92548,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92548 mod 26,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92548 mod TC,Not in chargemaster,92548,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92548 mod TC,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92549,Not in chargemaster,92549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92549,BCBS multispecialty AW base fee schedule,111.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92549 mod 26,Not in chargemaster,92549,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92549 mod 26,BCBS multispecialty AW base fee schedule,79.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92549 mod TC,Not in chargemaster,92549,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92549 mod TC,BCBS multispecialty AW base fee schedule,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92550,Not in chargemaster,92550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92550,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92551,Not in chargemaster,92551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92551,BCBS multispecialty AW base fee schedule,20.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92552,Not in chargemaster,92552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92552,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92553,Not in chargemaster,92553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92553,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92555,Not in chargemaster,92555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92555,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92556,Not in chargemaster,92556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92556,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92557,Not in chargemaster,92557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92557,BCBS multispecialty AW base fee schedule,57.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92558,Not in chargemaster,92558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92558,BCBS multispecialty AW base fee schedule,15.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92561,Not in chargemaster,92561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92561,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92562,Not in chargemaster,92562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92562,BCBS multispecialty AW base fee schedule,77.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92563,Not in chargemaster,92563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92563,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92564,Not in chargemaster,92564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92564,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92565,Not in chargemaster,92565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92565,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92567,92567,92567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92567,BCBS multispecialty AW base fee schedule,19.22,22.01,Fee schedule,,19.22,19.22,19.22,19.22,,,0
unity,Fee schedule,Facility 92568,Not in chargemaster,92568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92568,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92570,Not in chargemaster,92570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92570,BCBS multispecialty AW base fee schedule,52.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92571,Not in chargemaster,92571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92571,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92572,Not in chargemaster,92572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92572,BCBS multispecialty AW base fee schedule,60.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92575,Not in chargemaster,92575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92575,BCBS multispecialty AW base fee schedule,114.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92576,Not in chargemaster,92576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92576,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92577,Not in chargemaster,92577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92577,BCBS multispecialty AW base fee schedule,24.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92579,Not in chargemaster,92579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92579,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92582,Not in chargemaster,92582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92582,BCBS multispecialty AW base fee schedule,128.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92583,Not in chargemaster,92583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92583,BCBS multispecialty AW base fee schedule,84.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92584,Not in chargemaster,92584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92584,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92585,Not in chargemaster,92585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92585,BCBS multispecialty AW base fee schedule,236.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92585 mod 26,Not in chargemaster,92585,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92585 mod 26,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92585 mod TC,Not in chargemaster,92585,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92585 mod TC,BCBS multispecialty AW base fee schedule,189.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92586,Not in chargemaster,92586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92586,BCBS multispecialty AW base fee schedule,166.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92587,Not in chargemaster,92587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92587,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92587 mod 26,Not in chargemaster,92587,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92587 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92587 mod TC,Not in chargemaster,92587,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92587 mod TC,BCBS multispecialty AW base fee schedule,6.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92588,Not in chargemaster,92588,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92588,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92588 mod 26,Not in chargemaster,92588,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92588 mod 26,BCBS multispecialty AW base fee schedule,51.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92588 mod TC,Not in chargemaster,92588,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92588 mod TC,BCBS multispecialty AW base fee schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92596,Not in chargemaster,92596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92596,BCBS multispecialty AW base fee schedule,114.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92597,Not in chargemaster,92597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92597,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92601,Not in chargemaster,92601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92601,BCBS multispecialty AW base fee schedule,222.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92602,Not in chargemaster,92602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92602,BCBS multispecialty AW base fee schedule,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92603,Not in chargemaster,92603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92603,BCBS multispecialty AW base fee schedule,215.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92604,Not in chargemaster,92604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92604,BCBS multispecialty AW base fee schedule,120.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92605,Not in chargemaster,92605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92605,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92607,Not in chargemaster,92607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92607,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92608,Not in chargemaster,92608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92608,BCBS multispecialty AW base fee schedule,91.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92609,Not in chargemaster,92609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92609,BCBS multispecialty AW base fee schedule,190.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92610,Not in chargemaster,92610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92610,BCBS multispecialty AW base fee schedule,128.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92606,Not in chargemaster,92606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92606,BCBS multispecialty AW base fee schedule,127.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92611,Not in chargemaster,92611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92611,BCBS multispecialty AW base fee schedule,162.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92612,Not in chargemaster,92612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92612,BCBS multispecialty AW base fee schedule,120.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92613,Not in chargemaster,92613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92613,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92614,Not in chargemaster,92614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92614,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92615,Not in chargemaster,92615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92615,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92616,Not in chargemaster,92616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92616,BCBS multispecialty AW base fee schedule,176.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92617,Not in chargemaster,92617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92617,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92618,Not in chargemaster,92618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92618,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92620,Not in chargemaster,92620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92620,BCBS multispecialty AW base fee schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92621,Not in chargemaster,92621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92621,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92625,Not in chargemaster,92625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92625,BCBS multispecialty AW base fee schedule,110.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92626,Not in chargemaster,92626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92626,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92627,Not in chargemaster,92627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92627,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92961,Not in chargemaster,92961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92961,BCBS multispecialty AW base fee schedule,444.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92970,Not in chargemaster,92970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92970,BCBS multispecialty AW base fee schedule,340.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92971,Not in chargemaster,92971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92971,BCBS multispecialty AW base fee schedule,180.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92973,Not in chargemaster,92973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92973,BCBS multispecialty AW base fee schedule,317.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92974,Not in chargemaster,92974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92974,BCBS multispecialty AW base fee schedule,290.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92975,Not in chargemaster,92975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92975,BCBS multispecialty AW base fee schedule,677.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92977,Not in chargemaster,92977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92977,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92978,Not in chargemaster,92978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92978,BCBS multispecialty AW base fee schedule,169.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92978 mod 26,Not in chargemaster,92978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92978 mod 26,BCBS multispecialty AW base fee schedule,169.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92979,Not in chargemaster,92979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92979,BCBS multispecialty AW base fee schedule,137.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92979 mod 26,Not in chargemaster,92979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92979 mod 26,BCBS multispecialty AW base fee schedule,137.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92986,Not in chargemaster,92986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92986,BCBS multispecialty AW base fee schedule,2367.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92987,Not in chargemaster,92987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92987,BCBS multispecialty AW base fee schedule,2441.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92990,Not in chargemaster,92990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92990,BCBS multispecialty AW base fee schedule,1950.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92997,Not in chargemaster,92997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92997,BCBS multispecialty AW base fee schedule,1146.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92998,Not in chargemaster,92998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92998,BCBS multispecialty AW base fee schedule,580.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93000,Not in chargemaster,93000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93000,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93005,Not in chargemaster,93005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93005,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93010,93010,93010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93010,BCBS multispecialty AW base fee schedule,14.88,20,Fee schedule,,14.88,14.88,14.88,14.88,,,0
unity,Fee schedule,Facility 93015,Not in chargemaster,93015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93015,BCBS multispecialty AW base fee schedule,124,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93016,Not in chargemaster,93016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93016,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93017,Not in chargemaster,93017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93017,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93018,Not in chargemaster,93018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93018,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93024,Not in chargemaster,93024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93024,BCBS multispecialty AW base fee schedule,192.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93024 mod 26,Not in chargemaster,93024,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93024 mod 26,BCBS multispecialty AW base fee schedule,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93024 mod TC,Not in chargemaster,93024,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93024 mod TC,BCBS multispecialty AW base fee schedule,91.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93025,Not in chargemaster,93025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93025,BCBS multispecialty AW base fee schedule,246.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93025 mod 26,Not in chargemaster,93025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93025 mod 26,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93025 mod TC,Not in chargemaster,93025,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93025 mod TC,BCBS multispecialty AW base fee schedule,181.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93040,Not in chargemaster,93040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93040,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93041,Not in chargemaster,93041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93041,BCBS multispecialty AW base fee schedule,9.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93042,Not in chargemaster,93042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93042,BCBS multispecialty AW base fee schedule,12.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93050,Not in chargemaster,93050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93050,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93050 mod 26,Not in chargemaster,93050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93050 mod 26,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93050 mod TC,Not in chargemaster,93050,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93050 mod TC,BCBS multispecialty AW base fee schedule,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93224,Not in chargemaster,93224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93224,BCBS multispecialty AW base fee schedule,154.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93225,Not in chargemaster,93225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93225,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93226,Not in chargemaster,93226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93226,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93227,Not in chargemaster,93227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93227,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93228,Not in chargemaster,93228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93228,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93229,Not in chargemaster,93229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93229,BCBS multispecialty AW base fee schedule,1229.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93260,Not in chargemaster,93260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93260,BCBS multispecialty AW base fee schedule,126.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93260 mod 26,Not in chargemaster,93260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93260 mod 26,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93260 mod TC,Not in chargemaster,93260,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93260 mod TC,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93261,Not in chargemaster,93261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93261,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93261 mod 26,Not in chargemaster,93261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93261 mod 26,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93261 mod TC,Not in chargemaster,93261,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93261 mod TC,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93264,Not in chargemaster,93264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93264,BCBS multispecialty AW base fee schedule,63.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93268,Not in chargemaster,93268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93268,BCBS multispecialty AW base fee schedule,349.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93270,Not in chargemaster,93270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93270,BCBS multispecialty AW base fee schedule,15.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93271,Not in chargemaster,93271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93271,BCBS multispecialty AW base fee schedule,289.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93272,Not in chargemaster,93272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93272,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93278,Not in chargemaster,93278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93278,BCBS multispecialty AW base fee schedule,52.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93278 mod 26,Not in chargemaster,93278,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93278 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93278 mod TC,Not in chargemaster,93278,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93278 mod TC,BCBS multispecialty AW base fee schedule,30.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93279,Not in chargemaster,93279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93279,BCBS multispecialty AW base fee schedule,106.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93279 mod 26,Not in chargemaster,93279,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93279 mod 26,BCBS multispecialty AW base fee schedule,57.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93279 mod TC,Not in chargemaster,93279,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93279 mod TC,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93280,Not in chargemaster,93280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93280,BCBS multispecialty AW base fee schedule,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93280 mod 26,Not in chargemaster,93280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93280 mod 26,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93280 mod TC,Not in chargemaster,93280,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93280 mod TC,BCBS multispecialty AW base fee schedule,57.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93281,Not in chargemaster,93281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93281,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93281 mod 26,Not in chargemaster,93281,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93281 mod 26,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93281 mod TC,Not in chargemaster,93281,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93281 mod TC,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93282,Not in chargemaster,93282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93282,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93282 mod 26,Not in chargemaster,93282,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93282 mod 26,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93282 mod TC,Not in chargemaster,93282,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93282 mod TC,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93283,Not in chargemaster,93283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93283,BCBS multispecialty AW base fee schedule,161.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93283 mod 26,Not in chargemaster,93283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93283 mod 26,BCBS multispecialty AW base fee schedule,102.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93283 mod TC,Not in chargemaster,93283,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93283 mod TC,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93284,Not in chargemaster,93284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93284,BCBS multispecialty AW base fee schedule,174.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93284 mod 26,Not in chargemaster,93284,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93284 mod 26,BCBS multispecialty AW base fee schedule,111.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93284 mod TC,Not in chargemaster,93284,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93284 mod TC,BCBS multispecialty AW base fee schedule,62.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93285,Not in chargemaster,93285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93285,BCBS multispecialty AW base fee schedule,94.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93285 mod 26,Not in chargemaster,93285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93285 mod 26,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93285 mod TC,Not in chargemaster,93285,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93285 mod TC,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93286,Not in chargemaster,93286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93286,BCBS multispecialty AW base fee schedule,70.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93286 mod 26,Not in chargemaster,93286,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93286 mod 26,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93286 mod TC,Not in chargemaster,93286,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93286 mod TC,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93287,Not in chargemaster,93287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93287,BCBS multispecialty AW base fee schedule,84.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93287 mod 26,Not in chargemaster,93287,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93287 mod 26,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93287 mod TC,Not in chargemaster,93287,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93287 mod TC,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93288,Not in chargemaster,93288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93288,BCBS multispecialty AW base fee schedule,86.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93288 mod 26,Not in chargemaster,93288,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93288 mod 26,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93288 mod TC,Not in chargemaster,93288,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93288 mod TC,BCBS multispecialty AW base fee schedule,48.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93289,Not in chargemaster,93289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93289,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93289 mod 26,Not in chargemaster,93289,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93289 mod 26,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93289 mod TC,Not in chargemaster,93289,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93289 mod TC,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93290,Not in chargemaster,93290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93290,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93290 mod 26,Not in chargemaster,93290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93290 mod 26,BCBS multispecialty AW base fee schedule,38.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93290 mod TC,Not in chargemaster,93290,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93290 mod TC,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93291,Not in chargemaster,93291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93291,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93291 mod 26,Not in chargemaster,93291,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93291 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93291 mod TC,Not in chargemaster,93291,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93291 mod TC,BCBS multispecialty AW base fee schedule,42.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93292,Not in chargemaster,93292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93292,BCBS multispecialty AW base fee schedule,78.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93292 mod 26,Not in chargemaster,93292,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93292 mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93292 mod TC,Not in chargemaster,93292,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93292 mod TC,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93293,Not in chargemaster,93293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93293,BCBS multispecialty AW base fee schedule,90.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93293 mod 26,Not in chargemaster,93293,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93293 mod 26,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93293 mod TC,Not in chargemaster,93293,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93293 mod TC,BCBS multispecialty AW base fee schedule,63.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93294,Not in chargemaster,93294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93294,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93295,Not in chargemaster,93295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93295,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93296,Not in chargemaster,93296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93296,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93297,Not in chargemaster,93297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93297,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93298,Not in chargemaster,93298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93298,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93303,Not in chargemaster,93303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93303,BCBS multispecialty AW base fee schedule,407.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93303 mod 26,Not in chargemaster,93303,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93303 mod 26,BCBS multispecialty AW base fee schedule,112.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93303 mod TC,Not in chargemaster,93303,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93303 mod TC,BCBS multispecialty AW base fee schedule,295.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93304,Not in chargemaster,93304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93304,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93304 mod 26,Not in chargemaster,93304,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93304 mod 26,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93304 mod TC,Not in chargemaster,93304,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93304 mod TC,BCBS multispecialty AW base fee schedule,215.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93306,Not in chargemaster,93306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93306,BCBS multispecialty AW base fee schedule,363.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93306 mod 26,Not in chargemaster,93306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93306 mod 26,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93306 mod TC,Not in chargemaster,93306,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93306 mod TC,BCBS multispecialty AW base fee schedule,234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93307,Not in chargemaster,93307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93307,BCBS multispecialty AW base fee schedule,247.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93307 mod 26,Not in chargemaster,93307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93307 mod 26,BCBS multispecialty AW base fee schedule,79.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93307 mod TC,Not in chargemaster,93307,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93307 mod TC,BCBS multispecialty AW base fee schedule,168.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93308,Not in chargemaster,93308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93308,BCBS multispecialty AW base fee schedule,172.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93308 mod 26,Not in chargemaster,93308,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93308 mod 26,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93308 mod TC,Not in chargemaster,93308,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93308 mod TC,BCBS multispecialty AW base fee schedule,127.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93312,Not in chargemaster,93312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93312,BCBS multispecialty AW base fee schedule,431.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93312 mod 26,Not in chargemaster,93312,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93312 mod 26,BCBS multispecialty AW base fee schedule,193.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93312 mod TC,Not in chargemaster,93312,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93312 mod TC,BCBS multispecialty AW base fee schedule,238.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93313,Not in chargemaster,93313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93313,BCBS multispecialty AW base fee schedule,20.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93314,Not in chargemaster,93314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93314,BCBS multispecialty AW base fee schedule,414.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93314 mod 26,Not in chargemaster,93314,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93314 mod 26,BCBS multispecialty AW base fee schedule,160.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93314 mod TC,Not in chargemaster,93314,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93314 mod TC,BCBS multispecialty AW base fee schedule,253.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93315,Not in chargemaster,93315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93315,BCBS multispecialty AW base fee schedule,227.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93315 mod 26,Not in chargemaster,93315,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93315 mod 26,BCBS multispecialty AW base fee schedule,227.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93316,Not in chargemaster,93316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93316,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93317,Not in chargemaster,93317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93317,BCBS multispecialty AW base fee schedule,161.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93317 mod 26,Not in chargemaster,93317,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93317 mod 26,BCBS multispecialty AW base fee schedule,161.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93318,Not in chargemaster,93318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93318,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93318 mod 26,Not in chargemaster,93318,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93318 mod 26,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93320,Not in chargemaster,93320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93320,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93320 mod 26,Not in chargemaster,93320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93320 mod 26,BCBS multispecialty AW base fee schedule,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93320 mod TC,Not in chargemaster,93320,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93320 mod TC,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93321,Not in chargemaster,93321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93321,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93321 mod 26,Not in chargemaster,93321,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93321 mod 26,BCBS multispecialty AW base fee schedule,13.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93321 mod TC,Not in chargemaster,93321,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93321 mod TC,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93325,Not in chargemaster,93325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93325,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93325 mod 26,Not in chargemaster,93325,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93325 mod 26,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93325 mod TC,Not in chargemaster,93325,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93325 mod TC,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93350,Not in chargemaster,93350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93350,BCBS multispecialty AW base fee schedule,332.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93350 mod 26,Not in chargemaster,93350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93350 mod 26,BCBS multispecialty AW base fee schedule,125.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93350 mod TC,Not in chargemaster,93350,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93350 mod TC,BCBS multispecialty AW base fee schedule,207.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93351,Not in chargemaster,93351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93351,BCBS multispecialty AW base fee schedule,411.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93351 mod 26,Not in chargemaster,93351,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93351 mod 26,BCBS multispecialty AW base fee schedule,150.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93351 mod TC,Not in chargemaster,93351,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93351 mod TC,BCBS multispecialty AW base fee schedule,261.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93352,Not in chargemaster,93352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93352,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93355,Not in chargemaster,93355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93355,BCBS multispecialty AW base fee schedule,407.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93356,Not in chargemaster,93356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93356,BCBS multispecialty AW base fee schedule,21.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93571,Not in chargemaster,93571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93571,BCBS multispecialty AW base fee schedule,131.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93571 mod 26,Not in chargemaster,93571,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93571 mod 26,BCBS multispecialty AW base fee schedule,131.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93572,Not in chargemaster,93572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93572,BCBS multispecialty AW base fee schedule,94.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93572 mod 26,Not in chargemaster,93572,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93572 mod 26,BCBS multispecialty AW base fee schedule,94.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93580,Not in chargemaster,93580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93580,BCBS multispecialty AW base fee schedule,1753.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93581,Not in chargemaster,93581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93581,BCBS multispecialty AW base fee schedule,2388.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93582,Not in chargemaster,93582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93582,BCBS multispecialty AW base fee schedule,1195.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93583,Not in chargemaster,93583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93583,BCBS multispecialty AW base fee schedule,1336.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93590,Not in chargemaster,93590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93590,BCBS multispecialty AW base fee schedule,1936.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93591,Not in chargemaster,93591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93591,BCBS multispecialty AW base fee schedule,1605.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93592,Not in chargemaster,93592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93592,BCBS multispecialty AW base fee schedule,705.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93600,Not in chargemaster,93600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93600,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93600 mod 26,Not in chargemaster,93600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93600 mod 26,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93602,Not in chargemaster,93602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93602,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93602 mod 26,Not in chargemaster,93602,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93602 mod 26,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93603,Not in chargemaster,93603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93603,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93603 mod 26,Not in chargemaster,93603,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93603 mod 26,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93609,Not in chargemaster,93609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93609,BCBS multispecialty AW base fee schedule,499.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93609 mod 26,Not in chargemaster,93609,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93609 mod 26,BCBS multispecialty AW base fee schedule,499.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93610,Not in chargemaster,93610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93610,BCBS multispecialty AW base fee schedule,293.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93610 mod 26,Not in chargemaster,93610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93610 mod 26,BCBS multispecialty AW base fee schedule,293.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93612,Not in chargemaster,93612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93612,BCBS multispecialty AW base fee schedule,290.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93612 mod 26,Not in chargemaster,93612,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93612 mod 26,BCBS multispecialty AW base fee schedule,290.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93613,Not in chargemaster,93613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93613,BCBS multispecialty AW base fee schedule,535.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93615,Not in chargemaster,93615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93615,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93615 mod 26,Not in chargemaster,93615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93615 mod 26,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93616,Not in chargemaster,93616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93616,BCBS multispecialty AW base fee schedule,106.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93616 mod 26,Not in chargemaster,93616,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93616 mod 26,BCBS multispecialty AW base fee schedule,106.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93618,Not in chargemaster,93618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93618,BCBS multispecialty AW base fee schedule,396.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93618 mod 26,Not in chargemaster,93618,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93618 mod 26,BCBS multispecialty AW base fee schedule,396.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93619,Not in chargemaster,93619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93619,BCBS multispecialty AW base fee schedule,702.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93619 mod 26,Not in chargemaster,93619,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93619 mod 26,BCBS multispecialty AW base fee schedule,702.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93620,Not in chargemaster,93620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93620,BCBS multispecialty AW base fee schedule,1125.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93620 mod 26,Not in chargemaster,93620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93620 mod 26,BCBS multispecialty AW base fee schedule,1125.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93621,Not in chargemaster,93621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93621,BCBS multispecialty AW base fee schedule,210.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93621 mod 26,Not in chargemaster,93621,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93621 mod 26,BCBS multispecialty AW base fee schedule,210.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93622,Not in chargemaster,93622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93622,BCBS multispecialty AW base fee schedule,308.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93622 mod 26,Not in chargemaster,93622,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93622 mod 26,BCBS multispecialty AW base fee schedule,308.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93623,Not in chargemaster,93623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93623,BCBS multispecialty AW base fee schedule,284.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93623 mod 26,Not in chargemaster,93623,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93623 mod 26,BCBS multispecialty AW base fee schedule,284.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93624,Not in chargemaster,93624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93624,BCBS multispecialty AW base fee schedule,431.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93624 mod 26,Not in chargemaster,93624,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93624 mod 26,BCBS multispecialty AW base fee schedule,431.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93631,Not in chargemaster,93631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93631,BCBS multispecialty AW base fee schedule,709.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93631 mod 26,Not in chargemaster,93631,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93631 mod 26,BCBS multispecialty AW base fee schedule,709.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93640,Not in chargemaster,93640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93640,BCBS multispecialty AW base fee schedule,320.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93640 mod 26,Not in chargemaster,93640,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93640 mod 26,BCBS multispecialty AW base fee schedule,320.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93641,Not in chargemaster,93641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93641,BCBS multispecialty AW base fee schedule,561.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93641 mod 26,Not in chargemaster,93641,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93641 mod 26,BCBS multispecialty AW base fee schedule,561.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93642,Not in chargemaster,93642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93642,BCBS multispecialty AW base fee schedule,602.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93642 mod 26,Not in chargemaster,93642,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93642 mod 26,BCBS multispecialty AW base fee schedule,458.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93642 mod TC,Not in chargemaster,93642,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93642 mod TC,BCBS multispecialty AW base fee schedule,143.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93644,Not in chargemaster,93644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93644,BCBS multispecialty AW base fee schedule,349.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93644 mod 26,Not in chargemaster,93644,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93644 mod 26,BCBS multispecialty AW base fee schedule,258.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93644 mod TC,Not in chargemaster,93644,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93644 mod TC,BCBS multispecialty AW base fee schedule,90.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93650,Not in chargemaster,93650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93650,BCBS multispecialty AW base fee schedule,1064.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93653,Not in chargemaster,93653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93653,BCBS multispecialty AW base fee schedule,1505.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93654,Not in chargemaster,93654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93654,BCBS multispecialty AW base fee schedule,2016.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93655,Not in chargemaster,93655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93655,BCBS multispecialty AW base fee schedule,768.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93656,Not in chargemaster,93656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93656,BCBS multispecialty AW base fee schedule,2022.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93657,Not in chargemaster,93657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93657,BCBS multispecialty AW base fee schedule,767.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93660,Not in chargemaster,93660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93660,BCBS multispecialty AW base fee schedule,279,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93660 mod 26,Not in chargemaster,93660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93660 mod 26,BCBS multispecialty AW base fee schedule,165.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93660 mod TC,Not in chargemaster,93660,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93660 mod TC,BCBS multispecialty AW base fee schedule,113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93662,Not in chargemaster,93662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93662,BCBS multispecialty AW base fee schedule,252.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93662 mod 26,Not in chargemaster,93662,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93662 mod 26,BCBS multispecialty AW base fee schedule,252.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93668,Not in chargemaster,93668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93668,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93701,Not in chargemaster,93701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93701,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93702,Not in chargemaster,93702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93702,BCBS multispecialty AW base fee schedule,241.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93724,Not in chargemaster,93724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93724,BCBS multispecialty AW base fee schedule,498.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93724 mod 26,Not in chargemaster,93724,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93724 mod 26,BCBS multispecialty AW base fee schedule,431.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93724 mod TC,Not in chargemaster,93724,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93724 mod TC,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93740,Not in chargemaster,93740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93740,BCBS multispecialty AW base fee schedule,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93750,Not in chargemaster,93750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93750,BCBS multispecialty AW base fee schedule,85.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93880,Not in chargemaster,93880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93880,BCBS multispecialty AW base fee schedule,349.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93880 mod 26,93880,93880,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93880 mod 26,BCBS multispecialty AW base fee schedule,70.06,63.07,Fee schedule,,63.07,63.07,63.07,63.07,,,0
unity,Fee schedule,Facility 93880 mod TC,Not in chargemaster,93880,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93880 mod TC,BCBS multispecialty AW base fee schedule,279.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93882,Not in chargemaster,93882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93882,BCBS multispecialty AW base fee schedule,225.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93882 mod 26,Not in chargemaster,93882,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93882 mod 26,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93882 mod TC,Not in chargemaster,93882,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93882 mod TC,BCBS multispecialty AW base fee schedule,181.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93886,Not in chargemaster,93886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93886,BCBS multispecialty AW base fee schedule,477.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93886 mod 26,Not in chargemaster,93886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93886 mod 26,BCBS multispecialty AW base fee schedule,83.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93886 mod TC,Not in chargemaster,93886,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93886 mod TC,BCBS multispecialty AW base fee schedule,393.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93888,Not in chargemaster,93888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93888,BCBS multispecialty AW base fee schedule,284.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93888 mod 26,Not in chargemaster,93888,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93888 mod 26,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93888 mod TC,Not in chargemaster,93888,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93888 mod TC,BCBS multispecialty AW base fee schedule,238.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93890,Not in chargemaster,93890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93890,BCBS multispecialty AW base fee schedule,484.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93890 mod 26,Not in chargemaster,93890,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93890 mod 26,BCBS multispecialty AW base fee schedule,91.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93890 mod TC,Not in chargemaster,93890,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93890 mod TC,BCBS multispecialty AW base fee schedule,393.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93892,Not in chargemaster,93892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93892,BCBS multispecialty AW base fee schedule,546.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93892 mod 26,Not in chargemaster,93892,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93892 mod 26,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93892 mod TC,Not in chargemaster,93892,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93892 mod TC,BCBS multispecialty AW base fee schedule,440.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93893,Not in chargemaster,93893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93893,BCBS multispecialty AW base fee schedule,626.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93893 mod 26,Not in chargemaster,93893,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93893 mod 26,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93893 mod TC,Not in chargemaster,93893,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93893 mod TC,BCBS multispecialty AW base fee schedule,520.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93922,Not in chargemaster,93922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93922,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93922 mod 26,Not in chargemaster,93922,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93922 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93922 mod TC,Not in chargemaster,93922,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93922 mod TC,BCBS multispecialty AW base fee schedule,126.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93923,Not in chargemaster,93923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93923,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93923 mod 26,Not in chargemaster,93923,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93923 mod 26,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93923 mod TC,Not in chargemaster,93923,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93923 mod TC,BCBS multispecialty AW base fee schedule,192.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93924,Not in chargemaster,93924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93924,BCBS multispecialty AW base fee schedule,286.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93924 mod 26,Not in chargemaster,93924,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93924 mod 26,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93924 mod TC,Not in chargemaster,93924,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93924 mod TC,BCBS multispecialty AW base fee schedule,243.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93925,Not in chargemaster,93925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93925,BCBS multispecialty AW base fee schedule,444.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93925 mod 26,Not in chargemaster,93925,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93925 mod 26,BCBS multispecialty AW base fee schedule,68.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93925 mod TC,Not in chargemaster,93925,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93925 mod TC,BCBS multispecialty AW base fee schedule,375.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93926,Not in chargemaster,93926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93926,BCBS multispecialty AW base fee schedule,262.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93926 mod 26,Not in chargemaster,93926,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93926 mod 26,BCBS multispecialty AW base fee schedule,42.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93926 mod TC,Not in chargemaster,93926,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93926 mod TC,BCBS multispecialty AW base fee schedule,220.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93930,Not in chargemaster,93930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93930,BCBS multispecialty AW base fee schedule,361.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93930 mod 26,Not in chargemaster,93930,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93930 mod 26,BCBS multispecialty AW base fee schedule,70.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93930 mod TC,Not in chargemaster,93930,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93930 mod TC,BCBS multispecialty AW base fee schedule,290.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93931,Not in chargemaster,93931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93931,BCBS multispecialty AW base fee schedule,225.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93931 mod 26,Not in chargemaster,93931,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93931 mod 26,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93931 mod TC,Not in chargemaster,93931,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93931 mod TC,BCBS multispecialty AW base fee schedule,182.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93970,Not in chargemaster,93970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93970,BCBS multispecialty AW base fee schedule,341.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93970 mod 26,93970,93970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93970 mod 26,BCBS multispecialty AW base fee schedule,60.76,71.76,Fee schedule,,60.76,60.76,60.76,60.76,,,0
unity,Fee schedule,Facility 93970 mod TC,Not in chargemaster,93970,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93970 mod TC,BCBS multispecialty AW base fee schedule,280.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93971,Not in chargemaster,93971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93971,BCBS multispecialty AW base fee schedule,213.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93971 mod 26,93971,93971,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93971 mod 26,BCBS multispecialty AW base fee schedule,39.06,47.12,Fee schedule,,39.06,39.06,39.06,39.06,,,0
unity,Fee schedule,Facility 93971 mod TC,Not in chargemaster,93971,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93971 mod TC,BCBS multispecialty AW base fee schedule,174.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93975,Not in chargemaster,93975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93975,BCBS multispecialty AW base fee schedule,485.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93975 mod 26,Not in chargemaster,93975,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93975 mod 26,BCBS multispecialty AW base fee schedule,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93975 mod TC,Not in chargemaster,93975,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93975 mod TC,BCBS multispecialty AW base fee schedule,384.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93976,Not in chargemaster,93976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93976,BCBS multispecialty AW base fee schedule,287.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93976 mod 26,Not in chargemaster,93976,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93976 mod 26,BCBS multispecialty AW base fee schedule,70.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93976 mod TC,Not in chargemaster,93976,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93976 mod TC,BCBS multispecialty AW base fee schedule,217.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93978,Not in chargemaster,93978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93978,BCBS multispecialty AW base fee schedule,329.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93978 mod 26,Not in chargemaster,93978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93978 mod 26,BCBS multispecialty AW base fee schedule,69.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93978 mod TC,Not in chargemaster,93978,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93978 mod TC,BCBS multispecialty AW base fee schedule,260.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93979,Not in chargemaster,93979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93979,BCBS multispecialty AW base fee schedule,212.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93979 mod 26,Not in chargemaster,93979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93979 mod 26,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93979 mod TC,Not in chargemaster,93979,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93979 mod TC,BCBS multispecialty AW base fee schedule,168.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93980,Not in chargemaster,93980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93980,BCBS multispecialty AW base fee schedule,214.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93980 mod 26,Not in chargemaster,93980,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93980 mod 26,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93980 mod TC,Not in chargemaster,93980,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93980 mod TC,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93981,Not in chargemaster,93981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93981,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93981 mod 26,Not in chargemaster,93981,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93981 mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93981 mod TC,Not in chargemaster,93981,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93981 mod TC,BCBS multispecialty AW base fee schedule,91.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93985,Not in chargemaster,93985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93985,BCBS multispecialty AW base fee schedule,466.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93985 mod 26,Not in chargemaster,93985,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93985 mod 26,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93985 mod TC,Not in chargemaster,93985,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93985 mod TC,BCBS multispecialty AW base fee schedule,398.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93986,Not in chargemaster,93986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93986,BCBS multispecialty AW base fee schedule,270.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93986 mod 26,Not in chargemaster,93986,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93986 mod 26,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93986 mod TC,Not in chargemaster,93986,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93986 mod TC,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93990,Not in chargemaster,93990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93990,BCBS multispecialty AW base fee schedule,272.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93990 mod 26,Not in chargemaster,93990,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93990 mod 26,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93990 mod TC,Not in chargemaster,93990,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93990 mod TC,BCBS multispecialty AW base fee schedule,228.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94002,Not in chargemaster,94002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94002,BCBS multispecialty AW base fee schedule,163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94003,Not in chargemaster,94003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94003,BCBS multispecialty AW base fee schedule,117.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94004,Not in chargemaster,94004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94004,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94005,Not in chargemaster,94005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94005,BCBS multispecialty AW base fee schedule,163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94010,Not in chargemaster,94010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94010,BCBS multispecialty AW base fee schedule,62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94010 mod 26,Not in chargemaster,94010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94010 mod 26,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94010 mod TC,Not in chargemaster,94010,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94010 mod TC,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94011,Not in chargemaster,94011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94011,BCBS multispecialty AW base fee schedule,152.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94012,Not in chargemaster,94012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94012,BCBS multispecialty AW base fee schedule,248.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94013,Not in chargemaster,94013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94013,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94014,Not in chargemaster,94014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94014,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94015,Not in chargemaster,94015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94015,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94016,Not in chargemaster,94016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94016,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94060,Not in chargemaster,94060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94060,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94060 mod 26,Not in chargemaster,94060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94060 mod 26,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94060 mod TC,Not in chargemaster,94060,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94060 mod TC,BCBS multispecialty AW base fee schedule,80.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94070,Not in chargemaster,94070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94070,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94070 mod 26,Not in chargemaster,94070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94070 mod 26,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94070 mod TC,Not in chargemaster,94070,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94070 mod TC,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94150,Not in chargemaster,94150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94150,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94150 mod 26,Not in chargemaster,94150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94150 mod 26,BCBS multispecialty AW base fee schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94150 mod TC,Not in chargemaster,94150,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94150 mod TC,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94200,Not in chargemaster,94200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94200,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94200 mod 26,Not in chargemaster,94200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94200 mod 26,BCBS multispecialty AW base fee schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94200 mod TC,Not in chargemaster,94200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94200 mod TC,BCBS multispecialty AW base fee schedule,31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94250,Not in chargemaster,94250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94250,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94250 mod 26,Not in chargemaster,94250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94250 mod 26,BCBS multispecialty AW base fee schedule,9.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94250 mod TC,Not in chargemaster,94250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94250 mod TC,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94375,Not in chargemaster,94375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94375,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94375 mod 26,Not in chargemaster,94375,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94375 mod 26,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94375 mod TC,Not in chargemaster,94375,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94375 mod TC,BCBS multispecialty AW base fee schedule,42.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94400,Not in chargemaster,94400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94400,BCBS multispecialty AW base fee schedule,98.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94400 mod 26,Not in chargemaster,94400,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94400 mod 26,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94400 mod TC,Not in chargemaster,94400,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94400 mod TC,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94450,Not in chargemaster,94450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94450,BCBS multispecialty AW base fee schedule,116.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94450 mod 26,Not in chargemaster,94450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94450 mod 26,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94450 mod TC,Not in chargemaster,94450,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94450 mod TC,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94452,Not in chargemaster,94452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94452,BCBS multispecialty AW base fee schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94452 mod 26,Not in chargemaster,94452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94452 mod 26,BCBS multispecialty AW base fee schedule,25.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94452 mod TC,Not in chargemaster,94452,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94452 mod TC,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94453,Not in chargemaster,94453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94453,BCBS multispecialty AW base fee schedule,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94453 mod 26,Not in chargemaster,94453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94453 mod 26,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94453 mod TC,Not in chargemaster,94453,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94453 mod TC,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94610,Not in chargemaster,94610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94610,BCBS multispecialty AW base fee schedule,98.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94617,Not in chargemaster,94617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94617,BCBS multispecialty AW base fee schedule,159.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94617 mod 26,Not in chargemaster,94617,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94617 mod 26,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94617 mod TC,Not in chargemaster,94617,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94617 mod TC,BCBS multispecialty AW base fee schedule,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94618,Not in chargemaster,94618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94618,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94618 mod 26,Not in chargemaster,94618,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94618 mod 26,BCBS multispecialty AW base fee schedule,40.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94618 mod TC,Not in chargemaster,94618,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94618 mod TC,BCBS multispecialty AW base fee schedule,18.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94621,Not in chargemaster,94621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94621,BCBS multispecialty AW base fee schedule,279,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94621 mod 26,Not in chargemaster,94621,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94621 mod 26,BCBS multispecialty AW base fee schedule,123.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94621 mod TC,Not in chargemaster,94621,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94621 mod TC,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94640,94640,94640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94640,BCBS multispecialty AW base fee schedule,31,44,Fee schedule,,31,31,31,31,,,0
unity,Fee schedule,Facility 94644,Not in chargemaster,94644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94644,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94645,Not in chargemaster,94645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94645,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94660,Not in chargemaster,94660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94660,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93451,Not in chargemaster,93451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93451,BCBS multispecialty AW base fee schedule,1484.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93451 mod 26,Not in chargemaster,93451,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93451 mod 26,BCBS multispecialty AW base fee schedule,235.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93451 mod TC,Not in chargemaster,93451,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93451 mod TC,BCBS multispecialty AW base fee schedule,1248.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93452,Not in chargemaster,93452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93452,BCBS multispecialty AW base fee schedule,1606.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93452 mod 26,Not in chargemaster,93452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93452 mod 26,BCBS multispecialty AW base fee schedule,424.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93452 mod TC,Not in chargemaster,93452,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93452 mod TC,BCBS multispecialty AW base fee schedule,1181.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93453,Not in chargemaster,93453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93453,BCBS multispecialty AW base fee schedule,2070.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93453 mod 26,Not in chargemaster,93453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93453 mod 26,BCBS multispecialty AW base fee schedule,568.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93453 mod TC,Not in chargemaster,93453,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93453 mod TC,BCBS multispecialty AW base fee schedule,1501.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93454,Not in chargemaster,93454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93454,BCBS multispecialty AW base fee schedule,1610.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93454 mod 26,Not in chargemaster,93454,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93454 mod 26,BCBS multispecialty AW base fee schedule,429.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93454 mod TC,Not in chargemaster,93454,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93454 mod TC,BCBS multispecialty AW base fee schedule,1180.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93455,Not in chargemaster,93455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93455,BCBS multispecialty AW base fee schedule,1829.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93455 mod 26,Not in chargemaster,93455,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93455 mod 26,BCBS multispecialty AW base fee schedule,500.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93455 mod TC,Not in chargemaster,93455,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93455 mod TC,BCBS multispecialty AW base fee schedule,1329.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93456,Not in chargemaster,93456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93456,BCBS multispecialty AW base fee schedule,2037.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93456 mod 26,Not in chargemaster,93456,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93456 mod 26,BCBS multispecialty AW base fee schedule,559.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93456 mod TC,Not in chargemaster,93456,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93456 mod TC,BCBS multispecialty AW base fee schedule,1478.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93457,Not in chargemaster,93457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93457,BCBS multispecialty AW base fee schedule,2256.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93457 mod 26,Not in chargemaster,93457,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93457 mod 26,BCBS multispecialty AW base fee schedule,631.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93457 mod TC,Not in chargemaster,93457,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93457 mod TC,BCBS multispecialty AW base fee schedule,1625.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93458,Not in chargemaster,93458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93458,BCBS multispecialty AW base fee schedule,1885.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93458 mod 26,Not in chargemaster,93458,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93458 mod 26,BCBS multispecialty AW base fee schedule,530.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93458 mod TC,Not in chargemaster,93458,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93458 mod TC,BCBS multispecialty AW base fee schedule,1354.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93459,Not in chargemaster,93459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93459,BCBS multispecialty AW base fee schedule,2052.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93459 mod 26,Not in chargemaster,93459,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93459 mod 26,BCBS multispecialty AW base fee schedule,601.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93459 mod TC,Not in chargemaster,93459,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93459 mod TC,BCBS multispecialty AW base fee schedule,1450.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93460,Not in chargemaster,93460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93460,BCBS multispecialty AW base fee schedule,2271.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93460 mod 26,Not in chargemaster,93460,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93460 mod 26,BCBS multispecialty AW base fee schedule,672.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93460 mod TC,Not in chargemaster,93460,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93460 mod TC,BCBS multispecialty AW base fee schedule,1598.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93461,Not in chargemaster,93461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93461,BCBS multispecialty AW base fee schedule,2542,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93461 mod 26,Not in chargemaster,93461,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93461 mod 26,BCBS multispecialty AW base fee schedule,744,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93461 mod TC,Not in chargemaster,93461,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93461 mod TC,BCBS multispecialty AW base fee schedule,1798,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93462,Not in chargemaster,93462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93462,BCBS multispecialty AW base fee schedule,378.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93463,Not in chargemaster,93463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93463,BCBS multispecialty AW base fee schedule,174.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93464,Not in chargemaster,93464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93464,BCBS multispecialty AW base fee schedule,427.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93464 mod 26,Not in chargemaster,93464,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93464 mod 26,BCBS multispecialty AW base fee schedule,157.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93464 mod TC,Not in chargemaster,93464,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93464 mod TC,BCBS multispecialty AW base fee schedule,269.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93503,Not in chargemaster,93503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93503,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93505,Not in chargemaster,93505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93505,BCBS multispecialty AW base fee schedule,1249.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93505 mod 26,Not in chargemaster,93505,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93505 mod 26,BCBS multispecialty AW base fee schedule,400.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93505 mod TC,Not in chargemaster,93505,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93505 mod TC,BCBS multispecialty AW base fee schedule,849.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93530,Not in chargemaster,93530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93530,BCBS multispecialty AW base fee schedule,365.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93530 mod 26,Not in chargemaster,93530,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93530 mod 26,BCBS multispecialty AW base fee schedule,365.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93531,Not in chargemaster,93531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93531,BCBS multispecialty AW base fee schedule,759.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93531 mod 26,Not in chargemaster,93531,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93531 mod 26,BCBS multispecialty AW base fee schedule,759.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93532,Not in chargemaster,93532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93532,BCBS multispecialty AW base fee schedule,947.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93532 mod 26,Not in chargemaster,93532,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93532 mod 26,BCBS multispecialty AW base fee schedule,947.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93533,Not in chargemaster,93533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93533,BCBS multispecialty AW base fee schedule,634.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93533 mod 26,Not in chargemaster,93533,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93533 mod 26,BCBS multispecialty AW base fee schedule,634.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93561,Not in chargemaster,93561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93561,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93561 mod 26,Not in chargemaster,93561,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93561 mod 26,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93562,Not in chargemaster,93562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93562,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93562 mod 26,Not in chargemaster,93562,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93562 mod 26,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93563,Not in chargemaster,93563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93563,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93564,Not in chargemaster,93564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93564,BCBS multispecialty AW base fee schedule,110.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93565,Not in chargemaster,93565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93565,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93566,Not in chargemaster,93566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93566,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94662,Not in chargemaster,94662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94662,BCBS multispecialty AW base fee schedule,63.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94664,Not in chargemaster,94664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94664,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94667,Not in chargemaster,94667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94667,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94668,Not in chargemaster,94668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94668,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94669,Not in chargemaster,94669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94669,BCBS multispecialty AW base fee schedule,51.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94680,Not in chargemaster,94680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94680,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94680 mod 26,Not in chargemaster,94680,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94680 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94680 mod TC,Not in chargemaster,94680,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94680 mod TC,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94681,Not in chargemaster,94681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94681,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94681 mod 26,Not in chargemaster,94681,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94681 mod 26,BCBS multispecialty AW base fee schedule,17.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94681 mod TC,Not in chargemaster,94681,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94681 mod TC,BCBS multispecialty AW base fee schedule,74.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94690,Not in chargemaster,94690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94690,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94690 mod 26,Not in chargemaster,94690,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94690 mod 26,BCBS multispecialty AW base fee schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94690 mod TC,Not in chargemaster,94690,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94690 mod TC,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94726,Not in chargemaster,94726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94726,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94726 mod 26,Not in chargemaster,94726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94726 mod 26,BCBS multispecialty AW base fee schedule,21.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94726 mod TC,Not in chargemaster,94726,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94726 mod TC,BCBS multispecialty AW base fee schedule,71.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94727,Not in chargemaster,94727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94727,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94727 mod 26,Not in chargemaster,94727,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94727 mod 26,BCBS multispecialty AW base fee schedule,21.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94727 mod TC,Not in chargemaster,94727,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94727 mod TC,BCBS multispecialty AW base fee schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94728,Not in chargemaster,94728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94728,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94728 mod 26,Not in chargemaster,94728,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94728 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94728 mod TC,Not in chargemaster,94728,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94728 mod TC,BCBS multispecialty AW base fee schedule,48.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94729,Not in chargemaster,94729,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94729,BCBS multispecialty AW base fee schedule,98.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94729 mod 26,Not in chargemaster,94729,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94729 mod 26,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94729 mod TC,Not in chargemaster,94729,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94729 mod TC,BCBS multispecialty AW base fee schedule,82.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94750,Not in chargemaster,94750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94750,BCBS multispecialty AW base fee schedule,153.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94750 mod 26,Not in chargemaster,94750,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94750 mod 26,BCBS multispecialty AW base fee schedule,19.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94750 mod TC,Not in chargemaster,94750,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94750 mod TC,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94760,Not in chargemaster,94760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94760,BCBS multispecialty AW base fee schedule,4.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94761,Not in chargemaster,94761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94761,BCBS multispecialty AW base fee schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94762,Not in chargemaster,94762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94762,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94770,Not in chargemaster,94770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94770,BCBS multispecialty AW base fee schedule,13.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94780,Not in chargemaster,94780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94780,BCBS multispecialty AW base fee schedule,42.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92920,Not in chargemaster,92920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92920,BCBS multispecialty AW base fee schedule,955.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92924,Not in chargemaster,92924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92924,BCBS multispecialty AW base fee schedule,1138.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92928,Not in chargemaster,92928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92928,BCBS multispecialty AW base fee schedule,1062.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92933,Not in chargemaster,92933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92933,BCBS multispecialty AW base fee schedule,1192.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92937,Not in chargemaster,92937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92937,BCBS multispecialty AW base fee schedule,1061.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92941,Not in chargemaster,92941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92941,BCBS multispecialty AW base fee schedule,1194.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92943,Not in chargemaster,92943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92943,BCBS multispecialty AW base fee schedule,1194.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92950,92950,92950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92950,BCBS multispecialty AW base fee schedule,332.32,381.92,Fee schedule,,332.32,332.32,332.32,332.32,,,0
unity,Fee schedule,Facility 92640,Not in chargemaster,92640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92640,BCBS multispecialty AW base fee schedule,169.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92953,Not in chargemaster,92953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92953,BCBS multispecialty AW base fee schedule,1.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92960,Not in chargemaster,92960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92960,BCBS multispecialty AW base fee schedule,193.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93567,Not in chargemaster,93567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93567,BCBS multispecialty AW base fee schedule,94.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93568,Not in chargemaster,93568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93568,BCBS multispecialty AW base fee schedule,84.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93770,Not in chargemaster,93770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93770,BCBS multispecialty AW base fee schedule,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93784,Not in chargemaster,93784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93784,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93786,Not in chargemaster,93786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93786,BCBS multispecialty AW base fee schedule,39.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93788,Not in chargemaster,93788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93788,BCBS multispecialty AW base fee schedule,8.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93790,Not in chargemaster,93790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93790,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93792,Not in chargemaster,93792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93792,BCBS multispecialty AW base fee schedule,114.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93793,Not in chargemaster,93793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93793,BCBS multispecialty AW base fee schedule,20.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93797,Not in chargemaster,93797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93797,BCBS multispecialty AW base fee schedule,15.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93798,Not in chargemaster,93798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93798,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94781,Not in chargemaster,94781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94781,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95004,Not in chargemaster,95004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95004,BCBS multispecialty AW base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95012,Not in chargemaster,95012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95012,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95017,Not in chargemaster,95017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95017,BCBS multispecialty AW base fee schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95027,Not in chargemaster,95027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95027,BCBS multispecialty AW base fee schedule,8.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95028,Not in chargemaster,95028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95028,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95044,Not in chargemaster,95044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95044,BCBS multispecialty AW base fee schedule,9.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95052,Not in chargemaster,95052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95052,BCBS multispecialty AW base fee schedule,11.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95056,Not in chargemaster,95056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95056,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95060,Not in chargemaster,95060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95060,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95065,Not in chargemaster,95065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95065,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95070,Not in chargemaster,95070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95070,BCBS multispecialty AW base fee schedule,57.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95071,Not in chargemaster,95071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95071,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95076,Not in chargemaster,95076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95076,BCBS multispecialty AW base fee schedule,132.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95018,Not in chargemaster,95018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95018,BCBS multispecialty AW base fee schedule,12.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95024,Not in chargemaster,95024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95024,BCBS multispecialty AW base fee schedule,1.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95115,95115,95115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95115,BCBS multispecialty AW base fee schedule,16.12,19.88,Fee schedule,,16.12,16.12,16.12,16.12,,,0
unity,Fee schedule,Facility 95117,95117,95117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95117,BCBS multispecialty AW base fee schedule,18.6,22.73,Fee schedule,,18.6,18.6,18.6,18.6,,,0
unity,Fee schedule,Facility 95144,Not in chargemaster,95144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95144,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95079,Not in chargemaster,95079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95079,BCBS multispecialty AW base fee schedule,121.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95145,Not in chargemaster,95145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95145,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95146,Not in chargemaster,95146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95146,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95147,Not in chargemaster,95147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95147,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95148,Not in chargemaster,95148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95148,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95149,Not in chargemaster,95149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95149,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95165,Not in chargemaster,95165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95165,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95170,Not in chargemaster,95170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95170,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95860,Not in chargemaster,95860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95860,BCBS multispecialty AW base fee schedule,210.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95860 mod 26,Not in chargemaster,95860,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95860 mod 26,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95860 mod TC,Not in chargemaster,95860,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95860 mod TC,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95861,Not in chargemaster,95861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95861,BCBS multispecialty AW base fee schedule,301.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95861 mod 26,Not in chargemaster,95861,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95861 mod 26,BCBS multispecialty AW base fee schedule,146.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95861 mod TC,Not in chargemaster,95861,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95861 mod TC,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95863,Not in chargemaster,95863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95863,BCBS multispecialty AW base fee schedule,373.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95863 mod 26,Not in chargemaster,95863,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95863 mod 26,BCBS multispecialty AW base fee schedule,176.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95863 mod TC,Not in chargemaster,95863,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95863 mod TC,BCBS multispecialty AW base fee schedule,196.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95864,Not in chargemaster,95864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95864,BCBS multispecialty AW base fee schedule,438.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95864 mod 26,Not in chargemaster,95864,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95864 mod 26,BCBS multispecialty AW base fee schedule,188.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95864 mod TC,Not in chargemaster,95864,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95864 mod TC,BCBS multispecialty AW base fee schedule,249.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95865,Not in chargemaster,95865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95865,BCBS multispecialty AW base fee schedule,269.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95865 mod 26,Not in chargemaster,95865,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95865 mod 26,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95865 mod TC,Not in chargemaster,95865,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95865 mod TC,BCBS multispecialty AW base fee schedule,120.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95866,Not in chargemaster,95866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95866,BCBS multispecialty AW base fee schedule,237.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95866 mod 26,Not in chargemaster,95866,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95866 mod 26,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95866 mod TC,Not in chargemaster,95866,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95866 mod TC,BCBS multispecialty AW base fee schedule,119.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95867,Not in chargemaster,95867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95867,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95867 mod 26,Not in chargemaster,95867,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95867 mod 26,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95867 mod TC,Not in chargemaster,95867,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95867 mod TC,BCBS multispecialty AW base fee schedule,113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95868,Not in chargemaster,95868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95868,BCBS multispecialty AW base fee schedule,248,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95868 mod 26,Not in chargemaster,95868,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95868 mod 26,BCBS multispecialty AW base fee schedule,111.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95868 mod TC,Not in chargemaster,95868,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95868 mod TC,BCBS multispecialty AW base fee schedule,136.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95869,Not in chargemaster,95869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95869,BCBS multispecialty AW base fee schedule,168.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95869 mod 26,Not in chargemaster,95869,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95869 mod 26,BCBS multispecialty AW base fee schedule,35.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95869 mod TC,Not in chargemaster,95869,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95869 mod TC,BCBS multispecialty AW base fee schedule,132.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95870,Not in chargemaster,95870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95870,BCBS multispecialty AW base fee schedule,158.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95870 mod 26,Not in chargemaster,95870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95870 mod 26,BCBS multispecialty AW base fee schedule,35.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95870 mod TC,Not in chargemaster,95870,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95870 mod TC,BCBS multispecialty AW base fee schedule,123.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95872,Not in chargemaster,95872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95872,BCBS multispecialty AW base fee schedule,350.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95872 mod 26,Not in chargemaster,95872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95872 mod 26,BCBS multispecialty AW base fee schedule,269.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95872 mod TC,Not in chargemaster,95872,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95872 mod TC,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95873,Not in chargemaster,95873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95873,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95873 mod 26,Not in chargemaster,95873,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95873 mod 26,BCBS multispecialty AW base fee schedule,35.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95873 mod TC,Not in chargemaster,95873,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95873 mod TC,BCBS multispecialty AW base fee schedule,99.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95874,Not in chargemaster,95874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95874,BCBS multispecialty AW base fee schedule,138.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95874 mod 26,Not in chargemaster,95874,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95874 mod 26,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95874 mod TC,Not in chargemaster,95874,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95874 mod TC,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95875,Not in chargemaster,95875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95875,BCBS multispecialty AW base fee schedule,234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95875 mod 26,Not in chargemaster,95875,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95875 mod 26,BCBS multispecialty AW base fee schedule,104.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95875 mod TC,Not in chargemaster,95875,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95875 mod TC,BCBS multispecialty AW base fee schedule,130.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95885,Not in chargemaster,95885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95885,BCBS multispecialty AW base fee schedule,109.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95885 mod 26,Not in chargemaster,95885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95885 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95885 mod TC,Not in chargemaster,95885,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95885 mod TC,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95886,Not in chargemaster,95886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95886,BCBS multispecialty AW base fee schedule,170.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95886 mod 26,Not in chargemaster,95886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95886 mod 26,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95886 mod TC,Not in chargemaster,95886,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95886 mod TC,BCBS multispecialty AW base fee schedule,89.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95887,Not in chargemaster,95887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95887,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95887 mod 26,Not in chargemaster,95887,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95887 mod 26,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95887 mod TC,Not in chargemaster,95887,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95887 mod TC,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95905,Not in chargemaster,95905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95905,BCBS multispecialty AW base fee schedule,94.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95905 mod 26,Not in chargemaster,95905,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95905 mod 26,BCBS multispecialty AW base fee schedule,4.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95905 mod TC,Not in chargemaster,95905,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95905 mod TC,BCBS multispecialty AW base fee schedule,89.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95907,Not in chargemaster,95907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95907,BCBS multispecialty AW base fee schedule,168.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95907 mod 26,Not in chargemaster,95907,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95907 mod 26,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95907 mod TC,Not in chargemaster,95907,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95907 mod TC,BCBS multispecialty AW base fee schedule,72.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95908,Not in chargemaster,95908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95908,BCBS multispecialty AW base fee schedule,213.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95908 mod 26,Not in chargemaster,95908,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95908 mod 26,BCBS multispecialty AW base fee schedule,119.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95908 mod TC,Not in chargemaster,95908,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95908 mod TC,BCBS multispecialty AW base fee schedule,94.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95909,Not in chargemaster,95909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95909,BCBS multispecialty AW base fee schedule,255.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95909 mod 26,Not in chargemaster,95909,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95909 mod 26,BCBS multispecialty AW base fee schedule,142.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95909 mod TC,Not in chargemaster,95909,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95909 mod TC,BCBS multispecialty AW base fee schedule,112.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95910,Not in chargemaster,95910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95910,BCBS multispecialty AW base fee schedule,336.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95910 mod 26,Not in chargemaster,95910,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95910 mod 26,BCBS multispecialty AW base fee schedule,190.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95910 mod TC,Not in chargemaster,95910,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95910 mod TC,BCBS multispecialty AW base fee schedule,145.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95911,Not in chargemaster,95911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95911,BCBS multispecialty AW base fee schedule,402.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95911 mod 26,Not in chargemaster,95911,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95911 mod 26,BCBS multispecialty AW base fee schedule,236.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95911 mod TC,Not in chargemaster,95911,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95911 mod TC,BCBS multispecialty AW base fee schedule,166.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95912,Not in chargemaster,95912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95912,BCBS multispecialty AW base fee schedule,460.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95912 mod 26,Not in chargemaster,95912,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95912 mod 26,BCBS multispecialty AW base fee schedule,281.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95912 mod TC,Not in chargemaster,95912,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95912 mod TC,BCBS multispecialty AW base fee schedule,179.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95913,Not in chargemaster,95913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95913,BCBS multispecialty AW base fee schedule,533.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95913 mod 26,Not in chargemaster,95913,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95913 mod 26,BCBS multispecialty AW base fee schedule,334.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95913 mod TC,Not in chargemaster,95913,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95913 mod TC,BCBS multispecialty AW base fee schedule,199.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95921,Not in chargemaster,95921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95921,BCBS multispecialty AW base fee schedule,150.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95921 mod 26,Not in chargemaster,95921,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95921 mod 26,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95921 mod TC,Not in chargemaster,95921,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95921 mod TC,BCBS multispecialty AW base fee schedule,70.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95922,Not in chargemaster,95922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95922,BCBS multispecialty AW base fee schedule,172.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95922 mod 26,Not in chargemaster,95922,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95922 mod 26,BCBS multispecialty AW base fee schedule,85.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95922 mod TC,Not in chargemaster,95922,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95922 mod TC,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95923,Not in chargemaster,95923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95923,BCBS multispecialty AW base fee schedule,225.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95923 mod 26,Not in chargemaster,95923,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95923 mod 26,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95923 mod TC,Not in chargemaster,95923,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95923 mod TC,BCBS multispecialty AW base fee schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95924,Not in chargemaster,95924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95924,BCBS multispecialty AW base fee schedule,264.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95924 mod 26,Not in chargemaster,95924,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95924 mod 26,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95924 mod TC,Not in chargemaster,95924,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95924 mod TC,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95925,Not in chargemaster,95925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95925,BCBS multispecialty AW base fee schedule,244.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95925 mod 26,Not in chargemaster,95925,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95925 mod 26,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95925 mod TC,Not in chargemaster,95925,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95925 mod TC,BCBS multispecialty AW base fee schedule,195.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95926,Not in chargemaster,95926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95926,BCBS multispecialty AW base fee schedule,233.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95926 mod 26,Not in chargemaster,95926,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95926 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95926 mod TC,Not in chargemaster,95926,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95926 mod TC,BCBS multispecialty AW base fee schedule,184.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95927,Not in chargemaster,95927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95927,BCBS multispecialty AW base fee schedule,232.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95927 mod 26,Not in chargemaster,95927,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95927 mod 26,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95927 mod TC,Not in chargemaster,95927,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95927 mod TC,BCBS multispecialty AW base fee schedule,184.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95928,Not in chargemaster,95928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95928,BCBS multispecialty AW base fee schedule,395.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95928 mod 26,Not in chargemaster,95928,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95928 mod 26,BCBS multispecialty AW base fee schedule,141.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95928 mod TC,Not in chargemaster,95928,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95928 mod TC,BCBS multispecialty AW base fee schedule,254.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95929,Not in chargemaster,95929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95929,BCBS multispecialty AW base fee schedule,407.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95929 mod 26,Not in chargemaster,95929,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95929 mod 26,BCBS multispecialty AW base fee schedule,141.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95929 mod TC,Not in chargemaster,95929,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95929 mod TC,BCBS multispecialty AW base fee schedule,265.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95930,Not in chargemaster,95930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95930,BCBS multispecialty AW base fee schedule,116.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95930 mod 26,Not in chargemaster,95930,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95930 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95930 mod TC,Not in chargemaster,95930,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95930 mod TC,BCBS multispecialty AW base fee schedule,83.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95933,Not in chargemaster,95933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95933,BCBS multispecialty AW base fee schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95933 mod 26,Not in chargemaster,95933,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95933 mod 26,BCBS multispecialty AW base fee schedule,55.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95933 mod TC,Not in chargemaster,95933,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95933 mod TC,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95937,Not in chargemaster,95937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95937,BCBS multispecialty AW base fee schedule,164.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95937 mod 26,Not in chargemaster,95937,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95937 mod 26,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95937 mod TC,Not in chargemaster,95937,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95937 mod TC,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95938,Not in chargemaster,95938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95938,BCBS multispecialty AW base fee schedule,612.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95938 mod 26,Not in chargemaster,95938,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95938 mod 26,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95938 mod TC,Not in chargemaster,95938,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95938 mod TC,BCBS multispecialty AW base fee schedule,530.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95939,Not in chargemaster,95939,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95939,BCBS multispecialty AW base fee schedule,920.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95939 mod 26,Not in chargemaster,95939,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95939 mod 26,BCBS multispecialty AW base fee schedule,211.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95939 mod TC,Not in chargemaster,95939,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95939 mod TC,BCBS multispecialty AW base fee schedule,708.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95940,Not in chargemaster,95940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95940,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95954,Not in chargemaster,95954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95954,BCBS multispecialty AW base fee schedule,683.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95954 mod 26,Not in chargemaster,95954,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95954 mod 26,BCBS multispecialty AW base fee schedule,200.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95954 mod TC,Not in chargemaster,95954,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95954 mod TC,BCBS multispecialty AW base fee schedule,482.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95955,Not in chargemaster,95955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95955,BCBS multispecialty AW base fee schedule,368.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95955 mod 26,Not in chargemaster,95955,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95955 mod 26,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95955 mod TC,Not in chargemaster,95955,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95955 mod TC,BCBS multispecialty AW base fee schedule,272.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95957,Not in chargemaster,95957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95957,BCBS multispecialty AW base fee schedule,448.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95957 mod 26,Not in chargemaster,95957,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95957 mod 26,BCBS multispecialty AW base fee schedule,182.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95957 mod TC,Not in chargemaster,95957,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95957 mod TC,BCBS multispecialty AW base fee schedule,266.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95958,Not in chargemaster,95958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95958,BCBS multispecialty AW base fee schedule,1022.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95958 mod 26,Not in chargemaster,95958,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95958 mod 26,BCBS multispecialty AW base fee schedule,402.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95958 mod TC,Not in chargemaster,95958,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95958 mod TC,BCBS multispecialty AW base fee schedule,620,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95961,Not in chargemaster,95961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95961,BCBS multispecialty AW base fee schedule,544.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95961 mod 26,Not in chargemaster,95961,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95961 mod 26,BCBS multispecialty AW base fee schedule,286.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95961 mod TC,Not in chargemaster,95961,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95961 mod TC,BCBS multispecialty AW base fee schedule,258.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95962,Not in chargemaster,95962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95962,BCBS multispecialty AW base fee schedule,461.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95962 mod 26,Not in chargemaster,95962,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95962 mod 26,BCBS multispecialty AW base fee schedule,305.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95962 mod TC,Not in chargemaster,95962,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95962 mod TC,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95965,Not in chargemaster,95965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95965,BCBS multispecialty AW base fee schedule,744.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95965 mod 26,Not in chargemaster,95965,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95965 mod 26,BCBS multispecialty AW base fee schedule,744.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95966,Not in chargemaster,95966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95966,BCBS multispecialty AW base fee schedule,377.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95966 mod 26,Not in chargemaster,95966,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95966 mod 26,BCBS multispecialty AW base fee schedule,377.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95967,Not in chargemaster,95967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95967,BCBS multispecialty AW base fee schedule,329.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95967 mod 26,Not in chargemaster,95967,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95967 mod 26,BCBS multispecialty AW base fee schedule,329.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95970,Not in chargemaster,95970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95970,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95782,Not in chargemaster,95782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95782,BCBS multispecialty AW base fee schedule,1580.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95782 mod 26,Not in chargemaster,95782,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95782 mod 26,BCBS multispecialty AW base fee schedule,222.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95782 mod TC,Not in chargemaster,95782,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95782 mod TC,BCBS multispecialty AW base fee schedule,1357.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95783,Not in chargemaster,95783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95783,BCBS multispecialty AW base fee schedule,1680.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95783 mod 26,Not in chargemaster,95783,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95783 mod 26,BCBS multispecialty AW base fee schedule,241.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95783 mod TC,Not in chargemaster,95783,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95783 mod TC,BCBS multispecialty AW base fee schedule,1438.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95800,Not in chargemaster,95800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95800,BCBS multispecialty AW base fee schedule,290.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95800 mod 26,Not in chargemaster,95800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95800 mod 26,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95800 mod TC,Not in chargemaster,95800,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95800 mod TC,BCBS multispecialty AW base fee schedule,217,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95801,Not in chargemaster,95801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95801,BCBS multispecialty AW base fee schedule,156.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95801 mod 26,Not in chargemaster,95801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95801 mod 26,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95801 mod TC,Not in chargemaster,95801,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95801 mod TC,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95803,Not in chargemaster,95803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95803,BCBS multispecialty AW base fee schedule,261.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95803 mod 26,Not in chargemaster,95803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95803 mod 26,BCBS multispecialty AW base fee schedule,78.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95803 mod TC,Not in chargemaster,95803,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95803 mod TC,BCBS multispecialty AW base fee schedule,182.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95805,Not in chargemaster,95805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95805,BCBS multispecialty AW base fee schedule,726.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95805 mod 26,Not in chargemaster,95805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95805 mod 26,BCBS multispecialty AW base fee schedule,104.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95805 mod TC,Not in chargemaster,95805,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95805 mod TC,BCBS multispecialty AW base fee schedule,621.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95806,Not in chargemaster,95806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95806,BCBS multispecialty AW base fee schedule,204.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95806 mod 26,Not in chargemaster,95806,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95806 mod 26,BCBS multispecialty AW base fee schedule,79.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95806 mod TC,Not in chargemaster,95806,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95806 mod TC,BCBS multispecialty AW base fee schedule,125.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95807,Not in chargemaster,95807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95807,BCBS multispecialty AW base fee schedule,712.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95807 mod 26,Not in chargemaster,95807,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95807 mod 26,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95807 mod TC,Not in chargemaster,95807,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95807 mod TC,BCBS multispecialty AW base fee schedule,603.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95808,Not in chargemaster,95808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95808,BCBS multispecialty AW base fee schedule,1142.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95808 mod 26,Not in chargemaster,95808,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95808 mod 26,BCBS multispecialty AW base fee schedule,154.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95808 mod TC,Not in chargemaster,95808,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95808 mod TC,BCBS multispecialty AW base fee schedule,987.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95810,Not in chargemaster,95810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95810,BCBS multispecialty AW base fee schedule,1067.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95810 mod 26,Not in chargemaster,95810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95810 mod 26,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95810 mod TC,Not in chargemaster,95810,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95810 mod TC,BCBS multispecialty AW base fee schedule,853.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95811,Not in chargemaster,95811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95811,BCBS multispecialty AW base fee schedule,1114.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95811 mod 26,Not in chargemaster,95811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95811 mod 26,BCBS multispecialty AW base fee schedule,221.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95811 mod TC,Not in chargemaster,95811,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95811 mod TC,BCBS multispecialty AW base fee schedule,892.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95812,Not in chargemaster,95812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95812,BCBS multispecialty AW base fee schedule,575.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95812 mod 26,Not in chargemaster,95812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95812 mod 26,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95812 mod TC,Not in chargemaster,95812,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95812 mod TC,BCBS multispecialty AW base fee schedule,474.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95813,Not in chargemaster,95813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95813,BCBS multispecialty AW base fee schedule,716.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95813 mod 26,Not in chargemaster,95813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95813 mod 26,BCBS multispecialty AW base fee schedule,154.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95813 mod TC,Not in chargemaster,95813,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95813 mod TC,BCBS multispecialty AW base fee schedule,561.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95816,Not in chargemaster,95816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95816,BCBS multispecialty AW base fee schedule,638.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95816 mod 26,Not in chargemaster,95816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95816 mod 26,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95816 mod TC,Not in chargemaster,95816,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95816 mod TC,BCBS multispecialty AW base fee schedule,536.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95819,Not in chargemaster,95819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95819,BCBS multispecialty AW base fee schedule,758.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95819 mod 26,Not in chargemaster,95819,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95819 mod 26,BCBS multispecialty AW base fee schedule,102.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95819 mod TC,Not in chargemaster,95819,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95819 mod TC,BCBS multispecialty AW base fee schedule,655.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95822,Not in chargemaster,95822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95822,BCBS multispecialty AW base fee schedule,687.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95822 mod 26,Not in chargemaster,95822,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95822 mod 26,BCBS multispecialty AW base fee schedule,102.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95822 mod TC,Not in chargemaster,95822,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95822 mod TC,BCBS multispecialty AW base fee schedule,585.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95824,Not in chargemaster,95824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95824,BCBS multispecialty AW base fee schedule,69.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95824 mod 26,Not in chargemaster,95824,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95824 mod 26,BCBS multispecialty AW base fee schedule,69.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95829,Not in chargemaster,95829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95829,BCBS multispecialty AW base fee schedule,3281.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95829 mod 26,Not in chargemaster,95829,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95829 mod 26,BCBS multispecialty AW base fee schedule,597.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95829 mod TC,Not in chargemaster,95829,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95829 mod TC,BCBS multispecialty AW base fee schedule,2683.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95830,Not in chargemaster,95830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95830,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95249,Not in chargemaster,95249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95249,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95250,Not in chargemaster,95250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95250,BCBS multispecialty AW base fee schedule,262.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95251,Not in chargemaster,95251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95251,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95717,Not in chargemaster,95717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95717,BCBS multispecialty AW base fee schedule,179.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95180,Not in chargemaster,95180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95180,BCBS multispecialty AW base fee schedule,182.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95718,Not in chargemaster,95718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95718,BCBS multispecialty AW base fee schedule,236.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95719,Not in chargemaster,95719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95719,BCBS multispecialty AW base fee schedule,279,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95720,Not in chargemaster,95720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95720,BCBS multispecialty AW base fee schedule,365.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95721,Not in chargemaster,95721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95721,BCBS multispecialty AW base fee schedule,367.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95722,Not in chargemaster,95722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95722,BCBS multispecialty AW base fee schedule,446.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95723,Not in chargemaster,95723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95723,BCBS multispecialty AW base fee schedule,454.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95724,Not in chargemaster,95724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95724,BCBS multispecialty AW base fee schedule,569.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95725,Not in chargemaster,95725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95725,BCBS multispecialty AW base fee schedule,517.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95726,Not in chargemaster,95726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95726,BCBS multispecialty AW base fee schedule,719.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95836,Not in chargemaster,95836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95836,BCBS multispecialty AW base fee schedule,197.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95851,Not in chargemaster,95851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95851,BCBS multispecialty AW base fee schedule,10.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95852,Not in chargemaster,95852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95852,BCBS multispecialty AW base fee schedule,7.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95857,Not in chargemaster,95857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95857,BCBS multispecialty AW base fee schedule,39.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95971,Not in chargemaster,95971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95971,BCBS multispecialty AW base fee schedule,72.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95972,Not in chargemaster,95972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95972,BCBS multispecialty AW base fee schedule,73.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95976,Not in chargemaster,95976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95976,BCBS multispecialty AW base fee schedule,71.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95977,Not in chargemaster,95977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95977,BCBS multispecialty AW base fee schedule,94.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95980,Not in chargemaster,95980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95980,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95981,Not in chargemaster,95981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95981,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95982,Not in chargemaster,95982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95982,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95983,Not in chargemaster,95983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95983,BCBS multispecialty AW base fee schedule,89.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95984,Not in chargemaster,95984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95984,BCBS multispecialty AW base fee schedule,78.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95990,Not in chargemaster,95990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95990,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95991,Not in chargemaster,95991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95991,BCBS multispecialty AW base fee schedule,71.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96000,Not in chargemaster,96000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96000,BCBS multispecialty AW base fee schedule,165.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96001,Not in chargemaster,96001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96001,BCBS multispecialty AW base fee schedule,195.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96002,Not in chargemaster,96002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96002,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96003,Not in chargemaster,96003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96003,BCBS multispecialty AW base fee schedule,30.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96004,Not in chargemaster,96004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96004,BCBS multispecialty AW base fee schedule,200.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96020,Not in chargemaster,96020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96020,BCBS multispecialty AW base fee schedule,288.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96020 mod 26,Not in chargemaster,96020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96020 mod 26,BCBS multispecialty AW base fee schedule,288.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96040,Not in chargemaster,96040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96040,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96105,Not in chargemaster,96105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96105,BCBS multispecialty AW base fee schedule,181.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96110,Not in chargemaster,96110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96110,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96112,Not in chargemaster,96112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96112,BCBS multispecialty AW base fee schedule,225.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95992,Not in chargemaster,95992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95992,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96113,Not in chargemaster,96113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96113,BCBS multispecialty AW base fee schedule,102.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96116,Not in chargemaster,96116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96116,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96121,Not in chargemaster,96121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96121,BCBS multispecialty AW base fee schedule,137.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96125,Not in chargemaster,96125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96125,BCBS multispecialty AW base fee schedule,192.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96127,Not in chargemaster,96127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96127,BCBS multispecialty AW base fee schedule,8.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96130,Not in chargemaster,96130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96130,BCBS multispecialty AW base fee schedule,190.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96131,Not in chargemaster,96131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96131,BCBS multispecialty AW base fee schedule,146.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96132,Not in chargemaster,96132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96132,BCBS multispecialty AW base fee schedule,188.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96133,Not in chargemaster,96133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96133,BCBS multispecialty AW base fee schedule,145.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96136,Not in chargemaster,96136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96136,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96138,Not in chargemaster,96138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96138,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96139,Not in chargemaster,96139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96139,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96146,Not in chargemaster,96146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96146,BCBS multispecialty AW base fee schedule,3.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96156,Not in chargemaster,96156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96156,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96137,Not in chargemaster,96137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96137,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96158,Not in chargemaster,96158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96158,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96160,Not in chargemaster,96160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96160,BCBS multispecialty AW base fee schedule,4.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96161,Not in chargemaster,96161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96161,BCBS multispecialty AW base fee schedule,4.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96164,Not in chargemaster,96164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96164,BCBS multispecialty AW base fee schedule,15.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96159,Not in chargemaster,96159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96159,BCBS multispecialty AW base fee schedule,36.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96165,Not in chargemaster,96165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96165,BCBS multispecialty AW base fee schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96167,Not in chargemaster,96167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96167,BCBS multispecialty AW base fee schedule,113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96168,Not in chargemaster,96168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96168,BCBS multispecialty AW base fee schedule,40.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96360,Not in chargemaster,96360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96360,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96361,Not in chargemaster,96361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96361,BCBS multispecialty AW base fee schedule,23.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96365,Not in chargemaster,96365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96365,BCBS multispecialty AW base fee schedule,124,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96366,Not in chargemaster,96366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96366,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96367,Not in chargemaster,96367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96367,BCBS multispecialty AW base fee schedule,53.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96368,Not in chargemaster,96368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96368,BCBS multispecialty AW base fee schedule,36.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96369,Not in chargemaster,96369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96369,BCBS multispecialty AW base fee schedule,278.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96370,Not in chargemaster,96370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96370,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96371,Not in chargemaster,96371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96371,BCBS multispecialty AW base fee schedule,110.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96372,96372,96372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96372,BCBS multispecialty AW base fee schedule,24.8,37,Fee schedule,,24.8,24.8,24.8,24.8,,,0
unity,Fee schedule,Facility 96373,Not in chargemaster,96373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96373,BCBS multispecialty AW base fee schedule,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96374,Not in chargemaster,96374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96374,BCBS multispecialty AW base fee schedule,68.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96375,Not in chargemaster,96375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96375,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96377,Not in chargemaster,96377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96377,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96401,Not in chargemaster,96401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96401,BCBS multispecialty AW base fee schedule,137.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96402,Not in chargemaster,96402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96402,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96405,Not in chargemaster,96405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96405,BCBS multispecialty AW base fee schedule,52.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96409,Not in chargemaster,96409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96409,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96411,Not in chargemaster,96411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96411,BCBS multispecialty AW base fee schedule,102.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96413,Not in chargemaster,96413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96413,BCBS multispecialty AW base fee schedule,244.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96415,Not in chargemaster,96415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96415,BCBS multispecialty AW base fee schedule,52.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96416,Not in chargemaster,96416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96416,BCBS multispecialty AW base fee schedule,244.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96417,Not in chargemaster,96417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96417,BCBS multispecialty AW base fee schedule,119.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96420,Not in chargemaster,96420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96420,BCBS multispecialty AW base fee schedule,181.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96422,Not in chargemaster,96422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96422,BCBS multispecialty AW base fee schedule,298.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96423,Not in chargemaster,96423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96423,BCBS multispecialty AW base fee schedule,138.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96425,Not in chargemaster,96425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96425,BCBS multispecialty AW base fee schedule,316.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96440,Not in chargemaster,96440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96440,BCBS multispecialty AW base fee schedule,221.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96170,Not in chargemaster,96170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96170,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96171,Not in chargemaster,96171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96171,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96406,Not in chargemaster,96406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96406,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96446,Not in chargemaster,96446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96446,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96567,Not in chargemaster,96567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96567,BCBS multispecialty AW base fee schedule,233.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96570,Not in chargemaster,96570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96570,BCBS multispecialty AW base fee schedule,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96571,Not in chargemaster,96571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96571,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96573,Not in chargemaster,96573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96573,BCBS multispecialty AW base fee schedule,373.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96574,Not in chargemaster,96574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96574,BCBS multispecialty AW base fee schedule,469.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96900,Not in chargemaster,96900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96900,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96902,Not in chargemaster,96902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96902,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96521,Not in chargemaster,96521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96521,BCBS multispecialty AW base fee schedule,256.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96522,Not in chargemaster,96522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96522,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96523,Not in chargemaster,96523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96523,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96542,Not in chargemaster,96542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96542,BCBS multispecialty AW base fee schedule,75.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96904,Not in chargemaster,96904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96904,BCBS multispecialty AW base fee schedule,119.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96910,Not in chargemaster,96910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96910,BCBS multispecialty AW base fee schedule,203.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96912,Not in chargemaster,96912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96912,BCBS multispecialty AW base fee schedule,173.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96913,Not in chargemaster,96913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96913,BCBS multispecialty AW base fee schedule,251.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96920,Not in chargemaster,96920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96920,BCBS multispecialty AW base fee schedule,116.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96931,Not in chargemaster,96931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96931,BCBS multispecialty AW base fee schedule,301.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96932,Not in chargemaster,96932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96932,BCBS multispecialty AW base fee schedule,221.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96933,Not in chargemaster,96933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96933,BCBS multispecialty AW base fee schedule,80.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96934,Not in chargemaster,96934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96934,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96935,Not in chargemaster,96935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96935,BCBS multispecialty AW base fee schedule,107.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96936,Not in chargemaster,96936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96936,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97010,Not in chargemaster,97010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97010,BCBS multispecialty AW base fee schedule,8.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97012,Not in chargemaster,97012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97012,BCBS multispecialty AW base fee schedule,19.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97014,Not in chargemaster,97014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97014,BCBS multispecialty AW base fee schedule,18.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97016,Not in chargemaster,97016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97016,BCBS multispecialty AW base fee schedule,15.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97018,Not in chargemaster,97018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97018,BCBS multispecialty AW base fee schedule,7.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97022,Not in chargemaster,97022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97022,BCBS multispecialty AW base fee schedule,23.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97024,Not in chargemaster,97024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97024,BCBS multispecialty AW base fee schedule,9.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97026,Not in chargemaster,97026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97026,BCBS multispecialty AW base fee schedule,8.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97028,Not in chargemaster,97028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97028,BCBS multispecialty AW base fee schedule,10.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97032,Not in chargemaster,97032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97032,BCBS multispecialty AW base fee schedule,19.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97033,Not in chargemaster,97033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97033,BCBS multispecialty AW base fee schedule,26.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97034,Not in chargemaster,97034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97034,BCBS multispecialty AW base fee schedule,19.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97035,Not in chargemaster,97035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97035,BCBS multispecialty AW base fee schedule,18.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97036,Not in chargemaster,97036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97036,BCBS multispecialty AW base fee schedule,45.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97110,Not in chargemaster,97110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97110,BCBS multispecialty AW base fee schedule,39.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97112,Not in chargemaster,97112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97112,BCBS multispecialty AW base fee schedule,45.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97113,Not in chargemaster,97113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97113,BCBS multispecialty AW base fee schedule,50.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97116,Not in chargemaster,97116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97116,BCBS multispecialty AW base fee schedule,39.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97124,Not in chargemaster,97124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97124,BCBS multispecialty AW base fee schedule,37.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97129,Not in chargemaster,97129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97129,BCBS multispecialty AW base fee schedule,30.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97130,Not in chargemaster,97130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97130,BCBS multispecialty AW base fee schedule,29.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97140,Not in chargemaster,97140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97140,BCBS multispecialty AW base fee schedule,36.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97150,Not in chargemaster,97150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97150,BCBS multispecialty AW base fee schedule,23.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97161,Not in chargemaster,97161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97161,BCBS multispecialty AW base fee schedule,110.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97162,Not in chargemaster,97162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97162,BCBS multispecialty AW base fee schedule,110.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97163,Not in chargemaster,97163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97163,BCBS multispecialty AW base fee schedule,110.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97164,Not in chargemaster,97164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97164,BCBS multispecialty AW base fee schedule,75.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97165,Not in chargemaster,97165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97165,BCBS multispecialty AW base fee schedule,117.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97166,Not in chargemaster,97166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97166,BCBS multispecialty AW base fee schedule,116.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97167,Not in chargemaster,97167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97167,BCBS multispecialty AW base fee schedule,116.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97168,Not in chargemaster,97168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97168,BCBS multispecialty AW base fee schedule,80.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97530,Not in chargemaster,97530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97530,BCBS multispecialty AW base fee schedule,50.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97533,Not in chargemaster,97533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97533,BCBS multispecialty AW base fee schedule,66.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97535,Not in chargemaster,97535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97535,BCBS multispecialty AW base fee schedule,44.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97537,Not in chargemaster,97537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97537,BCBS multispecialty AW base fee schedule,42.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97542,Not in chargemaster,97542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97542,BCBS multispecialty AW base fee schedule,42.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97597,97597,97597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97597,BCBS multispecialty AW base fee schedule,47.78,190,Fee schedule,,47.78,47.78,47.78,47.78,,,0
unity,Fee schedule,Facility 96450,Not in chargemaster,96450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96450,BCBS multispecialty AW base fee schedule,140.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96921,Not in chargemaster,96921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96921,BCBS multispecialty AW base fee schedule,130.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96922,Not in chargemaster,96922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96922,BCBS multispecialty AW base fee schedule,211.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97598,Not in chargemaster,97598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97598,BCBS multispecialty AW base fee schedule,33.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97605,Not in chargemaster,97605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97605,BCBS multispecialty AW base fee schedule,33.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97606,Not in chargemaster,97606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97606,BCBS multispecialty AW base fee schedule,36.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97607,Not in chargemaster,97607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97607,BCBS multispecialty AW base fee schedule,29.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97608,Not in chargemaster,97608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97608,BCBS multispecialty AW base fee schedule,33.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97750,Not in chargemaster,97750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97750,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97755,Not in chargemaster,97755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97755,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97760,Not in chargemaster,97760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97760,BCBS multispecialty AW base fee schedule,63.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97761,Not in chargemaster,97761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97761,BCBS multispecialty AW base fee schedule,54.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97763,Not in chargemaster,97763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97763,BCBS multispecialty AW base fee schedule,68.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97802,Not in chargemaster,97802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97802,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97610,Not in chargemaster,97610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97610,BCBS multispecialty AW base fee schedule,24.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97803,Not in chargemaster,97803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97803,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97804,Not in chargemaster,97804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97804,BCBS multispecialty AW base fee schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97810,Not in chargemaster,97810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97810,BCBS multispecialty AW base fee schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97811,Not in chargemaster,97811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97811,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97813,Not in chargemaster,97813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97813,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97814,Not in chargemaster,97814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97814,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98925,Not in chargemaster,98925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98925,BCBS multispecialty AW base fee schedule,42.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98926,Not in chargemaster,98926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98926,BCBS multispecialty AW base fee schedule,63.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98927,Not in chargemaster,98927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98927,BCBS multispecialty AW base fee schedule,83.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98928,Not in chargemaster,98928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98928,BCBS multispecialty AW base fee schedule,104.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98929,Not in chargemaster,98929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98929,BCBS multispecialty AW base fee schedule,128.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98940,Not in chargemaster,98940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98940,BCBS multispecialty AW base fee schedule,39.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98941,Not in chargemaster,98941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98941,BCBS multispecialty AW base fee schedule,60.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98942,Not in chargemaster,98942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98942,BCBS multispecialty AW base fee schedule,82.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98943,Not in chargemaster,98943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98943,BCBS multispecialty AW base fee schedule,42.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98960,Not in chargemaster,98960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98960,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98961,Not in chargemaster,98961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98961,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98962,Not in chargemaster,98962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98962,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98966,Not in chargemaster,98966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98966,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99091,Not in chargemaster,99091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99091,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99151,Not in chargemaster,99151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99151,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99152,Not in chargemaster,99152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99152,BCBS multispecialty AW base fee schedule,21.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99153,Not in chargemaster,99153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99153,BCBS multispecialty AW base fee schedule,18.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99155,Not in chargemaster,99155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99155,BCBS multispecialty AW base fee schedule,150.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99156,Not in chargemaster,99156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99156,BCBS multispecialty AW base fee schedule,137.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99157,Not in chargemaster,99157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99157,BCBS multispecialty AW base fee schedule,112.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99170,Not in chargemaster,99170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99170,BCBS multispecialty AW base fee schedule,152.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99173,Not in chargemaster,99173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99173,BCBS multispecialty AW base fee schedule,4.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99174,Not in chargemaster,99174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99174,BCBS multispecialty AW base fee schedule,9.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99175,Not in chargemaster,99175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99175,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99177,Not in chargemaster,99177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99177,BCBS multispecialty AW base fee schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99183,Not in chargemaster,99183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99183,BCBS multispecialty AW base fee schedule,195.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99184,Not in chargemaster,99184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99184,BCBS multispecialty AW base fee schedule,392.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99188,Not in chargemaster,99188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99188,BCBS multispecialty AW base fee schedule,18.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99195,Not in chargemaster,99195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99195,BCBS multispecialty AW base fee schedule,176.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99201,99201,99201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99201,BCBS multispecialty AW base fee schedule,46.5,98,Fee schedule,,46.5,46.5,46.5,46.5,,,0
unity,Fee schedule,Facility 98967,Not in chargemaster,98967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98967,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98968,Not in chargemaster,98968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98968,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99202,99202,99202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99202,BCBS multispecialty AW base fee schedule,88.66,163,Fee schedule,,88.66,88.66,88.66,88.66,,,0
unity,Fee schedule,Facility 99203,99203,99203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99203,BCBS multispecialty AW base fee schedule,132.68,230,Fee schedule,,132.68,132.68,132.68,132.68,,,0
unity,Fee schedule,Facility 99217,99217,99217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99217,BCBS multispecialty AW base fee schedule,127.1,155,Fee schedule,,127.1,127.1,127.1,127.1,,,0
unity,Fee schedule,Facility 99218,99218,99218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99218,BCBS multispecialty AW base fee schedule,174.84,214,Fee schedule,,174.84,174.84,174.84,174.84,,,0
unity,Fee schedule,Facility 99219,99219,99219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99219,BCBS multispecialty AW base fee schedule,237.46,290,Fee schedule,,237.46,237.46,237.46,237.46,,,0
unity,Fee schedule,Facility 99220,99220,99220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99220,BCBS multispecialty AW base fee schedule,323.64,395,Fee schedule,,323.64,323.64,323.64,323.64,,,0
unity,Fee schedule,Facility 99221,99221,99221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99221,BCBS multispecialty AW base fee schedule,178.56,215,Fee schedule,,178.56,178.56,178.56,178.56,,,0
unity,Fee schedule,Facility 99222,99222,99222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99222,BCBS multispecialty AW base fee schedule,241.18,290,Fee schedule,,241.18,241.18,241.18,241.18,,,0
unity,Fee schedule,Facility 99223,99223,99223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99223,BCBS multispecialty AW base fee schedule,354.02,430,Fee schedule,,354.02,354.02,354.02,354.02,,,0
unity,Fee schedule,Facility 99224,99224,99224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99224,BCBS multispecialty AW base fee schedule,69.44,85,Fee schedule,,69.44,69.44,69.44,69.44,,,0
unity,Fee schedule,Facility 99225,99225,99225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99225,BCBS multispecialty AW base fee schedule,127.1,155,Fee schedule,,127.1,127.1,127.1,127.1,,,0
unity,Fee schedule,Facility 99226,99226,99226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99226,BCBS multispecialty AW base fee schedule,182.9,225,Fee schedule,,182.9,182.9,182.9,182.9,,,0
unity,Fee schedule,Facility 99231,99231,99231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99231,BCBS multispecialty AW base fee schedule,68.82,85,Fee schedule,,68.82,68.82,68.82,68.82,,,0
unity,Fee schedule,Facility 99232,99232,99232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99232,BCBS multispecialty AW base fee schedule,126.48,155,Fee schedule,,126.48,126.48,126.48,126.48,,,0
unity,Fee schedule,Facility 99233,99233,99233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99233,BCBS multispecialty AW base fee schedule,182.28,225,Fee schedule,,182.28,182.28,182.28,182.28,,,0
unity,Fee schedule,Facility 99234,99234,99234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99234,BCBS multispecialty AW base fee schedule,233.74,285,Fee schedule,,233.74,233.74,233.74,233.74,,,0
unity,Fee schedule,Facility 99235,99235,99235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99235,BCBS multispecialty AW base fee schedule,295.74,360,Fee schedule,,295.74,295.74,295.74,295.74,,,0
unity,Fee schedule,Facility 99236,99236,99236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99236,BCBS multispecialty AW base fee schedule,380.68,465,Fee schedule,,380.68,380.68,380.68,380.68,,,0
unity,Fee schedule,Facility 99238,99238,99238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99238,BCBS multispecialty AW base fee schedule,127.72,155,Fee schedule,,127.72,127.72,127.72,127.72,,,0
unity,Fee schedule,Facility 99239,99239,99239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99239,BCBS multispecialty AW base fee schedule,187.24,230,Fee schedule,,187.24,187.24,187.24,187.24,,,0
unity,Fee schedule,Facility 99241,99241,99241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99241,BCBS multispecialty AW base fee schedule,57.66,97.26,Fee schedule,,57.66,57.66,57.66,57.66,,,0
unity,Fee schedule,Facility 99204,99204,99204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99204,BCBS multispecialty AW base fee schedule,226.92,350,Fee schedule,,226.92,226.92,226.92,226.92,,,0
unity,Fee schedule,Facility 99205,99205,99205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99205,BCBS multispecialty AW base fee schedule,296.36,440,Fee schedule,,296.36,296.36,296.36,296.36,,,0
unity,Fee schedule,Facility 99211,99211,99211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99211,BCBS multispecialty AW base fee schedule,16.12,50,Fee schedule,,16.12,16.12,16.12,16.12,,,0
unity,Fee schedule,Facility 99212,99212,99212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99212,BCBS multispecialty AW base fee schedule,45.26,97,Fee schedule,,45.26,45.26,45.26,45.26,,,0
unity,Fee schedule,Facility 99213,99213,99213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99213,BCBS multispecialty AW base fee schedule,89.9,158,Fee schedule,,89.9,89.9,89.9,89.9,,,0
unity,Fee schedule,Facility 99214,99214,99214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99214,BCBS multispecialty AW base fee schedule,138.26,230,Fee schedule,,138.26,138.26,138.26,138.26,,,0
unity,Fee schedule,Facility 99215,99215,99215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99215,BCBS multispecialty AW base fee schedule,195.3,300,Fee schedule,,195.3,195.3,195.3,195.3,,,0
unity,Fee schedule,Facility 99242,Not in chargemaster,99242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99242,BCBS multispecialty AW base fee schedule,121.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99304,99304,99304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99304,BCBS multispecialty AW base fee schedule,158.1,195,Fee schedule,,158.1,158.1,158.1,158.1,,,0
unity,Fee schedule,Facility 99305,99305,99305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99305,BCBS multispecialty AW base fee schedule,226.3,235.13,Fee schedule,,226.3,226.3,226.3,226.3,,,0
unity,Fee schedule,Facility 99306,Not in chargemaster,99306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99306,BCBS multispecialty AW base fee schedule,292.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99307,99307,99307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99307,BCBS multispecialty AW base fee schedule,76.88,95,Fee schedule,,76.88,76.88,76.88,76.88,,,0
unity,Fee schedule,Facility 99308,99308,99308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99308,BCBS multispecialty AW base fee schedule,120.9,145,Fee schedule,,120.9,120.9,120.9,120.9,,,0
unity,Fee schedule,Facility 99309,99309,99309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99309,BCBS multispecialty AW base fee schedule,159.34,195,Fee schedule,,159.34,159.34,159.34,159.34,,,0
unity,Fee schedule,Facility 99310,Not in chargemaster,99310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99310,BCBS multispecialty AW base fee schedule,234.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99315,99315,99315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99315,BCBS multispecialty AW base fee schedule,128.34,149.08,Fee schedule,,128.34,128.34,128.34,128.34,,,0
unity,Fee schedule,Facility 99316,99316,99316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99316,BCBS multispecialty AW base fee schedule,184.14,213.68,Fee schedule,,184.14,184.14,184.14,184.14,,,0
unity,Fee schedule,Facility 99318,Not in chargemaster,99318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99318,BCBS multispecialty AW base fee schedule,168.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99324,Not in chargemaster,99324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99324,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99325,Not in chargemaster,99325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99325,BCBS multispecialty AW base fee schedule,138.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99326,Not in chargemaster,99326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99326,BCBS multispecialty AW base fee schedule,241.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99327,Not in chargemaster,99327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99327,BCBS multispecialty AW base fee schedule,324.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99328,Not in chargemaster,99328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99328,BCBS multispecialty AW base fee schedule,384.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99334,Not in chargemaster,99334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99334,BCBS multispecialty AW base fee schedule,105.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99335,Not in chargemaster,99335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99335,BCBS multispecialty AW base fee schedule,166.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99336,Not in chargemaster,99336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99336,BCBS multispecialty AW base fee schedule,235.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99337,Not in chargemaster,99337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99337,BCBS multispecialty AW base fee schedule,339.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99339,Not in chargemaster,99339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99339,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99340,Not in chargemaster,99340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99340,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99341,Not in chargemaster,99341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99341,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99342,Not in chargemaster,99342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99342,BCBS multispecialty AW base fee schedule,137.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99343,Not in chargemaster,99343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99343,BCBS multispecialty AW base fee schedule,225.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99344,Not in chargemaster,99344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99344,BCBS multispecialty AW base fee schedule,319.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99345,Not in chargemaster,99345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99345,BCBS multispecialty AW base fee schedule,388.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99347,Not in chargemaster,99347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99347,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99348,Not in chargemaster,99348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99348,BCBS multispecialty AW base fee schedule,146.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99349,Not in chargemaster,99349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99349,BCBS multispecialty AW base fee schedule,225.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99350,Not in chargemaster,99350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99350,BCBS multispecialty AW base fee schedule,313.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99354,Not in chargemaster,99354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99354,BCBS multispecialty AW base fee schedule,213.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99251,Not in chargemaster,99251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99251,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99252,Not in chargemaster,99252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99252,BCBS multispecialty AW base fee schedule,132.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99253,Not in chargemaster,99253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99253,BCBS multispecialty AW base fee schedule,203.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99254,Not in chargemaster,99254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99254,BCBS multispecialty AW base fee schedule,296.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99255,Not in chargemaster,99255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99255,BCBS multispecialty AW base fee schedule,357.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99281,99281,99281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99281,BCBS multispecialty AW base fee schedule,39.68,50,Fee schedule,,39.68,39.68,39.68,39.68,,,0
unity,Fee schedule,Facility 99282,99282,99282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99282,BCBS multispecialty AW base fee schedule,76.26,90,Fee schedule,,76.26,76.26,76.26,76.26,,,0
unity,Fee schedule,Facility 99283,99283,99283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99283,BCBS multispecialty AW base fee schedule,114.08,130,Fee schedule,,114.08,114.08,114.08,114.08,,,0
unity,Fee schedule,Facility 99284,99284,99284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99284,BCBS multispecialty AW base fee schedule,209.56,250,Fee schedule,,209.56,209.56,209.56,209.56,,,0
unity,Fee schedule,Facility 99285,99285,99285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99285,BCBS multispecialty AW base fee schedule,304.42,370,Fee schedule,,304.42,304.42,304.42,304.42,,,0
unity,Fee schedule,Facility 99291,99291,99291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99291,BCBS multispecialty AW base fee schedule,389.36,480,Fee schedule,,389.36,389.36,389.36,389.36,,,0
unity,Fee schedule,Facility 99243,Not in chargemaster,99243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99243,BCBS multispecialty AW base fee schedule,169.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99244,Not in chargemaster,99244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99244,BCBS multispecialty AW base fee schedule,273.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99245,Not in chargemaster,99245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99245,BCBS multispecialty AW base fee schedule,337.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99292,99292,99292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99292,BCBS multispecialty AW base fee schedule,195.92,262,Fee schedule,,195.92,195.92,195.92,195.92,,,0
unity,Fee schedule,Facility 99356,Not in chargemaster,99356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99356,BCBS multispecialty AW base fee schedule,161.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99357,Not in chargemaster,99357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99357,BCBS multispecialty AW base fee schedule,163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99358,Not in chargemaster,99358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99358,BCBS multispecialty AW base fee schedule,195.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99359,Not in chargemaster,99359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99359,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99360,Not in chargemaster,99360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99360,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99366,Not in chargemaster,99366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99366,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99367,Not in chargemaster,99367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99367,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99368,Not in chargemaster,99368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99368,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99374,Not in chargemaster,99374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99374,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99355,Not in chargemaster,99355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99355,BCBS multispecialty AW base fee schedule,160.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99375,Not in chargemaster,99375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99375,BCBS multispecialty AW base fee schedule,156.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99377,Not in chargemaster,99377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99377,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99378,Not in chargemaster,99378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99378,BCBS multispecialty AW base fee schedule,156.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99379,Not in chargemaster,99379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99379,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99380,Not in chargemaster,99380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99380,BCBS multispecialty AW base fee schedule,156.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99381,99381,99381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99381,BCBS multispecialty AW base fee schedule,135.78,238,Fee schedule,,135.78,135.78,135.78,135.78,,,0
unity,Fee schedule,Facility 99382,99382,99382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99382,BCBS multispecialty AW base fee schedule,145.08,238.51,Fee schedule,,145.08,145.08,145.08,145.08,,,0
unity,Fee schedule,Facility 99383,99383,99383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99383,BCBS multispecialty AW base fee schedule,153.76,255,Fee schedule,,153.76,153.76,153.76,153.76,,,0
unity,Fee schedule,Facility 99384,99384,99384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99384,BCBS multispecialty AW base fee schedule,181.66,290,Fee schedule,,181.66,181.66,181.66,181.66,,,0
unity,Fee schedule,Facility 99385,99385,99385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99385,BCBS multispecialty AW base fee schedule,174.22,282,Fee schedule,,174.22,174.22,174.22,174.22,,,0
unity,Fee schedule,Facility 99386,99386,99386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99386,BCBS multispecialty AW base fee schedule,211.42,325,Fee schedule,,211.42,211.42,211.42,211.42,,,0
unity,Fee schedule,Facility 99387,99387,99387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99387,BCBS multispecialty AW base fee schedule,227.54,342.17,Fee schedule,,227.54,227.54,227.54,227.54,,,0
unity,Fee schedule,Facility 99391,99391,99391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99391,BCBS multispecialty AW base fee schedule,124.62,210,Fee schedule,,124.62,124.62,124.62,124.62,,,0
unity,Fee schedule,Facility 99392,99392,99392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99392,BCBS multispecialty AW base fee schedule,135.78,225,Fee schedule,,135.78,135.78,135.78,135.78,,,0
unity,Fee schedule,Facility 99393,99393,99393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99393,BCBS multispecialty AW base fee schedule,135.78,225,Fee schedule,,135.78,135.78,135.78,135.78,,,0
unity,Fee schedule,Facility 99394,99394,99394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99394,BCBS multispecialty AW base fee schedule,153.76,250,Fee schedule,,153.76,153.76,153.76,153.76,,,0
unity,Fee schedule,Facility 99395,99395,99395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99395,BCBS multispecialty AW base fee schedule,158.1,250,Fee schedule,,158.1,158.1,158.1,158.1,,,0
unity,Fee schedule,Facility 99396,99396,99396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99396,BCBS multispecialty AW base fee schedule,172.36,270,Fee schedule,,172.36,172.36,172.36,172.36,,,0
unity,Fee schedule,Facility 99397,99397,99397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99397,BCBS multispecialty AW base fee schedule,181.66,290,Fee schedule,,181.66,181.66,181.66,181.66,,,0
unity,Fee schedule,Facility 99401,Not in chargemaster,99401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99401,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99402,Not in chargemaster,99402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99402,BCBS multispecialty AW base fee schedule,89.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99403,Not in chargemaster,99403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99403,BCBS multispecialty AW base fee schedule,132.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99404,Not in chargemaster,99404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99404,BCBS multispecialty AW base fee schedule,176.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99406,9420000,99406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99406,BCBS multispecialty AW base fee schedule,21.7,53.55,Fee schedule,,21.7,21.7,21.7,21.7,,,0
unity,Fee schedule,Facility 99407,9420001,99407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99407,BCBS multispecialty AW base fee schedule,45.88,101.14,Fee schedule,,45.88,45.88,45.88,45.88,,,0
unity,Fee schedule,Facility 99408,Not in chargemaster,99408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99408,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99409,Not in chargemaster,99409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99409,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99411,Not in chargemaster,99411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99411,BCBS multispecialty AW base fee schedule,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99412,Not in chargemaster,99412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99412,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99415,Not in chargemaster,99415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99415,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99416,Not in chargemaster,99416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99416,BCBS multispecialty AW base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99421,Not in chargemaster,99421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99421,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99422,Not in chargemaster,99422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99422,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99423,Not in chargemaster,99423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99423,BCBS multispecialty AW base fee schedule,75.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99441,Not in chargemaster,99441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99441,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99442,Not in chargemaster,99442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99442,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99446,Not in chargemaster,99446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99446,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99447,Not in chargemaster,99447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99447,BCBS multispecialty AW base fee schedule,63.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99448,Not in chargemaster,99448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99448,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99449,Not in chargemaster,99449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99449,BCBS multispecialty AW base fee schedule,127.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99451,Not in chargemaster,99451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99451,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99452,Not in chargemaster,99452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99452,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99453,Not in chargemaster,99453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99453,BCBS multispecialty AW base fee schedule,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99454,Not in chargemaster,99454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99454,BCBS multispecialty AW base fee schedule,107.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99457,Not in chargemaster,99457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99457,BCBS multispecialty AW base fee schedule,56.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99462,Not in chargemaster,99462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99462,BCBS multispecialty AW base fee schedule,73.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99463,Not in chargemaster,99463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99463,BCBS multispecialty AW base fee schedule,193.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99464,Not in chargemaster,99464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99464,BCBS multispecialty AW base fee schedule,130.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99465,Not in chargemaster,99465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99465,BCBS multispecialty AW base fee schedule,256.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99466,Not in chargemaster,99466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99466,BCBS multispecialty AW base fee schedule,417.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99467,Not in chargemaster,99467,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99467,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99468,Not in chargemaster,99468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99468,BCBS multispecialty AW base fee schedule,1610.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99469,Not in chargemaster,99469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99469,BCBS multispecialty AW base fee schedule,697.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99471,Not in chargemaster,99471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99471,BCBS multispecialty AW base fee schedule,1394.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99472,Not in chargemaster,99472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99472,BCBS multispecialty AW base fee schedule,704.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99473,Not in chargemaster,99473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99473,BCBS multispecialty AW base fee schedule,19.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99474,Not in chargemaster,99474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99474,BCBS multispecialty AW base fee schedule,15.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99475,Not in chargemaster,99475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99475,BCBS multispecialty AW base fee schedule,981.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99476,Not in chargemaster,99476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99476,BCBS multispecialty AW base fee schedule,607.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99477,Not in chargemaster,99477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99477,BCBS multispecialty AW base fee schedule,611.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99478,Not in chargemaster,99478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99478,BCBS multispecialty AW base fee schedule,240.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99479,Not in chargemaster,99479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99479,BCBS multispecialty AW base fee schedule,218.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99480,Not in chargemaster,99480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99480,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99483,Not in chargemaster,99483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99483,BCBS multispecialty AW base fee schedule,317.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99443,Not in chargemaster,99443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99443,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99458,Not in chargemaster,99458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99458,BCBS multispecialty AW base fee schedule,56.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99460,Not in chargemaster,99460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99460,BCBS multispecialty AW base fee schedule,167.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99461,Not in chargemaster,99461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99461,BCBS multispecialty AW base fee schedule,110.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99484,Not in chargemaster,99484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99484,BCBS multispecialty AW base fee schedule,56.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99485,Not in chargemaster,99485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99485,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99486,Not in chargemaster,99486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99486,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99487,Not in chargemaster,99487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99487,BCBS multispecialty AW base fee schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99489,Not in chargemaster,99489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99489,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99490,Not in chargemaster,99490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99490,BCBS multispecialty AW base fee schedule,56.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99491,Not in chargemaster,99491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99491,BCBS multispecialty AW base fee schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99492,Not in chargemaster,99492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99492,BCBS multispecialty AW base fee schedule,155,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99493,Not in chargemaster,99493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99493,BCBS multispecialty AW base fee schedule,139.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99494,Not in chargemaster,99494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99494,BCBS multispecialty AW base fee schedule,74.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99495,Not in chargemaster,99495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99495,BCBS multispecialty AW base fee schedule,215.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0071,Not in chargemaster,G0071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0071,BCBS multispecialty AW base fee schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0076,Not in chargemaster,G0076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0076,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0077,Not in chargemaster,G0077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0077,BCBS multispecialty AW base fee schedule,139.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0078,Not in chargemaster,G0078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0078,BCBS multispecialty AW base fee schedule,230.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0079,Not in chargemaster,G0079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0079,BCBS multispecialty AW base fee schedule,322.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0080,Not in chargemaster,G0080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0080,BCBS multispecialty AW base fee schedule,391.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0081,Not in chargemaster,G0081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0081,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0082,Not in chargemaster,G0082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0082,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0083,Not in chargemaster,G0083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0083,BCBS multispecialty AW base fee schedule,228.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0084,Not in chargemaster,G0084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0084,BCBS multispecialty AW base fee schedule,316.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0085,Not in chargemaster,G0085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0085,BCBS multispecialty AW base fee schedule,391.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0086,Not in chargemaster,G0086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0086,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0087,Not in chargemaster,G0087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0087,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0101,Not in chargemaster,G0101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0101,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99496,Not in chargemaster,99496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99496,BCBS multispecialty AW base fee schedule,284.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99497,Not in chargemaster,99497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99497,BCBS multispecialty AW base fee schedule,138.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99498,Not in chargemaster,99498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99498,BCBS multispecialty AW base fee schedule,130.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0102,Not in chargemaster,G0102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0102,BCBS multispecialty AW base fee schedule,15.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0106,Not in chargemaster,G0106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0106,BCBS multispecialty AW base fee schedule,369.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0106 mod 26,Not in chargemaster,G0106,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0106 mod 26,BCBS multispecialty AW base fee schedule,93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0106 mod TC,Not in chargemaster,G0106,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0106 mod TC,BCBS multispecialty AW base fee schedule,276.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0108,Not in chargemaster,G0108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0108,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0109,Not in chargemaster,G0109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0109,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0117,Not in chargemaster,G0117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0117,BCBS multispecialty AW base fee schedule,96.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0118,Not in chargemaster,G0118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0118,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0120,Not in chargemaster,G0120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0120,BCBS multispecialty AW base fee schedule,373.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0120 mod 26,Not in chargemaster,G0120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0120 mod 26,BCBS multispecialty AW base fee schedule,96.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0120 mod TC,Not in chargemaster,G0120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0120 mod TC,BCBS multispecialty AW base fee schedule,276.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0121,G0121,G0121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0121,BCBS multispecialty AW base fee schedule,332.32,469.74,Fee schedule,,332.32,332.32,332.32,332.32,,,0
unity,Fee schedule,Facility G0104,G0104,G0104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0104,BCBS multispecialty AW base fee schedule,99.82,137.02,Fee schedule,,99.82,99.82,99.82,99.82,,,0
unity,Fee schedule,Facility G0105,G0105,G0105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0105,BCBS multispecialty AW base fee schedule,331.08,469.74,Fee schedule,,331.08,331.08,331.08,331.08,,,0
unity,Fee schedule,Facility G0122,Not in chargemaster,G0122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0122,BCBS multispecialty AW base fee schedule,543.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0122 mod 26,Not in chargemaster,G0122,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0122 mod 26,BCBS multispecialty AW base fee schedule,88.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0122 mod TC,Not in chargemaster,G0122,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0122 mod TC,BCBS multispecialty AW base fee schedule,455.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0124,Not in chargemaster,G0124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0124,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0127,Not in chargemaster,G0127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0127,BCBS multispecialty AW base fee schedule,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0128,Not in chargemaster,G0128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0128,BCBS multispecialty AW base fee schedule,13.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0130,Not in chargemaster,G0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0130,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0130 mod 26,Not in chargemaster,G0130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0130 mod 26,BCBS multispecialty AW base fee schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0130 mod TC,Not in chargemaster,G0130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0130 mod TC,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0141,Not in chargemaster,G0141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0141,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0166,Not in chargemaster,G0166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0166,BCBS multispecialty AW base fee schedule,179.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0168,G0168,G0168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0168,BCBS multispecialty AW base fee schedule,33.48,200,Fee schedule,,33.48,33.48,33.48,33.48,,,0
unity,Fee schedule,Facility G0179,Not in chargemaster,G0179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0179,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0180,Not in chargemaster,G0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0180,BCBS multispecialty AW base fee schedule,93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0181,Not in chargemaster,G0181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0181,BCBS multispecialty AW base fee schedule,187.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0182,Not in chargemaster,G0182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0182,BCBS multispecialty AW base fee schedule,188.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0237,Not in chargemaster,G0237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0237,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0238,Not in chargemaster,G0238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0238,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0239,Not in chargemaster,G0239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0239,BCBS multispecialty AW base fee schedule,21.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0245,Not in chargemaster,G0245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0245,BCBS multispecialty AW base fee schedule,75.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0246,Not in chargemaster,G0246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0246,BCBS multispecialty AW base fee schedule,36.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0247,Not in chargemaster,G0247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0247,BCBS multispecialty AW base fee schedule,39.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0248,Not in chargemaster,G0248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0248,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0249,Not in chargemaster,G0249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0249,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0250,Not in chargemaster,G0250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0250,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0252,Not in chargemaster,G0252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0252,BCBS multispecialty AW base fee schedule,133.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0252 mod 26,Not in chargemaster,G0252,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0252 mod 26,BCBS multispecialty AW base fee schedule,133.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0276,Not in chargemaster,G0276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0276,BCBS multispecialty AW base fee schedule,667.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0277,Not in chargemaster,G0277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0277,BCBS multispecialty AW base fee schedule,237.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0278,Not in chargemaster,G0278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0278,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0279,Not in chargemaster,G0279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0279,BCBS multispecialty AW base fee schedule,96.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0279 mod 26,Not in chargemaster,G0279,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0279 mod 26,BCBS multispecialty AW base fee schedule,52.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0279 mod TC,Not in chargemaster,G0279,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0279 mod TC,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0281,Not in chargemaster,G0281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0281,BCBS multispecialty AW base fee schedule,24.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0283,Not in chargemaster,G0283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0283,BCBS multispecialty AW base fee schedule,24.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0288,Not in chargemaster,G0288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0288,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0289,Not in chargemaster,G0289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0289,BCBS multispecialty AW base fee schedule,155,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0296,Not in chargemaster,G0296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0296,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0268,Not in chargemaster,G0268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0268,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0270,Not in chargemaster,G0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0270,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0297,Not in chargemaster,G0297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0297,BCBS multispecialty AW base fee schedule,415.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0297 mod 26,Not in chargemaster,G0297,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0297 mod 26,BCBS multispecialty AW base fee schedule,89.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0297 mod TC,Not in chargemaster,G0297,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0297 mod TC,BCBS multispecialty AW base fee schedule,325.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0329,Not in chargemaster,G0329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0329,BCBS multispecialty AW base fee schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0337,Not in chargemaster,G0337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0337,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0341,Not in chargemaster,G0341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0341,BCBS multispecialty AW base fee schedule,643.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0342,Not in chargemaster,G0342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0342,BCBS multispecialty AW base fee schedule,1212.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0343,Not in chargemaster,G0343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0343,BCBS multispecialty AW base fee schedule,2001.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0372,Not in chargemaster,G0372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0372,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0396,Not in chargemaster,G0396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0396,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0271,Not in chargemaster,G0271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0271,BCBS multispecialty AW base fee schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0397,Not in chargemaster,G0397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0397,BCBS multispecialty AW base fee schedule,113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0403,Not in chargemaster,G0403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0403,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0404,Not in chargemaster,G0404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0404,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0405,G0405,G0405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0405,BCBS multispecialty AW base fee schedule,14.88,17.04,Fee schedule,,14.88,14.88,14.88,14.88,,,0
unity,Fee schedule,Facility G0406,Not in chargemaster,G0406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0406,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0407,Not in chargemaster,G0407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0407,BCBS multispecialty AW base fee schedule,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0408,Not in chargemaster,G0408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0408,BCBS multispecialty AW base fee schedule,181.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0409,Not in chargemaster,G0409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0409,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0412,Not in chargemaster,G0412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0412,BCBS multispecialty AW base fee schedule,1302.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0413,Not in chargemaster,G0413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0413,BCBS multispecialty AW base fee schedule,1904.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0414,Not in chargemaster,G0414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0414,BCBS multispecialty AW base fee schedule,1798.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0415,Not in chargemaster,G0415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0415,BCBS multispecialty AW base fee schedule,2454.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0416,Not in chargemaster,G0416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0416,BCBS multispecialty AW base fee schedule,597.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0416 mod 26,Not in chargemaster,G0416,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0416 mod 26,BCBS multispecialty AW base fee schedule,318.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0416 mod TC,Not in chargemaster,G0416,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0416 mod TC,BCBS multispecialty AW base fee schedule,279,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0420,Not in chargemaster,G0420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0420,BCBS multispecialty AW base fee schedule,196.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0421,Not in chargemaster,G0421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0421,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0422,Not in chargemaster,G0422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0422,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0423,Not in chargemaster,G0423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0423,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0424,Not in chargemaster,G0424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0424,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0425,Not in chargemaster,G0425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0425,BCBS multispecialty AW base fee schedule,174.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0426,Not in chargemaster,G0426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0426,BCBS multispecialty AW base fee schedule,237.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0427,Not in chargemaster,G0427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0427,BCBS multispecialty AW base fee schedule,352.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0429,Not in chargemaster,G0429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0429,BCBS multispecialty AW base fee schedule,122.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0438,G0438,G0438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0438,BCBS multispecialty AW base fee schedule,296.98,211.64,Fee schedule,,211.64,211.64,211.64,211.64,,,0
unity,Fee schedule,Facility G0439,G0439,G0439,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0439,BCBS multispecialty AW base fee schedule,201.5,143,Fee schedule,,143,143,143,143,,,0
unity,Fee schedule,Facility G0442,Not in chargemaster,G0442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0442,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0402,Not in chargemaster,G0402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0402,BCBS multispecialty AW base fee schedule,221.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0443,Not in chargemaster,G0443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0443,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0444,Not in chargemaster,G0444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0444,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0445,Not in chargemaster,G0445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0445,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0446,Not in chargemaster,G0446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0446,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0447,Not in chargemaster,G0447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0447,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0451,Not in chargemaster,G0451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0451,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0452,Not in chargemaster,G0452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0452,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0452 mod 26,Not in chargemaster,G0452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0452 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0453,Not in chargemaster,G0453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0453,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0454,Not in chargemaster,G0454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0454,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0455,Not in chargemaster,G0455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0455,BCBS multispecialty AW base fee schedule,128.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0459,Not in chargemaster,G0459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0459,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0460,Not in chargemaster,G0460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0460,BCBS multispecialty AW base fee schedule,223.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0473,Not in chargemaster,G0473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0473,BCBS multispecialty AW base fee schedule,20.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0508,Not in chargemaster,G0508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0508,BCBS multispecialty AW base fee schedule,368.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0509,Not in chargemaster,G0509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0509,BCBS multispecialty AW base fee schedule,339.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0511,G0511,G0511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0511,BCBS multispecialty AW base fee schedule,114.7,135,Fee schedule,,114.7,114.7,114.7,114.7,,,0
unity,Fee schedule,Facility G0512,Not in chargemaster,G0512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0512,BCBS multispecialty AW base fee schedule,243.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0513,Not in chargemaster,G0513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0513,BCBS multispecialty AW base fee schedule,107.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0500,Not in chargemaster,G0500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0500,BCBS multispecialty AW base fee schedule,9.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0506,Not in chargemaster,G0506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0506,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0514,Not in chargemaster,G0514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0514,BCBS multispecialty AW base fee schedule,107.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0516,Not in chargemaster,G0516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0516,BCBS multispecialty AW base fee schedule,199.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0517,Not in chargemaster,G0517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0517,BCBS multispecialty AW base fee schedule,203.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2001,Not in chargemaster,G2001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2001,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2002,Not in chargemaster,G2002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2002,BCBS multispecialty AW base fee schedule,139.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2003,Not in chargemaster,G2003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2003,BCBS multispecialty AW base fee schedule,230.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2004,Not in chargemaster,G2004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2004,BCBS multispecialty AW base fee schedule,322.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2005,Not in chargemaster,G2005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2005,BCBS multispecialty AW base fee schedule,391.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2006,Not in chargemaster,G2006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2006,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2007,Not in chargemaster,G2007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2007,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2008,Not in chargemaster,G2008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2008,BCBS multispecialty AW base fee schedule,228.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2009,Not in chargemaster,G2009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2009,BCBS multispecialty AW base fee schedule,316.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2010,Not in chargemaster,G2010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2010,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6001,Not in chargemaster,G6001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6001,BCBS multispecialty AW base fee schedule,205.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6001 mod 26,Not in chargemaster,G6001,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6001 mod 26,BCBS multispecialty AW base fee schedule,56.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6001 mod TC,Not in chargemaster,G6001,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6001 mod TC,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6002,Not in chargemaster,G6002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6002,BCBS multispecialty AW base fee schedule,140.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6002 mod 26,Not in chargemaster,G6002,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6002 mod 26,BCBS multispecialty AW base fee schedule,38.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6002 mod TC,Not in chargemaster,G6002,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6002 mod TC,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6003,Not in chargemaster,G6003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6003,BCBS multispecialty AW base fee schedule,348.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6004,Not in chargemaster,G6004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6004,BCBS multispecialty AW base fee schedule,263.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6005,Not in chargemaster,G6005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6005,BCBS multispecialty AW base fee schedule,263.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6006,Not in chargemaster,G6006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6006,BCBS multispecialty AW base fee schedule,246.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6007,Not in chargemaster,G6007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6007,BCBS multispecialty AW base fee schedule,463.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6008,Not in chargemaster,G6008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6008,BCBS multispecialty AW base fee schedule,340.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6009,Not in chargemaster,G6009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6009,BCBS multispecialty AW base fee schedule,337.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6010,Not in chargemaster,G6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6010,BCBS multispecialty AW base fee schedule,337.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6011,Not in chargemaster,G6011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6011,BCBS multispecialty AW base fee schedule,488.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6012,Not in chargemaster,G6012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6012,BCBS multispecialty AW base fee schedule,451.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6013,Not in chargemaster,G6013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6013,BCBS multispecialty AW base fee schedule,451.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6014,Not in chargemaster,G6014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6014,BCBS multispecialty AW base fee schedule,482.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6015,Not in chargemaster,G6015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6015,BCBS multispecialty AW base fee schedule,635.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G6016,Not in chargemaster,G6016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6016,BCBS multispecialty AW base fee schedule,633.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9157,Not in chargemaster,G9157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9157,BCBS multispecialty AW base fee schedule,171.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9187,Not in chargemaster,G9187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9187,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9481,Not in chargemaster,G9481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9481,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9482,Not in chargemaster,G9482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9482,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9483,Not in chargemaster,G9483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9483,BCBS multispecialty AW base fee schedule,96.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9484,Not in chargemaster,G9484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9484,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9485,Not in chargemaster,G9485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9485,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9486,Not in chargemaster,G9486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9486,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9487,Not in chargemaster,G9487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9487,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9488,Not in chargemaster,G9488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9488,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9489,Not in chargemaster,G9489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9489,BCBS multispecialty AW base fee schedule,140.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9490,Not in chargemaster,G9490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9490,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9685,Not in chargemaster,G9685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9685,BCBS multispecialty AW base fee schedule,354.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9868,Not in chargemaster,G9868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9868,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9869,Not in chargemaster,G9869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9869,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9870,Not in chargemaster,G9870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9870,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9978,Not in chargemaster,G9978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9978,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9979,Not in chargemaster,G9979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9979,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9980,Not in chargemaster,G9980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9980,BCBS multispecialty AW base fee schedule,132.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9981,Not in chargemaster,G9981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9981,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9982,Not in chargemaster,G9982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9982,BCBS multispecialty AW base fee schedule,296.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9983,Not in chargemaster,G9983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9983,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9984,Not in chargemaster,G9984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9984,BCBS multispecialty AW base fee schedule,89.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9985,Not in chargemaster,G9985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9985,BCBS multispecialty AW base fee schedule,138.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9986,Not in chargemaster,G9986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9986,BCBS multispecialty AW base fee schedule,195.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G9987,Not in chargemaster,G9987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9987,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility P3001,Not in chargemaster,P3001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P3001,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility Q0035,Not in chargemaster,Q0035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0035,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility Q0035 mod 26,Not in chargemaster,Q0035,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0035 mod 26,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility Q0035 mod TC,Not in chargemaster,Q0035,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0035 mod TC,BCBS multispecialty AW base fee schedule,17.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility Q0091,Not in chargemaster,Q0091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0091,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0518,Not in chargemaster,G0518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0518,BCBS multispecialty AW base fee schedule,369.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2011,Not in chargemaster,G2011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2011,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2012,Not in chargemaster,G2012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2012,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2013,Not in chargemaster,G2013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2013,BCBS multispecialty AW base fee schedule,391.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2014,Not in chargemaster,G2014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2014,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2015,Not in chargemaster,G2015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2015,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2058,Not in chargemaster,G2058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2058,BCBS multispecialty AW base fee schedule,48.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2061,Not in chargemaster,G2061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2061,BCBS multispecialty AW base fee schedule,21.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2062,Not in chargemaster,G2062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2062,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2063,Not in chargemaster,G2063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2063,BCBS multispecialty AW base fee schedule,57.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2064,Not in chargemaster,G2064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2064,BCBS multispecialty AW base fee schedule,135.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2065,Not in chargemaster,G2065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2065,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2082,Not in chargemaster,G2082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2082,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2083,Not in chargemaster,G2083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2083,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2086,Not in chargemaster,G2086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2086,BCBS multispecialty AW base fee schedule,517.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2087,Not in chargemaster,G2087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2087,BCBS multispecialty AW base fee schedule,504.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2088,Not in chargemaster,G2088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2088,BCBS multispecialty AW base fee schedule,60.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility Q0092,Not in chargemaster,Q0092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0092,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0509T mod 26,Not in chargemaster,0509T,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0509T mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0509T mod TC,Not in chargemaster,0509T,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0509T mod TC,BCBS multispecialty AW base fee schedule,96.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0509T,Not in chargemaster,0509T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0509T,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10004,Not in chargemaster,10004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10004,BCBS multispecialty AW base fee schedule,98.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10005,Not in chargemaster,10005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10005,BCBS multispecialty AW base fee schedule,243.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10006,Not in chargemaster,10006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10006,BCBS multispecialty AW base fee schedule,112.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10007,Not in chargemaster,10007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10007,BCBS multispecialty AW base fee schedule,558.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10008,Not in chargemaster,10008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10008,BCBS multispecialty AW base fee schedule,317.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10009,Not in chargemaster,10009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10009,BCBS multispecialty AW base fee schedule,882.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10010,Not in chargemaster,10010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10010,BCBS multispecialty AW base fee schedule,531.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10021,Not in chargemaster,10021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10021,BCBS multispecialty AW base fee schedule,185.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10030,Not in chargemaster,10030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10030,BCBS multispecialty AW base fee schedule,1161.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10035,Not in chargemaster,10035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10035,BCBS multispecialty AW base fee schedule,850.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10036,Not in chargemaster,10036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10036,BCBS multispecialty AW base fee schedule,723.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10040,Not in chargemaster,10040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10040,BCBS multispecialty AW base fee schedule,206.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10060,10060,10060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10060,BCBS multispecialty AW base fee schedule,227.9,255,Fee schedule,,227.9,227.9,227.9,227.9,,,0
unity,Fee schedule,Non-facility 10061,10061,10061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10061,BCBS multispecialty AW base fee schedule,395.51,445,Fee schedule,,395.51,395.51,395.51,395.51,,,0
unity,Fee schedule,Non-facility 10080,Not in chargemaster,10080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10080,BCBS multispecialty AW base fee schedule,396.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10081,Not in chargemaster,10081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10081,BCBS multispecialty AW base fee schedule,574.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10120,10120,10120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10120,BCBS multispecialty AW base fee schedule,285.54,325.83,Fee schedule,,285.54,285.54,285.54,285.54,,,0
unity,Fee schedule,Non-facility 10121,10121,10121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10121,BCBS multispecialty AW base fee schedule,514.1,588.48,Fee schedule,,514.1,514.1,514.1,514.1,,,0
unity,Fee schedule,Non-facility 10140,10140,10140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10140,BCBS multispecialty AW base fee schedule,321.31,347.12,Fee schedule,,321.31,321.31,321.31,321.31,,,0
unity,Fee schedule,Non-facility 10160,10160,10160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10160,BCBS multispecialty AW base fee schedule,245.79,277.56,Fee schedule,,245.79,245.79,245.79,245.79,,,0
unity,Fee schedule,Non-facility 10180,10180,10180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10180,BCBS multispecialty AW base fee schedule,483.63,405.82,Fee schedule,,405.82,405.82,405.82,405.82,,,0
unity,Fee schedule,Non-facility 11000,11000,11000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11000,BCBS multispecialty AW base fee schedule,106.66,115.01,Fee schedule,,106.66,106.66,106.66,106.66,,,0
unity,Fee schedule,Non-facility 11001,Not in chargemaster,11001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11001,BCBS multispecialty AW base fee schedule,44.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11004,Not in chargemaster,11004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11004,BCBS multispecialty AW base fee schedule,1105.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11005,Not in chargemaster,11005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11005,BCBS multispecialty AW base fee schedule,1505.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11006,Not in chargemaster,11006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11006,BCBS multispecialty AW base fee schedule,1357.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11008,Not in chargemaster,11008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11008,BCBS multispecialty AW base fee schedule,529.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11010,Not in chargemaster,11010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11010,BCBS multispecialty AW base fee schedule,898.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11011,Not in chargemaster,11011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11011,BCBS multispecialty AW base fee schedule,1000.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11012,Not in chargemaster,11012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11012,BCBS multispecialty AW base fee schedule,1281.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11042,11042,11042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11042,BCBS multispecialty AW base fee schedule,236.51,265,Fee schedule,,236.51,236.51,236.51,236.51,,,0
unity,Fee schedule,Non-facility 11043,Not in chargemaster,11043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11043,BCBS multispecialty AW base fee schedule,439.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11044,Not in chargemaster,11044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11044,BCBS multispecialty AW base fee schedule,593.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11045,Not in chargemaster,11045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11045,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11046,Not in chargemaster,11046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11046,BCBS multispecialty AW base fee schedule,140.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11047,Not in chargemaster,11047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11047,BCBS multispecialty AW base fee schedule,233.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11055,11055,11055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11055,BCBS multispecialty AW base fee schedule,117.93,120,Fee schedule,,117.93,117.93,117.93,117.93,,,0
unity,Fee schedule,Non-facility 11056,Not in chargemaster,11056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11056,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11057,Not in chargemaster,11057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11057,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11102,11102,11102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11102,BCBS multispecialty AW base fee schedule,188.15,210,Fee schedule,,188.15,188.15,188.15,188.15,,,0
unity,Fee schedule,Non-facility 11103,Not in chargemaster,11103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11103,BCBS multispecialty AW base fee schedule,100.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11104,11104,11104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11104,BCBS multispecialty AW base fee schedule,236.51,275,Fee schedule,,236.51,236.51,236.51,236.51,,,0
unity,Fee schedule,Non-facility 11105,11105,11105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11105,BCBS multispecialty AW base fee schedule,113.95,137.5,Fee schedule,,113.95,113.95,113.95,113.95,,,0
unity,Fee schedule,Non-facility 11106,Not in chargemaster,11106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11106,BCBS multispecialty AW base fee schedule,286.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11107,Not in chargemaster,11107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11107,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11200,11200,11200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11200,BCBS multispecialty AW base fee schedule,166.95,186.7,Fee schedule,,166.95,166.95,166.95,166.95,,,0
unity,Fee schedule,Non-facility 11201,11201,11201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11201,BCBS multispecialty AW base fee schedule,35.11,45,Fee schedule,,35.11,35.11,35.11,35.11,,,0
unity,Fee schedule,Non-facility 11300,11300,11300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11300,BCBS multispecialty AW base fee schedule,188.15,209.42,Fee schedule,,188.15,188.15,188.15,188.15,,,0
unity,Fee schedule,Non-facility 11301,11301,11301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11301,BCBS multispecialty AW base fee schedule,228.56,256.97,Fee schedule,,228.56,228.56,228.56,228.56,,,0
unity,Fee schedule,Non-facility 11302,11302,11302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11302,BCBS multispecialty AW base fee schedule,264.34,302.41,Fee schedule,,264.34,264.34,264.34,264.34,,,0
unity,Fee schedule,Non-facility 11303,11303,11303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11303,BCBS multispecialty AW base fee schedule,290.84,333.64,Fee schedule,,290.84,290.84,290.84,290.84,,,0
unity,Fee schedule,Non-facility 11305,11305,11305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11305,BCBS multispecialty AW base fee schedule,198.09,220,Fee schedule,,198.09,198.09,198.09,198.09,,,0
unity,Fee schedule,Non-facility 11306,11306,11306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11306,BCBS multispecialty AW base fee schedule,231.88,259.11,Fee schedule,,231.88,231.88,231.88,231.88,,,0
unity,Fee schedule,Non-facility 11307,11307,11307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11307,BCBS multispecialty AW base fee schedule,270.96,307.38,Fee schedule,,270.96,270.96,270.96,270.96,,,0
unity,Fee schedule,Non-facility 11308,Not in chargemaster,11308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11308,BCBS multispecialty AW base fee schedule,289.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11310,11310,11310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11310,BCBS multispecialty AW base fee schedule,217.96,243.5,Fee schedule,,217.96,217.96,217.96,217.96,,,0
unity,Fee schedule,Non-facility 11311,11311,11311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11311,BCBS multispecialty AW base fee schedule,258.38,290,Fee schedule,,258.38,258.38,258.38,258.38,,,0
unity,Fee schedule,Non-facility 11312,11312,11312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11312,BCBS multispecialty AW base fee schedule,298.79,345,Fee schedule,,298.79,298.79,298.79,298.79,,,0
unity,Fee schedule,Non-facility 11313,11313,11313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11313,BCBS multispecialty AW base fee schedule,349.14,400,Fee schedule,,349.14,349.14,349.14,349.14,,,0
unity,Fee schedule,Non-facility 11400,11400,11400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11400,BCBS multispecialty AW base fee schedule,236.51,264.09,Fee schedule,,236.51,236.51,236.51,236.51,,,0
unity,Fee schedule,Non-facility 11401,11401,11401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11401,BCBS multispecialty AW base fee schedule,288.19,318.74,Fee schedule,,288.19,288.19,288.19,288.19,,,0
unity,Fee schedule,Non-facility 11402,11402,11402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11402,BCBS multispecialty AW base fee schedule,319.99,365,Fee schedule,,319.99,319.99,319.99,319.99,,,0
unity,Fee schedule,Non-facility 11403,11403,11403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11403,BCBS multispecialty AW base fee schedule,369.68,420,Fee schedule,,369.68,369.68,369.68,369.68,,,0
unity,Fee schedule,Non-facility 11404,11404,11404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11404,BCBS multispecialty AW base fee schedule,420.03,462.84,Fee schedule,,420.03,420.03,420.03,420.03,,,0
unity,Fee schedule,Non-facility 11406,11406,11406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11406,BCBS multispecialty AW base fee schedule,600.89,685,Fee schedule,,600.89,600.89,600.89,600.89,,,0
unity,Fee schedule,Non-facility 11420,11420,11420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11420,BCBS multispecialty AW base fee schedule,238.5,265,Fee schedule,,238.5,238.5,238.5,238.5,,,0
unity,Fee schedule,Non-facility 11421,11421,11421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11421,BCBS multispecialty AW base fee schedule,300.78,336.48,Fee schedule,,300.78,300.78,300.78,300.78,,,0
unity,Fee schedule,Non-facility 11422,11422,11422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11422,BCBS multispecialty AW base fee schedule,338.54,380,Fee schedule,,338.54,338.54,338.54,338.54,,,0
unity,Fee schedule,Non-facility 11423,11423,11423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11423,BCBS multispecialty AW base fee schedule,384.91,430.89,Fee schedule,,384.91,384.91,384.91,384.91,,,0
unity,Fee schedule,Non-facility 11424,11424,11424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11424,BCBS multispecialty AW base fee schedule,444.54,494.78,Fee schedule,,444.54,444.54,444.54,444.54,,,0
unity,Fee schedule,Non-facility 11426,11426,11426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11426,BCBS multispecialty AW base fee schedule,637.99,725,Fee schedule,,637.99,637.99,637.99,637.99,,,0
unity,Fee schedule,Non-facility 11440,11440,11440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11440,BCBS multispecialty AW base fee schedule,263.01,297,Fee schedule,,263.01,263.01,263.01,263.01,,,0
unity,Fee schedule,Non-facility 11441,11441,11441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11441,BCBS multispecialty AW base fee schedule,323.3,367,Fee schedule,,323.3,323.3,323.3,323.3,,,0
unity,Fee schedule,Non-facility 11442,11442,11442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11442,BCBS multispecialty AW base fee schedule,359.74,410,Fee schedule,,359.74,359.74,359.74,359.74,,,0
unity,Fee schedule,Non-facility 11443,11443,11443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11443,BCBS multispecialty AW base fee schedule,427.31,476.32,Fee schedule,,427.31,427.31,427.31,427.31,,,0
unity,Fee schedule,Non-facility 11444,11444,11444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11444,BCBS multispecialty AW base fee schedule,535.96,594.87,Fee schedule,,535.96,535.96,535.96,535.96,,,0
unity,Fee schedule,Non-facility 11446,Not in chargemaster,11446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11446,BCBS multispecialty AW base fee schedule,738.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11450,Not in chargemaster,11450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11450,BCBS multispecialty AW base fee schedule,773.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11451,Not in chargemaster,11451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11451,BCBS multispecialty AW base fee schedule,963.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11462,Not in chargemaster,11462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11462,BCBS multispecialty AW base fee schedule,752.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11463,Not in chargemaster,11463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11463,BCBS multispecialty AW base fee schedule,979.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11470,Not in chargemaster,11470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11470,BCBS multispecialty AW base fee schedule,820.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11471,Not in chargemaster,11471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11471,BCBS multispecialty AW base fee schedule,999.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11600,11600,11600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11600,BCBS multispecialty AW base fee schedule,371.66,420,Fee schedule,,371.66,371.66,371.66,371.66,,,0
unity,Fee schedule,Non-facility 11601,11601,11601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11601,BCBS multispecialty AW base fee schedule,431.95,495,Fee schedule,,431.95,431.95,431.95,431.95,,,0
unity,Fee schedule,Non-facility 11602,11602,11602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11602,BCBS multispecialty AW base fee schedule,465.08,535,Fee schedule,,465.08,465.08,465.08,465.08,,,0
unity,Fee schedule,Non-facility 11603,11603,11603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11603,BCBS multispecialty AW base fee schedule,530,601.26,Fee schedule,,530,530,530,530,,,0
unity,Fee schedule,Non-facility 11604,11604,11604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11604,BCBS multispecialty AW base fee schedule,591.61,670.12,Fee schedule,,591.61,591.61,591.61,591.61,,,0
unity,Fee schedule,Non-facility 11606,11606,11606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11606,BCBS multispecialty AW base fee schedule,848.66,975,Fee schedule,,848.66,848.66,848.66,848.66,,,0
unity,Fee schedule,Non-facility 11620,Not in chargemaster,11620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11620,BCBS multispecialty AW base fee schedule,373.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11621,11621,11621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11621,BCBS multispecialty AW base fee schedule,433.94,490.52,Fee schedule,,433.94,433.94,433.94,433.94,,,0
unity,Fee schedule,Non-facility 11622,11622,11622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11622,BCBS multispecialty AW base fee schedule,480.31,547.31,Fee schedule,,480.31,480.31,480.31,480.31,,,0
unity,Fee schedule,Non-facility 11623,11623,11623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11623,BCBS multispecialty AW base fee schedule,564.45,639.6,Fee schedule,,564.45,564.45,564.45,564.45,,,0
unity,Fee schedule,Non-facility 11624,11624,11624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11624,BCBS multispecialty AW base fee schedule,639.31,719.09,Fee schedule,,639.31,639.31,639.31,639.31,,,0
unity,Fee schedule,Non-facility 11626,11626,11626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11626,BCBS multispecialty AW base fee schedule,772.48,866.04,Fee schedule,,772.48,772.48,772.48,772.48,,,0
unity,Fee schedule,Non-facility 11640,11640,11640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11640,BCBS multispecialty AW base fee schedule,382.26,430.18,Fee schedule,,382.26,382.26,382.26,382.26,,,0
unity,Fee schedule,Non-facility 11641,11641,11641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11641,BCBS multispecialty AW base fee schedule,449.18,508.28,Fee schedule,,449.18,449.18,449.18,449.18,,,0
unity,Fee schedule,Non-facility 11642,11642,11642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11642,BCBS multispecialty AW base fee schedule,509.46,577.84,Fee schedule,,509.46,509.46,509.46,509.46,,,0
unity,Fee schedule,Non-facility 11643,11643,11643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11643,BCBS multispecialty AW base fee schedule,600.23,680.05,Fee schedule,,600.23,600.23,600.23,600.23,,,0
unity,Fee schedule,Non-facility 11644,11644,11644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11644,BCBS multispecialty AW base fee schedule,740.68,837.64,Fee schedule,,740.68,740.68,740.68,740.68,,,0
unity,Fee schedule,Non-facility 11646,11646,11646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11646,BCBS multispecialty AW base fee schedule,965.26,1088.23,Fee schedule,,965.26,965.26,965.26,965.26,,,0
unity,Fee schedule,Non-facility 11719,Not in chargemaster,11719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11719,BCBS multispecialty AW base fee schedule,26.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11720,Not in chargemaster,11720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11720,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11721,Not in chargemaster,11721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11721,BCBS multispecialty AW base fee schedule,85.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11730,11730,11730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11730,BCBS multispecialty AW base fee schedule,208.03,235,Fee schedule,,208.03,208.03,208.03,208.03,,,0
unity,Fee schedule,Non-facility 11732,Not in chargemaster,11732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11732,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11740,11740,11740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11740,BCBS multispecialty AW base fee schedule,100.7,115,Fee schedule,,100.7,100.7,100.7,100.7,,,0
unity,Fee schedule,Non-facility 11750,11750,11750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11750,BCBS multispecialty AW base fee schedule,294.81,472.07,Fee schedule,,294.81,294.81,294.81,294.81,,,0
unity,Fee schedule,Non-facility 11755,Not in chargemaster,11755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11755,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11760,11760,11760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11760,BCBS multispecialty AW base fee schedule,367.69,501.88,Fee schedule,,367.69,367.69,367.69,367.69,,,0
unity,Fee schedule,Non-facility 11762,Not in chargemaster,11762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11762,BCBS multispecialty AW base fee schedule,559.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11765,11765,11765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11765,BCBS multispecialty AW base fee schedule,318,380,Fee schedule,,318,318,318,318,,,0
unity,Fee schedule,Non-facility 11770,11770,11770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11770,BCBS multispecialty AW base fee schedule,590.95,615,Fee schedule,,590.95,590.95,590.95,590.95,,,0
unity,Fee schedule,Non-facility 11771,11771,11771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11771,BCBS multispecialty AW base fee schedule,1145.46,1216,Fee schedule,,1145.46,1145.46,1145.46,1145.46,,,0
unity,Fee schedule,Non-facility 11772,Not in chargemaster,11772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11772,BCBS multispecialty AW base fee schedule,1387.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11900,11900,11900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11900,BCBS multispecialty AW base fee schedule,103.35,117.83,Fee schedule,,103.35,103.35,103.35,103.35,,,0
unity,Fee schedule,Non-facility 11901,Not in chargemaster,11901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11901,BCBS multispecialty AW base fee schedule,130.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11920,Not in chargemaster,11920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11920,BCBS multispecialty AW base fee schedule,353.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11921,Not in chargemaster,11921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11921,BCBS multispecialty AW base fee schedule,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11922,Not in chargemaster,11922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11922,BCBS multispecialty AW base fee schedule,113.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11950,Not in chargemaster,11950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11950,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11951,Not in chargemaster,11951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11951,BCBS multispecialty AW base fee schedule,203.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11952,Not in chargemaster,11952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11952,BCBS multispecialty AW base fee schedule,273.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11954,Not in chargemaster,11954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11954,BCBS multispecialty AW base fee schedule,300.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11960,Not in chargemaster,11960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11960,BCBS multispecialty AW base fee schedule,1862.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11970,Not in chargemaster,11970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11970,BCBS multispecialty AW base fee schedule,1167.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11971,Not in chargemaster,11971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11971,BCBS multispecialty AW base fee schedule,912.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11976,11976,11976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11976,BCBS multispecialty AW base fee schedule,274.94,306.67,Fee schedule,,274.94,274.94,274.94,274.94,,,0
unity,Fee schedule,Non-facility 11980,Not in chargemaster,11980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11980,BCBS multispecialty AW base fee schedule,178.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11981,11981,11981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11981,BCBS multispecialty AW base fee schedule,196.1,308,Fee schedule,,196.1,196.1,196.1,196.1,,,0
unity,Fee schedule,Non-facility 11982,Not in chargemaster,11982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11982,BCBS multispecialty AW base fee schedule,222.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11983,11983,11983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,11983,BCBS multispecialty AW base fee schedule,274.94,522.5,Fee schedule,,274.94,274.94,274.94,274.94,,,0
unity,Fee schedule,Non-facility 12001,12001,12001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12001,BCBS multispecialty AW base fee schedule,170.93,193.09,Fee schedule,,170.93,170.93,170.93,170.93,,,0
unity,Fee schedule,Non-facility 12002,12002,12002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12002,BCBS multispecialty AW base fee schedule,209.35,233.55,Fee schedule,,209.35,209.35,209.35,209.35,,,0
unity,Fee schedule,Non-facility 12004,12004,12004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12004,BCBS multispecialty AW base fee schedule,244.46,274.01,Fee schedule,,244.46,244.46,244.46,244.46,,,0
unity,Fee schedule,Non-facility 12005,12005,12005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12005,BCBS multispecialty AW base fee schedule,323.3,354.23,Fee schedule,,323.3,323.3,323.3,323.3,,,0
unity,Fee schedule,Non-facility 12006,Not in chargemaster,12006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12006,BCBS multispecialty AW base fee schedule,381.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12007,Not in chargemaster,12007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12007,BCBS multispecialty AW base fee schedule,435.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12011,12011,12011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12011,BCBS multispecialty AW base fee schedule,208.69,235.69,Fee schedule,,208.69,208.69,208.69,208.69,,,0
unity,Fee schedule,Non-facility 12013,12013,12013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12013,BCBS multispecialty AW base fee schedule,217.96,257.69,Fee schedule,,217.96,217.96,217.96,217.96,,,0
unity,Fee schedule,Non-facility 12014,12014,12014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12014,BCBS multispecialty AW base fee schedule,265,300.99,Fee schedule,,265,265,265,265,,,0
unity,Fee schedule,Non-facility 12015,12015,12015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12015,BCBS multispecialty AW base fee schedule,320.65,367,Fee schedule,,320.65,320.65,320.65,320.65,,,0
unity,Fee schedule,Non-facility 12016,Not in chargemaster,12016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12016,BCBS multispecialty AW base fee schedule,408.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12017,Not in chargemaster,12017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12017,BCBS multispecialty AW base fee schedule,296.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12018,Not in chargemaster,12018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12018,BCBS multispecialty AW base fee schedule,336.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12020,12020,12020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12020,BCBS multispecialty AW base fee schedule,557.16,601.26,Fee schedule,,557.16,557.16,557.16,557.16,,,0
unity,Fee schedule,Non-facility 12021,Not in chargemaster,12021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12021,BCBS multispecialty AW base fee schedule,324.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12031,12031,12031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12031,BCBS multispecialty AW base fee schedule,475.01,508.98,Fee schedule,,475.01,475.01,475.01,475.01,,,0
unity,Fee schedule,Non-facility 12032,12032,12032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12032,BCBS multispecialty AW base fee schedule,569.09,650.24,Fee schedule,,569.09,569.09,569.09,569.09,,,0
unity,Fee schedule,Non-facility 12034,12034,12034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12034,BCBS multispecialty AW base fee schedule,612.15,690,Fee schedule,,612.15,612.15,612.15,612.15,,,0
unity,Fee schedule,Non-facility 12035,12035,12035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12035,BCBS multispecialty AW base fee schedule,730.74,829.83,Fee schedule,,730.74,730.74,730.74,730.74,,,0
unity,Fee schedule,Non-facility 12036,Not in chargemaster,12036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12036,BCBS multispecialty AW base fee schedule,817.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12037,Not in chargemaster,12037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12037,BCBS multispecialty AW base fee schedule,928.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12041,12041,12041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12041,BCBS multispecialty AW base fee schedule,476.34,530,Fee schedule,,476.34,476.34,476.34,476.34,,,0
unity,Fee schedule,Non-facility 12042,12042,12042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12042,BCBS multispecialty AW base fee schedule,565.78,640,Fee schedule,,565.78,565.78,565.78,565.78,,,0
unity,Fee schedule,Non-facility 12044,12044,12044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12044,BCBS multispecialty AW base fee schedule,702.25,790,Fee schedule,,702.25,702.25,702.25,702.25,,,0
unity,Fee schedule,Non-facility 12045,Not in chargemaster,12045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12045,BCBS multispecialty AW base fee schedule,770.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12046,Not in chargemaster,12046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12046,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12047,Not in chargemaster,12047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12047,BCBS multispecialty AW base fee schedule,1022.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12051,12051,12051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12051,BCBS multispecialty AW base fee schedule,512.11,570,Fee schedule,,512.11,512.11,512.11,512.11,,,0
unity,Fee schedule,Non-facility 12052,12052,12052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12052,BCBS multispecialty AW base fee schedule,574.39,626.81,Fee schedule,,574.39,574.39,574.39,574.39,,,0
unity,Fee schedule,Non-facility 12053,12053,12053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12053,BCBS multispecialty AW base fee schedule,673.1,740.4,Fee schedule,,673.1,673.1,673.1,673.1,,,0
unity,Fee schedule,Non-facility 12054,12054,12054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12054,BCBS multispecialty AW base fee schedule,710.2,789.38,Fee schedule,,710.2,710.2,710.2,710.2,,,0
unity,Fee schedule,Non-facility 12055,Not in chargemaster,12055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12055,BCBS multispecialty AW base fee schedule,922.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12056,Not in chargemaster,12056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12056,BCBS multispecialty AW base fee schedule,1082.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12057,Not in chargemaster,12057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,12057,BCBS multispecialty AW base fee schedule,1150.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13100,Not in chargemaster,13100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13100,BCBS multispecialty AW base fee schedule,643.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13101,Not in chargemaster,13101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13101,BCBS multispecialty AW base fee schedule,755.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13102,Not in chargemaster,13102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13102,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13120,Not in chargemaster,13120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13120,BCBS multispecialty AW base fee schedule,671.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13121,Not in chargemaster,13121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13121,BCBS multispecialty AW base fee schedule,810.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13122,13122,13122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13122,BCBS multispecialty AW base fee schedule,247.78,284.66,Fee schedule,,247.78,247.78,247.78,247.78,,,0
unity,Fee schedule,Non-facility 13131,13131,13131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13131,BCBS multispecialty AW base fee schedule,736.04,819.9,Fee schedule,,736.04,736.04,736.04,736.04,,,0
unity,Fee schedule,Non-facility 13132,13132,13132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13132,BCBS multispecialty AW base fee schedule,900.34,1040,Fee schedule,,900.34,900.34,900.34,900.34,,,0
unity,Fee schedule,Non-facility 13133,Not in chargemaster,13133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13133,BCBS multispecialty AW base fee schedule,329.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13151,Not in chargemaster,13151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13151,BCBS multispecialty AW base fee schedule,803.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13152,Not in chargemaster,13152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13152,BCBS multispecialty AW base fee schedule,951.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13153,Not in chargemaster,13153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13153,BCBS multispecialty AW base fee schedule,361.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13160,13160,13160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,13160,BCBS multispecialty AW base fee schedule,1523.09,1707.23,Fee schedule,,1523.09,1523.09,1523.09,1523.09,,,0
unity,Fee schedule,Non-facility 14000,Not in chargemaster,14000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14000,BCBS multispecialty AW base fee schedule,1185.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14001,Not in chargemaster,14001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14001,BCBS multispecialty AW base fee schedule,1513.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14020,Not in chargemaster,14020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14020,BCBS multispecialty AW base fee schedule,1311.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14021,Not in chargemaster,14021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14021,BCBS multispecialty AW base fee schedule,1631.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14040,Not in chargemaster,14040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14040,BCBS multispecialty AW base fee schedule,1428.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14041,Not in chargemaster,14041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14041,BCBS multispecialty AW base fee schedule,1747.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14060,Not in chargemaster,14060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14060,BCBS multispecialty AW base fee schedule,1450.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14061,Not in chargemaster,14061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14061,BCBS multispecialty AW base fee schedule,1878.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14301,Not in chargemaster,14301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14301,BCBS multispecialty AW base fee schedule,2044.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14302,Not in chargemaster,14302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14302,BCBS multispecialty AW base fee schedule,418.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14350,Not in chargemaster,14350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,14350,BCBS multispecialty AW base fee schedule,1307.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15002,Not in chargemaster,15002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15002,BCBS multispecialty AW base fee schedule,665.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15003,Not in chargemaster,15003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15003,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15004,Not in chargemaster,15004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15004,BCBS multispecialty AW base fee schedule,757.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15005,Not in chargemaster,15005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15005,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15040,Not in chargemaster,15040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15040,BCBS multispecialty AW base fee schedule,494.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15050,Not in chargemaster,15050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15050,BCBS multispecialty AW base fee schedule,1111.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15100,Not in chargemaster,15100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15100,BCBS multispecialty AW base fee schedule,1645.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15101,Not in chargemaster,15101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15101,BCBS multispecialty AW base fee schedule,357.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15110,Not in chargemaster,15110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15110,BCBS multispecialty AW base fee schedule,1532.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15111,Not in chargemaster,15111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15111,BCBS multispecialty AW base fee schedule,220.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15115,Not in chargemaster,15115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15115,BCBS multispecialty AW base fee schedule,1513.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15116,Not in chargemaster,15116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15116,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15120,Not in chargemaster,15120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15120,BCBS multispecialty AW base fee schedule,1613.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15121,Not in chargemaster,15121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15121,BCBS multispecialty AW base fee schedule,400.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15130,Not in chargemaster,15130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15130,BCBS multispecialty AW base fee schedule,1366.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15131,Not in chargemaster,15131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15131,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15135,Not in chargemaster,15135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15135,BCBS multispecialty AW base fee schedule,1656.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15136,Not in chargemaster,15136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15136,BCBS multispecialty AW base fee schedule,187.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15150,Not in chargemaster,15150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15150,BCBS multispecialty AW base fee schedule,1344.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15151,Not in chargemaster,15151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15151,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15152,Not in chargemaster,15152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15152,BCBS multispecialty AW base fee schedule,296.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15155,Not in chargemaster,15155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15155,BCBS multispecialty AW base fee schedule,1527.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15156,Not in chargemaster,15156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15156,BCBS multispecialty AW base fee schedule,307.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15157,Not in chargemaster,15157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15157,BCBS multispecialty AW base fee schedule,343.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15200,Not in chargemaster,15200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15200,BCBS multispecialty AW base fee schedule,1585.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15201,Not in chargemaster,15201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15201,BCBS multispecialty AW base fee schedule,278.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15220,Not in chargemaster,15220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15220,BCBS multispecialty AW base fee schedule,1456.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15221,Not in chargemaster,15221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15221,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15240,Not in chargemaster,15240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15240,BCBS multispecialty AW base fee schedule,1757.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15241,Not in chargemaster,15241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15241,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15260,Not in chargemaster,15260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15260,BCBS multispecialty AW base fee schedule,1888.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15261,Not in chargemaster,15261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15261,BCBS multispecialty AW base fee schedule,396.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15271,Not in chargemaster,15271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15271,BCBS multispecialty AW base fee schedule,284.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15272,Not in chargemaster,15272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15272,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15273,Not in chargemaster,15273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15273,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15274,Not in chargemaster,15274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15274,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15275,Not in chargemaster,15275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15275,BCBS multispecialty AW base fee schedule,296.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15276,Not in chargemaster,15276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15276,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15277,Not in chargemaster,15277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15277,BCBS multispecialty AW base fee schedule,648.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15278,Not in chargemaster,15278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15278,BCBS multispecialty AW base fee schedule,176.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15570,Not in chargemaster,15570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15570,BCBS multispecialty AW base fee schedule,1737.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15572,Not in chargemaster,15572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15572,BCBS multispecialty AW base fee schedule,1676.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15574,Not in chargemaster,15574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15574,BCBS multispecialty AW base fee schedule,1705.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15576,Not in chargemaster,15576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15576,BCBS multispecialty AW base fee schedule,1507.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15600,Not in chargemaster,15600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15600,BCBS multispecialty AW base fee schedule,627.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15610,Not in chargemaster,15610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15610,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15620,Not in chargemaster,15620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15620,BCBS multispecialty AW base fee schedule,834.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15630,Not in chargemaster,15630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15630,BCBS multispecialty AW base fee schedule,865.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15650,Not in chargemaster,15650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15650,BCBS multispecialty AW base fee schedule,961.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15730,Not in chargemaster,15730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15730,BCBS multispecialty AW base fee schedule,2845.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15731,Not in chargemaster,15731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15731,BCBS multispecialty AW base fee schedule,2125.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15733,Not in chargemaster,15733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15733,BCBS multispecialty AW base fee schedule,1983.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15734,Not in chargemaster,15734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15734,BCBS multispecialty AW base fee schedule,2889.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15736,Not in chargemaster,15736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15736,BCBS multispecialty AW base fee schedule,2338.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15738,Not in chargemaster,15738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15738,BCBS multispecialty AW base fee schedule,2479.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15740,Not in chargemaster,15740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15740,BCBS multispecialty AW base fee schedule,1896.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15750,Not in chargemaster,15750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15750,BCBS multispecialty AW base fee schedule,1749.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15756,Not in chargemaster,15756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15756,BCBS multispecialty AW base fee schedule,4373.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15757,Not in chargemaster,15757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15757,BCBS multispecialty AW base fee schedule,4347.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15758,Not in chargemaster,15758,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15758,BCBS multispecialty AW base fee schedule,4375.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15760,Not in chargemaster,15760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15760,BCBS multispecialty AW base fee schedule,1599.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15769,Not in chargemaster,15769,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15769,BCBS multispecialty AW base fee schedule,918.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15770,Not in chargemaster,15770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15770,BCBS multispecialty AW base fee schedule,1262.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15771,Not in chargemaster,15771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15771,BCBS multispecialty AW base fee schedule,1096.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15772,Not in chargemaster,15772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15772,BCBS multispecialty AW base fee schedule,345.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15773,Not in chargemaster,15773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15773,BCBS multispecialty AW base fee schedule,1106.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15774,Not in chargemaster,15774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15774,BCBS multispecialty AW base fee schedule,335.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15775,Not in chargemaster,15775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15775,BCBS multispecialty AW base fee schedule,702.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15776,Not in chargemaster,15776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15776,BCBS multispecialty AW base fee schedule,963.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15777,Not in chargemaster,15777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15777,BCBS multispecialty AW base fee schedule,414.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15780,Not in chargemaster,15780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15780,BCBS multispecialty AW base fee schedule,1669.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15781,Not in chargemaster,15781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15781,BCBS multispecialty AW base fee schedule,1038.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15782,Not in chargemaster,15782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15782,BCBS multispecialty AW base fee schedule,1016.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15783,Not in chargemaster,15783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15783,BCBS multispecialty AW base fee schedule,874.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15786,Not in chargemaster,15786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15786,BCBS multispecialty AW base fee schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15787,Not in chargemaster,15787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15787,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15788,Not in chargemaster,15788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15788,BCBS multispecialty AW base fee schedule,812.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15789,Not in chargemaster,15789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15789,BCBS multispecialty AW base fee schedule,1018.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15792,Not in chargemaster,15792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15792,BCBS multispecialty AW base fee schedule,728.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15793,Not in chargemaster,15793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15793,BCBS multispecialty AW base fee schedule,903.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15819,Not in chargemaster,15819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15819,BCBS multispecialty AW base fee schedule,1521.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15820,Not in chargemaster,15820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15820,BCBS multispecialty AW base fee schedule,1075.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15821,Not in chargemaster,15821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15821,BCBS multispecialty AW base fee schedule,1154.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15823,Not in chargemaster,15823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15823,BCBS multispecialty AW base fee schedule,1155.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15822,Not in chargemaster,15822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15822,BCBS multispecialty AW base fee schedule,855.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15830,Not in chargemaster,15830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15830,BCBS multispecialty AW base fee schedule,2251.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15832,Not in chargemaster,15832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15832,BCBS multispecialty AW base fee schedule,1760.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15833,Not in chargemaster,15833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15833,BCBS multispecialty AW base fee schedule,1671.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15834,Not in chargemaster,15834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15834,BCBS multispecialty AW base fee schedule,1704.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15835,Not in chargemaster,15835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15835,BCBS multispecialty AW base fee schedule,1787.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15836,Not in chargemaster,15836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15836,BCBS multispecialty AW base fee schedule,1435.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15837,Not in chargemaster,15837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15837,BCBS multispecialty AW base fee schedule,1649.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15838,Not in chargemaster,15838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15838,BCBS multispecialty AW base fee schedule,1227.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15839,Not in chargemaster,15839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15839,BCBS multispecialty AW base fee schedule,1685.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15840,Not in chargemaster,15840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15840,BCBS multispecialty AW base fee schedule,1916.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15841,Not in chargemaster,15841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15841,BCBS multispecialty AW base fee schedule,3416.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15842,Not in chargemaster,15842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15842,BCBS multispecialty AW base fee schedule,5203.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15845,Not in chargemaster,15845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15845,BCBS multispecialty AW base fee schedule,1919.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15850,Not in chargemaster,15850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15850,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15851,Not in chargemaster,15851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15851,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15852,Not in chargemaster,15852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15852,BCBS multispecialty AW base fee schedule,88.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15860,Not in chargemaster,15860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15860,BCBS multispecialty AW base fee schedule,207.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15920,Not in chargemaster,15920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15920,BCBS multispecialty AW base fee schedule,1195.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15922,Not in chargemaster,15922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15922,BCBS multispecialty AW base fee schedule,1510.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15931,Not in chargemaster,15931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15931,BCBS multispecialty AW base fee schedule,1336.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15933,Not in chargemaster,15933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15933,BCBS multispecialty AW base fee schedule,1653.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15934,Not in chargemaster,15934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15934,BCBS multispecialty AW base fee schedule,1809.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15935,Not in chargemaster,15935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15935,BCBS multispecialty AW base fee schedule,2200.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15936,Not in chargemaster,15936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15936,BCBS multispecialty AW base fee schedule,1724.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15937,Not in chargemaster,15937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15937,BCBS multispecialty AW base fee schedule,1996.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15940,Not in chargemaster,15940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15940,BCBS multispecialty AW base fee schedule,1344.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15941,Not in chargemaster,15941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15941,BCBS multispecialty AW base fee schedule,1750.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15944,Not in chargemaster,15944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15944,BCBS multispecialty AW base fee schedule,1740.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15945,Not in chargemaster,15945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15945,BCBS multispecialty AW base fee schedule,1941.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15946,Not in chargemaster,15946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15946,BCBS multispecialty AW base fee schedule,3119.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15950,Not in chargemaster,15950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15950,BCBS multispecialty AW base fee schedule,1166.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15951,Not in chargemaster,15951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15951,BCBS multispecialty AW base fee schedule,1702.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15952,Not in chargemaster,15952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15952,BCBS multispecialty AW base fee schedule,1743.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15953,Not in chargemaster,15953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15953,BCBS multispecialty AW base fee schedule,1918.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15956,Not in chargemaster,15956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15956,BCBS multispecialty AW base fee schedule,2235.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15958,Not in chargemaster,15958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15958,BCBS multispecialty AW base fee schedule,2257.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 16000,16000,16000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16000,BCBS multispecialty AW base fee schedule,138.46,155,Fee schedule,,138.46,138.46,138.46,138.46,,,0
unity,Fee schedule,Non-facility 16020,16020,16020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16020,BCBS multispecialty AW base fee schedule,155.69,173.92,Fee schedule,,155.69,155.69,155.69,155.69,,,0
unity,Fee schedule,Non-facility 16025,16025,16025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16025,BCBS multispecialty AW base fee schedule,290.84,313.06,Fee schedule,,290.84,290.84,290.84,290.84,,,0
unity,Fee schedule,Non-facility 16030,Not in chargemaster,16030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16030,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 16035,Not in chargemaster,16035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16035,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 16036,Not in chargemaster,16036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,16036,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17000,17000,17000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17000,BCBS multispecialty AW base fee schedule,122.56,173.92,Fee schedule,,122.56,122.56,122.56,122.56,,,0
unity,Fee schedule,Non-facility 17003,17003,17003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17003,BCBS multispecialty AW base fee schedule,11.26,14.2,Fee schedule,,11.26,11.26,11.26,11.26,,,0
unity,Fee schedule,Non-facility 17004,17004,17004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17004,BCBS multispecialty AW base fee schedule,296.8,330,Fee schedule,,296.8,296.8,296.8,296.8,,,0
unity,Fee schedule,Non-facility 17106,Not in chargemaster,17106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17106,BCBS multispecialty AW base fee schedule,643.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17107,Not in chargemaster,17107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17107,BCBS multispecialty AW base fee schedule,843.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17108,Not in chargemaster,17108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17108,BCBS multispecialty AW base fee schedule,1201.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17110,17110,17110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17110,BCBS multispecialty AW base fee schedule,210.01,230,Fee schedule,,210.01,210.01,210.01,210.01,,,0
unity,Fee schedule,Non-facility 17111,17111,17111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17111,BCBS multispecialty AW base fee schedule,246.45,281.83,Fee schedule,,246.45,246.45,246.45,246.45,,,0
unity,Fee schedule,Non-facility 17250,Not in chargemaster,17250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17250,BCBS multispecialty AW base fee schedule,160.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17260,Not in chargemaster,17260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17260,BCBS multispecialty AW base fee schedule,181.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17261,Not in chargemaster,17261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17261,BCBS multispecialty AW base fee schedule,273.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17262,Not in chargemaster,17262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17262,BCBS multispecialty AW base fee schedule,331.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17263,Not in chargemaster,17263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17263,BCBS multispecialty AW base fee schedule,361.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17264,Not in chargemaster,17264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17264,BCBS multispecialty AW base fee schedule,386.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17266,Not in chargemaster,17266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17266,BCBS multispecialty AW base fee schedule,441.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17270,Not in chargemaster,17270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17270,BCBS multispecialty AW base fee schedule,279.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17271,Not in chargemaster,17271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17271,BCBS multispecialty AW base fee schedule,308.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17272,Not in chargemaster,17272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17272,BCBS multispecialty AW base fee schedule,352.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17273,Not in chargemaster,17273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17273,BCBS multispecialty AW base fee schedule,392.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17274,Not in chargemaster,17274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17274,BCBS multispecialty AW base fee schedule,461.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17276,Not in chargemaster,17276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17276,BCBS multispecialty AW base fee schedule,534.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17280,Not in chargemaster,17280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17280,BCBS multispecialty AW base fee schedule,261.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17281,Not in chargemaster,17281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17281,BCBS multispecialty AW base fee schedule,335.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17282,Not in chargemaster,17282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17282,BCBS multispecialty AW base fee schedule,385.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17283,Not in chargemaster,17283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17283,BCBS multispecialty AW base fee schedule,459.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17284,Not in chargemaster,17284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17284,BCBS multispecialty AW base fee schedule,523.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17286,Not in chargemaster,17286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17286,BCBS multispecialty AW base fee schedule,674.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17311,Not in chargemaster,17311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17311,BCBS multispecialty AW base fee schedule,1248.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17312,Not in chargemaster,17312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17312,BCBS multispecialty AW base fee schedule,748.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17313,Not in chargemaster,17313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17313,BCBS multispecialty AW base fee schedule,1169.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17314,Not in chargemaster,17314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17314,BCBS multispecialty AW base fee schedule,715.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17315,Not in chargemaster,17315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17315,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17340,Not in chargemaster,17340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17340,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17360,Not in chargemaster,17360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17360,BCBS multispecialty AW base fee schedule,233.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19000,19000,19000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19000,BCBS multispecialty AW base fee schedule,206.04,238.51,Fee schedule,,206.04,206.04,206.04,206.04,,,0
unity,Fee schedule,Non-facility 19001,Not in chargemaster,19001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19001,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19020,Not in chargemaster,19020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19020,BCBS multispecialty AW base fee schedule,897.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19030,Not in chargemaster,19030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19030,BCBS multispecialty AW base fee schedule,317.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19081,Not in chargemaster,19081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19081,BCBS multispecialty AW base fee schedule,1148.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19082,Not in chargemaster,19082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19082,BCBS multispecialty AW base fee schedule,926.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19083,Not in chargemaster,19083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19083,BCBS multispecialty AW base fee schedule,1136.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19084,Not in chargemaster,19084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19084,BCBS multispecialty AW base fee schedule,901,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19085,Not in chargemaster,19085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19085,BCBS multispecialty AW base fee schedule,1734.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19086,Not in chargemaster,19086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19086,BCBS multispecialty AW base fee schedule,1378.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19100,Not in chargemaster,19100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19100,BCBS multispecialty AW base fee schedule,291.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19101,Not in chargemaster,19101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19101,BCBS multispecialty AW base fee schedule,637.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19105,Not in chargemaster,19105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19105,BCBS multispecialty AW base fee schedule,5143.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19110,Not in chargemaster,19110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19110,BCBS multispecialty AW base fee schedule,928.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19112,Not in chargemaster,19112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19112,BCBS multispecialty AW base fee schedule,874.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19120,Not in chargemaster,19120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19120,BCBS multispecialty AW base fee schedule,961.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19125,Not in chargemaster,19125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19125,BCBS multispecialty AW base fee schedule,1063.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19126,Not in chargemaster,19126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19126,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19281,Not in chargemaster,19281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19281,BCBS multispecialty AW base fee schedule,461.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19282,Not in chargemaster,19282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19282,BCBS multispecialty AW base fee schedule,325.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19283,Not in chargemaster,19283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19283,BCBS multispecialty AW base fee schedule,512.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19284,Not in chargemaster,19284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19284,BCBS multispecialty AW base fee schedule,390.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19285,Not in chargemaster,19285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19285,BCBS multispecialty AW base fee schedule,859.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19286,Not in chargemaster,19286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19286,BCBS multispecialty AW base fee schedule,734.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19287,Not in chargemaster,19287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19287,BCBS multispecialty AW base fee schedule,1464.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19288,Not in chargemaster,19288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19288,BCBS multispecialty AW base fee schedule,1164.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19294,Not in chargemaster,19294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19294,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19296,Not in chargemaster,19296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19296,BCBS multispecialty AW base fee schedule,7567.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19297,Not in chargemaster,19297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19297,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19298,Not in chargemaster,19298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19298,BCBS multispecialty AW base fee schedule,1886.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19300,Not in chargemaster,19300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19300,BCBS multispecialty AW base fee schedule,1048.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19301,Not in chargemaster,19301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19301,BCBS multispecialty AW base fee schedule,1262.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19302,Not in chargemaster,19302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19302,BCBS multispecialty AW base fee schedule,1735.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19303,Not in chargemaster,19303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19303,BCBS multispecialty AW base fee schedule,1844.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19305,Not in chargemaster,19305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19305,BCBS multispecialty AW base fee schedule,2189.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19306,Not in chargemaster,19306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19306,BCBS multispecialty AW base fee schedule,2324.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19307,Not in chargemaster,19307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19307,BCBS multispecialty AW base fee schedule,2317.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19316,Not in chargemaster,19316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19316,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19318,Not in chargemaster,19318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19318,BCBS multispecialty AW base fee schedule,2101.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19324,Not in chargemaster,19324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19324,BCBS multispecialty AW base fee schedule,1020.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19325,Not in chargemaster,19325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19325,BCBS multispecialty AW base fee schedule,1238.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19328,Not in chargemaster,19328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19328,BCBS multispecialty AW base fee schedule,955.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19330,Not in chargemaster,19330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19330,BCBS multispecialty AW base fee schedule,1213.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19340,Not in chargemaster,19340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19340,BCBS multispecialty AW base fee schedule,1893.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19342,Not in chargemaster,19342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19342,BCBS multispecialty AW base fee schedule,1774.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19350,Not in chargemaster,19350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19350,BCBS multispecialty AW base fee schedule,1578.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19355,Not in chargemaster,19355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19355,BCBS multispecialty AW base fee schedule,1441.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19357,Not in chargemaster,19357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19357,BCBS multispecialty AW base fee schedule,2873.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19361,Not in chargemaster,19361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19361,BCBS multispecialty AW base fee schedule,3011.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19364,Not in chargemaster,19364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19364,BCBS multispecialty AW base fee schedule,5281.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19366,Not in chargemaster,19366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19366,BCBS multispecialty AW base fee schedule,2675.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19367,Not in chargemaster,19367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19367,BCBS multispecialty AW base fee schedule,3411.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19368,Not in chargemaster,19368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19368,BCBS multispecialty AW base fee schedule,4209.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19369,Not in chargemaster,19369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19369,BCBS multispecialty AW base fee schedule,3909.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19370,Not in chargemaster,19370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19370,BCBS multispecialty AW base fee schedule,1319.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19371,Not in chargemaster,19371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19371,BCBS multispecialty AW base fee schedule,1507.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19380,Not in chargemaster,19380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19380,BCBS multispecialty AW base fee schedule,1488.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19396,Not in chargemaster,19396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,19396,BCBS multispecialty AW base fee schedule,543.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20100,Not in chargemaster,20100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20100,BCBS multispecialty AW base fee schedule,1157.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20101,Not in chargemaster,20101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20101,BCBS multispecialty AW base fee schedule,908.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20102,Not in chargemaster,20102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20102,BCBS multispecialty AW base fee schedule,976.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20103,Not in chargemaster,20103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20103,BCBS multispecialty AW base fee schedule,1097.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20150,Not in chargemaster,20150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20150,BCBS multispecialty AW base fee schedule,1925.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20200,Not in chargemaster,20200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20200,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20205,20205,20205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20205,BCBS multispecialty AW base fee schedule,561.14,357.5,Fee schedule,,357.5,357.5,357.5,357.5,,,0
unity,Fee schedule,Non-facility 20206,Not in chargemaster,20206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20206,BCBS multispecialty AW base fee schedule,447.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20220,Not in chargemaster,20220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20220,BCBS multispecialty AW base fee schedule,466.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20225,Not in chargemaster,20225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20225,BCBS multispecialty AW base fee schedule,789.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20240,Not in chargemaster,20240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20240,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20245,Not in chargemaster,20245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20245,BCBS multispecialty AW base fee schedule,667.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20250,Not in chargemaster,20250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20250,BCBS multispecialty AW base fee schedule,753.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20251,Not in chargemaster,20251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20251,BCBS multispecialty AW base fee schedule,818.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20500,Not in chargemaster,20500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20500,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20501,Not in chargemaster,20501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20501,BCBS multispecialty AW base fee schedule,259.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20520,Not in chargemaster,20520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20520,BCBS multispecialty AW base fee schedule,399.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20525,Not in chargemaster,20525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20525,BCBS multispecialty AW base fee schedule,901,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20526,Not in chargemaster,20526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20526,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20527,Not in chargemaster,20527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20527,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20550,20550,20550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20550,BCBS multispecialty AW base fee schedule,103.35,122.1,Fee schedule,,103.35,103.35,103.35,103.35,,,0
unity,Fee schedule,Non-facility 20551,20551,20551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20551,BCBS multispecialty AW base fee schedule,106,126.36,Fee schedule,,106,106,106,106,,,0
unity,Fee schedule,Non-facility 20552,20552,20552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20552,BCBS multispecialty AW base fee schedule,105.34,120,Fee schedule,,105.34,105.34,105.34,105.34,,,0
unity,Fee schedule,Non-facility 20553,20553,20553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20553,BCBS multispecialty AW base fee schedule,120.58,154,Fee schedule,,120.58,120.58,120.58,120.58,,,0
unity,Fee schedule,Non-facility 20555,Not in chargemaster,20555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20555,BCBS multispecialty AW base fee schedule,628.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20560,Not in chargemaster,20560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20560,BCBS multispecialty AW base fee schedule,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20561,Not in chargemaster,20561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20561,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20600,20600,20600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20600,BCBS multispecialty AW base fee schedule,95.4,105,Fee schedule,,95.4,95.4,95.4,95.4,,,0
unity,Fee schedule,Non-facility 20604,20604,20604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20604,BCBS multispecialty AW base fee schedule,143.76,159,Fee schedule,,143.76,143.76,143.76,143.76,,,0
unity,Fee schedule,Non-facility 20605,20605,20605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20605,BCBS multispecialty AW base fee schedule,98.71,137.02,Fee schedule,,98.71,98.71,98.71,98.71,,,0
unity,Fee schedule,Non-facility 20606,Not in chargemaster,20606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20606,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20610,20610,20610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20610,BCBS multispecialty AW base fee schedule,117.26,129.23,Fee schedule,,117.26,117.26,117.26,117.26,,,0
unity,Fee schedule,Non-facility 20611,Not in chargemaster,20611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20611,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20612,Not in chargemaster,20612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20612,BCBS multispecialty AW base fee schedule,116.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20615,Not in chargemaster,20615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20615,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20650,Not in chargemaster,20650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20650,BCBS multispecialty AW base fee schedule,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20660,Not in chargemaster,20660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20660,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20661,Not in chargemaster,20661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20661,BCBS multispecialty AW base fee schedule,955.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20662,Not in chargemaster,20662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20662,BCBS multispecialty AW base fee schedule,980.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20663,Not in chargemaster,20663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20663,BCBS multispecialty AW base fee schedule,901.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20664,Not in chargemaster,20664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20664,BCBS multispecialty AW base fee schedule,1658.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20665,Not in chargemaster,20665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20665,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20670,Not in chargemaster,20670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20670,BCBS multispecialty AW base fee schedule,697.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20680,Not in chargemaster,20680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20680,BCBS multispecialty AW base fee schedule,1165.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20690,Not in chargemaster,20690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20690,BCBS multispecialty AW base fee schedule,1140.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20692,Not in chargemaster,20692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20692,BCBS multispecialty AW base fee schedule,2138.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20693,Not in chargemaster,20693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20693,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20694,Not in chargemaster,20694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20694,BCBS multispecialty AW base fee schedule,811.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20696,Not in chargemaster,20696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20696,BCBS multispecialty AW base fee schedule,2274.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20697,Not in chargemaster,20697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20697,BCBS multispecialty AW base fee schedule,3829.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20700,Not in chargemaster,20700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20700,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20701,Not in chargemaster,20701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20701,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20702,Not in chargemaster,20702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20702,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20703,Not in chargemaster,20703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20703,BCBS multispecialty AW base fee schedule,192.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20704,Not in chargemaster,20704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20704,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20705,Not in chargemaster,20705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20705,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20802,Not in chargemaster,20802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20802,BCBS multispecialty AW base fee schedule,5269.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20805,Not in chargemaster,20805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20805,BCBS multispecialty AW base fee schedule,6274.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20808,Not in chargemaster,20808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20808,BCBS multispecialty AW base fee schedule,7586.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20816,Not in chargemaster,20816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20816,BCBS multispecialty AW base fee schedule,3947.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20822,Not in chargemaster,20822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20822,BCBS multispecialty AW base fee schedule,3394.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20824,Not in chargemaster,20824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20824,BCBS multispecialty AW base fee schedule,3953.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20827,Not in chargemaster,20827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20827,BCBS multispecialty AW base fee schedule,3487.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20838,Not in chargemaster,20838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20838,BCBS multispecialty AW base fee schedule,5342.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20900,Not in chargemaster,20900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20900,BCBS multispecialty AW base fee schedule,771.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20902,Not in chargemaster,20902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20902,BCBS multispecialty AW base fee schedule,540.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20910,Not in chargemaster,20910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20910,BCBS multispecialty AW base fee schedule,894.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20912,Not in chargemaster,20912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20912,BCBS multispecialty AW base fee schedule,902.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20920,Not in chargemaster,20920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20920,BCBS multispecialty AW base fee schedule,743.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20922,Not in chargemaster,20922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20922,BCBS multispecialty AW base fee schedule,1130.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20924,Not in chargemaster,20924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20924,BCBS multispecialty AW base fee schedule,967.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20931,Not in chargemaster,20931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20931,BCBS multispecialty AW base fee schedule,213.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20932,Not in chargemaster,20932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20932,BCBS multispecialty AW base fee schedule,1366.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20933,Not in chargemaster,20933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20933,BCBS multispecialty AW base fee schedule,1256.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20934,Not in chargemaster,20934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20934,BCBS multispecialty AW base fee schedule,1366.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20937,Not in chargemaster,20937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20937,BCBS multispecialty AW base fee schedule,321.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20938,Not in chargemaster,20938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20938,BCBS multispecialty AW base fee schedule,353.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20939,Not in chargemaster,20939,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20939,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20950,Not in chargemaster,20950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20950,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20955,Not in chargemaster,20955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20955,BCBS multispecialty AW base fee schedule,4703.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20956,Not in chargemaster,20956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20956,BCBS multispecialty AW base fee schedule,5069.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20957,Not in chargemaster,20957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20957,BCBS multispecialty AW base fee schedule,5274.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20962,Not in chargemaster,20962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20962,BCBS multispecialty AW base fee schedule,5094.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20969,Not in chargemaster,20969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20969,BCBS multispecialty AW base fee schedule,5207.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20970,Not in chargemaster,20970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20970,BCBS multispecialty AW base fee schedule,5476.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20972,Not in chargemaster,20972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20972,BCBS multispecialty AW base fee schedule,5462.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20973,Not in chargemaster,20973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20973,BCBS multispecialty AW base fee schedule,5769.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20974,Not in chargemaster,20974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20974,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20975,Not in chargemaster,20975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20975,BCBS multispecialty AW base fee schedule,339.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20979,Not in chargemaster,20979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20979,BCBS multispecialty AW base fee schedule,101.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20982,Not in chargemaster,20982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20982,BCBS multispecialty AW base fee schedule,7229.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20983,Not in chargemaster,20983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20983,BCBS multispecialty AW base fee schedule,10772.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20985,Not in chargemaster,20985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20985,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21010,Not in chargemaster,21010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21010,BCBS multispecialty AW base fee schedule,1423.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21011,Not in chargemaster,21011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21011,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21012,Not in chargemaster,21012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21012,BCBS multispecialty AW base fee schedule,643.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21013,Not in chargemaster,21013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21013,BCBS multispecialty AW base fee schedule,1005.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21014,Not in chargemaster,21014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21014,BCBS multispecialty AW base fee schedule,993.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21015,Not in chargemaster,21015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21015,BCBS multispecialty AW base fee schedule,1343.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21016,Not in chargemaster,21016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21016,BCBS multispecialty AW base fee schedule,1927.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21025,Not in chargemaster,21025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21025,BCBS multispecialty AW base fee schedule,1566.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21026,Not in chargemaster,21026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21026,BCBS multispecialty AW base fee schedule,1065.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21029,Not in chargemaster,21029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21029,BCBS multispecialty AW base fee schedule,1447.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21030,Not in chargemaster,21030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21030,BCBS multispecialty AW base fee schedule,932.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21031,Not in chargemaster,21031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21031,BCBS multispecialty AW base fee schedule,736.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21032,Not in chargemaster,21032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21032,BCBS multispecialty AW base fee schedule,738.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21034,Not in chargemaster,21034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21034,BCBS multispecialty AW base fee schedule,2466.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21040,Not in chargemaster,21040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21040,BCBS multispecialty AW base fee schedule,939.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21044,Not in chargemaster,21044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21044,BCBS multispecialty AW base fee schedule,1642.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21045,Not in chargemaster,21045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21045,BCBS multispecialty AW base fee schedule,2298.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21046,Not in chargemaster,21046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21046,BCBS multispecialty AW base fee schedule,1992.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21047,Not in chargemaster,21047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21047,BCBS multispecialty AW base fee schedule,2434.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21048,Not in chargemaster,21048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21048,BCBS multispecialty AW base fee schedule,2020.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21049,Not in chargemaster,21049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21049,BCBS multispecialty AW base fee schedule,2298.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21050,Not in chargemaster,21050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21050,BCBS multispecialty AW base fee schedule,1670.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21060,Not in chargemaster,21060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21060,BCBS multispecialty AW base fee schedule,1518.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21070,Not in chargemaster,21070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21070,BCBS multispecialty AW base fee schedule,1193.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21073,Not in chargemaster,21073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21073,BCBS multispecialty AW base fee schedule,723.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21076,Not in chargemaster,21076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21076,BCBS multispecialty AW base fee schedule,1715.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21077,Not in chargemaster,21077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21077,BCBS multispecialty AW base fee schedule,4241.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21079,Not in chargemaster,21079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21079,BCBS multispecialty AW base fee schedule,2887.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21080,Not in chargemaster,21080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21080,BCBS multispecialty AW base fee schedule,3301.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21081,Not in chargemaster,21081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21081,BCBS multispecialty AW base fee schedule,3033.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21082,Not in chargemaster,21082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21082,BCBS multispecialty AW base fee schedule,2809.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21083,Not in chargemaster,21083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21083,BCBS multispecialty AW base fee schedule,2677.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21084,Not in chargemaster,21084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21084,BCBS multispecialty AW base fee schedule,3065.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21085,Not in chargemaster,21085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21085,BCBS multispecialty AW base fee schedule,1329.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21086,Not in chargemaster,21086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21086,BCBS multispecialty AW base fee schedule,3156.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21087,Not in chargemaster,21087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21087,BCBS multispecialty AW base fee schedule,3156.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21100,Not in chargemaster,21100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21100,BCBS multispecialty AW base fee schedule,1254.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21110,Not in chargemaster,21110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21110,BCBS multispecialty AW base fee schedule,1562.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21116,Not in chargemaster,21116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21116,BCBS multispecialty AW base fee schedule,372.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21120,Not in chargemaster,21120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21120,BCBS multispecialty AW base fee schedule,1273.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21121,Not in chargemaster,21121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21121,BCBS multispecialty AW base fee schedule,1287.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21122,Not in chargemaster,21122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21122,BCBS multispecialty AW base fee schedule,1466.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21123,Not in chargemaster,21123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21123,BCBS multispecialty AW base fee schedule,1666.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21125,Not in chargemaster,21125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21125,BCBS multispecialty AW base fee schedule,5358.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21127,Not in chargemaster,21127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21127,BCBS multispecialty AW base fee schedule,7628.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21137,Not in chargemaster,21137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21137,BCBS multispecialty AW base fee schedule,1440.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21138,Not in chargemaster,21138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21138,BCBS multispecialty AW base fee schedule,1760.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21139,Not in chargemaster,21139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21139,BCBS multispecialty AW base fee schedule,2125.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21141,Not in chargemaster,21141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21141,BCBS multispecialty AW base fee schedule,2547.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21142,Not in chargemaster,21142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21142,BCBS multispecialty AW base fee schedule,2618.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21143,Not in chargemaster,21143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21143,BCBS multispecialty AW base fee schedule,2720.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21145,Not in chargemaster,21145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21145,BCBS multispecialty AW base fee schedule,2976.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21146,Not in chargemaster,21146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21146,BCBS multispecialty AW base fee schedule,3106.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21147,Not in chargemaster,21147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21147,BCBS multispecialty AW base fee schedule,3274.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21150,Not in chargemaster,21150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21150,BCBS multispecialty AW base fee schedule,3133.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21151,Not in chargemaster,21151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21151,BCBS multispecialty AW base fee schedule,3450.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21154,Not in chargemaster,21154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21154,BCBS multispecialty AW base fee schedule,3712.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21155,Not in chargemaster,21155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21155,BCBS multispecialty AW base fee schedule,4120.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21159,Not in chargemaster,21159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21159,BCBS multispecialty AW base fee schedule,4941.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21160,Not in chargemaster,21160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21160,BCBS multispecialty AW base fee schedule,5360.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21172,Not in chargemaster,21172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21172,BCBS multispecialty AW base fee schedule,3992.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21175,Not in chargemaster,21175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21175,BCBS multispecialty AW base fee schedule,4265.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21179,Not in chargemaster,21179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21179,BCBS multispecialty AW base fee schedule,2928.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21180,Not in chargemaster,21180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21180,BCBS multispecialty AW base fee schedule,3275.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21181,Not in chargemaster,21181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21181,BCBS multispecialty AW base fee schedule,1421.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21182,Not in chargemaster,21182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21182,BCBS multispecialty AW base fee schedule,4086.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21183,Not in chargemaster,21183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21183,BCBS multispecialty AW base fee schedule,4451.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21184,Not in chargemaster,21184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21184,BCBS multispecialty AW base fee schedule,4791.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21188,Not in chargemaster,21188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21188,BCBS multispecialty AW base fee schedule,3085.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21193,Not in chargemaster,21193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21193,BCBS multispecialty AW base fee schedule,2370.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21194,Not in chargemaster,21194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21194,BCBS multispecialty AW base fee schedule,2732.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21195,Not in chargemaster,21195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21195,BCBS multispecialty AW base fee schedule,2619.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21196,Not in chargemaster,21196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21196,BCBS multispecialty AW base fee schedule,2712.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21198,Not in chargemaster,21198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21198,BCBS multispecialty AW base fee schedule,2110.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21199,Not in chargemaster,21199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21199,BCBS multispecialty AW base fee schedule,1979.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21206,Not in chargemaster,21206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21206,BCBS multispecialty AW base fee schedule,2180.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21208,Not in chargemaster,21208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21208,BCBS multispecialty AW base fee schedule,3227.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21209,Not in chargemaster,21209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21209,BCBS multispecialty AW base fee schedule,1521.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21210,Not in chargemaster,21210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21210,BCBS multispecialty AW base fee schedule,3744.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21215,Not in chargemaster,21215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21215,BCBS multispecialty AW base fee schedule,7771.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21230,Not in chargemaster,21230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21230,BCBS multispecialty AW base fee schedule,1416.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21235,Not in chargemaster,21235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21235,BCBS multispecialty AW base fee schedule,1371.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21240,Not in chargemaster,21240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21240,BCBS multispecialty AW base fee schedule,2043.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21242,Not in chargemaster,21242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21242,BCBS multispecialty AW base fee schedule,1934.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21243,Not in chargemaster,21243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21243,BCBS multispecialty AW base fee schedule,3117.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21244,Not in chargemaster,21244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21244,BCBS multispecialty AW base fee schedule,1942.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21245,Not in chargemaster,21245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21245,BCBS multispecialty AW base fee schedule,2290.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21246,Not in chargemaster,21246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21246,BCBS multispecialty AW base fee schedule,1635.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21247,Not in chargemaster,21247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21247,BCBS multispecialty AW base fee schedule,3042.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21248,Not in chargemaster,21248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21248,BCBS multispecialty AW base fee schedule,1944.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21249,Not in chargemaster,21249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21249,BCBS multispecialty AW base fee schedule,2661.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21255,Not in chargemaster,21255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21255,BCBS multispecialty AW base fee schedule,2602.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21256,Not in chargemaster,21256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21256,BCBS multispecialty AW base fee schedule,2383.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21260,Not in chargemaster,21260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21260,BCBS multispecialty AW base fee schedule,2656.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21261,Not in chargemaster,21261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21261,BCBS multispecialty AW base fee schedule,4711.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21263,Not in chargemaster,21263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21263,BCBS multispecialty AW base fee schedule,4357.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21267,Not in chargemaster,21267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21267,BCBS multispecialty AW base fee schedule,3106.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21268,Not in chargemaster,21268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21268,BCBS multispecialty AW base fee schedule,3897.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21270,Not in chargemaster,21270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21270,BCBS multispecialty AW base fee schedule,1932.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21275,Not in chargemaster,21275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21275,BCBS multispecialty AW base fee schedule,1616.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21280,Not in chargemaster,21280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21280,BCBS multispecialty AW base fee schedule,1089.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21282,Not in chargemaster,21282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21282,BCBS multispecialty AW base fee schedule,734.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21295,Not in chargemaster,21295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21295,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21296,Not in chargemaster,21296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21296,BCBS multispecialty AW base fee schedule,769.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21310,Not in chargemaster,21310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21310,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21315,Not in chargemaster,21315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21315,BCBS multispecialty AW base fee schedule,516.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21320,Not in chargemaster,21320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21320,BCBS multispecialty AW base fee schedule,478.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21325,Not in chargemaster,21325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21325,BCBS multispecialty AW base fee schedule,824.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21330,Not in chargemaster,21330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21330,BCBS multispecialty AW base fee schedule,1060.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21335,Not in chargemaster,21335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21335,BCBS multispecialty AW base fee schedule,1348.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21336,Not in chargemaster,21336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21336,BCBS multispecialty AW base fee schedule,1205.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21337,Not in chargemaster,21337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21337,BCBS multispecialty AW base fee schedule,775.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21338,Not in chargemaster,21338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21338,BCBS multispecialty AW base fee schedule,1241.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21339,Not in chargemaster,21339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21339,BCBS multispecialty AW base fee schedule,1411.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21340,Not in chargemaster,21340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21340,BCBS multispecialty AW base fee schedule,1413.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21343,Not in chargemaster,21343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21343,BCBS multispecialty AW base fee schedule,2033.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21344,Not in chargemaster,21344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21344,BCBS multispecialty AW base fee schedule,2628.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21345,Not in chargemaster,21345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21345,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21346,Not in chargemaster,21346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21346,BCBS multispecialty AW base fee schedule,1815.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21347,Not in chargemaster,21347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21347,BCBS multispecialty AW base fee schedule,1925.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21348,Not in chargemaster,21348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21348,BCBS multispecialty AW base fee schedule,2058.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21355,Not in chargemaster,21355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21355,BCBS multispecialty AW base fee schedule,812.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21356,Not in chargemaster,21356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21356,BCBS multispecialty AW base fee schedule,943.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21360,Not in chargemaster,21360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21360,BCBS multispecialty AW base fee schedule,969.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21365,Not in chargemaster,21365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21365,BCBS multispecialty AW base fee schedule,2096.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21366,Not in chargemaster,21366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21366,BCBS multispecialty AW base fee schedule,2453.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21385,Not in chargemaster,21385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21385,BCBS multispecialty AW base fee schedule,1429.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21386,Not in chargemaster,21386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21386,BCBS multispecialty AW base fee schedule,1240.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21387,Not in chargemaster,21387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21387,BCBS multispecialty AW base fee schedule,1492.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21390,Not in chargemaster,21390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21390,BCBS multispecialty AW base fee schedule,1521.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21395,Not in chargemaster,21395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21395,BCBS multispecialty AW base fee schedule,1943.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21400,Not in chargemaster,21400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21400,BCBS multispecialty AW base fee schedule,382.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21401,Not in chargemaster,21401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21401,BCBS multispecialty AW base fee schedule,979.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21406,Not in chargemaster,21406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21406,BCBS multispecialty AW base fee schedule,1109.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21407,Not in chargemaster,21407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21407,BCBS multispecialty AW base fee schedule,1224.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21408,Not in chargemaster,21408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21408,BCBS multispecialty AW base fee schedule,1733.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21421,Not in chargemaster,21421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21421,BCBS multispecialty AW base fee schedule,1270.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21422,Not in chargemaster,21422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21422,BCBS multispecialty AW base fee schedule,1222.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21423,Not in chargemaster,21423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21423,BCBS multispecialty AW base fee schedule,1460.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21431,Not in chargemaster,21431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21431,BCBS multispecialty AW base fee schedule,1319.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21432,Not in chargemaster,21432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21432,BCBS multispecialty AW base fee schedule,1375.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21433,Not in chargemaster,21433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21433,BCBS multispecialty AW base fee schedule,3346.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21435,Not in chargemaster,21435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21435,BCBS multispecialty AW base fee schedule,2701.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21436,Not in chargemaster,21436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21436,BCBS multispecialty AW base fee schedule,3923.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21440,Not in chargemaster,21440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21440,BCBS multispecialty AW base fee schedule,1187.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21445,Not in chargemaster,21445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21445,BCBS multispecialty AW base fee schedule,1470.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21450,Not in chargemaster,21450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21450,BCBS multispecialty AW base fee schedule,1089.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21451,Not in chargemaster,21451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21451,BCBS multispecialty AW base fee schedule,1427.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21452,Not in chargemaster,21452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21452,BCBS multispecialty AW base fee schedule,1332.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21453,Not in chargemaster,21453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21453,BCBS multispecialty AW base fee schedule,1902.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21454,Not in chargemaster,21454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21454,BCBS multispecialty AW base fee schedule,970.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21461,Not in chargemaster,21461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21461,BCBS multispecialty AW base fee schedule,3807.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21462,Not in chargemaster,21462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21462,BCBS multispecialty AW base fee schedule,4071.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21465,Not in chargemaster,21465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21465,BCBS multispecialty AW base fee schedule,1596.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21470,Not in chargemaster,21470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21470,BCBS multispecialty AW base fee schedule,2242.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21480,Not in chargemaster,21480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21480,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21485,Not in chargemaster,21485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21485,BCBS multispecialty AW base fee schedule,1670.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21490,Not in chargemaster,21490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21490,BCBS multispecialty AW base fee schedule,1574.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21497,Not in chargemaster,21497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21497,BCBS multispecialty AW base fee schedule,1298.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21501,Not in chargemaster,21501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21501,BCBS multispecialty AW base fee schedule,889.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21502,Not in chargemaster,21502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21502,BCBS multispecialty AW base fee schedule,967.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21510,Not in chargemaster,21510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21510,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21550,21550,21550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21550,BCBS multispecialty AW base fee schedule,496.88,565.05,Fee schedule,,496.88,496.88,496.88,496.88,,,0
unity,Fee schedule,Non-facility 21552,21552,21552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21552,BCBS multispecialty AW base fee schedule,853.96,941.29,Fee schedule,,853.96,853.96,853.96,853.96,,,0
unity,Fee schedule,Non-facility 21554,Not in chargemaster,21554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21554,BCBS multispecialty AW base fee schedule,1399.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21555,Not in chargemaster,21555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21555,BCBS multispecialty AW base fee schedule,812.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21556,Not in chargemaster,21556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21556,BCBS multispecialty AW base fee schedule,1008.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21557,Not in chargemaster,21557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21557,BCBS multispecialty AW base fee schedule,1826.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21558,Not in chargemaster,21558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21558,BCBS multispecialty AW base fee schedule,2574.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21600,Not in chargemaster,21600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21600,BCBS multispecialty AW base fee schedule,1056.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21601,Not in chargemaster,21601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21601,BCBS multispecialty AW base fee schedule,2263.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21602,Not in chargemaster,21602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21602,BCBS multispecialty AW base fee schedule,3036.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21603,Not in chargemaster,21603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21603,BCBS multispecialty AW base fee schedule,3360.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21610,Not in chargemaster,21610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21610,BCBS multispecialty AW base fee schedule,2285.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21615,Not in chargemaster,21615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21615,BCBS multispecialty AW base fee schedule,1183.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21616,Not in chargemaster,21616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21616,BCBS multispecialty AW base fee schedule,1372.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21620,Not in chargemaster,21620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21620,BCBS multispecialty AW base fee schedule,967.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21627,Not in chargemaster,21627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21627,BCBS multispecialty AW base fee schedule,1030.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21630,Not in chargemaster,21630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21630,BCBS multispecialty AW base fee schedule,2327.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21632,Not in chargemaster,21632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21632,BCBS multispecialty AW base fee schedule,2315.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21685,Not in chargemaster,21685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21685,BCBS multispecialty AW base fee schedule,1866.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21700,Not in chargemaster,21700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21700,BCBS multispecialty AW base fee schedule,686.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21705,Not in chargemaster,21705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21705,BCBS multispecialty AW base fee schedule,1029.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21720,Not in chargemaster,21720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21720,BCBS multispecialty AW base fee schedule,993.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21725,Not in chargemaster,21725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21725,BCBS multispecialty AW base fee schedule,1033.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21740,Not in chargemaster,21740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21740,BCBS multispecialty AW base fee schedule,1972.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21750,Not in chargemaster,21750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21750,BCBS multispecialty AW base fee schedule,1302.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21811,Not in chargemaster,21811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21811,BCBS multispecialty AW base fee schedule,1142.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21812,Not in chargemaster,21812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21812,BCBS multispecialty AW base fee schedule,1393.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21813,Not in chargemaster,21813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21813,BCBS multispecialty AW base fee schedule,1904.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21820,Not in chargemaster,21820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21820,BCBS multispecialty AW base fee schedule,276.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21825,Not in chargemaster,21825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21825,BCBS multispecialty AW base fee schedule,1036.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21920,Not in chargemaster,21920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21920,BCBS multispecialty AW base fee schedule,484.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21925,Not in chargemaster,21925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21925,BCBS multispecialty AW base fee schedule,889.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21930,Not in chargemaster,21930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21930,BCBS multispecialty AW base fee schedule,934.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21931,Not in chargemaster,21931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21931,BCBS multispecialty AW base fee schedule,902.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21932,Not in chargemaster,21932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21932,BCBS multispecialty AW base fee schedule,1270.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21933,Not in chargemaster,21933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21933,BCBS multispecialty AW base fee schedule,1416.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21935,Not in chargemaster,21935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21935,BCBS multispecialty AW base fee schedule,1969.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21936,Not in chargemaster,21936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21936,BCBS multispecialty AW base fee schedule,2716.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22010,Not in chargemaster,22010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22010,BCBS multispecialty AW base fee schedule,1836.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22015,Not in chargemaster,22015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22015,BCBS multispecialty AW base fee schedule,1807.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22100,Not in chargemaster,22100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22100,BCBS multispecialty AW base fee schedule,1635.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22101,Not in chargemaster,22101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22101,BCBS multispecialty AW base fee schedule,1665.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22102,Not in chargemaster,22102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22102,BCBS multispecialty AW base fee schedule,1566.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22103,Not in chargemaster,22103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22103,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22110,Not in chargemaster,22110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22110,BCBS multispecialty AW base fee schedule,1994.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22112,Not in chargemaster,22112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22112,BCBS multispecialty AW base fee schedule,2139.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22114,Not in chargemaster,22114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22114,BCBS multispecialty AW base fee schedule,2139.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22116,Not in chargemaster,22116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22116,BCBS multispecialty AW base fee schedule,270.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22206,Not in chargemaster,22206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22206,BCBS multispecialty AW base fee schedule,4703.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22207,Not in chargemaster,22207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22207,BCBS multispecialty AW base fee schedule,4601.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22208,Not in chargemaster,22208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22208,BCBS multispecialty AW base fee schedule,1134.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22210,Not in chargemaster,22210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22210,BCBS multispecialty AW base fee schedule,3428.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22212,Not in chargemaster,22212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22212,BCBS multispecialty AW base fee schedule,2865.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22214,Not in chargemaster,22214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22214,BCBS multispecialty AW base fee schedule,2876.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22216,Not in chargemaster,22216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22216,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22220,Not in chargemaster,22220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22220,BCBS multispecialty AW base fee schedule,3136.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22222,Not in chargemaster,22222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22222,BCBS multispecialty AW base fee schedule,3329.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22224,Not in chargemaster,22224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22224,BCBS multispecialty AW base fee schedule,3054.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22226,Not in chargemaster,22226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22226,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22310,Not in chargemaster,22310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22310,BCBS multispecialty AW base fee schedule,576.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22315,Not in chargemaster,22315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22315,BCBS multispecialty AW base fee schedule,1677.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22318,Not in chargemaster,22318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22318,BCBS multispecialty AW base fee schedule,3135.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22319,Not in chargemaster,22319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22319,BCBS multispecialty AW base fee schedule,3488.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22325,Not in chargemaster,22325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22325,BCBS multispecialty AW base fee schedule,2781.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22326,Not in chargemaster,22326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22326,BCBS multispecialty AW base fee schedule,2868.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22327,Not in chargemaster,22327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22327,BCBS multispecialty AW base fee schedule,2897.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22328,Not in chargemaster,22328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22328,BCBS multispecialty AW base fee schedule,541.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22505,Not in chargemaster,22505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22505,BCBS multispecialty AW base fee schedule,249.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22510,Not in chargemaster,22510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22510,BCBS multispecialty AW base fee schedule,3438.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22511,Not in chargemaster,22511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22511,BCBS multispecialty AW base fee schedule,3405.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22512,Not in chargemaster,22512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22512,BCBS multispecialty AW base fee schedule,1619.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22513,Not in chargemaster,22513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22513,BCBS multispecialty AW base fee schedule,12531.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22514,Not in chargemaster,22514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22514,BCBS multispecialty AW base fee schedule,12477.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22515,Not in chargemaster,22515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22515,BCBS multispecialty AW base fee schedule,6994.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22526,Not in chargemaster,22526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22526,BCBS multispecialty AW base fee schedule,4202.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22527,Not in chargemaster,22527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22527,BCBS multispecialty AW base fee schedule,3520.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22532,Not in chargemaster,22532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22532,BCBS multispecialty AW base fee schedule,3452.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22533,Not in chargemaster,22533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22533,BCBS multispecialty AW base fee schedule,3182.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22534,Not in chargemaster,22534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22534,BCBS multispecialty AW base fee schedule,694.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22548,Not in chargemaster,22548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22548,BCBS multispecialty AW base fee schedule,3742.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22551,Not in chargemaster,22551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22551,BCBS multispecialty AW base fee schedule,3271.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22552,Not in chargemaster,22552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22552,BCBS multispecialty AW base fee schedule,765.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22554,Not in chargemaster,22554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22554,BCBS multispecialty AW base fee schedule,2406.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22556,Not in chargemaster,22556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22556,BCBS multispecialty AW base fee schedule,3191.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22558,Not in chargemaster,22558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22558,BCBS multispecialty AW base fee schedule,2940.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22585,Not in chargemaster,22585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22585,BCBS multispecialty AW base fee schedule,630.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22586,Not in chargemaster,22586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22586,BCBS multispecialty AW base fee schedule,3874.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22590,Not in chargemaster,22590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22590,BCBS multispecialty AW base fee schedule,3022.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22595,Not in chargemaster,22595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22595,BCBS multispecialty AW base fee schedule,2881.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22600,Not in chargemaster,22600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22600,BCBS multispecialty AW base fee schedule,2470.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22610,Not in chargemaster,22610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22610,BCBS multispecialty AW base fee schedule,2428.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22612,Not in chargemaster,22612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22612,BCBS multispecialty AW base fee schedule,3047.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22614,Not in chargemaster,22614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22614,BCBS multispecialty AW base fee schedule,753.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22630,Not in chargemaster,22630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22630,BCBS multispecialty AW base fee schedule,3020.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22632,Not in chargemaster,22632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22632,BCBS multispecialty AW base fee schedule,620.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22633,Not in chargemaster,22633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22633,BCBS multispecialty AW base fee schedule,3555.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22634,Not in chargemaster,22634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22634,BCBS multispecialty AW base fee schedule,954.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22800,Not in chargemaster,22800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22800,BCBS multispecialty AW base fee schedule,2608.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22802,Not in chargemaster,22802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22802,BCBS multispecialty AW base fee schedule,4044.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22804,Not in chargemaster,22804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22804,BCBS multispecialty AW base fee schedule,4659.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22808,Not in chargemaster,22808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22808,BCBS multispecialty AW base fee schedule,3521.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22810,Not in chargemaster,22810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22810,BCBS multispecialty AW base fee schedule,3941.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22812,Not in chargemaster,22812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22812,BCBS multispecialty AW base fee schedule,4234.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22818,Not in chargemaster,22818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22818,BCBS multispecialty AW base fee schedule,4151.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22819,Not in chargemaster,22819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22819,BCBS multispecialty AW base fee schedule,4775.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22830,Not in chargemaster,22830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22830,BCBS multispecialty AW base fee schedule,1566.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22840,Not in chargemaster,22840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22840,BCBS multispecialty AW base fee schedule,1462.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22842,Not in chargemaster,22842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22842,BCBS multispecialty AW base fee schedule,1469.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22843,Not in chargemaster,22843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22843,BCBS multispecialty AW base fee schedule,1570.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22844,Not in chargemaster,22844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22844,BCBS multispecialty AW base fee schedule,1897.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22845,Not in chargemaster,22845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22845,BCBS multispecialty AW base fee schedule,1402.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22846,Not in chargemaster,22846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22846,BCBS multispecialty AW base fee schedule,1458.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22847,Not in chargemaster,22847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22847,BCBS multispecialty AW base fee schedule,1552.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22848,Not in chargemaster,22848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22848,BCBS multispecialty AW base fee schedule,693.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22849,Not in chargemaster,22849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22849,BCBS multispecialty AW base fee schedule,2500.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22850,Not in chargemaster,22850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22850,BCBS multispecialty AW base fee schedule,1397.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22852,Not in chargemaster,22852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22852,BCBS multispecialty AW base fee schedule,1341.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22853,Not in chargemaster,22853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22853,BCBS multispecialty AW base fee schedule,498.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22854,Not in chargemaster,22854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22854,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22855,Not in chargemaster,22855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22855,BCBS multispecialty AW base fee schedule,2127.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22856,Not in chargemaster,22856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22856,BCBS multispecialty AW base fee schedule,3138.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22857,Not in chargemaster,22857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22857,BCBS multispecialty AW base fee schedule,3398.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22858,Not in chargemaster,22858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22858,BCBS multispecialty AW base fee schedule,984.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22859,Not in chargemaster,22859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22859,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22861,Not in chargemaster,22861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22861,BCBS multispecialty AW base fee schedule,4438.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22862,Not in chargemaster,22862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22862,BCBS multispecialty AW base fee schedule,4425.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22864,Not in chargemaster,22864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22864,BCBS multispecialty AW base fee schedule,3957.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22865,Not in chargemaster,22865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22865,BCBS multispecialty AW base fee schedule,4318.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22867,Not in chargemaster,22867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22867,BCBS multispecialty AW base fee schedule,1873.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22868,Not in chargemaster,22868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22868,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22869,Not in chargemaster,22869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22869,BCBS multispecialty AW base fee schedule,851.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22870,Not in chargemaster,22870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22870,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22900,Not in chargemaster,22900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22900,BCBS multispecialty AW base fee schedule,1079.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22901,Not in chargemaster,22901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22901,BCBS multispecialty AW base fee schedule,1281.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22902,Not in chargemaster,22902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22902,BCBS multispecialty AW base fee schedule,873.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22903,Not in chargemaster,22903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22903,BCBS multispecialty AW base fee schedule,842.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22904,Not in chargemaster,22904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22904,BCBS multispecialty AW base fee schedule,2022.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22905,Not in chargemaster,22905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22905,BCBS multispecialty AW base fee schedule,2555.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23000,Not in chargemaster,23000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23000,BCBS multispecialty AW base fee schedule,1092.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23020,Not in chargemaster,23020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23020,BCBS multispecialty AW base fee schedule,1319.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23030,Not in chargemaster,23030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23030,BCBS multispecialty AW base fee schedule,824.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23031,Not in chargemaster,23031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23031,BCBS multispecialty AW base fee schedule,765.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23035,Not in chargemaster,23035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23035,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23040,Not in chargemaster,23040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23040,BCBS multispecialty AW base fee schedule,1372.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23044,Not in chargemaster,23044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23044,BCBS multispecialty AW base fee schedule,1081.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23065,Not in chargemaster,23065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23065,BCBS multispecialty AW base fee schedule,422.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23066,Not in chargemaster,23066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23066,BCBS multispecialty AW base fee schedule,1076.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23071,Not in chargemaster,23071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23071,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23073,Not in chargemaster,23073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23073,BCBS multispecialty AW base fee schedule,1332.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23075,Not in chargemaster,23075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23075,BCBS multispecialty AW base fee schedule,953.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23076,Not in chargemaster,23076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23076,BCBS multispecialty AW base fee schedule,1035.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23077,Not in chargemaster,23077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23077,BCBS multispecialty AW base fee schedule,2169.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23078,Not in chargemaster,23078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23078,BCBS multispecialty AW base fee schedule,2756.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23100,Not in chargemaster,23100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23100,BCBS multispecialty AW base fee schedule,960.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23101,Not in chargemaster,23101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23101,BCBS multispecialty AW base fee schedule,871.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23105,Not in chargemaster,23105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23105,BCBS multispecialty AW base fee schedule,1215.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23106,Not in chargemaster,23106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23106,BCBS multispecialty AW base fee schedule,952.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23107,Not in chargemaster,23107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23107,BCBS multispecialty AW base fee schedule,1260.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23120,Not in chargemaster,23120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23120,BCBS multispecialty AW base fee schedule,1116.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23125,Not in chargemaster,23125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23125,BCBS multispecialty AW base fee schedule,1356.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23130,Not in chargemaster,23130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23130,BCBS multispecialty AW base fee schedule,1171.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23140,Not in chargemaster,23140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23140,BCBS multispecialty AW base fee schedule,1057.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23145,Not in chargemaster,23145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23145,BCBS multispecialty AW base fee schedule,1329.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23146,Not in chargemaster,23146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23146,BCBS multispecialty AW base fee schedule,1188.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23150,Not in chargemaster,23150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23150,BCBS multispecialty AW base fee schedule,1274.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23155,Not in chargemaster,23155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23155,BCBS multispecialty AW base fee schedule,1521.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23156,Not in chargemaster,23156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23156,BCBS multispecialty AW base fee schedule,1296.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23170,Not in chargemaster,23170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23170,BCBS multispecialty AW base fee schedule,1073.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23172,Not in chargemaster,23172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23172,BCBS multispecialty AW base fee schedule,1084.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23174,Not in chargemaster,23174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23174,BCBS multispecialty AW base fee schedule,1452.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23180,Not in chargemaster,23180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23180,BCBS multispecialty AW base fee schedule,1271.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23182,Not in chargemaster,23182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23182,BCBS multispecialty AW base fee schedule,1259.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23184,Not in chargemaster,23184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23184,BCBS multispecialty AW base fee schedule,1410.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23190,Not in chargemaster,23190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23190,BCBS multispecialty AW base fee schedule,1095.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23195,Not in chargemaster,23195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23195,BCBS multispecialty AW base fee schedule,1429.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23200,Not in chargemaster,23200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23200,BCBS multispecialty AW base fee schedule,2891.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23210,Not in chargemaster,23210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23210,BCBS multispecialty AW base fee schedule,3397.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23220,Not in chargemaster,23220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23220,BCBS multispecialty AW base fee schedule,3735.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23330,Not in chargemaster,23330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23330,BCBS multispecialty AW base fee schedule,549.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23333,Not in chargemaster,23333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23333,BCBS multispecialty AW base fee schedule,885.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23334,Not in chargemaster,23334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23334,BCBS multispecialty AW base fee schedule,2041.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23335,Not in chargemaster,23335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23335,BCBS multispecialty AW base fee schedule,2434.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23350,Not in chargemaster,23350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23350,BCBS multispecialty AW base fee schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23395,Not in chargemaster,23395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23395,BCBS multispecialty AW base fee schedule,2456.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23397,Not in chargemaster,23397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23397,BCBS multispecialty AW base fee schedule,2185.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23400,Not in chargemaster,23400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23400,BCBS multispecialty AW base fee schedule,1860.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23405,Not in chargemaster,23405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23405,BCBS multispecialty AW base fee schedule,1184.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23406,Not in chargemaster,23406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23406,BCBS multispecialty AW base fee schedule,1470.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23410,Not in chargemaster,23410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23410,BCBS multispecialty AW base fee schedule,1568.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23412,Not in chargemaster,23412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23412,BCBS multispecialty AW base fee schedule,1631.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23415,Not in chargemaster,23415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23415,BCBS multispecialty AW base fee schedule,1332.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23420,Not in chargemaster,23420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23420,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23430,Not in chargemaster,23430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23430,BCBS multispecialty AW base fee schedule,1423.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23440,Not in chargemaster,23440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23440,BCBS multispecialty AW base fee schedule,1446.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23450,Not in chargemaster,23450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23450,BCBS multispecialty AW base fee schedule,1814.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23455,Not in chargemaster,23455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23455,BCBS multispecialty AW base fee schedule,1902.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23460,Not in chargemaster,23460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23460,BCBS multispecialty AW base fee schedule,2085.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23462,Not in chargemaster,23462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23462,BCBS multispecialty AW base fee schedule,2047.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23465,Not in chargemaster,23465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23465,BCBS multispecialty AW base fee schedule,2141.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23466,Not in chargemaster,23466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23466,BCBS multispecialty AW base fee schedule,2122.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23470,Not in chargemaster,23470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23470,BCBS multispecialty AW base fee schedule,2300.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23472,Not in chargemaster,23472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23472,BCBS multispecialty AW base fee schedule,2781.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23473,Not in chargemaster,23473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23473,BCBS multispecialty AW base fee schedule,3102.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23474,Not in chargemaster,23474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23474,BCBS multispecialty AW base fee schedule,3352.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23480,Not in chargemaster,23480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23480,BCBS multispecialty AW base fee schedule,1570.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23485,Not in chargemaster,23485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23485,BCBS multispecialty AW base fee schedule,1831.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23490,Not in chargemaster,23490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23490,BCBS multispecialty AW base fee schedule,1648.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23491,Not in chargemaster,23491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23491,BCBS multispecialty AW base fee schedule,1943.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23500,23500,23500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23500,BCBS multispecialty AW base fee schedule,418.7,467.8,Fee schedule,,418.7,418.7,418.7,418.7,,,0
unity,Fee schedule,Non-facility 23505,Not in chargemaster,23505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23505,BCBS multispecialty AW base fee schedule,679.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23515,Not in chargemaster,23515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23515,BCBS multispecialty AW base fee schedule,1376.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23520,Not in chargemaster,23520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23520,BCBS multispecialty AW base fee schedule,450.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23525,Not in chargemaster,23525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23525,BCBS multispecialty AW base fee schedule,742.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23530,Not in chargemaster,23530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23530,BCBS multispecialty AW base fee schedule,1096.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23532,Not in chargemaster,23532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23532,BCBS multispecialty AW base fee schedule,1194.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23540,Not in chargemaster,23540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23540,BCBS multispecialty AW base fee schedule,441.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23545,Not in chargemaster,23545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23545,BCBS multispecialty AW base fee schedule,653.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23550,Not in chargemaster,23550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23550,BCBS multispecialty AW base fee schedule,1094.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23552,Not in chargemaster,23552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23552,BCBS multispecialty AW base fee schedule,1248.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23570,Not in chargemaster,23570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23570,BCBS multispecialty AW base fee schedule,443.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23575,Not in chargemaster,23575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23575,BCBS multispecialty AW base fee schedule,772.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23585,Not in chargemaster,23585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23585,BCBS multispecialty AW base fee schedule,1874.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23600,Not in chargemaster,23600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23600,BCBS multispecialty AW base fee schedule,626.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23605,Not in chargemaster,23605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23605,BCBS multispecialty AW base fee schedule,891.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23615,Not in chargemaster,23615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23615,BCBS multispecialty AW base fee schedule,1689.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23616,Not in chargemaster,23616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23616,BCBS multispecialty AW base fee schedule,2369.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23620,Not in chargemaster,23620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23620,BCBS multispecialty AW base fee schedule,510.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23625,Not in chargemaster,23625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23625,BCBS multispecialty AW base fee schedule,724.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23630,Not in chargemaster,23630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23630,BCBS multispecialty AW base fee schedule,1489.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23650,23650,23650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23650,BCBS multispecialty AW base fee schedule,608.18,672.96,Fee schedule,,608.18,608.18,608.18,608.18,,,0
unity,Fee schedule,Non-facility 23655,23655,23655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23655,BCBS multispecialty AW base fee schedule,771.15,839.77,Fee schedule,,771.15,771.15,771.15,771.15,,,0
unity,Fee schedule,Non-facility 23660,Not in chargemaster,23660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23660,BCBS multispecialty AW base fee schedule,1116.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23665,Not in chargemaster,23665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23665,BCBS multispecialty AW base fee schedule,816.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23670,Not in chargemaster,23670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23670,BCBS multispecialty AW base fee schedule,1670.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23675,Not in chargemaster,23675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23675,BCBS multispecialty AW base fee schedule,1053.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23680,Not in chargemaster,23680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23680,BCBS multispecialty AW base fee schedule,1778.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23700,Not in chargemaster,23700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23700,BCBS multispecialty AW base fee schedule,372.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23800,Not in chargemaster,23800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23800,BCBS multispecialty AW base fee schedule,1964.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23802,Not in chargemaster,23802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23802,BCBS multispecialty AW base fee schedule,2453.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23900,Not in chargemaster,23900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23900,BCBS multispecialty AW base fee schedule,2655.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23920,Not in chargemaster,23920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23920,BCBS multispecialty AW base fee schedule,2151.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23921,Not in chargemaster,23921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23921,BCBS multispecialty AW base fee schedule,895.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23930,Not in chargemaster,23930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23930,BCBS multispecialty AW base fee schedule,677.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23931,Not in chargemaster,23931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23931,BCBS multispecialty AW base fee schedule,549.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23935,Not in chargemaster,23935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,23935,BCBS multispecialty AW base fee schedule,976.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24000,Not in chargemaster,24000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24000,BCBS multispecialty AW base fee schedule,912.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24006,Not in chargemaster,24006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24006,BCBS multispecialty AW base fee schedule,1360.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24065,Not in chargemaster,24065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24065,BCBS multispecialty AW base fee schedule,490.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24066,Not in chargemaster,24066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24066,BCBS multispecialty AW base fee schedule,1183.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24071,Not in chargemaster,24071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24071,BCBS multispecialty AW base fee schedule,777.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24073,24073,24073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24073,BCBS multispecialty AW base fee schedule,1332.95,1450.26,Fee schedule,,1332.95,1332.95,1332.95,1332.95,,,0
unity,Fee schedule,Non-facility 24075,Not in chargemaster,24075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24075,BCBS multispecialty AW base fee schedule,985.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24076,Not in chargemaster,24076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24076,BCBS multispecialty AW base fee schedule,1039.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24077,Not in chargemaster,24077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24077,BCBS multispecialty AW base fee schedule,1994.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24079,Not in chargemaster,24079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24079,BCBS multispecialty AW base fee schedule,2542.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24100,Not in chargemaster,24100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24100,BCBS multispecialty AW base fee schedule,798.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24101,Not in chargemaster,24101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24101,BCBS multispecialty AW base fee schedule,957.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24102,Not in chargemaster,24102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24102,BCBS multispecialty AW base fee schedule,1177.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24105,Not in chargemaster,24105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24105,BCBS multispecialty AW base fee schedule,674.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24110,Not in chargemaster,24110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24110,BCBS multispecialty AW base fee schedule,1121.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24115,Not in chargemaster,24115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24115,BCBS multispecialty AW base fee schedule,1409.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24116,Not in chargemaster,24116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24116,BCBS multispecialty AW base fee schedule,1647.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24120,Not in chargemaster,24120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24120,BCBS multispecialty AW base fee schedule,1016.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24125,Not in chargemaster,24125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24125,BCBS multispecialty AW base fee schedule,1187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24126,Not in chargemaster,24126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24126,BCBS multispecialty AW base fee schedule,1240.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24130,Not in chargemaster,24130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24130,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24134,Not in chargemaster,24134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24134,BCBS multispecialty AW base fee schedule,1429.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24136,Not in chargemaster,24136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24136,BCBS multispecialty AW base fee schedule,1207.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24138,Not in chargemaster,24138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24138,BCBS multispecialty AW base fee schedule,1299.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24140,Not in chargemaster,24140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24140,BCBS multispecialty AW base fee schedule,1343.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24145,Not in chargemaster,24145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24145,BCBS multispecialty AW base fee schedule,1134.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24147,Not in chargemaster,24147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24147,BCBS multispecialty AW base fee schedule,1191.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24149,Not in chargemaster,24149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24149,BCBS multispecialty AW base fee schedule,2244.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24150,Not in chargemaster,24150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24150,BCBS multispecialty AW base fee schedule,2968.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24152,Not in chargemaster,24152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24152,BCBS multispecialty AW base fee schedule,2578.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24155,Not in chargemaster,24155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24155,BCBS multispecialty AW base fee schedule,1630.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24160,Not in chargemaster,24160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24160,BCBS multispecialty AW base fee schedule,2407.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24164,Not in chargemaster,24164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24164,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24200,Not in chargemaster,24200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24200,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24201,Not in chargemaster,24201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24201,BCBS multispecialty AW base fee schedule,1043.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24220,Not in chargemaster,24220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24220,BCBS multispecialty AW base fee schedule,338.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24300,Not in chargemaster,24300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24300,BCBS multispecialty AW base fee schedule,811.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24301,Not in chargemaster,24301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24301,BCBS multispecialty AW base fee schedule,1432.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24305,Not in chargemaster,24305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24305,BCBS multispecialty AW base fee schedule,1106.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24310,Not in chargemaster,24310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24310,BCBS multispecialty AW base fee schedule,900.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24320,Not in chargemaster,24320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24320,BCBS multispecialty AW base fee schedule,1493.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24330,Not in chargemaster,24330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24330,BCBS multispecialty AW base fee schedule,1372.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24331,Not in chargemaster,24331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24331,BCBS multispecialty AW base fee schedule,1503.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24332,Not in chargemaster,24332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24332,BCBS multispecialty AW base fee schedule,1171.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24340,Not in chargemaster,24340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24340,BCBS multispecialty AW base fee schedule,1173.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24341,Not in chargemaster,24341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24341,BCBS multispecialty AW base fee schedule,1422.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24342,Not in chargemaster,24342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24342,BCBS multispecialty AW base fee schedule,1483.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24343,Not in chargemaster,24343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24343,BCBS multispecialty AW base fee schedule,1352.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24344,Not in chargemaster,24344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24344,BCBS multispecialty AW base fee schedule,2091.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24345,Not in chargemaster,24345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24345,BCBS multispecialty AW base fee schedule,1340.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24346,Not in chargemaster,24346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24346,BCBS multispecialty AW base fee schedule,2104.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24357,Not in chargemaster,24357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24357,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24358,Not in chargemaster,24358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24358,BCBS multispecialty AW base fee schedule,1005.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24359,Not in chargemaster,24359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24359,BCBS multispecialty AW base fee schedule,1264.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24360,Not in chargemaster,24360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24360,BCBS multispecialty AW base fee schedule,1724.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24361,Not in chargemaster,24361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24361,BCBS multispecialty AW base fee schedule,1927.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24362,Not in chargemaster,24362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24362,BCBS multispecialty AW base fee schedule,2029.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24363,Not in chargemaster,24363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24363,BCBS multispecialty AW base fee schedule,2781.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24365,Not in chargemaster,24365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24365,BCBS multispecialty AW base fee schedule,1222.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24366,Not in chargemaster,24366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24366,BCBS multispecialty AW base fee schedule,1305.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24370,Not in chargemaster,24370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24370,BCBS multispecialty AW base fee schedule,2957.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24371,Not in chargemaster,24371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24371,BCBS multispecialty AW base fee schedule,3411.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24400,Not in chargemaster,24400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24400,BCBS multispecialty AW base fee schedule,1574.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24410,Not in chargemaster,24410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24410,BCBS multispecialty AW base fee schedule,2023.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24420,Not in chargemaster,24420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24420,BCBS multispecialty AW base fee schedule,1960.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24430,Not in chargemaster,24430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24430,BCBS multispecialty AW base fee schedule,2020.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24435,Not in chargemaster,24435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24435,BCBS multispecialty AW base fee schedule,2056.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24470,Not in chargemaster,24470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24470,BCBS multispecialty AW base fee schedule,1283.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24495,Not in chargemaster,24495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24495,BCBS multispecialty AW base fee schedule,1551.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24498,Not in chargemaster,24498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24498,BCBS multispecialty AW base fee schedule,1657.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24500,24500,24500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24500,BCBS multispecialty AW base fee schedule,681.05,764.53,Fee schedule,,681.05,681.05,681.05,681.05,,,0
unity,Fee schedule,Non-facility 24505,Not in chargemaster,24505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24505,BCBS multispecialty AW base fee schedule,950.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24515,Not in chargemaster,24515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24515,BCBS multispecialty AW base fee schedule,1680.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24516,Not in chargemaster,24516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24516,BCBS multispecialty AW base fee schedule,1643,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24530,Not in chargemaster,24530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24530,BCBS multispecialty AW base fee schedule,722.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24535,Not in chargemaster,24535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24535,BCBS multispecialty AW base fee schedule,1175.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24538,Not in chargemaster,24538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24538,BCBS multispecialty AW base fee schedule,1458.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24545,Not in chargemaster,24545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24545,BCBS multispecialty AW base fee schedule,1778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24546,Not in chargemaster,24546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24546,BCBS multispecialty AW base fee schedule,1986.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24560,Not in chargemaster,24560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24560,BCBS multispecialty AW base fee schedule,624.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24565,Not in chargemaster,24565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24565,BCBS multispecialty AW base fee schedule,1023.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24566,Not in chargemaster,24566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24566,BCBS multispecialty AW base fee schedule,1372.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24575,Not in chargemaster,24575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24575,BCBS multispecialty AW base fee schedule,1399.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24576,Not in chargemaster,24576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24576,BCBS multispecialty AW base fee schedule,657.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24577,Not in chargemaster,24577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24577,BCBS multispecialty AW base fee schedule,1052.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24579,Not in chargemaster,24579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24579,BCBS multispecialty AW base fee schedule,1590,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24582,Not in chargemaster,24582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24582,BCBS multispecialty AW base fee schedule,1547.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24586,Not in chargemaster,24586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24586,BCBS multispecialty AW base fee schedule,2080.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24587,Not in chargemaster,24587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24587,BCBS multispecialty AW base fee schedule,2082.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24600,Not in chargemaster,24600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24600,BCBS multispecialty AW base fee schedule,706.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24605,Not in chargemaster,24605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24605,BCBS multispecialty AW base fee schedule,903.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24615,Not in chargemaster,24615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24615,BCBS multispecialty AW base fee schedule,1364.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24620,Not in chargemaster,24620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24620,BCBS multispecialty AW base fee schedule,1059.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24635,Not in chargemaster,24635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24635,BCBS multispecialty AW base fee schedule,1287.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24640,24640,24640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24640,BCBS multispecialty AW base fee schedule,191.46,305.95,Fee schedule,,191.46,191.46,191.46,191.46,,,0
unity,Fee schedule,Non-facility 24650,24650,24650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24650,BCBS multispecialty AW base fee schedule,497.54,560.79,Fee schedule,,497.54,497.54,497.54,497.54,,,0
unity,Fee schedule,Non-facility 24655,Not in chargemaster,24655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24655,BCBS multispecialty AW base fee schedule,840.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24665,Not in chargemaster,24665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24665,BCBS multispecialty AW base fee schedule,1250.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24666,Not in chargemaster,24666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24666,BCBS multispecialty AW base fee schedule,1401.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24670,Not in chargemaster,24670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24670,BCBS multispecialty AW base fee schedule,553.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24675,Not in chargemaster,24675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24675,BCBS multispecialty AW base fee schedule,873.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24685,Not in chargemaster,24685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24685,BCBS multispecialty AW base fee schedule,1248.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24800,Not in chargemaster,24800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24800,BCBS multispecialty AW base fee schedule,1589.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24802,Not in chargemaster,24802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24802,BCBS multispecialty AW base fee schedule,1917.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24900,Not in chargemaster,24900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24900,BCBS multispecialty AW base fee schedule,1411.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24920,Not in chargemaster,24920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24920,BCBS multispecialty AW base fee schedule,1401.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24925,Not in chargemaster,24925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24925,BCBS multispecialty AW base fee schedule,1083.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24930,Not in chargemaster,24930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24930,BCBS multispecialty AW base fee schedule,1481.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24931,Not in chargemaster,24931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24931,BCBS multispecialty AW base fee schedule,1784.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24935,Not in chargemaster,24935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24935,BCBS multispecialty AW base fee schedule,2271.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25000,Not in chargemaster,25000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25000,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25001,Not in chargemaster,25001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25001,BCBS multispecialty AW base fee schedule,654.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25020,Not in chargemaster,25020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25020,BCBS multispecialty AW base fee schedule,1216.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25023,Not in chargemaster,25023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25023,BCBS multispecialty AW base fee schedule,2284.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25024,Not in chargemaster,25024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25024,BCBS multispecialty AW base fee schedule,1495.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25025,Not in chargemaster,25025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25025,BCBS multispecialty AW base fee schedule,2303.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25028,Not in chargemaster,25028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25028,BCBS multispecialty AW base fee schedule,1130.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25031,Not in chargemaster,25031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25031,BCBS multispecialty AW base fee schedule,668.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25035,Not in chargemaster,25035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25035,BCBS multispecialty AW base fee schedule,1114.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25040,Not in chargemaster,25040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25040,BCBS multispecialty AW base fee schedule,1071.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25065,Not in chargemaster,25065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25065,BCBS multispecialty AW base fee schedule,488.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25066,Not in chargemaster,25066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25066,BCBS multispecialty AW base fee schedule,682.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25071,Not in chargemaster,25071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25071,BCBS multispecialty AW base fee schedule,811.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25073,Not in chargemaster,25073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25073,BCBS multispecialty AW base fee schedule,1022.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25075,Not in chargemaster,25075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25075,BCBS multispecialty AW base fee schedule,961.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25076,Not in chargemaster,25076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25076,BCBS multispecialty AW base fee schedule,987.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25077,Not in chargemaster,25077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25077,BCBS multispecialty AW base fee schedule,1699.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25078,Not in chargemaster,25078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25078,BCBS multispecialty AW base fee schedule,2228.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25085,Not in chargemaster,25085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25085,BCBS multispecialty AW base fee schedule,856.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25100,Not in chargemaster,25100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25100,BCBS multispecialty AW base fee schedule,662.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25101,Not in chargemaster,25101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25101,BCBS multispecialty AW base fee schedule,770.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25105,Not in chargemaster,25105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25105,BCBS multispecialty AW base fee schedule,925.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25107,Not in chargemaster,25107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25107,BCBS multispecialty AW base fee schedule,1173.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25109,Not in chargemaster,25109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25109,BCBS multispecialty AW base fee schedule,1025.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25110,Not in chargemaster,25110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25110,BCBS multispecialty AW base fee schedule,651.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25111,25111,25111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25111,BCBS multispecialty AW base fee schedule,612.15,678.63,Fee schedule,,612.15,612.15,612.15,612.15,,,0
unity,Fee schedule,Non-facility 25112,Not in chargemaster,25112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25112,BCBS multispecialty AW base fee schedule,738.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25115,Not in chargemaster,25115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25115,BCBS multispecialty AW base fee schedule,1444.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25116,Not in chargemaster,25116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25116,BCBS multispecialty AW base fee schedule,1146.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25118,Not in chargemaster,25118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25118,BCBS multispecialty AW base fee schedule,726.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25119,Not in chargemaster,25119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25119,BCBS multispecialty AW base fee schedule,946.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25120,Not in chargemaster,25120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25120,BCBS multispecialty AW base fee schedule,955.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25125,Not in chargemaster,25125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25125,BCBS multispecialty AW base fee schedule,1133.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25126,Not in chargemaster,25126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25126,BCBS multispecialty AW base fee schedule,1142.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25130,Not in chargemaster,25130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25130,BCBS multispecialty AW base fee schedule,855.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25135,Not in chargemaster,25135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25135,BCBS multispecialty AW base fee schedule,1067.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25136,Not in chargemaster,25136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25136,BCBS multispecialty AW base fee schedule,947.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25145,Not in chargemaster,25145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25145,BCBS multispecialty AW base fee schedule,991.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25150,Not in chargemaster,25150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25150,BCBS multispecialty AW base fee schedule,1078.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25151,Not in chargemaster,25151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25151,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25170,Not in chargemaster,25170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25170,BCBS multispecialty AW base fee schedule,2821.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25210,Not in chargemaster,25210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25210,BCBS multispecialty AW base fee schedule,935.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25215,Not in chargemaster,25215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25215,BCBS multispecialty AW base fee schedule,1179.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25230,Not in chargemaster,25230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25230,BCBS multispecialty AW base fee schedule,824.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25240,Not in chargemaster,25240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25240,BCBS multispecialty AW base fee schedule,818.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25246,Not in chargemaster,25246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25246,BCBS multispecialty AW base fee schedule,347.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25248,Not in chargemaster,25248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25248,BCBS multispecialty AW base fee schedule,793.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25250,Not in chargemaster,25250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25250,BCBS multispecialty AW base fee schedule,1015.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25251,Not in chargemaster,25251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25251,BCBS multispecialty AW base fee schedule,1376.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25259,Not in chargemaster,25259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25259,BCBS multispecialty AW base fee schedule,805.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25260,Not in chargemaster,25260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25260,BCBS multispecialty AW base fee schedule,1204.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25263,Not in chargemaster,25263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25263,BCBS multispecialty AW base fee schedule,1205.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25265,Not in chargemaster,25265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25265,BCBS multispecialty AW base fee schedule,1430.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25270,Not in chargemaster,25270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25270,BCBS multispecialty AW base fee schedule,940.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25272,Not in chargemaster,25272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25272,BCBS multispecialty AW base fee schedule,1065.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25274,Not in chargemaster,25274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25274,BCBS multispecialty AW base fee schedule,1271.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25275,Not in chargemaster,25275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25275,BCBS multispecialty AW base fee schedule,1283.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25280,Not in chargemaster,25280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25280,BCBS multispecialty AW base fee schedule,1079.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25290,Not in chargemaster,25290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25290,BCBS multispecialty AW base fee schedule,830.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25295,Not in chargemaster,25295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25295,BCBS multispecialty AW base fee schedule,1003.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25300,Not in chargemaster,25300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25300,BCBS multispecialty AW base fee schedule,1305.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25301,Not in chargemaster,25301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25301,BCBS multispecialty AW base fee schedule,1228.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25310,Not in chargemaster,25310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25310,BCBS multispecialty AW base fee schedule,1182.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25312,Not in chargemaster,25312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25312,BCBS multispecialty AW base fee schedule,1372.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25315,Not in chargemaster,25315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25315,BCBS multispecialty AW base fee schedule,1473.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25316,Not in chargemaster,25316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25316,BCBS multispecialty AW base fee schedule,1750.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25320,Not in chargemaster,25320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25320,BCBS multispecialty AW base fee schedule,1877.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25332,Not in chargemaster,25332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25332,BCBS multispecialty AW base fee schedule,1610.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25335,Not in chargemaster,25335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25335,BCBS multispecialty AW base fee schedule,1805.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25337,Not in chargemaster,25337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25337,BCBS multispecialty AW base fee schedule,1690.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25350,Not in chargemaster,25350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25350,BCBS multispecialty AW base fee schedule,1289.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25355,Not in chargemaster,25355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25355,BCBS multispecialty AW base fee schedule,1462.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25360,Not in chargemaster,25360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25360,BCBS multispecialty AW base fee schedule,1249.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25365,Not in chargemaster,25365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25365,BCBS multispecialty AW base fee schedule,1752.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25370,Not in chargemaster,25370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25370,BCBS multispecialty AW base fee schedule,1931.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25375,Not in chargemaster,25375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25375,BCBS multispecialty AW base fee schedule,1826.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25390,Not in chargemaster,25390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25390,BCBS multispecialty AW base fee schedule,1469.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25391,Not in chargemaster,25391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25391,BCBS multispecialty AW base fee schedule,1907.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25392,Not in chargemaster,25392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25392,BCBS multispecialty AW base fee schedule,1941.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25393,Not in chargemaster,25393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25393,BCBS multispecialty AW base fee schedule,2163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25394,Not in chargemaster,25394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25394,BCBS multispecialty AW base fee schedule,1500.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25400,Not in chargemaster,25400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25400,BCBS multispecialty AW base fee schedule,1535.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25405,Not in chargemaster,25405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25405,BCBS multispecialty AW base fee schedule,1984.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25415,Not in chargemaster,25415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25415,BCBS multispecialty AW base fee schedule,1853.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25420,Not in chargemaster,25420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25420,BCBS multispecialty AW base fee schedule,2233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25425,Not in chargemaster,25425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25425,BCBS multispecialty AW base fee schedule,1844.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25426,Not in chargemaster,25426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25426,BCBS multispecialty AW base fee schedule,2151.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25430,Not in chargemaster,25430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25430,BCBS multispecialty AW base fee schedule,1395.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25431,Not in chargemaster,25431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25431,BCBS multispecialty AW base fee schedule,1508.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25440,Not in chargemaster,25440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25440,BCBS multispecialty AW base fee schedule,1466.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25441,Not in chargemaster,25441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25441,BCBS multispecialty AW base fee schedule,1793.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25442,Not in chargemaster,25442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25442,BCBS multispecialty AW base fee schedule,1542.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25443,Not in chargemaster,25443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25443,BCBS multispecialty AW base fee schedule,1497.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25444,Not in chargemaster,25444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25444,BCBS multispecialty AW base fee schedule,1583.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25445,Not in chargemaster,25445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25445,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25446,Not in chargemaster,25446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25446,BCBS multispecialty AW base fee schedule,2243.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25447,Not in chargemaster,25447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25447,BCBS multispecialty AW base fee schedule,1582.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25449,Not in chargemaster,25449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25449,BCBS multispecialty AW base fee schedule,1978.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25450,Not in chargemaster,25450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25450,BCBS multispecialty AW base fee schedule,1178.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25455,Not in chargemaster,25455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25455,BCBS multispecialty AW base fee schedule,1391.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25490,Not in chargemaster,25490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25490,BCBS multispecialty AW base fee schedule,1374.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25491,Not in chargemaster,25491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25491,BCBS multispecialty AW base fee schedule,1412.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25492,Not in chargemaster,25492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25492,BCBS multispecialty AW base fee schedule,1732.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25500,Not in chargemaster,25500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25500,BCBS multispecialty AW base fee schedule,528.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25505,Not in chargemaster,25505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25505,BCBS multispecialty AW base fee schedule,959.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25515,Not in chargemaster,25515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25515,BCBS multispecialty AW base fee schedule,1278.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25520,Not in chargemaster,25520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25520,BCBS multispecialty AW base fee schedule,1091.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25525,Not in chargemaster,25525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25525,BCBS multispecialty AW base fee schedule,1506.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25526,Not in chargemaster,25526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25526,BCBS multispecialty AW base fee schedule,1825.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25530,25530,25530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25530,BCBS multispecialty AW base fee schedule,498.2,506.86,Fee schedule,,498.2,498.2,498.2,498.2,,,0
unity,Fee schedule,Non-facility 25535,Not in chargemaster,25535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25535,BCBS multispecialty AW base fee schedule,933.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25545,Not in chargemaster,25545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25545,BCBS multispecialty AW base fee schedule,1188.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25560,25560,25560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25560,BCBS multispecialty AW base fee schedule,539.94,610,Fee schedule,,539.94,539.94,539.94,539.94,,,0
unity,Fee schedule,Non-facility 25565,Not in chargemaster,25565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25565,BCBS multispecialty AW base fee schedule,983.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25574,Not in chargemaster,25574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25574,BCBS multispecialty AW base fee schedule,1286.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25575,Not in chargemaster,25575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25575,BCBS multispecialty AW base fee schedule,1722.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25600,25600,25600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25600,BCBS multispecialty AW base fee schedule,630.04,715,Fee schedule,,630.04,630.04,630.04,630.04,,,0
unity,Fee schedule,Non-facility 25605,25605,25605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25605,BCBS multispecialty AW base fee schedule,1032.18,1167.02,Fee schedule,,1032.18,1032.18,1032.18,1032.18,,,0
unity,Fee schedule,Non-facility 25606,Not in chargemaster,25606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25606,BCBS multispecialty AW base fee schedule,1266.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25607,Not in chargemaster,25607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25607,BCBS multispecialty AW base fee schedule,1404.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25608,Not in chargemaster,25608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25608,BCBS multispecialty AW base fee schedule,1575.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25609,Not in chargemaster,25609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25609,BCBS multispecialty AW base fee schedule,2004.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25622,25622,25622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25622,BCBS multispecialty AW base fee schedule,580.35,653.08,Fee schedule,,580.35,580.35,580.35,580.35,,,0
unity,Fee schedule,Non-facility 25624,Not in chargemaster,25624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25624,BCBS multispecialty AW base fee schedule,920.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25628,Not in chargemaster,25628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25628,BCBS multispecialty AW base fee schedule,1373.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25630,Not in chargemaster,25630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25630,BCBS multispecialty AW base fee schedule,581.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25635,Not in chargemaster,25635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25635,BCBS multispecialty AW base fee schedule,875.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25645,Not in chargemaster,25645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25645,BCBS multispecialty AW base fee schedule,1089.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25650,Not in chargemaster,25650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25650,BCBS multispecialty AW base fee schedule,619.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25651,Not in chargemaster,25651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25651,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25652,Not in chargemaster,25652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25652,BCBS multispecialty AW base fee schedule,1187.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25660,Not in chargemaster,25660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25660,BCBS multispecialty AW base fee schedule,791.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25670,Not in chargemaster,25670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25670,BCBS multispecialty AW base fee schedule,1161.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25671,Not in chargemaster,25671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25671,BCBS multispecialty AW base fee schedule,1013.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25675,Not in chargemaster,25675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25675,BCBS multispecialty AW base fee schedule,843.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25676,Not in chargemaster,25676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25676,BCBS multispecialty AW base fee schedule,1206.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25680,Not in chargemaster,25680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25680,BCBS multispecialty AW base fee schedule,1001.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25685,Not in chargemaster,25685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25685,BCBS multispecialty AW base fee schedule,1405.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25690,Not in chargemaster,25690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25690,BCBS multispecialty AW base fee schedule,927.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25695,Not in chargemaster,25695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25695,BCBS multispecialty AW base fee schedule,1212.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25800,Not in chargemaster,25800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25800,BCBS multispecialty AW base fee schedule,1397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25805,Not in chargemaster,25805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25805,BCBS multispecialty AW base fee schedule,1619.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25810,Not in chargemaster,25810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25810,BCBS multispecialty AW base fee schedule,1655.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25820,Not in chargemaster,25820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25820,BCBS multispecialty AW base fee schedule,1205.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25825,Not in chargemaster,25825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25825,BCBS multispecialty AW base fee schedule,1478.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25830,Not in chargemaster,25830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25830,BCBS multispecialty AW base fee schedule,1864.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25900,Not in chargemaster,25900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25900,BCBS multispecialty AW base fee schedule,1359.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25905,Not in chargemaster,25905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25905,BCBS multispecialty AW base fee schedule,1341.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25907,Not in chargemaster,25907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25907,BCBS multispecialty AW base fee schedule,1173.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25909,Not in chargemaster,25909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25909,BCBS multispecialty AW base fee schedule,1310.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25915,Not in chargemaster,25915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25915,BCBS multispecialty AW base fee schedule,2238.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25920,Not in chargemaster,25920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25920,BCBS multispecialty AW base fee schedule,1364.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25922,Not in chargemaster,25922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25922,BCBS multispecialty AW base fee schedule,1200.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25924,Not in chargemaster,25924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25924,BCBS multispecialty AW base fee schedule,1330.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25927,Not in chargemaster,25927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25927,BCBS multispecialty AW base fee schedule,1590,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25929,Not in chargemaster,25929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25929,BCBS multispecialty AW base fee schedule,1141.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25931,Not in chargemaster,25931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,25931,BCBS multispecialty AW base fee schedule,1465.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26010,26010,26010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26010,BCBS multispecialty AW base fee schedule,571.08,569.61,Fee schedule,,569.61,569.61,569.61,569.61,,,0
unity,Fee schedule,Non-facility 26011,Not in chargemaster,26011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26011,BCBS multispecialty AW base fee schedule,826.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26020,Not in chargemaster,26020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26020,BCBS multispecialty AW base fee schedule,1057.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26025,Not in chargemaster,26025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26025,BCBS multispecialty AW base fee schedule,802.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26030,Not in chargemaster,26030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26030,BCBS multispecialty AW base fee schedule,937.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26034,Not in chargemaster,26034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26034,BCBS multispecialty AW base fee schedule,1041.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26035,Not in chargemaster,26035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26035,BCBS multispecialty AW base fee schedule,1639.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26037,Not in chargemaster,26037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26037,BCBS multispecialty AW base fee schedule,1081.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26040,Not in chargemaster,26040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26040,BCBS multispecialty AW base fee schedule,596.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26045,Not in chargemaster,26045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26045,BCBS multispecialty AW base fee schedule,895.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26055,Not in chargemaster,26055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26055,BCBS multispecialty AW base fee schedule,1034.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26060,Not in chargemaster,26060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26060,BCBS multispecialty AW base fee schedule,490.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26070,Not in chargemaster,26070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26070,BCBS multispecialty AW base fee schedule,611.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26075,Not in chargemaster,26075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26075,BCBS multispecialty AW base fee schedule,638.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26080,Not in chargemaster,26080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26080,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26100,Not in chargemaster,26100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26100,BCBS multispecialty AW base fee schedule,643.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26105,Not in chargemaster,26105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26105,BCBS multispecialty AW base fee schedule,647.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26110,Not in chargemaster,26110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26110,BCBS multispecialty AW base fee schedule,614.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26111,Not in chargemaster,26111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26111,BCBS multispecialty AW base fee schedule,794.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26113,Not in chargemaster,26113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26113,BCBS multispecialty AW base fee schedule,1044.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26115,Not in chargemaster,26115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26115,BCBS multispecialty AW base fee schedule,1009.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26116,Not in chargemaster,26116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26116,BCBS multispecialty AW base fee schedule,1002.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26117,Not in chargemaster,26117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26117,BCBS multispecialty AW base fee schedule,1421.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26118,Not in chargemaster,26118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26118,BCBS multispecialty AW base fee schedule,2013.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26121,Not in chargemaster,26121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26121,BCBS multispecialty AW base fee schedule,1141.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26123,Not in chargemaster,26123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26123,BCBS multispecialty AW base fee schedule,1592.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26125,Not in chargemaster,26125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26125,BCBS multispecialty AW base fee schedule,521.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26130,Not in chargemaster,26130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26130,BCBS multispecialty AW base fee schedule,888.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26135,Not in chargemaster,26135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26135,BCBS multispecialty AW base fee schedule,1054.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26140,Not in chargemaster,26140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26140,BCBS multispecialty AW base fee schedule,965.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26145,Not in chargemaster,26145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26145,BCBS multispecialty AW base fee schedule,981.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26160,Not in chargemaster,26160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26160,BCBS multispecialty AW base fee schedule,1082.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26170,Not in chargemaster,26170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26170,BCBS multispecialty AW base fee schedule,775.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26180,Not in chargemaster,26180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26180,BCBS multispecialty AW base fee schedule,851.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26185,Not in chargemaster,26185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26185,BCBS multispecialty AW base fee schedule,1052.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26200,Not in chargemaster,26200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26200,BCBS multispecialty AW base fee schedule,861.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26205,Not in chargemaster,26205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26205,BCBS multispecialty AW base fee schedule,1154.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26210,Not in chargemaster,26210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26210,BCBS multispecialty AW base fee schedule,846.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26215,Not in chargemaster,26215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26215,BCBS multispecialty AW base fee schedule,1079.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26230,Not in chargemaster,26230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26230,BCBS multispecialty AW base fee schedule,954,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26235,Not in chargemaster,26235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26235,BCBS multispecialty AW base fee schedule,940.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26236,Not in chargemaster,26236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26236,BCBS multispecialty AW base fee schedule,841.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26250,Not in chargemaster,26250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26250,BCBS multispecialty AW base fee schedule,2040.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26260,Not in chargemaster,26260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26260,BCBS multispecialty AW base fee schedule,1528.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26262,Not in chargemaster,26262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26262,BCBS multispecialty AW base fee schedule,1205.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26320,Not in chargemaster,26320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26320,BCBS multispecialty AW base fee schedule,663.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26340,Not in chargemaster,26340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26340,BCBS multispecialty AW base fee schedule,648.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26341,Not in chargemaster,26341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26341,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26350,Not in chargemaster,26350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26350,BCBS multispecialty AW base fee schedule,1378.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26352,Not in chargemaster,26352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26352,BCBS multispecialty AW base fee schedule,1544.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26356,Not in chargemaster,26356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26356,BCBS multispecialty AW base fee schedule,1514.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26357,Not in chargemaster,26357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26357,BCBS multispecialty AW base fee schedule,1697.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26358,Not in chargemaster,26358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26358,BCBS multispecialty AW base fee schedule,1878.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26370,Not in chargemaster,26370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26370,BCBS multispecialty AW base fee schedule,1456.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26372,Not in chargemaster,26372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26372,BCBS multispecialty AW base fee schedule,1705.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26373,Not in chargemaster,26373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26373,BCBS multispecialty AW base fee schedule,1637.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26390,Not in chargemaster,26390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26390,BCBS multispecialty AW base fee schedule,1621.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26392,Not in chargemaster,26392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26392,BCBS multispecialty AW base fee schedule,1871.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26410,Not in chargemaster,26410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26410,BCBS multispecialty AW base fee schedule,1097.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26412,Not in chargemaster,26412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26412,BCBS multispecialty AW base fee schedule,1308.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26415,Not in chargemaster,26415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26415,BCBS multispecialty AW base fee schedule,1575.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26416,Not in chargemaster,26416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26416,BCBS multispecialty AW base fee schedule,1708.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26418,Not in chargemaster,26418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26418,BCBS multispecialty AW base fee schedule,1128.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26420,Not in chargemaster,26420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26420,BCBS multispecialty AW base fee schedule,1369.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26426,Not in chargemaster,26426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26426,BCBS multispecialty AW base fee schedule,957.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26428,Not in chargemaster,26428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26428,BCBS multispecialty AW base fee schedule,1466.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26432,Not in chargemaster,26432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26432,BCBS multispecialty AW base fee schedule,973.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26433,Not in chargemaster,26433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26433,BCBS multispecialty AW base fee schedule,1034.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26434,Not in chargemaster,26434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26434,BCBS multispecialty AW base fee schedule,1265.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26437,Not in chargemaster,26437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26437,BCBS multispecialty AW base fee schedule,1212.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26440,Not in chargemaster,26440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26440,BCBS multispecialty AW base fee schedule,1195.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26442,Not in chargemaster,26442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26442,BCBS multispecialty AW base fee schedule,1839.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26445,Not in chargemaster,26445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26445,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26449,Not in chargemaster,26449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26449,BCBS multispecialty AW base fee schedule,1323.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26450,Not in chargemaster,26450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26450,BCBS multispecialty AW base fee schedule,809.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26455,Not in chargemaster,26455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26455,BCBS multispecialty AW base fee schedule,803.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26460,Not in chargemaster,26460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26460,BCBS multispecialty AW base fee schedule,785.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26471,Not in chargemaster,26471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26471,BCBS multispecialty AW base fee schedule,1198.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26474,Not in chargemaster,26474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26474,BCBS multispecialty AW base fee schedule,1177.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26476,Not in chargemaster,26476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26476,BCBS multispecialty AW base fee schedule,1161.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26477,Not in chargemaster,26477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26477,BCBS multispecialty AW base fee schedule,1131.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26478,Not in chargemaster,26478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26478,BCBS multispecialty AW base fee schedule,1209.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26479,Not in chargemaster,26479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26479,BCBS multispecialty AW base fee schedule,1224.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26480,Not in chargemaster,26480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26480,BCBS multispecialty AW base fee schedule,1451.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26483,Not in chargemaster,26483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26483,BCBS multispecialty AW base fee schedule,1619.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26485,Not in chargemaster,26485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26485,BCBS multispecialty AW base fee schedule,1552.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26489,Not in chargemaster,26489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26489,BCBS multispecialty AW base fee schedule,1800.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26490,Not in chargemaster,26490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26490,BCBS multispecialty AW base fee schedule,1542.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26492,Not in chargemaster,26492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26492,BCBS multispecialty AW base fee schedule,1711.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26494,Not in chargemaster,26494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26494,BCBS multispecialty AW base fee schedule,1549.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26496,Not in chargemaster,26496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26496,BCBS multispecialty AW base fee schedule,1652.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26497,Not in chargemaster,26497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26497,BCBS multispecialty AW base fee schedule,1674.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26498,Not in chargemaster,26498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26498,BCBS multispecialty AW base fee schedule,2204.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26499,Not in chargemaster,26499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26499,BCBS multispecialty AW base fee schedule,1607.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26500,Not in chargemaster,26500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26500,BCBS multispecialty AW base fee schedule,1209.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26502,Not in chargemaster,26502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26502,BCBS multispecialty AW base fee schedule,1381.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26508,Not in chargemaster,26508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26508,BCBS multispecialty AW base fee schedule,1232.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26510,Not in chargemaster,26510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26510,BCBS multispecialty AW base fee schedule,1169.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26516,Not in chargemaster,26516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26516,BCBS multispecialty AW base fee schedule,1364.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26517,Not in chargemaster,26517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26517,BCBS multispecialty AW base fee schedule,1598.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26518,Not in chargemaster,26518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26518,BCBS multispecialty AW base fee schedule,1619.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26520,Not in chargemaster,26520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26520,BCBS multispecialty AW base fee schedule,1254.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26525,Not in chargemaster,26525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26525,BCBS multispecialty AW base fee schedule,1258.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26530,Not in chargemaster,26530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26530,BCBS multispecialty AW base fee schedule,1028.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26531,Not in chargemaster,26531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26531,BCBS multispecialty AW base fee schedule,1197.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26535,Not in chargemaster,26535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26535,BCBS multispecialty AW base fee schedule,826.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26536,Not in chargemaster,26536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26536,BCBS multispecialty AW base fee schedule,1379.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26540,Not in chargemaster,26540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26540,BCBS multispecialty AW base fee schedule,1279.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26541,Not in chargemaster,26541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26541,BCBS multispecialty AW base fee schedule,1547.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26542,Not in chargemaster,26542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26542,BCBS multispecialty AW base fee schedule,1320.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26545,Not in chargemaster,26545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26545,BCBS multispecialty AW base fee schedule,1376.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26546,Not in chargemaster,26546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26546,BCBS multispecialty AW base fee schedule,1917.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26548,Not in chargemaster,26548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26548,BCBS multispecialty AW base fee schedule,1472.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26550,Not in chargemaster,26550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26550,BCBS multispecialty AW base fee schedule,3142.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26551,Not in chargemaster,26551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26551,BCBS multispecialty AW base fee schedule,6305.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26553,Not in chargemaster,26553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26553,BCBS multispecialty AW base fee schedule,6264.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26554,Not in chargemaster,26554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26554,BCBS multispecialty AW base fee schedule,7306.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26555,Not in chargemaster,26555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26555,BCBS multispecialty AW base fee schedule,2624.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26556,Not in chargemaster,26556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26556,BCBS multispecialty AW base fee schedule,6507.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26560,Not in chargemaster,26560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26560,BCBS multispecialty AW base fee schedule,1153.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26561,Not in chargemaster,26561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26561,BCBS multispecialty AW base fee schedule,1825.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26562,Not in chargemaster,26562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26562,BCBS multispecialty AW base fee schedule,2575.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26565,Not in chargemaster,26565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26565,BCBS multispecialty AW base fee schedule,1315.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26567,Not in chargemaster,26567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26567,BCBS multispecialty AW base fee schedule,1323.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26568,Not in chargemaster,26568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26568,BCBS multispecialty AW base fee schedule,1734.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26580,Not in chargemaster,26580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26580,BCBS multispecialty AW base fee schedule,2900.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26587,Not in chargemaster,26587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26587,BCBS multispecialty AW base fee schedule,1990.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26590,Not in chargemaster,26590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26590,BCBS multispecialty AW base fee schedule,2701.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26591,Not in chargemaster,26591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26591,BCBS multispecialty AW base fee schedule,863.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26593,Not in chargemaster,26593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26593,BCBS multispecialty AW base fee schedule,1169.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26596,Not in chargemaster,26596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26596,BCBS multispecialty AW base fee schedule,1490.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26600,26600,26600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26600,BCBS multispecialty AW base fee schedule,563.13,640,Fee schedule,,563.13,563.13,563.13,563.13,,,0
unity,Fee schedule,Non-facility 26605,26605,26605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26605,BCBS multispecialty AW base fee schedule,618.11,700,Fee schedule,,618.11,618.11,618.11,618.11,,,0
unity,Fee schedule,Non-facility 26607,Not in chargemaster,26607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26607,BCBS multispecialty AW base fee schedule,925.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26608,Not in chargemaster,26608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26608,BCBS multispecialty AW base fee schedule,914.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26615,Not in chargemaster,26615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26615,BCBS multispecialty AW base fee schedule,1096.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26641,Not in chargemaster,26641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26641,BCBS multispecialty AW base fee schedule,728.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26645,Not in chargemaster,26645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26645,BCBS multispecialty AW base fee schedule,820.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26650,Not in chargemaster,26650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26650,BCBS multispecialty AW base fee schedule,912.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26665,Not in chargemaster,26665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26665,BCBS multispecialty AW base fee schedule,1193.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26670,Not in chargemaster,26670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26670,BCBS multispecialty AW base fee schedule,653.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26675,Not in chargemaster,26675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26675,BCBS multispecialty AW base fee schedule,873.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26676,Not in chargemaster,26676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26676,BCBS multispecialty AW base fee schedule,963.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26685,Not in chargemaster,26685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26685,BCBS multispecialty AW base fee schedule,1096.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26686,Not in chargemaster,26686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26686,BCBS multispecialty AW base fee schedule,1192.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26700,26700,26700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26700,BCBS multispecialty AW base fee schedule,632.69,690.71,Fee schedule,,632.69,632.69,632.69,632.69,,,0
unity,Fee schedule,Non-facility 26705,Not in chargemaster,26705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26705,BCBS multispecialty AW base fee schedule,801.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26706,Not in chargemaster,26706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26706,BCBS multispecialty AW base fee schedule,842.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26715,Not in chargemaster,26715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26715,BCBS multispecialty AW base fee schedule,1091.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26720,26720,26720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26720,BCBS multispecialty AW base fee schedule,374.98,425.99,Fee schedule,,374.98,374.98,374.98,374.98,,,0
unity,Fee schedule,Non-facility 26725,26725,26725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26725,BCBS multispecialty AW base fee schedule,645.94,719.09,Fee schedule,,645.94,645.94,645.94,645.94,,,0
unity,Fee schedule,Non-facility 26727,Not in chargemaster,26727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26727,BCBS multispecialty AW base fee schedule,898.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26735,Not in chargemaster,26735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26735,BCBS multispecialty AW base fee schedule,1133.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26740,Not in chargemaster,26740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26740,BCBS multispecialty AW base fee schedule,437.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26742,Not in chargemaster,26742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26742,BCBS multispecialty AW base fee schedule,708.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26746,Not in chargemaster,26746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26746,BCBS multispecialty AW base fee schedule,1416.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26750,26750,26750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26750,BCBS multispecialty AW base fee schedule,352.45,394.68,Fee schedule,,352.45,352.45,352.45,352.45,,,0
unity,Fee schedule,Non-facility 26755,26755,26755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26755,BCBS multispecialty AW base fee schedule,604.2,671.53,Fee schedule,,604.2,604.2,604.2,604.2,,,0
unity,Fee schedule,Non-facility 26756,Not in chargemaster,26756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26756,BCBS multispecialty AW base fee schedule,802.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26765,Not in chargemaster,26765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26765,BCBS multispecialty AW base fee schedule,955.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26770,26770,26770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26770,BCBS multispecialty AW base fee schedule,535.3,591.33,Fee schedule,,535.3,535.3,535.3,535.3,,,0
unity,Fee schedule,Non-facility 26775,Not in chargemaster,26775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26775,BCBS multispecialty AW base fee schedule,731.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26776,Not in chargemaster,26776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26776,BCBS multispecialty AW base fee schedule,850.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26785,Not in chargemaster,26785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26785,BCBS multispecialty AW base fee schedule,1040.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26820,Not in chargemaster,26820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26820,BCBS multispecialty AW base fee schedule,1527.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26841,Not in chargemaster,26841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26841,BCBS multispecialty AW base fee schedule,1408.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26842,Not in chargemaster,26842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26842,BCBS multispecialty AW base fee schedule,1514.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26843,Not in chargemaster,26843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26843,BCBS multispecialty AW base fee schedule,1434.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26844,Not in chargemaster,26844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26844,BCBS multispecialty AW base fee schedule,1587.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26850,Not in chargemaster,26850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26850,BCBS multispecialty AW base fee schedule,1343.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26852,Not in chargemaster,26852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26852,BCBS multispecialty AW base fee schedule,1537.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26860,Not in chargemaster,26860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26860,BCBS multispecialty AW base fee schedule,1102.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26861,Not in chargemaster,26861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26861,BCBS multispecialty AW base fee schedule,197.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26862,Not in chargemaster,26862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26862,BCBS multispecialty AW base fee schedule,1403.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26863,Not in chargemaster,26863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26863,BCBS multispecialty AW base fee schedule,438.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26910,Not in chargemaster,26910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26910,BCBS multispecialty AW base fee schedule,1400.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26951,Not in chargemaster,26951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26951,BCBS multispecialty AW base fee schedule,1268.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26952,Not in chargemaster,26952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26952,BCBS multispecialty AW base fee schedule,1252.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26990,Not in chargemaster,26990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26990,BCBS multispecialty AW base fee schedule,1250.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26991,Not in chargemaster,26991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26991,BCBS multispecialty AW base fee schedule,1354.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26992,Not in chargemaster,26992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,26992,BCBS multispecialty AW base fee schedule,1891.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27000,Not in chargemaster,27000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27000,BCBS multispecialty AW base fee schedule,771.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27001,Not in chargemaster,27001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27001,BCBS multispecialty AW base fee schedule,1034.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27003,Not in chargemaster,27003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27003,BCBS multispecialty AW base fee schedule,1141.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27005,Not in chargemaster,27005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27005,BCBS multispecialty AW base fee schedule,1382.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27006,Not in chargemaster,27006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27006,BCBS multispecialty AW base fee schedule,1371.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27025,Not in chargemaster,27025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27025,BCBS multispecialty AW base fee schedule,1756.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27027,Not in chargemaster,27027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27027,BCBS multispecialty AW base fee schedule,1710.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27030,Not in chargemaster,27030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27030,BCBS multispecialty AW base fee schedule,1796.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27033,Not in chargemaster,27033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27033,BCBS multispecialty AW base fee schedule,1862.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27035,Not in chargemaster,27035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27035,BCBS multispecialty AW base fee schedule,2187.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27036,Not in chargemaster,27036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27036,BCBS multispecialty AW base fee schedule,1935.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27040,Not in chargemaster,27040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27040,BCBS multispecialty AW base fee schedule,655.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27041,Not in chargemaster,27041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27041,BCBS multispecialty AW base fee schedule,1335.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27043,Not in chargemaster,27043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27043,BCBS multispecialty AW base fee schedule,899.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27045,Not in chargemaster,27045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27045,BCBS multispecialty AW base fee schedule,1415.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27047,Not in chargemaster,27047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27047,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27048,Not in chargemaster,27048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27048,BCBS multispecialty AW base fee schedule,1167.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27049,Not in chargemaster,27049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27049,BCBS multispecialty AW base fee schedule,2562.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27050,Not in chargemaster,27050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27050,BCBS multispecialty AW base fee schedule,767.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27052,Not in chargemaster,27052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27052,BCBS multispecialty AW base fee schedule,1103.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27054,Not in chargemaster,27054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27054,BCBS multispecialty AW base fee schedule,1312.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27057,Not in chargemaster,27057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27057,BCBS multispecialty AW base fee schedule,1939.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27059,Not in chargemaster,27059,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27059,BCBS multispecialty AW base fee schedule,3474.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27060,Not in chargemaster,27060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27060,BCBS multispecialty AW base fee schedule,887.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27062,Not in chargemaster,27062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27062,BCBS multispecialty AW base fee schedule,867.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27065,Not in chargemaster,27065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27065,BCBS multispecialty AW base fee schedule,993.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27066,Not in chargemaster,27066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27066,BCBS multispecialty AW base fee schedule,1549.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27067,Not in chargemaster,27067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27067,BCBS multispecialty AW base fee schedule,1980.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27070,Not in chargemaster,27070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27070,BCBS multispecialty AW base fee schedule,1677.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27071,Not in chargemaster,27071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27071,BCBS multispecialty AW base fee schedule,1807.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27075,Not in chargemaster,27075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27075,BCBS multispecialty AW base fee schedule,4011.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27076,Not in chargemaster,27076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27076,BCBS multispecialty AW base fee schedule,4856.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27077,Not in chargemaster,27077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27077,BCBS multispecialty AW base fee schedule,5419.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27078,Not in chargemaster,27078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27078,BCBS multispecialty AW base fee schedule,3953.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27080,Not in chargemaster,27080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27080,BCBS multispecialty AW base fee schedule,979.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27086,Not in chargemaster,27086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27086,BCBS multispecialty AW base fee schedule,581.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27087,Not in chargemaster,27087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27087,BCBS multispecialty AW base fee schedule,1178.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27090,Not in chargemaster,27090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27090,BCBS multispecialty AW base fee schedule,1590.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27091,Not in chargemaster,27091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27091,BCBS multispecialty AW base fee schedule,3058.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27093,Not in chargemaster,27093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27093,BCBS multispecialty AW base fee schedule,412.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27095,Not in chargemaster,27095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27095,BCBS multispecialty AW base fee schedule,553.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27096,Not in chargemaster,27096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27096,BCBS multispecialty AW base fee schedule,305.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27097,Not in chargemaster,27097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27097,BCBS multispecialty AW base fee schedule,1305.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27098,Not in chargemaster,27098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27098,BCBS multispecialty AW base fee schedule,1327.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27100,Not in chargemaster,27100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27100,BCBS multispecialty AW base fee schedule,1583.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27105,Not in chargemaster,27105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27105,BCBS multispecialty AW base fee schedule,1660.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27110,Not in chargemaster,27110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27110,BCBS multispecialty AW base fee schedule,1856.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27111,Not in chargemaster,27111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27111,BCBS multispecialty AW base fee schedule,1724.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27120,Not in chargemaster,27120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27120,BCBS multispecialty AW base fee schedule,2488.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27122,Not in chargemaster,27122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27122,BCBS multispecialty AW base fee schedule,2108.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27125,Not in chargemaster,27125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27125,BCBS multispecialty AW base fee schedule,2167.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27130,Not in chargemaster,27130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27130,BCBS multispecialty AW base fee schedule,2597.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27132,Not in chargemaster,27132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27132,BCBS multispecialty AW base fee schedule,3209.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27134,Not in chargemaster,27134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27134,BCBS multispecialty AW base fee schedule,3669.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27137,Not in chargemaster,27137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27137,BCBS multispecialty AW base fee schedule,2820.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27138,Not in chargemaster,27138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27138,BCBS multispecialty AW base fee schedule,2931.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27140,Not in chargemaster,27140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27140,BCBS multispecialty AW base fee schedule,1712.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27146,Not in chargemaster,27146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27146,BCBS multispecialty AW base fee schedule,2447.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27147,Not in chargemaster,27147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27147,BCBS multispecialty AW base fee schedule,2809,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27151,Not in chargemaster,27151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27151,BCBS multispecialty AW base fee schedule,3039.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27156,Not in chargemaster,27156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27156,BCBS multispecialty AW base fee schedule,3277.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27158,Not in chargemaster,27158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27158,BCBS multispecialty AW base fee schedule,2683.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27161,Not in chargemaster,27161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27161,BCBS multispecialty AW base fee schedule,2335.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27165,Not in chargemaster,27165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27165,BCBS multispecialty AW base fee schedule,2628.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27170,Not in chargemaster,27170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27170,BCBS multispecialty AW base fee schedule,2250.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27175,Not in chargemaster,27175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27175,BCBS multispecialty AW base fee schedule,1274.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27176,Not in chargemaster,27176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27176,BCBS multispecialty AW base fee schedule,1760.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27177,Not in chargemaster,27177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27177,BCBS multispecialty AW base fee schedule,2132.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27178,Not in chargemaster,27178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27178,BCBS multispecialty AW base fee schedule,1760.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27179,Not in chargemaster,27179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27179,BCBS multispecialty AW base fee schedule,1871.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27181,Not in chargemaster,27181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27181,BCBS multispecialty AW base fee schedule,2144.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27185,Not in chargemaster,27185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27185,BCBS multispecialty AW base fee schedule,1372.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27187,Not in chargemaster,27187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27187,BCBS multispecialty AW base fee schedule,1905.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27197,Not in chargemaster,27197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27197,BCBS multispecialty AW base fee schedule,243.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27198,Not in chargemaster,27198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27198,BCBS multispecialty AW base fee schedule,585.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27200,Not in chargemaster,27200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27200,BCBS multispecialty AW base fee schedule,352.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27202,Not in chargemaster,27202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27202,BCBS multispecialty AW base fee schedule,1012.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27215,Not in chargemaster,27215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27215,BCBS multispecialty AW base fee schedule,1155.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27216,Not in chargemaster,27216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27216,BCBS multispecialty AW base fee schedule,1713.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27217,Not in chargemaster,27217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27217,BCBS multispecialty AW base fee schedule,1607.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27218,Not in chargemaster,27218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27218,BCBS multispecialty AW base fee schedule,2217.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27220,Not in chargemaster,27220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27220,BCBS multispecialty AW base fee schedule,821.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27222,Not in chargemaster,27222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27222,BCBS multispecialty AW base fee schedule,1863.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27226,Not in chargemaster,27226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27226,BCBS multispecialty AW base fee schedule,2022.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27227,Not in chargemaster,27227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27227,BCBS multispecialty AW base fee schedule,3170.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27228,Not in chargemaster,27228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27228,BCBS multispecialty AW base fee schedule,3601.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27230,Not in chargemaster,27230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27230,BCBS multispecialty AW base fee schedule,920.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27232,Not in chargemaster,27232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27232,BCBS multispecialty AW base fee schedule,1432.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27235,Not in chargemaster,27235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27235,BCBS multispecialty AW base fee schedule,1737.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27236,Not in chargemaster,27236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27236,BCBS multispecialty AW base fee schedule,2287.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27238,Not in chargemaster,27238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27238,BCBS multispecialty AW base fee schedule,886.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27240,Not in chargemaster,27240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27240,BCBS multispecialty AW base fee schedule,1824.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27244,Not in chargemaster,27244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27244,BCBS multispecialty AW base fee schedule,2354.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27245,Not in chargemaster,27245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27245,BCBS multispecialty AW base fee schedule,2351.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27246,Not in chargemaster,27246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27246,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27248,Not in chargemaster,27248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27248,BCBS multispecialty AW base fee schedule,1429.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27250,Not in chargemaster,27250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27250,BCBS multispecialty AW base fee schedule,353.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27252,Not in chargemaster,27252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27252,BCBS multispecialty AW base fee schedule,1445.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27253,Not in chargemaster,27253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27253,BCBS multispecialty AW base fee schedule,1803.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27254,Not in chargemaster,27254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27254,BCBS multispecialty AW base fee schedule,2438.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27256,Not in chargemaster,27256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27256,BCBS multispecialty AW base fee schedule,581.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27257,Not in chargemaster,27257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27257,BCBS multispecialty AW base fee schedule,691.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27258,Not in chargemaster,27258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27258,BCBS multispecialty AW base fee schedule,2126.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27259,Not in chargemaster,27259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27259,BCBS multispecialty AW base fee schedule,2964.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27265,Not in chargemaster,27265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27265,BCBS multispecialty AW base fee schedule,772.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27266,Not in chargemaster,27266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27266,BCBS multispecialty AW base fee schedule,1113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27267,Not in chargemaster,27267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27267,BCBS multispecialty AW base fee schedule,834.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27268,Not in chargemaster,27268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27268,BCBS multispecialty AW base fee schedule,1034.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27269,Not in chargemaster,27269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27269,BCBS multispecialty AW base fee schedule,2384.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27275,Not in chargemaster,27275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27275,BCBS multispecialty AW base fee schedule,348.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27279,Not in chargemaster,27279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27279,BCBS multispecialty AW base fee schedule,1678.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27280,Not in chargemaster,27280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27280,BCBS multispecialty AW base fee schedule,2598.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27282,Not in chargemaster,27282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27282,BCBS multispecialty AW base fee schedule,1639.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27284,Not in chargemaster,27284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27284,BCBS multispecialty AW base fee schedule,3088.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27286,Not in chargemaster,27286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27286,BCBS multispecialty AW base fee schedule,3158.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27290,Not in chargemaster,27290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27290,BCBS multispecialty AW base fee schedule,3113.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27295,Not in chargemaster,27295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27295,BCBS multispecialty AW base fee schedule,2413.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27301,27301,27301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27301,BCBS multispecialty AW base fee schedule,1287.24,1239.27,Fee schedule,,1239.27,1239.27,1239.27,1239.27,,,0
unity,Fee schedule,Non-facility 27303,Not in chargemaster,27303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27303,BCBS multispecialty AW base fee schedule,1226.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27305,Not in chargemaster,27305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27305,BCBS multispecialty AW base fee schedule,918.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27306,Not in chargemaster,27306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27306,BCBS multispecialty AW base fee schedule,653.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27307,Not in chargemaster,27307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27307,BCBS multispecialty AW base fee schedule,916.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27310,Not in chargemaster,27310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27310,BCBS multispecialty AW base fee schedule,1398.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27323,Not in chargemaster,27323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27323,BCBS multispecialty AW base fee schedule,524.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27324,Not in chargemaster,27324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27324,BCBS multispecialty AW base fee schedule,771.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27325,Not in chargemaster,27325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27325,BCBS multispecialty AW base fee schedule,1071.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27326,Not in chargemaster,27326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27326,BCBS multispecialty AW base fee schedule,989.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27327,27327,27327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27327,BCBS multispecialty AW base fee schedule,923.53,605,Fee schedule,,605,605,605,605,,,0
unity,Fee schedule,Non-facility 27328,Not in chargemaster,27328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27328,BCBS multispecialty AW base fee schedule,1193.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27329,Not in chargemaster,27329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27329,BCBS multispecialty AW base fee schedule,1996.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27330,Not in chargemaster,27330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27330,BCBS multispecialty AW base fee schedule,785.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27331,Not in chargemaster,27331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27331,BCBS multispecialty AW base fee schedule,906.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27332,Not in chargemaster,27332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27332,BCBS multispecialty AW base fee schedule,1230.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27333,Not in chargemaster,27333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27333,BCBS multispecialty AW base fee schedule,1120.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27334,Not in chargemaster,27334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27334,BCBS multispecialty AW base fee schedule,1309.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27335,Not in chargemaster,27335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27335,BCBS multispecialty AW base fee schedule,1463.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27337,Not in chargemaster,27337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27337,BCBS multispecialty AW base fee schedule,802.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27339,Not in chargemaster,27339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27339,BCBS multispecialty AW base fee schedule,1446.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27340,Not in chargemaster,27340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27340,BCBS multispecialty AW base fee schedule,708.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27345,Not in chargemaster,27345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27345,BCBS multispecialty AW base fee schedule,923.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27347,Not in chargemaster,27347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27347,BCBS multispecialty AW base fee schedule,1006.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27350,Not in chargemaster,27350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27350,BCBS multispecialty AW base fee schedule,1247.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27355,Not in chargemaster,27355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27355,BCBS multispecialty AW base fee schedule,1156.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27356,Not in chargemaster,27356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27356,BCBS multispecialty AW base fee schedule,1413.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27357,Not in chargemaster,27357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27357,BCBS multispecialty AW base fee schedule,1560.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27358,Not in chargemaster,27358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27358,BCBS multispecialty AW base fee schedule,531.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27360,Not in chargemaster,27360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27360,BCBS multispecialty AW base fee schedule,1678.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27364,Not in chargemaster,27364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27364,BCBS multispecialty AW base fee schedule,2995.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27365,Not in chargemaster,27365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27365,BCBS multispecialty AW base fee schedule,3952.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27369,Not in chargemaster,27369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27369,BCBS multispecialty AW base fee schedule,296.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27372,Not in chargemaster,27372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27372,BCBS multispecialty AW base fee schedule,1142.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27380,Not in chargemaster,27380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27380,BCBS multispecialty AW base fee schedule,1161.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27381,Not in chargemaster,27381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27381,BCBS multispecialty AW base fee schedule,1546.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27385,Not in chargemaster,27385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27385,BCBS multispecialty AW base fee schedule,1124.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27386,Not in chargemaster,27386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27386,BCBS multispecialty AW base fee schedule,1615.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27390,Not in chargemaster,27390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27390,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27391,Not in chargemaster,27391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27391,BCBS multispecialty AW base fee schedule,1078.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27392,Not in chargemaster,27392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27392,BCBS multispecialty AW base fee schedule,1362.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27393,Not in chargemaster,27393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27393,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27394,Not in chargemaster,27394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27394,BCBS multispecialty AW base fee schedule,1250.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27395,Not in chargemaster,27395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27395,BCBS multispecialty AW base fee schedule,1683.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27396,Not in chargemaster,27396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27396,BCBS multispecialty AW base fee schedule,1178.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27397,Not in chargemaster,27397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27397,BCBS multispecialty AW base fee schedule,1749.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27400,Not in chargemaster,27400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27400,BCBS multispecialty AW base fee schedule,1328.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27403,Not in chargemaster,27403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27403,BCBS multispecialty AW base fee schedule,1229.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27405,Not in chargemaster,27405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27405,BCBS multispecialty AW base fee schedule,1291.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27407,Not in chargemaster,27407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27407,BCBS multispecialty AW base fee schedule,1520.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27409,Not in chargemaster,27409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27409,BCBS multispecialty AW base fee schedule,1850.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27412,Not in chargemaster,27412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27412,BCBS multispecialty AW base fee schedule,3160.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27415,Not in chargemaster,27415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27415,BCBS multispecialty AW base fee schedule,2628.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27416,Not in chargemaster,27416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27416,BCBS multispecialty AW base fee schedule,1876.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27418,Not in chargemaster,27418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27418,BCBS multispecialty AW base fee schedule,1584.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27420,Not in chargemaster,27420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27420,BCBS multispecialty AW base fee schedule,1422.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27422,Not in chargemaster,27422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27422,BCBS multispecialty AW base fee schedule,1423.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27424,Not in chargemaster,27424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27424,BCBS multispecialty AW base fee schedule,1430.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27425,Not in chargemaster,27425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27425,BCBS multispecialty AW base fee schedule,858.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27427,Not in chargemaster,27427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27427,BCBS multispecialty AW base fee schedule,1360.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27428,Not in chargemaster,27428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27428,BCBS multispecialty AW base fee schedule,2133.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27429,Not in chargemaster,27429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27429,BCBS multispecialty AW base fee schedule,2399.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27430,Not in chargemaster,27430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27430,BCBS multispecialty AW base fee schedule,1418.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27435,Not in chargemaster,27435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27435,BCBS multispecialty AW base fee schedule,1547.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27437,Not in chargemaster,27437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27437,BCBS multispecialty AW base fee schedule,1260.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27438,Not in chargemaster,27438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27438,BCBS multispecialty AW base fee schedule,1610.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27440,Not in chargemaster,27440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27440,BCBS multispecialty AW base fee schedule,1526.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27441,Not in chargemaster,27441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27441,BCBS multispecialty AW base fee schedule,1576.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27442,Not in chargemaster,27442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27442,BCBS multispecialty AW base fee schedule,1669.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27443,Not in chargemaster,27443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27443,BCBS multispecialty AW base fee schedule,1554.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27445,Not in chargemaster,27445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27445,BCBS multispecialty AW base fee schedule,2404.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27446,Not in chargemaster,27446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27446,BCBS multispecialty AW base fee schedule,2218.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27447,Not in chargemaster,27447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27447,BCBS multispecialty AW base fee schedule,2594.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27448,Not in chargemaster,27448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27448,BCBS multispecialty AW base fee schedule,1571.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27450,Not in chargemaster,27450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27450,BCBS multispecialty AW base fee schedule,1943.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27454,Not in chargemaster,27454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27454,BCBS multispecialty AW base fee schedule,2481.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27455,Not in chargemaster,27455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27455,BCBS multispecialty AW base fee schedule,1821.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27457,Not in chargemaster,27457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27457,BCBS multispecialty AW base fee schedule,1841.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27465,Not in chargemaster,27465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27465,BCBS multispecialty AW base fee schedule,2396.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27466,Not in chargemaster,27466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27466,BCBS multispecialty AW base fee schedule,2267.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27468,Not in chargemaster,27468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27468,BCBS multispecialty AW base fee schedule,2570.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27470,Not in chargemaster,27470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27470,BCBS multispecialty AW base fee schedule,2255.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27472,Not in chargemaster,27472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27472,BCBS multispecialty AW base fee schedule,2419.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27475,Not in chargemaster,27475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27475,BCBS multispecialty AW base fee schedule,1266.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27477,Not in chargemaster,27477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27477,BCBS multispecialty AW base fee schedule,1401.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27479,Not in chargemaster,27479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27479,BCBS multispecialty AW base fee schedule,1758.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27485,Not in chargemaster,27485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27485,BCBS multispecialty AW base fee schedule,1283.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27486,Not in chargemaster,27486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27486,BCBS multispecialty AW base fee schedule,2695.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27487,Not in chargemaster,27487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27487,BCBS multispecialty AW base fee schedule,3370.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27488,Not in chargemaster,27488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27488,BCBS multispecialty AW base fee schedule,2298.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27495,Not in chargemaster,27495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27495,BCBS multispecialty AW base fee schedule,2159.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27496,Not in chargemaster,27496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27496,BCBS multispecialty AW base fee schedule,1040.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27497,Not in chargemaster,27497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27497,BCBS multispecialty AW base fee schedule,1111.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27498,Not in chargemaster,27498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27498,BCBS multispecialty AW base fee schedule,1251.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27499,Not in chargemaster,27499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27499,BCBS multispecialty AW base fee schedule,1340.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27500,Not in chargemaster,27500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27500,BCBS multispecialty AW base fee schedule,993.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27501,Not in chargemaster,27501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27501,BCBS multispecialty AW base fee schedule,965.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27502,Not in chargemaster,27502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27502,BCBS multispecialty AW base fee schedule,1453.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27503,Not in chargemaster,27503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27503,BCBS multispecialty AW base fee schedule,1531.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27506,Not in chargemaster,27506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27506,BCBS multispecialty AW base fee schedule,2559.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27507,Not in chargemaster,27507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27507,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27508,Not in chargemaster,27508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27508,BCBS multispecialty AW base fee schedule,999.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27509,Not in chargemaster,27509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27509,BCBS multispecialty AW base fee schedule,1263.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27510,Not in chargemaster,27510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27510,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27511,Not in chargemaster,27511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27511,BCBS multispecialty AW base fee schedule,1913.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27513,Not in chargemaster,27513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27513,BCBS multispecialty AW base fee schedule,2379.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27514,Not in chargemaster,27514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27514,BCBS multispecialty AW base fee schedule,1854.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27516,Not in chargemaster,27516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27516,BCBS multispecialty AW base fee schedule,976.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27517,Not in chargemaster,27517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27517,BCBS multispecialty AW base fee schedule,1313.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27519,Not in chargemaster,27519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27519,BCBS multispecialty AW base fee schedule,1708.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27520,Not in chargemaster,27520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27520,BCBS multispecialty AW base fee schedule,612.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27524,Not in chargemaster,27524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27524,BCBS multispecialty AW base fee schedule,1439.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27530,27530,27530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27530,BCBS multispecialty AW base fee schedule,576.38,648.11,Fee schedule,,576.38,576.38,576.38,576.38,,,0
unity,Fee schedule,Non-facility 27532,Not in chargemaster,27532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27532,BCBS multispecialty AW base fee schedule,1176.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27535,Not in chargemaster,27535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27535,BCBS multispecialty AW base fee schedule,1719.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27536,Not in chargemaster,27536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27536,BCBS multispecialty AW base fee schedule,2275.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27538,Not in chargemaster,27538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27538,BCBS multispecialty AW base fee schedule,908.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27540,Not in chargemaster,27540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27540,BCBS multispecialty AW base fee schedule,1549.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27550,Not in chargemaster,27550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27550,BCBS multispecialty AW base fee schedule,997.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27552,Not in chargemaster,27552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27552,BCBS multispecialty AW base fee schedule,1201.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27556,Not in chargemaster,27556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27556,BCBS multispecialty AW base fee schedule,1681.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27557,Not in chargemaster,27557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27557,BCBS multispecialty AW base fee schedule,2006.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27558,Not in chargemaster,27558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27558,BCBS multispecialty AW base fee schedule,2287.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27560,Not in chargemaster,27560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27560,BCBS multispecialty AW base fee schedule,711.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27562,Not in chargemaster,27562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27562,BCBS multispecialty AW base fee schedule,928.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27566,Not in chargemaster,27566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27566,BCBS multispecialty AW base fee schedule,1710.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27570,Not in chargemaster,27570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27570,BCBS multispecialty AW base fee schedule,287.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27580,Not in chargemaster,27580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27580,BCBS multispecialty AW base fee schedule,2794.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27590,Not in chargemaster,27590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27590,BCBS multispecialty AW base fee schedule,1525.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27591,Not in chargemaster,27591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27591,BCBS multispecialty AW base fee schedule,1848.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27592,Not in chargemaster,27592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27592,BCBS multispecialty AW base fee schedule,1297.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27594,Not in chargemaster,27594,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27594,BCBS multispecialty AW base fee schedule,979.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27596,Not in chargemaster,27596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27596,BCBS multispecialty AW base fee schedule,1370.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27598,Not in chargemaster,27598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27598,BCBS multispecialty AW base fee schedule,1364.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27600,Not in chargemaster,27600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27600,BCBS multispecialty AW base fee schedule,775.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27601,Not in chargemaster,27601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27601,BCBS multispecialty AW base fee schedule,853.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27602,Not in chargemaster,27602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27602,BCBS multispecialty AW base fee schedule,929.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27603,Not in chargemaster,27603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27603,BCBS multispecialty AW base fee schedule,1015.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27604,Not in chargemaster,27604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27604,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27605,Not in chargemaster,27605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27605,BCBS multispecialty AW base fee schedule,651.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27606,Not in chargemaster,27606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27606,BCBS multispecialty AW base fee schedule,529.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27607,Not in chargemaster,27607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27607,BCBS multispecialty AW base fee schedule,1156.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27610,Not in chargemaster,27610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27610,BCBS multispecialty AW base fee schedule,1239.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27612,Not in chargemaster,27612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27612,BCBS multispecialty AW base fee schedule,1065.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27613,Not in chargemaster,27613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27613,BCBS multispecialty AW base fee schedule,478.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27614,Not in chargemaster,27614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27614,BCBS multispecialty AW base fee schedule,1102.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27615,Not in chargemaster,27615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27615,BCBS multispecialty AW base fee schedule,1964.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27616,Not in chargemaster,27616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27616,BCBS multispecialty AW base fee schedule,2439.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27618,Not in chargemaster,27618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27618,BCBS multispecialty AW base fee schedule,897.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27619,Not in chargemaster,27619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27619,BCBS multispecialty AW base fee schedule,881.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27620,Not in chargemaster,27620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27620,BCBS multispecialty AW base fee schedule,854.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27625,Not in chargemaster,27625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27625,BCBS multispecialty AW base fee schedule,1102.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27626,Not in chargemaster,27626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27626,BCBS multispecialty AW base fee schedule,1155.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27630,Not in chargemaster,27630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27630,BCBS multispecialty AW base fee schedule,1047.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27632,Not in chargemaster,27632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27632,BCBS multispecialty AW base fee schedule,791.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27634,Not in chargemaster,27634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27634,BCBS multispecialty AW base fee schedule,1307.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27635,Not in chargemaster,27635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27635,BCBS multispecialty AW base fee schedule,1111.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27637,Not in chargemaster,27637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27637,BCBS multispecialty AW base fee schedule,1430.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27638,Not in chargemaster,27638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27638,BCBS multispecialty AW base fee schedule,1464.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27640,Not in chargemaster,27640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27640,BCBS multispecialty AW base fee schedule,1589.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27641,Not in chargemaster,27641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27641,BCBS multispecialty AW base fee schedule,1264.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27645,Not in chargemaster,27645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27645,BCBS multispecialty AW base fee schedule,3397.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27646,Not in chargemaster,27646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27646,BCBS multispecialty AW base fee schedule,2948.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27647,Not in chargemaster,27647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27647,BCBS multispecialty AW base fee schedule,1943.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27648,Not in chargemaster,27648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27648,BCBS multispecialty AW base fee schedule,379.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27650,Not in chargemaster,27650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27650,BCBS multispecialty AW base fee schedule,1255.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27652,Not in chargemaster,27652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27652,BCBS multispecialty AW base fee schedule,1269.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27654,Not in chargemaster,27654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27654,BCBS multispecialty AW base fee schedule,1360.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27656,Not in chargemaster,27656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27656,BCBS multispecialty AW base fee schedule,1209.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27658,Not in chargemaster,27658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27658,BCBS multispecialty AW base fee schedule,704.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27659,Not in chargemaster,27659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27659,BCBS multispecialty AW base fee schedule,897.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27664,Not in chargemaster,27664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27664,BCBS multispecialty AW base fee schedule,687.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27665,Not in chargemaster,27665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27665,BCBS multispecialty AW base fee schedule,791.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27675,Not in chargemaster,27675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27675,BCBS multispecialty AW base fee schedule,936.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27676,Not in chargemaster,27676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27676,BCBS multispecialty AW base fee schedule,1142.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27680,Not in chargemaster,27680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27680,BCBS multispecialty AW base fee schedule,809.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27681,Not in chargemaster,27681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27681,BCBS multispecialty AW base fee schedule,987.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27685,Not in chargemaster,27685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27685,BCBS multispecialty AW base fee schedule,1260.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27686,Not in chargemaster,27686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27686,BCBS multispecialty AW base fee schedule,1034.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27687,Not in chargemaster,27687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27687,BCBS multispecialty AW base fee schedule,867.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27690,Not in chargemaster,27690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27690,BCBS multispecialty AW base fee schedule,1219.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27691,Not in chargemaster,27691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27691,BCBS multispecialty AW base fee schedule,1421.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27692,Not in chargemaster,27692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27692,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27695,Not in chargemaster,27695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27695,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27696,Not in chargemaster,27696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27696,BCBS multispecialty AW base fee schedule,1065.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27698,Not in chargemaster,27698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27698,BCBS multispecialty AW base fee schedule,1218.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27700,Not in chargemaster,27700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27700,BCBS multispecialty AW base fee schedule,1171.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27702,Not in chargemaster,27702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27702,BCBS multispecialty AW base fee schedule,1845.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27703,Not in chargemaster,27703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27703,BCBS multispecialty AW base fee schedule,2135.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27704,Not in chargemaster,27704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27704,BCBS multispecialty AW base fee schedule,1095.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27705,Not in chargemaster,27705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27705,BCBS multispecialty AW base fee schedule,1448.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27707,Not in chargemaster,27707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27707,BCBS multispecialty AW base fee schedule,761.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27709,Not in chargemaster,27709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27709,BCBS multispecialty AW base fee schedule,2233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27712,Not in chargemaster,27712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27712,BCBS multispecialty AW base fee schedule,2108.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27715,Not in chargemaster,27715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27715,BCBS multispecialty AW base fee schedule,2051.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27720,Not in chargemaster,27720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27720,BCBS multispecialty AW base fee schedule,1674.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27722,Not in chargemaster,27722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27722,BCBS multispecialty AW base fee schedule,1707.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27724,Not in chargemaster,27724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27724,BCBS multispecialty AW base fee schedule,2413.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27725,Not in chargemaster,27725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27725,BCBS multispecialty AW base fee schedule,2326.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27726,Not in chargemaster,27726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27726,BCBS multispecialty AW base fee schedule,1832.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27727,Not in chargemaster,27727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27727,BCBS multispecialty AW base fee schedule,1985.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27730,Not in chargemaster,27730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27730,BCBS multispecialty AW base fee schedule,1121.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27732,Not in chargemaster,27732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27732,BCBS multispecialty AW base fee schedule,859.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27734,Not in chargemaster,27734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27734,BCBS multispecialty AW base fee schedule,1255.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27740,Not in chargemaster,27740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27740,BCBS multispecialty AW base fee schedule,1353.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27742,Not in chargemaster,27742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27742,BCBS multispecialty AW base fee schedule,1486.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27745,Not in chargemaster,27745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27745,BCBS multispecialty AW base fee schedule,1454.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27750,Not in chargemaster,27750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27750,BCBS multispecialty AW base fee schedule,656.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27752,Not in chargemaster,27752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27752,BCBS multispecialty AW base fee schedule,1021.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27756,Not in chargemaster,27756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27756,BCBS multispecialty AW base fee schedule,1097.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27758,Not in chargemaster,27758,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27758,BCBS multispecialty AW base fee schedule,1711.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27759,Not in chargemaster,27759,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27759,BCBS multispecialty AW base fee schedule,1911.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27760,Not in chargemaster,27760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27760,BCBS multispecialty AW base fee schedule,633.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27762,Not in chargemaster,27762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27762,BCBS multispecialty AW base fee schedule,911.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27766,Not in chargemaster,27766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27766,BCBS multispecialty AW base fee schedule,1153.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27767,Not in chargemaster,27767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27767,BCBS multispecialty AW base fee schedule,545.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27768,Not in chargemaster,27768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27768,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27769,Not in chargemaster,27769,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27769,BCBS multispecialty AW base fee schedule,1394.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27780,27780,27780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27780,BCBS multispecialty AW base fee schedule,583,658.76,Fee schedule,,583,583,583,583,,,0
unity,Fee schedule,Non-facility 27781,Not in chargemaster,27781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27781,BCBS multispecialty AW base fee schedule,823.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27784,Not in chargemaster,27784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27784,BCBS multispecialty AW base fee schedule,1358.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27786,27786,27786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27786,BCBS multispecialty AW base fee schedule,596.91,680,Fee schedule,,596.91,596.91,596.91,596.91,,,0
unity,Fee schedule,Non-facility 27788,Not in chargemaster,27788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27788,BCBS multispecialty AW base fee schedule,808.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27792,Not in chargemaster,27792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27792,BCBS multispecialty AW base fee schedule,1236.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27808,Not in chargemaster,27808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27808,BCBS multispecialty AW base fee schedule,634.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27810,Not in chargemaster,27810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27810,BCBS multispecialty AW base fee schedule,893.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27814,Not in chargemaster,27814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27814,BCBS multispecialty AW base fee schedule,1466.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27816,Not in chargemaster,27816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27816,BCBS multispecialty AW base fee schedule,620.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27818,Not in chargemaster,27818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27818,BCBS multispecialty AW base fee schedule,926.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27822,Not in chargemaster,27822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27822,BCBS multispecialty AW base fee schedule,1654.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27823,Not in chargemaster,27823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27823,BCBS multispecialty AW base fee schedule,1872.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27824,Not in chargemaster,27824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27824,BCBS multispecialty AW base fee schedule,603.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27825,Not in chargemaster,27825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27825,BCBS multispecialty AW base fee schedule,1041.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27826,Not in chargemaster,27826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27826,BCBS multispecialty AW base fee schedule,1626.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27827,Not in chargemaster,27827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27827,BCBS multispecialty AW base fee schedule,2123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27828,Not in chargemaster,27828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27828,BCBS multispecialty AW base fee schedule,2524.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27829,Not in chargemaster,27829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27829,BCBS multispecialty AW base fee schedule,1338.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27830,Not in chargemaster,27830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27830,BCBS multispecialty AW base fee schedule,736.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27831,Not in chargemaster,27831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27831,BCBS multispecialty AW base fee schedule,770.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27832,Not in chargemaster,27832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27832,BCBS multispecialty AW base fee schedule,1445.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27840,27840,27840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27840,BCBS multispecialty AW base fee schedule,718.15,796.47,Fee schedule,,718.15,718.15,718.15,718.15,,,0
unity,Fee schedule,Non-facility 27842,Not in chargemaster,27842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27842,BCBS multispecialty AW base fee schedule,940.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27846,Not in chargemaster,27846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27846,BCBS multispecialty AW base fee schedule,1365.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27848,Not in chargemaster,27848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27848,BCBS multispecialty AW base fee schedule,1528.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27860,Not in chargemaster,27860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27860,BCBS multispecialty AW base fee schedule,325.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27870,Not in chargemaster,27870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27870,BCBS multispecialty AW base fee schedule,1955.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27871,Not in chargemaster,27871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27871,BCBS multispecialty AW base fee schedule,1317.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27880,Not in chargemaster,27880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27880,BCBS multispecialty AW base fee schedule,1745.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27881,Not in chargemaster,27881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27881,BCBS multispecialty AW base fee schedule,1645.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27882,Not in chargemaster,27882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27882,BCBS multispecialty AW base fee schedule,1146.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27884,Not in chargemaster,27884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27884,BCBS multispecialty AW base fee schedule,1097.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27886,Not in chargemaster,27886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27886,BCBS multispecialty AW base fee schedule,1256.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27888,Not in chargemaster,27888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27888,BCBS multispecialty AW base fee schedule,1255.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27889,Not in chargemaster,27889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27889,BCBS multispecialty AW base fee schedule,1232.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27892,Not in chargemaster,27892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27892,BCBS multispecialty AW base fee schedule,1052.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27893,Not in chargemaster,27893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27893,BCBS multispecialty AW base fee schedule,1167.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27894,Not in chargemaster,27894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,27894,BCBS multispecialty AW base fee schedule,1611.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28001,Not in chargemaster,28001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28001,BCBS multispecialty AW base fee schedule,533.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28002,Not in chargemaster,28002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28002,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28003,Not in chargemaster,28003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28003,BCBS multispecialty AW base fee schedule,1336.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28005,Not in chargemaster,28005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28005,BCBS multispecialty AW base fee schedule,1102.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28008,Not in chargemaster,28008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28008,BCBS multispecialty AW base fee schedule,828.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28010,Not in chargemaster,28010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28010,BCBS multispecialty AW base fee schedule,443.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28011,Not in chargemaster,28011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28011,BCBS multispecialty AW base fee schedule,602.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28020,Not in chargemaster,28020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28020,BCBS multispecialty AW base fee schedule,1026.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28022,Not in chargemaster,28022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28022,BCBS multispecialty AW base fee schedule,931.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28024,Not in chargemaster,28024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28024,BCBS multispecialty AW base fee schedule,873.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28035,Not in chargemaster,28035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28035,BCBS multispecialty AW base fee schedule,1005.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28039,Not in chargemaster,28039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28039,BCBS multispecialty AW base fee schedule,947.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28041,Not in chargemaster,28041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28041,BCBS multispecialty AW base fee schedule,865.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28043,Not in chargemaster,28043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28043,BCBS multispecialty AW base fee schedule,750.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28045,Not in chargemaster,28045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28045,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28046,Not in chargemaster,28046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28046,BCBS multispecialty AW base fee schedule,1369.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28047,Not in chargemaster,28047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28047,BCBS multispecialty AW base fee schedule,1992.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28050,Not in chargemaster,28050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28050,BCBS multispecialty AW base fee schedule,806.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28052,Not in chargemaster,28052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28052,BCBS multispecialty AW base fee schedule,851.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28054,Not in chargemaster,28054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28054,BCBS multispecialty AW base fee schedule,712.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28055,Not in chargemaster,28055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28055,BCBS multispecialty AW base fee schedule,738.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28060,Not in chargemaster,28060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28060,BCBS multispecialty AW base fee schedule,998.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28062,Not in chargemaster,28062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28062,BCBS multispecialty AW base fee schedule,1112.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28070,Not in chargemaster,28070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28070,BCBS multispecialty AW base fee schedule,1010.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28072,Not in chargemaster,28072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28072,BCBS multispecialty AW base fee schedule,931.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28080,Not in chargemaster,28080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28080,BCBS multispecialty AW base fee schedule,1005.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28086,Not in chargemaster,28086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28086,BCBS multispecialty AW base fee schedule,1025.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28088,Not in chargemaster,28088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28088,BCBS multispecialty AW base fee schedule,828.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28090,Not in chargemaster,28090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28090,BCBS multispecialty AW base fee schedule,893.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28092,Not in chargemaster,28092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28092,BCBS multispecialty AW base fee schedule,808.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28100,Not in chargemaster,28100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28100,BCBS multispecialty AW base fee schedule,1167.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28102,Not in chargemaster,28102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28102,BCBS multispecialty AW base fee schedule,1162.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28103,Not in chargemaster,28103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28103,BCBS multispecialty AW base fee schedule,744.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28104,Not in chargemaster,28104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28104,BCBS multispecialty AW base fee schedule,1010.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28106,Not in chargemaster,28106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28106,BCBS multispecialty AW base fee schedule,817.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28107,Not in chargemaster,28107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28107,BCBS multispecialty AW base fee schedule,977.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28108,Not in chargemaster,28108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28108,BCBS multispecialty AW base fee schedule,838.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28110,Not in chargemaster,28110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28110,BCBS multispecialty AW base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28111,Not in chargemaster,28111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28111,BCBS multispecialty AW base fee schedule,933.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28112,Not in chargemaster,28112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28112,BCBS multispecialty AW base fee schedule,932.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28113,Not in chargemaster,28113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28113,BCBS multispecialty AW base fee schedule,1122.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28114,Not in chargemaster,28114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28114,BCBS multispecialty AW base fee schedule,2019.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28116,Not in chargemaster,28116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28116,BCBS multispecialty AW base fee schedule,1458.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28118,Not in chargemaster,28118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28118,BCBS multispecialty AW base fee schedule,1147.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28119,Not in chargemaster,28119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28119,BCBS multispecialty AW base fee schedule,1001.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28120,Not in chargemaster,28120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28120,BCBS multispecialty AW base fee schedule,1293.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28122,Not in chargemaster,28122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28122,BCBS multispecialty AW base fee schedule,1137.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28124,Not in chargemaster,28124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28124,BCBS multispecialty AW base fee schedule,914.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28126,Not in chargemaster,28126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28126,BCBS multispecialty AW base fee schedule,749.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28130,Not in chargemaster,28130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28130,BCBS multispecialty AW base fee schedule,1206.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28140,Not in chargemaster,28140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28140,BCBS multispecialty AW base fee schedule,1124.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28150,Not in chargemaster,28150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28150,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28153,Not in chargemaster,28153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28153,BCBS multispecialty AW base fee schedule,789.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28160,Not in chargemaster,28160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28160,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28171,Not in chargemaster,28171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28171,BCBS multispecialty AW base fee schedule,2127.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28173,Not in chargemaster,28173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28173,BCBS multispecialty AW base fee schedule,1407.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28175,Not in chargemaster,28175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28175,BCBS multispecialty AW base fee schedule,903.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28190,Not in chargemaster,28190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28190,BCBS multispecialty AW base fee schedule,481.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28192,Not in chargemaster,28192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28192,BCBS multispecialty AW base fee schedule,894.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28193,Not in chargemaster,28193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28193,BCBS multispecialty AW base fee schedule,1012.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28200,Not in chargemaster,28200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28200,BCBS multispecialty AW base fee schedule,943.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28202,Not in chargemaster,28202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28202,BCBS multispecialty AW base fee schedule,1155.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28208,Not in chargemaster,28208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28208,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28210,Not in chargemaster,28210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28210,BCBS multispecialty AW base fee schedule,1125.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28220,Not in chargemaster,28220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28220,BCBS multispecialty AW base fee schedule,861.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28222,Not in chargemaster,28222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28222,BCBS multispecialty AW base fee schedule,991.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28225,Not in chargemaster,28225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28225,BCBS multispecialty AW base fee schedule,798.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28226,Not in chargemaster,28226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28226,BCBS multispecialty AW base fee schedule,1171.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28230,Not in chargemaster,28230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28230,BCBS multispecialty AW base fee schedule,832.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28232,Not in chargemaster,28232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28232,BCBS multispecialty AW base fee schedule,735.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28234,Not in chargemaster,28234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28234,BCBS multispecialty AW base fee schedule,782.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28238,Not in chargemaster,28238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28238,BCBS multispecialty AW base fee schedule,1272,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28240,Not in chargemaster,28240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28240,BCBS multispecialty AW base fee schedule,856.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28250,Not in chargemaster,28250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28250,BCBS multispecialty AW base fee schedule,1109.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28260,Not in chargemaster,28260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28260,BCBS multispecialty AW base fee schedule,1338.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28261,Not in chargemaster,28261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28261,BCBS multispecialty AW base fee schedule,2294.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28262,Not in chargemaster,28262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28262,BCBS multispecialty AW base fee schedule,2677.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28264,Not in chargemaster,28264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28264,BCBS multispecialty AW base fee schedule,1932.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28270,Not in chargemaster,28270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28270,BCBS multispecialty AW base fee schedule,941.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28272,Not in chargemaster,28272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28272,BCBS multispecialty AW base fee schedule,745.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28280,Not in chargemaster,28280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28280,BCBS multispecialty AW base fee schedule,982.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28285,Not in chargemaster,28285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28285,BCBS multispecialty AW base fee schedule,1025.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28286,Not in chargemaster,28286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28286,BCBS multispecialty AW base fee schedule,853.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28288,Not in chargemaster,28288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28288,BCBS multispecialty AW base fee schedule,1164.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28289,Not in chargemaster,28289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28289,BCBS multispecialty AW base fee schedule,1364.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28291,Not in chargemaster,28291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28291,BCBS multispecialty AW base fee schedule,1395.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28292,Not in chargemaster,28292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28292,BCBS multispecialty AW base fee schedule,1383.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28295,Not in chargemaster,28295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28295,BCBS multispecialty AW base fee schedule,1890.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28296,Not in chargemaster,28296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28296,BCBS multispecialty AW base fee schedule,1734.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28297,Not in chargemaster,28297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28297,BCBS multispecialty AW base fee schedule,2006.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28298,Not in chargemaster,28298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28298,BCBS multispecialty AW base fee schedule,1610.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28299,Not in chargemaster,28299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28299,BCBS multispecialty AW base fee schedule,1927.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28300,Not in chargemaster,28300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28300,BCBS multispecialty AW base fee schedule,1244.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28302,Not in chargemaster,28302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28302,BCBS multispecialty AW base fee schedule,1368.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28304,Not in chargemaster,28304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28304,BCBS multispecialty AW base fee schedule,1564.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28305,Not in chargemaster,28305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28305,BCBS multispecialty AW base fee schedule,1278.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28306,Not in chargemaster,28306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28306,BCBS multispecialty AW base fee schedule,1158.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28307,Not in chargemaster,28307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28307,BCBS multispecialty AW base fee schedule,1185.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28308,Not in chargemaster,28308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28308,BCBS multispecialty AW base fee schedule,1088.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28309,Not in chargemaster,28309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28309,BCBS multispecialty AW base fee schedule,1688.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28310,Not in chargemaster,28310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28310,BCBS multispecialty AW base fee schedule,1045.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28312,Not in chargemaster,28312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28312,BCBS multispecialty AW base fee schedule,959.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28313,Not in chargemaster,28313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28313,BCBS multispecialty AW base fee schedule,1002.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28315,Not in chargemaster,28315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28315,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28320,Not in chargemaster,28320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28320,BCBS multispecialty AW base fee schedule,1169.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28322,Not in chargemaster,28322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28322,BCBS multispecialty AW base fee schedule,1495.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28340,Not in chargemaster,28340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28340,BCBS multispecialty AW base fee schedule,1097.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28341,Not in chargemaster,28341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28341,BCBS multispecialty AW base fee schedule,1272,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28344,Not in chargemaster,28344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28344,BCBS multispecialty AW base fee schedule,812.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28345,Not in chargemaster,28345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28345,BCBS multispecialty AW base fee schedule,993.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28360,Not in chargemaster,28360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28360,BCBS multispecialty AW base fee schedule,2088.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28400,Not in chargemaster,28400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28400,BCBS multispecialty AW base fee schedule,469.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28405,Not in chargemaster,28405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28405,BCBS multispecialty AW base fee schedule,736.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28406,Not in chargemaster,28406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28406,BCBS multispecialty AW base fee schedule,1032.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28415,Not in chargemaster,28415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28415,BCBS multispecialty AW base fee schedule,2138.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28420,Not in chargemaster,28420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28420,BCBS multispecialty AW base fee schedule,2457.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28430,Not in chargemaster,28430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28430,BCBS multispecialty AW base fee schedule,453.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28435,Not in chargemaster,28435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28435,BCBS multispecialty AW base fee schedule,692.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28436,Not in chargemaster,28436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28436,BCBS multispecialty AW base fee schedule,891.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28445,Not in chargemaster,28445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28445,BCBS multispecialty AW base fee schedule,1981.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28446,Not in chargemaster,28446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28446,BCBS multispecialty AW base fee schedule,2341.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28450,Not in chargemaster,28450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28450,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28455,Not in chargemaster,28455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28455,BCBS multispecialty AW base fee schedule,547.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28456,Not in chargemaster,28456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28456,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28465,Not in chargemaster,28465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28465,BCBS multispecialty AW base fee schedule,1204.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28470,28470,28470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28470,BCBS multispecialty AW base fee schedule,414.73,476.32,Fee schedule,,414.73,414.73,414.73,414.73,,,0
unity,Fee schedule,Non-facility 28475,Not in chargemaster,28475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28475,BCBS multispecialty AW base fee schedule,488.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28476,Not in chargemaster,28476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28476,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28485,Not in chargemaster,28485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28485,BCBS multispecialty AW base fee schedule,1052.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28490,28490,28490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28490,BCBS multispecialty AW base fee schedule,269.64,316.6,Fee schedule,,269.64,269.64,269.64,269.64,,,0
unity,Fee schedule,Non-facility 28495,Not in chargemaster,28495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28495,BCBS multispecialty AW base fee schedule,337.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28496,Not in chargemaster,28496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28496,BCBS multispecialty AW base fee schedule,859.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28505,Not in chargemaster,28505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28505,BCBS multispecialty AW base fee schedule,1266.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28510,28510,28510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28510,BCBS multispecialty AW base fee schedule,229.89,266.2,Fee schedule,,229.89,229.89,229.89,229.89,,,0
unity,Fee schedule,Non-facility 28515,28515,28515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28515,BCBS multispecialty AW base fee schedule,309.39,355,Fee schedule,,309.39,309.39,309.39,309.39,,,0
unity,Fee schedule,Non-facility 28525,Not in chargemaster,28525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28525,BCBS multispecialty AW base fee schedule,1093.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28530,Not in chargemaster,28530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28530,BCBS multispecialty AW base fee schedule,218.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28531,Not in chargemaster,28531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28531,BCBS multispecialty AW base fee schedule,644.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28540,Not in chargemaster,28540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28540,BCBS multispecialty AW base fee schedule,369.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28545,Not in chargemaster,28545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28545,BCBS multispecialty AW base fee schedule,574.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28546,Not in chargemaster,28546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28546,BCBS multispecialty AW base fee schedule,1109.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28555,Not in chargemaster,28555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28555,BCBS multispecialty AW base fee schedule,1629.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28570,Not in chargemaster,28570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28570,BCBS multispecialty AW base fee schedule,435.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28575,Not in chargemaster,28575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28575,BCBS multispecialty AW base fee schedule,704.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28576,Not in chargemaster,28576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28576,BCBS multispecialty AW base fee schedule,738.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28585,Not in chargemaster,28585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28585,BCBS multispecialty AW base fee schedule,1652.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28600,Not in chargemaster,28600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28600,BCBS multispecialty AW base fee schedule,410.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28605,Not in chargemaster,28605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28605,BCBS multispecialty AW base fee schedule,634.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28606,Not in chargemaster,28606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28606,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28615,Not in chargemaster,28615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28615,BCBS multispecialty AW base fee schedule,1552.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28630,Not in chargemaster,28630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28630,BCBS multispecialty AW base fee schedule,297.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28635,Not in chargemaster,28635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28635,BCBS multispecialty AW base fee schedule,333.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28636,Not in chargemaster,28636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28636,BCBS multispecialty AW base fee schedule,594.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28645,Not in chargemaster,28645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28645,BCBS multispecialty AW base fee schedule,1254.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28660,Not in chargemaster,28660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28660,BCBS multispecialty AW base fee schedule,226.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28665,Not in chargemaster,28665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28665,BCBS multispecialty AW base fee schedule,292.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28666,Not in chargemaster,28666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28666,BCBS multispecialty AW base fee schedule,317.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28675,Not in chargemaster,28675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28675,BCBS multispecialty AW base fee schedule,1087.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28705,Not in chargemaster,28705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28705,BCBS multispecialty AW base fee schedule,2349.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28715,Not in chargemaster,28715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28715,BCBS multispecialty AW base fee schedule,1796.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28725,Not in chargemaster,28725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28725,BCBS multispecialty AW base fee schedule,1488.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28730,Not in chargemaster,28730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28730,BCBS multispecialty AW base fee schedule,1405.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28735,Not in chargemaster,28735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28735,BCBS multispecialty AW base fee schedule,1482.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28737,Not in chargemaster,28737,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28737,BCBS multispecialty AW base fee schedule,1317.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28740,Not in chargemaster,28740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28740,BCBS multispecialty AW base fee schedule,1603.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28750,Not in chargemaster,28750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28750,BCBS multispecialty AW base fee schedule,1523.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28755,Not in chargemaster,28755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28755,BCBS multispecialty AW base fee schedule,973.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28760,Not in chargemaster,28760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28760,BCBS multispecialty AW base fee schedule,1493.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28800,Not in chargemaster,28800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28800,BCBS multispecialty AW base fee schedule,1021.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28805,Not in chargemaster,28805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28805,BCBS multispecialty AW base fee schedule,1381.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28810,Not in chargemaster,28810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28810,BCBS multispecialty AW base fee schedule,819.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28820,Not in chargemaster,28820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28820,BCBS multispecialty AW base fee schedule,1067.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28825,Not in chargemaster,28825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28825,BCBS multispecialty AW base fee schedule,1020.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28890,Not in chargemaster,28890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,28890,BCBS multispecialty AW base fee schedule,608.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29000,Not in chargemaster,29000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29000,BCBS multispecialty AW base fee schedule,641.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29010,Not in chargemaster,29010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29010,BCBS multispecialty AW base fee schedule,505.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29015,Not in chargemaster,29015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29015,BCBS multispecialty AW base fee schedule,544.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29035,Not in chargemaster,29035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29035,BCBS multispecialty AW base fee schedule,472.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29040,Not in chargemaster,29040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29040,BCBS multispecialty AW base fee schedule,541.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29044,Not in chargemaster,29044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29044,BCBS multispecialty AW base fee schedule,530.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29046,Not in chargemaster,29046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29046,BCBS multispecialty AW base fee schedule,581.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29049,Not in chargemaster,29049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29049,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29055,Not in chargemaster,29055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29055,BCBS multispecialty AW base fee schedule,412.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29058,Not in chargemaster,29058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29058,BCBS multispecialty AW base fee schedule,232.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29065,29065,29065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29065,BCBS multispecialty AW base fee schedule,178.88,207.28,Fee schedule,,178.88,178.88,178.88,178.88,,,0
unity,Fee schedule,Non-facility 29075,29075,29075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29075,BCBS multispecialty AW base fee schedule,160.99,186.7,Fee schedule,,160.99,160.99,160.99,160.99,,,0
unity,Fee schedule,Non-facility 29085,Not in chargemaster,29085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29085,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29086,Not in chargemaster,29086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29086,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29105,29105,29105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29105,BCBS multispecialty AW base fee schedule,153.04,188.84,Fee schedule,,153.04,153.04,153.04,153.04,,,0
unity,Fee schedule,Non-facility 29125,29125,29125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29125,BCBS multispecialty AW base fee schedule,120.58,140.56,Fee schedule,,120.58,120.58,120.58,120.58,,,0
unity,Fee schedule,Non-facility 29126,Not in chargemaster,29126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29126,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29130,29130,29130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29130,BCBS multispecialty AW base fee schedule,78.18,87.32,Fee schedule,,78.18,78.18,78.18,78.18,,,0
unity,Fee schedule,Non-facility 29131,Not in chargemaster,29131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29131,BCBS multispecialty AW base fee schedule,98.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29200,Not in chargemaster,29200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29200,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29240,29240,29240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29240,BCBS multispecialty AW base fee schedule,58.3,122.1,Fee schedule,,58.3,58.3,58.3,58.3,,,0
unity,Fee schedule,Non-facility 29260,Not in chargemaster,29260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29260,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29280,Not in chargemaster,29280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29280,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29305,Not in chargemaster,29305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29305,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29325,Not in chargemaster,29325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29325,BCBS multispecialty AW base fee schedule,508.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29345,Not in chargemaster,29345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29345,BCBS multispecialty AW base fee schedule,255.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29355,Not in chargemaster,29355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29355,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29358,Not in chargemaster,29358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29358,BCBS multispecialty AW base fee schedule,298.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29365,Not in chargemaster,29365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29365,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29405,29405,29405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29405,BCBS multispecialty AW base fee schedule,149.73,175.34,Fee schedule,,149.73,149.73,149.73,149.73,,,0
unity,Fee schedule,Non-facility 29425,Not in chargemaster,29425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29425,BCBS multispecialty AW base fee schedule,143.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29435,Not in chargemaster,29435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29435,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29440,Not in chargemaster,29440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29440,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29445,Not in chargemaster,29445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29445,BCBS multispecialty AW base fee schedule,246.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29450,Not in chargemaster,29450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29450,BCBS multispecialty AW base fee schedule,272.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29505,29505,29505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29505,BCBS multispecialty AW base fee schedule,159.66,180.31,Fee schedule,,159.66,159.66,159.66,159.66,,,0
unity,Fee schedule,Non-facility 29515,29515,29515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29515,BCBS multispecialty AW base fee schedule,133.16,154.76,Fee schedule,,133.16,133.16,133.16,133.16,,,0
unity,Fee schedule,Non-facility 29520,Not in chargemaster,29520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29520,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29530,Not in chargemaster,29530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29530,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29540,Not in chargemaster,29540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29540,BCBS multispecialty AW base fee schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29550,Not in chargemaster,29550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29550,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29580,Not in chargemaster,29580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29580,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29581,29581,29581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29581,BCBS multispecialty AW base fee schedule,168.28,185,Fee schedule,,168.28,168.28,168.28,168.28,,,0
unity,Fee schedule,Non-facility 29584,Not in chargemaster,29584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29584,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29700,Not in chargemaster,29700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29700,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29705,Not in chargemaster,29705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29705,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29710,Not in chargemaster,29710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29710,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29720,Not in chargemaster,29720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29720,BCBS multispecialty AW base fee schedule,157.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29730,Not in chargemaster,29730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29730,BCBS multispecialty AW base fee schedule,116.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29740,Not in chargemaster,29740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29740,BCBS multispecialty AW base fee schedule,186.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29750,Not in chargemaster,29750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29750,BCBS multispecialty AW base fee schedule,202.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29800,Not in chargemaster,29800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29800,BCBS multispecialty AW base fee schedule,1008.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29804,Not in chargemaster,29804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29804,BCBS multispecialty AW base fee schedule,1176.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29805,Not in chargemaster,29805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29805,BCBS multispecialty AW base fee schedule,897.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29806,Not in chargemaster,29806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29806,BCBS multispecialty AW base fee schedule,2023.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29807,Not in chargemaster,29807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29807,BCBS multispecialty AW base fee schedule,1978.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29819,Not in chargemaster,29819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29819,BCBS multispecialty AW base fee schedule,1120.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29820,Not in chargemaster,29820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29820,BCBS multispecialty AW base fee schedule,1025.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29821,Not in chargemaster,29821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29821,BCBS multispecialty AW base fee schedule,1132.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29822,Not in chargemaster,29822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29822,BCBS multispecialty AW base fee schedule,1101.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29823,Not in chargemaster,29823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29823,BCBS multispecialty AW base fee schedule,1199.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29824,Not in chargemaster,29824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29824,BCBS multispecialty AW base fee schedule,1289.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29825,Not in chargemaster,29825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29825,BCBS multispecialty AW base fee schedule,1120.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29826,Not in chargemaster,29826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29826,BCBS multispecialty AW base fee schedule,334.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29827,Not in chargemaster,29827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29827,BCBS multispecialty AW base fee schedule,2047.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29828,Not in chargemaster,29828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29828,BCBS multispecialty AW base fee schedule,1756.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29830,Not in chargemaster,29830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29830,BCBS multispecialty AW base fee schedule,871.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29834,Not in chargemaster,29834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29834,BCBS multispecialty AW base fee schedule,940.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29835,Not in chargemaster,29835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29835,BCBS multispecialty AW base fee schedule,971.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29836,Not in chargemaster,29836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29836,BCBS multispecialty AW base fee schedule,1115.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29837,Not in chargemaster,29837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29837,BCBS multispecialty AW base fee schedule,1007,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29838,Not in chargemaster,29838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29838,BCBS multispecialty AW base fee schedule,1130.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29840,Not in chargemaster,29840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29840,BCBS multispecialty AW base fee schedule,860.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29843,Not in chargemaster,29843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29843,BCBS multispecialty AW base fee schedule,927.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29844,Not in chargemaster,29844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29844,BCBS multispecialty AW base fee schedule,954,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29845,Not in chargemaster,29845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29845,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29846,Not in chargemaster,29846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29846,BCBS multispecialty AW base fee schedule,997.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29847,Not in chargemaster,29847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29847,BCBS multispecialty AW base fee schedule,1038.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29848,Not in chargemaster,29848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29848,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29850,Not in chargemaster,29850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29850,BCBS multispecialty AW base fee schedule,1191.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29851,Not in chargemaster,29851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29851,BCBS multispecialty AW base fee schedule,1780.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29855,Not in chargemaster,29855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29855,BCBS multispecialty AW base fee schedule,1495.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29856,Not in chargemaster,29856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29856,BCBS multispecialty AW base fee schedule,1894.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29860,Not in chargemaster,29860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29860,BCBS multispecialty AW base fee schedule,1274.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29861,Not in chargemaster,29861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29861,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29862,Not in chargemaster,29862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29862,BCBS multispecialty AW base fee schedule,1553.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29863,Not in chargemaster,29863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29863,BCBS multispecialty AW base fee schedule,1558.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29866,Not in chargemaster,29866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29866,BCBS multispecialty AW base fee schedule,2009.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29867,Not in chargemaster,29867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29867,BCBS multispecialty AW base fee schedule,2445.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29868,Not in chargemaster,29868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29868,BCBS multispecialty AW base fee schedule,3202.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29870,Not in chargemaster,29870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29870,BCBS multispecialty AW base fee schedule,1087.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29871,Not in chargemaster,29871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29871,BCBS multispecialty AW base fee schedule,981.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29873,Not in chargemaster,29873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29873,BCBS multispecialty AW base fee schedule,1009.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29874,Not in chargemaster,29874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29874,BCBS multispecialty AW base fee schedule,1027.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29875,Not in chargemaster,29875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29875,BCBS multispecialty AW base fee schedule,948.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29876,Not in chargemaster,29876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29876,BCBS multispecialty AW base fee schedule,1248.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29877,Not in chargemaster,29877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29877,BCBS multispecialty AW base fee schedule,1186.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29879,Not in chargemaster,29879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29879,BCBS multispecialty AW base fee schedule,1264.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29880,Not in chargemaster,29880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29880,BCBS multispecialty AW base fee schedule,1072.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29881,Not in chargemaster,29881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29881,BCBS multispecialty AW base fee schedule,1033.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29882,Not in chargemaster,29882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29882,BCBS multispecialty AW base fee schedule,1323.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29883,Not in chargemaster,29883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29883,BCBS multispecialty AW base fee schedule,1608.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29884,Not in chargemaster,29884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29884,BCBS multispecialty AW base fee schedule,1182.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29885,Not in chargemaster,29885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29885,BCBS multispecialty AW base fee schedule,1442.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29886,Not in chargemaster,29886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29886,BCBS multispecialty AW base fee schedule,1215.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29887,Not in chargemaster,29887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29887,BCBS multispecialty AW base fee schedule,1435.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29888,Not in chargemaster,29888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29888,BCBS multispecialty AW base fee schedule,1876.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29889,Not in chargemaster,29889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29889,BCBS multispecialty AW base fee schedule,2339.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29891,Not in chargemaster,29891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29891,BCBS multispecialty AW base fee schedule,1279.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29892,Not in chargemaster,29892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29892,BCBS multispecialty AW base fee schedule,1244.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29893,Not in chargemaster,29893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29893,BCBS multispecialty AW base fee schedule,1213.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29894,Not in chargemaster,29894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29894,BCBS multispecialty AW base fee schedule,953.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29895,Not in chargemaster,29895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29895,BCBS multispecialty AW base fee schedule,887.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29897,Not in chargemaster,29897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29897,BCBS multispecialty AW base fee schedule,954.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29898,Not in chargemaster,29898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29898,BCBS multispecialty AW base fee schedule,1075.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29899,Not in chargemaster,29899,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29899,BCBS multispecialty AW base fee schedule,1972.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29900,Not in chargemaster,29900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29900,BCBS multispecialty AW base fee schedule,950.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29901,Not in chargemaster,29901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29901,BCBS multispecialty AW base fee schedule,1023.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29902,Not in chargemaster,29902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29902,BCBS multispecialty AW base fee schedule,1087.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29904,Not in chargemaster,29904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29904,BCBS multispecialty AW base fee schedule,1217.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29905,Not in chargemaster,29905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29905,BCBS multispecialty AW base fee schedule,988.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29906,Not in chargemaster,29906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29906,BCBS multispecialty AW base fee schedule,1268.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29907,Not in chargemaster,29907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29907,BCBS multispecialty AW base fee schedule,1676.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29914,Not in chargemaster,29914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29914,BCBS multispecialty AW base fee schedule,1902.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29915,Not in chargemaster,29915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29915,BCBS multispecialty AW base fee schedule,1959.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29916,Not in chargemaster,29916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,29916,BCBS multispecialty AW base fee schedule,1959.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30000,Not in chargemaster,30000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30000,BCBS multispecialty AW base fee schedule,475.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30020,Not in chargemaster,30020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30020,BCBS multispecialty AW base fee schedule,480.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30100,Not in chargemaster,30100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30100,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30110,Not in chargemaster,30110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30110,BCBS multispecialty AW base fee schedule,451.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30115,Not in chargemaster,30115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30115,BCBS multispecialty AW base fee schedule,841.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30117,Not in chargemaster,30117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30117,BCBS multispecialty AW base fee schedule,1753.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30118,Not in chargemaster,30118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30118,BCBS multispecialty AW base fee schedule,1463.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30120,Not in chargemaster,30120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30120,BCBS multispecialty AW base fee schedule,967.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30124,Not in chargemaster,30124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30124,BCBS multispecialty AW base fee schedule,551.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30125,Not in chargemaster,30125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30125,BCBS multispecialty AW base fee schedule,1189.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30130,Not in chargemaster,30130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30130,BCBS multispecialty AW base fee schedule,747.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30140,Not in chargemaster,30140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30140,BCBS multispecialty AW base fee schedule,535.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30150,Not in chargemaster,30150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30150,BCBS multispecialty AW base fee schedule,1488.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30160,Not in chargemaster,30160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30160,BCBS multispecialty AW base fee schedule,1497.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30200,Not in chargemaster,30200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30200,BCBS multispecialty AW base fee schedule,210.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30210,Not in chargemaster,30210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30210,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30220,Not in chargemaster,30220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30220,BCBS multispecialty AW base fee schedule,576.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30300,30300,30300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30300,BCBS multispecialty AW base fee schedule,357.75,276.13,Fee schedule,,276.13,276.13,276.13,276.13,,,0
unity,Fee schedule,Non-facility 30310,Not in chargemaster,30310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30310,BCBS multispecialty AW base fee schedule,384.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30320,Not in chargemaster,30320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30320,BCBS multispecialty AW base fee schedule,879.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30400,Not in chargemaster,30400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30400,BCBS multispecialty AW base fee schedule,2275.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30410,Not in chargemaster,30410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30410,BCBS multispecialty AW base fee schedule,2640.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30420,Not in chargemaster,30420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30420,BCBS multispecialty AW base fee schedule,2671.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30430,Not in chargemaster,30430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30430,BCBS multispecialty AW base fee schedule,1969.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30435,Not in chargemaster,30435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30435,BCBS multispecialty AW base fee schedule,2492.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30450,Not in chargemaster,30450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30450,BCBS multispecialty AW base fee schedule,3299.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30460,Not in chargemaster,30460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30460,BCBS multispecialty AW base fee schedule,1582.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30462,Not in chargemaster,30462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30462,BCBS multispecialty AW base fee schedule,3042.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30465,Not in chargemaster,30465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30465,BCBS multispecialty AW base fee schedule,1890.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30520,Not in chargemaster,30520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30520,BCBS multispecialty AW base fee schedule,1221.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30540,Not in chargemaster,30540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30540,BCBS multispecialty AW base fee schedule,1340.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30545,Not in chargemaster,30545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30545,BCBS multispecialty AW base fee schedule,1831.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30560,Not in chargemaster,30560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30560,BCBS multispecialty AW base fee schedule,552.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30580,Not in chargemaster,30580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30580,BCBS multispecialty AW base fee schedule,1179.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30600,Not in chargemaster,30600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30600,BCBS multispecialty AW base fee schedule,1117.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30620,Not in chargemaster,30620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30620,BCBS multispecialty AW base fee schedule,1209.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30630,Not in chargemaster,30630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30630,BCBS multispecialty AW base fee schedule,1222.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30801,Not in chargemaster,30801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30801,BCBS multispecialty AW base fee schedule,409.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30802,Not in chargemaster,30802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30802,BCBS multispecialty AW base fee schedule,520.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30901,30901,30901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30901,BCBS multispecialty AW base fee schedule,270.96,280,Fee schedule,,270.96,270.96,270.96,270.96,,,0
unity,Fee schedule,Non-facility 30903,Not in chargemaster,30903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30903,BCBS multispecialty AW base fee schedule,429.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30905,30905,30905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30905,BCBS multispecialty AW base fee schedule,638.65,560.79,Fee schedule,,560.79,560.79,560.79,560.79,,,0
unity,Fee schedule,Non-facility 30906,Not in chargemaster,30906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30906,BCBS multispecialty AW base fee schedule,665.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30915,Not in chargemaster,30915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30915,BCBS multispecialty AW base fee schedule,1111.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30920,Not in chargemaster,30920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30920,BCBS multispecialty AW base fee schedule,1611.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30930,Not in chargemaster,30930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,30930,BCBS multispecialty AW base fee schedule,223.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31000,Not in chargemaster,31000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31000,BCBS multispecialty AW base fee schedule,342.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31002,Not in chargemaster,31002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31002,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31020,Not in chargemaster,31020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31020,BCBS multispecialty AW base fee schedule,895.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31030,Not in chargemaster,31030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31030,BCBS multispecialty AW base fee schedule,1222.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31032,Not in chargemaster,31032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31032,BCBS multispecialty AW base fee schedule,1095.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31040,Not in chargemaster,31040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31040,BCBS multispecialty AW base fee schedule,1487.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31050,Not in chargemaster,31050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31050,BCBS multispecialty AW base fee schedule,939.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31051,Not in chargemaster,31051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31051,BCBS multispecialty AW base fee schedule,1258.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31070,Not in chargemaster,31070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31070,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31075,Not in chargemaster,31075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31075,BCBS multispecialty AW base fee schedule,1513.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31080,Not in chargemaster,31080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31080,BCBS multispecialty AW base fee schedule,1993.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31081,Not in chargemaster,31081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31081,BCBS multispecialty AW base fee schedule,2144.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31084,Not in chargemaster,31084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31084,BCBS multispecialty AW base fee schedule,2221.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31085,Not in chargemaster,31085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31085,BCBS multispecialty AW base fee schedule,2294.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31086,Not in chargemaster,31086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31086,BCBS multispecialty AW base fee schedule,2162.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31087,Not in chargemaster,31087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31087,BCBS multispecialty AW base fee schedule,2070.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31090,Not in chargemaster,31090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31090,BCBS multispecialty AW base fee schedule,2010.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31200,Not in chargemaster,31200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31200,BCBS multispecialty AW base fee schedule,1129.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31201,Not in chargemaster,31201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31201,BCBS multispecialty AW base fee schedule,1456.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31205,Not in chargemaster,31205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31205,BCBS multispecialty AW base fee schedule,1745.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31225,Not in chargemaster,31225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31225,BCBS multispecialty AW base fee schedule,3455.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31230,Not in chargemaster,31230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31230,BCBS multispecialty AW base fee schedule,3835.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31231,Not in chargemaster,31231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31231,BCBS multispecialty AW base fee schedule,363.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31233,Not in chargemaster,31233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31233,BCBS multispecialty AW base fee schedule,493.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31235,Not in chargemaster,31235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31235,BCBS multispecialty AW base fee schedule,562.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31237,Not in chargemaster,31237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31237,BCBS multispecialty AW base fee schedule,477.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31238,Not in chargemaster,31238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31238,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31239,Not in chargemaster,31239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31239,BCBS multispecialty AW base fee schedule,1153.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31240,Not in chargemaster,31240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31240,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31241,Not in chargemaster,31241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31241,BCBS multispecialty AW base fee schedule,846.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31253,Not in chargemaster,31253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31253,BCBS multispecialty AW base fee schedule,954,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31254,Not in chargemaster,31254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31254,BCBS multispecialty AW base fee schedule,794.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31255,Not in chargemaster,31255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31255,BCBS multispecialty AW base fee schedule,616.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31256,Not in chargemaster,31256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31256,BCBS multispecialty AW base fee schedule,342.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31257,Not in chargemaster,31257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31257,BCBS multispecialty AW base fee schedule,849.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31259,Not in chargemaster,31259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31259,BCBS multispecialty AW base fee schedule,899.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31267,Not in chargemaster,31267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31267,BCBS multispecialty AW base fee schedule,504.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31276,Not in chargemaster,31276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31276,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31287,Not in chargemaster,31287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31287,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31288,Not in chargemaster,31288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31288,BCBS multispecialty AW base fee schedule,444.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31290,Not in chargemaster,31290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31290,BCBS multispecialty AW base fee schedule,2167.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31291,Not in chargemaster,31291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31291,BCBS multispecialty AW base fee schedule,2315.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31292,Not in chargemaster,31292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31292,BCBS multispecialty AW base fee schedule,1882.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31293,Not in chargemaster,31293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31293,BCBS multispecialty AW base fee schedule,2034.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31294,Not in chargemaster,31294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31294,BCBS multispecialty AW base fee schedule,2330.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31295,Not in chargemaster,31295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31295,BCBS multispecialty AW base fee schedule,3547.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31296,Not in chargemaster,31296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31296,BCBS multispecialty AW base fee schedule,3595.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31297,Not in chargemaster,31297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31297,BCBS multispecialty AW base fee schedule,3519.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31298,Not in chargemaster,31298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31298,BCBS multispecialty AW base fee schedule,6764.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31300,Not in chargemaster,31300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31300,BCBS multispecialty AW base fee schedule,2393.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31360,Not in chargemaster,31360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31360,BCBS multispecialty AW base fee schedule,3923.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31365,Not in chargemaster,31365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31365,BCBS multispecialty AW base fee schedule,4855.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31367,Not in chargemaster,31367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31367,BCBS multispecialty AW base fee schedule,4148.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31368,Not in chargemaster,31368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31368,BCBS multispecialty AW base fee schedule,4601.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31370,Not in chargemaster,31370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31370,BCBS multispecialty AW base fee schedule,3897.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31375,Not in chargemaster,31375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31375,BCBS multispecialty AW base fee schedule,3699.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31380,Not in chargemaster,31380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31380,BCBS multispecialty AW base fee schedule,3647.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31382,Not in chargemaster,31382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31382,BCBS multispecialty AW base fee schedule,4000.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31390,Not in chargemaster,31390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31390,BCBS multispecialty AW base fee schedule,5371.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31395,Not in chargemaster,31395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31395,BCBS multispecialty AW base fee schedule,5661.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31400,Not in chargemaster,31400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31400,BCBS multispecialty AW base fee schedule,1856.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31420,Not in chargemaster,31420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31420,BCBS multispecialty AW base fee schedule,1556.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31500,31500,31500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31500,BCBS multispecialty AW base fee schedule,274.28,228.58,Fee schedule,,228.58,228.58,228.58,228.58,,,0
unity,Fee schedule,Non-facility 31502,Not in chargemaster,31502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31502,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31505,Not in chargemaster,31505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31505,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31510,Not in chargemaster,31510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31510,BCBS multispecialty AW base fee schedule,401.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31511,Not in chargemaster,31511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31511,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31512,Not in chargemaster,31512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31512,BCBS multispecialty AW base fee schedule,396.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31513,Not in chargemaster,31513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31513,BCBS multispecialty AW base fee schedule,246.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31515,Not in chargemaster,31515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31515,BCBS multispecialty AW base fee schedule,390.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31520,Not in chargemaster,31520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31520,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31525,Not in chargemaster,31525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31525,BCBS multispecialty AW base fee schedule,473.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31526,Not in chargemaster,31526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31526,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31527,Not in chargemaster,31527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31527,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31528,Not in chargemaster,31528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31528,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31529,Not in chargemaster,31529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31529,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31530,Not in chargemaster,31530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31530,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31531,Not in chargemaster,31531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31531,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31535,Not in chargemaster,31535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31535,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31536,Not in chargemaster,31536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31536,BCBS multispecialty AW base fee schedule,397.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31540,Not in chargemaster,31540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31540,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31541,Not in chargemaster,31541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31541,BCBS multispecialty AW base fee schedule,498.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31545,Not in chargemaster,31545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31545,BCBS multispecialty AW base fee schedule,684.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31546,Not in chargemaster,31546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31546,BCBS multispecialty AW base fee schedule,1040.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31551,Not in chargemaster,31551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31551,BCBS multispecialty AW base fee schedule,2887.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31552,Not in chargemaster,31552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31552,BCBS multispecialty AW base fee schedule,2785.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31553,Not in chargemaster,31553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31553,BCBS multispecialty AW base fee schedule,3170.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31554,Not in chargemaster,31554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31554,BCBS multispecialty AW base fee schedule,3171.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31560,Not in chargemaster,31560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31560,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31561,Not in chargemaster,31561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31561,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31570,Not in chargemaster,31570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31570,BCBS multispecialty AW base fee schedule,641.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31571,Not in chargemaster,31571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31571,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31572,Not in chargemaster,31572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31572,BCBS multispecialty AW base fee schedule,977.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31573,Not in chargemaster,31573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31573,BCBS multispecialty AW base fee schedule,518.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31574,Not in chargemaster,31574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31574,BCBS multispecialty AW base fee schedule,1890.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31575,Not in chargemaster,31575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31575,BCBS multispecialty AW base fee schedule,231.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31576,Not in chargemaster,31576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31576,BCBS multispecialty AW base fee schedule,505.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31577,Not in chargemaster,31577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31577,BCBS multispecialty AW base fee schedule,525.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31578,Not in chargemaster,31578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31578,BCBS multispecialty AW base fee schedule,569.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31579,Not in chargemaster,31579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31579,BCBS multispecialty AW base fee schedule,361.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31580,Not in chargemaster,31580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31580,BCBS multispecialty AW base fee schedule,2402.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31584,Not in chargemaster,31584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31584,BCBS multispecialty AW base fee schedule,2660.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31587,Not in chargemaster,31587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31587,BCBS multispecialty AW base fee schedule,2241.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31590,Not in chargemaster,31590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31590,BCBS multispecialty AW base fee schedule,1652.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31591,Not in chargemaster,31591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31591,BCBS multispecialty AW base fee schedule,2037.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31592,Not in chargemaster,31592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31592,BCBS multispecialty AW base fee schedule,3251.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31600,Not in chargemaster,31600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31600,BCBS multispecialty AW base fee schedule,588.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31601,Not in chargemaster,31601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31601,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31603,Not in chargemaster,31603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31603,BCBS multispecialty AW base fee schedule,616.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31605,Not in chargemaster,31605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31605,BCBS multispecialty AW base fee schedule,642.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31610,Not in chargemaster,31610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31610,BCBS multispecialty AW base fee schedule,1807.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31611,Not in chargemaster,31611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31611,BCBS multispecialty AW base fee schedule,1001.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31612,Not in chargemaster,31612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31612,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31613,Not in chargemaster,31613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31613,BCBS multispecialty AW base fee schedule,824.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31614,Not in chargemaster,31614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31614,BCBS multispecialty AW base fee schedule,1374.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31615,Not in chargemaster,31615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31615,BCBS multispecialty AW base fee schedule,323.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31622,Not in chargemaster,31622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31622,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31623,Not in chargemaster,31623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31623,BCBS multispecialty AW base fee schedule,507.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31624,Not in chargemaster,31624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31624,BCBS multispecialty AW base fee schedule,474.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31625,Not in chargemaster,31625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31625,BCBS multispecialty AW base fee schedule,649.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31626,Not in chargemaster,31626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31626,BCBS multispecialty AW base fee schedule,1578.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31627,Not in chargemaster,31627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31627,BCBS multispecialty AW base fee schedule,2405.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31628,Not in chargemaster,31628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31628,BCBS multispecialty AW base fee schedule,689,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31629,Not in chargemaster,31629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31629,BCBS multispecialty AW base fee schedule,851.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31630,Not in chargemaster,31630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31630,BCBS multispecialty AW base fee schedule,378.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31631,Not in chargemaster,31631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31631,BCBS multispecialty AW base fee schedule,434.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31632,Not in chargemaster,31632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31632,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31633,Not in chargemaster,31633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31633,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31634,Not in chargemaster,31634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31634,BCBS multispecialty AW base fee schedule,3242.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31635,Not in chargemaster,31635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31635,BCBS multispecialty AW base fee schedule,535.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31636,Not in chargemaster,31636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31636,BCBS multispecialty AW base fee schedule,419.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31637,Not in chargemaster,31637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31637,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31638,Not in chargemaster,31638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31638,BCBS multispecialty AW base fee schedule,475.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31640,Not in chargemaster,31640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31640,BCBS multispecialty AW base fee schedule,477.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31641,Not in chargemaster,31641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31641,BCBS multispecialty AW base fee schedule,488.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31643,Not in chargemaster,31643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31643,BCBS multispecialty AW base fee schedule,333.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31645,Not in chargemaster,31645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31645,BCBS multispecialty AW base fee schedule,498.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31646,Not in chargemaster,31646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31646,BCBS multispecialty AW base fee schedule,270.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31647,Not in chargemaster,31647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31647,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31648,Not in chargemaster,31648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31648,BCBS multispecialty AW base fee schedule,382.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31649,Not in chargemaster,31649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31649,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31651,Not in chargemaster,31651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31651,BCBS multispecialty AW base fee schedule,141.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31652,Not in chargemaster,31652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31652,BCBS multispecialty AW base fee schedule,2070.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31653,Not in chargemaster,31653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31653,BCBS multispecialty AW base fee schedule,2160.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31654,Not in chargemaster,31654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31654,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31660,Not in chargemaster,31660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31660,BCBS multispecialty AW base fee schedule,371.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31661,Not in chargemaster,31661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31661,BCBS multispecialty AW base fee schedule,394.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31717,Not in chargemaster,31717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31717,BCBS multispecialty AW base fee schedule,514.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31720,Not in chargemaster,31720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31720,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31725,Not in chargemaster,31725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31725,BCBS multispecialty AW base fee schedule,150.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31730,Not in chargemaster,31730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31730,BCBS multispecialty AW base fee schedule,2241.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31750,Not in chargemaster,31750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31750,BCBS multispecialty AW base fee schedule,2592.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31755,Not in chargemaster,31755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31755,BCBS multispecialty AW base fee schedule,3258.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31760,Not in chargemaster,31760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31760,BCBS multispecialty AW base fee schedule,2626.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31766,Not in chargemaster,31766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31766,BCBS multispecialty AW base fee schedule,3403.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31770,Not in chargemaster,31770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31770,BCBS multispecialty AW base fee schedule,2546.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31775,Not in chargemaster,31775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31775,BCBS multispecialty AW base fee schedule,2675.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31780,Not in chargemaster,31780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31780,BCBS multispecialty AW base fee schedule,2267.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31781,Not in chargemaster,31781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31781,BCBS multispecialty AW base fee schedule,2653.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31785,Not in chargemaster,31785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31785,BCBS multispecialty AW base fee schedule,2042.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31786,Not in chargemaster,31786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31786,BCBS multispecialty AW base fee schedule,2759.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31800,Not in chargemaster,31800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31800,BCBS multispecialty AW base fee schedule,1348.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31805,Not in chargemaster,31805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31805,BCBS multispecialty AW base fee schedule,1560.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31820,Not in chargemaster,31820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31820,BCBS multispecialty AW base fee schedule,822.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31825,Not in chargemaster,31825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31825,BCBS multispecialty AW base fee schedule,1136.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31830,Not in chargemaster,31830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,31830,BCBS multispecialty AW base fee schedule,878.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32035,Not in chargemaster,32035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32035,BCBS multispecialty AW base fee schedule,1391.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32036,Not in chargemaster,32036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32036,BCBS multispecialty AW base fee schedule,1490.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32096,Not in chargemaster,32096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32096,BCBS multispecialty AW base fee schedule,1533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32097,Not in chargemaster,32097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32097,BCBS multispecialty AW base fee schedule,1535.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32098,Not in chargemaster,32098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32098,BCBS multispecialty AW base fee schedule,1454.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32100,Not in chargemaster,32100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32100,BCBS multispecialty AW base fee schedule,1549.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32110,Not in chargemaster,32110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32110,BCBS multispecialty AW base fee schedule,2809,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32120,Not in chargemaster,32120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32120,BCBS multispecialty AW base fee schedule,1669.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32124,Not in chargemaster,32124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32124,BCBS multispecialty AW base fee schedule,1772.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32140,Not in chargemaster,32140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32140,BCBS multispecialty AW base fee schedule,1894.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32141,Not in chargemaster,32141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32141,BCBS multispecialty AW base fee schedule,2917.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32150,Not in chargemaster,32150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32150,BCBS multispecialty AW base fee schedule,1919.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32151,Not in chargemaster,32151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32151,BCBS multispecialty AW base fee schedule,1921.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32160,Not in chargemaster,32160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32160,BCBS multispecialty AW base fee schedule,1521.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32200,Not in chargemaster,32200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32200,BCBS multispecialty AW base fee schedule,2172.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32215,Not in chargemaster,32215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32215,BCBS multispecialty AW base fee schedule,1525.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32220,Not in chargemaster,32220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32220,BCBS multispecialty AW base fee schedule,3040.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32225,Not in chargemaster,32225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32225,BCBS multispecialty AW base fee schedule,1902.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32310,Not in chargemaster,32310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32310,BCBS multispecialty AW base fee schedule,1745.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32320,Not in chargemaster,32320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32320,BCBS multispecialty AW base fee schedule,3057.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32400,Not in chargemaster,32400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32400,BCBS multispecialty AW base fee schedule,302.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32405,Not in chargemaster,32405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32405,BCBS multispecialty AW base fee schedule,749.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32440,Not in chargemaster,32440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32440,BCBS multispecialty AW base fee schedule,2997.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32442,Not in chargemaster,32442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32442,BCBS multispecialty AW base fee schedule,5871.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32445,Not in chargemaster,32445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32445,BCBS multispecialty AW base fee schedule,6776.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32480,Not in chargemaster,32480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32480,BCBS multispecialty AW base fee schedule,2831.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32482,Not in chargemaster,32482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32482,BCBS multispecialty AW base fee schedule,3034.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32484,Not in chargemaster,32484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32484,BCBS multispecialty AW base fee schedule,2744.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32486,Not in chargemaster,32486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32486,BCBS multispecialty AW base fee schedule,4510.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32488,Not in chargemaster,32488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32488,BCBS multispecialty AW base fee schedule,4583.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32491,Not in chargemaster,32491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32491,BCBS multispecialty AW base fee schedule,2814.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32501,Not in chargemaster,32501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32501,BCBS multispecialty AW base fee schedule,466.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32503,Not in chargemaster,32503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32503,BCBS multispecialty AW base fee schedule,3439.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32504,Not in chargemaster,32504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32504,BCBS multispecialty AW base fee schedule,3919.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32505,Not in chargemaster,32505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32505,BCBS multispecialty AW base fee schedule,1782.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32506,Not in chargemaster,32506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32506,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32507,Not in chargemaster,32507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32507,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32540,Not in chargemaster,32540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32540,BCBS multispecialty AW base fee schedule,3319.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32550,Not in chargemaster,32550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32550,BCBS multispecialty AW base fee schedule,1487.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32551,32551,32551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32551,BCBS multispecialty AW base fee schedule,302.1,407,Fee schedule,,302.1,302.1,302.1,302.1,,,0
unity,Fee schedule,Non-facility 32552,Not in chargemaster,32552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32552,BCBS multispecialty AW base fee schedule,349.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32553,Not in chargemaster,32553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32553,BCBS multispecialty AW base fee schedule,1000.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32554,32554,32554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32554,BCBS multispecialty AW base fee schedule,419.36,220,Fee schedule,,220,220,220,220,,,0
unity,Fee schedule,Non-facility 32555,Not in chargemaster,32555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32555,BCBS multispecialty AW base fee schedule,586.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32556,Not in chargemaster,32556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32556,BCBS multispecialty AW base fee schedule,1262.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32557,Not in chargemaster,32557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32557,BCBS multispecialty AW base fee schedule,1162.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32560,Not in chargemaster,32560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32560,BCBS multispecialty AW base fee schedule,488.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32561,Not in chargemaster,32561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32561,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32562,Not in chargemaster,32562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32562,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32601,Not in chargemaster,32601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32601,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32604,Not in chargemaster,32604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32604,BCBS multispecialty AW base fee schedule,918.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32606,Not in chargemaster,32606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32606,BCBS multispecialty AW base fee schedule,886.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32607,Not in chargemaster,32607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32607,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32608,Not in chargemaster,32608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32608,BCBS multispecialty AW base fee schedule,726.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32609,Not in chargemaster,32609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32609,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32650,Not in chargemaster,32650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32650,BCBS multispecialty AW base fee schedule,1272.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32651,Not in chargemaster,32651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32651,BCBS multispecialty AW base fee schedule,2095.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32652,Not in chargemaster,32652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32652,BCBS multispecialty AW base fee schedule,3180,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32653,Not in chargemaster,32653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32653,BCBS multispecialty AW base fee schedule,2031.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32654,Not in chargemaster,32654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32654,BCBS multispecialty AW base fee schedule,2223.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32655,Not in chargemaster,32655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32655,BCBS multispecialty AW base fee schedule,1827.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32656,Not in chargemaster,32656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32656,BCBS multispecialty AW base fee schedule,1533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32658,Not in chargemaster,32658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32658,BCBS multispecialty AW base fee schedule,1364.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32659,Not in chargemaster,32659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32659,BCBS multispecialty AW base fee schedule,1398.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32661,Not in chargemaster,32661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32661,BCBS multispecialty AW base fee schedule,1525.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32662,Not in chargemaster,32662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32662,BCBS multispecialty AW base fee schedule,1705.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32663,Not in chargemaster,32663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32663,BCBS multispecialty AW base fee schedule,2678.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32664,Not in chargemaster,32664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32664,BCBS multispecialty AW base fee schedule,1620.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32665,Not in chargemaster,32665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32665,BCBS multispecialty AW base fee schedule,2357.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32666,Not in chargemaster,32666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32666,BCBS multispecialty AW base fee schedule,1661.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32667,Not in chargemaster,32667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32667,BCBS multispecialty AW base fee schedule,300.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32668,Not in chargemaster,32668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32668,BCBS multispecialty AW base fee schedule,300.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32669,Not in chargemaster,32669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32669,BCBS multispecialty AW base fee schedule,2572.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32670,Not in chargemaster,32670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32670,BCBS multispecialty AW base fee schedule,3072.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32671,Not in chargemaster,32671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32671,BCBS multispecialty AW base fee schedule,3401.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32672,Not in chargemaster,32672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32672,BCBS multispecialty AW base fee schedule,2916.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32673,Not in chargemaster,32673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32673,BCBS multispecialty AW base fee schedule,2330.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32674,Not in chargemaster,32674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32674,BCBS multispecialty AW base fee schedule,412.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32701,Not in chargemaster,32701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32701,BCBS multispecialty AW base fee schedule,410.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32800,Not in chargemaster,32800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32800,BCBS multispecialty AW base fee schedule,1807.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32810,Not in chargemaster,32810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32810,BCBS multispecialty AW base fee schedule,1721.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32815,Not in chargemaster,32815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32815,BCBS multispecialty AW base fee schedule,5360.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32820,Not in chargemaster,32820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32820,BCBS multispecialty AW base fee schedule,2543.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32851,Not in chargemaster,32851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32851,BCBS multispecialty AW base fee schedule,6283.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32852,Not in chargemaster,32852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32852,BCBS multispecialty AW base fee schedule,6826.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32853,Not in chargemaster,32853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32853,BCBS multispecialty AW base fee schedule,8807.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32854,Not in chargemaster,32854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32854,BCBS multispecialty AW base fee schedule,9354.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32900,Not in chargemaster,32900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32900,BCBS multispecialty AW base fee schedule,2718.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32905,Not in chargemaster,32905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32905,BCBS multispecialty AW base fee schedule,2554.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32906,Not in chargemaster,32906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32906,BCBS multispecialty AW base fee schedule,3157.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32940,Not in chargemaster,32940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32940,BCBS multispecialty AW base fee schedule,2359.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32960,Not in chargemaster,32960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32960,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32994,Not in chargemaster,32994,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32994,BCBS multispecialty AW base fee schedule,10319.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32997,Not in chargemaster,32997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32997,BCBS multispecialty AW base fee schedule,651.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32998,Not in chargemaster,32998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32998,BCBS multispecialty AW base fee schedule,6596.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33016,Not in chargemaster,33016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33016,BCBS multispecialty AW base fee schedule,453.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33017,Not in chargemaster,33017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33017,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33018,Not in chargemaster,33018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33018,BCBS multispecialty AW base fee schedule,535.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33019,Not in chargemaster,33019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33019,BCBS multispecialty AW base fee schedule,435.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33020,Not in chargemaster,33020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33020,BCBS multispecialty AW base fee schedule,1582.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33025,Not in chargemaster,33025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33025,BCBS multispecialty AW base fee schedule,1474.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33030,Not in chargemaster,33030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33030,BCBS multispecialty AW base fee schedule,3833.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33031,Not in chargemaster,33031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33031,BCBS multispecialty AW base fee schedule,4750.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33050,Not in chargemaster,33050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33050,BCBS multispecialty AW base fee schedule,1921.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33120,Not in chargemaster,33120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33120,BCBS multispecialty AW base fee schedule,4020.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33130,Not in chargemaster,33130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33130,BCBS multispecialty AW base fee schedule,2619.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33140,Not in chargemaster,33140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33140,BCBS multispecialty AW base fee schedule,2990.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33141,Not in chargemaster,33141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33141,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33202,Not in chargemaster,33202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33202,BCBS multispecialty AW base fee schedule,1476.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33203,Not in chargemaster,33203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33203,BCBS multispecialty AW base fee schedule,1544.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33206,Not in chargemaster,33206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33206,BCBS multispecialty AW base fee schedule,873.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33207,Not in chargemaster,33207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33207,BCBS multispecialty AW base fee schedule,922.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33208,Not in chargemaster,33208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33208,BCBS multispecialty AW base fee schedule,1002.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33210,Not in chargemaster,33210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33210,BCBS multispecialty AW base fee schedule,314.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33211,Not in chargemaster,33211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33211,BCBS multispecialty AW base fee schedule,324.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33212,Not in chargemaster,33212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33212,BCBS multispecialty AW base fee schedule,617.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33213,Not in chargemaster,33213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33213,BCBS multispecialty AW base fee schedule,644.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33214,Not in chargemaster,33214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33214,BCBS multispecialty AW base fee schedule,920.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33215,Not in chargemaster,33215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33215,BCBS multispecialty AW base fee schedule,596.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33216,Not in chargemaster,33216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33216,BCBS multispecialty AW base fee schedule,714.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33217,Not in chargemaster,33217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33217,BCBS multispecialty AW base fee schedule,704.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33218,Not in chargemaster,33218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33218,BCBS multispecialty AW base fee schedule,742,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33220,Not in chargemaster,33220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33220,BCBS multispecialty AW base fee schedule,722.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33221,Not in chargemaster,33221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33221,BCBS multispecialty AW base fee schedule,694.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33222,Not in chargemaster,33222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33222,BCBS multispecialty AW base fee schedule,651.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33223,Not in chargemaster,33223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33223,BCBS multispecialty AW base fee schedule,787.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33224,Not in chargemaster,33224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33224,BCBS multispecialty AW base fee schedule,992.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33225,Not in chargemaster,33225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33225,BCBS multispecialty AW base fee schedule,904.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33226,Not in chargemaster,33226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33226,BCBS multispecialty AW base fee schedule,954,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33227,Not in chargemaster,33227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33227,BCBS multispecialty AW base fee schedule,650.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33228,Not in chargemaster,33228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33228,BCBS multispecialty AW base fee schedule,681.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33229,Not in chargemaster,33229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33229,BCBS multispecialty AW base fee schedule,720.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33230,Not in chargemaster,33230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33230,BCBS multispecialty AW base fee schedule,734.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33231,Not in chargemaster,33231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33231,BCBS multispecialty AW base fee schedule,772.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33233,Not in chargemaster,33233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33233,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33234,Not in chargemaster,33234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33234,BCBS multispecialty AW base fee schedule,933.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33235,Not in chargemaster,33235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33235,BCBS multispecialty AW base fee schedule,1225.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33236,Not in chargemaster,33236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33236,BCBS multispecialty AW base fee schedule,1493.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33237,Not in chargemaster,33237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33237,BCBS multispecialty AW base fee schedule,1602.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33238,Not in chargemaster,33238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33238,BCBS multispecialty AW base fee schedule,1799.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33240,Not in chargemaster,33240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33240,BCBS multispecialty AW base fee schedule,701.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33241,Not in chargemaster,33241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33241,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33243,Not in chargemaster,33243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33243,BCBS multispecialty AW base fee schedule,2625.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33244,Not in chargemaster,33244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33244,BCBS multispecialty AW base fee schedule,1663.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33249,Not in chargemaster,33249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33249,BCBS multispecialty AW base fee schedule,1763.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33250,Not in chargemaster,33250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33250,BCBS multispecialty AW base fee schedule,2790.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33251,Not in chargemaster,33251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33251,BCBS multispecialty AW base fee schedule,3118.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33254,Not in chargemaster,33254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33254,BCBS multispecialty AW base fee schedule,2589.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33255,Not in chargemaster,33255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33255,BCBS multispecialty AW base fee schedule,3119.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33256,Not in chargemaster,33256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33256,BCBS multispecialty AW base fee schedule,3715.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33257,Not in chargemaster,33257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33257,BCBS multispecialty AW base fee schedule,1113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33258,Not in chargemaster,33258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33258,BCBS multispecialty AW base fee schedule,1244.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33259,Not in chargemaster,33259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33259,BCBS multispecialty AW base fee schedule,1615.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33261,Not in chargemaster,33261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33261,BCBS multispecialty AW base fee schedule,3090.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33262,Not in chargemaster,33262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33262,BCBS multispecialty AW base fee schedule,717.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33263,Not in chargemaster,33263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33263,BCBS multispecialty AW base fee schedule,745.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33264,Not in chargemaster,33264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33264,BCBS multispecialty AW base fee schedule,779.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33265,Not in chargemaster,33265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33265,BCBS multispecialty AW base fee schedule,2603.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33266,Not in chargemaster,33266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33266,BCBS multispecialty AW base fee schedule,3539.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33270,Not in chargemaster,33270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33270,BCBS multispecialty AW base fee schedule,1088.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33271,Not in chargemaster,33271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33271,BCBS multispecialty AW base fee schedule,872.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33272,Not in chargemaster,33272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33272,BCBS multispecialty AW base fee schedule,667.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33273,Not in chargemaster,33273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33273,BCBS multispecialty AW base fee schedule,767.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33274,Not in chargemaster,33274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33274,BCBS multispecialty AW base fee schedule,935.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33275,Not in chargemaster,33275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33275,BCBS multispecialty AW base fee schedule,1023.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33285,Not in chargemaster,33285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33285,BCBS multispecialty AW base fee schedule,9471.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33286,Not in chargemaster,33286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33286,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33289,Not in chargemaster,33289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33289,BCBS multispecialty AW base fee schedule,632.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33300,Not in chargemaster,33300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33300,BCBS multispecialty AW base fee schedule,4707.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33305,Not in chargemaster,33305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33305,BCBS multispecialty AW base fee schedule,7881.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33310,Not in chargemaster,33310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33310,BCBS multispecialty AW base fee schedule,2238.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33315,Not in chargemaster,33315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33315,BCBS multispecialty AW base fee schedule,3670.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33320,Not in chargemaster,33320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33320,BCBS multispecialty AW base fee schedule,2017.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33321,Not in chargemaster,33321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33321,BCBS multispecialty AW base fee schedule,2275.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33322,Not in chargemaster,33322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33322,BCBS multispecialty AW base fee schedule,2663.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33330,Not in chargemaster,33330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33330,BCBS multispecialty AW base fee schedule,2730.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33335,Not in chargemaster,33335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33335,BCBS multispecialty AW base fee schedule,3586.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33340,Not in chargemaster,33340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33340,BCBS multispecialty AW base fee schedule,1519.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33361,Not in chargemaster,33361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33361,BCBS multispecialty AW base fee schedule,2329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33362,Not in chargemaster,33362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33362,BCBS multispecialty AW base fee schedule,2538.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33363,Not in chargemaster,33363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33363,BCBS multispecialty AW base fee schedule,2631.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33364,Not in chargemaster,33364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33364,BCBS multispecialty AW base fee schedule,2632.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33365,Not in chargemaster,33365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33365,BCBS multispecialty AW base fee schedule,2781.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33366,Not in chargemaster,33366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33366,BCBS multispecialty AW base fee schedule,3028.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33367,Not in chargemaster,33367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33367,BCBS multispecialty AW base fee schedule,1211.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33368,Not in chargemaster,33368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33368,BCBS multispecialty AW base fee schedule,1429.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33369,Not in chargemaster,33369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33369,BCBS multispecialty AW base fee schedule,1886.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33390,Not in chargemaster,33390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33390,BCBS multispecialty AW base fee schedule,3704.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33391,Not in chargemaster,33391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33391,BCBS multispecialty AW base fee schedule,4401.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33404,Not in chargemaster,33404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33404,BCBS multispecialty AW base fee schedule,3353.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33405,Not in chargemaster,33405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33405,BCBS multispecialty AW base fee schedule,4356.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33406,Not in chargemaster,33406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33406,BCBS multispecialty AW base fee schedule,5529.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33410,Not in chargemaster,33410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33410,BCBS multispecialty AW base fee schedule,4881.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33411,Not in chargemaster,33411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33411,BCBS multispecialty AW base fee schedule,6452.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33412,Not in chargemaster,33412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33412,BCBS multispecialty AW base fee schedule,6059.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33413,Not in chargemaster,33413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33413,BCBS multispecialty AW base fee schedule,6202.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33414,Not in chargemaster,33414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33414,BCBS multispecialty AW base fee schedule,4123.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33415,Not in chargemaster,33415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33415,BCBS multispecialty AW base fee schedule,3897.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33416,Not in chargemaster,33416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33416,BCBS multispecialty AW base fee schedule,3878.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33417,Not in chargemaster,33417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33417,BCBS multispecialty AW base fee schedule,3195.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33418,Not in chargemaster,33418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33418,BCBS multispecialty AW base fee schedule,3455.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33419,Not in chargemaster,33419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33419,BCBS multispecialty AW base fee schedule,816.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33420,Not in chargemaster,33420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33420,BCBS multispecialty AW base fee schedule,2780.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33422,Not in chargemaster,33422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33422,BCBS multispecialty AW base fee schedule,3191.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33425,Not in chargemaster,33425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33425,BCBS multispecialty AW base fee schedule,5244.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33426,Not in chargemaster,33426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33426,BCBS multispecialty AW base fee schedule,4571.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33427,Not in chargemaster,33427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33427,BCBS multispecialty AW base fee schedule,4688.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33430,Not in chargemaster,33430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33430,BCBS multispecialty AW base fee schedule,5376.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33440,Not in chargemaster,33440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33440,BCBS multispecialty AW base fee schedule,6587.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33460,Not in chargemaster,33460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33460,BCBS multispecialty AW base fee schedule,4616.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33463,Not in chargemaster,33463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33463,BCBS multispecialty AW base fee schedule,5927.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33464,Not in chargemaster,33464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33464,BCBS multispecialty AW base fee schedule,4685.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33465,Not in chargemaster,33465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33465,BCBS multispecialty AW base fee schedule,5292.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33468,Not in chargemaster,33468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33468,BCBS multispecialty AW base fee schedule,4706.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33470,Not in chargemaster,33470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33470,BCBS multispecialty AW base fee schedule,2372.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33471,Not in chargemaster,33471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33471,BCBS multispecialty AW base fee schedule,2536.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33474,Not in chargemaster,33474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33474,BCBS multispecialty AW base fee schedule,4178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33475,Not in chargemaster,33475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33475,BCBS multispecialty AW base fee schedule,4475.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33476,Not in chargemaster,33476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33476,BCBS multispecialty AW base fee schedule,2916.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33477,Not in chargemaster,33477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33477,BCBS multispecialty AW base fee schedule,2611.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33478,Not in chargemaster,33478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33478,BCBS multispecialty AW base fee schedule,3013.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33496,Not in chargemaster,33496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33496,BCBS multispecialty AW base fee schedule,3192.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33500,Not in chargemaster,33500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33500,BCBS multispecialty AW base fee schedule,2994.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33501,Not in chargemaster,33501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33501,BCBS multispecialty AW base fee schedule,2138.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33502,Not in chargemaster,33502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33502,BCBS multispecialty AW base fee schedule,2444.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33503,Not in chargemaster,33503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33503,BCBS multispecialty AW base fee schedule,2539.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33504,Not in chargemaster,33504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33504,BCBS multispecialty AW base fee schedule,2807.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33505,Not in chargemaster,33505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33505,BCBS multispecialty AW base fee schedule,3961.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33506,Not in chargemaster,33506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33506,BCBS multispecialty AW base fee schedule,3942.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33507,Not in chargemaster,33507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33507,BCBS multispecialty AW base fee schedule,3305.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33508,Not in chargemaster,33508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33508,BCBS multispecialty AW base fee schedule,31.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33510,Not in chargemaster,33510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33510,BCBS multispecialty AW base fee schedule,3712.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33511,Not in chargemaster,33511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33511,BCBS multispecialty AW base fee schedule,4075.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33512,Not in chargemaster,33512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33512,BCBS multispecialty AW base fee schedule,4641.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33513,Not in chargemaster,33513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33513,BCBS multispecialty AW base fee schedule,4764.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33514,Not in chargemaster,33514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33514,BCBS multispecialty AW base fee schedule,5013.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33516,Not in chargemaster,33516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33516,BCBS multispecialty AW base fee schedule,5194.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33517,Not in chargemaster,33517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33517,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33518,Not in chargemaster,33518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33518,BCBS multispecialty AW base fee schedule,791.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33519,Not in chargemaster,33519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33519,BCBS multispecialty AW base fee schedule,1046.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33521,Not in chargemaster,33521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33521,BCBS multispecialty AW base fee schedule,1256.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33522,Not in chargemaster,33522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33522,BCBS multispecialty AW base fee schedule,1408.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33523,Not in chargemaster,33523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33523,BCBS multispecialty AW base fee schedule,1600.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33530,Not in chargemaster,33530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33530,BCBS multispecialty AW base fee schedule,1010.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33533,Not in chargemaster,33533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33533,BCBS multispecialty AW base fee schedule,3590.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33534,Not in chargemaster,33534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33534,BCBS multispecialty AW base fee schedule,4218.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33535,Not in chargemaster,33535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33535,BCBS multispecialty AW base fee schedule,4705.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33536,Not in chargemaster,33536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33536,BCBS multispecialty AW base fee schedule,5070.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33542,Not in chargemaster,33542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33542,BCBS multispecialty AW base fee schedule,5044.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33545,Not in chargemaster,33545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33545,BCBS multispecialty AW base fee schedule,5902.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33548,Not in chargemaster,33548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33548,BCBS multispecialty AW base fee schedule,5684.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33572,Not in chargemaster,33572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33572,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33600,Not in chargemaster,33600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33600,BCBS multispecialty AW base fee schedule,3292.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33602,Not in chargemaster,33602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33602,BCBS multispecialty AW base fee schedule,3196.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33606,Not in chargemaster,33606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33606,BCBS multispecialty AW base fee schedule,3408.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33608,Not in chargemaster,33608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33608,BCBS multispecialty AW base fee schedule,3451.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33610,Not in chargemaster,33610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33610,BCBS multispecialty AW base fee schedule,3402.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33611,Not in chargemaster,33611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33611,BCBS multispecialty AW base fee schedule,3743.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33612,Not in chargemaster,33612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33612,BCBS multispecialty AW base fee schedule,3843.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33615,Not in chargemaster,33615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33615,BCBS multispecialty AW base fee schedule,3829.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33617,Not in chargemaster,33617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33617,BCBS multispecialty AW base fee schedule,4150.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33619,Not in chargemaster,33619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33619,BCBS multispecialty AW base fee schedule,5252.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33620,Not in chargemaster,33620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33620,BCBS multispecialty AW base fee schedule,3164.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33621,Not in chargemaster,33621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33621,BCBS multispecialty AW base fee schedule,1782.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33622,Not in chargemaster,33622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33622,BCBS multispecialty AW base fee schedule,6600.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33641,Not in chargemaster,33641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33641,BCBS multispecialty AW base fee schedule,3144.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33645,Not in chargemaster,33645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33645,BCBS multispecialty AW base fee schedule,3321.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33647,Not in chargemaster,33647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33647,BCBS multispecialty AW base fee schedule,3486.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33660,Not in chargemaster,33660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33660,BCBS multispecialty AW base fee schedule,3370.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33665,Not in chargemaster,33665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33665,BCBS multispecialty AW base fee schedule,3671.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33670,Not in chargemaster,33670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33670,BCBS multispecialty AW base fee schedule,3788.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33675,Not in chargemaster,33675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33675,BCBS multispecialty AW base fee schedule,3782.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33676,Not in chargemaster,33676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33676,BCBS multispecialty AW base fee schedule,3882.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33677,Not in chargemaster,33677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33677,BCBS multispecialty AW base fee schedule,4034.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33681,Not in chargemaster,33681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33681,BCBS multispecialty AW base fee schedule,3529.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33684,Not in chargemaster,33684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33684,BCBS multispecialty AW base fee schedule,3623.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33688,Not in chargemaster,33688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33688,BCBS multispecialty AW base fee schedule,3617.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33690,Not in chargemaster,33690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33690,BCBS multispecialty AW base fee schedule,2298.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33692,Not in chargemaster,33692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33692,BCBS multispecialty AW base fee schedule,3755.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33694,Not in chargemaster,33694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33694,BCBS multispecialty AW base fee schedule,3743.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33697,Not in chargemaster,33697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33697,BCBS multispecialty AW base fee schedule,3943.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33702,Not in chargemaster,33702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33702,BCBS multispecialty AW base fee schedule,2964.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33710,Not in chargemaster,33710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33710,BCBS multispecialty AW base fee schedule,3935.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33720,Not in chargemaster,33720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33720,BCBS multispecialty AW base fee schedule,2966.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33722,Not in chargemaster,33722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33722,BCBS multispecialty AW base fee schedule,3121.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33724,Not in chargemaster,33724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33724,BCBS multispecialty AW base fee schedule,2950.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33726,Not in chargemaster,33726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33726,BCBS multispecialty AW base fee schedule,3899.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33730,Not in chargemaster,33730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33730,BCBS multispecialty AW base fee schedule,3846.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33732,Not in chargemaster,33732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33732,BCBS multispecialty AW base fee schedule,3159.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33735,Not in chargemaster,33735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33735,BCBS multispecialty AW base fee schedule,2481.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33736,Not in chargemaster,33736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33736,BCBS multispecialty AW base fee schedule,2694.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33737,Not in chargemaster,33737,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33737,BCBS multispecialty AW base fee schedule,2486.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33750,Not in chargemaster,33750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33750,BCBS multispecialty AW base fee schedule,2421.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33755,Not in chargemaster,33755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33755,BCBS multispecialty AW base fee schedule,2522.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33762,Not in chargemaster,33762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33762,BCBS multispecialty AW base fee schedule,2459.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33764,Not in chargemaster,33764,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33764,BCBS multispecialty AW base fee schedule,2522.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33766,Not in chargemaster,33766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33766,BCBS multispecialty AW base fee schedule,2557.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33767,Not in chargemaster,33767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33767,BCBS multispecialty AW base fee schedule,2727.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33768,Not in chargemaster,33768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33768,BCBS multispecialty AW base fee schedule,800.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33770,Not in chargemaster,33770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33770,BCBS multispecialty AW base fee schedule,4065.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33771,Not in chargemaster,33771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33771,BCBS multispecialty AW base fee schedule,4184.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33774,Not in chargemaster,33774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33774,BCBS multispecialty AW base fee schedule,3448.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33775,Not in chargemaster,33775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33775,BCBS multispecialty AW base fee schedule,3553.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33776,Not in chargemaster,33776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33776,BCBS multispecialty AW base fee schedule,3757.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33777,Not in chargemaster,33777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33777,BCBS multispecialty AW base fee schedule,3630.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33778,Not in chargemaster,33778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33778,BCBS multispecialty AW base fee schedule,4508.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33779,Not in chargemaster,33779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33779,BCBS multispecialty AW base fee schedule,4465.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33780,Not in chargemaster,33780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33780,BCBS multispecialty AW base fee schedule,4546.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33781,Not in chargemaster,33781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33781,BCBS multispecialty AW base fee schedule,4442.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33782,Not in chargemaster,33782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33782,BCBS multispecialty AW base fee schedule,6204.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33783,Not in chargemaster,33783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33783,BCBS multispecialty AW base fee schedule,6709.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33786,Not in chargemaster,33786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33786,BCBS multispecialty AW base fee schedule,4372.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33788,Not in chargemaster,33788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33788,BCBS multispecialty AW base fee schedule,2940.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33800,Not in chargemaster,33800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33800,BCBS multispecialty AW base fee schedule,1891.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33802,Not in chargemaster,33802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33802,BCBS multispecialty AW base fee schedule,2076.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33803,Not in chargemaster,33803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33803,BCBS multispecialty AW base fee schedule,2208.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33813,Not in chargemaster,33813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33813,BCBS multispecialty AW base fee schedule,2375.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33814,Not in chargemaster,33814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33814,BCBS multispecialty AW base fee schedule,2918.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33820,Not in chargemaster,33820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33820,BCBS multispecialty AW base fee schedule,1854.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33822,Not in chargemaster,33822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33822,BCBS multispecialty AW base fee schedule,1955.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33824,Not in chargemaster,33824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33824,BCBS multispecialty AW base fee schedule,2261.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33840,Not in chargemaster,33840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33840,BCBS multispecialty AW base fee schedule,2373.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33845,Not in chargemaster,33845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33845,BCBS multispecialty AW base fee schedule,2554.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33851,Not in chargemaster,33851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33851,BCBS multispecialty AW base fee schedule,2438,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33852,Not in chargemaster,33852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33852,BCBS multispecialty AW base fee schedule,2681.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33853,Not in chargemaster,33853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33853,BCBS multispecialty AW base fee schedule,3513.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33858,Not in chargemaster,33858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33858,BCBS multispecialty AW base fee schedule,6528.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33859,Not in chargemaster,33859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33859,BCBS multispecialty AW base fee schedule,4686.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33863,Not in chargemaster,33863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33863,BCBS multispecialty AW base fee schedule,6055.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33864,Not in chargemaster,33864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33864,BCBS multispecialty AW base fee schedule,6187.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33866,Not in chargemaster,33866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33866,BCBS multispecialty AW base fee schedule,1774.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33871,Not in chargemaster,33871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33871,BCBS multispecialty AW base fee schedule,6276.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33875,Not in chargemaster,33875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33875,BCBS multispecialty AW base fee schedule,5267.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33877,Not in chargemaster,33877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33877,BCBS multispecialty AW base fee schedule,6966.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33880,Not in chargemaster,33880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33880,BCBS multispecialty AW base fee schedule,3448.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33881,Not in chargemaster,33881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33881,BCBS multispecialty AW base fee schedule,2960.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33883,Not in chargemaster,33883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33883,BCBS multispecialty AW base fee schedule,2143.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33884,Not in chargemaster,33884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33884,BCBS multispecialty AW base fee schedule,761.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33886,Not in chargemaster,33886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33886,BCBS multispecialty AW base fee schedule,1838.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33889,Not in chargemaster,33889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33889,BCBS multispecialty AW base fee schedule,1520.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33891,Not in chargemaster,33891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33891,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33910,Not in chargemaster,33910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33910,BCBS multispecialty AW base fee schedule,5113.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33915,Not in chargemaster,33915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33915,BCBS multispecialty AW base fee schedule,2642.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33916,Not in chargemaster,33916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33916,BCBS multispecialty AW base fee schedule,8111.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33917,Not in chargemaster,33917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33917,BCBS multispecialty AW base fee schedule,2790.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33920,Not in chargemaster,33920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33920,BCBS multispecialty AW base fee schedule,3474.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33922,Not in chargemaster,33922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33922,BCBS multispecialty AW base fee schedule,2662.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33924,Not in chargemaster,33924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33924,BCBS multispecialty AW base fee schedule,549.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33925,Not in chargemaster,33925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33925,BCBS multispecialty AW base fee schedule,3295.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33926,Not in chargemaster,33926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33926,BCBS multispecialty AW base fee schedule,4640.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33927,Not in chargemaster,33927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33927,BCBS multispecialty AW base fee schedule,4906.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33935,Not in chargemaster,33935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33935,BCBS multispecialty AW base fee schedule,9518.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33945,Not in chargemaster,33945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33945,BCBS multispecialty AW base fee schedule,9349.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33946,Not in chargemaster,33946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33946,BCBS multispecialty AW base fee schedule,592.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33947,Not in chargemaster,33947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33947,BCBS multispecialty AW base fee schedule,659.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33948,Not in chargemaster,33948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33948,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33949,Not in chargemaster,33949,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33949,BCBS multispecialty AW base fee schedule,445.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33951,Not in chargemaster,33951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33951,BCBS multispecialty AW base fee schedule,815.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33952,Not in chargemaster,33952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33952,BCBS multispecialty AW base fee schedule,822.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33953,Not in chargemaster,33953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33953,BCBS multispecialty AW base fee schedule,908.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33954,Not in chargemaster,33954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33954,BCBS multispecialty AW base fee schedule,915.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33955,Not in chargemaster,33955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33955,BCBS multispecialty AW base fee schedule,1594.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33956,Not in chargemaster,33956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33956,BCBS multispecialty AW base fee schedule,1605.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33957,Not in chargemaster,33957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33957,BCBS multispecialty AW base fee schedule,355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33958,Not in chargemaster,33958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33958,BCBS multispecialty AW base fee schedule,355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33959,Not in chargemaster,33959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33959,BCBS multispecialty AW base fee schedule,449.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33962,Not in chargemaster,33962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33962,BCBS multispecialty AW base fee schedule,449.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33963,Not in chargemaster,33963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33963,BCBS multispecialty AW base fee schedule,899.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33964,Not in chargemaster,33964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33964,BCBS multispecialty AW base fee schedule,948.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33965,Not in chargemaster,33965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33965,BCBS multispecialty AW base fee schedule,355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33966,Not in chargemaster,33966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33966,BCBS multispecialty AW base fee schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33967,Not in chargemaster,33967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33967,BCBS multispecialty AW base fee schedule,497.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33968,Not in chargemaster,33968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33968,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33969,Not in chargemaster,33969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33969,BCBS multispecialty AW base fee schedule,524.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33970,Not in chargemaster,33970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33970,BCBS multispecialty AW base fee schedule,680.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33971,Not in chargemaster,33971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33971,BCBS multispecialty AW base fee schedule,1349.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33973,Not in chargemaster,33973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33973,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33974,Not in chargemaster,33974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33974,BCBS multispecialty AW base fee schedule,1702.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33975,Not in chargemaster,33975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33975,BCBS multispecialty AW base fee schedule,2509.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33976,Not in chargemaster,33976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33976,BCBS multispecialty AW base fee schedule,3051.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33977,Not in chargemaster,33977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33977,BCBS multispecialty AW base fee schedule,2161.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33978,Not in chargemaster,33978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33978,BCBS multispecialty AW base fee schedule,2554.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33979,Not in chargemaster,33979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33979,BCBS multispecialty AW base fee schedule,3743.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33980,Not in chargemaster,33980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33980,BCBS multispecialty AW base fee schedule,3415.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33981,Not in chargemaster,33981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33981,BCBS multispecialty AW base fee schedule,1599.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33982,Not in chargemaster,33982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33982,BCBS multispecialty AW base fee schedule,3757.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33983,Not in chargemaster,33983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33983,BCBS multispecialty AW base fee schedule,4442.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33984,Not in chargemaster,33984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33984,BCBS multispecialty AW base fee schedule,546.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33985,Not in chargemaster,33985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33985,BCBS multispecialty AW base fee schedule,987.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33986,Not in chargemaster,33986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33986,BCBS multispecialty AW base fee schedule,1006.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33987,Not in chargemaster,33987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33987,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33988,Not in chargemaster,33988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33988,BCBS multispecialty AW base fee schedule,1494.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33989,Not in chargemaster,33989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33989,BCBS multispecialty AW base fee schedule,948.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33990,Not in chargemaster,33990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33990,BCBS multispecialty AW base fee schedule,816.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33991,Not in chargemaster,33991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33991,BCBS multispecialty AW base fee schedule,1197.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33992,Not in chargemaster,33992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33992,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33993,Not in chargemaster,33993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,33993,BCBS multispecialty AW base fee schedule,333.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34001,Not in chargemaster,34001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34001,BCBS multispecialty AW base fee schedule,1759.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34051,Not in chargemaster,34051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34051,BCBS multispecialty AW base fee schedule,1898.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34101,Not in chargemaster,34101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34101,BCBS multispecialty AW base fee schedule,1151.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34111,Not in chargemaster,34111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34111,BCBS multispecialty AW base fee schedule,1157.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34151,Not in chargemaster,34151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34151,BCBS multispecialty AW base fee schedule,2677.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34201,Not in chargemaster,34201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34201,BCBS multispecialty AW base fee schedule,1975.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34203,Not in chargemaster,34203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34203,BCBS multispecialty AW base fee schedule,1829.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34401,Not in chargemaster,34401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34401,BCBS multispecialty AW base fee schedule,2795.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34421,Not in chargemaster,34421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34421,BCBS multispecialty AW base fee schedule,1428.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34451,Not in chargemaster,34451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34451,BCBS multispecialty AW base fee schedule,2763.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34471,Not in chargemaster,34471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34471,BCBS multispecialty AW base fee schedule,2074.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34490,Not in chargemaster,34490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34490,BCBS multispecialty AW base fee schedule,1226.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34501,Not in chargemaster,34501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34501,BCBS multispecialty AW base fee schedule,1713.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34502,Not in chargemaster,34502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34502,BCBS multispecialty AW base fee schedule,2965.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34510,Not in chargemaster,34510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34510,BCBS multispecialty AW base fee schedule,1963.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34520,Not in chargemaster,34520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34520,BCBS multispecialty AW base fee schedule,1902.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34530,Not in chargemaster,34530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34530,BCBS multispecialty AW base fee schedule,1805.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34701,Not in chargemaster,34701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34701,BCBS multispecialty AW base fee schedule,2395.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34702,Not in chargemaster,34702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34702,BCBS multispecialty AW base fee schedule,3575.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34703,Not in chargemaster,34703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34703,BCBS multispecialty AW base fee schedule,2642.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34704,Not in chargemaster,34704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34704,BCBS multispecialty AW base fee schedule,4401.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34705,Not in chargemaster,34705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34705,BCBS multispecialty AW base fee schedule,2950.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34706,Not in chargemaster,34706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34706,BCBS multispecialty AW base fee schedule,4448.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34707,Not in chargemaster,34707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34707,BCBS multispecialty AW base fee schedule,2235.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34708,Not in chargemaster,34708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34708,BCBS multispecialty AW base fee schedule,3568.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34709,Not in chargemaster,34709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34709,BCBS multispecialty AW base fee schedule,624.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34710,Not in chargemaster,34710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34710,BCBS multispecialty AW base fee schedule,1544.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34711,Not in chargemaster,34711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34711,BCBS multispecialty AW base fee schedule,575.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34712,Not in chargemaster,34712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34712,BCBS multispecialty AW base fee schedule,1272,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34713,Not in chargemaster,34713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34713,BCBS multispecialty AW base fee schedule,240.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34714,Not in chargemaster,34714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34714,BCBS multispecialty AW base fee schedule,521.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34715,Not in chargemaster,34715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34715,BCBS multispecialty AW base fee schedule,577.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34716,Not in chargemaster,34716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34716,BCBS multispecialty AW base fee schedule,715.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34717,Not in chargemaster,34717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34717,BCBS multispecialty AW base fee schedule,857.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34718,Not in chargemaster,34718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34718,BCBS multispecialty AW base fee schedule,2390.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34808,Not in chargemaster,34808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34808,BCBS multispecialty AW base fee schedule,384.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34812,Not in chargemaster,34812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34812,BCBS multispecialty AW base fee schedule,398.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34813,Not in chargemaster,34813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34813,BCBS multispecialty AW base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34820,Not in chargemaster,34820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34820,BCBS multispecialty AW base fee schedule,674.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34830,Not in chargemaster,34830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34830,BCBS multispecialty AW base fee schedule,3392.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34831,Not in chargemaster,34831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34831,BCBS multispecialty AW base fee schedule,3712.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34832,Not in chargemaster,34832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34832,BCBS multispecialty AW base fee schedule,3649.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34834,Not in chargemaster,34834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34834,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34833,Not in chargemaster,34833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34833,BCBS multispecialty AW base fee schedule,777.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35001,Not in chargemaster,35001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35001,BCBS multispecialty AW base fee schedule,2159.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35002,Not in chargemaster,35002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35002,BCBS multispecialty AW base fee schedule,2186.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35005,Not in chargemaster,35005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35005,BCBS multispecialty AW base fee schedule,1913.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35011,Not in chargemaster,35011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35011,BCBS multispecialty AW base fee schedule,1930.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35013,Not in chargemaster,35013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35013,BCBS multispecialty AW base fee schedule,2428.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35021,Not in chargemaster,35021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35021,BCBS multispecialty AW base fee schedule,2414.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35022,Not in chargemaster,35022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35022,BCBS multispecialty AW base fee schedule,2762.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35045,Not in chargemaster,35045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35045,BCBS multispecialty AW base fee schedule,1884.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35081,Not in chargemaster,35081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35081,BCBS multispecialty AW base fee schedule,3334.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35082,Not in chargemaster,35082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35082,BCBS multispecialty AW base fee schedule,4206.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35091,Not in chargemaster,35091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35091,BCBS multispecialty AW base fee schedule,3446.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35092,Not in chargemaster,35092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35092,BCBS multispecialty AW base fee schedule,5019.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35102,Not in chargemaster,35102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35102,BCBS multispecialty AW base fee schedule,3619.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35103,Not in chargemaster,35103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35103,BCBS multispecialty AW base fee schedule,4308.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35111,Not in chargemaster,35111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35111,BCBS multispecialty AW base fee schedule,2556.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35112,Not in chargemaster,35112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35112,BCBS multispecialty AW base fee schedule,3146.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35121,Not in chargemaster,35121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35121,BCBS multispecialty AW base fee schedule,3043.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35122,Not in chargemaster,35122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35122,BCBS multispecialty AW base fee schedule,3640.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35131,Not in chargemaster,35131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35131,BCBS multispecialty AW base fee schedule,2651.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35132,Not in chargemaster,35132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35132,BCBS multispecialty AW base fee schedule,3146.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35141,Not in chargemaster,35141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35141,BCBS multispecialty AW base fee schedule,2122.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35142,Not in chargemaster,35142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35142,BCBS multispecialty AW base fee schedule,2560.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35151,Not in chargemaster,35151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35151,BCBS multispecialty AW base fee schedule,2383.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35152,Not in chargemaster,35152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35152,BCBS multispecialty AW base fee schedule,2689.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35180,Not in chargemaster,35180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35180,BCBS multispecialty AW base fee schedule,1684.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35182,Not in chargemaster,35182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35182,BCBS multispecialty AW base fee schedule,3431.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35184,Not in chargemaster,35184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35184,BCBS multispecialty AW base fee schedule,1854.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35188,Not in chargemaster,35188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35188,BCBS multispecialty AW base fee schedule,2449.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35189,Not in chargemaster,35189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35189,BCBS multispecialty AW base fee schedule,2905.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35190,Not in chargemaster,35190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35190,BCBS multispecialty AW base fee schedule,1466.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35201,Not in chargemaster,35201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35201,BCBS multispecialty AW base fee schedule,1811.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35206,Not in chargemaster,35206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35206,BCBS multispecialty AW base fee schedule,1502.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35207,Not in chargemaster,35207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35207,BCBS multispecialty AW base fee schedule,1441.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35211,Not in chargemaster,35211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35211,BCBS multispecialty AW base fee schedule,2665.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35216,Not in chargemaster,35216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35216,BCBS multispecialty AW base fee schedule,3980.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35221,Not in chargemaster,35221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35221,BCBS multispecialty AW base fee schedule,2824.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35226,Not in chargemaster,35226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35226,BCBS multispecialty AW base fee schedule,1601.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35231,Not in chargemaster,35231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35231,BCBS multispecialty AW base fee schedule,2410.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35236,Not in chargemaster,35236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35236,BCBS multispecialty AW base fee schedule,1933.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35241,Not in chargemaster,35241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35241,BCBS multispecialty AW base fee schedule,2750.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35246,Not in chargemaster,35246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35246,BCBS multispecialty AW base fee schedule,3000.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35251,Not in chargemaster,35251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35251,BCBS multispecialty AW base fee schedule,3359.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35256,Not in chargemaster,35256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35256,BCBS multispecialty AW base fee schedule,1972.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35261,Not in chargemaster,35261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35261,BCBS multispecialty AW base fee schedule,1883.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35266,Not in chargemaster,35266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35266,BCBS multispecialty AW base fee schedule,1664.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35271,Not in chargemaster,35271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35271,BCBS multispecialty AW base fee schedule,2647.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35276,Not in chargemaster,35276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35276,BCBS multispecialty AW base fee schedule,2792.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35281,Not in chargemaster,35281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35281,BCBS multispecialty AW base fee schedule,3134.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35286,Not in chargemaster,35286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35286,BCBS multispecialty AW base fee schedule,1799.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35301,Not in chargemaster,35301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35301,BCBS multispecialty AW base fee schedule,2179.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35302,Not in chargemaster,35302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35302,BCBS multispecialty AW base fee schedule,2159.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35303,Not in chargemaster,35303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35303,BCBS multispecialty AW base fee schedule,2385,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35304,Not in chargemaster,35304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35304,BCBS multispecialty AW base fee schedule,2455.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35305,Not in chargemaster,35305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35305,BCBS multispecialty AW base fee schedule,2359.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35306,Not in chargemaster,35306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35306,BCBS multispecialty AW base fee schedule,858.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35311,Not in chargemaster,35311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35311,BCBS multispecialty AW base fee schedule,2989.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35321,Not in chargemaster,35321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35321,BCBS multispecialty AW base fee schedule,1718.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35331,Not in chargemaster,35331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35331,BCBS multispecialty AW base fee schedule,2797.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35341,Not in chargemaster,35341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35341,BCBS multispecialty AW base fee schedule,2648.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35351,Not in chargemaster,35351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35351,BCBS multispecialty AW base fee schedule,2471.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35355,Not in chargemaster,35355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35355,BCBS multispecialty AW base fee schedule,1986.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35361,Not in chargemaster,35361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35361,BCBS multispecialty AW base fee schedule,2930.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35363,Not in chargemaster,35363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35363,BCBS multispecialty AW base fee schedule,3126.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35371,Not in chargemaster,35371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35371,BCBS multispecialty AW base fee schedule,1573.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35372,Not in chargemaster,35372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35372,BCBS multispecialty AW base fee schedule,1884.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35390,Not in chargemaster,35390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35390,BCBS multispecialty AW base fee schedule,308.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35400,Not in chargemaster,35400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35400,BCBS multispecialty AW base fee schedule,286.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35500,Not in chargemaster,35500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35500,BCBS multispecialty AW base fee schedule,615.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35501,Not in chargemaster,35501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35501,BCBS multispecialty AW base fee schedule,2810.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35506,Not in chargemaster,35506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35506,BCBS multispecialty AW base fee schedule,2451.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35508,Not in chargemaster,35508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35508,BCBS multispecialty AW base fee schedule,2552.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35509,Not in chargemaster,35509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35509,BCBS multispecialty AW base fee schedule,2720.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35510,Not in chargemaster,35510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35510,BCBS multispecialty AW base fee schedule,2365.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35511,Not in chargemaster,35511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35511,BCBS multispecialty AW base fee schedule,2156.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35512,Not in chargemaster,35512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35512,BCBS multispecialty AW base fee schedule,2320.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35515,Not in chargemaster,35515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35515,BCBS multispecialty AW base fee schedule,2552.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35516,Not in chargemaster,35516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35516,BCBS multispecialty AW base fee schedule,2347.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35518,Not in chargemaster,35518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35518,BCBS multispecialty AW base fee schedule,2198.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35521,Not in chargemaster,35521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35521,BCBS multispecialty AW base fee schedule,2359.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35522,Not in chargemaster,35522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35522,BCBS multispecialty AW base fee schedule,2343.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35523,Not in chargemaster,35523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35523,BCBS multispecialty AW base fee schedule,2467.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35525,Not in chargemaster,35525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35525,BCBS multispecialty AW base fee schedule,2186.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35526,Not in chargemaster,35526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35526,BCBS multispecialty AW base fee schedule,3322.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35531,Not in chargemaster,35531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35531,BCBS multispecialty AW base fee schedule,3752.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35533,Not in chargemaster,35533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35533,BCBS multispecialty AW base fee schedule,2899.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35535,Not in chargemaster,35535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35535,BCBS multispecialty AW base fee schedule,3665.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35536,Not in chargemaster,35536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35536,BCBS multispecialty AW base fee schedule,3254.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35537,Not in chargemaster,35537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35537,BCBS multispecialty AW base fee schedule,4016.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35538,Not in chargemaster,35538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35538,BCBS multispecialty AW base fee schedule,4501.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35539,Not in chargemaster,35539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35539,BCBS multispecialty AW base fee schedule,4224.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35540,Not in chargemaster,35540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35540,BCBS multispecialty AW base fee schedule,4709.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35556,Not in chargemaster,35556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35556,BCBS multispecialty AW base fee schedule,2698.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35558,Not in chargemaster,35558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35558,BCBS multispecialty AW base fee schedule,2368.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35560,Not in chargemaster,35560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35560,BCBS multispecialty AW base fee schedule,3281.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35563,Not in chargemaster,35563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35563,BCBS multispecialty AW base fee schedule,2545.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35565,Not in chargemaster,35565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35565,BCBS multispecialty AW base fee schedule,2520.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35566,Not in chargemaster,35566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35566,BCBS multispecialty AW base fee schedule,3219.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35570,Not in chargemaster,35570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35570,BCBS multispecialty AW base fee schedule,2835.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35571,Not in chargemaster,35571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35571,BCBS multispecialty AW base fee schedule,2553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35572,Not in chargemaster,35572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35572,BCBS multispecialty AW base fee schedule,665.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35583,Not in chargemaster,35583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35583,BCBS multispecialty AW base fee schedule,2782.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35585,Not in chargemaster,35585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35585,BCBS multispecialty AW base fee schedule,3225.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35587,Not in chargemaster,35587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35587,BCBS multispecialty AW base fee schedule,2626.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35600,Not in chargemaster,35600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35600,BCBS multispecialty AW base fee schedule,492.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35601,Not in chargemaster,35601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35601,BCBS multispecialty AW base fee schedule,2693.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35606,Not in chargemaster,35606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35606,BCBS multispecialty AW base fee schedule,2258.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35612,Not in chargemaster,35612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35612,BCBS multispecialty AW base fee schedule,2007.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35616,Not in chargemaster,35616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35616,BCBS multispecialty AW base fee schedule,2121.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35621,Not in chargemaster,35621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35621,BCBS multispecialty AW base fee schedule,2112.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35623,Not in chargemaster,35623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35623,BCBS multispecialty AW base fee schedule,2526.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35626,Not in chargemaster,35626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35626,BCBS multispecialty AW base fee schedule,3055.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35631,Not in chargemaster,35631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35631,BCBS multispecialty AW base fee schedule,3566.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35632,Not in chargemaster,35632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35632,BCBS multispecialty AW base fee schedule,3479.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35633,Not in chargemaster,35633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35633,BCBS multispecialty AW base fee schedule,3819.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35634,Not in chargemaster,35634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35634,BCBS multispecialty AW base fee schedule,3405.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35636,Not in chargemaster,35636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35636,BCBS multispecialty AW base fee schedule,3069.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35637,Not in chargemaster,35637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35637,BCBS multispecialty AW base fee schedule,3194.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35638,Not in chargemaster,35638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35638,BCBS multispecialty AW base fee schedule,3358.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35642,Not in chargemaster,35642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35642,BCBS multispecialty AW base fee schedule,1895.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35645,Not in chargemaster,35645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35645,BCBS multispecialty AW base fee schedule,1820.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35646,Not in chargemaster,35646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35646,BCBS multispecialty AW base fee schedule,3305.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35647,Not in chargemaster,35647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35647,BCBS multispecialty AW base fee schedule,2980.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35650,Not in chargemaster,35650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35650,BCBS multispecialty AW base fee schedule,1965.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35654,Not in chargemaster,35654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35654,BCBS multispecialty AW base fee schedule,2638.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35656,Not in chargemaster,35656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35656,BCBS multispecialty AW base fee schedule,2080.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35661,Not in chargemaster,35661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35661,BCBS multispecialty AW base fee schedule,2087.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35663,Not in chargemaster,35663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35663,BCBS multispecialty AW base fee schedule,2341.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35665,Not in chargemaster,35665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35665,BCBS multispecialty AW base fee schedule,2261.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35666,Not in chargemaster,35666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35666,BCBS multispecialty AW base fee schedule,2452.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35671,Not in chargemaster,35671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35671,BCBS multispecialty AW base fee schedule,2163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35681,Not in chargemaster,35681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35681,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35682,Not in chargemaster,35682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35682,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35683,Not in chargemaster,35683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35683,BCBS multispecialty AW base fee schedule,787.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35685,Not in chargemaster,35685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35685,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35686,Not in chargemaster,35686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35686,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35691,Not in chargemaster,35691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35691,BCBS multispecialty AW base fee schedule,1818.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35693,Not in chargemaster,35693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35693,BCBS multispecialty AW base fee schedule,1602.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35694,Not in chargemaster,35694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35694,BCBS multispecialty AW base fee schedule,1900.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35695,Not in chargemaster,35695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35695,BCBS multispecialty AW base fee schedule,1972.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35697,Not in chargemaster,35697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35697,BCBS multispecialty AW base fee schedule,284.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35700,Not in chargemaster,35700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35700,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35701,Not in chargemaster,35701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35701,BCBS multispecialty AW base fee schedule,838.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35702,Not in chargemaster,35702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35702,BCBS multispecialty AW base fee schedule,788.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35703,Not in chargemaster,35703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35703,BCBS multispecialty AW base fee schedule,800.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35800,Not in chargemaster,35800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35800,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35820,Not in chargemaster,35820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35820,BCBS multispecialty AW base fee schedule,3861.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35840,Not in chargemaster,35840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35840,BCBS multispecialty AW base fee schedule,2309.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35860,Not in chargemaster,35860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35860,BCBS multispecialty AW base fee schedule,1610.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35870,Not in chargemaster,35870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35870,BCBS multispecialty AW base fee schedule,2396.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35875,Not in chargemaster,35875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35875,BCBS multispecialty AW base fee schedule,1146.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35876,Not in chargemaster,35876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35876,BCBS multispecialty AW base fee schedule,1823.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35879,Not in chargemaster,35879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35879,BCBS multispecialty AW base fee schedule,1782.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35881,Not in chargemaster,35881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35881,BCBS multispecialty AW base fee schedule,1966.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35883,Not in chargemaster,35883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35883,BCBS multispecialty AW base fee schedule,2314.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35884,Not in chargemaster,35884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35884,BCBS multispecialty AW base fee schedule,2386.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35901,Not in chargemaster,35901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35901,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35903,Not in chargemaster,35903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35903,BCBS multispecialty AW base fee schedule,1087.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35905,Not in chargemaster,35905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35905,BCBS multispecialty AW base fee schedule,3409.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35907,Not in chargemaster,35907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,35907,BCBS multispecialty AW base fee schedule,3666.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36000,Not in chargemaster,36000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36000,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36002,Not in chargemaster,36002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36002,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36005,Not in chargemaster,36005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36005,BCBS multispecialty AW base fee schedule,559.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36010,Not in chargemaster,36010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36010,BCBS multispecialty AW base fee schedule,996.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36011,Not in chargemaster,36011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36011,BCBS multispecialty AW base fee schedule,1634.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36012,Not in chargemaster,36012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36012,BCBS multispecialty AW base fee schedule,1660.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36013,Not in chargemaster,36013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36013,BCBS multispecialty AW base fee schedule,1509.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36014,Not in chargemaster,36014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36014,BCBS multispecialty AW base fee schedule,1572.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36015,Not in chargemaster,36015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36015,BCBS multispecialty AW base fee schedule,1703.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36100,Not in chargemaster,36100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36100,BCBS multispecialty AW base fee schedule,984.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36140,Not in chargemaster,36140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36140,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36160,Not in chargemaster,36160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36160,BCBS multispecialty AW base fee schedule,1032.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36200,Not in chargemaster,36200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36200,BCBS multispecialty AW base fee schedule,1116.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36215,Not in chargemaster,36215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36215,BCBS multispecialty AW base fee schedule,2035.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36216,Not in chargemaster,36216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36216,BCBS multispecialty AW base fee schedule,2157.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36217,Not in chargemaster,36217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36217,BCBS multispecialty AW base fee schedule,3573.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36218,Not in chargemaster,36218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36218,BCBS multispecialty AW base fee schedule,433.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36221,Not in chargemaster,36221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36221,BCBS multispecialty AW base fee schedule,1990.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36222,Not in chargemaster,36222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36222,BCBS multispecialty AW base fee schedule,2355.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36223,Not in chargemaster,36223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36223,BCBS multispecialty AW base fee schedule,3022.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36224,Not in chargemaster,36224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36224,BCBS multispecialty AW base fee schedule,3904.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36225,Not in chargemaster,36225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36225,BCBS multispecialty AW base fee schedule,2898.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36226,Not in chargemaster,36226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36226,BCBS multispecialty AW base fee schedule,3690.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36227,Not in chargemaster,36227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36227,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36228,Not in chargemaster,36228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36228,BCBS multispecialty AW base fee schedule,2495.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36245,Not in chargemaster,36245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36245,BCBS multispecialty AW base fee schedule,2530.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36246,Not in chargemaster,36246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36246,BCBS multispecialty AW base fee schedule,1626.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36247,Not in chargemaster,36247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36247,BCBS multispecialty AW base fee schedule,2863.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36248,Not in chargemaster,36248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36248,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36251,Not in chargemaster,36251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36251,BCBS multispecialty AW base fee schedule,2634.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36252,Not in chargemaster,36252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36252,BCBS multispecialty AW base fee schedule,2836.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36253,Not in chargemaster,36253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36253,BCBS multispecialty AW base fee schedule,4171.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36254,Not in chargemaster,36254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36254,BCBS multispecialty AW base fee schedule,4082.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36260,Not in chargemaster,36260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36260,BCBS multispecialty AW base fee schedule,1254.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36261,Not in chargemaster,36261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36261,BCBS multispecialty AW base fee schedule,778.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36262,Not in chargemaster,36262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36262,BCBS multispecialty AW base fee schedule,593.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36400,Not in chargemaster,36400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36400,BCBS multispecialty AW base fee schedule,50.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36405,Not in chargemaster,36405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36405,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36406,Not in chargemaster,36406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36406,BCBS multispecialty AW base fee schedule,31.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36410,Not in chargemaster,36410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36410,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36420,Not in chargemaster,36420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36420,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36425,Not in chargemaster,36425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36425,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36430,Not in chargemaster,36430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36430,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36440,Not in chargemaster,36440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36440,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36450,Not in chargemaster,36450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36450,BCBS multispecialty AW base fee schedule,326.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36455,Not in chargemaster,36455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36455,BCBS multispecialty AW base fee schedule,243.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36456,Not in chargemaster,36456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36456,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36460,Not in chargemaster,36460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36460,BCBS multispecialty AW base fee schedule,669.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36465,Not in chargemaster,36465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36465,BCBS multispecialty AW base fee schedule,2845.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36466,Not in chargemaster,36466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36466,BCBS multispecialty AW base fee schedule,3156.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36470,Not in chargemaster,36470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36470,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36471,Not in chargemaster,36471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36471,BCBS multispecialty AW base fee schedule,370.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36473,Not in chargemaster,36473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36473,BCBS multispecialty AW base fee schedule,2677.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36474,Not in chargemaster,36474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36474,BCBS multispecialty AW base fee schedule,545.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36475,Not in chargemaster,36475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36475,BCBS multispecialty AW base fee schedule,2579.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36476,Not in chargemaster,36476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36476,BCBS multispecialty AW base fee schedule,583.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36478,Not in chargemaster,36478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36478,BCBS multispecialty AW base fee schedule,2004.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36479,Not in chargemaster,36479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36479,BCBS multispecialty AW base fee schedule,614.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36481,Not in chargemaster,36481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36481,BCBS multispecialty AW base fee schedule,3620.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36482,Not in chargemaster,36482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36482,BCBS multispecialty AW base fee schedule,3579.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36483,Not in chargemaster,36483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36483,BCBS multispecialty AW base fee schedule,294.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36500,Not in chargemaster,36500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36500,BCBS multispecialty AW base fee schedule,350.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36510,Not in chargemaster,36510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36510,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36511,Not in chargemaster,36511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36511,BCBS multispecialty AW base fee schedule,208.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36512,Not in chargemaster,36512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36512,BCBS multispecialty AW base fee schedule,206.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36513,Not in chargemaster,36513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36513,BCBS multispecialty AW base fee schedule,208.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36514,Not in chargemaster,36514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36514,BCBS multispecialty AW base fee schedule,1270.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36516,Not in chargemaster,36516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36516,BCBS multispecialty AW base fee schedule,3672.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36522,Not in chargemaster,36522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36522,BCBS multispecialty AW base fee schedule,3617.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36555,Not in chargemaster,36555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36555,BCBS multispecialty AW base fee schedule,354.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36556,Not in chargemaster,36556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36556,BCBS multispecialty AW base fee schedule,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36557,Not in chargemaster,36557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36557,BCBS multispecialty AW base fee schedule,2077.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36558,Not in chargemaster,36558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36558,BCBS multispecialty AW base fee schedule,1535.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36560,Not in chargemaster,36560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36560,BCBS multispecialty AW base fee schedule,2479.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36561,Not in chargemaster,36561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36561,BCBS multispecialty AW base fee schedule,2027.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36563,Not in chargemaster,36563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36563,BCBS multispecialty AW base fee schedule,2247.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36565,Not in chargemaster,36565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36565,BCBS multispecialty AW base fee schedule,1657.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36566,Not in chargemaster,36566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36566,BCBS multispecialty AW base fee schedule,8760.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36568,Not in chargemaster,36568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36568,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36569,Not in chargemaster,36569,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36569,BCBS multispecialty AW base fee schedule,180.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36570,Not in chargemaster,36570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36570,BCBS multispecialty AW base fee schedule,2803.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36571,Not in chargemaster,36571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36571,BCBS multispecialty AW base fee schedule,2454.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36572,Not in chargemaster,36572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36572,BCBS multispecialty AW base fee schedule,817.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36573,Not in chargemaster,36573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36573,BCBS multispecialty AW base fee schedule,753.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36575,Not in chargemaster,36575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36575,BCBS multispecialty AW base fee schedule,302.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36576,Not in chargemaster,36576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36576,BCBS multispecialty AW base fee schedule,643.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36578,Not in chargemaster,36578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36578,BCBS multispecialty AW base fee schedule,889.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36580,Not in chargemaster,36580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36580,BCBS multispecialty AW base fee schedule,412.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36581,Not in chargemaster,36581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36581,BCBS multispecialty AW base fee schedule,1517.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36582,Not in chargemaster,36582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36582,BCBS multispecialty AW base fee schedule,1871.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36583,Not in chargemaster,36583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36583,BCBS multispecialty AW base fee schedule,2388.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36584,Not in chargemaster,36584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36584,BCBS multispecialty AW base fee schedule,657.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36585,Not in chargemaster,36585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36585,BCBS multispecialty AW base fee schedule,2081.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36589,Not in chargemaster,36589,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36589,BCBS multispecialty AW base fee schedule,315.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36590,Not in chargemaster,36590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36590,BCBS multispecialty AW base fee schedule,424,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36591,Not in chargemaster,36591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36591,BCBS multispecialty AW base fee schedule,46.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36592,Not in chargemaster,36592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36592,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36593,Not in chargemaster,36593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36593,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36595,Not in chargemaster,36595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36595,BCBS multispecialty AW base fee schedule,1185.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36596,Not in chargemaster,36596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36596,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36597,Not in chargemaster,36597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36597,BCBS multispecialty AW base fee schedule,251.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36598,Not in chargemaster,36598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36598,BCBS multispecialty AW base fee schedule,227.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36600,Not in chargemaster,36600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36600,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36620,Not in chargemaster,36620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36620,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36625,Not in chargemaster,36625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36625,BCBS multispecialty AW base fee schedule,202.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36640,Not in chargemaster,36640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36640,BCBS multispecialty AW base fee schedule,219.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36660,Not in chargemaster,36660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36660,BCBS multispecialty AW base fee schedule,130.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36680,Not in chargemaster,36680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36680,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36800,Not in chargemaster,36800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36800,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36810,Not in chargemaster,36810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36810,BCBS multispecialty AW base fee schedule,404.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36815,Not in chargemaster,36815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36815,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36818,Not in chargemaster,36818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36818,BCBS multispecialty AW base fee schedule,1332.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36819,Not in chargemaster,36819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36819,BCBS multispecialty AW base fee schedule,1409.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36820,Not in chargemaster,36820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36820,BCBS multispecialty AW base fee schedule,1404.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36821,Not in chargemaster,36821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36821,BCBS multispecialty AW base fee schedule,1279.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36823,Not in chargemaster,36823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36823,BCBS multispecialty AW base fee schedule,2697.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36825,Not in chargemaster,36825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36825,BCBS multispecialty AW base fee schedule,1531.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36830,Not in chargemaster,36830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36830,BCBS multispecialty AW base fee schedule,1285.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36831,Not in chargemaster,36831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36831,BCBS multispecialty AW base fee schedule,1185.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36832,Not in chargemaster,36832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36832,BCBS multispecialty AW base fee schedule,1455.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36833,Not in chargemaster,36833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36833,BCBS multispecialty AW base fee schedule,1560.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36835,Not in chargemaster,36835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36835,BCBS multispecialty AW base fee schedule,918.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36838,Not in chargemaster,36838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36838,BCBS multispecialty AW base fee schedule,2206.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36860,Not in chargemaster,36860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36860,BCBS multispecialty AW base fee schedule,467.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36861,Not in chargemaster,36861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36861,BCBS multispecialty AW base fee schedule,268.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36901,Not in chargemaster,36901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36901,BCBS multispecialty AW base fee schedule,1307.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36902,Not in chargemaster,36902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36902,BCBS multispecialty AW base fee schedule,2449.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36903,Not in chargemaster,36903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36903,BCBS multispecialty AW base fee schedule,9694.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36904,Not in chargemaster,36904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36904,BCBS multispecialty AW base fee schedule,3627.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36905,Not in chargemaster,36905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36905,BCBS multispecialty AW base fee schedule,4554.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36906,Not in chargemaster,36906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36906,BCBS multispecialty AW base fee schedule,12034.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36907,Not in chargemaster,36907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36907,BCBS multispecialty AW base fee schedule,1302.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36908,Not in chargemaster,36908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36908,BCBS multispecialty AW base fee schedule,3950.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36909,Not in chargemaster,36909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36909,BCBS multispecialty AW base fee schedule,3764.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37140,Not in chargemaster,37140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37140,BCBS multispecialty AW base fee schedule,4485.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37145,Not in chargemaster,37145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37145,BCBS multispecialty AW base fee schedule,4158.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37160,Not in chargemaster,37160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37160,BCBS multispecialty AW base fee schedule,4271.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37180,Not in chargemaster,37180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37180,BCBS multispecialty AW base fee schedule,4106.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37181,Not in chargemaster,37181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37181,BCBS multispecialty AW base fee schedule,4485.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37182,Not in chargemaster,37182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37182,BCBS multispecialty AW base fee schedule,1572.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37183,Not in chargemaster,37183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37183,BCBS multispecialty AW base fee schedule,11665.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37184,Not in chargemaster,37184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37184,BCBS multispecialty AW base fee schedule,3710.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37185,Not in chargemaster,37185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37185,BCBS multispecialty AW base fee schedule,1120.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37186,Not in chargemaster,37186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37186,BCBS multispecialty AW base fee schedule,2491,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37187,Not in chargemaster,37187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37187,BCBS multispecialty AW base fee schedule,3647.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37188,Not in chargemaster,37188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37188,BCBS multispecialty AW base fee schedule,3068.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37191,Not in chargemaster,37191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37191,BCBS multispecialty AW base fee schedule,4508.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37192,Not in chargemaster,37192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37192,BCBS multispecialty AW base fee schedule,2536.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37193,Not in chargemaster,37193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37193,BCBS multispecialty AW base fee schedule,2987.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37197,Not in chargemaster,37197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37197,BCBS multispecialty AW base fee schedule,3024.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37200,Not in chargemaster,37200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37200,BCBS multispecialty AW base fee schedule,417.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37211,Not in chargemaster,37211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37211,BCBS multispecialty AW base fee schedule,743.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37212,Not in chargemaster,37212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37212,BCBS multispecialty AW base fee schedule,649.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37213,Not in chargemaster,37213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37213,BCBS multispecialty AW base fee schedule,447.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37214,Not in chargemaster,37214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37214,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37215,Not in chargemaster,37215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37215,BCBS multispecialty AW base fee schedule,1923.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37216,Not in chargemaster,37216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37216,BCBS multispecialty AW base fee schedule,1872.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37217,Not in chargemaster,37217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37217,BCBS multispecialty AW base fee schedule,2078.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37218,Not in chargemaster,37218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37218,BCBS multispecialty AW base fee schedule,1574.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37220,Not in chargemaster,37220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37220,BCBS multispecialty AW base fee schedule,5439.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37221,Not in chargemaster,37221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37221,BCBS multispecialty AW base fee schedule,7365.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37222,Not in chargemaster,37222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37222,BCBS multispecialty AW base fee schedule,1407.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37223,Not in chargemaster,37223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37223,BCBS multispecialty AW base fee schedule,3607.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37224,Not in chargemaster,37224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37224,BCBS multispecialty AW base fee schedule,6469.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37225,Not in chargemaster,37225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37225,BCBS multispecialty AW base fee schedule,21260.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37226,Not in chargemaster,37226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37226,BCBS multispecialty AW base fee schedule,18881.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37227,Not in chargemaster,37227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37227,BCBS multispecialty AW base fee schedule,27336.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37228,Not in chargemaster,37228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37228,BCBS multispecialty AW base fee schedule,9311.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37229,Not in chargemaster,37229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37229,BCBS multispecialty AW base fee schedule,21342.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37230,Not in chargemaster,37230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37230,BCBS multispecialty AW base fee schedule,19195.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37231,Not in chargemaster,37231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37231,BCBS multispecialty AW base fee schedule,26573.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37232,Not in chargemaster,37232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37232,BCBS multispecialty AW base fee schedule,1925.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37233,Not in chargemaster,37233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37233,BCBS multispecialty AW base fee schedule,2365.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37234,Not in chargemaster,37234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37234,BCBS multispecialty AW base fee schedule,7315.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37235,Not in chargemaster,37235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37235,BCBS multispecialty AW base fee schedule,7708.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37236,Not in chargemaster,37236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37236,BCBS multispecialty AW base fee schedule,6352.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37237,Not in chargemaster,37237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37237,BCBS multispecialty AW base fee schedule,3524.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37238,Not in chargemaster,37238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37238,BCBS multispecialty AW base fee schedule,5984.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37239,Not in chargemaster,37239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37239,BCBS multispecialty AW base fee schedule,2772.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37241,Not in chargemaster,37241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37241,BCBS multispecialty AW base fee schedule,9287.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37242,Not in chargemaster,37242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37242,BCBS multispecialty AW base fee schedule,14361.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37243,Not in chargemaster,37243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37243,BCBS multispecialty AW base fee schedule,18124.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37244,Not in chargemaster,37244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37244,BCBS multispecialty AW base fee schedule,13301.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37246,Not in chargemaster,37246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37246,BCBS multispecialty AW base fee schedule,3865.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37247,Not in chargemaster,37247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37247,BCBS multispecialty AW base fee schedule,1360.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37248,Not in chargemaster,37248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37248,BCBS multispecialty AW base fee schedule,2844.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37249,Not in chargemaster,37249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37249,BCBS multispecialty AW base fee schedule,1038.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37252,Not in chargemaster,37252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37252,BCBS multispecialty AW base fee schedule,2205.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37253,Not in chargemaster,37253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37253,BCBS multispecialty AW base fee schedule,356.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37500,Not in chargemaster,37500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37500,BCBS multispecialty AW base fee schedule,1217.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37565,Not in chargemaster,37565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37565,BCBS multispecialty AW base fee schedule,1386.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37600,Not in chargemaster,37600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37600,BCBS multispecialty AW base fee schedule,1405.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37605,Not in chargemaster,37605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37605,BCBS multispecialty AW base fee schedule,1419.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37606,Not in chargemaster,37606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37606,BCBS multispecialty AW base fee schedule,1371.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37607,Not in chargemaster,37607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37607,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37609,Not in chargemaster,37609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37609,BCBS multispecialty AW base fee schedule,592.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37615,Not in chargemaster,37615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37615,BCBS multispecialty AW base fee schedule,1014.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37616,Not in chargemaster,37616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37616,BCBS multispecialty AW base fee schedule,2121.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37617,Not in chargemaster,37617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37617,BCBS multispecialty AW base fee schedule,2558.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37618,Not in chargemaster,37618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37618,BCBS multispecialty AW base fee schedule,743.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37619,Not in chargemaster,37619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37619,BCBS multispecialty AW base fee schedule,3337.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37650,Not in chargemaster,37650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37650,BCBS multispecialty AW base fee schedule,880.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37660,Not in chargemaster,37660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37660,BCBS multispecialty AW base fee schedule,2539.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37700,Not in chargemaster,37700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37700,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37718,Not in chargemaster,37718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37718,BCBS multispecialty AW base fee schedule,808.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37722,Not in chargemaster,37722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37722,BCBS multispecialty AW base fee schedule,906.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37735,Not in chargemaster,37735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37735,BCBS multispecialty AW base fee schedule,1116.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37760,Not in chargemaster,37760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37760,BCBS multispecialty AW base fee schedule,1199.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37761,Not in chargemaster,37761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37761,BCBS multispecialty AW base fee schedule,1040.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37765,Not in chargemaster,37765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37765,BCBS multispecialty AW base fee schedule,840.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37766,Not in chargemaster,37766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37766,BCBS multispecialty AW base fee schedule,981.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37780,Not in chargemaster,37780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37780,BCBS multispecialty AW base fee schedule,448.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37785,Not in chargemaster,37785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37785,BCBS multispecialty AW base fee schedule,675.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37788,Not in chargemaster,37788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37788,BCBS multispecialty AW base fee schedule,2419.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37790,Not in chargemaster,37790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37790,BCBS multispecialty AW base fee schedule,929.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38100,Not in chargemaster,38100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38100,BCBS multispecialty AW base fee schedule,2225.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38101,Not in chargemaster,38101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38101,BCBS multispecialty AW base fee schedule,2249.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38102,Not in chargemaster,38102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38102,BCBS multispecialty AW base fee schedule,505.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38115,Not in chargemaster,38115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38115,BCBS multispecialty AW base fee schedule,2463.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38120,Not in chargemaster,38120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38120,BCBS multispecialty AW base fee schedule,2031.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38200,Not in chargemaster,38200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38200,BCBS multispecialty AW base fee schedule,255.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38204,Not in chargemaster,38204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38204,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38205,Not in chargemaster,38205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38205,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38206,Not in chargemaster,38206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38206,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38207,Not in chargemaster,38207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38207,BCBS multispecialty AW base fee schedule,86.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38208,Not in chargemaster,38208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38208,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38209,Not in chargemaster,38209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38209,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38210,Not in chargemaster,38210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38210,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38211,Not in chargemaster,38211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38211,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38212,Not in chargemaster,38212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38212,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38213,Not in chargemaster,38213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38213,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38214,Not in chargemaster,38214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38214,BCBS multispecialty AW base fee schedule,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38215,Not in chargemaster,38215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38215,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38220,Not in chargemaster,38220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38220,BCBS multispecialty AW base fee schedule,316.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38221,Not in chargemaster,38221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38221,BCBS multispecialty AW base fee schedule,296.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38222,Not in chargemaster,38222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38222,BCBS multispecialty AW base fee schedule,327.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38230,Not in chargemaster,38230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38230,BCBS multispecialty AW base fee schedule,392.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38232,Not in chargemaster,38232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38232,BCBS multispecialty AW base fee schedule,381.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38240,Not in chargemaster,38240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38240,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38241,Not in chargemaster,38241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38241,BCBS multispecialty AW base fee schedule,332.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38242,Not in chargemaster,38242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38242,BCBS multispecialty AW base fee schedule,240.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38243,Not in chargemaster,38243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38243,BCBS multispecialty AW base fee schedule,231.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38300,Not in chargemaster,38300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38300,BCBS multispecialty AW base fee schedule,622.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38305,Not in chargemaster,38305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38305,BCBS multispecialty AW base fee schedule,936.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38308,Not in chargemaster,38308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38308,BCBS multispecialty AW base fee schedule,872.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38380,Not in chargemaster,38380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38380,BCBS multispecialty AW base fee schedule,1083.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38381,Not in chargemaster,38381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38381,BCBS multispecialty AW base fee schedule,1538.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38382,Not in chargemaster,38382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38382,BCBS multispecialty AW base fee schedule,1300.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38500,38500,38500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38500,BCBS multispecialty AW base fee schedule,641.3,506,Fee schedule,,506,506,506,506,,,0
unity,Fee schedule,Non-facility 38505,Not in chargemaster,38505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38505,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38510,38510,38510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38510,BCBS multispecialty AW base fee schedule,1000.38,880,Fee schedule,,880,880,880,880,,,0
unity,Fee schedule,Non-facility 38520,Not in chargemaster,38520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38520,BCBS multispecialty AW base fee schedule,890.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38525,38525,38525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38525,BCBS multispecialty AW base fee schedule,841.38,921.4,Fee schedule,,841.38,841.38,841.38,841.38,,,0
unity,Fee schedule,Non-facility 38530,Not in chargemaster,38530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38530,BCBS multispecialty AW base fee schedule,1082.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38531,Not in chargemaster,38531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38531,BCBS multispecialty AW base fee schedule,829.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38542,Not in chargemaster,38542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38542,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38550,Not in chargemaster,38550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38550,BCBS multispecialty AW base fee schedule,987.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38555,Not in chargemaster,38555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38555,BCBS multispecialty AW base fee schedule,1957.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38562,Not in chargemaster,38562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38562,BCBS multispecialty AW base fee schedule,1352.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38564,Not in chargemaster,38564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38564,BCBS multispecialty AW base fee schedule,1353.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38570,Not in chargemaster,38570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38570,BCBS multispecialty AW base fee schedule,979.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38571,Not in chargemaster,38571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38571,BCBS multispecialty AW base fee schedule,1270.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38572,Not in chargemaster,38572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38572,BCBS multispecialty AW base fee schedule,1743.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38573,Not in chargemaster,38573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38573,BCBS multispecialty AW base fee schedule,2220.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38700,Not in chargemaster,38700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38700,BCBS multispecialty AW base fee schedule,1529.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38720,Not in chargemaster,38720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38720,BCBS multispecialty AW base fee schedule,2552.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38724,Not in chargemaster,38724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38724,BCBS multispecialty AW base fee schedule,2752.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38740,Not in chargemaster,38740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38740,BCBS multispecialty AW base fee schedule,1344.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38745,Not in chargemaster,38745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38745,BCBS multispecialty AW base fee schedule,1692.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38746,Not in chargemaster,38746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38746,BCBS multispecialty AW base fee schedule,412.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38747,Not in chargemaster,38747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38747,BCBS multispecialty AW base fee schedule,515.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38760,Not in chargemaster,38760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38760,BCBS multispecialty AW base fee schedule,1609.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38765,Not in chargemaster,38765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38765,BCBS multispecialty AW base fee schedule,2498.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38770,Not in chargemaster,38770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38770,BCBS multispecialty AW base fee schedule,1538.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38780,Not in chargemaster,38780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38780,BCBS multispecialty AW base fee schedule,1982.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38790,Not in chargemaster,38790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38790,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38792,Not in chargemaster,38792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38792,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38794,Not in chargemaster,38794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38794,BCBS multispecialty AW base fee schedule,564.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38900,Not in chargemaster,38900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,38900,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39000,Not in chargemaster,39000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39000,BCBS multispecialty AW base fee schedule,950.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39010,Not in chargemaster,39010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39010,BCBS multispecialty AW base fee schedule,1507.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39200,Not in chargemaster,39200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39200,BCBS multispecialty AW base fee schedule,1670.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39220,Not in chargemaster,39220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39220,BCBS multispecialty AW base fee schedule,2173,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39401,Not in chargemaster,39401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39401,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39402,Not in chargemaster,39402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39402,BCBS multispecialty AW base fee schedule,773.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39501,Not in chargemaster,39501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39501,BCBS multispecialty AW base fee schedule,1641.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39503,Not in chargemaster,39503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39503,BCBS multispecialty AW base fee schedule,11474.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39540,Not in chargemaster,39540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39540,BCBS multispecialty AW base fee schedule,1676.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39541,Not in chargemaster,39541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39541,BCBS multispecialty AW base fee schedule,1810.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39545,Not in chargemaster,39545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39545,BCBS multispecialty AW base fee schedule,1712.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39560,Not in chargemaster,39560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39560,BCBS multispecialty AW base fee schedule,1533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39561,Not in chargemaster,39561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,39561,BCBS multispecialty AW base fee schedule,2376.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40490,Not in chargemaster,40490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40490,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40500,Not in chargemaster,40500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40500,BCBS multispecialty AW base fee schedule,974.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40510,40510,40510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40510,BCBS multispecialty AW base fee schedule,925.51,742.5,Fee schedule,,742.5,742.5,742.5,742.5,,,0
unity,Fee schedule,Non-facility 40520,Not in chargemaster,40520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40520,BCBS multispecialty AW base fee schedule,942.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40525,Not in chargemaster,40525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40525,BCBS multispecialty AW base fee schedule,1052.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40527,Not in chargemaster,40527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40527,BCBS multispecialty AW base fee schedule,1174.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40530,Not in chargemaster,40530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40530,BCBS multispecialty AW base fee schedule,1034.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40650,Not in chargemaster,40650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40650,BCBS multispecialty AW base fee schedule,879.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40652,Not in chargemaster,40652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40652,BCBS multispecialty AW base fee schedule,963.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40654,Not in chargemaster,40654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40654,BCBS multispecialty AW base fee schedule,1095.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40700,Not in chargemaster,40700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40700,BCBS multispecialty AW base fee schedule,1936.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40701,Not in chargemaster,40701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40701,BCBS multispecialty AW base fee schedule,2293.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40702,Not in chargemaster,40702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40702,BCBS multispecialty AW base fee schedule,1924.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40720,Not in chargemaster,40720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40720,BCBS multispecialty AW base fee schedule,1976.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40761,Not in chargemaster,40761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40761,BCBS multispecialty AW base fee schedule,2084.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40800,Not in chargemaster,40800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40800,BCBS multispecialty AW base fee schedule,394.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40801,Not in chargemaster,40801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40801,BCBS multispecialty AW base fee schedule,569.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40804,Not in chargemaster,40804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40804,BCBS multispecialty AW base fee schedule,372.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40805,Not in chargemaster,40805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40805,BCBS multispecialty AW base fee schedule,562.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40806,Not in chargemaster,40806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40806,BCBS multispecialty AW base fee schedule,188.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40808,Not in chargemaster,40808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40808,BCBS multispecialty AW base fee schedule,300.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40810,Not in chargemaster,40810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40810,BCBS multispecialty AW base fee schedule,398.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40812,Not in chargemaster,40812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40812,BCBS multispecialty AW base fee schedule,542.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40814,Not in chargemaster,40814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40814,BCBS multispecialty AW base fee schedule,720.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40816,Not in chargemaster,40816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40816,BCBS multispecialty AW base fee schedule,758.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40818,Not in chargemaster,40818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40818,BCBS multispecialty AW base fee schedule,694.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40819,Not in chargemaster,40819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40819,BCBS multispecialty AW base fee schedule,533.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40820,Not in chargemaster,40820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40820,BCBS multispecialty AW base fee schedule,491.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40830,Not in chargemaster,40830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40830,BCBS multispecialty AW base fee schedule,528.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40831,Not in chargemaster,40831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40831,BCBS multispecialty AW base fee schedule,674.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40840,Not in chargemaster,40840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40840,BCBS multispecialty AW base fee schedule,1585.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40842,Not in chargemaster,40842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40842,BCBS multispecialty AW base fee schedule,1735.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40843,Not in chargemaster,40843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40843,BCBS multispecialty AW base fee schedule,2263.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40844,Not in chargemaster,40844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40844,BCBS multispecialty AW base fee schedule,2844.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40845,Not in chargemaster,40845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,40845,BCBS multispecialty AW base fee schedule,2789.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41000,Not in chargemaster,41000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41000,BCBS multispecialty AW base fee schedule,300.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41005,Not in chargemaster,41005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41005,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41006,Not in chargemaster,41006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41006,BCBS multispecialty AW base fee schedule,649.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41007,Not in chargemaster,41007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41007,BCBS multispecialty AW base fee schedule,637.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41008,Not in chargemaster,41008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41008,BCBS multispecialty AW base fee schedule,728.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41009,Not in chargemaster,41009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41009,BCBS multispecialty AW base fee schedule,782.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41010,Not in chargemaster,41010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41010,BCBS multispecialty AW base fee schedule,395.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41015,Not in chargemaster,41015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41015,BCBS multispecialty AW base fee schedule,768.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41016,Not in chargemaster,41016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41016,BCBS multispecialty AW base fee schedule,861.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41017,Not in chargemaster,41017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41017,BCBS multispecialty AW base fee schedule,858.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41018,Not in chargemaster,41018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41018,BCBS multispecialty AW base fee schedule,965.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41019,Not in chargemaster,41019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41019,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41100,Not in chargemaster,41100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41100,BCBS multispecialty AW base fee schedule,331.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41105,Not in chargemaster,41105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41105,BCBS multispecialty AW base fee schedule,334.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41108,Not in chargemaster,41108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41108,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41110,Not in chargemaster,41110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41110,BCBS multispecialty AW base fee schedule,416.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41112,Not in chargemaster,41112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41112,BCBS multispecialty AW base fee schedule,634.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41113,Not in chargemaster,41113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41113,BCBS multispecialty AW base fee schedule,689,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41114,Not in chargemaster,41114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41114,BCBS multispecialty AW base fee schedule,1175.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41115,Not in chargemaster,41115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41115,BCBS multispecialty AW base fee schedule,480.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41116,Not in chargemaster,41116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41116,BCBS multispecialty AW base fee schedule,629.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41120,Not in chargemaster,41120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41120,BCBS multispecialty AW base fee schedule,2013.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41130,Not in chargemaster,41130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41130,BCBS multispecialty AW base fee schedule,2489.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41135,Not in chargemaster,41135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41135,BCBS multispecialty AW base fee schedule,4112.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41140,Not in chargemaster,41140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41140,BCBS multispecialty AW base fee schedule,4132.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41145,Not in chargemaster,41145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41145,BCBS multispecialty AW base fee schedule,5229.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41150,Not in chargemaster,41150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41150,BCBS multispecialty AW base fee schedule,4161.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41153,Not in chargemaster,41153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41153,BCBS multispecialty AW base fee schedule,4532.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41155,Not in chargemaster,41155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41155,BCBS multispecialty AW base fee schedule,5709.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41250,Not in chargemaster,41250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41250,BCBS multispecialty AW base fee schedule,528.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41251,Not in chargemaster,41251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41251,BCBS multispecialty AW base fee schedule,584.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41252,Not in chargemaster,41252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41252,BCBS multispecialty AW base fee schedule,608.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41510,Not in chargemaster,41510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41510,BCBS multispecialty AW base fee schedule,846.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41512,Not in chargemaster,41512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41512,BCBS multispecialty AW base fee schedule,1246.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41520,Not in chargemaster,41520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41520,BCBS multispecialty AW base fee schedule,673.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41530,Not in chargemaster,41530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41530,BCBS multispecialty AW base fee schedule,1796.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41800,Not in chargemaster,41800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41800,BCBS multispecialty AW base fee schedule,555.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41805,Not in chargemaster,41805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41805,BCBS multispecialty AW base fee schedule,559.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41806,Not in chargemaster,41806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41806,BCBS multispecialty AW base fee schedule,758.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41822,Not in chargemaster,41822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41822,BCBS multispecialty AW base fee schedule,654.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41823,Not in chargemaster,41823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41823,BCBS multispecialty AW base fee schedule,963.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41825,Not in chargemaster,41825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41825,BCBS multispecialty AW base fee schedule,410.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41826,Not in chargemaster,41826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41826,BCBS multispecialty AW base fee schedule,593.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41827,Not in chargemaster,41827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41827,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41828,Not in chargemaster,41828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41828,BCBS multispecialty AW base fee schedule,659.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41830,Not in chargemaster,41830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41830,BCBS multispecialty AW base fee schedule,865.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41872,Not in chargemaster,41872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41872,BCBS multispecialty AW base fee schedule,849.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41874,Not in chargemaster,41874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41874,BCBS multispecialty AW base fee schedule,742,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42000,Not in chargemaster,42000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42000,BCBS multispecialty AW base fee schedule,297.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42100,Not in chargemaster,42100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42100,BCBS multispecialty AW base fee schedule,279.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42104,Not in chargemaster,42104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42104,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42106,Not in chargemaster,42106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42106,BCBS multispecialty AW base fee schedule,504.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42107,Not in chargemaster,42107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42107,BCBS multispecialty AW base fee schedule,879.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42120,Not in chargemaster,42120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42120,BCBS multispecialty AW base fee schedule,1904.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42140,Not in chargemaster,42140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42140,BCBS multispecialty AW base fee schedule,532.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42145,Not in chargemaster,42145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42145,BCBS multispecialty AW base fee schedule,1311.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42160,Not in chargemaster,42160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42160,BCBS multispecialty AW base fee schedule,444.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42180,Not in chargemaster,42180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42180,BCBS multispecialty AW base fee schedule,475.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42182,Not in chargemaster,42182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42182,BCBS multispecialty AW base fee schedule,618.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42200,Not in chargemaster,42200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42200,BCBS multispecialty AW base fee schedule,1805.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42205,Not in chargemaster,42205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42205,BCBS multispecialty AW base fee schedule,1882.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42210,Not in chargemaster,42210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42210,BCBS multispecialty AW base fee schedule,2100.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42215,Not in chargemaster,42215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42215,BCBS multispecialty AW base fee schedule,1368.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42220,Not in chargemaster,42220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42220,BCBS multispecialty AW base fee schedule,1125.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42225,Not in chargemaster,42225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42225,BCBS multispecialty AW base fee schedule,1870.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42226,Not in chargemaster,42226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42226,BCBS multispecialty AW base fee schedule,1675.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42227,Not in chargemaster,42227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42227,BCBS multispecialty AW base fee schedule,1566.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42235,Not in chargemaster,42235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42235,BCBS multispecialty AW base fee schedule,1371.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42260,Not in chargemaster,42260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42260,BCBS multispecialty AW base fee schedule,1576.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42280,Not in chargemaster,42280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42280,BCBS multispecialty AW base fee schedule,336.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42281,Not in chargemaster,42281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42281,BCBS multispecialty AW base fee schedule,431.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42300,Not in chargemaster,42300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42300,BCBS multispecialty AW base fee schedule,404.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42305,Not in chargemaster,42305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42305,BCBS multispecialty AW base fee schedule,811.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42310,Not in chargemaster,42310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42310,BCBS multispecialty AW base fee schedule,330.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42320,Not in chargemaster,42320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42320,BCBS multispecialty AW base fee schedule,484.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42330,Not in chargemaster,42330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42330,BCBS multispecialty AW base fee schedule,439.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42335,Not in chargemaster,42335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42335,BCBS multispecialty AW base fee schedule,765.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42340,Not in chargemaster,42340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42340,BCBS multispecialty AW base fee schedule,940.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42400,Not in chargemaster,42400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42400,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42405,Not in chargemaster,42405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42405,BCBS multispecialty AW base fee schedule,570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42408,Not in chargemaster,42408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42408,BCBS multispecialty AW base fee schedule,995.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42409,Not in chargemaster,42409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42409,BCBS multispecialty AW base fee schedule,689,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42410,Not in chargemaster,42410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42410,BCBS multispecialty AW base fee schedule,1186.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42415,Not in chargemaster,42415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42415,BCBS multispecialty AW base fee schedule,2004.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42420,Not in chargemaster,42420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42420,BCBS multispecialty AW base fee schedule,2251.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42425,Not in chargemaster,42425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42425,BCBS multispecialty AW base fee schedule,1588.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42426,Not in chargemaster,42426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42426,BCBS multispecialty AW base fee schedule,2568.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42440,Not in chargemaster,42440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42440,BCBS multispecialty AW base fee schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42450,Not in chargemaster,42450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42450,BCBS multispecialty AW base fee schedule,873.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42500,Not in chargemaster,42500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42500,BCBS multispecialty AW base fee schedule,826.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42505,Not in chargemaster,42505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42505,BCBS multispecialty AW base fee schedule,1060.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42507,Not in chargemaster,42507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42507,BCBS multispecialty AW base fee schedule,944.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42509,Not in chargemaster,42509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42509,BCBS multispecialty AW base fee schedule,1568.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42510,Not in chargemaster,42510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42510,BCBS multispecialty AW base fee schedule,1162.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42550,Not in chargemaster,42550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42550,BCBS multispecialty AW base fee schedule,290.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42600,Not in chargemaster,42600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42600,BCBS multispecialty AW base fee schedule,965.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42650,Not in chargemaster,42650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42650,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42660,Not in chargemaster,42660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42660,BCBS multispecialty AW base fee schedule,233.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42665,Not in chargemaster,42665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42665,BCBS multispecialty AW base fee schedule,650.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42700,Not in chargemaster,42700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42700,BCBS multispecialty AW base fee schedule,361.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42720,Not in chargemaster,42720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42720,BCBS multispecialty AW base fee schedule,857.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42725,Not in chargemaster,42725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42725,BCBS multispecialty AW base fee schedule,1527.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42800,Not in chargemaster,42800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42800,BCBS multispecialty AW base fee schedule,297.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42804,Not in chargemaster,42804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42804,BCBS multispecialty AW base fee schedule,374.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42806,Not in chargemaster,42806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42806,BCBS multispecialty AW base fee schedule,419.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42808,Not in chargemaster,42808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42808,BCBS multispecialty AW base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42809,Not in chargemaster,42809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42809,BCBS multispecialty AW base fee schedule,381.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42810,Not in chargemaster,42810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42810,BCBS multispecialty AW base fee schedule,728.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42815,Not in chargemaster,42815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42815,BCBS multispecialty AW base fee schedule,1034.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42820,Not in chargemaster,42820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42820,BCBS multispecialty AW base fee schedule,547.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42821,Not in chargemaster,42821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42821,BCBS multispecialty AW base fee schedule,571.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42825,Not in chargemaster,42825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42825,BCBS multispecialty AW base fee schedule,498.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42826,Not in chargemaster,42826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42826,BCBS multispecialty AW base fee schedule,477,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42830,Not in chargemaster,42830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42830,BCBS multispecialty AW base fee schedule,394.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42831,Not in chargemaster,42831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42831,BCBS multispecialty AW base fee schedule,426.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42835,Not in chargemaster,42835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42835,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42836,Not in chargemaster,42836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42836,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42842,Not in chargemaster,42842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42842,BCBS multispecialty AW base fee schedule,1906.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42844,Not in chargemaster,42844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42844,BCBS multispecialty AW base fee schedule,2628.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42845,Not in chargemaster,42845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42845,BCBS multispecialty AW base fee schedule,4233.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42860,Not in chargemaster,42860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42860,BCBS multispecialty AW base fee schedule,357.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42870,Not in chargemaster,42870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42870,BCBS multispecialty AW base fee schedule,1111.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42890,Not in chargemaster,42890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42890,BCBS multispecialty AW base fee schedule,2701.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42892,Not in chargemaster,42892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42892,BCBS multispecialty AW base fee schedule,3551,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42894,Not in chargemaster,42894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42894,BCBS multispecialty AW base fee schedule,4487.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42900,Not in chargemaster,42900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42900,BCBS multispecialty AW base fee schedule,633.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42950,Not in chargemaster,42950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42950,BCBS multispecialty AW base fee schedule,1514.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42953,Not in chargemaster,42953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42953,BCBS multispecialty AW base fee schedule,1812.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42955,Not in chargemaster,42955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42955,BCBS multispecialty AW base fee schedule,1437.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42960,Not in chargemaster,42960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42960,BCBS multispecialty AW base fee schedule,313.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42961,Not in chargemaster,42961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42961,BCBS multispecialty AW base fee schedule,789.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42962,Not in chargemaster,42962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42962,BCBS multispecialty AW base fee schedule,973.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42970,Not in chargemaster,42970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42970,BCBS multispecialty AW base fee schedule,777.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42971,Not in chargemaster,42971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42971,BCBS multispecialty AW base fee schedule,857.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42972,Not in chargemaster,42972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,42972,BCBS multispecialty AW base fee schedule,961.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43020,Not in chargemaster,43020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43020,BCBS multispecialty AW base fee schedule,1077.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43030,Not in chargemaster,43030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43030,BCBS multispecialty AW base fee schedule,986.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43045,Not in chargemaster,43045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43045,BCBS multispecialty AW base fee schedule,2493.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43100,Not in chargemaster,43100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43100,BCBS multispecialty AW base fee schedule,1193.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43101,Not in chargemaster,43101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43101,BCBS multispecialty AW base fee schedule,1927.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43107,Not in chargemaster,43107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43107,BCBS multispecialty AW base fee schedule,5735.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43108,Not in chargemaster,43108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43108,BCBS multispecialty AW base fee schedule,8584.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43112,Not in chargemaster,43112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43112,BCBS multispecialty AW base fee schedule,6709.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43113,Not in chargemaster,43113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43113,BCBS multispecialty AW base fee schedule,8378.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43116,Not in chargemaster,43116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43116,BCBS multispecialty AW base fee schedule,9610.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43117,Not in chargemaster,43117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43117,BCBS multispecialty AW base fee schedule,6251.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43118,Not in chargemaster,43118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43118,BCBS multispecialty AW base fee schedule,6984.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43121,Not in chargemaster,43121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43121,BCBS multispecialty AW base fee schedule,5486.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43122,Not in chargemaster,43122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43122,BCBS multispecialty AW base fee schedule,4927.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43123,Not in chargemaster,43123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43123,BCBS multispecialty AW base fee schedule,8690.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43124,Not in chargemaster,43124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43124,BCBS multispecialty AW base fee schedule,7323.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43130,Not in chargemaster,43130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43130,BCBS multispecialty AW base fee schedule,1501.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43135,Not in chargemaster,43135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43135,BCBS multispecialty AW base fee schedule,2822.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43180,Not in chargemaster,43180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43180,BCBS multispecialty AW base fee schedule,1038.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43191,Not in chargemaster,43191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43191,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43192,Not in chargemaster,43192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43192,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43193,Not in chargemaster,43193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43193,BCBS multispecialty AW base fee schedule,321.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43194,Not in chargemaster,43194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43194,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43195,Not in chargemaster,43195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43195,BCBS multispecialty AW base fee schedule,349.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43196,Not in chargemaster,43196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43196,BCBS multispecialty AW base fee schedule,372.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43197,Not in chargemaster,43197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43197,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43198,Not in chargemaster,43198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43198,BCBS multispecialty AW base fee schedule,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43200,Not in chargemaster,43200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43200,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43201,Not in chargemaster,43201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43201,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43202,Not in chargemaster,43202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43202,BCBS multispecialty AW base fee schedule,638.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43204,Not in chargemaster,43204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43204,BCBS multispecialty AW base fee schedule,258.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43205,Not in chargemaster,43205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43205,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43206,Not in chargemaster,43206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43206,BCBS multispecialty AW base fee schedule,539.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43210,Not in chargemaster,43210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43210,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43211,Not in chargemaster,43211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43211,BCBS multispecialty AW base fee schedule,448.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43212,Not in chargemaster,43212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43212,BCBS multispecialty AW base fee schedule,363.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43213,Not in chargemaster,43213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43213,BCBS multispecialty AW base fee schedule,2318.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43214,Not in chargemaster,43214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43214,BCBS multispecialty AW base fee schedule,368.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43215,Not in chargemaster,43215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43215,BCBS multispecialty AW base fee schedule,725.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43216,Not in chargemaster,43216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43216,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43217,Not in chargemaster,43217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43217,BCBS multispecialty AW base fee schedule,757.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43220,43220,43220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43220,BCBS multispecialty AW base fee schedule,1907.34,282.81,Fee schedule,,282.81,282.81,282.81,282.81,,,0
unity,Fee schedule,Non-facility 43226,Not in chargemaster,43226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43226,BCBS multispecialty AW base fee schedule,675.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43227,Not in chargemaster,43227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43227,BCBS multispecialty AW base fee schedule,1171.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43229,Not in chargemaster,43229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43229,BCBS multispecialty AW base fee schedule,1313.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43231,Not in chargemaster,43231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43231,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43232,Not in chargemaster,43232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43232,BCBS multispecialty AW base fee schedule,380.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43233,Not in chargemaster,43233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43233,BCBS multispecialty AW base fee schedule,438.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43235,43235,43235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43235,BCBS multispecialty AW base fee schedule,528.68,315.35,Fee schedule,,315.35,315.35,315.35,315.35,,,0
unity,Fee schedule,Non-facility 43236,Not in chargemaster,43236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43236,BCBS multispecialty AW base fee schedule,705.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43237,Not in chargemaster,43237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43237,BCBS multispecialty AW base fee schedule,373.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43238,Not in chargemaster,43238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43238,BCBS multispecialty AW base fee schedule,443.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43239,43239,43239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43239,BCBS multispecialty AW base fee schedule,704.24,371.88,Fee schedule,,371.88,371.88,371.88,371.88,,,0
unity,Fee schedule,Non-facility 43240,Not in chargemaster,43240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43240,BCBS multispecialty AW base fee schedule,750.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43241,Not in chargemaster,43241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43241,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43242,Not in chargemaster,43242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43242,BCBS multispecialty AW base fee schedule,502.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43243,Not in chargemaster,43243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43243,BCBS multispecialty AW base fee schedule,453.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43244,Not in chargemaster,43244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43244,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43245,Not in chargemaster,43245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43245,BCBS multispecialty AW base fee schedule,1112.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43246,Not in chargemaster,43246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43246,BCBS multispecialty AW base fee schedule,384.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43247,43247,43247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43247,BCBS multispecialty AW base fee schedule,700.26,412.5,Fee schedule,,412.5,412.5,412.5,412.5,,,0
unity,Fee schedule,Non-facility 43248,Not in chargemaster,43248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43248,BCBS multispecialty AW base fee schedule,733.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43249,43249,43249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43249,BCBS multispecialty AW base fee schedule,2057.06,387.2,Fee schedule,,387.2,387.2,387.2,387.2,,,0
unity,Fee schedule,Non-facility 43250,Not in chargemaster,43250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43250,BCBS multispecialty AW base fee schedule,818.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43251,43251,43251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43251,BCBS multispecialty AW base fee schedule,899.68,440,Fee schedule,,440,440,440,440,,,0
unity,Fee schedule,Non-facility 43252,Not in chargemaster,43252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43252,BCBS multispecialty AW base fee schedule,612.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43253,Not in chargemaster,43253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43253,BCBS multispecialty AW base fee schedule,503.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43254,Not in chargemaster,43254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43254,BCBS multispecialty AW base fee schedule,516.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43255,Not in chargemaster,43255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43255,BCBS multispecialty AW base fee schedule,1238.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43257,Not in chargemaster,43257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43257,BCBS multispecialty AW base fee schedule,446.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43259,Not in chargemaster,43259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43259,BCBS multispecialty AW base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43260,Not in chargemaster,43260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43260,BCBS multispecialty AW base fee schedule,616.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43261,Not in chargemaster,43261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43261,BCBS multispecialty AW base fee schedule,646.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43262,Not in chargemaster,43262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43262,BCBS multispecialty AW base fee schedule,682.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43263,Not in chargemaster,43263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43263,BCBS multispecialty AW base fee schedule,682.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43264,Not in chargemaster,43264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43264,BCBS multispecialty AW base fee schedule,694.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43265,Not in chargemaster,43265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43265,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43266,Not in chargemaster,43266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43266,BCBS multispecialty AW base fee schedule,416.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43270,Not in chargemaster,43270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43270,BCBS multispecialty AW base fee schedule,1348.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43273,Not in chargemaster,43273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43273,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43274,Not in chargemaster,43274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43274,BCBS multispecialty AW base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43275,Not in chargemaster,43275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43275,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43276,Not in chargemaster,43276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43276,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43277,Not in chargemaster,43277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43277,BCBS multispecialty AW base fee schedule,723.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43278,Not in chargemaster,43278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43278,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43279,Not in chargemaster,43279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43279,BCBS multispecialty AW base fee schedule,2487.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43280,43280,43280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43280,BCBS multispecialty AW base fee schedule,2085.55,2381,Fee schedule,,2085.55,2085.55,2085.55,2085.55,,,0
unity,Fee schedule,Non-facility 43281,Not in chargemaster,43281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43281,BCBS multispecialty AW base fee schedule,2982.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43282,Not in chargemaster,43282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43282,BCBS multispecialty AW base fee schedule,3353.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43283,Not in chargemaster,43283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43283,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43284,Not in chargemaster,43284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43284,BCBS multispecialty AW base fee schedule,1254.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43285,Not in chargemaster,43285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43285,BCBS multispecialty AW base fee schedule,1292.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43286,Not in chargemaster,43286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43286,BCBS multispecialty AW base fee schedule,6114.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43287,Not in chargemaster,43287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43287,BCBS multispecialty AW base fee schedule,6920.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43288,Not in chargemaster,43288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43288,BCBS multispecialty AW base fee schedule,7274.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43300,Not in chargemaster,43300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43300,BCBS multispecialty AW base fee schedule,1171.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43305,Not in chargemaster,43305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43305,BCBS multispecialty AW base fee schedule,2072.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43310,Not in chargemaster,43310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43310,BCBS multispecialty AW base fee schedule,2843.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43312,Not in chargemaster,43312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43312,BCBS multispecialty AW base fee schedule,3058.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43313,Not in chargemaster,43313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43313,BCBS multispecialty AW base fee schedule,5243.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43314,Not in chargemaster,43314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43314,BCBS multispecialty AW base fee schedule,5650.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43320,Not in chargemaster,43320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43320,BCBS multispecialty AW base fee schedule,2699.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43325,Not in chargemaster,43325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43325,BCBS multispecialty AW base fee schedule,2624.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43327,Not in chargemaster,43327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43327,BCBS multispecialty AW base fee schedule,1583.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43328,Not in chargemaster,43328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43328,BCBS multispecialty AW base fee schedule,2159.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43330,Not in chargemaster,43330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43330,BCBS multispecialty AW base fee schedule,2581.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43331,Not in chargemaster,43331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43331,BCBS multispecialty AW base fee schedule,2567.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43332,Not in chargemaster,43332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43332,BCBS multispecialty AW base fee schedule,2233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43333,Not in chargemaster,43333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43333,BCBS multispecialty AW base fee schedule,2439.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43334,Not in chargemaster,43334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43334,BCBS multispecialty AW base fee schedule,2399.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43335,Not in chargemaster,43335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43335,BCBS multispecialty AW base fee schedule,2567.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43336,Not in chargemaster,43336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43336,BCBS multispecialty AW base fee schedule,2784.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43337,Not in chargemaster,43337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43337,BCBS multispecialty AW base fee schedule,2971.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43338,Not in chargemaster,43338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43338,BCBS multispecialty AW base fee schedule,223.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43340,Not in chargemaster,43340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43340,BCBS multispecialty AW base fee schedule,2665.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43341,Not in chargemaster,43341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43341,BCBS multispecialty AW base fee schedule,2685.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43351,Not in chargemaster,43351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43351,BCBS multispecialty AW base fee schedule,2522.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43352,Not in chargemaster,43352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43352,BCBS multispecialty AW base fee schedule,2041.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43360,Not in chargemaster,43360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43360,BCBS multispecialty AW base fee schedule,4320.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43361,Not in chargemaster,43361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43361,BCBS multispecialty AW base fee schedule,5208.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43400,Not in chargemaster,43400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43400,BCBS multispecialty AW base fee schedule,2942.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43405,Not in chargemaster,43405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43405,BCBS multispecialty AW base fee schedule,2789.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43410,Not in chargemaster,43410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43410,BCBS multispecialty AW base fee schedule,1945.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43415,Not in chargemaster,43415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43415,BCBS multispecialty AW base fee schedule,4938.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43420,Not in chargemaster,43420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43420,BCBS multispecialty AW base fee schedule,1927.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43425,Not in chargemaster,43425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43425,BCBS multispecialty AW base fee schedule,2765.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43450,Not in chargemaster,43450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43450,BCBS multispecialty AW base fee schedule,322.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43453,Not in chargemaster,43453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43453,BCBS multispecialty AW base fee schedule,1660.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43460,Not in chargemaster,43460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43460,BCBS multispecialty AW base fee schedule,406.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43500,Not in chargemaster,43500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43500,BCBS multispecialty AW base fee schedule,1512.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43501,Not in chargemaster,43501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43501,BCBS multispecialty AW base fee schedule,2602.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43502,Not in chargemaster,43502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43502,BCBS multispecialty AW base fee schedule,2948.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43510,Not in chargemaster,43510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43510,BCBS multispecialty AW base fee schedule,1831.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43520,Not in chargemaster,43520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43520,BCBS multispecialty AW base fee schedule,1320.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43605,Not in chargemaster,43605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43605,BCBS multispecialty AW base fee schedule,1619.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43610,Not in chargemaster,43610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43610,BCBS multispecialty AW base fee schedule,1893.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43611,Not in chargemaster,43611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43611,BCBS multispecialty AW base fee schedule,2360.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43620,Not in chargemaster,43620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43620,BCBS multispecialty AW base fee schedule,3835.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43621,Not in chargemaster,43621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43621,BCBS multispecialty AW base fee schedule,4387.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43622,Not in chargemaster,43622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43622,BCBS multispecialty AW base fee schedule,4473.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43631,Not in chargemaster,43631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43631,BCBS multispecialty AW base fee schedule,2802.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43632,Not in chargemaster,43632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43632,BCBS multispecialty AW base fee schedule,3931.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43633,Not in chargemaster,43633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43633,BCBS multispecialty AW base fee schedule,3718.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43634,Not in chargemaster,43634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43634,BCBS multispecialty AW base fee schedule,4113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43635,Not in chargemaster,43635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43635,BCBS multispecialty AW base fee schedule,217.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43640,Not in chargemaster,43640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43640,BCBS multispecialty AW base fee schedule,2275.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43641,Not in chargemaster,43641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43641,BCBS multispecialty AW base fee schedule,2326.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43644,Not in chargemaster,43644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43644,BCBS multispecialty AW base fee schedule,3356.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43645,Not in chargemaster,43645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43645,BCBS multispecialty AW base fee schedule,3574.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43651,Not in chargemaster,43651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43651,BCBS multispecialty AW base fee schedule,1264.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43652,Not in chargemaster,43652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43652,BCBS multispecialty AW base fee schedule,1476.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43653,Not in chargemaster,43653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43653,BCBS multispecialty AW base fee schedule,1107.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43752,Not in chargemaster,43752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43752,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43753,Not in chargemaster,43753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43753,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43754,Not in chargemaster,43754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43754,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43755,Not in chargemaster,43755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43755,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43756,Not in chargemaster,43756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43756,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43757,Not in chargemaster,43757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43757,BCBS multispecialty AW base fee schedule,646.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43761,Not in chargemaster,43761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43761,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43762,Not in chargemaster,43762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43762,BCBS multispecialty AW base fee schedule,427.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43763,Not in chargemaster,43763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43763,BCBS multispecialty AW base fee schedule,638.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43770,Not in chargemaster,43770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43770,BCBS multispecialty AW base fee schedule,2173.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43771,Not in chargemaster,43771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43771,BCBS multispecialty AW base fee schedule,2469.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43772,Not in chargemaster,43772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43772,BCBS multispecialty AW base fee schedule,1838.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43773,Not in chargemaster,43773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43773,BCBS multispecialty AW base fee schedule,2469.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43774,Not in chargemaster,43774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43774,BCBS multispecialty AW base fee schedule,1855.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43775,Not in chargemaster,43775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43775,BCBS multispecialty AW base fee schedule,2157.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43800,Not in chargemaster,43800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43800,BCBS multispecialty AW base fee schedule,1802,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43810,Not in chargemaster,43810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43810,BCBS multispecialty AW base fee schedule,1967.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43820,Not in chargemaster,43820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43820,BCBS multispecialty AW base fee schedule,2595.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43825,Not in chargemaster,43825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43825,BCBS multispecialty AW base fee schedule,2532.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43830,Not in chargemaster,43830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43830,BCBS multispecialty AW base fee schedule,1354.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43831,Not in chargemaster,43831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43831,BCBS multispecialty AW base fee schedule,1160.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43832,Not in chargemaster,43832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43832,BCBS multispecialty AW base fee schedule,2009.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43840,Not in chargemaster,43840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43840,BCBS multispecialty AW base fee schedule,2628.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43842,Not in chargemaster,43842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43842,BCBS multispecialty AW base fee schedule,2213.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43843,Not in chargemaster,43843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43843,BCBS multispecialty AW base fee schedule,2479.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43845,Not in chargemaster,43845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43845,BCBS multispecialty AW base fee schedule,3763,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43846,Not in chargemaster,43846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43846,BCBS multispecialty AW base fee schedule,3139.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43847,Not in chargemaster,43847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43847,BCBS multispecialty AW base fee schedule,3491.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43848,Not in chargemaster,43848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43848,BCBS multispecialty AW base fee schedule,3742.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43850,Not in chargemaster,43850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43850,BCBS multispecialty AW base fee schedule,3150.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43855,Not in chargemaster,43855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43855,BCBS multispecialty AW base fee schedule,3268.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43860,Not in chargemaster,43860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43860,BCBS multispecialty AW base fee schedule,3161.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43865,Not in chargemaster,43865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43865,BCBS multispecialty AW base fee schedule,3307.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43870,Not in chargemaster,43870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43870,BCBS multispecialty AW base fee schedule,1370.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43880,Not in chargemaster,43880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43880,BCBS multispecialty AW base fee schedule,3074.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43886,Not in chargemaster,43886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43886,BCBS multispecialty AW base fee schedule,700.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43887,Not in chargemaster,43887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43887,BCBS multispecialty AW base fee schedule,630.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43888,Not in chargemaster,43888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43888,BCBS multispecialty AW base fee schedule,891.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44005,44005,44005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44005,BCBS multispecialty AW base fee schedule,2110.06,2282.5,Fee schedule,,2110.06,2110.06,2110.06,2110.06,,,0
unity,Fee schedule,Non-facility 44010,Not in chargemaster,44010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44010,BCBS multispecialty AW base fee schedule,1648.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44015,Not in chargemaster,44015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44015,BCBS multispecialty AW base fee schedule,274.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44020,Not in chargemaster,44020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44020,BCBS multispecialty AW base fee schedule,1880.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44021,Not in chargemaster,44021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44021,BCBS multispecialty AW base fee schedule,1880.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44025,44025,44025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44025,BCBS multispecialty AW base fee schedule,1895.41,2077.77,Fee schedule,,1895.41,1895.41,1895.41,1895.41,,,0
unity,Fee schedule,Non-facility 44050,44050,44050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44050,BCBS multispecialty AW base fee schedule,1805.31,1962.77,Fee schedule,,1805.31,1805.31,1805.31,1805.31,,,0
unity,Fee schedule,Non-facility 44055,Not in chargemaster,44055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44055,BCBS multispecialty AW base fee schedule,2877.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44100,Not in chargemaster,44100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44100,BCBS multispecialty AW base fee schedule,206.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44110,Not in chargemaster,44110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44110,BCBS multispecialty AW base fee schedule,1625.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44111,Not in chargemaster,44111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44111,BCBS multispecialty AW base fee schedule,1884.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44120,Not in chargemaster,44120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44120,BCBS multispecialty AW base fee schedule,2360.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44121,Not in chargemaster,44121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44121,BCBS multispecialty AW base fee schedule,466.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44125,Not in chargemaster,44125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44125,BCBS multispecialty AW base fee schedule,2274.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44126,Not in chargemaster,44126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44126,BCBS multispecialty AW base fee schedule,4775.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44127,Not in chargemaster,44127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44127,BCBS multispecialty AW base fee schedule,5521.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44128,Not in chargemaster,44128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44128,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44130,Not in chargemaster,44130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44130,BCBS multispecialty AW base fee schedule,2536.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44139,Not in chargemaster,44139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44139,BCBS multispecialty AW base fee schedule,233.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44140,44140,44140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44140,BCBS multispecialty AW base fee schedule,2588.39,2813.2,Fee schedule,,2588.39,2588.39,2588.39,2588.39,,,0
unity,Fee schedule,Non-facility 44141,Not in chargemaster,44141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44141,BCBS multispecialty AW base fee schedule,3513.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44143,Not in chargemaster,44143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44143,BCBS multispecialty AW base fee schedule,3207.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44144,Not in chargemaster,44144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44144,BCBS multispecialty AW base fee schedule,3407.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44145,Not in chargemaster,44145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44145,BCBS multispecialty AW base fee schedule,3183.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44146,Not in chargemaster,44146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44146,BCBS multispecialty AW base fee schedule,4059.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44147,Not in chargemaster,44147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44147,BCBS multispecialty AW base fee schedule,3736.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44150,Not in chargemaster,44150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44150,BCBS multispecialty AW base fee schedule,3588.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44151,Not in chargemaster,44151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44151,BCBS multispecialty AW base fee schedule,4170.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44155,Not in chargemaster,44155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44155,BCBS multispecialty AW base fee schedule,3979.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44156,Not in chargemaster,44156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44156,BCBS multispecialty AW base fee schedule,4465.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44157,Not in chargemaster,44157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44157,BCBS multispecialty AW base fee schedule,4234.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44158,Not in chargemaster,44158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44158,BCBS multispecialty AW base fee schedule,4340.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44160,Not in chargemaster,44160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44160,BCBS multispecialty AW base fee schedule,2394.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44180,Not in chargemaster,44180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44180,BCBS multispecialty AW base fee schedule,1774.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44186,Not in chargemaster,44186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44186,BCBS multispecialty AW base fee schedule,1257.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44187,Not in chargemaster,44187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44187,BCBS multispecialty AW base fee schedule,2107.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44188,Not in chargemaster,44188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44188,BCBS multispecialty AW base fee schedule,2347.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44202,Not in chargemaster,44202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44202,BCBS multispecialty AW base fee schedule,2672.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44203,Not in chargemaster,44203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44203,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44204,Not in chargemaster,44204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44204,BCBS multispecialty AW base fee schedule,2961.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44205,Not in chargemaster,44205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44205,BCBS multispecialty AW base fee schedule,2571.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44206,Not in chargemaster,44206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44206,BCBS multispecialty AW base fee schedule,3364.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44207,Not in chargemaster,44207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44207,BCBS multispecialty AW base fee schedule,3490.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44208,Not in chargemaster,44208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44208,BCBS multispecialty AW base fee schedule,3801.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44210,Not in chargemaster,44210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44210,BCBS multispecialty AW base fee schedule,3401.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44211,Not in chargemaster,44211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44211,BCBS multispecialty AW base fee schedule,4055.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44212,Not in chargemaster,44212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44212,BCBS multispecialty AW base fee schedule,3910.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44213,Not in chargemaster,44213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44213,BCBS multispecialty AW base fee schedule,359.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44227,Not in chargemaster,44227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44227,BCBS multispecialty AW base fee schedule,3206.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44300,44300,44300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44300,BCBS multispecialty AW base fee schedule,1625.78,1772.54,Fee schedule,,1625.78,1625.78,1625.78,1625.78,,,0
unity,Fee schedule,Non-facility 44310,Not in chargemaster,44310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44310,BCBS multispecialty AW base fee schedule,2004.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44312,Not in chargemaster,44312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44312,BCBS multispecialty AW base fee schedule,1140.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44314,Not in chargemaster,44314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44314,BCBS multispecialty AW base fee schedule,1933.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44316,Not in chargemaster,44316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44316,BCBS multispecialty AW base fee schedule,2733.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44320,Not in chargemaster,44320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44320,BCBS multispecialty AW base fee schedule,2312.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44322,Not in chargemaster,44322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44322,BCBS multispecialty AW base fee schedule,1937.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44340,Not in chargemaster,44340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44340,BCBS multispecialty AW base fee schedule,1196.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44345,Not in chargemaster,44345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44345,BCBS multispecialty AW base fee schedule,2019.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44346,Not in chargemaster,44346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44346,BCBS multispecialty AW base fee schedule,2276.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44360,Not in chargemaster,44360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44360,BCBS multispecialty AW base fee schedule,274.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44361,Not in chargemaster,44361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44361,BCBS multispecialty AW base fee schedule,302.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44363,Not in chargemaster,44363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44363,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44364,Not in chargemaster,44364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44364,BCBS multispecialty AW base fee schedule,390.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44365,Not in chargemaster,44365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44365,BCBS multispecialty AW base fee schedule,347.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44366,Not in chargemaster,44366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44366,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44369,Not in chargemaster,44369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44369,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44370,Not in chargemaster,44370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44370,BCBS multispecialty AW base fee schedule,509.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44372,Not in chargemaster,44372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44372,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44373,Not in chargemaster,44373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44373,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44376,Not in chargemaster,44376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44376,BCBS multispecialty AW base fee schedule,543.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44377,Not in chargemaster,44377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44377,BCBS multispecialty AW base fee schedule,571.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44378,Not in chargemaster,44378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44378,BCBS multispecialty AW base fee schedule,735.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44379,Not in chargemaster,44379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44379,BCBS multispecialty AW base fee schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44380,Not in chargemaster,44380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44380,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44381,Not in chargemaster,44381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44381,BCBS multispecialty AW base fee schedule,1847.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44382,Not in chargemaster,44382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44382,BCBS multispecialty AW base fee schedule,539.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44384,Not in chargemaster,44384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44384,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44385,Not in chargemaster,44385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44385,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44386,Not in chargemaster,44386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44386,BCBS multispecialty AW base fee schedule,565.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44388,44388,44388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44388,BCBS multispecialty AW base fee schedule,575.71,668.17,Fee schedule,,575.71,575.71,575.71,575.71,,,0
unity,Fee schedule,Non-facility 44389,Not in chargemaster,44389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44389,BCBS multispecialty AW base fee schedule,757.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44390,Not in chargemaster,44390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44390,BCBS multispecialty AW base fee schedule,743.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44391,Not in chargemaster,44391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44391,BCBS multispecialty AW base fee schedule,1276.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44392,Not in chargemaster,44392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44392,BCBS multispecialty AW base fee schedule,700.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44394,Not in chargemaster,44394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44394,BCBS multispecialty AW base fee schedule,802.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44401,Not in chargemaster,44401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44401,BCBS multispecialty AW base fee schedule,5315.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44402,Not in chargemaster,44402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44402,BCBS multispecialty AW base fee schedule,500.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44403,Not in chargemaster,44403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44403,BCBS multispecialty AW base fee schedule,581.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44404,Not in chargemaster,44404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44404,BCBS multispecialty AW base fee schedule,753.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44405,Not in chargemaster,44405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44405,BCBS multispecialty AW base fee schedule,1054.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44406,Not in chargemaster,44406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44406,BCBS multispecialty AW base fee schedule,438.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44407,Not in chargemaster,44407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44407,BCBS multispecialty AW base fee schedule,526.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44408,Not in chargemaster,44408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44408,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44500,Not in chargemaster,44500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44500,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44602,Not in chargemaster,44602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44602,BCBS multispecialty AW base fee schedule,2722.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44603,Not in chargemaster,44603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44603,BCBS multispecialty AW base fee schedule,3123.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44604,Not in chargemaster,44604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44604,BCBS multispecialty AW base fee schedule,2039.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44605,Not in chargemaster,44605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44605,BCBS multispecialty AW base fee schedule,2512.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44615,Not in chargemaster,44615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44615,BCBS multispecialty AW base fee schedule,2077.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44620,Not in chargemaster,44620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44620,BCBS multispecialty AW base fee schedule,1666.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44625,Not in chargemaster,44625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44625,BCBS multispecialty AW base fee schedule,1946.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44626,Not in chargemaster,44626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44626,BCBS multispecialty AW base fee schedule,3082.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44640,Not in chargemaster,44640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44640,BCBS multispecialty AW base fee schedule,2695.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44650,Not in chargemaster,44650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44650,BCBS multispecialty AW base fee schedule,2786.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44660,Not in chargemaster,44660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44660,BCBS multispecialty AW base fee schedule,2565.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44661,Not in chargemaster,44661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44661,BCBS multispecialty AW base fee schedule,2985.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44680,Not in chargemaster,44680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44680,BCBS multispecialty AW base fee schedule,2045.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44700,Not in chargemaster,44700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44700,BCBS multispecialty AW base fee schedule,1925.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44701,Not in chargemaster,44701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44701,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44705,Not in chargemaster,44705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44705,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44720,Not in chargemaster,44720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44720,BCBS multispecialty AW base fee schedule,531.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44721,Not in chargemaster,44721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44721,BCBS multispecialty AW base fee schedule,742.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44800,Not in chargemaster,44800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44800,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44820,Not in chargemaster,44820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44820,BCBS multispecialty AW base fee schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44850,Not in chargemaster,44850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44850,BCBS multispecialty AW base fee schedule,1436.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44900,Not in chargemaster,44900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44900,BCBS multispecialty AW base fee schedule,1512.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44950,44950,44950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44950,BCBS multispecialty AW base fee schedule,1240.86,1346.62,Fee schedule,,1240.86,1240.86,1240.86,1240.86,,,0
unity,Fee schedule,Non-facility 44955,Not in chargemaster,44955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44955,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44960,Not in chargemaster,44960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44960,BCBS multispecialty AW base fee schedule,1693.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44970,44970,44970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,44970,BCBS multispecialty AW base fee schedule,1158.71,1375,Fee schedule,,1158.71,1158.71,1158.71,1158.71,,,0
unity,Fee schedule,Non-facility 45000,Not in chargemaster,45000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45000,BCBS multispecialty AW base fee schedule,818.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45005,Not in chargemaster,45005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45005,BCBS multispecialty AW base fee schedule,555.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45020,Not in chargemaster,45020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45020,BCBS multispecialty AW base fee schedule,1098.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45100,Not in chargemaster,45100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45100,BCBS multispecialty AW base fee schedule,573.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45108,Not in chargemaster,45108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45108,BCBS multispecialty AW base fee schedule,713.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45110,Not in chargemaster,45110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45110,BCBS multispecialty AW base fee schedule,3519.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45111,Not in chargemaster,45111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45111,BCBS multispecialty AW base fee schedule,2086.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45112,Not in chargemaster,45112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45112,BCBS multispecialty AW base fee schedule,3574.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45113,Not in chargemaster,45113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45113,BCBS multispecialty AW base fee schedule,3591.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45114,Not in chargemaster,45114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45114,BCBS multispecialty AW base fee schedule,3513.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45116,Not in chargemaster,45116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45116,BCBS multispecialty AW base fee schedule,2960.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45119,Not in chargemaster,45119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45119,BCBS multispecialty AW base fee schedule,3693.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45120,Not in chargemaster,45120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45120,BCBS multispecialty AW base fee schedule,3083.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45121,Not in chargemaster,45121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45121,BCBS multispecialty AW base fee schedule,3369.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45123,Not in chargemaster,45123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45123,BCBS multispecialty AW base fee schedule,2135.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45126,Not in chargemaster,45126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45126,BCBS multispecialty AW base fee schedule,5310.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45130,Not in chargemaster,45130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45130,BCBS multispecialty AW base fee schedule,2078.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45135,Not in chargemaster,45135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45135,BCBS multispecialty AW base fee schedule,2477.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45136,Not in chargemaster,45136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45136,BCBS multispecialty AW base fee schedule,3433.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45150,Not in chargemaster,45150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45150,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45160,Not in chargemaster,45160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45160,BCBS multispecialty AW base fee schedule,1976.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45171,45171,45171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45171,BCBS multispecialty AW base fee schedule,1159.38,1283.44,Fee schedule,,1159.38,1159.38,1159.38,1159.38,,,0
unity,Fee schedule,Non-facility 45172,Not in chargemaster,45172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45172,BCBS multispecialty AW base fee schedule,1557.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45190,Not in chargemaster,45190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45190,BCBS multispecialty AW base fee schedule,1339.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45300,Not in chargemaster,45300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45300,BCBS multispecialty AW base fee schedule,233.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45303,Not in chargemaster,45303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45303,BCBS multispecialty AW base fee schedule,1805.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45305,Not in chargemaster,45305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45305,BCBS multispecialty AW base fee schedule,306.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45307,Not in chargemaster,45307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45307,BCBS multispecialty AW base fee schedule,353.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45308,Not in chargemaster,45308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45308,BCBS multispecialty AW base fee schedule,347.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45309,Not in chargemaster,45309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45309,BCBS multispecialty AW base fee schedule,359.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45315,Not in chargemaster,45315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45315,BCBS multispecialty AW base fee schedule,392.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45317,Not in chargemaster,45317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45317,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45320,Not in chargemaster,45320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45320,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45321,Not in chargemaster,45321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45321,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45327,Not in chargemaster,45327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45327,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45330,45330,45330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45330,BCBS multispecialty AW base fee schedule,329.93,141.81,Fee schedule,,141.81,141.81,141.81,141.81,,,0
unity,Fee schedule,Non-facility 45331,45331,45331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45331,BCBS multispecialty AW base fee schedule,518.74,181.5,Fee schedule,,181.5,181.5,181.5,181.5,,,0
unity,Fee schedule,Non-facility 45332,Not in chargemaster,45332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45332,BCBS multispecialty AW base fee schedule,499.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45333,Not in chargemaster,45333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45333,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45334,Not in chargemaster,45334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45334,BCBS multispecialty AW base fee schedule,995.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45335,Not in chargemaster,45335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45335,BCBS multispecialty AW base fee schedule,502.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45337,Not in chargemaster,45337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45337,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45338,Not in chargemaster,45338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45338,BCBS multispecialty AW base fee schedule,534.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45340,Not in chargemaster,45340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45340,BCBS multispecialty AW base fee schedule,855.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45341,Not in chargemaster,45341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45341,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45342,Not in chargemaster,45342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45342,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45346,Not in chargemaster,45346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45346,BCBS multispecialty AW base fee schedule,5184.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45347,Not in chargemaster,45347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45347,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45349,Not in chargemaster,45349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45349,BCBS multispecialty AW base fee schedule,379.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45350,Not in chargemaster,45350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45350,BCBS multispecialty AW base fee schedule,1179.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45378,45378,45378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45378,BCBS multispecialty AW base fee schedule,624.08,460,Fee schedule,,460,460,460,460,,,0
unity,Fee schedule,Non-facility 45379,Not in chargemaster,45379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45379,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45380,45380,45380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45380,BCBS multispecialty AW base fee schedule,803.61,561.81,Fee schedule,,561.81,561.81,561.81,561.81,,,0
unity,Fee schedule,Non-facility 45381,Not in chargemaster,45381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45381,BCBS multispecialty AW base fee schedule,797.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45382,Not in chargemaster,45382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45382,BCBS multispecialty AW base fee schedule,1326.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45384,45384,45384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45384,BCBS multispecialty AW base fee schedule,896.36,585.72,Fee schedule,,585.72,585.72,585.72,585.72,,,0
unity,Fee schedule,Non-facility 45385,45385,45385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45385,BCBS multispecialty AW base fee schedule,839.39,666.19,Fee schedule,,666.19,666.19,666.19,666.19,,,0
unity,Fee schedule,Non-facility 45386,Not in chargemaster,45386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45386,BCBS multispecialty AW base fee schedule,1153.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45388,Not in chargemaster,45388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45388,BCBS multispecialty AW base fee schedule,5492.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45389,Not in chargemaster,45389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45389,BCBS multispecialty AW base fee schedule,554.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45390,Not in chargemaster,45390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45390,BCBS multispecialty AW base fee schedule,635.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45391,Not in chargemaster,45391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45391,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45392,Not in chargemaster,45392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45392,BCBS multispecialty AW base fee schedule,581.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45393,Not in chargemaster,45393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45393,BCBS multispecialty AW base fee schedule,484.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45395,Not in chargemaster,45395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45395,BCBS multispecialty AW base fee schedule,3768.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45397,Not in chargemaster,45397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45397,BCBS multispecialty AW base fee schedule,4098.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45398,Not in chargemaster,45398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45398,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45400,Not in chargemaster,45400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45400,BCBS multispecialty AW base fee schedule,2177.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45402,Not in chargemaster,45402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45402,BCBS multispecialty AW base fee schedule,2907.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45500,Not in chargemaster,45500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45500,BCBS multispecialty AW base fee schedule,1084.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45505,Not in chargemaster,45505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45505,BCBS multispecialty AW base fee schedule,1142.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45520,Not in chargemaster,45520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45520,BCBS multispecialty AW base fee schedule,294.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45540,Not in chargemaster,45540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45540,BCBS multispecialty AW base fee schedule,2031.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45541,Not in chargemaster,45541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45541,BCBS multispecialty AW base fee schedule,1811.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45550,Not in chargemaster,45550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45550,BCBS multispecialty AW base fee schedule,2807.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45560,Not in chargemaster,45560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45560,BCBS multispecialty AW base fee schedule,1326.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45562,Not in chargemaster,45562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45562,BCBS multispecialty AW base fee schedule,2167.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45563,Not in chargemaster,45563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45563,BCBS multispecialty AW base fee schedule,3199.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45800,Not in chargemaster,45800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45800,BCBS multispecialty AW base fee schedule,2447.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45805,Not in chargemaster,45805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45805,BCBS multispecialty AW base fee schedule,2836.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45820,Not in chargemaster,45820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45820,BCBS multispecialty AW base fee schedule,2454.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45825,Not in chargemaster,45825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45825,BCBS multispecialty AW base fee schedule,2964.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45900,Not in chargemaster,45900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45900,BCBS multispecialty AW base fee schedule,406.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45905,Not in chargemaster,45905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45905,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45910,Not in chargemaster,45910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45910,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45915,Not in chargemaster,45915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45915,BCBS multispecialty AW base fee schedule,655.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45990,Not in chargemaster,45990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,45990,BCBS multispecialty AW base fee schedule,203.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46020,Not in chargemaster,46020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46020,BCBS multispecialty AW base fee schedule,536.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46030,Not in chargemaster,46030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46030,BCBS multispecialty AW base fee schedule,273.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46040,46040,46040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46040,BCBS multispecialty AW base fee schedule,1042.11,882.38,Fee schedule,,882.38,882.38,882.38,882.38,,,0
unity,Fee schedule,Non-facility 46045,Not in chargemaster,46045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46045,BCBS multispecialty AW base fee schedule,838.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46050,46050,46050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46050,BCBS multispecialty AW base fee schedule,415.39,210.84,Fee schedule,,210.84,210.84,210.84,210.84,,,0
unity,Fee schedule,Non-facility 46060,Not in chargemaster,46060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46060,BCBS multispecialty AW base fee schedule,921.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46070,Not in chargemaster,46070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46070,BCBS multispecialty AW base fee schedule,506.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46080,Not in chargemaster,46080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46080,BCBS multispecialty AW base fee schedule,512.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46083,46083,46083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46083,BCBS multispecialty AW base fee schedule,365.7,227.16,Fee schedule,,227.16,227.16,227.16,227.16,,,0
unity,Fee schedule,Non-facility 46200,Not in chargemaster,46200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46200,BCBS multispecialty AW base fee schedule,877.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46220,Not in chargemaster,46220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46220,BCBS multispecialty AW base fee schedule,433.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46221,Not in chargemaster,46221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46221,BCBS multispecialty AW base fee schedule,519.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46230,Not in chargemaster,46230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46230,BCBS multispecialty AW base fee schedule,558.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46250,46250,46250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46250,BCBS multispecialty AW base fee schedule,902.33,669.42,Fee schedule,,669.42,669.42,669.42,669.42,,,0
unity,Fee schedule,Non-facility 46255,46255,46255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46255,BCBS multispecialty AW base fee schedule,985.8,751.04,Fee schedule,,751.04,751.04,751.04,751.04,,,0
unity,Fee schedule,Non-facility 46257,Not in chargemaster,46257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46257,BCBS multispecialty AW base fee schedule,818.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46258,Not in chargemaster,46258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46258,BCBS multispecialty AW base fee schedule,908.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46260,Not in chargemaster,46260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46260,BCBS multispecialty AW base fee schedule,918.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46261,Not in chargemaster,46261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46261,BCBS multispecialty AW base fee schedule,1004.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46262,Not in chargemaster,46262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46262,BCBS multispecialty AW base fee schedule,1065.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46270,46270,46270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46270,BCBS multispecialty AW base fee schedule,997.73,865,Fee schedule,,865,865,865,865,,,0
unity,Fee schedule,Non-facility 46275,Not in chargemaster,46275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46275,BCBS multispecialty AW base fee schedule,1051.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46280,Not in chargemaster,46280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46280,BCBS multispecialty AW base fee schedule,908.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46285,Not in chargemaster,46285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46285,BCBS multispecialty AW base fee schedule,1045.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46288,Not in chargemaster,46288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46288,BCBS multispecialty AW base fee schedule,1056.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46320,Not in chargemaster,46320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46320,BCBS multispecialty AW base fee schedule,374.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46500,Not in chargemaster,46500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46500,BCBS multispecialty AW base fee schedule,565.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46505,Not in chargemaster,46505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46505,BCBS multispecialty AW base fee schedule,566.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46600,46600,46600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46600,BCBS multispecialty AW base fee schedule,194.78,87.32,Fee schedule,,87.32,87.32,87.32,87.32,,,0
unity,Fee schedule,Non-facility 46601,Not in chargemaster,46601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46601,BCBS multispecialty AW base fee schedule,271.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46604,Not in chargemaster,46604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46604,BCBS multispecialty AW base fee schedule,1258.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46606,Not in chargemaster,46606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46606,BCBS multispecialty AW base fee schedule,484.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46607,Not in chargemaster,46607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46607,BCBS multispecialty AW base fee schedule,380.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0035,Not in chargemaster,Q0035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0035,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0091,Not in chargemaster,Q0091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0091,BCBS multispecialty AW base fee schedule,75.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0092,Not in chargemaster,Q0092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0092,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6005,Not in chargemaster,G6005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6005,BCBS multispecialty AW base fee schedule,263.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6006,Not in chargemaster,G6006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6006,BCBS multispecialty AW base fee schedule,246.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6007,Not in chargemaster,G6007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6007,BCBS multispecialty AW base fee schedule,463.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6008,Not in chargemaster,G6008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6008,BCBS multispecialty AW base fee schedule,340.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6009,Not in chargemaster,G6009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6009,BCBS multispecialty AW base fee schedule,337.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6010,Not in chargemaster,G6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6010,BCBS multispecialty AW base fee schedule,337.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6011,Not in chargemaster,G6011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6011,BCBS multispecialty AW base fee schedule,488.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6012,Not in chargemaster,G6012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6012,BCBS multispecialty AW base fee schedule,451.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6013,Not in chargemaster,G6013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6013,BCBS multispecialty AW base fee schedule,451.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6014,Not in chargemaster,G6014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6014,BCBS multispecialty AW base fee schedule,482.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6015,Not in chargemaster,G6015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6015,BCBS multispecialty AW base fee schedule,635.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6016,Not in chargemaster,G6016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6016,BCBS multispecialty AW base fee schedule,633.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9187,Not in chargemaster,G9187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9187,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9481,Not in chargemaster,G9481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9481,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9482,Not in chargemaster,G9482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9482,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9483,Not in chargemaster,G9483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9483,BCBS multispecialty AW base fee schedule,96.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9484,Not in chargemaster,G9484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9484,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9485,Not in chargemaster,G9485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9485,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9486,Not in chargemaster,G9486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9486,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9487,Not in chargemaster,G9487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9487,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9488,Not in chargemaster,G9488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9488,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9489,Not in chargemaster,G9489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9489,BCBS multispecialty AW base fee schedule,140.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9490,Not in chargemaster,G9490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9490,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9685,Not in chargemaster,G9685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9685,BCBS multispecialty AW base fee schedule,354.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9868,Not in chargemaster,G9868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9868,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9869,Not in chargemaster,G9869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9869,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9870,Not in chargemaster,G9870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9870,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9978,Not in chargemaster,G9978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9978,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9157,Not in chargemaster,G9157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9157,BCBS multispecialty AW base fee schedule,171.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9979,Not in chargemaster,G9979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9979,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9980,Not in chargemaster,G9980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9980,BCBS multispecialty AW base fee schedule,132.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9981,Not in chargemaster,G9981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9981,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9982,Not in chargemaster,G9982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9982,BCBS multispecialty AW base fee schedule,296.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9983,Not in chargemaster,G9983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9983,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9984,Not in chargemaster,G9984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9984,BCBS multispecialty AW base fee schedule,89.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9985,Not in chargemaster,G9985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9985,BCBS multispecialty AW base fee schedule,138.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9987,Not in chargemaster,G9987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9987,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9986,Not in chargemaster,G9986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9986,BCBS multispecialty AW base fee schedule,195.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility P3001,Not in chargemaster,P3001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P3001,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0035 mod 26,Not in chargemaster,Q0035,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0035 mod 26,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0035 mod TC,Not in chargemaster,Q0035,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0035 mod TC,BCBS multispecialty AW base fee schedule,17.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0416 mod 26,Not in chargemaster,G0416,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0416 mod 26,BCBS multispecialty AW base fee schedule,318.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0416 mod TC,Not in chargemaster,G0416,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0416 mod TC,BCBS multispecialty AW base fee schedule,279,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0420,Not in chargemaster,G0420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0420,BCBS multispecialty AW base fee schedule,196.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0421,Not in chargemaster,G0421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0421,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0422,Not in chargemaster,G0422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0422,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0423,Not in chargemaster,G0423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0423,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0424,Not in chargemaster,G0424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0424,BCBS multispecialty AW base fee schedule,52.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0425,Not in chargemaster,G0425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0425,BCBS multispecialty AW base fee schedule,174.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0426,Not in chargemaster,G0426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0426,BCBS multispecialty AW base fee schedule,237.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0427,Not in chargemaster,G0427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0427,BCBS multispecialty AW base fee schedule,352.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0429,Not in chargemaster,G0429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0429,BCBS multispecialty AW base fee schedule,171.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0438,G0438,G0438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0438,BCBS multispecialty AW base fee schedule,296.98,211.64,Fee schedule,,211.64,211.64,211.64,211.64,,,0
unity,Fee schedule,Non-facility G0439,G0439,G0439,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0439,BCBS multispecialty AW base fee schedule,201.5,143,Fee schedule,,143,143,143,143,,,0
unity,Fee schedule,Non-facility G0442,Not in chargemaster,G0442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0442,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0443,Not in chargemaster,G0443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0443,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0444,Not in chargemaster,G0444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0444,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0445,Not in chargemaster,G0445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0445,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0446,Not in chargemaster,G0446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0446,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0447,Not in chargemaster,G0447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0447,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0451,Not in chargemaster,G0451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0451,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0452,Not in chargemaster,G0452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0452,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0452 mod 26,Not in chargemaster,G0452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0452 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0453,Not in chargemaster,G0453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0453,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0454,Not in chargemaster,G0454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0454,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0455,Not in chargemaster,G0455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0455,BCBS multispecialty AW base fee schedule,225.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0459,Not in chargemaster,G0459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0459,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0460,Not in chargemaster,G0460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0460,BCBS multispecialty AW base fee schedule,372.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0473,Not in chargemaster,G0473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0473,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0500,Not in chargemaster,G0500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0500,BCBS multispecialty AW base fee schedule,99.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0506,Not in chargemaster,G0506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0506,BCBS multispecialty AW base fee schedule,109.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0508,Not in chargemaster,G0508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0508,BCBS multispecialty AW base fee schedule,368.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0509,Not in chargemaster,G0509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0509,BCBS multispecialty AW base fee schedule,339.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0511,G0511,G0511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0511,BCBS multispecialty AW base fee schedule,114.7,135,Fee schedule,,114.7,114.7,114.7,114.7,,,0
unity,Fee schedule,Non-facility G0512,Not in chargemaster,G0512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0512,BCBS multispecialty AW base fee schedule,243.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0513,Not in chargemaster,G0513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0513,BCBS multispecialty AW base fee schedule,114.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0514,Not in chargemaster,G0514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0514,BCBS multispecialty AW base fee schedule,114.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0516,Not in chargemaster,G0516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0516,BCBS multispecialty AW base fee schedule,463.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2001,Not in chargemaster,G2001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2001,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2002,Not in chargemaster,G2002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2002,BCBS multispecialty AW base fee schedule,139.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2003,Not in chargemaster,G2003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2003,BCBS multispecialty AW base fee schedule,230.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2004,Not in chargemaster,G2004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2004,BCBS multispecialty AW base fee schedule,322.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2005,Not in chargemaster,G2005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2005,BCBS multispecialty AW base fee schedule,391.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2006,Not in chargemaster,G2006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2006,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2007,Not in chargemaster,G2007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2007,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2008,Not in chargemaster,G2008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2008,BCBS multispecialty AW base fee schedule,228.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2009,Not in chargemaster,G2009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2009,BCBS multispecialty AW base fee schedule,316.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2010,Not in chargemaster,G2010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2010,BCBS multispecialty AW base fee schedule,21.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0517,Not in chargemaster,G0517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0517,BCBS multispecialty AW base fee schedule,430.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0518,Not in chargemaster,G0518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0518,BCBS multispecialty AW base fee schedule,920.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2011,Not in chargemaster,G2011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2011,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2012,Not in chargemaster,G2012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2012,BCBS multispecialty AW base fee schedule,25.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2013,Not in chargemaster,G2013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2013,BCBS multispecialty AW base fee schedule,391.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2014,Not in chargemaster,G2014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2014,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2015,Not in chargemaster,G2015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2015,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2058,Not in chargemaster,G2058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2058,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2061,Not in chargemaster,G2061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2061,BCBS multispecialty AW base fee schedule,21.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2062,Not in chargemaster,G2062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2062,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2063,Not in chargemaster,G2063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2063,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2064,Not in chargemaster,G2064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2064,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2065,Not in chargemaster,G2065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2065,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2082,Not in chargemaster,G2082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2082,BCBS multispecialty AW base fee schedule,1305.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2083,Not in chargemaster,G2083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2083,BCBS multispecialty AW base fee schedule,1907.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2086,Not in chargemaster,G2086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2086,BCBS multispecialty AW base fee schedule,709.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2087,Not in chargemaster,G2087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2087,BCBS multispecialty AW base fee schedule,633.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2088,Not in chargemaster,G2088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2088,BCBS multispecialty AW base fee schedule,120.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6001 mod 26,Not in chargemaster,G6001,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6001 mod 26,BCBS multispecialty AW base fee schedule,56.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6001 mod TC,Not in chargemaster,G6001,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6001 mod TC,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6001,Not in chargemaster,G6001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6001,BCBS multispecialty AW base fee schedule,205.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6002,Not in chargemaster,G6002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6002,BCBS multispecialty AW base fee schedule,140.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6002 mod 26,Not in chargemaster,G6002,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6002 mod 26,BCBS multispecialty AW base fee schedule,38.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6002 mod TC,Not in chargemaster,G6002,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6002 mod TC,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6003,Not in chargemaster,G6003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6003,BCBS multispecialty AW base fee schedule,348.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6004,Not in chargemaster,G6004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6004,BCBS multispecialty AW base fee schedule,263.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99498,Not in chargemaster,99498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99498,BCBS multispecialty AW base fee schedule,130.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99212,99212,99212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99212,BCBS multispecialty AW base fee schedule,79.36,97,Fee schedule,,79.36,79.36,79.36,79.36,,,0
unity,Fee schedule,Non-facility 99213,99213,99213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99213,BCBS multispecialty AW base fee schedule,130.82,158,Fee schedule,,130.82,130.82,130.82,130.82,,,0
unity,Fee schedule,Non-facility 99214,99214,99214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99214,BCBS multispecialty AW base fee schedule,189.72,230,Fee schedule,,189.72,189.72,189.72,189.72,,,0
unity,Fee schedule,Non-facility 99215,99215,99215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99215,BCBS multispecialty AW base fee schedule,254.82,300,Fee schedule,,254.82,254.82,254.82,254.82,,,0
unity,Fee schedule,Non-facility 99217,99217,99217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99217,BCBS multispecialty AW base fee schedule,127.1,155,Fee schedule,,127.1,127.1,127.1,127.1,,,0
unity,Fee schedule,Non-facility 99218,99218,99218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99218,BCBS multispecialty AW base fee schedule,174.84,214,Fee schedule,,174.84,174.84,174.84,174.84,,,0
unity,Fee schedule,Non-facility 99219,99219,99219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99219,BCBS multispecialty AW base fee schedule,237.46,290,Fee schedule,,237.46,237.46,237.46,237.46,,,0
unity,Fee schedule,Non-facility 99220,99220,99220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99220,BCBS multispecialty AW base fee schedule,323.64,395,Fee schedule,,323.64,323.64,323.64,323.64,,,0
unity,Fee schedule,Non-facility 99221,99221,99221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99221,BCBS multispecialty AW base fee schedule,178.56,215,Fee schedule,,178.56,178.56,178.56,178.56,,,0
unity,Fee schedule,Non-facility 99222,99222,99222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99222,BCBS multispecialty AW base fee schedule,241.18,290,Fee schedule,,241.18,241.18,241.18,241.18,,,0
unity,Fee schedule,Non-facility 99223,99223,99223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99223,BCBS multispecialty AW base fee schedule,354.02,430,Fee schedule,,354.02,354.02,354.02,354.02,,,0
unity,Fee schedule,Non-facility 99224,99224,99224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99224,BCBS multispecialty AW base fee schedule,69.44,85,Fee schedule,,69.44,69.44,69.44,69.44,,,0
unity,Fee schedule,Non-facility 99225,99225,99225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99225,BCBS multispecialty AW base fee schedule,127.1,155,Fee schedule,,127.1,127.1,127.1,127.1,,,0
unity,Fee schedule,Non-facility 99226,99226,99226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99226,BCBS multispecialty AW base fee schedule,182.9,225,Fee schedule,,182.9,182.9,182.9,182.9,,,0
unity,Fee schedule,Non-facility 99231,99231,99231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99231,BCBS multispecialty AW base fee schedule,68.82,85,Fee schedule,,68.82,68.82,68.82,68.82,,,0
unity,Fee schedule,Non-facility 99232,99232,99232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99232,BCBS multispecialty AW base fee schedule,126.48,155,Fee schedule,,126.48,126.48,126.48,126.48,,,0
unity,Fee schedule,Non-facility 99233,99233,99233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99233,BCBS multispecialty AW base fee schedule,182.28,225,Fee schedule,,182.28,182.28,182.28,182.28,,,0
unity,Fee schedule,Non-facility 99234,99234,99234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99234,BCBS multispecialty AW base fee schedule,233.74,285,Fee schedule,,233.74,233.74,233.74,233.74,,,0
unity,Fee schedule,Non-facility 99235,99235,99235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99235,BCBS multispecialty AW base fee schedule,295.74,360,Fee schedule,,295.74,295.74,295.74,295.74,,,0
unity,Fee schedule,Non-facility 99236,99236,99236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99236,BCBS multispecialty AW base fee schedule,380.68,465,Fee schedule,,380.68,380.68,380.68,380.68,,,0
unity,Fee schedule,Non-facility 99238,99238,99238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99238,BCBS multispecialty AW base fee schedule,127.72,155,Fee schedule,,127.72,127.72,127.72,127.72,,,0
unity,Fee schedule,Non-facility 99239,99239,99239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99239,BCBS multispecialty AW base fee schedule,187.24,230,Fee schedule,,187.24,187.24,187.24,187.24,,,0
unity,Fee schedule,Non-facility 99241,99241,99241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99241,BCBS multispecialty AW base fee schedule,83.7,97.26,Fee schedule,,83.7,83.7,83.7,83.7,,,0
unity,Fee schedule,Non-facility 99242,Not in chargemaster,99242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99242,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99243,Not in chargemaster,99243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99243,BCBS multispecialty AW base fee schedule,216.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99244,Not in chargemaster,99244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99244,BCBS multispecialty AW base fee schedule,324.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99245,Not in chargemaster,99245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99245,BCBS multispecialty AW base fee schedule,394.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99251,Not in chargemaster,99251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99251,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99252,Not in chargemaster,99252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99252,BCBS multispecialty AW base fee schedule,132.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99253,Not in chargemaster,99253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99253,BCBS multispecialty AW base fee schedule,203.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99254,Not in chargemaster,99254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99254,BCBS multispecialty AW base fee schedule,296.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99255,Not in chargemaster,99255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99255,BCBS multispecialty AW base fee schedule,357.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99281,99281,99281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99281,BCBS multispecialty AW base fee schedule,39.68,50,Fee schedule,,39.68,39.68,39.68,39.68,,,0
unity,Fee schedule,Non-facility 99282,99282,99282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99282,BCBS multispecialty AW base fee schedule,76.26,90,Fee schedule,,76.26,76.26,76.26,76.26,,,0
unity,Fee schedule,Non-facility 99283,99283,99283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99283,BCBS multispecialty AW base fee schedule,114.08,130,Fee schedule,,114.08,114.08,114.08,114.08,,,0
unity,Fee schedule,Non-facility 99284,99284,99284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99284,BCBS multispecialty AW base fee schedule,209.56,250,Fee schedule,,209.56,209.56,209.56,209.56,,,0
unity,Fee schedule,Non-facility 99285,99285,99285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99285,BCBS multispecialty AW base fee schedule,304.42,370,Fee schedule,,304.42,304.42,304.42,304.42,,,0
unity,Fee schedule,Non-facility 99291,99291,99291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99291,BCBS multispecialty AW base fee schedule,489.18,480,Fee schedule,,480,480,480,480,,,0
unity,Fee schedule,Non-facility 99292,99292,99292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99292,BCBS multispecialty AW base fee schedule,216.38,262,Fee schedule,,216.38,216.38,216.38,216.38,,,0
unity,Fee schedule,Non-facility 99304,99304,99304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99304,BCBS multispecialty AW base fee schedule,158.1,195,Fee schedule,,158.1,158.1,158.1,158.1,,,0
unity,Fee schedule,Non-facility 99305,99305,99305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99305,BCBS multispecialty AW base fee schedule,226.3,235.13,Fee schedule,,226.3,226.3,226.3,226.3,,,0
unity,Fee schedule,Non-facility 99306,Not in chargemaster,99306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99306,BCBS multispecialty AW base fee schedule,292.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99307,99307,99307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99307,BCBS multispecialty AW base fee schedule,76.88,95,Fee schedule,,76.88,76.88,76.88,76.88,,,0
unity,Fee schedule,Non-facility 99308,99308,99308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99308,BCBS multispecialty AW base fee schedule,120.9,145,Fee schedule,,120.9,120.9,120.9,120.9,,,0
unity,Fee schedule,Non-facility 99309,99309,99309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99309,BCBS multispecialty AW base fee schedule,159.34,195,Fee schedule,,159.34,159.34,159.34,159.34,,,0
unity,Fee schedule,Non-facility 99310,Not in chargemaster,99310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99310,BCBS multispecialty AW base fee schedule,234.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99315,99315,99315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99315,BCBS multispecialty AW base fee schedule,128.34,149.08,Fee schedule,,128.34,128.34,128.34,128.34,,,0
unity,Fee schedule,Non-facility 99316,99316,99316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99316,BCBS multispecialty AW base fee schedule,184.14,213.68,Fee schedule,,184.14,184.14,184.14,184.14,,,0
unity,Fee schedule,Non-facility 99318,Not in chargemaster,99318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99318,BCBS multispecialty AW base fee schedule,168.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99324,Not in chargemaster,99324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99324,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99325,Not in chargemaster,99325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99325,BCBS multispecialty AW base fee schedule,138.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99326,Not in chargemaster,99326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99326,BCBS multispecialty AW base fee schedule,241.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99327,Not in chargemaster,99327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99327,BCBS multispecialty AW base fee schedule,324.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99328,Not in chargemaster,99328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99328,BCBS multispecialty AW base fee schedule,384.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99334,Not in chargemaster,99334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99334,BCBS multispecialty AW base fee schedule,105.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99335,Not in chargemaster,99335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99335,BCBS multispecialty AW base fee schedule,166.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99336,Not in chargemaster,99336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99336,BCBS multispecialty AW base fee schedule,235.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99337,Not in chargemaster,99337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99337,BCBS multispecialty AW base fee schedule,339.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99339,Not in chargemaster,99339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99339,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99340,Not in chargemaster,99340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99340,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99341,Not in chargemaster,99341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99341,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99342,Not in chargemaster,99342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99342,BCBS multispecialty AW base fee schedule,137.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99343,Not in chargemaster,99343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99343,BCBS multispecialty AW base fee schedule,225.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99344,Not in chargemaster,99344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99344,BCBS multispecialty AW base fee schedule,319.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99345,Not in chargemaster,99345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99345,BCBS multispecialty AW base fee schedule,388.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99347,Not in chargemaster,99347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99347,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99348,Not in chargemaster,99348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99348,BCBS multispecialty AW base fee schedule,146.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99349,Not in chargemaster,99349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99349,BCBS multispecialty AW base fee schedule,225.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99350,Not in chargemaster,99350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99350,BCBS multispecialty AW base fee schedule,313.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99354,Not in chargemaster,99354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99354,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99355,Not in chargemaster,99355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99355,BCBS multispecialty AW base fee schedule,172.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99356,Not in chargemaster,99356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99356,BCBS multispecialty AW base fee schedule,161.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99357,Not in chargemaster,99357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99357,BCBS multispecialty AW base fee schedule,163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99358,Not in chargemaster,99358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99358,BCBS multispecialty AW base fee schedule,195.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99359,Not in chargemaster,99359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99359,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99360,Not in chargemaster,99360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99360,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99366,Not in chargemaster,99366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99366,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99367,Not in chargemaster,99367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99367,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99368,Not in chargemaster,99368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99368,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99374,Not in chargemaster,99374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99374,BCBS multispecialty AW base fee schedule,122.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99375,Not in chargemaster,99375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99375,BCBS multispecialty AW base fee schedule,183.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99377,Not in chargemaster,99377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99377,BCBS multispecialty AW base fee schedule,122.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99378,Not in chargemaster,99378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99378,BCBS multispecialty AW base fee schedule,183.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99379,Not in chargemaster,99379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99379,BCBS multispecialty AW base fee schedule,122.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99380,Not in chargemaster,99380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99380,BCBS multispecialty AW base fee schedule,183.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99381,99381,99381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99381,BCBS multispecialty AW base fee schedule,194.06,238,Fee schedule,,194.06,194.06,194.06,194.06,,,0
unity,Fee schedule,Non-facility 99382,99382,99382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99382,BCBS multispecialty AW base fee schedule,203.36,238.51,Fee schedule,,203.36,203.36,203.36,203.36,,,0
unity,Fee schedule,Non-facility 99383,99383,99383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99383,BCBS multispecialty AW base fee schedule,212.04,255,Fee schedule,,212.04,212.04,212.04,212.04,,,0
unity,Fee schedule,Non-facility 99384,99384,99384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99384,BCBS multispecialty AW base fee schedule,239.94,290,Fee schedule,,239.94,239.94,239.94,239.94,,,0
unity,Fee schedule,Non-facility 99385,99385,99385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99385,BCBS multispecialty AW base fee schedule,232.5,282,Fee schedule,,232.5,232.5,232.5,232.5,,,0
unity,Fee schedule,Non-facility 99386,99386,99386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99386,BCBS multispecialty AW base fee schedule,269.08,325,Fee schedule,,269.08,269.08,269.08,269.08,,,0
unity,Fee schedule,Non-facility 99387,99387,99387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99387,BCBS multispecialty AW base fee schedule,292.64,342.17,Fee schedule,,292.64,292.64,292.64,292.64,,,0
unity,Fee schedule,Non-facility 99391,99391,99391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99391,BCBS multispecialty AW base fee schedule,175.46,210,Fee schedule,,175.46,175.46,175.46,175.46,,,0
unity,Fee schedule,Non-facility 99392,99392,99392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99392,BCBS multispecialty AW base fee schedule,186.62,225,Fee schedule,,186.62,186.62,186.62,186.62,,,0
unity,Fee schedule,Non-facility 99393,99393,99393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99393,BCBS multispecialty AW base fee schedule,186,225,Fee schedule,,186,186,186,186,,,0
unity,Fee schedule,Non-facility 99394,99394,99394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99394,BCBS multispecialty AW base fee schedule,204.6,250,Fee schedule,,204.6,204.6,204.6,204.6,,,0
unity,Fee schedule,Non-facility 99395,99395,99395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99395,BCBS multispecialty AW base fee schedule,209.56,250,Fee schedule,,209.56,209.56,209.56,209.56,,,0
unity,Fee schedule,Non-facility 99396,99396,99396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99396,BCBS multispecialty AW base fee schedule,223.2,270,Fee schedule,,223.2,223.2,223.2,223.2,,,0
unity,Fee schedule,Non-facility 99397,99397,99397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99397,BCBS multispecialty AW base fee schedule,239.94,290,Fee schedule,,239.94,239.94,239.94,239.94,,,0
unity,Fee schedule,Non-facility 99401,Not in chargemaster,99401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99401,BCBS multispecialty AW base fee schedule,69.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99402,Not in chargemaster,99402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99402,BCBS multispecialty AW base fee schedule,114.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99403,Not in chargemaster,99403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99403,BCBS multispecialty AW base fee schedule,156.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99404,Not in chargemaster,99404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99404,BCBS multispecialty AW base fee schedule,200.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99406,9420000,99406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99406,BCBS multispecialty AW base fee schedule,26.66,53.55,Fee schedule,,26.66,26.66,26.66,26.66,,,0
unity,Fee schedule,Non-facility 99407,9420001,99407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99407,BCBS multispecialty AW base fee schedule,50.84,101.14,Fee schedule,,50.84,50.84,50.84,50.84,,,0
unity,Fee schedule,Non-facility 99408,Not in chargemaster,99408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99408,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99409,Not in chargemaster,99409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99409,BCBS multispecialty AW base fee schedule,122.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99411,Not in chargemaster,99411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99411,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99412,Not in chargemaster,99412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99412,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99415,Not in chargemaster,99415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99415,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99416,Not in chargemaster,99416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99416,BCBS multispecialty AW base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99421,Not in chargemaster,99421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99421,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99422,Not in chargemaster,99422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99422,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99423,Not in chargemaster,99423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99423,BCBS multispecialty AW base fee schedule,86.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99441,Not in chargemaster,99441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99441,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99442,Not in chargemaster,99442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99442,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99443,Not in chargemaster,99443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99443,BCBS multispecialty AW base fee schedule,70.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99446,Not in chargemaster,99446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99446,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99447,Not in chargemaster,99447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99447,BCBS multispecialty AW base fee schedule,63.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99448,Not in chargemaster,99448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99448,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99451,Not in chargemaster,99451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99451,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99452,Not in chargemaster,99452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99452,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99453,Not in chargemaster,99453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99453,BCBS multispecialty AW base fee schedule,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99449,Not in chargemaster,99449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99449,BCBS multispecialty AW base fee schedule,127.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99454,Not in chargemaster,99454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99454,BCBS multispecialty AW base fee schedule,107.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99457,Not in chargemaster,99457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99457,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99458,Not in chargemaster,99458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99458,BCBS multispecialty AW base fee schedule,72.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99460,Not in chargemaster,99460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99460,BCBS multispecialty AW base fee schedule,167.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99461,Not in chargemaster,99461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99461,BCBS multispecialty AW base fee schedule,159.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99462,Not in chargemaster,99462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99462,BCBS multispecialty AW base fee schedule,73.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99463,Not in chargemaster,99463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99463,BCBS multispecialty AW base fee schedule,193.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99464,Not in chargemaster,99464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99464,BCBS multispecialty AW base fee schedule,130.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99465,Not in chargemaster,99465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99465,BCBS multispecialty AW base fee schedule,256.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99466,Not in chargemaster,99466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99466,BCBS multispecialty AW base fee schedule,417.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99467,Not in chargemaster,99467,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99467,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99468,Not in chargemaster,99468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99468,BCBS multispecialty AW base fee schedule,1610.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99469,Not in chargemaster,99469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99469,BCBS multispecialty AW base fee schedule,697.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99471,Not in chargemaster,99471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99471,BCBS multispecialty AW base fee schedule,1394.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99472,Not in chargemaster,99472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99472,BCBS multispecialty AW base fee schedule,704.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99473,Not in chargemaster,99473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99473,BCBS multispecialty AW base fee schedule,19.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99474,Not in chargemaster,99474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99474,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99475,Not in chargemaster,99475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99475,BCBS multispecialty AW base fee schedule,981.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99476,Not in chargemaster,99476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99476,BCBS multispecialty AW base fee schedule,607.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99477,Not in chargemaster,99477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99477,BCBS multispecialty AW base fee schedule,611.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99478,Not in chargemaster,99478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99478,BCBS multispecialty AW base fee schedule,240.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99479,Not in chargemaster,99479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99479,BCBS multispecialty AW base fee schedule,218.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99480,Not in chargemaster,99480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99480,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99483,Not in chargemaster,99483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99483,BCBS multispecialty AW base fee schedule,455.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99484,Not in chargemaster,99484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99484,BCBS multispecialty AW base fee schedule,82.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99485,Not in chargemaster,99485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99485,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99486,Not in chargemaster,99486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99486,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99487,Not in chargemaster,99487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99487,BCBS multispecialty AW base fee schedule,158.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99489,Not in chargemaster,99489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99489,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99490,Not in chargemaster,99490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99490,BCBS multispecialty AW base fee schedule,72.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99491,Not in chargemaster,99491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99491,BCBS multispecialty AW base fee schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99492,Not in chargemaster,99492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99492,BCBS multispecialty AW base fee schedule,269.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99493,Not in chargemaster,99493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99493,BCBS multispecialty AW base fee schedule,217,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99494,Not in chargemaster,99494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99494,BCBS multispecialty AW base fee schedule,109.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99495,Not in chargemaster,99495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99495,BCBS multispecialty AW base fee schedule,322.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99496,Not in chargemaster,99496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99496,BCBS multispecialty AW base fee schedule,425.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99497,Not in chargemaster,99497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99497,BCBS multispecialty AW base fee schedule,149.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0071,Not in chargemaster,G0071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0071,BCBS multispecialty AW base fee schedule,23.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0076,Not in chargemaster,G0076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0076,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0077,Not in chargemaster,G0077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0077,BCBS multispecialty AW base fee schedule,139.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0078,Not in chargemaster,G0078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0078,BCBS multispecialty AW base fee schedule,230.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0079,Not in chargemaster,G0079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0079,BCBS multispecialty AW base fee schedule,322.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0080,Not in chargemaster,G0080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0080,BCBS multispecialty AW base fee schedule,391.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0081,Not in chargemaster,G0081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0081,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0082,Not in chargemaster,G0082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0082,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0083,Not in chargemaster,G0083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0083,BCBS multispecialty AW base fee schedule,228.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0084,Not in chargemaster,G0084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0084,BCBS multispecialty AW base fee schedule,316.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0085,Not in chargemaster,G0085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0085,BCBS multispecialty AW base fee schedule,391.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0086,Not in chargemaster,G0086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0086,BCBS multispecialty AW base fee schedule,135.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0087,Not in chargemaster,G0087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0087,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0101,Not in chargemaster,G0101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0101,BCBS multispecialty AW base fee schedule,70.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0102,Not in chargemaster,G0102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0102,BCBS multispecialty AW base fee schedule,39.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0104,G0104,G0104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0104,BCBS multispecialty AW base fee schedule,308.76,137.02,Fee schedule,,137.02,137.02,137.02,137.02,,,0
unity,Fee schedule,Non-facility G0105,G0105,G0105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0105,BCBS multispecialty AW base fee schedule,583.42,469.74,Fee schedule,,469.74,469.74,469.74,469.74,,,0
unity,Fee schedule,Non-facility G0106,Not in chargemaster,G0106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0106,BCBS multispecialty AW base fee schedule,369.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0106 mod 26,Not in chargemaster,G0106,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0106 mod 26,BCBS multispecialty AW base fee schedule,93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0106 mod TC,Not in chargemaster,G0106,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0106 mod TC,BCBS multispecialty AW base fee schedule,276.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0108,Not in chargemaster,G0108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0108,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0109,Not in chargemaster,G0109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0109,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0117,Not in chargemaster,G0117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0117,BCBS multispecialty AW base fee schedule,96.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0118,Not in chargemaster,G0118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0118,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0120 mod 26,Not in chargemaster,G0120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0120 mod 26,BCBS multispecialty AW base fee schedule,96.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0120 mod TC,Not in chargemaster,G0120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0120 mod TC,BCBS multispecialty AW base fee schedule,276.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0120,Not in chargemaster,G0120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0120,BCBS multispecialty AW base fee schedule,373.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0121,G0121,G0121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0121,BCBS multispecialty AW base fee schedule,584.66,469.74,Fee schedule,,469.74,469.74,469.74,469.74,,,0
unity,Fee schedule,Non-facility G0122 mod 26,Not in chargemaster,G0122,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0122 mod 26,BCBS multispecialty AW base fee schedule,88.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0122 mod TC,Not in chargemaster,G0122,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0122 mod TC,BCBS multispecialty AW base fee schedule,455.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0122,Not in chargemaster,G0122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0122,BCBS multispecialty AW base fee schedule,543.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0124,Not in chargemaster,G0124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0124,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0127,Not in chargemaster,G0127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0127,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0128,Not in chargemaster,G0128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0128,BCBS multispecialty AW base fee schedule,13.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0130 mod 26,Not in chargemaster,G0130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0130 mod 26,BCBS multispecialty AW base fee schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0130 mod TC,Not in chargemaster,G0130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0130 mod TC,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0130,Not in chargemaster,G0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0130,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0141,Not in chargemaster,G0141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0141,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0166,Not in chargemaster,G0166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0166,BCBS multispecialty AW base fee schedule,179.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0168,G0168,G0168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0168,BCBS multispecialty AW base fee schedule,187.86,200,Fee schedule,,187.86,187.86,187.86,187.86,,,0
unity,Fee schedule,Non-facility G0179,Not in chargemaster,G0179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0179,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0180,Not in chargemaster,G0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0180,BCBS multispecialty AW base fee schedule,93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0182,Not in chargemaster,G0182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0182,BCBS multispecialty AW base fee schedule,188.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0181,Not in chargemaster,G0181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0181,BCBS multispecialty AW base fee schedule,187.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0237,Not in chargemaster,G0237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0237,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0238,Not in chargemaster,G0238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0238,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0239,Not in chargemaster,G0239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0239,BCBS multispecialty AW base fee schedule,21.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0245,Not in chargemaster,G0245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0245,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0246,Not in chargemaster,G0246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0246,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0247,Not in chargemaster,G0247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0247,BCBS multispecialty AW base fee schedule,139.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0248,Not in chargemaster,G0248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0248,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0249,Not in chargemaster,G0249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0249,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0250,Not in chargemaster,G0250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0250,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0252 mod 26,Not in chargemaster,G0252,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0252 mod 26,BCBS multispecialty AW base fee schedule,133.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0252,Not in chargemaster,G0252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0252,BCBS multispecialty AW base fee schedule,133.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0268,Not in chargemaster,G0268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0268,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0270,Not in chargemaster,G0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0270,BCBS multispecialty AW base fee schedule,57.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0271,Not in chargemaster,G0271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0271,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0276,Not in chargemaster,G0276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0276,BCBS multispecialty AW base fee schedule,667.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0277,Not in chargemaster,G0277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0277,BCBS multispecialty AW base fee schedule,237.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0278,Not in chargemaster,G0278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0278,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0279,Not in chargemaster,G0279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0279,BCBS multispecialty AW base fee schedule,96.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0279 mod 26,Not in chargemaster,G0279,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0279 mod 26,BCBS multispecialty AW base fee schedule,52.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0279 mod TC,Not in chargemaster,G0279,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0279 mod TC,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0281,Not in chargemaster,G0281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0281,BCBS multispecialty AW base fee schedule,24.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0283,Not in chargemaster,G0283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0283,BCBS multispecialty AW base fee schedule,24.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0288,Not in chargemaster,G0288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0288,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0289,Not in chargemaster,G0289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0289,BCBS multispecialty AW base fee schedule,155,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0296,Not in chargemaster,G0296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0296,BCBS multispecialty AW base fee schedule,51.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0297,Not in chargemaster,G0297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0297,BCBS multispecialty AW base fee schedule,415.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0297 mod 26,Not in chargemaster,G0297,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0297 mod 26,BCBS multispecialty AW base fee schedule,89.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0297 mod TC,Not in chargemaster,G0297,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0297 mod TC,BCBS multispecialty AW base fee schedule,325.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0329,Not in chargemaster,G0329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0329,BCBS multispecialty AW base fee schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0337,Not in chargemaster,G0337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0337,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0341,Not in chargemaster,G0341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0341,BCBS multispecialty AW base fee schedule,3705.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0342,Not in chargemaster,G0342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0342,BCBS multispecialty AW base fee schedule,1212.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0397,Not in chargemaster,G0397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0397,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0343,Not in chargemaster,G0343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0343,BCBS multispecialty AW base fee schedule,2001.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0372,Not in chargemaster,G0372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0372,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0396,Not in chargemaster,G0396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0396,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0402,Not in chargemaster,G0402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0402,BCBS multispecialty AW base fee schedule,289.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0403,Not in chargemaster,G0403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0403,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0404,Not in chargemaster,G0404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0404,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0405,G0405,G0405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0405,BCBS multispecialty AW base fee schedule,14.88,17.04,Fee schedule,,14.88,14.88,14.88,14.88,,,0
unity,Fee schedule,Non-facility G0406,Not in chargemaster,G0406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0406,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0407,Not in chargemaster,G0407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0407,BCBS multispecialty AW base fee schedule,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0408,Not in chargemaster,G0408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0408,BCBS multispecialty AW base fee schedule,181.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0409,Not in chargemaster,G0409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0409,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0412,Not in chargemaster,G0412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0412,BCBS multispecialty AW base fee schedule,1302.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0413,Not in chargemaster,G0413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0413,BCBS multispecialty AW base fee schedule,1904.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0414,Not in chargemaster,G0414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0414,BCBS multispecialty AW base fee schedule,1798.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0415,Not in chargemaster,G0415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0415,BCBS multispecialty AW base fee schedule,2454.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0416,Not in chargemaster,G0416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0416,BCBS multispecialty AW base fee schedule,597.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92353,Not in chargemaster,92353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92353,BCBS multispecialty AW base fee schedule,89.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92354,Not in chargemaster,92354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92354,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92355,Not in chargemaster,92355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92355,BCBS multispecialty AW base fee schedule,35.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92358,Not in chargemaster,92358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92358,BCBS multispecialty AW base fee schedule,19.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92370,Not in chargemaster,92370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92370,BCBS multispecialty AW base fee schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92371,Not in chargemaster,92371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92371,BCBS multispecialty AW base fee schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92502,Not in chargemaster,92502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92502,BCBS multispecialty AW base fee schedule,166.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92504,Not in chargemaster,92504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92504,BCBS multispecialty AW base fee schedule,50.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92507,Not in chargemaster,92507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92507,BCBS multispecialty AW base fee schedule,139.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92508,Not in chargemaster,92508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92508,BCBS multispecialty AW base fee schedule,42.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92511,Not in chargemaster,92511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92511,BCBS multispecialty AW base fee schedule,197.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92512,Not in chargemaster,92512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92512,BCBS multispecialty AW base fee schedule,104.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92516,Not in chargemaster,92516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92516,BCBS multispecialty AW base fee schedule,120.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92520,Not in chargemaster,92520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92520,BCBS multispecialty AW base fee schedule,141.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92521,Not in chargemaster,92521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92521,BCBS multispecialty AW base fee schedule,199.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92522,Not in chargemaster,92522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92522,BCBS multispecialty AW base fee schedule,162.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92523,Not in chargemaster,92523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92523,BCBS multispecialty AW base fee schedule,341,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92524,Not in chargemaster,92524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92524,BCBS multispecialty AW base fee schedule,158.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92526,Not in chargemaster,92526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92526,BCBS multispecialty AW base fee schedule,153.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92537 mod 26,Not in chargemaster,92537,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92537 mod 26,BCBS multispecialty AW base fee schedule,55.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92537 mod TC,Not in chargemaster,92537,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92537 mod TC,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92537,Not in chargemaster,92537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92537,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92538,Not in chargemaster,92538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92538,BCBS multispecialty AW base fee schedule,29.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92538 mod 26,Not in chargemaster,92538,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92538 mod 26,BCBS multispecialty AW base fee schedule,20.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92538 mod TC,Not in chargemaster,92538,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92538 mod TC,BCBS multispecialty AW base fee schedule,8.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92540 mod 26,Not in chargemaster,92540,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92540 mod 26,BCBS multispecialty AW base fee schedule,140.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92540 mod TC,Not in chargemaster,92540,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92540 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92540,Not in chargemaster,92540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92540,BCBS multispecialty AW base fee schedule,188.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92541,Not in chargemaster,92541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92541,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92541 mod 26,Not in chargemaster,92541,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92541 mod 26,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92541 mod TC,Not in chargemaster,92541,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92541 mod TC,BCBS multispecialty AW base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92542 mod 26,Not in chargemaster,92542,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92542 mod 26,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92542 mod TC,Not in chargemaster,92542,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92542 mod TC,BCBS multispecialty AW base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92542,Not in chargemaster,92542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92542,BCBS multispecialty AW base fee schedule,52.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92544,Not in chargemaster,92544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92544,BCBS multispecialty AW base fee schedule,31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92544 mod 26,Not in chargemaster,92544,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92544 mod 26,BCBS multispecialty AW base fee schedule,25.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92544 mod TC,Not in chargemaster,92544,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92544 mod TC,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92545 mod 26,Not in chargemaster,92545,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92545 mod 26,BCBS multispecialty AW base fee schedule,23.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92545 mod TC,Not in chargemaster,92545,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92545 mod TC,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92545,Not in chargemaster,92545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92545,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92546,Not in chargemaster,92546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92546,BCBS multispecialty AW base fee schedule,195.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92546 mod 26,Not in chargemaster,92546,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92546 mod 26,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92546 mod TC,Not in chargemaster,92546,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92546 mod TC,BCBS multispecialty AW base fee schedule,168.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92547,Not in chargemaster,92547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92547,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92548,Not in chargemaster,92548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92548,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92548 mod 26,Not in chargemaster,92548,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92548 mod 26,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92548 mod TC,Not in chargemaster,92548,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92548 mod TC,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92549 mod 26,Not in chargemaster,92549,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92549 mod 26,BCBS multispecialty AW base fee schedule,79.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92549 mod TC,Not in chargemaster,92549,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92549 mod TC,BCBS multispecialty AW base fee schedule,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92549,Not in chargemaster,92549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92549,BCBS multispecialty AW base fee schedule,111.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92550,Not in chargemaster,92550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92550,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92551,Not in chargemaster,92551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92551,BCBS multispecialty AW base fee schedule,20.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92552,Not in chargemaster,92552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92552,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92553,Not in chargemaster,92553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92553,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92555,Not in chargemaster,92555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92555,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92556,Not in chargemaster,92556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92556,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92557,Not in chargemaster,92557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92557,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92558,Not in chargemaster,92558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92558,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92561,Not in chargemaster,92561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92561,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92562,Not in chargemaster,92562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92562,BCBS multispecialty AW base fee schedule,77.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92563,Not in chargemaster,92563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92563,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92564,Not in chargemaster,92564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92564,BCBS multispecialty AW base fee schedule,41.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92565,Not in chargemaster,92565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92565,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92567,92567,92567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92567,BCBS multispecialty AW base fee schedule,27.9,22.01,Fee schedule,,22.01,22.01,22.01,22.01,,,0
unity,Fee schedule,Non-facility 92568,Not in chargemaster,92568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92568,BCBS multispecialty AW base fee schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92570,Not in chargemaster,92570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92570,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92571,Not in chargemaster,92571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92571,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92572,Not in chargemaster,92572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92572,BCBS multispecialty AW base fee schedule,60.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92575,Not in chargemaster,92575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92575,BCBS multispecialty AW base fee schedule,114.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92576,Not in chargemaster,92576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92576,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92577,Not in chargemaster,92577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92577,BCBS multispecialty AW base fee schedule,24.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92579,Not in chargemaster,92579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92579,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92582,Not in chargemaster,92582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92582,BCBS multispecialty AW base fee schedule,128.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92583,Not in chargemaster,92583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92583,BCBS multispecialty AW base fee schedule,84.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92584,Not in chargemaster,92584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92584,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92585,Not in chargemaster,92585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92585,BCBS multispecialty AW base fee schedule,236.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92585 mod 26,Not in chargemaster,92585,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92585 mod 26,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92585 mod TC,Not in chargemaster,92585,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92585 mod TC,BCBS multispecialty AW base fee schedule,189.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92586,Not in chargemaster,92586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92586,BCBS multispecialty AW base fee schedule,166.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92587,Not in chargemaster,92587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92587,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92587 mod 26,Not in chargemaster,92587,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92587 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92587 mod TC,Not in chargemaster,92587,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92587 mod TC,BCBS multispecialty AW base fee schedule,6.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92588 mod 26,Not in chargemaster,92588,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92588 mod 26,BCBS multispecialty AW base fee schedule,51.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92588 mod TC,Not in chargemaster,92588,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92588 mod TC,BCBS multispecialty AW base fee schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92588,Not in chargemaster,92588,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92588,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92596,Not in chargemaster,92596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92596,BCBS multispecialty AW base fee schedule,114.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92597,Not in chargemaster,92597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92597,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92601,Not in chargemaster,92601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92601,BCBS multispecialty AW base fee schedule,293.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92602,Not in chargemaster,92602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92602,BCBS multispecialty AW base fee schedule,183.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92603,Not in chargemaster,92603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92603,BCBS multispecialty AW base fee schedule,273.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92604,Not in chargemaster,92604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92604,BCBS multispecialty AW base fee schedule,163.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92605,Not in chargemaster,92605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92605,BCBS multispecialty AW base fee schedule,167.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92606,Not in chargemaster,92606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92606,BCBS multispecialty AW base fee schedule,148.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92607,Not in chargemaster,92607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92607,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92608,Not in chargemaster,92608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92608,BCBS multispecialty AW base fee schedule,91.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92609,Not in chargemaster,92609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92609,BCBS multispecialty AW base fee schedule,190.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92610,Not in chargemaster,92610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92610,BCBS multispecialty AW base fee schedule,153.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92611,Not in chargemaster,92611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92611,BCBS multispecialty AW base fee schedule,162.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92612,Not in chargemaster,92612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92612,BCBS multispecialty AW base fee schedule,351.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92613,Not in chargemaster,92613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92613,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92614,Not in chargemaster,92614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92614,BCBS multispecialty AW base fee schedule,261.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92615,Not in chargemaster,92615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92615,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92616,Not in chargemaster,92616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92616,BCBS multispecialty AW base fee schedule,380.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92617,Not in chargemaster,92617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92617,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92618,Not in chargemaster,92618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92618,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92620,Not in chargemaster,92620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92620,BCBS multispecialty AW base fee schedule,165.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92621,Not in chargemaster,92621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92621,BCBS multispecialty AW base fee schedule,39.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92625,Not in chargemaster,92625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92625,BCBS multispecialty AW base fee schedule,124,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92627,Not in chargemaster,92627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92627,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92626,Not in chargemaster,92626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92626,BCBS multispecialty AW base fee schedule,158.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92640,Not in chargemaster,92640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92640,BCBS multispecialty AW base fee schedule,200.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92920,Not in chargemaster,92920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92920,BCBS multispecialty AW base fee schedule,955.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92924,Not in chargemaster,92924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92924,BCBS multispecialty AW base fee schedule,1138.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92928,Not in chargemaster,92928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92928,BCBS multispecialty AW base fee schedule,1062.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92933,Not in chargemaster,92933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92933,BCBS multispecialty AW base fee schedule,1192.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92937,Not in chargemaster,92937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92937,BCBS multispecialty AW base fee schedule,1061.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92941,Not in chargemaster,92941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92941,BCBS multispecialty AW base fee schedule,1194.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92943,Not in chargemaster,92943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92943,BCBS multispecialty AW base fee schedule,1194.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92950,92950,92950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92950,BCBS multispecialty AW base fee schedule,567.92,381.92,Fee schedule,,381.92,381.92,381.92,381.92,,,0
unity,Fee schedule,Non-facility 92953,Not in chargemaster,92953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92953,BCBS multispecialty AW base fee schedule,1.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92960,Not in chargemaster,92960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92960,BCBS multispecialty AW base fee schedule,279.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92961,Not in chargemaster,92961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92961,BCBS multispecialty AW base fee schedule,444.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92970,Not in chargemaster,92970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92970,BCBS multispecialty AW base fee schedule,340.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92971,Not in chargemaster,92971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92971,BCBS multispecialty AW base fee schedule,180.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92973,Not in chargemaster,92973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92973,BCBS multispecialty AW base fee schedule,317.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92974,Not in chargemaster,92974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92974,BCBS multispecialty AW base fee schedule,290.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92975,Not in chargemaster,92975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92975,BCBS multispecialty AW base fee schedule,677.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92977,Not in chargemaster,92977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92977,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92978,Not in chargemaster,92978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92978,BCBS multispecialty AW base fee schedule,169.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92978 mod 26,Not in chargemaster,92978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92978 mod 26,BCBS multispecialty AW base fee schedule,169.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92979,Not in chargemaster,92979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92979,BCBS multispecialty AW base fee schedule,137.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92979 mod 26,Not in chargemaster,92979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92979 mod 26,BCBS multispecialty AW base fee schedule,137.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92986,Not in chargemaster,92986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92986,BCBS multispecialty AW base fee schedule,2367.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92990,Not in chargemaster,92990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92990,BCBS multispecialty AW base fee schedule,1950.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92987,Not in chargemaster,92987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92987,BCBS multispecialty AW base fee schedule,2441.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92997,Not in chargemaster,92997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92997,BCBS multispecialty AW base fee schedule,1146.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92998,Not in chargemaster,92998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92998,BCBS multispecialty AW base fee schedule,580.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93000,Not in chargemaster,93000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93000,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93005,Not in chargemaster,93005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93005,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93010,93010,93010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93010,BCBS multispecialty AW base fee schedule,14.88,20,Fee schedule,,14.88,14.88,14.88,14.88,,,0
unity,Fee schedule,Non-facility 93015,Not in chargemaster,93015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93015,BCBS multispecialty AW base fee schedule,124,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93016,Not in chargemaster,93016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93016,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93017,Not in chargemaster,93017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93017,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93018,Not in chargemaster,93018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93018,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93024 mod 26,Not in chargemaster,93024,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93024 mod 26,BCBS multispecialty AW base fee schedule,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93024 mod TC,Not in chargemaster,93024,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93024 mod TC,BCBS multispecialty AW base fee schedule,91.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93024,Not in chargemaster,93024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93024,BCBS multispecialty AW base fee schedule,192.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93025,Not in chargemaster,93025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93025,BCBS multispecialty AW base fee schedule,246.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93025 mod 26,Not in chargemaster,93025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93025 mod 26,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93025 mod TC,Not in chargemaster,93025,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93025 mod TC,BCBS multispecialty AW base fee schedule,181.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93040,Not in chargemaster,93040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93040,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93041,Not in chargemaster,93041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93041,BCBS multispecialty AW base fee schedule,9.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93042,Not in chargemaster,93042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93042,BCBS multispecialty AW base fee schedule,12.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93050,Not in chargemaster,93050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93050,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93050 mod 26,Not in chargemaster,93050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93050 mod 26,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93050 mod TC,Not in chargemaster,93050,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93050 mod TC,BCBS multispecialty AW base fee schedule,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93224,Not in chargemaster,93224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93224,BCBS multispecialty AW base fee schedule,154.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93225,Not in chargemaster,93225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93225,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93226,Not in chargemaster,93226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93226,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93227,Not in chargemaster,93227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93227,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93228,Not in chargemaster,93228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93228,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93229,Not in chargemaster,93229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93229,BCBS multispecialty AW base fee schedule,1229.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93260 mod 26,Not in chargemaster,93260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93260 mod 26,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93260 mod TC,Not in chargemaster,93260,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93260 mod TC,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93260,Not in chargemaster,93260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93260,BCBS multispecialty AW base fee schedule,126.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93261,Not in chargemaster,93261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93261,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93261 mod 26,Not in chargemaster,93261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93261 mod 26,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93261 mod TC,Not in chargemaster,93261,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93261 mod TC,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93264,Not in chargemaster,93264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93264,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93268,Not in chargemaster,93268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93268,BCBS multispecialty AW base fee schedule,349.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93270,Not in chargemaster,93270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93270,BCBS multispecialty AW base fee schedule,15.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93271,Not in chargemaster,93271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93271,BCBS multispecialty AW base fee schedule,289.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93272,Not in chargemaster,93272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93272,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93278,Not in chargemaster,93278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93278,BCBS multispecialty AW base fee schedule,52.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93278 mod 26,Not in chargemaster,93278,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93278 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93278 mod TC,Not in chargemaster,93278,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93278 mod TC,BCBS multispecialty AW base fee schedule,30.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93279 mod 26,Not in chargemaster,93279,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93279 mod 26,BCBS multispecialty AW base fee schedule,57.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93279 mod TC,Not in chargemaster,93279,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93279 mod TC,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93279,Not in chargemaster,93279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93279,BCBS multispecialty AW base fee schedule,106.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93280,Not in chargemaster,93280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93280,BCBS multispecialty AW base fee schedule,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93280 mod 26,Not in chargemaster,93280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93280 mod 26,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93280 mod TC,Not in chargemaster,93280,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93280 mod TC,BCBS multispecialty AW base fee schedule,57.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93281 mod 26,Not in chargemaster,93281,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93281 mod 26,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93281 mod TC,Not in chargemaster,93281,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93281 mod TC,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93281,Not in chargemaster,93281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93281,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93282,Not in chargemaster,93282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93282,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93282 mod 26,Not in chargemaster,93282,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93282 mod 26,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93282 mod TC,Not in chargemaster,93282,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93282 mod TC,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93283 mod 26,Not in chargemaster,93283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93283 mod 26,BCBS multispecialty AW base fee schedule,102.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93283 mod TC,Not in chargemaster,93283,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93283 mod TC,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93283,Not in chargemaster,93283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93283,BCBS multispecialty AW base fee schedule,161.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93284,Not in chargemaster,93284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93284,BCBS multispecialty AW base fee schedule,174.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93284 mod 26,Not in chargemaster,93284,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93284 mod 26,BCBS multispecialty AW base fee schedule,111.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93284 mod TC,Not in chargemaster,93284,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93284 mod TC,BCBS multispecialty AW base fee schedule,62.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93285 mod 26,Not in chargemaster,93285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93285 mod 26,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93285 mod TC,Not in chargemaster,93285,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93285 mod TC,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93285,Not in chargemaster,93285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93285,BCBS multispecialty AW base fee schedule,94.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93286,Not in chargemaster,93286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93286,BCBS multispecialty AW base fee schedule,70.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93286 mod 26,Not in chargemaster,93286,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93286 mod 26,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93286 mod TC,Not in chargemaster,93286,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93286 mod TC,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93287 mod 26,Not in chargemaster,93287,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93287 mod 26,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93287 mod TC,Not in chargemaster,93287,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93287 mod TC,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93287,Not in chargemaster,93287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93287,BCBS multispecialty AW base fee schedule,84.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93288,Not in chargemaster,93288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93288,BCBS multispecialty AW base fee schedule,86.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93288 mod 26,Not in chargemaster,93288,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93288 mod 26,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93288 mod TC,Not in chargemaster,93288,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93288 mod TC,BCBS multispecialty AW base fee schedule,48.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93289 mod 26,Not in chargemaster,93289,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93289 mod 26,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93289 mod TC,Not in chargemaster,93289,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93289 mod TC,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93289,Not in chargemaster,93289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93289,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93290,Not in chargemaster,93290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93290,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93290 mod 26,Not in chargemaster,93290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93290 mod 26,BCBS multispecialty AW base fee schedule,38.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93290 mod TC,Not in chargemaster,93290,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93290 mod TC,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93291 mod 26,Not in chargemaster,93291,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93291 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93291 mod TC,Not in chargemaster,93291,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93291 mod TC,BCBS multispecialty AW base fee schedule,42.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93291,Not in chargemaster,93291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93291,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93292,Not in chargemaster,93292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93292,BCBS multispecialty AW base fee schedule,78.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93292 mod 26,Not in chargemaster,93292,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93292 mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93292 mod TC,Not in chargemaster,93292,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93292 mod TC,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93293 mod 26,Not in chargemaster,93293,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93293 mod 26,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93293 mod TC,Not in chargemaster,93293,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93293 mod TC,BCBS multispecialty AW base fee schedule,63.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93293,Not in chargemaster,93293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93293,BCBS multispecialty AW base fee schedule,90.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93294,Not in chargemaster,93294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93294,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93295,Not in chargemaster,93295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93295,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93296,Not in chargemaster,93296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93296,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93297,Not in chargemaster,93297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93297,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93298,Not in chargemaster,93298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93298,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93303 mod 26,Not in chargemaster,93303,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93303 mod 26,BCBS multispecialty AW base fee schedule,112.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93303 mod TC,Not in chargemaster,93303,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93303 mod TC,BCBS multispecialty AW base fee schedule,295.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93303,Not in chargemaster,93303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93303,BCBS multispecialty AW base fee schedule,407.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93304,Not in chargemaster,93304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93304,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93304 mod 26,Not in chargemaster,93304,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93304 mod 26,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93304 mod TC,Not in chargemaster,93304,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93304 mod TC,BCBS multispecialty AW base fee schedule,215.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93306 mod 26,Not in chargemaster,93306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93306 mod 26,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93306 mod TC,Not in chargemaster,93306,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93306 mod TC,BCBS multispecialty AW base fee schedule,234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93306,Not in chargemaster,93306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93306,BCBS multispecialty AW base fee schedule,363.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93307,Not in chargemaster,93307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93307,BCBS multispecialty AW base fee schedule,247.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93307 mod 26,Not in chargemaster,93307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93307 mod 26,BCBS multispecialty AW base fee schedule,79.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93307 mod TC,Not in chargemaster,93307,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93307 mod TC,BCBS multispecialty AW base fee schedule,168.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93308 mod 26,Not in chargemaster,93308,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93308 mod 26,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93308 mod TC,Not in chargemaster,93308,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93308 mod TC,BCBS multispecialty AW base fee schedule,127.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93308,Not in chargemaster,93308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93308,BCBS multispecialty AW base fee schedule,172.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93312,Not in chargemaster,93312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93312,BCBS multispecialty AW base fee schedule,431.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93312 mod 26,Not in chargemaster,93312,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93312 mod 26,BCBS multispecialty AW base fee schedule,193.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93312 mod TC,Not in chargemaster,93312,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93312 mod TC,BCBS multispecialty AW base fee schedule,238.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93313,Not in chargemaster,93313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93313,BCBS multispecialty AW base fee schedule,20.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93314,Not in chargemaster,93314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93314,BCBS multispecialty AW base fee schedule,414.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93314 mod 26,Not in chargemaster,93314,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93314 mod 26,BCBS multispecialty AW base fee schedule,160.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93314 mod TC,Not in chargemaster,93314,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93314 mod TC,BCBS multispecialty AW base fee schedule,253.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93315,Not in chargemaster,93315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93315,BCBS multispecialty AW base fee schedule,227.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93315 mod 26,Not in chargemaster,93315,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93315 mod 26,BCBS multispecialty AW base fee schedule,227.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93316,Not in chargemaster,93316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93316,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93317,Not in chargemaster,93317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93317,BCBS multispecialty AW base fee schedule,161.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93317 mod 26,Not in chargemaster,93317,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93317 mod 26,BCBS multispecialty AW base fee schedule,161.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93318,Not in chargemaster,93318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93318,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93318 mod 26,Not in chargemaster,93318,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93318 mod 26,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93320,Not in chargemaster,93320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93320,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93320 mod 26,Not in chargemaster,93320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93320 mod 26,BCBS multispecialty AW base fee schedule,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93320 mod TC,Not in chargemaster,93320,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93320 mod TC,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93321 mod 26,Not in chargemaster,93321,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93321 mod 26,BCBS multispecialty AW base fee schedule,13.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93321 mod TC,Not in chargemaster,93321,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93321 mod TC,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93321,Not in chargemaster,93321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93321,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93325,Not in chargemaster,93325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93325,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93325 mod 26,Not in chargemaster,93325,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93325 mod 26,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93325 mod TC,Not in chargemaster,93325,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93325 mod TC,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93350 mod 26,Not in chargemaster,93350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93350 mod 26,BCBS multispecialty AW base fee schedule,125.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93350 mod TC,Not in chargemaster,93350,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93350 mod TC,BCBS multispecialty AW base fee schedule,207.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93350,Not in chargemaster,93350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93350,BCBS multispecialty AW base fee schedule,332.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93351,Not in chargemaster,93351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93351,BCBS multispecialty AW base fee schedule,411.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93351 mod 26,Not in chargemaster,93351,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93351 mod 26,BCBS multispecialty AW base fee schedule,150.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93351 mod TC,Not in chargemaster,93351,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93351 mod TC,BCBS multispecialty AW base fee schedule,261.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93352,Not in chargemaster,93352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93352,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93355,Not in chargemaster,93355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93355,BCBS multispecialty AW base fee schedule,407.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93356,Not in chargemaster,93356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93356,BCBS multispecialty AW base fee schedule,70.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93451,Not in chargemaster,93451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93451,BCBS multispecialty AW base fee schedule,1484.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93451 mod 26,Not in chargemaster,93451,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93451 mod 26,BCBS multispecialty AW base fee schedule,235.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93451 mod TC,Not in chargemaster,93451,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93451 mod TC,BCBS multispecialty AW base fee schedule,1248.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93452 mod 26,Not in chargemaster,93452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93452 mod 26,BCBS multispecialty AW base fee schedule,424.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93452 mod TC,Not in chargemaster,93452,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93452 mod TC,BCBS multispecialty AW base fee schedule,1181.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93452,Not in chargemaster,93452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93452,BCBS multispecialty AW base fee schedule,1606.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93453,Not in chargemaster,93453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93453,BCBS multispecialty AW base fee schedule,2070.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93453 mod 26,Not in chargemaster,93453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93453 mod 26,BCBS multispecialty AW base fee schedule,568.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93453 mod TC,Not in chargemaster,93453,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93453 mod TC,BCBS multispecialty AW base fee schedule,1501.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93454 mod 26,Not in chargemaster,93454,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93454 mod 26,BCBS multispecialty AW base fee schedule,429.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93454 mod TC,Not in chargemaster,93454,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93454 mod TC,BCBS multispecialty AW base fee schedule,1180.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93454,Not in chargemaster,93454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93454,BCBS multispecialty AW base fee schedule,1610.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93455,Not in chargemaster,93455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93455,BCBS multispecialty AW base fee schedule,1829.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93455 mod 26,Not in chargemaster,93455,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93455 mod 26,BCBS multispecialty AW base fee schedule,500.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93455 mod TC,Not in chargemaster,93455,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93455 mod TC,BCBS multispecialty AW base fee schedule,1329.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93456 mod 26,Not in chargemaster,93456,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93456 mod 26,BCBS multispecialty AW base fee schedule,559.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93456 mod TC,Not in chargemaster,93456,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93456 mod TC,BCBS multispecialty AW base fee schedule,1478.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93456,Not in chargemaster,93456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93456,BCBS multispecialty AW base fee schedule,2037.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93457,Not in chargemaster,93457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93457,BCBS multispecialty AW base fee schedule,2256.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93457 mod 26,Not in chargemaster,93457,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93457 mod 26,BCBS multispecialty AW base fee schedule,631.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93457 mod TC,Not in chargemaster,93457,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93457 mod TC,BCBS multispecialty AW base fee schedule,1625.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93458 mod 26,Not in chargemaster,93458,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93458 mod 26,BCBS multispecialty AW base fee schedule,530.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93458 mod TC,Not in chargemaster,93458,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93458 mod TC,BCBS multispecialty AW base fee schedule,1354.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93458,Not in chargemaster,93458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93458,BCBS multispecialty AW base fee schedule,1885.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93459,Not in chargemaster,93459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93459,BCBS multispecialty AW base fee schedule,2052.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93459 mod 26,Not in chargemaster,93459,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93459 mod 26,BCBS multispecialty AW base fee schedule,601.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93459 mod TC,Not in chargemaster,93459,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93459 mod TC,BCBS multispecialty AW base fee schedule,1450.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93460 mod 26,Not in chargemaster,93460,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93460 mod 26,BCBS multispecialty AW base fee schedule,672.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93460 mod TC,Not in chargemaster,93460,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93460 mod TC,BCBS multispecialty AW base fee schedule,1598.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93460,Not in chargemaster,93460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93460,BCBS multispecialty AW base fee schedule,2271.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93461,Not in chargemaster,93461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93461,BCBS multispecialty AW base fee schedule,2542,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93461 mod 26,Not in chargemaster,93461,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93461 mod 26,BCBS multispecialty AW base fee schedule,744,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93461 mod TC,Not in chargemaster,93461,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93461 mod TC,BCBS multispecialty AW base fee schedule,1798,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93462,Not in chargemaster,93462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93462,BCBS multispecialty AW base fee schedule,378.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93463,Not in chargemaster,93463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93463,BCBS multispecialty AW base fee schedule,174.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93464 mod 26,Not in chargemaster,93464,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93464 mod 26,BCBS multispecialty AW base fee schedule,157.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93464 mod TC,Not in chargemaster,93464,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93464 mod TC,BCBS multispecialty AW base fee schedule,269.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93464,Not in chargemaster,93464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93464,BCBS multispecialty AW base fee schedule,427.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93503,Not in chargemaster,93503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93503,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93505 mod 26,Not in chargemaster,93505,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93505 mod 26,BCBS multispecialty AW base fee schedule,400.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93505 mod TC,Not in chargemaster,93505,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93505 mod TC,BCBS multispecialty AW base fee schedule,849.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93505,Not in chargemaster,93505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93505,BCBS multispecialty AW base fee schedule,1249.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93530,Not in chargemaster,93530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93530,BCBS multispecialty AW base fee schedule,365.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93530 mod 26,Not in chargemaster,93530,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93530 mod 26,BCBS multispecialty AW base fee schedule,365.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93531,Not in chargemaster,93531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93531,BCBS multispecialty AW base fee schedule,759.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93531 mod 26,Not in chargemaster,93531,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93531 mod 26,BCBS multispecialty AW base fee schedule,759.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93532,Not in chargemaster,93532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93532,BCBS multispecialty AW base fee schedule,947.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93532 mod 26,Not in chargemaster,93532,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93532 mod 26,BCBS multispecialty AW base fee schedule,947.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93533,Not in chargemaster,93533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93533,BCBS multispecialty AW base fee schedule,634.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93533 mod 26,Not in chargemaster,93533,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93533 mod 26,BCBS multispecialty AW base fee schedule,634.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93561,Not in chargemaster,93561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93561,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93561 mod 26,Not in chargemaster,93561,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93561 mod 26,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93562,Not in chargemaster,93562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93562,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93562 mod 26,Not in chargemaster,93562,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93562 mod 26,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93563,Not in chargemaster,93563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93563,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93564,Not in chargemaster,93564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93564,BCBS multispecialty AW base fee schedule,110.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93565,Not in chargemaster,93565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93565,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93566,Not in chargemaster,93566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93566,BCBS multispecialty AW base fee schedule,259.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93567,Not in chargemaster,93567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93567,BCBS multispecialty AW base fee schedule,220.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93568,Not in chargemaster,93568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93568,BCBS multispecialty AW base fee schedule,238.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93571,Not in chargemaster,93571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93571,BCBS multispecialty AW base fee schedule,131.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93571 mod 26,Not in chargemaster,93571,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93571 mod 26,BCBS multispecialty AW base fee schedule,131.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93572,Not in chargemaster,93572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93572,BCBS multispecialty AW base fee schedule,94.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93572 mod 26,Not in chargemaster,93572,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93572 mod 26,BCBS multispecialty AW base fee schedule,94.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93580,Not in chargemaster,93580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93580,BCBS multispecialty AW base fee schedule,1753.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93581,Not in chargemaster,93581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93581,BCBS multispecialty AW base fee schedule,2388.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93582,Not in chargemaster,93582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93582,BCBS multispecialty AW base fee schedule,1195.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93583,Not in chargemaster,93583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93583,BCBS multispecialty AW base fee schedule,1336.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93590,Not in chargemaster,93590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93590,BCBS multispecialty AW base fee schedule,1936.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93591,Not in chargemaster,93591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93591,BCBS multispecialty AW base fee schedule,1605.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93592,Not in chargemaster,93592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93592,BCBS multispecialty AW base fee schedule,705.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93600,Not in chargemaster,93600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93600,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93600 mod 26,Not in chargemaster,93600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93600 mod 26,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93602,Not in chargemaster,93602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93602,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93602 mod 26,Not in chargemaster,93602,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93602 mod 26,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93603,Not in chargemaster,93603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93603,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93603 mod 26,Not in chargemaster,93603,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93603 mod 26,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93609,Not in chargemaster,93609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93609,BCBS multispecialty AW base fee schedule,499.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93609 mod 26,Not in chargemaster,93609,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93609 mod 26,BCBS multispecialty AW base fee schedule,499.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93610,Not in chargemaster,93610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93610,BCBS multispecialty AW base fee schedule,293.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93610 mod 26,Not in chargemaster,93610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93610 mod 26,BCBS multispecialty AW base fee schedule,293.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93612,Not in chargemaster,93612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93612,BCBS multispecialty AW base fee schedule,290.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93612 mod 26,Not in chargemaster,93612,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93612 mod 26,BCBS multispecialty AW base fee schedule,290.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93613,Not in chargemaster,93613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93613,BCBS multispecialty AW base fee schedule,535.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93615,Not in chargemaster,93615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93615,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93615 mod 26,Not in chargemaster,93615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93615 mod 26,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93616,Not in chargemaster,93616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93616,BCBS multispecialty AW base fee schedule,106.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93616 mod 26,Not in chargemaster,93616,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93616 mod 26,BCBS multispecialty AW base fee schedule,106.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93618,Not in chargemaster,93618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93618,BCBS multispecialty AW base fee schedule,396.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93618 mod 26,Not in chargemaster,93618,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93618 mod 26,BCBS multispecialty AW base fee schedule,396.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93619,Not in chargemaster,93619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93619,BCBS multispecialty AW base fee schedule,702.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93619 mod 26,Not in chargemaster,93619,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93619 mod 26,BCBS multispecialty AW base fee schedule,702.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93620,Not in chargemaster,93620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93620,BCBS multispecialty AW base fee schedule,1125.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93620 mod 26,Not in chargemaster,93620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93620 mod 26,BCBS multispecialty AW base fee schedule,1125.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93621,Not in chargemaster,93621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93621,BCBS multispecialty AW base fee schedule,210.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93621 mod 26,Not in chargemaster,93621,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93621 mod 26,BCBS multispecialty AW base fee schedule,210.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93622,Not in chargemaster,93622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93622,BCBS multispecialty AW base fee schedule,308.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93622 mod 26,Not in chargemaster,93622,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93622 mod 26,BCBS multispecialty AW base fee schedule,308.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93623,Not in chargemaster,93623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93623,BCBS multispecialty AW base fee schedule,284.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93623 mod 26,Not in chargemaster,93623,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93623 mod 26,BCBS multispecialty AW base fee schedule,284.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93624,Not in chargemaster,93624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93624,BCBS multispecialty AW base fee schedule,431.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93624 mod 26,Not in chargemaster,93624,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93624 mod 26,BCBS multispecialty AW base fee schedule,431.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93631,Not in chargemaster,93631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93631,BCBS multispecialty AW base fee schedule,709.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93631 mod 26,Not in chargemaster,93631,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93631 mod 26,BCBS multispecialty AW base fee schedule,709.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93640,Not in chargemaster,93640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93640,BCBS multispecialty AW base fee schedule,320.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93640 mod 26,Not in chargemaster,93640,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93640 mod 26,BCBS multispecialty AW base fee schedule,320.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93641,Not in chargemaster,93641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93641,BCBS multispecialty AW base fee schedule,561.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93641 mod 26,Not in chargemaster,93641,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93641 mod 26,BCBS multispecialty AW base fee schedule,561.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93642,Not in chargemaster,93642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93642,BCBS multispecialty AW base fee schedule,602.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93642 mod 26,Not in chargemaster,93642,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93642 mod 26,BCBS multispecialty AW base fee schedule,458.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93642 mod TC,Not in chargemaster,93642,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93642 mod TC,BCBS multispecialty AW base fee schedule,143.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93644 mod 26,Not in chargemaster,93644,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93644 mod 26,BCBS multispecialty AW base fee schedule,258.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93644 mod TC,Not in chargemaster,93644,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93644 mod TC,BCBS multispecialty AW base fee schedule,90.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93644,Not in chargemaster,93644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93644,BCBS multispecialty AW base fee schedule,349.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93650,Not in chargemaster,93650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93650,BCBS multispecialty AW base fee schedule,1064.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93653,Not in chargemaster,93653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93653,BCBS multispecialty AW base fee schedule,1505.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93654,Not in chargemaster,93654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93654,BCBS multispecialty AW base fee schedule,2016.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93655,Not in chargemaster,93655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93655,BCBS multispecialty AW base fee schedule,768.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93656,Not in chargemaster,93656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93656,BCBS multispecialty AW base fee schedule,2022.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93657,Not in chargemaster,93657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93657,BCBS multispecialty AW base fee schedule,767.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93660,Not in chargemaster,93660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93660,BCBS multispecialty AW base fee schedule,279,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93660 mod 26,Not in chargemaster,93660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93660 mod 26,BCBS multispecialty AW base fee schedule,165.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93660 mod TC,Not in chargemaster,93660,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93660 mod TC,BCBS multispecialty AW base fee schedule,113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93662,Not in chargemaster,93662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93662,BCBS multispecialty AW base fee schedule,252.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93662 mod 26,Not in chargemaster,93662,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93662 mod 26,BCBS multispecialty AW base fee schedule,252.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93668,Not in chargemaster,93668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93668,BCBS multispecialty AW base fee schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93701,Not in chargemaster,93701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93701,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93702,Not in chargemaster,93702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93702,BCBS multispecialty AW base fee schedule,241.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93724 mod 26,Not in chargemaster,93724,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93724 mod 26,BCBS multispecialty AW base fee schedule,431.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93724 mod TC,Not in chargemaster,93724,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93724 mod TC,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93740,Not in chargemaster,93740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93740,BCBS multispecialty AW base fee schedule,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93724,Not in chargemaster,93724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93724,BCBS multispecialty AW base fee schedule,498.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93750,Not in chargemaster,93750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93750,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93770,Not in chargemaster,93770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93770,BCBS multispecialty AW base fee schedule,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93784,Not in chargemaster,93784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93784,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93786,Not in chargemaster,93786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93786,BCBS multispecialty AW base fee schedule,39.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93788,Not in chargemaster,93788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93788,BCBS multispecialty AW base fee schedule,8.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93790,Not in chargemaster,93790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93790,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93792,Not in chargemaster,93792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93792,BCBS multispecialty AW base fee schedule,114.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93793,Not in chargemaster,93793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93793,BCBS multispecialty AW base fee schedule,20.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93797,Not in chargemaster,93797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93797,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93798,Not in chargemaster,93798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93798,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93880,93880,93880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93880,BCBS multispecialty AW base fee schedule,349.68,63.07,Fee schedule,,63.07,63.07,63.07,63.07,,,0
unity,Fee schedule,Non-facility 93880 mod 26,93880,93880,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93880 mod 26,BCBS multispecialty AW base fee schedule,70.06,63.07,Fee schedule,,63.07,63.07,63.07,63.07,,,0
unity,Fee schedule,Non-facility 93880 mod TC,93880,93880,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93880 mod TC,BCBS multispecialty AW base fee schedule,279.62,63.07,Fee schedule,,63.07,63.07,63.07,63.07,,,0
unity,Fee schedule,Non-facility 93882 mod 26,Not in chargemaster,93882,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93882 mod 26,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93882 mod TC,Not in chargemaster,93882,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93882 mod TC,BCBS multispecialty AW base fee schedule,181.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93882,Not in chargemaster,93882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93882,BCBS multispecialty AW base fee schedule,225.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93886,Not in chargemaster,93886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93886,BCBS multispecialty AW base fee schedule,477.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93886 mod 26,Not in chargemaster,93886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93886 mod 26,BCBS multispecialty AW base fee schedule,83.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93886 mod TC,Not in chargemaster,93886,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93886 mod TC,BCBS multispecialty AW base fee schedule,393.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93888 mod 26,Not in chargemaster,93888,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93888 mod 26,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93888 mod TC,Not in chargemaster,93888,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93888 mod TC,BCBS multispecialty AW base fee schedule,238.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93888,Not in chargemaster,93888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93888,BCBS multispecialty AW base fee schedule,284.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93890,Not in chargemaster,93890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93890,BCBS multispecialty AW base fee schedule,484.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93890 mod 26,Not in chargemaster,93890,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93890 mod 26,BCBS multispecialty AW base fee schedule,91.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93890 mod TC,Not in chargemaster,93890,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93890 mod TC,BCBS multispecialty AW base fee schedule,393.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93892 mod 26,Not in chargemaster,93892,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93892 mod 26,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93892 mod TC,Not in chargemaster,93892,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93892 mod TC,BCBS multispecialty AW base fee schedule,440.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93892,Not in chargemaster,93892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93892,BCBS multispecialty AW base fee schedule,546.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93893,Not in chargemaster,93893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93893,BCBS multispecialty AW base fee schedule,626.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93893 mod 26,Not in chargemaster,93893,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93893 mod 26,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93893 mod TC,Not in chargemaster,93893,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93893 mod TC,BCBS multispecialty AW base fee schedule,520.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93922 mod 26,Not in chargemaster,93922,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93922 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93922 mod TC,Not in chargemaster,93922,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93922 mod TC,BCBS multispecialty AW base fee schedule,126.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93922,Not in chargemaster,93922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93922,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93923,Not in chargemaster,93923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93923,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93923 mod 26,Not in chargemaster,93923,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93923 mod 26,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93923 mod TC,Not in chargemaster,93923,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93923 mod TC,BCBS multispecialty AW base fee schedule,192.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93924 mod 26,Not in chargemaster,93924,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93924 mod 26,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93924 mod TC,Not in chargemaster,93924,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93924 mod TC,BCBS multispecialty AW base fee schedule,243.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93924,Not in chargemaster,93924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93924,BCBS multispecialty AW base fee schedule,286.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93925,Not in chargemaster,93925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93925,BCBS multispecialty AW base fee schedule,444.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93925 mod 26,Not in chargemaster,93925,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93925 mod 26,BCBS multispecialty AW base fee schedule,68.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93925 mod TC,Not in chargemaster,93925,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93925 mod TC,BCBS multispecialty AW base fee schedule,375.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93926 mod 26,Not in chargemaster,93926,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93926 mod 26,BCBS multispecialty AW base fee schedule,42.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93926 mod TC,Not in chargemaster,93926,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93926 mod TC,BCBS multispecialty AW base fee schedule,220.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93926,Not in chargemaster,93926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93926,BCBS multispecialty AW base fee schedule,262.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93930,Not in chargemaster,93930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93930,BCBS multispecialty AW base fee schedule,361.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93930 mod 26,Not in chargemaster,93930,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93930 mod 26,BCBS multispecialty AW base fee schedule,70.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93930 mod TC,Not in chargemaster,93930,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93930 mod TC,BCBS multispecialty AW base fee schedule,290.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93931 mod 26,Not in chargemaster,93931,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93931 mod 26,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93931 mod TC,Not in chargemaster,93931,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93931 mod TC,BCBS multispecialty AW base fee schedule,182.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93931,Not in chargemaster,93931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93931,BCBS multispecialty AW base fee schedule,225.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93970,93970,93970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93970,BCBS multispecialty AW base fee schedule,341.62,71.76,Fee schedule,,71.76,71.76,71.76,71.76,,,0
unity,Fee schedule,Non-facility 93970 mod 26,93970,93970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93970 mod 26,BCBS multispecialty AW base fee schedule,60.76,71.76,Fee schedule,,60.76,60.76,60.76,60.76,,,0
unity,Fee schedule,Non-facility 93970 mod TC,93970,93970,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93970 mod TC,BCBS multispecialty AW base fee schedule,280.86,71.76,Fee schedule,,71.76,71.76,71.76,71.76,,,0
unity,Fee schedule,Non-facility 93971 mod 26,93971,93971,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93971 mod 26,BCBS multispecialty AW base fee schedule,39.06,47.12,Fee schedule,,39.06,39.06,39.06,39.06,,,0
unity,Fee schedule,Non-facility 93971 mod TC,93971,93971,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93971 mod TC,BCBS multispecialty AW base fee schedule,174.22,47.12,Fee schedule,,47.12,47.12,47.12,47.12,,,0
unity,Fee schedule,Non-facility 93971,93971,93971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93971,BCBS multispecialty AW base fee schedule,213.28,47.12,Fee schedule,,47.12,47.12,47.12,47.12,,,0
unity,Fee schedule,Non-facility 93975,Not in chargemaster,93975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93975,BCBS multispecialty AW base fee schedule,485.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93975 mod 26,Not in chargemaster,93975,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93975 mod 26,BCBS multispecialty AW base fee schedule,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93975 mod TC,Not in chargemaster,93975,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93975 mod TC,BCBS multispecialty AW base fee schedule,384.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93976 mod 26,Not in chargemaster,93976,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93976 mod 26,BCBS multispecialty AW base fee schedule,70.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93976 mod TC,Not in chargemaster,93976,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93976 mod TC,BCBS multispecialty AW base fee schedule,217.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93976,Not in chargemaster,93976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93976,BCBS multispecialty AW base fee schedule,287.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93978,Not in chargemaster,93978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93978,BCBS multispecialty AW base fee schedule,329.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93978 mod 26,Not in chargemaster,93978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93978 mod 26,BCBS multispecialty AW base fee schedule,69.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93978 mod TC,Not in chargemaster,93978,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93978 mod TC,BCBS multispecialty AW base fee schedule,260.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93979 mod 26,Not in chargemaster,93979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93979 mod 26,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93979 mod TC,Not in chargemaster,93979,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93979 mod TC,BCBS multispecialty AW base fee schedule,168.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93979,Not in chargemaster,93979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93979,BCBS multispecialty AW base fee schedule,212.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93980,Not in chargemaster,93980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93980,BCBS multispecialty AW base fee schedule,214.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93980 mod 26,Not in chargemaster,93980,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93980 mod 26,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93980 mod TC,Not in chargemaster,93980,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93980 mod TC,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93981 mod 26,Not in chargemaster,93981,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93981 mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93981 mod TC,Not in chargemaster,93981,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93981 mod TC,BCBS multispecialty AW base fee schedule,91.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93981,Not in chargemaster,93981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93981,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93985,Not in chargemaster,93985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93985,BCBS multispecialty AW base fee schedule,466.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93985 mod 26,Not in chargemaster,93985,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93985 mod 26,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93985 mod TC,Not in chargemaster,93985,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93985 mod TC,BCBS multispecialty AW base fee schedule,398.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93986 mod 26,Not in chargemaster,93986,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93986 mod 26,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93986 mod TC,Not in chargemaster,93986,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93986 mod TC,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93986,Not in chargemaster,93986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93986,BCBS multispecialty AW base fee schedule,270.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93990,Not in chargemaster,93990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93990,BCBS multispecialty AW base fee schedule,272.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93990 mod 26,Not in chargemaster,93990,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93990 mod 26,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93990 mod TC,Not in chargemaster,93990,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93990 mod TC,BCBS multispecialty AW base fee schedule,228.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94002,Not in chargemaster,94002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94002,BCBS multispecialty AW base fee schedule,163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94003,Not in chargemaster,94003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94003,BCBS multispecialty AW base fee schedule,117.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94004,Not in chargemaster,94004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94004,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94005,Not in chargemaster,94005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94005,BCBS multispecialty AW base fee schedule,163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94010 mod 26,Not in chargemaster,94010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94010 mod 26,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94010 mod TC,Not in chargemaster,94010,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94010 mod TC,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94010,Not in chargemaster,94010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94010,BCBS multispecialty AW base fee schedule,62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94011,Not in chargemaster,94011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94011,BCBS multispecialty AW base fee schedule,152.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94012,Not in chargemaster,94012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94012,BCBS multispecialty AW base fee schedule,248.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94013,Not in chargemaster,94013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94013,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94014,Not in chargemaster,94014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94014,BCBS multispecialty AW base fee schedule,97.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94015,Not in chargemaster,94015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94015,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94016,Not in chargemaster,94016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94016,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94060,Not in chargemaster,94060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94060,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94060 mod 26,Not in chargemaster,94060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94060 mod 26,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94060 mod TC,Not in chargemaster,94060,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94060 mod TC,BCBS multispecialty AW base fee schedule,80.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94070 mod 26,Not in chargemaster,94070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94070 mod 26,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94070 mod TC,Not in chargemaster,94070,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94070 mod TC,BCBS multispecialty AW base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94070,Not in chargemaster,94070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94070,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94150,Not in chargemaster,94150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94150,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94150 mod 26,Not in chargemaster,94150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94150 mod 26,BCBS multispecialty AW base fee schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94150 mod TC,Not in chargemaster,94150,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94150 mod TC,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94200 mod 26,Not in chargemaster,94200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94200 mod 26,BCBS multispecialty AW base fee schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94200 mod TC,Not in chargemaster,94200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94200 mod TC,BCBS multispecialty AW base fee schedule,31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94200,Not in chargemaster,94200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94200,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94250,Not in chargemaster,94250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94250,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94250 mod 26,Not in chargemaster,94250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94250 mod 26,BCBS multispecialty AW base fee schedule,9.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94250 mod TC,Not in chargemaster,94250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94250 mod TC,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94375 mod 26,Not in chargemaster,94375,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94375 mod 26,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94375 mod TC,Not in chargemaster,94375,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94375 mod TC,BCBS multispecialty AW base fee schedule,42.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94375,Not in chargemaster,94375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94375,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94400,Not in chargemaster,94400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94400,BCBS multispecialty AW base fee schedule,98.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94400 mod 26,Not in chargemaster,94400,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94400 mod 26,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94400 mod TC,Not in chargemaster,94400,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94400 mod TC,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94450 mod 26,Not in chargemaster,94450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94450 mod 26,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94450 mod TC,Not in chargemaster,94450,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94450 mod TC,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94450,Not in chargemaster,94450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94450,BCBS multispecialty AW base fee schedule,116.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94452,Not in chargemaster,94452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94452,BCBS multispecialty AW base fee schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94452 mod 26,Not in chargemaster,94452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94452 mod 26,BCBS multispecialty AW base fee schedule,25.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94452 mod TC,Not in chargemaster,94452,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94452 mod TC,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94453 mod 26,Not in chargemaster,94453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94453 mod 26,BCBS multispecialty AW base fee schedule,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94453 mod TC,Not in chargemaster,94453,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94453 mod TC,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94453,Not in chargemaster,94453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94453,BCBS multispecialty AW base fee schedule,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94610,Not in chargemaster,94610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94610,BCBS multispecialty AW base fee schedule,98.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94617 mod 26,Not in chargemaster,94617,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94617 mod 26,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94617 mod TC,Not in chargemaster,94617,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94617 mod TC,BCBS multispecialty AW base fee schedule,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94617,Not in chargemaster,94617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94617,BCBS multispecialty AW base fee schedule,159.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94618,Not in chargemaster,94618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94618,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94618 mod 26,Not in chargemaster,94618,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94618 mod 26,BCBS multispecialty AW base fee schedule,40.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94618 mod TC,Not in chargemaster,94618,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94618 mod TC,BCBS multispecialty AW base fee schedule,18.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94621 mod 26,Not in chargemaster,94621,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94621 mod 26,BCBS multispecialty AW base fee schedule,123.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94621 mod TC,Not in chargemaster,94621,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94621 mod TC,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94621,Not in chargemaster,94621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94621,BCBS multispecialty AW base fee schedule,279,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94640,94640,94640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94640,BCBS multispecialty AW base fee schedule,31,44,Fee schedule,,31,31,31,31,,,0
unity,Fee schedule,Non-facility 94644,Not in chargemaster,94644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94644,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94645,Not in chargemaster,94645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94645,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94660,Not in chargemaster,94660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94660,BCBS multispecialty AW base fee schedule,112.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94662,Not in chargemaster,94662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94662,BCBS multispecialty AW base fee schedule,63.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94664,Not in chargemaster,94664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94664,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94667,Not in chargemaster,94667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94667,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94668,Not in chargemaster,94668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94668,BCBS multispecialty AW base fee schedule,50.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94669,Not in chargemaster,94669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94669,BCBS multispecialty AW base fee schedule,51.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94680 mod 26,Not in chargemaster,94680,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94680 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94680 mod TC,Not in chargemaster,94680,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94680 mod TC,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94680,Not in chargemaster,94680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94680,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94681,Not in chargemaster,94681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94681,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94681 mod 26,Not in chargemaster,94681,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94681 mod 26,BCBS multispecialty AW base fee schedule,17.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94681 mod TC,Not in chargemaster,94681,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94681 mod TC,BCBS multispecialty AW base fee schedule,74.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94690 mod 26,Not in chargemaster,94690,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94690 mod 26,BCBS multispecialty AW base fee schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94690 mod TC,Not in chargemaster,94690,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94690 mod TC,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94690,Not in chargemaster,94690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94690,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94726,Not in chargemaster,94726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94726,BCBS multispecialty AW base fee schedule,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94726 mod 26,Not in chargemaster,94726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94726 mod 26,BCBS multispecialty AW base fee schedule,21.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94726 mod TC,Not in chargemaster,94726,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94726 mod TC,BCBS multispecialty AW base fee schedule,71.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94727 mod 26,Not in chargemaster,94727,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94727 mod 26,BCBS multispecialty AW base fee schedule,21.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94727 mod TC,Not in chargemaster,94727,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94727 mod TC,BCBS multispecialty AW base fee schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94727,Not in chargemaster,94727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94727,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94728,Not in chargemaster,94728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94728,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94728 mod 26,Not in chargemaster,94728,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94728 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94728 mod TC,Not in chargemaster,94728,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94728 mod TC,BCBS multispecialty AW base fee schedule,48.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94729 mod 26,Not in chargemaster,94729,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94729 mod 26,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94729 mod TC,Not in chargemaster,94729,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94729 mod TC,BCBS multispecialty AW base fee schedule,82.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94729,Not in chargemaster,94729,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94729,BCBS multispecialty AW base fee schedule,98.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94750,Not in chargemaster,94750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94750,BCBS multispecialty AW base fee schedule,153.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94750 mod 26,Not in chargemaster,94750,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94750 mod 26,BCBS multispecialty AW base fee schedule,19.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94750 mod TC,Not in chargemaster,94750,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94750 mod TC,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94760,Not in chargemaster,94760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94760,BCBS multispecialty AW base fee schedule,4.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94761,Not in chargemaster,94761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94761,BCBS multispecialty AW base fee schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94770,Not in chargemaster,94770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94770,BCBS multispecialty AW base fee schedule,13.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94762,Not in chargemaster,94762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94762,BCBS multispecialty AW base fee schedule,45.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94780,Not in chargemaster,94780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94780,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94781,Not in chargemaster,94781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94781,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95004,Not in chargemaster,95004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95004,BCBS multispecialty AW base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95012,Not in chargemaster,95012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95012,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95017,Not in chargemaster,95017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95017,BCBS multispecialty AW base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95018,Not in chargemaster,95018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95018,BCBS multispecialty AW base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95024,Not in chargemaster,95024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95024,BCBS multispecialty AW base fee schedule,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95027,Not in chargemaster,95027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95027,BCBS multispecialty AW base fee schedule,8.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95028,Not in chargemaster,95028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95028,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95044,Not in chargemaster,95044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95044,BCBS multispecialty AW base fee schedule,9.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95052,Not in chargemaster,95052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95052,BCBS multispecialty AW base fee schedule,11.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95056,Not in chargemaster,95056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95056,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95060,Not in chargemaster,95060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95060,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95065,Not in chargemaster,95065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95065,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95070,Not in chargemaster,95070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95070,BCBS multispecialty AW base fee schedule,57.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95071,Not in chargemaster,95071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95071,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95076,Not in chargemaster,95076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95076,BCBS multispecialty AW base fee schedule,208.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95079,Not in chargemaster,95079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95079,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95115,95115,95115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95115,BCBS multispecialty AW base fee schedule,16.12,19.88,Fee schedule,,16.12,16.12,16.12,16.12,,,0
unity,Fee schedule,Non-facility 95117,95117,95117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95117,BCBS multispecialty AW base fee schedule,18.6,22.73,Fee schedule,,18.6,18.6,18.6,18.6,,,0
unity,Fee schedule,Non-facility 95144,Not in chargemaster,95144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95144,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95145,Not in chargemaster,95145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95145,BCBS multispecialty AW base fee schedule,53.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95146,Not in chargemaster,95146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95146,BCBS multispecialty AW base fee schedule,99.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95147,Not in chargemaster,95147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95147,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95148,Not in chargemaster,95148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95148,BCBS multispecialty AW base fee schedule,145.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95149,Not in chargemaster,95149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95149,BCBS multispecialty AW base fee schedule,193.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95165,Not in chargemaster,95165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95165,BCBS multispecialty AW base fee schedule,25.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95170,Not in chargemaster,95170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95170,BCBS multispecialty AW base fee schedule,19.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95180,Not in chargemaster,95180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95180,BCBS multispecialty AW base fee schedule,239.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95249,Not in chargemaster,95249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95249,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95251,Not in chargemaster,95251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95251,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95250,Not in chargemaster,95250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95250,BCBS multispecialty AW base fee schedule,262.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95717,Not in chargemaster,95717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95717,BCBS multispecialty AW base fee schedule,182.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95718,Not in chargemaster,95718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95718,BCBS multispecialty AW base fee schedule,239.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95719,Not in chargemaster,95719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95719,BCBS multispecialty AW base fee schedule,282.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95720,Not in chargemaster,95720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95720,BCBS multispecialty AW base fee schedule,371.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95721,Not in chargemaster,95721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95721,BCBS multispecialty AW base fee schedule,374.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95722,Not in chargemaster,95722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95722,BCBS multispecialty AW base fee schedule,454.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95723,Not in chargemaster,95723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95723,BCBS multispecialty AW base fee schedule,464.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95724,Not in chargemaster,95724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95724,BCBS multispecialty AW base fee schedule,580.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95725,Not in chargemaster,95725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95725,BCBS multispecialty AW base fee schedule,530.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95726,Not in chargemaster,95726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95726,BCBS multispecialty AW base fee schedule,733.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95782,Not in chargemaster,95782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95782,BCBS multispecialty AW base fee schedule,1580.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95782 mod 26,Not in chargemaster,95782,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95782 mod 26,BCBS multispecialty AW base fee schedule,222.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95782 mod TC,Not in chargemaster,95782,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95782 mod TC,BCBS multispecialty AW base fee schedule,1357.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95783 mod 26,Not in chargemaster,95783,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95783 mod 26,BCBS multispecialty AW base fee schedule,241.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95783 mod TC,Not in chargemaster,95783,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95783 mod TC,BCBS multispecialty AW base fee schedule,1438.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95783,Not in chargemaster,95783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95783,BCBS multispecialty AW base fee schedule,1680.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95800,Not in chargemaster,95800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95800,BCBS multispecialty AW base fee schedule,290.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95800 mod 26,Not in chargemaster,95800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95800 mod 26,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95800 mod TC,Not in chargemaster,95800,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95800 mod TC,BCBS multispecialty AW base fee schedule,217,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95801 mod 26,Not in chargemaster,95801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95801 mod 26,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95801 mod TC,Not in chargemaster,95801,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95801 mod TC,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95801,Not in chargemaster,95801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95801,BCBS multispecialty AW base fee schedule,156.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95803,Not in chargemaster,95803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95803,BCBS multispecialty AW base fee schedule,261.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95803 mod 26,Not in chargemaster,95803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95803 mod 26,BCBS multispecialty AW base fee schedule,78.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95803 mod TC,Not in chargemaster,95803,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95803 mod TC,BCBS multispecialty AW base fee schedule,182.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95805 mod 26,Not in chargemaster,95805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95805 mod 26,BCBS multispecialty AW base fee schedule,104.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95805 mod TC,Not in chargemaster,95805,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95805 mod TC,BCBS multispecialty AW base fee schedule,621.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95805,Not in chargemaster,95805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95805,BCBS multispecialty AW base fee schedule,726.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95806,Not in chargemaster,95806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95806,BCBS multispecialty AW base fee schedule,204.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95806 mod 26,Not in chargemaster,95806,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95806 mod 26,BCBS multispecialty AW base fee schedule,79.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95806 mod TC,Not in chargemaster,95806,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95806 mod TC,BCBS multispecialty AW base fee schedule,125.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95807 mod 26,Not in chargemaster,95807,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95807 mod 26,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95807 mod TC,Not in chargemaster,95807,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95807 mod TC,BCBS multispecialty AW base fee schedule,603.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95807,Not in chargemaster,95807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95807,BCBS multispecialty AW base fee schedule,712.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95808,Not in chargemaster,95808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95808,BCBS multispecialty AW base fee schedule,1142.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95808 mod 26,Not in chargemaster,95808,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95808 mod 26,BCBS multispecialty AW base fee schedule,154.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95808 mod TC,Not in chargemaster,95808,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95808 mod TC,BCBS multispecialty AW base fee schedule,987.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95810 mod 26,Not in chargemaster,95810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95810 mod 26,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95810 mod TC,Not in chargemaster,95810,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95810 mod TC,BCBS multispecialty AW base fee schedule,853.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95810,Not in chargemaster,95810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95810,BCBS multispecialty AW base fee schedule,1067.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95811,Not in chargemaster,95811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95811,BCBS multispecialty AW base fee schedule,1114.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95811 mod 26,Not in chargemaster,95811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95811 mod 26,BCBS multispecialty AW base fee schedule,221.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95811 mod TC,Not in chargemaster,95811,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95811 mod TC,BCBS multispecialty AW base fee schedule,892.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95812 mod 26,Not in chargemaster,95812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95812 mod 26,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95812 mod TC,Not in chargemaster,95812,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95812 mod TC,BCBS multispecialty AW base fee schedule,474.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95812,Not in chargemaster,95812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95812,BCBS multispecialty AW base fee schedule,575.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95813,Not in chargemaster,95813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95813,BCBS multispecialty AW base fee schedule,716.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95813 mod 26,Not in chargemaster,95813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95813 mod 26,BCBS multispecialty AW base fee schedule,154.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95813 mod TC,Not in chargemaster,95813,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95813 mod TC,BCBS multispecialty AW base fee schedule,561.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95816 mod 26,Not in chargemaster,95816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95816 mod 26,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95816 mod TC,Not in chargemaster,95816,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95816 mod TC,BCBS multispecialty AW base fee schedule,536.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95816,Not in chargemaster,95816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95816,BCBS multispecialty AW base fee schedule,638.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95819,Not in chargemaster,95819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95819,BCBS multispecialty AW base fee schedule,758.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95819 mod 26,Not in chargemaster,95819,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95819 mod 26,BCBS multispecialty AW base fee schedule,102.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95819 mod TC,Not in chargemaster,95819,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95819 mod TC,BCBS multispecialty AW base fee schedule,655.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95822 mod 26,Not in chargemaster,95822,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95822 mod 26,BCBS multispecialty AW base fee schedule,102.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95822 mod TC,Not in chargemaster,95822,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95822 mod TC,BCBS multispecialty AW base fee schedule,585.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95822,Not in chargemaster,95822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95822,BCBS multispecialty AW base fee schedule,687.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95824,Not in chargemaster,95824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95824,BCBS multispecialty AW base fee schedule,69.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95824 mod 26,Not in chargemaster,95824,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95824 mod 26,BCBS multispecialty AW base fee schedule,69.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95829 mod 26,Not in chargemaster,95829,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95829 mod 26,BCBS multispecialty AW base fee schedule,597.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95829 mod TC,Not in chargemaster,95829,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95829 mod TC,BCBS multispecialty AW base fee schedule,2683.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95829,Not in chargemaster,95829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95829,BCBS multispecialty AW base fee schedule,3281.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95830,Not in chargemaster,95830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95830,BCBS multispecialty AW base fee schedule,882.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95836,Not in chargemaster,95836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95836,BCBS multispecialty AW base fee schedule,197.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95851,Not in chargemaster,95851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95851,BCBS multispecialty AW base fee schedule,28.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95852,Not in chargemaster,95852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95852,BCBS multispecialty AW base fee schedule,24.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95857,Not in chargemaster,95857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95857,BCBS multispecialty AW base fee schedule,71.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95860 mod 26,Not in chargemaster,95860,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95860 mod 26,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95860 mod TC,Not in chargemaster,95860,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95860 mod TC,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95860,Not in chargemaster,95860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95860,BCBS multispecialty AW base fee schedule,210.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95861,Not in chargemaster,95861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95861,BCBS multispecialty AW base fee schedule,301.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95861 mod 26,Not in chargemaster,95861,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95861 mod 26,BCBS multispecialty AW base fee schedule,146.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95861 mod TC,Not in chargemaster,95861,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95861 mod TC,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95863 mod 26,Not in chargemaster,95863,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95863 mod 26,BCBS multispecialty AW base fee schedule,176.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95863 mod TC,Not in chargemaster,95863,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95863 mod TC,BCBS multispecialty AW base fee schedule,196.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95863,Not in chargemaster,95863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95863,BCBS multispecialty AW base fee schedule,373.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95864,Not in chargemaster,95864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95864,BCBS multispecialty AW base fee schedule,438.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95864 mod 26,Not in chargemaster,95864,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95864 mod 26,BCBS multispecialty AW base fee schedule,188.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95864 mod TC,Not in chargemaster,95864,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95864 mod TC,BCBS multispecialty AW base fee schedule,249.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95865 mod 26,Not in chargemaster,95865,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95865 mod 26,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95865 mod TC,Not in chargemaster,95865,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95865 mod TC,BCBS multispecialty AW base fee schedule,120.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95865,Not in chargemaster,95865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95865,BCBS multispecialty AW base fee schedule,269.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95866,Not in chargemaster,95866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95866,BCBS multispecialty AW base fee schedule,237.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95866 mod 26,Not in chargemaster,95866,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95866 mod 26,BCBS multispecialty AW base fee schedule,118.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95866 mod TC,Not in chargemaster,95866,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95866 mod TC,BCBS multispecialty AW base fee schedule,119.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95867 mod 26,Not in chargemaster,95867,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95867 mod 26,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95867 mod TC,Not in chargemaster,95867,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95867 mod TC,BCBS multispecialty AW base fee schedule,113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95867,Not in chargemaster,95867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95867,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95868,Not in chargemaster,95868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95868,BCBS multispecialty AW base fee schedule,248,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95868 mod 26,Not in chargemaster,95868,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95868 mod 26,BCBS multispecialty AW base fee schedule,111.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95868 mod TC,Not in chargemaster,95868,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95868 mod TC,BCBS multispecialty AW base fee schedule,136.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95869 mod 26,Not in chargemaster,95869,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95869 mod 26,BCBS multispecialty AW base fee schedule,35.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95869 mod TC,Not in chargemaster,95869,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95869 mod TC,BCBS multispecialty AW base fee schedule,132.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95869,Not in chargemaster,95869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95869,BCBS multispecialty AW base fee schedule,168.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95870,Not in chargemaster,95870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95870,BCBS multispecialty AW base fee schedule,158.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95870 mod 26,Not in chargemaster,95870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95870 mod 26,BCBS multispecialty AW base fee schedule,35.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95870 mod TC,Not in chargemaster,95870,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95870 mod TC,BCBS multispecialty AW base fee schedule,123.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95872 mod 26,Not in chargemaster,95872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95872 mod 26,BCBS multispecialty AW base fee schedule,269.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95872 mod TC,Not in chargemaster,95872,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95872 mod TC,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95872,Not in chargemaster,95872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95872,BCBS multispecialty AW base fee schedule,350.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95873,Not in chargemaster,95873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95873,BCBS multispecialty AW base fee schedule,134.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95873 mod 26,Not in chargemaster,95873,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95873 mod 26,BCBS multispecialty AW base fee schedule,35.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95873 mod TC,Not in chargemaster,95873,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95873 mod TC,BCBS multispecialty AW base fee schedule,99.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95874 mod 26,Not in chargemaster,95874,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95874 mod 26,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95874 mod TC,Not in chargemaster,95874,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95874 mod TC,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95874,Not in chargemaster,95874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95874,BCBS multispecialty AW base fee schedule,138.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95875,Not in chargemaster,95875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95875,BCBS multispecialty AW base fee schedule,234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95875 mod 26,Not in chargemaster,95875,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95875 mod 26,BCBS multispecialty AW base fee schedule,104.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95875 mod TC,Not in chargemaster,95875,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95875 mod TC,BCBS multispecialty AW base fee schedule,130.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95885 mod 26,Not in chargemaster,95885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95885 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95885 mod TC,Not in chargemaster,95885,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95885 mod TC,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95885,Not in chargemaster,95885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95885,BCBS multispecialty AW base fee schedule,109.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95886,Not in chargemaster,95886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95886,BCBS multispecialty AW base fee schedule,170.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95886 mod 26,Not in chargemaster,95886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95886 mod 26,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95886 mod TC,Not in chargemaster,95886,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95886 mod TC,BCBS multispecialty AW base fee schedule,89.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95887 mod 26,Not in chargemaster,95887,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95887 mod 26,BCBS multispecialty AW base fee schedule,66.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95887 mod TC,Not in chargemaster,95887,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95887 mod TC,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95887,Not in chargemaster,95887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95887,BCBS multispecialty AW base fee schedule,148.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95905,Not in chargemaster,95905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95905,BCBS multispecialty AW base fee schedule,94.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95905 mod 26,Not in chargemaster,95905,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95905 mod 26,BCBS multispecialty AW base fee schedule,4.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95905 mod TC,Not in chargemaster,95905,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95905 mod TC,BCBS multispecialty AW base fee schedule,89.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95907 mod 26,Not in chargemaster,95907,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95907 mod 26,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95907 mod TC,Not in chargemaster,95907,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95907 mod TC,BCBS multispecialty AW base fee schedule,72.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95907,Not in chargemaster,95907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95907,BCBS multispecialty AW base fee schedule,168.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95908,Not in chargemaster,95908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95908,BCBS multispecialty AW base fee schedule,213.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95908 mod 26,Not in chargemaster,95908,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95908 mod 26,BCBS multispecialty AW base fee schedule,119.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95908 mod TC,Not in chargemaster,95908,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95908 mod TC,BCBS multispecialty AW base fee schedule,94.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95909 mod 26,Not in chargemaster,95909,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95909 mod 26,BCBS multispecialty AW base fee schedule,142.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95909 mod TC,Not in chargemaster,95909,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95909 mod TC,BCBS multispecialty AW base fee schedule,112.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95909,Not in chargemaster,95909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95909,BCBS multispecialty AW base fee schedule,255.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95910,Not in chargemaster,95910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95910,BCBS multispecialty AW base fee schedule,336.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95910 mod 26,Not in chargemaster,95910,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95910 mod 26,BCBS multispecialty AW base fee schedule,190.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95910 mod TC,Not in chargemaster,95910,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95910 mod TC,BCBS multispecialty AW base fee schedule,145.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95911 mod 26,Not in chargemaster,95911,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95911 mod 26,BCBS multispecialty AW base fee schedule,236.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95911 mod TC,Not in chargemaster,95911,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95911 mod TC,BCBS multispecialty AW base fee schedule,166.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95911,Not in chargemaster,95911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95911,BCBS multispecialty AW base fee schedule,402.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95912,Not in chargemaster,95912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95912,BCBS multispecialty AW base fee schedule,460.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95912 mod 26,Not in chargemaster,95912,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95912 mod 26,BCBS multispecialty AW base fee schedule,281.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95912 mod TC,Not in chargemaster,95912,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95912 mod TC,BCBS multispecialty AW base fee schedule,179.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95913 mod 26,Not in chargemaster,95913,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95913 mod 26,BCBS multispecialty AW base fee schedule,334.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95913 mod TC,Not in chargemaster,95913,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95913 mod TC,BCBS multispecialty AW base fee schedule,199.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95913,Not in chargemaster,95913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95913,BCBS multispecialty AW base fee schedule,533.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95921,Not in chargemaster,95921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95921,BCBS multispecialty AW base fee schedule,150.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95921 mod 26,Not in chargemaster,95921,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95921 mod 26,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95921 mod TC,Not in chargemaster,95921,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95921 mod TC,BCBS multispecialty AW base fee schedule,70.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95922 mod 26,Not in chargemaster,95922,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95922 mod 26,BCBS multispecialty AW base fee schedule,85.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95922 mod TC,Not in chargemaster,95922,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95922 mod TC,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95922,Not in chargemaster,95922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95922,BCBS multispecialty AW base fee schedule,172.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95923,Not in chargemaster,95923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95923,BCBS multispecialty AW base fee schedule,225.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95923 mod 26,Not in chargemaster,95923,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95923 mod 26,BCBS multispecialty AW base fee schedule,81.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95923 mod TC,Not in chargemaster,95923,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95923 mod TC,BCBS multispecialty AW base fee schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95924 mod 26,Not in chargemaster,95924,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95924 mod 26,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95924 mod TC,Not in chargemaster,95924,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95924 mod TC,BCBS multispecialty AW base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95924,Not in chargemaster,95924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95924,BCBS multispecialty AW base fee schedule,264.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95925,Not in chargemaster,95925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95925,BCBS multispecialty AW base fee schedule,244.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95925 mod 26,Not in chargemaster,95925,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95925 mod 26,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95925 mod TC,Not in chargemaster,95925,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95925 mod TC,BCBS multispecialty AW base fee schedule,195.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95926 mod 26,Not in chargemaster,95926,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95926 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95926 mod TC,Not in chargemaster,95926,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95926 mod TC,BCBS multispecialty AW base fee schedule,184.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95926,Not in chargemaster,95926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95926,BCBS multispecialty AW base fee schedule,233.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95927,Not in chargemaster,95927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95927,BCBS multispecialty AW base fee schedule,232.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95927 mod 26,Not in chargemaster,95927,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95927 mod 26,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95927 mod TC,Not in chargemaster,95927,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95927 mod TC,BCBS multispecialty AW base fee schedule,184.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95928 mod 26,Not in chargemaster,95928,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95928 mod 26,BCBS multispecialty AW base fee schedule,141.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95928 mod TC,Not in chargemaster,95928,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95928 mod TC,BCBS multispecialty AW base fee schedule,254.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95928,Not in chargemaster,95928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95928,BCBS multispecialty AW base fee schedule,395.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95929,Not in chargemaster,95929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95929,BCBS multispecialty AW base fee schedule,407.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95929 mod 26,Not in chargemaster,95929,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95929 mod 26,BCBS multispecialty AW base fee schedule,141.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95929 mod TC,Not in chargemaster,95929,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95929 mod TC,BCBS multispecialty AW base fee schedule,265.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95930 mod 26,Not in chargemaster,95930,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95930 mod 26,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95930 mod TC,Not in chargemaster,95930,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95930 mod TC,BCBS multispecialty AW base fee schedule,83.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95930,Not in chargemaster,95930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95930,BCBS multispecialty AW base fee schedule,116.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95933,Not in chargemaster,95933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95933,BCBS multispecialty AW base fee schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95933 mod 26,Not in chargemaster,95933,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95933 mod 26,BCBS multispecialty AW base fee schedule,55.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95933 mod TC,Not in chargemaster,95933,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95933 mod TC,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95937 mod 26,Not in chargemaster,95937,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95937 mod 26,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95937 mod TC,Not in chargemaster,95937,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95937 mod TC,BCBS multispecialty AW base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95937,Not in chargemaster,95937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95937,BCBS multispecialty AW base fee schedule,164.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95938,Not in chargemaster,95938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95938,BCBS multispecialty AW base fee schedule,612.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95938 mod 26,Not in chargemaster,95938,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95938 mod 26,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95938 mod TC,Not in chargemaster,95938,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95938 mod TC,BCBS multispecialty AW base fee schedule,530.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95939 mod 26,Not in chargemaster,95939,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95939 mod 26,BCBS multispecialty AW base fee schedule,211.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95939 mod TC,Not in chargemaster,95939,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95939 mod TC,BCBS multispecialty AW base fee schedule,708.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95940,Not in chargemaster,95940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95940,BCBS multispecialty AW base fee schedule,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95939,Not in chargemaster,95939,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95939,BCBS multispecialty AW base fee schedule,920.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95954,Not in chargemaster,95954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95954,BCBS multispecialty AW base fee schedule,683.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95954 mod 26,Not in chargemaster,95954,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95954 mod 26,BCBS multispecialty AW base fee schedule,200.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95954 mod TC,Not in chargemaster,95954,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95954 mod TC,BCBS multispecialty AW base fee schedule,482.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95955 mod 26,Not in chargemaster,95955,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95955 mod 26,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95955 mod TC,Not in chargemaster,95955,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95955 mod TC,BCBS multispecialty AW base fee schedule,272.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95955,Not in chargemaster,95955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95955,BCBS multispecialty AW base fee schedule,368.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95957,Not in chargemaster,95957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95957,BCBS multispecialty AW base fee schedule,448.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95957 mod 26,Not in chargemaster,95957,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95957 mod 26,BCBS multispecialty AW base fee schedule,182.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95957 mod TC,Not in chargemaster,95957,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95957 mod TC,BCBS multispecialty AW base fee schedule,266.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95958 mod 26,Not in chargemaster,95958,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95958 mod 26,BCBS multispecialty AW base fee schedule,402.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95958 mod TC,Not in chargemaster,95958,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95958 mod TC,BCBS multispecialty AW base fee schedule,620,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95958,Not in chargemaster,95958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95958,BCBS multispecialty AW base fee schedule,1022.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95961,Not in chargemaster,95961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95961,BCBS multispecialty AW base fee schedule,544.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95961 mod 26,Not in chargemaster,95961,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95961 mod 26,BCBS multispecialty AW base fee schedule,286.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95961 mod TC,Not in chargemaster,95961,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95961 mod TC,BCBS multispecialty AW base fee schedule,258.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95962 mod 26,Not in chargemaster,95962,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95962 mod 26,BCBS multispecialty AW base fee schedule,305.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95962 mod TC,Not in chargemaster,95962,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95962 mod TC,BCBS multispecialty AW base fee schedule,155.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95962,Not in chargemaster,95962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95962,BCBS multispecialty AW base fee schedule,461.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95965,Not in chargemaster,95965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95965,BCBS multispecialty AW base fee schedule,744.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95965 mod 26,Not in chargemaster,95965,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95965 mod 26,BCBS multispecialty AW base fee schedule,744.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95966,Not in chargemaster,95966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95966,BCBS multispecialty AW base fee schedule,377.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95966 mod 26,Not in chargemaster,95966,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95966 mod 26,BCBS multispecialty AW base fee schedule,377.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95967,Not in chargemaster,95967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95967,BCBS multispecialty AW base fee schedule,329.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95967 mod 26,Not in chargemaster,95967,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95967 mod 26,BCBS multispecialty AW base fee schedule,329.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95970,Not in chargemaster,95970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95970,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95971,Not in chargemaster,95971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95971,BCBS multispecialty AW base fee schedule,89.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95972,Not in chargemaster,95972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95972,BCBS multispecialty AW base fee schedule,100.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95976,Not in chargemaster,95976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95976,BCBS multispecialty AW base fee schedule,73.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95977,Not in chargemaster,95977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95977,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95980,Not in chargemaster,95980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95980,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95981,Not in chargemaster,95981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95981,BCBS multispecialty AW base fee schedule,62.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95982,Not in chargemaster,95982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95982,BCBS multispecialty AW base fee schedule,99.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95983,Not in chargemaster,95983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95983,BCBS multispecialty AW base fee schedule,90.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95984,Not in chargemaster,95984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95984,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95990,Not in chargemaster,95990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95990,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95991,Not in chargemaster,95991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95991,BCBS multispecialty AW base fee schedule,200.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95992,Not in chargemaster,95992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95992,BCBS multispecialty AW base fee schedule,78.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96000,Not in chargemaster,96000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96000,BCBS multispecialty AW base fee schedule,165.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96001,Not in chargemaster,96001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96001,BCBS multispecialty AW base fee schedule,195.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96002,Not in chargemaster,96002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96002,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96003,Not in chargemaster,96003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96003,BCBS multispecialty AW base fee schedule,30.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96004,Not in chargemaster,96004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96004,BCBS multispecialty AW base fee schedule,200.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96020,Not in chargemaster,96020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96020,BCBS multispecialty AW base fee schedule,288.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96020 mod 26,Not in chargemaster,96020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96020 mod 26,BCBS multispecialty AW base fee schedule,288.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96040,Not in chargemaster,96040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96040,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96105,Not in chargemaster,96105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96105,BCBS multispecialty AW base fee schedule,181.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96110,Not in chargemaster,96110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96110,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96112,Not in chargemaster,96112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96112,BCBS multispecialty AW base fee schedule,241.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96113,Not in chargemaster,96113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96113,BCBS multispecialty AW base fee schedule,107.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96116,Not in chargemaster,96116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96116,BCBS multispecialty AW base fee schedule,171.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96121,Not in chargemaster,96121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96121,BCBS multispecialty AW base fee schedule,148.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96125,Not in chargemaster,96125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96125,BCBS multispecialty AW base fee schedule,192.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96127,Not in chargemaster,96127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96127,BCBS multispecialty AW base fee schedule,8.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96130,Not in chargemaster,96130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96130,BCBS multispecialty AW base fee schedule,209.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96131,Not in chargemaster,96131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96131,BCBS multispecialty AW base fee schedule,161.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96132,Not in chargemaster,96132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96132,BCBS multispecialty AW base fee schedule,234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96133,Not in chargemaster,96133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96133,BCBS multispecialty AW base fee schedule,176.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96136,Not in chargemaster,96136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96136,BCBS multispecialty AW base fee schedule,82.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96137,Not in chargemaster,96137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96137,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96138,Not in chargemaster,96138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96138,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96139,Not in chargemaster,96139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96139,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96146,Not in chargemaster,96146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96146,BCBS multispecialty AW base fee schedule,3.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96156,Not in chargemaster,96156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96156,BCBS multispecialty AW base fee schedule,171.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96158,Not in chargemaster,96158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96158,BCBS multispecialty AW base fee schedule,117.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96159,Not in chargemaster,96159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96159,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96160,Not in chargemaster,96160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96160,BCBS multispecialty AW base fee schedule,4.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96161,Not in chargemaster,96161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96161,BCBS multispecialty AW base fee schedule,4.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96164,Not in chargemaster,96164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96164,BCBS multispecialty AW base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96165,Not in chargemaster,96165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96165,BCBS multispecialty AW base fee schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96167,Not in chargemaster,96167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96167,BCBS multispecialty AW base fee schedule,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96168,Not in chargemaster,96168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96168,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96170,Not in chargemaster,96170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96170,BCBS multispecialty AW base fee schedule,142.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96171,Not in chargemaster,96171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96171,BCBS multispecialty AW base fee schedule,52.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96360,Not in chargemaster,96360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96360,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96361,Not in chargemaster,96361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96361,BCBS multispecialty AW base fee schedule,23.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96365,Not in chargemaster,96365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96365,BCBS multispecialty AW base fee schedule,124,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96366,Not in chargemaster,96366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96366,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96367,Not in chargemaster,96367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96367,BCBS multispecialty AW base fee schedule,53.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96368,Not in chargemaster,96368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96368,BCBS multispecialty AW base fee schedule,36.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96369,Not in chargemaster,96369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96369,BCBS multispecialty AW base fee schedule,278.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96370,Not in chargemaster,96370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96370,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96371,Not in chargemaster,96371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96371,BCBS multispecialty AW base fee schedule,110.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96372,96372,96372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96372,BCBS multispecialty AW base fee schedule,24.8,37,Fee schedule,,24.8,24.8,24.8,24.8,,,0
unity,Fee schedule,Non-facility 96373,Not in chargemaster,96373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96373,BCBS multispecialty AW base fee schedule,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96374,Not in chargemaster,96374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96374,BCBS multispecialty AW base fee schedule,68.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96375,Not in chargemaster,96375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96375,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96377,Not in chargemaster,96377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96377,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96401,Not in chargemaster,96401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96401,BCBS multispecialty AW base fee schedule,137.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96402,Not in chargemaster,96402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96402,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96405,Not in chargemaster,96405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96405,BCBS multispecialty AW base fee schedule,145.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96406,Not in chargemaster,96406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96406,BCBS multispecialty AW base fee schedule,223.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96409,Not in chargemaster,96409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96409,BCBS multispecialty AW base fee schedule,189.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96411,Not in chargemaster,96411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96411,BCBS multispecialty AW base fee schedule,102.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96413,Not in chargemaster,96413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96413,BCBS multispecialty AW base fee schedule,244.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96415,Not in chargemaster,96415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96415,BCBS multispecialty AW base fee schedule,52.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96416,Not in chargemaster,96416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96416,BCBS multispecialty AW base fee schedule,244.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96417,Not in chargemaster,96417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96417,BCBS multispecialty AW base fee schedule,119.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96420,Not in chargemaster,96420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96420,BCBS multispecialty AW base fee schedule,181.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96422,Not in chargemaster,96422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96422,BCBS multispecialty AW base fee schedule,298.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96423,Not in chargemaster,96423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96423,BCBS multispecialty AW base fee schedule,138.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96425,Not in chargemaster,96425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96425,BCBS multispecialty AW base fee schedule,316.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96440,Not in chargemaster,96440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96440,BCBS multispecialty AW base fee schedule,1564.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96446,Not in chargemaster,96446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96446,BCBS multispecialty AW base fee schedule,352.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96450,Not in chargemaster,96450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96450,BCBS multispecialty AW base fee schedule,314.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96521,Not in chargemaster,96521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96521,BCBS multispecialty AW base fee schedule,256.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96522,Not in chargemaster,96522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96522,BCBS multispecialty AW base fee schedule,213.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96523,Not in chargemaster,96523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96523,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96542,Not in chargemaster,96542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96542,BCBS multispecialty AW base fee schedule,230.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96567,Not in chargemaster,96567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96567,BCBS multispecialty AW base fee schedule,233.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96570,Not in chargemaster,96570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96570,BCBS multispecialty AW base fee schedule,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96571,Not in chargemaster,96571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96571,BCBS multispecialty AW base fee schedule,46.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96573,Not in chargemaster,96573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96573,BCBS multispecialty AW base fee schedule,373.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96574,Not in chargemaster,96574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96574,BCBS multispecialty AW base fee schedule,469.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96900,Not in chargemaster,96900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96900,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96902,Not in chargemaster,96902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96902,BCBS multispecialty AW base fee schedule,39.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96904,Not in chargemaster,96904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96904,BCBS multispecialty AW base fee schedule,119.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96910,Not in chargemaster,96910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96910,BCBS multispecialty AW base fee schedule,203.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96912,Not in chargemaster,96912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96912,BCBS multispecialty AW base fee schedule,173.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96913,Not in chargemaster,96913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96913,BCBS multispecialty AW base fee schedule,251.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96920,Not in chargemaster,96920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96920,BCBS multispecialty AW base fee schedule,285.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96921,Not in chargemaster,96921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96921,BCBS multispecialty AW base fee schedule,313.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96922,Not in chargemaster,96922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96922,BCBS multispecialty AW base fee schedule,427.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96931,Not in chargemaster,96931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96931,BCBS multispecialty AW base fee schedule,301.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96932,Not in chargemaster,96932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96932,BCBS multispecialty AW base fee schedule,221.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96933,Not in chargemaster,96933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96933,BCBS multispecialty AW base fee schedule,80.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96934,Not in chargemaster,96934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96934,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96935,Not in chargemaster,96935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96935,BCBS multispecialty AW base fee schedule,107.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96936,Not in chargemaster,96936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96936,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97010,Not in chargemaster,97010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97010,BCBS multispecialty AW base fee schedule,8.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97012,Not in chargemaster,97012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97012,BCBS multispecialty AW base fee schedule,19.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97014,Not in chargemaster,97014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97014,BCBS multispecialty AW base fee schedule,18.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97016,Not in chargemaster,97016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97016,BCBS multispecialty AW base fee schedule,15.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97018,Not in chargemaster,97018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97018,BCBS multispecialty AW base fee schedule,7.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97022,Not in chargemaster,97022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97022,BCBS multispecialty AW base fee schedule,23.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97024,Not in chargemaster,97024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97024,BCBS multispecialty AW base fee schedule,9.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97026,Not in chargemaster,97026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97026,BCBS multispecialty AW base fee schedule,8.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97028,Not in chargemaster,97028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97028,BCBS multispecialty AW base fee schedule,10.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97032,Not in chargemaster,97032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97032,BCBS multispecialty AW base fee schedule,19.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97033,Not in chargemaster,97033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97033,BCBS multispecialty AW base fee schedule,26.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97034,Not in chargemaster,97034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97034,BCBS multispecialty AW base fee schedule,19.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97035,Not in chargemaster,97035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97035,BCBS multispecialty AW base fee schedule,18.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97036,Not in chargemaster,97036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97036,BCBS multispecialty AW base fee schedule,45.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97110,Not in chargemaster,97110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97110,BCBS multispecialty AW base fee schedule,39.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97112,Not in chargemaster,97112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97112,BCBS multispecialty AW base fee schedule,45.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97113,Not in chargemaster,97113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97113,BCBS multispecialty AW base fee schedule,50.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97116,Not in chargemaster,97116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97116,BCBS multispecialty AW base fee schedule,39.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97124,Not in chargemaster,97124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97124,BCBS multispecialty AW base fee schedule,37.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97129,Not in chargemaster,97129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97129,BCBS multispecialty AW base fee schedule,30.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97130,Not in chargemaster,97130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97130,BCBS multispecialty AW base fee schedule,29.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97150,Not in chargemaster,97150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97150,BCBS multispecialty AW base fee schedule,23.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97140,Not in chargemaster,97140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97140,BCBS multispecialty AW base fee schedule,36.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97161,Not in chargemaster,97161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97161,BCBS multispecialty AW base fee schedule,110.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97162,Not in chargemaster,97162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97162,BCBS multispecialty AW base fee schedule,110.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97163,Not in chargemaster,97163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97163,BCBS multispecialty AW base fee schedule,110.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97164,Not in chargemaster,97164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97164,BCBS multispecialty AW base fee schedule,75.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97165,Not in chargemaster,97165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97165,BCBS multispecialty AW base fee schedule,117.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97166,Not in chargemaster,97166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97166,BCBS multispecialty AW base fee schedule,116.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97167,Not in chargemaster,97167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97167,BCBS multispecialty AW base fee schedule,116.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97168,Not in chargemaster,97168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97168,BCBS multispecialty AW base fee schedule,80.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97530,Not in chargemaster,97530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97530,BCBS multispecialty AW base fee schedule,50.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97533,Not in chargemaster,97533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97533,BCBS multispecialty AW base fee schedule,66.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97535,Not in chargemaster,97535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97535,BCBS multispecialty AW base fee schedule,44.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97537,Not in chargemaster,97537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97537,BCBS multispecialty AW base fee schedule,42.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97542,Not in chargemaster,97542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97542,BCBS multispecialty AW base fee schedule,42.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97597,97597,97597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97597,BCBS multispecialty AW base fee schedule,124.67,190,Fee schedule,,124.67,124.67,124.67,124.67,,,0
unity,Fee schedule,Non-facility 97598,Not in chargemaster,97598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97598,BCBS multispecialty AW base fee schedule,59.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97605,Not in chargemaster,97605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97605,BCBS multispecialty AW base fee schedule,56.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97606,Not in chargemaster,97606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97606,BCBS multispecialty AW base fee schedule,66.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97607,Not in chargemaster,97607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97607,BCBS multispecialty AW base fee schedule,432.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97608,Not in chargemaster,97608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97608,BCBS multispecialty AW base fee schedule,433.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97610,Not in chargemaster,97610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97610,BCBS multispecialty AW base fee schedule,415.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97750,Not in chargemaster,97750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97750,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97755,Not in chargemaster,97755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97755,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97760,Not in chargemaster,97760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97760,BCBS multispecialty AW base fee schedule,63.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97761,Not in chargemaster,97761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97761,BCBS multispecialty AW base fee schedule,54.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97763,Not in chargemaster,97763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97763,BCBS multispecialty AW base fee schedule,68.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97802,Not in chargemaster,97802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97802,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97803,Not in chargemaster,97803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97803,BCBS multispecialty AW base fee schedule,57.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97804,Not in chargemaster,97804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97804,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97810,Not in chargemaster,97810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97810,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97811,Not in chargemaster,97811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97811,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97813,Not in chargemaster,97813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97813,BCBS multispecialty AW base fee schedule,72.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97814,Not in chargemaster,97814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97814,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98925,Not in chargemaster,98925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98925,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98926,Not in chargemaster,98926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98926,BCBS multispecialty AW base fee schedule,79.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98927,Not in chargemaster,98927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98927,BCBS multispecialty AW base fee schedule,104.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98928,Not in chargemaster,98928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98928,BCBS multispecialty AW base fee schedule,127.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98929,Not in chargemaster,98929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98929,BCBS multispecialty AW base fee schedule,151.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98940,Not in chargemaster,98940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98940,BCBS multispecialty AW base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98941,Not in chargemaster,98941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98941,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98942,Not in chargemaster,98942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98942,BCBS multispecialty AW base fee schedule,93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98943,Not in chargemaster,98943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98943,BCBS multispecialty AW base fee schedule,48.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98960,Not in chargemaster,98960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98960,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98961,Not in chargemaster,98961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98961,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98962,Not in chargemaster,98962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98962,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98966,Not in chargemaster,98966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98966,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98968,Not in chargemaster,98968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98968,BCBS multispecialty AW base fee schedule,70.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98967,Not in chargemaster,98967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98967,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99091,Not in chargemaster,99091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99091,BCBS multispecialty AW base fee schedule,101.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99151,Not in chargemaster,99151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99151,BCBS multispecialty AW base fee schedule,130.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99152,Not in chargemaster,99152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99152,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99153,Not in chargemaster,99153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99153,BCBS multispecialty AW base fee schedule,18.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99155,Not in chargemaster,99155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99155,BCBS multispecialty AW base fee schedule,150.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99156,Not in chargemaster,99156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99156,BCBS multispecialty AW base fee schedule,137.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99157,Not in chargemaster,99157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99157,BCBS multispecialty AW base fee schedule,112.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99170,Not in chargemaster,99170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99170,BCBS multispecialty AW base fee schedule,277.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99173,Not in chargemaster,99173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99173,BCBS multispecialty AW base fee schedule,4.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99174,Not in chargemaster,99174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99174,BCBS multispecialty AW base fee schedule,9.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99175,Not in chargemaster,99175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99175,BCBS multispecialty AW base fee schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99177,Not in chargemaster,99177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99177,BCBS multispecialty AW base fee schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99183,Not in chargemaster,99183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99183,BCBS multispecialty AW base fee schedule,195.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99188,Not in chargemaster,99188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99188,BCBS multispecialty AW base fee schedule,21.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99184,Not in chargemaster,99184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99184,BCBS multispecialty AW base fee schedule,392.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99195,Not in chargemaster,99195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99195,BCBS multispecialty AW base fee schedule,176.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99201,99201,99201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99201,BCBS multispecialty AW base fee schedule,79.98,98,Fee schedule,,79.98,79.98,79.98,79.98,,,0
unity,Fee schedule,Non-facility 99202,99202,99202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99202,BCBS multispecialty AW base fee schedule,132.68,163,Fee schedule,,132.68,132.68,132.68,132.68,,,0
unity,Fee schedule,Non-facility 99203,99203,99203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99203,BCBS multispecialty AW base fee schedule,187.86,230,Fee schedule,,187.86,187.86,187.86,187.86,,,0
unity,Fee schedule,Non-facility 99204,99204,99204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99204,BCBS multispecialty AW base fee schedule,287.06,350,Fee schedule,,287.06,287.06,287.06,287.06,,,0
unity,Fee schedule,Non-facility 99205,99205,99205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99205,BCBS multispecialty AW base fee schedule,362.7,440,Fee schedule,,362.7,362.7,362.7,362.7,,,0
unity,Fee schedule,Non-facility 99211,99211,99211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99211,BCBS multispecialty AW base fee schedule,40.3,50,Fee schedule,,40.3,40.3,40.3,40.3,,,0
unity,Fee schedule,Non-facility 46608,Not in chargemaster,46608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46608,BCBS multispecialty AW base fee schedule,508.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46610,Not in chargemaster,46610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46610,BCBS multispecialty AW base fee schedule,483.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46611,Not in chargemaster,46611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46611,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46612,Not in chargemaster,46612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46612,BCBS multispecialty AW base fee schedule,589.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46614,Not in chargemaster,46614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46614,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46615,Not in chargemaster,46615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46615,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46700,Not in chargemaster,46700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46700,BCBS multispecialty AW base fee schedule,1256.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46705,Not in chargemaster,46705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46705,BCBS multispecialty AW base fee schedule,1082.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46706,Not in chargemaster,46706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46706,BCBS multispecialty AW base fee schedule,340.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46707,Not in chargemaster,46707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46707,BCBS multispecialty AW base fee schedule,954.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46710,Not in chargemaster,46710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46710,BCBS multispecialty AW base fee schedule,2141.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46712,Not in chargemaster,46712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46712,BCBS multispecialty AW base fee schedule,4306.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46715,Not in chargemaster,46715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46715,BCBS multispecialty AW base fee schedule,1059.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46716,Not in chargemaster,46716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46716,BCBS multispecialty AW base fee schedule,2347.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46730,Not in chargemaster,46730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46730,BCBS multispecialty AW base fee schedule,3808.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46735,Not in chargemaster,46735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46735,BCBS multispecialty AW base fee schedule,4391.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46740,Not in chargemaster,46740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46740,BCBS multispecialty AW base fee schedule,4157.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46742,Not in chargemaster,46742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46742,BCBS multispecialty AW base fee schedule,4816.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46744,Not in chargemaster,46744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46744,BCBS multispecialty AW base fee schedule,6827.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46746,Not in chargemaster,46746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46746,BCBS multispecialty AW base fee schedule,7533.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46748,Not in chargemaster,46748,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46748,BCBS multispecialty AW base fee schedule,8176.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46750,Not in chargemaster,46750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46750,BCBS multispecialty AW base fee schedule,1440.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46751,Not in chargemaster,46751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46751,BCBS multispecialty AW base fee schedule,1273.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46753,Not in chargemaster,46753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46753,BCBS multispecialty AW base fee schedule,1188.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46754,Not in chargemaster,46754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46754,BCBS multispecialty AW base fee schedule,616.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46760,Not in chargemaster,46760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46760,BCBS multispecialty AW base fee schedule,2093.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46761,Not in chargemaster,46761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46761,BCBS multispecialty AW base fee schedule,1766.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46900,Not in chargemaster,46900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46900,BCBS multispecialty AW base fee schedule,448.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46910,Not in chargemaster,46910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46910,BCBS multispecialty AW base fee schedule,489.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46916,Not in chargemaster,46916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46916,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46917,Not in chargemaster,46917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46917,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46922,Not in chargemaster,46922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46922,BCBS multispecialty AW base fee schedule,555.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46924,Not in chargemaster,46924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46924,BCBS multispecialty AW base fee schedule,1018.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46930,Not in chargemaster,46930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46930,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46940,Not in chargemaster,46940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46940,BCBS multispecialty AW base fee schedule,467.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46942,Not in chargemaster,46942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46942,BCBS multispecialty AW base fee schedule,445.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46945,Not in chargemaster,46945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46945,BCBS multispecialty AW base fee schedule,637.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46946,Not in chargemaster,46946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46946,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46947,Not in chargemaster,46947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46947,BCBS multispecialty AW base fee schedule,738.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46948,Not in chargemaster,46948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,46948,BCBS multispecialty AW base fee schedule,842.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47000,Not in chargemaster,47000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47000,BCBS multispecialty AW base fee schedule,586.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47001,Not in chargemaster,47001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47001,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47010,Not in chargemaster,47010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47010,BCBS multispecialty AW base fee schedule,2334.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47015,Not in chargemaster,47015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47015,BCBS multispecialty AW base fee schedule,2250.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47100,Not in chargemaster,47100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47100,BCBS multispecialty AW base fee schedule,1632.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47120,Not in chargemaster,47120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47120,BCBS multispecialty AW base fee schedule,4505.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47122,Not in chargemaster,47122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47122,BCBS multispecialty AW base fee schedule,6631.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47125,Not in chargemaster,47125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47125,BCBS multispecialty AW base fee schedule,5949.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47130,Not in chargemaster,47130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47130,BCBS multispecialty AW base fee schedule,6389.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47135,Not in chargemaster,47135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47135,BCBS multispecialty AW base fee schedule,10404.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47140,Not in chargemaster,47140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47140,BCBS multispecialty AW base fee schedule,6888.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47141,Not in chargemaster,47141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47141,BCBS multispecialty AW base fee schedule,8251.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47142,Not in chargemaster,47142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47142,BCBS multispecialty AW base fee schedule,9104.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47146,Not in chargemaster,47146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47146,BCBS multispecialty AW base fee schedule,634.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47147,Not in chargemaster,47147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47147,BCBS multispecialty AW base fee schedule,739.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47300,Not in chargemaster,47300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47300,BCBS multispecialty AW base fee schedule,2180.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47350,Not in chargemaster,47350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47350,BCBS multispecialty AW base fee schedule,2642.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47360,Not in chargemaster,47360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47360,BCBS multispecialty AW base fee schedule,3630.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47361,Not in chargemaster,47361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47361,BCBS multispecialty AW base fee schedule,5851.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47362,Not in chargemaster,47362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47362,BCBS multispecialty AW base fee schedule,2804.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47370,Not in chargemaster,47370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47370,BCBS multispecialty AW base fee schedule,2412.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47371,Not in chargemaster,47371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47371,BCBS multispecialty AW base fee schedule,2429.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47380,Not in chargemaster,47380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47380,BCBS multispecialty AW base fee schedule,2789.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47381,Not in chargemaster,47381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47381,BCBS multispecialty AW base fee schedule,2862.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47382,Not in chargemaster,47382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47382,BCBS multispecialty AW base fee schedule,8301.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47383,Not in chargemaster,47383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47383,BCBS multispecialty AW base fee schedule,12925.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47400,Not in chargemaster,47400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47400,BCBS multispecialty AW base fee schedule,4167.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47420,Not in chargemaster,47420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47420,BCBS multispecialty AW base fee schedule,2590.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47425,Not in chargemaster,47425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47425,BCBS multispecialty AW base fee schedule,2644.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47460,Not in chargemaster,47460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47460,BCBS multispecialty AW base fee schedule,2455.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47480,Not in chargemaster,47480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47480,BCBS multispecialty AW base fee schedule,1697.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47490,Not in chargemaster,47490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47490,BCBS multispecialty AW base fee schedule,635.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47531,Not in chargemaster,47531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47531,BCBS multispecialty AW base fee schedule,728.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47532,Not in chargemaster,47532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47532,BCBS multispecialty AW base fee schedule,1599.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47533,Not in chargemaster,47533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47533,BCBS multispecialty AW base fee schedule,2371.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47534,Not in chargemaster,47534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47534,BCBS multispecialty AW base fee schedule,2695.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47535,Not in chargemaster,47535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47535,BCBS multispecialty AW base fee schedule,1867.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47536,Not in chargemaster,47536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47536,BCBS multispecialty AW base fee schedule,1315.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47537,Not in chargemaster,47537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47537,BCBS multispecialty AW base fee schedule,848.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47538,Not in chargemaster,47538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47538,BCBS multispecialty AW base fee schedule,8073.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47539,Not in chargemaster,47539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47539,BCBS multispecialty AW base fee schedule,8902.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47540,Not in chargemaster,47540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47540,BCBS multispecialty AW base fee schedule,9082.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47541,Not in chargemaster,47541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47541,BCBS multispecialty AW base fee schedule,2293.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47542,Not in chargemaster,47542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47542,BCBS multispecialty AW base fee schedule,979.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47543,Not in chargemaster,47543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47543,BCBS multispecialty AW base fee schedule,873.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47544,Not in chargemaster,47544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47544,BCBS multispecialty AW base fee schedule,1874.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47550,Not in chargemaster,47550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47550,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47552,Not in chargemaster,47552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47552,BCBS multispecialty AW base fee schedule,527.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47553,Not in chargemaster,47553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47553,BCBS multispecialty AW base fee schedule,532.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47554,Not in chargemaster,47554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47554,BCBS multispecialty AW base fee schedule,995.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47555,Not in chargemaster,47555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47555,BCBS multispecialty AW base fee schedule,633.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47556,Not in chargemaster,47556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47556,BCBS multispecialty AW base fee schedule,717.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47562,47562,47562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47562,BCBS multispecialty AW base fee schedule,1271.34,1487.44,Fee schedule,,1271.34,1271.34,1271.34,1271.34,,,0
unity,Fee schedule,Non-facility 47563,Not in chargemaster,47563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47563,BCBS multispecialty AW base fee schedule,1383.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47564,Not in chargemaster,47564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47564,BCBS multispecialty AW base fee schedule,2151.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47570,Not in chargemaster,47570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47570,BCBS multispecialty AW base fee schedule,1498.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47600,47600,47600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47600,BCBS multispecialty AW base fee schedule,2065.01,2355,Fee schedule,,2065.01,2065.01,2065.01,2065.01,,,0
unity,Fee schedule,Non-facility 47605,Not in chargemaster,47605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47605,BCBS multispecialty AW base fee schedule,2173,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47610,Not in chargemaster,47610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47610,BCBS multispecialty AW base fee schedule,2426.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47612,Not in chargemaster,47612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47612,BCBS multispecialty AW base fee schedule,2467.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47620,Not in chargemaster,47620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47620,BCBS multispecialty AW base fee schedule,2663.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47700,Not in chargemaster,47700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47700,BCBS multispecialty AW base fee schedule,2041.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47701,Not in chargemaster,47701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47701,BCBS multispecialty AW base fee schedule,3360.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47711,Not in chargemaster,47711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47711,BCBS multispecialty AW base fee schedule,3010.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47712,Not in chargemaster,47712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47712,BCBS multispecialty AW base fee schedule,3865.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47715,Not in chargemaster,47715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47715,BCBS multispecialty AW base fee schedule,2574.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47720,Not in chargemaster,47720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47720,BCBS multispecialty AW base fee schedule,2233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47721,Not in chargemaster,47721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47721,BCBS multispecialty AW base fee schedule,2620.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47740,Not in chargemaster,47740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47740,BCBS multispecialty AW base fee schedule,2540.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47741,Not in chargemaster,47741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47741,BCBS multispecialty AW base fee schedule,2855.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47760,Not in chargemaster,47760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47760,BCBS multispecialty AW base fee schedule,4351.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47765,Not in chargemaster,47765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47765,BCBS multispecialty AW base fee schedule,5881.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47780,Not in chargemaster,47780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47780,BCBS multispecialty AW base fee schedule,4779.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47785,Not in chargemaster,47785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47785,BCBS multispecialty AW base fee schedule,6283.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47800,Not in chargemaster,47800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47800,BCBS multispecialty AW base fee schedule,3046.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47801,Not in chargemaster,47801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47801,BCBS multispecialty AW base fee schedule,2154.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47802,Not in chargemaster,47802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47802,BCBS multispecialty AW base fee schedule,2952.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47900,Not in chargemaster,47900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47900,BCBS multispecialty AW base fee schedule,2635.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48000,Not in chargemaster,48000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48000,BCBS multispecialty AW base fee schedule,3645.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48001,Not in chargemaster,48001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48001,BCBS multispecialty AW base fee schedule,4466.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48020,Not in chargemaster,48020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48020,BCBS multispecialty AW base fee schedule,2277.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48100,Not in chargemaster,48100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48100,BCBS multispecialty AW base fee schedule,1707.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48102,Not in chargemaster,48102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48102,BCBS multispecialty AW base fee schedule,1020.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48105,Not in chargemaster,48105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48105,BCBS multispecialty AW base fee schedule,5484.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48120,Not in chargemaster,48120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48120,BCBS multispecialty AW base fee schedule,2133.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48140,Not in chargemaster,48140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48140,BCBS multispecialty AW base fee schedule,3019.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48145,Not in chargemaster,48145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48145,BCBS multispecialty AW base fee schedule,3159.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48146,Not in chargemaster,48146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48146,BCBS multispecialty AW base fee schedule,3641.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48148,Not in chargemaster,48148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48148,BCBS multispecialty AW base fee schedule,2415.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48150,Not in chargemaster,48150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48150,BCBS multispecialty AW base fee schedule,6021.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48152,Not in chargemaster,48152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48152,BCBS multispecialty AW base fee schedule,5594.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48153,Not in chargemaster,48153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48153,BCBS multispecialty AW base fee schedule,5997.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48154,Not in chargemaster,48154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48154,BCBS multispecialty AW base fee schedule,5618.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48155,Not in chargemaster,48155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48155,BCBS multispecialty AW base fee schedule,3498.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48400,Not in chargemaster,48400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48400,BCBS multispecialty AW base fee schedule,208.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48500,Not in chargemaster,48500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48500,BCBS multispecialty AW base fee schedule,2224.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48510,Not in chargemaster,48510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48510,BCBS multispecialty AW base fee schedule,2120.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48520,Not in chargemaster,48520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48520,BCBS multispecialty AW base fee schedule,2111.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48540,Not in chargemaster,48540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48540,BCBS multispecialty AW base fee schedule,2533.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48545,Not in chargemaster,48545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48545,BCBS multispecialty AW base fee schedule,2602.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48547,Not in chargemaster,48547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48547,BCBS multispecialty AW base fee schedule,3468.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48548,Not in chargemaster,48548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48548,BCBS multispecialty AW base fee schedule,3217.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48552,Not in chargemaster,48552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48552,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48554,Not in chargemaster,48554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48554,BCBS multispecialty AW base fee schedule,4932.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48556,Not in chargemaster,48556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48556,BCBS multispecialty AW base fee schedule,2459.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49000,49000,49000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49000,BCBS multispecialty AW base fee schedule,1482.68,1618.51,Fee schedule,,1482.68,1482.68,1482.68,1482.68,,,0
unity,Fee schedule,Non-facility 49002,Not in chargemaster,49002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49002,BCBS multispecialty AW base fee schedule,2016.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49010,Not in chargemaster,49010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49010,BCBS multispecialty AW base fee schedule,1781.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49013,Not in chargemaster,49013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49013,BCBS multispecialty AW base fee schedule,842.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49014,Not in chargemaster,49014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49014,BCBS multispecialty AW base fee schedule,696.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49020,Not in chargemaster,49020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49020,BCBS multispecialty AW base fee schedule,3071.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49040,Not in chargemaster,49040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49040,BCBS multispecialty AW base fee schedule,1931.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49060,Not in chargemaster,49060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49060,BCBS multispecialty AW base fee schedule,2121.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49062,Not in chargemaster,49062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49062,BCBS multispecialty AW base fee schedule,1482.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49082,49082,49082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49082,BCBS multispecialty AW base fee schedule,385.58,157.31,Fee schedule,,157.31,157.31,157.31,157.31,,,0
unity,Fee schedule,Non-facility 49083,49083,49083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49083,BCBS multispecialty AW base fee schedule,567.1,280.32,Fee schedule,,280.32,280.32,280.32,280.32,,,0
unity,Fee schedule,Non-facility 49084,Not in chargemaster,49084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49084,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49180,Not in chargemaster,49180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49180,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49185,Not in chargemaster,49185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49185,BCBS multispecialty AW base fee schedule,2214.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49203,Not in chargemaster,49203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49203,BCBS multispecialty AW base fee schedule,2297.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49204,Not in chargemaster,49204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49204,BCBS multispecialty AW base fee schedule,2928.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49205,Not in chargemaster,49205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49205,BCBS multispecialty AW base fee schedule,3354.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49215,Not in chargemaster,49215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49215,BCBS multispecialty AW base fee schedule,4271.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49220,Not in chargemaster,49220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49220,BCBS multispecialty AW base fee schedule,1878.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49250,Not in chargemaster,49250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49250,BCBS multispecialty AW base fee schedule,1132.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49255,Not in chargemaster,49255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49255,BCBS multispecialty AW base fee schedule,1514.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49320,Not in chargemaster,49320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49320,BCBS multispecialty AW base fee schedule,632.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49321,Not in chargemaster,49321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49321,BCBS multispecialty AW base fee schedule,663.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49322,Not in chargemaster,49322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49322,BCBS multispecialty AW base fee schedule,718.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49323,Not in chargemaster,49323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49323,BCBS multispecialty AW base fee schedule,1234.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49324,Not in chargemaster,49324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49324,BCBS multispecialty AW base fee schedule,751.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49325,Not in chargemaster,49325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49325,BCBS multispecialty AW base fee schedule,801.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49326,Not in chargemaster,49326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49326,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49327,Not in chargemaster,49327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49327,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49400,Not in chargemaster,49400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49400,BCBS multispecialty AW base fee schedule,274.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49402,Not in chargemaster,49402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49402,BCBS multispecialty AW base fee schedule,1651.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49405,Not in chargemaster,49405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49405,BCBS multispecialty AW base fee schedule,1665.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49406,Not in chargemaster,49406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49406,BCBS multispecialty AW base fee schedule,1664.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49407,Not in chargemaster,49407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49407,BCBS multispecialty AW base fee schedule,1368.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49411,Not in chargemaster,49411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49411,BCBS multispecialty AW base fee schedule,922.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49412,Not in chargemaster,49412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49412,BCBS multispecialty AW base fee schedule,159.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49418,Not in chargemaster,49418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49418,BCBS multispecialty AW base fee schedule,2259.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49419,Not in chargemaster,49419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49419,BCBS multispecialty AW base fee schedule,829.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49421,Not in chargemaster,49421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49421,BCBS multispecialty AW base fee schedule,440.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49422,Not in chargemaster,49422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49422,BCBS multispecialty AW base fee schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49423,Not in chargemaster,49423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49423,BCBS multispecialty AW base fee schedule,1124.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49424,Not in chargemaster,49424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49424,BCBS multispecialty AW base fee schedule,317.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49425,Not in chargemaster,49425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49425,BCBS multispecialty AW base fee schedule,1374.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49426,Not in chargemaster,49426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49426,BCBS multispecialty AW base fee schedule,1288.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49427,Not in chargemaster,49427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49427,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49428,Not in chargemaster,49428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49428,BCBS multispecialty AW base fee schedule,833.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49429,Not in chargemaster,49429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49429,BCBS multispecialty AW base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49435,Not in chargemaster,49435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49435,BCBS multispecialty AW base fee schedule,231.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49436,Not in chargemaster,49436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49436,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49440,Not in chargemaster,49440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49440,BCBS multispecialty AW base fee schedule,1765.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49441,Not in chargemaster,49441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49441,BCBS multispecialty AW base fee schedule,2000.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49442,Not in chargemaster,49442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49442,BCBS multispecialty AW base fee schedule,1671.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49446,Not in chargemaster,49446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49446,BCBS multispecialty AW base fee schedule,1696.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49450,Not in chargemaster,49450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49450,BCBS multispecialty AW base fee schedule,1242.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49451,Not in chargemaster,49451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49451,BCBS multispecialty AW base fee schedule,1346.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49452,Not in chargemaster,49452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49452,BCBS multispecialty AW base fee schedule,1648.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49460,Not in chargemaster,49460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49460,BCBS multispecialty AW base fee schedule,1378,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49465,Not in chargemaster,49465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49465,BCBS multispecialty AW base fee schedule,287.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49491,Not in chargemaster,49491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49491,BCBS multispecialty AW base fee schedule,1537,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49492,Not in chargemaster,49492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49492,BCBS multispecialty AW base fee schedule,1850.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49495,Not in chargemaster,49495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49495,BCBS multispecialty AW base fee schedule,787.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49496,Not in chargemaster,49496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49496,BCBS multispecialty AW base fee schedule,1184.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49500,Not in chargemaster,49500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49500,BCBS multispecialty AW base fee schedule,794.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49501,Not in chargemaster,49501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49501,BCBS multispecialty AW base fee schedule,1167.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49505,49505,49505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49505,BCBS multispecialty AW base fee schedule,1005.01,1145,Fee schedule,,1005.01,1005.01,1005.01,1005.01,,,0
unity,Fee schedule,Non-facility 49507,49507,49507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49507,BCBS multispecialty AW base fee schedule,1130.89,1232.8,Fee schedule,,1130.89,1130.89,1130.89,1130.89,,,0
unity,Fee schedule,Non-facility 49520,49520,49520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49520,BCBS multispecialty AW base fee schedule,1219,1327.46,Fee schedule,,1219,1219,1219,1219,,,0
unity,Fee schedule,Non-facility 49521,Not in chargemaster,49521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49521,BCBS multispecialty AW base fee schedule,1383.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49525,Not in chargemaster,49525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49525,BCBS multispecialty AW base fee schedule,1107.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49540,Not in chargemaster,49540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49540,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49550,Not in chargemaster,49550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49550,BCBS multispecialty AW base fee schedule,1111.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49553,Not in chargemaster,49553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49553,BCBS multispecialty AW base fee schedule,1217.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49555,Not in chargemaster,49555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49555,BCBS multispecialty AW base fee schedule,1162.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49557,Not in chargemaster,49557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49557,BCBS multispecialty AW base fee schedule,1396.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49560,49560,49560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49560,BCBS multispecialty AW base fee schedule,1424.38,1625,Fee schedule,,1424.38,1424.38,1424.38,1424.38,,,0
unity,Fee schedule,Non-facility 49561,49561,49561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49561,BCBS multispecialty AW base fee schedule,1794.71,1949.29,Fee schedule,,1794.71,1794.71,1794.71,1794.71,,,0
unity,Fee schedule,Non-facility 49565,49565,49565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49565,BCBS multispecialty AW base fee schedule,1482.68,1612.11,Fee schedule,,1482.68,1482.68,1482.68,1482.68,,,0
unity,Fee schedule,Non-facility 49566,49566,49566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49566,BCBS multispecialty AW base fee schedule,1811.28,1969.88,Fee schedule,,1811.28,1811.28,1811.28,1811.28,,,0
unity,Fee schedule,Non-facility 49568,49568,49568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49568,BCBS multispecialty AW base fee schedule,516.75,590,Fee schedule,,516.75,516.75,516.75,516.75,,,0
unity,Fee schedule,Non-facility 49570,Not in chargemaster,49570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49570,BCBS multispecialty AW base fee schedule,802.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49572,Not in chargemaster,49572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49572,BCBS multispecialty AW base fee schedule,997.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49580,Not in chargemaster,49580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49580,BCBS multispecialty AW base fee schedule,641.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49582,Not in chargemaster,49582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49582,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49585,49585,49585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49585,BCBS multispecialty AW base fee schedule,858.6,937.74,Fee schedule,,858.6,858.6,858.6,858.6,,,0
unity,Fee schedule,Non-facility 49587,49587,49587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49587,BCBS multispecialty AW base fee schedule,918.23,1004.47,Fee schedule,,918.23,918.23,918.23,918.23,,,0
unity,Fee schedule,Non-facility 49590,Not in chargemaster,49590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49590,BCBS multispecialty AW base fee schedule,1105.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49600,Not in chargemaster,49600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49600,BCBS multispecialty AW base fee schedule,1415.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49605,Not in chargemaster,49605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49605,BCBS multispecialty AW base fee schedule,9580.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49606,Not in chargemaster,49606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49606,BCBS multispecialty AW base fee schedule,2192.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49610,Not in chargemaster,49610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49610,BCBS multispecialty AW base fee schedule,1333.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49611,Not in chargemaster,49611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49611,BCBS multispecialty AW base fee schedule,1173.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49650,49650,49650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49650,BCBS multispecialty AW base fee schedule,828.13,945,Fee schedule,,828.13,828.13,828.13,828.13,,,0
unity,Fee schedule,Non-facility 49651,49651,49651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49651,BCBS multispecialty AW base fee schedule,1078.55,1225,Fee schedule,,1078.55,1078.55,1078.55,1078.55,,,0
unity,Fee schedule,Non-facility 49652,Not in chargemaster,49652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49652,BCBS multispecialty AW base fee schedule,1436.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49653,Not in chargemaster,49653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49653,BCBS multispecialty AW base fee schedule,1794.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49654,Not in chargemaster,49654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49654,BCBS multispecialty AW base fee schedule,1631.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49655,Not in chargemaster,49655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49655,BCBS multispecialty AW base fee schedule,1995.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49656,Not in chargemaster,49656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49656,BCBS multispecialty AW base fee schedule,1770.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49657,Not in chargemaster,49657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49657,BCBS multispecialty AW base fee schedule,2551.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49900,Not in chargemaster,49900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49900,BCBS multispecialty AW base fee schedule,1573.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49904,Not in chargemaster,49904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49904,BCBS multispecialty AW base fee schedule,2688.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49905,Not in chargemaster,49905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,49905,BCBS multispecialty AW base fee schedule,682.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50010,Not in chargemaster,50010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50010,BCBS multispecialty AW base fee schedule,1407.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50020,Not in chargemaster,50020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50020,BCBS multispecialty AW base fee schedule,1937.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50040,Not in chargemaster,50040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50040,BCBS multispecialty AW base fee schedule,1764.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50045,Not in chargemaster,50045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50045,BCBS multispecialty AW base fee schedule,1782.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50060,Not in chargemaster,50060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50060,BCBS multispecialty AW base fee schedule,2180.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50065,Not in chargemaster,50065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50065,BCBS multispecialty AW base fee schedule,2312.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50070,Not in chargemaster,50070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50070,BCBS multispecialty AW base fee schedule,2267.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50075,Not in chargemaster,50075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50075,BCBS multispecialty AW base fee schedule,2789.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50080,Not in chargemaster,50080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50080,BCBS multispecialty AW base fee schedule,1662.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50081,Not in chargemaster,50081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50081,BCBS multispecialty AW base fee schedule,2444.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50100,Not in chargemaster,50100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50100,BCBS multispecialty AW base fee schedule,2084.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50120,Not in chargemaster,50120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50120,BCBS multispecialty AW base fee schedule,1815.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50125,Not in chargemaster,50125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50125,BCBS multispecialty AW base fee schedule,1878.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50130,Not in chargemaster,50130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50130,BCBS multispecialty AW base fee schedule,1976.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50135,Not in chargemaster,50135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50135,BCBS multispecialty AW base fee schedule,2145.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50200,Not in chargemaster,50200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50200,BCBS multispecialty AW base fee schedule,1024.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50205,Not in chargemaster,50205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50205,BCBS multispecialty AW base fee schedule,1453.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50220,Not in chargemaster,50220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50220,BCBS multispecialty AW base fee schedule,2008.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50225,Not in chargemaster,50225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50225,BCBS multispecialty AW base fee schedule,2300.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50230,Not in chargemaster,50230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50230,BCBS multispecialty AW base fee schedule,2453.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50234,Not in chargemaster,50234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50234,BCBS multispecialty AW base fee schedule,2492.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50236,Not in chargemaster,50236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50236,BCBS multispecialty AW base fee schedule,2802.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50240,Not in chargemaster,50240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50240,BCBS multispecialty AW base fee schedule,2536.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50250,Not in chargemaster,50250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50250,BCBS multispecialty AW base fee schedule,2328.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50280,Not in chargemaster,50280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50280,BCBS multispecialty AW base fee schedule,1834.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50320,Not in chargemaster,50320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50320,BCBS multispecialty AW base fee schedule,2896.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50290,Not in chargemaster,50290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50290,BCBS multispecialty AW base fee schedule,1718.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50327,Not in chargemaster,50327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50327,BCBS multispecialty AW base fee schedule,418.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50328,Not in chargemaster,50328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50328,BCBS multispecialty AW base fee schedule,366.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50329,Not in chargemaster,50329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50329,BCBS multispecialty AW base fee schedule,348.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50340,Not in chargemaster,50340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50340,BCBS multispecialty AW base fee schedule,1827.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50360,Not in chargemaster,50360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50360,BCBS multispecialty AW base fee schedule,4660.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50365,Not in chargemaster,50365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50365,BCBS multispecialty AW base fee schedule,5535.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50370,Not in chargemaster,50370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50370,BCBS multispecialty AW base fee schedule,2322.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50380,Not in chargemaster,50380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50380,BCBS multispecialty AW base fee schedule,3873.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50382,Not in chargemaster,50382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50382,BCBS multispecialty AW base fee schedule,2075.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50384,Not in chargemaster,50384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50384,BCBS multispecialty AW base fee schedule,1695.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50385,Not in chargemaster,50385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50385,BCBS multispecialty AW base fee schedule,2040.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50386,Not in chargemaster,50386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50386,BCBS multispecialty AW base fee schedule,1398.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50387,Not in chargemaster,50387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50387,BCBS multispecialty AW base fee schedule,1034.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50389,Not in chargemaster,50389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50389,BCBS multispecialty AW base fee schedule,708.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50390,Not in chargemaster,50390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50390,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50391,Not in chargemaster,50391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50391,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50396,Not in chargemaster,50396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50396,BCBS multispecialty AW base fee schedule,222.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50400,Not in chargemaster,50400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50400,BCBS multispecialty AW base fee schedule,2226.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50405,Not in chargemaster,50405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50405,BCBS multispecialty AW base fee schedule,2670.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50430,Not in chargemaster,50430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50430,BCBS multispecialty AW base fee schedule,1071.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50431,Not in chargemaster,50431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50431,BCBS multispecialty AW base fee schedule,487.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50432,Not in chargemaster,50432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50432,BCBS multispecialty AW base fee schedule,1676.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50433,Not in chargemaster,50433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50433,BCBS multispecialty AW base fee schedule,2168.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50434,Not in chargemaster,50434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50434,BCBS multispecialty AW base fee schedule,1726.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50435,Not in chargemaster,50435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50435,BCBS multispecialty AW base fee schedule,1061.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50436,Not in chargemaster,50436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50436,BCBS multispecialty AW base fee schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50437,Not in chargemaster,50437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50437,BCBS multispecialty AW base fee schedule,482.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50500,Not in chargemaster,50500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50500,BCBS multispecialty AW base fee schedule,2379.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50520,Not in chargemaster,50520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50520,BCBS multispecialty AW base fee schedule,2235.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50525,Not in chargemaster,50525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50525,BCBS multispecialty AW base fee schedule,2838.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50526,Not in chargemaster,50526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50526,BCBS multispecialty AW base fee schedule,3042.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50540,Not in chargemaster,50540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50540,BCBS multispecialty AW base fee schedule,2194.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50541,Not in chargemaster,50541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50541,BCBS multispecialty AW base fee schedule,1755.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50542,Not in chargemaster,50542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50542,BCBS multispecialty AW base fee schedule,2229.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50543,Not in chargemaster,50543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50543,BCBS multispecialty AW base fee schedule,2848.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50544,Not in chargemaster,50544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50544,BCBS multispecialty AW base fee schedule,2382.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50545,Not in chargemaster,50545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50545,BCBS multispecialty AW base fee schedule,2561.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50546,Not in chargemaster,50546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50546,BCBS multispecialty AW base fee schedule,2304.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50547,Not in chargemaster,50547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50547,BCBS multispecialty AW base fee schedule,3089.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50548,Not in chargemaster,50548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50548,BCBS multispecialty AW base fee schedule,2575.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50551,Not in chargemaster,50551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50551,BCBS multispecialty AW base fee schedule,686.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50553,Not in chargemaster,50553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50553,BCBS multispecialty AW base fee schedule,733.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50555,Not in chargemaster,50555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50555,BCBS multispecialty AW base fee schedule,787.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50557,Not in chargemaster,50557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50557,BCBS multispecialty AW base fee schedule,800.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50561,Not in chargemaster,50561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50561,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50562,Not in chargemaster,50562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50562,BCBS multispecialty AW base fee schedule,1108.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50570,Not in chargemaster,50570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50570,BCBS multispecialty AW base fee schedule,939.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50572,Not in chargemaster,50572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50572,BCBS multispecialty AW base fee schedule,1016.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50574,Not in chargemaster,50574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50574,BCBS multispecialty AW base fee schedule,1080.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50575,Not in chargemaster,50575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50575,BCBS multispecialty AW base fee schedule,1367.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50576,Not in chargemaster,50576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50576,BCBS multispecialty AW base fee schedule,1077.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50580,Not in chargemaster,50580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50580,BCBS multispecialty AW base fee schedule,1161.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50590,Not in chargemaster,50590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50590,BCBS multispecialty AW base fee schedule,1402.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50592,Not in chargemaster,50592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50592,BCBS multispecialty AW base fee schedule,6041.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50593,Not in chargemaster,50593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50593,BCBS multispecialty AW base fee schedule,8169.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50600,Not in chargemaster,50600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50600,BCBS multispecialty AW base fee schedule,1795.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50605,Not in chargemaster,50605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50605,BCBS multispecialty AW base fee schedule,1912.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50606,Not in chargemaster,50606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50606,BCBS multispecialty AW base fee schedule,1179.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50610,Not in chargemaster,50610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50610,BCBS multispecialty AW base fee schedule,1807.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50620,Not in chargemaster,50620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50620,BCBS multispecialty AW base fee schedule,1729.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50630,Not in chargemaster,50630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50630,BCBS multispecialty AW base fee schedule,1707.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50650,Not in chargemaster,50650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50650,BCBS multispecialty AW base fee schedule,1987.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50660,Not in chargemaster,50660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50660,BCBS multispecialty AW base fee schedule,2187.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50684,Not in chargemaster,50684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50684,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50686,Not in chargemaster,50686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50686,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50688,Not in chargemaster,50688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50688,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50690,Not in chargemaster,50690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50690,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50693,Not in chargemaster,50693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50693,BCBS multispecialty AW base fee schedule,1965.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50694,Not in chargemaster,50694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50694,BCBS multispecialty AW base fee schedule,2182.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50695,Not in chargemaster,50695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50695,BCBS multispecialty AW base fee schedule,2644.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50700,Not in chargemaster,50700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50700,BCBS multispecialty AW base fee schedule,1770.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50705,Not in chargemaster,50705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50705,BCBS multispecialty AW base fee schedule,3580.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50706,Not in chargemaster,50706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50706,BCBS multispecialty AW base fee schedule,1786.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50715,Not in chargemaster,50715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50715,BCBS multispecialty AW base fee schedule,2302.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50722,Not in chargemaster,50722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50722,BCBS multispecialty AW base fee schedule,1975.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50725,Not in chargemaster,50725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50725,BCBS multispecialty AW base fee schedule,2110.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50727,Not in chargemaster,50727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50727,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50728,Not in chargemaster,50728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50728,BCBS multispecialty AW base fee schedule,1409.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50740,Not in chargemaster,50740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50740,BCBS multispecialty AW base fee schedule,2361.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50750,Not in chargemaster,50750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50750,BCBS multispecialty AW base fee schedule,2206.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50760,Not in chargemaster,50760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50760,BCBS multispecialty AW base fee schedule,2165.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50770,Not in chargemaster,50770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50770,BCBS multispecialty AW base fee schedule,2206.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50780,Not in chargemaster,50780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50780,BCBS multispecialty AW base fee schedule,2120,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50782,Not in chargemaster,50782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50782,BCBS multispecialty AW base fee schedule,2056.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50783,Not in chargemaster,50783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50783,BCBS multispecialty AW base fee schedule,2156.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50785,Not in chargemaster,50785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50785,BCBS multispecialty AW base fee schedule,2322.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50800,Not in chargemaster,50800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50800,BCBS multispecialty AW base fee schedule,1772.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50810,Not in chargemaster,50810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50810,BCBS multispecialty AW base fee schedule,2703,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50815,Not in chargemaster,50815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50815,BCBS multispecialty AW base fee schedule,2341.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50820,Not in chargemaster,50820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50820,BCBS multispecialty AW base fee schedule,2514.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50825,Not in chargemaster,50825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50825,BCBS multispecialty AW base fee schedule,3170.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50830,Not in chargemaster,50830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50830,BCBS multispecialty AW base fee schedule,3448.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50840,Not in chargemaster,50840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50840,BCBS multispecialty AW base fee schedule,2352.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50845,Not in chargemaster,50845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50845,BCBS multispecialty AW base fee schedule,2393.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50860,Not in chargemaster,50860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50860,BCBS multispecialty AW base fee schedule,1808.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50900,Not in chargemaster,50900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50900,BCBS multispecialty AW base fee schedule,1610.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50920,Not in chargemaster,50920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50920,BCBS multispecialty AW base fee schedule,1684.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50930,Not in chargemaster,50930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50930,BCBS multispecialty AW base fee schedule,2108.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50940,Not in chargemaster,50940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50940,BCBS multispecialty AW base fee schedule,1696.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50945,Not in chargemaster,50945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50945,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50947,Not in chargemaster,50947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50947,BCBS multispecialty AW base fee schedule,2653.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50948,Not in chargemaster,50948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50948,BCBS multispecialty AW base fee schedule,2437.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50951,Not in chargemaster,50951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50951,BCBS multispecialty AW base fee schedule,718.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50953,Not in chargemaster,50953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50953,BCBS multispecialty AW base fee schedule,761.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50955,Not in chargemaster,50955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50955,BCBS multispecialty AW base fee schedule,813.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50957,Not in chargemaster,50957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50957,BCBS multispecialty AW base fee schedule,821.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50961,Not in chargemaster,50961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50961,BCBS multispecialty AW base fee schedule,739.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50970,Not in chargemaster,50970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50970,BCBS multispecialty AW base fee schedule,708.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50972,Not in chargemaster,50972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50972,BCBS multispecialty AW base fee schedule,685.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50974,Not in chargemaster,50974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50974,BCBS multispecialty AW base fee schedule,903.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50976,Not in chargemaster,50976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50976,BCBS multispecialty AW base fee schedule,891.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50980,Not in chargemaster,50980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50980,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51020,Not in chargemaster,51020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51020,BCBS multispecialty AW base fee schedule,895.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51030,Not in chargemaster,51030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51030,BCBS multispecialty AW base fee schedule,901.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51040,Not in chargemaster,51040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51040,BCBS multispecialty AW base fee schedule,552.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51045,Not in chargemaster,51045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51045,BCBS multispecialty AW base fee schedule,955.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51050,Not in chargemaster,51050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51050,BCBS multispecialty AW base fee schedule,901,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51060,Not in chargemaster,51060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51060,BCBS multispecialty AW base fee schedule,1113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51065,Not in chargemaster,51065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51065,BCBS multispecialty AW base fee schedule,1107.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51080,Not in chargemaster,51080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51080,BCBS multispecialty AW base fee schedule,781.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51100,Not in chargemaster,51100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51100,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51101,Not in chargemaster,51101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51101,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51102,Not in chargemaster,51102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51102,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51500,Not in chargemaster,51500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51500,BCBS multispecialty AW base fee schedule,1217.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51520,Not in chargemaster,51520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51520,BCBS multispecialty AW base fee schedule,1137.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51525,Not in chargemaster,51525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51525,BCBS multispecialty AW base fee schedule,1643.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51530,Not in chargemaster,51530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51530,BCBS multispecialty AW base fee schedule,1473.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51535,Not in chargemaster,51535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51535,BCBS multispecialty AW base fee schedule,1493.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51550,Not in chargemaster,51550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51550,BCBS multispecialty AW base fee schedule,1843.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51555,Not in chargemaster,51555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51555,BCBS multispecialty AW base fee schedule,2423.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51565,Not in chargemaster,51565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51565,BCBS multispecialty AW base fee schedule,2490.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51570,Not in chargemaster,51570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51570,BCBS multispecialty AW base fee schedule,2822.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51575,Not in chargemaster,51575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51575,BCBS multispecialty AW base fee schedule,3488.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51580,Not in chargemaster,51580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51580,BCBS multispecialty AW base fee schedule,3627.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51585,Not in chargemaster,51585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51585,BCBS multispecialty AW base fee schedule,4038.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51590,Not in chargemaster,51590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51590,BCBS multispecialty AW base fee schedule,3702.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51595,Not in chargemaster,51595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51595,BCBS multispecialty AW base fee schedule,4187.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51596,Not in chargemaster,51596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51596,BCBS multispecialty AW base fee schedule,4503.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51597,Not in chargemaster,51597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51597,BCBS multispecialty AW base fee schedule,4391.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51600,Not in chargemaster,51600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51600,BCBS multispecialty AW base fee schedule,389.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51605,Not in chargemaster,51605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51605,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51610,Not in chargemaster,51610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51610,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51700,Not in chargemaster,51700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51700,BCBS multispecialty AW base fee schedule,141.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51701,Not in chargemaster,51701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51701,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51702,51702,51702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51702,BCBS multispecialty AW base fee schedule,115.28,149.79,Fee schedule,,115.28,115.28,115.28,115.28,,,0
unity,Fee schedule,Non-facility 51703,Not in chargemaster,51703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51703,BCBS multispecialty AW base fee schedule,263.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51705,Not in chargemaster,51705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51705,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51710,Not in chargemaster,51710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51710,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51715,Not in chargemaster,51715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51715,BCBS multispecialty AW base fee schedule,647.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51720,Not in chargemaster,51720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51720,BCBS multispecialty AW base fee schedule,157.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51725,Not in chargemaster,51725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51725,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51725 mod 26,Not in chargemaster,51725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51725 mod 26,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51725 mod TC,Not in chargemaster,51725,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51725 mod TC,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51726 mod 26,Not in chargemaster,51726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51726 mod 26,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51726 mod TC,Not in chargemaster,51726,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51726 mod TC,BCBS multispecialty AW base fee schedule,384.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51726,Not in chargemaster,51726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51726,BCBS multispecialty AW base fee schedule,545.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51727,Not in chargemaster,51727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51727,BCBS multispecialty AW base fee schedule,654.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51727 mod 26,Not in chargemaster,51727,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51727 mod 26,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51727 mod TC,Not in chargemaster,51727,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51727 mod TC,BCBS multispecialty AW base fee schedule,450.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51728 mod 26,Not in chargemaster,51728,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51728 mod 26,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51728 mod TC,Not in chargemaster,51728,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51728 mod TC,BCBS multispecialty AW base fee schedule,462.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51728,Not in chargemaster,51728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51728,BCBS multispecialty AW base fee schedule,662.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51729,Not in chargemaster,51729,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51729,BCBS multispecialty AW base fee schedule,706.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51729 mod 26,Not in chargemaster,51729,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51729 mod 26,BCBS multispecialty AW base fee schedule,242.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51729 mod TC,Not in chargemaster,51729,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51729 mod TC,BCBS multispecialty AW base fee schedule,464.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51736 mod 26,Not in chargemaster,51736,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51736 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51736 mod TC,Not in chargemaster,51736,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51736 mod TC,BCBS multispecialty AW base fee schedule,9.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51736,Not in chargemaster,51736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51736,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51741,Not in chargemaster,51741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51741,BCBS multispecialty AW base fee schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51741 mod 26,Not in chargemaster,51741,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51741 mod 26,BCBS multispecialty AW base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51741 mod TC,Not in chargemaster,51741,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51741 mod TC,BCBS multispecialty AW base fee schedule,10.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51784 mod 26,Not in chargemaster,51784,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51784 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51784 mod TC,Not in chargemaster,51784,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51784 mod TC,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51784,Not in chargemaster,51784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51784,BCBS multispecialty AW base fee schedule,127.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51785,Not in chargemaster,51785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51785,BCBS multispecialty AW base fee schedule,704.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51785 mod 26,Not in chargemaster,51785,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51785 mod 26,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51785 mod TC,Not in chargemaster,51785,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51785 mod TC,BCBS multispecialty AW base fee schedule,528.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51792 mod 26,Not in chargemaster,51792,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51792 mod 26,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51792 mod TC,Not in chargemaster,51792,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51792 mod TC,BCBS multispecialty AW base fee schedule,361.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51792,Not in chargemaster,51792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51792,BCBS multispecialty AW base fee schedule,466.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51797,Not in chargemaster,51797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51797,BCBS multispecialty AW base fee schedule,305.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51797 mod 26,Not in chargemaster,51797,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51797 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51797 mod TC,Not in chargemaster,51797,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51797 mod TC,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51798,Not in chargemaster,51798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51798,BCBS multispecialty AW base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51800,Not in chargemaster,51800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51800,BCBS multispecialty AW base fee schedule,1995.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51820,Not in chargemaster,51820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51820,BCBS multispecialty AW base fee schedule,2073.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51840,Not in chargemaster,51840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51840,BCBS multispecialty AW base fee schedule,1305.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51841,Not in chargemaster,51841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51841,BCBS multispecialty AW base fee schedule,1511.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51845,Not in chargemaster,51845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51845,BCBS multispecialty AW base fee schedule,1113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51860,Not in chargemaster,51860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51860,BCBS multispecialty AW base fee schedule,1427.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51865,Not in chargemaster,51865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51865,BCBS multispecialty AW base fee schedule,1720.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51880,Not in chargemaster,51880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51880,BCBS multispecialty AW base fee schedule,891.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51900,Not in chargemaster,51900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51900,BCBS multispecialty AW base fee schedule,1576.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51920,Not in chargemaster,51920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51920,BCBS multispecialty AW base fee schedule,1459.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51925,Not in chargemaster,51925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51925,BCBS multispecialty AW base fee schedule,2035.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51940,Not in chargemaster,51940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51940,BCBS multispecialty AW base fee schedule,3140.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51960,Not in chargemaster,51960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51960,BCBS multispecialty AW base fee schedule,2650,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51980,Not in chargemaster,51980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51980,BCBS multispecialty AW base fee schedule,1364.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51990,Not in chargemaster,51990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51990,BCBS multispecialty AW base fee schedule,1430.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51992,Not in chargemaster,51992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,51992,BCBS multispecialty AW base fee schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52000,Not in chargemaster,52000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52000,BCBS multispecialty AW base fee schedule,396.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52001,Not in chargemaster,52001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52001,BCBS multispecialty AW base fee schedule,787.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52005,Not in chargemaster,52005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52005,BCBS multispecialty AW base fee schedule,554.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52007,Not in chargemaster,52007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52007,BCBS multispecialty AW base fee schedule,895.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52010,Not in chargemaster,52010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52010,BCBS multispecialty AW base fee schedule,750.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52204,Not in chargemaster,52204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52204,BCBS multispecialty AW base fee schedule,726.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52214,Not in chargemaster,52214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52214,BCBS multispecialty AW base fee schedule,1378.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52224,Not in chargemaster,52224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52224,BCBS multispecialty AW base fee schedule,1440.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52234,Not in chargemaster,52234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52234,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52235,Not in chargemaster,52235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52235,BCBS multispecialty AW base fee schedule,550.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52240,Not in chargemaster,52240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52240,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52250,Not in chargemaster,52250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52250,BCBS multispecialty AW base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52260,Not in chargemaster,52260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52260,BCBS multispecialty AW base fee schedule,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52265,Not in chargemaster,52265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52265,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52270,Not in chargemaster,52270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52270,BCBS multispecialty AW base fee schedule,759.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52275,Not in chargemaster,52275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52275,BCBS multispecialty AW base fee schedule,997.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52276,Not in chargemaster,52276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52276,BCBS multispecialty AW base fee schedule,504.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52277,Not in chargemaster,52277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52277,BCBS multispecialty AW base fee schedule,616.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52281,Not in chargemaster,52281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52281,BCBS multispecialty AW base fee schedule,606.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52282,Not in chargemaster,52282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52282,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52283,Not in chargemaster,52283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52283,BCBS multispecialty AW base fee schedule,616.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52285,Not in chargemaster,52285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52285,BCBS multispecialty AW base fee schedule,614.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52287,Not in chargemaster,52287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52287,BCBS multispecialty AW base fee schedule,680.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52290,Not in chargemaster,52290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52290,BCBS multispecialty AW base fee schedule,465.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52300,Not in chargemaster,52300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52300,BCBS multispecialty AW base fee schedule,533.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52301,Not in chargemaster,52301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52301,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52305,Not in chargemaster,52305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52305,BCBS multispecialty AW base fee schedule,532.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52310,Not in chargemaster,52310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52310,BCBS multispecialty AW base fee schedule,547.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52315,Not in chargemaster,52315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52315,BCBS multispecialty AW base fee schedule,879.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52317,Not in chargemaster,52317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52317,BCBS multispecialty AW base fee schedule,1654.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52318,Not in chargemaster,52318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52318,BCBS multispecialty AW base fee schedule,904.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52320,Not in chargemaster,52320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52320,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52325,Not in chargemaster,52325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52325,BCBS multispecialty AW base fee schedule,610.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52327,Not in chargemaster,52327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52327,BCBS multispecialty AW base fee schedule,502.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52330,Not in chargemaster,52330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52330,BCBS multispecialty AW base fee schedule,1098.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52332,Not in chargemaster,52332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52332,BCBS multispecialty AW base fee schedule,857.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52334,Not in chargemaster,52334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52334,BCBS multispecialty AW base fee schedule,349.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52341,Not in chargemaster,52341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52341,BCBS multispecialty AW base fee schedule,542.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52342,Not in chargemaster,52342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52342,BCBS multispecialty AW base fee schedule,588.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52343,Not in chargemaster,52343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52343,BCBS multispecialty AW base fee schedule,657.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52344,Not in chargemaster,52344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52344,BCBS multispecialty AW base fee schedule,704.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52345,Not in chargemaster,52345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52345,BCBS multispecialty AW base fee schedule,753.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52346,Not in chargemaster,52346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52346,BCBS multispecialty AW base fee schedule,851.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52351,Not in chargemaster,52351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52351,BCBS multispecialty AW base fee schedule,577.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52352,Not in chargemaster,52352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52352,BCBS multispecialty AW base fee schedule,677.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52353,Not in chargemaster,52353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52353,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52354,Not in chargemaster,52354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52354,BCBS multispecialty AW base fee schedule,796.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52355,Not in chargemaster,52355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52355,BCBS multispecialty AW base fee schedule,893.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52356,Not in chargemaster,52356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52356,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52400,Not in chargemaster,52400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52400,BCBS multispecialty AW base fee schedule,912.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52402,Not in chargemaster,52402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52402,BCBS multispecialty AW base fee schedule,510.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52441,Not in chargemaster,52441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52441,BCBS multispecialty AW base fee schedule,2563.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52442,Not in chargemaster,52442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52442,BCBS multispecialty AW base fee schedule,1866.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52450,Not in chargemaster,52450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52450,BCBS multispecialty AW base fee schedule,900.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52500,Not in chargemaster,52500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52500,BCBS multispecialty AW base fee schedule,934.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52601,Not in chargemaster,52601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52601,BCBS multispecialty AW base fee schedule,1394.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52630,Not in chargemaster,52630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52630,BCBS multispecialty AW base fee schedule,768.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52640,Not in chargemaster,52640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52640,BCBS multispecialty AW base fee schedule,604.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52647,Not in chargemaster,52647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52647,BCBS multispecialty AW base fee schedule,3070.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52648,Not in chargemaster,52648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52648,BCBS multispecialty AW base fee schedule,3168.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52649,Not in chargemaster,52649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52649,BCBS multispecialty AW base fee schedule,1578.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52700,Not in chargemaster,52700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,52700,BCBS multispecialty AW base fee schedule,843.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53000,Not in chargemaster,53000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53000,BCBS multispecialty AW base fee schedule,282.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53010,Not in chargemaster,53010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53010,BCBS multispecialty AW base fee schedule,562.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53020,Not in chargemaster,53020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53020,BCBS multispecialty AW base fee schedule,185.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53025,Not in chargemaster,53025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53025,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53040,Not in chargemaster,53040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53040,BCBS multispecialty AW base fee schedule,749.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53060,Not in chargemaster,53060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53060,BCBS multispecialty AW base fee schedule,356.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53080,Not in chargemaster,53080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53080,BCBS multispecialty AW base fee schedule,802.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53085,Not in chargemaster,53085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53085,BCBS multispecialty AW base fee schedule,1240.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53200,Not in chargemaster,53200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53200,BCBS multispecialty AW base fee schedule,300.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53210,Not in chargemaster,53210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53210,BCBS multispecialty AW base fee schedule,1493.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53215,Not in chargemaster,53215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53215,BCBS multispecialty AW base fee schedule,1776.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53220,Not in chargemaster,53220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53220,BCBS multispecialty AW base fee schedule,863.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53230,Not in chargemaster,53230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53230,BCBS multispecialty AW base fee schedule,1164.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53235,Not in chargemaster,53235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53235,BCBS multispecialty AW base fee schedule,1210.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53240,Not in chargemaster,53240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53240,BCBS multispecialty AW base fee schedule,809.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53250,Not in chargemaster,53250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53250,BCBS multispecialty AW base fee schedule,756.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53260,Not in chargemaster,53260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53260,BCBS multispecialty AW base fee schedule,388.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53265,Not in chargemaster,53265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53265,BCBS multispecialty AW base fee schedule,427.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53270,Not in chargemaster,53270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53270,BCBS multispecialty AW base fee schedule,396.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53275,Not in chargemaster,53275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53275,BCBS multispecialty AW base fee schedule,502.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53400,Not in chargemaster,53400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53400,BCBS multispecialty AW base fee schedule,1534.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53405,Not in chargemaster,53405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53405,BCBS multispecialty AW base fee schedule,1670.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53410,Not in chargemaster,53410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53410,BCBS multispecialty AW base fee schedule,1872.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53415,Not in chargemaster,53415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53415,BCBS multispecialty AW base fee schedule,2162.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53420,Not in chargemaster,53420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53420,BCBS multispecialty AW base fee schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53425,Not in chargemaster,53425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53425,BCBS multispecialty AW base fee schedule,1792.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53430,Not in chargemaster,53430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53430,BCBS multispecialty AW base fee schedule,1859.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53431,Not in chargemaster,53431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53431,BCBS multispecialty AW base fee schedule,2207.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53440,Not in chargemaster,53440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53440,BCBS multispecialty AW base fee schedule,1440.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53442,Not in chargemaster,53442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53442,BCBS multispecialty AW base fee schedule,1498.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53444,Not in chargemaster,53444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53444,BCBS multispecialty AW base fee schedule,1518.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53445,Not in chargemaster,53445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53445,BCBS multispecialty AW base fee schedule,1442.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53446,Not in chargemaster,53446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53446,BCBS multispecialty AW base fee schedule,1227.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53447,Not in chargemaster,53447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53447,BCBS multispecialty AW base fee schedule,1545.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53448,Not in chargemaster,53448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53448,BCBS multispecialty AW base fee schedule,2447.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53449,Not in chargemaster,53449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53449,BCBS multispecialty AW base fee schedule,1170.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53450,Not in chargemaster,53450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53450,BCBS multispecialty AW base fee schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53460,Not in chargemaster,53460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53460,BCBS multispecialty AW base fee schedule,874.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53500,Not in chargemaster,53500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53500,BCBS multispecialty AW base fee schedule,1434.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53502,Not in chargemaster,53502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53502,BCBS multispecialty AW base fee schedule,928.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53505,Not in chargemaster,53505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53505,BCBS multispecialty AW base fee schedule,927.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53510,Not in chargemaster,53510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53510,BCBS multispecialty AW base fee schedule,1207.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53515,Not in chargemaster,53515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53515,BCBS multispecialty AW base fee schedule,1522.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53520,Not in chargemaster,53520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53520,BCBS multispecialty AW base fee schedule,1065.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53600,Not in chargemaster,53600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53600,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53601,Not in chargemaster,53601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53601,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53605,Not in chargemaster,53605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53605,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53620,Not in chargemaster,53620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53620,BCBS multispecialty AW base fee schedule,279.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53621,Not in chargemaster,53621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53621,BCBS multispecialty AW base fee schedule,263.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53660,Not in chargemaster,53660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53660,BCBS multispecialty AW base fee schedule,133.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53661,Not in chargemaster,53661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53661,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53665,Not in chargemaster,53665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53665,BCBS multispecialty AW base fee schedule,73.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53850,Not in chargemaster,53850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53850,BCBS multispecialty AW base fee schedule,2937.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53852,Not in chargemaster,53852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53852,BCBS multispecialty AW base fee schedule,2848.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53854,Not in chargemaster,53854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53854,BCBS multispecialty AW base fee schedule,3390.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53855,Not in chargemaster,53855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53855,BCBS multispecialty AW base fee schedule,1397.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53860,Not in chargemaster,53860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,53860,BCBS multispecialty AW base fee schedule,3959.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54000,Not in chargemaster,54000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54000,BCBS multispecialty AW base fee schedule,297.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54001,Not in chargemaster,54001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54001,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54015,Not in chargemaster,54015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54015,BCBS multispecialty AW base fee schedule,584.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54050,Not in chargemaster,54050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54050,BCBS multispecialty AW base fee schedule,253.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54055,Not in chargemaster,54055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54055,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54056,Not in chargemaster,54056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54056,BCBS multispecialty AW base fee schedule,264.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54057,Not in chargemaster,54057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54057,BCBS multispecialty AW base fee schedule,261.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54060,Not in chargemaster,54060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54060,BCBS multispecialty AW base fee schedule,355.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54065,Not in chargemaster,54065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54065,BCBS multispecialty AW base fee schedule,415.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54100,Not in chargemaster,54100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54100,BCBS multispecialty AW base fee schedule,375.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54105,Not in chargemaster,54105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54105,BCBS multispecialty AW base fee schedule,512.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54110,Not in chargemaster,54110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54110,BCBS multispecialty AW base fee schedule,1193.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54111,Not in chargemaster,54111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54111,BCBS multispecialty AW base fee schedule,1531.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54112,Not in chargemaster,54112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54112,BCBS multispecialty AW base fee schedule,1793.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54115,Not in chargemaster,54115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54115,BCBS multispecialty AW base fee schedule,866.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54120,Not in chargemaster,54120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54120,BCBS multispecialty AW base fee schedule,1207.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54125,Not in chargemaster,54125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54125,BCBS multispecialty AW base fee schedule,1558.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54130,Not in chargemaster,54130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54130,BCBS multispecialty AW base fee schedule,2282.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54135,Not in chargemaster,54135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54135,BCBS multispecialty AW base fee schedule,2893.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54150,54150,54150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54150,BCBS multispecialty AW base fee schedule,291.5,325.83,Fee schedule,,291.5,291.5,291.5,291.5,,,0
unity,Fee schedule,Non-facility 54160,Not in chargemaster,54160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54160,BCBS multispecialty AW base fee schedule,416.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54161,Not in chargemaster,54161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54161,BCBS multispecialty AW base fee schedule,376.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54162,Not in chargemaster,54162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54162,BCBS multispecialty AW base fee schedule,489.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54163,Not in chargemaster,54163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54163,BCBS multispecialty AW base fee schedule,415.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54164,Not in chargemaster,54164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54164,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54200,Not in chargemaster,54200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54200,BCBS multispecialty AW base fee schedule,210.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54205,Not in chargemaster,54205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54205,BCBS multispecialty AW base fee schedule,1017.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54220,Not in chargemaster,54220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54220,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54230,Not in chargemaster,54230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54230,BCBS multispecialty AW base fee schedule,190.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54231,Not in chargemaster,54231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54231,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54235,Not in chargemaster,54235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54235,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54240,Not in chargemaster,54240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54240,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54240 mod 26,Not in chargemaster,54240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54240 mod 26,BCBS multispecialty AW base fee schedule,124.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54240 mod TC,Not in chargemaster,54240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54240 mod TC,BCBS multispecialty AW base fee schedule,70.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54250 mod 26,Not in chargemaster,54250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54250 mod 26,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54250 mod TC,Not in chargemaster,54250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54250 mod TC,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54250,Not in chargemaster,54250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54250,BCBS multispecialty AW base fee schedule,232.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54300,Not in chargemaster,54300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54300,BCBS multispecialty AW base fee schedule,1233.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54304,Not in chargemaster,54304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54304,BCBS multispecialty AW base fee schedule,1432.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54308,Not in chargemaster,54308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54308,BCBS multispecialty AW base fee schedule,1368.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54312,Not in chargemaster,54312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54312,BCBS multispecialty AW base fee schedule,1566.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54316,Not in chargemaster,54316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54316,BCBS multispecialty AW base fee schedule,1906.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54318,Not in chargemaster,54318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54318,BCBS multispecialty AW base fee schedule,1360.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54322,Not in chargemaster,54322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54322,BCBS multispecialty AW base fee schedule,1495.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54324,Not in chargemaster,54324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54324,BCBS multispecialty AW base fee schedule,1852.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54326,Not in chargemaster,54326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54326,BCBS multispecialty AW base fee schedule,1806.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54328,Not in chargemaster,54328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54328,BCBS multispecialty AW base fee schedule,1794.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54332,Not in chargemaster,54332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54332,BCBS multispecialty AW base fee schedule,1937.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54336,Not in chargemaster,54336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54336,BCBS multispecialty AW base fee schedule,2275.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54340,Not in chargemaster,54340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54340,BCBS multispecialty AW base fee schedule,1089.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54344,Not in chargemaster,54344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54344,BCBS multispecialty AW base fee schedule,1810.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54348,Not in chargemaster,54348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54348,BCBS multispecialty AW base fee schedule,1935.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54352,Not in chargemaster,54352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54352,BCBS multispecialty AW base fee schedule,2710.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54360,Not in chargemaster,54360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54360,BCBS multispecialty AW base fee schedule,1379.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54380,Not in chargemaster,54380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54380,BCBS multispecialty AW base fee schedule,1529.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54385,Not in chargemaster,54385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54385,BCBS multispecialty AW base fee schedule,1778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54390,Not in chargemaster,54390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54390,BCBS multispecialty AW base fee schedule,2375.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54400,Not in chargemaster,54400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54400,BCBS multispecialty AW base fee schedule,1016.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54401,Not in chargemaster,54401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54401,BCBS multispecialty AW base fee schedule,1257.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54405,Not in chargemaster,54405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54405,BCBS multispecialty AW base fee schedule,1548.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54406,Not in chargemaster,54406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54406,BCBS multispecialty AW base fee schedule,1398.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54408,Not in chargemaster,54408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54408,BCBS multispecialty AW base fee schedule,1512.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54410,Not in chargemaster,54410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54410,BCBS multispecialty AW base fee schedule,1646.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54411,Not in chargemaster,54411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54411,BCBS multispecialty AW base fee schedule,1968.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54415,Not in chargemaster,54415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54415,BCBS multispecialty AW base fee schedule,1011.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54416,Not in chargemaster,54416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54416,BCBS multispecialty AW base fee schedule,1360.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54417,Not in chargemaster,54417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54417,BCBS multispecialty AW base fee schedule,1719.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54420,Not in chargemaster,54420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54420,BCBS multispecialty AW base fee schedule,1346.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54430,Not in chargemaster,54430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54430,BCBS multispecialty AW base fee schedule,1222.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54435,Not in chargemaster,54435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54435,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54437,Not in chargemaster,54437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54437,BCBS multispecialty AW base fee schedule,1289.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54438,Not in chargemaster,54438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54438,BCBS multispecialty AW base fee schedule,2559.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54450,Not in chargemaster,54450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54450,BCBS multispecialty AW base fee schedule,131.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54500,Not in chargemaster,54500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54500,BCBS multispecialty AW base fee schedule,141.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54505,Not in chargemaster,54505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54505,BCBS multispecialty AW base fee schedule,401.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54512,Not in chargemaster,54512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54512,BCBS multispecialty AW base fee schedule,1030.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54520,Not in chargemaster,54520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54520,BCBS multispecialty AW base fee schedule,622.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54522,Not in chargemaster,54522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54522,BCBS multispecialty AW base fee schedule,1126.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54530,Not in chargemaster,54530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54530,BCBS multispecialty AW base fee schedule,969.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54535,Not in chargemaster,54535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54535,BCBS multispecialty AW base fee schedule,1423.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54550,Not in chargemaster,54550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54550,BCBS multispecialty AW base fee schedule,940.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54560,Not in chargemaster,54560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54560,BCBS multispecialty AW base fee schedule,1314.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54600,Not in chargemaster,54600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54600,BCBS multispecialty AW base fee schedule,865.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54620,Not in chargemaster,54620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54620,BCBS multispecialty AW base fee schedule,572.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54640,Not in chargemaster,54640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54640,BCBS multispecialty AW base fee schedule,831.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54650,Not in chargemaster,54650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54650,BCBS multispecialty AW base fee schedule,1361.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54660,Not in chargemaster,54660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54660,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54670,Not in chargemaster,54670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54670,BCBS multispecialty AW base fee schedule,778.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54680,Not in chargemaster,54680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54680,BCBS multispecialty AW base fee schedule,1507.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54690,Not in chargemaster,54690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54690,BCBS multispecialty AW base fee schedule,1254.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54692,Not in chargemaster,54692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54692,BCBS multispecialty AW base fee schedule,1450.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54700,54700,54700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54700,BCBS multispecialty AW base fee schedule,409.43,440,Fee schedule,,409.43,409.43,409.43,409.43,,,0
unity,Fee schedule,Non-facility 54800,Not in chargemaster,54800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54800,BCBS multispecialty AW base fee schedule,240.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54830,Not in chargemaster,54830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54830,BCBS multispecialty AW base fee schedule,710.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54840,Not in chargemaster,54840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54840,BCBS multispecialty AW base fee schedule,614.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54860,Not in chargemaster,54860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54860,BCBS multispecialty AW base fee schedule,799.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54861,Not in chargemaster,54861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54861,BCBS multispecialty AW base fee schedule,1085.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54865,Not in chargemaster,54865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54865,BCBS multispecialty AW base fee schedule,684.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54900,Not in chargemaster,54900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54900,BCBS multispecialty AW base fee schedule,1532.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54901,Not in chargemaster,54901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54901,BCBS multispecialty AW base fee schedule,2023.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55000,Not in chargemaster,55000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55000,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55040,Not in chargemaster,55040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55040,BCBS multispecialty AW base fee schedule,643.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55041,Not in chargemaster,55041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55041,BCBS multispecialty AW base fee schedule,977.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55060,Not in chargemaster,55060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55060,BCBS multispecialty AW base fee schedule,726.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55100,Not in chargemaster,55100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55100,BCBS multispecialty AW base fee schedule,425.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55110,Not in chargemaster,55110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55110,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55120,Not in chargemaster,55120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55120,BCBS multispecialty AW base fee schedule,675.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55150,Not in chargemaster,55150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55150,BCBS multispecialty AW base fee schedule,940.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55175,Not in chargemaster,55175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55175,BCBS multispecialty AW base fee schedule,692.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55180,Not in chargemaster,55180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55180,BCBS multispecialty AW base fee schedule,1325,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55200,Not in chargemaster,55200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55200,BCBS multispecialty AW base fee schedule,781.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55250,Not in chargemaster,55250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55250,BCBS multispecialty AW base fee schedule,683.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55300,Not in chargemaster,55300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55300,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55400,Not in chargemaster,55400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55400,BCBS multispecialty AW base fee schedule,955.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55500,Not in chargemaster,55500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55500,BCBS multispecialty AW base fee schedule,751.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55520,55520,55520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55520,BCBS multispecialty AW base fee schedule,874.5,812.79,Fee schedule,,812.79,812.79,812.79,812.79,,,0
unity,Fee schedule,Non-facility 55530,Not in chargemaster,55530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55530,BCBS multispecialty AW base fee schedule,671.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55535,Not in chargemaster,55535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55535,BCBS multispecialty AW base fee schedule,822.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55540,Not in chargemaster,55540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55540,BCBS multispecialty AW base fee schedule,1063.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55550,Not in chargemaster,55550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55550,BCBS multispecialty AW base fee schedule,819.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55600,Not in chargemaster,55600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55600,BCBS multispecialty AW base fee schedule,804.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55605,Not in chargemaster,55605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55605,BCBS multispecialty AW base fee schedule,998.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55650,Not in chargemaster,55650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55650,BCBS multispecialty AW base fee schedule,1372.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55680,Not in chargemaster,55680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55680,BCBS multispecialty AW base fee schedule,661.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55700,Not in chargemaster,55700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55700,BCBS multispecialty AW base fee schedule,469.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55705,Not in chargemaster,55705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55705,BCBS multispecialty AW base fee schedule,508.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55706,Not in chargemaster,55706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55706,BCBS multispecialty AW base fee schedule,712.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55720,Not in chargemaster,55720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55720,BCBS multispecialty AW base fee schedule,864.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55725,Not in chargemaster,55725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55725,BCBS multispecialty AW base fee schedule,1135.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55801,Not in chargemaster,55801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55801,BCBS multispecialty AW base fee schedule,2094.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55810,Not in chargemaster,55810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55810,BCBS multispecialty AW base fee schedule,2508.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55812,Not in chargemaster,55812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55812,BCBS multispecialty AW base fee schedule,3079.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55815,Not in chargemaster,55815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55815,BCBS multispecialty AW base fee schedule,3373.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55821,Not in chargemaster,55821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55821,BCBS multispecialty AW base fee schedule,1672.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55831,Not in chargemaster,55831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55831,BCBS multispecialty AW base fee schedule,1809.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55840,Not in chargemaster,55840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55840,BCBS multispecialty AW base fee schedule,2239.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55842,Not in chargemaster,55842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55842,BCBS multispecialty AW base fee schedule,2241.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55845,Not in chargemaster,55845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55845,BCBS multispecialty AW base fee schedule,2608.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55860,Not in chargemaster,55860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55860,BCBS multispecialty AW base fee schedule,1674.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55862,Not in chargemaster,55862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55862,BCBS multispecialty AW base fee schedule,2098.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55865,Not in chargemaster,55865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55865,BCBS multispecialty AW base fee schedule,2555.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55866,Not in chargemaster,55866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55866,BCBS multispecialty AW base fee schedule,2761.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55870,Not in chargemaster,55870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55870,BCBS multispecialty AW base fee schedule,333.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55873,Not in chargemaster,55873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55873,BCBS multispecialty AW base fee schedule,11628.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55874,Not in chargemaster,55874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55874,BCBS multispecialty AW base fee schedule,5769.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55875,Not in chargemaster,55875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55875,BCBS multispecialty AW base fee schedule,1470.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55876,Not in chargemaster,55876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55876,BCBS multispecialty AW base fee schedule,275.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55920,Not in chargemaster,55920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,55920,BCBS multispecialty AW base fee schedule,867.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56405,Not in chargemaster,56405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56405,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56420,Not in chargemaster,56420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56420,BCBS multispecialty AW base fee schedule,296.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56440,Not in chargemaster,56440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56440,BCBS multispecialty AW base fee schedule,347.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56441,Not in chargemaster,56441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56441,BCBS multispecialty AW base fee schedule,312.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56442,Not in chargemaster,56442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56442,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56501,Not in chargemaster,56501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56501,BCBS multispecialty AW base fee schedule,310.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56515,Not in chargemaster,56515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56515,BCBS multispecialty AW base fee schedule,480.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56605,Not in chargemaster,56605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56605,BCBS multispecialty AW base fee schedule,172.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56606,Not in chargemaster,56606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56606,BCBS multispecialty AW base fee schedule,73.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56620,Not in chargemaster,56620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56620,BCBS multispecialty AW base fee schedule,1054.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56625,Not in chargemaster,56625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56625,BCBS multispecialty AW base fee schedule,1232.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56630,Not in chargemaster,56630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56630,BCBS multispecialty AW base fee schedule,1794.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56631,Not in chargemaster,56631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56631,BCBS multispecialty AW base fee schedule,2241.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56632,Not in chargemaster,56632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56632,BCBS multispecialty AW base fee schedule,2668.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56633,Not in chargemaster,56633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56633,BCBS multispecialty AW base fee schedule,2316.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56634,Not in chargemaster,56634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56634,BCBS multispecialty AW base fee schedule,2443.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56637,Not in chargemaster,56637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56637,BCBS multispecialty AW base fee schedule,2838.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56640,Not in chargemaster,56640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56640,BCBS multispecialty AW base fee schedule,2873.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56700,Not in chargemaster,56700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56700,BCBS multispecialty AW base fee schedule,376.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56740,Not in chargemaster,56740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56740,BCBS multispecialty AW base fee schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56800,Not in chargemaster,56800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56800,BCBS multispecialty AW base fee schedule,475.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56805,Not in chargemaster,56805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56805,BCBS multispecialty AW base fee schedule,2227.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56810,Not in chargemaster,56810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56810,BCBS multispecialty AW base fee schedule,511.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56820,Not in chargemaster,56820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56820,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56821,Not in chargemaster,56821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,56821,BCBS multispecialty AW base fee schedule,302.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57000,Not in chargemaster,57000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57000,BCBS multispecialty AW base fee schedule,376.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57010,Not in chargemaster,57010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57010,BCBS multispecialty AW base fee schedule,857.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57020,Not in chargemaster,57020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57020,BCBS multispecialty AW base fee schedule,210.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57022,Not in chargemaster,57022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57022,BCBS multispecialty AW base fee schedule,337.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57023,Not in chargemaster,57023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57023,BCBS multispecialty AW base fee schedule,606.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57061,Not in chargemaster,57061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57061,BCBS multispecialty AW base fee schedule,268.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57065,Not in chargemaster,57065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57065,BCBS multispecialty AW base fee schedule,422.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57100,Not in chargemaster,57100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57100,BCBS multispecialty AW base fee schedule,182.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57105,Not in chargemaster,57105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57105,BCBS multispecialty AW base fee schedule,302.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57106,Not in chargemaster,57106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57106,BCBS multispecialty AW base fee schedule,986.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57107,Not in chargemaster,57107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57107,BCBS multispecialty AW base fee schedule,2751.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57109,Not in chargemaster,57109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57109,BCBS multispecialty AW base fee schedule,3268.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57110,Not in chargemaster,57110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57110,BCBS multispecialty AW base fee schedule,1731.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57111,Not in chargemaster,57111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57111,BCBS multispecialty AW base fee schedule,3268.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57112,Not in chargemaster,57112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57112,BCBS multispecialty AW base fee schedule,3496.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57120,Not in chargemaster,57120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57120,BCBS multispecialty AW base fee schedule,1001.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57130,Not in chargemaster,57130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57130,BCBS multispecialty AW base fee schedule,392.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57135,Not in chargemaster,57135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57135,BCBS multispecialty AW base fee schedule,422.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57150,Not in chargemaster,57150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57150,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57155,Not in chargemaster,57155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57155,BCBS multispecialty AW base fee schedule,722.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57156,Not in chargemaster,57156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57156,BCBS multispecialty AW base fee schedule,406.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57160,Not in chargemaster,57160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57160,BCBS multispecialty AW base fee schedule,129.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57170,Not in chargemaster,57170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57170,BCBS multispecialty AW base fee schedule,133.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57180,Not in chargemaster,57180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57180,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57200,Not in chargemaster,57200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57200,BCBS multispecialty AW base fee schedule,607.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57210,Not in chargemaster,57210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57210,BCBS multispecialty AW base fee schedule,733.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57220,Not in chargemaster,57220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57220,BCBS multispecialty AW base fee schedule,640.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57230,Not in chargemaster,57230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57230,BCBS multispecialty AW base fee schedule,785.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57240,Not in chargemaster,57240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57240,BCBS multispecialty AW base fee schedule,1158.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57250,Not in chargemaster,57250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57250,BCBS multispecialty AW base fee schedule,1166,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57260,Not in chargemaster,57260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57260,BCBS multispecialty AW base fee schedule,1485.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57265,Not in chargemaster,57265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57265,BCBS multispecialty AW base fee schedule,1668.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57267,Not in chargemaster,57267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57267,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57268,Not in chargemaster,57268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57268,BCBS multispecialty AW base fee schedule,951.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57270,Not in chargemaster,57270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57270,BCBS multispecialty AW base fee schedule,1552.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57280,Not in chargemaster,57280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57280,BCBS multispecialty AW base fee schedule,1846.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57282,Not in chargemaster,57282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57282,BCBS multispecialty AW base fee schedule,1005.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57283,Not in chargemaster,57283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57283,BCBS multispecialty AW base fee schedule,1341.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57284,Not in chargemaster,57284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57284,BCBS multispecialty AW base fee schedule,1582.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57285,Not in chargemaster,57285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57285,BCBS multispecialty AW base fee schedule,1317.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57287,Not in chargemaster,57287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57287,BCBS multispecialty AW base fee schedule,1370.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57288,Not in chargemaster,57288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57288,BCBS multispecialty AW base fee schedule,1403.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57289,Not in chargemaster,57289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57289,BCBS multispecialty AW base fee schedule,1500.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57291,Not in chargemaster,57291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57291,BCBS multispecialty AW base fee schedule,1038.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57292,Not in chargemaster,57292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57292,BCBS multispecialty AW base fee schedule,1585.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57295,Not in chargemaster,57295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57295,BCBS multispecialty AW base fee schedule,942.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57296,Not in chargemaster,57296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57296,BCBS multispecialty AW base fee schedule,1815.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57300,Not in chargemaster,57300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57300,BCBS multispecialty AW base fee schedule,1129.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57305,Not in chargemaster,57305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57305,BCBS multispecialty AW base fee schedule,1852.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57307,Not in chargemaster,57307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57307,BCBS multispecialty AW base fee schedule,2013.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57308,Not in chargemaster,57308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57308,BCBS multispecialty AW base fee schedule,1258.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57310,Not in chargemaster,57310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57310,BCBS multispecialty AW base fee schedule,917.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57311,Not in chargemaster,57311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57311,BCBS multispecialty AW base fee schedule,1038.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57320,Not in chargemaster,57320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57320,BCBS multispecialty AW base fee schedule,1050.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57330,Not in chargemaster,57330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57330,BCBS multispecialty AW base fee schedule,1448.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57335,Not in chargemaster,57335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57335,BCBS multispecialty AW base fee schedule,2249.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57400,Not in chargemaster,57400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57400,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57410,Not in chargemaster,57410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57410,BCBS multispecialty AW base fee schedule,203.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57415,Not in chargemaster,57415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57415,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57420,Not in chargemaster,57420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57420,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57421,Not in chargemaster,57421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57421,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57423,Not in chargemaster,57423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57423,BCBS multispecialty AW base fee schedule,1777.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57425,Not in chargemaster,57425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57425,BCBS multispecialty AW base fee schedule,1875.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57426,Not in chargemaster,57426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57426,BCBS multispecialty AW base fee schedule,1647.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57452,Not in chargemaster,57452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57452,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57454,Not in chargemaster,57454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57454,BCBS multispecialty AW base fee schedule,312.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57455,Not in chargemaster,57455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57455,BCBS multispecialty AW base fee schedule,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57456,Not in chargemaster,57456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57456,BCBS multispecialty AW base fee schedule,276.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57460,Not in chargemaster,57460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57460,BCBS multispecialty AW base fee schedule,581.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57461,Not in chargemaster,57461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57461,BCBS multispecialty AW base fee schedule,652.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57500,Not in chargemaster,57500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57500,BCBS multispecialty AW base fee schedule,272.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57505,Not in chargemaster,57505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57505,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57510,Not in chargemaster,57510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57510,BCBS multispecialty AW base fee schedule,286.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57511,Not in chargemaster,57511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57511,BCBS multispecialty AW base fee schedule,331.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57513,Not in chargemaster,57513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57513,BCBS multispecialty AW base fee schedule,336.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57520,Not in chargemaster,57520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57520,BCBS multispecialty AW base fee schedule,635.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57522,Not in chargemaster,57522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57522,BCBS multispecialty AW base fee schedule,546.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57530,Not in chargemaster,57530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57530,BCBS multispecialty AW base fee schedule,690.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57531,Not in chargemaster,57531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57531,BCBS multispecialty AW base fee schedule,3506.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57540,Not in chargemaster,57540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57540,BCBS multispecialty AW base fee schedule,1513.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57545,Not in chargemaster,57545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57545,BCBS multispecialty AW base fee schedule,1595.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57550,Not in chargemaster,57550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57550,BCBS multispecialty AW base fee schedule,807.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57555,Not in chargemaster,57555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57555,BCBS multispecialty AW base fee schedule,1175.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57556,Not in chargemaster,57556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57556,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57558,Not in chargemaster,57558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57558,BCBS multispecialty AW base fee schedule,274.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57700,Not in chargemaster,57700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57700,BCBS multispecialty AW base fee schedule,641.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57720,Not in chargemaster,57720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57720,BCBS multispecialty AW base fee schedule,618.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57800,Not in chargemaster,57800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,57800,BCBS multispecialty AW base fee schedule,133.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58100,58100,58100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58100,BCBS multispecialty AW base fee schedule,185.5,232.84,Fee schedule,,185.5,185.5,185.5,185.5,,,0
unity,Fee schedule,Non-facility 58110,Not in chargemaster,58110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58110,BCBS multispecialty AW base fee schedule,96.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58120,Not in chargemaster,58120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58120,BCBS multispecialty AW base fee schedule,535.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58140,Not in chargemaster,58140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58140,BCBS multispecialty AW base fee schedule,1783.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58145,Not in chargemaster,58145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58145,BCBS multispecialty AW base fee schedule,1075.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58146,Not in chargemaster,58146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58146,BCBS multispecialty AW base fee schedule,2224.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58150,58150,58150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58150,BCBS multispecialty AW base fee schedule,1937.81,2120.37,Fee schedule,,1937.81,1937.81,1937.81,1937.81,,,0
unity,Fee schedule,Non-facility 58152,Not in chargemaster,58152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58152,BCBS multispecialty AW base fee schedule,2407.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58180,Not in chargemaster,58180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58180,BCBS multispecialty AW base fee schedule,1844.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58200,Not in chargemaster,58200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58200,BCBS multispecialty AW base fee schedule,2585.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58210,Not in chargemaster,58210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58210,BCBS multispecialty AW base fee schedule,3469.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58240,Not in chargemaster,58240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58240,BCBS multispecialty AW base fee schedule,5552.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58260,Not in chargemaster,58260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58260,BCBS multispecialty AW base fee schedule,1603.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58262,Not in chargemaster,58262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58262,BCBS multispecialty AW base fee schedule,1780.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58263,Not in chargemaster,58263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58263,BCBS multispecialty AW base fee schedule,1912.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58267,Not in chargemaster,58267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58267,BCBS multispecialty AW base fee schedule,2047.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58270,Not in chargemaster,58270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58270,BCBS multispecialty AW base fee schedule,1711.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58275,Not in chargemaster,58275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58275,BCBS multispecialty AW base fee schedule,1898.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58280,Not in chargemaster,58280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58280,BCBS multispecialty AW base fee schedule,2035.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58285,Not in chargemaster,58285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58285,BCBS multispecialty AW base fee schedule,2681.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58290,Not in chargemaster,58290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58290,BCBS multispecialty AW base fee schedule,2216.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58291,Not in chargemaster,58291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58291,BCBS multispecialty AW base fee schedule,2401.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58292,Not in chargemaster,58292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58292,BCBS multispecialty AW base fee schedule,2531.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58293,Not in chargemaster,58293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58293,BCBS multispecialty AW base fee schedule,2630.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58294,Not in chargemaster,58294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58294,BCBS multispecialty AW base fee schedule,2347.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58300,Not in chargemaster,58300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58300,BCBS multispecialty AW base fee schedule,172.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58301,58301,58301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58301,BCBS multispecialty AW base fee schedule,192.79,215,Fee schedule,,192.79,192.79,192.79,192.79,,,0
unity,Fee schedule,Non-facility 58321,Not in chargemaster,58321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58321,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58322,Not in chargemaster,58322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58322,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58323,Not in chargemaster,58323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58323,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58340,Not in chargemaster,58340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58340,BCBS multispecialty AW base fee schedule,366.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58345,Not in chargemaster,58345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58345,BCBS multispecialty AW base fee schedule,547.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58346,Not in chargemaster,58346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58346,BCBS multispecialty AW base fee schedule,904.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58350,Not in chargemaster,58350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58350,BCBS multispecialty AW base fee schedule,239.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58353,Not in chargemaster,58353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58353,BCBS multispecialty AW base fee schedule,1888.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58356,Not in chargemaster,58356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58356,BCBS multispecialty AW base fee schedule,3447.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58400,Not in chargemaster,58400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58400,BCBS multispecialty AW base fee schedule,870.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58410,Not in chargemaster,58410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58410,BCBS multispecialty AW base fee schedule,1562.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58520,Not in chargemaster,58520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58520,BCBS multispecialty AW base fee schedule,1529.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58540,Not in chargemaster,58540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58540,BCBS multispecialty AW base fee schedule,1759.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58541,Not in chargemaster,58541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58541,BCBS multispecialty AW base fee schedule,1395.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58542,Not in chargemaster,58542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58542,BCBS multispecialty AW base fee schedule,1588.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58543,Not in chargemaster,58543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58543,BCBS multispecialty AW base fee schedule,1613.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58544,Not in chargemaster,58544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58544,BCBS multispecialty AW base fee schedule,1737.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58545,Not in chargemaster,58545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58545,BCBS multispecialty AW base fee schedule,1727.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58546,Not in chargemaster,58546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58546,BCBS multispecialty AW base fee schedule,2153.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58548,Not in chargemaster,58548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58548,BCBS multispecialty AW base fee schedule,3576.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58550,Not in chargemaster,58550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58550,BCBS multispecialty AW base fee schedule,1695.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58552,Not in chargemaster,58552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58552,BCBS multispecialty AW base fee schedule,1889.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58553,Not in chargemaster,58553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58553,BCBS multispecialty AW base fee schedule,2166.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58554,Not in chargemaster,58554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58554,BCBS multispecialty AW base fee schedule,2526.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58555,Not in chargemaster,58555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58555,BCBS multispecialty AW base fee schedule,613.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58558,Not in chargemaster,58558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58558,BCBS multispecialty AW base fee schedule,2624.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58559,Not in chargemaster,58559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58559,BCBS multispecialty AW base fee schedule,551.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58560,Not in chargemaster,58560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58560,BCBS multispecialty AW base fee schedule,606.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58561,Not in chargemaster,58561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58561,BCBS multispecialty AW base fee schedule,694.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58562,Not in chargemaster,58562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58562,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58563,Not in chargemaster,58563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58563,BCBS multispecialty AW base fee schedule,3684.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58565,Not in chargemaster,58565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58565,BCBS multispecialty AW base fee schedule,3421.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58570,Not in chargemaster,58570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58570,BCBS multispecialty AW base fee schedule,1523.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58571,Not in chargemaster,58571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58571,BCBS multispecialty AW base fee schedule,1717.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58572,Not in chargemaster,58572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58572,BCBS multispecialty AW base fee schedule,1978.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58573,Not in chargemaster,58573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58573,BCBS multispecialty AW base fee schedule,2320.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58575,Not in chargemaster,58575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58575,BCBS multispecialty AW base fee schedule,3637.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58600,Not in chargemaster,58600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58600,BCBS multispecialty AW base fee schedule,706.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58605,Not in chargemaster,58605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58605,BCBS multispecialty AW base fee schedule,639.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58611,Not in chargemaster,58611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58611,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58615,Not in chargemaster,58615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58615,BCBS multispecialty AW base fee schedule,479.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58660,Not in chargemaster,58660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58660,BCBS multispecialty AW base fee schedule,1301.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58661,Not in chargemaster,58661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58661,BCBS multispecialty AW base fee schedule,1249.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58662,Not in chargemaster,58662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58662,BCBS multispecialty AW base fee schedule,1366.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58670,Not in chargemaster,58670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58670,BCBS multispecialty AW base fee schedule,708.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58671,Not in chargemaster,58671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58671,BCBS multispecialty AW base fee schedule,706.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58672,Not in chargemaster,58672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58672,BCBS multispecialty AW base fee schedule,1411.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58673,Not in chargemaster,58673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58673,BCBS multispecialty AW base fee schedule,1533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58674,Not in chargemaster,58674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58674,BCBS multispecialty AW base fee schedule,1568.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58700,Not in chargemaster,58700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58700,BCBS multispecialty AW base fee schedule,1517.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58720,Not in chargemaster,58720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58720,BCBS multispecialty AW base fee schedule,1429.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58740,Not in chargemaster,58740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58740,BCBS multispecialty AW base fee schedule,1719.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58750,Not in chargemaster,58750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58750,BCBS multispecialty AW base fee schedule,1746.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58752,Not in chargemaster,58752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58752,BCBS multispecialty AW base fee schedule,1741.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58760,Not in chargemaster,58760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58760,BCBS multispecialty AW base fee schedule,1572.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58770,Not in chargemaster,58770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58770,BCBS multispecialty AW base fee schedule,1654.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58800,Not in chargemaster,58800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58800,BCBS multispecialty AW base fee schedule,659.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58805,Not in chargemaster,58805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58805,BCBS multispecialty AW base fee schedule,802.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58820,Not in chargemaster,58820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58820,BCBS multispecialty AW base fee schedule,627.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58822,Not in chargemaster,58822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58822,BCBS multispecialty AW base fee schedule,1363.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58825,Not in chargemaster,58825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58825,BCBS multispecialty AW base fee schedule,1354.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58900,Not in chargemaster,58900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58900,BCBS multispecialty AW base fee schedule,820.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58920,Not in chargemaster,58920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58920,BCBS multispecialty AW base fee schedule,1365.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58925,Not in chargemaster,58925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58925,BCBS multispecialty AW base fee schedule,1456.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58940,Not in chargemaster,58940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58940,BCBS multispecialty AW base fee schedule,1036.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58943,Not in chargemaster,58943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58943,BCBS multispecialty AW base fee schedule,2231.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58950,Not in chargemaster,58950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58950,BCBS multispecialty AW base fee schedule,2165.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58951,Not in chargemaster,58951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58951,BCBS multispecialty AW base fee schedule,2740.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58952,Not in chargemaster,58952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58952,BCBS multispecialty AW base fee schedule,3111.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58953,Not in chargemaster,58953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58953,BCBS multispecialty AW base fee schedule,3816.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58954,Not in chargemaster,58954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58954,BCBS multispecialty AW base fee schedule,4135.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58956,Not in chargemaster,58956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58956,BCBS multispecialty AW base fee schedule,2593.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58957,Not in chargemaster,58957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58957,BCBS multispecialty AW base fee schedule,3011.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58958,Not in chargemaster,58958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58958,BCBS multispecialty AW base fee schedule,3334.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58960,Not in chargemaster,58960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58960,BCBS multispecialty AW base fee schedule,1854.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58970,Not in chargemaster,58970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58970,BCBS multispecialty AW base fee schedule,447.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58976,Not in chargemaster,58976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58976,BCBS multispecialty AW base fee schedule,485.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59000,Not in chargemaster,59000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59000,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59001,Not in chargemaster,59001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59001,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59012,Not in chargemaster,59012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59012,BCBS multispecialty AW base fee schedule,388.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59015,Not in chargemaster,59015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59015,BCBS multispecialty AW base fee schedule,298.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59020,Not in chargemaster,59020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59020,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59020 mod 26,Not in chargemaster,59020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59020 mod 26,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59020 mod TC,Not in chargemaster,59020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59020 mod TC,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59025 mod 26,Not in chargemaster,59025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59025 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59025 mod TC,Not in chargemaster,59025,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59025 mod TC,BCBS multispecialty AW base fee schedule,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59025,Not in chargemaster,59025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59025,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59030,Not in chargemaster,59030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59030,BCBS multispecialty AW base fee schedule,217.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59050,Not in chargemaster,59050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59050,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59051,Not in chargemaster,59051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59051,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59070,Not in chargemaster,59070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59070,BCBS multispecialty AW base fee schedule,769.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59072,Not in chargemaster,59072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59072,BCBS multispecialty AW base fee schedule,1007,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59074,Not in chargemaster,59074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59074,BCBS multispecialty AW base fee schedule,740.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59076,Not in chargemaster,59076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59076,BCBS multispecialty AW base fee schedule,1007,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59100,Not in chargemaster,59100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59100,BCBS multispecialty AW base fee schedule,1633.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59120,Not in chargemaster,59120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59120,BCBS multispecialty AW base fee schedule,1556.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59121,Not in chargemaster,59121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59121,BCBS multispecialty AW base fee schedule,1558.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59130,Not in chargemaster,59130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59130,BCBS multispecialty AW base fee schedule,1813.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59135,Not in chargemaster,59135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59135,BCBS multispecialty AW base fee schedule,1793.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59136,Not in chargemaster,59136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59136,BCBS multispecialty AW base fee schedule,1719.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59140,Not in chargemaster,59140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59140,BCBS multispecialty AW base fee schedule,790.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59150,Not in chargemaster,59150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59150,BCBS multispecialty AW base fee schedule,1509.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59151,Not in chargemaster,59151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59151,BCBS multispecialty AW base fee schedule,1474.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59160,Not in chargemaster,59160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59160,BCBS multispecialty AW base fee schedule,458.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59200,Not in chargemaster,59200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59200,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59300,Not in chargemaster,59300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59300,BCBS multispecialty AW base fee schedule,407.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59320,Not in chargemaster,59320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59320,BCBS multispecialty AW base fee schedule,290.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59325,Not in chargemaster,59325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59325,BCBS multispecialty AW base fee schedule,465.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59350,Not in chargemaster,59350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59350,BCBS multispecialty AW base fee schedule,540.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59400,Not in chargemaster,59400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59400,BCBS multispecialty AW base fee schedule,4076.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59409,59409,59409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59409,BCBS multispecialty AW base fee schedule,1558.86,1744.14,Fee schedule,,1558.86,1558.86,1558.86,1558.86,,,0
unity,Fee schedule,Non-facility 59410,Not in chargemaster,59410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59410,BCBS multispecialty AW base fee schedule,2006.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59412,Not in chargemaster,59412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59412,BCBS multispecialty AW base fee schedule,198.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59414,Not in chargemaster,59414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59414,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59425,Not in chargemaster,59425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59425,BCBS multispecialty AW base fee schedule,895.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59426,Not in chargemaster,59426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59426,BCBS multispecialty AW base fee schedule,1593.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59430,Not in chargemaster,59430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59430,BCBS multispecialty AW base fee schedule,394.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59510,Not in chargemaster,59510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59510,BCBS multispecialty AW base fee schedule,4520.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59514,Not in chargemaster,59514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59514,BCBS multispecialty AW base fee schedule,1761.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59515,Not in chargemaster,59515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59515,BCBS multispecialty AW base fee schedule,2443.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59525,Not in chargemaster,59525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59525,BCBS multispecialty AW base fee schedule,934.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59610,Not in chargemaster,59610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59610,BCBS multispecialty AW base fee schedule,4289.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59612,Not in chargemaster,59612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59612,BCBS multispecialty AW base fee schedule,1761.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59614,Not in chargemaster,59614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59614,BCBS multispecialty AW base fee schedule,2189.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59618,Not in chargemaster,59618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59618,BCBS multispecialty AW base fee schedule,4579.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59620,Not in chargemaster,59620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59620,BCBS multispecialty AW base fee schedule,1825.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59622,Not in chargemaster,59622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59622,BCBS multispecialty AW base fee schedule,2525.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59812,Not in chargemaster,59812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59812,BCBS multispecialty AW base fee schedule,655.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59820,Not in chargemaster,59820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59820,BCBS multispecialty AW base fee schedule,785.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59821,Not in chargemaster,59821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59821,BCBS multispecialty AW base fee schedule,783.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59830,Not in chargemaster,59830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59830,BCBS multispecialty AW base fee schedule,869.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59840,Not in chargemaster,59840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59840,BCBS multispecialty AW base fee schedule,453.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59841,Not in chargemaster,59841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59841,BCBS multispecialty AW base fee schedule,779.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59850,Not in chargemaster,59850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59850,BCBS multispecialty AW base fee schedule,743.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59851,Not in chargemaster,59851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59851,BCBS multispecialty AW base fee schedule,797.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59852,Not in chargemaster,59852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59852,BCBS multispecialty AW base fee schedule,1098.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59855,Not in chargemaster,59855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59855,BCBS multispecialty AW base fee schedule,810.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59856,Not in chargemaster,59856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59856,BCBS multispecialty AW base fee schedule,951.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59857,Not in chargemaster,59857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59857,BCBS multispecialty AW base fee schedule,1113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59866,Not in chargemaster,59866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59866,BCBS multispecialty AW base fee schedule,459.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59870,Not in chargemaster,59870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59870,BCBS multispecialty AW base fee schedule,974.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59871,Not in chargemaster,59871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59871,BCBS multispecialty AW base fee schedule,255.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60000,Not in chargemaster,60000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60000,BCBS multispecialty AW base fee schedule,330.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60100,Not in chargemaster,60100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60100,BCBS multispecialty AW base fee schedule,210.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60200,Not in chargemaster,60200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60200,BCBS multispecialty AW base fee schedule,1268.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60210,Not in chargemaster,60210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60210,BCBS multispecialty AW base fee schedule,1351.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60212,Not in chargemaster,60212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60212,BCBS multispecialty AW base fee schedule,1977.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60220,Not in chargemaster,60220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60220,BCBS multispecialty AW base fee schedule,1347.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60225,Not in chargemaster,60225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60225,BCBS multispecialty AW base fee schedule,1780.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60240,Not in chargemaster,60240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60240,BCBS multispecialty AW base fee schedule,1757.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60252,Not in chargemaster,60252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60252,BCBS multispecialty AW base fee schedule,2526.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60254,Not in chargemaster,60254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60254,BCBS multispecialty AW base fee schedule,3193.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60260,Not in chargemaster,60260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60260,BCBS multispecialty AW base fee schedule,2083.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60270,Not in chargemaster,60270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60270,BCBS multispecialty AW base fee schedule,2615.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60271,Not in chargemaster,60271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60271,BCBS multispecialty AW base fee schedule,2019.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60280,Not in chargemaster,60280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60280,BCBS multispecialty AW base fee schedule,844.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60281,Not in chargemaster,60281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60281,BCBS multispecialty AW base fee schedule,1116.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60300,Not in chargemaster,60300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60300,BCBS multispecialty AW base fee schedule,214.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60500,Not in chargemaster,60500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60500,BCBS multispecialty AW base fee schedule,1853.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60502,Not in chargemaster,60502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60502,BCBS multispecialty AW base fee schedule,2484.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60505,Not in chargemaster,60505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60505,BCBS multispecialty AW base fee schedule,2657.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60512,Not in chargemaster,60512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60512,BCBS multispecialty AW base fee schedule,465.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60520,Not in chargemaster,60520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60520,BCBS multispecialty AW base fee schedule,2014,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60521,Not in chargemaster,60521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60521,BCBS multispecialty AW base fee schedule,2148.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60522,Not in chargemaster,60522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60522,BCBS multispecialty AW base fee schedule,2614.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60540,Not in chargemaster,60540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60540,BCBS multispecialty AW base fee schedule,2055.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60545,Not in chargemaster,60545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60545,BCBS multispecialty AW base fee schedule,2369.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60600,Not in chargemaster,60600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60600,BCBS multispecialty AW base fee schedule,2630.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60605,Not in chargemaster,60605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60605,BCBS multispecialty AW base fee schedule,3194.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60650,Not in chargemaster,60650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,60650,BCBS multispecialty AW base fee schedule,2293.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61000,Not in chargemaster,61000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61000,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61001,Not in chargemaster,61001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61001,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61020,Not in chargemaster,61020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61020,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61026,Not in chargemaster,61026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61026,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61050,Not in chargemaster,61050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61050,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61055,Not in chargemaster,61055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61055,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61070,Not in chargemaster,61070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61070,BCBS multispecialty AW base fee schedule,107.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61105,Not in chargemaster,61105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61105,BCBS multispecialty AW base fee schedule,877.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61107,Not in chargemaster,61107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61107,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61108,Not in chargemaster,61108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61108,BCBS multispecialty AW base fee schedule,1711.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61120,Not in chargemaster,61120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61120,BCBS multispecialty AW base fee schedule,1425.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61140,Not in chargemaster,61140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61140,BCBS multispecialty AW base fee schedule,2420.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61150,Not in chargemaster,61150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61150,BCBS multispecialty AW base fee schedule,2584.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61151,Not in chargemaster,61151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61151,BCBS multispecialty AW base fee schedule,1896.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61154,Not in chargemaster,61154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61154,BCBS multispecialty AW base fee schedule,2430.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61156,Not in chargemaster,61156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61156,BCBS multispecialty AW base fee schedule,2374.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61210,Not in chargemaster,61210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61210,BCBS multispecialty AW base fee schedule,705.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61215,Not in chargemaster,61215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61215,BCBS multispecialty AW base fee schedule,965.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61250,Not in chargemaster,61250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61250,BCBS multispecialty AW base fee schedule,1655.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61253,Not in chargemaster,61253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61253,BCBS multispecialty AW base fee schedule,1896.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61304,Not in chargemaster,61304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61304,BCBS multispecialty AW base fee schedule,3141.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61305,Not in chargemaster,61305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61305,BCBS multispecialty AW base fee schedule,3839.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61312,Not in chargemaster,61312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61312,BCBS multispecialty AW base fee schedule,3973.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61313,Not in chargemaster,61313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61313,BCBS multispecialty AW base fee schedule,3792.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61314,Not in chargemaster,61314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61314,BCBS multispecialty AW base fee schedule,3495.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61315,Not in chargemaster,61315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61315,BCBS multispecialty AW base fee schedule,3953.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61316,Not in chargemaster,61316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61316,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61320,Not in chargemaster,61320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61320,BCBS multispecialty AW base fee schedule,3633.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61321,Not in chargemaster,61321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61321,BCBS multispecialty AW base fee schedule,4070.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61322,Not in chargemaster,61322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61322,BCBS multispecialty AW base fee schedule,4552.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61323,Not in chargemaster,61323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61323,BCBS multispecialty AW base fee schedule,4587.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61330,Not in chargemaster,61330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61330,BCBS multispecialty AW base fee schedule,3429.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61333,Not in chargemaster,61333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61333,BCBS multispecialty AW base fee schedule,3869,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61340,Not in chargemaster,61340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61340,BCBS multispecialty AW base fee schedule,2755.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61343,Not in chargemaster,61343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61343,BCBS multispecialty AW base fee schedule,4202.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61345,Not in chargemaster,61345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61345,BCBS multispecialty AW base fee schedule,3905.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61450,Not in chargemaster,61450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61450,BCBS multispecialty AW base fee schedule,3675.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61458,Not in chargemaster,61458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61458,BCBS multispecialty AW base fee schedule,3847.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61460,Not in chargemaster,61460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61460,BCBS multispecialty AW base fee schedule,4029.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61500,Not in chargemaster,61500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61500,BCBS multispecialty AW base fee schedule,2510.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61501,Not in chargemaster,61501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61501,BCBS multispecialty AW base fee schedule,2178.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61510,Not in chargemaster,61510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61510,BCBS multispecialty AW base fee schedule,4197.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61512,Not in chargemaster,61512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61512,BCBS multispecialty AW base fee schedule,4890.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61514,Not in chargemaster,61514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61514,BCBS multispecialty AW base fee schedule,3653.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61516,Not in chargemaster,61516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61516,BCBS multispecialty AW base fee schedule,3580.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61517,Not in chargemaster,61517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61517,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61518,Not in chargemaster,61518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61518,BCBS multispecialty AW base fee schedule,5296.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61519,Not in chargemaster,61519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61519,BCBS multispecialty AW base fee schedule,5661.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61520,Not in chargemaster,61520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61520,BCBS multispecialty AW base fee schedule,7186.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61521,Not in chargemaster,61521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61521,BCBS multispecialty AW base fee schedule,6111.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61522,Not in chargemaster,61522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61522,BCBS multispecialty AW base fee schedule,4187.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61524,Not in chargemaster,61524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61524,BCBS multispecialty AW base fee schedule,3986.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61526,Not in chargemaster,61526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61526,BCBS multispecialty AW base fee schedule,6422.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61530,Not in chargemaster,61530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61530,BCBS multispecialty AW base fee schedule,5906.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61531,Not in chargemaster,61531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61531,BCBS multispecialty AW base fee schedule,2333.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61533,Not in chargemaster,61533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61533,BCBS multispecialty AW base fee schedule,2918.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61534,Not in chargemaster,61534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61534,BCBS multispecialty AW base fee schedule,3148.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61535,Not in chargemaster,61535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61535,BCBS multispecialty AW base fee schedule,1909.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61536,Not in chargemaster,61536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61536,BCBS multispecialty AW base fee schedule,4942.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61537,Not in chargemaster,61537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61537,BCBS multispecialty AW base fee schedule,4725.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61538,Not in chargemaster,61538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61538,BCBS multispecialty AW base fee schedule,5109.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61539,Not in chargemaster,61539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61539,BCBS multispecialty AW base fee schedule,4521.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61540,Not in chargemaster,61540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61540,BCBS multispecialty AW base fee schedule,4171.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61541,Not in chargemaster,61541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61541,BCBS multispecialty AW base fee schedule,4114.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61543,Not in chargemaster,61543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61543,BCBS multispecialty AW base fee schedule,4159.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61544,Not in chargemaster,61544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61544,BCBS multispecialty AW base fee schedule,3635.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61545,Not in chargemaster,61545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61545,BCBS multispecialty AW base fee schedule,6115.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61546,Not in chargemaster,61546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61546,BCBS multispecialty AW base fee schedule,4418.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61548,Not in chargemaster,61548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61548,BCBS multispecialty AW base fee schedule,2994.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61550,Not in chargemaster,61550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61550,BCBS multispecialty AW base fee schedule,2269.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61552,Not in chargemaster,61552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61552,BCBS multispecialty AW base fee schedule,2832.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61556,Not in chargemaster,61556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61556,BCBS multispecialty AW base fee schedule,3264.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61557,Not in chargemaster,61557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61557,BCBS multispecialty AW base fee schedule,3216.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61558,Not in chargemaster,61558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61558,BCBS multispecialty AW base fee schedule,3593.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61559,Not in chargemaster,61559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61559,BCBS multispecialty AW base fee schedule,4583.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61563,Not in chargemaster,61563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61563,BCBS multispecialty AW base fee schedule,3792.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61564,Not in chargemaster,61564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61564,BCBS multispecialty AW base fee schedule,4607.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61566,Not in chargemaster,61566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61566,BCBS multispecialty AW base fee schedule,4296.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61567,Not in chargemaster,61567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61567,BCBS multispecialty AW base fee schedule,4898.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61570,Not in chargemaster,61570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61570,BCBS multispecialty AW base fee schedule,3574.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61571,Not in chargemaster,61571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61571,BCBS multispecialty AW base fee schedule,3808.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61575,Not in chargemaster,61575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61575,BCBS multispecialty AW base fee schedule,4799.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61576,Not in chargemaster,61576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61576,BCBS multispecialty AW base fee schedule,8040.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61580,Not in chargemaster,61580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61580,BCBS multispecialty AW base fee schedule,4673.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61581,Not in chargemaster,61581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61581,BCBS multispecialty AW base fee schedule,5075.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61582,Not in chargemaster,61582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61582,BCBS multispecialty AW base fee schedule,5878.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61583,Not in chargemaster,61583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61583,BCBS multispecialty AW base fee schedule,5521.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61584,Not in chargemaster,61584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61584,BCBS multispecialty AW base fee schedule,5490.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61585,Not in chargemaster,61585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61585,BCBS multispecialty AW base fee schedule,6231.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61586,Not in chargemaster,61586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61586,BCBS multispecialty AW base fee schedule,4718.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61590,Not in chargemaster,61590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61590,BCBS multispecialty AW base fee schedule,5808.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61591,Not in chargemaster,61591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61591,BCBS multispecialty AW base fee schedule,5873.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61592,Not in chargemaster,61592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61592,BCBS multispecialty AW base fee schedule,6079.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61595,Not in chargemaster,61595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61595,BCBS multispecialty AW base fee schedule,4522.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61596,Not in chargemaster,61596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61596,BCBS multispecialty AW base fee schedule,4643.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61597,Not in chargemaster,61597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61597,BCBS multispecialty AW base fee schedule,5630.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61598,Not in chargemaster,61598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61598,BCBS multispecialty AW base fee schedule,5461.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61600,Not in chargemaster,61600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61600,BCBS multispecialty AW base fee schedule,4065.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61601,Not in chargemaster,61601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61601,BCBS multispecialty AW base fee schedule,4611.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61605,Not in chargemaster,61605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61605,BCBS multispecialty AW base fee schedule,4123.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61606,Not in chargemaster,61606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61606,BCBS multispecialty AW base fee schedule,5618,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61607,Not in chargemaster,61607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61607,BCBS multispecialty AW base fee schedule,5121.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61608,Not in chargemaster,61608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61608,BCBS multispecialty AW base fee schedule,6240.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61611,Not in chargemaster,61611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61611,BCBS multispecialty AW base fee schedule,898.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61613,Not in chargemaster,61613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61613,BCBS multispecialty AW base fee schedule,6318.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61615,Not in chargemaster,61615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61615,BCBS multispecialty AW base fee schedule,5386.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61616,Not in chargemaster,61616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61616,BCBS multispecialty AW base fee schedule,6363.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61618,Not in chargemaster,61618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61618,BCBS multispecialty AW base fee schedule,2441.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61619,Not in chargemaster,61619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61619,BCBS multispecialty AW base fee schedule,2691.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61623,Not in chargemaster,61623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61623,BCBS multispecialty AW base fee schedule,1097.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61624,Not in chargemaster,61624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61624,BCBS multispecialty AW base fee schedule,2208.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61626,Not in chargemaster,61626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61626,BCBS multispecialty AW base fee schedule,1696.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61630,Not in chargemaster,61630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61630,BCBS multispecialty AW base fee schedule,2618.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61635,Not in chargemaster,61635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61635,BCBS multispecialty AW base fee schedule,2783.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61640,Not in chargemaster,61640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61640,BCBS multispecialty AW base fee schedule,928.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61641,Not in chargemaster,61641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61641,BCBS multispecialty AW base fee schedule,325.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61642,Not in chargemaster,61642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61642,BCBS multispecialty AW base fee schedule,651.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61645,Not in chargemaster,61645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61645,BCBS multispecialty AW base fee schedule,1602.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61650,Not in chargemaster,61650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61650,BCBS multispecialty AW base fee schedule,1093.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61651,Not in chargemaster,61651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61651,BCBS multispecialty AW base fee schedule,468.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61680,Not in chargemaster,61680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61680,BCBS multispecialty AW base fee schedule,4314.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61682,Not in chargemaster,61682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61682,BCBS multispecialty AW base fee schedule,8197.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61684,Not in chargemaster,61684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61684,BCBS multispecialty AW base fee schedule,5453.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61686,Not in chargemaster,61686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61686,BCBS multispecialty AW base fee schedule,8888.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61690,Not in chargemaster,61690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61690,BCBS multispecialty AW base fee schedule,4176.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61692,Not in chargemaster,61692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61692,BCBS multispecialty AW base fee schedule,7029.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61697,Not in chargemaster,61697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61697,BCBS multispecialty AW base fee schedule,8126.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61698,Not in chargemaster,61698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61698,BCBS multispecialty AW base fee schedule,9145.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61700,Not in chargemaster,61700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61700,BCBS multispecialty AW base fee schedule,6543.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61702,Not in chargemaster,61702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61702,BCBS multispecialty AW base fee schedule,7757.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61703,Not in chargemaster,61703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61703,BCBS multispecialty AW base fee schedule,2596.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61705,Not in chargemaster,61705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61705,BCBS multispecialty AW base fee schedule,4987.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61708,Not in chargemaster,61708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61708,BCBS multispecialty AW base fee schedule,4877.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61710,Not in chargemaster,61710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61710,BCBS multispecialty AW base fee schedule,4113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61711,Not in chargemaster,61711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61711,BCBS multispecialty AW base fee schedule,4964.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61720,Not in chargemaster,61720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61720,BCBS multispecialty AW base fee schedule,2428.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61735,Not in chargemaster,61735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61735,BCBS multispecialty AW base fee schedule,3044.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61750,Not in chargemaster,61750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61750,BCBS multispecialty AW base fee schedule,2692.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61751,Not in chargemaster,61751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61751,BCBS multispecialty AW base fee schedule,2634.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61760,Not in chargemaster,61760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61760,BCBS multispecialty AW base fee schedule,3021.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61770,Not in chargemaster,61770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61770,BCBS multispecialty AW base fee schedule,3103.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61781,Not in chargemaster,61781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61781,BCBS multispecialty AW base fee schedule,451.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61782,Not in chargemaster,61782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61782,BCBS multispecialty AW base fee schedule,331.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61783,Not in chargemaster,61783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61783,BCBS multispecialty AW base fee schedule,447.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61790,Not in chargemaster,61790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61790,BCBS multispecialty AW base fee schedule,1676.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61791,Not in chargemaster,61791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61791,BCBS multispecialty AW base fee schedule,2149.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61796,Not in chargemaster,61796,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61796,BCBS multispecialty AW base fee schedule,1937.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61797,Not in chargemaster,61797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61797,BCBS multispecialty AW base fee schedule,420.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61798,Not in chargemaster,61798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61798,BCBS multispecialty AW base fee schedule,2636.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61799,Not in chargemaster,61799,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61799,BCBS multispecialty AW base fee schedule,581.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61800,Not in chargemaster,61800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61800,BCBS multispecialty AW base fee schedule,291.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61850,Not in chargemaster,61850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61850,BCBS multispecialty AW base fee schedule,1879.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61860,Not in chargemaster,61860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61860,BCBS multispecialty AW base fee schedule,2991.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61863,Not in chargemaster,61863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61863,BCBS multispecialty AW base fee schedule,2871.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61864,Not in chargemaster,61864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61864,BCBS multispecialty AW base fee schedule,543.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61867,Not in chargemaster,61867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61867,BCBS multispecialty AW base fee schedule,4366.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61868,Not in chargemaster,61868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61868,BCBS multispecialty AW base fee schedule,957.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61870,Not in chargemaster,61870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61870,BCBS multispecialty AW base fee schedule,2263.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61880,Not in chargemaster,61880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61880,BCBS multispecialty AW base fee schedule,1101.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61885,Not in chargemaster,61885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61885,BCBS multispecialty AW base fee schedule,989.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61886,Not in chargemaster,61886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61886,BCBS multispecialty AW base fee schedule,1635.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61888,Not in chargemaster,61888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,61888,BCBS multispecialty AW base fee schedule,754.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62000,Not in chargemaster,62000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62000,BCBS multispecialty AW base fee schedule,1970.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62005,Not in chargemaster,62005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62005,BCBS multispecialty AW base fee schedule,2428.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62010,Not in chargemaster,62010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62010,BCBS multispecialty AW base fee schedule,2933.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62100,Not in chargemaster,62100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62100,BCBS multispecialty AW base fee schedule,3022.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62115,Not in chargemaster,62115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62115,BCBS multispecialty AW base fee schedule,3206.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62117,Not in chargemaster,62117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62117,BCBS multispecialty AW base fee schedule,3761.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62120,Not in chargemaster,62120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62120,BCBS multispecialty AW base fee schedule,4016.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62121,Not in chargemaster,62121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62121,BCBS multispecialty AW base fee schedule,2983.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62140,Not in chargemaster,62140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62140,BCBS multispecialty AW base fee schedule,1959.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62141,Not in chargemaster,62141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62141,BCBS multispecialty AW base fee schedule,2181.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62142,Not in chargemaster,62142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62142,BCBS multispecialty AW base fee schedule,1691.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62143,Not in chargemaster,62143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62143,BCBS multispecialty AW base fee schedule,1989.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62145,Not in chargemaster,62145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62145,BCBS multispecialty AW base fee schedule,2721.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62146,Not in chargemaster,62146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62146,BCBS multispecialty AW base fee schedule,2161.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62147,Not in chargemaster,62147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62147,BCBS multispecialty AW base fee schedule,2718.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62148,Not in chargemaster,62148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62148,BCBS multispecialty AW base fee schedule,243.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62160,Not in chargemaster,62160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62160,BCBS multispecialty AW base fee schedule,362.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62161,Not in chargemaster,62161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62161,BCBS multispecialty AW base fee schedule,2891.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62162,Not in chargemaster,62162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62162,BCBS multispecialty AW base fee schedule,3612.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62163,Not in chargemaster,62163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62163,BCBS multispecialty AW base fee schedule,2341.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62164,Not in chargemaster,62164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62164,BCBS multispecialty AW base fee schedule,4000.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62165,Not in chargemaster,62165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62165,BCBS multispecialty AW base fee schedule,2908.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62180,Not in chargemaster,62180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62180,BCBS multispecialty AW base fee schedule,3058.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62190,Not in chargemaster,62190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62190,BCBS multispecialty AW base fee schedule,1767.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62192,Not in chargemaster,62192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62192,BCBS multispecialty AW base fee schedule,1876.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62194,Not in chargemaster,62194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62194,BCBS multispecialty AW base fee schedule,931.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62200,Not in chargemaster,62200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62200,BCBS multispecialty AW base fee schedule,2631.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62201,Not in chargemaster,62201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62201,BCBS multispecialty AW base fee schedule,2305.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62220,Not in chargemaster,62220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62220,BCBS multispecialty AW base fee schedule,1886.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62223,Not in chargemaster,62223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62223,BCBS multispecialty AW base fee schedule,1988.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62225,Not in chargemaster,62225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62225,BCBS multispecialty AW base fee schedule,1005.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62230,Not in chargemaster,62230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62230,BCBS multispecialty AW base fee schedule,1607.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62252 mod 26,Not in chargemaster,62252,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62252 mod 26,BCBS multispecialty AW base fee schedule,88.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62252 mod TC,Not in chargemaster,62252,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62252 mod TC,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62252,Not in chargemaster,62252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62252,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62256,Not in chargemaster,62256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62256,BCBS multispecialty AW base fee schedule,1150.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62258,Not in chargemaster,62258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62258,BCBS multispecialty AW base fee schedule,2122.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62263,Not in chargemaster,62263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62263,BCBS multispecialty AW base fee schedule,1159.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62264,Not in chargemaster,62264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62264,BCBS multispecialty AW base fee schedule,830.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62267,Not in chargemaster,62267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62267,BCBS multispecialty AW base fee schedule,503.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62268,Not in chargemaster,62268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62268,BCBS multispecialty AW base fee schedule,492.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62269,Not in chargemaster,62269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62269,BCBS multispecialty AW base fee schedule,506.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62270,Not in chargemaster,62270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62270,BCBS multispecialty AW base fee schedule,263.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62272,Not in chargemaster,62272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62272,BCBS multispecialty AW base fee schedule,345.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62273,Not in chargemaster,62273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62273,BCBS multispecialty AW base fee schedule,324.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62280,Not in chargemaster,62280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62280,BCBS multispecialty AW base fee schedule,670.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62281,Not in chargemaster,62281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62281,BCBS multispecialty AW base fee schedule,452.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62282,Not in chargemaster,62282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62282,BCBS multispecialty AW base fee schedule,580.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62284,Not in chargemaster,62284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62284,BCBS multispecialty AW base fee schedule,374.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62287,Not in chargemaster,62287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62287,BCBS multispecialty AW base fee schedule,1110.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62290,Not in chargemaster,62290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62290,BCBS multispecialty AW base fee schedule,667.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62291,Not in chargemaster,62291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62291,BCBS multispecialty AW base fee schedule,632.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62292,Not in chargemaster,62292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62292,BCBS multispecialty AW base fee schedule,1105.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62294,Not in chargemaster,62294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62294,BCBS multispecialty AW base fee schedule,1813.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62302,Not in chargemaster,62302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62302,BCBS multispecialty AW base fee schedule,488.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62303,Not in chargemaster,62303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62303,BCBS multispecialty AW base fee schedule,497.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62304,Not in chargemaster,62304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62304,BCBS multispecialty AW base fee schedule,481.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62305,Not in chargemaster,62305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62305,BCBS multispecialty AW base fee schedule,524.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62320,Not in chargemaster,62320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62320,BCBS multispecialty AW base fee schedule,309.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62321,Not in chargemaster,62321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62321,BCBS multispecialty AW base fee schedule,488.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62322,Not in chargemaster,62322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62322,BCBS multispecialty AW base fee schedule,282.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62323,Not in chargemaster,62323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62323,BCBS multispecialty AW base fee schedule,482.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62324,Not in chargemaster,62324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62324,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62325,Not in chargemaster,62325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62325,BCBS multispecialty AW base fee schedule,459.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62326,Not in chargemaster,62326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62326,BCBS multispecialty AW base fee schedule,276.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62327,Not in chargemaster,62327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62327,BCBS multispecialty AW base fee schedule,468.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62328,Not in chargemaster,62328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62328,BCBS multispecialty AW base fee schedule,490.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62329,Not in chargemaster,62329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62329,BCBS multispecialty AW base fee schedule,608.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62350,Not in chargemaster,62350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62350,BCBS multispecialty AW base fee schedule,758.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62351,Not in chargemaster,62351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62351,BCBS multispecialty AW base fee schedule,1664.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62355,Not in chargemaster,62355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62355,BCBS multispecialty AW base fee schedule,516.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62360,Not in chargemaster,62360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62360,BCBS multispecialty AW base fee schedule,598.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62361,Not in chargemaster,62361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62361,BCBS multispecialty AW base fee schedule,816.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62362,Not in chargemaster,62362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62362,BCBS multispecialty AW base fee schedule,730.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62365,Not in chargemaster,62365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62365,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62367,Not in chargemaster,62367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62367,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62368,Not in chargemaster,62368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62368,BCBS multispecialty AW base fee schedule,85.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62369,Not in chargemaster,62369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62369,BCBS multispecialty AW base fee schedule,180.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62370,Not in chargemaster,62370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62370,BCBS multispecialty AW base fee schedule,187.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63001,Not in chargemaster,63001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63001,BCBS multispecialty AW base fee schedule,2366.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63003,Not in chargemaster,63003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63003,BCBS multispecialty AW base fee schedule,2368.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63005,Not in chargemaster,63005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63005,BCBS multispecialty AW base fee schedule,2281.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63011,Not in chargemaster,63011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63011,BCBS multispecialty AW base fee schedule,2081.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63012,Not in chargemaster,63012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63012,BCBS multispecialty AW base fee schedule,2288.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63015,Not in chargemaster,63015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63015,BCBS multispecialty AW base fee schedule,2833.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63016,Not in chargemaster,63016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63016,BCBS multispecialty AW base fee schedule,2915.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63017,Not in chargemaster,63017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63017,BCBS multispecialty AW base fee schedule,2410.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63020,Not in chargemaster,63020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63020,BCBS multispecialty AW base fee schedule,2218.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63030,Not in chargemaster,63030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63030,BCBS multispecialty AW base fee schedule,1862.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63035,Not in chargemaster,63035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63035,BCBS multispecialty AW base fee schedule,367.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63042,Not in chargemaster,63042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63042,BCBS multispecialty AW base fee schedule,2487.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63040,Not in chargemaster,63040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63040,BCBS multispecialty AW base fee schedule,2669.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63045,Not in chargemaster,63045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63045,BCBS multispecialty AW base fee schedule,2463.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63046,Not in chargemaster,63046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63046,BCBS multispecialty AW base fee schedule,2351.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63047,Not in chargemaster,63047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63047,BCBS multispecialty AW base fee schedule,2113.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63048,Not in chargemaster,63048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63048,BCBS multispecialty AW base fee schedule,406.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63050,Not in chargemaster,63050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63050,BCBS multispecialty AW base fee schedule,2883.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63051,Not in chargemaster,63051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63051,BCBS multispecialty AW base fee schedule,3270.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63055,Not in chargemaster,63055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63055,BCBS multispecialty AW base fee schedule,3115.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63056,Not in chargemaster,63056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63056,BCBS multispecialty AW base fee schedule,2854.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63057,Not in chargemaster,63057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63057,BCBS multispecialty AW base fee schedule,614.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63064,Not in chargemaster,63064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63064,BCBS multispecialty AW base fee schedule,3413.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63066,Not in chargemaster,63066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63066,BCBS multispecialty AW base fee schedule,395.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63075,Not in chargemaster,63075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63075,BCBS multispecialty AW base fee schedule,2590.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63076,Not in chargemaster,63076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63076,BCBS multispecialty AW base fee schedule,473.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63077,Not in chargemaster,63077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63077,BCBS multispecialty AW base fee schedule,2889.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63078,Not in chargemaster,63078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63078,BCBS multispecialty AW base fee schedule,398.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63081,Not in chargemaster,63081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63081,BCBS multispecialty AW base fee schedule,3375.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63082,Not in chargemaster,63082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63082,BCBS multispecialty AW base fee schedule,511.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63085,Not in chargemaster,63085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63085,BCBS multispecialty AW base fee schedule,3692.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63086,Not in chargemaster,63086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63086,BCBS multispecialty AW base fee schedule,366.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63087,Not in chargemaster,63087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63087,BCBS multispecialty AW base fee schedule,4624.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63088,Not in chargemaster,63088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63088,BCBS multispecialty AW base fee schedule,492.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63090,Not in chargemaster,63090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63090,BCBS multispecialty AW base fee schedule,3768.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63091,Not in chargemaster,63091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63091,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63101,Not in chargemaster,63101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63101,BCBS multispecialty AW base fee schedule,4456.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63102,Not in chargemaster,63102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63102,BCBS multispecialty AW base fee schedule,4341.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63103,Not in chargemaster,63103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63103,BCBS multispecialty AW base fee schedule,565.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63170,Not in chargemaster,63170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63170,BCBS multispecialty AW base fee schedule,3044.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63172,Not in chargemaster,63172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63172,BCBS multispecialty AW base fee schedule,2650.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63173,Not in chargemaster,63173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63173,BCBS multispecialty AW base fee schedule,3298.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63180,Not in chargemaster,63180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63180,BCBS multispecialty AW base fee schedule,2839.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63182,Not in chargemaster,63182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63182,BCBS multispecialty AW base fee schedule,3117.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63185,Not in chargemaster,63185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63185,BCBS multispecialty AW base fee schedule,2196.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63190,Not in chargemaster,63190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63190,BCBS multispecialty AW base fee schedule,2386.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63191,Not in chargemaster,63191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63191,BCBS multispecialty AW base fee schedule,2634.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63194,Not in chargemaster,63194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63194,BCBS multispecialty AW base fee schedule,3051.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63195,Not in chargemaster,63195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63195,BCBS multispecialty AW base fee schedule,2932.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63196,Not in chargemaster,63196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63196,BCBS multispecialty AW base fee schedule,3404.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63197,Not in chargemaster,63197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63197,BCBS multispecialty AW base fee schedule,3270.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63198,Not in chargemaster,63198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63198,BCBS multispecialty AW base fee schedule,3998.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63199,Not in chargemaster,63199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63199,BCBS multispecialty AW base fee schedule,4190.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63200,Not in chargemaster,63200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63200,BCBS multispecialty AW base fee schedule,2927.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63250,Not in chargemaster,63250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63250,BCBS multispecialty AW base fee schedule,5696.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63251,Not in chargemaster,63251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63251,BCBS multispecialty AW base fee schedule,5822.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63252,Not in chargemaster,63252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63252,BCBS multispecialty AW base fee schedule,5821.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63265,Not in chargemaster,63265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63265,BCBS multispecialty AW base fee schedule,3198.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63266,Not in chargemaster,63266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63266,BCBS multispecialty AW base fee schedule,3295.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63267,Not in chargemaster,63267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63267,BCBS multispecialty AW base fee schedule,2628.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63268,Not in chargemaster,63268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63268,BCBS multispecialty AW base fee schedule,2711.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63270,Not in chargemaster,63270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63270,BCBS multispecialty AW base fee schedule,3975.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63271,Not in chargemaster,63271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63271,BCBS multispecialty AW base fee schedule,3964.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63272,Not in chargemaster,63272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63272,BCBS multispecialty AW base fee schedule,3616.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63273,Not in chargemaster,63273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63273,BCBS multispecialty AW base fee schedule,3569.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63275,Not in chargemaster,63275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63275,BCBS multispecialty AW base fee schedule,3454.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63276,Not in chargemaster,63276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63276,BCBS multispecialty AW base fee schedule,3427.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63277,Not in chargemaster,63277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63277,BCBS multispecialty AW base fee schedule,2987.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63278,Not in chargemaster,63278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63278,BCBS multispecialty AW base fee schedule,3041.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63280,Not in chargemaster,63280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63280,BCBS multispecialty AW base fee schedule,4056.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63281,Not in chargemaster,63281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63281,BCBS multispecialty AW base fee schedule,4009.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63282,Not in chargemaster,63282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63282,BCBS multispecialty AW base fee schedule,3781.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63283,Not in chargemaster,63283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63283,BCBS multispecialty AW base fee schedule,3635.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63285,Not in chargemaster,63285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63285,BCBS multispecialty AW base fee schedule,5011.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63286,Not in chargemaster,63286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63286,BCBS multispecialty AW base fee schedule,4952.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63287,Not in chargemaster,63287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63287,BCBS multispecialty AW base fee schedule,5260.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63290,Not in chargemaster,63290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63290,BCBS multispecialty AW base fee schedule,5351.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63295,Not in chargemaster,63295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63295,BCBS multispecialty AW base fee schedule,632.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63300,Not in chargemaster,63300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63300,BCBS multispecialty AW base fee schedule,3521.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63301,Not in chargemaster,63301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63301,BCBS multispecialty AW base fee schedule,4220.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63302,Not in chargemaster,63302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63302,BCBS multispecialty AW base fee schedule,4169.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63303,Not in chargemaster,63303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63303,BCBS multispecialty AW base fee schedule,4432.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63304,Not in chargemaster,63304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63304,BCBS multispecialty AW base fee schedule,4497.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63305,Not in chargemaster,63305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63305,BCBS multispecialty AW base fee schedule,4789.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63306,Not in chargemaster,63306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63306,BCBS multispecialty AW base fee schedule,4707.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63307,Not in chargemaster,63307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63307,BCBS multispecialty AW base fee schedule,4609.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63308,Not in chargemaster,63308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63308,BCBS multispecialty AW base fee schedule,620.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63600,Not in chargemaster,63600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63600,BCBS multispecialty AW base fee schedule,2085.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63610,Not in chargemaster,63610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63610,BCBS multispecialty AW base fee schedule,1109.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63620,Not in chargemaster,63620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63620,BCBS multispecialty AW base fee schedule,2139.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63621,Not in chargemaster,63621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63621,BCBS multispecialty AW base fee schedule,483.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63650,Not in chargemaster,63650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63650,BCBS multispecialty AW base fee schedule,3589.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63655,Not in chargemaster,63655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63655,BCBS multispecialty AW base fee schedule,1590.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63661,Not in chargemaster,63661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63661,BCBS multispecialty AW base fee schedule,1213.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63662,Not in chargemaster,63662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63662,BCBS multispecialty AW base fee schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63663,Not in chargemaster,63663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63663,BCBS multispecialty AW base fee schedule,1615.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63664,Not in chargemaster,63664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63664,BCBS multispecialty AW base fee schedule,1675.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63685,Not in chargemaster,63685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63685,BCBS multispecialty AW base fee schedule,687.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63688,Not in chargemaster,63688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63688,BCBS multispecialty AW base fee schedule,708.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63700,Not in chargemaster,63700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63700,BCBS multispecialty AW base fee schedule,2492.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63702,Not in chargemaster,63702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63702,BCBS multispecialty AW base fee schedule,2726.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63704,Not in chargemaster,63704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63704,BCBS multispecialty AW base fee schedule,3164.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63706,Not in chargemaster,63706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63706,BCBS multispecialty AW base fee schedule,3521.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63707,Not in chargemaster,63707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63707,BCBS multispecialty AW base fee schedule,1776.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63709,Not in chargemaster,63709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63709,BCBS multispecialty AW base fee schedule,2122.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63710,Not in chargemaster,63710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63710,BCBS multispecialty AW base fee schedule,2080.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63740,Not in chargemaster,63740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63740,BCBS multispecialty AW base fee schedule,1865.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63741,Not in chargemaster,63741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63741,BCBS multispecialty AW base fee schedule,1291.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63744,Not in chargemaster,63744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63744,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63746,Not in chargemaster,63746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63746,BCBS multispecialty AW base fee schedule,1152.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64400,Not in chargemaster,64400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64400,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64405,Not in chargemaster,64405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64405,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64408,Not in chargemaster,64408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64408,BCBS multispecialty AW base fee schedule,130.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64415,Not in chargemaster,64415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64415,BCBS multispecialty AW base fee schedule,213.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64416,Not in chargemaster,64416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64416,BCBS multispecialty AW base fee schedule,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64417,Not in chargemaster,64417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64417,BCBS multispecialty AW base fee schedule,257.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64418,Not in chargemaster,64418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64418,BCBS multispecialty AW base fee schedule,160.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64420,Not in chargemaster,64420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64420,BCBS multispecialty AW base fee schedule,188.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64421,Not in chargemaster,64421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64421,BCBS multispecialty AW base fee schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64425,Not in chargemaster,64425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64425,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64430,Not in chargemaster,64430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64430,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64435,Not in chargemaster,64435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64435,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64445,Not in chargemaster,64445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64445,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64446,Not in chargemaster,64446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64446,BCBS multispecialty AW base fee schedule,113.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64447,Not in chargemaster,64447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64447,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64448,Not in chargemaster,64448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64448,BCBS multispecialty AW base fee schedule,117.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64449,Not in chargemaster,64449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64449,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64450,64450,64450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64450,BCBS multispecialty AW base fee schedule,144.43,110,Fee schedule,,110,110,110,110,,,0
unity,Fee schedule,Non-facility 64451,Not in chargemaster,64451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64451,BCBS multispecialty AW base fee schedule,396.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64454,Not in chargemaster,64454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64454,BCBS multispecialty AW base fee schedule,400.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64455,Not in chargemaster,64455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64455,BCBS multispecialty AW base fee schedule,91.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64461,Not in chargemaster,64461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64461,BCBS multispecialty AW base fee schedule,248.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64462,Not in chargemaster,64462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64462,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64463,Not in chargemaster,64463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64463,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64479,Not in chargemaster,64479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64479,BCBS multispecialty AW base fee schedule,480.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64480,Not in chargemaster,64480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64480,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64483,Not in chargemaster,64483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64483,BCBS multispecialty AW base fee schedule,445.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64484,Not in chargemaster,64484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64484,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64486,Not in chargemaster,64486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64486,BCBS multispecialty AW base fee schedule,210.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64487,Not in chargemaster,64487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64487,BCBS multispecialty AW base fee schedule,341.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64488,Not in chargemaster,64488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64488,BCBS multispecialty AW base fee schedule,257.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64489,Not in chargemaster,64489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64489,BCBS multispecialty AW base fee schedule,529.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64490,Not in chargemaster,64490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64490,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64491,Not in chargemaster,64491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64491,BCBS multispecialty AW base fee schedule,180.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64492,Not in chargemaster,64492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64492,BCBS multispecialty AW base fee schedule,181.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64493,Not in chargemaster,64493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64493,BCBS multispecialty AW base fee schedule,326.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64494,Not in chargemaster,64494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64494,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64495,Not in chargemaster,64495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64495,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64505,Not in chargemaster,64505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64505,BCBS multispecialty AW base fee schedule,239.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64510,Not in chargemaster,64510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64510,BCBS multispecialty AW base fee schedule,261.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64517,Not in chargemaster,64517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64517,BCBS multispecialty AW base fee schedule,362.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64520,Not in chargemaster,64520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64520,BCBS multispecialty AW base fee schedule,403.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64530,Not in chargemaster,64530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64530,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64553,Not in chargemaster,64553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64553,BCBS multispecialty AW base fee schedule,3809.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64555,Not in chargemaster,64555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64555,BCBS multispecialty AW base fee schedule,3527.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64561,Not in chargemaster,64561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64561,BCBS multispecialty AW base fee schedule,1415.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64566,Not in chargemaster,64566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64566,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64568,Not in chargemaster,64568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64568,BCBS multispecialty AW base fee schedule,1196.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64569,Not in chargemaster,64569,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64569,BCBS multispecialty AW base fee schedule,1450.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64570,Not in chargemaster,64570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64570,BCBS multispecialty AW base fee schedule,1396.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64575,Not in chargemaster,64575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64575,BCBS multispecialty AW base fee schedule,649.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64580,Not in chargemaster,64580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64580,BCBS multispecialty AW base fee schedule,594.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64581,Not in chargemaster,64581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64581,BCBS multispecialty AW base fee schedule,1270.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64585,Not in chargemaster,64585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64585,BCBS multispecialty AW base fee schedule,467.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64590,Not in chargemaster,64590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64590,BCBS multispecialty AW base fee schedule,502.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64595,Not in chargemaster,64595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64595,BCBS multispecialty AW base fee schedule,450.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64600,Not in chargemaster,64600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64600,BCBS multispecialty AW base fee schedule,844.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64605,Not in chargemaster,64605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64605,BCBS multispecialty AW base fee schedule,1180.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64610,Not in chargemaster,64610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64610,BCBS multispecialty AW base fee schedule,1477.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64611,Not in chargemaster,64611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64611,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64612,Not in chargemaster,64612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64612,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64615,Not in chargemaster,64615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64615,BCBS multispecialty AW base fee schedule,286.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64616,Not in chargemaster,64616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64616,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64617,Not in chargemaster,64617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64617,BCBS multispecialty AW base fee schedule,306.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64620,Not in chargemaster,64620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64620,BCBS multispecialty AW base fee schedule,394.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64624,Not in chargemaster,64624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64624,BCBS multispecialty AW base fee schedule,766.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64625,Not in chargemaster,64625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64625,BCBS multispecialty AW base fee schedule,936.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64630,Not in chargemaster,64630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64630,BCBS multispecialty AW base fee schedule,459.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64632,Not in chargemaster,64632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64632,BCBS multispecialty AW base fee schedule,165.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64633,Not in chargemaster,64633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64633,BCBS multispecialty AW base fee schedule,791.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64634,Not in chargemaster,64634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64634,BCBS multispecialty AW base fee schedule,353.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64635,Not in chargemaster,64635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64635,BCBS multispecialty AW base fee schedule,782.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64636,Not in chargemaster,64636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64636,BCBS multispecialty AW base fee schedule,322.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64640,Not in chargemaster,64640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64640,BCBS multispecialty AW base fee schedule,467.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64642,Not in chargemaster,64642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64642,BCBS multispecialty AW base fee schedule,277.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64643,Not in chargemaster,64643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64643,BCBS multispecialty AW base fee schedule,175.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64644,Not in chargemaster,64644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64644,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64645,Not in chargemaster,64645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64645,BCBS multispecialty AW base fee schedule,221.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64646,Not in chargemaster,64646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64646,BCBS multispecialty AW base fee schedule,292.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64647,Not in chargemaster,64647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64647,BCBS multispecialty AW base fee schedule,337.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64650,Not in chargemaster,64650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64650,BCBS multispecialty AW base fee schedule,152.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64653,Not in chargemaster,64653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64653,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64680,Not in chargemaster,64680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64680,BCBS multispecialty AW base fee schedule,632.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64681,Not in chargemaster,64681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64681,BCBS multispecialty AW base fee schedule,1067.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64702,Not in chargemaster,64702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64702,BCBS multispecialty AW base fee schedule,959.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64704,Not in chargemaster,64704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64704,BCBS multispecialty AW base fee schedule,613.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64708,Not in chargemaster,64708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64708,BCBS multispecialty AW base fee schedule,961.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64712,Not in chargemaster,64712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64712,BCBS multispecialty AW base fee schedule,1122.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64713,Not in chargemaster,64713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64713,BCBS multispecialty AW base fee schedule,1495.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64714,Not in chargemaster,64714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64714,BCBS multispecialty AW base fee schedule,1399.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64716,Not in chargemaster,64716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64716,BCBS multispecialty AW base fee schedule,981.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64718,Not in chargemaster,64718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64718,BCBS multispecialty AW base fee schedule,1135.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64719,Not in chargemaster,64719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64719,BCBS multispecialty AW base fee schedule,767.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64721,Not in chargemaster,64721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64721,BCBS multispecialty AW base fee schedule,830.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64722,Not in chargemaster,64722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64722,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64726,Not in chargemaster,64726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64726,BCBS multispecialty AW base fee schedule,512.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64727,Not in chargemaster,64727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64727,BCBS multispecialty AW base fee schedule,349.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64732,Not in chargemaster,64732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64732,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64734,Not in chargemaster,64734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64734,BCBS multispecialty AW base fee schedule,954.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64736,Not in chargemaster,64736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64736,BCBS multispecialty AW base fee schedule,663.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64738,Not in chargemaster,64738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64738,BCBS multispecialty AW base fee schedule,861.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64740,Not in chargemaster,64740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64740,BCBS multispecialty AW base fee schedule,894.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64742,Not in chargemaster,64742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64742,BCBS multispecialty AW base fee schedule,930.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64744,Not in chargemaster,64744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64744,BCBS multispecialty AW base fee schedule,946.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64746,Not in chargemaster,64746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64746,BCBS multispecialty AW base fee schedule,824.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64755,Not in chargemaster,64755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64755,BCBS multispecialty AW base fee schedule,1776.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64760,Not in chargemaster,64760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64760,BCBS multispecialty AW base fee schedule,995.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64763,Not in chargemaster,64763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64763,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64766,Not in chargemaster,64766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64766,BCBS multispecialty AW base fee schedule,1215.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64771,Not in chargemaster,64771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64771,BCBS multispecialty AW base fee schedule,1160.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64772,Not in chargemaster,64772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64772,BCBS multispecialty AW base fee schedule,1077.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64774,Not in chargemaster,64774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64774,BCBS multispecialty AW base fee schedule,782.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64776,Not in chargemaster,64776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64776,BCBS multispecialty AW base fee schedule,743.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64778,Not in chargemaster,64778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64778,BCBS multispecialty AW base fee schedule,350.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64782,Not in chargemaster,64782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64782,BCBS multispecialty AW base fee schedule,869.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64783,Not in chargemaster,64783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64783,BCBS multispecialty AW base fee schedule,418.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64784,Not in chargemaster,64784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64784,BCBS multispecialty AW base fee schedule,1395.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64786,Not in chargemaster,64786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64786,BCBS multispecialty AW base fee schedule,1935.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64787,Not in chargemaster,64787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64787,BCBS multispecialty AW base fee schedule,461.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64788,Not in chargemaster,64788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64788,BCBS multispecialty AW base fee schedule,768.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64790,Not in chargemaster,64790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64790,BCBS multispecialty AW base fee schedule,1598.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64792,Not in chargemaster,64792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64792,BCBS multispecialty AW base fee schedule,2023.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64795,Not in chargemaster,64795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64795,BCBS multispecialty AW base fee schedule,369.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64802,Not in chargemaster,64802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64802,BCBS multispecialty AW base fee schedule,1592.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64804,Not in chargemaster,64804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64804,BCBS multispecialty AW base fee schedule,2263.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64809,Not in chargemaster,64809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64809,BCBS multispecialty AW base fee schedule,2074.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64818,Not in chargemaster,64818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64818,BCBS multispecialty AW base fee schedule,1493.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64820,Not in chargemaster,64820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64820,BCBS multispecialty AW base fee schedule,1393.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64821,Not in chargemaster,64821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64821,BCBS multispecialty AW base fee schedule,1328.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64822,Not in chargemaster,64822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64822,BCBS multispecialty AW base fee schedule,1328.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64823,Not in chargemaster,64823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64823,BCBS multispecialty AW base fee schedule,1509.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64831,Not in chargemaster,64831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64831,BCBS multispecialty AW base fee schedule,1315.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64832,Not in chargemaster,64832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64832,BCBS multispecialty AW base fee schedule,644.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64834,Not in chargemaster,64834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64834,BCBS multispecialty AW base fee schedule,1416.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64835,Not in chargemaster,64835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64835,BCBS multispecialty AW base fee schedule,1562.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64836,Not in chargemaster,64836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64836,BCBS multispecialty AW base fee schedule,1562.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64837,Not in chargemaster,64837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64837,BCBS multispecialty AW base fee schedule,704.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64840,Not in chargemaster,64840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64840,BCBS multispecialty AW base fee schedule,1841.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64856,Not in chargemaster,64856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64856,BCBS multispecialty AW base fee schedule,1936.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64857,Not in chargemaster,64857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64857,BCBS multispecialty AW base fee schedule,2016.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64858,Not in chargemaster,64858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64858,BCBS multispecialty AW base fee schedule,2254.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64859,Not in chargemaster,64859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64859,BCBS multispecialty AW base fee schedule,478.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64861,Not in chargemaster,64861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64861,BCBS multispecialty AW base fee schedule,2897.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64862,Not in chargemaster,64862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64862,BCBS multispecialty AW base fee schedule,2636.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64864,Not in chargemaster,64864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64864,BCBS multispecialty AW base fee schedule,1644.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64865,Not in chargemaster,64865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64865,BCBS multispecialty AW base fee schedule,2072.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64866,Not in chargemaster,64866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64866,BCBS multispecialty AW base fee schedule,2433.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64868,Not in chargemaster,64868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64868,BCBS multispecialty AW base fee schedule,1898.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64872,Not in chargemaster,64872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64872,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64874,Not in chargemaster,64874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64874,BCBS multispecialty AW base fee schedule,334.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64876,Not in chargemaster,64876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64876,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64885,Not in chargemaster,64885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64885,BCBS multispecialty AW base fee schedule,2110.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64886,Not in chargemaster,64886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64886,BCBS multispecialty AW base fee schedule,2434.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64890,Not in chargemaster,64890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64890,BCBS multispecialty AW base fee schedule,2069.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64891,Not in chargemaster,64891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64891,BCBS multispecialty AW base fee schedule,2201.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64892,Not in chargemaster,64892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64892,BCBS multispecialty AW base fee schedule,2012.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64893,Not in chargemaster,64893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64893,BCBS multispecialty AW base fee schedule,2147.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64895,Not in chargemaster,64895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64895,BCBS multispecialty AW base fee schedule,2544,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64896,Not in chargemaster,64896,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64896,BCBS multispecialty AW base fee schedule,2743.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64897,Not in chargemaster,64897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64897,BCBS multispecialty AW base fee schedule,2430.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64898,Not in chargemaster,64898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64898,BCBS multispecialty AW base fee schedule,2631.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64901,Not in chargemaster,64901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64901,BCBS multispecialty AW base fee schedule,1147.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64902,Not in chargemaster,64902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64902,BCBS multispecialty AW base fee schedule,1330.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64905,Not in chargemaster,64905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64905,BCBS multispecialty AW base fee schedule,1955.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64907,Not in chargemaster,64907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64907,BCBS multispecialty AW base fee schedule,2496.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64910,Not in chargemaster,64910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64910,BCBS multispecialty AW base fee schedule,1505.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64911,Not in chargemaster,64911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64911,BCBS multispecialty AW base fee schedule,1959.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64912,Not in chargemaster,64912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64912,BCBS multispecialty AW base fee schedule,1745.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64913,Not in chargemaster,64913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,64913,BCBS multispecialty AW base fee schedule,341.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65091,Not in chargemaster,65091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65091,BCBS multispecialty AW base fee schedule,1293.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65093,Not in chargemaster,65093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65093,BCBS multispecialty AW base fee schedule,1280.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65101,Not in chargemaster,65101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65101,BCBS multispecialty AW base fee schedule,1489.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65103,Not in chargemaster,65103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65103,BCBS multispecialty AW base fee schedule,1544.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65105,Not in chargemaster,65105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65105,BCBS multispecialty AW base fee schedule,1693.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65110,Not in chargemaster,65110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65110,BCBS multispecialty AW base fee schedule,2386.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65112,Not in chargemaster,65112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65112,BCBS multispecialty AW base fee schedule,2752.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65114,Not in chargemaster,65114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65114,BCBS multispecialty AW base fee schedule,2879.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65125,Not in chargemaster,65125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65125,BCBS multispecialty AW base fee schedule,858.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65130,Not in chargemaster,65130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65130,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65135,Not in chargemaster,65135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65135,BCBS multispecialty AW base fee schedule,1501.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65140,Not in chargemaster,65140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65140,BCBS multispecialty AW base fee schedule,1622.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65150,Not in chargemaster,65150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65150,BCBS multispecialty AW base fee schedule,1195.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65155,Not in chargemaster,65155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65155,BCBS multispecialty AW base fee schedule,1696,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65175,Not in chargemaster,65175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65175,BCBS multispecialty AW base fee schedule,1342.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65205,65205,65205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65205,BCBS multispecialty AW base fee schedule,70.23,120.68,Fee schedule,,70.23,70.23,70.23,70.23,,,0
unity,Fee schedule,Non-facility 65210,65210,65210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65210,BCBS multispecialty AW base fee schedule,86.13,149.08,Fee schedule,,86.13,86.13,86.13,86.13,,,0
unity,Fee schedule,Non-facility 65220,65220,65220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65220,BCBS multispecialty AW base fee schedule,112.63,124.23,Fee schedule,,112.63,112.63,112.63,112.63,,,0
unity,Fee schedule,Non-facility 65222,Not in chargemaster,65222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65222,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65235,Not in chargemaster,65235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65235,BCBS multispecialty AW base fee schedule,1347.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65260,Not in chargemaster,65260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65260,BCBS multispecialty AW base fee schedule,1823.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65265,Not in chargemaster,65265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65265,BCBS multispecialty AW base fee schedule,2047.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65270,Not in chargemaster,65270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65270,BCBS multispecialty AW base fee schedule,526.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65272,Not in chargemaster,65272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65272,BCBS multispecialty AW base fee schedule,973.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65273,Not in chargemaster,65273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65273,BCBS multispecialty AW base fee schedule,715.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65275,Not in chargemaster,65275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65275,BCBS multispecialty AW base fee schedule,1097.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65280,Not in chargemaster,65280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65280,BCBS multispecialty AW base fee schedule,1258.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65285,Not in chargemaster,65285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65285,BCBS multispecialty AW base fee schedule,2081.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65286,Not in chargemaster,65286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65286,BCBS multispecialty AW base fee schedule,1321.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65290,Not in chargemaster,65290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65290,BCBS multispecialty AW base fee schedule,920.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65400,Not in chargemaster,65400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65400,BCBS multispecialty AW base fee schedule,1285.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65410,Not in chargemaster,65410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65410,BCBS multispecialty AW base fee schedule,270.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65420,Not in chargemaster,65420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65420,BCBS multispecialty AW base fee schedule,994.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65426,Not in chargemaster,65426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65426,BCBS multispecialty AW base fee schedule,1247.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65430,Not in chargemaster,65430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65430,BCBS multispecialty AW base fee schedule,217.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65435,Not in chargemaster,65435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65435,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65436,Not in chargemaster,65436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65436,BCBS multispecialty AW base fee schedule,726.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65450,Not in chargemaster,65450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65450,BCBS multispecialty AW base fee schedule,612.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65600,Not in chargemaster,65600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65600,BCBS multispecialty AW base fee schedule,775.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65710,Not in chargemaster,65710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65710,BCBS multispecialty AW base fee schedule,2110.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65730,Not in chargemaster,65730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65730,BCBS multispecialty AW base fee schedule,2333.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65750,Not in chargemaster,65750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65750,BCBS multispecialty AW base fee schedule,2346.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65755,Not in chargemaster,65755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65755,BCBS multispecialty AW base fee schedule,2335.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65756,Not in chargemaster,65756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65756,BCBS multispecialty AW base fee schedule,2215.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65770,Not in chargemaster,65770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65770,BCBS multispecialty AW base fee schedule,2620.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65772,Not in chargemaster,65772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65772,BCBS multispecialty AW base fee schedule,848.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65775,Not in chargemaster,65775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65775,BCBS multispecialty AW base fee schedule,1055.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65778,Not in chargemaster,65778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65778,BCBS multispecialty AW base fee schedule,2636.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65779,Not in chargemaster,65779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65779,BCBS multispecialty AW base fee schedule,2280.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65780,Not in chargemaster,65780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65780,BCBS multispecialty AW base fee schedule,1248.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65781,Not in chargemaster,65781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65781,BCBS multispecialty AW base fee schedule,2495.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65782,Not in chargemaster,65782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65782,BCBS multispecialty AW base fee schedule,2154.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65785,Not in chargemaster,65785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65785,BCBS multispecialty AW base fee schedule,4468.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65800,Not in chargemaster,65800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65800,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65810,Not in chargemaster,65810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65810,BCBS multispecialty AW base fee schedule,870.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65815,Not in chargemaster,65815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65815,BCBS multispecialty AW base fee schedule,1207.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65820,Not in chargemaster,65820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65820,BCBS multispecialty AW base fee schedule,1471.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65850,Not in chargemaster,65850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65850,BCBS multispecialty AW base fee schedule,1580.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65855,Not in chargemaster,65855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65855,BCBS multispecialty AW base fee schedule,463.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65860,Not in chargemaster,65860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65860,BCBS multispecialty AW base fee schedule,581.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65865,Not in chargemaster,65865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65865,BCBS multispecialty AW base fee schedule,891.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65870,Not in chargemaster,65870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65870,BCBS multispecialty AW base fee schedule,1111.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65875,Not in chargemaster,65875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65875,BCBS multispecialty AW base fee schedule,1183.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65880,Not in chargemaster,65880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65880,BCBS multispecialty AW base fee schedule,1246.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65900,Not in chargemaster,65900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65900,BCBS multispecialty AW base fee schedule,1838.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65920,Not in chargemaster,65920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65920,BCBS multispecialty AW base fee schedule,1482.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65930,Not in chargemaster,65930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65930,BCBS multispecialty AW base fee schedule,1199.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66020,Not in chargemaster,66020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66020,BCBS multispecialty AW base fee schedule,363.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66030,Not in chargemaster,66030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66030,BCBS multispecialty AW base fee schedule,325.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66130,Not in chargemaster,66130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66130,BCBS multispecialty AW base fee schedule,1320.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66150,Not in chargemaster,66150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66150,BCBS multispecialty AW base fee schedule,1644.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66155,Not in chargemaster,66155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66155,BCBS multispecialty AW base fee schedule,1643,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66160,Not in chargemaster,66160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66160,BCBS multispecialty AW base fee schedule,1850.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66170,Not in chargemaster,66170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66170,BCBS multispecialty AW base fee schedule,2049.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66172,Not in chargemaster,66172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66172,BCBS multispecialty AW base fee schedule,2232.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66174,Not in chargemaster,66174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66174,BCBS multispecialty AW base fee schedule,1773.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66175,Not in chargemaster,66175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66175,BCBS multispecialty AW base fee schedule,1857.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66179,Not in chargemaster,66179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66179,BCBS multispecialty AW base fee schedule,2022.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66180,Not in chargemaster,66180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66180,BCBS multispecialty AW base fee schedule,2135.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66183,Not in chargemaster,66183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66183,BCBS multispecialty AW base fee schedule,1929.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66184,Not in chargemaster,66184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66184,BCBS multispecialty AW base fee schedule,1474.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66185,Not in chargemaster,66185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66185,BCBS multispecialty AW base fee schedule,1587.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66225,Not in chargemaster,66225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66225,BCBS multispecialty AW base fee schedule,1749,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66250,Not in chargemaster,66250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66250,BCBS multispecialty AW base fee schedule,1415.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66500,Not in chargemaster,66500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66500,BCBS multispecialty AW base fee schedule,699.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66505,Not in chargemaster,66505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66505,BCBS multispecialty AW base fee schedule,763.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66600,Not in chargemaster,66600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66600,BCBS multispecialty AW base fee schedule,1630.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66605,Not in chargemaster,66605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66605,BCBS multispecialty AW base fee schedule,2023.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66625,Not in chargemaster,66625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66625,BCBS multispecialty AW base fee schedule,803.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66630,Not in chargemaster,66630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66630,BCBS multispecialty AW base fee schedule,1063.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66635,Not in chargemaster,66635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66635,BCBS multispecialty AW base fee schedule,1073.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66680,Not in chargemaster,66680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66680,BCBS multispecialty AW base fee schedule,973.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66682,Not in chargemaster,66682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66682,BCBS multispecialty AW base fee schedule,1264.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66700,Not in chargemaster,66700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66700,BCBS multispecialty AW base fee schedule,848.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66710,Not in chargemaster,66710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66710,BCBS multispecialty AW base fee schedule,832.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66711,Not in chargemaster,66711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66711,BCBS multispecialty AW base fee schedule,942.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66720,Not in chargemaster,66720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66720,BCBS multispecialty AW base fee schedule,867.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66740,Not in chargemaster,66740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66740,BCBS multispecialty AW base fee schedule,824.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66761,Not in chargemaster,66761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66761,BCBS multispecialty AW base fee schedule,562.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66762,Not in chargemaster,66762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66762,BCBS multispecialty AW base fee schedule,895.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66770,Not in chargemaster,66770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66770,BCBS multispecialty AW base fee schedule,994.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66820,Not in chargemaster,66820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66820,BCBS multispecialty AW base fee schedule,806.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66821,Not in chargemaster,66821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66821,BCBS multispecialty AW base fee schedule,622.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66825,Not in chargemaster,66825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66825,BCBS multispecialty AW base fee schedule,1489.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66830,Not in chargemaster,66830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66830,BCBS multispecialty AW base fee schedule,1330.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66840,Not in chargemaster,66840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66840,BCBS multispecialty AW base fee schedule,1301.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66850,Not in chargemaster,66850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66850,BCBS multispecialty AW base fee schedule,1482.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66852,Not in chargemaster,66852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66852,BCBS multispecialty AW base fee schedule,1579.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66920,Not in chargemaster,66920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66920,BCBS multispecialty AW base fee schedule,1409.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66930,Not in chargemaster,66930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66930,BCBS multispecialty AW base fee schedule,1606.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66940,Not in chargemaster,66940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66940,BCBS multispecialty AW base fee schedule,1468.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66982,Not in chargemaster,66982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66982,BCBS multispecialty AW base fee schedule,1404.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66984,Not in chargemaster,66984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66984,BCBS multispecialty AW base fee schedule,1023.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66985,Not in chargemaster,66985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66985,BCBS multispecialty AW base fee schedule,1438.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66986,Not in chargemaster,66986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66986,BCBS multispecialty AW base fee schedule,1698.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66990,Not in chargemaster,66990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66990,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67005,Not in chargemaster,67005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67005,BCBS multispecialty AW base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67010,Not in chargemaster,67010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67010,BCBS multispecialty AW base fee schedule,1014.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67015,Not in chargemaster,67015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67015,BCBS multispecialty AW base fee schedule,1109.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67025,Not in chargemaster,67025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67025,BCBS multispecialty AW base fee schedule,1384.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67027,Not in chargemaster,67027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67027,BCBS multispecialty AW base fee schedule,1594.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67028,Not in chargemaster,67028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67028,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67030,Not in chargemaster,67030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67030,BCBS multispecialty AW base fee schedule,1018.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67031,Not in chargemaster,67031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67031,BCBS multispecialty AW base fee schedule,732.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67036,Not in chargemaster,67036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67036,BCBS multispecialty AW base fee schedule,1685.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67039,Not in chargemaster,67039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67039,BCBS multispecialty AW base fee schedule,1804.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67040,Not in chargemaster,67040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67040,BCBS multispecialty AW base fee schedule,1950.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67041,Not in chargemaster,67041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67041,BCBS multispecialty AW base fee schedule,2155.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67042,Not in chargemaster,67042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67042,BCBS multispecialty AW base fee schedule,2155.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67043,Not in chargemaster,67043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67043,BCBS multispecialty AW base fee schedule,2274.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67101,Not in chargemaster,67101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67101,BCBS multispecialty AW base fee schedule,622.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67105,Not in chargemaster,67105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67105,BCBS multispecialty AW base fee schedule,556.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67107,Not in chargemaster,67107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67107,BCBS multispecialty AW base fee schedule,2118.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67108,Not in chargemaster,67108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67108,BCBS multispecialty AW base fee schedule,2243.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67110,Not in chargemaster,67110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67110,BCBS multispecialty AW base fee schedule,1663.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67113,Not in chargemaster,67113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67113,BCBS multispecialty AW base fee schedule,2507.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67115,Not in chargemaster,67115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67115,BCBS multispecialty AW base fee schedule,934.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67120,Not in chargemaster,67120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67120,BCBS multispecialty AW base fee schedule,1251.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67121,Not in chargemaster,67121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67121,BCBS multispecialty AW base fee schedule,1697.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67141,Not in chargemaster,67141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67141,BCBS multispecialty AW base fee schedule,983.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67145,Not in chargemaster,67145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67145,BCBS multispecialty AW base fee schedule,990.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67208,Not in chargemaster,67208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67208,BCBS multispecialty AW base fee schedule,1126.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67210,Not in chargemaster,67210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67210,BCBS multispecialty AW base fee schedule,970.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67218,Not in chargemaster,67218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67218,BCBS multispecialty AW base fee schedule,2610.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67220,Not in chargemaster,67220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67220,BCBS multispecialty AW base fee schedule,999.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67221,Not in chargemaster,67221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67221,BCBS multispecialty AW base fee schedule,527.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67225,Not in chargemaster,67225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67225,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67227,Not in chargemaster,67227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67227,BCBS multispecialty AW base fee schedule,551.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67228,Not in chargemaster,67228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67228,BCBS multispecialty AW base fee schedule,640.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67229,Not in chargemaster,67229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67229,BCBS multispecialty AW base fee schedule,2182.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67250,Not in chargemaster,67250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67250,BCBS multispecialty AW base fee schedule,1578.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67255,Not in chargemaster,67255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67255,BCBS multispecialty AW base fee schedule,1281.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67311,Not in chargemaster,67311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67311,BCBS multispecialty AW base fee schedule,1118.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67312,Not in chargemaster,67312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67312,BCBS multispecialty AW base fee schedule,1344.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67314,Not in chargemaster,67314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67314,BCBS multispecialty AW base fee schedule,1270.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67316,Not in chargemaster,67316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67316,BCBS multispecialty AW base fee schedule,1507.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67318,Not in chargemaster,67318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67318,BCBS multispecialty AW base fee schedule,1326.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67320,Not in chargemaster,67320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67320,BCBS multispecialty AW base fee schedule,602.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67331,Not in chargemaster,67331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67331,BCBS multispecialty AW base fee schedule,573.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67332,Not in chargemaster,67332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67332,BCBS multispecialty AW base fee schedule,620.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67334,Not in chargemaster,67334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67334,BCBS multispecialty AW base fee schedule,564.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67335,Not in chargemaster,67335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67335,BCBS multispecialty AW base fee schedule,276.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67340,Not in chargemaster,67340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67340,BCBS multispecialty AW base fee schedule,670.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67343,Not in chargemaster,67343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67343,BCBS multispecialty AW base fee schedule,1232.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67345,Not in chargemaster,67345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67345,BCBS multispecialty AW base fee schedule,458.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67346,Not in chargemaster,67346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67346,BCBS multispecialty AW base fee schedule,361.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67400,Not in chargemaster,67400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67400,BCBS multispecialty AW base fee schedule,1846.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67405,Not in chargemaster,67405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67405,BCBS multispecialty AW base fee schedule,1587.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67412,Not in chargemaster,67412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67412,BCBS multispecialty AW base fee schedule,1729.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67413,Not in chargemaster,67413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67413,BCBS multispecialty AW base fee schedule,1709.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67414,Not in chargemaster,67414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67414,BCBS multispecialty AW base fee schedule,2622.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67415,Not in chargemaster,67415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67415,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67420,Not in chargemaster,67420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67420,BCBS multispecialty AW base fee schedule,3151.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67430,Not in chargemaster,67430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67430,BCBS multispecialty AW base fee schedule,2472.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67440,Not in chargemaster,67440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67440,BCBS multispecialty AW base fee schedule,2394.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67445,Not in chargemaster,67445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67445,BCBS multispecialty AW base fee schedule,2761.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67450,Not in chargemaster,67450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67450,BCBS multispecialty AW base fee schedule,2485.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67500,Not in chargemaster,67500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67500,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67505,Not in chargemaster,67505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67505,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67515,Not in chargemaster,67515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67515,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67550,Not in chargemaster,67550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67550,BCBS multispecialty AW base fee schedule,1922.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67560,Not in chargemaster,67560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67560,BCBS multispecialty AW base fee schedule,1969.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67570,Not in chargemaster,67570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67570,BCBS multispecialty AW base fee schedule,2363.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67700,Not in chargemaster,67700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67700,BCBS multispecialty AW base fee schedule,524.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67710,Not in chargemaster,67710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67710,BCBS multispecialty AW base fee schedule,442.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67715,Not in chargemaster,67715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67715,BCBS multispecialty AW base fee schedule,476.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67800,Not in chargemaster,67800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67800,BCBS multispecialty AW base fee schedule,241.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67801,Not in chargemaster,67801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67801,BCBS multispecialty AW base fee schedule,305.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67805,Not in chargemaster,67805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67805,BCBS multispecialty AW base fee schedule,378.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67808,Not in chargemaster,67808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67808,BCBS multispecialty AW base fee schedule,690.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67810,Not in chargemaster,67810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67810,BCBS multispecialty AW base fee schedule,339.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67820,Not in chargemaster,67820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67820,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67825,Not in chargemaster,67825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67825,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67830,Not in chargemaster,67830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67830,BCBS multispecialty AW base fee schedule,504.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67835,Not in chargemaster,67835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67835,BCBS multispecialty AW base fee schedule,823.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67840,Not in chargemaster,67840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67840,BCBS multispecialty AW base fee schedule,524.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67850,Not in chargemaster,67850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67850,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67875,Not in chargemaster,67875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67875,BCBS multispecialty AW base fee schedule,331.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67880,Not in chargemaster,67880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67880,BCBS multispecialty AW base fee schedule,867.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67882,Not in chargemaster,67882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67882,BCBS multispecialty AW base fee schedule,1066.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67900,Not in chargemaster,67900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67900,BCBS multispecialty AW base fee schedule,1212.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67901,Not in chargemaster,67901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67901,BCBS multispecialty AW base fee schedule,1466.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67902,Not in chargemaster,67902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67902,BCBS multispecialty AW base fee schedule,1358.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67903,Not in chargemaster,67903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67903,BCBS multispecialty AW base fee schedule,1126.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67904,Not in chargemaster,67904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67904,BCBS multispecialty AW base fee schedule,1385.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67906,Not in chargemaster,67906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67906,BCBS multispecialty AW base fee schedule,949.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67908,Not in chargemaster,67908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67908,BCBS multispecialty AW base fee schedule,968.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67909,Not in chargemaster,67909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67909,BCBS multispecialty AW base fee schedule,1022.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67911,Not in chargemaster,67911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67911,BCBS multispecialty AW base fee schedule,1050.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67912,Not in chargemaster,67912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67912,BCBS multispecialty AW base fee schedule,1701.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67914,Not in chargemaster,67914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67914,BCBS multispecialty AW base fee schedule,904.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67915,Not in chargemaster,67915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67915,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67916,Not in chargemaster,67916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67916,BCBS multispecialty AW base fee schedule,1136.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67917,Not in chargemaster,67917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67917,BCBS multispecialty AW base fee schedule,1159.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67921,Not in chargemaster,67921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67921,BCBS multispecialty AW base fee schedule,886.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67922,Not in chargemaster,67922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67922,BCBS multispecialty AW base fee schedule,557.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67923,Not in chargemaster,67923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67923,BCBS multispecialty AW base fee schedule,1136.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67924,Not in chargemaster,67924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67924,BCBS multispecialty AW base fee schedule,1210.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67930,Not in chargemaster,67930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67930,BCBS multispecialty AW base fee schedule,692.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67935,Not in chargemaster,67935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67935,BCBS multispecialty AW base fee schedule,1120.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67938,67938,67938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67938,BCBS multispecialty AW base fee schedule,487.6,528.86,Fee schedule,,487.6,487.6,487.6,487.6,,,0
unity,Fee schedule,Non-facility 67950,Not in chargemaster,67950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67950,BCBS multispecialty AW base fee schedule,1088.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67961,Not in chargemaster,67961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67961,BCBS multispecialty AW base fee schedule,1092.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67966,Not in chargemaster,67966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67966,BCBS multispecialty AW base fee schedule,1454.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67971,Not in chargemaster,67971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67971,BCBS multispecialty AW base fee schedule,1354.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67973,Not in chargemaster,67973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67973,BCBS multispecialty AW base fee schedule,1743.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67974,Not in chargemaster,67974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67974,BCBS multispecialty AW base fee schedule,1739.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67975,Not in chargemaster,67975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,67975,BCBS multispecialty AW base fee schedule,1283.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68020,Not in chargemaster,68020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68020,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68040,Not in chargemaster,68040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68040,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68100,Not in chargemaster,68100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68100,BCBS multispecialty AW base fee schedule,335.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68110,Not in chargemaster,68110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68110,BCBS multispecialty AW base fee schedule,439.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68115,Not in chargemaster,68115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68115,BCBS multispecialty AW base fee schedule,608.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68130,Not in chargemaster,68130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68130,BCBS multispecialty AW base fee schedule,1027.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68135,Not in chargemaster,68135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68135,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68200,Not in chargemaster,68200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68200,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68320,Not in chargemaster,68320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68320,BCBS multispecialty AW base fee schedule,1383.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68325,Not in chargemaster,68325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68325,BCBS multispecialty AW base fee schedule,1229.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68326,Not in chargemaster,68326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68326,BCBS multispecialty AW base fee schedule,1207.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68328,Not in chargemaster,68328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68328,BCBS multispecialty AW base fee schedule,1327.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68330,Not in chargemaster,68330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68330,BCBS multispecialty AW base fee schedule,1156.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68335,Not in chargemaster,68335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68335,BCBS multispecialty AW base fee schedule,1211.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68340,Not in chargemaster,68340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68340,BCBS multispecialty AW base fee schedule,1089.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68360,Not in chargemaster,68360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68360,BCBS multispecialty AW base fee schedule,1010.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68362,Not in chargemaster,68362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68362,BCBS multispecialty AW base fee schedule,1226.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68371,Not in chargemaster,68371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68371,BCBS multispecialty AW base fee schedule,773.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68400,Not in chargemaster,68400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68400,BCBS multispecialty AW base fee schedule,549.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68420,Not in chargemaster,68420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68420,BCBS multispecialty AW base fee schedule,619.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68440,Not in chargemaster,68440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68440,BCBS multispecialty AW base fee schedule,193.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68500,Not in chargemaster,68500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68500,BCBS multispecialty AW base fee schedule,1900.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68505,Not in chargemaster,68505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68505,BCBS multispecialty AW base fee schedule,1891.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68510,Not in chargemaster,68510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68510,BCBS multispecialty AW base fee schedule,855.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68520,Not in chargemaster,68520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68520,BCBS multispecialty AW base fee schedule,1330.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68525,Not in chargemaster,68525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68525,BCBS multispecialty AW base fee schedule,494.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68530,Not in chargemaster,68530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68530,BCBS multispecialty AW base fee schedule,813.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68540,Not in chargemaster,68540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68540,BCBS multispecialty AW base fee schedule,1789.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68550,Not in chargemaster,68550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68550,BCBS multispecialty AW base fee schedule,2209.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68700,Not in chargemaster,68700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68700,BCBS multispecialty AW base fee schedule,1130.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68705,Not in chargemaster,68705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68705,BCBS multispecialty AW base fee schedule,476.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68720,Not in chargemaster,68720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68720,BCBS multispecialty AW base fee schedule,1466.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68745,Not in chargemaster,68745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68745,BCBS multispecialty AW base fee schedule,1471.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68750,Not in chargemaster,68750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68750,BCBS multispecialty AW base fee schedule,1535.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68760,Not in chargemaster,68760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68760,BCBS multispecialty AW base fee schedule,402.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68761,Not in chargemaster,68761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68761,BCBS multispecialty AW base fee schedule,278.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68770,Not in chargemaster,68770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68770,BCBS multispecialty AW base fee schedule,1176.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68801,Not in chargemaster,68801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68801,BCBS multispecialty AW base fee schedule,172.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68810,Not in chargemaster,68810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68810,BCBS multispecialty AW base fee schedule,298.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68811,Not in chargemaster,68811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68811,BCBS multispecialty AW base fee schedule,253.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68815,Not in chargemaster,68815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68815,BCBS multispecialty AW base fee schedule,731.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68816,Not in chargemaster,68816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68816,BCBS multispecialty AW base fee schedule,1474.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68840,Not in chargemaster,68840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68840,BCBS multispecialty AW base fee schedule,245.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68850,Not in chargemaster,68850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,68850,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69000,Not in chargemaster,69000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69000,BCBS multispecialty AW base fee schedule,353.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69005,Not in chargemaster,69005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69005,BCBS multispecialty AW base fee schedule,409.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69020,Not in chargemaster,69020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69020,BCBS multispecialty AW base fee schedule,433.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69100,Not in chargemaster,69100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69100,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69105,Not in chargemaster,69105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69105,BCBS multispecialty AW base fee schedule,265,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69110,Not in chargemaster,69110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69110,BCBS multispecialty AW base fee schedule,871.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69120,Not in chargemaster,69120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69120,BCBS multispecialty AW base fee schedule,739.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69140,Not in chargemaster,69140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69140,BCBS multispecialty AW base fee schedule,1647.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69145,Not in chargemaster,69145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69145,BCBS multispecialty AW base fee schedule,751.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69150,Not in chargemaster,69150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69150,BCBS multispecialty AW base fee schedule,1937.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69155,Not in chargemaster,69155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69155,BCBS multispecialty AW base fee schedule,3090.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69200,69200,69200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69200,BCBS multispecialty AW base fee schedule,153.04,269.76,Fee schedule,,153.04,153.04,153.04,153.04,,,0
unity,Fee schedule,Non-facility 69205,Not in chargemaster,69205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69205,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69209,69209,69209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69209,BCBS multispecialty AW base fee schedule,26.5,30,Fee schedule,,26.5,26.5,26.5,26.5,,,0
unity,Fee schedule,Non-facility 69210,69210,69210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69210,BCBS multispecialty AW base fee schedule,90.1,110.75,Fee schedule,,90.1,90.1,90.1,90.1,,,0
unity,Fee schedule,Non-facility 69220,Not in chargemaster,69220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69220,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69222,Not in chargemaster,69222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69222,BCBS multispecialty AW base fee schedule,398.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69300,Not in chargemaster,69300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69300,BCBS multispecialty AW base fee schedule,1169.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69310,Not in chargemaster,69310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69310,BCBS multispecialty AW base fee schedule,2053.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69320,Not in chargemaster,69320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69320,BCBS multispecialty AW base fee schedule,2879.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69420,Not in chargemaster,69420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69420,BCBS multispecialty AW base fee schedule,351.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69421,Not in chargemaster,69421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69421,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69424,Not in chargemaster,69424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69424,BCBS multispecialty AW base fee schedule,239.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69433,Not in chargemaster,69433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69433,BCBS multispecialty AW base fee schedule,372.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69436,Not in chargemaster,69436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69436,BCBS multispecialty AW base fee schedule,296.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69440,Not in chargemaster,69440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69440,BCBS multispecialty AW base fee schedule,1292.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69450,Not in chargemaster,69450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69450,BCBS multispecialty AW base fee schedule,1022.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69501,Not in chargemaster,69501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69501,BCBS multispecialty AW base fee schedule,1350.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69502,Not in chargemaster,69502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69502,BCBS multispecialty AW base fee schedule,1796.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69505,Not in chargemaster,69505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69505,BCBS multispecialty AW base fee schedule,2267.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69511,Not in chargemaster,69511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69511,BCBS multispecialty AW base fee schedule,2322.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69530,Not in chargemaster,69530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69530,BCBS multispecialty AW base fee schedule,3115.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69535,Not in chargemaster,69535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69535,BCBS multispecialty AW base fee schedule,4998.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69540,Not in chargemaster,69540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69540,BCBS multispecialty AW base fee schedule,386.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69550,Not in chargemaster,69550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69550,BCBS multispecialty AW base fee schedule,1959.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69552,Not in chargemaster,69552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69552,BCBS multispecialty AW base fee schedule,2957.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69554,Not in chargemaster,69554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69554,BCBS multispecialty AW base fee schedule,4742.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69601,Not in chargemaster,69601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69601,BCBS multispecialty AW base fee schedule,1935.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69602,Not in chargemaster,69602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69602,BCBS multispecialty AW base fee schedule,2046.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69603,Not in chargemaster,69603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69603,BCBS multispecialty AW base fee schedule,2373.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69604,Not in chargemaster,69604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69604,BCBS multispecialty AW base fee schedule,2091.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69605,Not in chargemaster,69605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69605,BCBS multispecialty AW base fee schedule,2938.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69610,Not in chargemaster,69610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69610,BCBS multispecialty AW base fee schedule,712.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69620,Not in chargemaster,69620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69620,BCBS multispecialty AW base fee schedule,1328.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69631,Not in chargemaster,69631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69631,BCBS multispecialty AW base fee schedule,1662.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69632,Not in chargemaster,69632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69632,BCBS multispecialty AW base fee schedule,2025.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69633,Not in chargemaster,69633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69633,BCBS multispecialty AW base fee schedule,1962.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69635,Not in chargemaster,69635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69635,BCBS multispecialty AW base fee schedule,2324.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69636,Not in chargemaster,69636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69636,BCBS multispecialty AW base fee schedule,2600.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69637,Not in chargemaster,69637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69637,BCBS multispecialty AW base fee schedule,2588.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69641,Not in chargemaster,69641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69641,BCBS multispecialty AW base fee schedule,1957.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69642,Not in chargemaster,69642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69642,BCBS multispecialty AW base fee schedule,2515.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69643,Not in chargemaster,69643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69643,BCBS multispecialty AW base fee schedule,2298.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69644,Not in chargemaster,69644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69644,BCBS multispecialty AW base fee schedule,2784.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69645,Not in chargemaster,69645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69645,BCBS multispecialty AW base fee schedule,2740.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69646,Not in chargemaster,69646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69646,BCBS multispecialty AW base fee schedule,2904.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69650,Not in chargemaster,69650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69650,BCBS multispecialty AW base fee schedule,1507.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69660,Not in chargemaster,69660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69660,BCBS multispecialty AW base fee schedule,1740.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69661,Not in chargemaster,69661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69661,BCBS multispecialty AW base fee schedule,2271.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69662,Not in chargemaster,69662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69662,BCBS multispecialty AW base fee schedule,2167.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69666,Not in chargemaster,69666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69666,BCBS multispecialty AW base fee schedule,1520.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69667,Not in chargemaster,69667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69667,BCBS multispecialty AW base fee schedule,1519.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69670,Not in chargemaster,69670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69670,BCBS multispecialty AW base fee schedule,1778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69676,Not in chargemaster,69676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69676,BCBS multispecialty AW base fee schedule,1560.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69700,Not in chargemaster,69700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69700,BCBS multispecialty AW base fee schedule,1265.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69711,Not in chargemaster,69711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69711,BCBS multispecialty AW base fee schedule,1591.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69714,Not in chargemaster,69714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69714,BCBS multispecialty AW base fee schedule,1995.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69715,Not in chargemaster,69715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69715,BCBS multispecialty AW base fee schedule,2469.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69717,Not in chargemaster,69717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69717,BCBS multispecialty AW base fee schedule,2094.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69718,Not in chargemaster,69718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69718,BCBS multispecialty AW base fee schedule,2495.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69720,Not in chargemaster,69720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69720,BCBS multispecialty AW base fee schedule,2235.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69725,Not in chargemaster,69725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69725,BCBS multispecialty AW base fee schedule,3536.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69740,Not in chargemaster,69740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69740,BCBS multispecialty AW base fee schedule,2192.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69745,Not in chargemaster,69745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69745,BCBS multispecialty AW base fee schedule,2335.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69801,Not in chargemaster,69801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69801,BCBS multispecialty AW base fee schedule,400.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69805,Not in chargemaster,69805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69805,BCBS multispecialty AW base fee schedule,1956.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69806,Not in chargemaster,69806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69806,BCBS multispecialty AW base fee schedule,1752.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69905,Not in chargemaster,69905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69905,BCBS multispecialty AW base fee schedule,1723.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69910,Not in chargemaster,69910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69910,BCBS multispecialty AW base fee schedule,1886.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69915,Not in chargemaster,69915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69915,BCBS multispecialty AW base fee schedule,2864.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69930,Not in chargemaster,69930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69930,BCBS multispecialty AW base fee schedule,2302.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69950,Not in chargemaster,69950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69950,BCBS multispecialty AW base fee schedule,3328.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69955,Not in chargemaster,69955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69955,BCBS multispecialty AW base fee schedule,3721.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69960,Not in chargemaster,69960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69960,BCBS multispecialty AW base fee schedule,3590.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69970,Not in chargemaster,69970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69970,BCBS multispecialty AW base fee schedule,4031.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69990,Not in chargemaster,69990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,69990,BCBS multispecialty AW base fee schedule,417.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70010,Not in chargemaster,70010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70010,BCBS multispecialty AW base fee schedule,113.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70015 mod 26,Not in chargemaster,70015,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70015 mod 26,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70015 mod TC,Not in chargemaster,70015,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70015 mod TC,BCBS multispecialty AW base fee schedule,192.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70015,Not in chargemaster,70015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70015,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70030,Not in chargemaster,70030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70030,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70030 mod 26,Not in chargemaster,70030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70030 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70030 mod TC,Not in chargemaster,70030,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70030 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70100 mod 26,Not in chargemaster,70100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70100 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70100 mod TC,Not in chargemaster,70100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70100 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70100,Not in chargemaster,70100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70100,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70110,Not in chargemaster,70110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70110,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70110 mod 26,70110,70110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70110 mod 26,BCBS multispecialty AW base fee schedule,23.85,27.93,Fee schedule,,23.85,23.85,23.85,23.85,,,0
unity,Fee schedule,Non-facility 70110 mod TC,Not in chargemaster,70110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70110 mod TC,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70120 mod 26,Not in chargemaster,70120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70120 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70120 mod TC,Not in chargemaster,70120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70120 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70120,Not in chargemaster,70120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70120,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70130,Not in chargemaster,70130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70130,BCBS multispecialty AW base fee schedule,111.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70130 mod 26,Not in chargemaster,70130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70130 mod 26,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70130 mod TC,Not in chargemaster,70130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70130 mod TC,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70134 mod 26,Not in chargemaster,70134,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70134 mod 26,BCBS multispecialty AW base fee schedule,33.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70134 mod TC,Not in chargemaster,70134,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70134 mod TC,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70134,Not in chargemaster,70134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70134,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70140,Not in chargemaster,70140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70140,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70140 mod 26,Not in chargemaster,70140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70140 mod 26,BCBS multispecialty AW base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70140 mod TC,Not in chargemaster,70140,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70140 mod TC,BCBS multispecialty AW base fee schedule,39.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70150 mod 26,70150,70150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70150 mod 26,BCBS multispecialty AW base fee schedule,25.18,29.48,Fee schedule,,25.18,25.18,25.18,25.18,,,0
unity,Fee schedule,Non-facility 70150 mod TC,Not in chargemaster,70150,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70150 mod TC,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70150,Not in chargemaster,70150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70150,BCBS multispecialty AW base fee schedule,85.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70160,Not in chargemaster,70160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70160,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70160 mod 26,70160,70160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70160 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Non-facility 70160 mod TC,Not in chargemaster,70160,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70160 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70170,Not in chargemaster,70170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70170,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70170 mod 26,Not in chargemaster,70170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70170 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70190 mod 26,Not in chargemaster,70190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70190 mod 26,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70190 mod TC,Not in chargemaster,70190,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70190 mod TC,BCBS multispecialty AW base fee schedule,50.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70190,Not in chargemaster,70190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70190,BCBS multispecialty AW base fee schedule,71.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70200,Not in chargemaster,70200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70200,BCBS multispecialty AW base fee schedule,86.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70200 mod 26,Not in chargemaster,70200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70200 mod 26,BCBS multispecialty AW base fee schedule,26.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70200 mod TC,Not in chargemaster,70200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70200 mod TC,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70210 mod 26,Not in chargemaster,70210,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70210 mod 26,BCBS multispecialty AW base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70210 mod TC,Not in chargemaster,70210,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70210 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70210,Not in chargemaster,70210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70210,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70220,Not in chargemaster,70220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70220,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70220 mod 26,70220,70220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70220 mod 26,BCBS multispecialty AW base fee schedule,21.2,27.93,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Non-facility 70220 mod TC,Not in chargemaster,70220,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70220 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70240 mod 26,Not in chargemaster,70240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70240 mod 26,BCBS multispecialty AW base fee schedule,18.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70240 mod TC,Not in chargemaster,70240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70240 mod TC,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70240,Not in chargemaster,70240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70240,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70250,Not in chargemaster,70250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70250,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70250 mod 26,70250,70250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70250 mod 26,BCBS multispecialty AW base fee schedule,19.21,27.93,Fee schedule,,19.21,19.21,19.21,19.21,,,0
unity,Fee schedule,Non-facility 70250 mod TC,Not in chargemaster,70250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70250 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70260 mod 26,70260,70260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70260 mod 26,BCBS multispecialty AW base fee schedule,27.16,38.01,Fee schedule,,27.16,27.16,27.16,27.16,,,0
unity,Fee schedule,Non-facility 70260 mod TC,Not in chargemaster,70260,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70260 mod TC,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70260,Not in chargemaster,70260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70260,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70300,Not in chargemaster,70300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70300,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70300 mod 26,Not in chargemaster,70300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70300 mod 26,BCBS multispecialty AW base fee schedule,10.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70300 mod TC,Not in chargemaster,70300,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70300 mod TC,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70310 mod 26,Not in chargemaster,70310,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70310 mod 26,BCBS multispecialty AW base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70310 mod TC,Not in chargemaster,70310,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70310 mod TC,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70310,Not in chargemaster,70310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70310,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70320,Not in chargemaster,70320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70320,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70320 mod 26,Not in chargemaster,70320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70320 mod 26,BCBS multispecialty AW base fee schedule,21.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70320 mod TC,Not in chargemaster,70320,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70320 mod TC,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70328 mod 26,Not in chargemaster,70328,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70328 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70328 mod TC,Not in chargemaster,70328,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70328 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70328,Not in chargemaster,70328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70328,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70330,Not in chargemaster,70330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70330,BCBS multispecialty AW base fee schedule,96.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70330 mod 26,Not in chargemaster,70330,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70330 mod 26,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70330 mod TC,Not in chargemaster,70330,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70330 mod TC,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70332 mod 26,Not in chargemaster,70332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70332 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70332 mod TC,Not in chargemaster,70332,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70332 mod TC,BCBS multispecialty AW base fee schedule,100.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70332,Not in chargemaster,70332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70332,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70336,Not in chargemaster,70336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70336,BCBS multispecialty AW base fee schedule,575.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70336 mod 26,Not in chargemaster,70336,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70336 mod 26,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70336 mod TC,Not in chargemaster,70336,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70336 mod TC,BCBS multispecialty AW base fee schedule,435.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70350 mod 26,Not in chargemaster,70350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70350 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70350 mod TC,Not in chargemaster,70350,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70350 mod TC,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70350,Not in chargemaster,70350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70350,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70355,Not in chargemaster,70355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70355,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70355 mod 26,Not in chargemaster,70355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70355 mod 26,BCBS multispecialty AW base fee schedule,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70355 mod TC,Not in chargemaster,70355,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70355 mod TC,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70360 mod 26,70360,70360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70360 mod 26,BCBS multispecialty AW base fee schedule,17.23,18.62,Fee schedule,,17.23,17.23,17.23,17.23,,,0
unity,Fee schedule,Non-facility 70360 mod TC,Not in chargemaster,70360,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70360 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70360,Not in chargemaster,70360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70360,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70370,Not in chargemaster,70370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70370,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70370 mod 26,Not in chargemaster,70370,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70370 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70370 mod TC,Not in chargemaster,70370,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70370 mod TC,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70371 mod 26,Not in chargemaster,70371,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70371 mod 26,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70371 mod TC,Not in chargemaster,70371,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70371 mod TC,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70371,Not in chargemaster,70371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70371,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70380,Not in chargemaster,70380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70380,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70380 mod 26,Not in chargemaster,70380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70380 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70380 mod TC,Not in chargemaster,70380,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70380 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70390 mod 26,Not in chargemaster,70390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70390 mod 26,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70390 mod TC,Not in chargemaster,70390,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70390 mod TC,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70390,Not in chargemaster,70390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70390,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70450,Not in chargemaster,70450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70450,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70450 mod 26,70450,70450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70450 mod 26,BCBS multispecialty AW base fee schedule,80.16,93.07,Fee schedule,,80.16,80.16,80.16,80.16,,,0
unity,Fee schedule,Non-facility 70450 mod TC,Not in chargemaster,70450,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70450 mod TC,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70460 mod 26,70460,70460,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70460 mod 26,BCBS multispecialty AW base fee schedule,106,124.11,Fee schedule,,106,106,106,106,,,0
unity,Fee schedule,Non-facility 70460 mod TC,Not in chargemaster,70460,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70460 mod TC,BCBS multispecialty AW base fee schedule,198.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70460,Not in chargemaster,70460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70460,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70470,Not in chargemaster,70470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70470,BCBS multispecialty AW base fee schedule,356.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70470 mod 26,70470,70470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70470 mod 26,BCBS multispecialty AW base fee schedule,119.25,140.39,Fee schedule,,119.25,119.25,119.25,119.25,,,0
unity,Fee schedule,Non-facility 70470 mod TC,Not in chargemaster,70470,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70470 mod TC,BCBS multispecialty AW base fee schedule,237.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70480 mod 26,70480,70480,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70480 mod 26,BCBS multispecialty AW base fee schedule,119.91,141.94,Fee schedule,,119.91,119.91,119.91,119.91,,,0
unity,Fee schedule,Non-facility 70480 mod TC,Not in chargemaster,70480,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70480 mod TC,BCBS multispecialty AW base fee schedule,253.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70480,Not in chargemaster,70480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70480,BCBS multispecialty AW base fee schedule,373.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70481,Not in chargemaster,70481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70481,BCBS multispecialty AW base fee schedule,416.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70481 mod 26,Not in chargemaster,70481,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70481 mod 26,BCBS multispecialty AW base fee schedule,106,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70481 mod TC,Not in chargemaster,70481,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70481 mod TC,BCBS multispecialty AW base fee schedule,310.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70482 mod 26,70482,70482,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70482 mod 26,BCBS multispecialty AW base fee schedule,118.59,159.78,Fee schedule,,118.59,118.59,118.59,118.59,,,0
unity,Fee schedule,Non-facility 70482 mod TC,Not in chargemaster,70482,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70482 mod TC,BCBS multispecialty AW base fee schedule,343.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70482,Not in chargemaster,70482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70482,BCBS multispecialty AW base fee schedule,461.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70486,Not in chargemaster,70486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70486,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70486 mod 26,70486,70486,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70486 mod 26,BCBS multispecialty AW base fee schedule,80.83,125.65,Fee schedule,,80.83,80.83,80.83,80.83,,,0
unity,Fee schedule,Non-facility 70486 mod TC,Not in chargemaster,70486,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70486 mod TC,BCBS multispecialty AW base fee schedule,178.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70487 mod 26,Not in chargemaster,70487,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70487 mod 26,BCBS multispecialty AW base fee schedule,106,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70487 mod TC,Not in chargemaster,70487,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70487 mod TC,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70487,Not in chargemaster,70487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70487,BCBS multispecialty AW base fee schedule,311.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70488,Not in chargemaster,70488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70488,BCBS multispecialty AW base fee schedule,379.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70488 mod 26,Not in chargemaster,70488,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70488 mod 26,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70488 mod TC,Not in chargemaster,70488,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70488 mod TC,BCBS multispecialty AW base fee schedule,260.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70490 mod 26,Not in chargemaster,70490,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70490 mod 26,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70490 mod TC,Not in chargemaster,70490,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70490 mod TC,BCBS multispecialty AW base fee schedule,186.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70490,Not in chargemaster,70490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70490,BCBS multispecialty AW base fee schedule,306.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70491,Not in chargemaster,70491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70491,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70491 mod 26,70491,70491,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70491 mod 26,BCBS multispecialty AW base fee schedule,129.85,152.02,Fee schedule,,129.85,129.85,129.85,129.85,,,0
unity,Fee schedule,Non-facility 70491 mod TC,Not in chargemaster,70491,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70491 mod TC,BCBS multispecialty AW base fee schedule,247.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70492 mod 26,70492,70492,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70492 mod 26,BCBS multispecialty AW base fee schedule,153.04,159.78,Fee schedule,,153.04,153.04,153.04,153.04,,,0
unity,Fee schedule,Non-facility 70492 mod TC,Not in chargemaster,70492,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70492 mod TC,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70492,Not in chargemaster,70492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70492,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70496,Not in chargemaster,70496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70496,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70496 mod 26,Not in chargemaster,70496,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70496 mod 26,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70496 mod TC,Not in chargemaster,70496,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70496 mod TC,BCBS multispecialty AW base fee schedule,388.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70498 mod 26,Not in chargemaster,70498,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70498 mod 26,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70498 mod TC,Not in chargemaster,70498,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70498 mod TC,BCBS multispecialty AW base fee schedule,388.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70498,Not in chargemaster,70498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70498,BCBS multispecialty AW base fee schedule,552.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70540,Not in chargemaster,70540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70540,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70540 mod 26,Not in chargemaster,70540,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70540 mod 26,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70540 mod TC,Not in chargemaster,70540,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70540 mod TC,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70542 mod 26,Not in chargemaster,70542,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70542 mod 26,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70542 mod TC,Not in chargemaster,70542,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70542 mod TC,BCBS multispecialty AW base fee schedule,424.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70542,Not in chargemaster,70542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70542,BCBS multispecialty AW base fee schedule,577.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70543,Not in chargemaster,70543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70543,BCBS multispecialty AW base fee schedule,726.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70543 mod 26,70543,70543,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70543 mod 26,BCBS multispecialty AW base fee schedule,200.74,236.57,Fee schedule,,200.74,200.74,200.74,200.74,,,0
unity,Fee schedule,Non-facility 70543 mod TC,Not in chargemaster,70543,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70543 mod TC,BCBS multispecialty AW base fee schedule,525.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70544 mod 26,70544,70544,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70544 mod 26,BCBS multispecialty AW base fee schedule,112.63,132.64,Fee schedule,,112.63,112.63,112.63,112.63,,,0
unity,Fee schedule,Non-facility 70544 mod TC,Not in chargemaster,70544,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70544 mod TC,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70544,Not in chargemaster,70544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70544,BCBS multispecialty AW base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70545,Not in chargemaster,70545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70545,BCBS multispecialty AW base fee schedule,477.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70545 mod 26,Not in chargemaster,70545,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70545 mod 26,BCBS multispecialty AW base fee schedule,112.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70545 mod TC,Not in chargemaster,70545,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70545 mod TC,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70546 mod 26,Not in chargemaster,70546,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70546 mod 26,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70546 mod TC,Not in chargemaster,70546,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70546 mod TC,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70546,Not in chargemaster,70546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70546,BCBS multispecialty AW base fee schedule,692.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70547,Not in chargemaster,70547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70547,BCBS multispecialty AW base fee schedule,459.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70547 mod 26,Not in chargemaster,70547,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70547 mod 26,BCBS multispecialty AW base fee schedule,113.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70547 mod TC,Not in chargemaster,70547,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70547 mod TC,BCBS multispecialty AW base fee schedule,345.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70548 mod 26,Not in chargemaster,70548,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70548 mod 26,BCBS multispecialty AW base fee schedule,141.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70548 mod TC,Not in chargemaster,70548,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70548 mod TC,BCBS multispecialty AW base fee schedule,371.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70548,Not in chargemaster,70548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70548,BCBS multispecialty AW base fee schedule,512.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70549,Not in chargemaster,70549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70549,BCBS multispecialty AW base fee schedule,726.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70549 mod 26,Not in chargemaster,70549,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70549 mod 26,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70549 mod TC,Not in chargemaster,70549,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70549 mod TC,BCBS multispecialty AW base fee schedule,557.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70551 mod 26,70551,70551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70551 mod 26,BCBS multispecialty AW base fee schedule,139.79,162.89,Fee schedule,,139.79,139.79,139.79,139.79,,,0
unity,Fee schedule,Non-facility 70551 mod TC,Not in chargemaster,70551,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70551 mod TC,BCBS multispecialty AW base fee schedule,276.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70551,Not in chargemaster,70551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70551,BCBS multispecialty AW base fee schedule,416.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70552,Not in chargemaster,70552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70552,BCBS multispecialty AW base fee schedule,575.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70552 mod 26,Not in chargemaster,70552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70552 mod 26,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70552 mod TC,Not in chargemaster,70552,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70552 mod TC,BCBS multispecialty AW base fee schedule,408.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70553 mod 26,70553,70553,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70553 mod 26,BCBS multispecialty AW base fee schedule,215.31,260.62,Fee schedule,,215.31,215.31,215.31,215.31,,,0
unity,Fee schedule,Non-facility 70553 mod TC,Not in chargemaster,70553,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70553 mod TC,BCBS multispecialty AW base fee schedule,465.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70553,Not in chargemaster,70553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70553,BCBS multispecialty AW base fee schedule,680.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70554,Not in chargemaster,70554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70554,BCBS multispecialty AW base fee schedule,805.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70554 mod 26,Not in chargemaster,70554,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70554 mod 26,BCBS multispecialty AW base fee schedule,198.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70554 mod TC,Not in chargemaster,70554,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70554 mod TC,BCBS multispecialty AW base fee schedule,607.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70555,Not in chargemaster,70555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70555,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70555 mod 26,Not in chargemaster,70555,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70555 mod 26,BCBS multispecialty AW base fee schedule,236.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70557,Not in chargemaster,70557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70557,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70557 mod 26,Not in chargemaster,70557,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70557 mod 26,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70558,Not in chargemaster,70558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70558,BCBS multispecialty AW base fee schedule,322.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70558 mod 26,Not in chargemaster,70558,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70558 mod 26,BCBS multispecialty AW base fee schedule,322.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70559,Not in chargemaster,70559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70559,BCBS multispecialty AW base fee schedule,309.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70559 mod 26,Not in chargemaster,70559,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,70559 mod 26,BCBS multispecialty AW base fee schedule,309.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71045,Not in chargemaster,71045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71045,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71045 mod 26,71045,71045,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71045 mod 26,BCBS multispecialty AW base fee schedule,17.23,20.17,Fee schedule,,17.23,17.23,17.23,17.23,,,0
unity,Fee schedule,Non-facility 71045 mod TC,Not in chargemaster,71045,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71045 mod TC,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71046 mod 26,71046,71046,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71046 mod 26,BCBS multispecialty AW base fee schedule,20.54,24.05,Fee schedule,,20.54,20.54,20.54,20.54,,,0
unity,Fee schedule,Non-facility 71046 mod TC,Not in chargemaster,71046,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71046 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71046,Not in chargemaster,71046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71046,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71047,Not in chargemaster,71047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71047,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71047 mod 26,71047,71047,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71047 mod 26,BCBS multispecialty AW base fee schedule,25.84,30.25,Fee schedule,,25.84,25.84,25.84,25.84,,,0
unity,Fee schedule,Non-facility 71047 mod TC,Not in chargemaster,71047,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71047 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71048 mod 26,71048,71048,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71048 mod 26,BCBS multispecialty AW base fee schedule,30.48,18.34,Fee schedule,,18.34,18.34,18.34,18.34,,,0
unity,Fee schedule,Non-facility 71048 mod TC,Not in chargemaster,71048,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71048 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71048,Not in chargemaster,71048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71048,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71100,Not in chargemaster,71100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71100,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71100 mod 26,71100,71100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71100 mod 26,BCBS multispecialty AW base fee schedule,21.2,24.82,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Non-facility 71100 mod TC,Not in chargemaster,71100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71100 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71101 mod 26,71101,71101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71101 mod 26,BCBS multispecialty AW base fee schedule,25.18,29.48,Fee schedule,,25.18,25.18,25.18,25.18,,,0
unity,Fee schedule,Non-facility 71101 mod TC,Not in chargemaster,71101,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71101 mod TC,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71101,Not in chargemaster,71101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71101,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71110,Not in chargemaster,71110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71110,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71110 mod 26,Not in chargemaster,71110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71110 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71110 mod TC,Not in chargemaster,71110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71110 mod TC,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71111 mod 26,Not in chargemaster,71111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71111 mod 26,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71111 mod TC,Not in chargemaster,71111,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71111 mod TC,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71111,Not in chargemaster,71111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71111,BCBS multispecialty AW base fee schedule,95.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71120,Not in chargemaster,71120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71120,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71120 mod 26,Not in chargemaster,71120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71120 mod 26,BCBS multispecialty AW base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71120 mod TC,Not in chargemaster,71120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71120 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71130 mod 26,71130,71130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71130 mod 26,BCBS multispecialty AW base fee schedule,21.2,24.82,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Non-facility 71130 mod TC,Not in chargemaster,71130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71130 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71130,Not in chargemaster,71130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71130,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71250,Not in chargemaster,71250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71250,BCBS multispecialty AW base fee schedule,294.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71250 mod 26,71250,71250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71250 mod 26,BCBS multispecialty AW base fee schedule,108.65,111.69,Fee schedule,,108.65,108.65,108.65,108.65,,,0
unity,Fee schedule,Non-facility 71250 mod TC,Not in chargemaster,71250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71250 mod TC,BCBS multispecialty AW base fee schedule,186.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71260 mod 26,71260,71260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71260 mod 26,BCBS multispecialty AW base fee schedule,117.26,137.29,Fee schedule,,117.26,117.26,117.26,117.26,,,0
unity,Fee schedule,Non-facility 71260 mod TC,Not in chargemaster,71260,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71260 mod TC,BCBS multispecialty AW base fee schedule,248.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71260,Not in chargemaster,71260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71260,BCBS multispecialty AW base fee schedule,365.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71270,Not in chargemaster,71270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71270,BCBS multispecialty AW base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71270 mod 26,71270,71270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71270 mod 26,BCBS multispecialty AW base fee schedule,129.19,151.25,Fee schedule,,129.19,129.19,129.19,129.19,,,0
unity,Fee schedule,Non-facility 71270 mod TC,Not in chargemaster,71270,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71270 mod TC,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71275 mod 26,Not in chargemaster,71275,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71275 mod 26,BCBS multispecialty AW base fee schedule,170.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71275 mod TC,Not in chargemaster,71275,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71275 mod TC,BCBS multispecialty AW base fee schedule,394.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71275,Not in chargemaster,71275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71275,BCBS multispecialty AW base fee schedule,565.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71550,Not in chargemaster,71550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71550,BCBS multispecialty AW base fee schedule,739.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71550 mod 26,Not in chargemaster,71550,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71550 mod 26,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71550 mod TC,Not in chargemaster,71550,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71550 mod TC,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71551 mod 26,Not in chargemaster,71551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71551 mod 26,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71551 mod TC,Not in chargemaster,71551,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71551 mod TC,BCBS multispecialty AW base fee schedule,653.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71551,Not in chargemaster,71551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71551,BCBS multispecialty AW base fee schedule,815.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71552,Not in chargemaster,71552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71552,BCBS multispecialty AW base fee schedule,1032.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71552 mod 26,Not in chargemaster,71552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71552 mod 26,BCBS multispecialty AW base fee schedule,210.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71552 mod TC,Not in chargemaster,71552,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71552 mod TC,BCBS multispecialty AW base fee schedule,821.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71555 mod 26,Not in chargemaster,71555,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71555 mod 26,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71555 mod TC,Not in chargemaster,71555,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71555 mod TC,BCBS multispecialty AW base fee schedule,547.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71555,Not in chargemaster,71555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,71555,BCBS multispecialty AW base fee schedule,716.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72020,Not in chargemaster,72020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72020,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72020 mod 26,72020,72020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72020 mod 26,BCBS multispecialty AW base fee schedule,15.24,17.06,Fee schedule,,15.24,15.24,15.24,15.24,,,0
unity,Fee schedule,Non-facility 72020 mod TC,Not in chargemaster,72020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72020 mod TC,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72040 mod 26,72040,72040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72040 mod 26,BCBS multispecialty AW base fee schedule,21.2,31.41,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Non-facility 72040 mod TC,Not in chargemaster,72040,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72040 mod TC,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72040,Not in chargemaster,72040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72040,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72050,Not in chargemaster,72050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72050,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72050 mod 26,72050,72050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72050 mod 26,BCBS multispecialty AW base fee schedule,25.84,35.68,Fee schedule,,25.84,25.84,25.84,25.84,,,0
unity,Fee schedule,Non-facility 72050 mod TC,Not in chargemaster,72050,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72050 mod TC,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72052 mod 26,Not in chargemaster,72052,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72052 mod 26,BCBS multispecialty AW base fee schedule,28.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72052 mod TC,Not in chargemaster,72052,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72052 mod TC,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72052,Not in chargemaster,72052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72052,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72070,Not in chargemaster,72070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72070,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72070 mod 26,72070,72070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72070 mod 26,BCBS multispecialty AW base fee schedule,19.21,24.82,Fee schedule,,19.21,19.21,19.21,19.21,,,0
unity,Fee schedule,Non-facility 72070 mod TC,Not in chargemaster,72070,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72070 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72072 mod 26,72072,72072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72072 mod 26,BCBS multispecialty AW base fee schedule,21.86,24.05,Fee schedule,,21.86,21.86,21.86,21.86,,,0
unity,Fee schedule,Non-facility 72072 mod TC,Not in chargemaster,72072,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72072 mod TC,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72072,Not in chargemaster,72072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72072,BCBS multispecialty AW base fee schedule,71.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72074,Not in chargemaster,72074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72074,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72074 mod 26,Not in chargemaster,72074,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72074 mod 26,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72074 mod TC,Not in chargemaster,72074,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72074 mod TC,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72080 mod 26,Not in chargemaster,72080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72080 mod 26,BCBS multispecialty AW base fee schedule,20.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72080 mod TC,Not in chargemaster,72080,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72080 mod TC,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72080,Not in chargemaster,72080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72080,BCBS multispecialty AW base fee schedule,63.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72081,Not in chargemaster,72081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72081,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72081 mod 26,72081,72081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72081 mod 26,BCBS multispecialty AW base fee schedule,25.18,33,Fee schedule,,25.18,25.18,25.18,25.18,,,0
unity,Fee schedule,Non-facility 72081 mod TC,Not in chargemaster,72081,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72081 mod TC,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72082 mod 26,72082,72082,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72082 mod 26,BCBS multispecialty AW base fee schedule,30.48,40.13,Fee schedule,,30.48,30.48,30.48,30.48,,,0
unity,Fee schedule,Non-facility 72082 mod TC,Not in chargemaster,72082,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72082 mod TC,BCBS multispecialty AW base fee schedule,95.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72082,Not in chargemaster,72082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72082,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72083,Not in chargemaster,72083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72083,BCBS multispecialty AW base fee schedule,146.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72083 mod 26,Not in chargemaster,72083,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72083 mod 26,BCBS multispecialty AW base fee schedule,34.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72083 mod TC,Not in chargemaster,72083,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72083 mod TC,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72084 mod 26,Not in chargemaster,72084,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72084 mod 26,BCBS multispecialty AW base fee schedule,39.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72084 mod TC,Not in chargemaster,72084,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72084 mod TC,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72084,Not in chargemaster,72084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72084,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72100,Not in chargemaster,72100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72100,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72100 mod 26,72100,72100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72100 mod 26,BCBS multispecialty AW base fee schedule,21.2,26.38,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Non-facility 72100 mod TC,Not in chargemaster,72100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72100 mod TC,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72110 mod 26,72110,72110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72110 mod 26,BCBS multispecialty AW base fee schedule,24.51,35.68,Fee schedule,,24.51,24.51,24.51,24.51,,,0
unity,Fee schedule,Non-facility 72110 mod TC,Not in chargemaster,72110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72110 mod TC,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72110,Not in chargemaster,72110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72110,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72114,Not in chargemaster,72114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72114,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72114 mod 26,Not in chargemaster,72114,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72114 mod 26,BCBS multispecialty AW base fee schedule,28.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72114 mod TC,Not in chargemaster,72114,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72114 mod TC,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72120 mod 26,Not in chargemaster,72120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72120 mod 26,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72120 mod TC,Not in chargemaster,72120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72120 mod TC,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72120,Not in chargemaster,72120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72120,BCBS multispecialty AW base fee schedule,73.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72125,Not in chargemaster,72125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72125,BCBS multispecialty AW base fee schedule,290.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72125 mod 26,72125,72125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72125 mod 26,BCBS multispecialty AW base fee schedule,94.08,136.14,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Non-facility 72125 mod TC,Not in chargemaster,72125,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72125 mod TC,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72126 mod 26,Not in chargemaster,72126,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72126 mod 26,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72126 mod TC,Not in chargemaster,72126,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72126 mod TC,BCBS multispecialty AW base fee schedule,249.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72126,Not in chargemaster,72126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72126,BCBS multispecialty AW base fee schedule,364.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72127,Not in chargemaster,72127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72127,BCBS multispecialty AW base fee schedule,429.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72127 mod 26,Not in chargemaster,72127,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72127 mod 26,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72127 mod TC,Not in chargemaster,72127,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72127 mod TC,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72128 mod 26,72128,72128,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72128 mod 26,BCBS multispecialty AW base fee schedule,94.08,128.07,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Non-facility 72128 mod TC,Not in chargemaster,72128,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72128 mod TC,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72128,Not in chargemaster,72128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72128,BCBS multispecialty AW base fee schedule,290.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72129,Not in chargemaster,72129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72129,BCBS multispecialty AW base fee schedule,367.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72129 mod 26,Not in chargemaster,72129,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72129 mod 26,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72129 mod TC,Not in chargemaster,72129,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72129 mod TC,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72130 mod 26,Not in chargemaster,72130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72130 mod 26,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72130 mod TC,Not in chargemaster,72130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72130 mod TC,BCBS multispecialty AW base fee schedule,310.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72130,Not in chargemaster,72130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72130,BCBS multispecialty AW base fee schedule,429.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72131,Not in chargemaster,72131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72131,BCBS multispecialty AW base fee schedule,288.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72131 mod 26,72131,72131,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72131 mod 26,BCBS multispecialty AW base fee schedule,94.08,128.07,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Non-facility 72131 mod TC,Not in chargemaster,72131,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72131 mod TC,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72132 mod 26,Not in chargemaster,72132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72132 mod 26,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72132 mod TC,Not in chargemaster,72132,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72132 mod TC,BCBS multispecialty AW base fee schedule,250.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72132,Not in chargemaster,72132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72132,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72133,Not in chargemaster,72133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72133,BCBS multispecialty AW base fee schedule,427.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72133 mod 26,Not in chargemaster,72133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72133 mod 26,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72133 mod TC,Not in chargemaster,72133,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72133 mod TC,BCBS multispecialty AW base fee schedule,308.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72141 mod 26,72141,72141,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72141 mod 26,BCBS multispecialty AW base fee schedule,139.79,177.63,Fee schedule,,139.79,139.79,139.79,139.79,,,0
unity,Fee schedule,Non-facility 72141 mod TC,Not in chargemaster,72141,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72141 mod TC,BCBS multispecialty AW base fee schedule,265,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72141,Not in chargemaster,72141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72141,BCBS multispecialty AW base fee schedule,404.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72142,Not in chargemaster,72142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72142,BCBS multispecialty AW base fee schedule,588.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72142 mod 26,Not in chargemaster,72142,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72142 mod 26,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72142 mod TC,Not in chargemaster,72142,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72142 mod TC,BCBS multispecialty AW base fee schedule,420.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72146 mod 26,72146,72146,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72146 mod 26,BCBS multispecialty AW base fee schedule,139.79,177.63,Fee schedule,,139.79,139.79,139.79,139.79,,,0
unity,Fee schedule,Non-facility 72146 mod TC,Not in chargemaster,72146,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72146 mod TC,BCBS multispecialty AW base fee schedule,265,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72146,Not in chargemaster,72146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72146,BCBS multispecialty AW base fee schedule,404.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72147,Not in chargemaster,72147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72147,BCBS multispecialty AW base fee schedule,584.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72147 mod 26,Not in chargemaster,72147,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72147 mod 26,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72147 mod TC,Not in chargemaster,72147,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72147 mod TC,BCBS multispecialty AW base fee schedule,416.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72148 mod 26,72148,72148,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72148 mod 26,BCBS multispecialty AW base fee schedule,139.79,203.5,Fee schedule,,139.79,139.79,139.79,139.79,,,0
unity,Fee schedule,Non-facility 72148 mod TC,Not in chargemaster,72148,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72148 mod TC,BCBS multispecialty AW base fee schedule,265.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72148,Not in chargemaster,72148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72148,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72149,Not in chargemaster,72149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72149,BCBS multispecialty AW base fee schedule,579.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72149 mod 26,Not in chargemaster,72149,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72149 mod 26,BCBS multispecialty AW base fee schedule,167.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72149 mod TC,Not in chargemaster,72149,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72149 mod TC,BCBS multispecialty AW base fee schedule,411.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72156 mod 26,72156,72156,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72156 mod 26,BCBS multispecialty AW base fee schedule,215.31,284.66,Fee schedule,,215.31,215.31,215.31,215.31,,,0
unity,Fee schedule,Non-facility 72156 mod TC,Not in chargemaster,72156,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72156 mod TC,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72156,Not in chargemaster,72156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72156,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72157,Not in chargemaster,72157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72157,BCBS multispecialty AW base fee schedule,687.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72157 mod 26,72157,72157,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72157 mod 26,BCBS multispecialty AW base fee schedule,215.31,291.08,Fee schedule,,215.31,215.31,215.31,215.31,,,0
unity,Fee schedule,Non-facility 72157 mod TC,Not in chargemaster,72157,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72157 mod TC,BCBS multispecialty AW base fee schedule,471.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72158 mod 26,72158,72158,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72158 mod 26,BCBS multispecialty AW base fee schedule,215.31,262.94,Fee schedule,,215.31,215.31,215.31,215.31,,,0
unity,Fee schedule,Non-facility 72158 mod TC,Not in chargemaster,72158,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72158 mod TC,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72158,Not in chargemaster,72158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72158,BCBS multispecialty AW base fee schedule,684.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72159,Not in chargemaster,72159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72159,BCBS multispecialty AW base fee schedule,743.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72159 mod 26,Not in chargemaster,72159,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72159 mod 26,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72159 mod TC,Not in chargemaster,72159,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72159 mod TC,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72170 mod 26,72170,72170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72170 mod 26,BCBS multispecialty AW base fee schedule,16.56,27.5,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Non-facility 72170 mod TC,Not in chargemaster,72170,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72170 mod TC,BCBS multispecialty AW base fee schedule,36.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72170,Not in chargemaster,72170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72170,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72190,Not in chargemaster,72190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72190,BCBS multispecialty AW base fee schedule,75.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72190 mod 26,Not in chargemaster,72190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72190 mod 26,BCBS multispecialty AW base fee schedule,23.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72190 mod TC,Not in chargemaster,72190,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72190 mod TC,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72191 mod 26,Not in chargemaster,72191,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72191 mod 26,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72191 mod TC,Not in chargemaster,72191,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72191 mod TC,BCBS multispecialty AW base fee schedule,433.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72191,Not in chargemaster,72191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72191,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72192,Not in chargemaster,72192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72192,BCBS multispecialty AW base fee schedule,270.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72192 mod 26,72192,72192,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72192 mod 26,BCBS multispecialty AW base fee schedule,102.03,138.82,Fee schedule,,102.03,102.03,102.03,102.03,,,0
unity,Fee schedule,Non-facility 72192 mod TC,Not in chargemaster,72192,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72192 mod TC,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72193 mod 26,72193,72193,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72193 mod 26,BCBS multispecialty AW base fee schedule,108.65,148.68,Fee schedule,,108.65,108.65,108.65,108.65,,,0
unity,Fee schedule,Non-facility 72193 mod TC,Not in chargemaster,72193,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72193 mod TC,BCBS multispecialty AW base fee schedule,342.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72193,Not in chargemaster,72193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72193,BCBS multispecialty AW base fee schedule,451.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72194,Not in chargemaster,72194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72194,BCBS multispecialty AW base fee schedule,507.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72194 mod 26,72194,72194,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72194 mod 26,BCBS multispecialty AW base fee schedule,114.61,134.19,Fee schedule,,114.61,114.61,114.61,114.61,,,0
unity,Fee schedule,Non-facility 72194 mod TC,Not in chargemaster,72194,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72194 mod TC,BCBS multispecialty AW base fee schedule,392.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72195 mod 26,Not in chargemaster,72195,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72195 mod 26,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72195 mod TC,Not in chargemaster,72195,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72195 mod TC,BCBS multispecialty AW base fee schedule,358.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72195,Not in chargemaster,72195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72195,BCBS multispecialty AW base fee schedule,496.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72196,Not in chargemaster,72196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72196,BCBS multispecialty AW base fee schedule,579.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72196 mod 26,Not in chargemaster,72196,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72196 mod 26,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72196 mod TC,Not in chargemaster,72196,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72196 mod TC,BCBS multispecialty AW base fee schedule,416.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72197 mod 26,72197,72197,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72197 mod 26,BCBS multispecialty AW base fee schedule,205.38,248.2,Fee schedule,,205.38,205.38,205.38,205.38,,,0
unity,Fee schedule,Non-facility 72197 mod TC,Not in chargemaster,72197,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72197 mod TC,BCBS multispecialty AW base fee schedule,522.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72197,Not in chargemaster,72197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72197,BCBS multispecialty AW base fee schedule,728.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72198,Not in chargemaster,72198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72198,BCBS multispecialty AW base fee schedule,719.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72198 mod 26,Not in chargemaster,72198,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72198 mod 26,BCBS multispecialty AW base fee schedule,166.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72198 mod TC,Not in chargemaster,72198,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72198 mod TC,BCBS multispecialty AW base fee schedule,552.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72200 mod 26,72200,72200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72200 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Non-facility 72200 mod TC,Not in chargemaster,72200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72200 mod TC,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72200,Not in chargemaster,72200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72200,BCBS multispecialty AW base fee schedule,59.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72202,Not in chargemaster,72202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72202,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72202 mod 26,Not in chargemaster,72202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72202 mod 26,BCBS multispecialty AW base fee schedule,21.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72202 mod TC,Not in chargemaster,72202,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72202 mod TC,BCBS multispecialty AW base fee schedule,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72220 mod 26,72220,72220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72220 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Non-facility 72220 mod TC,Not in chargemaster,72220,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72220 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72220,Not in chargemaster,72220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72220,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72240,Not in chargemaster,72240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72240,BCBS multispecialty AW base fee schedule,208.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72240 mod 26,Not in chargemaster,72240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72240 mod 26,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72240 mod TC,Not in chargemaster,72240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72240 mod TC,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72255 mod 26,Not in chargemaster,72255,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72255 mod 26,BCBS multispecialty AW base fee schedule,89.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72255 mod TC,Not in chargemaster,72255,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72255 mod TC,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72255,Not in chargemaster,72255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72255,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72265,Not in chargemaster,72265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72265,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72265 mod 26,Not in chargemaster,72265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72265 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72265 mod TC,Not in chargemaster,72265,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72265 mod TC,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72270 mod 26,Not in chargemaster,72270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72270 mod 26,BCBS multispecialty AW base fee schedule,126.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72270 mod TC,Not in chargemaster,72270,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72270 mod TC,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72270,Not in chargemaster,72270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72270,BCBS multispecialty AW base fee schedule,265,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72275,Not in chargemaster,72275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72275,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72275 mod 26,Not in chargemaster,72275,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72275 mod 26,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72275 mod TC,Not in chargemaster,72275,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72275 mod TC,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72285 mod 26,Not in chargemaster,72285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72285 mod 26,BCBS multispecialty AW base fee schedule,111.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72285 mod TC,Not in chargemaster,72285,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72285 mod TC,BCBS multispecialty AW base fee schedule,117.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72285,Not in chargemaster,72285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72285,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72295,Not in chargemaster,72295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72295,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72295 mod 26,Not in chargemaster,72295,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72295 mod 26,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72295 mod TC,Not in chargemaster,72295,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,72295 mod TC,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73000 mod 26,73000,73000,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73000 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73000 mod TC,Not in chargemaster,73000,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73000 mod TC,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73000,Not in chargemaster,73000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73000,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73010,Not in chargemaster,73010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73010,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73010 mod 26,73010,73010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73010 mod 26,BCBS multispecialty AW base fee schedule,17.23,21.71,Fee schedule,,17.23,17.23,17.23,17.23,,,0
unity,Fee schedule,Non-facility 73010 mod TC,Not in chargemaster,73010,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73010 mod TC,BCBS multispecialty AW base fee schedule,34.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73020 mod 26,73020,73020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73020 mod 26,BCBS multispecialty AW base fee schedule,14.58,17.06,Fee schedule,,14.58,14.58,14.58,14.58,,,0
unity,Fee schedule,Non-facility 73020 mod TC,Not in chargemaster,73020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73020 mod TC,BCBS multispecialty AW base fee schedule,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73020,Not in chargemaster,73020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73020,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73030,Not in chargemaster,73030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73030,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73030 mod 26,73030,73030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73030 mod 26,BCBS multispecialty AW base fee schedule,17.89,22.5,Fee schedule,,17.89,17.89,17.89,17.89,,,0
unity,Fee schedule,Non-facility 73030 mod TC,Not in chargemaster,73030,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73030 mod TC,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73040 mod 26,Not in chargemaster,73040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73040 mod 26,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73040 mod TC,Not in chargemaster,73040,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73040 mod TC,BCBS multispecialty AW base fee schedule,172.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73040,Not in chargemaster,73040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73040,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73050,Not in chargemaster,73050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73050,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73050 mod 26,Not in chargemaster,73050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73050 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73050 mod TC,Not in chargemaster,73050,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73050 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73060 mod 26,73060,73060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73060 mod 26,BCBS multispecialty AW base fee schedule,15.9,19.39,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73060 mod TC,Not in chargemaster,73060,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73060 mod TC,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73060,Not in chargemaster,73060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73060,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73070,Not in chargemaster,73070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73070,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73070 mod 26,73070,73070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73070 mod 26,BCBS multispecialty AW base fee schedule,15.9,17.83,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73070 mod TC,Not in chargemaster,73070,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73070 mod TC,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73080 mod 26,Not in chargemaster,73080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73080 mod 26,BCBS multispecialty AW base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73080 mod TC,Not in chargemaster,73080,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73080 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73080,Not in chargemaster,73080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73080,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73085,Not in chargemaster,73085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73085,BCBS multispecialty AW base fee schedule,210.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73085 mod 26,Not in chargemaster,73085,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73085 mod 26,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73085 mod TC,Not in chargemaster,73085,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73085 mod TC,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73090 mod 26,73090,73090,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73090 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73090 mod TC,Not in chargemaster,73090,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73090 mod TC,BCBS multispecialty AW base fee schedule,37.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73090,Not in chargemaster,73090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73090,BCBS multispecialty AW base fee schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73092,Not in chargemaster,73092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73092,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73092 mod 26,73092,73092,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73092 mod 26,BCBS multispecialty AW base fee schedule,15.24,18.62,Fee schedule,,15.24,15.24,15.24,15.24,,,0
unity,Fee schedule,Non-facility 73092 mod TC,Not in chargemaster,73092,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73092 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73100 mod 26,73100,73100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73100 mod 26,BCBS multispecialty AW base fee schedule,15.9,20.94,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73100 mod TC,Not in chargemaster,73100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73100 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73100,Not in chargemaster,73100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73100,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73110,Not in chargemaster,73110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73110,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73110 mod 26,73110,73110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73110 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Non-facility 73110 mod TC,Not in chargemaster,73110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73110 mod TC,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73115 mod 26,Not in chargemaster,73115,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73115 mod 26,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73115 mod TC,Not in chargemaster,73115,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73115 mod TC,BCBS multispecialty AW base fee schedule,182.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73115,Not in chargemaster,73115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73115,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73120,Not in chargemaster,73120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73120,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73120 mod 26,73120,73120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73120 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73120 mod TC,Not in chargemaster,73120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73120 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73130 mod 26,73130,73130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73130 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Non-facility 73130 mod TC,Not in chargemaster,73130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73130 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73130,Not in chargemaster,73130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73130,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73140,Not in chargemaster,73140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73140,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73140 mod 26,73140,73140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73140 mod 26,BCBS multispecialty AW base fee schedule,13.25,17.91,Fee schedule,,13.25,13.25,13.25,13.25,,,0
unity,Fee schedule,Non-facility 73140 mod TC,Not in chargemaster,73140,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73140 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73200 mod 26,73200,73200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73200 mod 26,BCBS multispecialty AW base fee schedule,94.08,111.69,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Non-facility 73200 mod TC,Not in chargemaster,73200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73200 mod TC,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73200,Not in chargemaster,73200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73200,BCBS multispecialty AW base fee schedule,333.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73201,Not in chargemaster,73201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73201,BCBS multispecialty AW base fee schedule,414.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73201 mod 26,Not in chargemaster,73201,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73201 mod 26,BCBS multispecialty AW base fee schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73201 mod TC,Not in chargemaster,73201,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73201 mod TC,BCBS multispecialty AW base fee schedule,306.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73202 mod 26,Not in chargemaster,73202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73202 mod 26,BCBS multispecialty AW base fee schedule,114.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73202 mod TC,Not in chargemaster,73202,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73202 mod TC,BCBS multispecialty AW base fee schedule,403.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73202,Not in chargemaster,73202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73202,BCBS multispecialty AW base fee schedule,518.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73206,Not in chargemaster,73206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73206,BCBS multispecialty AW base fee schedule,612.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73206 mod 26,Not in chargemaster,73206,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73206 mod 26,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73206 mod TC,Not in chargemaster,73206,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73206 mod TC,BCBS multispecialty AW base fee schedule,443.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73218 mod 26,Not in chargemaster,73218,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73218 mod 26,BCBS multispecialty AW base fee schedule,127.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73218 mod TC,Not in chargemaster,73218,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73218 mod TC,BCBS multispecialty AW base fee schedule,530.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73218,Not in chargemaster,73218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73218,BCBS multispecialty AW base fee schedule,657.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73219,Not in chargemaster,73219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73219,BCBS multispecialty AW base fee schedule,727.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73219 mod 26,Not in chargemaster,73219,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73219 mod 26,BCBS multispecialty AW base fee schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73219 mod TC,Not in chargemaster,73219,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73219 mod TC,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73220 mod 26,Not in chargemaster,73220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73220 mod 26,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73220 mod TC,Not in chargemaster,73220,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73220 mod TC,BCBS multispecialty AW base fee schedule,691.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73220,Not in chargemaster,73220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73220,BCBS multispecialty AW base fee schedule,893.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73221,Not in chargemaster,73221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73221,BCBS multispecialty AW base fee schedule,428.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73221 mod 26,73221,73221,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73221 mod 26,BCBS multispecialty AW base fee schedule,129.19,152.02,Fee schedule,,129.19,129.19,129.19,129.19,,,0
unity,Fee schedule,Non-facility 73221 mod TC,Not in chargemaster,73221,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73221 mod TC,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73222 mod 26,Not in chargemaster,73222,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73222 mod 26,BCBS multispecialty AW base fee schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73222 mod TC,Not in chargemaster,73222,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73222 mod TC,BCBS multispecialty AW base fee schedule,528.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73222,Not in chargemaster,73222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73222,BCBS multispecialty AW base fee schedule,681.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73223,Not in chargemaster,73223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73223,BCBS multispecialty AW base fee schedule,842.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73223 mod 26,Not in chargemaster,73223,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73223 mod 26,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73223 mod TC,Not in chargemaster,73223,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73223 mod TC,BCBS multispecialty AW base fee schedule,641.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73225 mod 26,Not in chargemaster,73225,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73225 mod 26,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73225 mod TC,Not in chargemaster,73225,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73225 mod TC,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73225,Not in chargemaster,73225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73225,BCBS multispecialty AW base fee schedule,737.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73501,Not in chargemaster,73501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73501,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73501 mod 26,Not in chargemaster,73501,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73501 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73501 mod TC,Not in chargemaster,73501,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73501 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73502 mod 26,Not in chargemaster,73502,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73502 mod 26,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73502 mod TC,Not in chargemaster,73502,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73502 mod TC,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73502,Not in chargemaster,73502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73502,BCBS multispecialty AW base fee schedule,84.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73503,Not in chargemaster,73503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73503,BCBS multispecialty AW base fee schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73503 mod 26,Not in chargemaster,73503,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73503 mod 26,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73503 mod TC,Not in chargemaster,73503,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73503 mod TC,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73521 mod 26,Not in chargemaster,73521,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73521 mod 26,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73521 mod TC,Not in chargemaster,73521,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73521 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73521,Not in chargemaster,73521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73521,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73522,Not in chargemaster,73522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73522,BCBS multispecialty AW base fee schedule,96.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73522 mod 26,Not in chargemaster,73522,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73522 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73522 mod TC,Not in chargemaster,73522,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73522 mod TC,BCBS multispecialty AW base fee schedule,68.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73523 mod 26,Not in chargemaster,73523,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73523 mod 26,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73523 mod TC,Not in chargemaster,73523,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73523 mod TC,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73523,Not in chargemaster,73523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73523,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73525,Not in chargemaster,73525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73525,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73525 mod 26,Not in chargemaster,73525,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73525 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73525 mod TC,Not in chargemaster,73525,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73525 mod TC,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73551 mod 26,Not in chargemaster,73551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73551 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73551 mod TC,Not in chargemaster,73551,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73551 mod TC,BCBS multispecialty AW base fee schedule,38.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73551,Not in chargemaster,73551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73551,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73552,Not in chargemaster,73552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73552,BCBS multispecialty AW base fee schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73552 mod 26,Not in chargemaster,73552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73552 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73552 mod TC,Not in chargemaster,73552,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73552 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73560 mod 26,73560,73560,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73560 mod 26,BCBS multispecialty AW base fee schedule,15.9,21.71,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73560 mod TC,Not in chargemaster,73560,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73560 mod TC,BCBS multispecialty AW base fee schedule,46.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73560,Not in chargemaster,73560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73560,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73562,Not in chargemaster,73562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73562,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73562 mod 26,73562,73562,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73562 mod 26,BCBS multispecialty AW base fee schedule,17.89,22.5,Fee schedule,,17.89,17.89,17.89,17.89,,,0
unity,Fee schedule,Non-facility 73562 mod TC,Not in chargemaster,73562,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73562 mod TC,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73564 mod 26,73564,73564,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73564 mod 26,BCBS multispecialty AW base fee schedule,21.2,27.15,Fee schedule,,21.2,21.2,21.2,21.2,,,0
unity,Fee schedule,Non-facility 73564 mod TC,Not in chargemaster,73564,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73564 mod TC,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73564,Not in chargemaster,73564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73564,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73565,Not in chargemaster,73565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73565,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73565 mod 26,73565,73565,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73565 mod 26,BCBS multispecialty AW base fee schedule,16.56,21.71,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Non-facility 73565 mod TC,Not in chargemaster,73565,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73565 mod TC,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73580 mod 26,Not in chargemaster,73580,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73580 mod 26,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73580 mod TC,Not in chargemaster,73580,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73580 mod TC,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73580,Not in chargemaster,73580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73580,BCBS multispecialty AW base fee schedule,254.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73590,Not in chargemaster,73590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73590,BCBS multispecialty AW base fee schedule,56.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73590 mod 26,73590,73590,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73590 mod 26,BCBS multispecialty AW base fee schedule,15.24,19.39,Fee schedule,,15.24,15.24,15.24,15.24,,,0
unity,Fee schedule,Non-facility 73590 mod TC,Not in chargemaster,73590,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73590 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73592 mod 26,Not in chargemaster,73592,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73592 mod 26,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73592 mod TC,Not in chargemaster,73592,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73592 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73592,Not in chargemaster,73592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73592,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73600,Not in chargemaster,73600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73600,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73600 mod 26,73600,73600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73600 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73600 mod TC,Not in chargemaster,73600,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73600 mod TC,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73610 mod 26,73610,73610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73610 mod 26,BCBS multispecialty AW base fee schedule,16.56,19.39,Fee schedule,,16.56,16.56,16.56,16.56,,,0
unity,Fee schedule,Non-facility 73610 mod TC,Not in chargemaster,73610,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73610 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73610,Not in chargemaster,73610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73610,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73615,Not in chargemaster,73615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73615,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73615 mod 26,Not in chargemaster,73615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73615 mod 26,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73615 mod TC,Not in chargemaster,73615,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73615 mod TC,BCBS multispecialty AW base fee schedule,184.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73620 mod 26,73620,73620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73620 mod 26,BCBS multispecialty AW base fee schedule,14.58,17.06,Fee schedule,,14.58,14.58,14.58,14.58,,,0
unity,Fee schedule,Non-facility 73620 mod TC,Not in chargemaster,73620,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73620 mod TC,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73620,Not in chargemaster,73620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73620,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73630,Not in chargemaster,73630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73630,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73630 mod 26,73630,73630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73630 mod 26,BCBS multispecialty AW base fee schedule,15.9,18.62,Fee schedule,,15.9,15.9,15.9,15.9,,,0
unity,Fee schedule,Non-facility 73630 mod TC,Not in chargemaster,73630,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73630 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73650 mod 26,73650,73650,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73650 mod 26,BCBS multispecialty AW base fee schedule,15.24,17.83,Fee schedule,,15.24,15.24,15.24,15.24,,,0
unity,Fee schedule,Non-facility 73650 mod TC,Not in chargemaster,73650,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73650 mod TC,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73650,Not in chargemaster,73650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73650,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73660,Not in chargemaster,73660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73660,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73660 mod 26,73660,73660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73660 mod 26,BCBS multispecialty AW base fee schedule,12.59,14.74,Fee schedule,,12.59,12.59,12.59,12.59,,,0
unity,Fee schedule,Non-facility 73660 mod TC,Not in chargemaster,73660,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73660 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73700 mod 26,73700,73700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73700 mod 26,BCBS multispecialty AW base fee schedule,94.08,128.07,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Non-facility 73700 mod TC,Not in chargemaster,73700,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73700 mod TC,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73700,Not in chargemaster,73700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73700,BCBS multispecialty AW base fee schedule,288.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73701,Not in chargemaster,73701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73701,BCBS multispecialty AW base fee schedule,361.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73701 mod 26,73701,73701,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73701 mod 26,BCBS multispecialty AW base fee schedule,108.65,148.68,Fee schedule,,108.65,108.65,108.65,108.65,,,0
unity,Fee schedule,Non-facility 73701 mod TC,Not in chargemaster,73701,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73701 mod TC,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73702 mod 26,Not in chargemaster,73702,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73702 mod 26,BCBS multispecialty AW base fee schedule,113.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73702 mod TC,Not in chargemaster,73702,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73702 mod TC,BCBS multispecialty AW base fee schedule,320.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73702,Not in chargemaster,73702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73702,BCBS multispecialty AW base fee schedule,434.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73706,Not in chargemaster,73706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73706,BCBS multispecialty AW base fee schedule,662.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73706 mod 26,Not in chargemaster,73706,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73706 mod 26,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73706 mod TC,Not in chargemaster,73706,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73706 mod TC,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73718 mod 26,73718,73718,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73718 mod 26,BCBS multispecialty AW base fee schedule,126.54,148.93,Fee schedule,,126.54,126.54,126.54,126.54,,,0
unity,Fee schedule,Non-facility 73718 mod TC,Not in chargemaster,73718,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73718 mod TC,BCBS multispecialty AW base fee schedule,353.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73718,Not in chargemaster,73718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73718,BCBS multispecialty AW base fee schedule,480.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73719,Not in chargemaster,73719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73719,BCBS multispecialty AW base fee schedule,568.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73719 mod 26,Not in chargemaster,73719,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73719 mod 26,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73719 mod TC,Not in chargemaster,73719,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73719 mod TC,BCBS multispecialty AW base fee schedule,415.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73720 mod 26,73720,73720,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73720 mod 26,BCBS multispecialty AW base fee schedule,200.74,236.57,Fee schedule,,200.74,200.74,200.74,200.74,,,0
unity,Fee schedule,Non-facility 73720 mod TC,Not in chargemaster,73720,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73720 mod TC,BCBS multispecialty AW base fee schedule,526.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73720,Not in chargemaster,73720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73720,BCBS multispecialty AW base fee schedule,727.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73721,Not in chargemaster,73721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73721,BCBS multispecialty AW base fee schedule,426.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73721 mod 26,73721,73721,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73721 mod 26,BCBS multispecialty AW base fee schedule,127.2,152.02,Fee schedule,,127.2,127.2,127.2,127.2,,,0
unity,Fee schedule,Non-facility 73721 mod TC,Not in chargemaster,73721,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73721 mod TC,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73722 mod 26,Not in chargemaster,73722,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73722 mod 26,BCBS multispecialty AW base fee schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73722 mod TC,Not in chargemaster,73722,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73722 mod TC,BCBS multispecialty AW base fee schedule,529.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73722,Not in chargemaster,73722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73722,BCBS multispecialty AW base fee schedule,683.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73723,Not in chargemaster,73723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73723,BCBS multispecialty AW base fee schedule,841.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73723 mod 26,Not in chargemaster,73723,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73723 mod 26,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73723 mod TC,Not in chargemaster,73723,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73723 mod TC,BCBS multispecialty AW base fee schedule,639.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73725 mod 26,Not in chargemaster,73725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73725 mod 26,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73725 mod TC,Not in chargemaster,73725,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73725 mod TC,BCBS multispecialty AW base fee schedule,551.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73725,Not in chargemaster,73725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,73725,BCBS multispecialty AW base fee schedule,720.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74018,Not in chargemaster,74018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74018,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74018 mod 26,74018,74018,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74018 mod 26,BCBS multispecialty AW base fee schedule,17.23,20.17,Fee schedule,,17.23,17.23,17.23,17.23,,,0
unity,Fee schedule,Non-facility 74018 mod TC,Not in chargemaster,74018,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74018 mod TC,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74019 mod 26,74019,74019,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74019 mod 26,BCBS multispecialty AW base fee schedule,21.86,29.48,Fee schedule,,21.86,21.86,21.86,21.86,,,0
unity,Fee schedule,Non-facility 74019 mod TC,Not in chargemaster,74019,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74019 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74019,Not in chargemaster,74019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74019,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74021,Not in chargemaster,74021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74021,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74021 mod 26,74021,74021,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74021 mod 26,BCBS multispecialty AW base fee schedule,25.18,34.89,Fee schedule,,25.18,25.18,25.18,25.18,,,0
unity,Fee schedule,Non-facility 74021 mod TC,Not in chargemaster,74021,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74021 mod TC,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74022 mod 26,74022,74022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74022 mod 26,BCBS multispecialty AW base fee schedule,29.81,34.9,Fee schedule,,29.81,29.81,29.81,29.81,,,0
unity,Fee schedule,Non-facility 74022 mod TC,Not in chargemaster,74022,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74022 mod TC,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74022,Not in chargemaster,74022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74022,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74150,Not in chargemaster,74150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74150,BCBS multispecialty AW base fee schedule,278.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74150 mod 26,74150,74150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74150 mod 26,BCBS multispecialty AW base fee schedule,111.96,151.95,Fee schedule,,111.96,111.96,111.96,111.96,,,0
unity,Fee schedule,Non-facility 74150 mod TC,Not in chargemaster,74150,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74150 mod TC,BCBS multispecialty AW base fee schedule,166.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74160 mod 26,74160,74160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74160 mod 26,BCBS multispecialty AW base fee schedule,119.91,162.11,Fee schedule,,119.91,119.91,119.91,119.91,,,0
unity,Fee schedule,Non-facility 74160 mod TC,Not in chargemaster,74160,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74160 mod TC,BCBS multispecialty AW base fee schedule,341.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74160,Not in chargemaster,74160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74160,BCBS multispecialty AW base fee schedule,461.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74170,Not in chargemaster,74170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74170,BCBS multispecialty AW base fee schedule,520.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74170 mod 26,74170,74170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74170 mod 26,BCBS multispecialty AW base fee schedule,131.84,179.12,Fee schedule,,131.84,131.84,131.84,131.84,,,0
unity,Fee schedule,Non-facility 74170 mod TC,Not in chargemaster,74170,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74170 mod TC,BCBS multispecialty AW base fee schedule,388.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74174 mod 26,Not in chargemaster,74174,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74174 mod 26,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74174 mod TC,Not in chargemaster,74174,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74174 mod TC,BCBS multispecialty AW base fee schedule,549.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74174,Not in chargemaster,74174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74174,BCBS multispecialty AW base fee schedule,755.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74175,Not in chargemaster,74175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74175,BCBS multispecialty AW base fee schedule,602.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74175 mod 26,Not in chargemaster,74175,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74175 mod 26,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74175 mod TC,Not in chargemaster,74175,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74175 mod TC,BCBS multispecialty AW base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74176 mod 26,74176,74176,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74176 mod 26,BCBS multispecialty AW base fee schedule,163.64,222.11,Fee schedule,,163.64,163.64,163.64,163.64,,,0
unity,Fee schedule,Non-facility 74176 mod TC,Not in chargemaster,74176,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74176 mod TC,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74176,Not in chargemaster,74176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74176,BCBS multispecialty AW base fee schedule,372.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74177,Not in chargemaster,74177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74177,BCBS multispecialty AW base fee schedule,610.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74177 mod 26,74177,74177,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74177 mod 26,BCBS multispecialty AW base fee schedule,171.59,232.86,Fee schedule,,171.59,171.59,171.59,171.59,,,0
unity,Fee schedule,Non-facility 74177 mod TC,Not in chargemaster,74177,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74177 mod TC,BCBS multispecialty AW base fee schedule,438.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74178 mod 26,74178,74178,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74178 mod 26,BCBS multispecialty AW base fee schedule,188.15,255.26,Fee schedule,,188.15,188.15,188.15,188.15,,,0
unity,Fee schedule,Non-facility 74178 mod TC,Not in chargemaster,74178,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74178 mod TC,BCBS multispecialty AW base fee schedule,497.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74178,Not in chargemaster,74178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74178,BCBS multispecialty AW base fee schedule,685.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74181,Not in chargemaster,74181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74181,BCBS multispecialty AW base fee schedule,420.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74181 mod 26,74181,74181,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74181 mod 26,BCBS multispecialty AW base fee schedule,137.8,160.56,Fee schedule,,137.8,137.8,137.8,137.8,,,0
unity,Fee schedule,Non-facility 74181 mod TC,Not in chargemaster,74181,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74181 mod TC,BCBS multispecialty AW base fee schedule,282.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74182 mod 26,Not in chargemaster,74182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74182 mod 26,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74182 mod TC,Not in chargemaster,74182,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74182 mod TC,BCBS multispecialty AW base fee schedule,492.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74182,Not in chargemaster,74182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74182,BCBS multispecialty AW base fee schedule,655.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74183,Not in chargemaster,74183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74183,BCBS multispecialty AW base fee schedule,729.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74183 mod 26,74183,74183,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74183 mod 26,BCBS multispecialty AW base fee schedule,205.38,248.2,Fee schedule,,205.38,205.38,205.38,205.38,,,0
unity,Fee schedule,Non-facility 74183 mod TC,Not in chargemaster,74183,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74183 mod TC,BCBS multispecialty AW base fee schedule,524.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74185 mod 26,74185,74185,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74185 mod 26,BCBS multispecialty AW base fee schedule,167.61,227.52,Fee schedule,,167.61,167.61,167.61,167.61,,,0
unity,Fee schedule,Non-facility 74185 mod TC,Not in chargemaster,74185,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74185 mod TC,BCBS multispecialty AW base fee schedule,555.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74185,Not in chargemaster,74185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74185,BCBS multispecialty AW base fee schedule,722.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74190,Not in chargemaster,74190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74190,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74190 mod 26,Not in chargemaster,74190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74190 mod 26,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74210,Not in chargemaster,74210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74210,BCBS multispecialty AW base fee schedule,176.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74210 mod 26,Not in chargemaster,74210,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74210 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74210 mod TC,Not in chargemaster,74210,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74210 mod TC,BCBS multispecialty AW base fee schedule,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74220 mod 26,Not in chargemaster,74220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74220 mod 26,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74220 mod TC,Not in chargemaster,74220,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74220 mod TC,BCBS multispecialty AW base fee schedule,123.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74220,Not in chargemaster,74220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74220,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74221,Not in chargemaster,74221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74221,BCBS multispecialty AW base fee schedule,202.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74221 mod 26,Not in chargemaster,74221,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74221 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74221 mod TC,Not in chargemaster,74221,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74221 mod TC,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74230 mod 26,Not in chargemaster,74230,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74230 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74230 mod TC,Not in chargemaster,74230,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74230 mod TC,BCBS multispecialty AW base fee schedule,191.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74230,Not in chargemaster,74230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74230,BCBS multispecialty AW base fee schedule,241.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74235,Not in chargemaster,74235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74235,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74235 mod 26,Not in chargemaster,74235,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74235 mod 26,BCBS multispecialty AW base fee schedule,111.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74240,Not in chargemaster,74240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74240,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74240 mod 26,Not in chargemaster,74240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74240 mod 26,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74240 mod TC,Not in chargemaster,74240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74240 mod TC,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74246 mod 26,Not in chargemaster,74246,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74246 mod 26,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74246 mod TC,Not in chargemaster,74246,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74246 mod TC,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74246,Not in chargemaster,74246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74246,BCBS multispecialty AW base fee schedule,258.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74248,Not in chargemaster,74248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74248,BCBS multispecialty AW base fee schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74248 mod 26,Not in chargemaster,74248,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74248 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74248 mod TC,Not in chargemaster,74248,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74248 mod TC,BCBS multispecialty AW base fee schedule,88.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74250 mod 26,Not in chargemaster,74250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74250 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74250 mod TC,Not in chargemaster,74250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74250 mod TC,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74250,Not in chargemaster,74250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74250,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74251,Not in chargemaster,74251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74251,BCBS multispecialty AW base fee schedule,749.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74251 mod 26,Not in chargemaster,74251,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74251 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74251 mod TC,Not in chargemaster,74251,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74251 mod TC,BCBS multispecialty AW base fee schedule,639.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74261 mod 26,Not in chargemaster,74261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74261 mod 26,BCBS multispecialty AW base fee schedule,225.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74261 mod TC,Not in chargemaster,74261,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74261 mod TC,BCBS multispecialty AW base fee schedule,665.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74261,Not in chargemaster,74261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74261,BCBS multispecialty AW base fee schedule,890.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74262,Not in chargemaster,74262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74262,BCBS multispecialty AW base fee schedule,1001.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74262 mod 26,Not in chargemaster,74262,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74262 mod 26,BCBS multispecialty AW base fee schedule,234.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74262 mod TC,Not in chargemaster,74262,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74262 mod TC,BCBS multispecialty AW base fee schedule,766.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74263 mod 26,Not in chargemaster,74263,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74263 mod 26,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74263 mod TC,Not in chargemaster,74263,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74263 mod TC,BCBS multispecialty AW base fee schedule,1185.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74263,Not in chargemaster,74263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74263,BCBS multispecialty AW base fee schedule,1401.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74270,Not in chargemaster,74270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74270,BCBS multispecialty AW base fee schedule,287.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74270 mod 26,Not in chargemaster,74270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74270 mod 26,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74270 mod TC,Not in chargemaster,74270,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74270 mod TC,BCBS multispecialty AW base fee schedule,190.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74280 mod 26,Not in chargemaster,74280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74280 mod 26,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74280 mod TC,Not in chargemaster,74280,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74280 mod TC,BCBS multispecialty AW base fee schedule,295.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74280,Not in chargemaster,74280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74280,BCBS multispecialty AW base fee schedule,413.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74283,Not in chargemaster,74283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74283,BCBS multispecialty AW base fee schedule,463.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74283 mod 26,Not in chargemaster,74283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74283 mod 26,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74283 mod TC,Not in chargemaster,74283,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74283 mod TC,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74290 mod 26,Not in chargemaster,74290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74290 mod 26,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74290 mod TC,Not in chargemaster,74290,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74290 mod TC,BCBS multispecialty AW base fee schedule,123.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74290,Not in chargemaster,74290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74290,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74300,Not in chargemaster,74300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74300,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74300 mod 26,74300,74300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74300 mod 26,BCBS multispecialty AW base fee schedule,33.79,46.57,Fee schedule,,33.79,33.79,33.79,33.79,,,0
unity,Fee schedule,Non-facility 74301,Not in chargemaster,74301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74301,BCBS multispecialty AW base fee schedule,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74301 mod 26,Not in chargemaster,74301,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74301 mod 26,BCBS multispecialty AW base fee schedule,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74328,Not in chargemaster,74328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74328,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74328 mod 26,Not in chargemaster,74328,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74328 mod 26,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74329,Not in chargemaster,74329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74329,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74329 mod 26,Not in chargemaster,74329,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74329 mod 26,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74330,Not in chargemaster,74330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74330,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74330 mod 26,Not in chargemaster,74330,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74330 mod 26,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74340,Not in chargemaster,74340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74340,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74340 mod 26,Not in chargemaster,74340,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74340 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74355,Not in chargemaster,74355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74355,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74355 mod 26,Not in chargemaster,74355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74355 mod 26,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74360,Not in chargemaster,74360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74360,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74360 mod 26,Not in chargemaster,74360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74360 mod 26,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74363,Not in chargemaster,74363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74363,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74363 mod 26,Not in chargemaster,74363,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74363 mod 26,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74400,Not in chargemaster,74400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74400,BCBS multispecialty AW base fee schedule,238.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74400 mod 26,Not in chargemaster,74400,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74400 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74400 mod TC,Not in chargemaster,74400,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74400 mod TC,BCBS multispecialty AW base fee schedule,192.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74410 mod 26,Not in chargemaster,74410,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74410 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74410 mod TC,Not in chargemaster,74410,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74410 mod TC,BCBS multispecialty AW base fee schedule,197.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74410,Not in chargemaster,74410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74410,BCBS multispecialty AW base fee schedule,242.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74415,Not in chargemaster,74415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74415,BCBS multispecialty AW base fee schedule,283.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74415 mod 26,Not in chargemaster,74415,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74415 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74415 mod TC,Not in chargemaster,74415,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74415 mod TC,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74420 mod 26,Not in chargemaster,74420,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74420 mod 26,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74420 mod TC,Not in chargemaster,74420,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74420 mod TC,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74420,Not in chargemaster,74420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74420,BCBS multispecialty AW base fee schedule,137.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74425,Not in chargemaster,74425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74425,BCBS multispecialty AW base fee schedule,242.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74425 mod 26,Not in chargemaster,74425,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74425 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74425 mod TC,Not in chargemaster,74425,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74425 mod TC,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74430 mod 26,Not in chargemaster,74430,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74430 mod 26,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74430 mod TC,Not in chargemaster,74430,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74430 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74430,Not in chargemaster,74430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74430,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74440,Not in chargemaster,74440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74440,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74440 mod 26,Not in chargemaster,74440,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74440 mod 26,BCBS multispecialty AW base fee schedule,34.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74440 mod TC,Not in chargemaster,74440,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74440 mod TC,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74445,Not in chargemaster,74445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74445,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74445 mod 26,Not in chargemaster,74445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74445 mod 26,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74450,Not in chargemaster,74450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74450,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74450 mod 26,Not in chargemaster,74450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74450 mod 26,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74455 mod 26,Not in chargemaster,74455,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74455 mod 26,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74455 mod TC,Not in chargemaster,74455,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74455 mod TC,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74455,Not in chargemaster,74455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74455,BCBS multispecialty AW base fee schedule,181.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74470,Not in chargemaster,74470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74470,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74470 mod 26,Not in chargemaster,74470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74470 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74485,Not in chargemaster,74485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74485,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74485 mod 26,Not in chargemaster,74485,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74485 mod 26,BCBS multispecialty AW base fee schedule,75.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74485 mod TC,Not in chargemaster,74485,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74485 mod TC,BCBS multispecialty AW base fee schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74710 mod 26,Not in chargemaster,74710,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74710 mod 26,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74710 mod TC,Not in chargemaster,74710,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74710 mod TC,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74710,Not in chargemaster,74710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74710,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74712,Not in chargemaster,74712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74712,BCBS multispecialty AW base fee schedule,882.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74712 mod 26,Not in chargemaster,74712,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74712 mod 26,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74712 mod TC,Not in chargemaster,74712,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74712 mod TC,BCBS multispecialty AW base fee schedule,601.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74713 mod 26,Not in chargemaster,74713,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74713 mod 26,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74713 mod TC,Not in chargemaster,74713,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74713 mod TC,BCBS multispecialty AW base fee schedule,253.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74713,Not in chargemaster,74713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74713,BCBS multispecialty AW base fee schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74740,Not in chargemaster,74740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74740,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74740 mod 26,Not in chargemaster,74740,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74740 mod 26,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74740 mod TC,Not in chargemaster,74740,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74740 mod TC,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74742,Not in chargemaster,74742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74742,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74742 mod 26,Not in chargemaster,74742,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74742 mod 26,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74775,Not in chargemaster,74775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74775,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74775 mod 26,Not in chargemaster,74775,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,74775 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75557 mod 26,Not in chargemaster,75557,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75557 mod 26,BCBS multispecialty AW base fee schedule,217.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75557 mod TC,Not in chargemaster,75557,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75557 mod TC,BCBS multispecialty AW base fee schedule,379.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75557,Not in chargemaster,75557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75557,BCBS multispecialty AW base fee schedule,596.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75559,Not in chargemaster,75559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75559,BCBS multispecialty AW base fee schedule,828.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75559 mod 26,Not in chargemaster,75559,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75559 mod 26,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75559 mod TC,Not in chargemaster,75559,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75559 mod TC,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75561 mod 26,Not in chargemaster,75561,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75561 mod 26,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75561 mod TC,Not in chargemaster,75561,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75561 mod TC,BCBS multispecialty AW base fee schedule,543.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75561,Not in chargemaster,75561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75561,BCBS multispecialty AW base fee schedule,783.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75563,Not in chargemaster,75563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75563,BCBS multispecialty AW base fee schedule,927.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75563 mod 26,Not in chargemaster,75563,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75563 mod 26,BCBS multispecialty AW base fee schedule,276.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75563 mod TC,Not in chargemaster,75563,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75563 mod TC,BCBS multispecialty AW base fee schedule,651.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75565 mod 26,Not in chargemaster,75565,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75565 mod 26,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75565 mod TC,Not in chargemaster,75565,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75565 mod TC,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75565,Not in chargemaster,75565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75565,BCBS multispecialty AW base fee schedule,98.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75571,Not in chargemaster,75571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75571,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75571 mod 26,Not in chargemaster,75571,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75571 mod 26,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75571 mod TC,Not in chargemaster,75571,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75571 mod TC,BCBS multispecialty AW base fee schedule,141.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75572 mod 26,Not in chargemaster,75572,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75572 mod 26,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75572 mod TC,Not in chargemaster,75572,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75572 mod TC,BCBS multispecialty AW base fee schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75572,Not in chargemaster,75572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75572,BCBS multispecialty AW base fee schedule,464.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75573,Not in chargemaster,75573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75573,BCBS multispecialty AW base fee schedule,624.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75573 mod 26,Not in chargemaster,75573,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75573 mod 26,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75573 mod TC,Not in chargemaster,75573,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75573 mod TC,BCBS multispecialty AW base fee schedule,386.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75574 mod 26,Not in chargemaster,75574,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75574 mod 26,BCBS multispecialty AW base fee schedule,221.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75574 mod TC,Not in chargemaster,75574,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75574 mod TC,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75574,Not in chargemaster,75574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75574,BCBS multispecialty AW base fee schedule,671.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75600,Not in chargemaster,75600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75600,BCBS multispecialty AW base fee schedule,374.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75600 mod 26,Not in chargemaster,75600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75600 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75600 mod TC,Not in chargemaster,75600,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75600 mod TC,BCBS multispecialty AW base fee schedule,327.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75605 mod 26,Not in chargemaster,75605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75605 mod 26,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75605 mod TC,Not in chargemaster,75605,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75605 mod TC,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75605,Not in chargemaster,75605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75605,BCBS multispecialty AW base fee schedule,243.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75625,Not in chargemaster,75625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75625,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75625 mod 26,Not in chargemaster,75625,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75625 mod 26,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75625 mod TC,Not in chargemaster,75625,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75625 mod TC,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75630 mod 26,Not in chargemaster,75630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75630 mod 26,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75630 mod TC,Not in chargemaster,75630,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75630 mod TC,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75630,Not in chargemaster,75630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75630,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75635,Not in chargemaster,75635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75635,BCBS multispecialty AW base fee schedule,827.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75635 mod 26,Not in chargemaster,75635,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75635 mod 26,BCBS multispecialty AW base fee schedule,221.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75635 mod TC,Not in chargemaster,75635,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75635 mod TC,BCBS multispecialty AW base fee schedule,605.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75705 mod 26,Not in chargemaster,75705,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75705 mod 26,BCBS multispecialty AW base fee schedule,219.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75705 mod TC,Not in chargemaster,75705,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75705 mod TC,BCBS multispecialty AW base fee schedule,250.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75705,Not in chargemaster,75705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75705,BCBS multispecialty AW base fee schedule,469.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75710,Not in chargemaster,75710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75710,BCBS multispecialty AW base fee schedule,306.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75710 mod 26,Not in chargemaster,75710,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75710 mod 26,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75710 mod TC,Not in chargemaster,75710,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75710 mod TC,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75716 mod 26,Not in chargemaster,75716,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75716 mod 26,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75716 mod TC,Not in chargemaster,75716,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75716 mod TC,BCBS multispecialty AW base fee schedule,147.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75716,Not in chargemaster,75716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75716,BCBS multispecialty AW base fee schedule,327.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75726,Not in chargemaster,75726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75726,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75726 mod 26,Not in chargemaster,75726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75726 mod 26,BCBS multispecialty AW base fee schedule,184.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75726 mod TC,Not in chargemaster,75726,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75726 mod TC,BCBS multispecialty AW base fee schedule,160.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75731 mod 26,Not in chargemaster,75731,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75731 mod 26,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75731 mod TC,Not in chargemaster,75731,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75731 mod TC,BCBS multispecialty AW base fee schedule,197.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75731,Not in chargemaster,75731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75731,BCBS multispecialty AW base fee schedule,304.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75733,Not in chargemaster,75733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75733,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75733 mod 26,Not in chargemaster,75733,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75733 mod 26,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75733 mod TC,Not in chargemaster,75733,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75733 mod TC,BCBS multispecialty AW base fee schedule,209.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75736 mod 26,Not in chargemaster,75736,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75736 mod 26,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75736 mod TC,Not in chargemaster,75736,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75736 mod TC,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75736,Not in chargemaster,75736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75736,BCBS multispecialty AW base fee schedule,281.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75741,Not in chargemaster,75741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75741,BCBS multispecialty AW base fee schedule,266.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75741 mod 26,Not in chargemaster,75741,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75741 mod 26,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75741 mod TC,Not in chargemaster,75741,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75741 mod TC,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75743 mod 26,Not in chargemaster,75743,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75743 mod 26,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75743 mod TC,Not in chargemaster,75743,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75743 mod TC,BCBS multispecialty AW base fee schedule,150.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75743,Not in chargemaster,75743,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75743,BCBS multispecialty AW base fee schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75746,Not in chargemaster,75746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75746,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75746 mod 26,Not in chargemaster,75746,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75746 mod 26,BCBS multispecialty AW base fee schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75746 mod TC,Not in chargemaster,75746,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75746 mod TC,BCBS multispecialty AW base fee schedule,165.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75756 mod 26,Not in chargemaster,75756,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75756 mod 26,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75756 mod TC,Not in chargemaster,75756,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75756 mod TC,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75756,Not in chargemaster,75756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75756,BCBS multispecialty AW base fee schedule,306.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75774,Not in chargemaster,75774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75774,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75774 mod 26,Not in chargemaster,75774,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75774 mod 26,BCBS multispecialty AW base fee schedule,91.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75774 mod TC,Not in chargemaster,75774,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75774 mod TC,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75801,Not in chargemaster,75801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75801,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75801 mod 26,Not in chargemaster,75801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75801 mod 26,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75803,Not in chargemaster,75803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75803,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75803 mod 26,Not in chargemaster,75803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75803 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75805,Not in chargemaster,75805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75805,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75805 mod 26,Not in chargemaster,75805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75805 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75807,Not in chargemaster,75807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75807,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75807 mod 26,Not in chargemaster,75807,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75807 mod 26,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75809 mod 26,Not in chargemaster,75809,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75809 mod 26,BCBS multispecialty AW base fee schedule,44.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75809 mod TC,Not in chargemaster,75809,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75809 mod TC,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75809,Not in chargemaster,75809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75809,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75810,Not in chargemaster,75810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75810,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75810 mod 26,Not in chargemaster,75810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75810 mod 26,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75820,Not in chargemaster,75820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75820,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75820 mod 26,Not in chargemaster,75820,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75820 mod 26,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75820 mod TC,Not in chargemaster,75820,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75820 mod TC,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75822 mod 26,Not in chargemaster,75822,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75822 mod 26,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75822 mod TC,Not in chargemaster,75822,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75822 mod TC,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75822,Not in chargemaster,75822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75822,BCBS multispecialty AW base fee schedule,235.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75825,Not in chargemaster,75825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75825,BCBS multispecialty AW base fee schedule,235.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75825 mod 26,Not in chargemaster,75825,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75825 mod 26,BCBS multispecialty AW base fee schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75825 mod TC,Not in chargemaster,75825,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75825 mod TC,BCBS multispecialty AW base fee schedule,131.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75827 mod 26,Not in chargemaster,75827,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75827 mod 26,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75827 mod TC,Not in chargemaster,75827,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75827 mod TC,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75827,Not in chargemaster,75827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75827,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75831,Not in chargemaster,75831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75831,BCBS multispecialty AW base fee schedule,245.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75831 mod 26,Not in chargemaster,75831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75831 mod 26,BCBS multispecialty AW base fee schedule,102.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75831 mod TC,Not in chargemaster,75831,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75831 mod TC,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75833 mod 26,Not in chargemaster,75833,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75833 mod 26,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75833 mod TC,Not in chargemaster,75833,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75833 mod TC,BCBS multispecialty AW base fee schedule,158.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75833,Not in chargemaster,75833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75833,BCBS multispecialty AW base fee schedule,294.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75840,Not in chargemaster,75840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75840,BCBS multispecialty AW base fee schedule,263.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75840 mod 26,Not in chargemaster,75840,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75840 mod 26,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75840 mod TC,Not in chargemaster,75840,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75840 mod TC,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75842 mod 26,Not in chargemaster,75842,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75842 mod 26,BCBS multispecialty AW base fee schedule,141.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75842 mod TC,Not in chargemaster,75842,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75842 mod TC,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75842,Not in chargemaster,75842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75842,BCBS multispecialty AW base fee schedule,320.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75860,Not in chargemaster,75860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75860,BCBS multispecialty AW base fee schedule,257.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75860 mod 26,Not in chargemaster,75860,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75860 mod 26,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75860 mod TC,Not in chargemaster,75860,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75860 mod TC,BCBS multispecialty AW base fee schedule,152.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75870 mod 26,Not in chargemaster,75870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75870 mod 26,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75870 mod TC,Not in chargemaster,75870,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75870 mod TC,BCBS multispecialty AW base fee schedule,222.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75870,Not in chargemaster,75870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75870,BCBS multispecialty AW base fee schedule,342.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75872,Not in chargemaster,75872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75872,BCBS multispecialty AW base fee schedule,263.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75872 mod 26,Not in chargemaster,75872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75872 mod 26,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75872 mod TC,Not in chargemaster,75872,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75872 mod TC,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75880 mod 26,Not in chargemaster,75880,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75880 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75880 mod TC,Not in chargemaster,75880,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75880 mod TC,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75880,Not in chargemaster,75880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75880,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75885,Not in chargemaster,75885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75885,BCBS multispecialty AW base fee schedule,278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75885 mod 26,Not in chargemaster,75885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75885 mod 26,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75885 mod TC,Not in chargemaster,75885,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75885 mod TC,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75887 mod 26,Not in chargemaster,75887,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75887 mod 26,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75887 mod TC,Not in chargemaster,75887,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75887 mod TC,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75887,Not in chargemaster,75887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75887,BCBS multispecialty AW base fee schedule,280.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75889,Not in chargemaster,75889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75889,BCBS multispecialty AW base fee schedule,252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75889 mod 26,Not in chargemaster,75889,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75889 mod 26,BCBS multispecialty AW base fee schedule,101.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75889 mod TC,Not in chargemaster,75889,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75889 mod TC,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75891 mod 26,Not in chargemaster,75891,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75891 mod 26,BCBS multispecialty AW base fee schedule,103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75891 mod TC,Not in chargemaster,75891,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75891 mod TC,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75891,Not in chargemaster,75891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75891,BCBS multispecialty AW base fee schedule,256.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75893,Not in chargemaster,75893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75893,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75893 mod 26,Not in chargemaster,75893,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75893 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75893 mod TC,Not in chargemaster,75893,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75893 mod TC,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75894,Not in chargemaster,75894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75894,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75894 mod 26,Not in chargemaster,75894,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75894 mod 26,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75898,Not in chargemaster,75898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75898,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75898 mod 26,Not in chargemaster,75898,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75898 mod 26,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75901 mod 26,Not in chargemaster,75901,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75901 mod 26,BCBS multispecialty AW base fee schedule,44.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75901 mod TC,Not in chargemaster,75901,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75901 mod TC,BCBS multispecialty AW base fee schedule,363.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75901,Not in chargemaster,75901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75901,BCBS multispecialty AW base fee schedule,407.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75902,Not in chargemaster,75902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75902,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75902 mod 26,Not in chargemaster,75902,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75902 mod 26,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75902 mod TC,Not in chargemaster,75902,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75902 mod TC,BCBS multispecialty AW base fee schedule,123.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75956,Not in chargemaster,75956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75956,BCBS multispecialty AW base fee schedule,649.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75956 mod 26,Not in chargemaster,75956,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75956 mod 26,BCBS multispecialty AW base fee schedule,649.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75957,Not in chargemaster,75957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75957,BCBS multispecialty AW base fee schedule,555.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75957 mod 26,Not in chargemaster,75957,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75957 mod 26,BCBS multispecialty AW base fee schedule,555.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75958,Not in chargemaster,75958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75958,BCBS multispecialty AW base fee schedule,368.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75958 mod 26,Not in chargemaster,75958,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75958 mod 26,BCBS multispecialty AW base fee schedule,368.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75959,Not in chargemaster,75959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75959,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75959 mod 26,Not in chargemaster,75959,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75959 mod 26,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75970,Not in chargemaster,75970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75970,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75970 mod 26,Not in chargemaster,75970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75970 mod 26,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75984 mod 26,Not in chargemaster,75984,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75984 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75984 mod TC,Not in chargemaster,75984,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75984 mod TC,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75984,Not in chargemaster,75984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75984,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75989,Not in chargemaster,75989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75989,BCBS multispecialty AW base fee schedule,227.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75989 mod 26,Not in chargemaster,75989,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75989 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75989 mod TC,Not in chargemaster,75989,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,75989 mod TC,BCBS multispecialty AW base fee schedule,117.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76000 mod 26,Not in chargemaster,76000,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76000 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76000 mod TC,Not in chargemaster,76000,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76000 mod TC,BCBS multispecialty AW base fee schedule,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76000,Not in chargemaster,76000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76000,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76010,Not in chargemaster,76010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76010,BCBS multispecialty AW base fee schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76010 mod 26,Not in chargemaster,76010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76010 mod 26,BCBS multispecialty AW base fee schedule,17.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76010 mod TC,Not in chargemaster,76010,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76010 mod TC,BCBS multispecialty AW base fee schedule,36.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76080 mod 26,Not in chargemaster,76080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76080 mod 26,BCBS multispecialty AW base fee schedule,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76080 mod TC,Not in chargemaster,76080,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76080 mod TC,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76080,Not in chargemaster,76080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76080,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76098,Not in chargemaster,76098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76098,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76098 mod 26,Not in chargemaster,76098,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76098 mod 26,BCBS multispecialty AW base fee schedule,29.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76098 mod TC,Not in chargemaster,76098,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76098 mod TC,BCBS multispecialty AW base fee schedule,50.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76100 mod 26,Not in chargemaster,76100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76100 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76100 mod TC,Not in chargemaster,76100,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76100 mod TC,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76100,Not in chargemaster,76100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76100,BCBS multispecialty AW base fee schedule,182.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76101,Not in chargemaster,76101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76101,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76101 mod 26,Not in chargemaster,76101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76101 mod 26,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76101 mod TC,Not in chargemaster,76101,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76101 mod TC,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76102 mod 26,Not in chargemaster,76102,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76102 mod 26,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76102 mod TC,Not in chargemaster,76102,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76102 mod TC,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76102,Not in chargemaster,76102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76102,BCBS multispecialty AW base fee schedule,328.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76120,Not in chargemaster,76120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76120,BCBS multispecialty AW base fee schedule,202.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76120 mod 26,Not in chargemaster,76120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76120 mod 26,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76120 mod TC,Not in chargemaster,76120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76120 mod TC,BCBS multispecialty AW base fee schedule,166.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76125 mod 26,Not in chargemaster,76125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76125 mod 26,BCBS multispecialty AW base fee schedule,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76125,Not in chargemaster,76125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76125,BCBS multispecialty AW base fee schedule,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76376,Not in chargemaster,76376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76376,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76376 mod 26,Not in chargemaster,76376,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76376 mod 26,BCBS multispecialty AW base fee schedule,18.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76376 mod TC,Not in chargemaster,76376,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76376 mod TC,BCBS multispecialty AW base fee schedule,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76377 mod 26,Not in chargemaster,76377,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76377 mod 26,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76377 mod TC,Not in chargemaster,76377,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76377 mod TC,BCBS multispecialty AW base fee schedule,59.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76377,Not in chargemaster,76377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76377,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76380,Not in chargemaster,76380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76380,BCBS multispecialty AW base fee schedule,269.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76380 mod 26,Not in chargemaster,76380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76380 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76380 mod TC,Not in chargemaster,76380,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76380 mod TC,BCBS multispecialty AW base fee schedule,178.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76390 mod 26,Not in chargemaster,76390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76390 mod 26,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76390 mod TC,Not in chargemaster,76390,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76390 mod TC,BCBS multispecialty AW base fee schedule,661.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76390,Not in chargemaster,76390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76390,BCBS multispecialty AW base fee schedule,793.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76391,Not in chargemaster,76391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76391,BCBS multispecialty AW base fee schedule,433.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76391 mod 26,Not in chargemaster,76391,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76391 mod 26,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76391 mod TC,Not in chargemaster,76391,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76391 mod TC,BCBS multispecialty AW base fee schedule,328.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76506 mod 26,Not in chargemaster,76506,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76506 mod 26,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76506 mod TC,Not in chargemaster,76506,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76506 mod TC,BCBS multispecialty AW base fee schedule,155.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76506,Not in chargemaster,76506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76506,BCBS multispecialty AW base fee schedule,215.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76510,Not in chargemaster,76510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76510,BCBS multispecialty AW base fee schedule,169.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76510 mod 26,Not in chargemaster,76510,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76510 mod 26,BCBS multispecialty AW base fee schedule,88.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76510 mod TC,Not in chargemaster,76510,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76510 mod TC,BCBS multispecialty AW base fee schedule,80.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76511 mod 26,Not in chargemaster,76511,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76511 mod 26,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76511 mod TC,Not in chargemaster,76511,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76511 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76511,Not in chargemaster,76511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76511,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76512,Not in chargemaster,76512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76512,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76512 mod 26,Not in chargemaster,76512,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76512 mod 26,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76512 mod TC,Not in chargemaster,76512,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76512 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76513 mod 26,Not in chargemaster,76513,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76513 mod 26,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76513 mod TC,Not in chargemaster,76513,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76513 mod TC,BCBS multispecialty AW base fee schedule,118.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76513,Not in chargemaster,76513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76513,BCBS multispecialty AW base fee schedule,186.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76514,Not in chargemaster,76514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76514,BCBS multispecialty AW base fee schedule,22.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76514 mod 26,Not in chargemaster,76514,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76514 mod 26,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76514 mod TC,Not in chargemaster,76514,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76514 mod TC,BCBS multispecialty AW base fee schedule,7.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76516 mod 26,Not in chargemaster,76516,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76516 mod 26,BCBS multispecialty AW base fee schedule,43.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76516 mod TC,Not in chargemaster,76516,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76516 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76516,Not in chargemaster,76516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76516,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76519,Not in chargemaster,76519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76519,BCBS multispecialty AW base fee schedule,124.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76519 mod 26,Not in chargemaster,76519,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76519 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76519 mod TC,Not in chargemaster,76519,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76519 mod TC,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76529 mod 26,Not in chargemaster,76529,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76529 mod 26,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76529 mod TC,Not in chargemaster,76529,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76529 mod TC,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76529,Not in chargemaster,76529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76529,BCBS multispecialty AW base fee schedule,155.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76536,Not in chargemaster,76536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76536,BCBS multispecialty AW base fee schedule,216.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76536 mod 26,76536,76536,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76536 mod 26,BCBS multispecialty AW base fee schedule,53,62.05,Fee schedule,,53,53,53,53,,,0
unity,Fee schedule,Non-facility 76536 mod TC,Not in chargemaster,76536,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76536 mod TC,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76604 mod 26,Not in chargemaster,76604,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76604 mod 26,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76604 mod TC,Not in chargemaster,76604,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76604 mod TC,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76604,Not in chargemaster,76604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76604,BCBS multispecialty AW base fee schedule,147.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76641,Not in chargemaster,76641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76641,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76641 mod 26,Not in chargemaster,76641,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76641 mod 26,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76641 mod TC,Not in chargemaster,76641,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76641 mod TC,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76642 mod 26,Not in chargemaster,76642,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76642 mod 26,BCBS multispecialty AW base fee schedule,63.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76642 mod TC,Not in chargemaster,76642,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76642 mod TC,BCBS multispecialty AW base fee schedule,100.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76642,Not in chargemaster,76642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76642,BCBS multispecialty AW base fee schedule,163.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76700,Not in chargemaster,76700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76700,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76700 mod 26,76700,76700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76700 mod 26,BCBS multispecialty AW base fee schedule,76.85,89.2,Fee schedule,,76.85,76.85,76.85,76.85,,,0
unity,Fee schedule,Non-facility 76700 mod TC,Not in chargemaster,76700,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76700 mod TC,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76705 mod 26,76705,76705,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76705 mod 26,BCBS multispecialty AW base fee schedule,54.99,59.23,Fee schedule,,54.99,54.99,54.99,54.99,,,0
unity,Fee schedule,Non-facility 76705 mod TC,Not in chargemaster,76705,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76705 mod TC,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76705,Not in chargemaster,76705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76705,BCBS multispecialty AW base fee schedule,170.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76706,Not in chargemaster,76706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76706,BCBS multispecialty AW base fee schedule,212.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76706 mod 26,Not in chargemaster,76706,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76706 mod 26,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76706 mod TC,Not in chargemaster,76706,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76706 mod TC,BCBS multispecialty AW base fee schedule,160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76770 mod 26,76770,76770,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76770 mod 26,BCBS multispecialty AW base fee schedule,68.9,81.44,Fee schedule,,68.9,68.9,68.9,68.9,,,0
unity,Fee schedule,Non-facility 76770 mod TC,Not in chargemaster,76770,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76770 mod TC,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76770,Not in chargemaster,76770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76770,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76775,Not in chargemaster,76775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76775,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76775 mod 26,76775,76775,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76775 mod 26,BCBS multispecialty AW base fee schedule,54.33,63.61,Fee schedule,,54.33,54.33,54.33,54.33,,,0
unity,Fee schedule,Non-facility 76775 mod TC,Not in chargemaster,76775,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76775 mod TC,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76776 mod 26,Not in chargemaster,76776,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76776 mod 26,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76776 mod TC,Not in chargemaster,76776,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76776 mod TC,BCBS multispecialty AW base fee schedule,219.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76776,Not in chargemaster,76776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76776,BCBS multispecialty AW base fee schedule,292.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76800,Not in chargemaster,76800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76800,BCBS multispecialty AW base fee schedule,267.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76800 mod 26,Not in chargemaster,76800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76800 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76800 mod TC,Not in chargemaster,76800,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76800 mod TC,BCBS multispecialty AW base fee schedule,157.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76801 mod 26,76801,76801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76801 mod 26,BCBS multispecialty AW base fee schedule,93.41,109.37,Fee schedule,,93.41,93.41,93.41,93.41,,,0
unity,Fee schedule,Non-facility 76801 mod TC,Not in chargemaster,76801,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76801 mod TC,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76801,Not in chargemaster,76801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76801,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76802,Not in chargemaster,76802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76802,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76802 mod 26,Not in chargemaster,76802,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76802 mod 26,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76802 mod TC,Not in chargemaster,76802,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76802 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76805 mod 26,76805,76805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76805 mod 26,BCBS multispecialty AW base fee schedule,93.41,110.14,Fee schedule,,93.41,93.41,93.41,93.41,,,0
unity,Fee schedule,Non-facility 76805 mod TC,Not in chargemaster,76805,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76805 mod TC,BCBS multispecialty AW base fee schedule,168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76805,Not in chargemaster,76805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76805,BCBS multispecialty AW base fee schedule,261.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76810,Not in chargemaster,76810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76810,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76810 mod 26,76810,76810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76810 mod 26,BCBS multispecialty AW base fee schedule,92.75,108.58,Fee schedule,,92.75,92.75,92.75,92.75,,,0
unity,Fee schedule,Non-facility 76810 mod TC,Not in chargemaster,76810,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76810 mod TC,BCBS multispecialty AW base fee schedule,78.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76811 mod 26,Not in chargemaster,76811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76811 mod 26,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76811 mod TC,Not in chargemaster,76811,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76811 mod TC,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76811,Not in chargemaster,76811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76811,BCBS multispecialty AW base fee schedule,331.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76812,Not in chargemaster,76812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76812,BCBS multispecialty AW base fee schedule,371.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76812 mod 26,Not in chargemaster,76812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76812 mod 26,BCBS multispecialty AW base fee schedule,166.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76812 mod TC,Not in chargemaster,76812,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76812 mod TC,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76813 mod 26,Not in chargemaster,76813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76813 mod 26,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76813 mod TC,Not in chargemaster,76813,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76813 mod TC,BCBS multispecialty AW base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76813,Not in chargemaster,76813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76813,BCBS multispecialty AW base fee schedule,226.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76814,Not in chargemaster,76814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76814,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76814 mod 26,Not in chargemaster,76814,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76814 mod 26,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76814 mod TC,Not in chargemaster,76814,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76814 mod TC,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76815 mod 26,76815,76815,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76815 mod 26,BCBS multispecialty AW base fee schedule,60.95,70.58,Fee schedule,,60.95,60.95,60.95,60.95,,,0
unity,Fee schedule,Non-facility 76815 mod TC,Not in chargemaster,76815,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76815 mod TC,BCBS multispecialty AW base fee schedule,96.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76815,Not in chargemaster,76815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76815,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76816,Not in chargemaster,76816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76816,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76816 mod 26,Not in chargemaster,76816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76816 mod 26,BCBS multispecialty AW base fee schedule,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76816 mod TC,Not in chargemaster,76816,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76816 mod TC,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76817 mod 26,76817,76817,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76817 mod 26,BCBS multispecialty AW base fee schedule,70.23,83.77,Fee schedule,,70.23,70.23,70.23,70.23,,,0
unity,Fee schedule,Non-facility 76817 mod TC,Not in chargemaster,76817,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76817 mod TC,BCBS multispecialty AW base fee schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76817,Not in chargemaster,76817,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76817,BCBS multispecialty AW base fee schedule,178.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76818,Not in chargemaster,76818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76818,BCBS multispecialty AW base fee schedule,220.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76818 mod 26,Not in chargemaster,76818,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76818 mod 26,BCBS multispecialty AW base fee schedule,98.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76818 mod TC,Not in chargemaster,76818,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76818 mod TC,BCBS multispecialty AW base fee schedule,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76819 mod 26,Not in chargemaster,76819,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76819 mod 26,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76819 mod TC,Not in chargemaster,76819,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76819 mod TC,BCBS multispecialty AW base fee schedule,90.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76819,Not in chargemaster,76819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76819,BCBS multispecialty AW base fee schedule,162.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76820,Not in chargemaster,76820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76820,BCBS multispecialty AW base fee schedule,87.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76820 mod 26,Not in chargemaster,76820,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76820 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76820 mod TC,Not in chargemaster,76820,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76820 mod TC,BCBS multispecialty AW base fee schedule,40.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76821 mod 26,Not in chargemaster,76821,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76821 mod 26,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76821 mod TC,Not in chargemaster,76821,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76821 mod TC,BCBS multispecialty AW base fee schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76821,Not in chargemaster,76821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76821,BCBS multispecialty AW base fee schedule,168.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76825,Not in chargemaster,76825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76825,BCBS multispecialty AW base fee schedule,510.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76825 mod 26,Not in chargemaster,76825,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76825 mod 26,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76825 mod TC,Not in chargemaster,76825,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76825 mod TC,BCBS multispecialty AW base fee schedule,356.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76826 mod 26,Not in chargemaster,76826,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76826 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76826 mod TC,Not in chargemaster,76826,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76826 mod TC,BCBS multispecialty AW base fee schedule,226.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76826,Not in chargemaster,76826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76826,BCBS multispecialty AW base fee schedule,303.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76827,Not in chargemaster,76827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76827,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76827 mod 26,Not in chargemaster,76827,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76827 mod 26,BCBS multispecialty AW base fee schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76827 mod TC,Not in chargemaster,76827,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76827 mod TC,BCBS multispecialty AW base fee schedule,83.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76828 mod 26,Not in chargemaster,76828,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76828 mod 26,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76828 mod TC,Not in chargemaster,76828,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76828 mod TC,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76828,Not in chargemaster,76828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76828,BCBS multispecialty AW base fee schedule,97.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76830,Not in chargemaster,76830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76830,BCBS multispecialty AW base fee schedule,229.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76830 mod 26,76830,76830,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76830 mod 26,BCBS multispecialty AW base fee schedule,64.93,76.79,Fee schedule,,64.93,64.93,64.93,64.93,,,0
unity,Fee schedule,Non-facility 76830 mod TC,Not in chargemaster,76830,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76830 mod TC,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76831 mod 26,Not in chargemaster,76831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76831 mod 26,BCBS multispecialty AW base fee schedule,67.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76831 mod TC,Not in chargemaster,76831,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76831 mod TC,BCBS multispecialty AW base fee schedule,155.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76831,Not in chargemaster,76831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76831,BCBS multispecialty AW base fee schedule,222.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76856,Not in chargemaster,76856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76856,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76856 mod 26,76856,76856,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76856 mod 26,BCBS multispecialty AW base fee schedule,64.26,76.01,Fee schedule,,64.26,64.26,64.26,64.26,,,0
unity,Fee schedule,Non-facility 76856 mod TC,Not in chargemaster,76856,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76856 mod TC,BCBS multispecialty AW base fee schedule,140.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76857 mod 26,Not in chargemaster,76857,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76857 mod 26,BCBS multispecialty AW base fee schedule,46.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76857 mod TC,Not in chargemaster,76857,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76857 mod TC,BCBS multispecialty AW base fee schedule,44.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76857,Not in chargemaster,76857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76857,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76870,Not in chargemaster,76870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76870,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76870 mod 26,76870,76870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76870 mod 26,BCBS multispecialty AW base fee schedule,59.63,70.58,Fee schedule,,59.63,59.63,59.63,59.63,,,0
unity,Fee schedule,Non-facility 76870 mod TC,Not in chargemaster,76870,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76870 mod TC,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76872 mod 26,Not in chargemaster,76872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76872 mod 26,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76872 mod TC,Not in chargemaster,76872,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76872 mod TC,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76872,Not in chargemaster,76872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76872,BCBS multispecialty AW base fee schedule,293.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76873,Not in chargemaster,76873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76873,BCBS multispecialty AW base fee schedule,328.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76873 mod 26,Not in chargemaster,76873,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76873 mod 26,BCBS multispecialty AW base fee schedule,147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76873 mod TC,Not in chargemaster,76873,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76873 mod TC,BCBS multispecialty AW base fee schedule,181.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76881 mod 26,Not in chargemaster,76881,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76881 mod 26,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76881 mod TC,Not in chargemaster,76881,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76881 mod TC,BCBS multispecialty AW base fee schedule,86.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76881,Not in chargemaster,76881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76881,BCBS multispecialty AW base fee schedule,145.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76882,Not in chargemaster,76882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76882,BCBS multispecialty AW base fee schedule,106.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76882 mod 26,Not in chargemaster,76882,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76882 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76882 mod TC,Not in chargemaster,76882,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76882 mod TC,BCBS multispecialty AW base fee schedule,60.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76885 mod 26,Not in chargemaster,76885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76885 mod 26,BCBS multispecialty AW base fee schedule,69.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76885 mod TC,Not in chargemaster,76885,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76885 mod TC,BCBS multispecialty AW base fee schedule,198.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76885,Not in chargemaster,76885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76885,BCBS multispecialty AW base fee schedule,268.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76886,Not in chargemaster,76886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76886,BCBS multispecialty AW base fee schedule,196.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76886 mod 26,Not in chargemaster,76886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76886 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76886 mod TC,Not in chargemaster,76886,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76886 mod TC,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76932,Not in chargemaster,76932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76932,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76932 mod 26,Not in chargemaster,76932,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76932 mod 26,BCBS multispecialty AW base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76936 mod 26,Not in chargemaster,76936,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76936 mod 26,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76936 mod TC,Not in chargemaster,76936,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76936 mod TC,BCBS multispecialty AW base fee schedule,321.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76936,Not in chargemaster,76936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76936,BCBS multispecialty AW base fee schedule,504.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76937,Not in chargemaster,76937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76937,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76937 mod 26,76937,76937,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76937 mod 26,BCBS multispecialty AW base fee schedule,27.16,33.38,Fee schedule,,27.16,27.16,27.16,27.16,,,0
unity,Fee schedule,Non-facility 76937 mod TC,Not in chargemaster,76937,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76937 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76940,Not in chargemaster,76940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76940,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76940 mod 26,Not in chargemaster,76940,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76940 mod 26,BCBS multispecialty AW base fee schedule,194.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76941,Not in chargemaster,76941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76941,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76941 mod 26,Not in chargemaster,76941,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76941 mod 26,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76942 mod 26,76942,76942,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76942 mod 26,BCBS multispecialty AW base fee schedule,59.63,74.91,Fee schedule,,59.63,59.63,59.63,59.63,,,0
unity,Fee schedule,Non-facility 76942 mod TC,Not in chargemaster,76942,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76942 mod TC,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76942,Not in chargemaster,76942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76942,BCBS multispecialty AW base fee schedule,107.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76945,Not in chargemaster,76945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76945,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76945 mod 26,Not in chargemaster,76945,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76945 mod 26,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76946,Not in chargemaster,76946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76946,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76946 mod 26,Not in chargemaster,76946,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76946 mod 26,BCBS multispecialty AW base fee schedule,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76946 mod TC,Not in chargemaster,76946,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76946 mod TC,BCBS multispecialty AW base fee schedule,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76948 mod 26,Not in chargemaster,76948,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76948 mod 26,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76948 mod TC,Not in chargemaster,76948,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76948 mod TC,BCBS multispecialty AW base fee schedule,80.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76948,Not in chargemaster,76948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76948,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76965,Not in chargemaster,76965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76965,BCBS multispecialty AW base fee schedule,174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76965 mod 26,Not in chargemaster,76965,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76965 mod 26,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76965 mod TC,Not in chargemaster,76965,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76965 mod TC,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76970 mod 26,Not in chargemaster,76970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76970 mod 26,BCBS multispecialty AW base fee schedule,36.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76970 mod TC,Not in chargemaster,76970,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76970 mod TC,BCBS multispecialty AW base fee schedule,129.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76970,Not in chargemaster,76970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76970,BCBS multispecialty AW base fee schedule,166.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76975,Not in chargemaster,76975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76975,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76975 mod 26,Not in chargemaster,76975,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76975 mod 26,BCBS multispecialty AW base fee schedule,78.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76977,Not in chargemaster,76977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76977,BCBS multispecialty AW base fee schedule,13.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76977 mod 26,Not in chargemaster,76977,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76977 mod 26,BCBS multispecialty AW base fee schedule,5.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76977 mod TC,Not in chargemaster,76977,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76977 mod TC,BCBS multispecialty AW base fee schedule,7.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76978 mod 26,Not in chargemaster,76978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76978 mod 26,BCBS multispecialty AW base fee schedule,151.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76978 mod TC,Not in chargemaster,76978,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76978 mod TC,BCBS multispecialty AW base fee schedule,458.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76978,Not in chargemaster,76978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76978,BCBS multispecialty AW base fee schedule,610.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76979,Not in chargemaster,76979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76979,BCBS multispecialty AW base fee schedule,414.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76979 mod 26,Not in chargemaster,76979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76979 mod 26,BCBS multispecialty AW base fee schedule,80.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76979 mod TC,Not in chargemaster,76979,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76979 mod TC,BCBS multispecialty AW base fee schedule,333.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76981 mod 26,Not in chargemaster,76981,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76981 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76981 mod TC,Not in chargemaster,76981,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76981 mod TC,BCBS multispecialty AW base fee schedule,145.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76981,Not in chargemaster,76981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76981,BCBS multispecialty AW base fee schedule,201.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76982,Not in chargemaster,76982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76982,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76982 mod 26,Not in chargemaster,76982,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76982 mod 26,BCBS multispecialty AW base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76982 mod TC,Not in chargemaster,76982,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76982 mod TC,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76983 mod 26,Not in chargemaster,76983,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76983 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76983 mod TC,Not in chargemaster,76983,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76983 mod TC,BCBS multispecialty AW base fee schedule,63.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76983,Not in chargemaster,76983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76983,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76998,Not in chargemaster,76998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76998,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76998 mod 26,Not in chargemaster,76998,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76998 mod 26,BCBS multispecialty AW base fee schedule,119.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77001,Not in chargemaster,77001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77001,BCBS multispecialty AW base fee schedule,179.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77001 mod 26,Not in chargemaster,77001,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77001 mod 26,BCBS multispecialty AW base fee schedule,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77001 mod TC,Not in chargemaster,77001,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77001 mod TC,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77002 mod 26,Not in chargemaster,77002,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77002 mod 26,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77002 mod TC,Not in chargemaster,77002,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77002 mod TC,BCBS multispecialty AW base fee schedule,149.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77002,Not in chargemaster,77002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77002,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77003,Not in chargemaster,77003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77003,BCBS multispecialty AW base fee schedule,188.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77003 mod 26,Not in chargemaster,77003,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77003 mod 26,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77003 mod TC,Not in chargemaster,77003,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77003 mod TC,BCBS multispecialty AW base fee schedule,132.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77011 mod 26,Not in chargemaster,77011,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77011 mod 26,BCBS multispecialty AW base fee schedule,119.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77011 mod TC,Not in chargemaster,77011,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77011 mod TC,BCBS multispecialty AW base fee schedule,315.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77011,Not in chargemaster,77011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77011,BCBS multispecialty AW base fee schedule,435.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77012,Not in chargemaster,77012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77012,BCBS multispecialty AW base fee schedule,282.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77012 mod 26,Not in chargemaster,77012,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77012 mod 26,BCBS multispecialty AW base fee schedule,139.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77012 mod TC,Not in chargemaster,77012,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77012 mod TC,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77013,Not in chargemaster,77013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77013,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77013 mod 26,Not in chargemaster,77013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77013 mod 26,BCBS multispecialty AW base fee schedule,359.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77014 mod 26,Not in chargemaster,77014,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77014 mod 26,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77014 mod TC,Not in chargemaster,77014,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77014 mod TC,BCBS multispecialty AW base fee schedule,143.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77014,Not in chargemaster,77014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77014,BCBS multispecialty AW base fee schedule,228.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77021,Not in chargemaster,77021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77021,BCBS multispecialty AW base fee schedule,867.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77021 mod 26,Not in chargemaster,77021,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77021 mod 26,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77021 mod TC,Not in chargemaster,77021,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77021 mod TC,BCBS multispecialty AW base fee schedule,730.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77022,Not in chargemaster,77022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77022,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77022 mod 26,Not in chargemaster,77022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77022 mod 26,BCBS multispecialty AW base fee schedule,405.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77046 mod 26,Not in chargemaster,77046,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77046 mod 26,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77046 mod TC,Not in chargemaster,77046,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77046 mod TC,BCBS multispecialty AW base fee schedule,320.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77046,Not in chargemaster,77046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77046,BCBS multispecialty AW base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77047,Not in chargemaster,77047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77047,BCBS multispecialty AW base fee schedule,469.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77047 mod 26,Not in chargemaster,77047,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77047 mod 26,BCBS multispecialty AW base fee schedule,150.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77047 mod TC,Not in chargemaster,77047,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77047 mod TC,BCBS multispecialty AW base fee schedule,318.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77048 mod 26,Not in chargemaster,77048,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77048 mod 26,BCBS multispecialty AW base fee schedule,196.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77048 mod TC,Not in chargemaster,77048,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77048 mod TC,BCBS multispecialty AW base fee schedule,527.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77048,Not in chargemaster,77048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77048,BCBS multispecialty AW base fee schedule,724.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77049,Not in chargemaster,77049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77049,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77049 mod 26,Not in chargemaster,77049,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77049 mod 26,BCBS multispecialty AW base fee schedule,215.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77049 mod TC,Not in chargemaster,77049,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77049 mod TC,BCBS multispecialty AW base fee schedule,525.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77053 mod 26,Not in chargemaster,77053,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77053 mod 26,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77053 mod TC,Not in chargemaster,77053,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77053 mod TC,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77053,Not in chargemaster,77053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77053,BCBS multispecialty AW base fee schedule,106,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77054,Not in chargemaster,77054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77054,BCBS multispecialty AW base fee schedule,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77054 mod 26,Not in chargemaster,77054,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77054 mod 26,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77054 mod TC,Not in chargemaster,77054,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77054 mod TC,BCBS multispecialty AW base fee schedule,94.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77063 mod 26,Not in chargemaster,77063,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77063 mod 26,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77063 mod TC,Not in chargemaster,77063,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77063 mod TC,BCBS multispecialty AW base fee schedule,46.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77063,Not in chargemaster,77063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77063,BCBS multispecialty AW base fee schedule,102.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77065,Not in chargemaster,77065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77065,BCBS multispecialty AW base fee schedule,250.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77065 mod 26,77065,77065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77065 mod 26,BCBS multispecialty AW base fee schedule,76.85,103.4,Fee schedule,,76.85,76.85,76.85,76.85,,,0
unity,Fee schedule,Non-facility 77065 mod TC,Not in chargemaster,77065,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77065 mod TC,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77066 mod 26,77066,77066,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77066 mod 26,BCBS multispecialty AW base fee schedule,94.08,127.6,Fee schedule,,94.08,94.08,94.08,94.08,,,0
unity,Fee schedule,Non-facility 77066 mod TC,Not in chargemaster,77066,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77066 mod TC,BCBS multispecialty AW base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77066,Not in chargemaster,77066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77066,BCBS multispecialty AW base fee schedule,315.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77067,Not in chargemaster,77067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77067,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77067 mod 26,77067,77067,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77067 mod 26,BCBS multispecialty AW base fee schedule,72.21,91.21,Fee schedule,,72.21,72.21,72.21,72.21,,,0
unity,Fee schedule,Non-facility 77067 mod TC,Not in chargemaster,77067,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77067 mod TC,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77071,Not in chargemaster,77071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77071,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77072,Not in chargemaster,77072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77072,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77072 mod 26,Not in chargemaster,77072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77072 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77072 mod TC,Not in chargemaster,77072,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77072 mod TC,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77073 mod 26,Not in chargemaster,77073,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77073 mod 26,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77073 mod TC,Not in chargemaster,77073,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77073 mod TC,BCBS multispecialty AW base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77073,Not in chargemaster,77073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77073,BCBS multispecialty AW base fee schedule,82.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77074,Not in chargemaster,77074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77074,BCBS multispecialty AW base fee schedule,117.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77074 mod 26,Not in chargemaster,77074,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77074 mod 26,BCBS multispecialty AW base fee schedule,41.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77074 mod TC,Not in chargemaster,77074,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77074 mod TC,BCBS multispecialty AW base fee schedule,76.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77075 mod 26,Not in chargemaster,77075,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77075 mod 26,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77075 mod TC,Not in chargemaster,77075,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77075 mod TC,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77075,Not in chargemaster,77075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77075,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77076,Not in chargemaster,77076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77076,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77076 mod 26,Not in chargemaster,77076,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77076 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77076 mod TC,Not in chargemaster,77076,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77076 mod TC,BCBS multispecialty AW base fee schedule,126.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77077 mod 26,Not in chargemaster,77077,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77077 mod 26,BCBS multispecialty AW base fee schedule,32.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77077 mod TC,Not in chargemaster,77077,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77077 mod TC,BCBS multispecialty AW base fee schedule,53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77077,Not in chargemaster,77077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77077,BCBS multispecialty AW base fee schedule,85.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77078,Not in chargemaster,77078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77078,BCBS multispecialty AW base fee schedule,213.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77078 mod 26,Not in chargemaster,77078,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77078 mod 26,BCBS multispecialty AW base fee schedule,23.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77078 mod TC,Not in chargemaster,77078,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77078 mod TC,BCBS multispecialty AW base fee schedule,190.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77080 mod 26,77080,77080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77080 mod 26,BCBS multispecialty AW base fee schedule,18.55,22.5,Fee schedule,,18.55,18.55,18.55,18.55,,,0
unity,Fee schedule,Non-facility 77080 mod TC,Not in chargemaster,77080,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77080 mod TC,BCBS multispecialty AW base fee schedule,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77080,Not in chargemaster,77080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77080,BCBS multispecialty AW base fee schedule,73.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77081,Not in chargemaster,77081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77081,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77081 mod 26,Not in chargemaster,77081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77081 mod 26,BCBS multispecialty AW base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77081 mod TC,Not in chargemaster,77081,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77081 mod TC,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77084 mod 26,Not in chargemaster,77084,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77084 mod 26,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77084 mod TC,Not in chargemaster,77084,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77084 mod TC,BCBS multispecialty AW base fee schedule,541.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77084,Not in chargemaster,77084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77084,BCBS multispecialty AW base fee schedule,692.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77085,Not in chargemaster,77085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77085,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77085 mod 26,Not in chargemaster,77085,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77085 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77085 mod TC,Not in chargemaster,77085,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77085 mod TC,BCBS multispecialty AW base fee schedule,71.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77086 mod 26,Not in chargemaster,77086,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77086 mod 26,BCBS multispecialty AW base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77086 mod TC,Not in chargemaster,77086,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77086 mod TC,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77086,Not in chargemaster,77086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77086,BCBS multispecialty AW base fee schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77261,Not in chargemaster,77261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77261,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77262,Not in chargemaster,77262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77262,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77263,Not in chargemaster,77263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77263,BCBS multispecialty AW base fee schedule,319.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77280 mod 26,Not in chargemaster,77280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77280 mod 26,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77280 mod TC,Not in chargemaster,77280,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77280 mod TC,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77280,Not in chargemaster,77280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77280,BCBS multispecialty AW base fee schedule,520.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77285,Not in chargemaster,77285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77285,BCBS multispecialty AW base fee schedule,871.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77285 mod 26,Not in chargemaster,77285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77285 mod 26,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77285 mod TC,Not in chargemaster,77285,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77285 mod TC,BCBS multispecialty AW base fee schedule,761.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77290 mod 26,Not in chargemaster,77290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77290 mod 26,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77290 mod TC,Not in chargemaster,77290,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77290 mod TC,BCBS multispecialty AW base fee schedule,776.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77290,Not in chargemaster,77290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77290,BCBS multispecialty AW base fee schedule,932.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77293,Not in chargemaster,77293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77293,BCBS multispecialty AW base fee schedule,846.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77293 mod 26,Not in chargemaster,77293,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77293 mod 26,BCBS multispecialty AW base fee schedule,200.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77293 mod TC,Not in chargemaster,77293,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77293 mod TC,BCBS multispecialty AW base fee schedule,645.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77295 mod 26,Not in chargemaster,77295,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77295 mod 26,BCBS multispecialty AW base fee schedule,426.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77295 mod TC,Not in chargemaster,77295,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77295 mod TC,BCBS multispecialty AW base fee schedule,487.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77295,Not in chargemaster,77295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77295,BCBS multispecialty AW base fee schedule,914.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77300,Not in chargemaster,77300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77300,BCBS multispecialty AW base fee schedule,124.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77300 mod 26,Not in chargemaster,77300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77300 mod 26,BCBS multispecialty AW base fee schedule,61.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77300 mod TC,Not in chargemaster,77300,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77300 mod TC,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77301 mod 26,Not in chargemaster,77301,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77301 mod 26,BCBS multispecialty AW base fee schedule,794.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77301 mod TC,Not in chargemaster,77301,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77301 mod TC,BCBS multispecialty AW base fee schedule,2783.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77301,Not in chargemaster,77301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77301,BCBS multispecialty AW base fee schedule,3578.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77306,Not in chargemaster,77306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77306,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77306 mod 26,Not in chargemaster,77306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77306 mod 26,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77306 mod TC,Not in chargemaster,77306,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77306 mod TC,BCBS multispecialty AW base fee schedule,140.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77307 mod 26,Not in chargemaster,77307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77307 mod 26,BCBS multispecialty AW base fee schedule,288.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77307 mod TC,Not in chargemaster,77307,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77307 mod TC,BCBS multispecialty AW base fee schedule,254.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77307,Not in chargemaster,77307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77307,BCBS multispecialty AW base fee schedule,543.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77316,Not in chargemaster,77316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77316,BCBS multispecialty AW base fee schedule,408.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77316 mod 26,Not in chargemaster,77316,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77316 mod 26,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77316 mod TC,Not in chargemaster,77316,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77316 mod TC,BCBS multispecialty AW base fee schedule,268.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77317 mod 26,Not in chargemaster,77317,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77317 mod 26,BCBS multispecialty AW base fee schedule,183.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77317 mod TC,Not in chargemaster,77317,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77317 mod TC,BCBS multispecialty AW base fee schedule,352.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77317,Not in chargemaster,77317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77317,BCBS multispecialty AW base fee schedule,535.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77318,Not in chargemaster,77318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77318,BCBS multispecialty AW base fee schedule,766.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77318 mod 26,Not in chargemaster,77318,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77318 mod 26,BCBS multispecialty AW base fee schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77318 mod TC,Not in chargemaster,77318,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77318 mod TC,BCBS multispecialty AW base fee schedule,478.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77321 mod 26,Not in chargemaster,77321,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77321 mod 26,BCBS multispecialty AW base fee schedule,96.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77321 mod TC,Not in chargemaster,77321,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77321 mod TC,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77321,Not in chargemaster,77321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77321,BCBS multispecialty AW base fee schedule,177.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77331,Not in chargemaster,77331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77331,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77331 mod 26,Not in chargemaster,77331,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77331 mod 26,BCBS multispecialty AW base fee schedule,86.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77331 mod TC,Not in chargemaster,77331,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77331 mod TC,BCBS multispecialty AW base fee schedule,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77332 mod 26,Not in chargemaster,77332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77332 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77332 mod TC,Not in chargemaster,77332,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77332 mod TC,BCBS multispecialty AW base fee schedule,43.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77332,Not in chargemaster,77332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77332,BCBS multispecialty AW base fee schedule,88.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77333,Not in chargemaster,77333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77333,BCBS multispecialty AW base fee schedule,225.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77333 mod 26,Not in chargemaster,77333,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77333 mod 26,BCBS multispecialty AW base fee schedule,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77333 mod TC,Not in chargemaster,77333,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77333 mod TC,BCBS multispecialty AW base fee schedule,151.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77334 mod 26,Not in chargemaster,77334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77334 mod 26,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77334 mod TC,Not in chargemaster,77334,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77334 mod TC,BCBS multispecialty AW base fee schedule,123.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77334,Not in chargemaster,77334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77334,BCBS multispecialty AW base fee schedule,239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77336,Not in chargemaster,77336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77336,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77338 mod 26,Not in chargemaster,77338,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77338 mod 26,BCBS multispecialty AW base fee schedule,426.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77338 mod TC,Not in chargemaster,77338,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77338 mod TC,BCBS multispecialty AW base fee schedule,486.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77338,Not in chargemaster,77338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77338,BCBS multispecialty AW base fee schedule,912.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77370,Not in chargemaster,77370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77370,BCBS multispecialty AW base fee schedule,232.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77373,Not in chargemaster,77373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77373,BCBS multispecialty AW base fee schedule,2259.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77401,Not in chargemaster,77401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77401,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77372,Not in chargemaster,77372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77372,BCBS multispecialty AW base fee schedule,1962.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77417,Not in chargemaster,77417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77417,BCBS multispecialty AW base fee schedule,21.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77427,Not in chargemaster,77427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77427,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77431,Not in chargemaster,77431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77431,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77432,Not in chargemaster,77432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77432,BCBS multispecialty AW base fee schedule,805.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77435,Not in chargemaster,77435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77435,BCBS multispecialty AW base fee schedule,1216.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77469,Not in chargemaster,77469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77469,BCBS multispecialty AW base fee schedule,602.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77470,Not in chargemaster,77470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77470,BCBS multispecialty AW base fee schedule,251.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77470 mod 26,Not in chargemaster,77470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77470 mod 26,BCBS multispecialty AW base fee schedule,203.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77470 mod TC,Not in chargemaster,77470,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77470 mod TC,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77600 mod 26,Not in chargemaster,77600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77600 mod 26,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77600 mod TC,Not in chargemaster,77600,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77600 mod TC,BCBS multispecialty AW base fee schedule,738.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77600,Not in chargemaster,77600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77600,BCBS multispecialty AW base fee schedule,872.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77605,Not in chargemaster,77605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77605,BCBS multispecialty AW base fee schedule,1590,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77605 mod 26,Not in chargemaster,77605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77605 mod 26,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77605 mod TC,Not in chargemaster,77605,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77605 mod TC,BCBS multispecialty AW base fee schedule,1395.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77610 mod 26,Not in chargemaster,77610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77610 mod 26,BCBS multispecialty AW base fee schedule,130.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77610 mod TC,Not in chargemaster,77610,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77610 mod TC,BCBS multispecialty AW base fee schedule,1147.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77610,Not in chargemaster,77610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77610,BCBS multispecialty AW base fee schedule,1277.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77615,Not in chargemaster,77615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77615,BCBS multispecialty AW base fee schedule,1999.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77615 mod 26,Not in chargemaster,77615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77615 mod 26,BCBS multispecialty AW base fee schedule,184.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77615 mod TC,Not in chargemaster,77615,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77615 mod TC,BCBS multispecialty AW base fee schedule,1815.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77620 mod 26,Not in chargemaster,77620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77620 mod 26,BCBS multispecialty AW base fee schedule,161.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77620 mod TC,Not in chargemaster,77620,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77620 mod TC,BCBS multispecialty AW base fee schedule,985.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77620,Not in chargemaster,77620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77620,BCBS multispecialty AW base fee schedule,1146.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77750,Not in chargemaster,77750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77750,BCBS multispecialty AW base fee schedule,722.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77750 mod 26,Not in chargemaster,77750,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77750 mod 26,BCBS multispecialty AW base fee schedule,496.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77750 mod TC,Not in chargemaster,77750,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77750 mod TC,BCBS multispecialty AW base fee schedule,225.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77761 mod 26,Not in chargemaster,77761,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77761 mod 26,BCBS multispecialty AW base fee schedule,382.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77761 mod TC,Not in chargemaster,77761,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77761 mod TC,BCBS multispecialty AW base fee schedule,374.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77761,Not in chargemaster,77761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77761,BCBS multispecialty AW base fee schedule,757.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77762,Not in chargemaster,77762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77762,BCBS multispecialty AW base fee schedule,1004.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77762 mod 26,Not in chargemaster,77762,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77762 mod 26,BCBS multispecialty AW base fee schedule,574.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77762 mod TC,Not in chargemaster,77762,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77762 mod TC,BCBS multispecialty AW base fee schedule,429.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77763 mod 26,Not in chargemaster,77763,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77763 mod 26,BCBS multispecialty AW base fee schedule,862.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77763 mod TC,Not in chargemaster,77763,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77763 mod TC,BCBS multispecialty AW base fee schedule,555.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77763,Not in chargemaster,77763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77763,BCBS multispecialty AW base fee schedule,1417.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77767,Not in chargemaster,77767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77767,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77767 mod 26,Not in chargemaster,77767,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77767 mod 26,BCBS multispecialty AW base fee schedule,105.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77767 mod TC,Not in chargemaster,77767,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77767 mod TC,BCBS multispecialty AW base fee schedule,343.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77768 mod 26,Not in chargemaster,77768,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77768 mod 26,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77768 mod TC,Not in chargemaster,77768,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77768 mod TC,BCBS multispecialty AW base fee schedule,533.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77768,Not in chargemaster,77768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77768,BCBS multispecialty AW base fee schedule,673.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77770,Not in chargemaster,77770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77770,BCBS multispecialty AW base fee schedule,630.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77770 mod 26,Not in chargemaster,77770,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77770 mod 26,BCBS multispecialty AW base fee schedule,194.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77770 mod TC,Not in chargemaster,77770,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77770 mod TC,BCBS multispecialty AW base fee schedule,435.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77771 mod 26,Not in chargemaster,77771,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77771 mod 26,BCBS multispecialty AW base fee schedule,377.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77771 mod TC,Not in chargemaster,77771,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77771 mod TC,BCBS multispecialty AW base fee schedule,746.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77771,Not in chargemaster,77771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77771,BCBS multispecialty AW base fee schedule,1124.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77772,Not in chargemaster,77772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77772,BCBS multispecialty AW base fee schedule,1693.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77772 mod 26,Not in chargemaster,77772,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77772 mod 26,BCBS multispecialty AW base fee schedule,533.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77772 mod TC,Not in chargemaster,77772,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77772 mod TC,BCBS multispecialty AW base fee schedule,1159.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77778 mod 26,Not in chargemaster,77778,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77778 mod 26,BCBS multispecialty AW base fee schedule,871.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77778 mod TC,Not in chargemaster,77778,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77778 mod TC,BCBS multispecialty AW base fee schedule,755.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77778,Not in chargemaster,77778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77778,BCBS multispecialty AW base fee schedule,1627.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77789,Not in chargemaster,77789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77789,BCBS multispecialty AW base fee schedule,240.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77789 mod 26,Not in chargemaster,77789,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77789 mod 26,BCBS multispecialty AW base fee schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77789 mod TC,Not in chargemaster,77789,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77789 mod TC,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77790,Not in chargemaster,77790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77790,BCBS multispecialty AW base fee schedule,28.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78012,Not in chargemaster,78012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78012,BCBS multispecialty AW base fee schedule,154.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78012 mod 26,Not in chargemaster,78012,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78012 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78012 mod TC,Not in chargemaster,78012,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78012 mod TC,BCBS multispecialty AW base fee schedule,136.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78013 mod 26,Not in chargemaster,78013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78013 mod 26,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78013 mod TC,Not in chargemaster,78013,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78013 mod TC,BCBS multispecialty AW base fee schedule,329.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78013,Not in chargemaster,78013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78013,BCBS multispecialty AW base fee schedule,363.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78014,Not in chargemaster,78014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78014,BCBS multispecialty AW base fee schedule,454.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78014 mod 26,Not in chargemaster,78014,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78014 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78014 mod TC,Not in chargemaster,78014,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78014 mod TC,BCBS multispecialty AW base fee schedule,408.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78015 mod 26,Not in chargemaster,78015,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78015 mod 26,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78015 mod TC,Not in chargemaster,78015,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78015 mod TC,BCBS multispecialty AW base fee schedule,363.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78015,Not in chargemaster,78015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78015,BCBS multispecialty AW base fee schedule,425.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78016,Not in chargemaster,78016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78016,BCBS multispecialty AW base fee schedule,535.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78016 mod 26,Not in chargemaster,78016,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78016 mod 26,BCBS multispecialty AW base fee schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78016 mod TC,Not in chargemaster,78016,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78016 mod TC,BCBS multispecialty AW base fee schedule,471.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78018 mod 26,Not in chargemaster,78018,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78018 mod 26,BCBS multispecialty AW base fee schedule,77.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78018 mod TC,Not in chargemaster,78018,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78018 mod TC,BCBS multispecialty AW base fee schedule,516.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78018,Not in chargemaster,78018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78018,BCBS multispecialty AW base fee schedule,593.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78020,Not in chargemaster,78020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78020,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78020 mod 26,Not in chargemaster,78020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78020 mod 26,BCBS multispecialty AW base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78020 mod TC,Not in chargemaster,78020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78020 mod TC,BCBS multispecialty AW base fee schedule,104.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78070 mod 26,Not in chargemaster,78070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78070 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78070 mod TC,Not in chargemaster,78070,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78070 mod TC,BCBS multispecialty AW base fee schedule,488.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78070,Not in chargemaster,78070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78070,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78071,Not in chargemaster,78071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78071,BCBS multispecialty AW base fee schedule,670.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78071 mod 26,Not in chargemaster,78071,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78071 mod 26,BCBS multispecialty AW base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78071 mod TC,Not in chargemaster,78071,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78071 mod TC,BCBS multispecialty AW base fee schedule,560.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78072 mod 26,Not in chargemaster,78072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78072 mod 26,BCBS multispecialty AW base fee schedule,144.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78072 mod TC,Not in chargemaster,78072,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78072 mod TC,BCBS multispecialty AW base fee schedule,700.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78072,Not in chargemaster,78072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78072,BCBS multispecialty AW base fee schedule,845.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78075,Not in chargemaster,78075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78075,BCBS multispecialty AW base fee schedule,849.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78075 mod 26,Not in chargemaster,78075,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78075 mod 26,BCBS multispecialty AW base fee schedule,69.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78075 mod TC,Not in chargemaster,78075,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78075 mod TC,BCBS multispecialty AW base fee schedule,779.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78102 mod 26,Not in chargemaster,78102,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78102 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78102 mod TC,Not in chargemaster,78102,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78102 mod TC,BCBS multispecialty AW base fee schedule,272.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78102,Not in chargemaster,78102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78102,BCBS multispecialty AW base fee schedule,322.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78103,Not in chargemaster,78103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78103,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78103 mod 26,Not in chargemaster,78103,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78103 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78103 mod TC,Not in chargemaster,78103,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78103 mod TC,BCBS multispecialty AW base fee schedule,345.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78104 mod 26,Not in chargemaster,78104,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78104 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78104 mod TC,Not in chargemaster,78104,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78104 mod TC,BCBS multispecialty AW base fee schedule,400.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78104,Not in chargemaster,78104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78104,BCBS multispecialty AW base fee schedule,473.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78110,Not in chargemaster,78110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78110,BCBS multispecialty AW base fee schedule,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78110 mod 26,Not in chargemaster,78110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78110 mod 26,BCBS multispecialty AW base fee schedule,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78110 mod TC,Not in chargemaster,78110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78110 mod TC,BCBS multispecialty AW base fee schedule,116.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78111 mod 26,Not in chargemaster,78111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78111 mod 26,BCBS multispecialty AW base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78111 mod TC,Not in chargemaster,78111,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78111 mod TC,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78111,Not in chargemaster,78111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78111,BCBS multispecialty AW base fee schedule,139.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78120,Not in chargemaster,78120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78120,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78120 mod 26,Not in chargemaster,78120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78120 mod 26,BCBS multispecialty AW base fee schedule,18.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78120 mod TC,Not in chargemaster,78120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78120 mod TC,BCBS multispecialty AW base fee schedule,116.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78121 mod 26,Not in chargemaster,78121,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78121 mod 26,BCBS multispecialty AW base fee schedule,25.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78121 mod TC,Not in chargemaster,78121,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78121 mod TC,BCBS multispecialty AW base fee schedule,121.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78121,Not in chargemaster,78121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78121,BCBS multispecialty AW base fee schedule,147.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78122,Not in chargemaster,78122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78122,BCBS multispecialty AW base fee schedule,182.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78122 mod 26,Not in chargemaster,78122,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78122 mod 26,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78122 mod TC,Not in chargemaster,78122,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78122 mod TC,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78130 mod 26,Not in chargemaster,78130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78130 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78130 mod TC,Not in chargemaster,78130,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78130 mod TC,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78130,Not in chargemaster,78130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78130,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78135,Not in chargemaster,78135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78135,BCBS multispecialty AW base fee schedule,530,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78135 mod 26,Not in chargemaster,78135,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78135 mod 26,BCBS multispecialty AW base fee schedule,50.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78135 mod TC,Not in chargemaster,78135,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78135 mod TC,BCBS multispecialty AW base fee schedule,479.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78140 mod 26,Not in chargemaster,78140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78140 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78140 mod TC,Not in chargemaster,78140,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78140 mod TC,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78140,Not in chargemaster,78140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78140,BCBS multispecialty AW base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78185,Not in chargemaster,78185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78185,BCBS multispecialty AW base fee schedule,323.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78185 mod 26,Not in chargemaster,78185,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78185 mod 26,BCBS multispecialty AW base fee schedule,31.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78185 mod TC,Not in chargemaster,78185,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78185 mod TC,BCBS multispecialty AW base fee schedule,291.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78191 mod 26,Not in chargemaster,78191,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78191 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78191 mod TC,Not in chargemaster,78191,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78191 mod TC,BCBS multispecialty AW base fee schedule,189.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78191,Not in chargemaster,78191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78191,BCBS multispecialty AW base fee schedule,237.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78195,Not in chargemaster,78195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78195,BCBS multispecialty AW base fee schedule,672.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78195 mod 26,Not in chargemaster,78195,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78195 mod 26,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78195 mod TC,Not in chargemaster,78195,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78195 mod TC,BCBS multispecialty AW base fee schedule,563.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78201 mod 26,Not in chargemaster,78201,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78201 mod 26,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78201 mod TC,Not in chargemaster,78201,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78201 mod TC,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78201,Not in chargemaster,78201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78201,BCBS multispecialty AW base fee schedule,361.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78202,Not in chargemaster,78202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78202,BCBS multispecialty AW base fee schedule,389.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78202 mod 26,Not in chargemaster,78202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78202 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78202 mod TC,Not in chargemaster,78202,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78202 mod TC,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78215 mod 26,Not in chargemaster,78215,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78215 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78215 mod TC,Not in chargemaster,78215,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78215 mod TC,BCBS multispecialty AW base fee schedule,325.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78215,Not in chargemaster,78215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78215,BCBS multispecialty AW base fee schedule,370.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78216,Not in chargemaster,78216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78216,BCBS multispecialty AW base fee schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78216 mod 26,Not in chargemaster,78216,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78216 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78216 mod TC,Not in chargemaster,78216,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78216 mod TC,BCBS multispecialty AW base fee schedule,193.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78226 mod 26,Not in chargemaster,78226,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78226 mod 26,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78226 mod TC,Not in chargemaster,78226,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78226 mod TC,BCBS multispecialty AW base fee schedule,553.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78226,Not in chargemaster,78226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78226,BCBS multispecialty AW base fee schedule,621.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78227,Not in chargemaster,78227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78227,BCBS multispecialty AW base fee schedule,839.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78227 mod 26,Not in chargemaster,78227,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78227 mod 26,BCBS multispecialty AW base fee schedule,84.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78227 mod TC,Not in chargemaster,78227,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78227 mod TC,BCBS multispecialty AW base fee schedule,755.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78230 mod 26,Not in chargemaster,78230,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78230 mod 26,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78230 mod TC,Not in chargemaster,78230,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78230 mod TC,BCBS multispecialty AW base fee schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78230,Not in chargemaster,78230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78230,BCBS multispecialty AW base fee schedule,330.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78231,Not in chargemaster,78231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78231,BCBS multispecialty AW base fee schedule,200.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78231 mod 26,Not in chargemaster,78231,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78231 mod 26,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78231 mod TC,Not in chargemaster,78231,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78231 mod TC,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78232 mod 26,Not in chargemaster,78232,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78232 mod 26,BCBS multispecialty AW base fee schedule,37.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78232 mod TC,Not in chargemaster,78232,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78232 mod TC,BCBS multispecialty AW base fee schedule,159,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78232,Not in chargemaster,78232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78232,BCBS multispecialty AW base fee schedule,196.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78258,Not in chargemaster,78258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78258,BCBS multispecialty AW base fee schedule,410.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78258 mod 26,Not in chargemaster,78258,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78258 mod 26,BCBS multispecialty AW base fee schedule,65.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78258 mod TC,Not in chargemaster,78258,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78258 mod TC,BCBS multispecialty AW base fee schedule,344.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78261 mod 26,Not in chargemaster,78261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78261 mod 26,BCBS multispecialty AW base fee schedule,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78261 mod TC,Not in chargemaster,78261,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78261 mod TC,BCBS multispecialty AW base fee schedule,332.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78261,Not in chargemaster,78261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78261,BCBS multispecialty AW base fee schedule,386.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78262,Not in chargemaster,78262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78262,BCBS multispecialty AW base fee schedule,454.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78262 mod 26,Not in chargemaster,78262,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78262 mod 26,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78262 mod TC,Not in chargemaster,78262,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78262 mod TC,BCBS multispecialty AW base fee schedule,391.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78264 mod 26,Not in chargemaster,78264,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78264 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78264 mod TC,Not in chargemaster,78264,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78264 mod TC,BCBS multispecialty AW base fee schedule,557.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78264,Not in chargemaster,78264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78264,BCBS multispecialty AW base fee schedule,630.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78265,Not in chargemaster,78265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78265,BCBS multispecialty AW base fee schedule,745.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78265 mod 26,Not in chargemaster,78265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78265 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78265 mod TC,Not in chargemaster,78265,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78265 mod TC,BCBS multispecialty AW base fee schedule,655.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78266 mod 26,Not in chargemaster,78266,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78266 mod 26,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78266 mod TC,Not in chargemaster,78266,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78266 mod TC,BCBS multispecialty AW base fee schedule,722.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78266,Not in chargemaster,78266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78266,BCBS multispecialty AW base fee schedule,815.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78278,Not in chargemaster,78278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78278,BCBS multispecialty AW base fee schedule,660.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78278 mod 26,Not in chargemaster,78278,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78278 mod 26,BCBS multispecialty AW base fee schedule,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78278 mod TC,Not in chargemaster,78278,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78278 mod TC,BCBS multispecialty AW base fee schedule,568.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78282,Not in chargemaster,78282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78282,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78282 mod 26,Not in chargemaster,78282,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78282 mod 26,BCBS multispecialty AW base fee schedule,30.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78290,Not in chargemaster,78290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78290,BCBS multispecialty AW base fee schedule,625.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78290 mod 26,Not in chargemaster,78290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78290 mod 26,BCBS multispecialty AW base fee schedule,62.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78290 mod TC,Not in chargemaster,78290,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78290 mod TC,BCBS multispecialty AW base fee schedule,563.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78291 mod 26,Not in chargemaster,78291,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78291 mod 26,BCBS multispecialty AW base fee schedule,80.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78291 mod TC,Not in chargemaster,78291,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78291 mod TC,BCBS multispecialty AW base fee schedule,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78291,Not in chargemaster,78291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78291,BCBS multispecialty AW base fee schedule,483.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78300,Not in chargemaster,78300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78300,BCBS multispecialty AW base fee schedule,434.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78300 mod 26,78300,78300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78300 mod 26,BCBS multispecialty AW base fee schedule,58.3,79.71,Fee schedule,,58.3,58.3,58.3,58.3,,,0
unity,Fee schedule,Non-facility 78300 mod TC,Not in chargemaster,78300,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78300 mod TC,BCBS multispecialty AW base fee schedule,376.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78305 mod 26,78305,78305,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78305 mod 26,BCBS multispecialty AW base fee schedule,77.51,104.8,Fee schedule,,77.51,77.51,77.51,77.51,,,0
unity,Fee schedule,Non-facility 78305 mod TC,Not in chargemaster,78305,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78305 mod TC,BCBS multispecialty AW base fee schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78305,Not in chargemaster,78305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78305,BCBS multispecialty AW base fee schedule,526.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78306,Not in chargemaster,78306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78306,BCBS multispecialty AW base fee schedule,571.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78306 mod 26,78306,78306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78306 mod 26,BCBS multispecialty AW base fee schedule,80.16,108.37,Fee schedule,,80.16,80.16,80.16,80.16,,,0
unity,Fee schedule,Non-facility 78306 mod TC,Not in chargemaster,78306,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78306 mod TC,BCBS multispecialty AW base fee schedule,490.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78315 mod 26,Not in chargemaster,78315,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78315 mod 26,BCBS multispecialty AW base fee schedule,94.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78315 mod TC,Not in chargemaster,78315,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78315 mod TC,BCBS multispecialty AW base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78315,Not in chargemaster,78315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78315,BCBS multispecialty AW base fee schedule,656.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78350,Not in chargemaster,78350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78350,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78350 mod 26,Not in chargemaster,78350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78350 mod 26,BCBS multispecialty AW base fee schedule,20.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78350 mod TC,Not in chargemaster,78350,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78350 mod TC,BCBS multispecialty AW base fee schedule,39.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78351,Not in chargemaster,78351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78351,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78414,Not in chargemaster,78414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78414,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78414 mod 26,Not in chargemaster,78414,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78414 mod 26,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78428 mod 26,Not in chargemaster,78428,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78428 mod 26,BCBS multispecialty AW base fee schedule,70.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78428 mod TC,Not in chargemaster,78428,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78428 mod TC,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78428,Not in chargemaster,78428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78428,BCBS multispecialty AW base fee schedule,351.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78429,Not in chargemaster,78429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78429,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78429 mod 26,Not in chargemaster,78429,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78429 mod 26,BCBS multispecialty AW base fee schedule,157.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78430,Not in chargemaster,78430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78430,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78430 mod 26,Not in chargemaster,78430,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78430 mod 26,BCBS multispecialty AW base fee schedule,149.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78431,Not in chargemaster,78431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78431,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78431 mod 26,Not in chargemaster,78431,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78431 mod 26,BCBS multispecialty AW base fee schedule,173.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78432,Not in chargemaster,78432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78432,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78432 mod 26,Not in chargemaster,78432,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78432 mod 26,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78433,Not in chargemaster,78433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78433,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78433 mod 26,Not in chargemaster,78433,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78433 mod 26,BCBS multispecialty AW base fee schedule,202.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78434,Not in chargemaster,78434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78434,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78434 mod 26,Not in chargemaster,78434,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78434 mod 26,BCBS multispecialty AW base fee schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78445 mod 26,Not in chargemaster,78445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78445 mod 26,BCBS multispecialty AW base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78445 mod TC,Not in chargemaster,78445,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78445 mod TC,BCBS multispecialty AW base fee schedule,323.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78445,Not in chargemaster,78445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78445,BCBS multispecialty AW base fee schedule,371,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78451,Not in chargemaster,78451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78451,BCBS multispecialty AW base fee schedule,637.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78451 mod 26,Not in chargemaster,78451,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78451 mod 26,BCBS multispecialty AW base fee schedule,125.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78451 mod TC,Not in chargemaster,78451,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78451 mod TC,BCBS multispecialty AW base fee schedule,512.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78452 mod 26,Not in chargemaster,78452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78452 mod 26,BCBS multispecialty AW base fee schedule,148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78452 mod TC,Not in chargemaster,78452,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78452 mod TC,BCBS multispecialty AW base fee schedule,741.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78452,Not in chargemaster,78452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78452,BCBS multispecialty AW base fee schedule,889.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78453,Not in chargemaster,78453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78453,BCBS multispecialty AW base fee schedule,573.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78453 mod 26,Not in chargemaster,78453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78453 mod 26,BCBS multispecialty AW base fee schedule,93.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78453 mod TC,Not in chargemaster,78453,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78453 mod TC,BCBS multispecialty AW base fee schedule,480.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78454 mod 26,Not in chargemaster,78454,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78454 mod 26,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78454 mod TC,Not in chargemaster,78454,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78454 mod TC,BCBS multispecialty AW base fee schedule,697.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78454,Not in chargemaster,78454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78454,BCBS multispecialty AW base fee schedule,822.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78456,Not in chargemaster,78456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78456,BCBS multispecialty AW base fee schedule,584.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78456 mod 26,Not in chargemaster,78456,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78456 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78456 mod TC,Not in chargemaster,78456,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78456 mod TC,BCBS multispecialty AW base fee schedule,493.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78457 mod 26,Not in chargemaster,78457,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78457 mod 26,BCBS multispecialty AW base fee schedule,70.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78457 mod TC,Not in chargemaster,78457,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78457 mod TC,BCBS multispecialty AW base fee schedule,262.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78457,Not in chargemaster,78457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78457,BCBS multispecialty AW base fee schedule,332.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78458,Not in chargemaster,78458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78458,BCBS multispecialty AW base fee schedule,389.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78458 mod 26,Not in chargemaster,78458,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78458 mod 26,BCBS multispecialty AW base fee schedule,85.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78458 mod TC,Not in chargemaster,78458,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78458 mod TC,BCBS multispecialty AW base fee schedule,304.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78459,Not in chargemaster,78459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78459,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78459 mod 26,Not in chargemaster,78459,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78459 mod 26,BCBS multispecialty AW base fee schedule,142.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78466 mod 26,Not in chargemaster,78466,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78466 mod 26,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78466 mod TC,Not in chargemaster,78466,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78466 mod TC,BCBS multispecialty AW base fee schedule,312.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78466,Not in chargemaster,78466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78466,BCBS multispecialty AW base fee schedule,378.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78468,Not in chargemaster,78468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78468,BCBS multispecialty AW base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78468 mod 26,Not in chargemaster,78468,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78468 mod 26,BCBS multispecialty AW base fee schedule,72.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78468 mod TC,Not in chargemaster,78468,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78468 mod TC,BCBS multispecialty AW base fee schedule,292.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78469 mod 26,Not in chargemaster,78469,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78469 mod 26,BCBS multispecialty AW base fee schedule,84.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78469 mod TC,Not in chargemaster,78469,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78469 mod TC,BCBS multispecialty AW base fee schedule,338.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78469,Not in chargemaster,78469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78469,BCBS multispecialty AW base fee schedule,423.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78472,Not in chargemaster,78472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78472,BCBS multispecialty AW base fee schedule,431.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78472 mod 26,Not in chargemaster,78472,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78472 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78472 mod TC,Not in chargemaster,78472,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78472 mod TC,BCBS multispecialty AW base fee schedule,340.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78473 mod 26,Not in chargemaster,78473,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78473 mod 26,BCBS multispecialty AW base fee schedule,133.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78473 mod TC,Not in chargemaster,78473,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78473 mod TC,BCBS multispecialty AW base fee schedule,414.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78473,Not in chargemaster,78473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78473,BCBS multispecialty AW base fee schedule,547.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78481,Not in chargemaster,78481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78481,BCBS multispecialty AW base fee schedule,333.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78481 mod 26,Not in chargemaster,78481,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78481 mod 26,BCBS multispecialty AW base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78481 mod TC,Not in chargemaster,78481,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78481 mod TC,BCBS multispecialty AW base fee schedule,242.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78483 mod 26,Not in chargemaster,78483,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78483 mod 26,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78483 mod TC,Not in chargemaster,78483,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78483 mod TC,BCBS multispecialty AW base fee schedule,321.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78483,Not in chargemaster,78483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78483,BCBS multispecialty AW base fee schedule,456.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78491,Not in chargemaster,78491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78491,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78491 mod 26,Not in chargemaster,78491,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78491 mod 26,BCBS multispecialty AW base fee schedule,138.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78492,Not in chargemaster,78492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78492,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78492 mod 26,Not in chargemaster,78492,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78492 mod 26,BCBS multispecialty AW base fee schedule,162.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78494,Not in chargemaster,78494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78494,BCBS multispecialty AW base fee schedule,428.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78494 mod 26,Not in chargemaster,78494,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78494 mod 26,BCBS multispecialty AW base fee schedule,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78494 mod TC,Not in chargemaster,78494,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78494 mod TC,BCBS multispecialty AW base fee schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78496 mod 26,Not in chargemaster,78496,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78496 mod 26,BCBS multispecialty AW base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78496 mod TC,Not in chargemaster,78496,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78496 mod TC,BCBS multispecialty AW base fee schedule,35.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78496,Not in chargemaster,78496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78496,BCBS multispecialty AW base fee schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78579,Not in chargemaster,78579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78579,BCBS multispecialty AW base fee schedule,355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78579 mod 26,Not in chargemaster,78579,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78579 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78579 mod TC,Not in chargemaster,78579,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78579 mod TC,BCBS multispecialty AW base fee schedule,310.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78580 mod 26,78580,78580,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78580 mod 26,BCBS multispecialty AW base fee schedule,68.24,93.14,Fee schedule,,68.24,68.24,68.24,68.24,,,0
unity,Fee schedule,Non-facility 78580 mod TC,Not in chargemaster,78580,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78580 mod TC,BCBS multispecialty AW base fee schedule,380.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78580,Not in chargemaster,78580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78580,BCBS multispecialty AW base fee schedule,448.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78582,Not in chargemaster,78582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78582,BCBS multispecialty AW base fee schedule,632.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78582 mod 26,Not in chargemaster,78582,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78582 mod 26,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78582 mod TC,Not in chargemaster,78582,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78582 mod TC,BCBS multispecialty AW base fee schedule,533.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78597 mod 26,Not in chargemaster,78597,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78597 mod 26,BCBS multispecialty AW base fee schedule,66.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78597 mod TC,Not in chargemaster,78597,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78597 mod TC,BCBS multispecialty AW base fee schedule,314.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78597,Not in chargemaster,78597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78597,BCBS multispecialty AW base fee schedule,380.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78598,Not in chargemaster,78598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78598,BCBS multispecialty AW base fee schedule,576.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78598 mod 26,Not in chargemaster,78598,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78598 mod 26,BCBS multispecialty AW base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78598 mod TC,Not in chargemaster,78598,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78598 mod TC,BCBS multispecialty AW base fee schedule,499.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78600 mod 26,Not in chargemaster,78600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78600 mod 26,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78600 mod TC,Not in chargemaster,78600,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78600 mod TC,BCBS multispecialty AW base fee schedule,307.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78600,Not in chargemaster,78600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78600,BCBS multispecialty AW base fee schedule,348.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78601,Not in chargemaster,78601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78601,BCBS multispecialty AW base fee schedule,410.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78601 mod 26,Not in chargemaster,78601,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78601 mod 26,BCBS multispecialty AW base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78601 mod TC,Not in chargemaster,78601,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78601 mod TC,BCBS multispecialty AW base fee schedule,363.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78605 mod 26,Not in chargemaster,78605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78605 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78605 mod TC,Not in chargemaster,78605,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78605 mod TC,BCBS multispecialty AW base fee schedule,328.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78605,Not in chargemaster,78605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78605,BCBS multispecialty AW base fee schedule,378.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78606,Not in chargemaster,78606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78606,BCBS multispecialty AW base fee schedule,626.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78606 mod 26,Not in chargemaster,78606,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78606 mod 26,BCBS multispecialty AW base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78606 mod TC,Not in chargemaster,78606,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78606 mod TC,BCBS multispecialty AW base fee schedule,567.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78608,Not in chargemaster,78608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78608,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78608 mod 26,Not in chargemaster,78608,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78608 mod 26,BCBS multispecialty AW base fee schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78609,Not in chargemaster,78609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78609,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78609 mod 26,Not in chargemaster,78609,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78609 mod 26,BCBS multispecialty AW base fee schedule,143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78610 mod 26,Not in chargemaster,78610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78610 mod 26,BCBS multispecialty AW base fee schedule,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78610 mod TC,Not in chargemaster,78610,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78610 mod TC,BCBS multispecialty AW base fee schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78610,Not in chargemaster,78610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78610,BCBS multispecialty AW base fee schedule,329.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78630,Not in chargemaster,78630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78630,BCBS multispecialty AW base fee schedule,639.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78630 mod 26,Not in chargemaster,78630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78630 mod 26,BCBS multispecialty AW base fee schedule,62.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78630 mod TC,Not in chargemaster,78630,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78630 mod TC,BCBS multispecialty AW base fee schedule,577.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78635 mod 26,Not in chargemaster,78635,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78635 mod 26,BCBS multispecialty AW base fee schedule,57.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78635 mod TC,Not in chargemaster,78635,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78635 mod TC,BCBS multispecialty AW base fee schedule,582.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78635,Not in chargemaster,78635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78635,BCBS multispecialty AW base fee schedule,639.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78645,Not in chargemaster,78645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78645,BCBS multispecialty AW base fee schedule,614.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78645 mod 26,Not in chargemaster,78645,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78645 mod 26,BCBS multispecialty AW base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78645 mod TC,Not in chargemaster,78645,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78645 mod TC,BCBS multispecialty AW base fee schedule,563.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78650 mod 26,Not in chargemaster,78650,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78650 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78650 mod TC,Not in chargemaster,78650,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78650 mod TC,BCBS multispecialty AW base fee schedule,474.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78650,Not in chargemaster,78650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78650,BCBS multispecialty AW base fee schedule,522.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78660,Not in chargemaster,78660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78660,BCBS multispecialty AW base fee schedule,349.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78660 mod 26,Not in chargemaster,78660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78660 mod 26,BCBS multispecialty AW base fee schedule,49.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78660 mod TC,Not in chargemaster,78660,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78660 mod TC,BCBS multispecialty AW base fee schedule,299.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78700 mod 26,Not in chargemaster,78700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78700 mod 26,BCBS multispecialty AW base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78700 mod TC,Not in chargemaster,78700,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78700 mod TC,BCBS multispecialty AW base fee schedule,282.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78700,Not in chargemaster,78700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78700,BCBS multispecialty AW base fee schedule,323.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78701,Not in chargemaster,78701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78701,BCBS multispecialty AW base fee schedule,414.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78701 mod 26,Not in chargemaster,78701,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78701 mod 26,BCBS multispecialty AW base fee schedule,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78701 mod TC,Not in chargemaster,78701,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78701 mod TC,BCBS multispecialty AW base fee schedule,369.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78707 mod 26,Not in chargemaster,78707,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78707 mod 26,BCBS multispecialty AW base fee schedule,88.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78707 mod TC,Not in chargemaster,78707,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78707 mod TC,BCBS multispecialty AW base fee schedule,353.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78707,Not in chargemaster,78707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78707,BCBS multispecialty AW base fee schedule,441.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78708,Not in chargemaster,78708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78708,BCBS multispecialty AW base fee schedule,335.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78708 mod 26,Not in chargemaster,78708,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78708 mod 26,BCBS multispecialty AW base fee schedule,110.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78708 mod TC,Not in chargemaster,78708,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78708 mod TC,BCBS multispecialty AW base fee schedule,224.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78709 mod 26,Not in chargemaster,78709,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78709 mod 26,BCBS multispecialty AW base fee schedule,127.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78709 mod TC,Not in chargemaster,78709,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78709 mod TC,BCBS multispecialty AW base fee schedule,567.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78709,Not in chargemaster,78709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78709,BCBS multispecialty AW base fee schedule,695.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78725,Not in chargemaster,78725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78725,BCBS multispecialty AW base fee schedule,205.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78725 mod 26,Not in chargemaster,78725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78725 mod 26,BCBS multispecialty AW base fee schedule,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78725 mod TC,Not in chargemaster,78725,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78725 mod TC,BCBS multispecialty AW base fee schedule,171.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78730 mod 26,Not in chargemaster,78730,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78730 mod 26,BCBS multispecialty AW base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78730 mod TC,Not in chargemaster,78730,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78730 mod TC,BCBS multispecialty AW base fee schedule,129.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78730,Not in chargemaster,78730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78730,BCBS multispecialty AW base fee schedule,143.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78740,Not in chargemaster,78740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78740,BCBS multispecialty AW base fee schedule,411.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78740 mod 26,Not in chargemaster,78740,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78740 mod 26,BCBS multispecialty AW base fee schedule,51.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78740 mod TC,Not in chargemaster,78740,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78740 mod TC,BCBS multispecialty AW base fee schedule,360.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78761 mod 26,Not in chargemaster,78761,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78761 mod 26,BCBS multispecialty AW base fee schedule,66.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78761 mod TC,Not in chargemaster,78761,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78761 mod TC,BCBS multispecialty AW base fee schedule,334.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78761,Not in chargemaster,78761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78761,BCBS multispecialty AW base fee schedule,401.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78800,Not in chargemaster,78800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78800,BCBS multispecialty AW base fee schedule,490.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78800 mod 26,Not in chargemaster,78800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78800 mod 26,BCBS multispecialty AW base fee schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78800 mod TC,Not in chargemaster,78800,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78800 mod TC,BCBS multispecialty AW base fee schedule,429.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78801 mod 26,Not in chargemaster,78801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78801 mod 26,BCBS multispecialty AW base fee schedule,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78801 mod TC,Not in chargemaster,78801,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78801 mod TC,BCBS multispecialty AW base fee schedule,470.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78801,Not in chargemaster,78801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78801,BCBS multispecialty AW base fee schedule,538.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78802,Not in chargemaster,78802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78802,BCBS multispecialty AW base fee schedule,591.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78802 mod 26,Not in chargemaster,78802,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78802 mod 26,BCBS multispecialty AW base fee schedule,72.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78802 mod TC,Not in chargemaster,78802,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78802 mod TC,BCBS multispecialty AW base fee schedule,519.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78803 mod 26,Not in chargemaster,78803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78803 mod 26,BCBS multispecialty AW base fee schedule,98.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78803 mod TC,Not in chargemaster,78803,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78803 mod TC,BCBS multispecialty AW base fee schedule,637.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78803,Not in chargemaster,78803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78803,BCBS multispecialty AW base fee schedule,736.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78804,Not in chargemaster,78804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78804,BCBS multispecialty AW base fee schedule,1250.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78804 mod 26,Not in chargemaster,78804,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78804 mod 26,BCBS multispecialty AW base fee schedule,92.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78804 mod TC,Not in chargemaster,78804,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78804 mod TC,BCBS multispecialty AW base fee schedule,1157.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78808,Not in chargemaster,78808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78808,BCBS multispecialty AW base fee schedule,75.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78811,Not in chargemaster,78811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78811,BCBS multispecialty AW base fee schedule,141.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78811 mod 26,Not in chargemaster,78811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78811 mod 26,BCBS multispecialty AW base fee schedule,141.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78812,Not in chargemaster,78812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78812,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78812 mod 26,Not in chargemaster,78812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78812 mod 26,BCBS multispecialty AW base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78813,Not in chargemaster,78813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78813,BCBS multispecialty AW base fee schedule,174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78813 mod 26,Not in chargemaster,78813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78813 mod 26,BCBS multispecialty AW base fee schedule,174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78814,Not in chargemaster,78814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78814,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78814 mod 26,Not in chargemaster,78814,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78814 mod 26,BCBS multispecialty AW base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78815,Not in chargemaster,78815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78815,BCBS multispecialty AW base fee schedule,5237.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78815 mod 26,Not in chargemaster,78815,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78815 mod 26,BCBS multispecialty AW base fee schedule,223.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78815 mod TC,Not in chargemaster,78815,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78815 mod TC,BCBS multispecialty AW base fee schedule,5014.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78816 mod 26,Not in chargemaster,78816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78816 mod 26,BCBS multispecialty AW base fee schedule,225.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78816 mod TC,Not in chargemaster,78816,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78816 mod TC,BCBS multispecialty AW base fee schedule,4985.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78816,Not in chargemaster,78816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78816,BCBS multispecialty AW base fee schedule,5210.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78830,Not in chargemaster,78830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78830,BCBS multispecialty AW base fee schedule,932.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78830 mod 26,Not in chargemaster,78830,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78830 mod 26,BCBS multispecialty AW base fee schedule,135.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78830 mod TC,Not in chargemaster,78830,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78830 mod TC,BCBS multispecialty AW base fee schedule,796.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78831 mod 26,Not in chargemaster,78831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78831 mod 26,BCBS multispecialty AW base fee schedule,164.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78831 mod TC,Not in chargemaster,78831,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78831 mod TC,BCBS multispecialty AW base fee schedule,1183.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78831,Not in chargemaster,78831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78831,BCBS multispecialty AW base fee schedule,1348.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78832,Not in chargemaster,78832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78832,BCBS multispecialty AW base fee schedule,1754.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78832 mod 26,Not in chargemaster,78832,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78832 mod 26,BCBS multispecialty AW base fee schedule,192.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78832 mod TC,Not in chargemaster,78832,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78832 mod TC,BCBS multispecialty AW base fee schedule,1562.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78835 mod 26,Not in chargemaster,78835,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78835 mod 26,BCBS multispecialty AW base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78835 mod TC,Not in chargemaster,78835,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78835 mod TC,BCBS multispecialty AW base fee schedule,153.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78835,Not in chargemaster,78835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78835,BCBS multispecialty AW base fee schedule,195.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79005,Not in chargemaster,79005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79005,BCBS multispecialty AW base fee schedule,259.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79005 mod 26,Not in chargemaster,79005,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79005 mod 26,BCBS multispecialty AW base fee schedule,165.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79005 mod TC,Not in chargemaster,79005,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79005 mod TC,BCBS multispecialty AW base fee schedule,94.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79101 mod 26,Not in chargemaster,79101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79101 mod 26,BCBS multispecialty AW base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79101 mod TC,Not in chargemaster,79101,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79101 mod TC,BCBS multispecialty AW base fee schedule,95.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79101,Not in chargemaster,79101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79101,BCBS multispecialty AW base fee schedule,280.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79200,Not in chargemaster,79200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79200,BCBS multispecialty AW base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79200 mod 26,Not in chargemaster,79200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79200 mod 26,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79200 mod TC,Not in chargemaster,79200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79200 mod TC,BCBS multispecialty AW base fee schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79300,Not in chargemaster,79300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79300,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79300 mod 26,Not in chargemaster,79300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79300 mod 26,BCBS multispecialty AW base fee schedule,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79403,Not in chargemaster,79403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79403,BCBS multispecialty AW base fee schedule,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79403 mod 26,Not in chargemaster,79403,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79403 mod 26,BCBS multispecialty AW base fee schedule,204.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79403 mod TC,Not in chargemaster,79403,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79403 mod TC,BCBS multispecialty AW base fee schedule,152.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79440 mod 26,Not in chargemaster,79440,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79440 mod 26,BCBS multispecialty AW base fee schedule,156.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79440 mod TC,Not in chargemaster,79440,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79440 mod TC,BCBS multispecialty AW base fee schedule,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79440,Not in chargemaster,79440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79440,BCBS multispecialty AW base fee schedule,230.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79445,Not in chargemaster,79445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79445,BCBS multispecialty AW base fee schedule,214.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79445 mod 26,Not in chargemaster,79445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,79445 mod 26,BCBS multispecialty AW base fee schedule,214.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 80500,Not in chargemaster,80500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80500,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 80502,Not in chargemaster,80502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80502,BCBS multispecialty AW base fee schedule,116.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 83020,Not in chargemaster,83020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83020,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 83020 mod 26,Not in chargemaster,83020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83020 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 84165,Not in chargemaster,84165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84165,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 84165 mod 26,Not in chargemaster,84165,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84165 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 84166,Not in chargemaster,84166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84166,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 84166 mod 26,Not in chargemaster,84166,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84166 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 84181,Not in chargemaster,84181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84181,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 84181 mod 26,Not in chargemaster,84181,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84181 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 84182,Not in chargemaster,84182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84182,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 84182 mod 26,Not in chargemaster,84182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84182 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85060,Not in chargemaster,85060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85060,BCBS multispecialty AW base fee schedule,38.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85097,Not in chargemaster,85097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85097,BCBS multispecialty AW base fee schedule,108.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85390,Not in chargemaster,85390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85390,BCBS multispecialty AW base fee schedule,58.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85390 mod 26,Not in chargemaster,85390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85390 mod 26,BCBS multispecialty AW base fee schedule,58.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85396,Not in chargemaster,85396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85396,BCBS multispecialty AW base fee schedule,31.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85576,Not in chargemaster,85576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85576,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85576 mod 26,Not in chargemaster,85576,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85576 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86077,Not in chargemaster,86077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86077,BCBS multispecialty AW base fee schedule,85.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86078,Not in chargemaster,86078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86078,BCBS multispecialty AW base fee schedule,85.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86079,Not in chargemaster,86079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86079,BCBS multispecialty AW base fee schedule,85.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86153,Not in chargemaster,86153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86153,BCBS multispecialty AW base fee schedule,54.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86153 mod 26,Not in chargemaster,86153,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86153 mod 26,BCBS multispecialty AW base fee schedule,54.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86255,Not in chargemaster,86255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86255,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86255 mod 26,Not in chargemaster,86255,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86255 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86256,Not in chargemaster,86256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86256,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86256 mod 26,Not in chargemaster,86256,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86256 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86320,Not in chargemaster,86320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86320,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86320 mod 26,Not in chargemaster,86320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86320 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86325,Not in chargemaster,86325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86325,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86325 mod 26,Not in chargemaster,86325,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86325 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86327,Not in chargemaster,86327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86327,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86327 mod 26,Not in chargemaster,86327,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86327 mod 26,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86334,Not in chargemaster,86334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86334,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86334 mod 26,Not in chargemaster,86334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86334 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86335,Not in chargemaster,86335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86335,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86335 mod 26,Not in chargemaster,86335,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86335 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86486,Not in chargemaster,86486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86486,BCBS multispecialty AW base fee schedule,8.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86490,Not in chargemaster,86490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86490,BCBS multispecialty AW base fee schedule,136.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86510,Not in chargemaster,86510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86510,BCBS multispecialty AW base fee schedule,10.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86580,Not in chargemaster,86580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86580,BCBS multispecialty AW base fee schedule,14.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 87164,Not in chargemaster,87164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87164,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 87164 mod 26,Not in chargemaster,87164,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87164 mod 26,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 87207,Not in chargemaster,87207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87207,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 87207 mod 26,Not in chargemaster,87207,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87207 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88104 mod 26,Not in chargemaster,88104,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88104 mod 26,BCBS multispecialty AW base fee schedule,44.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88104 mod TC,Not in chargemaster,88104,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88104 mod TC,BCBS multispecialty AW base fee schedule,61.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88104,Not in chargemaster,88104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88104,BCBS multispecialty AW base fee schedule,106.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88106,Not in chargemaster,88106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88106,BCBS multispecialty AW base fee schedule,100.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88106 mod 26,Not in chargemaster,88106,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88106 mod 26,BCBS multispecialty AW base fee schedule,30.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88106 mod TC,Not in chargemaster,88106,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88106 mod TC,BCBS multispecialty AW base fee schedule,69.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88108 mod 26,Not in chargemaster,88108,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88108 mod 26,BCBS multispecialty AW base fee schedule,35.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88108 mod TC,Not in chargemaster,88108,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88108 mod TC,BCBS multispecialty AW base fee schedule,60.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88108,Not in chargemaster,88108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88108,BCBS multispecialty AW base fee schedule,96.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88112,Not in chargemaster,88112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88112,BCBS multispecialty AW base fee schedule,104.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88112 mod 26,Not in chargemaster,88112,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88112 mod 26,BCBS multispecialty AW base fee schedule,44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88112 mod TC,Not in chargemaster,88112,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88112 mod TC,BCBS multispecialty AW base fee schedule,60.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88120 mod 26,Not in chargemaster,88120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88120 mod 26,BCBS multispecialty AW base fee schedule,91.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88120 mod TC,Not in chargemaster,88120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88120 mod TC,BCBS multispecialty AW base fee schedule,806.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88120,Not in chargemaster,88120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88120,BCBS multispecialty AW base fee schedule,898.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88121,Not in chargemaster,88121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88121,BCBS multispecialty AW base fee schedule,686.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88121 mod 26,Not in chargemaster,88121,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88121 mod 26,BCBS multispecialty AW base fee schedule,77.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88121 mod TC,Not in chargemaster,88121,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88121 mod TC,BCBS multispecialty AW base fee schedule,608.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88125 mod 26,Not in chargemaster,88125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88125 mod 26,BCBS multispecialty AW base fee schedule,22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88125 mod TC,Not in chargemaster,88125,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88125 mod TC,BCBS multispecialty AW base fee schedule,19.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88125,Not in chargemaster,88125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88125,BCBS multispecialty AW base fee schedule,41.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88141,Not in chargemaster,88141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88141,BCBS multispecialty AW base fee schedule,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88160 mod 26,Not in chargemaster,88160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88160 mod 26,BCBS multispecialty AW base fee schedule,41.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88160 mod TC,Not in chargemaster,88160,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88160 mod TC,BCBS multispecialty AW base fee schedule,69.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88160,Not in chargemaster,88160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88160,BCBS multispecialty AW base fee schedule,110.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88161,Not in chargemaster,88161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88161,BCBS multispecialty AW base fee schedule,106.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88161 mod 26,Not in chargemaster,88161,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88161 mod 26,BCBS multispecialty AW base fee schedule,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88161 mod TC,Not in chargemaster,88161,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88161 mod TC,BCBS multispecialty AW base fee schedule,66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88162 mod 26,Not in chargemaster,88162,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88162 mod 26,BCBS multispecialty AW base fee schedule,61.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88162 mod TC,Not in chargemaster,88162,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88162 mod TC,BCBS multispecialty AW base fee schedule,92.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88162,Not in chargemaster,88162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88162,BCBS multispecialty AW base fee schedule,154,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88172,Not in chargemaster,88172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88172,BCBS multispecialty AW base fee schedule,86.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88172 mod 26,Not in chargemaster,88172,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88172 mod 26,BCBS multispecialty AW base fee schedule,57.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88172 mod TC,Not in chargemaster,88172,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88172 mod TC,BCBS multispecialty AW base fee schedule,29.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88173 mod 26,Not in chargemaster,88173,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88173 mod 26,BCBS multispecialty AW base fee schedule,112.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88173 mod TC,Not in chargemaster,88173,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88173 mod TC,BCBS multispecialty AW base fee schedule,127.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88173,Not in chargemaster,88173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88173,BCBS multispecialty AW base fee schedule,239.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88177,Not in chargemaster,88177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88177,BCBS multispecialty AW base fee schedule,46.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88177 mod 26,Not in chargemaster,88177,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88177 mod 26,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88177 mod TC,Not in chargemaster,88177,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88177 mod TC,BCBS multispecialty AW base fee schedule,11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88182 mod 26,Not in chargemaster,88182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88182 mod 26,BCBS multispecialty AW base fee schedule,61.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88182 mod TC,Not in chargemaster,88182,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88182 mod TC,BCBS multispecialty AW base fee schedule,152.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88182,Not in chargemaster,88182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88182,BCBS multispecialty AW base fee schedule,213.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88184,Not in chargemaster,88184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88184,BCBS multispecialty AW base fee schedule,103.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88185,Not in chargemaster,88185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88185,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88187,Not in chargemaster,88187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88187,BCBS multispecialty AW base fee schedule,59.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88188,Not in chargemaster,88188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88188,BCBS multispecialty AW base fee schedule,100.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88189,Not in chargemaster,88189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88189,BCBS multispecialty AW base fee schedule,135.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88291,Not in chargemaster,88291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88291,BCBS multispecialty AW base fee schedule,52.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88300,Not in chargemaster,88300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88300,BCBS multispecialty AW base fee schedule,24.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88300 mod 26,Not in chargemaster,88300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88300 mod 26,BCBS multispecialty AW base fee schedule,7.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88300 mod TC,Not in chargemaster,88300,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88300 mod TC,BCBS multispecialty AW base fee schedule,17.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88302 mod 26,Not in chargemaster,88302,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88302 mod 26,BCBS multispecialty AW base fee schedule,11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88302 mod TC,Not in chargemaster,88302,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88302 mod TC,BCBS multispecialty AW base fee schedule,36.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88302,Not in chargemaster,88302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88302,BCBS multispecialty AW base fee schedule,47.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88304,Not in chargemaster,88304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88304,BCBS multispecialty AW base fee schedule,63.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88304 mod 26,Not in chargemaster,88304,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88304 mod 26,BCBS multispecialty AW base fee schedule,18.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88304 mod TC,Not in chargemaster,88304,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88304 mod TC,BCBS multispecialty AW base fee schedule,45.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88305 mod 26,Not in chargemaster,88305,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88305 mod 26,BCBS multispecialty AW base fee schedule,59.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88305 mod TC,Not in chargemaster,88305,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88305 mod TC,BCBS multispecialty AW base fee schedule,48.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88305,Not in chargemaster,88305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88305,BCBS multispecialty AW base fee schedule,108.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88307,Not in chargemaster,88307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88307,BCBS multispecialty AW base fee schedule,429,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88307 mod 26,Not in chargemaster,88307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88307 mod 26,BCBS multispecialty AW base fee schedule,132,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88307 mod TC,Not in chargemaster,88307,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88307 mod TC,BCBS multispecialty AW base fee schedule,297,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88309 mod 26,Not in chargemaster,88309,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88309 mod 26,BCBS multispecialty AW base fee schedule,232.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88309 mod TC,Not in chargemaster,88309,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88309 mod TC,BCBS multispecialty AW base fee schedule,419.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88309,Not in chargemaster,88309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88309,BCBS multispecialty AW base fee schedule,651.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88311,Not in chargemaster,88311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88311,BCBS multispecialty AW base fee schedule,33.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88311 mod 26,Not in chargemaster,88311,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88311 mod 26,BCBS multispecialty AW base fee schedule,19.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88311 mod TC,Not in chargemaster,88311,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88311 mod TC,BCBS multispecialty AW base fee schedule,13.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88312 mod 26,Not in chargemaster,88312,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88312 mod 26,BCBS multispecialty AW base fee schedule,42.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88312 mod TC,Not in chargemaster,88312,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88312 mod TC,BCBS multispecialty AW base fee schedule,121,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88312,Not in chargemaster,88312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88312,BCBS multispecialty AW base fee schedule,163.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88313,Not in chargemaster,88313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88313,BCBS multispecialty AW base fee schedule,117.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88313 mod 26,Not in chargemaster,88313,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88313 mod 26,BCBS multispecialty AW base fee schedule,19.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88313 mod TC,Not in chargemaster,88313,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88313 mod TC,BCBS multispecialty AW base fee schedule,98.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88314 mod 26,Not in chargemaster,88314,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88314 mod 26,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88314 mod TC,Not in chargemaster,88314,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88314 mod TC,BCBS multispecialty AW base fee schedule,114.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88314,Not in chargemaster,88314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88314,BCBS multispecialty AW base fee schedule,150.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88319,Not in chargemaster,88319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88319,BCBS multispecialty AW base fee schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88319 mod 26,Not in chargemaster,88319,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88319 mod 26,BCBS multispecialty AW base fee schedule,42.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88319 mod TC,Not in chargemaster,88319,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88319 mod TC,BCBS multispecialty AW base fee schedule,130.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88321,Not in chargemaster,88321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88321,BCBS multispecialty AW base fee schedule,156.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88323,Not in chargemaster,88323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88323,BCBS multispecialty AW base fee schedule,179.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88323 mod 26,Not in chargemaster,88323,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88323 mod 26,BCBS multispecialty AW base fee schedule,138.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88323 mod TC,Not in chargemaster,88323,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88323 mod TC,BCBS multispecialty AW base fee schedule,40.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88325,Not in chargemaster,88325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88325,BCBS multispecialty AW base fee schedule,272.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88329,Not in chargemaster,88329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88329,BCBS multispecialty AW base fee schedule,83.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88331 mod 26,Not in chargemaster,88331,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88331 mod 26,BCBS multispecialty AW base fee schedule,99.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88331 mod TC,Not in chargemaster,88331,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88331 mod TC,BCBS multispecialty AW base fee schedule,53.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88331,Not in chargemaster,88331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88331,BCBS multispecialty AW base fee schedule,152.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88332,Not in chargemaster,88332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88332,BCBS multispecialty AW base fee schedule,84.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88332 mod 26,Not in chargemaster,88332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88332 mod 26,BCBS multispecialty AW base fee schedule,49.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88332 mod TC,Not in chargemaster,88332,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88332 mod TC,BCBS multispecialty AW base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88333 mod 26,Not in chargemaster,88333,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88333 mod 26,BCBS multispecialty AW base fee schedule,99.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88333 mod TC,Not in chargemaster,88333,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88333 mod TC,BCBS multispecialty AW base fee schedule,40.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88333,Not in chargemaster,88333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88333,BCBS multispecialty AW base fee schedule,140.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88334,Not in chargemaster,88334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88334,BCBS multispecialty AW base fee schedule,88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88334 mod 26,Not in chargemaster,88334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88334 mod 26,BCBS multispecialty AW base fee schedule,60.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88334 mod TC,Not in chargemaster,88334,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88334 mod TC,BCBS multispecialty AW base fee schedule,27.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88341 mod 26,Not in chargemaster,88341,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88341 mod 26,BCBS multispecialty AW base fee schedule,45.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88341 mod TC,Not in chargemaster,88341,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88341 mod TC,BCBS multispecialty AW base fee schedule,98.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88341,Not in chargemaster,88341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88341,BCBS multispecialty AW base fee schedule,143.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88342,Not in chargemaster,88342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88342,BCBS multispecialty AW base fee schedule,163.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88342 mod 26,Not in chargemaster,88342,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88342 mod 26,BCBS multispecialty AW base fee schedule,56.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88342 mod TC,Not in chargemaster,88342,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88342 mod TC,BCBS multispecialty AW base fee schedule,107.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88344 mod 26,Not in chargemaster,88344,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88344 mod 26,BCBS multispecialty AW base fee schedule,61.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88344 mod TC,Not in chargemaster,88344,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88344 mod TC,BCBS multispecialty AW base fee schedule,206.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88344,Not in chargemaster,88344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88344,BCBS multispecialty AW base fee schedule,267.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88346,Not in chargemaster,88346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88346,BCBS multispecialty AW base fee schedule,195.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88346 mod 26,Not in chargemaster,88346,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88346 mod 26,BCBS multispecialty AW base fee schedule,57.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88346 mod TC,Not in chargemaster,88346,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88346 mod TC,BCBS multispecialty AW base fee schedule,138.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88348 mod 26,Not in chargemaster,88348,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88348 mod 26,BCBS multispecialty AW base fee schedule,121.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88348 mod TC,Not in chargemaster,88348,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88348 mod TC,BCBS multispecialty AW base fee schedule,479.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88348,Not in chargemaster,88348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88348,BCBS multispecialty AW base fee schedule,600.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88350,Not in chargemaster,88350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88350,BCBS multispecialty AW base fee schedule,143.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88350 mod 26,Not in chargemaster,88350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88350 mod 26,BCBS multispecialty AW base fee schedule,46.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88350 mod TC,Not in chargemaster,88350,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88350 mod TC,BCBS multispecialty AW base fee schedule,97.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88355 mod 26,Not in chargemaster,88355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88355 mod 26,BCBS multispecialty AW base fee schedule,130.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88355 mod TC,Not in chargemaster,88355,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88355 mod TC,BCBS multispecialty AW base fee schedule,82.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88355,Not in chargemaster,88355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88355,BCBS multispecialty AW base fee schedule,213.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88356,Not in chargemaster,88356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88356,BCBS multispecialty AW base fee schedule,366.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88356 mod 26,Not in chargemaster,88356,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88356 mod 26,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88356 mod TC,Not in chargemaster,88356,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88356 mod TC,BCBS multispecialty AW base fee schedule,162.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88358 mod 26,Not in chargemaster,88358,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88358 mod 26,BCBS multispecialty AW base fee schedule,79.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88358 mod TC,Not in chargemaster,88358,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88358 mod TC,BCBS multispecialty AW base fee schedule,127.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88358,Not in chargemaster,88358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88358,BCBS multispecialty AW base fee schedule,207.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88360,Not in chargemaster,88360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88360,BCBS multispecialty AW base fee schedule,194.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88360 mod 26,Not in chargemaster,88360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88360 mod 26,BCBS multispecialty AW base fee schedule,67.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88360 mod TC,Not in chargemaster,88360,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88360 mod TC,BCBS multispecialty AW base fee schedule,127.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88361 mod 26,Not in chargemaster,88361,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88361 mod 26,BCBS multispecialty AW base fee schedule,70.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88361 mod TC,Not in chargemaster,88361,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88361 mod TC,BCBS multispecialty AW base fee schedule,125.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88361,Not in chargemaster,88361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88361,BCBS multispecialty AW base fee schedule,196.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88362,Not in chargemaster,88362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88362,BCBS multispecialty AW base fee schedule,354.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88362 mod 26,Not in chargemaster,88362,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88362 mod 26,BCBS multispecialty AW base fee schedule,179.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88362 mod TC,Not in chargemaster,88362,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88362 mod TC,BCBS multispecialty AW base fee schedule,174.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88363,Not in chargemaster,88363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88363,BCBS multispecialty AW base fee schedule,36.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88364,Not in chargemaster,88364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88364,BCBS multispecialty AW base fee schedule,213.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88364 mod 26,Not in chargemaster,88364,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88364 mod 26,BCBS multispecialty AW base fee schedule,55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88364 mod TC,Not in chargemaster,88364,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88364 mod TC,BCBS multispecialty AW base fee schedule,158.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88365 mod 26,Not in chargemaster,88365,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88365 mod 26,BCBS multispecialty AW base fee schedule,69.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88365 mod TC,Not in chargemaster,88365,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88365 mod TC,BCBS multispecialty AW base fee schedule,210.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88365,Not in chargemaster,88365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88365,BCBS multispecialty AW base fee schedule,280.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88366,Not in chargemaster,88366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88366,BCBS multispecialty AW base fee schedule,429,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88366 mod 26,Not in chargemaster,88366,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88366 mod 26,BCBS multispecialty AW base fee schedule,99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88366 mod TC,Not in chargemaster,88366,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88366 mod TC,BCBS multispecialty AW base fee schedule,330,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88367 mod 26,Not in chargemaster,88367,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88367 mod 26,BCBS multispecialty AW base fee schedule,54.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88367 mod TC,Not in chargemaster,88367,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88367 mod TC,BCBS multispecialty AW base fee schedule,121,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88367,Not in chargemaster,88367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88367,BCBS multispecialty AW base fee schedule,175.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88368,Not in chargemaster,88368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88368,BCBS multispecialty AW base fee schedule,204.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88368 mod 26,Not in chargemaster,88368,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88368 mod 26,BCBS multispecialty AW base fee schedule,66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88368 mod TC,Not in chargemaster,88368,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88368 mod TC,BCBS multispecialty AW base fee schedule,138.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88369 mod 26,Not in chargemaster,88369,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88369 mod 26,BCBS multispecialty AW base fee schedule,51.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88369 mod TC,Not in chargemaster,88369,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88369 mod TC,BCBS multispecialty AW base fee schedule,125.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88369,Not in chargemaster,88369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88369,BCBS multispecialty AW base fee schedule,177.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88371,Not in chargemaster,88371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88371,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88371 mod 26,Not in chargemaster,88371,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88371 mod 26,BCBS multispecialty AW base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88372,Not in chargemaster,88372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88372,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88372 mod 26,Not in chargemaster,88372,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88372 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88373,Not in chargemaster,88373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88373,BCBS multispecialty AW base fee schedule,114.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88373 mod 26,Not in chargemaster,88373,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88373 mod 26,BCBS multispecialty AW base fee schedule,42.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88373 mod TC,Not in chargemaster,88373,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88373 mod TC,BCBS multispecialty AW base fee schedule,72.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88374 mod 26,Not in chargemaster,88374,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88374 mod 26,BCBS multispecialty AW base fee schedule,70.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88374 mod TC,Not in chargemaster,88374,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88374 mod TC,BCBS multispecialty AW base fee schedule,460.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88374,Not in chargemaster,88374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88374,BCBS multispecialty AW base fee schedule,530.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88375,Not in chargemaster,88375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88375,BCBS multispecialty AW base fee schedule,78.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88377 mod 26,Not in chargemaster,88377,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88377 mod 26,BCBS multispecialty AW base fee schedule,102.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88377 mod TC,Not in chargemaster,88377,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88377 mod TC,BCBS multispecialty AW base fee schedule,524.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88377,Not in chargemaster,88377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88377,BCBS multispecialty AW base fee schedule,627.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88380,Not in chargemaster,88380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88380,BCBS multispecialty AW base fee schedule,210.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88380 mod 26,Not in chargemaster,88380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88380 mod 26,BCBS multispecialty AW base fee schedule,88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88380 mod TC,Not in chargemaster,88380,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88380 mod TC,BCBS multispecialty AW base fee schedule,122.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88381 mod 26,Not in chargemaster,88381,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88381 mod 26,BCBS multispecialty AW base fee schedule,39.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88381 mod TC,Not in chargemaster,88381,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88381 mod TC,BCBS multispecialty AW base fee schedule,239.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88381,Not in chargemaster,88381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88381,BCBS multispecialty AW base fee schedule,278.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88387,Not in chargemaster,88387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88387,BCBS multispecialty AW base fee schedule,55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88387 mod 26,Not in chargemaster,88387,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88387 mod 26,BCBS multispecialty AW base fee schedule,44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88387 mod TC,Not in chargemaster,88387,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88387 mod TC,BCBS multispecialty AW base fee schedule,11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88388 mod 26,Not in chargemaster,88388,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88388 mod 26,BCBS multispecialty AW base fee schedule,37.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88388 mod TC,Not in chargemaster,88388,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88388 mod TC,BCBS multispecialty AW base fee schedule,19.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88388,Not in chargemaster,88388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88388,BCBS multispecialty AW base fee schedule,57.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 89049,Not in chargemaster,89049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89049,BCBS multispecialty AW base fee schedule,392.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 89060,Not in chargemaster,89060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89060,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 89060 mod 26,Not in chargemaster,89060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89060 mod 26,BCBS multispecialty AW base fee schedule,29.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 89220,Not in chargemaster,89220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89220,BCBS multispecialty AW base fee schedule,25.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 89230,Not in chargemaster,89230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89230,BCBS multispecialty AW base fee schedule,3.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90460,Not in chargemaster,90460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90460,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90461,Not in chargemaster,90461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90461,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90471,90471,90471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90471,BCBS multispecialty AW base fee schedule,24.8,33.57,Fee schedule,,24.8,24.8,24.8,24.8,,,0
unity,Fee schedule,Non-facility 90472,90472,90472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90472,BCBS multispecialty AW base fee schedule,22.32,21,Fee schedule,,21,21,21,21,,,0
unity,Fee schedule,Non-facility 90473,90473,90473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90473,BCBS multispecialty AW base fee schedule,24.8,40.47,Fee schedule,,24.8,24.8,24.8,24.8,,,0
unity,Fee schedule,Non-facility 90474,Not in chargemaster,90474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90474,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90785,Not in chargemaster,90785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90785,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90792,Not in chargemaster,90792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90792,BCBS multispecialty AW base fee schedule,276.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90791,Not in chargemaster,90791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90791,BCBS multispecialty AW base fee schedule,249.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90839,Not in chargemaster,90839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90839,BCBS multispecialty AW base fee schedule,253.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90840,Not in chargemaster,90840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90840,BCBS multispecialty AW base fee schedule,121.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90845,Not in chargemaster,90845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90845,BCBS multispecialty AW base fee schedule,172.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90846,Not in chargemaster,90846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90846,BCBS multispecialty AW base fee schedule,177.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90847,Not in chargemaster,90847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90847,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90849,Not in chargemaster,90849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90849,BCBS multispecialty AW base fee schedule,63.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90853,Not in chargemaster,90853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90853,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90865,Not in chargemaster,90865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90865,BCBS multispecialty AW base fee schedule,297.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90863,Not in chargemaster,90863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90863,BCBS multispecialty AW base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90870,Not in chargemaster,90870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90870,BCBS multispecialty AW base fee schedule,309.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90875,Not in chargemaster,90875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90875,BCBS multispecialty AW base fee schedule,109.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90876,Not in chargemaster,90876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90876,BCBS multispecialty AW base fee schedule,190.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90880,Not in chargemaster,90880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90880,BCBS multispecialty AW base fee schedule,190.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90885,Not in chargemaster,90885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90885,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90887,Not in chargemaster,90887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90887,BCBS multispecialty AW base fee schedule,155,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90901,Not in chargemaster,90901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90901,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90912,Not in chargemaster,90912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90912,BCBS multispecialty AW base fee schedule,140.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90913,Not in chargemaster,90913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90913,BCBS multispecialty AW base fee schedule,57.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90935,Not in chargemaster,90935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90935,BCBS multispecialty AW base fee schedule,128.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90937,Not in chargemaster,90937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90937,BCBS multispecialty AW base fee schedule,184.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90945,Not in chargemaster,90945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90945,BCBS multispecialty AW base fee schedule,151.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90947,Not in chargemaster,90947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90947,BCBS multispecialty AW base fee schedule,219.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90951,Not in chargemaster,90951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90951,BCBS multispecialty AW base fee schedule,1649.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90954,Not in chargemaster,90954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90954,BCBS multispecialty AW base fee schedule,1430.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90955,Not in chargemaster,90955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90955,BCBS multispecialty AW base fee schedule,806,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90956,Not in chargemaster,90956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90956,BCBS multispecialty AW base fee schedule,561.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90957,Not in chargemaster,90957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90957,BCBS multispecialty AW base fee schedule,1134.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90958,Not in chargemaster,90958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90958,BCBS multispecialty AW base fee schedule,770.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90959,Not in chargemaster,90959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90959,BCBS multispecialty AW base fee schedule,521.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90960,Not in chargemaster,90960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90960,BCBS multispecialty AW base fee schedule,500.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90961,Not in chargemaster,90961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90961,BCBS multispecialty AW base fee schedule,420.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90962,Not in chargemaster,90962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90962,BCBS multispecialty AW base fee schedule,324.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90963,Not in chargemaster,90963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90963,BCBS multispecialty AW base fee schedule,958.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90964,Not in chargemaster,90964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90964,BCBS multispecialty AW base fee schedule,838.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90965,Not in chargemaster,90965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90965,BCBS multispecialty AW base fee schedule,801.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90966,Not in chargemaster,90966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90966,BCBS multispecialty AW base fee schedule,419.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90967,Not in chargemaster,90967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90967,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90968,Not in chargemaster,90968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90968,BCBS multispecialty AW base fee schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90969,Not in chargemaster,90969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90969,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90970,Not in chargemaster,90970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90970,BCBS multispecialty AW base fee schedule,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90997,Not in chargemaster,90997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90997,BCBS multispecialty AW base fee schedule,158.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91010,Not in chargemaster,91010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91010,BCBS multispecialty AW base fee schedule,353.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91010 mod 26,Not in chargemaster,91010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91010 mod 26,BCBS multispecialty AW base fee schedule,117.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91010 mod TC,Not in chargemaster,91010,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91010 mod TC,BCBS multispecialty AW base fee schedule,236.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91013 mod 26,Not in chargemaster,91013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91013 mod 26,BCBS multispecialty AW base fee schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91013 mod TC,Not in chargemaster,91013,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91013 mod TC,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91013,Not in chargemaster,91013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91013,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91020,Not in chargemaster,91020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91020,BCBS multispecialty AW base fee schedule,455.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91020 mod 26,Not in chargemaster,91020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91020 mod 26,BCBS multispecialty AW base fee schedule,131.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91020 mod TC,Not in chargemaster,91020,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91020 mod TC,BCBS multispecialty AW base fee schedule,324.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91022 mod 26,Not in chargemaster,91022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91022 mod 26,BCBS multispecialty AW base fee schedule,131.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91022 mod TC,Not in chargemaster,91022,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91022 mod TC,BCBS multispecialty AW base fee schedule,164.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91022,Not in chargemaster,91022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91022,BCBS multispecialty AW base fee schedule,295.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91030,Not in chargemaster,91030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91030,BCBS multispecialty AW base fee schedule,244.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91030 mod 26,Not in chargemaster,91030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91030 mod 26,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91030 mod TC,Not in chargemaster,91030,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91030 mod TC,BCBS multispecialty AW base fee schedule,161.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91034 mod 26,Not in chargemaster,91034,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91034 mod 26,BCBS multispecialty AW base fee schedule,89.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91034 mod TC,Not in chargemaster,91034,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91034 mod TC,BCBS multispecialty AW base fee schedule,246.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91034,Not in chargemaster,91034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91034,BCBS multispecialty AW base fee schedule,335.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91035,Not in chargemaster,91035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91035,BCBS multispecialty AW base fee schedule,850.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91035 mod 26,Not in chargemaster,91035,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91035 mod 26,BCBS multispecialty AW base fee schedule,146.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91035 mod TC,Not in chargemaster,91035,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91035 mod TC,BCBS multispecialty AW base fee schedule,703.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91037 mod 26,Not in chargemaster,91037,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91037 mod 26,BCBS multispecialty AW base fee schedule,88.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91037 mod TC,Not in chargemaster,91037,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91037 mod TC,BCBS multispecialty AW base fee schedule,203.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91037,Not in chargemaster,91037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91037,BCBS multispecialty AW base fee schedule,292.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91038,Not in chargemaster,91038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91038,BCBS multispecialty AW base fee schedule,771.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91038 mod 26,Not in chargemaster,91038,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91038 mod 26,BCBS multispecialty AW base fee schedule,100.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91038 mod TC,Not in chargemaster,91038,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91038 mod TC,BCBS multispecialty AW base fee schedule,671.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91040 mod 26,Not in chargemaster,91040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91040 mod 26,BCBS multispecialty AW base fee schedule,90.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91040 mod TC,Not in chargemaster,91040,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91040 mod TC,BCBS multispecialty AW base fee schedule,802.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91040,Not in chargemaster,91040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91040,BCBS multispecialty AW base fee schedule,892.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91065,Not in chargemaster,91065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91065,BCBS multispecialty AW base fee schedule,140.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91065 mod 26,Not in chargemaster,91065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91065 mod 26,BCBS multispecialty AW base fee schedule,17.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91065 mod TC,Not in chargemaster,91065,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91065 mod TC,BCBS multispecialty AW base fee schedule,122.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91110 mod 26,Not in chargemaster,91110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91110 mod 26,BCBS multispecialty AW base fee schedule,226.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91110 mod TC,Not in chargemaster,91110,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91110 mod TC,BCBS multispecialty AW base fee schedule,1284.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91110,Not in chargemaster,91110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91110,BCBS multispecialty AW base fee schedule,1510.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91111,Not in chargemaster,91111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91111,BCBS multispecialty AW base fee schedule,1517.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91111 mod 26,Not in chargemaster,91111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91111 mod 26,BCBS multispecialty AW base fee schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91111 mod TC,Not in chargemaster,91111,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91111 mod TC,BCBS multispecialty AW base fee schedule,1426,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91112 mod 26,Not in chargemaster,91112,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91112 mod 26,BCBS multispecialty AW base fee schedule,191.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91112 mod TC,Not in chargemaster,91112,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91112 mod TC,BCBS multispecialty AW base fee schedule,2349.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91112,Not in chargemaster,91112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91112,BCBS multispecialty AW base fee schedule,2541.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91117,Not in chargemaster,91117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91117,BCBS multispecialty AW base fee schedule,243.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91120 mod 26,Not in chargemaster,91120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91120 mod 26,BCBS multispecialty AW base fee schedule,87.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91120 mod TC,Not in chargemaster,91120,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91120 mod TC,BCBS multispecialty AW base fee schedule,767.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91120,Not in chargemaster,91120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91120,BCBS multispecialty AW base fee schedule,854.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91122,Not in chargemaster,91122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91122,BCBS multispecialty AW base fee schedule,442.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91122 mod 26,Not in chargemaster,91122,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91122 mod 26,BCBS multispecialty AW base fee schedule,158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91122 mod TC,Not in chargemaster,91122,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91122 mod TC,BCBS multispecialty AW base fee schedule,283.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91132 mod 26,Not in chargemaster,91132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91132 mod 26,BCBS multispecialty AW base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91132 mod TC,Not in chargemaster,91132,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91132 mod TC,BCBS multispecialty AW base fee schedule,520.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91132,Not in chargemaster,91132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91132,BCBS multispecialty AW base fee schedule,567.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91133,Not in chargemaster,91133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91133,BCBS multispecialty AW base fee schedule,608.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91133 mod 26,Not in chargemaster,91133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91133 mod 26,BCBS multispecialty AW base fee schedule,60.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91133 mod TC,Not in chargemaster,91133,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91133 mod TC,BCBS multispecialty AW base fee schedule,548.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91200 mod 26,Not in chargemaster,91200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91200 mod 26,BCBS multispecialty AW base fee schedule,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91200 mod TC,Not in chargemaster,91200,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91200 mod TC,BCBS multispecialty AW base fee schedule,40.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91200,Not in chargemaster,91200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,91200,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92002,Not in chargemaster,92002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92002,BCBS multispecialty AW base fee schedule,107.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92004,Not in chargemaster,92004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92004,BCBS multispecialty AW base fee schedule,192.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92012,Not in chargemaster,92012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92012,BCBS multispecialty AW base fee schedule,113.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92014,Not in chargemaster,92014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92014,BCBS multispecialty AW base fee schedule,161.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92015,Not in chargemaster,92015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92015,BCBS multispecialty AW base fee schedule,25.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92018,Not in chargemaster,92018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92018,BCBS multispecialty AW base fee schedule,251.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92019,Not in chargemaster,92019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92019,BCBS multispecialty AW base fee schedule,128.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92020,Not in chargemaster,92020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92020,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92025,Not in chargemaster,92025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92025,BCBS multispecialty AW base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92025 mod 26,Not in chargemaster,92025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92025 mod 26,BCBS multispecialty AW base fee schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92025 mod TC,Not in chargemaster,92025,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92025 mod TC,BCBS multispecialty AW base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92060 mod 26,Not in chargemaster,92060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92060 mod 26,BCBS multispecialty AW base fee schedule,66.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92060 mod TC,Not in chargemaster,92060,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92060 mod TC,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92060,Not in chargemaster,92060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92060,BCBS multispecialty AW base fee schedule,110.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92065,Not in chargemaster,92065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92065,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92065 mod 26,Not in chargemaster,92065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92065 mod 26,BCBS multispecialty AW base fee schedule,31.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92065 mod TC,Not in chargemaster,92065,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92065 mod TC,BCBS multispecialty AW base fee schedule,60.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92071,Not in chargemaster,92071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92071,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92072,Not in chargemaster,92072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92072,BCBS multispecialty AW base fee schedule,224.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92081 mod 26,Not in chargemaster,92081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92081 mod 26,BCBS multispecialty AW base fee schedule,28.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92081 mod TC,Not in chargemaster,92081,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92081 mod TC,BCBS multispecialty AW base fee schedule,30.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92081,Not in chargemaster,92081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92081,BCBS multispecialty AW base fee schedule,58.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92082,Not in chargemaster,92082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92082,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92082 mod 26,Not in chargemaster,92082,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92082 mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92082 mod TC,Not in chargemaster,92082,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92082 mod TC,BCBS multispecialty AW base fee schedule,45.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92083 mod 26,Not in chargemaster,92083,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92083 mod 26,BCBS multispecialty AW base fee schedule,48.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92083 mod TC,Not in chargemaster,92083,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92083 mod TC,BCBS multispecialty AW base fee schedule,62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92083,Not in chargemaster,92083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92083,BCBS multispecialty AW base fee schedule,110.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92100,Not in chargemaster,92100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92100,BCBS multispecialty AW base fee schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92132 mod 26,Not in chargemaster,92132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92132 mod 26,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92132 mod TC,Not in chargemaster,92132,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92132 mod TC,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92132,Not in chargemaster,92132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92132,BCBS multispecialty AW base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92133,Not in chargemaster,92133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92133,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92133 mod 26,Not in chargemaster,92133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92133 mod 26,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92133 mod TC,Not in chargemaster,92133,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92133 mod TC,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92134 mod 26,Not in chargemaster,92134,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92134 mod 26,BCBS multispecialty AW base fee schedule,44.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92134 mod TC,Not in chargemaster,92134,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92134 mod TC,BCBS multispecialty AW base fee schedule,26.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92134,Not in chargemaster,92134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92134,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92136,Not in chargemaster,92136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92136,BCBS multispecialty AW base fee schedule,109.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92136 mod 26,Not in chargemaster,92136,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92136 mod 26,BCBS multispecialty AW base fee schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92136 mod TC,Not in chargemaster,92136,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92136 mod TC,BCBS multispecialty AW base fee schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92145 mod 26,Not in chargemaster,92145,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92145 mod 26,BCBS multispecialty AW base fee schedule,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92145 mod TC,Not in chargemaster,92145,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92145 mod TC,BCBS multispecialty AW base fee schedule,12.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92145,Not in chargemaster,92145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92145,BCBS multispecialty AW base fee schedule,26.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92201,Not in chargemaster,92201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92201,BCBS multispecialty AW base fee schedule,44.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92202,Not in chargemaster,92202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92202,BCBS multispecialty AW base fee schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92227,Not in chargemaster,92227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92227,BCBS multispecialty AW base fee schedule,23.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92228 mod 26,Not in chargemaster,92228,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92228 mod 26,BCBS multispecialty AW base fee schedule,36.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92228 mod TC,Not in chargemaster,92228,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92228 mod TC,BCBS multispecialty AW base fee schedule,22.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92228,Not in chargemaster,92228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92228,BCBS multispecialty AW base fee schedule,59.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92230,Not in chargemaster,92230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92230,BCBS multispecialty AW base fee schedule,135.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92235 mod 26,Not in chargemaster,92235,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92235 mod 26,BCBS multispecialty AW base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92235 mod TC,Not in chargemaster,92235,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92235 mod TC,BCBS multispecialty AW base fee schedule,106.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92235,Not in chargemaster,92235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92235,BCBS multispecialty AW base fee schedule,181.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92240,Not in chargemaster,92240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92240,BCBS multispecialty AW base fee schedule,352.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92240 mod 26,Not in chargemaster,92240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92240 mod 26,BCBS multispecialty AW base fee schedule,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92240 mod TC,Not in chargemaster,92240,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92240 mod TC,BCBS multispecialty AW base fee schedule,269.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92242 mod 26,Not in chargemaster,92242,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92242 mod 26,BCBS multispecialty AW base fee schedule,95.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92242 mod TC,Not in chargemaster,92242,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92242 mod TC,BCBS multispecialty AW base fee schedule,320.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92242,Not in chargemaster,92242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92242,BCBS multispecialty AW base fee schedule,416.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92250,Not in chargemaster,92250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92250,BCBS multispecialty AW base fee schedule,78.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92250 mod 26,Not in chargemaster,92250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92250 mod 26,BCBS multispecialty AW base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92250 mod TC,Not in chargemaster,92250,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92250 mod TC,BCBS multispecialty AW base fee schedule,40.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92260,Not in chargemaster,92260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92260,BCBS multispecialty AW base fee schedule,34.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92265,Not in chargemaster,92265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92265,BCBS multispecialty AW base fee schedule,151.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92265 mod 26,Not in chargemaster,92265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92265 mod 26,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92265 mod TC,Not in chargemaster,92265,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92265 mod TC,BCBS multispecialty AW base fee schedule,70.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92270 mod 26,Not in chargemaster,92270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92270 mod 26,BCBS multispecialty AW base fee schedule,75.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92270 mod TC,Not in chargemaster,92270,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92270 mod TC,BCBS multispecialty AW base fee schedule,94.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92270,Not in chargemaster,92270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92270,BCBS multispecialty AW base fee schedule,169.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92273,Not in chargemaster,92273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92273,BCBS multispecialty AW base fee schedule,228.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92273 mod 26,Not in chargemaster,92273,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92273 mod 26,BCBS multispecialty AW base fee schedule,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92273 mod TC,Not in chargemaster,92273,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92273 mod TC,BCBS multispecialty AW base fee schedule,163.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92274 mod 26,Not in chargemaster,92274,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92274 mod 26,BCBS multispecialty AW base fee schedule,57.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92274 mod TC,Not in chargemaster,92274,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92274 mod TC,BCBS multispecialty AW base fee schedule,96.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92274,Not in chargemaster,92274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92274,BCBS multispecialty AW base fee schedule,154.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92283,Not in chargemaster,92283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92283,BCBS multispecialty AW base fee schedule,92.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92283 mod 26,Not in chargemaster,92283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92283 mod 26,BCBS multispecialty AW base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92283 mod TC,Not in chargemaster,92283,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92283 mod TC,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92284 mod 26,Not in chargemaster,92284,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92284 mod 26,BCBS multispecialty AW base fee schedule,22.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92284 mod TC,Not in chargemaster,92284,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92284 mod TC,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92284,Not in chargemaster,92284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92284,BCBS multispecialty AW base fee schedule,104.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92285,Not in chargemaster,92285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92285,BCBS multispecialty AW base fee schedule,38.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92285 mod 26,Not in chargemaster,92285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92285 mod 26,BCBS multispecialty AW base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92285 mod TC,Not in chargemaster,92285,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92285 mod TC,BCBS multispecialty AW base fee schedule,32.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92286 mod 26,Not in chargemaster,92286,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92286 mod 26,BCBS multispecialty AW base fee schedule,39.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92286 mod TC,Not in chargemaster,92286,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92286 mod TC,BCBS multispecialty AW base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92286,Not in chargemaster,92286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92286,BCBS multispecialty AW base fee schedule,68.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92287,Not in chargemaster,92287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92287,BCBS multispecialty AW base fee schedule,276.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92287 mod 26,Not in chargemaster,92287,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92287 mod 26,BCBS multispecialty AW base fee schedule,81.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92287 mod TC,Not in chargemaster,92287,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92287 mod TC,BCBS multispecialty AW base fee schedule,194.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92310,Not in chargemaster,92310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92310,BCBS multispecialty AW base fee schedule,130.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92311,Not in chargemaster,92311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92311,BCBS multispecialty AW base fee schedule,134.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92312,Not in chargemaster,92312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92312,BCBS multispecialty AW base fee schedule,155.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92313,Not in chargemaster,92313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92313,BCBS multispecialty AW base fee schedule,126.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92314,Not in chargemaster,92314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92314,BCBS multispecialty AW base fee schedule,150.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92315,Not in chargemaster,92315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92315,BCBS multispecialty AW base fee schedule,137.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92316,Not in chargemaster,92316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92316,BCBS multispecialty AW base fee schedule,171.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92317,Not in chargemaster,92317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92317,BCBS multispecialty AW base fee schedule,143.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92325,Not in chargemaster,92325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92325,BCBS multispecialty AW base fee schedule,77.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92326,Not in chargemaster,92326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92326,BCBS multispecialty AW base fee schedule,65.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92340,Not in chargemaster,92340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92340,BCBS multispecialty AW base fee schedule,61.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92341,Not in chargemaster,92341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92341,BCBS multispecialty AW base fee schedule,71.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92342,Not in chargemaster,92342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92342,BCBS multispecialty AW base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92352,Not in chargemaster,92352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92352,BCBS multispecialty AW base fee schedule,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0001U,Not in chargemaster,0001U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0001U,BCBSMN Non-RVU base fee schedule,792,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0002M,Not in chargemaster,0002M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0002M,BCBSMN Non-RVU base fee schedule,553.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0002U,Not in chargemaster,0002U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0002U,BCBSMN Non-RVU base fee schedule,27.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0003M,Not in chargemaster,0003M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0003M,BCBSMN Non-RVU base fee schedule,553.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0003U,Not in chargemaster,0003U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0003U,BCBSMN Non-RVU base fee schedule,1045,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0004M,Not in chargemaster,0004M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0004M,BCBSMN Non-RVU base fee schedule,86.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0005U,Not in chargemaster,0005U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0005U,BCBSMN Non-RVU base fee schedule,836,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0006M,Not in chargemaster,0006M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0006M,BCBSMN Non-RVU base fee schedule,165,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0007M,Not in chargemaster,0007M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0007M,BCBSMN Non-RVU base fee schedule,412.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0007U,Not in chargemaster,0007U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0007U,BCBSMN Non-RVU base fee schedule,125.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0008U,Not in chargemaster,0008U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0008U,BCBSMN Non-RVU base fee schedule,657.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0009U,Not in chargemaster,0009U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0009U,BCBSMN Non-RVU base fee schedule,117.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0010U,Not in chargemaster,0010U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0010U,BCBSMN Non-RVU base fee schedule,469.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0011M,Not in chargemaster,0011M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0011M,BCBSMN Non-RVU base fee schedule,836,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0011U,Not in chargemaster,0011U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0011U,BCBSMN Non-RVU base fee schedule,125.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0012M,Not in chargemaster,0012M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0012M,BCBSMN Non-RVU base fee schedule,836,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0012U,Not in chargemaster,0012U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0012U,BCBSMN Non-RVU base fee schedule,2767.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0013M,Not in chargemaster,0013M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0013M,BCBSMN Non-RVU base fee schedule,836,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0013U,Not in chargemaster,0013U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0013U,BCBSMN Non-RVU base fee schedule,2767.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0014M,Not in chargemaster,0014M,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0014M,BCBSMN Non-RVU base fee schedule,503.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0014U,Not in chargemaster,0014U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0014U,BCBSMN Non-RVU base fee schedule,2767.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0016U,Not in chargemaster,0016U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0016U,BCBSMN Non-RVU base fee schedule,180.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0017U,Not in chargemaster,0017U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0017U,BCBSMN Non-RVU base fee schedule,100.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0018U,Not in chargemaster,0018U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0018U,BCBSMN Non-RVU base fee schedule,3302.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0019U,Not in chargemaster,0019U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0019U,BCBSMN Non-RVU base fee schedule,4042.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0021U,Not in chargemaster,0021U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0021U,BCBSMN Non-RVU base fee schedule,836,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0022U,Not in chargemaster,0022U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0022U,BCBSMN Non-RVU base fee schedule,2145,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0023U,Not in chargemaster,0023U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0023U,BCBSMN Non-RVU base fee schedule,273.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0024U,Not in chargemaster,0024U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0024U,BCBSMN Non-RVU base fee schedule,37.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0025U,Not in chargemaster,0025U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0025U,BCBSMN Non-RVU base fee schedule,94.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0026U,Not in chargemaster,0026U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0026U,BCBSMN Non-RVU base fee schedule,3960,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0027U,Not in chargemaster,0027U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0027U,BCBSMN Non-RVU base fee schedule,149.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0029U,Not in chargemaster,0029U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0029U,BCBSMN Non-RVU base fee schedule,816.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0030U,Not in chargemaster,0030U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0030U,BCBSMN Non-RVU base fee schedule,147.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0031U,Not in chargemaster,0031U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0031U,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0032U,Not in chargemaster,0032U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0032U,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0033U,Not in chargemaster,0033U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0033U,BCBSMN Non-RVU base fee schedule,384.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0034U,Not in chargemaster,0034U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0034U,BCBSMN Non-RVU base fee schedule,512.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0035U,Not in chargemaster,0035U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0035U,BCBSMN Non-RVU base fee schedule,595.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0036U,Not in chargemaster,0036U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0036U,BCBSMN Non-RVU base fee schedule,5258,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0037U,Not in chargemaster,0037U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0037U,BCBSMN Non-RVU base fee schedule,3850,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0038U,Not in chargemaster,0038U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0038U,BCBSMN Non-RVU base fee schedule,32.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0039U,Not in chargemaster,0039U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0039U,BCBSMN Non-RVU base fee schedule,15.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0040U,Not in chargemaster,0040U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0040U,BCBSMN Non-RVU base fee schedule,450.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0041U,Not in chargemaster,0041U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0041U,BCBSMN Non-RVU base fee schedule,18.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0042T,Not in chargemaster,0042T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0042T,BCBSMN Non-RVU base fee schedule,264.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0042U,Not in chargemaster,0042U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0042U,BCBSMN Non-RVU base fee schedule,18.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0043U,Not in chargemaster,0043U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0043U,BCBSMN Non-RVU base fee schedule,16.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0044U,Not in chargemaster,0044U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0044U,BCBSMN Non-RVU base fee schedule,16.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0045U,Not in chargemaster,0045U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0045U,BCBSMN Non-RVU base fee schedule,4260.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0046U,Not in chargemaster,0046U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0046U,BCBSMN Non-RVU base fee schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0047U,Not in chargemaster,0047U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0047U,BCBSMN Non-RVU base fee schedule,4260.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0048U,Not in chargemaster,0048U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0048U,BCBSMN Non-RVU base fee schedule,3211.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0049U,Not in chargemaster,0049U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0049U,BCBSMN Non-RVU base fee schedule,271.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0050U,Not in chargemaster,0050U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0050U,BCBSMN Non-RVU base fee schedule,3208.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0051U,Not in chargemaster,0051U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0051U,BCBSMN Non-RVU base fee schedule,213.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0052U,Not in chargemaster,0052U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0052U,BCBSMN Non-RVU base fee schedule,37.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0053U,Not in chargemaster,0053U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0053U,BCBSMN Non-RVU base fee schedule,2233,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0054T,Not in chargemaster,0054T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0054T,BCBSMN Non-RVU base fee schedule,65.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0054U,Not in chargemaster,0054U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0054U,BCBSMN Non-RVU base fee schedule,163.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0055T,Not in chargemaster,0055T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0055T,BCBSMN Non-RVU base fee schedule,174.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0055U,Not in chargemaster,0055U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0055U,BCBSMN Non-RVU base fee schedule,3564,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0056U,Not in chargemaster,0056U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0056U,BCBSMN Non-RVU base fee schedule,2767.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0058T,Not in chargemaster,0058T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0058T,BCBSMN Non-RVU base fee schedule,321.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0058U,Not in chargemaster,0058U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0058U,BCBSMN Non-RVU base fee schedule,355.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0059U,Not in chargemaster,0059U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0059U,BCBSMN Non-RVU base fee schedule,355.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0060U,Not in chargemaster,0060U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0060U,BCBSMN Non-RVU base fee schedule,834.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0061U,Not in chargemaster,0061U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0061U,BCBSMN Non-RVU base fee schedule,27.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0064U,Not in chargemaster,0064U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0064U,BCBSMN Non-RVU base fee schedule,34.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0065U,Not in chargemaster,0065U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0065U,BCBSMN Non-RVU base fee schedule,19.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0066U,Not in chargemaster,0066U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0066U,BCBSMN Non-RVU base fee schedule,16.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0068U,Not in chargemaster,0068U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0068U,BCBSMN Non-RVU base fee schedule,156.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0069U,Not in chargemaster,0069U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0069U,BCBSMN Non-RVU base fee schedule,418,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0070U,Not in chargemaster,0070U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0070U,BCBSMN Non-RVU base fee schedule,744.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0071U,Not in chargemaster,0071U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0071U,BCBSMN Non-RVU base fee schedule,331.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0072T,Not in chargemaster,0072T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0072T,BCBSMN Non-RVU base fee schedule,696.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0072U,Not in chargemaster,0072U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0072U,BCBSMN Non-RVU base fee schedule,496,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0073U,Not in chargemaster,0073U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0073U,BCBSMN Non-RVU base fee schedule,496,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0074U,Not in chargemaster,0074U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0074U,BCBSMN Non-RVU base fee schedule,496,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0075T,Not in chargemaster,0075T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0075T,BCBSMN Non-RVU base fee schedule,629.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0075U,Not in chargemaster,0075U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0075U,BCBSMN Non-RVU base fee schedule,496,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0076T,Not in chargemaster,0076T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0076T,BCBSMN Non-RVU base fee schedule,292.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0076U,Not in chargemaster,0076U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0076U,BCBSMN Non-RVU base fee schedule,496,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0078U,Not in chargemaster,0078U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0078U,BCBSMN Non-RVU base fee schedule,496,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0080U,Not in chargemaster,0080U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0080U,BCBSMN Non-RVU base fee schedule,3872,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0082U,Not in chargemaster,0082U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0082U,BCBSMN Non-RVU base fee schedule,271.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0084U,Not in chargemaster,0084U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0084U,BCBSMN Non-RVU base fee schedule,792,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0085T,Not in chargemaster,0085T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0085T,BCBSMN Non-RVU base fee schedule,110.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0087U,Not in chargemaster,0087U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0087U,BCBSMN Non-RVU base fee schedule,2821,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0088U,Not in chargemaster,0088U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0088U,BCBSMN Non-RVU base fee schedule,2821,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0089U,Not in chargemaster,0089U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0089U,BCBSMN Non-RVU base fee schedule,836,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0090U,Not in chargemaster,0090U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0090U,BCBSMN Non-RVU base fee schedule,2145,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0092U,Not in chargemaster,0092U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0092U,BCBSMN Non-RVU base fee schedule,2010,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0093U,Not in chargemaster,0093U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0093U,BCBSMN Non-RVU base fee schedule,68.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0094U,Not in chargemaster,0094U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0094U,BCBSMN Non-RVU base fee schedule,5031.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0096U,Not in chargemaster,0096U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0096U,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0101U,Not in chargemaster,0101U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0101U,BCBSMN Non-RVU base fee schedule,1286.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0102U,Not in chargemaster,0102U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0102U,BCBSMN Non-RVU base fee schedule,1229.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0103U,Not in chargemaster,0103U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0103U,BCBSMN Non-RVU base fee schedule,1229.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0105U,Not in chargemaster,0105U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0105U,BCBSMN Non-RVU base fee schedule,1045,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0106T,Not in chargemaster,0106T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0106T,BCBSMN Non-RVU base fee schedule,31.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0107T,Not in chargemaster,0107T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0107T,BCBSMN Non-RVU base fee schedule,31.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0107U,Not in chargemaster,0107U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0107U,BCBSMN Non-RVU base fee schedule,17.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0108T,Not in chargemaster,0108T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0108T,BCBSMN Non-RVU base fee schedule,31.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0109T,Not in chargemaster,0109T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0109T,BCBSMN Non-RVU base fee schedule,31.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0109U,Not in chargemaster,0109U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0109U,BCBSMN Non-RVU base fee schedule,156.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0110T,Not in chargemaster,0110T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0110T,BCBSMN Non-RVU base fee schedule,74.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0110U,Not in chargemaster,0110U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0110U,BCBSMN Non-RVU base fee schedule,29.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0111U,Not in chargemaster,0111U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0111U,BCBSMN Non-RVU base fee schedule,750.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0113U,Not in chargemaster,0113U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0113U,BCBSMN Non-RVU base fee schedule,836,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0116U,Not in chargemaster,0116U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0116U,BCBSMN Non-RVU base fee schedule,271.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0118U,Not in chargemaster,0118U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0118U,BCBSMN Non-RVU base fee schedule,759.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0120U,Not in chargemaster,0120U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0120U,BCBSMN Non-RVU base fee schedule,3068.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0126T,Not in chargemaster,0126T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0126T,BCBSMN Non-RVU base fee schedule,135.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0129U,Not in chargemaster,0129U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0129U,BCBSMN Non-RVU base fee schedule,1229.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0130U,Not in chargemaster,0130U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0130U,BCBSMN Non-RVU base fee schedule,643.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0153U,Not in chargemaster,0153U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0153U,BCBSMN Non-RVU base fee schedule,3873,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0154U,Not in chargemaster,0154U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0154U,BCBSMN Non-RVU base fee schedule,329.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0155U,Not in chargemaster,0155U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0155U,BCBSMN Non-RVU base fee schedule,193.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0156U,Not in chargemaster,0156U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0156U,BCBSMN Non-RVU base fee schedule,646.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0163U,Not in chargemaster,0163U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0163U,BCBSMN Non-RVU base fee schedule,508.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0166U,Not in chargemaster,0166U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0166U,BCBSMN Non-RVU base fee schedule,503.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0167U,Not in chargemaster,0167U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0167U,BCBSMN Non-RVU base fee schedule,15.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0168U,Not in chargemaster,0168U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0168U,BCBSMN Non-RVU base fee schedule,759.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0169U,Not in chargemaster,0169U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0169U,BCBSMN Non-RVU base fee schedule,466.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0171U,Not in chargemaster,0171U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0171U,BCBSMN Non-RVU base fee schedule,2916.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0172U,Not in chargemaster,0172U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0172U,BCBSMN Non-RVU base fee schedule,218.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0173U,Not in chargemaster,0173U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0173U,BCBSMN Non-RVU base fee schedule,251.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0174T,Not in chargemaster,0174T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0174T,BCBSMN Non-RVU base fee schedule,315.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0174U,Not in chargemaster,0174U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0174U,BCBSMN Non-RVU base fee schedule,218.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0175T,Not in chargemaster,0175T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0175T,BCBSMN Non-RVU base fee schedule,395.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0175U,Not in chargemaster,0175U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0175U,BCBSMN Non-RVU base fee schedule,251.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0177U,Not in chargemaster,0177U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0177U,BCBSMN Non-RVU base fee schedule,193.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0179U,Not in chargemaster,0179U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0179U,BCBSMN Non-RVU base fee schedule,597.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0180U,Not in chargemaster,0180U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0180U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0181U,Not in chargemaster,0181U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0181U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0182U,Not in chargemaster,0182U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0182U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0183U,Not in chargemaster,0183U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0183U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0184T,Not in chargemaster,0184T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0184T,BCBSMN Non-RVU base fee schedule,999.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0184U,Not in chargemaster,0184U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0184U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0185U,Not in chargemaster,0185U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0185U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0186U,Not in chargemaster,0186U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0186U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0187U,Not in chargemaster,0187U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0187U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0188U,Not in chargemaster,0188U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0188U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0189U,Not in chargemaster,0189U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0189U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0190U,Not in chargemaster,0190U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0190U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0191T,Not in chargemaster,0191T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0191T,BCBSMN Non-RVU base fee schedule,1829.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0191U,Not in chargemaster,0191U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0191U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0192U,Not in chargemaster,0192U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0192U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0193U,Not in chargemaster,0193U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0193U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0194U,Not in chargemaster,0194U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0194U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0195U,Not in chargemaster,0195U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0195U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0196U,Not in chargemaster,0196U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0196U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0197U,Not in chargemaster,0197U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0197U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0198T,Not in chargemaster,0198T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0198T,BCBSMN Non-RVU base fee schedule,17.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0198U,Not in chargemaster,0198U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0198U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 01996,Not in chargemaster,1996,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,1996,BCBSMN Non-RVU base fee schedule,107.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0199U,Not in chargemaster,0199U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0199U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0200T,Not in chargemaster,0200T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0200T,BCBSMN Non-RVU base fee schedule,1038.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0200U,Not in chargemaster,0200U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0200U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0201T,Not in chargemaster,0201T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0201T,BCBSMN Non-RVU base fee schedule,1558.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0201U,Not in chargemaster,0201U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0201U,BCBSMN Non-RVU base fee schedule,185.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0202U,Not in chargemaster,0202U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0202U,BCBSMN Non-RVU base fee schedule,416.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0207T,Not in chargemaster,0207T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0207T,BCBSMN Non-RVU base fee schedule,420.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0208T,Not in chargemaster,0208T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0208T,BCBSMN Non-RVU base fee schedule,34.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0209T,Not in chargemaster,0209T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0209T,BCBSMN Non-RVU base fee schedule,45.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0210T,Not in chargemaster,0210T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0210T,BCBSMN Non-RVU base fee schedule,25.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0210U,Not in chargemaster,0210U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0210U,BCBSMN Non-RVU base fee schedule,4.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0211T,Not in chargemaster,0211T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0211T,BCBSMN Non-RVU base fee schedule,39.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0212T,Not in chargemaster,0212T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0212T,BCBSMN Non-RVU base fee schedule,72.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0213T,Not in chargemaster,0213T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0213T,BCBSMN Non-RVU base fee schedule,138.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0214T,Not in chargemaster,0214T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0214T,BCBSMN Non-RVU base fee schedule,135.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0215T,Not in chargemaster,0215T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0215T,BCBSMN Non-RVU base fee schedule,137.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0216T,Not in chargemaster,0216T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0216T,BCBSMN Non-RVU base fee schedule,249.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0217T,Not in chargemaster,0217T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0217T,BCBSMN Non-RVU base fee schedule,121.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0218T,Not in chargemaster,0218T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0218T,BCBSMN Non-RVU base fee schedule,123.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0219T,Not in chargemaster,0219T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0219T,BCBSMN Non-RVU base fee schedule,208.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0220T,Not in chargemaster,0220T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0220T,BCBSMN Non-RVU base fee schedule,208.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0221T,Not in chargemaster,0221T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0221T,BCBSMN Non-RVU base fee schedule,208.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0222T,Not in chargemaster,0222T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0222T,BCBSMN Non-RVU base fee schedule,208.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0223U,Not in chargemaster,0223U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0223U,BCBSMN Non-RVU base fee schedule,416.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0224U,Not in chargemaster,0224U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0224U,BCBSMN Non-RVU base fee schedule,42.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0225U,Not in chargemaster,0225U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0225U,BCBSMN Non-RVU base fee schedule,416.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0226U,Not in chargemaster,0226U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0226U,BCBSMN Non-RVU base fee schedule,42.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0228T,Not in chargemaster,0228T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0228T,BCBSMN Non-RVU base fee schedule,571.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0229T,Not in chargemaster,0229T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0229T,BCBSMN Non-RVU base fee schedule,339.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0230T,Not in chargemaster,0230T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0230T,BCBSMN Non-RVU base fee schedule,554.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0231T,Not in chargemaster,0231T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0231T,BCBSMN Non-RVU base fee schedule,330.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0232T,Not in chargemaster,0232T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0232T,BCBSMN Non-RVU base fee schedule,479.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0234T,Not in chargemaster,0234T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0234T,BCBSMN Non-RVU base fee schedule,1076.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0238T,Not in chargemaster,0238T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0238T,BCBSMN Non-RVU base fee schedule,2464.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0240U,Not in chargemaster,0240U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0240U,BCBSMN Non-RVU base fee schedule,142.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0241U,Not in chargemaster,0241U,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0241U,BCBSMN Non-RVU base fee schedule,142.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0253T,Not in chargemaster,0253T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0253T,BCBSMN Non-RVU base fee schedule,1010.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0263T,Not in chargemaster,0263T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0263T,BCBSMN Non-RVU base fee schedule,695.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0275T,Not in chargemaster,0275T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0275T,BCBSMN Non-RVU base fee schedule,452.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0278T,Not in chargemaster,0278T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0278T,BCBSMN Non-RVU base fee schedule,295.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0290T,Not in chargemaster,0290T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0290T,BCBSMN Non-RVU base fee schedule,156.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0295T,Not in chargemaster,0295T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0295T,BCBSMN Non-RVU base fee schedule,109.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0296T,Not in chargemaster,0296T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0296T,BCBSMN Non-RVU base fee schedule,18.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0297T,Not in chargemaster,0297T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0297T,BCBSMN Non-RVU base fee schedule,76.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0298T,Not in chargemaster,0298T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0298T,BCBSMN Non-RVU base fee schedule,18.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0308T,Not in chargemaster,0308T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0308T,BCBSMN Non-RVU base fee schedule,1336.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0317T,Not in chargemaster,0317T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0317T,BCBSMN Non-RVU base fee schedule,77.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0329T,Not in chargemaster,0329T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0329T,BCBSMN Non-RVU base fee schedule,83.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0330T,Not in chargemaster,0330T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0330T,BCBSMN Non-RVU base fee schedule,28.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0331T,Not in chargemaster,0331T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0331T,BCBSMN Non-RVU base fee schedule,321.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0332T,Not in chargemaster,0332T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0332T,BCBSMN Non-RVU base fee schedule,443.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0333T,Not in chargemaster,0333T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0333T,BCBSMN Non-RVU base fee schedule,256.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0335T,Not in chargemaster,0335T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0335T,BCBSMN Non-RVU base fee schedule,2320.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0338T,Not in chargemaster,0338T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0338T,BCBSMN Non-RVU base fee schedule,530.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0339T,Not in chargemaster,0339T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0339T,BCBSMN Non-RVU base fee schedule,690.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0342T,Not in chargemaster,0342T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0342T,BCBSMN Non-RVU base fee schedule,177.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0345T,Not in chargemaster,0345T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0345T,BCBSMN Non-RVU base fee schedule,3693.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0347T,Not in chargemaster,0347T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0347T,BCBSMN Non-RVU base fee schedule,1124.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0348T,Not in chargemaster,0348T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0348T,BCBSMN Non-RVU base fee schedule,154.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0349T,Not in chargemaster,0349T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0349T,BCBSMN Non-RVU base fee schedule,63.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0350T,Not in chargemaster,0350T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0350T,BCBSMN Non-RVU base fee schedule,54.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0351T,Not in chargemaster,0351T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0351T,BCBSMN Non-RVU base fee schedule,1194.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0352T,Not in chargemaster,0352T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0352T,BCBSMN Non-RVU base fee schedule,148.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0353T,Not in chargemaster,0353T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0353T,BCBSMN Non-RVU base fee schedule,1194.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0354T,Not in chargemaster,0354T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0354T,BCBSMN Non-RVU base fee schedule,148.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0355T,Not in chargemaster,0355T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0355T,BCBSMN Non-RVU base fee schedule,1416.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0356T,Not in chargemaster,0356T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0356T,BCBSMN Non-RVU base fee schedule,260.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0358T,Not in chargemaster,0358T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0358T,BCBSMN Non-RVU base fee schedule,0.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0362T,Not in chargemaster,0362T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0362T,BCBSMN Non-RVU base fee schedule,72.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0373T,Not in chargemaster,0373T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0373T,BCBSMN Non-RVU base fee schedule,218.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0376T,Not in chargemaster,0376T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0376T,BCBSMN Non-RVU base fee schedule,933.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0378T,Not in chargemaster,0378T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0378T,BCBSMN Non-RVU base fee schedule,58.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0379T,Not in chargemaster,0379T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0379T,BCBSMN Non-RVU base fee schedule,58.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0381T,Not in chargemaster,0381T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0381T,BCBSMN Non-RVU base fee schedule,30.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0382T,Not in chargemaster,0382T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0382T,BCBSMN Non-RVU base fee schedule,19.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0383T,Not in chargemaster,0383T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0383T,BCBSMN Non-RVU base fee schedule,60.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0384T,Not in chargemaster,0384T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0384T,BCBSMN Non-RVU base fee schedule,38.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0385T,Not in chargemaster,0385T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0385T,BCBSMN Non-RVU base fee schedule,90.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0386T,Not in chargemaster,0386T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0386T,BCBSMN Non-RVU base fee schedule,57.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0394T,Not in chargemaster,0394T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0394T,BCBSMN Non-RVU base fee schedule,211.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0395T,Not in chargemaster,0395T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0395T,BCBSMN Non-RVU base fee schedule,211.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0397T,Not in chargemaster,0397T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0397T,BCBSMN Non-RVU base fee schedule,640.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0402T,Not in chargemaster,0402T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0402T,BCBSMN Non-RVU base fee schedule,2142.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0403T,Not in chargemaster,0403T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0403T,BCBSMN Non-RVU base fee schedule,13.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0420T,Not in chargemaster,0420T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0420T,BCBSMN Non-RVU base fee schedule,1229.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0421T,Not in chargemaster,0421T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0421T,BCBSMN Non-RVU base fee schedule,1597.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0423T,Not in chargemaster,0423T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0423T,BCBSMN Non-RVU base fee schedule,55.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0437T,Not in chargemaster,0437T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0437T,BCBSMN Non-RVU base fee schedule,426.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0439T,Not in chargemaster,0439T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0439T,BCBSMN Non-RVU base fee schedule,89.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0440T,Not in chargemaster,0440T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0440T,BCBSMN Non-RVU base fee schedule,262.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0441T,Not in chargemaster,0441T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0441T,BCBSMN Non-RVU base fee schedule,262.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0442T,Not in chargemaster,0442T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0442T,BCBSMN Non-RVU base fee schedule,262.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0443T,Not in chargemaster,0443T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0443T,BCBSMN Non-RVU base fee schedule,428.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0444T,Not in chargemaster,0444T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0444T,BCBSMN Non-RVU base fee schedule,260.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0445T,Not in chargemaster,0445T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0445T,BCBSMN Non-RVU base fee schedule,260.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0446T,Not in chargemaster,0446T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0446T,BCBSMN Non-RVU base fee schedule,857.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0447T,Not in chargemaster,0447T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0447T,BCBSMN Non-RVU base fee schedule,313.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0448T,Not in chargemaster,0448T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0448T,BCBSMN Non-RVU base fee schedule,1251,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0449T,Not in chargemaster,0449T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0449T,BCBSMN Non-RVU base fee schedule,1356.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0450T,Not in chargemaster,0450T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0450T,BCBSMN Non-RVU base fee schedule,914.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0451T,Not in chargemaster,0451T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0451T,BCBSMN Non-RVU base fee schedule,1038.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0452T,Not in chargemaster,0452T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0452T,BCBSMN Non-RVU base fee schedule,1038.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0453T,Not in chargemaster,0453T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0453T,BCBSMN Non-RVU base fee schedule,1038.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0454T,Not in chargemaster,0454T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0454T,BCBSMN Non-RVU base fee schedule,1038.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0455T,Not in chargemaster,0455T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0455T,BCBSMN Non-RVU base fee schedule,2282.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0456T,Not in chargemaster,0456T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0456T,BCBSMN Non-RVU base fee schedule,2282.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0457T,Not in chargemaster,0457T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0457T,BCBSMN Non-RVU base fee schedule,2282.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0458T,Not in chargemaster,0458T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0458T,BCBSMN Non-RVU base fee schedule,2282.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0459T,Not in chargemaster,0459T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0459T,BCBSMN Non-RVU base fee schedule,367.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0460T,Not in chargemaster,0460T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0460T,BCBSMN Non-RVU base fee schedule,367.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0461T,Not in chargemaster,0461T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0461T,BCBSMN Non-RVU base fee schedule,367.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0462T,Not in chargemaster,0462T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0462T,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0463T,Not in chargemaster,0463T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0463T,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0464T,Not in chargemaster,0464T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0464T,BCBSMN Non-RVU base fee schedule,228.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0465T,Not in chargemaster,0465T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0465T,BCBSMN Non-RVU base fee schedule,200.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0466T,Not in chargemaster,0466T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0466T,BCBSMN Non-RVU base fee schedule,1311.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0467T,Not in chargemaster,0467T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0467T,BCBSMN Non-RVU base fee schedule,1579.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0468T,Not in chargemaster,0468T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0468T,BCBSMN Non-RVU base fee schedule,1322.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0469T,Not in chargemaster,0469T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0469T,BCBSMN Non-RVU base fee schedule,72.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0474T,Not in chargemaster,0474T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0474T,BCBSMN Non-RVU base fee schedule,1010.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0479T,Not in chargemaster,0479T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0479T,BCBSMN Non-RVU base fee schedule,232.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0480T,Not in chargemaster,0480T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0480T,BCBSMN Non-RVU base fee schedule,50.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0483T,Not in chargemaster,0483T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0483T,BCBSMN Non-RVU base fee schedule,3644.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0484T,Not in chargemaster,0484T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0484T,BCBSMN Non-RVU base fee schedule,3644.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0485T,Not in chargemaster,0485T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0485T,BCBSMN Non-RVU base fee schedule,458.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0486T,Not in chargemaster,0486T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0486T,BCBSMN Non-RVU base fee schedule,687.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0488T,Not in chargemaster,0488T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0488T,BCBSMN Non-RVU base fee schedule,44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0494T,Not in chargemaster,0494T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0494T,BCBSMN Non-RVU base fee schedule,1485,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0495T,Not in chargemaster,0495T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0495T,BCBSMN Non-RVU base fee schedule,879.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0496T,Not in chargemaster,0496T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0496T,BCBSMN Non-RVU base fee schedule,439.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0497T,Not in chargemaster,0497T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0497T,BCBSMN Non-RVU base fee schedule,46.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0498T,Not in chargemaster,0498T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0498T,BCBSMN Non-RVU base fee schedule,44.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0499T,Not in chargemaster,0499T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0499T,BCBSMN Non-RVU base fee schedule,540.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0500T,Not in chargemaster,0500T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0500T,BCBSMN Non-RVU base fee schedule,52.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0505T,Not in chargemaster,0505T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0505T,BCBSMN Non-RVU base fee schedule,17496.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0506T,Not in chargemaster,0506T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0506T,BCBSMN Non-RVU base fee schedule,116.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0507T,Not in chargemaster,0507T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0507T,BCBSMN Non-RVU base fee schedule,22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0508T,Not in chargemaster,0508T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0508T,BCBSMN Non-RVU base fee schedule,14.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0510T,Not in chargemaster,0510T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0510T,BCBSMN Non-RVU base fee schedule,1223.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0511T,Not in chargemaster,0511T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0511T,BCBSMN Non-RVU base fee schedule,2932.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0514T,Not in chargemaster,0514T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0514T,BCBSMN Non-RVU base fee schedule,177.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0521T,Not in chargemaster,0521T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0521T,BCBSMN Non-RVU base fee schedule,53.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0522T,Not in chargemaster,0522T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0522T,BCBSMN Non-RVU base fee schedule,53.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0523T,Not in chargemaster,0523T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0523T,BCBSMN Non-RVU base fee schedule,168.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0524T,Not in chargemaster,0524T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0524T,BCBSMN Non-RVU base fee schedule,4157.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0528T,Not in chargemaster,0528T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0528T,BCBSMN Non-RVU base fee schedule,53.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0529T,Not in chargemaster,0529T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0529T,BCBSMN Non-RVU base fee schedule,53.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0537T,Not in chargemaster,0537T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0537T,BCBSMN Non-RVU base fee schedule,234.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0541T,Not in chargemaster,0541T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0541T,BCBSMN Non-RVU base fee schedule,690.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0542T,Not in chargemaster,0542T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0542T,BCBSMN Non-RVU base fee schedule,132.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0591T,Not in chargemaster,0591T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0591T,BCBSMN Non-RVU base fee schedule,47.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0592T,Not in chargemaster,0592T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0592T,BCBSMN Non-RVU base fee schedule,47.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0593T,Not in chargemaster,0593T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0593T,BCBSMN Non-RVU base fee schedule,23.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 0615T,Not in chargemaster,0615T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,0615T,BCBSMN Non-RVU base fee schedule,13.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 10011,Not in chargemaster,10011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10011,BCBSMN Non-RVU base fee schedule,916.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 10012,Not in chargemaster,10012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,10012,BCBSMN Non-RVU base fee schedule,552.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15824,Not in chargemaster,15824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15824,BCBSMN Non-RVU base fee schedule,1027.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15825,Not in chargemaster,15825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15825,BCBSMN Non-RVU base fee schedule,1510.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15826,Not in chargemaster,15826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15826,BCBSMN Non-RVU base fee schedule,1027.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15828,Not in chargemaster,15828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15828,BCBSMN Non-RVU base fee schedule,1110.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15829,Not in chargemaster,15829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15829,BCBSMN Non-RVU base fee schedule,3377.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15847,Not in chargemaster,15847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15847,BCBSMN Non-RVU base fee schedule,334.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15876,Not in chargemaster,15876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15876,BCBSMN Non-RVU base fee schedule,50.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15877,Not in chargemaster,15877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15877,BCBSMN Non-RVU base fee schedule,655.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15878,Not in chargemaster,15878,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15878,BCBSMN Non-RVU base fee schedule,43.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 15879,Not in chargemaster,15879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,15879,BCBSMN Non-RVU base fee schedule,259.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 17380,Not in chargemaster,17380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,17380,BCBSMN Non-RVU base fee schedule,52.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 20930,Not in chargemaster,20930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20930,BCBSMN Non-RVU base fee schedule,82.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 20936,Not in chargemaster,20936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,20936,BCBSMN Non-RVU base fee schedule,87.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 21088,Not in chargemaster,21088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21088,BCBSMN Non-RVU base fee schedule,301.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 21742,Not in chargemaster,21742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21742,BCBSMN Non-RVU base fee schedule,1249.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 21743,Not in chargemaster,21743,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,21743,BCBSMN Non-RVU base fee schedule,1341.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 22841,Not in chargemaster,22841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,22841,BCBSMN Non-RVU base fee schedule,499.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 24940,Not in chargemaster,24940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,24940,BCBSMN Non-RVU base fee schedule,1004.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 32850,Not in chargemaster,32850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32850,BCBSMN Non-RVU base fee schedule,1485,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 32855,Not in chargemaster,32855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32855,BCBSMN Non-RVU base fee schedule,879.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 32856,Not in chargemaster,32856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,32856,BCBSMN Non-RVU base fee schedule,6.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34839,Not in chargemaster,34839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34839,BCBSMN Non-RVU base fee schedule,227.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34841,Not in chargemaster,34841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34841,BCBSMN Non-RVU base fee schedule,342.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34842,Not in chargemaster,34842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34842,BCBSMN Non-RVU base fee schedule,474.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34843,Not in chargemaster,34843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34843,BCBSMN Non-RVU base fee schedule,606.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34844,Not in chargemaster,34844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34844,BCBSMN Non-RVU base fee schedule,738.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34845,Not in chargemaster,34845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34845,BCBSMN Non-RVU base fee schedule,342.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34846,Not in chargemaster,34846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34846,BCBSMN Non-RVU base fee schedule,474.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34847,Not in chargemaster,34847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34847,BCBSMN Non-RVU base fee schedule,606.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 34848,Not in chargemaster,34848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,34848,BCBSMN Non-RVU base fee schedule,738.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 36415,Not in chargemaster,36415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36415,BCBSMN Non-RVU base fee schedule,3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 36416,Not in chargemaster,36416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36416,BCBSMN Non-RVU base fee schedule,3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 36468,Not in chargemaster,36468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,36468,BCBSMN Non-RVU base fee schedule,110,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 37195,Not in chargemaster,37195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,37195,BCBSMN Non-RVU base fee schedule,665.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 41599,Not in chargemaster,41599,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41599,BCBSMN Non-RVU base fee schedule,770.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 41820,Not in chargemaster,41820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41820,BCBSMN Non-RVU base fee schedule,232.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 41821,Not in chargemaster,41821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41821,BCBSMN Non-RVU base fee schedule,37.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 41850,Not in chargemaster,41850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41850,BCBSMN Non-RVU base fee schedule,84.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 41870,Not in chargemaster,41870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,41870,BCBSMN Non-RVU base fee schedule,211.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 43647,Not in chargemaster,43647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43647,BCBSMN Non-RVU base fee schedule,1140.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 43648,Not in chargemaster,43648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43648,BCBSMN Non-RVU base fee schedule,1286.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 43881,Not in chargemaster,43881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43881,BCBSMN Non-RVU base fee schedule,1094.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 43882,Not in chargemaster,43882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,43882,BCBSMN Non-RVU base fee schedule,1263.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 47133,Not in chargemaster,47133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47133,BCBSMN Non-RVU base fee schedule,4095.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 47143,Not in chargemaster,47143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,47143,BCBSMN Non-RVU base fee schedule,1574.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 48160,Not in chargemaster,48160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48160,BCBSMN Non-RVU base fee schedule,2201.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 48550,Not in chargemaster,48550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,48550,BCBSMN Non-RVU base fee schedule,2768.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 50300,Not in chargemaster,50300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50300,BCBSMN Non-RVU base fee schedule,860.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 50323,Not in chargemaster,50323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50323,BCBSMN Non-RVU base fee schedule,144.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 50325,Not in chargemaster,50325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,50325,BCBSMN Non-RVU base fee schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 54440,Not in chargemaster,54440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,54440,BCBSMN Non-RVU base fee schedule,391.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 58974,Not in chargemaster,58974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,58974,BCBSMN Non-RVU base fee schedule,130.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 59897,Not in chargemaster,59897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,59897,BCBSMN Non-RVU base fee schedule,2085.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 62380,Not in chargemaster,62380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,62380,BCBSMN Non-RVU base fee schedule,1951.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 63043,Not in chargemaster,63043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63043,BCBSMN Non-RVU base fee schedule,422.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 63044,Not in chargemaster,63044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,63044,BCBSMN Non-RVU base fee schedule,401.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 65757,Not in chargemaster,65757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65757,BCBSMN Non-RVU base fee schedule,88.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 65760,Not in chargemaster,65760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65760,BCBSMN Non-RVU base fee schedule,804.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 65765,Not in chargemaster,65765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65765,BCBSMN Non-RVU base fee schedule,1615.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 65767,Not in chargemaster,65767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65767,BCBSMN Non-RVU base fee schedule,1038.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 65771,Not in chargemaster,65771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,65771,BCBSMN Non-RVU base fee schedule,941.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 66983,Not in chargemaster,66983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66983,BCBSMN Non-RVU base fee schedule,1398.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 66987,Not in chargemaster,66987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66987,BCBSMN Non-RVU base fee schedule,1495.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 66988,Not in chargemaster,66988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,66988,BCBSMN Non-RVU base fee schedule,1204.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 76140,Not in chargemaster,76140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,76140,BCBSMN Non-RVU base fee schedule,13.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77061,Not in chargemaster,77061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77061,BCBSMN Non-RVU base fee schedule,14.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77062,Not in chargemaster,77062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77062,BCBSMN Non-RVU base fee schedule,29.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77371,Not in chargemaster,77371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77371,BCBSMN Non-RVU base fee schedule,1738.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77385,Not in chargemaster,77385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77385,BCBSMN Non-RVU base fee schedule,631.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77386,Not in chargemaster,77386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77386,BCBSMN Non-RVU base fee schedule,734.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77387,Not in chargemaster,77387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77387,BCBSMN Non-RVU base fee schedule,70.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77402,Not in chargemaster,77402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77402,BCBSMN Non-RVU base fee schedule,260.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77407,Not in chargemaster,77407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77407,BCBSMN Non-RVU base fee schedule,472.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77412,Not in chargemaster,77412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77412,BCBSMN Non-RVU base fee schedule,448.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77423,Not in chargemaster,77423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77423,BCBSMN Non-RVU base fee schedule,129.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77424,Not in chargemaster,77424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77424,BCBSMN Non-RVU base fee schedule,326.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77425,Not in chargemaster,77425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77425,BCBSMN Non-RVU base fee schedule,326.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77522,Not in chargemaster,77522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77522,BCBSMN Non-RVU base fee schedule,985.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 77525,Not in chargemaster,77525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,77525,BCBSMN Non-RVU base fee schedule,985.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 78267,Not in chargemaster,78267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78267,BCBSMN Non-RVU base fee schedule,12.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 78268,Not in chargemaster,78268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,78268,BCBSMN Non-RVU base fee schedule,103.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80047,Not in chargemaster,80047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80047,BCBSMN Non-RVU base fee schedule,13.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80048,Not in chargemaster,80048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80048,BCBSMN Non-RVU base fee schedule,8.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80050,Not in chargemaster,80050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80050,BCBSMN Non-RVU base fee schedule,50.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80051,Not in chargemaster,80051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80051,BCBSMN Non-RVU base fee schedule,7.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80053,Not in chargemaster,80053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80053,BCBSMN Non-RVU base fee schedule,10.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80055,Not in chargemaster,80055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80055,BCBSMN Non-RVU base fee schedule,52.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80061,Not in chargemaster,80061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80061,BCBSMN Non-RVU base fee schedule,13.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80069,Not in chargemaster,80069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80069,BCBSMN Non-RVU base fee schedule,8.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80074,Not in chargemaster,80074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80074,BCBSMN Non-RVU base fee schedule,52.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80076,Not in chargemaster,80076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80076,BCBSMN Non-RVU base fee schedule,8.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80081,Not in chargemaster,80081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80081,BCBSMN Non-RVU base fee schedule,82.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80145,Not in chargemaster,80145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80145,BCBSMN Non-RVU base fee schedule,42.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80150,Not in chargemaster,80150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80150,BCBSMN Non-RVU base fee schedule,16.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80155,Not in chargemaster,80155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80155,BCBSMN Non-RVU base fee schedule,42.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80156,Not in chargemaster,80156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80156,BCBSMN Non-RVU base fee schedule,16.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80157,Not in chargemaster,80157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80157,BCBSMN Non-RVU base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80158,Not in chargemaster,80158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80158,BCBSMN Non-RVU base fee schedule,19.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80159,Not in chargemaster,80159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80159,BCBSMN Non-RVU base fee schedule,22.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80162,Not in chargemaster,80162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80162,BCBSMN Non-RVU base fee schedule,14.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80163,Not in chargemaster,80163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80163,BCBSMN Non-RVU base fee schedule,14.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80164,Not in chargemaster,80164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80164,BCBSMN Non-RVU base fee schedule,14.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80165,Not in chargemaster,80165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80165,BCBSMN Non-RVU base fee schedule,14.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80168,Not in chargemaster,80168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80168,BCBSMN Non-RVU base fee schedule,17.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80169,Not in chargemaster,80169,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80169,BCBSMN Non-RVU base fee schedule,15.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80170,Not in chargemaster,80170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80170,BCBSMN Non-RVU base fee schedule,18.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80171,Not in chargemaster,80171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80171,BCBSMN Non-RVU base fee schedule,23.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80173,Not in chargemaster,80173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80173,BCBSMN Non-RVU base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80175,Not in chargemaster,80175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80175,BCBSMN Non-RVU base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80176,Not in chargemaster,80176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80176,BCBSMN Non-RVU base fee schedule,16.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80177,Not in chargemaster,80177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80177,BCBSMN Non-RVU base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80178,Not in chargemaster,80178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80178,BCBSMN Non-RVU base fee schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80180,Not in chargemaster,80180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80180,BCBSMN Non-RVU base fee schedule,19.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80183,Not in chargemaster,80183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80183,BCBSMN Non-RVU base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80184,Not in chargemaster,80184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80184,BCBSMN Non-RVU base fee schedule,16.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80185,Not in chargemaster,80185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80185,BCBSMN Non-RVU base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80186,Not in chargemaster,80186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80186,BCBSMN Non-RVU base fee schedule,15.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80187,Not in chargemaster,80187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80187,BCBSMN Non-RVU base fee schedule,29.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80188,Not in chargemaster,80188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80188,BCBSMN Non-RVU base fee schedule,18.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80190,Not in chargemaster,80190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80190,BCBSMN Non-RVU base fee schedule,66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80192,Not in chargemaster,80192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80192,BCBSMN Non-RVU base fee schedule,18.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80194,Not in chargemaster,80194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80194,BCBSMN Non-RVU base fee schedule,16.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80195,Not in chargemaster,80195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80195,BCBSMN Non-RVU base fee schedule,15.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80197,Not in chargemaster,80197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80197,BCBSMN Non-RVU base fee schedule,15.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80198,Not in chargemaster,80198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80198,BCBSMN Non-RVU base fee schedule,15.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80199,Not in chargemaster,80199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80199,BCBSMN Non-RVU base fee schedule,29.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80200,Not in chargemaster,80200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80200,BCBSMN Non-RVU base fee schedule,17.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80201,Not in chargemaster,80201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80201,BCBSMN Non-RVU base fee schedule,13.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80202,Not in chargemaster,80202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80202,BCBSMN Non-RVU base fee schedule,14.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80203,Not in chargemaster,80203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80203,BCBSMN Non-RVU base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80230,Not in chargemaster,80230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80230,BCBSMN Non-RVU base fee schedule,42.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80235,Not in chargemaster,80235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80235,BCBSMN Non-RVU base fee schedule,29.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80280,Not in chargemaster,80280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80280,BCBSMN Non-RVU base fee schedule,42.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80285,Not in chargemaster,80285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80285,BCBSMN Non-RVU base fee schedule,29.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80299,Not in chargemaster,80299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80299,BCBSMN Non-RVU base fee schedule,20.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80305,Not in chargemaster,80305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80305,BCBSMN Non-RVU base fee schedule,12.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80306,Not in chargemaster,80306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80306,BCBSMN Non-RVU base fee schedule,18.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80307,Not in chargemaster,80307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80307,BCBSMN Non-RVU base fee schedule,68.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80320,Not in chargemaster,80320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80320,BCBSMN Non-RVU base fee schedule,16.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80321,Not in chargemaster,80321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80321,BCBSMN Non-RVU base fee schedule,16.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80322,Not in chargemaster,80322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80322,BCBSMN Non-RVU base fee schedule,16.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80323,Not in chargemaster,80323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80323,BCBSMN Non-RVU base fee schedule,51.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80324,Not in chargemaster,80324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80324,BCBSMN Non-RVU base fee schedule,26.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80325,Not in chargemaster,80325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80325,BCBSMN Non-RVU base fee schedule,26.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80326,Not in chargemaster,80326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80326,BCBSMN Non-RVU base fee schedule,6.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80327,Not in chargemaster,80327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80327,BCBSMN Non-RVU base fee schedule,44.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80328,Not in chargemaster,80328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80328,BCBSMN Non-RVU base fee schedule,44.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80329,Not in chargemaster,80329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80329,BCBSMN Non-RVU base fee schedule,34.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80330,Not in chargemaster,80330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80330,BCBSMN Non-RVU base fee schedule,34.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80331,Not in chargemaster,80331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80331,BCBSMN Non-RVU base fee schedule,6.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80332,Not in chargemaster,80332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80332,BCBSMN Non-RVU base fee schedule,23.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80333,Not in chargemaster,80333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80333,BCBSMN Non-RVU base fee schedule,23.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80334,Not in chargemaster,80334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80334,BCBSMN Non-RVU base fee schedule,9.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80335,Not in chargemaster,80335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80335,BCBSMN Non-RVU base fee schedule,30.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80336,Not in chargemaster,80336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80336,BCBSMN Non-RVU base fee schedule,30.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80337,Not in chargemaster,80337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80337,BCBSMN Non-RVU base fee schedule,16.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80338,Not in chargemaster,80338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80338,BCBSMN Non-RVU base fee schedule,9.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80339,Not in chargemaster,80339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80339,BCBSMN Non-RVU base fee schedule,23.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80340,Not in chargemaster,80340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80340,BCBSMN Non-RVU base fee schedule,23.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80341,Not in chargemaster,80341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80341,BCBSMN Non-RVU base fee schedule,13.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80342,Not in chargemaster,80342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80342,BCBSMN Non-RVU base fee schedule,26.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80343,Not in chargemaster,80343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80343,BCBSMN Non-RVU base fee schedule,26.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80344,Not in chargemaster,80344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80344,BCBSMN Non-RVU base fee schedule,5.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80345,Not in chargemaster,80345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80345,BCBSMN Non-RVU base fee schedule,19.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80346,Not in chargemaster,80346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80346,BCBSMN Non-RVU base fee schedule,33.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80347,Not in chargemaster,80347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80347,BCBSMN Non-RVU base fee schedule,6.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80348,Not in chargemaster,80348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80348,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80349,Not in chargemaster,80349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80349,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80350,Not in chargemaster,80350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80350,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80351,Not in chargemaster,80351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80351,BCBSMN Non-RVU base fee schedule,23.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80352,Not in chargemaster,80352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80352,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80353,Not in chargemaster,80353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80353,BCBSMN Non-RVU base fee schedule,25.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80354,Not in chargemaster,80354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80354,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80355,Not in chargemaster,80355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80355,BCBSMN Non-RVU base fee schedule,21.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80356,Not in chargemaster,80356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80356,BCBSMN Non-RVU base fee schedule,30.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80357,Not in chargemaster,80357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80357,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80358,Not in chargemaster,80358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80358,BCBSMN Non-RVU base fee schedule,27.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80359,Not in chargemaster,80359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80359,BCBSMN Non-RVU base fee schedule,26.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80360,Not in chargemaster,80360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80360,BCBSMN Non-RVU base fee schedule,26.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80361,Not in chargemaster,80361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80361,BCBSMN Non-RVU base fee schedule,35.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80362,Not in chargemaster,80362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80362,BCBSMN Non-RVU base fee schedule,33.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80363,Not in chargemaster,80363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80363,BCBSMN Non-RVU base fee schedule,33.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80364,Not in chargemaster,80364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80364,BCBSMN Non-RVU base fee schedule,18.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80365,Not in chargemaster,80365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80365,BCBSMN Non-RVU base fee schedule,20.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80366,Not in chargemaster,80366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80366,BCBSMN Non-RVU base fee schedule,25.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80367,Not in chargemaster,80367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80367,BCBSMN Non-RVU base fee schedule,8.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80368,Not in chargemaster,80368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80368,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80369,Not in chargemaster,80369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80369,BCBSMN Non-RVU base fee schedule,30.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80370,Not in chargemaster,80370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80370,BCBSMN Non-RVU base fee schedule,30.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80371,Not in chargemaster,80371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80371,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80372,Not in chargemaster,80372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80372,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80373,Not in chargemaster,80373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80373,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80374,Not in chargemaster,80374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80374,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80375,Not in chargemaster,80375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80375,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80376,Not in chargemaster,80376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80376,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80377,Not in chargemaster,80377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80377,BCBSMN Non-RVU base fee schedule,5.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80400,Not in chargemaster,80400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80400,BCBSMN Non-RVU base fee schedule,35.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80402,Not in chargemaster,80402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80402,BCBSMN Non-RVU base fee schedule,95.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80406,Not in chargemaster,80406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80406,BCBSMN Non-RVU base fee schedule,86.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80408,Not in chargemaster,80408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80408,BCBSMN Non-RVU base fee schedule,138.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80410,Not in chargemaster,80410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80410,BCBSMN Non-RVU base fee schedule,88.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80412,Not in chargemaster,80412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80412,BCBSMN Non-RVU base fee schedule,881.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80414,Not in chargemaster,80414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80414,BCBSMN Non-RVU base fee schedule,56.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80415,Not in chargemaster,80415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80415,BCBSMN Non-RVU base fee schedule,61.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80416,Not in chargemaster,80416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80416,BCBSMN Non-RVU base fee schedule,230.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80417,Not in chargemaster,80417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80417,BCBSMN Non-RVU base fee schedule,48.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80418,Not in chargemaster,80418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80418,BCBSMN Non-RVU base fee schedule,637.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80420,Not in chargemaster,80420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80420,BCBSMN Non-RVU base fee schedule,178.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80422,Not in chargemaster,80422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80422,BCBSMN Non-RVU base fee schedule,50.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80424,Not in chargemaster,80424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80424,BCBSMN Non-RVU base fee schedule,55.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80426,Not in chargemaster,80426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80426,BCBSMN Non-RVU base fee schedule,163.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80428,Not in chargemaster,80428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80428,BCBSMN Non-RVU base fee schedule,73.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80430,Not in chargemaster,80430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80430,BCBSMN Non-RVU base fee schedule,142.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80432,Not in chargemaster,80432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80432,BCBSMN Non-RVU base fee schedule,182.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80434,Not in chargemaster,80434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80434,BCBSMN Non-RVU base fee schedule,313.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80435,Not in chargemaster,80435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80435,BCBSMN Non-RVU base fee schedule,113.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80436,Not in chargemaster,80436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80436,BCBSMN Non-RVU base fee schedule,100.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80438,Not in chargemaster,80438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80438,BCBSMN Non-RVU base fee schedule,55.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 80439,Not in chargemaster,80439,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,80439,BCBSMN Non-RVU base fee schedule,73.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81000,Not in chargemaster,81000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81000,BCBSMN Non-RVU base fee schedule,4.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81001,Not in chargemaster,81001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81001,BCBSMN Non-RVU base fee schedule,3.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81002,Not in chargemaster,81002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81002,BCBSMN Non-RVU base fee schedule,3.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81003,Not in chargemaster,81003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81003,BCBSMN Non-RVU base fee schedule,2.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81005,Not in chargemaster,81005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81005,BCBSMN Non-RVU base fee schedule,2.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81007,Not in chargemaster,81007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81007,BCBSMN Non-RVU base fee schedule,29.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81015,Not in chargemaster,81015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81015,BCBSMN Non-RVU base fee schedule,3.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81020,Not in chargemaster,81020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81020,BCBSMN Non-RVU base fee schedule,5.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81025,Not in chargemaster,81025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81025,BCBSMN Non-RVU base fee schedule,9.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81050,Not in chargemaster,81050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81050,BCBSMN Non-RVU base fee schedule,4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81105,Not in chargemaster,81105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81105,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81106,Not in chargemaster,81106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81106,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81107,Not in chargemaster,81107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81107,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81108,Not in chargemaster,81108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81108,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81109,Not in chargemaster,81109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81109,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81110,Not in chargemaster,81110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81110,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81111,Not in chargemaster,81111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81111,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81112,Not in chargemaster,81112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81112,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81120,Not in chargemaster,81120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81120,BCBSMN Non-RVU base fee schedule,212.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81121,Not in chargemaster,81121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81121,BCBSMN Non-RVU base fee schedule,325.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81161,Not in chargemaster,81161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81161,BCBSMN Non-RVU base fee schedule,306.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81162,Not in chargemaster,81162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81162,BCBSMN Non-RVU base fee schedule,1025,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81163,Not in chargemaster,81163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81163,BCBSMN Non-RVU base fee schedule,1029.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81164,Not in chargemaster,81164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81164,BCBSMN Non-RVU base fee schedule,642.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81165,Not in chargemaster,81165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81165,BCBSMN Non-RVU base fee schedule,622.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81166,Not in chargemaster,81166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81166,BCBSMN Non-RVU base fee schedule,331.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81167,Not in chargemaster,81167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81167,BCBSMN Non-RVU base fee schedule,311.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81170,Not in chargemaster,81170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81170,BCBSMN Non-RVU base fee schedule,330,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81171,Not in chargemaster,81171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81171,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81172,Not in chargemaster,81172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81172,BCBSMN Non-RVU base fee schedule,302.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81173,Not in chargemaster,81173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81173,BCBSMN Non-RVU base fee schedule,331.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81174,Not in chargemaster,81174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81174,BCBSMN Non-RVU base fee schedule,203.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81175,Not in chargemaster,81175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81175,BCBSMN Non-RVU base fee schedule,744.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81176,Not in chargemaster,81176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81176,BCBSMN Non-RVU base fee schedule,266.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81177,Not in chargemaster,81177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81177,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81178,Not in chargemaster,81178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81178,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81179,Not in chargemaster,81179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81179,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81180,Not in chargemaster,81180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81180,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81181,Not in chargemaster,81181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81181,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81182,Not in chargemaster,81182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81182,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81183,Not in chargemaster,81183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81183,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81184,Not in chargemaster,81184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81184,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81185,Not in chargemaster,81185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81185,BCBSMN Non-RVU base fee schedule,930.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81186,Not in chargemaster,81186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81186,BCBSMN Non-RVU base fee schedule,203.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81187,Not in chargemaster,81187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81187,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81188,Not in chargemaster,81188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81188,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81189,Not in chargemaster,81189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81189,BCBSMN Non-RVU base fee schedule,302.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81190,Not in chargemaster,81190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81190,BCBSMN Non-RVU base fee schedule,203.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81200,Not in chargemaster,81200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81200,BCBSMN Non-RVU base fee schedule,51.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81201,Not in chargemaster,81201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81201,BCBSMN Non-RVU base fee schedule,858,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81202,Not in chargemaster,81202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81202,BCBSMN Non-RVU base fee schedule,308,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81203,Not in chargemaster,81203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81203,BCBSMN Non-RVU base fee schedule,220,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81204,Not in chargemaster,81204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81204,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81205,Not in chargemaster,81205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81205,BCBSMN Non-RVU base fee schedule,104.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81206,Not in chargemaster,81206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81206,BCBSMN Non-RVU base fee schedule,180.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81207,Not in chargemaster,81207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81207,BCBSMN Non-RVU base fee schedule,159.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81208,Not in chargemaster,81208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81208,BCBSMN Non-RVU base fee schedule,236.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81209,Not in chargemaster,81209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81209,BCBSMN Non-RVU base fee schedule,43.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81210,Not in chargemaster,81210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81210,BCBSMN Non-RVU base fee schedule,192.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81212,Not in chargemaster,81212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81212,BCBSMN Non-RVU base fee schedule,484,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81215,Not in chargemaster,81215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81215,BCBSMN Non-RVU base fee schedule,412.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81216,Not in chargemaster,81216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81216,BCBSMN Non-RVU base fee schedule,203.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81217,Not in chargemaster,81217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81217,BCBSMN Non-RVU base fee schedule,412.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81218,Not in chargemaster,81218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81218,BCBSMN Non-RVU base fee schedule,266.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81219,Not in chargemaster,81219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81219,BCBSMN Non-RVU base fee schedule,133.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81220,Not in chargemaster,81220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81220,BCBSMN Non-RVU base fee schedule,612.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81221,Not in chargemaster,81221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81221,BCBSMN Non-RVU base fee schedule,106.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81222,Not in chargemaster,81222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81222,BCBSMN Non-RVU base fee schedule,478.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81223,Not in chargemaster,81223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81223,BCBSMN Non-RVU base fee schedule,548.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81224,Not in chargemaster,81224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81224,BCBSMN Non-RVU base fee schedule,185.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81225,Not in chargemaster,81225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81225,BCBSMN Non-RVU base fee schedule,320.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81226,Not in chargemaster,81226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81226,BCBSMN Non-RVU base fee schedule,496,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81227,Not in chargemaster,81227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81227,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81228,Not in chargemaster,81228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81228,BCBSMN Non-RVU base fee schedule,990,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81229,Not in chargemaster,81229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81229,BCBSMN Non-RVU base fee schedule,1276,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81230,Not in chargemaster,81230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81230,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81231,Not in chargemaster,81231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81231,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81232,Not in chargemaster,81232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81232,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81233,Not in chargemaster,81233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81233,BCBSMN Non-RVU base fee schedule,192.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81234,Not in chargemaster,81234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81234,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81235,Not in chargemaster,81235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81235,BCBSMN Non-RVU base fee schedule,357.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81236,Not in chargemaster,81236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81236,BCBSMN Non-RVU base fee schedule,311.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81237,Not in chargemaster,81237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81237,BCBSMN Non-RVU base fee schedule,192.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81238,Not in chargemaster,81238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81238,BCBSMN Non-RVU base fee schedule,660,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81239,Not in chargemaster,81239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81239,BCBSMN Non-RVU base fee schedule,302.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81240,Not in chargemaster,81240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81240,BCBSMN Non-RVU base fee schedule,72.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81241,Not in chargemaster,81241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81241,BCBSMN Non-RVU base fee schedule,80.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81242,Not in chargemaster,81242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81242,BCBSMN Non-RVU base fee schedule,40.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81243,Not in chargemaster,81243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81243,BCBSMN Non-RVU base fee schedule,62.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81244,Not in chargemaster,81244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81244,BCBSMN Non-RVU base fee schedule,49.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81245,Not in chargemaster,81245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81245,BCBSMN Non-RVU base fee schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81246,Not in chargemaster,81246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81246,BCBSMN Non-RVU base fee schedule,91.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81247,Not in chargemaster,81247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81247,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81248,Not in chargemaster,81248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81248,BCBSMN Non-RVU base fee schedule,412.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81249,Not in chargemaster,81249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81249,BCBSMN Non-RVU base fee schedule,660,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81250,Not in chargemaster,81250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81250,BCBSMN Non-RVU base fee schedule,64.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81251,Not in chargemaster,81251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81251,BCBSMN Non-RVU base fee schedule,51.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81252,Not in chargemaster,81252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81252,BCBSMN Non-RVU base fee schedule,111.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81253,Not in chargemaster,81253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81253,BCBSMN Non-RVU base fee schedule,67.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81254,Not in chargemaster,81254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81254,BCBSMN Non-RVU base fee schedule,38.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81255,Not in chargemaster,81255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81255,BCBSMN Non-RVU base fee schedule,56.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81256,Not in chargemaster,81256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81256,BCBSMN Non-RVU base fee schedule,71.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81257,Not in chargemaster,81257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81257,BCBSMN Non-RVU base fee schedule,112.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81258,Not in chargemaster,81258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81258,BCBSMN Non-RVU base fee schedule,412.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81259,Not in chargemaster,81259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81259,BCBSMN Non-RVU base fee schedule,660,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81260,Not in chargemaster,81260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81260,BCBSMN Non-RVU base fee schedule,43.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81261,Not in chargemaster,81261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81261,BCBSMN Non-RVU base fee schedule,217.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81262,Not in chargemaster,81262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81262,BCBSMN Non-RVU base fee schedule,75.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81263,Not in chargemaster,81263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81263,BCBSMN Non-RVU base fee schedule,323.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81264,Not in chargemaster,81264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81264,BCBSMN Non-RVU base fee schedule,190,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81265,Not in chargemaster,81265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81265,BCBSMN Non-RVU base fee schedule,256.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81266,Not in chargemaster,81266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81266,BCBSMN Non-RVU base fee schedule,335.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81267,Not in chargemaster,81267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81267,BCBSMN Non-RVU base fee schedule,228.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81268,Not in chargemaster,81268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81268,BCBSMN Non-RVU base fee schedule,286.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81269,Not in chargemaster,81269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81269,BCBSMN Non-RVU base fee schedule,222.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81270,Not in chargemaster,81270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81270,BCBSMN Non-RVU base fee schedule,100.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81271,Not in chargemaster,81271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81271,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81272,Not in chargemaster,81272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81272,BCBSMN Non-RVU base fee schedule,362.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81273,Not in chargemaster,81273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81273,BCBSMN Non-RVU base fee schedule,137.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81274,Not in chargemaster,81274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81274,BCBSMN Non-RVU base fee schedule,302.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81275,Not in chargemaster,81275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81275,BCBSMN Non-RVU base fee schedule,212.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81276,Not in chargemaster,81276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81276,BCBSMN Non-RVU base fee schedule,212.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81277,Not in chargemaster,81277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81277,BCBSMN Non-RVU base fee schedule,1276,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81283,Not in chargemaster,81283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81283,BCBSMN Non-RVU base fee schedule,80.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81284,Not in chargemaster,81284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81284,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81285,Not in chargemaster,81285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81285,BCBSMN Non-RVU base fee schedule,302.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81286,Not in chargemaster,81286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81286,BCBSMN Non-RVU base fee schedule,302.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81287,Not in chargemaster,81287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81287,BCBSMN Non-RVU base fee schedule,137.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81288,Not in chargemaster,81288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81288,BCBSMN Non-RVU base fee schedule,211.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81289,Not in chargemaster,81289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81289,BCBSMN Non-RVU base fee schedule,203.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81290,Not in chargemaster,81290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81290,BCBSMN Non-RVU base fee schedule,43.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81291,Not in chargemaster,81291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81291,BCBSMN Non-RVU base fee schedule,71.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81292,Not in chargemaster,81292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81292,BCBSMN Non-RVU base fee schedule,742.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81293,Not in chargemaster,81293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81293,BCBSMN Non-RVU base fee schedule,364.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81294,Not in chargemaster,81294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81294,BCBSMN Non-RVU base fee schedule,222.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81295,Not in chargemaster,81295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81295,BCBSMN Non-RVU base fee schedule,419.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81296,Not in chargemaster,81296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81296,BCBSMN Non-RVU base fee schedule,371.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81297,Not in chargemaster,81297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81297,BCBSMN Non-RVU base fee schedule,234.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81298,Not in chargemaster,81298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81298,BCBSMN Non-RVU base fee schedule,706.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81299,Not in chargemaster,81299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81299,BCBSMN Non-RVU base fee schedule,338.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81300,Not in chargemaster,81300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81300,BCBSMN Non-RVU base fee schedule,261.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81301,Not in chargemaster,81301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81301,BCBSMN Non-RVU base fee schedule,383.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81302,Not in chargemaster,81302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81302,BCBSMN Non-RVU base fee schedule,580.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81303,Not in chargemaster,81303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81303,BCBSMN Non-RVU base fee schedule,132,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81304,Not in chargemaster,81304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81304,BCBSMN Non-RVU base fee schedule,165,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81305,Not in chargemaster,81305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81305,BCBSMN Non-RVU base fee schedule,192.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81306,Not in chargemaster,81306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81306,BCBSMN Non-RVU base fee schedule,320.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81307,Not in chargemaster,81307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81307,BCBSMN Non-RVU base fee schedule,311.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81308,Not in chargemaster,81308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81308,BCBSMN Non-RVU base fee schedule,331.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81309,Not in chargemaster,81309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81309,BCBSMN Non-RVU base fee schedule,302.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81310,Not in chargemaster,81310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81310,BCBSMN Non-RVU base fee schedule,271.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81311,Not in chargemaster,81311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81311,BCBSMN Non-RVU base fee schedule,325.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81312,Not in chargemaster,81312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81312,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81313,Not in chargemaster,81313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81313,BCBSMN Non-RVU base fee schedule,280.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81314,Not in chargemaster,81314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81314,BCBSMN Non-RVU base fee schedule,362.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81315,Not in chargemaster,81315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81315,BCBSMN Non-RVU base fee schedule,228.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81316,Not in chargemaster,81316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81316,BCBSMN Non-RVU base fee schedule,228.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81317,Not in chargemaster,81317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81317,BCBSMN Non-RVU base fee schedule,744.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81318,Not in chargemaster,81318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81318,BCBSMN Non-RVU base fee schedule,364.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81319,Not in chargemaster,81319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81319,BCBSMN Non-RVU base fee schedule,223.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81320,Not in chargemaster,81320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81320,BCBSMN Non-RVU base fee schedule,320.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81321,Not in chargemaster,81321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81321,BCBSMN Non-RVU base fee schedule,660,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81322,Not in chargemaster,81322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81322,BCBSMN Non-RVU base fee schedule,51.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81323,Not in chargemaster,81323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81323,BCBSMN Non-RVU base fee schedule,330,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81324,Not in chargemaster,81324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81324,BCBSMN Non-RVU base fee schedule,834.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81325,Not in chargemaster,81325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81325,BCBSMN Non-RVU base fee schedule,846.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81326,Not in chargemaster,81326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81326,BCBSMN Non-RVU base fee schedule,51.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81327,Not in chargemaster,81327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81327,BCBSMN Non-RVU base fee schedule,211.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81328,Not in chargemaster,81328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81328,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81329,Not in chargemaster,81329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81329,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81330,Not in chargemaster,81330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81330,BCBSMN Non-RVU base fee schedule,51.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81331,Not in chargemaster,81331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81331,BCBSMN Non-RVU base fee schedule,56.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81332,Not in chargemaster,81332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81332,BCBSMN Non-RVU base fee schedule,48.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81333,Not in chargemaster,81333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81333,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81334,Not in chargemaster,81334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81334,BCBSMN Non-RVU base fee schedule,362.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81335,Not in chargemaster,81335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81335,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81336,Not in chargemaster,81336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81336,BCBSMN Non-RVU base fee schedule,331.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81337,Not in chargemaster,81337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81337,BCBSMN Non-RVU base fee schedule,203.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81340,Not in chargemaster,81340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81340,BCBSMN Non-RVU base fee schedule,229.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81341,Not in chargemaster,81341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81341,BCBSMN Non-RVU base fee schedule,54.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81342,Not in chargemaster,81342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81342,BCBSMN Non-RVU base fee schedule,221.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81343,Not in chargemaster,81343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81343,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81344,Not in chargemaster,81344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81344,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81345,Not in chargemaster,81345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81345,BCBSMN Non-RVU base fee schedule,203.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81346,Not in chargemaster,81346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81346,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81350,Not in chargemaster,81350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81350,BCBSMN Non-RVU base fee schedule,257.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81355,Not in chargemaster,81355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81355,BCBSMN Non-RVU base fee schedule,97.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81361,Not in chargemaster,81361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81361,BCBSMN Non-RVU base fee schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81362,Not in chargemaster,81362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81362,BCBSMN Non-RVU base fee schedule,412.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81363,Not in chargemaster,81363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81363,BCBSMN Non-RVU base fee schedule,222.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81364,Not in chargemaster,81364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81364,BCBSMN Non-RVU base fee schedule,357.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81370,Not in chargemaster,81370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81370,BCBSMN Non-RVU base fee schedule,442.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81371,Not in chargemaster,81371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81371,BCBSMN Non-RVU base fee schedule,444.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81372,Not in chargemaster,81372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81372,BCBSMN Non-RVU base fee schedule,443.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81373,Not in chargemaster,81373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81373,BCBSMN Non-RVU base fee schedule,140.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81374,Not in chargemaster,81374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81374,BCBSMN Non-RVU base fee schedule,81.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81375,Not in chargemaster,81375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81375,BCBSMN Non-RVU base fee schedule,242.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81376,Not in chargemaster,81376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81376,BCBSMN Non-RVU base fee schedule,134.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81377,Not in chargemaster,81377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81377,BCBSMN Non-RVU base fee schedule,104.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81378,Not in chargemaster,81378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81378,BCBSMN Non-RVU base fee schedule,380.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81379,Not in chargemaster,81379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81379,BCBSMN Non-RVU base fee schedule,368.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81380,Not in chargemaster,81380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81380,BCBSMN Non-RVU base fee schedule,194.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81381,Not in chargemaster,81381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81381,BCBSMN Non-RVU base fee schedule,186.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81382,Not in chargemaster,81382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81382,BCBSMN Non-RVU base fee schedule,136.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81383,Not in chargemaster,81383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81383,BCBSMN Non-RVU base fee schedule,120.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81400,Not in chargemaster,81400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81400,BCBSMN Non-RVU base fee schedule,70.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81401,Not in chargemaster,81401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81401,BCBSMN Non-RVU base fee schedule,150.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81402,Not in chargemaster,81402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81402,BCBSMN Non-RVU base fee schedule,165.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81403,Not in chargemaster,81403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81403,BCBSMN Non-RVU base fee schedule,203.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81404,Not in chargemaster,81404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81404,BCBSMN Non-RVU base fee schedule,302.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81405,Not in chargemaster,81405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81405,BCBSMN Non-RVU base fee schedule,331.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81406,Not in chargemaster,81406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81406,BCBSMN Non-RVU base fee schedule,311.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81407,Not in chargemaster,81407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81407,BCBSMN Non-RVU base fee schedule,930.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81408,Not in chargemaster,81408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81408,BCBSMN Non-RVU base fee schedule,2200,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81410,Not in chargemaster,81410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81410,BCBSMN Non-RVU base fee schedule,554.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81411,Not in chargemaster,81411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81411,BCBSMN Non-RVU base fee schedule,1485.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81412,Not in chargemaster,81412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81412,BCBSMN Non-RVU base fee schedule,2693.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81413,Not in chargemaster,81413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81413,BCBSMN Non-RVU base fee schedule,643.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81414,Not in chargemaster,81414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81414,BCBSMN Non-RVU base fee schedule,643.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81415,Not in chargemaster,81415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81415,BCBSMN Non-RVU base fee schedule,5258,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81416,Not in chargemaster,81416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81416,BCBSMN Non-RVU base fee schedule,1000,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81417,Not in chargemaster,81417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81417,BCBSMN Non-RVU base fee schedule,352,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81420,Not in chargemaster,81420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81420,BCBSMN Non-RVU base fee schedule,834.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81422,Not in chargemaster,81422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81422,BCBSMN Non-RVU base fee schedule,834.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81425,Not in chargemaster,81425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81425,BCBSMN Non-RVU base fee schedule,5534.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81426,Not in chargemaster,81426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81426,BCBSMN Non-RVU base fee schedule,2980.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81427,Not in chargemaster,81427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81427,BCBSMN Non-RVU base fee schedule,2571.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81430,Not in chargemaster,81430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81430,BCBSMN Non-RVU base fee schedule,1787.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81431,Not in chargemaster,81431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81431,BCBSMN Non-RVU base fee schedule,747.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81432,Not in chargemaster,81432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81432,BCBSMN Non-RVU base fee schedule,746.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81433,Not in chargemaster,81433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81433,BCBSMN Non-RVU base fee schedule,482.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81434,Not in chargemaster,81434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81434,BCBSMN Non-RVU base fee schedule,657.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81435,Not in chargemaster,81435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81435,BCBSMN Non-RVU base fee schedule,643.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81436,Not in chargemaster,81436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81436,BCBSMN Non-RVU base fee schedule,643.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81437,Not in chargemaster,81437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81437,BCBSMN Non-RVU base fee schedule,482.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81438,Not in chargemaster,81438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81438,BCBSMN Non-RVU base fee schedule,482.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81439,Not in chargemaster,81439,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81439,BCBSMN Non-RVU base fee schedule,643.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81440,Not in chargemaster,81440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81440,BCBSMN Non-RVU base fee schedule,3656.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81442,Not in chargemaster,81442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81442,BCBSMN Non-RVU base fee schedule,2357.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81443,Not in chargemaster,81443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81443,BCBSMN Non-RVU base fee schedule,2693.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81445,Not in chargemaster,81445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81445,BCBSMN Non-RVU base fee schedule,657.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81448,Not in chargemaster,81448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81448,BCBSMN Non-RVU base fee schedule,643.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81450,Not in chargemaster,81450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81450,BCBSMN Non-RVU base fee schedule,835.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81455,Not in chargemaster,81455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81455,BCBSMN Non-RVU base fee schedule,3211.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81460,Not in chargemaster,81460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81460,BCBSMN Non-RVU base fee schedule,1415.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81465,Not in chargemaster,81465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81465,BCBSMN Non-RVU base fee schedule,1029.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81470,Not in chargemaster,81470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81470,BCBSMN Non-RVU base fee schedule,1005.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81471,Not in chargemaster,81471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81471,BCBSMN Non-RVU base fee schedule,1005.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81490,Not in chargemaster,81490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81490,BCBSMN Non-RVU base fee schedule,924.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81493,Not in chargemaster,81493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81493,BCBSMN Non-RVU base fee schedule,1155,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81500,Not in chargemaster,81500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81500,BCBSMN Non-RVU base fee schedule,286.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81503,Not in chargemaster,81503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81503,BCBSMN Non-RVU base fee schedule,986.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81504,Not in chargemaster,81504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81504,BCBSMN Non-RVU base fee schedule,572,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81506,Not in chargemaster,81506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81506,BCBSMN Non-RVU base fee schedule,75.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81507,Not in chargemaster,81507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81507,BCBSMN Non-RVU base fee schedule,874.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81508,Not in chargemaster,81508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81508,BCBSMN Non-RVU base fee schedule,59.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81509,Not in chargemaster,81509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81509,BCBSMN Non-RVU base fee schedule,1636.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81510,Not in chargemaster,81510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81510,BCBSMN Non-RVU base fee schedule,61.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81511,Not in chargemaster,81511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81511,BCBSMN Non-RVU base fee schedule,168.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81512,Not in chargemaster,81512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81512,BCBSMN Non-RVU base fee schedule,76.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81518,Not in chargemaster,81518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81518,BCBSMN Non-RVU base fee schedule,4260.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81519,Not in chargemaster,81519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81519,BCBSMN Non-RVU base fee schedule,4260.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81520,Not in chargemaster,81520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81520,BCBSMN Non-RVU base fee schedule,2761.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81521,Not in chargemaster,81521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81521,BCBSMN Non-RVU base fee schedule,4260.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81522,Not in chargemaster,81522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81522,BCBSMN Non-RVU base fee schedule,4260.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81525,Not in chargemaster,81525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81525,BCBSMN Non-RVU base fee schedule,3427.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81528,Not in chargemaster,81528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81528,BCBSMN Non-RVU base fee schedule,559.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81535,Not in chargemaster,81535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81535,BCBSMN Non-RVU base fee schedule,637.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81536,Not in chargemaster,81536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81536,BCBSMN Non-RVU base fee schedule,195.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81538,Not in chargemaster,81538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81538,BCBSMN Non-RVU base fee schedule,3158.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81539,Not in chargemaster,81539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81539,BCBSMN Non-RVU base fee schedule,836,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81540,Not in chargemaster,81540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81540,BCBSMN Non-RVU base fee schedule,4125,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81541,Not in chargemaster,81541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81541,BCBSMN Non-RVU base fee schedule,4260.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81542,Not in chargemaster,81542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81542,BCBSMN Non-RVU base fee schedule,3873,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81545,Not in chargemaster,81545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81545,BCBSMN Non-RVU base fee schedule,3960,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81551,Not in chargemaster,81551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81551,BCBSMN Non-RVU base fee schedule,2233,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81552,Not in chargemaster,81552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81552,BCBSMN Non-RVU base fee schedule,3873,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81595,Not in chargemaster,81595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81595,BCBSMN Non-RVU base fee schedule,3564,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81596,Not in chargemaster,81596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81596,BCBSMN Non-RVU base fee schedule,79.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 81599,Not in chargemaster,81599,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,81599,BCBSMN Non-RVU base fee schedule,67.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82009,Not in chargemaster,82009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82009,BCBSMN Non-RVU base fee schedule,4.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82010,Not in chargemaster,82010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82010,BCBSMN Non-RVU base fee schedule,8.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82013,Not in chargemaster,82013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82013,BCBSMN Non-RVU base fee schedule,13.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82016,Not in chargemaster,82016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82016,BCBSMN Non-RVU base fee schedule,18.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82017,Not in chargemaster,82017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82017,BCBSMN Non-RVU base fee schedule,18.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82024,Not in chargemaster,82024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82024,BCBSMN Non-RVU base fee schedule,42.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82030,Not in chargemaster,82030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82030,BCBSMN Non-RVU base fee schedule,28.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82040,Not in chargemaster,82040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82040,BCBSMN Non-RVU base fee schedule,4.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82042,Not in chargemaster,82042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82042,BCBSMN Non-RVU base fee schedule,7.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82043,Not in chargemaster,82043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82043,BCBSMN Non-RVU base fee schedule,5.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82044,Not in chargemaster,82044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82044,BCBSMN Non-RVU base fee schedule,6.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82045,Not in chargemaster,82045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82045,BCBSMN Non-RVU base fee schedule,37.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82075,Not in chargemaster,82075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82075,BCBSMN Non-RVU base fee schedule,33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82085,Not in chargemaster,82085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82085,BCBSMN Non-RVU base fee schedule,10.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82088,Not in chargemaster,82088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82088,BCBSMN Non-RVU base fee schedule,44.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82103,Not in chargemaster,82103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82103,BCBSMN Non-RVU base fee schedule,14.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82104,Not in chargemaster,82104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82104,BCBSMN Non-RVU base fee schedule,15.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82105,Not in chargemaster,82105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82105,BCBSMN Non-RVU base fee schedule,18.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82106,Not in chargemaster,82106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82106,BCBSMN Non-RVU base fee schedule,18.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82107,Not in chargemaster,82107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82107,BCBSMN Non-RVU base fee schedule,70.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82108,Not in chargemaster,82108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82108,BCBSMN Non-RVU base fee schedule,28.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82120,Not in chargemaster,82120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82120,BCBSMN Non-RVU base fee schedule,5.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82127,Not in chargemaster,82127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82127,BCBSMN Non-RVU base fee schedule,15.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82128,Not in chargemaster,82128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82128,BCBSMN Non-RVU base fee schedule,15.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82131,Not in chargemaster,82131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82131,BCBSMN Non-RVU base fee schedule,25.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82135,Not in chargemaster,82135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82135,BCBSMN Non-RVU base fee schedule,18.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82136,Not in chargemaster,82136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82136,BCBSMN Non-RVU base fee schedule,21.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82139,Not in chargemaster,82139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82139,BCBSMN Non-RVU base fee schedule,18.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82140,Not in chargemaster,82140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82140,BCBSMN Non-RVU base fee schedule,16.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82143,Not in chargemaster,82143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82143,BCBSMN Non-RVU base fee schedule,10.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82150,Not in chargemaster,82150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82150,BCBSMN Non-RVU base fee schedule,6.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82154,Not in chargemaster,82154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82154,BCBSMN Non-RVU base fee schedule,31.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82157,Not in chargemaster,82157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82157,BCBSMN Non-RVU base fee schedule,32.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82160,Not in chargemaster,82160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82160,BCBSMN Non-RVU base fee schedule,28.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82163,Not in chargemaster,82163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82163,BCBSMN Non-RVU base fee schedule,22.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82164,Not in chargemaster,82164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82164,BCBSMN Non-RVU base fee schedule,16.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82172,Not in chargemaster,82172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82172,BCBSMN Non-RVU base fee schedule,23.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82175,Not in chargemaster,82175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82175,BCBSMN Non-RVU base fee schedule,20.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82180,Not in chargemaster,82180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82180,BCBSMN Non-RVU base fee schedule,10.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82190,Not in chargemaster,82190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82190,BCBSMN Non-RVU base fee schedule,17.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82232,Not in chargemaster,82232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82232,BCBSMN Non-RVU base fee schedule,17.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82239,Not in chargemaster,82239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82239,BCBSMN Non-RVU base fee schedule,18.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82240,Not in chargemaster,82240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82240,BCBSMN Non-RVU base fee schedule,29.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82247,Not in chargemaster,82247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82247,BCBSMN Non-RVU base fee schedule,5.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82248,Not in chargemaster,82248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82248,BCBSMN Non-RVU base fee schedule,5.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82252,Not in chargemaster,82252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82252,BCBSMN Non-RVU base fee schedule,5.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82261,Not in chargemaster,82261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82261,BCBSMN Non-RVU base fee schedule,18.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82270,Not in chargemaster,82270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82270,BCBSMN Non-RVU base fee schedule,4.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82271,Not in chargemaster,82271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82271,BCBSMN Non-RVU base fee schedule,5.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82272,Not in chargemaster,82272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82272,BCBSMN Non-RVU base fee schedule,4.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82274,Not in chargemaster,82274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82274,BCBSMN Non-RVU base fee schedule,15.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82286,Not in chargemaster,82286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82286,BCBSMN Non-RVU base fee schedule,5.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82300,Not in chargemaster,82300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82300,BCBSMN Non-RVU base fee schedule,26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82306,Not in chargemaster,82306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82306,BCBSMN Non-RVU base fee schedule,32.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82308,Not in chargemaster,82308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82308,BCBSMN Non-RVU base fee schedule,29.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82310,Not in chargemaster,82310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82310,BCBSMN Non-RVU base fee schedule,5.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82330,Not in chargemaster,82330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82330,BCBSMN Non-RVU base fee schedule,13.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82331,Not in chargemaster,82331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82331,BCBSMN Non-RVU base fee schedule,14.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82340,Not in chargemaster,82340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82340,BCBSMN Non-RVU base fee schedule,6.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82355,Not in chargemaster,82355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82355,BCBSMN Non-RVU base fee schedule,12.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82360,Not in chargemaster,82360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82360,BCBSMN Non-RVU base fee schedule,14.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82365,Not in chargemaster,82365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82365,BCBSMN Non-RVU base fee schedule,14.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82370,Not in chargemaster,82370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82370,BCBSMN Non-RVU base fee schedule,13.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82373,Not in chargemaster,82373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82373,BCBSMN Non-RVU base fee schedule,19.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82374,Not in chargemaster,82374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82374,BCBSMN Non-RVU base fee schedule,4.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82375,Not in chargemaster,82375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82375,BCBSMN Non-RVU base fee schedule,13.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82376,Not in chargemaster,82376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82376,BCBSMN Non-RVU base fee schedule,15.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82378,Not in chargemaster,82378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82378,BCBSMN Non-RVU base fee schedule,20.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82379,Not in chargemaster,82379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82379,BCBSMN Non-RVU base fee schedule,18.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82380,Not in chargemaster,82380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82380,BCBSMN Non-RVU base fee schedule,10.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82382,Not in chargemaster,82382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82382,BCBSMN Non-RVU base fee schedule,30.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82383,Not in chargemaster,82383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82383,BCBSMN Non-RVU base fee schedule,31.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82384,Not in chargemaster,82384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82384,BCBSMN Non-RVU base fee schedule,27.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82387,Not in chargemaster,82387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82387,BCBSMN Non-RVU base fee schedule,19.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82390,Not in chargemaster,82390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82390,BCBSMN Non-RVU base fee schedule,11.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82397,Not in chargemaster,82397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82397,BCBSMN Non-RVU base fee schedule,15.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82415,Not in chargemaster,82415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82415,BCBSMN Non-RVU base fee schedule,13.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82435,Not in chargemaster,82435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82435,BCBSMN Non-RVU base fee schedule,4.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82436,Not in chargemaster,82436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82436,BCBSMN Non-RVU base fee schedule,6.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82438,Not in chargemaster,82438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82438,BCBSMN Non-RVU base fee schedule,5.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82441,Not in chargemaster,82441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82441,BCBSMN Non-RVU base fee schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82465,Not in chargemaster,82465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82465,BCBSMN Non-RVU base fee schedule,4.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82480,Not in chargemaster,82480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82480,BCBSMN Non-RVU base fee schedule,8.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82482,Not in chargemaster,82482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82482,BCBSMN Non-RVU base fee schedule,10.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82485,Not in chargemaster,82485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82485,BCBSMN Non-RVU base fee schedule,22.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82495,Not in chargemaster,82495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82495,BCBSMN Non-RVU base fee schedule,22.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82507,Not in chargemaster,82507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82507,BCBSMN Non-RVU base fee schedule,30.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82523,Not in chargemaster,82523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82523,BCBSMN Non-RVU base fee schedule,18.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82525,Not in chargemaster,82525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82525,BCBSMN Non-RVU base fee schedule,13.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82528,Not in chargemaster,82528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82528,BCBSMN Non-RVU base fee schedule,24.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82530,Not in chargemaster,82530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82530,BCBSMN Non-RVU base fee schedule,18.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82533,Not in chargemaster,82533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82533,BCBSMN Non-RVU base fee schedule,17.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82540,Not in chargemaster,82540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82540,BCBSMN Non-RVU base fee schedule,5.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82542,Not in chargemaster,82542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82542,BCBSMN Non-RVU base fee schedule,26.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82550,Not in chargemaster,82550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82550,BCBSMN Non-RVU base fee schedule,6.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82552,Not in chargemaster,82552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82552,BCBSMN Non-RVU base fee schedule,14.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82553,Not in chargemaster,82553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82553,BCBSMN Non-RVU base fee schedule,12.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82554,Not in chargemaster,82554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82554,BCBSMN Non-RVU base fee schedule,13.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82565,Not in chargemaster,82565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82565,BCBSMN Non-RVU base fee schedule,5.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82570,Not in chargemaster,82570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82570,BCBSMN Non-RVU base fee schedule,5.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82575,Not in chargemaster,82575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82575,BCBSMN Non-RVU base fee schedule,10.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82585,Not in chargemaster,82585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82585,BCBSMN Non-RVU base fee schedule,15.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82595,Not in chargemaster,82595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82595,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82600,Not in chargemaster,82600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82600,BCBSMN Non-RVU base fee schedule,21.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82607,Not in chargemaster,82607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82607,BCBSMN Non-RVU base fee schedule,16.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82608,Not in chargemaster,82608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82608,BCBSMN Non-RVU base fee schedule,15.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82610,Not in chargemaster,82610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82610,BCBSMN Non-RVU base fee schedule,20.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82615,Not in chargemaster,82615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82615,BCBSMN Non-RVU base fee schedule,10.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82626,Not in chargemaster,82626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82626,BCBSMN Non-RVU base fee schedule,27.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82627,Not in chargemaster,82627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82627,BCBSMN Non-RVU base fee schedule,24.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82633,Not in chargemaster,82633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82633,BCBSMN Non-RVU base fee schedule,34.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82634,Not in chargemaster,82634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82634,BCBSMN Non-RVU base fee schedule,32.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82638,Not in chargemaster,82638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82638,BCBSMN Non-RVU base fee schedule,13.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82642,Not in chargemaster,82642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82642,BCBSMN Non-RVU base fee schedule,32.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82652,Not in chargemaster,82652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82652,BCBSMN Non-RVU base fee schedule,42.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82656,Not in chargemaster,82656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82656,BCBSMN Non-RVU base fee schedule,12.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82657,Not in chargemaster,82657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82657,BCBSMN Non-RVU base fee schedule,24.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82658,Not in chargemaster,82658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82658,BCBSMN Non-RVU base fee schedule,48.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82664,Not in chargemaster,82664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82664,BCBSMN Non-RVU base fee schedule,67.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82668,Not in chargemaster,82668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82668,BCBSMN Non-RVU base fee schedule,20.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82670,Not in chargemaster,82670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82670,BCBSMN Non-RVU base fee schedule,30.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82671,Not in chargemaster,82671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82671,BCBSMN Non-RVU base fee schedule,35.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82672,Not in chargemaster,82672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82672,BCBSMN Non-RVU base fee schedule,23.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82677,Not in chargemaster,82677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82677,BCBSMN Non-RVU base fee schedule,26.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82679,Not in chargemaster,82679,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82679,BCBSMN Non-RVU base fee schedule,24.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82693,Not in chargemaster,82693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82693,BCBSMN Non-RVU base fee schedule,16.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82696,Not in chargemaster,82696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82696,BCBSMN Non-RVU base fee schedule,28.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82705,Not in chargemaster,82705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82705,BCBSMN Non-RVU base fee schedule,5.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82710,Not in chargemaster,82710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82710,BCBSMN Non-RVU base fee schedule,18.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82715,Not in chargemaster,82715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82715,BCBSMN Non-RVU base fee schedule,25.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82725,Not in chargemaster,82725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82725,BCBSMN Non-RVU base fee schedule,20.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82726,Not in chargemaster,82726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82726,BCBSMN Non-RVU base fee schedule,21.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82728,Not in chargemaster,82728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82728,BCBSMN Non-RVU base fee schedule,14.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82731,Not in chargemaster,82731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82731,BCBSMN Non-RVU base fee schedule,70.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82735,Not in chargemaster,82735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82735,BCBSMN Non-RVU base fee schedule,20.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82746,Not in chargemaster,82746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82746,BCBSMN Non-RVU base fee schedule,16.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82747,Not in chargemaster,82747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82747,BCBSMN Non-RVU base fee schedule,19.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82757,Not in chargemaster,82757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82757,BCBSMN Non-RVU base fee schedule,19.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82759,Not in chargemaster,82759,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82759,BCBSMN Non-RVU base fee schedule,23.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82760,Not in chargemaster,82760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82760,BCBSMN Non-RVU base fee schedule,12.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82775,Not in chargemaster,82775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82775,BCBSMN Non-RVU base fee schedule,23.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82776,Not in chargemaster,82776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82776,BCBSMN Non-RVU base fee schedule,12.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82777,Not in chargemaster,82777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82777,BCBSMN Non-RVU base fee schedule,48.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82784,Not in chargemaster,82784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82784,BCBSMN Non-RVU base fee schedule,10.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82785,Not in chargemaster,82785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82785,BCBSMN Non-RVU base fee schedule,18.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82787,Not in chargemaster,82787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82787,BCBSMN Non-RVU base fee schedule,8.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82800,Not in chargemaster,82800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82800,BCBSMN Non-RVU base fee schedule,12.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82803,Not in chargemaster,82803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82803,BCBSMN Non-RVU base fee schedule,28.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82805,Not in chargemaster,82805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82805,BCBSMN Non-RVU base fee schedule,86.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82810,Not in chargemaster,82810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82810,BCBSMN Non-RVU base fee schedule,10.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82820,Not in chargemaster,82820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82820,BCBSMN Non-RVU base fee schedule,14.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82930,Not in chargemaster,82930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82930,BCBSMN Non-RVU base fee schedule,7.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82938,Not in chargemaster,82938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82938,BCBSMN Non-RVU base fee schedule,19.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82941,Not in chargemaster,82941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82941,BCBSMN Non-RVU base fee schedule,19.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82943,Not in chargemaster,82943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82943,BCBSMN Non-RVU base fee schedule,15.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82945,Not in chargemaster,82945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82945,BCBSMN Non-RVU base fee schedule,4.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82946,Not in chargemaster,82946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82946,BCBSMN Non-RVU base fee schedule,19.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82947,Not in chargemaster,82947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82947,BCBSMN Non-RVU base fee schedule,3.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82948,Not in chargemaster,82948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82948,BCBSMN Non-RVU base fee schedule,5.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82950,Not in chargemaster,82950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82950,BCBSMN Non-RVU base fee schedule,4.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82951,Not in chargemaster,82951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82951,BCBSMN Non-RVU base fee schedule,12.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82952,Not in chargemaster,82952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82952,BCBSMN Non-RVU base fee schedule,3.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82955,Not in chargemaster,82955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82955,BCBSMN Non-RVU base fee schedule,10.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82960,Not in chargemaster,82960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82960,BCBSMN Non-RVU base fee schedule,6.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82962,Not in chargemaster,82962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82962,BCBSMN Non-RVU base fee schedule,3.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82963,Not in chargemaster,82963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82963,BCBSMN Non-RVU base fee schedule,23.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82965,Not in chargemaster,82965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82965,BCBSMN Non-RVU base fee schedule,14.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82977,Not in chargemaster,82977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82977,BCBSMN Non-RVU base fee schedule,7.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82978,Not in chargemaster,82978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82978,BCBSMN Non-RVU base fee schedule,17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82979,Not in chargemaster,82979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82979,BCBSMN Non-RVU base fee schedule,10.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 82985,Not in chargemaster,82985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,82985,BCBSMN Non-RVU base fee schedule,16.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83001,Not in chargemaster,83001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83001,BCBSMN Non-RVU base fee schedule,18.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83002,Not in chargemaster,83002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83002,BCBSMN Non-RVU base fee schedule,18.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83003,Not in chargemaster,83003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83003,BCBSMN Non-RVU base fee schedule,18.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83006,Not in chargemaster,83006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83006,BCBSMN Non-RVU base fee schedule,83.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83009,Not in chargemaster,83009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83009,BCBSMN Non-RVU base fee schedule,74.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83010,Not in chargemaster,83010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83010,BCBSMN Non-RVU base fee schedule,13.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83012,Not in chargemaster,83012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83012,BCBSMN Non-RVU base fee schedule,29.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83013,Not in chargemaster,83013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83013,BCBSMN Non-RVU base fee schedule,74.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83014,Not in chargemaster,83014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83014,BCBSMN Non-RVU base fee schedule,8.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83015,Not in chargemaster,83015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83015,BCBSMN Non-RVU base fee schedule,23.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83018,Not in chargemaster,83018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83018,BCBSMN Non-RVU base fee schedule,24.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83021,Not in chargemaster,83021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83021,BCBSMN Non-RVU base fee schedule,19.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83026,Not in chargemaster,83026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83026,BCBSMN Non-RVU base fee schedule,4.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83030,Not in chargemaster,83030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83030,BCBSMN Non-RVU base fee schedule,11.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83033,Not in chargemaster,83033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83033,BCBSMN Non-RVU base fee schedule,8.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83036,Not in chargemaster,83036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83036,BCBSMN Non-RVU base fee schedule,9.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83037,Not in chargemaster,83037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83037,BCBSMN Non-RVU base fee schedule,9.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83045,Not in chargemaster,83045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83045,BCBSMN Non-RVU base fee schedule,7.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83050,Not in chargemaster,83050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83050,BCBSMN Non-RVU base fee schedule,9.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83051,Not in chargemaster,83051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83051,BCBSMN Non-RVU base fee schedule,8.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83060,Not in chargemaster,83060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83060,BCBSMN Non-RVU base fee schedule,9.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83065,Not in chargemaster,83065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83065,BCBSMN Non-RVU base fee schedule,9.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83068,Not in chargemaster,83068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83068,BCBSMN Non-RVU base fee schedule,10.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83069,Not in chargemaster,83069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83069,BCBSMN Non-RVU base fee schedule,4.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83070,Not in chargemaster,83070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83070,BCBSMN Non-RVU base fee schedule,5.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83080,Not in chargemaster,83080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83080,BCBSMN Non-RVU base fee schedule,18.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83088,Not in chargemaster,83088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83088,BCBSMN Non-RVU base fee schedule,32.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83090,Not in chargemaster,83090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83090,BCBSMN Non-RVU base fee schedule,19.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83150,Not in chargemaster,83150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83150,BCBSMN Non-RVU base fee schedule,24.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83491,Not in chargemaster,83491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83491,BCBSMN Non-RVU base fee schedule,19.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83497,Not in chargemaster,83497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83497,BCBSMN Non-RVU base fee schedule,14.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83498,Not in chargemaster,83498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83498,BCBSMN Non-RVU base fee schedule,29.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83500,Not in chargemaster,83500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83500,BCBSMN Non-RVU base fee schedule,24.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83505,Not in chargemaster,83505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83505,BCBSMN Non-RVU base fee schedule,26.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83516,Not in chargemaster,83516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83516,BCBSMN Non-RVU base fee schedule,11.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83518,Not in chargemaster,83518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83518,BCBSMN Non-RVU base fee schedule,9.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83519,Not in chargemaster,83519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83519,BCBSMN Non-RVU base fee schedule,20.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83520,Not in chargemaster,83520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83520,BCBSMN Non-RVU base fee schedule,17.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83525,Not in chargemaster,83525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83525,BCBSMN Non-RVU base fee schedule,12.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83527,Not in chargemaster,83527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83527,BCBSMN Non-RVU base fee schedule,14.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83528,Not in chargemaster,83528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83528,BCBSMN Non-RVU base fee schedule,21.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83540,Not in chargemaster,83540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83540,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83550,Not in chargemaster,83550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83550,BCBSMN Non-RVU base fee schedule,9.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83570,Not in chargemaster,83570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83570,BCBSMN Non-RVU base fee schedule,9.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83582,Not in chargemaster,83582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83582,BCBSMN Non-RVU base fee schedule,17.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83586,Not in chargemaster,83586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83586,BCBSMN Non-RVU base fee schedule,14.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83593,Not in chargemaster,83593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83593,BCBSMN Non-RVU base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83605,Not in chargemaster,83605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83605,BCBSMN Non-RVU base fee schedule,11.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83615,Not in chargemaster,83615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83615,BCBSMN Non-RVU base fee schedule,6.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83625,Not in chargemaster,83625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83625,BCBSMN Non-RVU base fee schedule,14.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83630,Not in chargemaster,83630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83630,BCBSMN Non-RVU base fee schedule,21.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83631,Not in chargemaster,83631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83631,BCBSMN Non-RVU base fee schedule,21.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83632,Not in chargemaster,83632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83632,BCBSMN Non-RVU base fee schedule,22.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83633,Not in chargemaster,83633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83633,BCBSMN Non-RVU base fee schedule,12.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83655,Not in chargemaster,83655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83655,BCBSMN Non-RVU base fee schedule,12.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83661,Not in chargemaster,83661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83661,BCBSMN Non-RVU base fee schedule,24.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83662,Not in chargemaster,83662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83662,BCBSMN Non-RVU base fee schedule,20.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83663,Not in chargemaster,83663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83663,BCBSMN Non-RVU base fee schedule,20.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83664,Not in chargemaster,83664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83664,BCBSMN Non-RVU base fee schedule,21.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83670,Not in chargemaster,83670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83670,BCBSMN Non-RVU base fee schedule,10.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83690,Not in chargemaster,83690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83690,BCBSMN Non-RVU base fee schedule,7.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83695,Not in chargemaster,83695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83695,BCBSMN Non-RVU base fee schedule,15.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83698,Not in chargemaster,83698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83698,BCBSMN Non-RVU base fee schedule,50.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83700,Not in chargemaster,83700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83700,BCBSMN Non-RVU base fee schedule,12.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83701,Not in chargemaster,83701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83701,BCBSMN Non-RVU base fee schedule,37.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83704,Not in chargemaster,83704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83704,BCBSMN Non-RVU base fee schedule,37.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83718,Not in chargemaster,83718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83718,BCBSMN Non-RVU base fee schedule,8.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83719,Not in chargemaster,83719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83719,BCBSMN Non-RVU base fee schedule,14.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83721,Not in chargemaster,83721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83721,BCBSMN Non-RVU base fee schedule,10.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83722,Not in chargemaster,83722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83722,BCBSMN Non-RVU base fee schedule,37.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83727,Not in chargemaster,83727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83727,BCBSMN Non-RVU base fee schedule,18.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83735,Not in chargemaster,83735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83735,BCBSMN Non-RVU base fee schedule,7.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83775,Not in chargemaster,83775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83775,BCBSMN Non-RVU base fee schedule,8.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83785,Not in chargemaster,83785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83785,BCBSMN Non-RVU base fee schedule,29.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83789,Not in chargemaster,83789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83789,BCBSMN Non-RVU base fee schedule,26.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83825,Not in chargemaster,83825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83825,BCBSMN Non-RVU base fee schedule,17.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83835,Not in chargemaster,83835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83835,BCBSMN Non-RVU base fee schedule,18.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83857,Not in chargemaster,83857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83857,BCBSMN Non-RVU base fee schedule,11.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83861,Not in chargemaster,83861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83861,BCBSMN Non-RVU base fee schedule,22.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83864,Not in chargemaster,83864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83864,BCBSMN Non-RVU base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83872,Not in chargemaster,83872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83872,BCBSMN Non-RVU base fee schedule,6.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83873,Not in chargemaster,83873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83873,BCBSMN Non-RVU base fee schedule,18.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83874,Not in chargemaster,83874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83874,BCBSMN Non-RVU base fee schedule,14.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83876,Not in chargemaster,83876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83876,BCBSMN Non-RVU base fee schedule,55.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83880,Not in chargemaster,83880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83880,BCBSMN Non-RVU base fee schedule,39.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83883,Not in chargemaster,83883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83883,BCBSMN Non-RVU base fee schedule,14.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83885,Not in chargemaster,83885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83885,BCBSMN Non-RVU base fee schedule,26.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83915,Not in chargemaster,83915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83915,BCBSMN Non-RVU base fee schedule,12.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83916,Not in chargemaster,83916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83916,BCBSMN Non-RVU base fee schedule,30.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83918,Not in chargemaster,83918,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83918,BCBSMN Non-RVU base fee schedule,25.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83919,Not in chargemaster,83919,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83919,BCBSMN Non-RVU base fee schedule,18.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83921,Not in chargemaster,83921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83921,BCBSMN Non-RVU base fee schedule,23.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83930,Not in chargemaster,83930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83930,BCBSMN Non-RVU base fee schedule,7.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83935,Not in chargemaster,83935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83935,BCBSMN Non-RVU base fee schedule,7.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83937,Not in chargemaster,83937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83937,BCBSMN Non-RVU base fee schedule,32.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83945,Not in chargemaster,83945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83945,BCBSMN Non-RVU base fee schedule,15.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83950,Not in chargemaster,83950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83950,BCBSMN Non-RVU base fee schedule,70.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83951,Not in chargemaster,83951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83951,BCBSMN Non-RVU base fee schedule,70.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83970,Not in chargemaster,83970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83970,BCBSMN Non-RVU base fee schedule,45.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83986,Not in chargemaster,83986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83986,BCBSMN Non-RVU base fee schedule,3.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83987,Not in chargemaster,83987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83987,BCBSMN Non-RVU base fee schedule,3.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83992,Not in chargemaster,83992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83992,BCBSMN Non-RVU base fee schedule,16.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 83993,Not in chargemaster,83993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,83993,BCBSMN Non-RVU base fee schedule,21.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84030,Not in chargemaster,84030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84030,BCBSMN Non-RVU base fee schedule,6.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84035,Not in chargemaster,84035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84035,BCBSMN Non-RVU base fee schedule,4.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84060,Not in chargemaster,84060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84060,BCBSMN Non-RVU base fee schedule,8.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84066,Not in chargemaster,84066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84066,BCBSMN Non-RVU base fee schedule,10.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84075,Not in chargemaster,84075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84075,BCBSMN Non-RVU base fee schedule,5.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84078,Not in chargemaster,84078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84078,BCBSMN Non-RVU base fee schedule,9.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84080,Not in chargemaster,84080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84080,BCBSMN Non-RVU base fee schedule,16.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84081,Not in chargemaster,84081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84081,BCBSMN Non-RVU base fee schedule,18.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84085,Not in chargemaster,84085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84085,BCBSMN Non-RVU base fee schedule,10.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84087,Not in chargemaster,84087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84087,BCBSMN Non-RVU base fee schedule,11.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84100,Not in chargemaster,84100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84100,BCBSMN Non-RVU base fee schedule,5.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84105,Not in chargemaster,84105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84105,BCBSMN Non-RVU base fee schedule,6.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84106,Not in chargemaster,84106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84106,BCBSMN Non-RVU base fee schedule,6.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84110,Not in chargemaster,84110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84110,BCBSMN Non-RVU base fee schedule,9.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84112,Not in chargemaster,84112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84112,BCBSMN Non-RVU base fee schedule,107.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84119,Not in chargemaster,84119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84119,BCBSMN Non-RVU base fee schedule,14.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84120,Not in chargemaster,84120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84120,BCBSMN Non-RVU base fee schedule,16.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84126,Not in chargemaster,84126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84126,BCBSMN Non-RVU base fee schedule,43.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84132,Not in chargemaster,84132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84132,BCBSMN Non-RVU base fee schedule,4.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84133,Not in chargemaster,84133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84133,BCBSMN Non-RVU base fee schedule,5.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84134,Not in chargemaster,84134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84134,BCBSMN Non-RVU base fee schedule,16.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84135,Not in chargemaster,84135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84135,BCBSMN Non-RVU base fee schedule,23.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84138,Not in chargemaster,84138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84138,BCBSMN Non-RVU base fee schedule,23.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84140,Not in chargemaster,84140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84140,BCBSMN Non-RVU base fee schedule,22.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84143,Not in chargemaster,84143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84143,BCBSMN Non-RVU base fee schedule,25.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84144,Not in chargemaster,84144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84144,BCBSMN Non-RVU base fee schedule,22.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84145,Not in chargemaster,84145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84145,BCBSMN Non-RVU base fee schedule,29.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84146,Not in chargemaster,84146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84146,BCBSMN Non-RVU base fee schedule,21.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84150,Not in chargemaster,84150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84150,BCBSMN Non-RVU base fee schedule,45.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84152,Not in chargemaster,84152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84152,BCBSMN Non-RVU base fee schedule,20.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84153,Not in chargemaster,84153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84153,BCBSMN Non-RVU base fee schedule,20.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84154,Not in chargemaster,84154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84154,BCBSMN Non-RVU base fee schedule,20.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84155,Not in chargemaster,84155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84155,BCBSMN Non-RVU base fee schedule,3.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84156,Not in chargemaster,84156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84156,BCBSMN Non-RVU base fee schedule,4.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84157,Not in chargemaster,84157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84157,BCBSMN Non-RVU base fee schedule,4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84160,Not in chargemaster,84160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84160,BCBSMN Non-RVU base fee schedule,6.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84163,Not in chargemaster,84163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84163,BCBSMN Non-RVU base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84202,Not in chargemaster,84202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84202,BCBSMN Non-RVU base fee schedule,15.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84203,Not in chargemaster,84203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84203,BCBSMN Non-RVU base fee schedule,10.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84206,Not in chargemaster,84206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84206,BCBSMN Non-RVU base fee schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84207,Not in chargemaster,84207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84207,BCBSMN Non-RVU base fee schedule,30.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84210,Not in chargemaster,84210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84210,BCBSMN Non-RVU base fee schedule,15.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84220,Not in chargemaster,84220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84220,BCBSMN Non-RVU base fee schedule,10.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84228,Not in chargemaster,84228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84228,BCBSMN Non-RVU base fee schedule,12.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84233,Not in chargemaster,84233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84233,BCBSMN Non-RVU base fee schedule,96.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84234,Not in chargemaster,84234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84234,BCBSMN Non-RVU base fee schedule,71.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84235,Not in chargemaster,84235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84235,BCBSMN Non-RVU base fee schedule,78.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84238,Not in chargemaster,84238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84238,BCBSMN Non-RVU base fee schedule,40.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84244,Not in chargemaster,84244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84244,BCBSMN Non-RVU base fee schedule,24.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84252,Not in chargemaster,84252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84252,BCBSMN Non-RVU base fee schedule,22.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84255,Not in chargemaster,84255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84255,BCBSMN Non-RVU base fee schedule,28.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84260,Not in chargemaster,84260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84260,BCBSMN Non-RVU base fee schedule,34.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84270,Not in chargemaster,84270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84270,BCBSMN Non-RVU base fee schedule,23.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84275,Not in chargemaster,84275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84275,BCBSMN Non-RVU base fee schedule,14.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84285,Not in chargemaster,84285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84285,BCBSMN Non-RVU base fee schedule,27.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84295,Not in chargemaster,84295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84295,BCBSMN Non-RVU base fee schedule,4.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84300,Not in chargemaster,84300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84300,BCBSMN Non-RVU base fee schedule,5.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84302,Not in chargemaster,84302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84302,BCBSMN Non-RVU base fee schedule,5.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84305,Not in chargemaster,84305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84305,BCBSMN Non-RVU base fee schedule,23.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84307,Not in chargemaster,84307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84307,BCBSMN Non-RVU base fee schedule,20.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84311,Not in chargemaster,84311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84311,BCBSMN Non-RVU base fee schedule,8.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84315,Not in chargemaster,84315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84315,BCBSMN Non-RVU base fee schedule,3.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84375,Not in chargemaster,84375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84375,BCBSMN Non-RVU base fee schedule,42.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84376,Not in chargemaster,84376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84376,BCBSMN Non-RVU base fee schedule,6.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84377,Not in chargemaster,84377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84377,BCBSMN Non-RVU base fee schedule,6.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84378,Not in chargemaster,84378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84378,BCBSMN Non-RVU base fee schedule,12.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84379,Not in chargemaster,84379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84379,BCBSMN Non-RVU base fee schedule,12.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84392,Not in chargemaster,84392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84392,BCBSMN Non-RVU base fee schedule,6.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84402,Not in chargemaster,84402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84402,BCBSMN Non-RVU base fee schedule,28.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84403,Not in chargemaster,84403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84403,BCBSMN Non-RVU base fee schedule,28.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84410,Not in chargemaster,84410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84410,BCBSMN Non-RVU base fee schedule,56.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84425,Not in chargemaster,84425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84425,BCBSMN Non-RVU base fee schedule,23.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84430,Not in chargemaster,84430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84430,BCBSMN Non-RVU base fee schedule,12.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84431,Not in chargemaster,84431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84431,BCBSMN Non-RVU base fee schedule,38.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84432,Not in chargemaster,84432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84432,BCBSMN Non-RVU base fee schedule,17.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84436,Not in chargemaster,84436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84436,BCBSMN Non-RVU base fee schedule,7.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84437,Not in chargemaster,84437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84437,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84439,Not in chargemaster,84439,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84439,BCBSMN Non-RVU base fee schedule,9.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84442,Not in chargemaster,84442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84442,BCBSMN Non-RVU base fee schedule,16.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84443,Not in chargemaster,84443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84443,BCBSMN Non-RVU base fee schedule,16.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84445,Not in chargemaster,84445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84445,BCBSMN Non-RVU base fee schedule,55.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84446,Not in chargemaster,84446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84446,BCBSMN Non-RVU base fee schedule,15.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84449,Not in chargemaster,84449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84449,BCBSMN Non-RVU base fee schedule,19.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84450,Not in chargemaster,84450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84450,BCBSMN Non-RVU base fee schedule,5.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84460,Not in chargemaster,84460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84460,BCBSMN Non-RVU base fee schedule,5.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84466,Not in chargemaster,84466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84466,BCBSMN Non-RVU base fee schedule,14.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84478,Not in chargemaster,84478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84478,BCBSMN Non-RVU base fee schedule,5.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84479,Not in chargemaster,84479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84479,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84480,Not in chargemaster,84480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84480,BCBSMN Non-RVU base fee schedule,15.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84481,Not in chargemaster,84481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84481,BCBSMN Non-RVU base fee schedule,18.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84482,Not in chargemaster,84482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84482,BCBSMN Non-RVU base fee schedule,17.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84484,Not in chargemaster,84484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84484,BCBSMN Non-RVU base fee schedule,13.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84485,Not in chargemaster,84485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84485,BCBSMN Non-RVU base fee schedule,7.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84488,Not in chargemaster,84488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84488,BCBSMN Non-RVU base fee schedule,8.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84490,Not in chargemaster,84490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84490,BCBSMN Non-RVU base fee schedule,10.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84510,Not in chargemaster,84510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84510,BCBSMN Non-RVU base fee schedule,11.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84512,Not in chargemaster,84512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84512,BCBSMN Non-RVU base fee schedule,11.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84520,Not in chargemaster,84520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84520,BCBSMN Non-RVU base fee schedule,3.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84525,Not in chargemaster,84525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84525,BCBSMN Non-RVU base fee schedule,5.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84540,Not in chargemaster,84540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84540,BCBSMN Non-RVU base fee schedule,6.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84545,Not in chargemaster,84545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84545,BCBSMN Non-RVU base fee schedule,7.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84550,Not in chargemaster,84550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84550,BCBSMN Non-RVU base fee schedule,4.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84560,Not in chargemaster,84560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84560,BCBSMN Non-RVU base fee schedule,5.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84577,Not in chargemaster,84577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84577,BCBSMN Non-RVU base fee schedule,18.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84578,Not in chargemaster,84578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84578,BCBSMN Non-RVU base fee schedule,4.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84580,Not in chargemaster,84580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84580,BCBSMN Non-RVU base fee schedule,10.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84583,Not in chargemaster,84583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84583,BCBSMN Non-RVU base fee schedule,6.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84585,Not in chargemaster,84585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84585,BCBSMN Non-RVU base fee schedule,17.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84586,Not in chargemaster,84586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84586,BCBSMN Non-RVU base fee schedule,38.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84588,Not in chargemaster,84588,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84588,BCBSMN Non-RVU base fee schedule,37.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84590,Not in chargemaster,84590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84590,BCBSMN Non-RVU base fee schedule,12.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84591,Not in chargemaster,84591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84591,BCBSMN Non-RVU base fee schedule,18.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84597,Not in chargemaster,84597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84597,BCBSMN Non-RVU base fee schedule,15.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84600,Not in chargemaster,84600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84600,BCBSMN Non-RVU base fee schedule,18.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84620,Not in chargemaster,84620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84620,BCBSMN Non-RVU base fee schedule,14.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84630,Not in chargemaster,84630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84630,BCBSMN Non-RVU base fee schedule,12.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84681,Not in chargemaster,84681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84681,BCBSMN Non-RVU base fee schedule,22.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84702,Not in chargemaster,84702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84702,BCBSMN Non-RVU base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84703,Not in chargemaster,84703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84703,BCBSMN Non-RVU base fee schedule,7.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84704,Not in chargemaster,84704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84704,BCBSMN Non-RVU base fee schedule,16.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 84830,Not in chargemaster,84830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,84830,BCBSMN Non-RVU base fee schedule,13.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85002,Not in chargemaster,85002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85002,BCBSMN Non-RVU base fee schedule,5.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85004,Not in chargemaster,85004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85004,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85007,Not in chargemaster,85007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85007,BCBSMN Non-RVU base fee schedule,4.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85008,Not in chargemaster,85008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85008,BCBSMN Non-RVU base fee schedule,3.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85009,Not in chargemaster,85009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85009,BCBSMN Non-RVU base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85013,Not in chargemaster,85013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85013,BCBSMN Non-RVU base fee schedule,7.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85014,Not in chargemaster,85014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85014,BCBSMN Non-RVU base fee schedule,2.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85018,Not in chargemaster,85018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85018,BCBSMN Non-RVU base fee schedule,2.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85025,Not in chargemaster,85025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85025,BCBSMN Non-RVU base fee schedule,7.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85027,Not in chargemaster,85027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85027,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85032,Not in chargemaster,85032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85032,BCBSMN Non-RVU base fee schedule,4.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85041,Not in chargemaster,85041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85041,BCBSMN Non-RVU base fee schedule,3.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85044,Not in chargemaster,85044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85044,BCBSMN Non-RVU base fee schedule,4.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85045,Not in chargemaster,85045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85045,BCBSMN Non-RVU base fee schedule,4.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85046,Not in chargemaster,85046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85046,BCBSMN Non-RVU base fee schedule,6.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85048,Not in chargemaster,85048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85048,BCBSMN Non-RVU base fee schedule,2.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85049,Not in chargemaster,85049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85049,BCBSMN Non-RVU base fee schedule,4.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85055,Not in chargemaster,85055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85055,BCBSMN Non-RVU base fee schedule,39.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85130,Not in chargemaster,85130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85130,BCBSMN Non-RVU base fee schedule,13.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85170,Not in chargemaster,85170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85170,BCBSMN Non-RVU base fee schedule,17.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85175,Not in chargemaster,85175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85175,BCBSMN Non-RVU base fee schedule,22.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85210,Not in chargemaster,85210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85210,BCBSMN Non-RVU base fee schedule,14.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85220,Not in chargemaster,85220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85220,BCBSMN Non-RVU base fee schedule,19.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85230,Not in chargemaster,85230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85230,BCBSMN Non-RVU base fee schedule,19.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85240,Not in chargemaster,85240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85240,BCBSMN Non-RVU base fee schedule,19.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85244,Not in chargemaster,85244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85244,BCBSMN Non-RVU base fee schedule,22.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85245,Not in chargemaster,85245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85245,BCBSMN Non-RVU base fee schedule,25.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85246,Not in chargemaster,85246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85246,BCBSMN Non-RVU base fee schedule,25.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85247,Not in chargemaster,85247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85247,BCBSMN Non-RVU base fee schedule,25.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85250,Not in chargemaster,85250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85250,BCBSMN Non-RVU base fee schedule,20.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85260,Not in chargemaster,85260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85260,BCBSMN Non-RVU base fee schedule,19.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85270,Not in chargemaster,85270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85270,BCBSMN Non-RVU base fee schedule,19.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85280,Not in chargemaster,85280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85280,BCBSMN Non-RVU base fee schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85290,Not in chargemaster,85290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85290,BCBSMN Non-RVU base fee schedule,17.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85291,Not in chargemaster,85291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85291,BCBSMN Non-RVU base fee schedule,10.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85292,Not in chargemaster,85292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85292,BCBSMN Non-RVU base fee schedule,20.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85293,Not in chargemaster,85293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85293,BCBSMN Non-RVU base fee schedule,20.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85300,Not in chargemaster,85300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85300,BCBSMN Non-RVU base fee schedule,13.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85301,Not in chargemaster,85301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85301,BCBSMN Non-RVU base fee schedule,11.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85302,Not in chargemaster,85302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85302,BCBSMN Non-RVU base fee schedule,13.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85303,Not in chargemaster,85303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85303,BCBSMN Non-RVU base fee schedule,15.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85305,Not in chargemaster,85305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85305,BCBSMN Non-RVU base fee schedule,12.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85306,Not in chargemaster,85306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85306,BCBSMN Non-RVU base fee schedule,16.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85307,Not in chargemaster,85307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85307,BCBSMN Non-RVU base fee schedule,16.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85335,Not in chargemaster,85335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85335,BCBSMN Non-RVU base fee schedule,14.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85337,Not in chargemaster,85337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85337,BCBSMN Non-RVU base fee schedule,19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85345,Not in chargemaster,85345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85345,BCBSMN Non-RVU base fee schedule,5.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85347,Not in chargemaster,85347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85347,BCBSMN Non-RVU base fee schedule,4.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85348,Not in chargemaster,85348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85348,BCBSMN Non-RVU base fee schedule,4.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85360,Not in chargemaster,85360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85360,BCBSMN Non-RVU base fee schedule,9.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85362,Not in chargemaster,85362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85362,BCBSMN Non-RVU base fee schedule,7.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85366,Not in chargemaster,85366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85366,BCBSMN Non-RVU base fee schedule,88.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85370,Not in chargemaster,85370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85370,BCBSMN Non-RVU base fee schedule,13.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85378,Not in chargemaster,85378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85378,BCBSMN Non-RVU base fee schedule,10.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85379,Not in chargemaster,85379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85379,BCBSMN Non-RVU base fee schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85380,Not in chargemaster,85380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85380,BCBSMN Non-RVU base fee schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85384,Not in chargemaster,85384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85384,BCBSMN Non-RVU base fee schedule,10.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85385,Not in chargemaster,85385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85385,BCBSMN Non-RVU base fee schedule,15.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85397,Not in chargemaster,85397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85397,BCBSMN Non-RVU base fee schedule,33.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85400,Not in chargemaster,85400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85400,BCBSMN Non-RVU base fee schedule,8.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85410,Not in chargemaster,85410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85410,BCBSMN Non-RVU base fee schedule,8.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85415,Not in chargemaster,85415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85415,BCBSMN Non-RVU base fee schedule,18.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85420,Not in chargemaster,85420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85420,BCBSMN Non-RVU base fee schedule,7.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85421,Not in chargemaster,85421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85421,BCBSMN Non-RVU base fee schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85441,Not in chargemaster,85441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85441,BCBSMN Non-RVU base fee schedule,4.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85445,Not in chargemaster,85445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85445,BCBSMN Non-RVU base fee schedule,7.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85460,Not in chargemaster,85460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85460,BCBSMN Non-RVU base fee schedule,8.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85461,Not in chargemaster,85461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85461,BCBSMN Non-RVU base fee schedule,10.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85475,Not in chargemaster,85475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85475,BCBSMN Non-RVU base fee schedule,9.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85520,Not in chargemaster,85520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85520,BCBSMN Non-RVU base fee schedule,14.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85525,Not in chargemaster,85525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85525,BCBSMN Non-RVU base fee schedule,13.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85530,Not in chargemaster,85530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85530,BCBSMN Non-RVU base fee schedule,14.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85536,Not in chargemaster,85536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85536,BCBSMN Non-RVU base fee schedule,7.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85540,Not in chargemaster,85540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85540,BCBSMN Non-RVU base fee schedule,9.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85547,Not in chargemaster,85547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85547,BCBSMN Non-RVU base fee schedule,9.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85549,Not in chargemaster,85549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85549,BCBSMN Non-RVU base fee schedule,20.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85555,Not in chargemaster,85555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85555,BCBSMN Non-RVU base fee schedule,8.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85557,Not in chargemaster,85557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85557,BCBSMN Non-RVU base fee schedule,14.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85597,Not in chargemaster,85597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85597,BCBSMN Non-RVU base fee schedule,19.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85598,Not in chargemaster,85598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85598,BCBSMN Non-RVU base fee schedule,19.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85610,Not in chargemaster,85610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85610,BCBSMN Non-RVU base fee schedule,4.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85611,Not in chargemaster,85611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85611,BCBSMN Non-RVU base fee schedule,4.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85612,Not in chargemaster,85612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85612,BCBSMN Non-RVU base fee schedule,19.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85613,Not in chargemaster,85613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85613,BCBSMN Non-RVU base fee schedule,10.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85635,Not in chargemaster,85635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85635,BCBSMN Non-RVU base fee schedule,10.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85651,Not in chargemaster,85651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85651,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85652,Not in chargemaster,85652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85652,BCBSMN Non-RVU base fee schedule,2.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85660,Not in chargemaster,85660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85660,BCBSMN Non-RVU base fee schedule,6.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85670,Not in chargemaster,85670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85670,BCBSMN Non-RVU base fee schedule,6.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85675,Not in chargemaster,85675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85675,BCBSMN Non-RVU base fee schedule,7.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85705,Not in chargemaster,85705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85705,BCBSMN Non-RVU base fee schedule,10.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85730,Not in chargemaster,85730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85730,BCBSMN Non-RVU base fee schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85732,Not in chargemaster,85732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85732,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 85810,Not in chargemaster,85810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,85810,BCBSMN Non-RVU base fee schedule,12.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86000,Not in chargemaster,86000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86000,BCBSMN Non-RVU base fee schedule,7.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86001,Not in chargemaster,86001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86001,BCBSMN Non-RVU base fee schedule,8.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86003,Not in chargemaster,86003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86003,BCBSMN Non-RVU base fee schedule,5.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86005,Not in chargemaster,86005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86005,BCBSMN Non-RVU base fee schedule,8.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86008,Not in chargemaster,86008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86008,BCBSMN Non-RVU base fee schedule,19.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86021,Not in chargemaster,86021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86021,BCBSMN Non-RVU base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86022,Not in chargemaster,86022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86022,BCBSMN Non-RVU base fee schedule,20.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86023,Not in chargemaster,86023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86023,BCBSMN Non-RVU base fee schedule,13.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86038,Not in chargemaster,86038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86038,BCBSMN Non-RVU base fee schedule,13.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86039,Not in chargemaster,86039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86039,BCBSMN Non-RVU base fee schedule,12.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86060,Not in chargemaster,86060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86060,BCBSMN Non-RVU base fee schedule,8.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86063,Not in chargemaster,86063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86063,BCBSMN Non-RVU base fee schedule,6.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86140,Not in chargemaster,86140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86140,BCBSMN Non-RVU base fee schedule,5.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86141,Not in chargemaster,86141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86141,BCBSMN Non-RVU base fee schedule,14.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86146,Not in chargemaster,86146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86146,BCBSMN Non-RVU base fee schedule,28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86147,Not in chargemaster,86147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86147,BCBSMN Non-RVU base fee schedule,28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86148,Not in chargemaster,86148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86148,BCBSMN Non-RVU base fee schedule,17.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86152,Not in chargemaster,86152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86152,BCBSMN Non-RVU base fee schedule,275.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86155,Not in chargemaster,86155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86155,BCBSMN Non-RVU base fee schedule,17.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86156,Not in chargemaster,86156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86156,BCBSMN Non-RVU base fee schedule,8.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86157,Not in chargemaster,86157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86157,BCBSMN Non-RVU base fee schedule,8.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86160,Not in chargemaster,86160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86160,BCBSMN Non-RVU base fee schedule,13.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86161,Not in chargemaster,86161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86161,BCBSMN Non-RVU base fee schedule,13.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86162,Not in chargemaster,86162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86162,BCBSMN Non-RVU base fee schedule,22.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86171,Not in chargemaster,86171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86171,BCBSMN Non-RVU base fee schedule,11.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86200,Not in chargemaster,86200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86200,BCBSMN Non-RVU base fee schedule,14.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86215,Not in chargemaster,86215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86215,BCBSMN Non-RVU base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86225,Not in chargemaster,86225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86225,BCBSMN Non-RVU base fee schedule,15.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86226,Not in chargemaster,86226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86226,BCBSMN Non-RVU base fee schedule,13.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86235,Not in chargemaster,86235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86235,BCBSMN Non-RVU base fee schedule,19.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86277,Not in chargemaster,86277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86277,BCBSMN Non-RVU base fee schedule,17.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86280,Not in chargemaster,86280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86280,BCBSMN Non-RVU base fee schedule,9.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86294,Not in chargemaster,86294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86294,BCBSMN Non-RVU base fee schedule,25.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86300,Not in chargemaster,86300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86300,BCBSMN Non-RVU base fee schedule,22.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86301,Not in chargemaster,86301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86301,BCBSMN Non-RVU base fee schedule,22.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86304,Not in chargemaster,86304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86304,BCBSMN Non-RVU base fee schedule,22.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86305,Not in chargemaster,86305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86305,BCBSMN Non-RVU base fee schedule,22.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86308,Not in chargemaster,86308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86308,BCBSMN Non-RVU base fee schedule,5.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86309,Not in chargemaster,86309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86309,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86310,Not in chargemaster,86310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86310,BCBSMN Non-RVU base fee schedule,8.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86316,Not in chargemaster,86316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86316,BCBSMN Non-RVU base fee schedule,22.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86317,Not in chargemaster,86317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86317,BCBSMN Non-RVU base fee schedule,16.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86318,Not in chargemaster,86318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86318,BCBSMN Non-RVU base fee schedule,18.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86328,Not in chargemaster,86328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86328,BCBSMN Non-RVU base fee schedule,45.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86329,Not in chargemaster,86329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86329,BCBSMN Non-RVU base fee schedule,15.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86331,Not in chargemaster,86331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86331,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86332,Not in chargemaster,86332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86332,BCBSMN Non-RVU base fee schedule,26.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86336,Not in chargemaster,86336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86336,BCBSMN Non-RVU base fee schedule,17.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86337,Not in chargemaster,86337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86337,BCBSMN Non-RVU base fee schedule,23.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86340,Not in chargemaster,86340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86340,BCBSMN Non-RVU base fee schedule,16.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86341,Not in chargemaster,86341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86341,BCBSMN Non-RVU base fee schedule,25.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86343,Not in chargemaster,86343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86343,BCBSMN Non-RVU base fee schedule,13.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86344,Not in chargemaster,86344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86344,BCBSMN Non-RVU base fee schedule,11.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86352,Not in chargemaster,86352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86352,BCBSMN Non-RVU base fee schedule,149.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86353,Not in chargemaster,86353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86353,BCBSMN Non-RVU base fee schedule,53.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86355,Not in chargemaster,86355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86355,BCBSMN Non-RVU base fee schedule,41.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86356,Not in chargemaster,86356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86356,BCBSMN Non-RVU base fee schedule,29.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86357,Not in chargemaster,86357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86357,BCBSMN Non-RVU base fee schedule,41.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86359,Not in chargemaster,86359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86359,BCBSMN Non-RVU base fee schedule,41.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86360,Not in chargemaster,86360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86360,BCBSMN Non-RVU base fee schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86361,Not in chargemaster,86361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86361,BCBSMN Non-RVU base fee schedule,29.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86367,Not in chargemaster,86367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86367,BCBSMN Non-RVU base fee schedule,85.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86376,Not in chargemaster,86376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86376,BCBSMN Non-RVU base fee schedule,16.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86382,Not in chargemaster,86382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86382,BCBSMN Non-RVU base fee schedule,18.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86384,Not in chargemaster,86384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86384,BCBSMN Non-RVU base fee schedule,14.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86386,Not in chargemaster,86386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86386,BCBSMN Non-RVU base fee schedule,21.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86403,Not in chargemaster,86403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86403,BCBSMN Non-RVU base fee schedule,12.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86406,Not in chargemaster,86406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86406,BCBSMN Non-RVU base fee schedule,11.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86408,Not in chargemaster,86408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86408,BCBSMN Non-RVU base fee schedule,42.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86409,Not in chargemaster,86409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86409,BCBSMN Non-RVU base fee schedule,105.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86413,Not in chargemaster,86413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86413,BCBSMN Non-RVU base fee schedule,42.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86430,Not in chargemaster,86430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86430,BCBSMN Non-RVU base fee schedule,6.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86431,Not in chargemaster,86431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86431,BCBSMN Non-RVU base fee schedule,6.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86480,Not in chargemaster,86480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86480,BCBSMN Non-RVU base fee schedule,68.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86481,Not in chargemaster,86481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86481,BCBSMN Non-RVU base fee schedule,110,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86485,Not in chargemaster,86485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86485,BCBSMN Non-RVU base fee schedule,10.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86590,Not in chargemaster,86590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86590,BCBSMN Non-RVU base fee schedule,13.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86592,Not in chargemaster,86592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86592,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86593,Not in chargemaster,86593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86593,BCBSMN Non-RVU base fee schedule,4.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86602,Not in chargemaster,86602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86602,BCBSMN Non-RVU base fee schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86603,Not in chargemaster,86603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86603,BCBSMN Non-RVU base fee schedule,14.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86606,Not in chargemaster,86606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86606,BCBSMN Non-RVU base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86609,Not in chargemaster,86609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86609,BCBSMN Non-RVU base fee schedule,14.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86611,Not in chargemaster,86611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86611,BCBSMN Non-RVU base fee schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86612,Not in chargemaster,86612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86612,BCBSMN Non-RVU base fee schedule,14.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86615,Not in chargemaster,86615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86615,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86617,Not in chargemaster,86617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86617,BCBSMN Non-RVU base fee schedule,17.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86618,Not in chargemaster,86618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86618,BCBSMN Non-RVU base fee schedule,17.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86619,Not in chargemaster,86619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86619,BCBSMN Non-RVU base fee schedule,14.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86622,Not in chargemaster,86622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86622,BCBSMN Non-RVU base fee schedule,9.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86625,Not in chargemaster,86625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86625,BCBSMN Non-RVU base fee schedule,14.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86628,Not in chargemaster,86628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86628,BCBSMN Non-RVU base fee schedule,13.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86631,Not in chargemaster,86631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86631,BCBSMN Non-RVU base fee schedule,13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86632,Not in chargemaster,86632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86632,BCBSMN Non-RVU base fee schedule,13.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86635,Not in chargemaster,86635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86635,BCBSMN Non-RVU base fee schedule,12.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86638,Not in chargemaster,86638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86638,BCBSMN Non-RVU base fee schedule,13.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86641,Not in chargemaster,86641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86641,BCBSMN Non-RVU base fee schedule,15.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86644,Not in chargemaster,86644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86644,BCBSMN Non-RVU base fee schedule,15.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86645,Not in chargemaster,86645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86645,BCBSMN Non-RVU base fee schedule,18.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86648,Not in chargemaster,86648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86648,BCBSMN Non-RVU base fee schedule,16.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86651,Not in chargemaster,86651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86651,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86652,Not in chargemaster,86652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86652,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86653,Not in chargemaster,86653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86653,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86654,Not in chargemaster,86654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86654,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86658,Not in chargemaster,86658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86658,BCBSMN Non-RVU base fee schedule,14.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86663,Not in chargemaster,86663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86663,BCBSMN Non-RVU base fee schedule,14.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86664,Not in chargemaster,86664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86664,BCBSMN Non-RVU base fee schedule,16.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86665,Not in chargemaster,86665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86665,BCBSMN Non-RVU base fee schedule,19.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86666,Not in chargemaster,86666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86666,BCBSMN Non-RVU base fee schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86668,Not in chargemaster,86668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86668,BCBSMN Non-RVU base fee schedule,15.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86671,Not in chargemaster,86671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86671,BCBSMN Non-RVU base fee schedule,13.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86674,Not in chargemaster,86674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86674,BCBSMN Non-RVU base fee schedule,16.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86677,Not in chargemaster,86677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86677,BCBSMN Non-RVU base fee schedule,18.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86682,Not in chargemaster,86682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86682,BCBSMN Non-RVU base fee schedule,14.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86684,Not in chargemaster,86684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86684,BCBSMN Non-RVU base fee schedule,17.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86687,Not in chargemaster,86687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86687,BCBSMN Non-RVU base fee schedule,10,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86688,Not in chargemaster,86688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86688,BCBSMN Non-RVU base fee schedule,15.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86689,Not in chargemaster,86689,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86689,BCBSMN Non-RVU base fee schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86692,Not in chargemaster,86692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86692,BCBSMN Non-RVU base fee schedule,18.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86694,Not in chargemaster,86694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86694,BCBSMN Non-RVU base fee schedule,15.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86695,Not in chargemaster,86695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86695,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86696,Not in chargemaster,86696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86696,BCBSMN Non-RVU base fee schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86698,Not in chargemaster,86698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86698,BCBSMN Non-RVU base fee schedule,15.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86701,Not in chargemaster,86701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86701,BCBSMN Non-RVU base fee schedule,8.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86702,Not in chargemaster,86702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86702,BCBSMN Non-RVU base fee schedule,14.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86703,Not in chargemaster,86703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86703,BCBSMN Non-RVU base fee schedule,15.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86704,Not in chargemaster,86704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86704,BCBSMN Non-RVU base fee schedule,13.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86705,Not in chargemaster,86705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86705,BCBSMN Non-RVU base fee schedule,12.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86706,Not in chargemaster,86706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86706,BCBSMN Non-RVU base fee schedule,11.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86707,Not in chargemaster,86707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86707,BCBSMN Non-RVU base fee schedule,12.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86708,Not in chargemaster,86708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86708,BCBSMN Non-RVU base fee schedule,13.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86709,Not in chargemaster,86709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86709,BCBSMN Non-RVU base fee schedule,12.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86710,Not in chargemaster,86710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86710,BCBSMN Non-RVU base fee schedule,14.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86711,Not in chargemaster,86711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86711,BCBSMN Non-RVU base fee schedule,18.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86713,Not in chargemaster,86713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86713,BCBSMN Non-RVU base fee schedule,16.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86717,Not in chargemaster,86717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86717,BCBSMN Non-RVU base fee schedule,13.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86720,Not in chargemaster,86720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86720,BCBSMN Non-RVU base fee schedule,17.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86723,Not in chargemaster,86723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86723,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86727,Not in chargemaster,86727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86727,BCBSMN Non-RVU base fee schedule,14.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86732,Not in chargemaster,86732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86732,BCBSMN Non-RVU base fee schedule,16.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86735,Not in chargemaster,86735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86735,BCBSMN Non-RVU base fee schedule,14.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86738,Not in chargemaster,86738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86738,BCBSMN Non-RVU base fee schedule,14.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86741,Not in chargemaster,86741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86741,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86744,Not in chargemaster,86744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86744,BCBSMN Non-RVU base fee schedule,17.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86747,Not in chargemaster,86747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86747,BCBSMN Non-RVU base fee schedule,16.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86750,Not in chargemaster,86750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86750,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86753,Not in chargemaster,86753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86753,BCBSMN Non-RVU base fee schedule,13.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86756,Not in chargemaster,86756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86756,BCBSMN Non-RVU base fee schedule,17.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86757,Not in chargemaster,86757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86757,BCBSMN Non-RVU base fee schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86759,Not in chargemaster,86759,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86759,BCBSMN Non-RVU base fee schedule,20.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86762,Not in chargemaster,86762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86762,BCBSMN Non-RVU base fee schedule,15.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86765,Not in chargemaster,86765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86765,BCBSMN Non-RVU base fee schedule,14.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86768,Not in chargemaster,86768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86768,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86769,Not in chargemaster,86769,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86769,BCBSMN Non-RVU base fee schedule,42.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86771,Not in chargemaster,86771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86771,BCBSMN Non-RVU base fee schedule,26.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86774,Not in chargemaster,86774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86774,BCBSMN Non-RVU base fee schedule,16.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86777,Not in chargemaster,86777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86777,BCBSMN Non-RVU base fee schedule,15.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86778,Not in chargemaster,86778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86778,BCBSMN Non-RVU base fee schedule,15.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86780,Not in chargemaster,86780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86780,BCBSMN Non-RVU base fee schedule,13.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86784,Not in chargemaster,86784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86784,BCBSMN Non-RVU base fee schedule,13.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86787,Not in chargemaster,86787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86787,BCBSMN Non-RVU base fee schedule,14.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86788,Not in chargemaster,86788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86788,BCBSMN Non-RVU base fee schedule,18.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86789,Not in chargemaster,86789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86789,BCBSMN Non-RVU base fee schedule,15.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86790,Not in chargemaster,86790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86790,BCBSMN Non-RVU base fee schedule,14.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86793,Not in chargemaster,86793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86793,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86794,Not in chargemaster,86794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86794,BCBSMN Non-RVU base fee schedule,18.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86800,Not in chargemaster,86800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86800,BCBSMN Non-RVU base fee schedule,17.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86803,Not in chargemaster,86803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86803,BCBSMN Non-RVU base fee schedule,14.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86804,Not in chargemaster,86804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86804,BCBSMN Non-RVU base fee schedule,17.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86805,Not in chargemaster,86805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86805,BCBSMN Non-RVU base fee schedule,208.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86806,Not in chargemaster,86806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86806,BCBSMN Non-RVU base fee schedule,52.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86807,Not in chargemaster,86807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86807,BCBSMN Non-RVU base fee schedule,86.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86808,Not in chargemaster,86808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86808,BCBSMN Non-RVU base fee schedule,32.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86812,Not in chargemaster,86812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86812,BCBSMN Non-RVU base fee schedule,28.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86813,Not in chargemaster,86813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86813,BCBSMN Non-RVU base fee schedule,63.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86816,Not in chargemaster,86816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86816,BCBSMN Non-RVU base fee schedule,33.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86817,Not in chargemaster,86817,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86817,BCBSMN Non-RVU base fee schedule,116.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86821,Not in chargemaster,86821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86821,BCBSMN Non-RVU base fee schedule,40.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86825,Not in chargemaster,86825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86825,BCBSMN Non-RVU base fee schedule,120.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86826,Not in chargemaster,86826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86826,BCBSMN Non-RVU base fee schedule,40.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86828,Not in chargemaster,86828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86828,BCBSMN Non-RVU base fee schedule,70.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86829,Not in chargemaster,86829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86829,BCBSMN Non-RVU base fee schedule,70.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86830,Not in chargemaster,86830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86830,BCBSMN Non-RVU base fee schedule,105.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86831,Not in chargemaster,86831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86831,BCBSMN Non-RVU base fee schedule,90.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86832,Not in chargemaster,86832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86832,BCBSMN Non-RVU base fee schedule,356.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86833,Not in chargemaster,86833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86833,BCBSMN Non-RVU base fee schedule,358.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86834,Not in chargemaster,86834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86834,BCBSMN Non-RVU base fee schedule,393.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86835,Not in chargemaster,86835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86835,BCBSMN Non-RVU base fee schedule,355.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86850,Not in chargemaster,86850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86850,BCBSMN Non-RVU base fee schedule,10.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86860,Not in chargemaster,86860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86860,BCBSMN Non-RVU base fee schedule,22.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86870,Not in chargemaster,86870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86870,BCBSMN Non-RVU base fee schedule,37.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86880,Not in chargemaster,86880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86880,BCBSMN Non-RVU base fee schedule,5.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86885,Not in chargemaster,86885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86885,BCBSMN Non-RVU base fee schedule,6.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86886,Not in chargemaster,86886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86886,BCBSMN Non-RVU base fee schedule,5.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86890,Not in chargemaster,86890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86890,BCBSMN Non-RVU base fee schedule,89.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86891,Not in chargemaster,86891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86891,BCBSMN Non-RVU base fee schedule,140.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86900,Not in chargemaster,86900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86900,BCBSMN Non-RVU base fee schedule,3.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86901,Not in chargemaster,86901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86901,BCBSMN Non-RVU base fee schedule,3.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86902,Not in chargemaster,86902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86902,BCBSMN Non-RVU base fee schedule,6.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86904,Not in chargemaster,86904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86904,BCBSMN Non-RVU base fee schedule,17.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86905,Not in chargemaster,86905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86905,BCBSMN Non-RVU base fee schedule,4.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86906,Not in chargemaster,86906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86906,BCBSMN Non-RVU base fee schedule,8.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86910,Not in chargemaster,86910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86910,BCBSMN Non-RVU base fee schedule,24.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86920,Not in chargemaster,86920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86920,BCBSMN Non-RVU base fee schedule,18.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86921,Not in chargemaster,86921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86921,BCBSMN Non-RVU base fee schedule,11.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86922,Not in chargemaster,86922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86922,BCBSMN Non-RVU base fee schedule,18.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86923,Not in chargemaster,86923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86923,BCBSMN Non-RVU base fee schedule,14.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86927,Not in chargemaster,86927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86927,BCBSMN Non-RVU base fee schedule,12.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86940,Not in chargemaster,86940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86940,BCBSMN Non-RVU base fee schedule,9.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86941,Not in chargemaster,86941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86941,BCBSMN Non-RVU base fee schedule,13.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86945,Not in chargemaster,86945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86945,BCBSMN Non-RVU base fee schedule,31.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86950,Not in chargemaster,86950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86950,BCBSMN Non-RVU base fee schedule,64.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86960,Not in chargemaster,86960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86960,BCBSMN Non-RVU base fee schedule,129.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86965,Not in chargemaster,86965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86965,BCBSMN Non-RVU base fee schedule,27.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86970,Not in chargemaster,86970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86970,BCBSMN Non-RVU base fee schedule,22.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86971,Not in chargemaster,86971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86971,BCBSMN Non-RVU base fee schedule,22.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86972,Not in chargemaster,86972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86972,BCBSMN Non-RVU base fee schedule,35.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86975,Not in chargemaster,86975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86975,BCBSMN Non-RVU base fee schedule,29.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86976,Not in chargemaster,86976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86976,BCBSMN Non-RVU base fee schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86977,Not in chargemaster,86977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86977,BCBSMN Non-RVU base fee schedule,29.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86978,Not in chargemaster,86978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86978,BCBSMN Non-RVU base fee schedule,30.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 86985,Not in chargemaster,86985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,86985,BCBSMN Non-RVU base fee schedule,26.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87003,Not in chargemaster,87003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87003,BCBSMN Non-RVU base fee schedule,18.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87015,Not in chargemaster,87015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87015,BCBSMN Non-RVU base fee schedule,7.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87040,Not in chargemaster,87040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87040,BCBSMN Non-RVU base fee schedule,11.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87045,Not in chargemaster,87045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87045,BCBSMN Non-RVU base fee schedule,10.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87046,Not in chargemaster,87046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87046,BCBSMN Non-RVU base fee schedule,10.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87070,Not in chargemaster,87070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87070,BCBSMN Non-RVU base fee schedule,9.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87071,Not in chargemaster,87071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87071,BCBSMN Non-RVU base fee schedule,10.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87073,Not in chargemaster,87073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87073,BCBSMN Non-RVU base fee schedule,10.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87075,Not in chargemaster,87075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87075,BCBSMN Non-RVU base fee schedule,10.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87076,Not in chargemaster,87076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87076,BCBSMN Non-RVU base fee schedule,8.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87077,Not in chargemaster,87077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87077,BCBSMN Non-RVU base fee schedule,8.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87081,Not in chargemaster,87081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87081,BCBSMN Non-RVU base fee schedule,7.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87084,Not in chargemaster,87084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87084,BCBSMN Non-RVU base fee schedule,29.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87086,Not in chargemaster,87086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87086,BCBSMN Non-RVU base fee schedule,8.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87088,Not in chargemaster,87088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87088,BCBSMN Non-RVU base fee schedule,8.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87101,Not in chargemaster,87101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87101,BCBSMN Non-RVU base fee schedule,8.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87102,Not in chargemaster,87102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87102,BCBSMN Non-RVU base fee schedule,9.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87103,Not in chargemaster,87103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87103,BCBSMN Non-RVU base fee schedule,22.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87106,Not in chargemaster,87106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87106,BCBSMN Non-RVU base fee schedule,11.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87107,Not in chargemaster,87107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87107,BCBSMN Non-RVU base fee schedule,11.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87109,Not in chargemaster,87109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87109,BCBSMN Non-RVU base fee schedule,16.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87110,Not in chargemaster,87110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87110,BCBSMN Non-RVU base fee schedule,21.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87116,Not in chargemaster,87116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87116,BCBSMN Non-RVU base fee schedule,11.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87118,Not in chargemaster,87118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87118,BCBSMN Non-RVU base fee schedule,16.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87140,Not in chargemaster,87140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87140,BCBSMN Non-RVU base fee schedule,6.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87143,Not in chargemaster,87143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87143,BCBSMN Non-RVU base fee schedule,13.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87147,Not in chargemaster,87147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87147,BCBSMN Non-RVU base fee schedule,5.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87149,Not in chargemaster,87149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87149,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87150,Not in chargemaster,87150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87150,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87152,Not in chargemaster,87152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87152,BCBSMN Non-RVU base fee schedule,8.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87153,Not in chargemaster,87153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87153,BCBSMN Non-RVU base fee schedule,126.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87158,Not in chargemaster,87158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87158,BCBSMN Non-RVU base fee schedule,8.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87166,Not in chargemaster,87166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87166,BCBSMN Non-RVU base fee schedule,12.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87168,Not in chargemaster,87168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87168,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87169,Not in chargemaster,87169,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87169,BCBSMN Non-RVU base fee schedule,4.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87172,Not in chargemaster,87172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87172,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87176,Not in chargemaster,87176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87176,BCBSMN Non-RVU base fee schedule,6.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87177,Not in chargemaster,87177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87177,BCBSMN Non-RVU base fee schedule,9.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87181,Not in chargemaster,87181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87181,BCBSMN Non-RVU base fee schedule,5.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87184,Not in chargemaster,87184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87184,BCBSMN Non-RVU base fee schedule,8.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87185,Not in chargemaster,87185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87185,BCBSMN Non-RVU base fee schedule,5.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87186,Not in chargemaster,87186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87186,BCBSMN Non-RVU base fee schedule,9.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87187,Not in chargemaster,87187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87187,BCBSMN Non-RVU base fee schedule,44.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87188,Not in chargemaster,87188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87188,BCBSMN Non-RVU base fee schedule,7.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87190,Not in chargemaster,87190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87190,BCBSMN Non-RVU base fee schedule,8.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87197,Not in chargemaster,87197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87197,BCBSMN Non-RVU base fee schedule,16.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87205,Not in chargemaster,87205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87205,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87206,Not in chargemaster,87206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87206,BCBSMN Non-RVU base fee schedule,5.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87209,Not in chargemaster,87209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87209,BCBSMN Non-RVU base fee schedule,19.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87210,Not in chargemaster,87210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87210,BCBSMN Non-RVU base fee schedule,5.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87220,Not in chargemaster,87220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87220,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87230,Not in chargemaster,87230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87230,BCBSMN Non-RVU base fee schedule,21.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87250,Not in chargemaster,87250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87250,BCBSMN Non-RVU base fee schedule,21.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87252,Not in chargemaster,87252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87252,BCBSMN Non-RVU base fee schedule,28.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87253,Not in chargemaster,87253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87253,BCBSMN Non-RVU base fee schedule,22.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87254,Not in chargemaster,87254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87254,BCBSMN Non-RVU base fee schedule,21.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87255,Not in chargemaster,87255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87255,BCBSMN Non-RVU base fee schedule,37.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87260,Not in chargemaster,87260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87260,BCBSMN Non-RVU base fee schedule,15.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87265,Not in chargemaster,87265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87265,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87267,Not in chargemaster,87267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87267,BCBSMN Non-RVU base fee schedule,14.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87269,Not in chargemaster,87269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87269,BCBSMN Non-RVU base fee schedule,14.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87270,Not in chargemaster,87270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87270,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87271,Not in chargemaster,87271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87271,BCBSMN Non-RVU base fee schedule,14.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87272,Not in chargemaster,87272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87272,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87273,Not in chargemaster,87273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87273,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87274,Not in chargemaster,87274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87274,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87275,Not in chargemaster,87275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87275,BCBSMN Non-RVU base fee schedule,13.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87276,Not in chargemaster,87276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87276,BCBSMN Non-RVU base fee schedule,17.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87278,Not in chargemaster,87278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87278,BCBSMN Non-RVU base fee schedule,17.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87279,Not in chargemaster,87279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87279,BCBSMN Non-RVU base fee schedule,18.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87280,Not in chargemaster,87280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87280,BCBSMN Non-RVU base fee schedule,14.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87281,Not in chargemaster,87281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87281,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87283,Not in chargemaster,87283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87283,BCBSMN Non-RVU base fee schedule,66.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87285,Not in chargemaster,87285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87285,BCBSMN Non-RVU base fee schedule,13.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87290,Not in chargemaster,87290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87290,BCBSMN Non-RVU base fee schedule,14.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87299,Not in chargemaster,87299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87299,BCBSMN Non-RVU base fee schedule,17.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87300,Not in chargemaster,87300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87300,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87301,Not in chargemaster,87301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87301,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87305,Not in chargemaster,87305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87305,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87320,Not in chargemaster,87320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87320,BCBSMN Non-RVU base fee schedule,16.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87324,Not in chargemaster,87324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87324,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87327,Not in chargemaster,87327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87327,BCBSMN Non-RVU base fee schedule,14.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87328,Not in chargemaster,87328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87328,BCBSMN Non-RVU base fee schedule,15.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87329,Not in chargemaster,87329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87329,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87332,Not in chargemaster,87332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87332,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87335,Not in chargemaster,87335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87335,BCBSMN Non-RVU base fee schedule,13.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87336,Not in chargemaster,87336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87336,BCBSMN Non-RVU base fee schedule,17.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87337,Not in chargemaster,87337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87337,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87338,Not in chargemaster,87338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87338,BCBSMN Non-RVU base fee schedule,14.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87339,Not in chargemaster,87339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87339,BCBSMN Non-RVU base fee schedule,17.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87340,Not in chargemaster,87340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87340,BCBSMN Non-RVU base fee schedule,11.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87341,Not in chargemaster,87341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87341,BCBSMN Non-RVU base fee schedule,11.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87350,Not in chargemaster,87350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87350,BCBSMN Non-RVU base fee schedule,12.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87380,Not in chargemaster,87380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87380,BCBSMN Non-RVU base fee schedule,20.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87385,Not in chargemaster,87385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87385,BCBSMN Non-RVU base fee schedule,14.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87389,Not in chargemaster,87389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87389,BCBSMN Non-RVU base fee schedule,24.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87390,Not in chargemaster,87390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87390,BCBSMN Non-RVU base fee schedule,26.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87391,Not in chargemaster,87391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87391,BCBSMN Non-RVU base fee schedule,24.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87400,Not in chargemaster,87400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87400,BCBSMN Non-RVU base fee schedule,15.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87420,Not in chargemaster,87420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87420,BCBSMN Non-RVU base fee schedule,15.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87425,Not in chargemaster,87425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87425,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87426,Not in chargemaster,87426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87426,BCBSMN Non-RVU base fee schedule,45.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87427,Not in chargemaster,87427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87427,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87430,Not in chargemaster,87430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87430,BCBSMN Non-RVU base fee schedule,18.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87449,Not in chargemaster,87449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87449,BCBSMN Non-RVU base fee schedule,11.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87450,Not in chargemaster,87450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87450,BCBSMN Non-RVU base fee schedule,10.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87451,Not in chargemaster,87451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87451,BCBSMN Non-RVU base fee schedule,11.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87471,Not in chargemaster,87471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87471,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87472,Not in chargemaster,87472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87472,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87475,Not in chargemaster,87475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87475,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87476,Not in chargemaster,87476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87476,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87480,Not in chargemaster,87480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87480,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87481,Not in chargemaster,87481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87481,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87482,Not in chargemaster,87482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87482,BCBSMN Non-RVU base fee schedule,61.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87483,Not in chargemaster,87483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87483,BCBSMN Non-RVU base fee schedule,458.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87485,Not in chargemaster,87485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87485,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87486,Not in chargemaster,87486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87486,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87487,Not in chargemaster,87487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87487,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87490,Not in chargemaster,87490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87490,BCBSMN Non-RVU base fee schedule,25.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87491,Not in chargemaster,87491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87491,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87492,Not in chargemaster,87492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87492,BCBSMN Non-RVU base fee schedule,58.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87493,Not in chargemaster,87493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87493,BCBSMN Non-RVU base fee schedule,41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87495,Not in chargemaster,87495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87495,BCBSMN Non-RVU base fee schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87496,Not in chargemaster,87496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87496,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87497,Not in chargemaster,87497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87497,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87498,Not in chargemaster,87498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87498,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87500,Not in chargemaster,87500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87500,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87501,Not in chargemaster,87501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87501,BCBSMN Non-RVU base fee schedule,56.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87502,Not in chargemaster,87502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87502,BCBSMN Non-RVU base fee schedule,95.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87503,Not in chargemaster,87503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87503,BCBSMN Non-RVU base fee schedule,32.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87505,Not in chargemaster,87505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87505,BCBSMN Non-RVU base fee schedule,141.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87506,Not in chargemaster,87506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87506,BCBSMN Non-RVU base fee schedule,289.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87507,Not in chargemaster,87507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87507,BCBSMN Non-RVU base fee schedule,458.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87510,Not in chargemaster,87510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87510,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87511,Not in chargemaster,87511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87511,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87512,Not in chargemaster,87512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87512,BCBSMN Non-RVU base fee schedule,45.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87516,Not in chargemaster,87516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87516,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87517,Not in chargemaster,87517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87517,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87520,Not in chargemaster,87520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87520,BCBSMN Non-RVU base fee schedule,34.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87521,Not in chargemaster,87521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87521,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87522,Not in chargemaster,87522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87522,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87525,Not in chargemaster,87525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87525,BCBSMN Non-RVU base fee schedule,32.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87526,Not in chargemaster,87526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87526,BCBSMN Non-RVU base fee schedule,43.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87527,Not in chargemaster,87527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87527,BCBSMN Non-RVU base fee schedule,45.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87528,Not in chargemaster,87528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87528,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87529,Not in chargemaster,87529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87529,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87530,Not in chargemaster,87530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87530,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87531,Not in chargemaster,87531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87531,BCBSMN Non-RVU base fee schedule,63.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87532,Not in chargemaster,87532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87532,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87533,Not in chargemaster,87533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87533,BCBSMN Non-RVU base fee schedule,45.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87534,Not in chargemaster,87534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87534,BCBSMN Non-RVU base fee schedule,24.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87535,Not in chargemaster,87535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87535,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87536,Not in chargemaster,87536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87536,BCBSMN Non-RVU base fee schedule,93.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87537,Not in chargemaster,87537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87537,BCBSMN Non-RVU base fee schedule,24.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87538,Not in chargemaster,87538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87538,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87539,Not in chargemaster,87539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87539,BCBSMN Non-RVU base fee schedule,64.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87540,Not in chargemaster,87540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87540,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87541,Not in chargemaster,87541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87541,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87542,Not in chargemaster,87542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87542,BCBSMN Non-RVU base fee schedule,45.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87550,Not in chargemaster,87550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87550,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87551,Not in chargemaster,87551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87551,BCBSMN Non-RVU base fee schedule,53.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87552,Not in chargemaster,87552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87552,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87555,Not in chargemaster,87555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87555,BCBSMN Non-RVU base fee schedule,29.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87556,Not in chargemaster,87556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87556,BCBSMN Non-RVU base fee schedule,45.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87557,Not in chargemaster,87557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87557,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87560,Not in chargemaster,87560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87560,BCBSMN Non-RVU base fee schedule,30.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87561,Not in chargemaster,87561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87561,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87562,Not in chargemaster,87562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87562,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87563,Not in chargemaster,87563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87563,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87580,Not in chargemaster,87580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87580,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87581,Not in chargemaster,87581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87581,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87582,Not in chargemaster,87582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87582,BCBSMN Non-RVU base fee schedule,332.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87590,Not in chargemaster,87590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87590,BCBSMN Non-RVU base fee schedule,29.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87591,Not in chargemaster,87591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87591,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87592,Not in chargemaster,87592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87592,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87623,Not in chargemaster,87623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87623,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87624,Not in chargemaster,87624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87624,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87625,Not in chargemaster,87625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87625,BCBSMN Non-RVU base fee schedule,44.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87631,Not in chargemaster,87631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87631,BCBSMN Non-RVU base fee schedule,142.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87632,Not in chargemaster,87632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87632,BCBSMN Non-RVU base fee schedule,239.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87633,Not in chargemaster,87633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87633,BCBSMN Non-RVU base fee schedule,416.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87634,Not in chargemaster,87634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87634,BCBSMN Non-RVU base fee schedule,70.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87635,Not in chargemaster,87635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87635,BCBSMN Non-RVU base fee schedule,51.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87636,Not in chargemaster,87636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87636,BCBSMN Non-RVU base fee schedule,142.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87637,Not in chargemaster,87637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87637,BCBSMN Non-RVU base fee schedule,142.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87640,Not in chargemaster,87640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87640,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87641,Not in chargemaster,87641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87641,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87650,Not in chargemaster,87650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87650,BCBSMN Non-RVU base fee schedule,20.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87651,Not in chargemaster,87651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87651,BCBSMN Non-RVU base fee schedule,35.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87652,Not in chargemaster,87652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87652,BCBSMN Non-RVU base fee schedule,45.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87653,Not in chargemaster,87653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87653,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87660,Not in chargemaster,87660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87660,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87661,Not in chargemaster,87661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87661,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87662,Not in chargemaster,87662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87662,BCBSMN Non-RVU base fee schedule,56.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87797,Not in chargemaster,87797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87797,BCBSMN Non-RVU base fee schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87798,Not in chargemaster,87798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87798,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87799,Not in chargemaster,87799,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87799,BCBSMN Non-RVU base fee schedule,47.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87800,Not in chargemaster,87800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87800,BCBSMN Non-RVU base fee schedule,48.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87801,Not in chargemaster,87801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87801,BCBSMN Non-RVU base fee schedule,70.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87802,Not in chargemaster,87802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87802,BCBSMN Non-RVU base fee schedule,14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87803,Not in chargemaster,87803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87803,BCBSMN Non-RVU base fee schedule,17.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87804,Not in chargemaster,87804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87804,BCBSMN Non-RVU base fee schedule,16.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87806,Not in chargemaster,87806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87806,BCBSMN Non-RVU base fee schedule,32.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87807,Not in chargemaster,87807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87807,BCBSMN Non-RVU base fee schedule,13.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87808,Not in chargemaster,87808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87808,BCBSMN Non-RVU base fee schedule,15.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87809,Not in chargemaster,87809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87809,BCBSMN Non-RVU base fee schedule,21.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87810,Not in chargemaster,87810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87810,BCBSMN Non-RVU base fee schedule,38.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87811,Not in chargemaster,87811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87811,BCBSMN Non-RVU base fee schedule,41.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87850,Not in chargemaster,87850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87850,BCBSMN Non-RVU base fee schedule,27.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87880,Not in chargemaster,87880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87880,BCBSMN Non-RVU base fee schedule,16.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87899,Not in chargemaster,87899,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87899,BCBSMN Non-RVU base fee schedule,16.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87900,Not in chargemaster,87900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87900,BCBSMN Non-RVU base fee schedule,143.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87901,Not in chargemaster,87901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87901,BCBSMN Non-RVU base fee schedule,283.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87902,Not in chargemaster,87902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87902,BCBSMN Non-RVU base fee schedule,283.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87903,Not in chargemaster,87903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87903,BCBSMN Non-RVU base fee schedule,537.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87904,Not in chargemaster,87904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87904,BCBSMN Non-RVU base fee schedule,28.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87905,Not in chargemaster,87905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87905,BCBSMN Non-RVU base fee schedule,12.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87906,Not in chargemaster,87906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87906,BCBSMN Non-RVU base fee schedule,141.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87910,Not in chargemaster,87910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87910,BCBSMN Non-RVU base fee schedule,283.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 87912,Not in chargemaster,87912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,87912,BCBSMN Non-RVU base fee schedule,283.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88007,Not in chargemaster,88007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88007,BCBSMN Non-RVU base fee schedule,9.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88014,Not in chargemaster,88014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88014,BCBSMN Non-RVU base fee schedule,35.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88130,Not in chargemaster,88130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88130,BCBSMN Non-RVU base fee schedule,19.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88140,Not in chargemaster,88140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88140,BCBSMN Non-RVU base fee schedule,8.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88142,Not in chargemaster,88142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88142,BCBSMN Non-RVU base fee schedule,22.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88143,Not in chargemaster,88143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88143,BCBSMN Non-RVU base fee schedule,25.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88147,Not in chargemaster,88147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88147,BCBSMN Non-RVU base fee schedule,55.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88148,Not in chargemaster,88148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88148,BCBSMN Non-RVU base fee schedule,17.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88150,Not in chargemaster,88150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88150,BCBSMN Non-RVU base fee schedule,16.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88152,Not in chargemaster,88152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88152,BCBSMN Non-RVU base fee schedule,30.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88153,Not in chargemaster,88153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88153,BCBSMN Non-RVU base fee schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88155,Not in chargemaster,88155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88155,BCBSMN Non-RVU base fee schedule,16.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88164,Not in chargemaster,88164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88164,BCBSMN Non-RVU base fee schedule,16.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88165,Not in chargemaster,88165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88165,BCBSMN Non-RVU base fee schedule,46.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88166,Not in chargemaster,88166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88166,BCBSMN Non-RVU base fee schedule,16.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88167,Not in chargemaster,88167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88167,BCBSMN Non-RVU base fee schedule,16.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88174,Not in chargemaster,88174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88174,BCBSMN Non-RVU base fee schedule,27.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88175,Not in chargemaster,88175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88175,BCBSMN Non-RVU base fee schedule,29.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88230,Not in chargemaster,88230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88230,BCBSMN Non-RVU base fee schedule,128.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88233,Not in chargemaster,88233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88233,BCBSMN Non-RVU base fee schedule,154.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88235,Not in chargemaster,88235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88235,BCBSMN Non-RVU base fee schedule,165.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88237,Not in chargemaster,88237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88237,BCBSMN Non-RVU base fee schedule,158.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88239,Not in chargemaster,88239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88239,BCBSMN Non-RVU base fee schedule,162.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88240,Not in chargemaster,88240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88240,BCBSMN Non-RVU base fee schedule,14.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88241,Not in chargemaster,88241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88241,BCBSMN Non-RVU base fee schedule,13.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88245,Not in chargemaster,88245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88245,BCBSMN Non-RVU base fee schedule,190.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88248,Not in chargemaster,88248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88248,BCBSMN Non-RVU base fee schedule,190.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88249,Not in chargemaster,88249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88249,BCBSMN Non-RVU base fee schedule,190.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88261,Not in chargemaster,88261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88261,BCBSMN Non-RVU base fee schedule,290.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88262,Not in chargemaster,88262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88262,BCBSMN Non-RVU base fee schedule,138.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88263,Not in chargemaster,88263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88263,BCBSMN Non-RVU base fee schedule,165.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88264,Not in chargemaster,88264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88264,BCBSMN Non-RVU base fee schedule,159.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88267,Not in chargemaster,88267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88267,BCBSMN Non-RVU base fee schedule,207.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88269,Not in chargemaster,88269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88269,BCBSMN Non-RVU base fee schedule,191.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88271,Not in chargemaster,88271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88271,BCBSMN Non-RVU base fee schedule,23.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88272,Not in chargemaster,88272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88272,BCBSMN Non-RVU base fee schedule,44.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88273,Not in chargemaster,88273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88273,BCBSMN Non-RVU base fee schedule,38.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88274,Not in chargemaster,88274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88274,BCBSMN Non-RVU base fee schedule,46.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88275,Not in chargemaster,88275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88275,BCBSMN Non-RVU base fee schedule,56.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88280,Not in chargemaster,88280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88280,BCBSMN Non-RVU base fee schedule,36.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88283,Not in chargemaster,88283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88283,BCBSMN Non-RVU base fee schedule,75.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88285,Not in chargemaster,88285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88285,BCBSMN Non-RVU base fee schedule,29.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88289,Not in chargemaster,88289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88289,BCBSMN Non-RVU base fee schedule,37.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88720,Not in chargemaster,88720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88720,BCBSMN Non-RVU base fee schedule,5.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88738,Not in chargemaster,88738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88738,BCBSMN Non-RVU base fee schedule,5.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88740,Not in chargemaster,88740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88740,BCBSMN Non-RVU base fee schedule,10.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 88741,Not in chargemaster,88741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,88741,BCBSMN Non-RVU base fee schedule,10.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89050,Not in chargemaster,89050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89050,BCBSMN Non-RVU base fee schedule,5.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89051,Not in chargemaster,89051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89051,BCBSMN Non-RVU base fee schedule,6.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89055,Not in chargemaster,89055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89055,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89125,Not in chargemaster,89125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89125,BCBSMN Non-RVU base fee schedule,6.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89160,Not in chargemaster,89160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89160,BCBSMN Non-RVU base fee schedule,5.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89190,Not in chargemaster,89190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89190,BCBSMN Non-RVU base fee schedule,6.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89250,Not in chargemaster,89250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89250,BCBSMN Non-RVU base fee schedule,434.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89253,Not in chargemaster,89253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89253,BCBSMN Non-RVU base fee schedule,256.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89254,Not in chargemaster,89254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89254,BCBSMN Non-RVU base fee schedule,460,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89255,Not in chargemaster,89255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89255,BCBSMN Non-RVU base fee schedule,264.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89257,Not in chargemaster,89257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89257,BCBSMN Non-RVU base fee schedule,313.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89258,Not in chargemaster,89258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89258,BCBSMN Non-RVU base fee schedule,390.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89259,Not in chargemaster,89259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89259,BCBSMN Non-RVU base fee schedule,160.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89260,Not in chargemaster,89260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89260,BCBSMN Non-RVU base fee schedule,62.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89261,Not in chargemaster,89261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89261,BCBSMN Non-RVU base fee schedule,159.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89264,Not in chargemaster,89264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89264,BCBSMN Non-RVU base fee schedule,164.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89268,Not in chargemaster,89268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89268,BCBSMN Non-RVU base fee schedule,220,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89272,Not in chargemaster,89272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89272,BCBSMN Non-RVU base fee schedule,609.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89280,Not in chargemaster,89280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89280,BCBSMN Non-RVU base fee schedule,860.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89281,Not in chargemaster,89281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89281,BCBSMN Non-RVU base fee schedule,1015.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89290,Not in chargemaster,89290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89290,BCBSMN Non-RVU base fee schedule,816.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89291,Not in chargemaster,89291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89291,BCBSMN Non-RVU base fee schedule,1286.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89300,Not in chargemaster,89300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89300,BCBSMN Non-RVU base fee schedule,9.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89310,Not in chargemaster,89310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89310,BCBSMN Non-RVU base fee schedule,9.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89320,Not in chargemaster,89320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89320,BCBSMN Non-RVU base fee schedule,13.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89321,Not in chargemaster,89321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89321,BCBSMN Non-RVU base fee schedule,12.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89322,Not in chargemaster,89322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89322,BCBSMN Non-RVU base fee schedule,17.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89325,Not in chargemaster,89325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89325,BCBSMN Non-RVU base fee schedule,11.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89329,Not in chargemaster,89329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89329,BCBSMN Non-RVU base fee schedule,21.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89330,Not in chargemaster,89330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89330,BCBSMN Non-RVU base fee schedule,11.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89331,Not in chargemaster,89331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89331,BCBSMN Non-RVU base fee schedule,21.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89335,Not in chargemaster,89335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89335,BCBSMN Non-RVU base fee schedule,313.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89337,Not in chargemaster,89337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89337,BCBSMN Non-RVU base fee schedule,321.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89342,Not in chargemaster,89342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89342,BCBSMN Non-RVU base fee schedule,248.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89343,Not in chargemaster,89343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89343,BCBSMN Non-RVU base fee schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89346,Not in chargemaster,89346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89346,BCBSMN Non-RVU base fee schedule,40.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89352,Not in chargemaster,89352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89352,BCBSMN Non-RVU base fee schedule,256.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 89353,Not in chargemaster,89353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,89353,BCBSMN Non-RVU base fee schedule,16.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90281,Not in chargemaster,90281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90281,BCBSMN Non-RVU base fee schedule,44.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90283,Not in chargemaster,90283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90283,BCBSMN Non-RVU base fee schedule,76.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90284,Not in chargemaster,90284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90284,BCBSMN Non-RVU base fee schedule,19.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90287,Not in chargemaster,90287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90287,BCBSMN Non-RVU base fee schedule,306.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90291,Not in chargemaster,90291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90291,BCBSMN Non-RVU base fee schedule,1440.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90296,Not in chargemaster,90296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90296,BCBSMN Non-RVU base fee schedule,220.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90371,Not in chargemaster,90371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90371,BCBSMN Non-RVU base fee schedule,115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90375,Not in chargemaster,90375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90375,BCBSMN Non-RVU base fee schedule,277.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90376,Not in chargemaster,90376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90376,BCBSMN Non-RVU base fee schedule,278.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90378,Not in chargemaster,90378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90378,BCBSMN Non-RVU base fee schedule,1604.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90384,Not in chargemaster,90384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90384,BCBSMN Non-RVU base fee schedule,107.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90385,Not in chargemaster,90385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90385,BCBSMN Non-RVU base fee schedule,34.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90386,Not in chargemaster,90386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90386,BCBSMN Non-RVU base fee schedule,209.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90389,Not in chargemaster,90389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90389,BCBSMN Non-RVU base fee schedule,567.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90396,Not in chargemaster,90396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90396,BCBSMN Non-RVU base fee schedule,461.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90581,Not in chargemaster,90581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90581,BCBSMN Non-RVU base fee schedule,201.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90585,Not in chargemaster,90585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90585,BCBSMN Non-RVU base fee schedule,141.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90586,Not in chargemaster,90586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90586,BCBSMN Non-RVU base fee schedule,141.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90620,90620,90620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90620,BCBSMN Non-RVU base fee schedule,182.71,243.61,Fee schedule,,182.71,182.71,182.71,182.71,,,0
unity,Fee schedule,Non-RVU 90621,Not in chargemaster,90621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90621,BCBSMN Non-RVU base fee schedule,152.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90625,Not in chargemaster,90625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90625,BCBSMN Non-RVU base fee schedule,229.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90630,Not in chargemaster,90630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90630,BCBSMN Non-RVU base fee schedule,20.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90632,90632,90632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90632,BCBSMN Non-RVU base fee schedule,59.91,68,Fee schedule,,59.91,59.91,59.91,59.91,,,0
unity,Fee schedule,Non-RVU 90633,90633,90633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90633,BCBSMN Non-RVU base fee schedule,35.42,48.56,Fee schedule,,35.42,35.42,35.42,35.42,,,0
unity,Fee schedule,Non-RVU 90634,Not in chargemaster,90634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90634,BCBSMN Non-RVU base fee schedule,34.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90636,Not in chargemaster,90636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90636,BCBSMN Non-RVU base fee schedule,111.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90644,Not in chargemaster,90644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90644,BCBSMN Non-RVU base fee schedule,261.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90647,Not in chargemaster,90647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90647,BCBSMN Non-RVU base fee schedule,26.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90648,90648,90648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90648,BCBSMN Non-RVU base fee schedule,17.36,17.72,Fee schedule,,17.36,17.36,17.36,17.36,,,0
unity,Fee schedule,Non-RVU 90649,Not in chargemaster,90649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90649,BCBSMN Non-RVU base fee schedule,163.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90650,Not in chargemaster,90650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90650,BCBSMN Non-RVU base fee schedule,266.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90651,90651,90651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90651,BCBSMN Non-RVU base fee schedule,232.36,336.48,Fee schedule,,232.36,232.36,232.36,232.36,,,0
unity,Fee schedule,Non-RVU 90653,Not in chargemaster,90653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90653,BCBSMN Non-RVU base fee schedule,59.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90654,Not in chargemaster,90654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90654,BCBSMN Non-RVU base fee schedule,18.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90655,Not in chargemaster,90655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90655,BCBSMN Non-RVU base fee schedule,17.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90656,Not in chargemaster,90656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90656,BCBSMN Non-RVU base fee schedule,19.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90657,Not in chargemaster,90657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90657,BCBSMN Non-RVU base fee schedule,6.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90658,Not in chargemaster,90658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90658,BCBSMN Non-RVU base fee schedule,12.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90660,Not in chargemaster,90660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90660,BCBSMN Non-RVU base fee schedule,20.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90661,Not in chargemaster,90661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90661,BCBSMN Non-RVU base fee schedule,22.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90662,90662,90662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90662,BCBSMN Non-RVU base fee schedule,60.98,63.8,Fee schedule,,60.98,60.98,60.98,60.98,,,0
unity,Fee schedule,Non-RVU 90670,90670,90670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90670,BCBSMN Non-RVU base fee schedule,214.62,299.22,Fee schedule,,214.62,214.62,214.62,214.62,,,0
unity,Fee schedule,Non-RVU 90672,Not in chargemaster,90672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90672,BCBSMN Non-RVU base fee schedule,26.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90673,Not in chargemaster,90673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90673,BCBSMN Non-RVU base fee schedule,40.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90674,Not in chargemaster,90674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90674,BCBSMN Non-RVU base fee schedule,29.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90675,90675,90675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90675,BCBSMN Non-RVU base fee schedule,277.82,840.17,Fee schedule,,277.82,277.82,277.82,277.82,,,0
unity,Fee schedule,Non-RVU 90676,Not in chargemaster,90676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90676,BCBSMN Non-RVU base fee schedule,343.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90680,90680,90680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90680,BCBSMN Non-RVU base fee schedule,86.09,125.58,Fee schedule,,86.09,86.09,86.09,86.09,,,0
unity,Fee schedule,Non-RVU 90681,Not in chargemaster,90681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90681,BCBSMN Non-RVU base fee schedule,126.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90682,Not in chargemaster,90682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90682,BCBSMN Non-RVU base fee schedule,60.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90685,90685,90685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90685,BCBSMN Non-RVU base fee schedule,21.13,25,Fee schedule,,21.13,21.13,21.13,21.13,,,0
unity,Fee schedule,Non-RVU 90686,90686,90686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90686,BCBSMN Non-RVU base fee schedule,19.58,25,Fee schedule,,19.58,19.58,19.58,19.58,,,0
unity,Fee schedule,Non-RVU 90687,Not in chargemaster,90687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90687,BCBSMN Non-RVU base fee schedule,9.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90688,Not in chargemaster,90688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90688,BCBSMN Non-RVU base fee schedule,19.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90690,Not in chargemaster,90690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90690,BCBSMN Non-RVU base fee schedule,14.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90691,Not in chargemaster,90691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90691,BCBSMN Non-RVU base fee schedule,104.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90694,Not in chargemaster,90694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90694,BCBSMN Non-RVU base fee schedule,61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90696,90696,90696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90696,BCBSMN Non-RVU base fee schedule,54.18,76.21,Fee schedule,,54.18,54.18,54.18,54.18,,,0
unity,Fee schedule,Non-RVU 90698,Not in chargemaster,90698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90698,BCBSMN Non-RVU base fee schedule,101.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90700,90700,90700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90700,BCBSMN Non-RVU base fee schedule,25.51,0.01,Fee schedule,,0.01,0.01,0.01,0.01,,,0
unity,Fee schedule,Non-RVU 90702,Not in chargemaster,90702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90702,BCBSMN Non-RVU base fee schedule,34.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90707,90707,90707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90707,BCBSMN Non-RVU base fee schedule,79.87,116.53,Fee schedule,,79.87,79.87,79.87,79.87,,,0
unity,Fee schedule,Non-RVU 90710,90710,90710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90710,BCBSMN Non-RVU base fee schedule,228.93,334.41,Fee schedule,,228.93,228.93,228.93,228.93,,,0
unity,Fee schedule,Non-RVU 90713,90713,90713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90713,BCBSMN Non-RVU base fee schedule,34.11,0.01,Fee schedule,,0.01,0.01,0.01,0.01,,,0
unity,Fee schedule,Non-RVU 90714,90714,90714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90714,BCBSMN Non-RVU base fee schedule,25.11,49.68,Fee schedule,,25.11,25.11,25.11,25.11,,,0
unity,Fee schedule,Non-RVU 90715,90715,90715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90715,BCBSMN Non-RVU base fee schedule,33.64,61.93,Fee schedule,,33.64,33.64,33.64,33.64,,,0
unity,Fee schedule,Non-RVU 90716,90716,90716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90716,BCBSMN Non-RVU base fee schedule,138.31,192.39,Fee schedule,,138.31,138.31,138.31,138.31,,,0
unity,Fee schedule,Non-RVU 90717,Not in chargemaster,90717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90717,BCBSMN Non-RVU base fee schedule,380.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90723,90723,90723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90723,BCBSMN Non-RVU base fee schedule,83.94,117.43,Fee schedule,,83.94,83.94,83.94,83.94,,,0
unity,Fee schedule,Non-RVU 90732,90732,90732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90732,BCBSMN Non-RVU base fee schedule,114.21,158.87,Fee schedule,,114.21,114.21,114.21,114.21,,,0
unity,Fee schedule,Non-RVU 90733,Not in chargemaster,90733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90733,BCBSMN Non-RVU base fee schedule,106.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90734,90734,90734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90734,BCBSMN Non-RVU base fee schedule,125.5,174.84,Fee schedule,,125.5,125.5,125.5,125.5,,,0
unity,Fee schedule,Non-RVU 90736,Not in chargemaster,90736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90736,BCBSMN Non-RVU base fee schedule,196.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90738,Not in chargemaster,90738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90738,BCBSMN Non-RVU base fee schedule,259.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90739,Not in chargemaster,90739,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90739,BCBSMN Non-RVU base fee schedule,131.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90740,Not in chargemaster,90740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90740,BCBSMN Non-RVU base fee schedule,134.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90743,Not in chargemaster,90743,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90743,BCBSMN Non-RVU base fee schedule,26.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90744,90744,90744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90744,BCBSMN Non-RVU base fee schedule,26.9,28,Fee schedule,,26.9,26.9,26.9,26.9,,,0
unity,Fee schedule,Non-RVU 90746,90746,90746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90746,BCBSMN Non-RVU base fee schedule,67.06,88.17,Fee schedule,,67.06,67.06,67.06,67.06,,,0
unity,Fee schedule,Non-RVU 90747,Not in chargemaster,90747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90747,BCBSMN Non-RVU base fee schedule,134.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90748,Not in chargemaster,90748,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90748,BCBSMN Non-RVU base fee schedule,42.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90750,90750,90750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90750,BCBSMN Non-RVU base fee schedule,154.44,224.43,Fee schedule,,154.44,154.44,154.44,154.44,,,0
unity,Fee schedule,Non-RVU 90756,Not in chargemaster,90756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90756,BCBSMN Non-RVU base fee schedule,27.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90867,Not in chargemaster,90867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90867,BCBSMN Non-RVU base fee schedule,367.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90868,Not in chargemaster,90868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90868,BCBSMN Non-RVU base fee schedule,213.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90869,Not in chargemaster,90869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90869,BCBSMN Non-RVU base fee schedule,308.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90882,Not in chargemaster,90882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90882,BCBSMN Non-RVU base fee schedule,36.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90889,Not in chargemaster,90889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90889,BCBSMN Non-RVU base fee schedule,64.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90940,Not in chargemaster,90940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90940,BCBSMN Non-RVU base fee schedule,40.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90952,Not in chargemaster,90952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90952,BCBSMN Non-RVU base fee schedule,884.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90953,Not in chargemaster,90953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90953,BCBSMN Non-RVU base fee schedule,884.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90989,Not in chargemaster,90989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90989,BCBSMN Non-RVU base fee schedule,261.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 90993,Not in chargemaster,90993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,90993,BCBSMN Non-RVU base fee schedule,55.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92531,Not in chargemaster,92531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92531,BCBSMN Non-RVU base fee schedule,30.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92532,Not in chargemaster,92532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92532,BCBSMN Non-RVU base fee schedule,12.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92533,Not in chargemaster,92533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92533,BCBSMN Non-RVU base fee schedule,17.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92534,Not in chargemaster,92534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92534,BCBSMN Non-RVU base fee schedule,13.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92560,Not in chargemaster,92560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92560,BCBSMN Non-RVU base fee schedule,14.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92590,Not in chargemaster,92590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92590,BCBSMN Non-RVU base fee schedule,39.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92591,Not in chargemaster,92591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92591,BCBSMN Non-RVU base fee schedule,50.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92592,Not in chargemaster,92592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92592,BCBSMN Non-RVU base fee schedule,15.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92593,Not in chargemaster,92593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92593,BCBSMN Non-RVU base fee schedule,25.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92594,Not in chargemaster,92594,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92594,BCBSMN Non-RVU base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92595,Not in chargemaster,92595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92595,BCBSMN Non-RVU base fee schedule,32.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92630,Not in chargemaster,92630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92630,BCBSMN Non-RVU base fee schedule,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92633,Not in chargemaster,92633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92633,BCBSMN Non-RVU base fee schedule,95.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92921,Not in chargemaster,92921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92921,BCBSMN Non-RVU base fee schedule,161.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92925,Not in chargemaster,92925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92925,BCBSMN Non-RVU base fee schedule,310.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92929,Not in chargemaster,92929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92929,BCBSMN Non-RVU base fee schedule,383.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92934,Not in chargemaster,92934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92934,BCBSMN Non-RVU base fee schedule,310.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92938,Not in chargemaster,92938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92938,BCBSMN Non-RVU base fee schedule,1756.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92944,Not in chargemaster,92944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92944,BCBSMN Non-RVU base fee schedule,1756.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92992,Not in chargemaster,92992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92992,BCBSMN Non-RVU base fee schedule,775.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 92993,Not in chargemaster,92993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,92993,BCBSMN Non-RVU base fee schedule,1784.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 93745,Not in chargemaster,93745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93745,BCBSMN Non-RVU base fee schedule,305.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 93895,Not in chargemaster,93895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,93895,BCBSMN Non-RVU base fee schedule,135.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 94642,Not in chargemaster,94642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94642,BCBSMN Non-RVU base fee schedule,31.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 94772,Not in chargemaster,94772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94772,BCBSMN Non-RVU base fee schedule,201.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 94774,Not in chargemaster,94774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94774,BCBSMN Non-RVU base fee schedule,432.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 94775,Not in chargemaster,94775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94775,BCBSMN Non-RVU base fee schedule,69.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 94776,Not in chargemaster,94776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94776,BCBSMN Non-RVU base fee schedule,325.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 94777,Not in chargemaster,94777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,94777,BCBSMN Non-RVU base fee schedule,19.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95120,Not in chargemaster,95120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95120,BCBSMN Non-RVU base fee schedule,7.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95125,Not in chargemaster,95125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95125,BCBSMN Non-RVU base fee schedule,9.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95130,Not in chargemaster,95130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95130,BCBSMN Non-RVU base fee schedule,13.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95131,Not in chargemaster,95131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95131,BCBSMN Non-RVU base fee schedule,16.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95132,Not in chargemaster,95132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95132,BCBSMN Non-RVU base fee schedule,19.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95133,Not in chargemaster,95133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95133,BCBSMN Non-RVU base fee schedule,24.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95134,Not in chargemaster,95134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95134,BCBSMN Non-RVU base fee schedule,38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95700,Not in chargemaster,95700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95700,BCBSMN Non-RVU base fee schedule,506.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95705,Not in chargemaster,95705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95705,BCBSMN Non-RVU base fee schedule,253.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95706,Not in chargemaster,95706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95706,BCBSMN Non-RVU base fee schedule,253.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95707,Not in chargemaster,95707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95707,BCBSMN Non-RVU base fee schedule,253.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95708,Not in chargemaster,95708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95708,BCBSMN Non-RVU base fee schedule,485.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95709,Not in chargemaster,95709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95709,BCBSMN Non-RVU base fee schedule,485.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95710,Not in chargemaster,95710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95710,BCBSMN Non-RVU base fee schedule,485.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95711,Not in chargemaster,95711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95711,BCBSMN Non-RVU base fee schedule,506.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95712,Not in chargemaster,95712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95712,BCBSMN Non-RVU base fee schedule,506.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95713,Not in chargemaster,95713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95713,BCBSMN Non-RVU base fee schedule,971.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95714,Not in chargemaster,95714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95714,BCBSMN Non-RVU base fee schedule,971.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95715,Not in chargemaster,95715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95715,BCBSMN Non-RVU base fee schedule,971.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95716,Not in chargemaster,95716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95716,BCBSMN Non-RVU base fee schedule,1817.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95941,Not in chargemaster,95941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95941,BCBSMN Non-RVU base fee schedule,77.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 95943,Not in chargemaster,95943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,95943,BCBSMN Non-RVU base fee schedule,92.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 96376,Not in chargemaster,96376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96376,BCBSMN Non-RVU base fee schedule,6.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 96379,Not in chargemaster,96379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,96379,BCBSMN Non-RVU base fee schedule,1.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97039,Not in chargemaster,97039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97039,BCBSMN Non-RVU base fee schedule,21.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97139,Not in chargemaster,97139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97139,BCBSMN Non-RVU base fee schedule,21.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97151,Not in chargemaster,97151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97151,BCBSMN Non-RVU base fee schedule,35.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97152,Not in chargemaster,97152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97152,BCBSMN Non-RVU base fee schedule,10.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97153,Not in chargemaster,97153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97153,BCBSMN Non-RVU base fee schedule,17.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97154,Not in chargemaster,97154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97154,BCBSMN Non-RVU base fee schedule,5.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97155,Not in chargemaster,97155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97155,BCBSMN Non-RVU base fee schedule,17.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97156,Not in chargemaster,97156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97156,BCBSMN Non-RVU base fee schedule,17.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97157,Not in chargemaster,97157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97157,BCBSMN Non-RVU base fee schedule,5.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97158,Not in chargemaster,97158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97158,BCBSMN Non-RVU base fee schedule,9.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97545,Not in chargemaster,97545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97545,BCBSMN Non-RVU base fee schedule,116.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97546,Not in chargemaster,97546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97546,BCBSMN Non-RVU base fee schedule,37.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 97602,Not in chargemaster,97602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,97602,BCBSMN Non-RVU base fee schedule,59.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 98970,Not in chargemaster,98970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98970,BCBSMN Non-RVU base fee schedule,22.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 98971,Not in chargemaster,98971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98971,BCBSMN Non-RVU base fee schedule,45.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 98972,Not in chargemaster,98972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,98972,BCBSMN Non-RVU base fee schedule,72.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99000,Not in chargemaster,99000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99000,BCBSMN Non-RVU base fee schedule,3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99001,Not in chargemaster,99001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99001,BCBSMN Non-RVU base fee schedule,8.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99002,Not in chargemaster,99002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99002,BCBSMN Non-RVU base fee schedule,8.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99024,99024,99024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99024,BCBSMN Non-RVU base fee schedule,3.05,0,Fee schedule,,0,0,0,0,,,0
unity,Fee schedule,Non-RVU 99050,Not in chargemaster,99050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99050,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99051,Not in chargemaster,99051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99051,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99053,Not in chargemaster,99053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99053,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99070,Not in chargemaster,99070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99070,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99078,Not in chargemaster,99078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99078,BCBSMN Non-RVU base fee schedule,17.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99080,Not in chargemaster,99080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99080,BCBSMN Non-RVU base fee schedule,0.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99172,Not in chargemaster,99172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99172,BCBSMN Non-RVU base fee schedule,12.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99190,Not in chargemaster,99190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99190,BCBSMN Non-RVU base fee schedule,205.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99191,Not in chargemaster,99191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99191,BCBSMN Non-RVU base fee schedule,147.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99192,Not in chargemaster,99192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99192,BCBSMN Non-RVU base fee schedule,178.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99288,Not in chargemaster,99288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99288,BCBSMN Non-RVU base fee schedule,91.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99450,Not in chargemaster,99450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99450,BCBSMN Non-RVU base fee schedule,20.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99455,Not in chargemaster,99455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99455,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99500,Not in chargemaster,99500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99500,BCBSMN Non-RVU base fee schedule,125.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99501,Not in chargemaster,99501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99501,BCBSMN Non-RVU base fee schedule,62.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99502,Not in chargemaster,99502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99502,BCBSMN Non-RVU base fee schedule,62.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99601,Not in chargemaster,99601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99601,BCBSMN Non-RVU base fee schedule,125.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99602,Not in chargemaster,99602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99602,BCBSMN Non-RVU base fee schedule,62.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99605,Not in chargemaster,99605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99605,BCBSMN Non-RVU base fee schedule,52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99606,Not in chargemaster,99606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99606,BCBSMN Non-RVU base fee schedule,34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU 99607,Not in chargemaster,99607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,99607,BCBSMN Non-RVU base fee schedule,24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0130,Not in chargemaster,A0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0130,BCBSMN Non-RVU base fee schedule,18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0225,Not in chargemaster,A0225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0225,BCBSMN Non-RVU base fee schedule,452.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0380,Not in chargemaster,A0380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0380,BCBSMN Non-RVU base fee schedule,7.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0382,Not in chargemaster,A0382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0382,BCBSMN Non-RVU base fee schedule,10.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0384,Not in chargemaster,A0384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0384,BCBSMN Non-RVU base fee schedule,11.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0390,Not in chargemaster,A0390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0390,BCBSMN Non-RVU base fee schedule,7.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0392,Not in chargemaster,A0392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0392,BCBSMN Non-RVU base fee schedule,1.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0394,Not in chargemaster,A0394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0394,BCBSMN Non-RVU base fee schedule,12.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0396,Not in chargemaster,A0396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0396,BCBSMN Non-RVU base fee schedule,17.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0398,Not in chargemaster,A0398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0398,BCBSMN Non-RVU base fee schedule,10.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0422,Not in chargemaster,A0422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0422,BCBSMN Non-RVU base fee schedule,22.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0424,Not in chargemaster,A0424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0424,BCBSMN Non-RVU base fee schedule,18.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0425,Not in chargemaster,A0425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0425,BCBSMN Non-RVU base fee schedule,12.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0426,Not in chargemaster,A0426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0426,BCBSMN Non-RVU base fee schedule,454.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0427,Not in chargemaster,A0427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0427,BCBSMN Non-RVU base fee schedule,719.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0428,Not in chargemaster,A0428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0428,BCBSMN Non-RVU base fee schedule,378.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0429,Not in chargemaster,A0429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0429,BCBSMN Non-RVU base fee schedule,688.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0430,Not in chargemaster,A0430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0430,BCBSMN Non-RVU base fee schedule,5036.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0431,Not in chargemaster,A0431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0431,BCBSMN Non-RVU base fee schedule,5855.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0432,Not in chargemaster,A0432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0432,BCBSMN Non-RVU base fee schedule,662.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0433,Not in chargemaster,A0433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0433,BCBSMN Non-RVU base fee schedule,1041.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0434,Not in chargemaster,A0434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0434,BCBSMN Non-RVU base fee schedule,1230.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0435,Not in chargemaster,A0435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0435,BCBSMN Non-RVU base fee schedule,14.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0436,Not in chargemaster,A0436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0436,BCBSMN Non-RVU base fee schedule,38.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0888,Not in chargemaster,A0888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0888,BCBSMN Non-RVU base fee schedule,9.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A0998,Not in chargemaster,A0998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A0998,BCBSMN Non-RVU base fee schedule,355.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4206,Not in chargemaster,A4206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4206,BCBSMN Non-RVU base fee schedule,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4207,Not in chargemaster,A4207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4207,BCBSMN Non-RVU base fee schedule,0.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4208,Not in chargemaster,A4208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4208,BCBSMN Non-RVU base fee schedule,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4209,Not in chargemaster,A4209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4209,BCBSMN Non-RVU base fee schedule,0.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4210,Not in chargemaster,A4210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4210,BCBSMN Non-RVU base fee schedule,0.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4211,Not in chargemaster,A4211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4211,BCBSMN Non-RVU base fee schedule,0.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4212,Not in chargemaster,A4212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4212,BCBSMN Non-RVU base fee schedule,7.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4213,Not in chargemaster,A4213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4213,BCBSMN Non-RVU base fee schedule,0.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4215,Not in chargemaster,A4215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4215,BCBSMN Non-RVU base fee schedule,0.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4216,Not in chargemaster,A4216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4216,BCBSMN Non-RVU base fee schedule,0.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4217,Not in chargemaster,A4217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4217,BCBSMN Non-RVU base fee schedule,3.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4218,Not in chargemaster,A4218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4218,BCBSMN Non-RVU base fee schedule,0.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4220,Not in chargemaster,A4220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4220,BCBSMN Non-RVU base fee schedule,33.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4221,Not in chargemaster,A4221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4221,BCBSMN Non-RVU base fee schedule,21.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4222,Not in chargemaster,A4222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4222,BCBSMN Non-RVU base fee schedule,42.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4223,Not in chargemaster,A4223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4223,BCBSMN Non-RVU base fee schedule,58.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4224,Not in chargemaster,A4224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4224,BCBSMN Non-RVU base fee schedule,21.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4225,Not in chargemaster,A4225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4225,BCBSMN Non-RVU base fee schedule,2.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4230,Not in chargemaster,A4230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4230,BCBSMN Non-RVU base fee schedule,10.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4231,Not in chargemaster,A4231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4231,BCBSMN Non-RVU base fee schedule,6.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4232,Not in chargemaster,A4232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4232,BCBSMN Non-RVU base fee schedule,2.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4233,Not in chargemaster,A4233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4233,BCBSMN Non-RVU base fee schedule,0.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4234,Not in chargemaster,A4234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4234,BCBSMN Non-RVU base fee schedule,2.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4235,Not in chargemaster,A4235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4235,BCBSMN Non-RVU base fee schedule,0.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4236,Not in chargemaster,A4236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4236,BCBSMN Non-RVU base fee schedule,1.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4244,Not in chargemaster,A4244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4244,BCBSMN Non-RVU base fee schedule,1.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4245,Not in chargemaster,A4245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4245,BCBSMN Non-RVU base fee schedule,4.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4246,Not in chargemaster,A4246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4246,BCBSMN Non-RVU base fee schedule,2.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4247,Not in chargemaster,A4247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4247,BCBSMN Non-RVU base fee schedule,2.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4248,Not in chargemaster,A4248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4248,BCBSMN Non-RVU base fee schedule,0.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4250,Not in chargemaster,A4250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4250,BCBSMN Non-RVU base fee schedule,14.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4252,Not in chargemaster,A4252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4252,BCBSMN Non-RVU base fee schedule,4.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4253,Not in chargemaster,A4253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4253,BCBSMN Non-RVU base fee schedule,7.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4255,Not in chargemaster,A4255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4255,BCBSMN Non-RVU base fee schedule,4.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4256,Not in chargemaster,A4256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4256,BCBSMN Non-RVU base fee schedule,3.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4257,Not in chargemaster,A4257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4257,BCBSMN Non-RVU base fee schedule,13.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4258,Not in chargemaster,A4258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4258,BCBSMN Non-RVU base fee schedule,1.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4259,Not in chargemaster,A4259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4259,BCBSMN Non-RVU base fee schedule,1.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4262,Not in chargemaster,A4262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4262,BCBSMN Non-RVU base fee schedule,0.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4263,Not in chargemaster,A4263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4263,BCBSMN Non-RVU base fee schedule,44.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4264,Not in chargemaster,A4264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4264,BCBSMN Non-RVU base fee schedule,398.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4265,Not in chargemaster,A4265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4265,BCBSMN Non-RVU base fee schedule,3.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4266,Not in chargemaster,A4266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4266,BCBSMN Non-RVU base fee schedule,72.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4267,Not in chargemaster,A4267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4267,BCBSMN Non-RVU base fee schedule,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4268,Not in chargemaster,A4268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4268,BCBSMN Non-RVU base fee schedule,2.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4269,Not in chargemaster,A4269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4269,BCBSMN Non-RVU base fee schedule,9.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4270,Not in chargemaster,A4270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4270,BCBSMN Non-RVU base fee schedule,16.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4280,Not in chargemaster,A4280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4280,BCBSMN Non-RVU base fee schedule,5.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4281,Not in chargemaster,A4281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4281,BCBSMN Non-RVU base fee schedule,3.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4282,Not in chargemaster,A4282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4282,BCBSMN Non-RVU base fee schedule,3.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4283,Not in chargemaster,A4283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4283,BCBSMN Non-RVU base fee schedule,3.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4284,Not in chargemaster,A4284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4284,BCBSMN Non-RVU base fee schedule,10.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4285,Not in chargemaster,A4285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4285,BCBSMN Non-RVU base fee schedule,4.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4286,Not in chargemaster,A4286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4286,BCBSMN Non-RVU base fee schedule,3.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4290,Not in chargemaster,A4290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4290,BCBSMN Non-RVU base fee schedule,142.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4300,Not in chargemaster,A4300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4300,BCBSMN Non-RVU base fee schedule,4.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4305,Not in chargemaster,A4305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4305,BCBSMN Non-RVU base fee schedule,24.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4306,Not in chargemaster,A4306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4306,BCBSMN Non-RVU base fee schedule,33.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4310,Not in chargemaster,A4310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4310,BCBSMN Non-RVU base fee schedule,8.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4311,Not in chargemaster,A4311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4311,BCBSMN Non-RVU base fee schedule,15.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4312,Not in chargemaster,A4312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4312,BCBSMN Non-RVU base fee schedule,18.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4313,Not in chargemaster,A4313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4313,BCBSMN Non-RVU base fee schedule,19.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4314,Not in chargemaster,A4314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4314,BCBSMN Non-RVU base fee schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4315,Not in chargemaster,A4315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4315,BCBSMN Non-RVU base fee schedule,27.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4316,Not in chargemaster,A4316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4316,BCBSMN Non-RVU base fee schedule,29.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4320,Not in chargemaster,A4320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4320,BCBSMN Non-RVU base fee schedule,5.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4322,Not in chargemaster,A4322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4322,BCBSMN Non-RVU base fee schedule,3.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4326,Not in chargemaster,A4326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4326,BCBSMN Non-RVU base fee schedule,11.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4327,Not in chargemaster,A4327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4327,BCBSMN Non-RVU base fee schedule,46.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4328,Not in chargemaster,A4328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4328,BCBSMN Non-RVU base fee schedule,10.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4330,Not in chargemaster,A4330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4330,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4331,Not in chargemaster,A4331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4331,BCBSMN Non-RVU base fee schedule,3.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4332,Not in chargemaster,A4332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4332,BCBSMN Non-RVU base fee schedule,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4333,Not in chargemaster,A4333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4333,BCBSMN Non-RVU base fee schedule,2.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4334,Not in chargemaster,A4334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4334,BCBSMN Non-RVU base fee schedule,5.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4335,Not in chargemaster,A4335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4335,BCBSMN Non-RVU base fee schedule,0.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4336,Not in chargemaster,A4336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4336,BCBSMN Non-RVU base fee schedule,1.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4338,Not in chargemaster,A4338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4338,BCBSMN Non-RVU base fee schedule,12.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4340,Not in chargemaster,A4340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4340,BCBSMN Non-RVU base fee schedule,28.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4344,Not in chargemaster,A4344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4344,BCBSMN Non-RVU base fee schedule,16.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4346,Not in chargemaster,A4346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4346,BCBSMN Non-RVU base fee schedule,20.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4349,Not in chargemaster,A4349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4349,BCBSMN Non-RVU base fee schedule,2.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4351,Not in chargemaster,A4351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4351,BCBSMN Non-RVU base fee schedule,1.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4352,Not in chargemaster,A4352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4352,BCBSMN Non-RVU base fee schedule,5.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4353,Not in chargemaster,A4353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4353,BCBSMN Non-RVU base fee schedule,7.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4354,Not in chargemaster,A4354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4354,BCBSMN Non-RVU base fee schedule,12.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4355,Not in chargemaster,A4355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4355,BCBSMN Non-RVU base fee schedule,9.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4356,Not in chargemaster,A4356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4356,BCBSMN Non-RVU base fee schedule,47.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4357,Not in chargemaster,A4357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4357,BCBSMN Non-RVU base fee schedule,10.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4358,Not in chargemaster,A4358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4358,BCBSMN Non-RVU base fee schedule,6.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4360,Not in chargemaster,A4360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4360,BCBSMN Non-RVU base fee schedule,0.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4361,Not in chargemaster,A4361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4361,BCBSMN Non-RVU base fee schedule,19.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4362,Not in chargemaster,A4362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4362,BCBSMN Non-RVU base fee schedule,3.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4363,Not in chargemaster,A4363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4363,BCBSMN Non-RVU base fee schedule,2.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4364,Not in chargemaster,A4364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4364,BCBSMN Non-RVU base fee schedule,3.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4366,Not in chargemaster,A4366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4366,BCBSMN Non-RVU base fee schedule,1.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4367,Not in chargemaster,A4367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4367,BCBSMN Non-RVU base fee schedule,7.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4368,Not in chargemaster,A4368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4368,BCBSMN Non-RVU base fee schedule,0.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4369,Not in chargemaster,A4369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4369,BCBSMN Non-RVU base fee schedule,2.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4371,Not in chargemaster,A4371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4371,BCBSMN Non-RVU base fee schedule,3.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4372,Not in chargemaster,A4372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4372,BCBSMN Non-RVU base fee schedule,4.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4373,Not in chargemaster,A4373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4373,BCBSMN Non-RVU base fee schedule,6.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4375,Not in chargemaster,A4375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4375,BCBSMN Non-RVU base fee schedule,17.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4376,Not in chargemaster,A4376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4376,BCBSMN Non-RVU base fee schedule,49.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4377,Not in chargemaster,A4377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4377,BCBSMN Non-RVU base fee schedule,4.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4378,Not in chargemaster,A4378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4378,BCBSMN Non-RVU base fee schedule,32.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4379,Not in chargemaster,A4379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4379,BCBSMN Non-RVU base fee schedule,15.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4380,Not in chargemaster,A4380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4380,BCBSMN Non-RVU base fee schedule,39.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4381,Not in chargemaster,A4381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4381,BCBSMN Non-RVU base fee schedule,4.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4382,Not in chargemaster,A4382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4382,BCBSMN Non-RVU base fee schedule,25.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4383,Not in chargemaster,A4383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4383,BCBSMN Non-RVU base fee schedule,29.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4384,Not in chargemaster,A4384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4384,BCBSMN Non-RVU base fee schedule,10.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4385,Not in chargemaster,A4385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4385,BCBSMN Non-RVU base fee schedule,5.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4387,Not in chargemaster,A4387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4387,BCBSMN Non-RVU base fee schedule,2.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4388,Not in chargemaster,A4388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4388,BCBSMN Non-RVU base fee schedule,4.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4389,Not in chargemaster,A4389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4389,BCBSMN Non-RVU base fee schedule,6.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4390,Not in chargemaster,A4390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4390,BCBSMN Non-RVU base fee schedule,10.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4391,Not in chargemaster,A4391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4391,BCBSMN Non-RVU base fee schedule,7.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4392,Not in chargemaster,A4392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4392,BCBSMN Non-RVU base fee schedule,8.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4393,Not in chargemaster,A4393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4393,BCBSMN Non-RVU base fee schedule,9.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4394,Not in chargemaster,A4394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4394,BCBSMN Non-RVU base fee schedule,2.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4395,Not in chargemaster,A4395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4395,BCBSMN Non-RVU base fee schedule,0.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4396,Not in chargemaster,A4396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4396,BCBSMN Non-RVU base fee schedule,42.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4397,Not in chargemaster,A4397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4397,BCBSMN Non-RVU base fee schedule,5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4398,Not in chargemaster,A4398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4398,BCBSMN Non-RVU base fee schedule,14.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4399,Not in chargemaster,A4399,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4399,BCBSMN Non-RVU base fee schedule,12.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4400,Not in chargemaster,A4400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4400,BCBSMN Non-RVU base fee schedule,51.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4402,Not in chargemaster,A4402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4402,BCBSMN Non-RVU base fee schedule,1.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4404,Not in chargemaster,A4404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4404,BCBSMN Non-RVU base fee schedule,1.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4405,Not in chargemaster,A4405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4405,BCBSMN Non-RVU base fee schedule,3.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4406,Not in chargemaster,A4406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4406,BCBSMN Non-RVU base fee schedule,5.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4407,Not in chargemaster,A4407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4407,BCBSMN Non-RVU base fee schedule,9.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4408,Not in chargemaster,A4408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4408,BCBSMN Non-RVU base fee schedule,10.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4409,Not in chargemaster,A4409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4409,BCBSMN Non-RVU base fee schedule,6.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4410,Not in chargemaster,A4410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4410,BCBSMN Non-RVU base fee schedule,9.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4411,Not in chargemaster,A4411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4411,BCBSMN Non-RVU base fee schedule,5.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4412,Not in chargemaster,A4412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4412,BCBSMN Non-RVU base fee schedule,2.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4413,Not in chargemaster,A4413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4413,BCBSMN Non-RVU base fee schedule,5.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4414,Not in chargemaster,A4414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4414,BCBSMN Non-RVU base fee schedule,5.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4415,Not in chargemaster,A4415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4415,BCBSMN Non-RVU base fee schedule,6.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4416,Not in chargemaster,A4416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4416,BCBSMN Non-RVU base fee schedule,2.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4417,Not in chargemaster,A4417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4417,BCBSMN Non-RVU base fee schedule,3.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4418,Not in chargemaster,A4418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4418,BCBSMN Non-RVU base fee schedule,1.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4419,Not in chargemaster,A4419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4419,BCBSMN Non-RVU base fee schedule,1.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4420,Not in chargemaster,A4420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4420,BCBSMN Non-RVU base fee schedule,1.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4421,Not in chargemaster,A4421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4421,BCBSMN Non-RVU base fee schedule,5.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4422,Not in chargemaster,A4422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4422,BCBSMN Non-RVU base fee schedule,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4423,Not in chargemaster,A4423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4423,BCBSMN Non-RVU base fee schedule,1.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4424,Not in chargemaster,A4424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4424,BCBSMN Non-RVU base fee schedule,4.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4425,Not in chargemaster,A4425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4425,BCBSMN Non-RVU base fee schedule,3.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4426,Not in chargemaster,A4426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4426,BCBSMN Non-RVU base fee schedule,2.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4427,Not in chargemaster,A4427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4427,BCBSMN Non-RVU base fee schedule,2.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4428,Not in chargemaster,A4428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4428,BCBSMN Non-RVU base fee schedule,6.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4429,Not in chargemaster,A4429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4429,BCBSMN Non-RVU base fee schedule,8.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4430,Not in chargemaster,A4430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4430,BCBSMN Non-RVU base fee schedule,8.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4431,Not in chargemaster,A4431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4431,BCBSMN Non-RVU base fee schedule,6.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4432,Not in chargemaster,A4432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4432,BCBSMN Non-RVU base fee schedule,3.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4433,Not in chargemaster,A4433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4433,BCBSMN Non-RVU base fee schedule,3.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4434,Not in chargemaster,A4434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4434,BCBSMN Non-RVU base fee schedule,3.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4435,Not in chargemaster,A4435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4435,BCBSMN Non-RVU base fee schedule,6.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4450,Not in chargemaster,A4450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4450,BCBSMN Non-RVU base fee schedule,0.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4452,Not in chargemaster,A4452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4452,BCBSMN Non-RVU base fee schedule,0.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4455,Not in chargemaster,A4455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4455,BCBSMN Non-RVU base fee schedule,1.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4456,Not in chargemaster,A4456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4456,BCBSMN Non-RVU base fee schedule,0.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4458,Not in chargemaster,A4458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4458,BCBSMN Non-RVU base fee schedule,5.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4459,Not in chargemaster,A4459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4459,BCBSMN Non-RVU base fee schedule,152.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4461,Not in chargemaster,A4461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4461,BCBSMN Non-RVU base fee schedule,3.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4463,Not in chargemaster,A4463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4463,BCBSMN Non-RVU base fee schedule,13.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4465,Not in chargemaster,A4465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4465,BCBSMN Non-RVU base fee schedule,7.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4467,Not in chargemaster,A4467,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4467,BCBSMN Non-RVU base fee schedule,28.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4480,Not in chargemaster,A4480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4480,BCBSMN Non-RVU base fee schedule,5.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4481,Not in chargemaster,A4481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4481,BCBSMN Non-RVU base fee schedule,0.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4483,Not in chargemaster,A4483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4483,BCBSMN Non-RVU base fee schedule,4.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4490,Not in chargemaster,A4490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4490,BCBSMN Non-RVU base fee schedule,22.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4495,Not in chargemaster,A4495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4495,BCBSMN Non-RVU base fee schedule,29.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4500,Not in chargemaster,A4500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4500,BCBSMN Non-RVU base fee schedule,24.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4510,Not in chargemaster,A4510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4510,BCBSMN Non-RVU base fee schedule,56.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4520,Not in chargemaster,A4520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4520,BCBSMN Non-RVU base fee schedule,0.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4550,Not in chargemaster,A4550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4550,BCBSMN Non-RVU base fee schedule,10,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4553,Not in chargemaster,A4553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4553,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4554,Not in chargemaster,A4554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4554,BCBSMN Non-RVU base fee schedule,0.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4555,Not in chargemaster,A4555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4555,BCBSMN Non-RVU base fee schedule,9.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4556,Not in chargemaster,A4556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4556,BCBSMN Non-RVU base fee schedule,10.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4557,Not in chargemaster,A4557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4557,BCBSMN Non-RVU base fee schedule,14.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4558,Not in chargemaster,A4558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4558,BCBSMN Non-RVU base fee schedule,5.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4559,Not in chargemaster,A4559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4559,BCBSMN Non-RVU base fee schedule,0.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4561,Not in chargemaster,A4561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4561,BCBSMN Non-RVU base fee schedule,21.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4562,Not in chargemaster,A4562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4562,BCBSMN Non-RVU base fee schedule,53.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4563,Not in chargemaster,A4563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4563,BCBSMN Non-RVU base fee schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4565,Not in chargemaster,A4565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4565,BCBSMN Non-RVU base fee schedule,8.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4566,Not in chargemaster,A4566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4566,BCBSMN Non-RVU base fee schedule,10.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4570,Not in chargemaster,A4570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4570,BCBSMN Non-RVU base fee schedule,14.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4575,Not in chargemaster,A4575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4575,BCBSMN Non-RVU base fee schedule,440,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4580,Not in chargemaster,A4580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4580,BCBSMN Non-RVU base fee schedule,16.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4590,Not in chargemaster,A4590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4590,BCBSMN Non-RVU base fee schedule,25.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4595,Not in chargemaster,A4595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4595,BCBSMN Non-RVU base fee schedule,20.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4600,Not in chargemaster,A4600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4600,BCBSMN Non-RVU base fee schedule,7.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4601,Not in chargemaster,A4601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4601,BCBSMN Non-RVU base fee schedule,45.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4602,Not in chargemaster,A4602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4602,BCBSMN Non-RVU base fee schedule,3.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4604,Not in chargemaster,A4604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4604,BCBSMN Non-RVU base fee schedule,39.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4605,Not in chargemaster,A4605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4605,BCBSMN Non-RVU base fee schedule,17.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4606,Not in chargemaster,A4606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4606,BCBSMN Non-RVU base fee schedule,23.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4608,Not in chargemaster,A4608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4608,BCBSMN Non-RVU base fee schedule,52.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4611,Not in chargemaster,A4611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4611,BCBSMN Non-RVU base fee schedule,100.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4612,Not in chargemaster,A4612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4612,BCBSMN Non-RVU base fee schedule,63.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4613,Not in chargemaster,A4613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4613,BCBSMN Non-RVU base fee schedule,82.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4614,Not in chargemaster,A4614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4614,BCBSMN Non-RVU base fee schedule,24.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4615,Not in chargemaster,A4615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4615,BCBSMN Non-RVU base fee schedule,0.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4616,Not in chargemaster,A4616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4616,BCBSMN Non-RVU base fee schedule,0.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4617,Not in chargemaster,A4617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4617,BCBSMN Non-RVU base fee schedule,3.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4618,Not in chargemaster,A4618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4618,BCBSMN Non-RVU base fee schedule,8.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4618 mod RR,Not in chargemaster,A4618,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4618 mod RR,BCBSMN Non-RVU base fee schedule,0.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4619,Not in chargemaster,A4619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4619,BCBSMN Non-RVU base fee schedule,1.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4620,Not in chargemaster,A4620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4620,BCBSMN Non-RVU base fee schedule,0.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4623,Not in chargemaster,A4623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4623,BCBSMN Non-RVU base fee schedule,6.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4624,Not in chargemaster,A4624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4624,BCBSMN Non-RVU base fee schedule,2.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4625,Not in chargemaster,A4625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4625,BCBSMN Non-RVU base fee schedule,7.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4626,Not in chargemaster,A4626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4626,BCBSMN Non-RVU base fee schedule,3.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4627,Not in chargemaster,A4627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4627,BCBSMN Non-RVU base fee schedule,28.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4628,Not in chargemaster,A4628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4628,BCBSMN Non-RVU base fee schedule,3.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4629,Not in chargemaster,A4629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4629,BCBSMN Non-RVU base fee schedule,4.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4630,Not in chargemaster,A4630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4630,BCBSMN Non-RVU base fee schedule,5.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4633,Not in chargemaster,A4633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4633,BCBSMN Non-RVU base fee schedule,42.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4634,Not in chargemaster,A4634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4634,BCBSMN Non-RVU base fee schedule,1.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4635,Not in chargemaster,A4635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4635,BCBSMN Non-RVU base fee schedule,4.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4635 mod RR,Not in chargemaster,A4635,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4635 mod RR,BCBSMN Non-RVU base fee schedule,0.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4636,Not in chargemaster,A4636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4636,BCBSMN Non-RVU base fee schedule,3.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4636 mod RR,Not in chargemaster,A4636,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4636 mod RR,BCBSMN Non-RVU base fee schedule,0.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4637,Not in chargemaster,A4637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4637,BCBSMN Non-RVU base fee schedule,1.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4637 mod RR,Not in chargemaster,A4637,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4637 mod RR,BCBSMN Non-RVU base fee schedule,0.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4639,Not in chargemaster,A4639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4639,BCBSMN Non-RVU base fee schedule,315.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4639 mod RR,Not in chargemaster,A4639,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4639 mod RR,BCBSMN Non-RVU base fee schedule,31.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4640,Not in chargemaster,A4640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4640,BCBSMN Non-RVU base fee schedule,54.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4640 mod RR,Not in chargemaster,A4640,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4640 mod RR,BCBSMN Non-RVU base fee schedule,5.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4641,Not in chargemaster,A4641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4641,BCBSMN Non-RVU base fee schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4642,Not in chargemaster,A4642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4642,BCBSMN Non-RVU base fee schedule,831.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4648,Not in chargemaster,A4648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4648,BCBSMN Non-RVU base fee schedule,135.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4649,Not in chargemaster,A4649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4649,BCBSMN Non-RVU base fee schedule,11.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4650,Not in chargemaster,A4650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4650,BCBSMN Non-RVU base fee schedule,0.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4651,Not in chargemaster,A4651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4651,BCBSMN Non-RVU base fee schedule,33.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4653,Not in chargemaster,A4653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4653,BCBSMN Non-RVU base fee schedule,8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4657,Not in chargemaster,A4657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4657,BCBSMN Non-RVU base fee schedule,0.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4660,Not in chargemaster,A4660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4660,BCBSMN Non-RVU base fee schedule,59.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4663,Not in chargemaster,A4663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4663,BCBSMN Non-RVU base fee schedule,22.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4670,Not in chargemaster,A4670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4670,BCBSMN Non-RVU base fee schedule,82.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4671,Not in chargemaster,A4671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4671,BCBSMN Non-RVU base fee schedule,29.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4714,Not in chargemaster,A4714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4714,BCBSMN Non-RVU base fee schedule,1.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4720,Not in chargemaster,A4720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4720,BCBSMN Non-RVU base fee schedule,5.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4721,Not in chargemaster,A4721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4721,BCBSMN Non-RVU base fee schedule,11.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4722,Not in chargemaster,A4722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4722,BCBSMN Non-RVU base fee schedule,17.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4723,Not in chargemaster,A4723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4723,BCBSMN Non-RVU base fee schedule,23.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4724,Not in chargemaster,A4724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4724,BCBSMN Non-RVU base fee schedule,29.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4725,Not in chargemaster,A4725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4725,BCBSMN Non-RVU base fee schedule,35.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4726,Not in chargemaster,A4726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4726,BCBSMN Non-RVU base fee schedule,35.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4728,Not in chargemaster,A4728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4728,BCBSMN Non-RVU base fee schedule,3.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4736,Not in chargemaster,A4736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4736,BCBSMN Non-RVU base fee schedule,1.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4737,Not in chargemaster,A4737,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4737,BCBSMN Non-RVU base fee schedule,0.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4750,Not in chargemaster,A4750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4750,BCBSMN Non-RVU base fee schedule,3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4755,Not in chargemaster,A4755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4755,BCBSMN Non-RVU base fee schedule,3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4772,Not in chargemaster,A4772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4772,BCBSMN Non-RVU base fee schedule,77.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4773,Not in chargemaster,A4773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4773,BCBSMN Non-RVU base fee schedule,18.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4802,Not in chargemaster,A4802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4802,BCBSMN Non-RVU base fee schedule,8.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4860,Not in chargemaster,A4860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4860,BCBSMN Non-RVU base fee schedule,5.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4927,Not in chargemaster,A4927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4927,BCBSMN Non-RVU base fee schedule,9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4928,Not in chargemaster,A4928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4928,BCBSMN Non-RVU base fee schedule,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4930,Not in chargemaster,A4930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4930,BCBSMN Non-RVU base fee schedule,0.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A4931,Not in chargemaster,A4931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A4931,BCBSMN Non-RVU base fee schedule,6.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5051,Not in chargemaster,A5051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5051,BCBSMN Non-RVU base fee schedule,2.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5052,Not in chargemaster,A5052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5052,BCBSMN Non-RVU base fee schedule,1.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5053,Not in chargemaster,A5053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5053,BCBSMN Non-RVU base fee schedule,1.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5054,Not in chargemaster,A5054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5054,BCBSMN Non-RVU base fee schedule,1.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5055,Not in chargemaster,A5055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5055,BCBSMN Non-RVU base fee schedule,1.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5056,Not in chargemaster,A5056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5056,BCBSMN Non-RVU base fee schedule,4.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5057,Not in chargemaster,A5057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5057,BCBSMN Non-RVU base fee schedule,10.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5061,Not in chargemaster,A5061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5061,BCBSMN Non-RVU base fee schedule,3.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5062,Not in chargemaster,A5062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5062,BCBSMN Non-RVU base fee schedule,2.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5063,Not in chargemaster,A5063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5063,BCBSMN Non-RVU base fee schedule,2.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5071,Not in chargemaster,A5071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5071,BCBSMN Non-RVU base fee schedule,6.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5072,Not in chargemaster,A5072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5072,BCBSMN Non-RVU base fee schedule,3.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5073,Not in chargemaster,A5073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5073,BCBSMN Non-RVU base fee schedule,3.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5081,Not in chargemaster,A5081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5081,BCBSMN Non-RVU base fee schedule,3.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5082,Not in chargemaster,A5082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5082,BCBSMN Non-RVU base fee schedule,11.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5083,Not in chargemaster,A5083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5083,BCBSMN Non-RVU base fee schedule,0.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5093,Not in chargemaster,A5093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5093,BCBSMN Non-RVU base fee schedule,2.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5102,Not in chargemaster,A5102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5102,BCBSMN Non-RVU base fee schedule,23.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5105,Not in chargemaster,A5105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5105,BCBSMN Non-RVU base fee schedule,42.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5112,Not in chargemaster,A5112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5112,BCBSMN Non-RVU base fee schedule,35.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5113,Not in chargemaster,A5113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5113,BCBSMN Non-RVU base fee schedule,4.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5114,Not in chargemaster,A5114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5114,BCBSMN Non-RVU base fee schedule,9.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5120,Not in chargemaster,A5120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5120,BCBSMN Non-RVU base fee schedule,0.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5121,Not in chargemaster,A5121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5121,BCBSMN Non-RVU base fee schedule,7.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5122,Not in chargemaster,A5122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5122,BCBSMN Non-RVU base fee schedule,12.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5126,Not in chargemaster,A5126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5126,BCBSMN Non-RVU base fee schedule,1.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5131,Not in chargemaster,A5131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5131,BCBSMN Non-RVU base fee schedule,14.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5200,Not in chargemaster,A5200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5200,BCBSMN Non-RVU base fee schedule,11.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5500,Not in chargemaster,A5500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5500,BCBSMN Non-RVU base fee schedule,66.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5501,Not in chargemaster,A5501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5501,BCBSMN Non-RVU base fee schedule,199.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5503,Not in chargemaster,A5503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5503,BCBSMN Non-RVU base fee schedule,31.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5504,Not in chargemaster,A5504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5504,BCBSMN Non-RVU base fee schedule,31.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5505,Not in chargemaster,A5505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5505,BCBSMN Non-RVU base fee schedule,31.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5506,Not in chargemaster,A5506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5506,BCBSMN Non-RVU base fee schedule,31.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5507,Not in chargemaster,A5507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5507,BCBSMN Non-RVU base fee schedule,31.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5508,Not in chargemaster,A5508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5508,BCBSMN Non-RVU base fee schedule,22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5510,Not in chargemaster,A5510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5510,BCBSMN Non-RVU base fee schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5512,Not in chargemaster,A5512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5512,BCBSMN Non-RVU base fee schedule,27.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5513,Not in chargemaster,A5513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5513,BCBSMN Non-RVU base fee schedule,40.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A5514,Not in chargemaster,A5514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A5514,BCBSMN Non-RVU base fee schedule,40.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6010,Not in chargemaster,A6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6010,BCBSMN Non-RVU base fee schedule,32.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6011,Not in chargemaster,A6011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6011,BCBSMN Non-RVU base fee schedule,2.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6021,Not in chargemaster,A6021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6021,BCBSMN Non-RVU base fee schedule,21.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6022,Not in chargemaster,A6022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6022,BCBSMN Non-RVU base fee schedule,21.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6023,Not in chargemaster,A6023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6023,BCBSMN Non-RVU base fee schedule,198.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6024,Not in chargemaster,A6024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6024,BCBSMN Non-RVU base fee schedule,6.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6025,Not in chargemaster,A6025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6025,BCBSMN Non-RVU base fee schedule,6.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6154,Not in chargemaster,A6154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6154,BCBSMN Non-RVU base fee schedule,15.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6196,Not in chargemaster,A6196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6196,BCBSMN Non-RVU base fee schedule,7.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6197,Not in chargemaster,A6197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6197,BCBSMN Non-RVU base fee schedule,17.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6198,Not in chargemaster,A6198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6198,BCBSMN Non-RVU base fee schedule,16.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6199,Not in chargemaster,A6199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6199,BCBSMN Non-RVU base fee schedule,5.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6203,Not in chargemaster,A6203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6203,BCBSMN Non-RVU base fee schedule,3.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6204,Not in chargemaster,A6204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6204,BCBSMN Non-RVU base fee schedule,6.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6205,Not in chargemaster,A6205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6205,BCBSMN Non-RVU base fee schedule,2.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6206,Not in chargemaster,A6206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6206,BCBSMN Non-RVU base fee schedule,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6207,Not in chargemaster,A6207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6207,BCBSMN Non-RVU base fee schedule,7.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6208,Not in chargemaster,A6208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6208,BCBSMN Non-RVU base fee schedule,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6209,Not in chargemaster,A6209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6209,BCBSMN Non-RVU base fee schedule,7.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6210,Not in chargemaster,A6210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6210,BCBSMN Non-RVU base fee schedule,20.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6211,Not in chargemaster,A6211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6211,BCBSMN Non-RVU base fee schedule,30.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6212,Not in chargemaster,A6212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6212,BCBSMN Non-RVU base fee schedule,10.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6213,Not in chargemaster,A6213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6213,BCBSMN Non-RVU base fee schedule,16.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6214,Not in chargemaster,A6214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6214,BCBSMN Non-RVU base fee schedule,10.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6215,Not in chargemaster,A6215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6215,BCBSMN Non-RVU base fee schedule,2.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6216,Not in chargemaster,A6216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6216,BCBSMN Non-RVU base fee schedule,0.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6217,Not in chargemaster,A6217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6217,BCBSMN Non-RVU base fee schedule,0.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6218,Not in chargemaster,A6218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6218,BCBSMN Non-RVU base fee schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6219,Not in chargemaster,A6219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6219,BCBSMN Non-RVU base fee schedule,1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6220,Not in chargemaster,A6220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6220,BCBSMN Non-RVU base fee schedule,2.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6221,Not in chargemaster,A6221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6221,BCBSMN Non-RVU base fee schedule,2.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6222,Not in chargemaster,A6222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6222,BCBSMN Non-RVU base fee schedule,2.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6223,Not in chargemaster,A6223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6223,BCBSMN Non-RVU base fee schedule,2.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6224,Not in chargemaster,A6224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6224,BCBSMN Non-RVU base fee schedule,3.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6228,Not in chargemaster,A6228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6228,BCBSMN Non-RVU base fee schedule,2.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6229,Not in chargemaster,A6229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6229,BCBSMN Non-RVU base fee schedule,3.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6230,Not in chargemaster,A6230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6230,BCBSMN Non-RVU base fee schedule,4.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6231,Not in chargemaster,A6231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6231,BCBSMN Non-RVU base fee schedule,4.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6232,Not in chargemaster,A6232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6232,BCBSMN Non-RVU base fee schedule,7.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6233,Not in chargemaster,A6233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6233,BCBSMN Non-RVU base fee schedule,20.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6234,Not in chargemaster,A6234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6234,BCBSMN Non-RVU base fee schedule,6.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6235,Not in chargemaster,A6235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6235,BCBSMN Non-RVU base fee schedule,17.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6236,Not in chargemaster,A6236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6236,BCBSMN Non-RVU base fee schedule,28.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6237,Not in chargemaster,A6237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6237,BCBSMN Non-RVU base fee schedule,8.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6238,Not in chargemaster,A6238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6238,BCBSMN Non-RVU base fee schedule,23.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6239,Not in chargemaster,A6239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6239,BCBSMN Non-RVU base fee schedule,23.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6240,Not in chargemaster,A6240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6240,BCBSMN Non-RVU base fee schedule,12.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6241,Not in chargemaster,A6241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6241,BCBSMN Non-RVU base fee schedule,2.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6242,Not in chargemaster,A6242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6242,BCBSMN Non-RVU base fee schedule,6.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6243,Not in chargemaster,A6243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6243,BCBSMN Non-RVU base fee schedule,12.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6244,Not in chargemaster,A6244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6244,BCBSMN Non-RVU base fee schedule,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6245,Not in chargemaster,A6245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6245,BCBSMN Non-RVU base fee schedule,7.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6246,Not in chargemaster,A6246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6246,BCBSMN Non-RVU base fee schedule,10.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6247,Not in chargemaster,A6247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6247,BCBSMN Non-RVU base fee schedule,24.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6248,Not in chargemaster,A6248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6248,BCBSMN Non-RVU base fee schedule,16.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6250,Not in chargemaster,A6250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6250,BCBSMN Non-RVU base fee schedule,4.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6251,Not in chargemaster,A6251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6251,BCBSMN Non-RVU base fee schedule,2.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6252,Not in chargemaster,A6252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6252,BCBSMN Non-RVU base fee schedule,3.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6253,Not in chargemaster,A6253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6253,BCBSMN Non-RVU base fee schedule,6.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6254,Not in chargemaster,A6254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6254,BCBSMN Non-RVU base fee schedule,1.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6255,Not in chargemaster,A6255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6255,BCBSMN Non-RVU base fee schedule,3.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6256,Not in chargemaster,A6256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6256,BCBSMN Non-RVU base fee schedule,11.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6257,Not in chargemaster,A6257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6257,BCBSMN Non-RVU base fee schedule,1.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6258,Not in chargemaster,A6258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6258,BCBSMN Non-RVU base fee schedule,4.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6259,Not in chargemaster,A6259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6259,BCBSMN Non-RVU base fee schedule,11.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6260,Not in chargemaster,A6260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6260,BCBSMN Non-RVU base fee schedule,7.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6261,Not in chargemaster,A6261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6261,BCBSMN Non-RVU base fee schedule,30.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6262,Not in chargemaster,A6262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6262,BCBSMN Non-RVU base fee schedule,0.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6266,Not in chargemaster,A6266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6266,BCBSMN Non-RVU base fee schedule,2.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6402,Not in chargemaster,A6402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6402,BCBSMN Non-RVU base fee schedule,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6403,Not in chargemaster,A6403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6403,BCBSMN Non-RVU base fee schedule,0.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6404,Not in chargemaster,A6404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6404,BCBSMN Non-RVU base fee schedule,0.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6407,Not in chargemaster,A6407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6407,BCBSMN Non-RVU base fee schedule,1.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6410,Not in chargemaster,A6410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6410,BCBSMN Non-RVU base fee schedule,0.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6411,Not in chargemaster,A6411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6411,BCBSMN Non-RVU base fee schedule,0.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6412,Not in chargemaster,A6412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6412,BCBSMN Non-RVU base fee schedule,2.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6413,Not in chargemaster,A6413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6413,BCBSMN Non-RVU base fee schedule,0.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6441,Not in chargemaster,A6441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6441,BCBSMN Non-RVU base fee schedule,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6442,Not in chargemaster,A6442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6442,BCBSMN Non-RVU base fee schedule,0.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6443,Not in chargemaster,A6443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6443,BCBSMN Non-RVU base fee schedule,0.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6444,Not in chargemaster,A6444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6444,BCBSMN Non-RVU base fee schedule,0.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6445,Not in chargemaster,A6445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6445,BCBSMN Non-RVU base fee schedule,0.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6446,Not in chargemaster,A6446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6446,BCBSMN Non-RVU base fee schedule,0.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6447,Not in chargemaster,A6447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6447,BCBSMN Non-RVU base fee schedule,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6448,Not in chargemaster,A6448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6448,BCBSMN Non-RVU base fee schedule,1.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6449,Not in chargemaster,A6449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6449,BCBSMN Non-RVU base fee schedule,1.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6450,Not in chargemaster,A6450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6450,BCBSMN Non-RVU base fee schedule,1.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6451,Not in chargemaster,A6451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6451,BCBSMN Non-RVU base fee schedule,1.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6452,Not in chargemaster,A6452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6452,BCBSMN Non-RVU base fee schedule,6.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6453,Not in chargemaster,A6453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6453,BCBSMN Non-RVU base fee schedule,0.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6454,Not in chargemaster,A6454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6454,BCBSMN Non-RVU base fee schedule,0.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6455,Not in chargemaster,A6455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6455,BCBSMN Non-RVU base fee schedule,1.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6456,Not in chargemaster,A6456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6456,BCBSMN Non-RVU base fee schedule,1.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6457,Not in chargemaster,A6457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6457,BCBSMN Non-RVU base fee schedule,1.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6460,Not in chargemaster,A6460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6460,BCBSMN Non-RVU base fee schedule,2.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6461,Not in chargemaster,A6461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6461,BCBSMN Non-RVU base fee schedule,3.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6502,Not in chargemaster,A6502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6502,BCBSMN Non-RVU base fee schedule,9.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6503,Not in chargemaster,A6503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6503,BCBSMN Non-RVU base fee schedule,129.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6504,Not in chargemaster,A6504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6504,BCBSMN Non-RVU base fee schedule,124.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6506,Not in chargemaster,A6506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6506,BCBSMN Non-RVU base fee schedule,113.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6507,Not in chargemaster,A6507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6507,BCBSMN Non-RVU base fee schedule,107.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6508,Not in chargemaster,A6508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6508,BCBSMN Non-RVU base fee schedule,269.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6509,Not in chargemaster,A6509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6509,BCBSMN Non-RVU base fee schedule,233.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6511,Not in chargemaster,A6511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6511,BCBSMN Non-RVU base fee schedule,1122.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6530,Not in chargemaster,A6530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6530,BCBSMN Non-RVU base fee schedule,20,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6531,Not in chargemaster,A6531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6531,BCBSMN Non-RVU base fee schedule,45.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6532,Not in chargemaster,A6532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6532,BCBSMN Non-RVU base fee schedule,63.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6533,Not in chargemaster,A6533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6533,BCBSMN Non-RVU base fee schedule,40.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6534,Not in chargemaster,A6534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6534,BCBSMN Non-RVU base fee schedule,39.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6535,Not in chargemaster,A6535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6535,BCBSMN Non-RVU base fee schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6536,Not in chargemaster,A6536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6536,BCBSMN Non-RVU base fee schedule,12.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6537,Not in chargemaster,A6537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6537,BCBSMN Non-RVU base fee schedule,23.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6538,Not in chargemaster,A6538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6538,BCBSMN Non-RVU base fee schedule,36.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6539,Not in chargemaster,A6539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6539,BCBSMN Non-RVU base fee schedule,52.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6540,Not in chargemaster,A6540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6540,BCBSMN Non-RVU base fee schedule,55.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6541,Not in chargemaster,A6541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6541,BCBSMN Non-RVU base fee schedule,84.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6544,Not in chargemaster,A6544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6544,BCBSMN Non-RVU base fee schedule,28.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6545,Not in chargemaster,A6545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6545,BCBSMN Non-RVU base fee schedule,89.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A6550,Not in chargemaster,A6550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A6550,BCBSMN Non-RVU base fee schedule,24.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7000,Not in chargemaster,A7000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7000,BCBSMN Non-RVU base fee schedule,7.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7001,Not in chargemaster,A7001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7001,BCBSMN Non-RVU base fee schedule,34.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7002,Not in chargemaster,A7002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7002,BCBSMN Non-RVU base fee schedule,4.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7003,Not in chargemaster,A7003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7003,BCBSMN Non-RVU base fee schedule,2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7004,Not in chargemaster,A7004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7004,BCBSMN Non-RVU base fee schedule,1.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7005,Not in chargemaster,A7005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7005,BCBSMN Non-RVU base fee schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7006,Not in chargemaster,A7006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7006,BCBSMN Non-RVU base fee schedule,8.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7007,Not in chargemaster,A7007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7007,BCBSMN Non-RVU base fee schedule,3.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7008,Not in chargemaster,A7008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7008,BCBSMN Non-RVU base fee schedule,11.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7009,Not in chargemaster,A7009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7009,BCBSMN Non-RVU base fee schedule,43.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7010,Not in chargemaster,A7010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7010,BCBSMN Non-RVU base fee schedule,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7012,Not in chargemaster,A7012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7012,BCBSMN Non-RVU base fee schedule,3.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7013,Not in chargemaster,A7013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7013,BCBSMN Non-RVU base fee schedule,0.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7014,Not in chargemaster,A7014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7014,BCBSMN Non-RVU base fee schedule,3.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7015,Not in chargemaster,A7015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7015,BCBSMN Non-RVU base fee schedule,1.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7016,Not in chargemaster,A7016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7016,BCBSMN Non-RVU base fee schedule,7.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7017,Not in chargemaster,A7017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7017,BCBSMN Non-RVU base fee schedule,127.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7017 mod RR,Not in chargemaster,A7017,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7017 mod RR,BCBSMN Non-RVU base fee schedule,12.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7018,Not in chargemaster,A7018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7018,BCBSMN Non-RVU base fee schedule,0.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7020,Not in chargemaster,A7020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7020,BCBSMN Non-RVU base fee schedule,15.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7025,Not in chargemaster,A7025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7025,BCBSMN Non-RVU base fee schedule,477.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7025 mod RR,Not in chargemaster,A7025,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7025 mod RR,BCBSMN Non-RVU base fee schedule,47.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7026,Not in chargemaster,A7026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7026,BCBSMN Non-RVU base fee schedule,30.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7027,Not in chargemaster,A7027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7027,BCBSMN Non-RVU base fee schedule,121.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7028,Not in chargemaster,A7028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7028,BCBSMN Non-RVU base fee schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7029,Not in chargemaster,A7029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7029,BCBSMN Non-RVU base fee schedule,18.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7030,Not in chargemaster,A7030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7030,BCBSMN Non-RVU base fee schedule,88.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7031,Not in chargemaster,A7031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7031,BCBSMN Non-RVU base fee schedule,33.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7032,Not in chargemaster,A7032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7032,BCBSMN Non-RVU base fee schedule,18.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7033,Not in chargemaster,A7033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7033,BCBSMN Non-RVU base fee schedule,15.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7034,Not in chargemaster,A7034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7034,BCBSMN Non-RVU base fee schedule,56.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7035,Not in chargemaster,A7035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7035,BCBSMN Non-RVU base fee schedule,18.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7036,Not in chargemaster,A7036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7036,BCBSMN Non-RVU base fee schedule,10.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7037,Not in chargemaster,A7037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7037,BCBSMN Non-RVU base fee schedule,11.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7038,Not in chargemaster,A7038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7038,BCBSMN Non-RVU base fee schedule,2.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7039,Not in chargemaster,A7039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7039,BCBSMN Non-RVU base fee schedule,5.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7040,Not in chargemaster,A7040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7040,BCBSMN Non-RVU base fee schedule,42.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7041,Not in chargemaster,A7041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7041,BCBSMN Non-RVU base fee schedule,79.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7044,Not in chargemaster,A7044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7044,BCBSMN Non-RVU base fee schedule,81.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7045,Not in chargemaster,A7045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7045,BCBSMN Non-RVU base fee schedule,11.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7045 mod RR,Not in chargemaster,A7045,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7045 mod RR,BCBSMN Non-RVU base fee schedule,1.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7046,Not in chargemaster,A7046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7046,BCBSMN Non-RVU base fee schedule,15.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7047,Not in chargemaster,A7047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7047,BCBSMN Non-RVU base fee schedule,126.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7048,Not in chargemaster,A7048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7048,BCBSMN Non-RVU base fee schedule,44.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7501,Not in chargemaster,A7501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7501,BCBSMN Non-RVU base fee schedule,109.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7502,Not in chargemaster,A7502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7502,BCBSMN Non-RVU base fee schedule,52.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7503,Not in chargemaster,A7503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7503,BCBSMN Non-RVU base fee schedule,11.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7504,Not in chargemaster,A7504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7504,BCBSMN Non-RVU base fee schedule,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7505,Not in chargemaster,A7505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7505,BCBSMN Non-RVU base fee schedule,4.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7506,Not in chargemaster,A7506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7506,BCBSMN Non-RVU base fee schedule,0.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7507,Not in chargemaster,A7507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7507,BCBSMN Non-RVU base fee schedule,2.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7508,Not in chargemaster,A7508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7508,BCBSMN Non-RVU base fee schedule,3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7509,Not in chargemaster,A7509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7509,BCBSMN Non-RVU base fee schedule,1.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7520,Not in chargemaster,A7520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7520,BCBSMN Non-RVU base fee schedule,49.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7521,Not in chargemaster,A7521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7521,BCBSMN Non-RVU base fee schedule,49.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7522,Not in chargemaster,A7522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7522,BCBSMN Non-RVU base fee schedule,47.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7523,Not in chargemaster,A7523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7523,BCBSMN Non-RVU base fee schedule,6.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7524,Not in chargemaster,A7524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7524,BCBSMN Non-RVU base fee schedule,80.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7525,Not in chargemaster,A7525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7525,BCBSMN Non-RVU base fee schedule,2.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7526,Not in chargemaster,A7526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7526,BCBSMN Non-RVU base fee schedule,3.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A7527,Not in chargemaster,A7527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A7527,BCBSMN Non-RVU base fee schedule,3.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A8000,Not in chargemaster,A8000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A8000,BCBSMN Non-RVU base fee schedule,160.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A8000 mod RR,Not in chargemaster,A8000,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A8000 mod RR,BCBSMN Non-RVU base fee schedule,16.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A8001,Not in chargemaster,A8001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A8001,BCBSMN Non-RVU base fee schedule,160.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A8001 mod RR,Not in chargemaster,A8001,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A8001 mod RR,BCBSMN Non-RVU base fee schedule,16.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A8002,Not in chargemaster,A8002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A8002,BCBSMN Non-RVU base fee schedule,153.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A8003,Not in chargemaster,A8003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A8003,BCBSMN Non-RVU base fee schedule,153.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A8004,Not in chargemaster,A8004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A8004,BCBSMN Non-RVU base fee schedule,105.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9150,Not in chargemaster,A9150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9150,BCBSMN Non-RVU base fee schedule,9.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9152,Not in chargemaster,A9152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9152,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9270,Not in chargemaster,A9270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9270,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9272,Not in chargemaster,A9272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9272,BCBSMN Non-RVU base fee schedule,22.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9273,Not in chargemaster,A9273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9273,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9274,Not in chargemaster,A9274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9274,BCBSMN Non-RVU base fee schedule,35.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9275,Not in chargemaster,A9275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9275,BCBSMN Non-RVU base fee schedule,188.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9276,Not in chargemaster,A9276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9276,BCBSMN Non-RVU base fee schedule,10.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9277,Not in chargemaster,A9277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9277,BCBSMN Non-RVU base fee schedule,457.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9277 mod RR,Not in chargemaster,A9277,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9277 mod RR,BCBSMN Non-RVU base fee schedule,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9278,Not in chargemaster,A9278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9278,BCBSMN Non-RVU base fee schedule,426.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9279,Not in chargemaster,A9279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9279,BCBSMN Non-RVU base fee schedule,40.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9279 mod RR,Not in chargemaster,A9279,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9279 mod RR,BCBSMN Non-RVU base fee schedule,4.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9280,Not in chargemaster,A9280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9280,BCBSMN Non-RVU base fee schedule,162.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9280 mod RR,Not in chargemaster,A9280,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9280 mod RR,BCBSMN Non-RVU base fee schedule,16.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9281,Not in chargemaster,A9281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9281,BCBSMN Non-RVU base fee schedule,14.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9282,Not in chargemaster,A9282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9282,BCBSMN Non-RVU base fee schedule,350,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9283,Not in chargemaster,A9283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9283,BCBSMN Non-RVU base fee schedule,9.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9284,Not in chargemaster,A9284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9284,BCBSMN Non-RVU base fee schedule,13.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9285,Not in chargemaster,A9285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9285,BCBSMN Non-RVU base fee schedule,9.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9286,Not in chargemaster,A9286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9286,BCBSMN Non-RVU base fee schedule,4.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9300,Not in chargemaster,A9300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9300,BCBSMN Non-RVU base fee schedule,6.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9300 mod RR,Not in chargemaster,A9300,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9300 mod RR,BCBSMN Non-RVU base fee schedule,0.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9500,Not in chargemaster,A9500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9500,BCBSMN Non-RVU base fee schedule,121.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9501,Not in chargemaster,A9501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9501,BCBSMN Non-RVU base fee schedule,121.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9502,Not in chargemaster,A9502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9502,BCBSMN Non-RVU base fee schedule,73.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9503,Not in chargemaster,A9503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9503,BCBSMN Non-RVU base fee schedule,0.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9505,Not in chargemaster,A9505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9505,BCBSMN Non-RVU base fee schedule,30,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9507,Not in chargemaster,A9507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9507,BCBSMN Non-RVU base fee schedule,1315,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9508,Not in chargemaster,A9508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9508,BCBSMN Non-RVU base fee schedule,247.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9509,Not in chargemaster,A9509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9509,BCBSMN Non-RVU base fee schedule,41.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9510,Not in chargemaster,A9510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9510,BCBSMN Non-RVU base fee schedule,43.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9512,Not in chargemaster,A9512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9512,BCBSMN Non-RVU base fee schedule,0.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9513,Not in chargemaster,A9513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9513,BCBSMN Non-RVU base fee schedule,249.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9515,Not in chargemaster,A9515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9515,BCBSMN Non-RVU base fee schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9516,Not in chargemaster,A9516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9516,BCBSMN Non-RVU base fee schedule,180.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9517,Not in chargemaster,A9517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9517,BCBSMN Non-RVU base fee schedule,35.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9520,Not in chargemaster,A9520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9520,BCBSMN Non-RVU base fee schedule,226.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9521,Not in chargemaster,A9521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9521,BCBSMN Non-RVU base fee schedule,231.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9526,Not in chargemaster,A9526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9526,BCBSMN Non-RVU base fee schedule,162.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9527,Not in chargemaster,A9527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9527,BCBSMN Non-RVU base fee schedule,6.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9528,Not in chargemaster,A9528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9528,BCBSMN Non-RVU base fee schedule,164.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9529,Not in chargemaster,A9529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9529,BCBSMN Non-RVU base fee schedule,6.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9530,Not in chargemaster,A9530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9530,BCBSMN Non-RVU base fee schedule,6.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9531,Not in chargemaster,A9531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9531,BCBSMN Non-RVU base fee schedule,5.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9536,Not in chargemaster,A9536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9536,BCBSMN Non-RVU base fee schedule,1330,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9537,Not in chargemaster,A9537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9537,BCBSMN Non-RVU base fee schedule,53.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9538,Not in chargemaster,A9538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9538,BCBSMN Non-RVU base fee schedule,17.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9539,Not in chargemaster,A9539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9539,BCBSMN Non-RVU base fee schedule,20.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9540,Not in chargemaster,A9540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9540,BCBSMN Non-RVU base fee schedule,18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9541,Not in chargemaster,A9541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9541,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9542,Not in chargemaster,A9542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9542,BCBSMN Non-RVU base fee schedule,3500,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9543,Not in chargemaster,A9543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9543,BCBSMN Non-RVU base fee schedule,31500,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9547,Not in chargemaster,A9547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9547,BCBSMN Non-RVU base fee schedule,806.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9548,Not in chargemaster,A9548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9548,BCBSMN Non-RVU base fee schedule,326.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9551,Not in chargemaster,A9551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9551,BCBSMN Non-RVU base fee schedule,510,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9552,Not in chargemaster,A9552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9552,BCBSMN Non-RVU base fee schedule,248.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9553,Not in chargemaster,A9553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9553,BCBSMN Non-RVU base fee schedule,564,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9554,Not in chargemaster,A9554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9554,BCBSMN Non-RVU base fee schedule,31.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9555,Not in chargemaster,A9555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9555,BCBSMN Non-RVU base fee schedule,263.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9556,Not in chargemaster,A9556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9556,BCBSMN Non-RVU base fee schedule,56.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9557,Not in chargemaster,A9557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9557,BCBSMN Non-RVU base fee schedule,1067.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9558,Not in chargemaster,A9558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9558,BCBSMN Non-RVU base fee schedule,30.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9560,Not in chargemaster,A9560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9560,BCBSMN Non-RVU base fee schedule,100,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9561,Not in chargemaster,A9561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9561,BCBSMN Non-RVU base fee schedule,27.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9562,Not in chargemaster,A9562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9562,BCBSMN Non-RVU base fee schedule,575.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9563,Not in chargemaster,A9563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9563,BCBSMN Non-RVU base fee schedule,304.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9564,Not in chargemaster,A9564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9564,BCBSMN Non-RVU base fee schedule,290.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9566,Not in chargemaster,A9566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9566,BCBSMN Non-RVU base fee schedule,38.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9567,Not in chargemaster,A9567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9567,BCBSMN Non-RVU base fee schedule,38.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9569,Not in chargemaster,A9569,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9569,BCBSMN Non-RVU base fee schedule,1138,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9570,Not in chargemaster,A9570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9570,BCBSMN Non-RVU base fee schedule,1612.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9571,Not in chargemaster,A9571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9571,BCBSMN Non-RVU base fee schedule,1612.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9572,Not in chargemaster,A9572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9572,BCBSMN Non-RVU base fee schedule,1775.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9575,Not in chargemaster,A9575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9575,BCBSMN Non-RVU base fee schedule,0.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9576,Not in chargemaster,A9576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9576,BCBSMN Non-RVU base fee schedule,1.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9577,Not in chargemaster,A9577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9577,BCBSMN Non-RVU base fee schedule,1.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9578,Not in chargemaster,A9578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9578,BCBSMN Non-RVU base fee schedule,1.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9579,Not in chargemaster,A9579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9579,BCBSMN Non-RVU base fee schedule,1.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9580,Not in chargemaster,A9580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9580,BCBSMN Non-RVU base fee schedule,12.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9581,Not in chargemaster,A9581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9581,BCBSMN Non-RVU base fee schedule,14.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9582,Not in chargemaster,A9582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9582,BCBSMN Non-RVU base fee schedule,5394.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9583,Not in chargemaster,A9583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9583,BCBSMN Non-RVU base fee schedule,18.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9584,Not in chargemaster,A9584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9584,BCBSMN Non-RVU base fee schedule,1006.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9585,Not in chargemaster,A9585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9585,BCBSMN Non-RVU base fee schedule,0.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9586,Not in chargemaster,A9586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9586,BCBSMN Non-RVU base fee schedule,1317.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9587,Not in chargemaster,A9587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9587,BCBSMN Non-RVU base fee schedule,56.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9588,Not in chargemaster,A9588,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9588,BCBSMN Non-RVU base fee schedule,408.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9589,Not in chargemaster,A9589,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9589,BCBSMN Non-RVU base fee schedule,1145.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9590,Not in chargemaster,A9590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9590,BCBSMN Non-RVU base fee schedule,308.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9597,Not in chargemaster,A9597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9597,BCBSMN Non-RVU base fee schedule,1.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9598,Not in chargemaster,A9598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9598,BCBSMN Non-RVU base fee schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9604,Not in chargemaster,A9604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9604,BCBSMN Non-RVU base fee schedule,1073.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9698,Not in chargemaster,A9698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9698,BCBSMN Non-RVU base fee schedule,216.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9700,Not in chargemaster,A9700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9700,BCBSMN Non-RVU base fee schedule,118.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU A9901,Not in chargemaster,A9901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,A9901,BCBSMN Non-RVU base fee schedule,88.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4034,Not in chargemaster,B4034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4034,BCBSMN Non-RVU base fee schedule,4.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4035,Not in chargemaster,B4035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4035,BCBSMN Non-RVU base fee schedule,8.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4036,Not in chargemaster,B4036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4036,BCBSMN Non-RVU base fee schedule,5.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4081,Not in chargemaster,B4081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4081,BCBSMN Non-RVU base fee schedule,18.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4082,Not in chargemaster,B4082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4082,BCBSMN Non-RVU base fee schedule,13.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4083,Not in chargemaster,B4083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4083,BCBSMN Non-RVU base fee schedule,2.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4087,Not in chargemaster,B4087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4087,BCBSMN Non-RVU base fee schedule,30.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4088,Not in chargemaster,B4088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4088,BCBSMN Non-RVU base fee schedule,32.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4100,Not in chargemaster,B4100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4100,BCBSMN Non-RVU base fee schedule,0.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4102,Not in chargemaster,B4102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4102,BCBSMN Non-RVU base fee schedule,6.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4103,Not in chargemaster,B4103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4103,BCBSMN Non-RVU base fee schedule,0.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4104,Not in chargemaster,B4104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4104,BCBSMN Non-RVU base fee schedule,2.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4105,Not in chargemaster,B4105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4105,BCBSMN Non-RVU base fee schedule,0.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4149,Not in chargemaster,B4149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4149,BCBSMN Non-RVU base fee schedule,1.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4150,Not in chargemaster,B4150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4150,BCBSMN Non-RVU base fee schedule,0.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4152,Not in chargemaster,B4152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4152,BCBSMN Non-RVU base fee schedule,0.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4153,Not in chargemaster,B4153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4153,BCBSMN Non-RVU base fee schedule,1.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4154,Not in chargemaster,B4154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4154,BCBSMN Non-RVU base fee schedule,0.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4155,Not in chargemaster,B4155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4155,BCBSMN Non-RVU base fee schedule,0.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4157,Not in chargemaster,B4157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4157,BCBSMN Non-RVU base fee schedule,6.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4158,Not in chargemaster,B4158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4158,BCBSMN Non-RVU base fee schedule,3.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4159,Not in chargemaster,B4159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4159,BCBSMN Non-RVU base fee schedule,1.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4160,Not in chargemaster,B4160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4160,BCBSMN Non-RVU base fee schedule,1.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4161,Not in chargemaster,B4161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4161,BCBSMN Non-RVU base fee schedule,2.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4162,Not in chargemaster,B4162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4162,BCBSMN Non-RVU base fee schedule,7.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4164,Not in chargemaster,B4164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4164,BCBSMN Non-RVU base fee schedule,18.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4168,Not in chargemaster,B4168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4168,BCBSMN Non-RVU base fee schedule,26.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4176,Not in chargemaster,B4176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4176,BCBSMN Non-RVU base fee schedule,52.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4178,Not in chargemaster,B4178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4178,BCBSMN Non-RVU base fee schedule,62.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4180,Not in chargemaster,B4180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4180,BCBSMN Non-RVU base fee schedule,26.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4185,Not in chargemaster,B4185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4185,BCBSMN Non-RVU base fee schedule,12.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4189,Not in chargemaster,B4189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4189,BCBSMN Non-RVU base fee schedule,193,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4193,Not in chargemaster,B4193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4193,BCBSMN Non-RVU base fee schedule,249.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4197,Not in chargemaster,B4197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4197,BCBSMN Non-RVU base fee schedule,303.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4199,Not in chargemaster,B4199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4199,BCBSMN Non-RVU base fee schedule,346.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4216,Not in chargemaster,B4216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4216,BCBSMN Non-RVU base fee schedule,8.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4220,Not in chargemaster,B4220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4220,BCBSMN Non-RVU base fee schedule,8.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4222,Not in chargemaster,B4222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4222,BCBSMN Non-RVU base fee schedule,10.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B4224,Not in chargemaster,B4224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B4224,BCBSMN Non-RVU base fee schedule,27.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B5000,Not in chargemaster,B5000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B5000,BCBSMN Non-RVU base fee schedule,12.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B5100,Not in chargemaster,B5100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B5100,BCBSMN Non-RVU base fee schedule,5.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B5200,Not in chargemaster,B5200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B5200,BCBSMN Non-RVU base fee schedule,0.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B9002,Not in chargemaster,B9002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B9002,BCBSMN Non-RVU base fee schedule,901.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B9002 mod RR,Not in chargemaster,B9002,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B9002 mod RR,BCBSMN Non-RVU base fee schedule,88.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B9004,Not in chargemaster,B9004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B9004,BCBSMN Non-RVU base fee schedule,2739.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B9004 mod RR,Not in chargemaster,B9004,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B9004 mod RR,BCBSMN Non-RVU base fee schedule,433.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B9006,Not in chargemaster,B9006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B9006,BCBSMN Non-RVU base fee schedule,2739.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU B9006 mod RR,Not in chargemaster,B9006,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,B9006 mod RR,BCBSMN Non-RVU base fee schedule,433.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1713,Not in chargemaster,C1713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1713,BCBSMN Non-RVU base fee schedule,2156.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1725,Not in chargemaster,C1725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1725,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1780,Not in chargemaster,C1780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1780,BCBSMN Non-RVU base fee schedule,175.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1782,Not in chargemaster,C1782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1782,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1820,Not in chargemaster,C1820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1820,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1822,Not in chargemaster,C1822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1822,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1823,Not in chargemaster,C1823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1823,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1841,Not in chargemaster,C1841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1841,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C1842,Not in chargemaster,C1842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C1842,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C2613,Not in chargemaster,C2613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C2613,BCBSMN Non-RVU base fee schedule,858.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C2623,Not in chargemaster,C2623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C2623,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C2624,Not in chargemaster,C2624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C2624,BCBSMN Non-RVU base fee schedule,400.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C2635,Not in chargemaster,C2635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C2635,BCBSMN Non-RVU base fee schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C2644,Not in chargemaster,C2644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C2644,BCBSMN Non-RVU base fee schedule,52.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C2645,Not in chargemaster,C2645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C2645,BCBSMN Non-RVU base fee schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C5271,Not in chargemaster,C5271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C5271,BCBSMN Non-RVU base fee schedule,338.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C5272,Not in chargemaster,C5272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C5272,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C5273,Not in chargemaster,C5273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C5273,BCBSMN Non-RVU base fee schedule,1132.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C5274,Not in chargemaster,C5274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C5274,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C5275,Not in chargemaster,C5275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C5275,BCBSMN Non-RVU base fee schedule,338.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C5276,Not in chargemaster,C5276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C5276,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C5277,Not in chargemaster,C5277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C5277,BCBSMN Non-RVU base fee schedule,338.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C5278,Not in chargemaster,C5278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C5278,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C8908,Not in chargemaster,C8908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C8908,BCBSMN Non-RVU base fee schedule,237.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C8929,Not in chargemaster,C8929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C8929,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9046,Not in chargemaster,C9046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9046,BCBSMN Non-RVU base fee schedule,1.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9047,Not in chargemaster,C9047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9047,BCBSMN Non-RVU base fee schedule,676.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9055,Not in chargemaster,C9055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9055,BCBSMN Non-RVU base fee schedule,75.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9060,Not in chargemaster,C9060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9060,BCBSMN Non-RVU base fee schedule,3723,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9062,Not in chargemaster,C9062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9062,BCBSMN Non-RVU base fee schedule,42.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9064,Not in chargemaster,C9064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9064,BCBSMN Non-RVU base fee schedule,272.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9065,Not in chargemaster,C9065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9065,BCBSMN Non-RVU base fee schedule,326.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9066,Not in chargemaster,C9066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9066,BCBSMN Non-RVU base fee schedule,114.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9067,Not in chargemaster,C9067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9067,BCBSMN Non-RVU base fee schedule,3092.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9113,Not in chargemaster,C9113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9113,BCBSMN Non-RVU base fee schedule,6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9132,Not in chargemaster,C9132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9132,BCBSMN Non-RVU base fee schedule,1.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9248,Not in chargemaster,C9248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9248,BCBSMN Non-RVU base fee schedule,0.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9254,Not in chargemaster,C9254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9254,BCBSMN Non-RVU base fee schedule,2.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9257,Not in chargemaster,C9257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9257,BCBSMN Non-RVU base fee schedule,6.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9285,Not in chargemaster,C9285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9285,BCBSMN Non-RVU base fee schedule,13.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9290,Not in chargemaster,C9290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9290,BCBSMN Non-RVU base fee schedule,1.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9293,Not in chargemaster,C9293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9293,BCBSMN Non-RVU base fee schedule,25301.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9460,Not in chargemaster,C9460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9460,BCBSMN Non-RVU base fee schedule,30.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9462,Not in chargemaster,C9462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9462,BCBSMN Non-RVU base fee schedule,0.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9482,Not in chargemaster,C9482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9482,BCBSMN Non-RVU base fee schedule,9.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9734,Not in chargemaster,C9734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9734,BCBSMN Non-RVU base fee schedule,1030.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9739,Not in chargemaster,C9739,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9739,BCBSMN Non-RVU base fee schedule,1657.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9740,Not in chargemaster,C9740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9740,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9745,Not in chargemaster,C9745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9745,BCBSMN Non-RVU base fee schedule,2896.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9747,Not in chargemaster,C9747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9747,BCBSMN Non-RVU base fee schedule,4049.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9749,Not in chargemaster,C9749,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9749,BCBSMN Non-RVU base fee schedule,1311.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9751,Not in chargemaster,C9751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9751,BCBSMN Non-RVU base fee schedule,389.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9752,Not in chargemaster,C9752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9752,BCBSMN Non-RVU base fee schedule,6822.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9753,Not in chargemaster,C9753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9753,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9762,Not in chargemaster,C9762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9762,BCBSMN Non-RVU base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9763,Not in chargemaster,C9763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9763,BCBSMN Non-RVU base fee schedule,561.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU C9803,Not in chargemaster,C9803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,C9803,BCBSMN Non-RVU base fee schedule,22.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0120,Not in chargemaster,D0120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0120,BCBSMN Non-RVU base fee schedule,57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0140,Not in chargemaster,D0140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0140,BCBSMN Non-RVU base fee schedule,87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0145,Not in chargemaster,D0145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0145,BCBSMN Non-RVU base fee schedule,89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0150,Not in chargemaster,D0150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0150,BCBSMN Non-RVU base fee schedule,106.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0160,Not in chargemaster,D0160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0160,BCBSMN Non-RVU base fee schedule,201,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0170,Not in chargemaster,D0170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0170,BCBSMN Non-RVU base fee schedule,80.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0171,Not in chargemaster,D0171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0171,BCBSMN Non-RVU base fee schedule,61.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0180,Not in chargemaster,D0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0180,BCBSMN Non-RVU base fee schedule,126.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0190,Not in chargemaster,D0190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0190,BCBSMN Non-RVU base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0191,Not in chargemaster,D0191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0191,BCBSMN Non-RVU base fee schedule,49.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0210,Not in chargemaster,D0210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0210,BCBSMN Non-RVU base fee schedule,152,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0220,Not in chargemaster,D0220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0220,BCBSMN Non-RVU base fee schedule,32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0230,Not in chargemaster,D0230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0230,BCBSMN Non-RVU base fee schedule,35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0240,Not in chargemaster,D0240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0240,BCBSMN Non-RVU base fee schedule,55.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0250,Not in chargemaster,D0250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0250,BCBSMN Non-RVU base fee schedule,101.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0251,Not in chargemaster,D0251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0251,BCBSMN Non-RVU base fee schedule,101.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0270,Not in chargemaster,D0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0270,BCBSMN Non-RVU base fee schedule,31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0272,Not in chargemaster,D0272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0272,BCBSMN Non-RVU base fee schedule,48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0273,Not in chargemaster,D0273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0273,BCBSMN Non-RVU base fee schedule,57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0274,Not in chargemaster,D0274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0274,BCBSMN Non-RVU base fee schedule,65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0277,Not in chargemaster,D0277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0277,BCBSMN Non-RVU base fee schedule,99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0310,Not in chargemaster,D0310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0310,BCBSMN Non-RVU base fee schedule,475,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0320,Not in chargemaster,D0320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0320,BCBSMN Non-RVU base fee schedule,843,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0321,Not in chargemaster,D0321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0321,BCBSMN Non-RVU base fee schedule,203.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0322,Not in chargemaster,D0322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0322,BCBSMN Non-RVU base fee schedule,673,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0330,Not in chargemaster,D0330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0330,BCBSMN Non-RVU base fee schedule,137,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0340,Not in chargemaster,D0340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0340,BCBSMN Non-RVU base fee schedule,165.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0350,Not in chargemaster,D0350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0350,BCBSMN Non-RVU base fee schedule,165.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0351,Not in chargemaster,D0351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0351,BCBSMN Non-RVU base fee schedule,350.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0364,Not in chargemaster,D0364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0364,BCBSMN Non-RVU base fee schedule,571.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0365,Not in chargemaster,D0365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0365,BCBSMN Non-RVU base fee schedule,571.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0366,Not in chargemaster,D0366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0366,BCBSMN Non-RVU base fee schedule,571.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0367,Not in chargemaster,D0367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0367,BCBSMN Non-RVU base fee schedule,571.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0368,Not in chargemaster,D0368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0368,BCBSMN Non-RVU base fee schedule,571.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0369,Not in chargemaster,D0369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0369,BCBSMN Non-RVU base fee schedule,1409.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0370,Not in chargemaster,D0370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0370,BCBSMN Non-RVU base fee schedule,510.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0371,Not in chargemaster,D0371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0371,BCBSMN Non-RVU base fee schedule,1320.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0380,Not in chargemaster,D0380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0380,BCBSMN Non-RVU base fee schedule,352.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0381,Not in chargemaster,D0381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0381,BCBSMN Non-RVU base fee schedule,352.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0382,Not in chargemaster,D0382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0382,BCBSMN Non-RVU base fee schedule,352.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0383,Not in chargemaster,D0383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0383,BCBSMN Non-RVU base fee schedule,352.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0384,Not in chargemaster,D0384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0384,BCBSMN Non-RVU base fee schedule,352.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0385,Not in chargemaster,D0385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0385,BCBSMN Non-RVU base fee schedule,2123.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0386,Not in chargemaster,D0386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0386,BCBSMN Non-RVU base fee schedule,531.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0391,Not in chargemaster,D0391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0391,BCBSMN Non-RVU base fee schedule,351.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0393,Not in chargemaster,D0393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0393,BCBSMN Non-RVU base fee schedule,476.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0394,Not in chargemaster,D0394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0394,BCBSMN Non-RVU base fee schedule,476.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0395,Not in chargemaster,D0395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0395,BCBSMN Non-RVU base fee schedule,476.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0411,Not in chargemaster,D0411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0411,BCBSMN Non-RVU base fee schedule,17.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0412,Not in chargemaster,D0412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0412,BCBSMN Non-RVU base fee schedule,17.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0414,Not in chargemaster,D0414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0414,BCBSMN Non-RVU base fee schedule,228,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0415,Not in chargemaster,D0415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0415,BCBSMN Non-RVU base fee schedule,66.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0416,Not in chargemaster,D0416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0416,BCBSMN Non-RVU base fee schedule,101.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0417,Not in chargemaster,D0417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0417,BCBSMN Non-RVU base fee schedule,143,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0418,Not in chargemaster,D0418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0418,BCBSMN Non-RVU base fee schedule,113,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0419,Not in chargemaster,D0419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0419,BCBSMN Non-RVU base fee schedule,17.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0422,Not in chargemaster,D0422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0422,BCBSMN Non-RVU base fee schedule,62.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0423,Not in chargemaster,D0423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0423,BCBSMN Non-RVU base fee schedule,64.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0425,Not in chargemaster,D0425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0425,BCBSMN Non-RVU base fee schedule,45.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0431,Not in chargemaster,D0431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0431,BCBSMN Non-RVU base fee schedule,72.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0460,Not in chargemaster,D0460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0460,BCBSMN Non-RVU base fee schedule,60.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0470,Not in chargemaster,D0470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0470,BCBSMN Non-RVU base fee schedule,146,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0472,Not in chargemaster,D0472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0472,BCBSMN Non-RVU base fee schedule,98.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0473,Not in chargemaster,D0473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0473,BCBSMN Non-RVU base fee schedule,183.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0474,Not in chargemaster,D0474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0474,BCBSMN Non-RVU base fee schedule,275.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0475,Not in chargemaster,D0475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0475,BCBSMN Non-RVU base fee schedule,107.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0476,Not in chargemaster,D0476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0476,BCBSMN Non-RVU base fee schedule,275.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0477,Not in chargemaster,D0477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0477,BCBSMN Non-RVU base fee schedule,275.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0478,Not in chargemaster,D0478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0478,BCBSMN Non-RVU base fee schedule,151.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0479,Not in chargemaster,D0479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0479,BCBSMN Non-RVU base fee schedule,203.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0480,Not in chargemaster,D0480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0480,BCBSMN Non-RVU base fee schedule,151.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0481,Not in chargemaster,D0481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0481,BCBSMN Non-RVU base fee schedule,415.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0482,Not in chargemaster,D0482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0482,BCBSMN Non-RVU base fee schedule,138.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0483,Not in chargemaster,D0483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0483,BCBSMN Non-RVU base fee schedule,151.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0484,Not in chargemaster,D0484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0484,BCBSMN Non-RVU base fee schedule,229.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0485,Not in chargemaster,D0485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0485,BCBSMN Non-RVU base fee schedule,310.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0486,Not in chargemaster,D0486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0486,BCBSMN Non-RVU base fee schedule,274.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0502,Not in chargemaster,D0502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0502,BCBSMN Non-RVU base fee schedule,177.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0600,Not in chargemaster,D0600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0600,BCBSMN Non-RVU base fee schedule,11.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0601,Not in chargemaster,D0601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0601,BCBSMN Non-RVU base fee schedule,83.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0602,Not in chargemaster,D0602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0602,BCBSMN Non-RVU base fee schedule,76.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0603,Not in chargemaster,D0603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0603,BCBSMN Non-RVU base fee schedule,76.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D0999,Not in chargemaster,D0999,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D0999,BCBSMN Non-RVU base fee schedule,11.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1110,Not in chargemaster,D1110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1110,BCBSMN Non-RVU base fee schedule,103,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1120,Not in chargemaster,D1120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1120,BCBSMN Non-RVU base fee schedule,69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1206,Not in chargemaster,D1206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1206,BCBSMN Non-RVU base fee schedule,71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1208,Not in chargemaster,D1208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1208,BCBSMN Non-RVU base fee schedule,51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1310,Not in chargemaster,D1310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1310,BCBSMN Non-RVU base fee schedule,71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1320,Not in chargemaster,D1320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1320,BCBSMN Non-RVU base fee schedule,44.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1330,Not in chargemaster,D1330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1330,BCBSMN Non-RVU base fee schedule,62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1351,Not in chargemaster,D1351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1351,BCBSMN Non-RVU base fee schedule,61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1352,Not in chargemaster,D1352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1352,BCBSMN Non-RVU base fee schedule,186,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1353,Not in chargemaster,D1353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1353,BCBSMN Non-RVU base fee schedule,61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1354,Not in chargemaster,D1354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1354,BCBSMN Non-RVU base fee schedule,80.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1510,Not in chargemaster,D1510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1510,BCBSMN Non-RVU base fee schedule,389.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1516,Not in chargemaster,D1516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1516,BCBSMN Non-RVU base fee schedule,570,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1517,Not in chargemaster,D1517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1517,BCBSMN Non-RVU base fee schedule,570,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1520,Not in chargemaster,D1520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1520,BCBSMN Non-RVU base fee schedule,477.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1526,Not in chargemaster,D1526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1526,BCBSMN Non-RVU base fee schedule,594,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1527,Not in chargemaster,D1527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1527,BCBSMN Non-RVU base fee schedule,594,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1551,Not in chargemaster,D1551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1551,BCBSMN Non-RVU base fee schedule,82.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1552,Not in chargemaster,D1552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1552,BCBSMN Non-RVU base fee schedule,82.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1553,Not in chargemaster,D1553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1553,BCBSMN Non-RVU base fee schedule,82.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1556,Not in chargemaster,D1556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1556,BCBSMN Non-RVU base fee schedule,89.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1557,Not in chargemaster,D1557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1557,BCBSMN Non-RVU base fee schedule,89.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1558,Not in chargemaster,D1558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1558,BCBSMN Non-RVU base fee schedule,89.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D1575,Not in chargemaster,D1575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D1575,BCBSMN Non-RVU base fee schedule,477.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2140,Not in chargemaster,D2140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2140,BCBSMN Non-RVU base fee schedule,132,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2150,Not in chargemaster,D2150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2150,BCBSMN Non-RVU base fee schedule,191,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2160,Not in chargemaster,D2160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2160,BCBSMN Non-RVU base fee schedule,227.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2161,Not in chargemaster,D2161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2161,BCBSMN Non-RVU base fee schedule,264.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2330,Not in chargemaster,D2330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2330,BCBSMN Non-RVU base fee schedule,180,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2331,Not in chargemaster,D2331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2331,BCBSMN Non-RVU base fee schedule,217,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2332,Not in chargemaster,D2332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2332,BCBSMN Non-RVU base fee schedule,268,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2335,Not in chargemaster,D2335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2335,BCBSMN Non-RVU base fee schedule,322,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2390,Not in chargemaster,D2390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2390,BCBSMN Non-RVU base fee schedule,650,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2391,Not in chargemaster,D2391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2391,BCBSMN Non-RVU base fee schedule,202,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2392,Not in chargemaster,D2392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2392,BCBSMN Non-RVU base fee schedule,263,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2393,Not in chargemaster,D2393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2393,BCBSMN Non-RVU base fee schedule,331,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2394,Not in chargemaster,D2394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2394,BCBSMN Non-RVU base fee schedule,413,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2410,Not in chargemaster,D2410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2410,BCBSMN Non-RVU base fee schedule,525.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2420,Not in chargemaster,D2420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2420,BCBSMN Non-RVU base fee schedule,623.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2430,Not in chargemaster,D2430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2430,BCBSMN Non-RVU base fee schedule,865.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2510,Not in chargemaster,D2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2510,BCBSMN Non-RVU base fee schedule,797,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2520,Not in chargemaster,D2520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2520,BCBSMN Non-RVU base fee schedule,1013,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2530,Not in chargemaster,D2530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2530,BCBSMN Non-RVU base fee schedule,1038,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2542,Not in chargemaster,D2542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2542,BCBSMN Non-RVU base fee schedule,1019,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2543,Not in chargemaster,D2543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2543,BCBSMN Non-RVU base fee schedule,1106,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2544,Not in chargemaster,D2544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2544,BCBSMN Non-RVU base fee schedule,1134,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2610,Not in chargemaster,D2610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2610,BCBSMN Non-RVU base fee schedule,935,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2620,Not in chargemaster,D2620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2620,BCBSMN Non-RVU base fee schedule,1058,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2630,Not in chargemaster,D2630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2630,BCBSMN Non-RVU base fee schedule,1080,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2642,Not in chargemaster,D2642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2642,BCBSMN Non-RVU base fee schedule,1023,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2643,Not in chargemaster,D2643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2643,BCBSMN Non-RVU base fee schedule,1100,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2644,Not in chargemaster,D2644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2644,BCBSMN Non-RVU base fee schedule,1168,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2650,Not in chargemaster,D2650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2650,BCBSMN Non-RVU base fee schedule,719,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2651,Not in chargemaster,D2651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2651,BCBSMN Non-RVU base fee schedule,769.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2652,Not in chargemaster,D2652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2652,BCBSMN Non-RVU base fee schedule,850.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2662,Not in chargemaster,D2662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2662,BCBSMN Non-RVU base fee schedule,778.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2663,Not in chargemaster,D2663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2663,BCBSMN Non-RVU base fee schedule,924.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2664,Not in chargemaster,D2664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2664,BCBSMN Non-RVU base fee schedule,1003.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2710,Not in chargemaster,D2710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2710,BCBSMN Non-RVU base fee schedule,588,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2712,Not in chargemaster,D2712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2712,BCBSMN Non-RVU base fee schedule,618,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2720,Not in chargemaster,D2720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2720,BCBSMN Non-RVU base fee schedule,1177,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2721,Not in chargemaster,D2721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2721,BCBSMN Non-RVU base fee schedule,1092.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2722,Not in chargemaster,D2722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2722,BCBSMN Non-RVU base fee schedule,1132,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2740,Not in chargemaster,D2740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2740,BCBSMN Non-RVU base fee schedule,1313,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2750,Not in chargemaster,D2750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2750,BCBSMN Non-RVU base fee schedule,1293,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2751,Not in chargemaster,D2751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2751,BCBSMN Non-RVU base fee schedule,1133.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2752,Not in chargemaster,D2752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2752,BCBSMN Non-RVU base fee schedule,1223,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2753,Not in chargemaster,D2753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2753,BCBSMN Non-RVU base fee schedule,1446.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2780,Not in chargemaster,D2780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2780,BCBSMN Non-RVU base fee schedule,1239,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2781,Not in chargemaster,D2781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2781,BCBSMN Non-RVU base fee schedule,1097,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2782,Not in chargemaster,D2782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2782,BCBSMN Non-RVU base fee schedule,1350,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2783,Not in chargemaster,D2783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2783,BCBSMN Non-RVU base fee schedule,1234.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2790,Not in chargemaster,D2790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2790,BCBSMN Non-RVU base fee schedule,1293,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2791,Not in chargemaster,D2791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2791,BCBSMN Non-RVU base fee schedule,1097,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2792,Not in chargemaster,D2792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2792,BCBSMN Non-RVU base fee schedule,1179,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2794,Not in chargemaster,D2794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2794,BCBSMN Non-RVU base fee schedule,1165.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2799,Not in chargemaster,D2799,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2799,BCBSMN Non-RVU base fee schedule,470,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2910,Not in chargemaster,D2910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2910,BCBSMN Non-RVU base fee schedule,119,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2915,Not in chargemaster,D2915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2915,BCBSMN Non-RVU base fee schedule,149.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2920,Not in chargemaster,D2920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2920,BCBSMN Non-RVU base fee schedule,119,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2921,Not in chargemaster,D2921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2921,BCBSMN Non-RVU base fee schedule,367.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2929,Not in chargemaster,D2929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2929,BCBSMN Non-RVU base fee schedule,470,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2930,Not in chargemaster,D2930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2930,BCBSMN Non-RVU base fee schedule,330.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2931,Not in chargemaster,D2931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2931,BCBSMN Non-RVU base fee schedule,388,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2932,Not in chargemaster,D2932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2932,BCBSMN Non-RVU base fee schedule,382,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2933,Not in chargemaster,D2933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2933,BCBSMN Non-RVU base fee schedule,437,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2934,Not in chargemaster,D2934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2934,BCBSMN Non-RVU base fee schedule,434,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2940,Not in chargemaster,D2940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2940,BCBSMN Non-RVU base fee schedule,305,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2941,Not in chargemaster,D2941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2941,BCBSMN Non-RVU base fee schedule,119.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2949,Not in chargemaster,D2949,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2949,BCBSMN Non-RVU base fee schedule,101.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2950,Not in chargemaster,D2950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2950,BCBSMN Non-RVU base fee schedule,302,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2951,Not in chargemaster,D2951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2951,BCBSMN Non-RVU base fee schedule,103.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2952,Not in chargemaster,D2952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2952,BCBSMN Non-RVU base fee schedule,479,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2953,Not in chargemaster,D2953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2953,BCBSMN Non-RVU base fee schedule,238,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2954,Not in chargemaster,D2954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2954,BCBSMN Non-RVU base fee schedule,418,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2955,Not in chargemaster,D2955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2955,BCBSMN Non-RVU base fee schedule,299,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2957,Not in chargemaster,D2957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2957,BCBSMN Non-RVU base fee schedule,195,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2960,Not in chargemaster,D2960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2960,BCBSMN Non-RVU base fee schedule,918,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2961,Not in chargemaster,D2961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2961,BCBSMN Non-RVU base fee schedule,1046,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2962,Not in chargemaster,D2962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2962,BCBSMN Non-RVU base fee schedule,1470,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2971,Not in chargemaster,D2971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2971,BCBSMN Non-RVU base fee schedule,318,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2975,Not in chargemaster,D2975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2975,BCBSMN Non-RVU base fee schedule,635,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2980,Not in chargemaster,D2980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2980,BCBSMN Non-RVU base fee schedule,630,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2981,Not in chargemaster,D2981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2981,BCBSMN Non-RVU base fee schedule,186.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2982,Not in chargemaster,D2982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2982,BCBSMN Non-RVU base fee schedule,186.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2983,Not in chargemaster,D2983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2983,BCBSMN Non-RVU base fee schedule,219,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D2990,Not in chargemaster,D2990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D2990,BCBSMN Non-RVU base fee schedule,110.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3110,Not in chargemaster,D3110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3110,BCBSMN Non-RVU base fee schedule,88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3120,Not in chargemaster,D3120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3120,BCBSMN Non-RVU base fee schedule,74.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3220,Not in chargemaster,D3220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3220,BCBSMN Non-RVU base fee schedule,202.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3221,Not in chargemaster,D3221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3221,BCBSMN Non-RVU base fee schedule,265.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3222,Not in chargemaster,D3222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3222,BCBSMN Non-RVU base fee schedule,309,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3230,Not in chargemaster,D3230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3230,BCBSMN Non-RVU base fee schedule,264.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3240,Not in chargemaster,D3240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3240,BCBSMN Non-RVU base fee schedule,321.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3310,Not in chargemaster,D3310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3310,BCBSMN Non-RVU base fee schedule,896.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3320,Not in chargemaster,D3320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3320,BCBSMN Non-RVU base fee schedule,1045.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3330,Not in chargemaster,D3330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3330,BCBSMN Non-RVU base fee schedule,1411.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3331,Not in chargemaster,D3331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3331,BCBSMN Non-RVU base fee schedule,310.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3332,Not in chargemaster,D3332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3332,BCBSMN Non-RVU base fee schedule,437.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3333,Not in chargemaster,D3333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3333,BCBSMN Non-RVU base fee schedule,266,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3346,Not in chargemaster,D3346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3346,BCBSMN Non-RVU base fee schedule,1100,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3347,Not in chargemaster,D3347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3347,BCBSMN Non-RVU base fee schedule,1300,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3348,Not in chargemaster,D3348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3348,BCBSMN Non-RVU base fee schedule,1587.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3351,Not in chargemaster,D3351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3351,BCBSMN Non-RVU base fee schedule,491,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3352,Not in chargemaster,D3352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3352,BCBSMN Non-RVU base fee schedule,204,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3353,Not in chargemaster,D3353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3353,BCBSMN Non-RVU base fee schedule,1224,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3355,Not in chargemaster,D3355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3355,BCBSMN Non-RVU base fee schedule,491,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3356,Not in chargemaster,D3356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3356,BCBSMN Non-RVU base fee schedule,193.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3357,Not in chargemaster,D3357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3357,BCBSMN Non-RVU base fee schedule,784,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3410,Not in chargemaster,D3410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3410,BCBSMN Non-RVU base fee schedule,988,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3421,Not in chargemaster,D3421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3421,BCBSMN Non-RVU base fee schedule,1093,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3425,Not in chargemaster,D3425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3425,BCBSMN Non-RVU base fee schedule,1248,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3426,Not in chargemaster,D3426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3426,BCBSMN Non-RVU base fee schedule,401,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3427,Not in chargemaster,D3427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3427,BCBSMN Non-RVU base fee schedule,773.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3428,Not in chargemaster,D3428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3428,BCBSMN Non-RVU base fee schedule,1030,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3429,Not in chargemaster,D3429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3429,BCBSMN Non-RVU base fee schedule,1076.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3430,Not in chargemaster,D3430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3430,BCBSMN Non-RVU base fee schedule,312,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3431,Not in chargemaster,D3431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3431,BCBSMN Non-RVU base fee schedule,1325.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3432,Not in chargemaster,D3432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3432,BCBSMN Non-RVU base fee schedule,1139.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3450,Not in chargemaster,D3450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3450,BCBSMN Non-RVU base fee schedule,729.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3460,Not in chargemaster,D3460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3460,BCBSMN Non-RVU base fee schedule,2522,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3470,Not in chargemaster,D3470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3470,BCBSMN Non-RVU base fee schedule,1099,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3910,Not in chargemaster,D3910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3910,BCBSMN Non-RVU base fee schedule,212.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3920,Not in chargemaster,D3920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3920,BCBSMN Non-RVU base fee schedule,665,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D3950,Not in chargemaster,D3950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D3950,BCBSMN Non-RVU base fee schedule,212,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4210,Not in chargemaster,D4210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4210,BCBSMN Non-RVU base fee schedule,965,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4211,Not in chargemaster,D4211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4211,BCBSMN Non-RVU base fee schedule,509,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4212,Not in chargemaster,D4212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4212,BCBSMN Non-RVU base fee schedule,367.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4230,Not in chargemaster,D4230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4230,BCBSMN Non-RVU base fee schedule,1779.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4231,Not in chargemaster,D4231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4231,BCBSMN Non-RVU base fee schedule,1238.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4240,Not in chargemaster,D4240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4240,BCBSMN Non-RVU base fee schedule,1261,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4241,Not in chargemaster,D4241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4241,BCBSMN Non-RVU base fee schedule,1043.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4245,Not in chargemaster,D4245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4245,BCBSMN Non-RVU base fee schedule,935,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4249,Not in chargemaster,D4249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4249,BCBSMN Non-RVU base fee schedule,1300,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4260,Not in chargemaster,D4260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4260,BCBSMN Non-RVU base fee schedule,1990,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4261,Not in chargemaster,D4261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4261,BCBSMN Non-RVU base fee schedule,1139,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4263,Not in chargemaster,D4263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4263,BCBSMN Non-RVU base fee schedule,662.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4264,Not in chargemaster,D4264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4264,BCBSMN Non-RVU base fee schedule,585,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4265,Not in chargemaster,D4265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4265,BCBSMN Non-RVU base fee schedule,723.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4266,Not in chargemaster,D4266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4266,BCBSMN Non-RVU base fee schedule,725,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4267,Not in chargemaster,D4267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4267,BCBSMN Non-RVU base fee schedule,804,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4268,Not in chargemaster,D4268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4268,BCBSMN Non-RVU base fee schedule,601.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4270,Not in chargemaster,D4270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4270,BCBSMN Non-RVU base fee schedule,1411,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4273,Not in chargemaster,D4273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4273,BCBSMN Non-RVU base fee schedule,1249.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4274,Not in chargemaster,D4274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4274,BCBSMN Non-RVU base fee schedule,1045,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4275,Not in chargemaster,D4275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4275,BCBSMN Non-RVU base fee schedule,1117.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4276,Not in chargemaster,D4276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4276,BCBSMN Non-RVU base fee schedule,1181.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4277,Not in chargemaster,D4277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4277,BCBSMN Non-RVU base fee schedule,1117.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4278,Not in chargemaster,D4278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4278,BCBSMN Non-RVU base fee schedule,664.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4283,Not in chargemaster,D4283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4283,BCBSMN Non-RVU base fee schedule,955.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4285,Not in chargemaster,D4285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4285,BCBSMN Non-RVU base fee schedule,534.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4320,Not in chargemaster,D4320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4320,BCBSMN Non-RVU base fee schedule,492,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4321,Not in chargemaster,D4321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4321,BCBSMN Non-RVU base fee schedule,461,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4341,Not in chargemaster,D4341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4341,BCBSMN Non-RVU base fee schedule,380,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4342,Not in chargemaster,D4342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4342,BCBSMN Non-RVU base fee schedule,282,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4346,Not in chargemaster,D4346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4346,BCBSMN Non-RVU base fee schedule,176.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4355,Not in chargemaster,D4355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4355,BCBSMN Non-RVU base fee schedule,201,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4381,Not in chargemaster,D4381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4381,BCBSMN Non-RVU base fee schedule,312,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4910,Not in chargemaster,D4910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4910,BCBSMN Non-RVU base fee schedule,206.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4920,Not in chargemaster,D4920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4920,BCBSMN Non-RVU base fee schedule,139,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D4921,Not in chargemaster,D4921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D4921,BCBSMN Non-RVU base fee schedule,108.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5110,Not in chargemaster,D5110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5110,BCBSMN Non-RVU base fee schedule,2370,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5120,Not in chargemaster,D5120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5120,BCBSMN Non-RVU base fee schedule,2352,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5130,Not in chargemaster,D5130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5130,BCBSMN Non-RVU base fee schedule,2370,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5140,Not in chargemaster,D5140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5140,BCBSMN Non-RVU base fee schedule,2352,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5211,Not in chargemaster,D5211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5211,BCBSMN Non-RVU base fee schedule,1577,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5212,Not in chargemaster,D5212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5212,BCBSMN Non-RVU base fee schedule,1577,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5213,Not in chargemaster,D5213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5213,BCBSMN Non-RVU base fee schedule,2384,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5214,Not in chargemaster,D5214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5214,BCBSMN Non-RVU base fee schedule,2384,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5221,Not in chargemaster,D5221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5221,BCBSMN Non-RVU base fee schedule,1566.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5222,Not in chargemaster,D5222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5222,BCBSMN Non-RVU base fee schedule,1566.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5223,Not in chargemaster,D5223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5223,BCBSMN Non-RVU base fee schedule,2059.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5224,Not in chargemaster,D5224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5224,BCBSMN Non-RVU base fee schedule,2059.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5225,Not in chargemaster,D5225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5225,BCBSMN Non-RVU base fee schedule,1577,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5226,Not in chargemaster,D5226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5226,BCBSMN Non-RVU base fee schedule,1577,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5282,Not in chargemaster,D5282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5282,BCBSMN Non-RVU base fee schedule,1083,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5283,Not in chargemaster,D5283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5283,BCBSMN Non-RVU base fee schedule,1083,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5284,Not in chargemaster,D5284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5284,BCBSMN Non-RVU base fee schedule,980.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5286,Not in chargemaster,D5286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5286,BCBSMN Non-RVU base fee schedule,980.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5410,Not in chargemaster,D5410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5410,BCBSMN Non-RVU base fee schedule,110.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5411,Not in chargemaster,D5411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5411,BCBSMN Non-RVU base fee schedule,128.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5421,Not in chargemaster,D5421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5421,BCBSMN Non-RVU base fee schedule,107.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5422,Not in chargemaster,D5422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5422,BCBSMN Non-RVU base fee schedule,99.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5511,Not in chargemaster,D5511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5511,BCBSMN Non-RVU base fee schedule,294,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5512,Not in chargemaster,D5512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5512,BCBSMN Non-RVU base fee schedule,231.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5520,Not in chargemaster,D5520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5520,BCBSMN Non-RVU base fee schedule,209,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5611,Not in chargemaster,D5611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5611,BCBSMN Non-RVU base fee schedule,241.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5612,Not in chargemaster,D5612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5612,BCBSMN Non-RVU base fee schedule,241.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5621,Not in chargemaster,D5621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5621,BCBSMN Non-RVU base fee schedule,294,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5622,Not in chargemaster,D5622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5622,BCBSMN Non-RVU base fee schedule,235.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5630,Not in chargemaster,D5630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5630,BCBSMN Non-RVU base fee schedule,291,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5640,Not in chargemaster,D5640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5640,BCBSMN Non-RVU base fee schedule,221,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5650,Not in chargemaster,D5650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5650,BCBSMN Non-RVU base fee schedule,275,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5660,Not in chargemaster,D5660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5660,BCBSMN Non-RVU base fee schedule,334,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5670,Not in chargemaster,D5670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5670,BCBSMN Non-RVU base fee schedule,1055,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5671,Not in chargemaster,D5671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5671,BCBSMN Non-RVU base fee schedule,1055,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5710,Not in chargemaster,D5710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5710,BCBSMN Non-RVU base fee schedule,821,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5711,Not in chargemaster,D5711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5711,BCBSMN Non-RVU base fee schedule,821,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5720,Not in chargemaster,D5720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5720,BCBSMN Non-RVU base fee schedule,642,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5721,Not in chargemaster,D5721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5721,BCBSMN Non-RVU base fee schedule,642,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5730,Not in chargemaster,D5730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5730,BCBSMN Non-RVU base fee schedule,443,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5731,Not in chargemaster,D5731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5731,BCBSMN Non-RVU base fee schedule,443,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5740,Not in chargemaster,D5740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5740,BCBSMN Non-RVU base fee schedule,429.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5741,Not in chargemaster,D5741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5741,BCBSMN Non-RVU base fee schedule,393,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5750,Not in chargemaster,D5750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5750,BCBSMN Non-RVU base fee schedule,670,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5751,Not in chargemaster,D5751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5751,BCBSMN Non-RVU base fee schedule,679,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5760,Not in chargemaster,D5760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5760,BCBSMN Non-RVU base fee schedule,611,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5761,Not in chargemaster,D5761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5761,BCBSMN Non-RVU base fee schedule,611,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5810,Not in chargemaster,D5810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5810,BCBSMN Non-RVU base fee schedule,1175,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5811,Not in chargemaster,D5811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5811,BCBSMN Non-RVU base fee schedule,1175,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5820,Not in chargemaster,D5820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5820,BCBSMN Non-RVU base fee schedule,715,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5821,Not in chargemaster,D5821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5821,BCBSMN Non-RVU base fee schedule,745,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5850,Not in chargemaster,D5850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5850,BCBSMN Non-RVU base fee schedule,198,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5851,Not in chargemaster,D5851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5851,BCBSMN Non-RVU base fee schedule,198,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5862,Not in chargemaster,D5862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5862,BCBSMN Non-RVU base fee schedule,588,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5863,Not in chargemaster,D5863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5863,BCBSMN Non-RVU base fee schedule,2200,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5864,Not in chargemaster,D5864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5864,BCBSMN Non-RVU base fee schedule,2200,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5865,Not in chargemaster,D5865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5865,BCBSMN Non-RVU base fee schedule,2200,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5866,Not in chargemaster,D5866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5866,BCBSMN Non-RVU base fee schedule,2219.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5867,Not in chargemaster,D5867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5867,BCBSMN Non-RVU base fee schedule,249.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5875,Not in chargemaster,D5875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5875,BCBSMN Non-RVU base fee schedule,1321,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5876,Not in chargemaster,D5876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5876,BCBSMN Non-RVU base fee schedule,224.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5911,Not in chargemaster,D5911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5911,BCBSMN Non-RVU base fee schedule,102.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5912,Not in chargemaster,D5912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5912,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5913,Not in chargemaster,D5913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5913,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5914,Not in chargemaster,D5914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5914,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5915,Not in chargemaster,D5915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5915,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5916,Not in chargemaster,D5916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5916,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5919,Not in chargemaster,D5919,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5919,BCBSMN Non-RVU base fee schedule,62.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5922,Not in chargemaster,D5922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5922,BCBSMN Non-RVU base fee schedule,327.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5923,Not in chargemaster,D5923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5923,BCBSMN Non-RVU base fee schedule,456,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5924,Not in chargemaster,D5924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5924,BCBSMN Non-RVU base fee schedule,345,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5925,Not in chargemaster,D5925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5925,BCBSMN Non-RVU base fee schedule,228.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5926,Not in chargemaster,D5926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5926,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5927,Not in chargemaster,D5927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5927,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5928,Not in chargemaster,D5928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5928,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5929,Not in chargemaster,D5929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5929,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5931,Not in chargemaster,D5931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5931,BCBSMN Non-RVU base fee schedule,3475.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5932,Not in chargemaster,D5932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5932,BCBSMN Non-RVU base fee schedule,6499.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5933,Not in chargemaster,D5933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5933,BCBSMN Non-RVU base fee schedule,2069.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5934,Not in chargemaster,D5934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5934,BCBSMN Non-RVU base fee schedule,5924.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5935,Not in chargemaster,D5935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5935,BCBSMN Non-RVU base fee schedule,5154.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5936,Not in chargemaster,D5936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5936,BCBSMN Non-RVU base fee schedule,2391,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5937,Not in chargemaster,D5937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5937,BCBSMN Non-RVU base fee schedule,873.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5951,Not in chargemaster,D5951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5951,BCBSMN Non-RVU base fee schedule,285.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5952,Not in chargemaster,D5952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5952,BCBSMN Non-RVU base fee schedule,805,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5953,Not in chargemaster,D5953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5953,BCBSMN Non-RVU base fee schedule,3074,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5954,Not in chargemaster,D5954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5954,BCBSMN Non-RVU base fee schedule,941,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5955,Not in chargemaster,D5955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5955,BCBSMN Non-RVU base fee schedule,1481,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5958,Not in chargemaster,D5958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5958,BCBSMN Non-RVU base fee schedule,2758.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5959,Not in chargemaster,D5959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5959,BCBSMN Non-RVU base fee schedule,170.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5960,Not in chargemaster,D5960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5960,BCBSMN Non-RVU base fee schedule,399.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5982,Not in chargemaster,D5982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5982,BCBSMN Non-RVU base fee schedule,555,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5983,Not in chargemaster,D5983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5983,BCBSMN Non-RVU base fee schedule,370.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5984,Not in chargemaster,D5984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5984,BCBSMN Non-RVU base fee schedule,388.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5985,Not in chargemaster,D5985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5985,BCBSMN Non-RVU base fee schedule,907.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5986,Not in chargemaster,D5986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5986,BCBSMN Non-RVU base fee schedule,292,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5987,Not in chargemaster,D5987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5987,BCBSMN Non-RVU base fee schedule,398.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5988,Not in chargemaster,D5988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5988,BCBSMN Non-RVU base fee schedule,708,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5991,Not in chargemaster,D5991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5991,BCBSMN Non-RVU base fee schedule,169,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5992,Not in chargemaster,D5992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5992,BCBSMN Non-RVU base fee schedule,107,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5993,Not in chargemaster,D5993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5993,BCBSMN Non-RVU base fee schedule,214,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D5994,Not in chargemaster,D5994,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D5994,BCBSMN Non-RVU base fee schedule,164,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6010,Not in chargemaster,D6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6010,BCBSMN Non-RVU base fee schedule,2500,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6011,Not in chargemaster,D6011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6011,BCBSMN Non-RVU base fee schedule,300,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6012,Not in chargemaster,D6012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6012,BCBSMN Non-RVU base fee schedule,2543.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6013,Not in chargemaster,D6013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6013,BCBSMN Non-RVU base fee schedule,2691.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6040,Not in chargemaster,D6040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6040,BCBSMN Non-RVU base fee schedule,9261,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6050,Not in chargemaster,D6050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6050,BCBSMN Non-RVU base fee schedule,6909,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6051,Not in chargemaster,D6051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6051,BCBSMN Non-RVU base fee schedule,574.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6052,Not in chargemaster,D6052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6052,BCBSMN Non-RVU base fee schedule,712.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6055,Not in chargemaster,D6055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6055,BCBSMN Non-RVU base fee schedule,1025.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6056,Not in chargemaster,D6056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6056,BCBSMN Non-RVU base fee schedule,694,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6057,Not in chargemaster,D6057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6057,BCBSMN Non-RVU base fee schedule,841.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6058,Not in chargemaster,D6058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6058,BCBSMN Non-RVU base fee schedule,1656,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6059,Not in chargemaster,D6059,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6059,BCBSMN Non-RVU base fee schedule,1264.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6060,Not in chargemaster,D6060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6060,BCBSMN Non-RVU base fee schedule,1320.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6061,Not in chargemaster,D6061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6061,BCBSMN Non-RVU base fee schedule,1337,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6062,Not in chargemaster,D6062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6062,BCBSMN Non-RVU base fee schedule,1554,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6063,Not in chargemaster,D6063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6063,BCBSMN Non-RVU base fee schedule,1278.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6064,Not in chargemaster,D6064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6064,BCBSMN Non-RVU base fee schedule,1337.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6065,Not in chargemaster,D6065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6065,BCBSMN Non-RVU base fee schedule,1959,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6066,Not in chargemaster,D6066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6066,BCBSMN Non-RVU base fee schedule,1851,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6067,Not in chargemaster,D6067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6067,BCBSMN Non-RVU base fee schedule,1878,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6068,Not in chargemaster,D6068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6068,BCBSMN Non-RVU base fee schedule,1249.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6069,Not in chargemaster,D6069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6069,BCBSMN Non-RVU base fee schedule,1428.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6070,Not in chargemaster,D6070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6070,BCBSMN Non-RVU base fee schedule,1445.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6071,Not in chargemaster,D6071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6071,BCBSMN Non-RVU base fee schedule,1374.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6072,Not in chargemaster,D6072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6072,BCBSMN Non-RVU base fee schedule,1492.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6073,Not in chargemaster,D6073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6073,BCBSMN Non-RVU base fee schedule,1362.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6074,Not in chargemaster,D6074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6074,BCBSMN Non-RVU base fee schedule,1447.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6075,Not in chargemaster,D6075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6075,BCBSMN Non-RVU base fee schedule,1922,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6076,Not in chargemaster,D6076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6076,BCBSMN Non-RVU base fee schedule,1873,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6077,Not in chargemaster,D6077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6077,BCBSMN Non-RVU base fee schedule,1816,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6080,Not in chargemaster,D6080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6080,BCBSMN Non-RVU base fee schedule,248,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6081,Not in chargemaster,D6081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6081,BCBSMN Non-RVU base fee schedule,64.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6082,Not in chargemaster,D6082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6082,BCBSMN Non-RVU base fee schedule,1405.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6083,Not in chargemaster,D6083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6083,BCBSMN Non-RVU base fee schedule,1446.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6084,Not in chargemaster,D6084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6084,BCBSMN Non-RVU base fee schedule,1446.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6085,Not in chargemaster,D6085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6085,BCBSMN Non-RVU base fee schedule,426.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6086,Not in chargemaster,D6086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6086,BCBSMN Non-RVU base fee schedule,1306.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6087,Not in chargemaster,D6087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6087,BCBSMN Non-RVU base fee schedule,1424.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6088,Not in chargemaster,D6088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6088,BCBSMN Non-RVU base fee schedule,1424.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6090,Not in chargemaster,D6090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6090,BCBSMN Non-RVU base fee schedule,327,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6091,Not in chargemaster,D6091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6091,BCBSMN Non-RVU base fee schedule,578.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6092,Not in chargemaster,D6092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6092,BCBSMN Non-RVU base fee schedule,143,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6093,Not in chargemaster,D6093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6093,BCBSMN Non-RVU base fee schedule,215,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6094,Not in chargemaster,D6094,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6094,BCBSMN Non-RVU base fee schedule,1251,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6095,Not in chargemaster,D6095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6095,BCBSMN Non-RVU base fee schedule,734,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6096,Not in chargemaster,D6096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6096,BCBSMN Non-RVU base fee schedule,232.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6097,Not in chargemaster,D6097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6097,BCBSMN Non-RVU base fee schedule,1446.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6098,Not in chargemaster,D6098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6098,BCBSMN Non-RVU base fee schedule,1326.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6099,Not in chargemaster,D6099,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6099,BCBSMN Non-RVU base fee schedule,1446.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6100,Not in chargemaster,D6100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6100,BCBSMN Non-RVU base fee schedule,847.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6101,Not in chargemaster,D6101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6101,BCBSMN Non-RVU base fee schedule,1029,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6102,Not in chargemaster,D6102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6102,BCBSMN Non-RVU base fee schedule,1331.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6103,Not in chargemaster,D6103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6103,BCBSMN Non-RVU base fee schedule,715.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6104,Not in chargemaster,D6104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6104,BCBSMN Non-RVU base fee schedule,585,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6110,Not in chargemaster,D6110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6110,BCBSMN Non-RVU base fee schedule,2367,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6111,Not in chargemaster,D6111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6111,BCBSMN Non-RVU base fee schedule,2367,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6112,Not in chargemaster,D6112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6112,BCBSMN Non-RVU base fee schedule,2331.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6113,Not in chargemaster,D6113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6113,BCBSMN Non-RVU base fee schedule,2331.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6114,Not in chargemaster,D6114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6114,BCBSMN Non-RVU base fee schedule,7632,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6115,Not in chargemaster,D6115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6115,BCBSMN Non-RVU base fee schedule,7632,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6116,Not in chargemaster,D6116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6116,BCBSMN Non-RVU base fee schedule,3711,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6117,Not in chargemaster,D6117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6117,BCBSMN Non-RVU base fee schedule,3711,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6118,Not in chargemaster,D6118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6118,BCBSMN Non-RVU base fee schedule,1830.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6119,Not in chargemaster,D6119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6119,BCBSMN Non-RVU base fee schedule,1830.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6120,Not in chargemaster,D6120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6120,BCBSMN Non-RVU base fee schedule,1446.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6121,Not in chargemaster,D6121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6121,BCBSMN Non-RVU base fee schedule,1424.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6122,Not in chargemaster,D6122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6122,BCBSMN Non-RVU base fee schedule,1424.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6123,Not in chargemaster,D6123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6123,BCBSMN Non-RVU base fee schedule,1424.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6190,Not in chargemaster,D6190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6190,BCBSMN Non-RVU base fee schedule,422.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6194,Not in chargemaster,D6194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6194,BCBSMN Non-RVU base fee schedule,1251,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6195,Not in chargemaster,D6195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6195,BCBSMN Non-RVU base fee schedule,1446.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6205,Not in chargemaster,D6205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6205,BCBSMN Non-RVU base fee schedule,868.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6210,Not in chargemaster,D6210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6210,BCBSMN Non-RVU base fee schedule,1291,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6211,Not in chargemaster,D6211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6211,BCBSMN Non-RVU base fee schedule,1097,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6212,Not in chargemaster,D6212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6212,BCBSMN Non-RVU base fee schedule,1179,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6214,Not in chargemaster,D6214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6214,BCBSMN Non-RVU base fee schedule,1156,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6240,Not in chargemaster,D6240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6240,BCBSMN Non-RVU base fee schedule,1291,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6241,Not in chargemaster,D6241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6241,BCBSMN Non-RVU base fee schedule,1233,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6242,Not in chargemaster,D6242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6242,BCBSMN Non-RVU base fee schedule,1216,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6243,Not in chargemaster,D6243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6243,BCBSMN Non-RVU base fee schedule,1276.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6245,Not in chargemaster,D6245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6245,BCBSMN Non-RVU base fee schedule,1334,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6250,Not in chargemaster,D6250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6250,BCBSMN Non-RVU base fee schedule,1177,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6251,Not in chargemaster,D6251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6251,BCBSMN Non-RVU base fee schedule,1084,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6252,Not in chargemaster,D6252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6252,BCBSMN Non-RVU base fee schedule,1132,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6253,Not in chargemaster,D6253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6253,BCBSMN Non-RVU base fee schedule,450,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6545,Not in chargemaster,D6545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6545,BCBSMN Non-RVU base fee schedule,992.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6548,Not in chargemaster,D6548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6548,BCBSMN Non-RVU base fee schedule,991.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6549,Not in chargemaster,D6549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6549,BCBSMN Non-RVU base fee schedule,528.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6600,Not in chargemaster,D6600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6600,BCBSMN Non-RVU base fee schedule,915,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6601,Not in chargemaster,D6601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6601,BCBSMN Non-RVU base fee schedule,959,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6602,Not in chargemaster,D6602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6602,BCBSMN Non-RVU base fee schedule,995,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6603,Not in chargemaster,D6603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6603,BCBSMN Non-RVU base fee schedule,1073,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6604,Not in chargemaster,D6604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6604,BCBSMN Non-RVU base fee schedule,943,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6605,Not in chargemaster,D6605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6605,BCBSMN Non-RVU base fee schedule,1001,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6606,Not in chargemaster,D6606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6606,BCBSMN Non-RVU base fee schedule,954,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6607,Not in chargemaster,D6607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6607,BCBSMN Non-RVU base fee schedule,1031,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6608,Not in chargemaster,D6608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6608,BCBSMN Non-RVU base fee schedule,980,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6609,Not in chargemaster,D6609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6609,BCBSMN Non-RVU base fee schedule,1029,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6610,Not in chargemaster,D6610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6610,BCBSMN Non-RVU base fee schedule,1059,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6611,Not in chargemaster,D6611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6611,BCBSMN Non-RVU base fee schedule,1153,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6612,Not in chargemaster,D6612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6612,BCBSMN Non-RVU base fee schedule,1033,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6613,Not in chargemaster,D6613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6613,BCBSMN Non-RVU base fee schedule,1080,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6614,Not in chargemaster,D6614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6614,BCBSMN Non-RVU base fee schedule,1027,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6615,Not in chargemaster,D6615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6615,BCBSMN Non-RVU base fee schedule,1035,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6624,Not in chargemaster,D6624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6624,BCBSMN Non-RVU base fee schedule,991,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6634,Not in chargemaster,D6634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6634,BCBSMN Non-RVU base fee schedule,1037,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6710,Not in chargemaster,D6710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6710,BCBSMN Non-RVU base fee schedule,912.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6720,Not in chargemaster,D6720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6720,BCBSMN Non-RVU base fee schedule,1177,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6721,Not in chargemaster,D6721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6721,BCBSMN Non-RVU base fee schedule,1052,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6722,Not in chargemaster,D6722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6722,BCBSMN Non-RVU base fee schedule,1099,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6740,Not in chargemaster,D6740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6740,BCBSMN Non-RVU base fee schedule,1334,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6750,Not in chargemaster,D6750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6750,BCBSMN Non-RVU base fee schedule,1346,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6751,Not in chargemaster,D6751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6751,BCBSMN Non-RVU base fee schedule,1115,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6752,Not in chargemaster,D6752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6752,BCBSMN Non-RVU base fee schedule,1216,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6753,Not in chargemaster,D6753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6753,BCBSMN Non-RVU base fee schedule,1446.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6780,Not in chargemaster,D6780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6780,BCBSMN Non-RVU base fee schedule,1230,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6781,Not in chargemaster,D6781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6781,BCBSMN Non-RVU base fee schedule,1097,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6782,Not in chargemaster,D6782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6782,BCBSMN Non-RVU base fee schedule,1179,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6783,Not in chargemaster,D6783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6783,BCBSMN Non-RVU base fee schedule,1200,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6784,Not in chargemaster,D6784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6784,BCBSMN Non-RVU base fee schedule,1253.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6790,Not in chargemaster,D6790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6790,BCBSMN Non-RVU base fee schedule,1291,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6791,Not in chargemaster,D6791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6791,BCBSMN Non-RVU base fee schedule,1097,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6792,Not in chargemaster,D6792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6792,BCBSMN Non-RVU base fee schedule,1179,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6793,Not in chargemaster,D6793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6793,BCBSMN Non-RVU base fee schedule,407.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6794,Not in chargemaster,D6794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6794,BCBSMN Non-RVU base fee schedule,1179,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6920,Not in chargemaster,D6920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6920,BCBSMN Non-RVU base fee schedule,596.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6930,Not in chargemaster,D6930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6930,BCBSMN Non-RVU base fee schedule,169,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6940,Not in chargemaster,D6940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6940,BCBSMN Non-RVU base fee schedule,367.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6950,Not in chargemaster,D6950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6950,BCBSMN Non-RVU base fee schedule,763,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6980,Not in chargemaster,D6980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6980,BCBSMN Non-RVU base fee schedule,318,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D6985,Not in chargemaster,D6985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D6985,BCBSMN Non-RVU base fee schedule,886.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7111,Not in chargemaster,D7111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7111,BCBSMN Non-RVU base fee schedule,139,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7140,Not in chargemaster,D7140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7140,BCBSMN Non-RVU base fee schedule,177,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7210,Not in chargemaster,D7210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7210,BCBSMN Non-RVU base fee schedule,324.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7220,Not in chargemaster,D7220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7220,BCBSMN Non-RVU base fee schedule,393,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7230,Not in chargemaster,D7230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7230,BCBSMN Non-RVU base fee schedule,518,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7240,Not in chargemaster,D7240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7240,BCBSMN Non-RVU base fee schedule,592,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7241,Not in chargemaster,D7241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7241,BCBSMN Non-RVU base fee schedule,768,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7250,Not in chargemaster,D7250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7250,BCBSMN Non-RVU base fee schedule,337,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7251,Not in chargemaster,D7251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7251,BCBSMN Non-RVU base fee schedule,662.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7260,Not in chargemaster,D7260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7260,BCBSMN Non-RVU base fee schedule,2874,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7261,Not in chargemaster,D7261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7261,BCBSMN Non-RVU base fee schedule,1065.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7270,Not in chargemaster,D7270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7270,BCBSMN Non-RVU base fee schedule,929.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7272,Not in chargemaster,D7272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7272,BCBSMN Non-RVU base fee schedule,835,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7280,Not in chargemaster,D7280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7280,BCBSMN Non-RVU base fee schedule,702,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7282,Not in chargemaster,D7282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7282,BCBSMN Non-RVU base fee schedule,370.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7283,Not in chargemaster,D7283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7283,BCBSMN Non-RVU base fee schedule,363.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7285,Not in chargemaster,D7285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7285,BCBSMN Non-RVU base fee schedule,1419,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7286,Not in chargemaster,D7286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7286,BCBSMN Non-RVU base fee schedule,592,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7287,Not in chargemaster,D7287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7287,BCBSMN Non-RVU base fee schedule,186.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7288,Not in chargemaster,D7288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7288,BCBSMN Non-RVU base fee schedule,186.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7290,Not in chargemaster,D7290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7290,BCBSMN Non-RVU base fee schedule,605,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7291,Not in chargemaster,D7291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7291,BCBSMN Non-RVU base fee schedule,278,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7292,Not in chargemaster,D7292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7292,BCBSMN Non-RVU base fee schedule,1687.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7293,Not in chargemaster,D7293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7293,BCBSMN Non-RVU base fee schedule,1622,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7294,Not in chargemaster,D7294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7294,BCBSMN Non-RVU base fee schedule,1622,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7295,Not in chargemaster,D7295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7295,BCBSMN Non-RVU base fee schedule,1324,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7296,Not in chargemaster,D7296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7296,BCBSMN Non-RVU base fee schedule,327.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7297,Not in chargemaster,D7297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7297,BCBSMN Non-RVU base fee schedule,427.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7310,Not in chargemaster,D7310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7310,BCBSMN Non-RVU base fee schedule,546,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7311,Not in chargemaster,D7311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7311,BCBSMN Non-RVU base fee schedule,392,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7320,Not in chargemaster,D7320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7320,BCBSMN Non-RVU base fee schedule,581,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7321,Not in chargemaster,D7321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7321,BCBSMN Non-RVU base fee schedule,462,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7340,Not in chargemaster,D7340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7340,BCBSMN Non-RVU base fee schedule,2908,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7350,Not in chargemaster,D7350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7350,BCBSMN Non-RVU base fee schedule,6230.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7410,Not in chargemaster,D7410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7410,BCBSMN Non-RVU base fee schedule,1287,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7411,Not in chargemaster,D7411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7411,BCBSMN Non-RVU base fee schedule,1339.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7412,Not in chargemaster,D7412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7412,BCBSMN Non-RVU base fee schedule,2131,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7413,Not in chargemaster,D7413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7413,BCBSMN Non-RVU base fee schedule,1303,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7414,Not in chargemaster,D7414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7414,BCBSMN Non-RVU base fee schedule,1635.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7415,Not in chargemaster,D7415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7415,BCBSMN Non-RVU base fee schedule,2347,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7440,Not in chargemaster,D7440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7440,BCBSMN Non-RVU base fee schedule,2262,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7441,Not in chargemaster,D7441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7441,BCBSMN Non-RVU base fee schedule,2839,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7450,Not in chargemaster,D7450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7450,BCBSMN Non-RVU base fee schedule,1188,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7451,Not in chargemaster,D7451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7451,BCBSMN Non-RVU base fee schedule,1673,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7460,Not in chargemaster,D7460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7460,BCBSMN Non-RVU base fee schedule,1163,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7461,Not in chargemaster,D7461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7461,BCBSMN Non-RVU base fee schedule,2041,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7465,Not in chargemaster,D7465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7465,BCBSMN Non-RVU base fee schedule,722,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7471,Not in chargemaster,D7471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7471,BCBSMN Non-RVU base fee schedule,1500,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7472,Not in chargemaster,D7472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7472,BCBSMN Non-RVU base fee schedule,1515,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7473,Not in chargemaster,D7473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7473,BCBSMN Non-RVU base fee schedule,1393,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7485,Not in chargemaster,D7485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7485,BCBSMN Non-RVU base fee schedule,1204,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7490,Not in chargemaster,D7490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7490,BCBSMN Non-RVU base fee schedule,10205,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7510,Not in chargemaster,D7510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7510,BCBSMN Non-RVU base fee schedule,400,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7511,Not in chargemaster,D7511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7511,BCBSMN Non-RVU base fee schedule,1453,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7520,Not in chargemaster,D7520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7520,BCBSMN Non-RVU base fee schedule,1594.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7521,Not in chargemaster,D7521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7521,BCBSMN Non-RVU base fee schedule,1752.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7530,Not in chargemaster,D7530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7530,BCBSMN Non-RVU base fee schedule,599,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7540,Not in chargemaster,D7540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7540,BCBSMN Non-RVU base fee schedule,949.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7550,Not in chargemaster,D7550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7550,BCBSMN Non-RVU base fee schedule,926.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7560,Not in chargemaster,D7560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7560,BCBSMN Non-RVU base fee schedule,3271,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7610,Not in chargemaster,D7610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7610,BCBSMN Non-RVU base fee schedule,5101.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7620,Not in chargemaster,D7620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7620,BCBSMN Non-RVU base fee schedule,3825.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7630,Not in chargemaster,D7630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7630,BCBSMN Non-RVU base fee schedule,6632.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7640,Not in chargemaster,D7640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7640,BCBSMN Non-RVU base fee schedule,4363,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7650,Not in chargemaster,D7650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7650,BCBSMN Non-RVU base fee schedule,4138.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7660,Not in chargemaster,D7660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7660,BCBSMN Non-RVU base fee schedule,2495.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7670,Not in chargemaster,D7670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7670,BCBSMN Non-RVU base fee schedule,1467.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7671,Not in chargemaster,D7671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7671,BCBSMN Non-RVU base fee schedule,2765.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7680,Not in chargemaster,D7680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7680,BCBSMN Non-RVU base fee schedule,9565.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7710,Not in chargemaster,D7710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7710,BCBSMN Non-RVU base fee schedule,5995.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7720,Not in chargemaster,D7720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7720,BCBSMN Non-RVU base fee schedule,4363,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7730,Not in chargemaster,D7730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7730,BCBSMN Non-RVU base fee schedule,8673,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7740,Not in chargemaster,D7740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7740,BCBSMN Non-RVU base fee schedule,4291.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7750,Not in chargemaster,D7750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7750,BCBSMN Non-RVU base fee schedule,5458.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7760,Not in chargemaster,D7760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7760,BCBSMN Non-RVU base fee schedule,3940.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7770,Not in chargemaster,D7770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7770,BCBSMN Non-RVU base fee schedule,2967.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7771,Not in chargemaster,D7771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7771,BCBSMN Non-RVU base fee schedule,2289.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7780,Not in chargemaster,D7780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7780,BCBSMN Non-RVU base fee schedule,12754.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7810,Not in chargemaster,D7810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7810,BCBSMN Non-RVU base fee schedule,5610.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7820,Not in chargemaster,D7820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7820,BCBSMN Non-RVU base fee schedule,918.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7830,Not in chargemaster,D7830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7830,BCBSMN Non-RVU base fee schedule,1609.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7840,Not in chargemaster,D7840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7840,BCBSMN Non-RVU base fee schedule,7648.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7850,Not in chargemaster,D7850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7850,BCBSMN Non-RVU base fee schedule,6604.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7852,Not in chargemaster,D7852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7852,BCBSMN Non-RVU base fee schedule,7562.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7854,Not in chargemaster,D7854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7854,BCBSMN Non-RVU base fee schedule,7804.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7856,Not in chargemaster,D7856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7856,BCBSMN Non-RVU base fee schedule,5537.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7858,Not in chargemaster,D7858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7858,BCBSMN Non-RVU base fee schedule,5023,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7860,Not in chargemaster,D7860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7860,BCBSMN Non-RVU base fee schedule,6727.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7865,Not in chargemaster,D7865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7865,BCBSMN Non-RVU base fee schedule,10841.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7870,Not in chargemaster,D7870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7870,BCBSMN Non-RVU base fee schedule,357.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7871,Not in chargemaster,D7871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7871,BCBSMN Non-RVU base fee schedule,565,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7872,Not in chargemaster,D7872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7872,BCBSMN Non-RVU base fee schedule,3115,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7873,Not in chargemaster,D7873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7873,BCBSMN Non-RVU base fee schedule,2171,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7874,Not in chargemaster,D7874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7874,BCBSMN Non-RVU base fee schedule,3018,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7875,Not in chargemaster,D7875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7875,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7876,Not in chargemaster,D7876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7876,BCBSMN Non-RVU base fee schedule,9999,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7877,Not in chargemaster,D7877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7877,BCBSMN Non-RVU base fee schedule,3097,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7880,Not in chargemaster,D7880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7880,BCBSMN Non-RVU base fee schedule,1176,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7881,Not in chargemaster,D7881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7881,BCBSMN Non-RVU base fee schedule,93.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7910,Not in chargemaster,D7910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7910,BCBSMN Non-RVU base fee schedule,740,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7911,Not in chargemaster,D7911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7911,BCBSMN Non-RVU base fee schedule,1322,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7912,Not in chargemaster,D7912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7912,BCBSMN Non-RVU base fee schedule,2296.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7920,Not in chargemaster,D7920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7920,BCBSMN Non-RVU base fee schedule,3761.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7921,Not in chargemaster,D7921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7921,BCBSMN Non-RVU base fee schedule,404.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7922,Not in chargemaster,D7922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7922,BCBSMN Non-RVU base fee schedule,114,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7940,Not in chargemaster,D7940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7940,BCBSMN Non-RVU base fee schedule,5747.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7941,Not in chargemaster,D7941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7941,BCBSMN Non-RVU base fee schedule,9579.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7943,Not in chargemaster,D7943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7943,BCBSMN Non-RVU base fee schedule,9326.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7944,Not in chargemaster,D7944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7944,BCBSMN Non-RVU base fee schedule,7843.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7945,Not in chargemaster,D7945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7945,BCBSMN Non-RVU base fee schedule,10436.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7946,Not in chargemaster,D7946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7946,BCBSMN Non-RVU base fee schedule,12928.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7947,Not in chargemaster,D7947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7947,BCBSMN Non-RVU base fee schedule,11035.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7948,Not in chargemaster,D7948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7948,BCBSMN Non-RVU base fee schedule,14112.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7949,Not in chargemaster,D7949,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7949,BCBSMN Non-RVU base fee schedule,18380.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7950,Not in chargemaster,D7950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7950,BCBSMN Non-RVU base fee schedule,2824.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7951,Not in chargemaster,D7951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7951,BCBSMN Non-RVU base fee schedule,2895.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7952,Not in chargemaster,D7952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7952,BCBSMN Non-RVU base fee schedule,2895.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7953,Not in chargemaster,D7953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7953,BCBSMN Non-RVU base fee schedule,567,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7955,Not in chargemaster,D7955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7955,BCBSMN Non-RVU base fee schedule,2851.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7960,Not in chargemaster,D7960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7960,BCBSMN Non-RVU base fee schedule,477.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7963,Not in chargemaster,D7963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7963,BCBSMN Non-RVU base fee schedule,676.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7970,Not in chargemaster,D7970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7970,BCBSMN Non-RVU base fee schedule,963.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7971,Not in chargemaster,D7971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7971,BCBSMN Non-RVU base fee schedule,318,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7972,Not in chargemaster,D7972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7972,BCBSMN Non-RVU base fee schedule,872.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7979,Not in chargemaster,D7979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7979,BCBSMN Non-RVU base fee schedule,213.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7980,Not in chargemaster,D7980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7980,BCBSMN Non-RVU base fee schedule,981.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7981,Not in chargemaster,D7981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7981,BCBSMN Non-RVU base fee schedule,5198,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7982,Not in chargemaster,D7982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7982,BCBSMN Non-RVU base fee schedule,2321.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7983,Not in chargemaster,D7983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7983,BCBSMN Non-RVU base fee schedule,2227.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7990,Not in chargemaster,D7990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7990,BCBSMN Non-RVU base fee schedule,1916.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7991,Not in chargemaster,D7991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7991,BCBSMN Non-RVU base fee schedule,4673.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7995,Not in chargemaster,D7995,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7995,BCBSMN Non-RVU base fee schedule,1609.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7996,Not in chargemaster,D7996,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7996,BCBSMN Non-RVU base fee schedule,939,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7997,Not in chargemaster,D7997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7997,BCBSMN Non-RVU base fee schedule,455,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D7998,Not in chargemaster,D7998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D7998,BCBSMN Non-RVU base fee schedule,1557.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8010,Not in chargemaster,D8010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8010,BCBSMN Non-RVU base fee schedule,2736.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8020,Not in chargemaster,D8020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8020,BCBSMN Non-RVU base fee schedule,3159.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8030,Not in chargemaster,D8030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8030,BCBSMN Non-RVU base fee schedule,3576.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8040,Not in chargemaster,D8040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8040,BCBSMN Non-RVU base fee schedule,4868,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8050,Not in chargemaster,D8050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8050,BCBSMN Non-RVU base fee schedule,3335,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8060,Not in chargemaster,D8060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8060,BCBSMN Non-RVU base fee schedule,3335,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8070,Not in chargemaster,D8070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8070,BCBSMN Non-RVU base fee schedule,6670,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8080,Not in chargemaster,D8080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8080,BCBSMN Non-RVU base fee schedule,6670,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8090,Not in chargemaster,D8090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8090,BCBSMN Non-RVU base fee schedule,6670,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8210,Not in chargemaster,D8210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8210,BCBSMN Non-RVU base fee schedule,1028.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8220,Not in chargemaster,D8220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8220,BCBSMN Non-RVU base fee schedule,1114.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8660,Not in chargemaster,D8660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8660,BCBSMN Non-RVU base fee schedule,616.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8670,Not in chargemaster,D8670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8670,BCBSMN Non-RVU base fee schedule,320.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8680,Not in chargemaster,D8680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8680,BCBSMN Non-RVU base fee schedule,877,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8681,Not in chargemaster,D8681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8681,BCBSMN Non-RVU base fee schedule,225.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8690,Not in chargemaster,D8690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8690,BCBSMN Non-RVU base fee schedule,663.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8695,Not in chargemaster,D8695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8695,BCBSMN Non-RVU base fee schedule,456,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8696,Not in chargemaster,D8696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8696,BCBSMN Non-RVU base fee schedule,264.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8697,Not in chargemaster,D8697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8697,BCBSMN Non-RVU base fee schedule,264.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8698,Not in chargemaster,D8698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8698,BCBSMN Non-RVU base fee schedule,114,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8699,Not in chargemaster,D8699,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8699,BCBSMN Non-RVU base fee schedule,114,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8701,Not in chargemaster,D8701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8701,BCBSMN Non-RVU base fee schedule,259.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8702,Not in chargemaster,D8702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8702,BCBSMN Non-RVU base fee schedule,259.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8703,Not in chargemaster,D8703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8703,BCBSMN Non-RVU base fee schedule,650.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D8704,Not in chargemaster,D8704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D8704,BCBSMN Non-RVU base fee schedule,650.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9110,Not in chargemaster,D9110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9110,BCBSMN Non-RVU base fee schedule,147,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9120,Not in chargemaster,D9120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9120,BCBSMN Non-RVU base fee schedule,198,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9130,Not in chargemaster,D9130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9130,BCBSMN Non-RVU base fee schedule,98.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9210,Not in chargemaster,D9210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9210,BCBSMN Non-RVU base fee schedule,44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9211,Not in chargemaster,D9211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9211,BCBSMN Non-RVU base fee schedule,49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9212,Not in chargemaster,D9212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9212,BCBSMN Non-RVU base fee schedule,97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9215,Not in chargemaster,D9215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9215,BCBSMN Non-RVU base fee schedule,52.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9219,Not in chargemaster,D9219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9219,BCBSMN Non-RVU base fee schedule,93.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9222,Not in chargemaster,D9222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9222,BCBSMN Non-RVU base fee schedule,342,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9223,Not in chargemaster,D9223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9223,BCBSMN Non-RVU base fee schedule,311.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9230,Not in chargemaster,D9230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9230,BCBSMN Non-RVU base fee schedule,77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9239,Not in chargemaster,D9239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9239,BCBSMN Non-RVU base fee schedule,285,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9243,Not in chargemaster,D9243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9243,BCBSMN Non-RVU base fee schedule,259.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9248,Not in chargemaster,D9248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9248,BCBSMN Non-RVU base fee schedule,318,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9310,Not in chargemaster,D9310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9310,BCBSMN Non-RVU base fee schedule,122,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9311,Not in chargemaster,D9311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9311,BCBSMN Non-RVU base fee schedule,240.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9410,Not in chargemaster,D9410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9410,BCBSMN Non-RVU base fee schedule,274.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9420,Not in chargemaster,D9420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9420,BCBSMN Non-RVU base fee schedule,351.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9430,Not in chargemaster,D9430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9430,BCBSMN Non-RVU base fee schedule,68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9440,Not in chargemaster,D9440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9440,BCBSMN Non-RVU base fee schedule,183.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9450,Not in chargemaster,D9450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9450,BCBSMN Non-RVU base fee schedule,110.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9610,Not in chargemaster,D9610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9610,BCBSMN Non-RVU base fee schedule,74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9612,Not in chargemaster,D9612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9612,BCBSMN Non-RVU base fee schedule,164.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9613,Not in chargemaster,D9613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9613,BCBSMN Non-RVU base fee schedule,82.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9630,Not in chargemaster,D9630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9630,BCBSMN Non-RVU base fee schedule,57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9910,Not in chargemaster,D9910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9910,BCBSMN Non-RVU base fee schedule,54.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9911,Not in chargemaster,D9911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9911,BCBSMN Non-RVU base fee schedule,78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9920,Not in chargemaster,D9920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9920,BCBSMN Non-RVU base fee schedule,109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9930,Not in chargemaster,D9930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9930,BCBSMN Non-RVU base fee schedule,131,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9932,Not in chargemaster,D9932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9932,BCBSMN Non-RVU base fee schedule,129.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9933,Not in chargemaster,D9933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9933,BCBSMN Non-RVU base fee schedule,129.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9934,Not in chargemaster,D9934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9934,BCBSMN Non-RVU base fee schedule,129.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9935,Not in chargemaster,D9935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9935,BCBSMN Non-RVU base fee schedule,129.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9941,Not in chargemaster,D9941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9941,BCBSMN Non-RVU base fee schedule,190.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9942,Not in chargemaster,D9942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9942,BCBSMN Non-RVU base fee schedule,195.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9943,Not in chargemaster,D9943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9943,BCBSMN Non-RVU base fee schedule,82.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9944,Not in chargemaster,D9944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9944,BCBSMN Non-RVU base fee schedule,671.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9945,Not in chargemaster,D9945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9945,BCBSMN Non-RVU base fee schedule,343.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9946,Not in chargemaster,D9946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9946,BCBSMN Non-RVU base fee schedule,427.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9950,Not in chargemaster,D9950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9950,BCBSMN Non-RVU base fee schedule,313,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9951,Not in chargemaster,D9951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9951,BCBSMN Non-RVU base fee schedule,187.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9952,Not in chargemaster,D9952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9952,BCBSMN Non-RVU base fee schedule,881,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9961,Not in chargemaster,D9961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9961,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9970,Not in chargemaster,D9970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9970,BCBSMN Non-RVU base fee schedule,121.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9971,Not in chargemaster,D9971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9971,BCBSMN Non-RVU base fee schedule,154,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9972,Not in chargemaster,D9972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9972,BCBSMN Non-RVU base fee schedule,386.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9973,Not in chargemaster,D9973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9973,BCBSMN Non-RVU base fee schedule,119,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9974,Not in chargemaster,D9974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9974,BCBSMN Non-RVU base fee schedule,299,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9975,Not in chargemaster,D9975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9975,BCBSMN Non-RVU base fee schedule,237.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9990,Not in chargemaster,D9990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9990,BCBSMN Non-RVU base fee schedule,12.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9991,Not in chargemaster,D9991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9991,BCBSMN Non-RVU base fee schedule,69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9992,Not in chargemaster,D9992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9992,BCBSMN Non-RVU base fee schedule,69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9993,Not in chargemaster,D9993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9993,BCBSMN Non-RVU base fee schedule,69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9994,Not in chargemaster,D9994,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9994,BCBSMN Non-RVU base fee schedule,69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9995,Not in chargemaster,D9995,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9995,BCBSMN Non-RVU base fee schedule,44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU D9996,Not in chargemaster,D9996,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,D9996,BCBSMN Non-RVU base fee schedule,44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0100,Not in chargemaster,E0100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0100,BCBSMN Non-RVU base fee schedule,22.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0100 mod RR,Not in chargemaster,E0100,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0100 mod RR,BCBSMN Non-RVU base fee schedule,6.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0105,Not in chargemaster,E0105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0105,BCBSMN Non-RVU base fee schedule,49.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0105 mod RR,Not in chargemaster,E0105,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0105 mod RR,BCBSMN Non-RVU base fee schedule,9.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0110,Not in chargemaster,E0110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0110,BCBSMN Non-RVU base fee schedule,81.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0110 mod RR,Not in chargemaster,E0110,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0110 mod RR,BCBSMN Non-RVU base fee schedule,16.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0111,Not in chargemaster,E0111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0111,BCBSMN Non-RVU base fee schedule,50.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0111 mod RR,Not in chargemaster,E0111,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0111 mod RR,BCBSMN Non-RVU base fee schedule,8.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0112,Not in chargemaster,E0112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0112,BCBSMN Non-RVU base fee schedule,38.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0112 mod RR,Not in chargemaster,E0112,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0112 mod RR,BCBSMN Non-RVU base fee schedule,10.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0113,Not in chargemaster,E0113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0113,BCBSMN Non-RVU base fee schedule,22.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0113 mod RR,Not in chargemaster,E0113,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0113 mod RR,BCBSMN Non-RVU base fee schedule,4.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0114,Not in chargemaster,E0114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0114,BCBSMN Non-RVU base fee schedule,48.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0114 mod RR,Not in chargemaster,E0114,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0114 mod RR,BCBSMN Non-RVU base fee schedule,8.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0116,Not in chargemaster,E0116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0116,BCBSMN Non-RVU base fee schedule,26.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0116 mod RR,Not in chargemaster,E0116,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0116 mod RR,BCBSMN Non-RVU base fee schedule,5.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0117,Not in chargemaster,E0117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0117,BCBSMN Non-RVU base fee schedule,211.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0117 mod RR,Not in chargemaster,E0117,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0117 mod RR,BCBSMN Non-RVU base fee schedule,21.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0118,Not in chargemaster,E0118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0118,BCBSMN Non-RVU base fee schedule,480,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0118 mod RR,Not in chargemaster,E0118,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0118 mod RR,BCBSMN Non-RVU base fee schedule,48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0130,Not in chargemaster,E0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0130,BCBSMN Non-RVU base fee schedule,51.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0130 mod RR,Not in chargemaster,E0130,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0130 mod RR,BCBSMN Non-RVU base fee schedule,9.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0135,Not in chargemaster,E0135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0135,BCBSMN Non-RVU base fee schedule,58.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0135 mod RR,Not in chargemaster,E0135,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0135 mod RR,BCBSMN Non-RVU base fee schedule,9.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0140,Not in chargemaster,E0140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0140,BCBSMN Non-RVU base fee schedule,314.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0140 mod RR,Not in chargemaster,E0140,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0140 mod RR,BCBSMN Non-RVU base fee schedule,31.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0141,Not in chargemaster,E0141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0141,BCBSMN Non-RVU base fee schedule,70.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0141 mod RR,Not in chargemaster,E0141,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0141 mod RR,BCBSMN Non-RVU base fee schedule,12.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0143,Not in chargemaster,E0143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0143,BCBSMN Non-RVU base fee schedule,71.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0143 mod RR,Not in chargemaster,E0143,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0143 mod RR,BCBSMN Non-RVU base fee schedule,12.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0144,Not in chargemaster,E0144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0144,BCBSMN Non-RVU base fee schedule,279.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0144 mod RR,Not in chargemaster,E0144,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0144 mod RR,BCBSMN Non-RVU base fee schedule,27.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0147,Not in chargemaster,E0147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0147,BCBSMN Non-RVU base fee schedule,457.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0147 mod RR,Not in chargemaster,E0147,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0147 mod RR,BCBSMN Non-RVU base fee schedule,45.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0148,Not in chargemaster,E0148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0148,BCBSMN Non-RVU base fee schedule,97.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0148 mod RR,Not in chargemaster,E0148,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0148 mod RR,BCBSMN Non-RVU base fee schedule,9.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0149,Not in chargemaster,E0149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0149,BCBSMN Non-RVU base fee schedule,165.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0149 mod RR,Not in chargemaster,E0149,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0149 mod RR,BCBSMN Non-RVU base fee schedule,16.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0153,Not in chargemaster,E0153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0153,BCBSMN Non-RVU base fee schedule,65.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0153 mod RR,Not in chargemaster,E0153,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0153 mod RR,BCBSMN Non-RVU base fee schedule,8.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0154,Not in chargemaster,E0154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0154,BCBSMN Non-RVU base fee schedule,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0154 mod RR,Not in chargemaster,E0154,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0154 mod RR,BCBSMN Non-RVU base fee schedule,6.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0155,Not in chargemaster,E0155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0155,BCBSMN Non-RVU base fee schedule,24.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0155 mod RR,Not in chargemaster,E0155,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0155 mod RR,BCBSMN Non-RVU base fee schedule,2.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0156,Not in chargemaster,E0156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0156,BCBSMN Non-RVU base fee schedule,17.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0156 mod RR,Not in chargemaster,E0156,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0156 mod RR,BCBSMN Non-RVU base fee schedule,2.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0157,Not in chargemaster,E0157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0157,BCBSMN Non-RVU base fee schedule,62.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0157 mod RR,Not in chargemaster,E0157,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0157 mod RR,BCBSMN Non-RVU base fee schedule,6.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0158,Not in chargemaster,E0158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0158,BCBSMN Non-RVU base fee schedule,24.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0158 mod RR,Not in chargemaster,E0158,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0158 mod RR,BCBSMN Non-RVU base fee schedule,2.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0159,Not in chargemaster,E0159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0159,BCBSMN Non-RVU base fee schedule,15.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0159 mod RR,Not in chargemaster,E0159,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0159 mod RR,BCBSMN Non-RVU base fee schedule,1.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0160,Not in chargemaster,E0160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0160,BCBSMN Non-RVU base fee schedule,31.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0160 mod RR,Not in chargemaster,E0160,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0160 mod RR,BCBSMN Non-RVU base fee schedule,3.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0161,Not in chargemaster,E0161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0161,BCBSMN Non-RVU base fee schedule,25.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0161 mod RR,Not in chargemaster,E0161,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0161 mod RR,BCBSMN Non-RVU base fee schedule,3.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0162,Not in chargemaster,E0162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0162,BCBSMN Non-RVU base fee schedule,129.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0162 mod RR,Not in chargemaster,E0162,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0162 mod RR,BCBSMN Non-RVU base fee schedule,13.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0163,Not in chargemaster,E0163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0163,BCBSMN Non-RVU base fee schedule,74.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0163 mod RR,Not in chargemaster,E0163,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0163 mod RR,BCBSMN Non-RVU base fee schedule,15.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0165,Not in chargemaster,E0165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0165,BCBSMN Non-RVU base fee schedule,155.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0165 mod RR,Not in chargemaster,E0165,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0165 mod RR,BCBSMN Non-RVU base fee schedule,15.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0167,Not in chargemaster,E0167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0167,BCBSMN Non-RVU base fee schedule,11.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0167 mod RR,Not in chargemaster,E0167,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0167 mod RR,BCBSMN Non-RVU base fee schedule,1.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0168,Not in chargemaster,E0168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0168,BCBSMN Non-RVU base fee schedule,135.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0168 mod RR,Not in chargemaster,E0168,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0168 mod RR,BCBSMN Non-RVU base fee schedule,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0170,Not in chargemaster,E0170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0170,BCBSMN Non-RVU base fee schedule,1718.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0170 mod RR,Not in chargemaster,E0170,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0170 mod RR,BCBSMN Non-RVU base fee schedule,171.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0171,Not in chargemaster,E0171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0171,BCBSMN Non-RVU base fee schedule,315.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0171 mod RR,Not in chargemaster,E0171,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0171 mod RR,BCBSMN Non-RVU base fee schedule,31.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0172,Not in chargemaster,E0172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0172,BCBSMN Non-RVU base fee schedule,834.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0175,Not in chargemaster,E0175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0175,BCBSMN Non-RVU base fee schedule,58.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0175 mod RR,Not in chargemaster,E0175,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0175 mod RR,BCBSMN Non-RVU base fee schedule,5.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0181,Not in chargemaster,E0181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0181,BCBSMN Non-RVU base fee schedule,222.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0181 mod RR,Not in chargemaster,E0181,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0181 mod RR,BCBSMN Non-RVU base fee schedule,22.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0182,Not in chargemaster,E0182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0182,BCBSMN Non-RVU base fee schedule,250.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0182 mod RR,Not in chargemaster,E0182,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0182 mod RR,BCBSMN Non-RVU base fee schedule,25.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0184,Not in chargemaster,E0184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0184,BCBSMN Non-RVU base fee schedule,164.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0184 mod RR,Not in chargemaster,E0184,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0184 mod RR,BCBSMN Non-RVU base fee schedule,18.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0185,Not in chargemaster,E0185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0185,BCBSMN Non-RVU base fee schedule,249.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0185 mod RR,Not in chargemaster,E0185,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0185 mod RR,BCBSMN Non-RVU base fee schedule,31.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0186,Not in chargemaster,E0186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0186,BCBSMN Non-RVU base fee schedule,189.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0186 mod RR,Not in chargemaster,E0186,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0186 mod RR,BCBSMN Non-RVU base fee schedule,18.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0187,Not in chargemaster,E0187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0187,BCBSMN Non-RVU base fee schedule,216.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0187 mod RR,Not in chargemaster,E0187,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0187 mod RR,BCBSMN Non-RVU base fee schedule,21.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0188,Not in chargemaster,E0188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0188,BCBSMN Non-RVU base fee schedule,25.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0188 mod RR,Not in chargemaster,E0188,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0188 mod RR,BCBSMN Non-RVU base fee schedule,2.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0189,Not in chargemaster,E0189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0189,BCBSMN Non-RVU base fee schedule,51.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0189 mod RR,Not in chargemaster,E0189,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0189 mod RR,BCBSMN Non-RVU base fee schedule,5.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0190,Not in chargemaster,E0190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0190,BCBSMN Non-RVU base fee schedule,35.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0190 mod RR,Not in chargemaster,E0190,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0190 mod RR,BCBSMN Non-RVU base fee schedule,3.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0191,Not in chargemaster,E0191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0191,BCBSMN Non-RVU base fee schedule,9.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0191 mod RR,Not in chargemaster,E0191,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0191 mod RR,BCBSMN Non-RVU base fee schedule,0.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0193,Not in chargemaster,E0193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0193,BCBSMN Non-RVU base fee schedule,7667.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0193 mod RR,Not in chargemaster,E0193,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0193 mod RR,BCBSMN Non-RVU base fee schedule,766.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0194 mod RR,Not in chargemaster,E0194,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0194 mod RR,BCBSMN Non-RVU base fee schedule,3036.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0196,Not in chargemaster,E0196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0196,BCBSMN Non-RVU base fee schedule,303.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0196 mod RR,Not in chargemaster,E0196,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0196 mod RR,BCBSMN Non-RVU base fee schedule,30.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0197,Not in chargemaster,E0197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0197,BCBSMN Non-RVU base fee schedule,260.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0197 mod RR,Not in chargemaster,E0197,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0197 mod RR,BCBSMN Non-RVU base fee schedule,26.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0198,Not in chargemaster,E0198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0198,BCBSMN Non-RVU base fee schedule,243.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0198 mod RR,Not in chargemaster,E0198,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0198 mod RR,BCBSMN Non-RVU base fee schedule,24.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0199,Not in chargemaster,E0199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0199,BCBSMN Non-RVU base fee schedule,29.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0199 mod RR,Not in chargemaster,E0199,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0199 mod RR,BCBSMN Non-RVU base fee schedule,2.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0200,Not in chargemaster,E0200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0200,BCBSMN Non-RVU base fee schedule,70.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0200 mod RR,Not in chargemaster,E0200,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0200 mod RR,BCBSMN Non-RVU base fee schedule,9.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0202,Not in chargemaster,E0202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0202,BCBSMN Non-RVU base fee schedule,601.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0202 mod RR,Not in chargemaster,E0202,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0202 mod RR,BCBSMN Non-RVU base fee schedule,60.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0203,Not in chargemaster,E0203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0203,BCBSMN Non-RVU base fee schedule,240,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0203 mod RR,Not in chargemaster,E0203,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0203 mod RR,BCBSMN Non-RVU base fee schedule,24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0205,Not in chargemaster,E0205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0205,BCBSMN Non-RVU base fee schedule,181.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0205 mod RR,Not in chargemaster,E0205,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0205 mod RR,BCBSMN Non-RVU base fee schedule,20.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0210,Not in chargemaster,E0210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0210,BCBSMN Non-RVU base fee schedule,34.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0210 mod RR,Not in chargemaster,E0210,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0210 mod RR,BCBSMN Non-RVU base fee schedule,3.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0215,Not in chargemaster,E0215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0215,BCBSMN Non-RVU base fee schedule,62.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0215 mod RR,Not in chargemaster,E0215,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0215 mod RR,BCBSMN Non-RVU base fee schedule,6.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0217,Not in chargemaster,E0217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0217,BCBSMN Non-RVU base fee schedule,519.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0217 mod RR,Not in chargemaster,E0217,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0217 mod RR,BCBSMN Non-RVU base fee schedule,57.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0218,Not in chargemaster,E0218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0218,BCBSMN Non-RVU base fee schedule,189.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0218 mod RR,Not in chargemaster,E0218,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0218 mod RR,BCBSMN Non-RVU base fee schedule,18.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0221,Not in chargemaster,E0221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0221,BCBSMN Non-RVU base fee schedule,2113.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0221 mod RR,Not in chargemaster,E0221,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0221 mod RR,BCBSMN Non-RVU base fee schedule,211.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0225,Not in chargemaster,E0225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0225,BCBSMN Non-RVU base fee schedule,406.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0225 mod RR,Not in chargemaster,E0225,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0225 mod RR,BCBSMN Non-RVU base fee schedule,40.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0235,Not in chargemaster,E0235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0235,BCBSMN Non-RVU base fee schedule,189.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0235 mod RR,Not in chargemaster,E0235,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0235 mod RR,BCBSMN Non-RVU base fee schedule,18.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0236,Not in chargemaster,E0236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0236,BCBSMN Non-RVU base fee schedule,412.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0236 mod RR,Not in chargemaster,E0236,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0236 mod RR,BCBSMN Non-RVU base fee schedule,41.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0239,Not in chargemaster,E0239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0239,BCBSMN Non-RVU base fee schedule,399.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0239 mod RR,Not in chargemaster,E0239,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0239 mod RR,BCBSMN Non-RVU base fee schedule,39.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0240,Not in chargemaster,E0240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0240,BCBSMN Non-RVU base fee schedule,145.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0243,Not in chargemaster,E0243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0243,BCBSMN Non-RVU base fee schedule,27.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0243 mod RR,Not in chargemaster,E0243,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0243 mod RR,BCBSMN Non-RVU base fee schedule,2.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0244,Not in chargemaster,E0244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0244,BCBSMN Non-RVU base fee schedule,57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0245,Not in chargemaster,E0245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0245,BCBSMN Non-RVU base fee schedule,145.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0245 mod RR,Not in chargemaster,E0245,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0245 mod RR,BCBSMN Non-RVU base fee schedule,14.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0247,Not in chargemaster,E0247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0247,BCBSMN Non-RVU base fee schedule,32.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0247 mod RR,Not in chargemaster,E0247,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0247 mod RR,BCBSMN Non-RVU base fee schedule,3.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0248,Not in chargemaster,E0248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0248,BCBSMN Non-RVU base fee schedule,54.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0248 mod RR,Not in chargemaster,E0248,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0248 mod RR,BCBSMN Non-RVU base fee schedule,5.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0249,Not in chargemaster,E0249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0249,BCBSMN Non-RVU base fee schedule,88.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0249 mod RR,Not in chargemaster,E0249,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0249 mod RR,BCBSMN Non-RVU base fee schedule,9.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0250,Not in chargemaster,E0250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0250,BCBSMN Non-RVU base fee schedule,773.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0250 mod RR,Not in chargemaster,E0250,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0250 mod RR,BCBSMN Non-RVU base fee schedule,77.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0251,Not in chargemaster,E0251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0251,BCBSMN Non-RVU base fee schedule,643.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0251 mod RR,Not in chargemaster,E0251,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0251 mod RR,BCBSMN Non-RVU base fee schedule,64.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0255,Not in chargemaster,E0255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0255,BCBSMN Non-RVU base fee schedule,869.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0255 mod RR,Not in chargemaster,E0255,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0255 mod RR,BCBSMN Non-RVU base fee schedule,86.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0256,Not in chargemaster,E0256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0256,BCBSMN Non-RVU base fee schedule,664.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0256 mod RR,Not in chargemaster,E0256,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0256 mod RR,BCBSMN Non-RVU base fee schedule,66.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0260,Not in chargemaster,E0260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0260,BCBSMN Non-RVU base fee schedule,978.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0260 mod RR,Not in chargemaster,E0260,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0260 mod RR,BCBSMN Non-RVU base fee schedule,97.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0261,Not in chargemaster,E0261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0261,BCBSMN Non-RVU base fee schedule,864.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0261 mod RR,Not in chargemaster,E0261,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0261 mod RR,BCBSMN Non-RVU base fee schedule,86.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0265,Not in chargemaster,E0265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0265,BCBSMN Non-RVU base fee schedule,1504.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0265 mod RR,Not in chargemaster,E0265,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0265 mod RR,BCBSMN Non-RVU base fee schedule,150.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0266,Not in chargemaster,E0266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0266,BCBSMN Non-RVU base fee schedule,1440.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0266 mod RR,Not in chargemaster,E0266,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0266 mod RR,BCBSMN Non-RVU base fee schedule,144.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0271,Not in chargemaster,E0271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0271,BCBSMN Non-RVU base fee schedule,160.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0271 mod RR,Not in chargemaster,E0271,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0271 mod RR,BCBSMN Non-RVU base fee schedule,16.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0272,Not in chargemaster,E0272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0272,BCBSMN Non-RVU base fee schedule,159.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0272 mod RR,Not in chargemaster,E0272,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0272 mod RR,BCBSMN Non-RVU base fee schedule,16.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0274,Not in chargemaster,E0274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0274,BCBSMN Non-RVU base fee schedule,52.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0274 mod RR,Not in chargemaster,E0274,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0274 mod RR,BCBSMN Non-RVU base fee schedule,5.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0275,Not in chargemaster,E0275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0275,BCBSMN Non-RVU base fee schedule,13.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0275 mod RR,Not in chargemaster,E0275,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0275 mod RR,BCBSMN Non-RVU base fee schedule,1.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0276,Not in chargemaster,E0276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0276,BCBSMN Non-RVU base fee schedule,12.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0276 mod RR,Not in chargemaster,E0276,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0276 mod RR,BCBSMN Non-RVU base fee schedule,1.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0277,Not in chargemaster,E0277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0277,BCBSMN Non-RVU base fee schedule,4314.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0277 mod RR,Not in chargemaster,E0277,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0277 mod RR,BCBSMN Non-RVU base fee schedule,431.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0280,Not in chargemaster,E0280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0280,BCBSMN Non-RVU base fee schedule,29.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0280 mod RR,Not in chargemaster,E0280,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0280 mod RR,BCBSMN Non-RVU base fee schedule,3.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0290,Not in chargemaster,E0290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0290,BCBSMN Non-RVU base fee schedule,592.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0290 mod RR,Not in chargemaster,E0290,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0290 mod RR,BCBSMN Non-RVU base fee schedule,59.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0291,Not in chargemaster,E0291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0291,BCBSMN Non-RVU base fee schedule,484.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0291 mod RR,Not in chargemaster,E0291,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0291 mod RR,BCBSMN Non-RVU base fee schedule,48.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0292,Not in chargemaster,E0292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0292,BCBSMN Non-RVU base fee schedule,668.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0292 mod RR,Not in chargemaster,E0292,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0292 mod RR,BCBSMN Non-RVU base fee schedule,66.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0293,Not in chargemaster,E0293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0293,BCBSMN Non-RVU base fee schedule,575.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0293 mod RR,Not in chargemaster,E0293,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0293 mod RR,BCBSMN Non-RVU base fee schedule,57.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0294,Not in chargemaster,E0294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0294,BCBSMN Non-RVU base fee schedule,854.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0294 mod RR,Not in chargemaster,E0294,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0294 mod RR,BCBSMN Non-RVU base fee schedule,85.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0295,Not in chargemaster,E0295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0295,BCBSMN Non-RVU base fee schedule,825.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0295 mod RR,Not in chargemaster,E0295,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0295 mod RR,BCBSMN Non-RVU base fee schedule,82.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0296,Not in chargemaster,E0296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0296,BCBSMN Non-RVU base fee schedule,1198.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0296 mod RR,Not in chargemaster,E0296,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0296 mod RR,BCBSMN Non-RVU base fee schedule,119.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0297,Not in chargemaster,E0297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0297,BCBSMN Non-RVU base fee schedule,1097.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0297 mod RR,Not in chargemaster,E0297,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0297 mod RR,BCBSMN Non-RVU base fee schedule,109.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0300,Not in chargemaster,E0300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0300,BCBSMN Non-RVU base fee schedule,2542.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0300 mod RR,Not in chargemaster,E0300,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0300 mod RR,BCBSMN Non-RVU base fee schedule,254.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0301,Not in chargemaster,E0301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0301,BCBSMN Non-RVU base fee schedule,2104.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0301 mod RR,Not in chargemaster,E0301,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0301 mod RR,BCBSMN Non-RVU base fee schedule,210.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0302,Not in chargemaster,E0302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0302,BCBSMN Non-RVU base fee schedule,5794.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0302 mod RR,Not in chargemaster,E0302,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0302 mod RR,BCBSMN Non-RVU base fee schedule,579.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0303,Not in chargemaster,E0303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0303,BCBSMN Non-RVU base fee schedule,2273.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0303 mod RR,Not in chargemaster,E0303,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0303 mod RR,BCBSMN Non-RVU base fee schedule,227.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0304,Not in chargemaster,E0304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0304,BCBSMN Non-RVU base fee schedule,6122.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0304 mod RR,Not in chargemaster,E0304,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0304 mod RR,BCBSMN Non-RVU base fee schedule,612.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0305,Not in chargemaster,E0305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0305,BCBSMN Non-RVU base fee schedule,138.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0305 mod RR,Not in chargemaster,E0305,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0305 mod RR,BCBSMN Non-RVU base fee schedule,13.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0310,Not in chargemaster,E0310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0310,BCBSMN Non-RVU base fee schedule,142.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0310 mod RR,Not in chargemaster,E0310,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0310 mod RR,BCBSMN Non-RVU base fee schedule,15.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0316,Not in chargemaster,E0316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0316,BCBSMN Non-RVU base fee schedule,1999.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0316 mod RR,Not in chargemaster,E0316,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0316 mod RR,BCBSMN Non-RVU base fee schedule,199.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0325,Not in chargemaster,E0325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0325,BCBSMN Non-RVU base fee schedule,9.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0325 mod RR,Not in chargemaster,E0325,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0325 mod RR,BCBSMN Non-RVU base fee schedule,1.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0326,Not in chargemaster,E0326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0326,BCBSMN Non-RVU base fee schedule,9.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0326 mod RR,Not in chargemaster,E0326,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0326 mod RR,BCBSMN Non-RVU base fee schedule,1.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0328,Not in chargemaster,E0328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0328,BCBSMN Non-RVU base fee schedule,6104.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0328 mod RR,Not in chargemaster,E0328,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0328 mod RR,BCBSMN Non-RVU base fee schedule,610.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0329,Not in chargemaster,E0329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0329,BCBSMN Non-RVU base fee schedule,1474.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0329 mod RR,Not in chargemaster,E0329,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0329 mod RR,BCBSMN Non-RVU base fee schedule,147.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0370,Not in chargemaster,E0370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0370,BCBSMN Non-RVU base fee schedule,21.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0371,Not in chargemaster,E0371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0371,BCBSMN Non-RVU base fee schedule,3087.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0371 mod RR,Not in chargemaster,E0371,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0371 mod RR,BCBSMN Non-RVU base fee schedule,308.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0372,Not in chargemaster,E0372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0372,BCBSMN Non-RVU base fee schedule,3537.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0372 mod RR,Not in chargemaster,E0372,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0372 mod RR,BCBSMN Non-RVU base fee schedule,353.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0373,Not in chargemaster,E0373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0373,BCBSMN Non-RVU base fee schedule,3893.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0373 mod RR,Not in chargemaster,E0373,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0373 mod RR,BCBSMN Non-RVU base fee schedule,389.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0424 mod RR,Not in chargemaster,E0424,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0424 mod RR,BCBSMN Non-RVU base fee schedule,123.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0425,Not in chargemaster,E0425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0425,BCBSMN Non-RVU base fee schedule,2982.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0430,Not in chargemaster,E0430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0430,BCBSMN Non-RVU base fee schedule,6.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0431 mod RR,Not in chargemaster,E0431,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0431 mod RR,BCBSMN Non-RVU base fee schedule,21.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0433 mod RR,Not in chargemaster,E0433,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0433 mod RR,BCBSMN Non-RVU base fee schedule,40.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0434 mod RR,Not in chargemaster,E0434,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0434 mod RR,BCBSMN Non-RVU base fee schedule,40.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0435,Not in chargemaster,E0435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0435,BCBSMN Non-RVU base fee schedule,515.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0439 mod RR,Not in chargemaster,E0439,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0439 mod RR,BCBSMN Non-RVU base fee schedule,123.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0440,Not in chargemaster,E0440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0440,BCBSMN Non-RVU base fee schedule,2982.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0441,Not in chargemaster,E0441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0441,BCBSMN Non-RVU base fee schedule,58.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0442,Not in chargemaster,E0442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0442,BCBSMN Non-RVU base fee schedule,58.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0443,Not in chargemaster,E0443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0443,BCBSMN Non-RVU base fee schedule,56.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0444,Not in chargemaster,E0444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0444,BCBSMN Non-RVU base fee schedule,56.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0445 mod RR,Not in chargemaster,E0445,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0445 mod RR,BCBSMN Non-RVU base fee schedule,280,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0447,Not in chargemaster,E0447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0447,BCBSMN Non-RVU base fee schedule,84.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0455,Not in chargemaster,E0455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0455,BCBSMN Non-RVU base fee schedule,125.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0455 mod RR,Not in chargemaster,E0455,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0455 mod RR,BCBSMN Non-RVU base fee schedule,12.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0457,Not in chargemaster,E0457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0457,BCBSMN Non-RVU base fee schedule,565.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0457 mod RR,Not in chargemaster,E0457,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0457 mod RR,BCBSMN Non-RVU base fee schedule,56.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0459,Not in chargemaster,E0459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0459,BCBSMN Non-RVU base fee schedule,468.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0459 mod RR,Not in chargemaster,E0459,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0459 mod RR,BCBSMN Non-RVU base fee schedule,46.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0462,Not in chargemaster,E0462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0462,BCBSMN Non-RVU base fee schedule,2803.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0462 mod RR,Not in chargemaster,E0462,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0462 mod RR,BCBSMN Non-RVU base fee schedule,280.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0465 mod RR,Not in chargemaster,E0465,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0465 mod RR,BCBSMN Non-RVU base fee schedule,998.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0466 mod RR,Not in chargemaster,E0466,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0466 mod RR,BCBSMN Non-RVU base fee schedule,998.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0467 mod RR,Not in chargemaster,E0467,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0467 mod RR,BCBSMN Non-RVU base fee schedule,1173.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0470,Not in chargemaster,E0470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0470,BCBSMN Non-RVU base fee schedule,1130.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0470 mod RR,Not in chargemaster,E0470,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0470 mod RR,BCBSMN Non-RVU base fee schedule,113.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0471,Not in chargemaster,E0471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0471,BCBSMN Non-RVU base fee schedule,2811.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0471 mod RR,Not in chargemaster,E0471,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0471 mod RR,BCBSMN Non-RVU base fee schedule,281.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0472 mod RR,Not in chargemaster,E0472,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0472 mod RR,BCBSMN Non-RVU base fee schedule,452.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0480,Not in chargemaster,E0480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0480,BCBSMN Non-RVU base fee schedule,410.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0480 mod RR,Not in chargemaster,E0480,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0480 mod RR,BCBSMN Non-RVU base fee schedule,41.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0482,Not in chargemaster,E0482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0482,BCBSMN Non-RVU base fee schedule,4721.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0482 mod RR,Not in chargemaster,E0482,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0482 mod RR,BCBSMN Non-RVU base fee schedule,472.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0483,Not in chargemaster,E0483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0483,BCBSMN Non-RVU base fee schedule,11671.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0483 mod RR,Not in chargemaster,E0483,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0483 mod RR,BCBSMN Non-RVU base fee schedule,1167.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0484,Not in chargemaster,E0484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0484,BCBSMN Non-RVU base fee schedule,38.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0484 mod RR,Not in chargemaster,E0484,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0484 mod RR,BCBSMN Non-RVU base fee schedule,3.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0485,Not in chargemaster,E0485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0485,BCBSMN Non-RVU base fee schedule,323.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0486,Not in chargemaster,E0486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0486,BCBSMN Non-RVU base fee schedule,1273.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0500 mod RR,Not in chargemaster,E0500,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0500 mod RR,BCBSMN Non-RVU base fee schedule,99.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0550,Not in chargemaster,E0550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0550,BCBSMN Non-RVU base fee schedule,550.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0550 mod RR,Not in chargemaster,E0550,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0550 mod RR,BCBSMN Non-RVU base fee schedule,55.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0555,Not in chargemaster,E0555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0555,BCBSMN Non-RVU base fee schedule,61.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0555 mod RR,Not in chargemaster,E0555,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0555 mod RR,BCBSMN Non-RVU base fee schedule,6.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0560,Not in chargemaster,E0560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0560,BCBSMN Non-RVU base fee schedule,154.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0560 mod RR,Not in chargemaster,E0560,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0560 mod RR,BCBSMN Non-RVU base fee schedule,18.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0561,Not in chargemaster,E0561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0561,BCBSMN Non-RVU base fee schedule,69.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0561 mod RR,Not in chargemaster,E0561,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0561 mod RR,BCBSMN Non-RVU base fee schedule,6.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0562,Not in chargemaster,E0562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0562,BCBSMN Non-RVU base fee schedule,135.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0562 mod RR,Not in chargemaster,E0562,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0562 mod RR,BCBSMN Non-RVU base fee schedule,13.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0565,Not in chargemaster,E0565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0565,BCBSMN Non-RVU base fee schedule,531.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0565 mod RR,Not in chargemaster,E0565,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0565 mod RR,BCBSMN Non-RVU base fee schedule,53.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0570,Not in chargemaster,E0570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0570,BCBSMN Non-RVU base fee schedule,118.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0570 mod RR,Not in chargemaster,E0570,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0570 mod RR,BCBSMN Non-RVU base fee schedule,11.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0572,Not in chargemaster,E0572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0572,BCBSMN Non-RVU base fee schedule,356.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0572 mod RR,Not in chargemaster,E0572,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0572 mod RR,BCBSMN Non-RVU base fee schedule,35.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0574,Not in chargemaster,E0574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0574,BCBSMN Non-RVU base fee schedule,442,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0574 mod RR,Not in chargemaster,E0574,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0574 mod RR,BCBSMN Non-RVU base fee schedule,44.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0575,Not in chargemaster,E0575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0575,BCBSMN Non-RVU base fee schedule,1023.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0575 mod RR,Not in chargemaster,E0575,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0575 mod RR,BCBSMN Non-RVU base fee schedule,102.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0580,Not in chargemaster,E0580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0580,BCBSMN Non-RVU base fee schedule,120.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0580 mod RR,Not in chargemaster,E0580,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0580 mod RR,BCBSMN Non-RVU base fee schedule,12.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0585,Not in chargemaster,E0585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0585,BCBSMN Non-RVU base fee schedule,338.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0585 mod RR,Not in chargemaster,E0585,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0585 mod RR,BCBSMN Non-RVU base fee schedule,33.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0600,Not in chargemaster,E0600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0600,BCBSMN Non-RVU base fee schedule,502.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0600 mod RR,Not in chargemaster,E0600,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0600 mod RR,BCBSMN Non-RVU base fee schedule,50.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0601,Not in chargemaster,E0601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0601,BCBSMN Non-RVU base fee schedule,422.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0601 mod RR,Not in chargemaster,E0601,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0601 mod RR,BCBSMN Non-RVU base fee schedule,42.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0602,Not in chargemaster,E0602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0602,BCBSMN Non-RVU base fee schedule,30.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0602 mod RR,Not in chargemaster,E0602,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0602 mod RR,BCBSMN Non-RVU base fee schedule,3.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0603,Not in chargemaster,E0603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0603,BCBSMN Non-RVU base fee schedule,256.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0603 mod RR,Not in chargemaster,E0603,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0603 mod RR,BCBSMN Non-RVU base fee schedule,25.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0604 mod RR,Not in chargemaster,E0604,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0604 mod RR,BCBSMN Non-RVU base fee schedule,51.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0605,Not in chargemaster,E0605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0605,BCBSMN Non-RVU base fee schedule,27.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0605 mod RR,Not in chargemaster,E0605,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0605 mod RR,BCBSMN Non-RVU base fee schedule,2.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0606,Not in chargemaster,E0606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0606,BCBSMN Non-RVU base fee schedule,252.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0606 mod RR,Not in chargemaster,E0606,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0606 mod RR,BCBSMN Non-RVU base fee schedule,25.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0607,Not in chargemaster,E0607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0607,BCBSMN Non-RVU base fee schedule,69.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0607 mod RR,Not in chargemaster,E0607,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0607 mod RR,BCBSMN Non-RVU base fee schedule,6.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0610,Not in chargemaster,E0610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0610,BCBSMN Non-RVU base fee schedule,248.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0610 mod RR,Not in chargemaster,E0610,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0610 mod RR,BCBSMN Non-RVU base fee schedule,26.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0615,Not in chargemaster,E0615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0615,BCBSMN Non-RVU base fee schedule,440.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0615 mod RR,Not in chargemaster,E0615,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0615 mod RR,BCBSMN Non-RVU base fee schedule,51.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0616,Not in chargemaster,E0616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0616,BCBSMN Non-RVU base fee schedule,3628.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0617,Not in chargemaster,E0617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0617,BCBSMN Non-RVU base fee schedule,3337.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0617 mod RR,Not in chargemaster,E0617,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0617 mod RR,BCBSMN Non-RVU base fee schedule,333.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0618,Not in chargemaster,E0618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0618,BCBSMN Non-RVU base fee schedule,3078.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0618 mod RR,Not in chargemaster,E0618,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0618 mod RR,BCBSMN Non-RVU base fee schedule,307.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0619,Not in chargemaster,E0619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0619,BCBSMN Non-RVU base fee schedule,2856.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0619 mod RR,Not in chargemaster,E0619,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0619 mod RR,BCBSMN Non-RVU base fee schedule,285.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0620,Not in chargemaster,E0620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0620,BCBSMN Non-RVU base fee schedule,959.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0620 mod RR,Not in chargemaster,E0620,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0620 mod RR,BCBSMN Non-RVU base fee schedule,95.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0621,Not in chargemaster,E0621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0621,BCBSMN Non-RVU base fee schedule,87.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0621 mod RR,Not in chargemaster,E0621,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0621 mod RR,BCBSMN Non-RVU base fee schedule,8.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0625,Not in chargemaster,E0625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0625,BCBSMN Non-RVU base fee schedule,498.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0625 mod RR,Not in chargemaster,E0625,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0625 mod RR,BCBSMN Non-RVU base fee schedule,49.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0627,Not in chargemaster,E0627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0627,BCBSMN Non-RVU base fee schedule,304.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0627 mod RR,Not in chargemaster,E0627,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0627 mod RR,BCBSMN Non-RVU base fee schedule,30.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0629,Not in chargemaster,E0629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0629,BCBSMN Non-RVU base fee schedule,299.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0629 mod RR,Not in chargemaster,E0629,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0629 mod RR,BCBSMN Non-RVU base fee schedule,29.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0630,Not in chargemaster,E0630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0630,BCBSMN Non-RVU base fee schedule,784.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0630 mod RR,Not in chargemaster,E0630,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0630 mod RR,BCBSMN Non-RVU base fee schedule,78.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0635,Not in chargemaster,E0635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0635,BCBSMN Non-RVU base fee schedule,1141.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0635 mod RR,Not in chargemaster,E0635,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0635 mod RR,BCBSMN Non-RVU base fee schedule,114.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0636,Not in chargemaster,E0636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0636,BCBSMN Non-RVU base fee schedule,10848.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0636 mod RR,Not in chargemaster,E0636,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0636 mod RR,BCBSMN Non-RVU base fee schedule,1084.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0637,Not in chargemaster,E0637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0637,BCBSMN Non-RVU base fee schedule,2104.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0637 mod RR,Not in chargemaster,E0637,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0637 mod RR,BCBSMN Non-RVU base fee schedule,210.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0638,Not in chargemaster,E0638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0638,BCBSMN Non-RVU base fee schedule,1375,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0638 mod RR,Not in chargemaster,E0638,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0638 mod RR,BCBSMN Non-RVU base fee schedule,137.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0639,Not in chargemaster,E0639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0639,BCBSMN Non-RVU base fee schedule,1041.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0639 mod RR,Not in chargemaster,E0639,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0639 mod RR,BCBSMN Non-RVU base fee schedule,104.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0640,Not in chargemaster,E0640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0640,BCBSMN Non-RVU base fee schedule,1041.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0640 mod RR,Not in chargemaster,E0640,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0640 mod RR,BCBSMN Non-RVU base fee schedule,104.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0641,Not in chargemaster,E0641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0641,BCBSMN Non-RVU base fee schedule,870.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0641 mod RR,Not in chargemaster,E0641,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0641 mod RR,BCBSMN Non-RVU base fee schedule,87.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0642,Not in chargemaster,E0642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0642,BCBSMN Non-RVU base fee schedule,853.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0642 mod RR,Not in chargemaster,E0642,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0642 mod RR,BCBSMN Non-RVU base fee schedule,85.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0650,Not in chargemaster,E0650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0650,BCBSMN Non-RVU base fee schedule,753.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0650 mod RR,Not in chargemaster,E0650,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0650 mod RR,BCBSMN Non-RVU base fee schedule,80.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0651,Not in chargemaster,E0651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0651,BCBSMN Non-RVU base fee schedule,867.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0651 mod RR,Not in chargemaster,E0651,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0651 mod RR,BCBSMN Non-RVU base fee schedule,87.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0652,Not in chargemaster,E0652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0652,BCBSMN Non-RVU base fee schedule,4711.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0652 mod RR,Not in chargemaster,E0652,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0652 mod RR,BCBSMN Non-RVU base fee schedule,465.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0655,Not in chargemaster,E0655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0655,BCBSMN Non-RVU base fee schedule,108.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0655 mod RR,Not in chargemaster,E0655,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0655 mod RR,BCBSMN Non-RVU base fee schedule,11.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0656,Not in chargemaster,E0656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0656,BCBSMN Non-RVU base fee schedule,634.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0656 mod RR,Not in chargemaster,E0656,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0656 mod RR,BCBSMN Non-RVU base fee schedule,63.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0657,Not in chargemaster,E0657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0657,BCBSMN Non-RVU base fee schedule,595.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0657 mod RR,Not in chargemaster,E0657,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0657 mod RR,BCBSMN Non-RVU base fee schedule,59.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0660,Not in chargemaster,E0660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0660,BCBSMN Non-RVU base fee schedule,149.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0660 mod RR,Not in chargemaster,E0660,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0660 mod RR,BCBSMN Non-RVU base fee schedule,15.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0665,Not in chargemaster,E0665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0665,BCBSMN Non-RVU base fee schedule,135.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0665 mod RR,Not in chargemaster,E0665,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0665 mod RR,BCBSMN Non-RVU base fee schedule,13.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0666,Not in chargemaster,E0666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0666,BCBSMN Non-RVU base fee schedule,127.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0666 mod RR,Not in chargemaster,E0666,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0666 mod RR,BCBSMN Non-RVU base fee schedule,12.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0667,Not in chargemaster,E0667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0667,BCBSMN Non-RVU base fee schedule,287.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0667 mod RR,Not in chargemaster,E0667,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0667 mod RR,BCBSMN Non-RVU base fee schedule,32.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0668,Not in chargemaster,E0668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0668,BCBSMN Non-RVU base fee schedule,392.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0668 mod RR,Not in chargemaster,E0668,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0668 mod RR,BCBSMN Non-RVU base fee schedule,38.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0669,Not in chargemaster,E0669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0669,BCBSMN Non-RVU base fee schedule,191.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0669 mod RR,Not in chargemaster,E0669,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0669 mod RR,BCBSMN Non-RVU base fee schedule,19.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0670,Not in chargemaster,E0670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0670,BCBSMN Non-RVU base fee schedule,1117.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0670 mod RR,Not in chargemaster,E0670,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0670 mod RR,BCBSMN Non-RVU base fee schedule,119.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0671,Not in chargemaster,E0671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0671,BCBSMN Non-RVU base fee schedule,434.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0671 mod RR,Not in chargemaster,E0671,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0671 mod RR,BCBSMN Non-RVU base fee schedule,43.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0672,Not in chargemaster,E0672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0672,BCBSMN Non-RVU base fee schedule,337.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0672 mod RR,Not in chargemaster,E0672,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0672 mod RR,BCBSMN Non-RVU base fee schedule,33.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0673,Not in chargemaster,E0673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0673,BCBSMN Non-RVU base fee schedule,280.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0673 mod RR,Not in chargemaster,E0673,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0673 mod RR,BCBSMN Non-RVU base fee schedule,28.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0675,Not in chargemaster,E0675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0675,BCBSMN Non-RVU base fee schedule,4221.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0675 mod RR,Not in chargemaster,E0675,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0675 mod RR,BCBSMN Non-RVU base fee schedule,422.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0691,Not in chargemaster,E0691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0691,BCBSMN Non-RVU base fee schedule,939.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0691 mod RR,Not in chargemaster,E0691,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0691 mod RR,BCBSMN Non-RVU base fee schedule,93.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0692,Not in chargemaster,E0692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0692,BCBSMN Non-RVU base fee schedule,1179.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0692 mod RR,Not in chargemaster,E0692,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0692 mod RR,BCBSMN Non-RVU base fee schedule,117.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0693,Not in chargemaster,E0693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0693,BCBSMN Non-RVU base fee schedule,1454.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0693 mod RR,Not in chargemaster,E0693,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0693 mod RR,BCBSMN Non-RVU base fee schedule,145.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0694,Not in chargemaster,E0694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0694,BCBSMN Non-RVU base fee schedule,4629.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0694 mod RR,Not in chargemaster,E0694,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0694 mod RR,BCBSMN Non-RVU base fee schedule,462.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0700,Not in chargemaster,E0700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0700,BCBSMN Non-RVU base fee schedule,13.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0705,Not in chargemaster,E0705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0705,BCBSMN Non-RVU base fee schedule,47.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0705 mod RR,Not in chargemaster,E0705,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0705 mod RR,BCBSMN Non-RVU base fee schedule,4.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0710,Not in chargemaster,E0710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0710,BCBSMN Non-RVU base fee schedule,15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0720,Not in chargemaster,E0720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0720,BCBSMN Non-RVU base fee schedule,198.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0720 mod RR,Not in chargemaster,E0720,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0720 mod RR,BCBSMN Non-RVU base fee schedule,19.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0730,Not in chargemaster,E0730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0730,BCBSMN Non-RVU base fee schedule,219.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0730 mod RR,Not in chargemaster,E0730,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0730 mod RR,BCBSMN Non-RVU base fee schedule,21.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0731,Not in chargemaster,E0731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0731,BCBSMN Non-RVU base fee schedule,199.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0740,Not in chargemaster,E0740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0740,BCBSMN Non-RVU base fee schedule,574.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0740 mod RR,Not in chargemaster,E0740,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0740 mod RR,BCBSMN Non-RVU base fee schedule,57.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0744,Not in chargemaster,E0744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0744,BCBSMN Non-RVU base fee schedule,903.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0744 mod RR,Not in chargemaster,E0744,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0744 mod RR,BCBSMN Non-RVU base fee schedule,90.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0745,Not in chargemaster,E0745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0745,BCBSMN Non-RVU base fee schedule,982.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0745 mod RR,Not in chargemaster,E0745,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0745 mod RR,BCBSMN Non-RVU base fee schedule,98.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0746,Not in chargemaster,E0746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0746,BCBSMN Non-RVU base fee schedule,60.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0746 mod RR,Not in chargemaster,E0746,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0746 mod RR,BCBSMN Non-RVU base fee schedule,6.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0747,Not in chargemaster,E0747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0747,BCBSMN Non-RVU base fee schedule,3973.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0747 mod RR,Not in chargemaster,E0747,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0747 mod RR,BCBSMN Non-RVU base fee schedule,397.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0748,Not in chargemaster,E0748,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0748,BCBSMN Non-RVU base fee schedule,4068,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0748 mod RR,Not in chargemaster,E0748,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0748 mod RR,BCBSMN Non-RVU base fee schedule,406.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0749,Not in chargemaster,E0749,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0749,BCBSMN Non-RVU base fee schedule,3005.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0749 mod RR,Not in chargemaster,E0749,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0749 mod RR,BCBSMN Non-RVU base fee schedule,300.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0760,Not in chargemaster,E0760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0760,BCBSMN Non-RVU base fee schedule,3380.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0760 mod RR,Not in chargemaster,E0760,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0760 mod RR,BCBSMN Non-RVU base fee schedule,338.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0761,Not in chargemaster,E0761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0761,BCBSMN Non-RVU base fee schedule,4299.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0761 mod RR,Not in chargemaster,E0761,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0761 mod RR,BCBSMN Non-RVU base fee schedule,429.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0762,Not in chargemaster,E0762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0762,BCBSMN Non-RVU base fee schedule,1026.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0762 mod RR,Not in chargemaster,E0762,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0762 mod RR,BCBSMN Non-RVU base fee schedule,102.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0764,Not in chargemaster,E0764,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0764,BCBSMN Non-RVU base fee schedule,12149.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0764 mod RR,Not in chargemaster,E0764,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0764 mod RR,BCBSMN Non-RVU base fee schedule,1214.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0765,Not in chargemaster,E0765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0765,BCBSMN Non-RVU base fee schedule,87.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0765 mod RR,Not in chargemaster,E0765,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0765 mod RR,BCBSMN Non-RVU base fee schedule,8.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0766,Not in chargemaster,E0766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0766,BCBSMN Non-RVU base fee schedule,120208.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0766 mod RR,Not in chargemaster,E0766,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0766 mod RR,BCBSMN Non-RVU base fee schedule,12020.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0770,Not in chargemaster,E0770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0770,BCBSMN Non-RVU base fee schedule,2518.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0770 mod RR,Not in chargemaster,E0770,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0770 mod RR,BCBSMN Non-RVU base fee schedule,251.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0776,Not in chargemaster,E0776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0776,BCBSMN Non-RVU base fee schedule,127.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0776 mod RR,Not in chargemaster,E0776,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0776 mod RR,BCBSMN Non-RVU base fee schedule,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0779,Not in chargemaster,E0779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0779,BCBSMN Non-RVU base fee schedule,181.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0779 mod RR,Not in chargemaster,E0779,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0779 mod RR,BCBSMN Non-RVU base fee schedule,18.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0780,Not in chargemaster,E0780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0780,BCBSMN Non-RVU base fee schedule,10.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0780 mod RR,Not in chargemaster,E0780,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0780 mod RR,BCBSMN Non-RVU base fee schedule,1.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0781,Not in chargemaster,E0781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0781,BCBSMN Non-RVU base fee schedule,2617.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0781 mod RR,Not in chargemaster,E0781,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0781 mod RR,BCBSMN Non-RVU base fee schedule,261.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0782,Not in chargemaster,E0782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0782,BCBSMN Non-RVU base fee schedule,3815.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0782 mod RR,Not in chargemaster,E0782,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0782 mod RR,BCBSMN Non-RVU base fee schedule,381.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0783,Not in chargemaster,E0783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0783,BCBSMN Non-RVU base fee schedule,8559.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0783 mod RR,Not in chargemaster,E0783,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0783 mod RR,BCBSMN Non-RVU base fee schedule,856.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0784,Not in chargemaster,E0784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0784,BCBSMN Non-RVU base fee schedule,4390.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0784 mod RR,Not in chargemaster,E0784,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0784 mod RR,BCBSMN Non-RVU base fee schedule,439.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0785,Not in chargemaster,E0785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0785,BCBSMN Non-RVU base fee schedule,494.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0786,Not in chargemaster,E0786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0786,BCBSMN Non-RVU base fee schedule,8048.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0786 mod RR,Not in chargemaster,E0786,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0786 mod RR,BCBSMN Non-RVU base fee schedule,804.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0791,Not in chargemaster,E0791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0791,BCBSMN Non-RVU base fee schedule,2858.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0791 mod RR,Not in chargemaster,E0791,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0791 mod RR,BCBSMN Non-RVU base fee schedule,285.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0830,Not in chargemaster,E0830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0830,BCBSMN Non-RVU base fee schedule,571.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0830 mod RR,Not in chargemaster,E0830,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0830 mod RR,BCBSMN Non-RVU base fee schedule,57.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0840,Not in chargemaster,E0840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0840,BCBSMN Non-RVU base fee schedule,76.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0840 mod RR,Not in chargemaster,E0840,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0840 mod RR,BCBSMN Non-RVU base fee schedule,17.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0849,Not in chargemaster,E0849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0849,BCBSMN Non-RVU base fee schedule,565.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0849 mod RR,Not in chargemaster,E0849,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0849 mod RR,BCBSMN Non-RVU base fee schedule,56.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0850,Not in chargemaster,E0850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0850,BCBSMN Non-RVU base fee schedule,109.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0850 mod RR,Not in chargemaster,E0850,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0850 mod RR,BCBSMN Non-RVU base fee schedule,15.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0855,Not in chargemaster,E0855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0855,BCBSMN Non-RVU base fee schedule,551.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0855 mod RR,Not in chargemaster,E0855,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0855 mod RR,BCBSMN Non-RVU base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0856,Not in chargemaster,E0856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0856,BCBSMN Non-RVU base fee schedule,168.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0856 mod RR,Not in chargemaster,E0856,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0856 mod RR,BCBSMN Non-RVU base fee schedule,16.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0860,Not in chargemaster,E0860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0860,BCBSMN Non-RVU base fee schedule,35.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0860 mod RR,Not in chargemaster,E0860,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0860 mod RR,BCBSMN Non-RVU base fee schedule,6.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0870,Not in chargemaster,E0870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0870,BCBSMN Non-RVU base fee schedule,110.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0870 mod RR,Not in chargemaster,E0870,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0870 mod RR,BCBSMN Non-RVU base fee schedule,14.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0880,Not in chargemaster,E0880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0880,BCBSMN Non-RVU base fee schedule,113.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0880 mod RR,Not in chargemaster,E0880,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0880 mod RR,BCBSMN Non-RVU base fee schedule,20.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0890,Not in chargemaster,E0890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0890,BCBSMN Non-RVU base fee schedule,124.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0890 mod RR,Not in chargemaster,E0890,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0890 mod RR,BCBSMN Non-RVU base fee schedule,30.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0900,Not in chargemaster,E0900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0900,BCBSMN Non-RVU base fee schedule,133.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0900 mod RR,Not in chargemaster,E0900,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0900 mod RR,BCBSMN Non-RVU base fee schedule,28.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0910,Not in chargemaster,E0910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0910,BCBSMN Non-RVU base fee schedule,137.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0910 mod RR,Not in chargemaster,E0910,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0910 mod RR,BCBSMN Non-RVU base fee schedule,13.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0911,Not in chargemaster,E0911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0911,BCBSMN Non-RVU base fee schedule,451.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0911 mod RR,Not in chargemaster,E0911,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0911 mod RR,BCBSMN Non-RVU base fee schedule,45.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0912,Not in chargemaster,E0912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0912,BCBSMN Non-RVU base fee schedule,959.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0912 mod RR,Not in chargemaster,E0912,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0912 mod RR,BCBSMN Non-RVU base fee schedule,95.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0920,Not in chargemaster,E0920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0920,BCBSMN Non-RVU base fee schedule,456.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0920 mod RR,Not in chargemaster,E0920,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0920 mod RR,BCBSMN Non-RVU base fee schedule,45.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0930,Not in chargemaster,E0930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0930,BCBSMN Non-RVU base fee schedule,448.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0930 mod RR,Not in chargemaster,E0930,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0930 mod RR,BCBSMN Non-RVU base fee schedule,44.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0935 mod RR,Not in chargemaster,E0935,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0935 mod RR,BCBSMN Non-RVU base fee schedule,23.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0936 mod RR,Not in chargemaster,E0936,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0936 mod RR,BCBSMN Non-RVU base fee schedule,22.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0940,Not in chargemaster,E0940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0940,BCBSMN Non-RVU base fee schedule,272.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0940 mod RR,Not in chargemaster,E0940,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0940 mod RR,BCBSMN Non-RVU base fee schedule,27.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0941,Not in chargemaster,E0941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0941,BCBSMN Non-RVU base fee schedule,476.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0941 mod RR,Not in chargemaster,E0941,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0941 mod RR,BCBSMN Non-RVU base fee schedule,47.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0942,Not in chargemaster,E0942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0942,BCBSMN Non-RVU base fee schedule,20.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0942 mod RR,Not in chargemaster,E0942,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0942 mod RR,BCBSMN Non-RVU base fee schedule,2.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0944,Not in chargemaster,E0944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0944,BCBSMN Non-RVU base fee schedule,47.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0944 mod RR,Not in chargemaster,E0944,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0944 mod RR,BCBSMN Non-RVU base fee schedule,4.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0945,Not in chargemaster,E0945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0945,BCBSMN Non-RVU base fee schedule,46.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0945 mod RR,Not in chargemaster,E0945,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0945 mod RR,BCBSMN Non-RVU base fee schedule,4.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0946,Not in chargemaster,E0946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0946,BCBSMN Non-RVU base fee schedule,552.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0946 mod RR,Not in chargemaster,E0946,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0946 mod RR,BCBSMN Non-RVU base fee schedule,55.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0947,Not in chargemaster,E0947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0947,BCBSMN Non-RVU base fee schedule,538.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0947 mod RR,Not in chargemaster,E0947,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0947 mod RR,BCBSMN Non-RVU base fee schedule,55.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0948,Not in chargemaster,E0948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0948,BCBSMN Non-RVU base fee schedule,521.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0948 mod RR,Not in chargemaster,E0948,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0948 mod RR,BCBSMN Non-RVU base fee schedule,52.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0950,Not in chargemaster,E0950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0950,BCBSMN Non-RVU base fee schedule,76.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0950 mod RR,Not in chargemaster,E0950,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0950 mod RR,BCBSMN Non-RVU base fee schedule,7.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0951,Not in chargemaster,E0951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0951,BCBSMN Non-RVU base fee schedule,13.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0951 mod RR,Not in chargemaster,E0951,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0951 mod RR,BCBSMN Non-RVU base fee schedule,1.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0952,Not in chargemaster,E0952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0952,BCBSMN Non-RVU base fee schedule,14.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0952 mod RR,Not in chargemaster,E0952,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0952 mod RR,BCBSMN Non-RVU base fee schedule,1.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0953,Not in chargemaster,E0953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0953,BCBSMN Non-RVU base fee schedule,81.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0953 mod RR,Not in chargemaster,E0953,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0953 mod RR,BCBSMN Non-RVU base fee schedule,8.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0954,Not in chargemaster,E0954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0954,BCBSMN Non-RVU base fee schedule,47.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0954 mod RR,Not in chargemaster,E0954,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0954 mod RR,BCBSMN Non-RVU base fee schedule,4.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0955,Not in chargemaster,E0955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0955,BCBSMN Non-RVU base fee schedule,168.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0955 mod RR,Not in chargemaster,E0955,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0955 mod RR,BCBSMN Non-RVU base fee schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0956,Not in chargemaster,E0956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0956,BCBSMN Non-RVU base fee schedule,81.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0956 mod RR,Not in chargemaster,E0956,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0956 mod RR,BCBSMN Non-RVU base fee schedule,8.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0957,Not in chargemaster,E0957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0957,BCBSMN Non-RVU base fee schedule,119.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0957 mod RR,Not in chargemaster,E0957,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0957 mod RR,BCBSMN Non-RVU base fee schedule,12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0958,Not in chargemaster,E0958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0958,BCBSMN Non-RVU base fee schedule,431.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0958 mod RR,Not in chargemaster,E0958,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0958 mod RR,BCBSMN Non-RVU base fee schedule,43.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0959,Not in chargemaster,E0959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0959,BCBSMN Non-RVU base fee schedule,41.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0959 mod RR,Not in chargemaster,E0959,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0959 mod RR,BCBSMN Non-RVU base fee schedule,4.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0960,Not in chargemaster,E0960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0960,BCBSMN Non-RVU base fee schedule,75.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0960 mod RR,Not in chargemaster,E0960,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0960 mod RR,BCBSMN Non-RVU base fee schedule,7.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0961,Not in chargemaster,E0961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0961,BCBSMN Non-RVU base fee schedule,25.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0961 mod RR,Not in chargemaster,E0961,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0961 mod RR,BCBSMN Non-RVU base fee schedule,2.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0966,Not in chargemaster,E0966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0966,BCBSMN Non-RVU base fee schedule,71.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0966 mod RR,Not in chargemaster,E0966,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0966 mod RR,BCBSMN Non-RVU base fee schedule,7.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0967,Not in chargemaster,E0967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0967,BCBSMN Non-RVU base fee schedule,68.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0967 mod RR,Not in chargemaster,E0967,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0967 mod RR,BCBSMN Non-RVU base fee schedule,6.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0968,Not in chargemaster,E0968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0968,BCBSMN Non-RVU base fee schedule,194.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0968 mod RR,Not in chargemaster,E0968,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0968 mod RR,BCBSMN Non-RVU base fee schedule,19.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0969,Not in chargemaster,E0969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0969,BCBSMN Non-RVU base fee schedule,163.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0969 mod RR,Not in chargemaster,E0969,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0969 mod RR,BCBSMN Non-RVU base fee schedule,16.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0970,Not in chargemaster,E0970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0970,BCBSMN Non-RVU base fee schedule,42.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0970 mod RR,Not in chargemaster,E0970,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0970 mod RR,BCBSMN Non-RVU base fee schedule,4.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0971,Not in chargemaster,E0971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0971,BCBSMN Non-RVU base fee schedule,37.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0971 mod RR,Not in chargemaster,E0971,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0971 mod RR,BCBSMN Non-RVU base fee schedule,3.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0973,Not in chargemaster,E0973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0973,BCBSMN Non-RVU base fee schedule,77.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0973 mod RR,Not in chargemaster,E0973,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0973 mod RR,BCBSMN Non-RVU base fee schedule,7.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0974,Not in chargemaster,E0974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0974,BCBSMN Non-RVU base fee schedule,76.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0974 mod RR,Not in chargemaster,E0974,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0974 mod RR,BCBSMN Non-RVU base fee schedule,7.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0978,Not in chargemaster,E0978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0978,BCBSMN Non-RVU base fee schedule,30.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0978 mod RR,Not in chargemaster,E0978,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0978 mod RR,BCBSMN Non-RVU base fee schedule,3.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0980,Not in chargemaster,E0980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0980,BCBSMN Non-RVU base fee schedule,33.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0980 mod RR,Not in chargemaster,E0980,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0980 mod RR,BCBSMN Non-RVU base fee schedule,3.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0981,Not in chargemaster,E0981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0981,BCBSMN Non-RVU base fee schedule,36.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0981 mod RR,Not in chargemaster,E0981,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0981 mod RR,BCBSMN Non-RVU base fee schedule,3.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0982,Not in chargemaster,E0982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0982,BCBSMN Non-RVU base fee schedule,39.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0982 mod RR,Not in chargemaster,E0982,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0982 mod RR,BCBSMN Non-RVU base fee schedule,3.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0983,Not in chargemaster,E0983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0983,BCBSMN Non-RVU base fee schedule,2743.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0983 mod RR,Not in chargemaster,E0983,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0983 mod RR,BCBSMN Non-RVU base fee schedule,274.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0984,Not in chargemaster,E0984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0984,BCBSMN Non-RVU base fee schedule,2007.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0984 mod RR,Not in chargemaster,E0984,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0984 mod RR,BCBSMN Non-RVU base fee schedule,200.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0985,Not in chargemaster,E0985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0985,BCBSMN Non-RVU base fee schedule,220.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0985 mod RR,Not in chargemaster,E0985,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0985 mod RR,BCBSMN Non-RVU base fee schedule,22.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0986,Not in chargemaster,E0986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0986,BCBSMN Non-RVU base fee schedule,5340.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0986 mod RR,Not in chargemaster,E0986,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0986 mod RR,BCBSMN Non-RVU base fee schedule,534.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0988,Not in chargemaster,E0988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0988,BCBSMN Non-RVU base fee schedule,3286.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0988 mod RR,Not in chargemaster,E0988,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0988 mod RR,BCBSMN Non-RVU base fee schedule,328.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0990,Not in chargemaster,E0990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0990,BCBSMN Non-RVU base fee schedule,80.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0990 mod RR,Not in chargemaster,E0990,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0990 mod RR,BCBSMN Non-RVU base fee schedule,9.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0992,Not in chargemaster,E0992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0992,BCBSMN Non-RVU base fee schedule,83.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0992 mod RR,Not in chargemaster,E0992,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0992 mod RR,BCBSMN Non-RVU base fee schedule,8.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0994,Not in chargemaster,E0994,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0994,BCBSMN Non-RVU base fee schedule,15.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0994 mod RR,Not in chargemaster,E0994,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0994 mod RR,BCBSMN Non-RVU base fee schedule,1.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0995,Not in chargemaster,E0995,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0995,BCBSMN Non-RVU base fee schedule,25.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E0995 mod RR,Not in chargemaster,E0995,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E0995 mod RR,BCBSMN Non-RVU base fee schedule,2.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1002,Not in chargemaster,E1002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1002,BCBSMN Non-RVU base fee schedule,3654.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1002 mod RR,Not in chargemaster,E1002,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1002 mod RR,BCBSMN Non-RVU base fee schedule,365.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1003,Not in chargemaster,E1003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1003,BCBSMN Non-RVU base fee schedule,4111.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1003 mod RR,Not in chargemaster,E1003,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1003 mod RR,BCBSMN Non-RVU base fee schedule,411.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1004,Not in chargemaster,E1004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1004,BCBSMN Non-RVU base fee schedule,4538.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1004 mod RR,Not in chargemaster,E1004,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1004 mod RR,BCBSMN Non-RVU base fee schedule,453.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1005,Not in chargemaster,E1005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1005,BCBSMN Non-RVU base fee schedule,4938.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1005 mod RR,Not in chargemaster,E1005,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1005 mod RR,BCBSMN Non-RVU base fee schedule,493.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1006,Not in chargemaster,E1006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1006,BCBSMN Non-RVU base fee schedule,6068.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1006 mod RR,Not in chargemaster,E1006,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1006 mod RR,BCBSMN Non-RVU base fee schedule,606.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1007,Not in chargemaster,E1007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1007,BCBSMN Non-RVU base fee schedule,7877.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1007 mod RR,Not in chargemaster,E1007,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1007 mod RR,BCBSMN Non-RVU base fee schedule,787.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1008,Not in chargemaster,E1008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1008,BCBSMN Non-RVU base fee schedule,7974.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1008 mod RR,Not in chargemaster,E1008,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1008 mod RR,BCBSMN Non-RVU base fee schedule,797.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1010,Not in chargemaster,E1010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1010,BCBSMN Non-RVU base fee schedule,1062.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1010 mod RR,Not in chargemaster,E1010,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1010 mod RR,BCBSMN Non-RVU base fee schedule,106.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1012,Not in chargemaster,E1012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1012,BCBSMN Non-RVU base fee schedule,1062.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1012 mod RR,Not in chargemaster,E1012,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1012 mod RR,BCBSMN Non-RVU base fee schedule,106.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1014,Not in chargemaster,E1014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1014,BCBSMN Non-RVU base fee schedule,401.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1014 mod RR,Not in chargemaster,E1014,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1014 mod RR,BCBSMN Non-RVU base fee schedule,40.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1015,Not in chargemaster,E1015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1015,BCBSMN Non-RVU base fee schedule,117.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1015 mod RR,Not in chargemaster,E1015,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1015 mod RR,BCBSMN Non-RVU base fee schedule,11.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1016,Not in chargemaster,E1016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1016,BCBSMN Non-RVU base fee schedule,112.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1016 mod RR,Not in chargemaster,E1016,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1016 mod RR,BCBSMN Non-RVU base fee schedule,11.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1020,Not in chargemaster,E1020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1020,BCBSMN Non-RVU base fee schedule,205.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1020 mod RR,Not in chargemaster,E1020,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1020 mod RR,BCBSMN Non-RVU base fee schedule,20.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1028,Not in chargemaster,E1028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1028,BCBSMN Non-RVU base fee schedule,165.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1028 mod RR,Not in chargemaster,E1028,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1028 mod RR,BCBSMN Non-RVU base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1029,Not in chargemaster,E1029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1029,BCBSMN Non-RVU base fee schedule,349.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1029 mod RR,Not in chargemaster,E1029,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1029 mod RR,BCBSMN Non-RVU base fee schedule,34.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1030,Not in chargemaster,E1030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1030,BCBSMN Non-RVU base fee schedule,1100.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1030 mod RR,Not in chargemaster,E1030,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1030 mod RR,BCBSMN Non-RVU base fee schedule,110.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1031,Not in chargemaster,E1031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1031,BCBSMN Non-RVU base fee schedule,451.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1031 mod RR,Not in chargemaster,E1031,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1031 mod RR,BCBSMN Non-RVU base fee schedule,45.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1035,Not in chargemaster,E1035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1035,BCBSMN Non-RVU base fee schedule,6342.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1035 mod RR,Not in chargemaster,E1035,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1035 mod RR,BCBSMN Non-RVU base fee schedule,634.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1036,Not in chargemaster,E1036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1036,BCBSMN Non-RVU base fee schedule,9048.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1036 mod RR,Not in chargemaster,E1036,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1036 mod RR,BCBSMN Non-RVU base fee schedule,904.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1037,Not in chargemaster,E1037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1037,BCBSMN Non-RVU base fee schedule,1136.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1037 mod RR,Not in chargemaster,E1037,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1037 mod RR,BCBSMN Non-RVU base fee schedule,113.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1038,Not in chargemaster,E1038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1038,BCBSMN Non-RVU base fee schedule,172.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1038 mod RR,Not in chargemaster,E1038,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1038 mod RR,BCBSMN Non-RVU base fee schedule,17.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1039,Not in chargemaster,E1039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1039,BCBSMN Non-RVU base fee schedule,354.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1039 mod RR,Not in chargemaster,E1039,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1039 mod RR,BCBSMN Non-RVU base fee schedule,35.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1050,Not in chargemaster,E1050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1050,BCBSMN Non-RVU base fee schedule,956.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1050 mod RR,Not in chargemaster,E1050,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1050 mod RR,BCBSMN Non-RVU base fee schedule,95.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1060,Not in chargemaster,E1060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1060,BCBSMN Non-RVU base fee schedule,1192.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1060 mod RR,Not in chargemaster,E1060,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1060 mod RR,BCBSMN Non-RVU base fee schedule,119.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1070,Not in chargemaster,E1070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1070,BCBSMN Non-RVU base fee schedule,1156.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1070 mod RR,Not in chargemaster,E1070,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1070 mod RR,BCBSMN Non-RVU base fee schedule,115.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1083,Not in chargemaster,E1083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1083,BCBSMN Non-RVU base fee schedule,734.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1083 mod RR,Not in chargemaster,E1083,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1083 mod RR,BCBSMN Non-RVU base fee schedule,73.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1084,Not in chargemaster,E1084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1084,BCBSMN Non-RVU base fee schedule,915.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1084 mod RR,Not in chargemaster,E1084,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1084 mod RR,BCBSMN Non-RVU base fee schedule,91.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1085,Not in chargemaster,E1085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1085,BCBSMN Non-RVU base fee schedule,792.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1085 mod RR,Not in chargemaster,E1085,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1085 mod RR,BCBSMN Non-RVU base fee schedule,79.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1086,Not in chargemaster,E1086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1086,BCBSMN Non-RVU base fee schedule,817.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1086 mod RR,Not in chargemaster,E1086,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1086 mod RR,BCBSMN Non-RVU base fee schedule,81.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1087,Not in chargemaster,E1087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1087,BCBSMN Non-RVU base fee schedule,1389.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1087 mod RR,Not in chargemaster,E1087,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1087 mod RR,BCBSMN Non-RVU base fee schedule,138.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1088,Not in chargemaster,E1088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1088,BCBSMN Non-RVU base fee schedule,1407.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1088 mod RR,Not in chargemaster,E1088,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1088 mod RR,BCBSMN Non-RVU base fee schedule,140.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1089,Not in chargemaster,E1089,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1089,BCBSMN Non-RVU base fee schedule,1026.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1089 mod RR,Not in chargemaster,E1089,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1089 mod RR,BCBSMN Non-RVU base fee schedule,97.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1090,Not in chargemaster,E1090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1090,BCBSMN Non-RVU base fee schedule,1324.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1090 mod RR,Not in chargemaster,E1090,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1090 mod RR,BCBSMN Non-RVU base fee schedule,132.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1092,Not in chargemaster,E1092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1092,BCBSMN Non-RVU base fee schedule,1410.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1092 mod RR,Not in chargemaster,E1092,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1092 mod RR,BCBSMN Non-RVU base fee schedule,141.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1093,Not in chargemaster,E1093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1093,BCBSMN Non-RVU base fee schedule,1060.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1093 mod RR,Not in chargemaster,E1093,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1093 mod RR,BCBSMN Non-RVU base fee schedule,106.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1100,Not in chargemaster,E1100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1100,BCBSMN Non-RVU base fee schedule,968.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1100 mod RR,Not in chargemaster,E1100,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1100 mod RR,BCBSMN Non-RVU base fee schedule,96.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1110,Not in chargemaster,E1110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1110,BCBSMN Non-RVU base fee schedule,1115.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1110 mod RR,Not in chargemaster,E1110,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1110 mod RR,BCBSMN Non-RVU base fee schedule,111.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1130,Not in chargemaster,E1130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1130,BCBSMN Non-RVU base fee schedule,512.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1130 mod RR,Not in chargemaster,E1130,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1130 mod RR,BCBSMN Non-RVU base fee schedule,51.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1140,Not in chargemaster,E1140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1140,BCBSMN Non-RVU base fee schedule,721,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1140 mod RR,Not in chargemaster,E1140,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1140 mod RR,BCBSMN Non-RVU base fee schedule,72.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1150,Not in chargemaster,E1150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1150,BCBSMN Non-RVU base fee schedule,840.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1150 mod RR,Not in chargemaster,E1150,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1150 mod RR,BCBSMN Non-RVU base fee schedule,84.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1160,Not in chargemaster,E1160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1160,BCBSMN Non-RVU base fee schedule,617.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1160 mod RR,Not in chargemaster,E1160,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1160 mod RR,BCBSMN Non-RVU base fee schedule,61.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1161,Not in chargemaster,E1161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1161,BCBSMN Non-RVU base fee schedule,2597.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1161 mod RR,Not in chargemaster,E1161,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1161 mod RR,BCBSMN Non-RVU base fee schedule,259.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1170,Not in chargemaster,E1170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1170,BCBSMN Non-RVU base fee schedule,833.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1170 mod RR,Not in chargemaster,E1170,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1170 mod RR,BCBSMN Non-RVU base fee schedule,83.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1171,Not in chargemaster,E1171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1171,BCBSMN Non-RVU base fee schedule,806.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1171 mod RR,Not in chargemaster,E1171,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1171 mod RR,BCBSMN Non-RVU base fee schedule,80.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1172,Not in chargemaster,E1172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1172,BCBSMN Non-RVU base fee schedule,1075.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1172 mod RR,Not in chargemaster,E1172,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1172 mod RR,BCBSMN Non-RVU base fee schedule,107.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1180,Not in chargemaster,E1180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1180,BCBSMN Non-RVU base fee schedule,1112.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1180 mod RR,Not in chargemaster,E1180,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1180 mod RR,BCBSMN Non-RVU base fee schedule,111.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1190,Not in chargemaster,E1190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1190,BCBSMN Non-RVU base fee schedule,1285.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1190 mod RR,Not in chargemaster,E1190,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1190 mod RR,BCBSMN Non-RVU base fee schedule,128.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1195,Not in chargemaster,E1195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1195,BCBSMN Non-RVU base fee schedule,1172.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1195 mod RR,Not in chargemaster,E1195,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1195 mod RR,BCBSMN Non-RVU base fee schedule,117.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1200,Not in chargemaster,E1200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1200,BCBSMN Non-RVU base fee schedule,811.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1200 mod RR,Not in chargemaster,E1200,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1200 mod RR,BCBSMN Non-RVU base fee schedule,81.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1220,Not in chargemaster,E1220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1220,BCBSMN Non-RVU base fee schedule,777.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1220 mod RR,Not in chargemaster,E1220,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1220 mod RR,BCBSMN Non-RVU base fee schedule,77.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1221,Not in chargemaster,E1221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1221,BCBSMN Non-RVU base fee schedule,443.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1221 mod RR,Not in chargemaster,E1221,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1221 mod RR,BCBSMN Non-RVU base fee schedule,44.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1222,Not in chargemaster,E1222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1222,BCBSMN Non-RVU base fee schedule,725.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1222 mod RR,Not in chargemaster,E1222,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1222 mod RR,BCBSMN Non-RVU base fee schedule,72.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1223,Not in chargemaster,E1223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1223,BCBSMN Non-RVU base fee schedule,718.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1223 mod RR,Not in chargemaster,E1223,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1223 mod RR,BCBSMN Non-RVU base fee schedule,71.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1224,Not in chargemaster,E1224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1224,BCBSMN Non-RVU base fee schedule,757.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1224 mod RR,Not in chargemaster,E1224,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1224 mod RR,BCBSMN Non-RVU base fee schedule,75.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1225,Not in chargemaster,E1225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1225,BCBSMN Non-RVU base fee schedule,438.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1225 mod RR,Not in chargemaster,E1225,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1225 mod RR,BCBSMN Non-RVU base fee schedule,43.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1226,Not in chargemaster,E1226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1226,BCBSMN Non-RVU base fee schedule,467.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1226 mod RR,Not in chargemaster,E1226,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1226 mod RR,BCBSMN Non-RVU base fee schedule,47.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1227,Not in chargemaster,E1227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1227,BCBSMN Non-RVU base fee schedule,246.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1227 mod RR,Not in chargemaster,E1227,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1227 mod RR,BCBSMN Non-RVU base fee schedule,24.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1228,Not in chargemaster,E1228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1228,BCBSMN Non-RVU base fee schedule,261.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1228 mod RR,Not in chargemaster,E1228,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1228 mod RR,BCBSMN Non-RVU base fee schedule,26.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1230,Not in chargemaster,E1230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1230,BCBSMN Non-RVU base fee schedule,2364.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1230 mod RR,Not in chargemaster,E1230,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1230 mod RR,BCBSMN Non-RVU base fee schedule,232.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1232,Not in chargemaster,E1232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1232,BCBSMN Non-RVU base fee schedule,2347.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1232 mod RR,Not in chargemaster,E1232,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1232 mod RR,BCBSMN Non-RVU base fee schedule,234.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1233,Not in chargemaster,E1233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1233,BCBSMN Non-RVU base fee schedule,2432.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1233 mod RR,Not in chargemaster,E1233,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1233 mod RR,BCBSMN Non-RVU base fee schedule,243.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1234,Not in chargemaster,E1234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1234,BCBSMN Non-RVU base fee schedule,2117.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1234 mod RR,Not in chargemaster,E1234,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1234 mod RR,BCBSMN Non-RVU base fee schedule,211.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1235,Not in chargemaster,E1235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1235,BCBSMN Non-RVU base fee schedule,2039.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1235 mod RR,Not in chargemaster,E1235,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1235 mod RR,BCBSMN Non-RVU base fee schedule,203.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1236,Not in chargemaster,E1236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1236,BCBSMN Non-RVU base fee schedule,1799.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1236 mod RR,Not in chargemaster,E1236,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1236 mod RR,BCBSMN Non-RVU base fee schedule,179.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1237,Not in chargemaster,E1237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1237,BCBSMN Non-RVU base fee schedule,1814.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1237 mod RR,Not in chargemaster,E1237,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1237 mod RR,BCBSMN Non-RVU base fee schedule,181.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1238,Not in chargemaster,E1238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1238,BCBSMN Non-RVU base fee schedule,1799.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1238 mod RR,Not in chargemaster,E1238,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1238 mod RR,BCBSMN Non-RVU base fee schedule,179.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1240,Not in chargemaster,E1240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1240,BCBSMN Non-RVU base fee schedule,1077.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1240 mod RR,Not in chargemaster,E1240,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1240 mod RR,BCBSMN Non-RVU base fee schedule,107.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1250,Not in chargemaster,E1250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1250,BCBSMN Non-RVU base fee schedule,662.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1250 mod RR,Not in chargemaster,E1250,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1250 mod RR,BCBSMN Non-RVU base fee schedule,63.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1260,Not in chargemaster,E1260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1260,BCBSMN Non-RVU base fee schedule,1013.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1260 mod RR,Not in chargemaster,E1260,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1260 mod RR,BCBSMN Non-RVU base fee schedule,101.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1270,Not in chargemaster,E1270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1270,BCBSMN Non-RVU base fee schedule,836.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1270 mod RR,Not in chargemaster,E1270,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1270 mod RR,BCBSMN Non-RVU base fee schedule,83.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1280,Not in chargemaster,E1280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1280,BCBSMN Non-RVU base fee schedule,1224.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1280 mod RR,Not in chargemaster,E1280,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1280 mod RR,BCBSMN Non-RVU base fee schedule,122.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1285,Not in chargemaster,E1285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1285,BCBSMN Non-RVU base fee schedule,98.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1285 mod RR,Not in chargemaster,E1285,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1285 mod RR,BCBSMN Non-RVU base fee schedule,9.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1290,Not in chargemaster,E1290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1290,BCBSMN Non-RVU base fee schedule,1217.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1290 mod RR,Not in chargemaster,E1290,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1290 mod RR,BCBSMN Non-RVU base fee schedule,121.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1295,Not in chargemaster,E1295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1295,BCBSMN Non-RVU base fee schedule,1133.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1295 mod RR,Not in chargemaster,E1295,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1295 mod RR,BCBSMN Non-RVU base fee schedule,113.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1296,Not in chargemaster,E1296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1296,BCBSMN Non-RVU base fee schedule,498.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1296 mod RR,Not in chargemaster,E1296,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1296 mod RR,BCBSMN Non-RVU base fee schedule,49.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1297,Not in chargemaster,E1297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1297,BCBSMN Non-RVU base fee schedule,107.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1297 mod RR,Not in chargemaster,E1297,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1297 mod RR,BCBSMN Non-RVU base fee schedule,10.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1298,Not in chargemaster,E1298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1298,BCBSMN Non-RVU base fee schedule,426.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1298 mod RR,Not in chargemaster,E1298,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1298 mod RR,BCBSMN Non-RVU base fee schedule,42.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1310,Not in chargemaster,E1310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1310,BCBSMN Non-RVU base fee schedule,1908.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1310 mod RR,Not in chargemaster,E1310,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1310 mod RR,BCBSMN Non-RVU base fee schedule,163.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1352,Not in chargemaster,E1352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1352,BCBSMN Non-RVU base fee schedule,26.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1352 mod RR,Not in chargemaster,E1352,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1352 mod RR,BCBSMN Non-RVU base fee schedule,2.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1353,Not in chargemaster,E1353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1353,BCBSMN Non-RVU base fee schedule,29.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1353 mod RR,Not in chargemaster,E1353,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1353 mod RR,BCBSMN Non-RVU base fee schedule,2.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1354,Not in chargemaster,E1354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1354,BCBSMN Non-RVU base fee schedule,23.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1354 mod RR,Not in chargemaster,E1354,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1354 mod RR,BCBSMN Non-RVU base fee schedule,2.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1355,Not in chargemaster,E1355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1355,BCBSMN Non-RVU base fee schedule,22.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1355 mod RR,Not in chargemaster,E1355,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1355 mod RR,BCBSMN Non-RVU base fee schedule,2.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1356,Not in chargemaster,E1356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1356,BCBSMN Non-RVU base fee schedule,22.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1356 mod RR,Not in chargemaster,E1356,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1356 mod RR,BCBSMN Non-RVU base fee schedule,2.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1357,Not in chargemaster,E1357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1357,BCBSMN Non-RVU base fee schedule,606.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1357 mod RR,Not in chargemaster,E1357,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1357 mod RR,BCBSMN Non-RVU base fee schedule,60.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1372,Not in chargemaster,E1372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1372,BCBSMN Non-RVU base fee schedule,138.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1372 mod RR,Not in chargemaster,E1372,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1372 mod RR,BCBSMN Non-RVU base fee schedule,16.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1390 mod RR,Not in chargemaster,E1390,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1390 mod RR,BCBSMN Non-RVU base fee schedule,75.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1391 mod RR,Not in chargemaster,E1391,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1391 mod RR,BCBSMN Non-RVU base fee schedule,123.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1392 mod RR,Not in chargemaster,E1392,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1392 mod RR,BCBSMN Non-RVU base fee schedule,40.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1405,Not in chargemaster,E1405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1405,BCBSMN Non-RVU base fee schedule,1555.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1405 mod RR,Not in chargemaster,E1405,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1405 mod RR,BCBSMN Non-RVU base fee schedule,155.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1406,Not in chargemaster,E1406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1406,BCBSMN Non-RVU base fee schedule,1345.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1406 mod RR,Not in chargemaster,E1406,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1406 mod RR,BCBSMN Non-RVU base fee schedule,134.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1510,Not in chargemaster,E1510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1510,BCBSMN Non-RVU base fee schedule,724.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1520,Not in chargemaster,E1520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1520,BCBSMN Non-RVU base fee schedule,74.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1530,Not in chargemaster,E1530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1530,BCBSMN Non-RVU base fee schedule,107.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1540,Not in chargemaster,E1540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1540,BCBSMN Non-RVU base fee schedule,66.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1560,Not in chargemaster,E1560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1560,BCBSMN Non-RVU base fee schedule,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1570,Not in chargemaster,E1570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1570,BCBSMN Non-RVU base fee schedule,117.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1575,Not in chargemaster,E1575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1575,BCBSMN Non-RVU base fee schedule,31.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1590,Not in chargemaster,E1590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1590,BCBSMN Non-RVU base fee schedule,1208.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1594,Not in chargemaster,E1594,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1594,BCBSMN Non-RVU base fee schedule,498.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1600,Not in chargemaster,E1600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1600,BCBSMN Non-RVU base fee schedule,540.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1610,Not in chargemaster,E1610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1610,BCBSMN Non-RVU base fee schedule,719.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1615,Not in chargemaster,E1615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1615,BCBSMN Non-RVU base fee schedule,292.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1634,Not in chargemaster,E1634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1634,BCBSMN Non-RVU base fee schedule,3.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1636,Not in chargemaster,E1636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1636,BCBSMN Non-RVU base fee schedule,1690.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1637,Not in chargemaster,E1637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1637,BCBSMN Non-RVU base fee schedule,4.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1639,Not in chargemaster,E1639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1639,BCBSMN Non-RVU base fee schedule,155.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1700,Not in chargemaster,E1700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1700,BCBSMN Non-RVU base fee schedule,378.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1700 mod RR,Not in chargemaster,E1700,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1700 mod RR,BCBSMN Non-RVU base fee schedule,37.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1701,Not in chargemaster,E1701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1701,BCBSMN Non-RVU base fee schedule,11.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1702,Not in chargemaster,E1702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1702,BCBSMN Non-RVU base fee schedule,23.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1800,Not in chargemaster,E1800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1800,BCBSMN Non-RVU base fee schedule,1344.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1800 mod RR,Not in chargemaster,E1800,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1800 mod RR,BCBSMN Non-RVU base fee schedule,134.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1801,Not in chargemaster,E1801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1801,BCBSMN Non-RVU base fee schedule,1416.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1801 mod RR,Not in chargemaster,E1801,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1801 mod RR,BCBSMN Non-RVU base fee schedule,141.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1802,Not in chargemaster,E1802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1802,BCBSMN Non-RVU base fee schedule,3587.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1802 mod RR,Not in chargemaster,E1802,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1802 mod RR,BCBSMN Non-RVU base fee schedule,358.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1805,Not in chargemaster,E1805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1805,BCBSMN Non-RVU base fee schedule,1387.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1805 mod RR,Not in chargemaster,E1805,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1805 mod RR,BCBSMN Non-RVU base fee schedule,138.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1806,Not in chargemaster,E1806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1806,BCBSMN Non-RVU base fee schedule,1162.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1806 mod RR,Not in chargemaster,E1806,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1806 mod RR,BCBSMN Non-RVU base fee schedule,116.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1810,Not in chargemaster,E1810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1810,BCBSMN Non-RVU base fee schedule,1367.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1810 mod RR,Not in chargemaster,E1810,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1810 mod RR,BCBSMN Non-RVU base fee schedule,136.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1811,Not in chargemaster,E1811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1811,BCBSMN Non-RVU base fee schedule,1472.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1811 mod RR,Not in chargemaster,E1811,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1811 mod RR,BCBSMN Non-RVU base fee schedule,147.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1812,Not in chargemaster,E1812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1812,BCBSMN Non-RVU base fee schedule,944.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1812 mod RR,Not in chargemaster,E1812,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1812 mod RR,BCBSMN Non-RVU base fee schedule,94.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1815,Not in chargemaster,E1815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1815,BCBSMN Non-RVU base fee schedule,1387.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1815 mod RR,Not in chargemaster,E1815,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1815 mod RR,BCBSMN Non-RVU base fee schedule,138.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1816,Not in chargemaster,E1816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1816,BCBSMN Non-RVU base fee schedule,1495.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1816 mod RR,Not in chargemaster,E1816,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1816 mod RR,BCBSMN Non-RVU base fee schedule,149.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1818,Not in chargemaster,E1818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1818,BCBSMN Non-RVU base fee schedule,1526.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1818 mod RR,Not in chargemaster,E1818,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1818 mod RR,BCBSMN Non-RVU base fee schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1820,Not in chargemaster,E1820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1820,BCBSMN Non-RVU base fee schedule,85.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1820 mod RR,Not in chargemaster,E1820,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1820 mod RR,BCBSMN Non-RVU base fee schedule,8.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1821,Not in chargemaster,E1821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1821,BCBSMN Non-RVU base fee schedule,110.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1821 mod RR,Not in chargemaster,E1821,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1821 mod RR,BCBSMN Non-RVU base fee schedule,10.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1825,Not in chargemaster,E1825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1825,BCBSMN Non-RVU base fee schedule,1387.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1825 mod RR,Not in chargemaster,E1825,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1825 mod RR,BCBSMN Non-RVU base fee schedule,138.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1830,Not in chargemaster,E1830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1830,BCBSMN Non-RVU base fee schedule,1387.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1830 mod RR,Not in chargemaster,E1830,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1830 mod RR,BCBSMN Non-RVU base fee schedule,138.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1831,Not in chargemaster,E1831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1831,BCBSMN Non-RVU base fee schedule,725.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1831 mod RR,Not in chargemaster,E1831,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1831 mod RR,BCBSMN Non-RVU base fee schedule,72.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1840,Not in chargemaster,E1840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1840,BCBSMN Non-RVU base fee schedule,4112.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1840 mod RR,Not in chargemaster,E1840,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1840 mod RR,BCBSMN Non-RVU base fee schedule,411.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1841,Not in chargemaster,E1841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1841,BCBSMN Non-RVU base fee schedule,4973.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E1841 mod RR,Not in chargemaster,E1841,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E1841 mod RR,BCBSMN Non-RVU base fee schedule,497.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2000,Not in chargemaster,E2000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2000,BCBSMN Non-RVU base fee schedule,569.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2000 mod RR,Not in chargemaster,E2000,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2000 mod RR,BCBSMN Non-RVU base fee schedule,56.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2100,Not in chargemaster,E2100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2100,BCBSMN Non-RVU base fee schedule,650.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2100 mod RR,Not in chargemaster,E2100,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2100 mod RR,BCBSMN Non-RVU base fee schedule,65.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2101,Not in chargemaster,E2101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2101,BCBSMN Non-RVU base fee schedule,197.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2101 mod RR,Not in chargemaster,E2101,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2101 mod RR,BCBSMN Non-RVU base fee schedule,19.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2120,Not in chargemaster,E2120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2120,BCBSMN Non-RVU base fee schedule,3112.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2120 mod RR,Not in chargemaster,E2120,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2120 mod RR,BCBSMN Non-RVU base fee schedule,311.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2201,Not in chargemaster,E2201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2201,BCBSMN Non-RVU base fee schedule,342.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2201 mod RR,Not in chargemaster,E2201,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2201 mod RR,BCBSMN Non-RVU base fee schedule,34.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2202,Not in chargemaster,E2202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2202,BCBSMN Non-RVU base fee schedule,462.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2202 mod RR,Not in chargemaster,E2202,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2202 mod RR,BCBSMN Non-RVU base fee schedule,46.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2203,Not in chargemaster,E2203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2203,BCBSMN Non-RVU base fee schedule,450.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2203 mod RR,Not in chargemaster,E2203,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2203 mod RR,BCBSMN Non-RVU base fee schedule,45.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2204,Not in chargemaster,E2204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2204,BCBSMN Non-RVU base fee schedule,776.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2204 mod RR,Not in chargemaster,E2204,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2204 mod RR,BCBSMN Non-RVU base fee schedule,77.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2205,Not in chargemaster,E2205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2205,BCBSMN Non-RVU base fee schedule,33.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2205 mod RR,Not in chargemaster,E2205,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2205 mod RR,BCBSMN Non-RVU base fee schedule,3.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2206,Not in chargemaster,E2206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2206,BCBSMN Non-RVU base fee schedule,39.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2206 mod RR,Not in chargemaster,E2206,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2206 mod RR,BCBSMN Non-RVU base fee schedule,3.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2207,Not in chargemaster,E2207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2207,BCBSMN Non-RVU base fee schedule,44.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2207 mod RR,Not in chargemaster,E2207,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2207 mod RR,BCBSMN Non-RVU base fee schedule,4.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2208,Not in chargemaster,E2208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2208,BCBSMN Non-RVU base fee schedule,90.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2208 mod RR,Not in chargemaster,E2208,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2208 mod RR,BCBSMN Non-RVU base fee schedule,9.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2209,Not in chargemaster,E2209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2209,BCBSMN Non-RVU base fee schedule,88.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2209 mod RR,Not in chargemaster,E2209,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2209 mod RR,BCBSMN Non-RVU base fee schedule,8.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2210,Not in chargemaster,E2210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2210,BCBSMN Non-RVU base fee schedule,5.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2210 mod RR,Not in chargemaster,E2210,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2210 mod RR,BCBSMN Non-RVU base fee schedule,0.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2211,Not in chargemaster,E2211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2211,BCBSMN Non-RVU base fee schedule,34.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2211 mod RR,Not in chargemaster,E2211,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2211 mod RR,BCBSMN Non-RVU base fee schedule,3.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2212,Not in chargemaster,E2212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2212,BCBSMN Non-RVU base fee schedule,6.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2212 mod RR,Not in chargemaster,E2212,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2212 mod RR,BCBSMN Non-RVU base fee schedule,0.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2213,Not in chargemaster,E2213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2213,BCBSMN Non-RVU base fee schedule,30.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2213 mod RR,Not in chargemaster,E2213,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2213 mod RR,BCBSMN Non-RVU base fee schedule,3.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2214,Not in chargemaster,E2214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2214,BCBSMN Non-RVU base fee schedule,34.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2214 mod RR,Not in chargemaster,E2214,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2214 mod RR,BCBSMN Non-RVU base fee schedule,3.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2215,Not in chargemaster,E2215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2215,BCBSMN Non-RVU base fee schedule,9.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2215 mod RR,Not in chargemaster,E2215,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2215 mod RR,BCBSMN Non-RVU base fee schedule,0.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2216,Not in chargemaster,E2216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2216,BCBSMN Non-RVU base fee schedule,44.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2216 mod RR,Not in chargemaster,E2216,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2216 mod RR,BCBSMN Non-RVU base fee schedule,4.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2217,Not in chargemaster,E2217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2217,BCBSMN Non-RVU base fee schedule,39.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2217 mod RR,Not in chargemaster,E2217,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2217 mod RR,BCBSMN Non-RVU base fee schedule,4.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2218,Not in chargemaster,E2218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2218,BCBSMN Non-RVU base fee schedule,44.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2218 mod RR,Not in chargemaster,E2218,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2218 mod RR,BCBSMN Non-RVU base fee schedule,4.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2219,Not in chargemaster,E2219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2219,BCBSMN Non-RVU base fee schedule,39.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2219 mod RR,Not in chargemaster,E2219,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2219 mod RR,BCBSMN Non-RVU base fee schedule,4.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2220,Not in chargemaster,E2220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2220,BCBSMN Non-RVU base fee schedule,26.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2220 mod RR,Not in chargemaster,E2220,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2220 mod RR,BCBSMN Non-RVU base fee schedule,2.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2221,Not in chargemaster,E2221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2221,BCBSMN Non-RVU base fee schedule,26.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2221 mod RR,Not in chargemaster,E2221,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2221 mod RR,BCBSMN Non-RVU base fee schedule,2.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2222,Not in chargemaster,E2222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2222,BCBSMN Non-RVU base fee schedule,21.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2222 mod RR,Not in chargemaster,E2222,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2222 mod RR,BCBSMN Non-RVU base fee schedule,2.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2224,Not in chargemaster,E2224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2224,BCBSMN Non-RVU base fee schedule,96.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2224 mod RR,Not in chargemaster,E2224,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2224 mod RR,BCBSMN Non-RVU base fee schedule,9.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2225,Not in chargemaster,E2225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2225,BCBSMN Non-RVU base fee schedule,18.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2225 mod RR,Not in chargemaster,E2225,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2225 mod RR,BCBSMN Non-RVU base fee schedule,1.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2226,Not in chargemaster,E2226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2226,BCBSMN Non-RVU base fee schedule,38.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2226 mod RR,Not in chargemaster,E2226,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2226 mod RR,BCBSMN Non-RVU base fee schedule,3.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2227,Not in chargemaster,E2227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2227,BCBSMN Non-RVU base fee schedule,2053.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2227 mod RR,Not in chargemaster,E2227,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2227 mod RR,BCBSMN Non-RVU base fee schedule,205.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2228,Not in chargemaster,E2228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2228,BCBSMN Non-RVU base fee schedule,989.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2228 mod RR,Not in chargemaster,E2228,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2228 mod RR,BCBSMN Non-RVU base fee schedule,99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2231,Not in chargemaster,E2231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2231,BCBSMN Non-RVU base fee schedule,146.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2231 mod RR,Not in chargemaster,E2231,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2231 mod RR,BCBSMN Non-RVU base fee schedule,14.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2291,Not in chargemaster,E2291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2291,BCBSMN Non-RVU base fee schedule,156.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2291 mod RR,Not in chargemaster,E2291,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2291 mod RR,BCBSMN Non-RVU base fee schedule,15.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2292,Not in chargemaster,E2292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2292,BCBSMN Non-RVU base fee schedule,85.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2292 mod RR,Not in chargemaster,E2292,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2292 mod RR,BCBSMN Non-RVU base fee schedule,8.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2293,Not in chargemaster,E2293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2293,BCBSMN Non-RVU base fee schedule,293,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2293 mod RR,Not in chargemaster,E2293,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2293 mod RR,BCBSMN Non-RVU base fee schedule,29.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2294,Not in chargemaster,E2294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2294,BCBSMN Non-RVU base fee schedule,347.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2294 mod RR,Not in chargemaster,E2294,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2294 mod RR,BCBSMN Non-RVU base fee schedule,34.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2295,Not in chargemaster,E2295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2295,BCBSMN Non-RVU base fee schedule,354.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2295 mod RR,Not in chargemaster,E2295,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2295 mod RR,BCBSMN Non-RVU base fee schedule,35.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2300,Not in chargemaster,E2300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2300,BCBSMN Non-RVU base fee schedule,1742.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2300 mod RR,Not in chargemaster,E2300,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2300 mod RR,BCBSMN Non-RVU base fee schedule,174.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2301,Not in chargemaster,E2301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2301,BCBSMN Non-RVU base fee schedule,4550.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2301 mod RR,Not in chargemaster,E2301,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2301 mod RR,BCBSMN Non-RVU base fee schedule,455.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2310,Not in chargemaster,E2310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2310,BCBSMN Non-RVU base fee schedule,1062.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2310 mod RR,Not in chargemaster,E2310,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2310 mod RR,BCBSMN Non-RVU base fee schedule,106.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2311,Not in chargemaster,E2311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2311,BCBSMN Non-RVU base fee schedule,2147.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2311 mod RR,Not in chargemaster,E2311,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2311 mod RR,BCBSMN Non-RVU base fee schedule,214.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2312,Not in chargemaster,E2312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2312,BCBSMN Non-RVU base fee schedule,2213.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2312 mod RR,Not in chargemaster,E2312,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2312 mod RR,BCBSMN Non-RVU base fee schedule,221.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2313,Not in chargemaster,E2313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2313,BCBSMN Non-RVU base fee schedule,351.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2313 mod RR,Not in chargemaster,E2313,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2313 mod RR,BCBSMN Non-RVU base fee schedule,35.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2321,Not in chargemaster,E2321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2321,BCBSMN Non-RVU base fee schedule,1443.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2321 mod RR,Not in chargemaster,E2321,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2321 mod RR,BCBSMN Non-RVU base fee schedule,144.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2322,Not in chargemaster,E2322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2322,BCBSMN Non-RVU base fee schedule,1320.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2322 mod RR,Not in chargemaster,E2322,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2322 mod RR,BCBSMN Non-RVU base fee schedule,132.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2323,Not in chargemaster,E2323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2323,BCBSMN Non-RVU base fee schedule,61.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2323 mod RR,Not in chargemaster,E2323,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2323 mod RR,BCBSMN Non-RVU base fee schedule,6.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2324,Not in chargemaster,E2324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2324,BCBSMN Non-RVU base fee schedule,39.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2324 mod RR,Not in chargemaster,E2324,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2324 mod RR,BCBSMN Non-RVU base fee schedule,3.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2325,Not in chargemaster,E2325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2325,BCBSMN Non-RVU base fee schedule,1261.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2325 mod RR,Not in chargemaster,E2325,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2325 mod RR,BCBSMN Non-RVU base fee schedule,126.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2326,Not in chargemaster,E2326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2326,BCBSMN Non-RVU base fee schedule,327.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2326 mod RR,Not in chargemaster,E2326,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2326 mod RR,BCBSMN Non-RVU base fee schedule,32.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2327,Not in chargemaster,E2327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2327,BCBSMN Non-RVU base fee schedule,2456.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2327 mod RR,Not in chargemaster,E2327,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2327 mod RR,BCBSMN Non-RVU base fee schedule,245.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2328,Not in chargemaster,E2328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2328,BCBSMN Non-RVU base fee schedule,4648.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2328 mod RR,Not in chargemaster,E2328,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2328 mod RR,BCBSMN Non-RVU base fee schedule,464.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2329,Not in chargemaster,E2329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2329,BCBSMN Non-RVU base fee schedule,1667.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2329 mod RR,Not in chargemaster,E2329,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2329 mod RR,BCBSMN Non-RVU base fee schedule,166.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2330,Not in chargemaster,E2330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2330,BCBSMN Non-RVU base fee schedule,3216.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2330 mod RR,Not in chargemaster,E2330,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2330 mod RR,BCBSMN Non-RVU base fee schedule,321.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2331,Not in chargemaster,E2331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2331,BCBSMN Non-RVU base fee schedule,975.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2331 mod RR,Not in chargemaster,E2331,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2331 mod RR,BCBSMN Non-RVU base fee schedule,97.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2340,Not in chargemaster,E2340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2340,BCBSMN Non-RVU base fee schedule,374.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2340 mod RR,Not in chargemaster,E2340,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2340 mod RR,BCBSMN Non-RVU base fee schedule,37.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2341,Not in chargemaster,E2341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2341,BCBSMN Non-RVU base fee schedule,562.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2341 mod RR,Not in chargemaster,E2341,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2341 mod RR,BCBSMN Non-RVU base fee schedule,56.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2342,Not in chargemaster,E2342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2342,BCBSMN Non-RVU base fee schedule,468.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2342 mod RR,Not in chargemaster,E2342,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2342 mod RR,BCBSMN Non-RVU base fee schedule,46.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2343,Not in chargemaster,E2343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2343,BCBSMN Non-RVU base fee schedule,749.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2343 mod RR,Not in chargemaster,E2343,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2343 mod RR,BCBSMN Non-RVU base fee schedule,74.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2351,Not in chargemaster,E2351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2351,BCBSMN Non-RVU base fee schedule,629.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2351 mod RR,Not in chargemaster,E2351,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2351 mod RR,BCBSMN Non-RVU base fee schedule,62.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2358,Not in chargemaster,E2358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2358,BCBSMN Non-RVU base fee schedule,91.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2358 mod RR,Not in chargemaster,E2358,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2358 mod RR,BCBSMN Non-RVU base fee schedule,9.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2359,Not in chargemaster,E2359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2359,BCBSMN Non-RVU base fee schedule,170.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2359 mod RR,Not in chargemaster,E2359,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2359 mod RR,BCBSMN Non-RVU base fee schedule,17.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2360,Not in chargemaster,E2360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2360,BCBSMN Non-RVU base fee schedule,99.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2360 mod RR,Not in chargemaster,E2360,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2360 mod RR,BCBSMN Non-RVU base fee schedule,10.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2361,Not in chargemaster,E2361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2361,BCBSMN Non-RVU base fee schedule,117.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2361 mod RR,Not in chargemaster,E2361,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2361 mod RR,BCBSMN Non-RVU base fee schedule,11.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2362,Not in chargemaster,E2362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2362,BCBSMN Non-RVU base fee schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2362 mod RR,Not in chargemaster,E2362,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2362 mod RR,BCBSMN Non-RVU base fee schedule,9.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2363,Not in chargemaster,E2363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2363,BCBSMN Non-RVU base fee schedule,153.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2363 mod RR,Not in chargemaster,E2363,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2363 mod RR,BCBSMN Non-RVU base fee schedule,15.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2364,Not in chargemaster,E2364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2364,BCBSMN Non-RVU base fee schedule,99.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2364 mod RR,Not in chargemaster,E2364,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2364 mod RR,BCBSMN Non-RVU base fee schedule,10.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2365,Not in chargemaster,E2365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2365,BCBSMN Non-RVU base fee schedule,87.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2365 mod RR,Not in chargemaster,E2365,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2365 mod RR,BCBSMN Non-RVU base fee schedule,8.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2366,Not in chargemaster,E2366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2366,BCBSMN Non-RVU base fee schedule,193.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2366 mod RR,Not in chargemaster,E2366,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2366 mod RR,BCBSMN Non-RVU base fee schedule,19.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2367,Not in chargemaster,E2367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2367,BCBSMN Non-RVU base fee schedule,368.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2367 mod RR,Not in chargemaster,E2367,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2367 mod RR,BCBSMN Non-RVU base fee schedule,36.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2368,Not in chargemaster,E2368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2368,BCBSMN Non-RVU base fee schedule,449.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2368 mod RR,Not in chargemaster,E2368,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2368 mod RR,BCBSMN Non-RVU base fee schedule,44.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2369,Not in chargemaster,E2369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2369,BCBSMN Non-RVU base fee schedule,407.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2369 mod RR,Not in chargemaster,E2369,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2369 mod RR,BCBSMN Non-RVU base fee schedule,40.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2370,Not in chargemaster,E2370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2370,BCBSMN Non-RVU base fee schedule,645.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2370 mod RR,Not in chargemaster,E2370,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2370 mod RR,BCBSMN Non-RVU base fee schedule,64.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2371,Not in chargemaster,E2371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2371,BCBSMN Non-RVU base fee schedule,134.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2371 mod RR,Not in chargemaster,E2371,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2371 mod RR,BCBSMN Non-RVU base fee schedule,13.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2372,Not in chargemaster,E2372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2372,BCBSMN Non-RVU base fee schedule,91.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2372 mod RR,Not in chargemaster,E2372,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2372 mod RR,BCBSMN Non-RVU base fee schedule,9.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2373,Not in chargemaster,E2373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2373,BCBSMN Non-RVU base fee schedule,756.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2373 mod RR,Not in chargemaster,E2373,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2373 mod RR,BCBSMN Non-RVU base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2374,Not in chargemaster,E2374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2374,BCBSMN Non-RVU base fee schedule,487.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2374 mod RR,Not in chargemaster,E2374,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2374 mod RR,BCBSMN Non-RVU base fee schedule,48.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2375,Not in chargemaster,E2375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2375,BCBSMN Non-RVU base fee schedule,744.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2375 mod RR,Not in chargemaster,E2375,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2375 mod RR,BCBSMN Non-RVU base fee schedule,74.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2376,Not in chargemaster,E2376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2376,BCBSMN Non-RVU base fee schedule,1217.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2376 mod RR,Not in chargemaster,E2376,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2376 mod RR,BCBSMN Non-RVU base fee schedule,121.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2377,Not in chargemaster,E2377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2377,BCBSMN Non-RVU base fee schedule,445.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2377 mod RR,Not in chargemaster,E2377,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2377 mod RR,BCBSMN Non-RVU base fee schedule,44.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2378,Not in chargemaster,E2378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2378,BCBSMN Non-RVU base fee schedule,559.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2378 mod RR,Not in chargemaster,E2378,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2378 mod RR,BCBSMN Non-RVU base fee schedule,55.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2381,Not in chargemaster,E2381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2381,BCBSMN Non-RVU base fee schedule,63.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2381 mod RR,Not in chargemaster,E2381,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2381 mod RR,BCBSMN Non-RVU base fee schedule,6.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2382,Not in chargemaster,E2382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2382,BCBSMN Non-RVU base fee schedule,17.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2382 mod RR,Not in chargemaster,E2382,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2382 mod RR,BCBSMN Non-RVU base fee schedule,1.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2383,Not in chargemaster,E2383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2383,BCBSMN Non-RVU base fee schedule,129.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2383 mod RR,Not in chargemaster,E2383,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2383 mod RR,BCBSMN Non-RVU base fee schedule,12.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2384,Not in chargemaster,E2384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2384,BCBSMN Non-RVU base fee schedule,65.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2384 mod RR,Not in chargemaster,E2384,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2384 mod RR,BCBSMN Non-RVU base fee schedule,6.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2385,Not in chargemaster,E2385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2385,BCBSMN Non-RVU base fee schedule,41.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2385 mod RR,Not in chargemaster,E2385,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2385 mod RR,BCBSMN Non-RVU base fee schedule,4.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2386,Not in chargemaster,E2386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2386,BCBSMN Non-RVU base fee schedule,116.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2386 mod RR,Not in chargemaster,E2386,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2386 mod RR,BCBSMN Non-RVU base fee schedule,11.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2387,Not in chargemaster,E2387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2387,BCBSMN Non-RVU base fee schedule,53.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2387 mod RR,Not in chargemaster,E2387,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2387 mod RR,BCBSMN Non-RVU base fee schedule,5.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2388,Not in chargemaster,E2388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2388,BCBSMN Non-RVU base fee schedule,43.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2388 mod RR,Not in chargemaster,E2388,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2388 mod RR,BCBSMN Non-RVU base fee schedule,4.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2389,Not in chargemaster,E2389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2389,BCBSMN Non-RVU base fee schedule,24.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2389 mod RR,Not in chargemaster,E2389,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2389 mod RR,BCBSMN Non-RVU base fee schedule,2.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2390,Not in chargemaster,E2390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2390,BCBSMN Non-RVU base fee schedule,37.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2390 mod RR,Not in chargemaster,E2390,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2390 mod RR,BCBSMN Non-RVU base fee schedule,3.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2391,Not in chargemaster,E2391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2391,BCBSMN Non-RVU base fee schedule,17.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2391 mod RR,Not in chargemaster,E2391,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2391 mod RR,BCBSMN Non-RVU base fee schedule,1.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2392,Not in chargemaster,E2392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2392,BCBSMN Non-RVU base fee schedule,44.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2392 mod RR,Not in chargemaster,E2392,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2392 mod RR,BCBSMN Non-RVU base fee schedule,4.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2394,Not in chargemaster,E2394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2394,BCBSMN Non-RVU base fee schedule,62.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2394 mod RR,Not in chargemaster,E2394,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2394 mod RR,BCBSMN Non-RVU base fee schedule,6.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2395,Not in chargemaster,E2395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2395,BCBSMN Non-RVU base fee schedule,45.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2395 mod RR,Not in chargemaster,E2395,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2395 mod RR,BCBSMN Non-RVU base fee schedule,4.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2396,Not in chargemaster,E2396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2396,BCBSMN Non-RVU base fee schedule,53.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2396 mod RR,Not in chargemaster,E2396,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2396 mod RR,BCBSMN Non-RVU base fee schedule,5.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2397,Not in chargemaster,E2397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2397,BCBSMN Non-RVU base fee schedule,429.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2397 mod RR,Not in chargemaster,E2397,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2397 mod RR,BCBSMN Non-RVU base fee schedule,42.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2402 mod RR,Not in chargemaster,E2402,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2402 mod RR,BCBSMN Non-RVU base fee schedule,36.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2500,Not in chargemaster,E2500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2500,BCBSMN Non-RVU base fee schedule,408.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2500 mod RR,Not in chargemaster,E2500,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2500 mod RR,BCBSMN Non-RVU base fee schedule,40.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2502,Not in chargemaster,E2502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2502,BCBSMN Non-RVU base fee schedule,1250.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2502 mod RR,Not in chargemaster,E2502,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2502 mod RR,BCBSMN Non-RVU base fee schedule,125.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2504,Not in chargemaster,E2504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2504,BCBSMN Non-RVU base fee schedule,1649.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2504 mod RR,Not in chargemaster,E2504,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2504 mod RR,BCBSMN Non-RVU base fee schedule,164.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2506,Not in chargemaster,E2506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2506,BCBSMN Non-RVU base fee schedule,2418.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2506 mod RR,Not in chargemaster,E2506,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2506 mod RR,BCBSMN Non-RVU base fee schedule,241.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2508,Not in chargemaster,E2508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2508,BCBSMN Non-RVU base fee schedule,3739.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2508 mod RR,Not in chargemaster,E2508,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2508 mod RR,BCBSMN Non-RVU base fee schedule,373.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2510,Not in chargemaster,E2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2510,BCBSMN Non-RVU base fee schedule,7076.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2510 mod RR,Not in chargemaster,E2510,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2510 mod RR,BCBSMN Non-RVU base fee schedule,707.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2512,Not in chargemaster,E2512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2512,BCBSMN Non-RVU base fee schedule,591.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2512 mod RR,Not in chargemaster,E2512,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2512 mod RR,BCBSMN Non-RVU base fee schedule,59.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2601,Not in chargemaster,E2601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2601,BCBSMN Non-RVU base fee schedule,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2601 mod RR,Not in chargemaster,E2601,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2601 mod RR,BCBSMN Non-RVU base fee schedule,4.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2602,Not in chargemaster,E2602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2602,BCBSMN Non-RVU base fee schedule,93.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2602 mod RR,Not in chargemaster,E2602,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2602 mod RR,BCBSMN Non-RVU base fee schedule,9.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2603,Not in chargemaster,E2603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2603,BCBSMN Non-RVU base fee schedule,117.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2603 mod RR,Not in chargemaster,E2603,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2603 mod RR,BCBSMN Non-RVU base fee schedule,11.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2604,Not in chargemaster,E2604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2604,BCBSMN Non-RVU base fee schedule,154.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2604 mod RR,Not in chargemaster,E2604,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2604 mod RR,BCBSMN Non-RVU base fee schedule,15.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2605,Not in chargemaster,E2605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2605,BCBSMN Non-RVU base fee schedule,221.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2605 mod RR,Not in chargemaster,E2605,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2605 mod RR,BCBSMN Non-RVU base fee schedule,22.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2606,Not in chargemaster,E2606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2606,BCBSMN Non-RVU base fee schedule,350.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2606 mod RR,Not in chargemaster,E2606,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2606 mod RR,BCBSMN Non-RVU base fee schedule,35.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2607,Not in chargemaster,E2607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2607,BCBSMN Non-RVU base fee schedule,227.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2607 mod RR,Not in chargemaster,E2607,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2607 mod RR,BCBSMN Non-RVU base fee schedule,22.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2608,Not in chargemaster,E2608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2608,BCBSMN Non-RVU base fee schedule,279.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2608 mod RR,Not in chargemaster,E2608,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2608 mod RR,BCBSMN Non-RVU base fee schedule,27.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2610,Not in chargemaster,E2610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2610,BCBSMN Non-RVU base fee schedule,65.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2610 mod RR,Not in chargemaster,E2610,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2610 mod RR,BCBSMN Non-RVU base fee schedule,6.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2611,Not in chargemaster,E2611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2611,BCBSMN Non-RVU base fee schedule,215.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2611 mod RR,Not in chargemaster,E2611,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2611 mod RR,BCBSMN Non-RVU base fee schedule,21.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2612,Not in chargemaster,E2612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2612,BCBSMN Non-RVU base fee schedule,336.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2612 mod RR,Not in chargemaster,E2612,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2612 mod RR,BCBSMN Non-RVU base fee schedule,33.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2613,Not in chargemaster,E2613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2613,BCBSMN Non-RVU base fee schedule,324.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2613 mod RR,Not in chargemaster,E2613,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2613 mod RR,BCBSMN Non-RVU base fee schedule,32.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2614,Not in chargemaster,E2614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2614,BCBSMN Non-RVU base fee schedule,463.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2614 mod RR,Not in chargemaster,E2614,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2614 mod RR,BCBSMN Non-RVU base fee schedule,46.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2615,Not in chargemaster,E2615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2615,BCBSMN Non-RVU base fee schedule,372.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2615 mod RR,Not in chargemaster,E2615,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2615 mod RR,BCBSMN Non-RVU base fee schedule,37.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2616,Not in chargemaster,E2616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2616,BCBSMN Non-RVU base fee schedule,501.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2616 mod RR,Not in chargemaster,E2616,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2616 mod RR,BCBSMN Non-RVU base fee schedule,50.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2619,Not in chargemaster,E2619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2619,BCBSMN Non-RVU base fee schedule,45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2619 mod RR,Not in chargemaster,E2619,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2619 mod RR,BCBSMN Non-RVU base fee schedule,4.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2620,Not in chargemaster,E2620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2620,BCBSMN Non-RVU base fee schedule,427.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2620 mod RR,Not in chargemaster,E2620,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2620 mod RR,BCBSMN Non-RVU base fee schedule,42.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2621,Not in chargemaster,E2621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2621,BCBSMN Non-RVU base fee schedule,472.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2621 mod RR,Not in chargemaster,E2621,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2621 mod RR,BCBSMN Non-RVU base fee schedule,47.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2622,Not in chargemaster,E2622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2622,BCBSMN Non-RVU base fee schedule,288.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2622 mod RR,Not in chargemaster,E2622,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2622 mod RR,BCBSMN Non-RVU base fee schedule,28.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2623,Not in chargemaster,E2623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2623,BCBSMN Non-RVU base fee schedule,365.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2623 mod RR,Not in chargemaster,E2623,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2623 mod RR,BCBSMN Non-RVU base fee schedule,36.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2624,Not in chargemaster,E2624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2624,BCBSMN Non-RVU base fee schedule,291.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2624 mod RR,Not in chargemaster,E2624,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2624 mod RR,BCBSMN Non-RVU base fee schedule,29.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2625,Not in chargemaster,E2625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2625,BCBSMN Non-RVU base fee schedule,365.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2625 mod RR,Not in chargemaster,E2625,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2625 mod RR,BCBSMN Non-RVU base fee schedule,36.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2626,Not in chargemaster,E2626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2626,BCBSMN Non-RVU base fee schedule,633.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2626 mod RR,Not in chargemaster,E2626,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2626 mod RR,BCBSMN Non-RVU base fee schedule,63.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2627,Not in chargemaster,E2627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2627,BCBSMN Non-RVU base fee schedule,880.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2627 mod RR,Not in chargemaster,E2627,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2627 mod RR,BCBSMN Non-RVU base fee schedule,88.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2628,Not in chargemaster,E2628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2628,BCBSMN Non-RVU base fee schedule,757.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2628 mod RR,Not in chargemaster,E2628,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2628 mod RR,BCBSMN Non-RVU base fee schedule,75.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2629,Not in chargemaster,E2629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2629,BCBSMN Non-RVU base fee schedule,943.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2629 mod RR,Not in chargemaster,E2629,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2629 mod RR,BCBSMN Non-RVU base fee schedule,94.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2630,Not in chargemaster,E2630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2630,BCBSMN Non-RVU base fee schedule,627.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2630 mod RR,Not in chargemaster,E2630,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2630 mod RR,BCBSMN Non-RVU base fee schedule,62.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2631,Not in chargemaster,E2631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2631,BCBSMN Non-RVU base fee schedule,234.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2631 mod RR,Not in chargemaster,E2631,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2631 mod RR,BCBSMN Non-RVU base fee schedule,23.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2632,Not in chargemaster,E2632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2632,BCBSMN Non-RVU base fee schedule,158.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2632 mod RR,Not in chargemaster,E2632,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2632 mod RR,BCBSMN Non-RVU base fee schedule,15.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2633,Not in chargemaster,E2633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2633,BCBSMN Non-RVU base fee schedule,126.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E2633 mod RR,Not in chargemaster,E2633,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E2633 mod RR,BCBSMN Non-RVU base fee schedule,12.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E8000,Not in chargemaster,E8000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E8000,BCBSMN Non-RVU base fee schedule,819.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E8000 mod RR,Not in chargemaster,E8000,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E8000 mod RR,BCBSMN Non-RVU base fee schedule,81.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E8001,Not in chargemaster,E8001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E8001,BCBSMN Non-RVU base fee schedule,2182.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E8001 mod RR,Not in chargemaster,E8001,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E8001 mod RR,BCBSMN Non-RVU base fee schedule,218.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E8002,Not in chargemaster,E8002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E8002,BCBSMN Non-RVU base fee schedule,1117.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU E8002 mod RR,Not in chargemaster,E8002,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,E8002 mod RR,BCBSMN Non-RVU base fee schedule,111.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0008,Not in chargemaster,G0008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0008,BCBSMN Non-RVU base fee schedule,10.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0009,Not in chargemaster,G0009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0009,BCBSMN Non-RVU base fee schedule,10.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0010,Not in chargemaster,G0010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0010,BCBSMN Non-RVU base fee schedule,10.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0027,Not in chargemaster,G0027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0027,BCBSMN Non-RVU base fee schedule,7.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0068,Not in chargemaster,G0068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0068,BCBSMN Non-RVU base fee schedule,124.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0069,Not in chargemaster,G0069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0069,BCBSMN Non-RVU base fee schedule,194.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0070,Not in chargemaster,G0070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0070,BCBSMN Non-RVU base fee schedule,212.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0103,Not in chargemaster,G0103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0103,BCBSMN Non-RVU base fee schedule,21.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0123,Not in chargemaster,G0123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0123,BCBSMN Non-RVU base fee schedule,22.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0129,Not in chargemaster,G0129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0129,BCBSMN Non-RVU base fee schedule,35.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0143,Not in chargemaster,G0143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0143,BCBSMN Non-RVU base fee schedule,29.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0144,Not in chargemaster,G0144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0144,BCBSMN Non-RVU base fee schedule,48.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0145,Not in chargemaster,G0145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0145,BCBSMN Non-RVU base fee schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0147,Not in chargemaster,G0147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0147,BCBSMN Non-RVU base fee schedule,16.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0148,Not in chargemaster,G0148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0148,BCBSMN Non-RVU base fee schedule,35.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0151,Not in chargemaster,G0151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0151,BCBSMN Non-RVU base fee schedule,35.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0152,Not in chargemaster,G0152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0152,BCBSMN Non-RVU base fee schedule,36.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0153,Not in chargemaster,G0153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0153,BCBSMN Non-RVU base fee schedule,37.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0157,Not in chargemaster,G0157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0157,BCBSMN Non-RVU base fee schedule,35.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0158,Not in chargemaster,G0158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0158,BCBSMN Non-RVU base fee schedule,36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0159,Not in chargemaster,G0159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0159,BCBSMN Non-RVU base fee schedule,35.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0177,Not in chargemaster,G0177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0177,BCBSMN Non-RVU base fee schedule,19.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0186,Not in chargemaster,G0186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0186,BCBSMN Non-RVU base fee schedule,1173.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0219,Not in chargemaster,G0219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0219,BCBSMN Non-RVU base fee schedule,377.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0235,Not in chargemaster,G0235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0235,BCBSMN Non-RVU base fee schedule,3191.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0255,Not in chargemaster,G0255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0255,BCBSMN Non-RVU base fee schedule,102.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0257,Not in chargemaster,G0257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0257,BCBSMN Non-RVU base fee schedule,101.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0259,Not in chargemaster,G0259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0259,BCBSMN Non-RVU base fee schedule,475.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0260,Not in chargemaster,G0260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0260,BCBSMN Non-RVU base fee schedule,124.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0269,Not in chargemaster,G0269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0269,BCBSMN Non-RVU base fee schedule,38.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0282,Not in chargemaster,G0282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0282,BCBSMN Non-RVU base fee schedule,17.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0295,Not in chargemaster,G0295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0295,BCBSMN Non-RVU base fee schedule,17.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0299,Not in chargemaster,G0299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0299,BCBSMN Non-RVU base fee schedule,10.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0300,Not in chargemaster,G0300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0300,BCBSMN Non-RVU base fee schedule,7.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0306,Not in chargemaster,G0306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0306,BCBSMN Non-RVU base fee schedule,8.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0307,Not in chargemaster,G0307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0307,BCBSMN Non-RVU base fee schedule,7.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0328,Not in chargemaster,G0328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0328,BCBSMN Non-RVU base fee schedule,18.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0333,Not in chargemaster,G0333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0333,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0378,Not in chargemaster,G0378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0378,BCBSMN Non-RVU base fee schedule,57.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0379,Not in chargemaster,G0379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0379,BCBSMN Non-RVU base fee schedule,187.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0380,Not in chargemaster,G0380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0380,BCBSMN Non-RVU base fee schedule,23.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0381,Not in chargemaster,G0381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0381,BCBSMN Non-RVU base fee schedule,39.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0382,Not in chargemaster,G0382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0382,BCBSMN Non-RVU base fee schedule,88.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0383,Not in chargemaster,G0383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0383,BCBSMN Non-RVU base fee schedule,138.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0384,Not in chargemaster,G0384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0384,BCBSMN Non-RVU base fee schedule,216.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0390,Not in chargemaster,G0390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0390,BCBSMN Non-RVU base fee schedule,366.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0398,Not in chargemaster,G0398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0398,BCBSMN Non-RVU base fee schedule,311.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0399,Not in chargemaster,G0399,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0399,BCBSMN Non-RVU base fee schedule,185.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0400,Not in chargemaster,G0400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0400,BCBSMN Non-RVU base fee schedule,311.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0410,Not in chargemaster,G0410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0410,BCBSMN Non-RVU base fee schedule,44.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0411,Not in chargemaster,G0411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0411,BCBSMN Non-RVU base fee schedule,50.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0432,Not in chargemaster,G0432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0432,BCBSMN Non-RVU base fee schedule,21.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0433,Not in chargemaster,G0433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0433,BCBSMN Non-RVU base fee schedule,18.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0435,Not in chargemaster,G0435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0435,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0448,Not in chargemaster,G0448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0448,BCBSMN Non-RVU base fee schedule,739.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0458,Not in chargemaster,G0458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0458,BCBSMN Non-RVU base fee schedule,211.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0463,Not in chargemaster,G0463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0463,BCBSMN Non-RVU base fee schedule,17.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0466,Not in chargemaster,G0466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0466,BCBSMN Non-RVU base fee schedule,93.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0467,Not in chargemaster,G0467,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0467,BCBSMN Non-RVU base fee schedule,117.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0468,Not in chargemaster,G0468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0468,BCBSMN Non-RVU base fee schedule,263.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0469,Not in chargemaster,G0469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0469,BCBSMN Non-RVU base fee schedule,226.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0470,Not in chargemaster,G0470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0470,BCBSMN Non-RVU base fee schedule,226.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0471,Not in chargemaster,G0471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0471,BCBSMN Non-RVU base fee schedule,5.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0472,Not in chargemaster,G0472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0472,BCBSMN Non-RVU base fee schedule,46.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0475,Not in chargemaster,G0475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0475,BCBSMN Non-RVU base fee schedule,24.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0476,Not in chargemaster,G0476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0476,BCBSMN Non-RVU base fee schedule,38.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0480,Not in chargemaster,G0480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0480,BCBSMN Non-RVU base fee schedule,125.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0481,Not in chargemaster,G0481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0481,BCBSMN Non-RVU base fee schedule,172.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0482,Not in chargemaster,G0482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0482,BCBSMN Non-RVU base fee schedule,218.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0483,Not in chargemaster,G0483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0483,BCBSMN Non-RVU base fee schedule,271.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0490,Not in chargemaster,G0490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0490,BCBSMN Non-RVU base fee schedule,92.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0491,Not in chargemaster,G0491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0491,BCBSMN Non-RVU base fee schedule,101.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0492,Not in chargemaster,G0492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0492,BCBSMN Non-RVU base fee schedule,152.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0493,Not in chargemaster,G0493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0493,BCBSMN Non-RVU base fee schedule,8.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0494,Not in chargemaster,G0494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0494,BCBSMN Non-RVU base fee schedule,6.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0495,Not in chargemaster,G0495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0495,BCBSMN Non-RVU base fee schedule,8.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0496,Not in chargemaster,G0496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0496,BCBSMN Non-RVU base fee schedule,6.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0498,Not in chargemaster,G0498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0498,BCBSMN Non-RVU base fee schedule,238.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0499,Not in chargemaster,G0499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0499,BCBSMN Non-RVU base fee schedule,31.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0501,Not in chargemaster,G0501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0501,BCBSMN Non-RVU base fee schedule,72.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0659,Not in chargemaster,G0659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0659,BCBSMN Non-RVU base fee schedule,68.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0913,Not in chargemaster,G0913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0913,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0914,Not in chargemaster,G0914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0914,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0915,Not in chargemaster,G0915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0915,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0916,Not in chargemaster,G0916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0916,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0917,Not in chargemaster,G0917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0917,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G0918,Not in chargemaster,G0918,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G0918,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1001,Not in chargemaster,G1001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1001,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1002,Not in chargemaster,G1002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1002,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1003,Not in chargemaster,G1003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1003,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1004,Not in chargemaster,G1004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1004,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1005,Not in chargemaster,G1005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1005,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1006,Not in chargemaster,G1006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1006,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1007,Not in chargemaster,G1007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1007,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1008,Not in chargemaster,G1008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1008,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1009,Not in chargemaster,G1009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1009,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1010,Not in chargemaster,G1010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1010,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1011,Not in chargemaster,G1011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1011,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1012,Not in chargemaster,G1012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1012,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1013,Not in chargemaster,G1013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1013,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1014,Not in chargemaster,G1014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1014,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1015,Not in chargemaster,G1015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1015,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1016,Not in chargemaster,G1016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1016,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1017,Not in chargemaster,G1017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1017,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1018,Not in chargemaster,G1018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1018,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1019,Not in chargemaster,G1019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1019,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1020,Not in chargemaster,G1020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1020,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1021,Not in chargemaster,G1021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1021,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1022,Not in chargemaster,G1022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1022,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G1023,Not in chargemaster,G1023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G1023,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2000,Not in chargemaster,G2000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2000,BCBSMN Non-RVU base fee schedule,301.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2021,Not in chargemaster,G2021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2021,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2022,Not in chargemaster,G2022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2022,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2023,Not in chargemaster,G2023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2023,BCBSMN Non-RVU base fee schedule,23.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2024,Not in chargemaster,G2024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2024,BCBSMN Non-RVU base fee schedule,25.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2025,Not in chargemaster,G2025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2025,BCBSMN Non-RVU base fee schedule,93.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2066,Not in chargemaster,G2066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2066,BCBSMN Non-RVU base fee schedule,132.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2067,Not in chargemaster,G2067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2067,BCBSMN Non-RVU base fee schedule,207.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2068,Not in chargemaster,G2068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2068,BCBSMN Non-RVU base fee schedule,258.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2069,Not in chargemaster,G2069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2069,BCBSMN Non-RVU base fee schedule,1757.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2070,Not in chargemaster,G2070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2070,BCBSMN Non-RVU base fee schedule,5326.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2071,Not in chargemaster,G2071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2071,BCBSMN Non-RVU base fee schedule,427.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2072,Not in chargemaster,G2072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2072,BCBSMN Non-RVU base fee schedule,5545.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2073,Not in chargemaster,G2073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2073,BCBSMN Non-RVU base fee schedule,1342.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2074,Not in chargemaster,G2074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2074,BCBSMN Non-RVU base fee schedule,161.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2076,Not in chargemaster,G2076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2076,BCBSMN Non-RVU base fee schedule,179.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2077,Not in chargemaster,G2077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2077,BCBSMN Non-RVU base fee schedule,110.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2078,Not in chargemaster,G2078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2078,BCBSMN Non-RVU base fee schedule,35.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2079,Not in chargemaster,G2079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2079,BCBSMN Non-RVU base fee schedule,86.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2080,Not in chargemaster,G2080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2080,BCBSMN Non-RVU base fee schedule,30.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2081,Not in chargemaster,G2081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2081,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2089,Not in chargemaster,G2089,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2089,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2090,Not in chargemaster,G2090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2090,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2091,Not in chargemaster,G2091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2091,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2092,Not in chargemaster,G2092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2092,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2093,Not in chargemaster,G2093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2093,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2094,Not in chargemaster,G2094,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2094,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2095,Not in chargemaster,G2095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2095,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2096,Not in chargemaster,G2096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2096,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2097,Not in chargemaster,G2097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2097,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2098,Not in chargemaster,G2098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2098,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2099,Not in chargemaster,G2099,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2099,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2100,Not in chargemaster,G2100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2100,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2101,Not in chargemaster,G2101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2101,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2102,Not in chargemaster,G2102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2102,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2103,Not in chargemaster,G2103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2103,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2104,Not in chargemaster,G2104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2104,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2105,Not in chargemaster,G2105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2105,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2106,Not in chargemaster,G2106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2106,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2107,Not in chargemaster,G2107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2107,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2108,Not in chargemaster,G2108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2108,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2109,Not in chargemaster,G2109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2109,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2110,Not in chargemaster,G2110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2110,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2112,Not in chargemaster,G2112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2112,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2113,Not in chargemaster,G2113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2113,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2114,Not in chargemaster,G2114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2114,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2115,Not in chargemaster,G2115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2115,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2116,Not in chargemaster,G2116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2116,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2117,Not in chargemaster,G2117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2117,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2118,Not in chargemaster,G2118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2118,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2119,Not in chargemaster,G2119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2119,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2120,Not in chargemaster,G2120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2120,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2121,Not in chargemaster,G2121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2121,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2122,Not in chargemaster,G2122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2122,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2123,Not in chargemaster,G2123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2123,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2124,Not in chargemaster,G2124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2124,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2125,Not in chargemaster,G2125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2125,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2126,Not in chargemaster,G2126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2126,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2127,Not in chargemaster,G2127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2127,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2128,Not in chargemaster,G2128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2128,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2129,Not in chargemaster,G2129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2129,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2130,Not in chargemaster,G2130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2130,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2131,Not in chargemaster,G2131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2131,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2132,Not in chargemaster,G2132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2132,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2133,Not in chargemaster,G2133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2133,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2134,Not in chargemaster,G2134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2134,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2135,Not in chargemaster,G2135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2135,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2136,Not in chargemaster,G2136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2136,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2137,Not in chargemaster,G2137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2137,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2138,Not in chargemaster,G2138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2138,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2139,Not in chargemaster,G2139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2139,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2140,Not in chargemaster,G2140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2140,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2141,Not in chargemaster,G2141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2141,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2142,Not in chargemaster,G2142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2142,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2143,Not in chargemaster,G2143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2143,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2144,Not in chargemaster,G2144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2144,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2145,Not in chargemaster,G2145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2145,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2146,Not in chargemaster,G2146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2146,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2147,Not in chargemaster,G2147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2147,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2148,Not in chargemaster,G2148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2148,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2149,Not in chargemaster,G2149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2149,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2150,Not in chargemaster,G2150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2150,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2151,Not in chargemaster,G2151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2151,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2152,Not in chargemaster,G2152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2152,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2153,Not in chargemaster,G2153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2153,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2154,Not in chargemaster,G2154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2154,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2155,Not in chargemaster,G2155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2155,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2156,Not in chargemaster,G2156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2156,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2157,Not in chargemaster,G2157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2157,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2158,Not in chargemaster,G2158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2158,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2159,Not in chargemaster,G2159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2159,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2160,Not in chargemaster,G2160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2160,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2161,Not in chargemaster,G2161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2161,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2162,Not in chargemaster,G2162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2162,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2163,Not in chargemaster,G2163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2163,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2164,Not in chargemaster,G2164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2164,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2165,Not in chargemaster,G2165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2165,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2166,Not in chargemaster,G2166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2166,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2167,Not in chargemaster,G2167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2167,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2168,Not in chargemaster,G2168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2168,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G2169,Not in chargemaster,G2169,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G2169,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G6017,Not in chargemaster,G6017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G6017,BCBSMN Non-RVU base fee schedule,60.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8397,Not in chargemaster,G8397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8397,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8398,Not in chargemaster,G8398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8398,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8399,Not in chargemaster,G8399,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8399,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8404,Not in chargemaster,G8404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8404,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8410,Not in chargemaster,G8410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8410,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8417,Not in chargemaster,G8417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8417,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8418,Not in chargemaster,G8418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8418,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8419,Not in chargemaster,G8419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8419,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8420,Not in chargemaster,G8420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8420,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8421,Not in chargemaster,G8421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8421,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8427,Not in chargemaster,G8427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8427,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8428,Not in chargemaster,G8428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8428,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8430,Not in chargemaster,G8430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8430,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8431,Not in chargemaster,G8431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8431,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8432,Not in chargemaster,G8432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8432,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8433,Not in chargemaster,G8433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8433,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8442,Not in chargemaster,G8442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8442,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8482,Not in chargemaster,G8482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8482,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8484,Not in chargemaster,G8484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8484,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8509,Not in chargemaster,G8509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8509,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8510,Not in chargemaster,G8510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8510,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8511,Not in chargemaster,G8511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8511,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8539,Not in chargemaster,G8539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8539,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8541,Not in chargemaster,G8541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8541,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8542,Not in chargemaster,G8542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8542,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8543,Not in chargemaster,G8543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8543,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8573,Not in chargemaster,G8573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8573,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8574,Not in chargemaster,G8574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8574,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8575,Not in chargemaster,G8575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8575,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8576,Not in chargemaster,G8576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8576,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8577,Not in chargemaster,G8577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8577,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8578,Not in chargemaster,G8578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8578,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8694,Not in chargemaster,G8694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8694,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8708,Not in chargemaster,G8708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8708,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8709,Not in chargemaster,G8709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8709,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8710,Not in chargemaster,G8710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8710,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8711,Not in chargemaster,G8711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8711,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8712,Not in chargemaster,G8712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8712,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8721,Not in chargemaster,G8721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8721,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8722,Not in chargemaster,G8722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8722,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8723,Not in chargemaster,G8723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8723,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8724,Not in chargemaster,G8724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8724,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8730,Not in chargemaster,G8730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8730,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8731,Not in chargemaster,G8731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8731,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8732,Not in chargemaster,G8732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8732,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8733,Not in chargemaster,G8733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8733,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8734,Not in chargemaster,G8734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8734,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8735,Not in chargemaster,G8735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8735,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8749,Not in chargemaster,G8749,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8749,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8752,Not in chargemaster,G8752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8752,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8753,Not in chargemaster,G8753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8753,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8754,Not in chargemaster,G8754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8754,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8755,Not in chargemaster,G8755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8755,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8756,Not in chargemaster,G8756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8756,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8783,Not in chargemaster,G8783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8783,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8785,Not in chargemaster,G8785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8785,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8797,Not in chargemaster,G8797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8797,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8798,Not in chargemaster,G8798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8798,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8806,Not in chargemaster,G8806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8806,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8807,Not in chargemaster,G8807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8807,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8808,Not in chargemaster,G8808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8808,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8809,Not in chargemaster,G8809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8809,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8810,Not in chargemaster,G8810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8810,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8811,Not in chargemaster,G8811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8811,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8815,Not in chargemaster,G8815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8815,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8816,Not in chargemaster,G8816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8816,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8817,Not in chargemaster,G8817,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8817,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8818,Not in chargemaster,G8818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8818,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8825,Not in chargemaster,G8825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8825,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8826,Not in chargemaster,G8826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8826,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8833,Not in chargemaster,G8833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8833,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8834,Not in chargemaster,G8834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8834,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8838,Not in chargemaster,G8838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8838,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8839,Not in chargemaster,G8839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8839,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8840,Not in chargemaster,G8840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8840,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8841,Not in chargemaster,G8841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8841,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8842,Not in chargemaster,G8842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8842,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8843,Not in chargemaster,G8843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8843,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8844,Not in chargemaster,G8844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8844,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8845,Not in chargemaster,G8845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8845,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8846,Not in chargemaster,G8846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8846,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8849,Not in chargemaster,G8849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8849,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8850,Not in chargemaster,G8850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8850,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8851,Not in chargemaster,G8851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8851,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8852,Not in chargemaster,G8852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8852,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8854,Not in chargemaster,G8854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8854,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8855,Not in chargemaster,G8855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8855,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8856,Not in chargemaster,G8856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8856,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8857,Not in chargemaster,G8857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8857,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8858,Not in chargemaster,G8858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8858,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8863,Not in chargemaster,G8863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8863,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8864,Not in chargemaster,G8864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8864,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8865,Not in chargemaster,G8865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8865,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8866,Not in chargemaster,G8866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8866,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8867,Not in chargemaster,G8867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8867,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8869,Not in chargemaster,G8869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8869,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8872,Not in chargemaster,G8872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8872,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8873,Not in chargemaster,G8873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8873,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8874,Not in chargemaster,G8874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8874,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8875,Not in chargemaster,G8875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8875,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8876,Not in chargemaster,G8876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8876,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8877,Not in chargemaster,G8877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8877,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8878,Not in chargemaster,G8878,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8878,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8880,Not in chargemaster,G8880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8880,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8881,Not in chargemaster,G8881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8881,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8882,Not in chargemaster,G8882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8882,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8883,Not in chargemaster,G8883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8883,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8884,Not in chargemaster,G8884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8884,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8885,Not in chargemaster,G8885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8885,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8907,Not in chargemaster,G8907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8907,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8908,Not in chargemaster,G8908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8908,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8909,Not in chargemaster,G8909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8909,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8910,Not in chargemaster,G8910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8910,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8911,Not in chargemaster,G8911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8911,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8912,Not in chargemaster,G8912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8912,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8913,Not in chargemaster,G8913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8913,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8914,Not in chargemaster,G8914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8914,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8915,Not in chargemaster,G8915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8915,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8916,Not in chargemaster,G8916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8916,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8917,Not in chargemaster,G8917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8917,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8918,Not in chargemaster,G8918,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8918,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8923,Not in chargemaster,G8923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8923,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8924,Not in chargemaster,G8924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8924,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8925,Not in chargemaster,G8925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8925,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8926,Not in chargemaster,G8926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8926,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8934,Not in chargemaster,G8934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8934,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8935,Not in chargemaster,G8935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8935,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8936,Not in chargemaster,G8936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8936,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8937,Not in chargemaster,G8937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8937,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8938,Not in chargemaster,G8938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8938,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8939,Not in chargemaster,G8939,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8939,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8941,Not in chargemaster,G8941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8941,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8942,Not in chargemaster,G8942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8942,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8944,Not in chargemaster,G8944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8944,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8946,Not in chargemaster,G8946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8946,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8950,Not in chargemaster,G8950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8950,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8952,Not in chargemaster,G8952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8952,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8955,Not in chargemaster,G8955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8955,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8956,Not in chargemaster,G8956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8956,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8958,Not in chargemaster,G8958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8958,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8959,Not in chargemaster,G8959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8959,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8960,Not in chargemaster,G8960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8960,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8961,Not in chargemaster,G8961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8961,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8962,Not in chargemaster,G8962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8962,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8963,Not in chargemaster,G8963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8963,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8964,Not in chargemaster,G8964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8964,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8965,Not in chargemaster,G8965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8965,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8966,Not in chargemaster,G8966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8966,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8967,Not in chargemaster,G8967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8967,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8968,Not in chargemaster,G8968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8968,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8969,Not in chargemaster,G8969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8969,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8970,Not in chargemaster,G8970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8970,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8973,Not in chargemaster,G8973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8973,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8974,Not in chargemaster,G8974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8974,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8975,Not in chargemaster,G8975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8975,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G8976,Not in chargemaster,G8976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G8976,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9002,Not in chargemaster,G9002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9002,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9012,Not in chargemaster,G9012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9012,BCBSMN Non-RVU base fee schedule,20.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9050,Not in chargemaster,G9050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9050,BCBSMN Non-RVU base fee schedule,7.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9051,Not in chargemaster,G9051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9051,BCBSMN Non-RVU base fee schedule,9.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9052,Not in chargemaster,G9052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9052,BCBSMN Non-RVU base fee schedule,10.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9053,Not in chargemaster,G9053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9053,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9054,Not in chargemaster,G9054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9054,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9055,Not in chargemaster,G9055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9055,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9056,Not in chargemaster,G9056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9056,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9057,Not in chargemaster,G9057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9057,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9058,Not in chargemaster,G9058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9058,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9059,Not in chargemaster,G9059,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9059,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9060,Not in chargemaster,G9060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9060,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9061,Not in chargemaster,G9061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9061,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9062,Not in chargemaster,G9062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9062,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9063,Not in chargemaster,G9063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9063,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9064,Not in chargemaster,G9064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9064,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9065,Not in chargemaster,G9065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9065,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9066,Not in chargemaster,G9066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9066,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9067,Not in chargemaster,G9067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9067,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9068,Not in chargemaster,G9068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9068,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9069,Not in chargemaster,G9069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9069,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9070,Not in chargemaster,G9070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9070,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9071,Not in chargemaster,G9071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9071,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9072,Not in chargemaster,G9072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9072,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9073,Not in chargemaster,G9073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9073,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9074,Not in chargemaster,G9074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9074,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9075,Not in chargemaster,G9075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9075,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9077,Not in chargemaster,G9077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9077,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9078,Not in chargemaster,G9078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9078,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9079,Not in chargemaster,G9079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9079,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9080,Not in chargemaster,G9080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9080,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9083,Not in chargemaster,G9083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9083,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9084,Not in chargemaster,G9084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9084,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9085,Not in chargemaster,G9085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9085,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9086,Not in chargemaster,G9086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9086,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9087,Not in chargemaster,G9087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9087,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9088,Not in chargemaster,G9088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9088,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9089,Not in chargemaster,G9089,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9089,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9090,Not in chargemaster,G9090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9090,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9091,Not in chargemaster,G9091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9091,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9092,Not in chargemaster,G9092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9092,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9093,Not in chargemaster,G9093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9093,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9094,Not in chargemaster,G9094,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9094,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9095,Not in chargemaster,G9095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9095,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9096,Not in chargemaster,G9096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9096,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9097,Not in chargemaster,G9097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9097,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9098,Not in chargemaster,G9098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9098,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9099,Not in chargemaster,G9099,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9099,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9100,Not in chargemaster,G9100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9100,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9101,Not in chargemaster,G9101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9101,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9102,Not in chargemaster,G9102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9102,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9103,Not in chargemaster,G9103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9103,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9104,Not in chargemaster,G9104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9104,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9105,Not in chargemaster,G9105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9105,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9106,Not in chargemaster,G9106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9106,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9107,Not in chargemaster,G9107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9107,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9108,Not in chargemaster,G9108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9108,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9109,Not in chargemaster,G9109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9109,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9110,Not in chargemaster,G9110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9110,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9111,Not in chargemaster,G9111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9111,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9112,Not in chargemaster,G9112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9112,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9113,Not in chargemaster,G9113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9113,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9114,Not in chargemaster,G9114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9114,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9115,Not in chargemaster,G9115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9115,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9116,Not in chargemaster,G9116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9116,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9117,Not in chargemaster,G9117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9117,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9123,Not in chargemaster,G9123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9123,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9124,Not in chargemaster,G9124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9124,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9125,Not in chargemaster,G9125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9125,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9126,Not in chargemaster,G9126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9126,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9128,Not in chargemaster,G9128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9128,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9129,Not in chargemaster,G9129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9129,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9130,Not in chargemaster,G9130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9130,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9131,Not in chargemaster,G9131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9131,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9132,Not in chargemaster,G9132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9132,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9133,Not in chargemaster,G9133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9133,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9134,Not in chargemaster,G9134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9134,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9135,Not in chargemaster,G9135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9135,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9136,Not in chargemaster,G9136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9136,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9137,Not in chargemaster,G9137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9137,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9138,Not in chargemaster,G9138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9138,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9139,Not in chargemaster,G9139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9139,BCBSMN Non-RVU base fee schedule,23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9140,Not in chargemaster,G9140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9140,BCBSMN Non-RVU base fee schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9143,Not in chargemaster,G9143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9143,BCBSMN Non-RVU base fee schedule,132.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9148,Not in chargemaster,G9148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9148,BCBSMN Non-RVU base fee schedule,10.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9149,Not in chargemaster,G9149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9149,BCBSMN Non-RVU base fee schedule,10.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9150,Not in chargemaster,G9150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9150,BCBSMN Non-RVU base fee schedule,10.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9156,Not in chargemaster,G9156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9156,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9188,Not in chargemaster,G9188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9188,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9189,Not in chargemaster,G9189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9189,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9190,Not in chargemaster,G9190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9190,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9191,Not in chargemaster,G9191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9191,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9192,Not in chargemaster,G9192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9192,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9196,Not in chargemaster,G9196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9196,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9197,Not in chargemaster,G9197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9197,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9198,Not in chargemaster,G9198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9198,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9212,Not in chargemaster,G9212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9212,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9213,Not in chargemaster,G9213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9213,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9223,Not in chargemaster,G9223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9223,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9225,Not in chargemaster,G9225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9225,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9226,Not in chargemaster,G9226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9226,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9227,Not in chargemaster,G9227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9227,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9228,Not in chargemaster,G9228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9228,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9229,Not in chargemaster,G9229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9229,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9230,Not in chargemaster,G9230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9230,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9231,Not in chargemaster,G9231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9231,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9232,Not in chargemaster,G9232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9232,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9239,Not in chargemaster,G9239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9239,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9240,Not in chargemaster,G9240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9240,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9241,Not in chargemaster,G9241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9241,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9242,Not in chargemaster,G9242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9242,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9243,Not in chargemaster,G9243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9243,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9246,Not in chargemaster,G9246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9246,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9247,Not in chargemaster,G9247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9247,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9250,Not in chargemaster,G9250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9250,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9251,Not in chargemaster,G9251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9251,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9254,Not in chargemaster,G9254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9254,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9255,Not in chargemaster,G9255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9255,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9256,Not in chargemaster,G9256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9256,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9257,Not in chargemaster,G9257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9257,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9258,Not in chargemaster,G9258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9258,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9259,Not in chargemaster,G9259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9259,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9260,Not in chargemaster,G9260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9260,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9261,Not in chargemaster,G9261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9261,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9262,Not in chargemaster,G9262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9262,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9263,Not in chargemaster,G9263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9263,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9264,Not in chargemaster,G9264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9264,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9265,Not in chargemaster,G9265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9265,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9266,Not in chargemaster,G9266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9266,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9267,Not in chargemaster,G9267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9267,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9268,Not in chargemaster,G9268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9268,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9269,Not in chargemaster,G9269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9269,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9270,Not in chargemaster,G9270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9270,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9273,Not in chargemaster,G9273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9273,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9274,Not in chargemaster,G9274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9274,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9275,Not in chargemaster,G9275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9275,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9276,Not in chargemaster,G9276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9276,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9277,Not in chargemaster,G9277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9277,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9278,Not in chargemaster,G9278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9278,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9279,Not in chargemaster,G9279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9279,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9280,Not in chargemaster,G9280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9280,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9281,Not in chargemaster,G9281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9281,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9282,Not in chargemaster,G9282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9282,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9283,Not in chargemaster,G9283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9283,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9284,Not in chargemaster,G9284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9284,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9285,Not in chargemaster,G9285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9285,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9286,Not in chargemaster,G9286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9286,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9287,Not in chargemaster,G9287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9287,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9288,Not in chargemaster,G9288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9288,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9289,Not in chargemaster,G9289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9289,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9290,Not in chargemaster,G9290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9290,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9291,Not in chargemaster,G9291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9291,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9292,Not in chargemaster,G9292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9292,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9293,Not in chargemaster,G9293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9293,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9294,Not in chargemaster,G9294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9294,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9295,Not in chargemaster,G9295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9295,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9296,Not in chargemaster,G9296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9296,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9297,Not in chargemaster,G9297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9297,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9298,Not in chargemaster,G9298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9298,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9299,Not in chargemaster,G9299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9299,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9300,Not in chargemaster,G9300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9300,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9301,Not in chargemaster,G9301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9301,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9302,Not in chargemaster,G9302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9302,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9303,Not in chargemaster,G9303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9303,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9304,Not in chargemaster,G9304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9304,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9305,Not in chargemaster,G9305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9305,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9306,Not in chargemaster,G9306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9306,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9307,Not in chargemaster,G9307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9307,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9308,Not in chargemaster,G9308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9308,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9309,Not in chargemaster,G9309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9309,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9310,Not in chargemaster,G9310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9310,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9311,Not in chargemaster,G9311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9311,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9312,Not in chargemaster,G9312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9312,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9313,Not in chargemaster,G9313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9313,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9314,Not in chargemaster,G9314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9314,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9315,Not in chargemaster,G9315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9315,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9316,Not in chargemaster,G9316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9316,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9317,Not in chargemaster,G9317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9317,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9318,Not in chargemaster,G9318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9318,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9319,Not in chargemaster,G9319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9319,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9321,Not in chargemaster,G9321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9321,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9322,Not in chargemaster,G9322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9322,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9326,Not in chargemaster,G9326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9326,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9327,Not in chargemaster,G9327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9327,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9329,Not in chargemaster,G9329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9329,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9340,Not in chargemaster,G9340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9340,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9341,Not in chargemaster,G9341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9341,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9342,Not in chargemaster,G9342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9342,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9344,Not in chargemaster,G9344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9344,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9345,Not in chargemaster,G9345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9345,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9347,Not in chargemaster,G9347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9347,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9348,Not in chargemaster,G9348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9348,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9349,Not in chargemaster,G9349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9349,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9350,Not in chargemaster,G9350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9350,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9351,Not in chargemaster,G9351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9351,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9352,Not in chargemaster,G9352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9352,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9353,Not in chargemaster,G9353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9353,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9354,Not in chargemaster,G9354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9354,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9355,Not in chargemaster,G9355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9355,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9356,Not in chargemaster,G9356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9356,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9357,Not in chargemaster,G9357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9357,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9358,Not in chargemaster,G9358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9358,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9359,Not in chargemaster,G9359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9359,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9360,Not in chargemaster,G9360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9360,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9364,Not in chargemaster,G9364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9364,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9365,Not in chargemaster,G9365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9365,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9366,Not in chargemaster,G9366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9366,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9367,Not in chargemaster,G9367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9367,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9368,Not in chargemaster,G9368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9368,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9380,Not in chargemaster,G9380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9380,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9382,Not in chargemaster,G9382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9382,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9383,Not in chargemaster,G9383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9383,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9384,Not in chargemaster,G9384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9384,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9385,Not in chargemaster,G9385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9385,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9386,Not in chargemaster,G9386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9386,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9389,Not in chargemaster,G9389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9389,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9390,Not in chargemaster,G9390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9390,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9393,Not in chargemaster,G9393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9393,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9394,Not in chargemaster,G9394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9394,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9395,Not in chargemaster,G9395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9395,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9396,Not in chargemaster,G9396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9396,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9399,Not in chargemaster,G9399,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9399,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9400,Not in chargemaster,G9400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9400,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9401,Not in chargemaster,G9401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9401,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9402,Not in chargemaster,G9402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9402,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9403,Not in chargemaster,G9403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9403,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9404,Not in chargemaster,G9404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9404,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9405,Not in chargemaster,G9405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9405,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9406,Not in chargemaster,G9406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9406,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9407,Not in chargemaster,G9407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9407,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9408,Not in chargemaster,G9408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9408,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9409,Not in chargemaster,G9409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9409,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9410,Not in chargemaster,G9410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9410,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9411,Not in chargemaster,G9411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9411,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9412,Not in chargemaster,G9412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9412,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9413,Not in chargemaster,G9413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9413,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9414,Not in chargemaster,G9414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9414,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9415,Not in chargemaster,G9415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9415,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9416,Not in chargemaster,G9416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9416,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9417,Not in chargemaster,G9417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9417,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9418,Not in chargemaster,G9418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9418,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9419,Not in chargemaster,G9419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9419,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9420,Not in chargemaster,G9420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9420,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9421,Not in chargemaster,G9421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9421,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9422,Not in chargemaster,G9422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9422,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9423,Not in chargemaster,G9423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9423,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9424,Not in chargemaster,G9424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9424,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9425,Not in chargemaster,G9425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9425,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9426,Not in chargemaster,G9426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9426,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9427,Not in chargemaster,G9427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9427,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9428,Not in chargemaster,G9428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9428,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9429,Not in chargemaster,G9429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9429,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9430,Not in chargemaster,G9430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9430,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9431,Not in chargemaster,G9431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9431,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9432,Not in chargemaster,G9432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9432,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9434,Not in chargemaster,G9434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9434,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9448,Not in chargemaster,G9448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9448,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9449,Not in chargemaster,G9449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9449,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9450,Not in chargemaster,G9450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9450,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9451,Not in chargemaster,G9451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9451,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9452,Not in chargemaster,G9452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9452,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9453,Not in chargemaster,G9453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9453,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9454,Not in chargemaster,G9454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9454,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9455,Not in chargemaster,G9455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9455,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9456,Not in chargemaster,G9456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9456,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9457,Not in chargemaster,G9457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9457,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9458,Not in chargemaster,G9458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9458,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9459,Not in chargemaster,G9459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9459,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9460,Not in chargemaster,G9460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9460,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9468,Not in chargemaster,G9468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9468,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9469,Not in chargemaster,G9469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9469,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9470,Not in chargemaster,G9470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9470,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9471,Not in chargemaster,G9471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9471,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9473,Not in chargemaster,G9473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9473,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9474,Not in chargemaster,G9474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9474,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9475,Not in chargemaster,G9475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9475,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9476,Not in chargemaster,G9476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9476,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9477,Not in chargemaster,G9477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9477,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9478,Not in chargemaster,G9478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9478,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9479,Not in chargemaster,G9479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9479,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9480,Not in chargemaster,G9480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9480,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9497,Not in chargemaster,G9497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9497,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9498,Not in chargemaster,G9498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9498,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9500,Not in chargemaster,G9500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9500,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9501,Not in chargemaster,G9501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9501,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9502,Not in chargemaster,G9502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9502,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9503,Not in chargemaster,G9503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9503,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9504,Not in chargemaster,G9504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9504,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9505,Not in chargemaster,G9505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9505,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9506,Not in chargemaster,G9506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9506,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9507,Not in chargemaster,G9507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9507,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9508,Not in chargemaster,G9508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9508,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9509,Not in chargemaster,G9509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9509,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9510,Not in chargemaster,G9510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9510,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9511,Not in chargemaster,G9511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9511,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9512,Not in chargemaster,G9512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9512,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9513,Not in chargemaster,G9513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9513,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9514,Not in chargemaster,G9514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9514,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9515,Not in chargemaster,G9515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9515,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9516,Not in chargemaster,G9516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9516,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9517,Not in chargemaster,G9517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9517,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9518,Not in chargemaster,G9518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9518,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9519,Not in chargemaster,G9519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9519,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9520,Not in chargemaster,G9520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9520,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9521,Not in chargemaster,G9521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9521,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9522,Not in chargemaster,G9522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9522,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9523,Not in chargemaster,G9523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9523,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9524,Not in chargemaster,G9524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9524,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9525,Not in chargemaster,G9525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9525,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9526,Not in chargemaster,G9526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9526,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9529,Not in chargemaster,G9529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9529,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9530,Not in chargemaster,G9530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9530,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9531,Not in chargemaster,G9531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9531,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9532,Not in chargemaster,G9532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9532,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9533,Not in chargemaster,G9533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9533,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9537,Not in chargemaster,G9537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9537,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9539,Not in chargemaster,G9539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9539,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9540,Not in chargemaster,G9540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9540,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9541,Not in chargemaster,G9541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9541,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9542,Not in chargemaster,G9542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9542,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9543,Not in chargemaster,G9543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9543,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9544,Not in chargemaster,G9544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9544,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9547,Not in chargemaster,G9547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9547,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9548,Not in chargemaster,G9548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9548,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9549,Not in chargemaster,G9549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9549,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9550,Not in chargemaster,G9550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9550,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9551,Not in chargemaster,G9551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9551,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9552,Not in chargemaster,G9552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9552,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9553,Not in chargemaster,G9553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9553,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9554,Not in chargemaster,G9554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9554,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9555,Not in chargemaster,G9555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9555,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9556,Not in chargemaster,G9556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9556,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9557,Not in chargemaster,G9557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9557,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9558,Not in chargemaster,G9558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9558,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9559,Not in chargemaster,G9559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9559,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9560,Not in chargemaster,G9560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9560,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9561,Not in chargemaster,G9561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9561,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9562,Not in chargemaster,G9562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9562,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9563,Not in chargemaster,G9563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9563,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9573,Not in chargemaster,G9573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9573,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9574,Not in chargemaster,G9574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9574,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9577,Not in chargemaster,G9577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9577,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9578,Not in chargemaster,G9578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9578,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9579,Not in chargemaster,G9579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9579,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9580,Not in chargemaster,G9580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9580,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9582,Not in chargemaster,G9582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9582,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9583,Not in chargemaster,G9583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9583,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9584,Not in chargemaster,G9584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9584,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9585,Not in chargemaster,G9585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9585,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9593,Not in chargemaster,G9593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9593,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9594,Not in chargemaster,G9594,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9594,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9595,Not in chargemaster,G9595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9595,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9596,Not in chargemaster,G9596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9596,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9597,Not in chargemaster,G9597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9597,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9598,Not in chargemaster,G9598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9598,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9599,Not in chargemaster,G9599,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9599,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9600,Not in chargemaster,G9600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9600,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9601,Not in chargemaster,G9601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9601,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9602,Not in chargemaster,G9602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9602,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9603,Not in chargemaster,G9603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9603,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9604,Not in chargemaster,G9604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9604,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9605,Not in chargemaster,G9605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9605,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9606,Not in chargemaster,G9606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9606,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9607,Not in chargemaster,G9607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9607,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9608,Not in chargemaster,G9608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9608,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9609,Not in chargemaster,G9609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9609,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9610,Not in chargemaster,G9610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9610,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9611,Not in chargemaster,G9611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9611,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9612,Not in chargemaster,G9612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9612,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9613,Not in chargemaster,G9613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9613,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9614,Not in chargemaster,G9614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9614,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9615,Not in chargemaster,G9615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9615,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9616,Not in chargemaster,G9616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9616,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9617,Not in chargemaster,G9617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9617,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9618,Not in chargemaster,G9618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9618,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9620,Not in chargemaster,G9620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9620,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9621,Not in chargemaster,G9621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9621,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9622,Not in chargemaster,G9622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9622,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9623,Not in chargemaster,G9623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9623,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9624,Not in chargemaster,G9624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9624,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9625,Not in chargemaster,G9625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9625,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9626,Not in chargemaster,G9626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9626,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9627,Not in chargemaster,G9627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9627,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9628,Not in chargemaster,G9628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9628,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9629,Not in chargemaster,G9629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9629,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9630,Not in chargemaster,G9630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9630,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9631,Not in chargemaster,G9631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9631,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9632,Not in chargemaster,G9632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9632,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9633,Not in chargemaster,G9633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9633,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9634,Not in chargemaster,G9634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9634,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9635,Not in chargemaster,G9635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9635,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9636,Not in chargemaster,G9636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9636,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9637,Not in chargemaster,G9637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9637,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9638,Not in chargemaster,G9638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9638,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9639,Not in chargemaster,G9639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9639,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9640,Not in chargemaster,G9640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9640,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9641,Not in chargemaster,G9641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9641,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9642,Not in chargemaster,G9642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9642,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9643,Not in chargemaster,G9643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9643,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9644,Not in chargemaster,G9644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9644,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9645,Not in chargemaster,G9645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9645,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9646,Not in chargemaster,G9646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9646,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9647,Not in chargemaster,G9647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9647,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9648,Not in chargemaster,G9648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9648,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9649,Not in chargemaster,G9649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9649,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9651,Not in chargemaster,G9651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9651,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9654,Not in chargemaster,G9654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9654,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9655,Not in chargemaster,G9655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9655,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9656,Not in chargemaster,G9656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9656,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9658,Not in chargemaster,G9658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9658,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9659,Not in chargemaster,G9659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9659,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9660,Not in chargemaster,G9660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9660,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9661,Not in chargemaster,G9661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9661,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9662,Not in chargemaster,G9662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9662,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9663,Not in chargemaster,G9663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9663,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9664,Not in chargemaster,G9664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9664,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9665,Not in chargemaster,G9665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9665,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9666,Not in chargemaster,G9666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9666,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9674,Not in chargemaster,G9674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9674,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9675,Not in chargemaster,G9675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9675,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9676,Not in chargemaster,G9676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9676,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9678,Not in chargemaster,G9678,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9678,BCBSMN Non-RVU base fee schedule,160,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9679,Not in chargemaster,G9679,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9679,BCBSMN Non-RVU base fee schedule,74.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9680,Not in chargemaster,G9680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9680,BCBSMN Non-RVU base fee schedule,74.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9681,Not in chargemaster,G9681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9681,BCBSMN Non-RVU base fee schedule,74.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9682,Not in chargemaster,G9682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9682,BCBSMN Non-RVU base fee schedule,74.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9683,Not in chargemaster,G9683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9683,BCBSMN Non-RVU base fee schedule,74.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9684,Not in chargemaster,G9684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9684,BCBSMN Non-RVU base fee schedule,74.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9687,Not in chargemaster,G9687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9687,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9688,Not in chargemaster,G9688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9688,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9689,Not in chargemaster,G9689,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9689,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9690,Not in chargemaster,G9690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9690,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9691,Not in chargemaster,G9691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9691,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9692,Not in chargemaster,G9692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9692,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9693,Not in chargemaster,G9693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9693,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9694,Not in chargemaster,G9694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9694,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9695,Not in chargemaster,G9695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9695,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9696,Not in chargemaster,G9696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9696,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9697,Not in chargemaster,G9697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9697,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9698,Not in chargemaster,G9698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9698,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9699,Not in chargemaster,G9699,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9699,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9700,Not in chargemaster,G9700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9700,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9701,Not in chargemaster,G9701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9701,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9702,Not in chargemaster,G9702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9702,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9703,Not in chargemaster,G9703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9703,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9704,Not in chargemaster,G9704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9704,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9705,Not in chargemaster,G9705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9705,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9706,Not in chargemaster,G9706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9706,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9707,Not in chargemaster,G9707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9707,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9708,Not in chargemaster,G9708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9708,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9709,Not in chargemaster,G9709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9709,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9710,Not in chargemaster,G9710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9710,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9711,Not in chargemaster,G9711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9711,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9712,Not in chargemaster,G9712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9712,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9713,Not in chargemaster,G9713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9713,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9714,Not in chargemaster,G9714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9714,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9715,Not in chargemaster,G9715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9715,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9716,Not in chargemaster,G9716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9716,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9717,Not in chargemaster,G9717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9717,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9718,Not in chargemaster,G9718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9718,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9719,Not in chargemaster,G9719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9719,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9720,Not in chargemaster,G9720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9720,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9721,Not in chargemaster,G9721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9721,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9722,Not in chargemaster,G9722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9722,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9723,Not in chargemaster,G9723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9723,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9724,Not in chargemaster,G9724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9724,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9725,Not in chargemaster,G9725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9725,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9726,Not in chargemaster,G9726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9726,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9727,Not in chargemaster,G9727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9727,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9728,Not in chargemaster,G9728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9728,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9729,Not in chargemaster,G9729,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9729,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9730,Not in chargemaster,G9730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9730,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9731,Not in chargemaster,G9731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9731,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9732,Not in chargemaster,G9732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9732,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9733,Not in chargemaster,G9733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9733,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9734,Not in chargemaster,G9734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9734,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9735,Not in chargemaster,G9735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9735,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9736,Not in chargemaster,G9736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9736,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9737,Not in chargemaster,G9737,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9737,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9738,Not in chargemaster,G9738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9738,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9739,Not in chargemaster,G9739,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9739,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9740,Not in chargemaster,G9740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9740,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9741,Not in chargemaster,G9741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9741,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9744,Not in chargemaster,G9744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9744,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9745,Not in chargemaster,G9745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9745,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9746,Not in chargemaster,G9746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9746,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9747,Not in chargemaster,G9747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9747,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9748,Not in chargemaster,G9748,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9748,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9749,Not in chargemaster,G9749,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9749,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9750,Not in chargemaster,G9750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9750,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9751,Not in chargemaster,G9751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9751,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9752,Not in chargemaster,G9752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9752,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9753,Not in chargemaster,G9753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9753,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9754,Not in chargemaster,G9754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9754,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9755,Not in chargemaster,G9755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9755,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9756,Not in chargemaster,G9756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9756,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9757,Not in chargemaster,G9757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9757,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9758,Not in chargemaster,G9758,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9758,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9759,Not in chargemaster,G9759,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9759,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9760,Not in chargemaster,G9760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9760,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9761,Not in chargemaster,G9761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9761,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9762,Not in chargemaster,G9762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9762,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9763,Not in chargemaster,G9763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9763,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9764,Not in chargemaster,G9764,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9764,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9765,Not in chargemaster,G9765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9765,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9766,Not in chargemaster,G9766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9766,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9767,Not in chargemaster,G9767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9767,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9768,Not in chargemaster,G9768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9768,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9769,Not in chargemaster,G9769,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9769,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9770,Not in chargemaster,G9770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9770,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9771,Not in chargemaster,G9771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9771,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9772,Not in chargemaster,G9772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9772,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9773,Not in chargemaster,G9773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9773,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9774,Not in chargemaster,G9774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9774,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9775,Not in chargemaster,G9775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9775,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9776,Not in chargemaster,G9776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9776,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9777,Not in chargemaster,G9777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9777,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9778,Not in chargemaster,G9778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9778,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9779,Not in chargemaster,G9779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9779,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9780,Not in chargemaster,G9780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9780,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9781,Not in chargemaster,G9781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9781,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9782,Not in chargemaster,G9782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9782,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9783,Not in chargemaster,G9783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9783,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9784,Not in chargemaster,G9784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9784,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9785,Not in chargemaster,G9785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9785,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9786,Not in chargemaster,G9786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9786,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9787,Not in chargemaster,G9787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9787,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9788,Not in chargemaster,G9788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9788,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9789,Not in chargemaster,G9789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9789,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9790,Not in chargemaster,G9790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9790,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9791,Not in chargemaster,G9791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9791,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9792,Not in chargemaster,G9792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9792,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9793,Not in chargemaster,G9793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9793,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9794,Not in chargemaster,G9794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9794,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9795,Not in chargemaster,G9795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9795,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9796,Not in chargemaster,G9796,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9796,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9797,Not in chargemaster,G9797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9797,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9798,Not in chargemaster,G9798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9798,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9799,Not in chargemaster,G9799,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9799,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9800,Not in chargemaster,G9800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9800,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9801,Not in chargemaster,G9801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9801,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9802,Not in chargemaster,G9802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9802,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9803,Not in chargemaster,G9803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9803,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9804,Not in chargemaster,G9804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9804,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9805,Not in chargemaster,G9805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9805,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9806,Not in chargemaster,G9806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9806,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9807,Not in chargemaster,G9807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9807,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9808,Not in chargemaster,G9808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9808,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9809,Not in chargemaster,G9809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9809,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9810,Not in chargemaster,G9810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9810,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9811,Not in chargemaster,G9811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9811,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9812,Not in chargemaster,G9812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9812,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9813,Not in chargemaster,G9813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9813,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9814,Not in chargemaster,G9814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9814,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9815,Not in chargemaster,G9815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9815,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9816,Not in chargemaster,G9816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9816,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9817,Not in chargemaster,G9817,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9817,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9818,Not in chargemaster,G9818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9818,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9819,Not in chargemaster,G9819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9819,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9820,Not in chargemaster,G9820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9820,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9821,Not in chargemaster,G9821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9821,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9822,Not in chargemaster,G9822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9822,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9823,Not in chargemaster,G9823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9823,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9824,Not in chargemaster,G9824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9824,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9825,Not in chargemaster,G9825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9825,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9826,Not in chargemaster,G9826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9826,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9827,Not in chargemaster,G9827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9827,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9828,Not in chargemaster,G9828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9828,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9829,Not in chargemaster,G9829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9829,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9830,Not in chargemaster,G9830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9830,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9831,Not in chargemaster,G9831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9831,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9832,Not in chargemaster,G9832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9832,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9833,Not in chargemaster,G9833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9833,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9834,Not in chargemaster,G9834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9834,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9835,Not in chargemaster,G9835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9835,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9836,Not in chargemaster,G9836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9836,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9837,Not in chargemaster,G9837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9837,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9838,Not in chargemaster,G9838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9838,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9839,Not in chargemaster,G9839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9839,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9840,Not in chargemaster,G9840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9840,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9841,Not in chargemaster,G9841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9841,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9842,Not in chargemaster,G9842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9842,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9843,Not in chargemaster,G9843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9843,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9844,Not in chargemaster,G9844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9844,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9845,Not in chargemaster,G9845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9845,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9846,Not in chargemaster,G9846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9846,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9847,Not in chargemaster,G9847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9847,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9848,Not in chargemaster,G9848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9848,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9849,Not in chargemaster,G9849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9849,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9850,Not in chargemaster,G9850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9850,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9851,Not in chargemaster,G9851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9851,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9852,Not in chargemaster,G9852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9852,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9853,Not in chargemaster,G9853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9853,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9854,Not in chargemaster,G9854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9854,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9855,Not in chargemaster,G9855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9855,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9856,Not in chargemaster,G9856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9856,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9857,Not in chargemaster,G9857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9857,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9858,Not in chargemaster,G9858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9858,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9859,Not in chargemaster,G9859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9859,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9860,Not in chargemaster,G9860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9860,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9861,Not in chargemaster,G9861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9861,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9862,Not in chargemaster,G9862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9862,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9873,Not in chargemaster,G9873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9873,BCBSMN Non-RVU base fee schedule,25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9874,Not in chargemaster,G9874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9874,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9875,Not in chargemaster,G9875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9875,BCBSMN Non-RVU base fee schedule,90,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9876,Not in chargemaster,G9876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9876,BCBSMN Non-RVU base fee schedule,15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9877,Not in chargemaster,G9877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9877,BCBSMN Non-RVU base fee schedule,15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9878,Not in chargemaster,G9878,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9878,BCBSMN Non-RVU base fee schedule,60,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9879,Not in chargemaster,G9879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9879,BCBSMN Non-RVU base fee schedule,60,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9880,Not in chargemaster,G9880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9880,BCBSMN Non-RVU base fee schedule,160,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9881,Not in chargemaster,G9881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9881,BCBSMN Non-RVU base fee schedule,25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9882,Not in chargemaster,G9882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9882,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9883,Not in chargemaster,G9883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9883,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9884,Not in chargemaster,G9884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9884,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9885,Not in chargemaster,G9885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9885,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9890,Not in chargemaster,G9890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9890,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9891,Not in chargemaster,G9891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9891,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9892,Not in chargemaster,G9892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9892,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9893,Not in chargemaster,G9893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9893,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9894,Not in chargemaster,G9894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9894,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9895,Not in chargemaster,G9895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9895,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9896,Not in chargemaster,G9896,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9896,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9897,Not in chargemaster,G9897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9897,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9898,Not in chargemaster,G9898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9898,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9899,Not in chargemaster,G9899,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9899,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9900,Not in chargemaster,G9900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9900,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9901,Not in chargemaster,G9901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9901,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9902,Not in chargemaster,G9902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9902,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9903,Not in chargemaster,G9903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9903,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9904,Not in chargemaster,G9904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9904,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9905,Not in chargemaster,G9905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9905,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9906,Not in chargemaster,G9906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9906,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9907,Not in chargemaster,G9907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9907,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9908,Not in chargemaster,G9908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9908,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9909,Not in chargemaster,G9909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9909,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9910,Not in chargemaster,G9910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9910,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9911,Not in chargemaster,G9911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9911,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9912,Not in chargemaster,G9912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9912,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9913,Not in chargemaster,G9913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9913,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9914,Not in chargemaster,G9914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9914,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9915,Not in chargemaster,G9915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9915,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9916,Not in chargemaster,G9916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9916,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9917,Not in chargemaster,G9917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9917,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9918,Not in chargemaster,G9918,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9918,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9919,Not in chargemaster,G9919,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9919,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9920,Not in chargemaster,G9920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9920,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9921,Not in chargemaster,G9921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9921,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9922,Not in chargemaster,G9922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9922,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9923,Not in chargemaster,G9923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9923,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9924,Not in chargemaster,G9924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9924,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9925,Not in chargemaster,G9925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9925,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9926,Not in chargemaster,G9926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9926,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9927,Not in chargemaster,G9927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9927,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9928,Not in chargemaster,G9928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9928,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9929,Not in chargemaster,G9929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9929,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9930,Not in chargemaster,G9930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9930,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9931,Not in chargemaster,G9931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9931,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9932,Not in chargemaster,G9932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9932,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9933,Not in chargemaster,G9933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9933,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9934,Not in chargemaster,G9934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9934,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9935,Not in chargemaster,G9935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9935,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9936,Not in chargemaster,G9936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9936,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9937,Not in chargemaster,G9937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9937,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9938,Not in chargemaster,G9938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9938,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9939,Not in chargemaster,G9939,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9939,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9940,Not in chargemaster,G9940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9940,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9942,Not in chargemaster,G9942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9942,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9943,Not in chargemaster,G9943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9943,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9945,Not in chargemaster,G9945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9945,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9946,Not in chargemaster,G9946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9946,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9948,Not in chargemaster,G9948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9948,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9949,Not in chargemaster,G9949,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9949,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9954,Not in chargemaster,G9954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9954,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9955,Not in chargemaster,G9955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9955,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9956,Not in chargemaster,G9956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9956,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9957,Not in chargemaster,G9957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9957,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9958,Not in chargemaster,G9958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9958,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9959,Not in chargemaster,G9959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9959,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9960,Not in chargemaster,G9960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9960,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9961,Not in chargemaster,G9961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9961,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9962,Not in chargemaster,G9962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9962,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9963,Not in chargemaster,G9963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9963,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9964,Not in chargemaster,G9964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9964,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9965,Not in chargemaster,G9965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9965,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9966,Not in chargemaster,G9966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9966,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9967,Not in chargemaster,G9967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9967,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9968,Not in chargemaster,G9968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9968,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9969,Not in chargemaster,G9969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9969,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9970,Not in chargemaster,G9970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9970,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9974,Not in chargemaster,G9974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9974,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9975,Not in chargemaster,G9975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9975,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9976,Not in chargemaster,G9976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9976,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU G9977,Not in chargemaster,G9977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,G9977,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0001,Not in chargemaster,H0001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0001,BCBSMN Non-RVU base fee schedule,162.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0002,Not in chargemaster,H0002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0002,BCBSMN Non-RVU base fee schedule,199.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0004,Not in chargemaster,H0004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0004,BCBSMN Non-RVU base fee schedule,21.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0005,Not in chargemaster,H0005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0005,BCBSMN Non-RVU base fee schedule,34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0006,Not in chargemaster,H0006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0006,BCBSMN Non-RVU base fee schedule,103.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0008,Not in chargemaster,H0008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0008,BCBSMN Non-RVU base fee schedule,110,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0009,Not in chargemaster,H0009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0009,BCBSMN Non-RVU base fee schedule,123.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0011,Not in chargemaster,H0011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0011,BCBSMN Non-RVU base fee schedule,289.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0014,Not in chargemaster,H0014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0014,BCBSMN Non-RVU base fee schedule,118.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0015,Not in chargemaster,H0015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0015,BCBSMN Non-RVU base fee schedule,244.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0018,Not in chargemaster,H0018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0018,BCBSMN Non-RVU base fee schedule,274.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0019,Not in chargemaster,H0019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0019,BCBSMN Non-RVU base fee schedule,162.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0020,Not in chargemaster,H0020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0020,BCBSMN Non-RVU base fee schedule,13.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0022,Not in chargemaster,H0022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0022,BCBSMN Non-RVU base fee schedule,20.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0025,Not in chargemaster,H0025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0025,BCBSMN Non-RVU base fee schedule,11.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0031,Not in chargemaster,H0031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0031,BCBSMN Non-RVU base fee schedule,86.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0032,Not in chargemaster,H0032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0032,BCBSMN Non-RVU base fee schedule,20.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0033,Not in chargemaster,H0033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0033,BCBSMN Non-RVU base fee schedule,35.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0034,Not in chargemaster,H0034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0034,BCBSMN Non-RVU base fee schedule,68.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0035,Not in chargemaster,H0035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0035,BCBSMN Non-RVU base fee schedule,69.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0038,Not in chargemaster,H0038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0038,BCBSMN Non-RVU base fee schedule,11.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0039,Not in chargemaster,H0039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0039,BCBSMN Non-RVU base fee schedule,30.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0046,Not in chargemaster,H0046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0046,BCBSMN Non-RVU base fee schedule,0.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0047,Not in chargemaster,H0047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0047,BCBSMN Non-RVU base fee schedule,22.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0048,Not in chargemaster,H0048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0048,BCBSMN Non-RVU base fee schedule,40.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0049,Not in chargemaster,H0049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0049,BCBSMN Non-RVU base fee schedule,16.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H0050,Not in chargemaster,H0050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H0050,BCBSMN Non-RVU base fee schedule,53.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H1000,Not in chargemaster,H1000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H1000,BCBSMN Non-RVU base fee schedule,5.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H1001,Not in chargemaster,H1001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H1001,BCBSMN Non-RVU base fee schedule,64.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H1002,Not in chargemaster,H1002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H1002,BCBSMN Non-RVU base fee schedule,25.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H1003,Not in chargemaster,H1003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H1003,BCBSMN Non-RVU base fee schedule,38.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H1004,Not in chargemaster,H1004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H1004,BCBSMN Non-RVU base fee schedule,52.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H1005,Not in chargemaster,H1005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H1005,BCBSMN Non-RVU base fee schedule,68.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H1010,Not in chargemaster,H1010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H1010,BCBSMN Non-RVU base fee schedule,231.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H1011,Not in chargemaster,H1011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H1011,BCBSMN Non-RVU base fee schedule,184,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2000,Not in chargemaster,H2000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2000,BCBSMN Non-RVU base fee schedule,55.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2010,Not in chargemaster,H2010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2010,BCBSMN Non-RVU base fee schedule,16.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2011,Not in chargemaster,H2011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2011,BCBSMN Non-RVU base fee schedule,39.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2012,Not in chargemaster,H2012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2012,BCBSMN Non-RVU base fee schedule,21.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2013,Not in chargemaster,H2013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2013,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2014,Not in chargemaster,H2014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2014,BCBSMN Non-RVU base fee schedule,12.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2015,Not in chargemaster,H2015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2015,BCBSMN Non-RVU base fee schedule,13.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2016,Not in chargemaster,H2016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2016,BCBSMN Non-RVU base fee schedule,40.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2017,Not in chargemaster,H2017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2017,BCBSMN Non-RVU base fee schedule,18.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2019,Not in chargemaster,H2019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2019,BCBSMN Non-RVU base fee schedule,6.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2019 mod U1,Not in chargemaster,H2019,U1,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2019 mod U1,BCBSMN Non-RVU base fee schedule,42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2020,Not in chargemaster,H2020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2020,BCBSMN Non-RVU base fee schedule,158.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2027,Not in chargemaster,H2027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2027,BCBSMN Non-RVU base fee schedule,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2028,Not in chargemaster,H2028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2028,BCBSMN Non-RVU base fee schedule,40.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2029,Not in chargemaster,H2029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2029,BCBSMN Non-RVU base fee schedule,91.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU H2035,Not in chargemaster,H2035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,H2035,BCBSMN Non-RVU base fee schedule,72.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0120,Not in chargemaster,J0120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0120,BCBSMN Non-RVU base fee schedule,0.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0121,Not in chargemaster,J0121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0121,BCBSMN Non-RVU base fee schedule,3.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0122,Not in chargemaster,J0122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0122,BCBSMN Non-RVU base fee schedule,1.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0129,Not in chargemaster,J0129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0129,BCBSMN Non-RVU base fee schedule,54.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0130,Not in chargemaster,J0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0130,BCBSMN Non-RVU base fee schedule,1429.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0131,Not in chargemaster,J0131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0131,BCBSMN Non-RVU base fee schedule,0.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0132,Not in chargemaster,J0132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0132,BCBSMN Non-RVU base fee schedule,0.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0133,Not in chargemaster,J0133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0133,BCBSMN Non-RVU base fee schedule,0.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0135,Not in chargemaster,J0135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0135,BCBSMN Non-RVU base fee schedule,1133.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0153,Not in chargemaster,J0153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0153,BCBSMN Non-RVU base fee schedule,0.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0171,J0171,J0171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0171,BCBSMN Non-RVU base fee schedule,0.82,1.14,Fee schedule,,0.82,0.82,0.82,0.82,,,0
unity,Fee schedule,Non-RVU J0178,Not in chargemaster,J0178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0178,BCBSMN Non-RVU base fee schedule,945.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0179,Not in chargemaster,J0179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0179,BCBSMN Non-RVU base fee schedule,317.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0180,Not in chargemaster,J0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0180,BCBSMN Non-RVU base fee schedule,183.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0185,Not in chargemaster,J0185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0185,BCBSMN Non-RVU base fee schedule,2.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0190,Not in chargemaster,J0190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0190,BCBSMN Non-RVU base fee schedule,5.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0200,Not in chargemaster,J0200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0200,BCBSMN Non-RVU base fee schedule,980.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0202,Not in chargemaster,J0202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0202,BCBSMN Non-RVU base fee schedule,1949.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0205,Not in chargemaster,J0205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0205,BCBSMN Non-RVU base fee schedule,44.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0207,Not in chargemaster,J0207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0207,BCBSMN Non-RVU base fee schedule,1011.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0210,Not in chargemaster,J0210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0210,BCBSMN Non-RVU base fee schedule,42.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0215,Not in chargemaster,J0215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0215,BCBSMN Non-RVU base fee schedule,41.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0220,Not in chargemaster,J0220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0220,BCBSMN Non-RVU base fee schedule,206.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0221,Not in chargemaster,J0221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0221,BCBSMN Non-RVU base fee schedule,171.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0222,Not in chargemaster,J0222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0222,BCBSMN Non-RVU base fee schedule,98.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0223,Not in chargemaster,J0223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0223,BCBSMN Non-RVU base fee schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0256,Not in chargemaster,J0256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0256,BCBSMN Non-RVU base fee schedule,4.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0257,Not in chargemaster,J0257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0257,BCBSMN Non-RVU base fee schedule,4.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0270,Not in chargemaster,J0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0270,BCBSMN Non-RVU base fee schedule,4.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0275,Not in chargemaster,J0275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0275,BCBSMN Non-RVU base fee schedule,28.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0278,Not in chargemaster,J0278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0278,BCBSMN Non-RVU base fee schedule,1.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0280,Not in chargemaster,J0280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0280,BCBSMN Non-RVU base fee schedule,10.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0282,Not in chargemaster,J0282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0282,BCBSMN Non-RVU base fee schedule,0.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0285,Not in chargemaster,J0285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0285,BCBSMN Non-RVU base fee schedule,38.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0287,Not in chargemaster,J0287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0287,BCBSMN Non-RVU base fee schedule,9.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0288,Not in chargemaster,J0288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0288,BCBSMN Non-RVU base fee schedule,14.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0289,Not in chargemaster,J0289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0289,BCBSMN Non-RVU base fee schedule,26.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0290,Not in chargemaster,J0290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0290,BCBSMN Non-RVU base fee schedule,0.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0291,Not in chargemaster,J0291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0291,BCBSMN Non-RVU base fee schedule,3.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0295,Not in chargemaster,J0295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0295,BCBSMN Non-RVU base fee schedule,2.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0300,Not in chargemaster,J0300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0300,BCBSMN Non-RVU base fee schedule,186.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0330,Not in chargemaster,J0330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0330,BCBSMN Non-RVU base fee schedule,0.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0348,Not in chargemaster,J0348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0348,BCBSMN Non-RVU base fee schedule,0.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0350,Not in chargemaster,J0350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0350,BCBSMN Non-RVU base fee schedule,2325.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0360,Not in chargemaster,J0360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0360,BCBSMN Non-RVU base fee schedule,3.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0364,Not in chargemaster,J0364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0364,BCBSMN Non-RVU base fee schedule,37.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0365,Not in chargemaster,J0365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0365,BCBSMN Non-RVU base fee schedule,2.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0380,Not in chargemaster,J0380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0380,BCBSMN Non-RVU base fee schedule,11.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0390,Not in chargemaster,J0390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0390,BCBSMN Non-RVU base fee schedule,13.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0395,Not in chargemaster,J0395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0395,BCBSMN Non-RVU base fee schedule,123.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0400,Not in chargemaster,J0400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0400,BCBSMN Non-RVU base fee schedule,0.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0401,Not in chargemaster,J0401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0401,BCBSMN Non-RVU base fee schedule,5.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0456,Not in chargemaster,J0456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0456,BCBSMN Non-RVU base fee schedule,2.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0461,Not in chargemaster,J0461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0461,BCBSMN Non-RVU base fee schedule,0.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0470,Not in chargemaster,J0470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0470,BCBSMN Non-RVU base fee schedule,54.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0475,Not in chargemaster,J0475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0475,BCBSMN Non-RVU base fee schedule,173.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0476,Not in chargemaster,J0476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0476,BCBSMN Non-RVU base fee schedule,60.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0480,Not in chargemaster,J0480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0480,BCBSMN Non-RVU base fee schedule,3808.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0485,Not in chargemaster,J0485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0485,BCBSMN Non-RVU base fee schedule,3.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0490,Not in chargemaster,J0490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0490,BCBSMN Non-RVU base fee schedule,45.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0500,Not in chargemaster,J0500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0500,BCBSMN Non-RVU base fee schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0515,Not in chargemaster,J0515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0515,BCBSMN Non-RVU base fee schedule,17.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0517,Not in chargemaster,J0517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0517,BCBSMN Non-RVU base fee schedule,170.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0520,Not in chargemaster,J0520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0520,BCBSMN Non-RVU base fee schedule,4.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0558,Not in chargemaster,J0558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0558,BCBSMN Non-RVU base fee schedule,10.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0561,J0561,J0561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0561,BCBSMN Non-RVU base fee schedule,13.76,34.03,Fee schedule,,13.76,13.76,13.76,13.76,,,0
unity,Fee schedule,Non-RVU J0565,Not in chargemaster,J0565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0565,BCBSMN Non-RVU base fee schedule,39.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0567,Not in chargemaster,J0567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0567,BCBSMN Non-RVU base fee schedule,93.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0570,Not in chargemaster,J0570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0570,BCBSMN Non-RVU base fee schedule,1211.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0583,Not in chargemaster,J0583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0583,BCBSMN Non-RVU base fee schedule,0.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0584,Not in chargemaster,J0584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0584,BCBSMN Non-RVU base fee schedule,353.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0585,Not in chargemaster,J0585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0585,BCBSMN Non-RVU base fee schedule,6.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0586,Not in chargemaster,J0586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0586,BCBSMN Non-RVU base fee schedule,8.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0587,Not in chargemaster,J0587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0587,BCBSMN Non-RVU base fee schedule,11.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0588,Not in chargemaster,J0588,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0588,BCBSMN Non-RVU base fee schedule,5.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0592,Not in chargemaster,J0592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0592,BCBSMN Non-RVU base fee schedule,4.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0593,Not in chargemaster,J0593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0593,BCBSMN Non-RVU base fee schedule,77.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0594,Not in chargemaster,J0594,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0594,BCBSMN Non-RVU base fee schedule,4.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0595,Not in chargemaster,J0595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0595,BCBSMN Non-RVU base fee schedule,2.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0596,Not in chargemaster,J0596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0596,BCBSMN Non-RVU base fee schedule,28.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0597,Not in chargemaster,J0597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0597,BCBSMN Non-RVU base fee schedule,51.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0598,Not in chargemaster,J0598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0598,BCBSMN Non-RVU base fee schedule,56.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0599,Not in chargemaster,J0599,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0599,BCBSMN Non-RVU base fee schedule,9.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0600,Not in chargemaster,J0600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0600,BCBSMN Non-RVU base fee schedule,5594.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0604,Not in chargemaster,J0604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0604,BCBSMN Non-RVU base fee schedule,0.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0606,Not in chargemaster,J0606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0606,BCBSMN Non-RVU base fee schedule,3.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0610,Not in chargemaster,J0610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0610,BCBSMN Non-RVU base fee schedule,3.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0620,Not in chargemaster,J0620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0620,BCBSMN Non-RVU base fee schedule,0.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0630,Not in chargemaster,J0630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0630,BCBSMN Non-RVU base fee schedule,2656.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0636,Not in chargemaster,J0636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0636,BCBSMN Non-RVU base fee schedule,0.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0637,Not in chargemaster,J0637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0637,BCBSMN Non-RVU base fee schedule,7.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0638,Not in chargemaster,J0638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0638,BCBSMN Non-RVU base fee schedule,111,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0640,Not in chargemaster,J0640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0640,BCBSMN Non-RVU base fee schedule,3.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0641,Not in chargemaster,J0641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0641,BCBSMN Non-RVU base fee schedule,0.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0642,Not in chargemaster,J0642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0642,BCBSMN Non-RVU base fee schedule,2.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0670,Not in chargemaster,J0670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0670,BCBSMN Non-RVU base fee schedule,2.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0690,Not in chargemaster,J0690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0690,BCBSMN Non-RVU base fee schedule,0.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0691,Not in chargemaster,J0691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0691,BCBSMN Non-RVU base fee schedule,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0692,Not in chargemaster,J0692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0692,BCBSMN Non-RVU base fee schedule,1.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0694,Not in chargemaster,J0694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0694,BCBSMN Non-RVU base fee schedule,5.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0695,Not in chargemaster,J0695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0695,BCBSMN Non-RVU base fee schedule,5.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0696,J0696,J0696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0696,BCBSMN Non-RVU base fee schedule,0.6,33,Fee schedule,,0.6,0.6,0.6,0.6,,,0
unity,Fee schedule,Non-RVU J0697,Not in chargemaster,J0697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0697,BCBSMN Non-RVU base fee schedule,2.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0698,Not in chargemaster,J0698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0698,BCBSMN Non-RVU base fee schedule,2.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0702,Not in chargemaster,J0702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0702,BCBSMN Non-RVU base fee schedule,7.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0706,Not in chargemaster,J0706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0706,BCBSMN Non-RVU base fee schedule,2.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0710,Not in chargemaster,J0710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0710,BCBSMN Non-RVU base fee schedule,2.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0712,Not in chargemaster,J0712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0712,BCBSMN Non-RVU base fee schedule,3.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0713,Not in chargemaster,J0713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0713,BCBSMN Non-RVU base fee schedule,2.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0714,Not in chargemaster,J0714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0714,BCBSMN Non-RVU base fee schedule,92.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0715,Not in chargemaster,J0715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0715,BCBSMN Non-RVU base fee schedule,5.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0716,Not in chargemaster,J0716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0716,BCBSMN Non-RVU base fee schedule,4735.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0717,Not in chargemaster,J0717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0717,BCBSMN Non-RVU base fee schedule,8.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0720,Not in chargemaster,J0720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0720,BCBSMN Non-RVU base fee schedule,38.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0725,Not in chargemaster,J0725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0725,BCBSMN Non-RVU base fee schedule,21.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0735,Not in chargemaster,J0735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0735,BCBSMN Non-RVU base fee schedule,17.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0740,Not in chargemaster,J0740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0740,BCBSMN Non-RVU base fee schedule,633.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0743,Not in chargemaster,J0743,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0743,BCBSMN Non-RVU base fee schedule,5.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0744,Not in chargemaster,J0744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0744,BCBSMN Non-RVU base fee schedule,1.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0745,Not in chargemaster,J0745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0745,BCBSMN Non-RVU base fee schedule,1.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0770,Not in chargemaster,J0770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0770,BCBSMN Non-RVU base fee schedule,19.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0775,Not in chargemaster,J0775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0775,BCBSMN Non-RVU base fee schedule,48.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0780,Not in chargemaster,J0780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0780,BCBSMN Non-RVU base fee schedule,8.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0791,Not in chargemaster,J0791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0791,BCBSMN Non-RVU base fee schedule,122.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0795,Not in chargemaster,J0795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0795,BCBSMN Non-RVU base fee schedule,9.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0800,Not in chargemaster,J0800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0800,BCBSMN Non-RVU base fee schedule,3923.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0834,Not in chargemaster,J0834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0834,BCBSMN Non-RVU base fee schedule,37.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0840,Not in chargemaster,J0840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0840,BCBSMN Non-RVU base fee schedule,3284.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0841,Not in chargemaster,J0841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0841,BCBSMN Non-RVU base fee schedule,1260.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0850,Not in chargemaster,J0850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0850,BCBSMN Non-RVU base fee schedule,1129.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0875,Not in chargemaster,J0875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0875,BCBSMN Non-RVU base fee schedule,15.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0878,Not in chargemaster,J0878,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0878,BCBSMN Non-RVU base fee schedule,0.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0881,Not in chargemaster,J0881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0881,BCBSMN Non-RVU base fee schedule,3.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0882,Not in chargemaster,J0882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0882,BCBSMN Non-RVU base fee schedule,3.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0883,Not in chargemaster,J0883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0883,BCBSMN Non-RVU base fee schedule,4.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0884,Not in chargemaster,J0884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0884,BCBSMN Non-RVU base fee schedule,4.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0885,Not in chargemaster,J0885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0885,BCBSMN Non-RVU base fee schedule,10.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0887,Not in chargemaster,J0887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0887,BCBSMN Non-RVU base fee schedule,1.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0888,Not in chargemaster,J0888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0888,BCBSMN Non-RVU base fee schedule,1.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0890,Not in chargemaster,J0890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0890,BCBSMN Non-RVU base fee schedule,9.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0894,Not in chargemaster,J0894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0894,BCBSMN Non-RVU base fee schedule,4.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0895,Not in chargemaster,J0895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0895,BCBSMN Non-RVU base fee schedule,7.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0897,Not in chargemaster,J0897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0897,BCBSMN Non-RVU base fee schedule,19.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J0945,Not in chargemaster,J0945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J0945,BCBSMN Non-RVU base fee schedule,0.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1000,Not in chargemaster,J1000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1000,BCBSMN Non-RVU base fee schedule,21.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1020,Not in chargemaster,J1020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1020,BCBSMN Non-RVU base fee schedule,3.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1030,J1030,J1030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1030,BCBSMN Non-RVU base fee schedule,6.29,39.85,Fee schedule,,6.29,6.29,6.29,6.29,,,0
unity,Fee schedule,Non-RVU J1040,J1040,J1040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1040,BCBSMN Non-RVU base fee schedule,11.9,50.74,Fee schedule,,11.9,11.9,11.9,11.9,,,0
unity,Fee schedule,Non-RVU J1050,J1050,J1050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1050,BCBSMN Non-RVU base fee schedule,0.56,0.51,Fee schedule,,0.51,0.51,0.51,0.51,,,0
unity,Fee schedule,Non-RVU J1071,J1071,J1071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1071,BCBSMN Non-RVU base fee schedule,0.03,0.11,Fee schedule,,0.03,0.03,0.03,0.03,,,0
unity,Fee schedule,Non-RVU J1094,Not in chargemaster,J1094,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1094,BCBSMN Non-RVU base fee schedule,0.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1095,Not in chargemaster,J1095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1095,BCBSMN Non-RVU base fee schedule,1.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1096,Not in chargemaster,J1096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1096,BCBSMN Non-RVU base fee schedule,137.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1097,Not in chargemaster,J1097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1097,BCBSMN Non-RVU base fee schedule,118.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1100,J1100,J1100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1100,BCBSMN Non-RVU base fee schedule,0.12,24.2,Fee schedule,,0.12,0.12,0.12,0.12,,,0
unity,Fee schedule,Non-RVU J1110,Not in chargemaster,J1110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1110,BCBSMN Non-RVU base fee schedule,54.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1120,Not in chargemaster,J1120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1120,BCBSMN Non-RVU base fee schedule,14.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1130,Not in chargemaster,J1130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1130,BCBSMN Non-RVU base fee schedule,0.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1160,Not in chargemaster,J1160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1160,BCBSMN Non-RVU base fee schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1162,Not in chargemaster,J1162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1162,BCBSMN Non-RVU base fee schedule,3780.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1165,Not in chargemaster,J1165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1165,BCBSMN Non-RVU base fee schedule,0.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1170,Not in chargemaster,J1170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1170,BCBSMN Non-RVU base fee schedule,3.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1180,Not in chargemaster,J1180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1180,BCBSMN Non-RVU base fee schedule,7.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1190,Not in chargemaster,J1190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1190,BCBSMN Non-RVU base fee schedule,197.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1200,J1200,J1200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1200,BCBSMN Non-RVU base fee schedule,0.9,2.71,Fee schedule,,0.9,0.9,0.9,0.9,,,0
unity,Fee schedule,Non-RVU J1205,Not in chargemaster,J1205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1205,BCBSMN Non-RVU base fee schedule,50.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1212,Not in chargemaster,J1212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1212,BCBSMN Non-RVU base fee schedule,616.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1230,Not in chargemaster,J1230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1230,BCBSMN Non-RVU base fee schedule,16.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1240,Not in chargemaster,J1240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1240,BCBSMN Non-RVU base fee schedule,6.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1245,Not in chargemaster,J1245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1245,BCBSMN Non-RVU base fee schedule,2.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1250,Not in chargemaster,J1250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1250,BCBSMN Non-RVU base fee schedule,6.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1260,Not in chargemaster,J1260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1260,BCBSMN Non-RVU base fee schedule,7.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1265,Not in chargemaster,J1265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1265,BCBSMN Non-RVU base fee schedule,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1267,Not in chargemaster,J1267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1267,BCBSMN Non-RVU base fee schedule,0.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1270,Not in chargemaster,J1270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1270,BCBSMN Non-RVU base fee schedule,0.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1290,Not in chargemaster,J1290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1290,BCBSMN Non-RVU base fee schedule,497.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1300,Not in chargemaster,J1300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1300,BCBSMN Non-RVU base fee schedule,230.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1301,Not in chargemaster,J1301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1301,BCBSMN Non-RVU base fee schedule,19.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1303,Not in chargemaster,J1303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1303,BCBSMN Non-RVU base fee schedule,226.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1320,Not in chargemaster,J1320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1320,BCBSMN Non-RVU base fee schedule,2.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1322,Not in chargemaster,J1322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1322,BCBSMN Non-RVU base fee schedule,241.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1324,Not in chargemaster,J1324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1324,BCBSMN Non-RVU base fee schedule,0.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1325,Not in chargemaster,J1325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1325,BCBSMN Non-RVU base fee schedule,16.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1327,Not in chargemaster,J1327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1327,BCBSMN Non-RVU base fee schedule,39.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1330,Not in chargemaster,J1330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1330,BCBSMN Non-RVU base fee schedule,4.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1335,Not in chargemaster,J1335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1335,BCBSMN Non-RVU base fee schedule,38.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1364,Not in chargemaster,J1364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1364,BCBSMN Non-RVU base fee schedule,75.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1380,Not in chargemaster,J1380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1380,BCBSMN Non-RVU base fee schedule,8.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1410,Not in chargemaster,J1410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1410,BCBSMN Non-RVU base fee schedule,308.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1428,Not in chargemaster,J1428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1428,BCBSMN Non-RVU base fee schedule,163.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1430,Not in chargemaster,J1430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1430,BCBSMN Non-RVU base fee schedule,444.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1435,Not in chargemaster,J1435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1435,BCBSMN Non-RVU base fee schedule,0.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1436,Not in chargemaster,J1436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1436,BCBSMN Non-RVU base fee schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1438,Not in chargemaster,J1438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1438,BCBSMN Non-RVU base fee schedule,352.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1439,Not in chargemaster,J1439,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1439,BCBSMN Non-RVU base fee schedule,1.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1442,Not in chargemaster,J1442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1442,BCBSMN Non-RVU base fee schedule,0.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1443,Not in chargemaster,J1443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1443,BCBSMN Non-RVU base fee schedule,0.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1444,Not in chargemaster,J1444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1444,BCBSMN Non-RVU base fee schedule,0.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1447,Not in chargemaster,J1447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1447,BCBSMN Non-RVU base fee schedule,0.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1450,Not in chargemaster,J1450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1450,BCBSMN Non-RVU base fee schedule,4.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1451,Not in chargemaster,J1451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1451,BCBSMN Non-RVU base fee schedule,11.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1452,Not in chargemaster,J1452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1452,BCBSMN Non-RVU base fee schedule,820,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1453,Not in chargemaster,J1453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1453,BCBSMN Non-RVU base fee schedule,1.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1454,Not in chargemaster,J1454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1454,BCBSMN Non-RVU base fee schedule,301.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1455,Not in chargemaster,J1455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1455,BCBSMN Non-RVU base fee schedule,79.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1457,Not in chargemaster,J1457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1457,BCBSMN Non-RVU base fee schedule,2.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1458,Not in chargemaster,J1458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1458,BCBSMN Non-RVU base fee schedule,397.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1459,Not in chargemaster,J1459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1459,BCBSMN Non-RVU base fee schedule,40.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1460,Not in chargemaster,J1460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1460,BCBSMN Non-RVU base fee schedule,40.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1555,Not in chargemaster,J1555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1555,BCBSMN Non-RVU base fee schedule,14.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1556,Not in chargemaster,J1556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1556,BCBSMN Non-RVU base fee schedule,69.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1557,Not in chargemaster,J1557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1557,BCBSMN Non-RVU base fee schedule,46.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1558,Not in chargemaster,J1558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1558,BCBSMN Non-RVU base fee schedule,16.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1559,Not in chargemaster,J1559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1559,BCBSMN Non-RVU base fee schedule,10.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1560,Not in chargemaster,J1560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1560,BCBSMN Non-RVU base fee schedule,408.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1561,Not in chargemaster,J1561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1561,BCBSMN Non-RVU base fee schedule,40.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1562,Not in chargemaster,J1562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1562,BCBSMN Non-RVU base fee schedule,183.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1566,Not in chargemaster,J1566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1566,BCBSMN Non-RVU base fee schedule,63.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1568,Not in chargemaster,J1568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1568,BCBSMN Non-RVU base fee schedule,38.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1569,Not in chargemaster,J1569,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1569,BCBSMN Non-RVU base fee schedule,39.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1570,Not in chargemaster,J1570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1570,BCBSMN Non-RVU base fee schedule,34.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1571,Not in chargemaster,J1571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1571,BCBSMN Non-RVU base fee schedule,58.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1572,Not in chargemaster,J1572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1572,BCBSMN Non-RVU base fee schedule,35.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1573,Not in chargemaster,J1573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1573,BCBSMN Non-RVU base fee schedule,185.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1575,Not in chargemaster,J1575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1575,BCBSMN Non-RVU base fee schedule,14.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1580,Not in chargemaster,J1580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1580,BCBSMN Non-RVU base fee schedule,1.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1595,Not in chargemaster,J1595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1595,BCBSMN Non-RVU base fee schedule,207.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1600,Not in chargemaster,J1600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1600,BCBSMN Non-RVU base fee schedule,23.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1602,Not in chargemaster,J1602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1602,BCBSMN Non-RVU base fee schedule,20.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1610,Not in chargemaster,J1610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1610,BCBSMN Non-RVU base fee schedule,217.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1620,Not in chargemaster,J1620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1620,BCBSMN Non-RVU base fee schedule,198.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1626,Not in chargemaster,J1626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1626,BCBSMN Non-RVU base fee schedule,0.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1627,Not in chargemaster,J1627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1627,BCBSMN Non-RVU base fee schedule,1.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1628,Not in chargemaster,J1628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1628,BCBSMN Non-RVU base fee schedule,116.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1630,Not in chargemaster,J1630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1630,BCBSMN Non-RVU base fee schedule,1.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1631,Not in chargemaster,J1631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1631,BCBSMN Non-RVU base fee schedule,16.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1632,Not in chargemaster,J1632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1632,BCBSMN Non-RVU base fee schedule,75.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1640,Not in chargemaster,J1640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1640,BCBSMN Non-RVU base fee schedule,23.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1642,Not in chargemaster,J1642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1642,BCBSMN Non-RVU base fee schedule,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1644,Not in chargemaster,J1644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1644,BCBSMN Non-RVU base fee schedule,0.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1645,Not in chargemaster,J1645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1645,BCBSMN Non-RVU base fee schedule,12.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1650,Not in chargemaster,J1650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1650,BCBSMN Non-RVU base fee schedule,0.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1652,Not in chargemaster,J1652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1652,BCBSMN Non-RVU base fee schedule,1.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1655,Not in chargemaster,J1655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1655,BCBSMN Non-RVU base fee schedule,4.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1670,Not in chargemaster,J1670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1670,BCBSMN Non-RVU base fee schedule,462.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1700,Not in chargemaster,J1700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1700,BCBSMN Non-RVU base fee schedule,0.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1710,Not in chargemaster,J1710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1710,BCBSMN Non-RVU base fee schedule,4.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1720,Not in chargemaster,J1720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1720,BCBSMN Non-RVU base fee schedule,13.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1726,Not in chargemaster,J1726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1726,BCBSMN Non-RVU base fee schedule,29.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1729,Not in chargemaster,J1729,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1729,BCBSMN Non-RVU base fee schedule,29.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1730,Not in chargemaster,J1730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1730,BCBSMN Non-RVU base fee schedule,70.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1738,Not in chargemaster,J1738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1738,BCBSMN Non-RVU base fee schedule,3.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1740,Not in chargemaster,J1740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1740,BCBSMN Non-RVU base fee schedule,44.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1741,Not in chargemaster,J1741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1741,BCBSMN Non-RVU base fee schedule,2.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1742,Not in chargemaster,J1742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1742,BCBSMN Non-RVU base fee schedule,258.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1743,Not in chargemaster,J1743,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1743,BCBSMN Non-RVU base fee schedule,542.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1744,Not in chargemaster,J1744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1744,BCBSMN Non-RVU base fee schedule,360.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1745,Not in chargemaster,J1745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1745,BCBSMN Non-RVU base fee schedule,57.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1746,Not in chargemaster,J1746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1746,BCBSMN Non-RVU base fee schedule,58.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1750,Not in chargemaster,J1750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1750,BCBSMN Non-RVU base fee schedule,14.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1756,Not in chargemaster,J1756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1756,BCBSMN Non-RVU base fee schedule,0.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1786,Not in chargemaster,J1786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1786,BCBSMN Non-RVU base fee schedule,42.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1790,Not in chargemaster,J1790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1790,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1800,Not in chargemaster,J1800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1800,BCBSMN Non-RVU base fee schedule,1.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1810,Not in chargemaster,J1810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1810,BCBSMN Non-RVU base fee schedule,13.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1815,Not in chargemaster,J1815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1815,BCBSMN Non-RVU base fee schedule,0.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1817,Not in chargemaster,J1817,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1817,BCBSMN Non-RVU base fee schedule,10.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1826,Not in chargemaster,J1826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1826,BCBSMN Non-RVU base fee schedule,4867.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1830,Not in chargemaster,J1830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1830,BCBSMN Non-RVU base fee schedule,454.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1833,Not in chargemaster,J1833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1833,BCBSMN Non-RVU base fee schedule,0.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1835,Not in chargemaster,J1835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1835,BCBSMN Non-RVU base fee schedule,46.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1840,Not in chargemaster,J1840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1840,BCBSMN Non-RVU base fee schedule,7.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1850,Not in chargemaster,J1850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1850,BCBSMN Non-RVU base fee schedule,1.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1885,J1885,J1885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1885,BCBSMN Non-RVU base fee schedule,0.52,5.44,Fee schedule,,0.52,0.52,0.52,0.52,,,0
unity,Fee schedule,Non-RVU J1890,Not in chargemaster,J1890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1890,BCBSMN Non-RVU base fee schedule,8.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1930,Not in chargemaster,J1930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1930,BCBSMN Non-RVU base fee schedule,63.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1931,Not in chargemaster,J1931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1931,BCBSMN Non-RVU base fee schedule,32.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1940,J1940,J1940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1940,BCBSMN Non-RVU base fee schedule,0.59,2.09,Fee schedule,,0.59,0.59,0.59,0.59,,,0
unity,Fee schedule,Non-RVU J1943,Not in chargemaster,J1943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1943,BCBSMN Non-RVU base fee schedule,2.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1944,Not in chargemaster,J1944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1944,BCBSMN Non-RVU base fee schedule,2.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1945,Not in chargemaster,J1945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1945,BCBSMN Non-RVU base fee schedule,610.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1950,Not in chargemaster,J1950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1950,BCBSMN Non-RVU base fee schedule,1271.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1953,Not in chargemaster,J1953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1953,BCBSMN Non-RVU base fee schedule,0.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1955,Not in chargemaster,J1955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1955,BCBSMN Non-RVU base fee schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1956,Not in chargemaster,J1956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1956,BCBSMN Non-RVU base fee schedule,0.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1960,Not in chargemaster,J1960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1960,BCBSMN Non-RVU base fee schedule,45.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1980,Not in chargemaster,J1980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1980,BCBSMN Non-RVU base fee schedule,31.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J1990,Not in chargemaster,J1990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J1990,BCBSMN Non-RVU base fee schedule,23.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2001,Not in chargemaster,J2001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2001,BCBSMN Non-RVU base fee schedule,0.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2010,Not in chargemaster,J2010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2010,BCBSMN Non-RVU base fee schedule,13.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2020,Not in chargemaster,J2020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2020,BCBSMN Non-RVU base fee schedule,5.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2060,J2060,J2060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2060,BCBSMN Non-RVU base fee schedule,0.7,23.93,Fee schedule,,0.7,0.7,0.7,0.7,,,0
unity,Fee schedule,Non-RVU J2062,Not in chargemaster,J2062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2062,BCBSMN Non-RVU base fee schedule,15.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2150,Not in chargemaster,J2150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2150,BCBSMN Non-RVU base fee schedule,2.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2170,Not in chargemaster,J2170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2170,BCBSMN Non-RVU base fee schedule,125.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2175,Not in chargemaster,J2175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2175,BCBSMN Non-RVU base fee schedule,4.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2180,Not in chargemaster,J2180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2180,BCBSMN Non-RVU base fee schedule,4.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2182,Not in chargemaster,J2182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2182,BCBSMN Non-RVU base fee schedule,29.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2185,Not in chargemaster,J2185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2185,BCBSMN Non-RVU base fee schedule,0.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2186,Not in chargemaster,J2186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2186,BCBSMN Non-RVU base fee schedule,1.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2210,Not in chargemaster,J2210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2210,BCBSMN Non-RVU base fee schedule,18.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2212,Not in chargemaster,J2212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2212,BCBSMN Non-RVU base fee schedule,1.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2248,Not in chargemaster,J2248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2248,BCBSMN Non-RVU base fee schedule,1.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2250,Not in chargemaster,J2250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2250,BCBSMN Non-RVU base fee schedule,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2260,Not in chargemaster,J2260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2260,BCBSMN Non-RVU base fee schedule,1.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2270,Not in chargemaster,J2270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2270,BCBSMN Non-RVU base fee schedule,2.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2274,Not in chargemaster,J2274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2274,BCBSMN Non-RVU base fee schedule,11.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2278,Not in chargemaster,J2278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2278,BCBSMN Non-RVU base fee schedule,7.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2280,Not in chargemaster,J2280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2280,BCBSMN Non-RVU base fee schedule,8.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2300,Not in chargemaster,J2300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2300,BCBSMN Non-RVU base fee schedule,3.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2310,Not in chargemaster,J2310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2310,BCBSMN Non-RVU base fee schedule,13.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2315,Not in chargemaster,J2315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2315,BCBSMN Non-RVU base fee schedule,3.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2320,Not in chargemaster,J2320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2320,BCBSMN Non-RVU base fee schedule,5.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2323,Not in chargemaster,J2323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2323,BCBSMN Non-RVU base fee schedule,20.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2325,Not in chargemaster,J2325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2325,BCBSMN Non-RVU base fee schedule,71.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2326,Not in chargemaster,J2326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2326,BCBSMN Non-RVU base fee schedule,1083.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2350,Not in chargemaster,J2350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2350,BCBSMN Non-RVU base fee schedule,57.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2353,Not in chargemaster,J2353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2353,BCBSMN Non-RVU base fee schedule,206.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2354,Not in chargemaster,J2354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2354,BCBSMN Non-RVU base fee schedule,0.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2355,Not in chargemaster,J2355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2355,BCBSMN Non-RVU base fee schedule,467.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2357,Not in chargemaster,J2357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2357,BCBSMN Non-RVU base fee schedule,37.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2358,Not in chargemaster,J2358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2358,BCBSMN Non-RVU base fee schedule,2.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2360,Not in chargemaster,J2360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2360,BCBSMN Non-RVU base fee schedule,7.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2370,Not in chargemaster,J2370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2370,BCBSMN Non-RVU base fee schedule,3.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2400,Not in chargemaster,J2400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2400,BCBSMN Non-RVU base fee schedule,24.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2405,J2405,J2405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2405,BCBSMN Non-RVU base fee schedule,0.09,1.14,Fee schedule,,0.09,0.09,0.09,0.09,,,0
unity,Fee schedule,Non-RVU J2407,Not in chargemaster,J2407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2407,BCBSMN Non-RVU base fee schedule,23.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2410,Not in chargemaster,J2410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2410,BCBSMN Non-RVU base fee schedule,2.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2425,Not in chargemaster,J2425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2425,BCBSMN Non-RVU base fee schedule,21.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2426,Not in chargemaster,J2426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2426,BCBSMN Non-RVU base fee schedule,11.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2430,Not in chargemaster,J2430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2430,BCBSMN Non-RVU base fee schedule,11.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2440,Not in chargemaster,J2440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2440,BCBSMN Non-RVU base fee schedule,38.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2460,Not in chargemaster,J2460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2460,BCBSMN Non-RVU base fee schedule,0.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2469,Not in chargemaster,J2469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2469,BCBSMN Non-RVU base fee schedule,6.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2501,Not in chargemaster,J2501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2501,BCBSMN Non-RVU base fee schedule,0.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2502,Not in chargemaster,J2502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2502,BCBSMN Non-RVU base fee schedule,230.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2503,Not in chargemaster,J2503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2503,BCBSMN Non-RVU base fee schedule,721.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2504,Not in chargemaster,J2504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2504,BCBSMN Non-RVU base fee schedule,367.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2505,Not in chargemaster,J2505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2505,BCBSMN Non-RVU base fee schedule,4257.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2507,Not in chargemaster,J2507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2507,BCBSMN Non-RVU base fee schedule,2621.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2510,Not in chargemaster,J2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2510,BCBSMN Non-RVU base fee schedule,29.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2513,Not in chargemaster,J2513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2513,BCBSMN Non-RVU base fee schedule,13.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2515,Not in chargemaster,J2515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2515,BCBSMN Non-RVU base fee schedule,34.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2540,Not in chargemaster,J2540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2540,BCBSMN Non-RVU base fee schedule,1.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2543,Not in chargemaster,J2543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2543,BCBSMN Non-RVU base fee schedule,1.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2545,Not in chargemaster,J2545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2545,BCBSMN Non-RVU base fee schedule,121.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2547,Not in chargemaster,J2547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2547,BCBSMN Non-RVU base fee schedule,1.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2550,Not in chargemaster,J2550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2550,BCBSMN Non-RVU base fee schedule,2.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2560,Not in chargemaster,J2560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2560,BCBSMN Non-RVU base fee schedule,42.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2562,Not in chargemaster,J2562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2562,BCBSMN Non-RVU base fee schedule,347.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2590,Not in chargemaster,J2590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2590,BCBSMN Non-RVU base fee schedule,1.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2597,Not in chargemaster,J2597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2597,BCBSMN Non-RVU base fee schedule,11.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2650,Not in chargemaster,J2650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2650,BCBSMN Non-RVU base fee schedule,0.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2670,Not in chargemaster,J2670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2670,BCBSMN Non-RVU base fee schedule,3.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2675,Not in chargemaster,J2675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2675,BCBSMN Non-RVU base fee schedule,1.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2680,Not in chargemaster,J2680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2680,BCBSMN Non-RVU base fee schedule,9.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2690,Not in chargemaster,J2690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2690,BCBSMN Non-RVU base fee schedule,97.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2700,Not in chargemaster,J2700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2700,BCBSMN Non-RVU base fee schedule,1.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2704,Not in chargemaster,J2704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2704,BCBSMN Non-RVU base fee schedule,0.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2710,Not in chargemaster,J2710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2710,BCBSMN Non-RVU base fee schedule,0.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2720,Not in chargemaster,J2720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2720,BCBSMN Non-RVU base fee schedule,1.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2724,Not in chargemaster,J2724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2724,BCBSMN Non-RVU base fee schedule,15.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2725,Not in chargemaster,J2725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2725,BCBSMN Non-RVU base fee schedule,42.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2730,Not in chargemaster,J2730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2730,BCBSMN Non-RVU base fee schedule,87.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2760,Not in chargemaster,J2760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2760,BCBSMN Non-RVU base fee schedule,381.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2765,J2765,J2765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2765,BCBSMN Non-RVU base fee schedule,1.2,3.41,Fee schedule,,1.2,1.2,1.2,1.2,,,0
unity,Fee schedule,Non-RVU J2770,Not in chargemaster,J2770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2770,BCBSMN Non-RVU base fee schedule,417.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2778,Not in chargemaster,J2778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2778,BCBSMN Non-RVU base fee schedule,347.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2780,Not in chargemaster,J2780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2780,BCBSMN Non-RVU base fee schedule,4.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2783,Not in chargemaster,J2783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2783,BCBSMN Non-RVU base fee schedule,292.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2785,Not in chargemaster,J2785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2785,BCBSMN Non-RVU base fee schedule,59.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2786,Not in chargemaster,J2786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2786,BCBSMN Non-RVU base fee schedule,9.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2787,Not in chargemaster,J2787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2787,BCBSMN Non-RVU base fee schedule,2907,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2788,Not in chargemaster,J2788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2788,BCBSMN Non-RVU base fee schedule,25.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2790,Not in chargemaster,J2790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2790,BCBSMN Non-RVU base fee schedule,74.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2791,J2791,J2791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2791,BCBSMN Non-RVU base fee schedule,4.76,192.5,Fee schedule,,4.76,4.76,4.76,4.76,,,0
unity,Fee schedule,Non-RVU J2792,Not in chargemaster,J2792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2792,BCBSMN Non-RVU base fee schedule,29.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2793,Not in chargemaster,J2793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2793,BCBSMN Non-RVU base fee schedule,23.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2794,Not in chargemaster,J2794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2794,BCBSMN Non-RVU base fee schedule,10.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2795,Not in chargemaster,J2795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2795,BCBSMN Non-RVU base fee schedule,0.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2796,Not in chargemaster,J2796,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2796,BCBSMN Non-RVU base fee schedule,74.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2797,Not in chargemaster,J2797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2797,BCBSMN Non-RVU base fee schedule,0.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2798,Not in chargemaster,J2798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2798,BCBSMN Non-RVU base fee schedule,9.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2800,Not in chargemaster,J2800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2800,BCBSMN Non-RVU base fee schedule,8.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2805,Not in chargemaster,J2805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2805,BCBSMN Non-RVU base fee schedule,110.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2810,Not in chargemaster,J2810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2810,BCBSMN Non-RVU base fee schedule,0.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2820,Not in chargemaster,J2820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2820,BCBSMN Non-RVU base fee schedule,43.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2840,Not in chargemaster,J2840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2840,BCBSMN Non-RVU base fee schedule,520.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2850,Not in chargemaster,J2850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2850,BCBSMN Non-RVU base fee schedule,27.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2860,Not in chargemaster,J2860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2860,BCBSMN Non-RVU base fee schedule,103.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2910,Not in chargemaster,J2910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2910,BCBSMN Non-RVU base fee schedule,26.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2916,Not in chargemaster,J2916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2916,BCBSMN Non-RVU base fee schedule,1.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2920,J2920,J2920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2920,BCBSMN Non-RVU base fee schedule,4.58,5.5,Fee schedule,,4.58,4.58,4.58,4.58,,,0
unity,Fee schedule,Non-RVU J2930,J2930,J2930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2930,BCBSMN Non-RVU base fee schedule,6.32,7.25,Fee schedule,,6.32,6.32,6.32,6.32,,,0
unity,Fee schedule,Non-RVU J2940,Not in chargemaster,J2940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2940,BCBSMN Non-RVU base fee schedule,42.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2941,Not in chargemaster,J2941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2941,BCBSMN Non-RVU base fee schedule,130.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2950,Not in chargemaster,J2950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2950,BCBSMN Non-RVU base fee schedule,0.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2993,Not in chargemaster,J2993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2993,BCBSMN Non-RVU base fee schedule,2301.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2995,Not in chargemaster,J2995,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2995,BCBSMN Non-RVU base fee schedule,87.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J2997,Not in chargemaster,J2997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J2997,BCBSMN Non-RVU base fee schedule,87.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3000,Not in chargemaster,J3000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3000,BCBSMN Non-RVU base fee schedule,32.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3010,Not in chargemaster,J3010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3010,BCBSMN Non-RVU base fee schedule,0.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3030,Not in chargemaster,J3030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3030,BCBSMN Non-RVU base fee schedule,62.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3031,Not in chargemaster,J3031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3031,BCBSMN Non-RVU base fee schedule,2.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3032,Not in chargemaster,J3032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3032,BCBSMN Non-RVU base fee schedule,15.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3060,Not in chargemaster,J3060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3060,BCBSMN Non-RVU base fee schedule,39.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3070,Not in chargemaster,J3070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3070,BCBSMN Non-RVU base fee schedule,108.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3090,Not in chargemaster,J3090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3090,BCBSMN Non-RVU base fee schedule,1.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3095,Not in chargemaster,J3095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3095,BCBSMN Non-RVU base fee schedule,5.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3101,Not in chargemaster,J3101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3101,BCBSMN Non-RVU base fee schedule,125.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3105,Not in chargemaster,J3105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3105,BCBSMN Non-RVU base fee schedule,2.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3110,Not in chargemaster,J3110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3110,BCBSMN Non-RVU base fee schedule,58.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3111,Not in chargemaster,J3111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3111,BCBSMN Non-RVU base fee schedule,9.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3121,Not in chargemaster,J3121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3121,BCBSMN Non-RVU base fee schedule,0.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3145,Not in chargemaster,J3145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3145,BCBSMN Non-RVU base fee schedule,1.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3230,Not in chargemaster,J3230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3230,BCBSMN Non-RVU base fee schedule,31.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3240,Not in chargemaster,J3240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3240,BCBSMN Non-RVU base fee schedule,1700.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3241,Not in chargemaster,J3241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3241,BCBSMN Non-RVU base fee schedule,315.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3243,Not in chargemaster,J3243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3243,BCBSMN Non-RVU base fee schedule,1.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3245,Not in chargemaster,J3245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3245,BCBSMN Non-RVU base fee schedule,131.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3246,Not in chargemaster,J3246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3246,BCBSMN Non-RVU base fee schedule,10.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3250,Not in chargemaster,J3250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3250,BCBSMN Non-RVU base fee schedule,36.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3260,Not in chargemaster,J3260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3260,BCBSMN Non-RVU base fee schedule,3.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3262,Not in chargemaster,J3262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3262,BCBSMN Non-RVU base fee schedule,5.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3265,Not in chargemaster,J3265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3265,BCBSMN Non-RVU base fee schedule,1.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3280,Not in chargemaster,J3280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3280,BCBSMN Non-RVU base fee schedule,11.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3285,Not in chargemaster,J3285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3285,BCBSMN Non-RVU base fee schedule,62.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3300,Not in chargemaster,J3300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3300,BCBSMN Non-RVU base fee schedule,3.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3301,J3301,J3301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3301,BCBSMN Non-RVU base fee schedule,1.56,10.75,Fee schedule,,1.56,1.56,1.56,1.56,,,0
unity,Fee schedule,Non-RVU J3302,Not in chargemaster,J3302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3302,BCBSMN Non-RVU base fee schedule,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3303,Not in chargemaster,J3303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3303,BCBSMN Non-RVU base fee schedule,0.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3304,Not in chargemaster,J3304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3304,BCBSMN Non-RVU base fee schedule,18.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3305,Not in chargemaster,J3305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3305,BCBSMN Non-RVU base fee schedule,159.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3310,Not in chargemaster,J3310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3310,BCBSMN Non-RVU base fee schedule,6.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3315,Not in chargemaster,J3315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3315,BCBSMN Non-RVU base fee schedule,263.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3316,Not in chargemaster,J3316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3316,BCBSMN Non-RVU base fee schedule,2857.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3320,Not in chargemaster,J3320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3320,BCBSMN Non-RVU base fee schedule,20.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3350,Not in chargemaster,J3350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3350,BCBSMN Non-RVU base fee schedule,71.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3355,Not in chargemaster,J3355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3355,BCBSMN Non-RVU base fee schedule,127.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3357,Not in chargemaster,J3357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3357,BCBSMN Non-RVU base fee schedule,190.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3358,Not in chargemaster,J3358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3358,BCBSMN Non-RVU base fee schedule,11.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3360,Not in chargemaster,J3360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3360,BCBSMN Non-RVU base fee schedule,9.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3364,Not in chargemaster,J3364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3364,BCBSMN Non-RVU base fee schedule,10.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3365,Not in chargemaster,J3365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3365,BCBSMN Non-RVU base fee schedule,489.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3370,Not in chargemaster,J3370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3370,BCBSMN Non-RVU base fee schedule,3.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3380,Not in chargemaster,J3380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3380,BCBSMN Non-RVU base fee schedule,20.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3385,Not in chargemaster,J3385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3385,BCBSMN Non-RVU base fee schedule,345.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3396,Not in chargemaster,J3396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3396,BCBSMN Non-RVU base fee schedule,11.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3397,Not in chargemaster,J3397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3397,BCBSMN Non-RVU base fee schedule,221.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3398,Not in chargemaster,J3398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3398,BCBSMN Non-RVU base fee schedule,433500,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3399,Not in chargemaster,J3399,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3399,BCBSMN Non-RVU base fee schedule,2125000,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3400,Not in chargemaster,J3400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3400,BCBSMN Non-RVU base fee schedule,12.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3410,Not in chargemaster,J3410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3410,BCBSMN Non-RVU base fee schedule,7.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3411,J3411,J3411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3411,BCBSMN Non-RVU base fee schedule,1.65,13.72,Fee schedule,,1.65,1.65,1.65,1.65,,,0
unity,Fee schedule,Non-RVU J3415,Not in chargemaster,J3415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3415,BCBSMN Non-RVU base fee schedule,6.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3420,J3420,J3420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3420,BCBSMN Non-RVU base fee schedule,2.21,10,Fee schedule,,2.21,2.21,2.21,2.21,,,0
unity,Fee schedule,Non-RVU J3430,Not in chargemaster,J3430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3430,BCBSMN Non-RVU base fee schedule,4.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3465,Not in chargemaster,J3465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3465,BCBSMN Non-RVU base fee schedule,2.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3470,Not in chargemaster,J3470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3470,BCBSMN Non-RVU base fee schedule,22.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3471,Not in chargemaster,J3471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3471,BCBSMN Non-RVU base fee schedule,0.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3472,Not in chargemaster,J3472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3472,BCBSMN Non-RVU base fee schedule,151.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3473,Not in chargemaster,J3473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3473,BCBSMN Non-RVU base fee schedule,0.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3475,Not in chargemaster,J3475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3475,BCBSMN Non-RVU base fee schedule,0.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3480,Not in chargemaster,J3480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3480,BCBSMN Non-RVU base fee schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3485,Not in chargemaster,J3485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3485,BCBSMN Non-RVU base fee schedule,1.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3486,Not in chargemaster,J3486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3486,BCBSMN Non-RVU base fee schedule,17.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3489,Not in chargemaster,J3489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3489,BCBSMN Non-RVU base fee schedule,10.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3520,Not in chargemaster,J3520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3520,BCBSMN Non-RVU base fee schedule,1.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3530,Not in chargemaster,J3530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3530,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J3570,Not in chargemaster,J3570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J3570,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7030,Not in chargemaster,J7030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7030,BCBSMN Non-RVU base fee schedule,2.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7040,Not in chargemaster,J7040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7040,BCBSMN Non-RVU base fee schedule,1.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7042,Not in chargemaster,J7042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7042,BCBSMN Non-RVU base fee schedule,0.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7050,Not in chargemaster,J7050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7050,BCBSMN Non-RVU base fee schedule,0.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7060,Not in chargemaster,J7060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7060,BCBSMN Non-RVU base fee schedule,1.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7070,Not in chargemaster,J7070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7070,BCBSMN Non-RVU base fee schedule,3.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7100,Not in chargemaster,J7100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7100,BCBSMN Non-RVU base fee schedule,17.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7110,Not in chargemaster,J7110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7110,BCBSMN Non-RVU base fee schedule,15.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7120,Not in chargemaster,J7120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7120,BCBSMN Non-RVU base fee schedule,2.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7121,Not in chargemaster,J7121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7121,BCBSMN Non-RVU base fee schedule,4.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7131,Not in chargemaster,J7131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7131,BCBSMN Non-RVU base fee schedule,0.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7170,Not in chargemaster,J7170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7170,BCBSMN Non-RVU base fee schedule,47.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7175,Not in chargemaster,J7175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7175,BCBSMN Non-RVU base fee schedule,7.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7177,Not in chargemaster,J7177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7177,BCBSMN Non-RVU base fee schedule,2.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7178,Not in chargemaster,J7178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7178,BCBSMN Non-RVU base fee schedule,1.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7179,Not in chargemaster,J7179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7179,BCBSMN Non-RVU base fee schedule,1.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7180,Not in chargemaster,J7180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7180,BCBSMN Non-RVU base fee schedule,8.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7181,Not in chargemaster,J7181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7181,BCBSMN Non-RVU base fee schedule,15.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7182,Not in chargemaster,J7182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7182,BCBSMN Non-RVU base fee schedule,1.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7183,Not in chargemaster,J7183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7183,BCBSMN Non-RVU base fee schedule,1.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7185,Not in chargemaster,J7185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7185,BCBSMN Non-RVU base fee schedule,1.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7186,Not in chargemaster,J7186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7186,BCBSMN Non-RVU base fee schedule,1.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7187,Not in chargemaster,J7187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7187,BCBSMN Non-RVU base fee schedule,1.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7188,Not in chargemaster,J7188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7188,BCBSMN Non-RVU base fee schedule,3.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7189,Not in chargemaster,J7189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7189,BCBSMN Non-RVU base fee schedule,2.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7190,Not in chargemaster,J7190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7190,BCBSMN Non-RVU base fee schedule,1.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7191,Not in chargemaster,J7191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7191,BCBSMN Non-RVU base fee schedule,1.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7192,Not in chargemaster,J7192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7192,BCBSMN Non-RVU base fee schedule,1.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7193,Not in chargemaster,J7193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7193,BCBSMN Non-RVU base fee schedule,1.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7194,Not in chargemaster,J7194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7194,BCBSMN Non-RVU base fee schedule,1.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7195,Not in chargemaster,J7195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7195,BCBSMN Non-RVU base fee schedule,1.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7196,Not in chargemaster,J7196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7196,BCBSMN Non-RVU base fee schedule,0.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7197,Not in chargemaster,J7197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7197,BCBSMN Non-RVU base fee schedule,3.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7198,Not in chargemaster,J7198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7198,BCBSMN Non-RVU base fee schedule,1.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7200,Not in chargemaster,J7200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7200,BCBSMN Non-RVU base fee schedule,1.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7201,Not in chargemaster,J7201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7201,BCBSMN Non-RVU base fee schedule,3.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7202,Not in chargemaster,J7202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7202,BCBSMN Non-RVU base fee schedule,4.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7203,Not in chargemaster,J7203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7203,BCBSMN Non-RVU base fee schedule,3.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7205,Not in chargemaster,J7205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7205,BCBSMN Non-RVU base fee schedule,2.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7207,Not in chargemaster,J7207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7207,BCBSMN Non-RVU base fee schedule,1.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7208,Not in chargemaster,J7208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7208,BCBSMN Non-RVU base fee schedule,2.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7209,Not in chargemaster,J7209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7209,BCBSMN Non-RVU base fee schedule,1.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7210,Not in chargemaster,J7210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7210,BCBSMN Non-RVU base fee schedule,1.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7211,Not in chargemaster,J7211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7211,BCBSMN Non-RVU base fee schedule,1.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7296,Not in chargemaster,J7296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7296,BCBSMN Non-RVU base fee schedule,972.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7297,Not in chargemaster,J7297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7297,BCBSMN Non-RVU base fee schedule,802.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7298,J7298,J7298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7298,BCBSMN Non-RVU base fee schedule,972.58,1200,Fee schedule,,972.58,972.58,972.58,972.58,,,0
unity,Fee schedule,Non-RVU J7300,J7300,J7300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7300,BCBSMN Non-RVU base fee schedule,902.19,2301.2,Fee schedule,,902.19,902.19,902.19,902.19,,,0
unity,Fee schedule,Non-RVU J7301,Not in chargemaster,J7301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7301,BCBSMN Non-RVU base fee schedule,809.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7303,Not in chargemaster,J7303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7303,BCBSMN Non-RVU base fee schedule,157.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7304,Not in chargemaster,J7304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7304,BCBSMN Non-RVU base fee schedule,43.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7306,Not in chargemaster,J7306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7306,BCBSMN Non-RVU base fee schedule,507.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7307,J7307,J7307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7307,BCBSMN Non-RVU base fee schedule,953.51,990,Fee schedule,,953.51,953.51,953.51,953.51,,,0
unity,Fee schedule,Non-RVU J7308,J7308,J7308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7308,BCBSMN Non-RVU base fee schedule,392.37,522.5,Fee schedule,,392.37,392.37,392.37,392.37,,,0
unity,Fee schedule,Non-RVU J7309,Not in chargemaster,J7309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7309,BCBSMN Non-RVU base fee schedule,80.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7310,Not in chargemaster,J7310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7310,BCBSMN Non-RVU base fee schedule,16960,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7311,Not in chargemaster,J7311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7311,BCBSMN Non-RVU base fee schedule,341.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7312,Not in chargemaster,J7312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7312,BCBSMN Non-RVU base fee schedule,200.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7313,Not in chargemaster,J7313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7313,BCBSMN Non-RVU base fee schedule,490.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7314,Not in chargemaster,J7314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7314,BCBSMN Non-RVU base fee schedule,472.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7315,Not in chargemaster,J7315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7315,BCBSMN Non-RVU base fee schedule,25.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7316,Not in chargemaster,J7316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7316,BCBSMN Non-RVU base fee schedule,1046.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7318,Not in chargemaster,J7318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7318,BCBSMN Non-RVU base fee schedule,16.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7320,Not in chargemaster,J7320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7320,BCBSMN Non-RVU base fee schedule,8.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7321,Not in chargemaster,J7321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7321,BCBSMN Non-RVU base fee schedule,82.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7322,Not in chargemaster,J7322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7322,BCBSMN Non-RVU base fee schedule,30.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7323,J7323,J7323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7323,BCBSMN Non-RVU base fee schedule,144.69,878.13,Fee schedule,,144.69,144.69,144.69,144.69,,,0
unity,Fee schedule,Non-RVU J7324,Not in chargemaster,J7324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7324,BCBSMN Non-RVU base fee schedule,140.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7325,Not in chargemaster,J7325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7325,BCBSMN Non-RVU base fee schedule,11.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7326,Not in chargemaster,J7326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7326,BCBSMN Non-RVU base fee schedule,1122,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7327,Not in chargemaster,J7327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7327,BCBSMN Non-RVU base fee schedule,781.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7328,Not in chargemaster,J7328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7328,BCBSMN Non-RVU base fee schedule,2.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7329,Not in chargemaster,J7329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7329,BCBSMN Non-RVU base fee schedule,8.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7330,Not in chargemaster,J7330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7330,BCBSMN Non-RVU base fee schedule,38942.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7332,Not in chargemaster,J7332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7332,BCBSMN Non-RVU base fee schedule,17.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7336,Not in chargemaster,J7336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7336,BCBSMN Non-RVU base fee schedule,3.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7340,Not in chargemaster,J7340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7340,BCBSMN Non-RVU base fee schedule,212.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7342,Not in chargemaster,J7342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7342,BCBSMN Non-RVU base fee schedule,28.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7345,Not in chargemaster,J7345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7345,BCBSMN Non-RVU base fee schedule,1.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7351,Not in chargemaster,J7351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7351,BCBSMN Non-RVU base fee schedule,198.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7401,Not in chargemaster,J7401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7401,BCBSMN Non-RVU base fee schedule,34.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7500,Not in chargemaster,J7500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7500,BCBSMN Non-RVU base fee schedule,0.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7501,Not in chargemaster,J7501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7501,BCBSMN Non-RVU base fee schedule,217.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7502,Not in chargemaster,J7502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7502,BCBSMN Non-RVU base fee schedule,2.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7503,Not in chargemaster,J7503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7503,BCBSMN Non-RVU base fee schedule,1.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7504,Not in chargemaster,J7504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7504,BCBSMN Non-RVU base fee schedule,2060.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7505,Not in chargemaster,J7505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7505,BCBSMN Non-RVU base fee schedule,1237,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7507,Not in chargemaster,J7507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7507,BCBSMN Non-RVU base fee schedule,0.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7508,Not in chargemaster,J7508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7508,BCBSMN Non-RVU base fee schedule,0.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7509,Not in chargemaster,J7509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7509,BCBSMN Non-RVU base fee schedule,0.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7510,Not in chargemaster,J7510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7510,BCBSMN Non-RVU base fee schedule,0.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7511,Not in chargemaster,J7511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7511,BCBSMN Non-RVU base fee schedule,765.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7512,Not in chargemaster,J7512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7512,BCBSMN Non-RVU base fee schedule,0.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7513,Not in chargemaster,J7513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7513,BCBSMN Non-RVU base fee schedule,563.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7515,Not in chargemaster,J7515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7515,BCBSMN Non-RVU base fee schedule,0.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7516,Not in chargemaster,J7516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7516,BCBSMN Non-RVU base fee schedule,58.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7517,Not in chargemaster,J7517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7517,BCBSMN Non-RVU base fee schedule,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7518,Not in chargemaster,J7518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7518,BCBSMN Non-RVU base fee schedule,2.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7520,Not in chargemaster,J7520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7520,BCBSMN Non-RVU base fee schedule,6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7525,Not in chargemaster,J7525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7525,BCBSMN Non-RVU base fee schedule,211.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7527,Not in chargemaster,J7527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7527,BCBSMN Non-RVU base fee schedule,8.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7604,Not in chargemaster,J7604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7604,BCBSMN Non-RVU base fee schedule,12.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7605,Not in chargemaster,J7605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7605,BCBSMN Non-RVU base fee schedule,10.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7606,Not in chargemaster,J7606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7606,BCBSMN Non-RVU base fee schedule,12.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7607,Not in chargemaster,J7607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7607,BCBSMN Non-RVU base fee schedule,1.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7608,Not in chargemaster,J7608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7608,BCBSMN Non-RVU base fee schedule,5.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7609,Not in chargemaster,J7609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7609,BCBSMN Non-RVU base fee schedule,0.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7610,Not in chargemaster,J7610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7610,BCBSMN Non-RVU base fee schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7611,Not in chargemaster,J7611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7611,BCBSMN Non-RVU base fee schedule,0.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7612,Not in chargemaster,J7612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7612,BCBSMN Non-RVU base fee schedule,0.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7613,J7613,J7613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7613,BCBSMN Non-RVU base fee schedule,0.04,3.85,Fee schedule,,0.04,0.04,0.04,0.04,,,0
unity,Fee schedule,Non-RVU J7614,Not in chargemaster,J7614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7614,BCBSMN Non-RVU base fee schedule,0.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7615,Not in chargemaster,J7615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7615,BCBSMN Non-RVU base fee schedule,0.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7620,J7620,J7620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7620,BCBSMN Non-RVU base fee schedule,0.13,3.85,Fee schedule,,0.13,0.13,0.13,0.13,,,0
unity,Fee schedule,Non-RVU J7624,Not in chargemaster,J7624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7624,BCBSMN Non-RVU base fee schedule,0.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7626,Not in chargemaster,J7626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7626,BCBSMN Non-RVU base fee schedule,1.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7627,Not in chargemaster,J7627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7627,BCBSMN Non-RVU base fee schedule,9.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7628,Not in chargemaster,J7628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7628,BCBSMN Non-RVU base fee schedule,0.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7629,Not in chargemaster,J7629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7629,BCBSMN Non-RVU base fee schedule,0.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7631,Not in chargemaster,J7631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7631,BCBSMN Non-RVU base fee schedule,4.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7632,Not in chargemaster,J7632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7632,BCBSMN Non-RVU base fee schedule,9.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7633,Not in chargemaster,J7633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7633,BCBSMN Non-RVU base fee schedule,8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7634,Not in chargemaster,J7634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7634,BCBSMN Non-RVU base fee schedule,5.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7635,Not in chargemaster,J7635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7635,BCBSMN Non-RVU base fee schedule,11.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7636,Not in chargemaster,J7636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7636,BCBSMN Non-RVU base fee schedule,11.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7637,Not in chargemaster,J7637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7637,BCBSMN Non-RVU base fee schedule,0.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7638,Not in chargemaster,J7638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7638,BCBSMN Non-RVU base fee schedule,0.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7639,Not in chargemaster,J7639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7639,BCBSMN Non-RVU base fee schedule,47.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7640,Not in chargemaster,J7640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7640,BCBSMN Non-RVU base fee schedule,5.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7642,Not in chargemaster,J7642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7642,BCBSMN Non-RVU base fee schedule,26.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7643,Not in chargemaster,J7643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7643,BCBSMN Non-RVU base fee schedule,26.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7644,Not in chargemaster,J7644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7644,BCBSMN Non-RVU base fee schedule,0.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7645,Not in chargemaster,J7645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7645,BCBSMN Non-RVU base fee schedule,0.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7647,Not in chargemaster,J7647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7647,BCBSMN Non-RVU base fee schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7648,Not in chargemaster,J7648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7648,BCBSMN Non-RVU base fee schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7649,Not in chargemaster,J7649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7649,BCBSMN Non-RVU base fee schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7650,Not in chargemaster,J7650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7650,BCBSMN Non-RVU base fee schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7657,Not in chargemaster,J7657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7657,BCBSMN Non-RVU base fee schedule,8.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7658,Not in chargemaster,J7658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7658,BCBSMN Non-RVU base fee schedule,2060.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7659,Not in chargemaster,J7659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7659,BCBSMN Non-RVU base fee schedule,2060.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7660,Not in chargemaster,J7660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7660,BCBSMN Non-RVU base fee schedule,8.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7665,Not in chargemaster,J7665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7665,BCBSMN Non-RVU base fee schedule,0.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7667,Not in chargemaster,J7667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7667,BCBSMN Non-RVU base fee schedule,0.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7668,Not in chargemaster,J7668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7668,BCBSMN Non-RVU base fee schedule,0.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7669,Not in chargemaster,J7669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7669,BCBSMN Non-RVU base fee schedule,0.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7670,Not in chargemaster,J7670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7670,BCBSMN Non-RVU base fee schedule,0.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7674,Not in chargemaster,J7674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7674,BCBSMN Non-RVU base fee schedule,0.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7676,Not in chargemaster,J7676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7676,BCBSMN Non-RVU base fee schedule,161.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7677,Not in chargemaster,J7677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7677,BCBSMN Non-RVU base fee schedule,0.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7680,Not in chargemaster,J7680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7680,BCBSMN Non-RVU base fee schedule,25.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7681,Not in chargemaster,J7681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7681,BCBSMN Non-RVU base fee schedule,25.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7682,Not in chargemaster,J7682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7682,BCBSMN Non-RVU base fee schedule,39.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7683,Not in chargemaster,J7683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7683,BCBSMN Non-RVU base fee schedule,0.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7684,Not in chargemaster,J7684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7684,BCBSMN Non-RVU base fee schedule,0.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7685,Not in chargemaster,J7685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7685,BCBSMN Non-RVU base fee schedule,69.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J7686,Not in chargemaster,J7686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J7686,BCBSMN Non-RVU base fee schedule,612.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8501,Not in chargemaster,J8501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8501,BCBSMN Non-RVU base fee schedule,4.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8510,Not in chargemaster,J8510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8510,BCBSMN Non-RVU base fee schedule,23.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8515,Not in chargemaster,J8515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8515,BCBSMN Non-RVU base fee schedule,15.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8520,Not in chargemaster,J8520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8520,BCBSMN Non-RVU base fee schedule,0.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8521,Not in chargemaster,J8521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8521,BCBSMN Non-RVU base fee schedule,2.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8530,Not in chargemaster,J8530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8530,BCBSMN Non-RVU base fee schedule,2.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8540,Not in chargemaster,J8540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8540,BCBSMN Non-RVU base fee schedule,0.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8560,Not in chargemaster,J8560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8560,BCBSMN Non-RVU base fee schedule,75.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8562,Not in chargemaster,J8562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8562,BCBSMN Non-RVU base fee schedule,81.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8565,Not in chargemaster,J8565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8565,BCBSMN Non-RVU base fee schedule,264.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8600,Not in chargemaster,J8600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8600,BCBSMN Non-RVU base fee schedule,10.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8610,Not in chargemaster,J8610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8610,BCBSMN Non-RVU base fee schedule,0.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8650,Not in chargemaster,J8650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8650,BCBSMN Non-RVU base fee schedule,39.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8655,Not in chargemaster,J8655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8655,BCBSMN Non-RVU base fee schedule,246.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8670,Not in chargemaster,J8670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8670,BCBSMN Non-RVU base fee schedule,2.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8700,Not in chargemaster,J8700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8700,BCBSMN Non-RVU base fee schedule,0.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J8705,Not in chargemaster,J8705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J8705,BCBSMN Non-RVU base fee schedule,103.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9000,Not in chargemaster,J9000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9000,BCBSMN Non-RVU base fee schedule,3.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9015,Not in chargemaster,J9015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9015,BCBSMN Non-RVU base fee schedule,4777.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9017,Not in chargemaster,J9017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9017,BCBSMN Non-RVU base fee schedule,46.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9019,Not in chargemaster,J9019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9019,BCBSMN Non-RVU base fee schedule,435.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9020,Not in chargemaster,J9020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9020,BCBSMN Non-RVU base fee schedule,67.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9022,Not in chargemaster,J9022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9022,BCBSMN Non-RVU base fee schedule,81.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9023,Not in chargemaster,J9023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9023,BCBSMN Non-RVU base fee schedule,88.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9025,Not in chargemaster,J9025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9025,BCBSMN Non-RVU base fee schedule,1.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9027,Not in chargemaster,J9027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9027,BCBSMN Non-RVU base fee schedule,56.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9030,Not in chargemaster,J9030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9030,BCBSMN Non-RVU base fee schedule,2.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9032,Not in chargemaster,J9032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9032,BCBSMN Non-RVU base fee schedule,42.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9033,Not in chargemaster,J9033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9033,BCBSMN Non-RVU base fee schedule,28.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9034,Not in chargemaster,J9034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9034,BCBSMN Non-RVU base fee schedule,22.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9035,Not in chargemaster,J9035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9035,BCBSMN Non-RVU base fee schedule,84.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9036,Not in chargemaster,J9036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9036,BCBSMN Non-RVU base fee schedule,25.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9039,Not in chargemaster,J9039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9039,BCBSMN Non-RVU base fee schedule,119.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9040,Not in chargemaster,J9040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9040,BCBSMN Non-RVU base fee schedule,23.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9041,Not in chargemaster,J9041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9041,BCBSMN Non-RVU base fee schedule,47.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9042,Not in chargemaster,J9042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9042,BCBSMN Non-RVU base fee schedule,177.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9043,Not in chargemaster,J9043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9043,BCBSMN Non-RVU base fee schedule,184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9044,Not in chargemaster,J9044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9044,BCBSMN Non-RVU base fee schedule,23.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9045,Not in chargemaster,J9045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9045,BCBSMN Non-RVU base fee schedule,2.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9047,Not in chargemaster,J9047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9047,BCBSMN Non-RVU base fee schedule,39.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9050,Not in chargemaster,J9050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9050,BCBSMN Non-RVU base fee schedule,2749.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9055,Not in chargemaster,J9055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9055,BCBSMN Non-RVU base fee schedule,66.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9057,Not in chargemaster,J9057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9057,BCBSMN Non-RVU base fee schedule,79.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9060,Not in chargemaster,J9060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9060,BCBSMN Non-RVU base fee schedule,2.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9065,Not in chargemaster,J9065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9065,BCBSMN Non-RVU base fee schedule,21.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9070,Not in chargemaster,J9070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9070,BCBSMN Non-RVU base fee schedule,34.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9098,Not in chargemaster,J9098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9098,BCBSMN Non-RVU base fee schedule,659.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9100,Not in chargemaster,J9100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9100,BCBSMN Non-RVU base fee schedule,0.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9119,Not in chargemaster,J9119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9119,BCBSMN Non-RVU base fee schedule,28.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9120,Not in chargemaster,J9120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9120,BCBSMN Non-RVU base fee schedule,1161.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9130,Not in chargemaster,J9130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9130,BCBSMN Non-RVU base fee schedule,4.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9145,Not in chargemaster,J9145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9145,BCBSMN Non-RVU base fee schedule,56.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9150,Not in chargemaster,J9150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9150,BCBSMN Non-RVU base fee schedule,50.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9151,Not in chargemaster,J9151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9151,BCBSMN Non-RVU base fee schedule,234.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9153,Not in chargemaster,J9153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9153,BCBSMN Non-RVU base fee schedule,205.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9155,Not in chargemaster,J9155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9155,BCBSMN Non-RVU base fee schedule,4.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9160,Not in chargemaster,J9160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9160,BCBSMN Non-RVU base fee schedule,1814.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9165,Not in chargemaster,J9165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9165,BCBSMN Non-RVU base fee schedule,12.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9171,Not in chargemaster,J9171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9171,BCBSMN Non-RVU base fee schedule,1.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9173,Not in chargemaster,J9173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9173,BCBSMN Non-RVU base fee schedule,79.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9175,Not in chargemaster,J9175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9175,BCBSMN Non-RVU base fee schedule,9.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9176,Not in chargemaster,J9176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9176,BCBSMN Non-RVU base fee schedule,6.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9177,Not in chargemaster,J9177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9177,BCBSMN Non-RVU base fee schedule,27.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9178,Not in chargemaster,J9178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9178,BCBSMN Non-RVU base fee schedule,1.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9179,Not in chargemaster,J9179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9179,BCBSMN Non-RVU base fee schedule,122.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9181,Not in chargemaster,J9181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9181,BCBSMN Non-RVU base fee schedule,0.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9185,Not in chargemaster,J9185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9185,BCBSMN Non-RVU base fee schedule,50.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9190,Not in chargemaster,J9190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9190,BCBSMN Non-RVU base fee schedule,1.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9200,Not in chargemaster,J9200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9200,BCBSMN Non-RVU base fee schedule,89.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9201,Not in chargemaster,J9201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9201,BCBSMN Non-RVU base fee schedule,4.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9202,Not in chargemaster,J9202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9202,BCBSMN Non-RVU base fee schedule,529.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9203,Not in chargemaster,J9203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9203,BCBSMN Non-RVU base fee schedule,209.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9204,Not in chargemaster,J9204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9204,BCBSMN Non-RVU base fee schedule,210.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9205,Not in chargemaster,J9205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9205,BCBSMN Non-RVU base fee schedule,52.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9206,Not in chargemaster,J9206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9206,BCBSMN Non-RVU base fee schedule,2.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9207,Not in chargemaster,J9207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9207,BCBSMN Non-RVU base fee schedule,100.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9208,Not in chargemaster,J9208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9208,BCBSMN Non-RVU base fee schedule,28.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9209,Not in chargemaster,J9209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9209,BCBSMN Non-RVU base fee schedule,2.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9210,Not in chargemaster,J9210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9210,BCBSMN Non-RVU base fee schedule,738.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9211,Not in chargemaster,J9211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9211,BCBSMN Non-RVU base fee schedule,38.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9212,Not in chargemaster,J9212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9212,BCBSMN Non-RVU base fee schedule,54.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9213,Not in chargemaster,J9213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9213,BCBSMN Non-RVU base fee schedule,20.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9214,Not in chargemaster,J9214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9214,BCBSMN Non-RVU base fee schedule,35.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9215,Not in chargemaster,J9215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9215,BCBSMN Non-RVU base fee schedule,30.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9216,Not in chargemaster,J9216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9216,BCBSMN Non-RVU base fee schedule,491.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9217,J9217,J9217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9217,BCBSMN Non-RVU base fee schedule,241.58,301.85,Fee schedule,,241.58,241.58,241.58,241.58,,,0
unity,Fee schedule,Non-RVU J9218,Not in chargemaster,J9218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9218,BCBSMN Non-RVU base fee schedule,10.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9219,Not in chargemaster,J9219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9219,BCBSMN Non-RVU base fee schedule,5398.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9225,Not in chargemaster,J9225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9225,BCBSMN Non-RVU base fee schedule,4325.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9226,Not in chargemaster,J9226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9226,BCBSMN Non-RVU base fee schedule,38508.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9227,Not in chargemaster,J9227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9227,BCBSMN Non-RVU base fee schedule,66.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9228,Not in chargemaster,J9228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9228,BCBSMN Non-RVU base fee schedule,162.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9229,Not in chargemaster,J9229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9229,BCBSMN Non-RVU base fee schedule,2387.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9230,Not in chargemaster,J9230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9230,BCBSMN Non-RVU base fee schedule,336.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9245,Not in chargemaster,J9245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9245,BCBSMN Non-RVU base fee schedule,665.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9250,Not in chargemaster,J9250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9250,BCBSMN Non-RVU base fee schedule,0.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9260,Not in chargemaster,J9260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9260,BCBSMN Non-RVU base fee schedule,2.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9261,Not in chargemaster,J9261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9261,BCBSMN Non-RVU base fee schedule,160.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9262,Not in chargemaster,J9262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9262,BCBSMN Non-RVU base fee schedule,3.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9263,Not in chargemaster,J9263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9263,BCBSMN Non-RVU base fee schedule,0.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9264,Not in chargemaster,J9264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9264,BCBSMN Non-RVU base fee schedule,13.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9266,Not in chargemaster,J9266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9266,BCBSMN Non-RVU base fee schedule,18450.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9267,Not in chargemaster,J9267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9267,BCBSMN Non-RVU base fee schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9268,Not in chargemaster,J9268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9268,BCBSMN Non-RVU base fee schedule,2214.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9269,Not in chargemaster,J9269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9269,BCBSMN Non-RVU base fee schedule,260.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9270,Not in chargemaster,J9270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9270,BCBSMN Non-RVU base fee schedule,74.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9271,Not in chargemaster,J9271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9271,BCBSMN Non-RVU base fee schedule,52.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9280,Not in chargemaster,J9280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9280,BCBSMN Non-RVU base fee schedule,83.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9285,Not in chargemaster,J9285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9285,BCBSMN Non-RVU base fee schedule,54.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9293,Not in chargemaster,J9293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9293,BCBSMN Non-RVU base fee schedule,29.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9295,Not in chargemaster,J9295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9295,BCBSMN Non-RVU base fee schedule,6.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9299,Not in chargemaster,J9299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9299,BCBSMN Non-RVU base fee schedule,29.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9301,Not in chargemaster,J9301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9301,BCBSMN Non-RVU base fee schedule,66.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9302,Not in chargemaster,J9302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9302,BCBSMN Non-RVU base fee schedule,63.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9303,Not in chargemaster,J9303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9303,BCBSMN Non-RVU base fee schedule,124.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9305,Not in chargemaster,J9305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9305,BCBSMN Non-RVU base fee schedule,74.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9306,Not in chargemaster,J9306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9306,BCBSMN Non-RVU base fee schedule,13.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9307,Not in chargemaster,J9307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9307,BCBSMN Non-RVU base fee schedule,310.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9308,Not in chargemaster,J9308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9308,BCBSMN Non-RVU base fee schedule,62.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9309,Not in chargemaster,J9309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9309,BCBSMN Non-RVU base fee schedule,119.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9311,Not in chargemaster,J9311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9311,BCBSMN Non-RVU base fee schedule,45.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9312,Not in chargemaster,J9312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9312,BCBSMN Non-RVU base fee schedule,99.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9313,Not in chargemaster,J9313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9313,BCBSMN Non-RVU base fee schedule,21.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9315,Not in chargemaster,J9315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9315,BCBSMN Non-RVU base fee schedule,231.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9320,Not in chargemaster,J9320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9320,BCBSMN Non-RVU base fee schedule,370.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9325,Not in chargemaster,J9325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9325,BCBSMN Non-RVU base fee schedule,54.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9328,Not in chargemaster,J9328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9328,BCBSMN Non-RVU base fee schedule,10.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9330,Not in chargemaster,J9330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9330,BCBSMN Non-RVU base fee schedule,50.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9340,Not in chargemaster,J9340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9340,BCBSMN Non-RVU base fee schedule,432.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9351,Not in chargemaster,J9351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9351,BCBSMN Non-RVU base fee schedule,1.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9352,Not in chargemaster,J9352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9352,BCBSMN Non-RVU base fee schedule,328.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9354,Not in chargemaster,J9354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9354,BCBSMN Non-RVU base fee schedule,33.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9355,Not in chargemaster,J9355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9355,BCBSMN Non-RVU base fee schedule,111.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9356,Not in chargemaster,J9356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9356,BCBSMN Non-RVU base fee schedule,83.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9357,Not in chargemaster,J9357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9357,BCBSMN Non-RVU base fee schedule,1497.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9358,Not in chargemaster,J9358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9358,BCBSMN Non-RVU base fee schedule,24.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9360,Not in chargemaster,J9360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9360,BCBSMN Non-RVU base fee schedule,4.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9370,Not in chargemaster,J9370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9370,BCBSMN Non-RVU base fee schedule,5.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9371,Not in chargemaster,J9371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9371,BCBSMN Non-RVU base fee schedule,3229.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9390,Not in chargemaster,J9390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9390,BCBSMN Non-RVU base fee schedule,12.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9395,Not in chargemaster,J9395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9395,BCBSMN Non-RVU base fee schedule,89.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9400,Not in chargemaster,J9400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9400,BCBSMN Non-RVU base fee schedule,8.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU J9600,Not in chargemaster,J9600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,J9600,BCBSMN Non-RVU base fee schedule,21460.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0001,Not in chargemaster,K0001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0001,BCBSMN Non-RVU base fee schedule,394.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0001 mod RR,Not in chargemaster,K0001,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0001 mod RR,BCBSMN Non-RVU base fee schedule,39.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0002,Not in chargemaster,K0002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0002,BCBSMN Non-RVU base fee schedule,592.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0002 mod RR,Not in chargemaster,K0002,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0002 mod RR,BCBSMN Non-RVU base fee schedule,59.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0003,Not in chargemaster,K0003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0003,BCBSMN Non-RVU base fee schedule,659.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0003 mod RR,Not in chargemaster,K0003,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0003 mod RR,BCBSMN Non-RVU base fee schedule,65.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0004,Not in chargemaster,K0004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0004,BCBSMN Non-RVU base fee schedule,840.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0004 mod RR,Not in chargemaster,K0004,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0004 mod RR,BCBSMN Non-RVU base fee schedule,84.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0005,Not in chargemaster,K0005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0005,BCBSMN Non-RVU base fee schedule,1933.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0005 mod RR,Not in chargemaster,K0005,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0005 mod RR,BCBSMN Non-RVU base fee schedule,193.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0006,Not in chargemaster,K0006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0006,BCBSMN Non-RVU base fee schedule,907.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0006 mod RR,Not in chargemaster,K0006,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0006 mod RR,BCBSMN Non-RVU base fee schedule,90.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0007,Not in chargemaster,K0007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0007,BCBSMN Non-RVU base fee schedule,1432.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0007 mod RR,Not in chargemaster,K0007,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0007 mod RR,BCBSMN Non-RVU base fee schedule,143.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0009,Not in chargemaster,K0009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0009,BCBSMN Non-RVU base fee schedule,816.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0009 mod RR,Not in chargemaster,K0009,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0009 mod RR,BCBSMN Non-RVU base fee schedule,81.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0010,Not in chargemaster,K0010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0010,BCBSMN Non-RVU base fee schedule,3975.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0010 mod RR,Not in chargemaster,K0010,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0010 mod RR,BCBSMN Non-RVU base fee schedule,397.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0011,Not in chargemaster,K0011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0011,BCBSMN Non-RVU base fee schedule,5624,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0011 mod RR,Not in chargemaster,K0011,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0011 mod RR,BCBSMN Non-RVU base fee schedule,562.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0012,Not in chargemaster,K0012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0012,BCBSMN Non-RVU base fee schedule,3567.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0012 mod RR,Not in chargemaster,K0012,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0012 mod RR,BCBSMN Non-RVU base fee schedule,356.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0015,Not in chargemaster,K0015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0015,BCBSMN Non-RVU base fee schedule,157.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0015 mod RR,Not in chargemaster,K0015,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0015 mod RR,BCBSMN Non-RVU base fee schedule,15.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0017,Not in chargemaster,K0017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0017,BCBSMN Non-RVU base fee schedule,44.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0017 mod RR,Not in chargemaster,K0017,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0017 mod RR,BCBSMN Non-RVU base fee schedule,4.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0018,Not in chargemaster,K0018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0018,BCBSMN Non-RVU base fee schedule,24.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0018 mod RR,Not in chargemaster,K0018,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0018 mod RR,BCBSMN Non-RVU base fee schedule,2.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0019,Not in chargemaster,K0019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0019,BCBSMN Non-RVU base fee schedule,14.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0019 mod RR,Not in chargemaster,K0019,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0019 mod RR,BCBSMN Non-RVU base fee schedule,1.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0020,Not in chargemaster,K0020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0020,BCBSMN Non-RVU base fee schedule,41.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0020 mod RR,Not in chargemaster,K0020,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0020 mod RR,BCBSMN Non-RVU base fee schedule,4.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0037,Not in chargemaster,K0037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0037,BCBSMN Non-RVU base fee schedule,40.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0037 mod RR,Not in chargemaster,K0037,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0037 mod RR,BCBSMN Non-RVU base fee schedule,3.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0038,Not in chargemaster,K0038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0038,BCBSMN Non-RVU base fee schedule,21.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0038 mod RR,Not in chargemaster,K0038,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0038 mod RR,BCBSMN Non-RVU base fee schedule,2.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0039,Not in chargemaster,K0039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0039,BCBSMN Non-RVU base fee schedule,46.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0039 mod RR,Not in chargemaster,K0039,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0039 mod RR,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0040,Not in chargemaster,K0040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0040,BCBSMN Non-RVU base fee schedule,58.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0040 mod RR,Not in chargemaster,K0040,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0040 mod RR,BCBSMN Non-RVU base fee schedule,5.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0041,Not in chargemaster,K0041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0041,BCBSMN Non-RVU base fee schedule,45.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0041 mod RR,Not in chargemaster,K0041,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0041 mod RR,BCBSMN Non-RVU base fee schedule,4.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0042,Not in chargemaster,K0042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0042,BCBSMN Non-RVU base fee schedule,30.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0042 mod RR,Not in chargemaster,K0042,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0042 mod RR,BCBSMN Non-RVU base fee schedule,3.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0043,Not in chargemaster,K0043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0043,BCBSMN Non-RVU base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0043 mod RR,Not in chargemaster,K0043,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0043 mod RR,BCBSMN Non-RVU base fee schedule,1.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0044,Not in chargemaster,K0044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0044,BCBSMN Non-RVU base fee schedule,14.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0044 mod RR,Not in chargemaster,K0044,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0044 mod RR,BCBSMN Non-RVU base fee schedule,1.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0045,Not in chargemaster,K0045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0045,BCBSMN Non-RVU base fee schedule,50.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0045 mod RR,Not in chargemaster,K0045,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0045 mod RR,BCBSMN Non-RVU base fee schedule,5.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0046,Not in chargemaster,K0046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0046,BCBSMN Non-RVU base fee schedule,17.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0046 mod RR,Not in chargemaster,K0046,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0046 mod RR,BCBSMN Non-RVU base fee schedule,1.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0047,Not in chargemaster,K0047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0047,BCBSMN Non-RVU base fee schedule,64.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0047 mod RR,Not in chargemaster,K0047,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0047 mod RR,BCBSMN Non-RVU base fee schedule,6.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0050,Not in chargemaster,K0050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0050,BCBSMN Non-RVU base fee schedule,28.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0050 mod RR,Not in chargemaster,K0050,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0050 mod RR,BCBSMN Non-RVU base fee schedule,2.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0051,Not in chargemaster,K0051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0051,BCBSMN Non-RVU base fee schedule,46.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0051 mod RR,Not in chargemaster,K0051,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0051 mod RR,BCBSMN Non-RVU base fee schedule,4.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0052,Not in chargemaster,K0052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0052,BCBSMN Non-RVU base fee schedule,75.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0052 mod RR,Not in chargemaster,K0052,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0052 mod RR,BCBSMN Non-RVU base fee schedule,7.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0053,Not in chargemaster,K0053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0053,BCBSMN Non-RVU base fee schedule,86.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0053 mod RR,Not in chargemaster,K0053,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0053 mod RR,BCBSMN Non-RVU base fee schedule,8.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0056,Not in chargemaster,K0056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0056,BCBSMN Non-RVU base fee schedule,94.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0056 mod RR,Not in chargemaster,K0056,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0056 mod RR,BCBSMN Non-RVU base fee schedule,9.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0065,Not in chargemaster,K0065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0065,BCBSMN Non-RVU base fee schedule,45.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0065 mod RR,Not in chargemaster,K0065,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0065 mod RR,BCBSMN Non-RVU base fee schedule,4.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0069,Not in chargemaster,K0069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0069,BCBSMN Non-RVU base fee schedule,97.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0069 mod RR,Not in chargemaster,K0069,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0069 mod RR,BCBSMN Non-RVU base fee schedule,9.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0070,Not in chargemaster,K0070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0070,BCBSMN Non-RVU base fee schedule,180.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0070 mod RR,Not in chargemaster,K0070,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0070 mod RR,BCBSMN Non-RVU base fee schedule,18.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0071,Not in chargemaster,K0071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0071,BCBSMN Non-RVU base fee schedule,109.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0071 mod RR,Not in chargemaster,K0071,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0071 mod RR,BCBSMN Non-RVU base fee schedule,10.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0072,Not in chargemaster,K0072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0072,BCBSMN Non-RVU base fee schedule,66.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0072 mod RR,Not in chargemaster,K0072,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0072 mod RR,BCBSMN Non-RVU base fee schedule,6.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0073,Not in chargemaster,K0073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0073,BCBSMN Non-RVU base fee schedule,35.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0073 mod RR,Not in chargemaster,K0073,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0073 mod RR,BCBSMN Non-RVU base fee schedule,3.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0077,Not in chargemaster,K0077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0077,BCBSMN Non-RVU base fee schedule,56.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0077 mod RR,Not in chargemaster,K0077,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0077 mod RR,BCBSMN Non-RVU base fee schedule,5.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0098,Not in chargemaster,K0098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0098,BCBSMN Non-RVU base fee schedule,23.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0098 mod RR,Not in chargemaster,K0098,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0098 mod RR,BCBSMN Non-RVU base fee schedule,2.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0105,Not in chargemaster,K0105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0105,BCBSMN Non-RVU base fee schedule,99.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0105 mod RR,Not in chargemaster,K0105,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0105 mod RR,BCBSMN Non-RVU base fee schedule,9.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0195,Not in chargemaster,K0195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0195,BCBSMN Non-RVU base fee schedule,154.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0195 mod RR,Not in chargemaster,K0195,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0195 mod RR,BCBSMN Non-RVU base fee schedule,15.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0455,Not in chargemaster,K0455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0455,BCBSMN Non-RVU base fee schedule,2769.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0455 mod RR,Not in chargemaster,K0455,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0455 mod RR,BCBSMN Non-RVU base fee schedule,276.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0462 mod RR,Not in chargemaster,K0462,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0462 mod RR,BCBSMN Non-RVU base fee schedule,115.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0552,Not in chargemaster,K0552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0552,BCBSMN Non-RVU base fee schedule,2.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0553,Not in chargemaster,K0553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0553,BCBSMN Non-RVU base fee schedule,200.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0554,Not in chargemaster,K0554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0554,BCBSMN Non-RVU base fee schedule,204.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0554 mod RR,Not in chargemaster,K0554,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0554 mod RR,BCBSMN Non-RVU base fee schedule,20.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0601,Not in chargemaster,K0601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0601,BCBSMN Non-RVU base fee schedule,1.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0602,Not in chargemaster,K0602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0602,BCBSMN Non-RVU base fee schedule,6.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0603,Not in chargemaster,K0603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0603,BCBSMN Non-RVU base fee schedule,0.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0604,Not in chargemaster,K0604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0604,BCBSMN Non-RVU base fee schedule,6.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0605,Not in chargemaster,K0605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0605,BCBSMN Non-RVU base fee schedule,14.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0606,Not in chargemaster,K0606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0606,BCBSMN Non-RVU base fee schedule,27646.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0606 mod RR,Not in chargemaster,K0606,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0606 mod RR,BCBSMN Non-RVU base fee schedule,2764.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0607,Not in chargemaster,K0607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0607,BCBSMN Non-RVU base fee schedule,213.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0607 mod RR,Not in chargemaster,K0607,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0607 mod RR,BCBSMN Non-RVU base fee schedule,21.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0608,Not in chargemaster,K0608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0608,BCBSMN Non-RVU base fee schedule,126.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0608 mod RR,Not in chargemaster,K0608,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0608 mod RR,BCBSMN Non-RVU base fee schedule,12.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0609,Not in chargemaster,K0609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0609,BCBSMN Non-RVU base fee schedule,842.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0669,Not in chargemaster,K0669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0669,BCBSMN Non-RVU base fee schedule,68.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0669 mod RR,Not in chargemaster,K0669,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0669 mod RR,BCBSMN Non-RVU base fee schedule,6.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0672,Not in chargemaster,K0672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0672,BCBSMN Non-RVU base fee schedule,76.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0730,Not in chargemaster,K0730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0730,BCBSMN Non-RVU base fee schedule,1892.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0730 mod RR,Not in chargemaster,K0730,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0730 mod RR,BCBSMN Non-RVU base fee schedule,189.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0733,Not in chargemaster,K0733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0733,BCBSMN Non-RVU base fee schedule,27.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0733 mod RR,Not in chargemaster,K0733,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0733 mod RR,BCBSMN Non-RVU base fee schedule,2.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0738 mod RR,Not in chargemaster,K0738,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0738 mod RR,BCBSMN Non-RVU base fee schedule,40.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0739,Not in chargemaster,K0739,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0739,BCBSMN Non-RVU base fee schedule,15.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0740,Not in chargemaster,K0740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0740,BCBSMN Non-RVU base fee schedule,10.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0744,Not in chargemaster,K0744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0744,BCBSMN Non-RVU base fee schedule,1.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0800,Not in chargemaster,K0800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0800,BCBSMN Non-RVU base fee schedule,986.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0800 mod RR,Not in chargemaster,K0800,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0800 mod RR,BCBSMN Non-RVU base fee schedule,98.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0801,Not in chargemaster,K0801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0801,BCBSMN Non-RVU base fee schedule,1677.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0801 mod RR,Not in chargemaster,K0801,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0801 mod RR,BCBSMN Non-RVU base fee schedule,167.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0802,Not in chargemaster,K0802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0802,BCBSMN Non-RVU base fee schedule,2046.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0802 mod RR,Not in chargemaster,K0802,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0802 mod RR,BCBSMN Non-RVU base fee schedule,204.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0806,Not in chargemaster,K0806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0806,BCBSMN Non-RVU base fee schedule,1329.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0806 mod RR,Not in chargemaster,K0806,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0806 mod RR,BCBSMN Non-RVU base fee schedule,132.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0807,Not in chargemaster,K0807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0807,BCBSMN Non-RVU base fee schedule,2036.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0807 mod RR,Not in chargemaster,K0807,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0807 mod RR,BCBSMN Non-RVU base fee schedule,203.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0808,Not in chargemaster,K0808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0808,BCBSMN Non-RVU base fee schedule,3150.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0808 mod RR,Not in chargemaster,K0808,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0808 mod RR,BCBSMN Non-RVU base fee schedule,315.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0812,Not in chargemaster,K0812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0812,BCBSMN Non-RVU base fee schedule,2261.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0812 mod RR,Not in chargemaster,K0812,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0812 mod RR,BCBSMN Non-RVU base fee schedule,226.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0813,Not in chargemaster,K0813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0813,BCBSMN Non-RVU base fee schedule,3045.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0813 mod RR,Not in chargemaster,K0813,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0813 mod RR,BCBSMN Non-RVU base fee schedule,304.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0814,Not in chargemaster,K0814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0814,BCBSMN Non-RVU base fee schedule,3570.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0814 mod RR,Not in chargemaster,K0814,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0814 mod RR,BCBSMN Non-RVU base fee schedule,357.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0815,Not in chargemaster,K0815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0815,BCBSMN Non-RVU base fee schedule,4017.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0815 mod RR,Not in chargemaster,K0815,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0815 mod RR,BCBSMN Non-RVU base fee schedule,401.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0816,Not in chargemaster,K0816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0816,BCBSMN Non-RVU base fee schedule,3801.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0816 mod RR,Not in chargemaster,K0816,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0816 mod RR,BCBSMN Non-RVU base fee schedule,380.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0820,Not in chargemaster,K0820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0820,BCBSMN Non-RVU base fee schedule,3198.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0820 mod RR,Not in chargemaster,K0820,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0820 mod RR,BCBSMN Non-RVU base fee schedule,319.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0821,Not in chargemaster,K0821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0821,BCBSMN Non-RVU base fee schedule,3761.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0821 mod RR,Not in chargemaster,K0821,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0821 mod RR,BCBSMN Non-RVU base fee schedule,376.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0822,Not in chargemaster,K0822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0822,BCBSMN Non-RVU base fee schedule,4357.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0822 mod RR,Not in chargemaster,K0822,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0822 mod RR,BCBSMN Non-RVU base fee schedule,435.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0823,Not in chargemaster,K0823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0823,BCBSMN Non-RVU base fee schedule,4270.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0823 mod RR,Not in chargemaster,K0823,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0823 mod RR,BCBSMN Non-RVU base fee schedule,427.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0824,Not in chargemaster,K0824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0824,BCBSMN Non-RVU base fee schedule,5617.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0824 mod RR,Not in chargemaster,K0824,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0824 mod RR,BCBSMN Non-RVU base fee schedule,561.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0825,Not in chargemaster,K0825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0825,BCBSMN Non-RVU base fee schedule,5166.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0825 mod RR,Not in chargemaster,K0825,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0825 mod RR,BCBSMN Non-RVU base fee schedule,516.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0826,Not in chargemaster,K0826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0826,BCBSMN Non-RVU base fee schedule,8141.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0826 mod RR,Not in chargemaster,K0826,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0826 mod RR,BCBSMN Non-RVU base fee schedule,814.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0827,Not in chargemaster,K0827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0827,BCBSMN Non-RVU base fee schedule,7008.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0827 mod RR,Not in chargemaster,K0827,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0827 mod RR,BCBSMN Non-RVU base fee schedule,700.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0828,Not in chargemaster,K0828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0828,BCBSMN Non-RVU base fee schedule,9478.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0828 mod RR,Not in chargemaster,K0828,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0828 mod RR,BCBSMN Non-RVU base fee schedule,947.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0829,Not in chargemaster,K0829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0829,BCBSMN Non-RVU base fee schedule,8949.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0829 mod RR,Not in chargemaster,K0829,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0829 mod RR,BCBSMN Non-RVU base fee schedule,894.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0830,Not in chargemaster,K0830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0830,BCBSMN Non-RVU base fee schedule,3914.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0830 mod RR,Not in chargemaster,K0830,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0830 mod RR,BCBSMN Non-RVU base fee schedule,391.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0831,Not in chargemaster,K0831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0831,BCBSMN Non-RVU base fee schedule,3914.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0831 mod RR,Not in chargemaster,K0831,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0831 mod RR,BCBSMN Non-RVU base fee schedule,391.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0835,Not in chargemaster,K0835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0835,BCBSMN Non-RVU base fee schedule,4563.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0835 mod RR,Not in chargemaster,K0835,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0835 mod RR,BCBSMN Non-RVU base fee schedule,456.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0836,Not in chargemaster,K0836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0836,BCBSMN Non-RVU base fee schedule,4733.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0836 mod RR,Not in chargemaster,K0836,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0836 mod RR,BCBSMN Non-RVU base fee schedule,473.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0837,Not in chargemaster,K0837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0837,BCBSMN Non-RVU base fee schedule,5597.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0837 mod RR,Not in chargemaster,K0837,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0837 mod RR,BCBSMN Non-RVU base fee schedule,559.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0838,Not in chargemaster,K0838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0838,BCBSMN Non-RVU base fee schedule,4989.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0838 mod RR,Not in chargemaster,K0838,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0838 mod RR,BCBSMN Non-RVU base fee schedule,498.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0839,Not in chargemaster,K0839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0839,BCBSMN Non-RVU base fee schedule,7319.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0839 mod RR,Not in chargemaster,K0839,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0839 mod RR,BCBSMN Non-RVU base fee schedule,731.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0840,Not in chargemaster,K0840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0840,BCBSMN Non-RVU base fee schedule,11147.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0840 mod RR,Not in chargemaster,K0840,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0840 mod RR,BCBSMN Non-RVU base fee schedule,1114.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0841,Not in chargemaster,K0841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0841,BCBSMN Non-RVU base fee schedule,4963.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0841 mod RR,Not in chargemaster,K0841,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0841 mod RR,BCBSMN Non-RVU base fee schedule,496.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0842,Not in chargemaster,K0842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0842,BCBSMN Non-RVU base fee schedule,4960.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0842 mod RR,Not in chargemaster,K0842,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0842 mod RR,BCBSMN Non-RVU base fee schedule,496.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0843,Not in chargemaster,K0843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0843,BCBSMN Non-RVU base fee schedule,5940.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0843 mod RR,Not in chargemaster,K0843,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0843 mod RR,BCBSMN Non-RVU base fee schedule,594.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0848,Not in chargemaster,K0848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0848,BCBSMN Non-RVU base fee schedule,7500.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0848 mod RR,Not in chargemaster,K0848,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0848 mod RR,BCBSMN Non-RVU base fee schedule,750.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0849,Not in chargemaster,K0849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0849,BCBSMN Non-RVU base fee schedule,7211.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0849 mod RR,Not in chargemaster,K0849,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0849 mod RR,BCBSMN Non-RVU base fee schedule,721.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0850,Not in chargemaster,K0850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0850,BCBSMN Non-RVU base fee schedule,8700.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0850 mod RR,Not in chargemaster,K0850,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0850 mod RR,BCBSMN Non-RVU base fee schedule,870.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0851,Not in chargemaster,K0851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0851,BCBSMN Non-RVU base fee schedule,8365.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0851 mod RR,Not in chargemaster,K0851,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0851 mod RR,BCBSMN Non-RVU base fee schedule,836.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0852,Not in chargemaster,K0852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0852,BCBSMN Non-RVU base fee schedule,10052.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0852 mod RR,Not in chargemaster,K0852,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0852 mod RR,BCBSMN Non-RVU base fee schedule,1005.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0853,Not in chargemaster,K0853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0853,BCBSMN Non-RVU base fee schedule,10326.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0853 mod RR,Not in chargemaster,K0853,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0853 mod RR,BCBSMN Non-RVU base fee schedule,1032.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0854,Not in chargemaster,K0854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0854,BCBSMN Non-RVU base fee schedule,13680.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0854 mod RR,Not in chargemaster,K0854,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0854 mod RR,BCBSMN Non-RVU base fee schedule,1368.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0855,Not in chargemaster,K0855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0855,BCBSMN Non-RVU base fee schedule,12923.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0855 mod RR,Not in chargemaster,K0855,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0855 mod RR,BCBSMN Non-RVU base fee schedule,1292.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0856,Not in chargemaster,K0856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0856,BCBSMN Non-RVU base fee schedule,8050.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0856 mod RR,Not in chargemaster,K0856,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0856 mod RR,BCBSMN Non-RVU base fee schedule,805.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0857,Not in chargemaster,K0857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0857,BCBSMN Non-RVU base fee schedule,8212.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0857 mod RR,Not in chargemaster,K0857,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0857 mod RR,BCBSMN Non-RVU base fee schedule,821.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0858,Not in chargemaster,K0858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0858,BCBSMN Non-RVU base fee schedule,9988.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0858 mod RR,Not in chargemaster,K0858,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0858 mod RR,BCBSMN Non-RVU base fee schedule,998.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0859,Not in chargemaster,K0859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0859,BCBSMN Non-RVU base fee schedule,9526.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0859 mod RR,Not in chargemaster,K0859,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0859 mod RR,BCBSMN Non-RVU base fee schedule,952.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0860,Not in chargemaster,K0860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0860,BCBSMN Non-RVU base fee schedule,14270.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0860 mod RR,Not in chargemaster,K0860,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0860 mod RR,BCBSMN Non-RVU base fee schedule,1427.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0861,Not in chargemaster,K0861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0861,BCBSMN Non-RVU base fee schedule,8063.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0861 mod RR,Not in chargemaster,K0861,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0861 mod RR,BCBSMN Non-RVU base fee schedule,806.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0862,Not in chargemaster,K0862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0862,BCBSMN Non-RVU base fee schedule,9988.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0862 mod RR,Not in chargemaster,K0862,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0862 mod RR,BCBSMN Non-RVU base fee schedule,998.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0863,Not in chargemaster,K0863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0863,BCBSMN Non-RVU base fee schedule,14270.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0863 mod RR,Not in chargemaster,K0863,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0863 mod RR,BCBSMN Non-RVU base fee schedule,1427.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0864,Not in chargemaster,K0864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0864,BCBSMN Non-RVU base fee schedule,16981.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0864 mod RR,Not in chargemaster,K0864,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0864 mod RR,BCBSMN Non-RVU base fee schedule,1698.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0868,Not in chargemaster,K0868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0868,BCBSMN Non-RVU base fee schedule,4785.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0868 mod RR,Not in chargemaster,K0868,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0868 mod RR,BCBSMN Non-RVU base fee schedule,478.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0869,Not in chargemaster,K0869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0869,BCBSMN Non-RVU base fee schedule,4785.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0869 mod RR,Not in chargemaster,K0869,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0869 mod RR,BCBSMN Non-RVU base fee schedule,455.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0877,Not in chargemaster,K0877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0877,BCBSMN Non-RVU base fee schedule,4202.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0877 mod RR,Not in chargemaster,K0877,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0877 mod RR,BCBSMN Non-RVU base fee schedule,420.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0879,Not in chargemaster,K0879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0879,BCBSMN Non-RVU base fee schedule,5675.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0879 mod RR,Not in chargemaster,K0879,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0879 mod RR,BCBSMN Non-RVU base fee schedule,540.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0880,Not in chargemaster,K0880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0880,BCBSMN Non-RVU base fee schedule,8881.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0880 mod RR,Not in chargemaster,K0880,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0880 mod RR,BCBSMN Non-RVU base fee schedule,888.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0884,Not in chargemaster,K0884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0884,BCBSMN Non-RVU base fee schedule,6416.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0884 mod RR,Not in chargemaster,K0884,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0884 mod RR,BCBSMN Non-RVU base fee schedule,641.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0885,Not in chargemaster,K0885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0885,BCBSMN Non-RVU base fee schedule,6340.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0885 mod RR,Not in chargemaster,K0885,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0885 mod RR,BCBSMN Non-RVU base fee schedule,603.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0886,Not in chargemaster,K0886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0886,BCBSMN Non-RVU base fee schedule,5856.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0886 mod RR,Not in chargemaster,K0886,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0886 mod RR,BCBSMN Non-RVU base fee schedule,557.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0890,Not in chargemaster,K0890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0890,BCBSMN Non-RVU base fee schedule,9850.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0890 mod RR,Not in chargemaster,K0890,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0890 mod RR,BCBSMN Non-RVU base fee schedule,985.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0891,Not in chargemaster,K0891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0891,BCBSMN Non-RVU base fee schedule,12789.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU K0891 mod RR,Not in chargemaster,K0891,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,K0891 mod RR,BCBSMN Non-RVU base fee schedule,1278.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0112,Not in chargemaster,L0112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0112,BCBSMN Non-RVU base fee schedule,1261.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0113,Not in chargemaster,L0113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0113,BCBSMN Non-RVU base fee schedule,257.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0120,Not in chargemaster,L0120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0120,BCBSMN Non-RVU base fee schedule,23.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0130,Not in chargemaster,L0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0130,BCBSMN Non-RVU base fee schedule,137.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0140,Not in chargemaster,L0140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0140,BCBSMN Non-RVU base fee schedule,53.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0150,Not in chargemaster,L0150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0150,BCBSMN Non-RVU base fee schedule,96.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0160,Not in chargemaster,L0160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0160,BCBSMN Non-RVU base fee schedule,140.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0170,Not in chargemaster,L0170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0170,BCBSMN Non-RVU base fee schedule,724.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0172,Not in chargemaster,L0172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0172,BCBSMN Non-RVU base fee schedule,127.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0174,Not in chargemaster,L0174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0174,BCBSMN Non-RVU base fee schedule,251.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0180,Not in chargemaster,L0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0180,BCBSMN Non-RVU base fee schedule,406.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0190,Not in chargemaster,L0190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0190,BCBSMN Non-RVU base fee schedule,479.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0200,Not in chargemaster,L0200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0200,BCBSMN Non-RVU base fee schedule,556.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0220,Not in chargemaster,L0220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0220,BCBSMN Non-RVU base fee schedule,116.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0450,Not in chargemaster,L0450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0450,BCBSMN Non-RVU base fee schedule,146.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0452,Not in chargemaster,L0452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0452,BCBSMN Non-RVU base fee schedule,118.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0454,Not in chargemaster,L0454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0454,BCBSMN Non-RVU base fee schedule,312.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0455,Not in chargemaster,L0455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0455,BCBSMN Non-RVU base fee schedule,312.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0456,Not in chargemaster,L0456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0456,BCBSMN Non-RVU base fee schedule,896.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0457,Not in chargemaster,L0457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0457,BCBSMN Non-RVU base fee schedule,896.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0458,Not in chargemaster,L0458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0458,BCBSMN Non-RVU base fee schedule,804.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0460,Not in chargemaster,L0460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0460,BCBSMN Non-RVU base fee schedule,905.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0462,Not in chargemaster,L0462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0462,BCBSMN Non-RVU base fee schedule,1125.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0464,Not in chargemaster,L0464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0464,BCBSMN Non-RVU base fee schedule,1340.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0466,Not in chargemaster,L0466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0466,BCBSMN Non-RVU base fee schedule,342.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0467,Not in chargemaster,L0467,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0467,BCBSMN Non-RVU base fee schedule,342.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0468,Not in chargemaster,L0468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0468,BCBSMN Non-RVU base fee schedule,428.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0469,Not in chargemaster,L0469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0469,BCBSMN Non-RVU base fee schedule,428.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0470,Not in chargemaster,L0470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0470,BCBSMN Non-RVU base fee schedule,593.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0472,Not in chargemaster,L0472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0472,BCBSMN Non-RVU base fee schedule,365.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0480,Not in chargemaster,L0480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0480,BCBSMN Non-RVU base fee schedule,1361.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0482,Not in chargemaster,L0482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0482,BCBSMN Non-RVU base fee schedule,1521.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0484,Not in chargemaster,L0484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0484,BCBSMN Non-RVU base fee schedule,1642.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0486,Not in chargemaster,L0486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0486,BCBSMN Non-RVU base fee schedule,1845.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0488,Not in chargemaster,L0488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0488,BCBSMN Non-RVU base fee schedule,905.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0490,Not in chargemaster,L0490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0490,BCBSMN Non-RVU base fee schedule,255.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0491,Not in chargemaster,L0491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0491,BCBSMN Non-RVU base fee schedule,692.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0492,Not in chargemaster,L0492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0492,BCBSMN Non-RVU base fee schedule,450.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0621,Not in chargemaster,L0621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0621,BCBSMN Non-RVU base fee schedule,77.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0622,Not in chargemaster,L0622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0622,BCBSMN Non-RVU base fee schedule,240.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0623,Not in chargemaster,L0623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0623,BCBSMN Non-RVU base fee schedule,159.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0624,Not in chargemaster,L0624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0624,BCBSMN Non-RVU base fee schedule,36.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0625,Not in chargemaster,L0625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0625,BCBSMN Non-RVU base fee schedule,49.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0626,Not in chargemaster,L0626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0626,BCBSMN Non-RVU base fee schedule,70.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0627,Not in chargemaster,L0627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0627,BCBSMN Non-RVU base fee schedule,370.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0628,Not in chargemaster,L0628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0628,BCBSMN Non-RVU base fee schedule,75.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0629,Not in chargemaster,L0629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0629,BCBSMN Non-RVU base fee schedule,139.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0630,Not in chargemaster,L0630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0630,BCBSMN Non-RVU base fee schedule,146.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0631,Not in chargemaster,L0631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0631,BCBSMN Non-RVU base fee schedule,925.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0632,Not in chargemaster,L0632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0632,BCBSMN Non-RVU base fee schedule,1171.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0633,Not in chargemaster,L0633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0633,BCBSMN Non-RVU base fee schedule,258.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0634,Not in chargemaster,L0634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0634,BCBSMN Non-RVU base fee schedule,58.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0635,Not in chargemaster,L0635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0635,BCBSMN Non-RVU base fee schedule,900.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0636,Not in chargemaster,L0636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0636,BCBSMN Non-RVU base fee schedule,1222.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0637,Not in chargemaster,L0637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0637,BCBSMN Non-RVU base fee schedule,1168.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0638,Not in chargemaster,L0638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0638,BCBSMN Non-RVU base fee schedule,1189.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0639,Not in chargemaster,L0639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0639,BCBSMN Non-RVU base fee schedule,1168.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0640,Not in chargemaster,L0640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0640,BCBSMN Non-RVU base fee schedule,943.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0641,Not in chargemaster,L0641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0641,BCBSMN Non-RVU base fee schedule,70.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0642,Not in chargemaster,L0642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0642,BCBSMN Non-RVU base fee schedule,370.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0643,Not in chargemaster,L0643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0643,BCBSMN Non-RVU base fee schedule,146.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0648,Not in chargemaster,L0648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0648,BCBSMN Non-RVU base fee schedule,925.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0649,Not in chargemaster,L0649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0649,BCBSMN Non-RVU base fee schedule,258.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0650,Not in chargemaster,L0650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0650,BCBSMN Non-RVU base fee schedule,1168.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0651,Not in chargemaster,L0651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0651,BCBSMN Non-RVU base fee schedule,1168.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0700,Not in chargemaster,L0700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0700,BCBSMN Non-RVU base fee schedule,1794.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0710,Not in chargemaster,L0710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0710,BCBSMN Non-RVU base fee schedule,1973.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0810,Not in chargemaster,L0810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0810,BCBSMN Non-RVU base fee schedule,2410,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0820,Not in chargemaster,L0820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0820,BCBSMN Non-RVU base fee schedule,1895.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0830,Not in chargemaster,L0830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0830,BCBSMN Non-RVU base fee schedule,2900.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0859,Not in chargemaster,L0859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0859,BCBSMN Non-RVU base fee schedule,1027.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0861,Not in chargemaster,L0861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0861,BCBSMN Non-RVU base fee schedule,194.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0970,Not in chargemaster,L0970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0970,BCBSMN Non-RVU base fee schedule,96.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0972,Not in chargemaster,L0972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0972,BCBSMN Non-RVU base fee schedule,87.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0974,Not in chargemaster,L0974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0974,BCBSMN Non-RVU base fee schedule,157.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0976,Not in chargemaster,L0976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0976,BCBSMN Non-RVU base fee schedule,134.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0978,Not in chargemaster,L0978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0978,BCBSMN Non-RVU base fee schedule,169.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0980,Not in chargemaster,L0980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0980,BCBSMN Non-RVU base fee schedule,15.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0982,Not in chargemaster,L0982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0982,BCBSMN Non-RVU base fee schedule,14.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L0984,Not in chargemaster,L0984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L0984,BCBSMN Non-RVU base fee schedule,61.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1000,Not in chargemaster,L1000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1000,BCBSMN Non-RVU base fee schedule,1828.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1001,Not in chargemaster,L1001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1001,BCBSMN Non-RVU base fee schedule,1602.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1005,Not in chargemaster,L1005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1005,BCBSMN Non-RVU base fee schedule,2885.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1010,Not in chargemaster,L1010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1010,BCBSMN Non-RVU base fee schedule,75.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1020,Not in chargemaster,L1020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1020,BCBSMN Non-RVU base fee schedule,97.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1025,Not in chargemaster,L1025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1025,BCBSMN Non-RVU base fee schedule,140.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1030,Not in chargemaster,L1030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1030,BCBSMN Non-RVU base fee schedule,70.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1040,Not in chargemaster,L1040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1040,BCBSMN Non-RVU base fee schedule,79.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1050,Not in chargemaster,L1050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1050,BCBSMN Non-RVU base fee schedule,90.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1060,Not in chargemaster,L1060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1060,BCBSMN Non-RVU base fee schedule,97.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1070,Not in chargemaster,L1070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1070,BCBSMN Non-RVU base fee schedule,101.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1080,Not in chargemaster,L1080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1080,BCBSMN Non-RVU base fee schedule,47.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1085,Not in chargemaster,L1085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1085,BCBSMN Non-RVU base fee schedule,157.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1090,Not in chargemaster,L1090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1090,BCBSMN Non-RVU base fee schedule,90.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1100,Not in chargemaster,L1100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1100,BCBSMN Non-RVU base fee schedule,171.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1110,Not in chargemaster,L1110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1110,BCBSMN Non-RVU base fee schedule,287.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1120,Not in chargemaster,L1120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1120,BCBSMN Non-RVU base fee schedule,34.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1200,Not in chargemaster,L1200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1200,BCBSMN Non-RVU base fee schedule,1613.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1210,Not in chargemaster,L1210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1210,BCBSMN Non-RVU base fee schedule,220.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1220,Not in chargemaster,L1220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1220,BCBSMN Non-RVU base fee schedule,214.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1230,Not in chargemaster,L1230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1230,BCBSMN Non-RVU base fee schedule,601.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1240,Not in chargemaster,L1240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1240,BCBSMN Non-RVU base fee schedule,82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1250,Not in chargemaster,L1250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1250,BCBSMN Non-RVU base fee schedule,71.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1260,Not in chargemaster,L1260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1260,BCBSMN Non-RVU base fee schedule,85.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1270,Not in chargemaster,L1270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1270,BCBSMN Non-RVU base fee schedule,74.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1280,Not in chargemaster,L1280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1280,BCBSMN Non-RVU base fee schedule,78.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1290,Not in chargemaster,L1290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1290,BCBSMN Non-RVU base fee schedule,70.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1300,Not in chargemaster,L1300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1300,BCBSMN Non-RVU base fee schedule,1553.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1310,Not in chargemaster,L1310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1310,BCBSMN Non-RVU base fee schedule,1618.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1600,Not in chargemaster,L1600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1600,BCBSMN Non-RVU base fee schedule,116.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1610,Not in chargemaster,L1610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1610,BCBSMN Non-RVU base fee schedule,49.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1620,Not in chargemaster,L1620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1620,BCBSMN Non-RVU base fee schedule,141.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1630,Not in chargemaster,L1630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1630,BCBSMN Non-RVU base fee schedule,190.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1640,Not in chargemaster,L1640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1640,BCBSMN Non-RVU base fee schedule,426.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1650,Not in chargemaster,L1650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1650,BCBSMN Non-RVU base fee schedule,222.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1652,Not in chargemaster,L1652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1652,BCBSMN Non-RVU base fee schedule,321.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1660,Not in chargemaster,L1660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1660,BCBSMN Non-RVU base fee schedule,162.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1680,Not in chargemaster,L1680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1680,BCBSMN Non-RVU base fee schedule,1027.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1685,Not in chargemaster,L1685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1685,BCBSMN Non-RVU base fee schedule,1002.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1686,Not in chargemaster,L1686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1686,BCBSMN Non-RVU base fee schedule,844.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1690,Not in chargemaster,L1690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1690,BCBSMN Non-RVU base fee schedule,1743.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1700,Not in chargemaster,L1700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1700,BCBSMN Non-RVU base fee schedule,1402.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1710,Not in chargemaster,L1710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1710,BCBSMN Non-RVU base fee schedule,1786.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1720,Not in chargemaster,L1720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1720,BCBSMN Non-RVU base fee schedule,1330.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1730,Not in chargemaster,L1730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1730,BCBSMN Non-RVU base fee schedule,1122.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1755,Not in chargemaster,L1755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1755,BCBSMN Non-RVU base fee schedule,1614.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1810,Not in chargemaster,L1810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1810,BCBSMN Non-RVU base fee schedule,92.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1812,Not in chargemaster,L1812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1812,BCBSMN Non-RVU base fee schedule,92.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1820,Not in chargemaster,L1820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1820,BCBSMN Non-RVU base fee schedule,128.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1830,Not in chargemaster,L1830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1830,BCBSMN Non-RVU base fee schedule,75.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1831,Not in chargemaster,L1831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1831,BCBSMN Non-RVU base fee schedule,265.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1832,Not in chargemaster,L1832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1832,BCBSMN Non-RVU base fee schedule,621.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1833,Not in chargemaster,L1833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1833,BCBSMN Non-RVU base fee schedule,621.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1834,Not in chargemaster,L1834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1834,BCBSMN Non-RVU base fee schedule,654.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1836,Not in chargemaster,L1836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1836,BCBSMN Non-RVU base fee schedule,120.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1840,Not in chargemaster,L1840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1840,BCBSMN Non-RVU base fee schedule,847.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1843,Not in chargemaster,L1843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1843,BCBSMN Non-RVU base fee schedule,809.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1844,Not in chargemaster,L1844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1844,BCBSMN Non-RVU base fee schedule,1373.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1845,Not in chargemaster,L1845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1845,BCBSMN Non-RVU base fee schedule,755.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1846,Not in chargemaster,L1846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1846,BCBSMN Non-RVU base fee schedule,1054.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1847,Not in chargemaster,L1847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1847,BCBSMN Non-RVU base fee schedule,518.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1848,Not in chargemaster,L1848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1848,BCBSMN Non-RVU base fee schedule,518.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1850,Not in chargemaster,L1850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1850,BCBSMN Non-RVU base fee schedule,256.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1851,Not in chargemaster,L1851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1851,BCBSMN Non-RVU base fee schedule,809.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1852,Not in chargemaster,L1852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1852,BCBSMN Non-RVU base fee schedule,755.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1860,Not in chargemaster,L1860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1860,BCBSMN Non-RVU base fee schedule,1124.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1900,Not in chargemaster,L1900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1900,BCBSMN Non-RVU base fee schedule,257.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1902,Not in chargemaster,L1902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1902,BCBSMN Non-RVU base fee schedule,67.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1904,Not in chargemaster,L1904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1904,BCBSMN Non-RVU base fee schedule,406.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1906,Not in chargemaster,L1906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1906,BCBSMN Non-RVU base fee schedule,101.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1907,Not in chargemaster,L1907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1907,BCBSMN Non-RVU base fee schedule,507.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1910,Not in chargemaster,L1910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1910,BCBSMN Non-RVU base fee schedule,252.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1920,Not in chargemaster,L1920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1920,BCBSMN Non-RVU base fee schedule,370.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1930,Not in chargemaster,L1930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1930,BCBSMN Non-RVU base fee schedule,227.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1932,Not in chargemaster,L1932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1932,BCBSMN Non-RVU base fee schedule,804.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1940,Not in chargemaster,L1940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1940,BCBSMN Non-RVU base fee schedule,439.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1945,Not in chargemaster,L1945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1945,BCBSMN Non-RVU base fee schedule,1012.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1950,Not in chargemaster,L1950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1950,BCBSMN Non-RVU base fee schedule,693.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1951,Not in chargemaster,L1951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1951,BCBSMN Non-RVU base fee schedule,757.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1960,Not in chargemaster,L1960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1960,BCBSMN Non-RVU base fee schedule,558.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1970,Not in chargemaster,L1970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1970,BCBSMN Non-RVU base fee schedule,624.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1971,Not in chargemaster,L1971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1971,BCBSMN Non-RVU base fee schedule,422.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1980,Not in chargemaster,L1980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1980,BCBSMN Non-RVU base fee schedule,364.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L1990,Not in chargemaster,L1990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L1990,BCBSMN Non-RVU base fee schedule,421.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2000,Not in chargemaster,L2000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2000,BCBSMN Non-RVU base fee schedule,1008.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2005,Not in chargemaster,L2005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2005,BCBSMN Non-RVU base fee schedule,3694.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2010,Not in chargemaster,L2010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2010,BCBSMN Non-RVU base fee schedule,786.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2020,Not in chargemaster,L2020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2020,BCBSMN Non-RVU base fee schedule,993.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2030,Not in chargemaster,L2030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2030,BCBSMN Non-RVU base fee schedule,976.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2034,Not in chargemaster,L2034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2034,BCBSMN Non-RVU base fee schedule,1831.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2035,Not in chargemaster,L2035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2035,BCBSMN Non-RVU base fee schedule,156.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2036,Not in chargemaster,L2036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2036,BCBSMN Non-RVU base fee schedule,1671.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2037,Not in chargemaster,L2037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2037,BCBSMN Non-RVU base fee schedule,1495.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2038,Not in chargemaster,L2038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2038,BCBSMN Non-RVU base fee schedule,1205.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2040,Not in chargemaster,L2040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2040,BCBSMN Non-RVU base fee schedule,182.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2050,Not in chargemaster,L2050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2050,BCBSMN Non-RVU base fee schedule,439.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2060,Not in chargemaster,L2060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2060,BCBSMN Non-RVU base fee schedule,549.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2070,Not in chargemaster,L2070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2070,BCBSMN Non-RVU base fee schedule,139.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2080,Not in chargemaster,L2080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2080,BCBSMN Non-RVU base fee schedule,336.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2090,Not in chargemaster,L2090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2090,BCBSMN Non-RVU base fee schedule,448.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2106,Not in chargemaster,L2106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2106,BCBSMN Non-RVU base fee schedule,710.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2108,Not in chargemaster,L2108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2108,BCBSMN Non-RVU base fee schedule,1036.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2112,Not in chargemaster,L2112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2112,BCBSMN Non-RVU base fee schedule,454.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2114,Not in chargemaster,L2114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2114,BCBSMN Non-RVU base fee schedule,569.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2116,Not in chargemaster,L2116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2116,BCBSMN Non-RVU base fee schedule,694.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2126,Not in chargemaster,L2126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2126,BCBSMN Non-RVU base fee schedule,1151.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2128,Not in chargemaster,L2128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2128,BCBSMN Non-RVU base fee schedule,1445.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2132,Not in chargemaster,L2132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2132,BCBSMN Non-RVU base fee schedule,877.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2134,Not in chargemaster,L2134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2134,BCBSMN Non-RVU base fee schedule,1039.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2136,Not in chargemaster,L2136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2136,BCBSMN Non-RVU base fee schedule,1137.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2180,Not in chargemaster,L2180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2180,BCBSMN Non-RVU base fee schedule,119.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2182,Not in chargemaster,L2182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2182,BCBSMN Non-RVU base fee schedule,103.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2184,Not in chargemaster,L2184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2184,BCBSMN Non-RVU base fee schedule,104.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2186,Not in chargemaster,L2186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2186,BCBSMN Non-RVU base fee schedule,138.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2188,Not in chargemaster,L2188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2188,BCBSMN Non-RVU base fee schedule,252.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2190,Not in chargemaster,L2190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2190,BCBSMN Non-RVU base fee schedule,76.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2192,Not in chargemaster,L2192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2192,BCBSMN Non-RVU base fee schedule,300.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2200,Not in chargemaster,L2200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2200,BCBSMN Non-RVU base fee schedule,45.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2210,Not in chargemaster,L2210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2210,BCBSMN Non-RVU base fee schedule,56.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2220,Not in chargemaster,L2220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2220,BCBSMN Non-RVU base fee schedule,72.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2230,Not in chargemaster,L2230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2230,BCBSMN Non-RVU base fee schedule,86.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2232,Not in chargemaster,L2232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2232,BCBSMN Non-RVU base fee schedule,87.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2240,Not in chargemaster,L2240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2240,BCBSMN Non-RVU base fee schedule,85.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2250,Not in chargemaster,L2250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2250,BCBSMN Non-RVU base fee schedule,301.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2260,Not in chargemaster,L2260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2260,BCBSMN Non-RVU base fee schedule,169,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2265,Not in chargemaster,L2265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2265,BCBSMN Non-RVU base fee schedule,121.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2270,Not in chargemaster,L2270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2270,BCBSMN Non-RVU base fee schedule,55.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2275,Not in chargemaster,L2275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2275,BCBSMN Non-RVU base fee schedule,117.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2280,Not in chargemaster,L2280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2280,BCBSMN Non-RVU base fee schedule,509,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2300,Not in chargemaster,L2300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2300,BCBSMN Non-RVU base fee schedule,226.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2310,Not in chargemaster,L2310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2310,BCBSMN Non-RVU base fee schedule,103.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2320,Not in chargemaster,L2320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2320,BCBSMN Non-RVU base fee schedule,173.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2330,Not in chargemaster,L2330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2330,BCBSMN Non-RVU base fee schedule,331.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2335,Not in chargemaster,L2335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2335,BCBSMN Non-RVU base fee schedule,253.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2340,Not in chargemaster,L2340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2340,BCBSMN Non-RVU base fee schedule,376.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2350,Not in chargemaster,L2350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2350,BCBSMN Non-RVU base fee schedule,751.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2360,Not in chargemaster,L2360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2360,BCBSMN Non-RVU base fee schedule,46.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2370,Not in chargemaster,L2370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2370,BCBSMN Non-RVU base fee schedule,288.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2375,Not in chargemaster,L2375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2375,BCBSMN Non-RVU base fee schedule,110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2380,Not in chargemaster,L2380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2380,BCBSMN Non-RVU base fee schedule,116.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2385,Not in chargemaster,L2385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2385,BCBSMN Non-RVU base fee schedule,132.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2387,Not in chargemaster,L2387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2387,BCBSMN Non-RVU base fee schedule,172.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2390,Not in chargemaster,L2390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2390,BCBSMN Non-RVU base fee schedule,92.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2395,Not in chargemaster,L2395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2395,BCBSMN Non-RVU base fee schedule,131.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2397,Not in chargemaster,L2397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2397,BCBSMN Non-RVU base fee schedule,110.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2405,Not in chargemaster,L2405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2405,BCBSMN Non-RVU base fee schedule,78.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2415,Not in chargemaster,L2415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2415,BCBSMN Non-RVU base fee schedule,109.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2425,Not in chargemaster,L2425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2425,BCBSMN Non-RVU base fee schedule,129.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2430,Not in chargemaster,L2430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2430,BCBSMN Non-RVU base fee schedule,129.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2492,Not in chargemaster,L2492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2492,BCBSMN Non-RVU base fee schedule,105.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2500,Not in chargemaster,L2500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2500,BCBSMN Non-RVU base fee schedule,282.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2510,Not in chargemaster,L2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2510,BCBSMN Non-RVU base fee schedule,727.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2520,Not in chargemaster,L2520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2520,BCBSMN Non-RVU base fee schedule,484.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2525,Not in chargemaster,L2525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2525,BCBSMN Non-RVU base fee schedule,1027.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2526,Not in chargemaster,L2526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2526,BCBSMN Non-RVU base fee schedule,577.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2530,Not in chargemaster,L2530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2530,BCBSMN Non-RVU base fee schedule,216.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2540,Not in chargemaster,L2540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2540,BCBSMN Non-RVU base fee schedule,409.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2550,Not in chargemaster,L2550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2550,BCBSMN Non-RVU base fee schedule,306.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2570,Not in chargemaster,L2570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2570,BCBSMN Non-RVU base fee schedule,401.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2580,Not in chargemaster,L2580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2580,BCBSMN Non-RVU base fee schedule,391.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2600,Not in chargemaster,L2600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2600,BCBSMN Non-RVU base fee schedule,192.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2610,Not in chargemaster,L2610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2610,BCBSMN Non-RVU base fee schedule,212.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2620,Not in chargemaster,L2620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2620,BCBSMN Non-RVU base fee schedule,225.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2622,Not in chargemaster,L2622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2622,BCBSMN Non-RVU base fee schedule,286.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2624,Not in chargemaster,L2624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2624,BCBSMN Non-RVU base fee schedule,351.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2627,Not in chargemaster,L2627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2627,BCBSMN Non-RVU base fee schedule,1927.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2628,Not in chargemaster,L2628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2628,BCBSMN Non-RVU base fee schedule,1412.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2630,Not in chargemaster,L2630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2630,BCBSMN Non-RVU base fee schedule,208.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2640,Not in chargemaster,L2640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2640,BCBSMN Non-RVU base fee schedule,283.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2650,Not in chargemaster,L2650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2650,BCBSMN Non-RVU base fee schedule,124.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2660,Not in chargemaster,L2660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2660,BCBSMN Non-RVU base fee schedule,161.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2670,Not in chargemaster,L2670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2670,BCBSMN Non-RVU base fee schedule,143.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2680,Not in chargemaster,L2680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2680,BCBSMN Non-RVU base fee schedule,131.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2750,Not in chargemaster,L2750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2750,BCBSMN Non-RVU base fee schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2755,Not in chargemaster,L2755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2755,BCBSMN Non-RVU base fee schedule,117.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2760,Not in chargemaster,L2760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2760,BCBSMN Non-RVU base fee schedule,51.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2768,Not in chargemaster,L2768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2768,BCBSMN Non-RVU base fee schedule,117.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2780,Not in chargemaster,L2780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2780,BCBSMN Non-RVU base fee schedule,57.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2785,Not in chargemaster,L2785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2785,BCBSMN Non-RVU base fee schedule,26.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2795,Not in chargemaster,L2795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2795,BCBSMN Non-RVU base fee schedule,73.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2800,Not in chargemaster,L2800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2800,BCBSMN Non-RVU base fee schedule,90.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2810,Not in chargemaster,L2810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2810,BCBSMN Non-RVU base fee schedule,73.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2820,Not in chargemaster,L2820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2820,BCBSMN Non-RVU base fee schedule,73.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2830,Not in chargemaster,L2830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2830,BCBSMN Non-RVU base fee schedule,79.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2840,Not in chargemaster,L2840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2840,BCBSMN Non-RVU base fee schedule,38.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2850,Not in chargemaster,L2850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2850,BCBSMN Non-RVU base fee schedule,54.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L2861,Not in chargemaster,L2861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L2861,BCBSMN Non-RVU base fee schedule,284.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3000,Not in chargemaster,L3000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3000,BCBSMN Non-RVU base fee schedule,283.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3001,Not in chargemaster,L3001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3001,BCBSMN Non-RVU base fee schedule,119.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3002,Not in chargemaster,L3002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3002,BCBSMN Non-RVU base fee schedule,145.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3003,Not in chargemaster,L3003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3003,BCBSMN Non-RVU base fee schedule,157.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3010,Not in chargemaster,L3010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3010,BCBSMN Non-RVU base fee schedule,157.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3020,Not in chargemaster,L3020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3020,BCBSMN Non-RVU base fee schedule,178.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3030,Not in chargemaster,L3030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3030,BCBSMN Non-RVU base fee schedule,68.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3031,Not in chargemaster,L3031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3031,BCBSMN Non-RVU base fee schedule,110.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3040,Not in chargemaster,L3040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3040,BCBSMN Non-RVU base fee schedule,42.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3050,Not in chargemaster,L3050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3050,BCBSMN Non-RVU base fee schedule,42.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3060,Not in chargemaster,L3060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3060,BCBSMN Non-RVU base fee schedule,66.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3070,Not in chargemaster,L3070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3070,BCBSMN Non-RVU base fee schedule,28.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3080,Not in chargemaster,L3080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3080,BCBSMN Non-RVU base fee schedule,28.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3090,Not in chargemaster,L3090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3090,BCBSMN Non-RVU base fee schedule,36.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3100,Not in chargemaster,L3100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3100,BCBSMN Non-RVU base fee schedule,39.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3140,Not in chargemaster,L3140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3140,BCBSMN Non-RVU base fee schedule,80.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3150,Not in chargemaster,L3150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3150,BCBSMN Non-RVU base fee schedule,73.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3160,Not in chargemaster,L3160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3160,BCBSMN Non-RVU base fee schedule,15.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3170,Not in chargemaster,L3170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3170,BCBSMN Non-RVU base fee schedule,45.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3201,Not in chargemaster,L3201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3201,BCBSMN Non-RVU base fee schedule,26.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3202,Not in chargemaster,L3202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3202,BCBSMN Non-RVU base fee schedule,31.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3204,Not in chargemaster,L3204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3204,BCBSMN Non-RVU base fee schedule,56.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3206,Not in chargemaster,L3206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3206,BCBSMN Non-RVU base fee schedule,57.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3208,Not in chargemaster,L3208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3208,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3209,Not in chargemaster,L3209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3209,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3211,Not in chargemaster,L3211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3211,BCBSMN Non-RVU base fee schedule,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3215,Not in chargemaster,L3215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3215,BCBSMN Non-RVU base fee schedule,24.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3216,Not in chargemaster,L3216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3216,BCBSMN Non-RVU base fee schedule,30.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3217,Not in chargemaster,L3217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3217,BCBSMN Non-RVU base fee schedule,50.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3219,Not in chargemaster,L3219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3219,BCBSMN Non-RVU base fee schedule,105.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3221,Not in chargemaster,L3221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3221,BCBSMN Non-RVU base fee schedule,90.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3222,Not in chargemaster,L3222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3222,BCBSMN Non-RVU base fee schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3224,Not in chargemaster,L3224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3224,BCBSMN Non-RVU base fee schedule,60.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3225,Not in chargemaster,L3225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3225,BCBSMN Non-RVU base fee schedule,66.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3230,Not in chargemaster,L3230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3230,BCBSMN Non-RVU base fee schedule,188.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3250,Not in chargemaster,L3250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3250,BCBSMN Non-RVU base fee schedule,137.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3252,Not in chargemaster,L3252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3252,BCBSMN Non-RVU base fee schedule,268,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3253,Not in chargemaster,L3253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3253,BCBSMN Non-RVU base fee schedule,185.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3254,Not in chargemaster,L3254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3254,BCBSMN Non-RVU base fee schedule,15.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3255,Not in chargemaster,L3255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3255,BCBSMN Non-RVU base fee schedule,15.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3257,Not in chargemaster,L3257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3257,BCBSMN Non-RVU base fee schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3260,Not in chargemaster,L3260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3260,BCBSMN Non-RVU base fee schedule,9.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3265,Not in chargemaster,L3265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3265,BCBSMN Non-RVU base fee schedule,14.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3300,Not in chargemaster,L3300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3300,BCBSMN Non-RVU base fee schedule,47.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3310,Not in chargemaster,L3310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3310,BCBSMN Non-RVU base fee schedule,73.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3320,Not in chargemaster,L3320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3320,BCBSMN Non-RVU base fee schedule,23.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3330,Not in chargemaster,L3330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3330,BCBSMN Non-RVU base fee schedule,510.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3332,Not in chargemaster,L3332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3332,BCBSMN Non-RVU base fee schedule,66.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3334,Not in chargemaster,L3334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3334,BCBSMN Non-RVU base fee schedule,34.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3340,Not in chargemaster,L3340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3340,BCBSMN Non-RVU base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3350,Not in chargemaster,L3350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3350,BCBSMN Non-RVU base fee schedule,20.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3360,Not in chargemaster,L3360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3360,BCBSMN Non-RVU base fee schedule,32.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3370,Not in chargemaster,L3370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3370,BCBSMN Non-RVU base fee schedule,44.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3380,Not in chargemaster,L3380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3380,BCBSMN Non-RVU base fee schedule,44.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3390,Not in chargemaster,L3390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3390,BCBSMN Non-RVU base fee schedule,44.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3400,Not in chargemaster,L3400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3400,BCBSMN Non-RVU base fee schedule,36.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3410,Not in chargemaster,L3410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3410,BCBSMN Non-RVU base fee schedule,83.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3420,Not in chargemaster,L3420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3420,BCBSMN Non-RVU base fee schedule,49.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3430,Not in chargemaster,L3430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3430,BCBSMN Non-RVU base fee schedule,144.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3440,Not in chargemaster,L3440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3440,BCBSMN Non-RVU base fee schedule,68.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3450,Not in chargemaster,L3450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3450,BCBSMN Non-RVU base fee schedule,95.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3455,Not in chargemaster,L3455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3455,BCBSMN Non-RVU base fee schedule,36.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3460,Not in chargemaster,L3460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3460,BCBSMN Non-RVU base fee schedule,30.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3465,Not in chargemaster,L3465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3465,BCBSMN Non-RVU base fee schedule,52.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3470,Not in chargemaster,L3470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3470,BCBSMN Non-RVU base fee schedule,56.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3480,Not in chargemaster,L3480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3480,BCBSMN Non-RVU base fee schedule,56.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3485,Not in chargemaster,L3485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3485,BCBSMN Non-RVU base fee schedule,6.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3500,Not in chargemaster,L3500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3500,BCBSMN Non-RVU base fee schedule,26.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3510,Not in chargemaster,L3510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3510,BCBSMN Non-RVU base fee schedule,26.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3520,Not in chargemaster,L3520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3520,BCBSMN Non-RVU base fee schedule,28.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3530,Not in chargemaster,L3530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3530,BCBSMN Non-RVU base fee schedule,28.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3540,Not in chargemaster,L3540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3540,BCBSMN Non-RVU base fee schedule,45.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3550,Not in chargemaster,L3550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3550,BCBSMN Non-RVU base fee schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3560,Not in chargemaster,L3560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3560,BCBSMN Non-RVU base fee schedule,20.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3570,Not in chargemaster,L3570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3570,BCBSMN Non-RVU base fee schedule,76.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3580,Not in chargemaster,L3580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3580,BCBSMN Non-RVU base fee schedule,58.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3590,Not in chargemaster,L3590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3590,BCBSMN Non-RVU base fee schedule,48.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3595,Not in chargemaster,L3595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3595,BCBSMN Non-RVU base fee schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3600,Not in chargemaster,L3600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3600,BCBSMN Non-RVU base fee schedule,68.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3610,Not in chargemaster,L3610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3610,BCBSMN Non-RVU base fee schedule,90.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3620,Not in chargemaster,L3620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3620,BCBSMN Non-RVU base fee schedule,68.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3630,Not in chargemaster,L3630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3630,BCBSMN Non-RVU base fee schedule,90.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3640,Not in chargemaster,L3640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3640,BCBSMN Non-RVU base fee schedule,39.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3650,Not in chargemaster,L3650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3650,BCBSMN Non-RVU base fee schedule,59.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3660,Not in chargemaster,L3660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3660,BCBSMN Non-RVU base fee schedule,84.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3670,Not in chargemaster,L3670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3670,BCBSMN Non-RVU base fee schedule,93.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3671,Not in chargemaster,L3671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3671,BCBSMN Non-RVU base fee schedule,739.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3674,Not in chargemaster,L3674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3674,BCBSMN Non-RVU base fee schedule,969.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3675,Not in chargemaster,L3675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3675,BCBSMN Non-RVU base fee schedule,144.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3677,Not in chargemaster,L3677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3677,BCBSMN Non-RVU base fee schedule,151.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3678,Not in chargemaster,L3678,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3678,BCBSMN Non-RVU base fee schedule,148.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3702,Not in chargemaster,L3702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3702,BCBSMN Non-RVU base fee schedule,236.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3710,Not in chargemaster,L3710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3710,BCBSMN Non-RVU base fee schedule,117.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3720,Not in chargemaster,L3720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3720,BCBSMN Non-RVU base fee schedule,560.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3730,Not in chargemaster,L3730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3730,BCBSMN Non-RVU base fee schedule,743.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3740,Not in chargemaster,L3740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3740,BCBSMN Non-RVU base fee schedule,881.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3760,Not in chargemaster,L3760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3760,BCBSMN Non-RVU base fee schedule,410.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3761,Not in chargemaster,L3761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3761,BCBSMN Non-RVU base fee schedule,410.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3762,Not in chargemaster,L3762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3762,BCBSMN Non-RVU base fee schedule,88.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3763,Not in chargemaster,L3763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3763,BCBSMN Non-RVU base fee schedule,614.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3764,Not in chargemaster,L3764,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3764,BCBSMN Non-RVU base fee schedule,642.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3765,Not in chargemaster,L3765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3765,BCBSMN Non-RVU base fee schedule,1052.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3766,Not in chargemaster,L3766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3766,BCBSMN Non-RVU base fee schedule,1114.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3806,Not in chargemaster,L3806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3806,BCBSMN Non-RVU base fee schedule,372.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3807,Not in chargemaster,L3807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3807,BCBSMN Non-RVU base fee schedule,205.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3808,Not in chargemaster,L3808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3808,BCBSMN Non-RVU base fee schedule,292.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3809,Not in chargemaster,L3809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3809,BCBSMN Non-RVU base fee schedule,205.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3891,Not in chargemaster,L3891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3891,BCBSMN Non-RVU base fee schedule,273.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3900,Not in chargemaster,L3900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3900,BCBSMN Non-RVU base fee schedule,1329.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3901,Not in chargemaster,L3901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3901,BCBSMN Non-RVU base fee schedule,1742.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3904,Not in chargemaster,L3904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3904,BCBSMN Non-RVU base fee schedule,2769.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3905,Not in chargemaster,L3905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3905,BCBSMN Non-RVU base fee schedule,813.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3906,Not in chargemaster,L3906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3906,BCBSMN Non-RVU base fee schedule,415.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3908,Not in chargemaster,L3908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3908,BCBSMN Non-RVU base fee schedule,60.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3912,Not in chargemaster,L3912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3912,BCBSMN Non-RVU base fee schedule,86.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3913,Not in chargemaster,L3913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3913,BCBSMN Non-RVU base fee schedule,222.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3915,Not in chargemaster,L3915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3915,BCBSMN Non-RVU base fee schedule,436.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3916,Not in chargemaster,L3916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3916,BCBSMN Non-RVU base fee schedule,436.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3917,Not in chargemaster,L3917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3917,BCBSMN Non-RVU base fee schedule,86.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3918,Not in chargemaster,L3918,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3918,BCBSMN Non-RVU base fee schedule,86.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3919,Not in chargemaster,L3919,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3919,BCBSMN Non-RVU base fee schedule,222.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3921,Not in chargemaster,L3921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3921,BCBSMN Non-RVU base fee schedule,263.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3923,Not in chargemaster,L3923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3923,BCBSMN Non-RVU base fee schedule,79.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3924,Not in chargemaster,L3924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3924,BCBSMN Non-RVU base fee schedule,79.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3925,Not in chargemaster,L3925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3925,BCBSMN Non-RVU base fee schedule,53.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3927,Not in chargemaster,L3927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3927,BCBSMN Non-RVU base fee schedule,28.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3929,Not in chargemaster,L3929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3929,BCBSMN Non-RVU base fee schedule,74.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3930,Not in chargemaster,L3930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3930,BCBSMN Non-RVU base fee schedule,74.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3931,Not in chargemaster,L3931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3931,BCBSMN Non-RVU base fee schedule,171.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3933,Not in chargemaster,L3933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3933,BCBSMN Non-RVU base fee schedule,175.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3935,Not in chargemaster,L3935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3935,BCBSMN Non-RVU base fee schedule,181.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3960,Not in chargemaster,L3960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3960,BCBSMN Non-RVU base fee schedule,654.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3961,Not in chargemaster,L3961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3961,BCBSMN Non-RVU base fee schedule,1378.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3962,Not in chargemaster,L3962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3962,BCBSMN Non-RVU base fee schedule,591.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3967,Not in chargemaster,L3967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3967,BCBSMN Non-RVU base fee schedule,1627.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3971,Not in chargemaster,L3971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3971,BCBSMN Non-RVU base fee schedule,1545.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3973,Not in chargemaster,L3973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3973,BCBSMN Non-RVU base fee schedule,1627.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3975,Not in chargemaster,L3975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3975,BCBSMN Non-RVU base fee schedule,1378.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3976,Not in chargemaster,L3976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3976,BCBSMN Non-RVU base fee schedule,1378.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3977,Not in chargemaster,L3977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3977,BCBSMN Non-RVU base fee schedule,1545.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3978,Not in chargemaster,L3978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3978,BCBSMN Non-RVU base fee schedule,1627.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3980,Not in chargemaster,L3980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3980,BCBSMN Non-RVU base fee schedule,317.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3981,Not in chargemaster,L3981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3981,BCBSMN Non-RVU base fee schedule,825.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3982,Not in chargemaster,L3982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3982,BCBSMN Non-RVU base fee schedule,322.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3984,Not in chargemaster,L3984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3984,BCBSMN Non-RVU base fee schedule,283.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L3995,Not in chargemaster,L3995,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L3995,BCBSMN Non-RVU base fee schedule,33.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4000,Not in chargemaster,L4000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4000,BCBSMN Non-RVU base fee schedule,1191.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4002,Not in chargemaster,L4002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4002,BCBSMN Non-RVU base fee schedule,37.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4010,Not in chargemaster,L4010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4010,BCBSMN Non-RVU base fee schedule,724.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4020,Not in chargemaster,L4020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4020,BCBSMN Non-RVU base fee schedule,869.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4030,Not in chargemaster,L4030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4030,BCBSMN Non-RVU base fee schedule,552.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4040,Not in chargemaster,L4040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4040,BCBSMN Non-RVU base fee schedule,374.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4045,Not in chargemaster,L4045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4045,BCBSMN Non-RVU base fee schedule,276.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4050,Not in chargemaster,L4050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4050,BCBSMN Non-RVU base fee schedule,370.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4055,Not in chargemaster,L4055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4055,BCBSMN Non-RVU base fee schedule,225.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4060,Not in chargemaster,L4060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4060,BCBSMN Non-RVU base fee schedule,292.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4070,Not in chargemaster,L4070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4070,BCBSMN Non-RVU base fee schedule,237.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4080,Not in chargemaster,L4080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4080,BCBSMN Non-RVU base fee schedule,89.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4090,Not in chargemaster,L4090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4090,BCBSMN Non-RVU base fee schedule,76.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4100,Not in chargemaster,L4100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4100,BCBSMN Non-RVU base fee schedule,91.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4110,Not in chargemaster,L4110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4110,BCBSMN Non-RVU base fee schedule,71.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4130,Not in chargemaster,L4130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4130,BCBSMN Non-RVU base fee schedule,432.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4205,Not in chargemaster,L4205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4205,BCBSMN Non-RVU base fee schedule,23.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4210,Not in chargemaster,L4210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4210,BCBSMN Non-RVU base fee schedule,17.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4350,Not in chargemaster,L4350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4350,BCBSMN Non-RVU base fee schedule,87.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4360,Not in chargemaster,L4360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4360,BCBSMN Non-RVU base fee schedule,233.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4361,Not in chargemaster,L4361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4361,BCBSMN Non-RVU base fee schedule,233.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4370,Not in chargemaster,L4370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4370,BCBSMN Non-RVU base fee schedule,212.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4386,Not in chargemaster,L4386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4386,BCBSMN Non-RVU base fee schedule,142.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4387,Not in chargemaster,L4387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4387,BCBSMN Non-RVU base fee schedule,142.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4392,Not in chargemaster,L4392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4392,BCBSMN Non-RVU base fee schedule,21.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4394,Not in chargemaster,L4394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4394,BCBSMN Non-RVU base fee schedule,15.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4396,Not in chargemaster,L4396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4396,BCBSMN Non-RVU base fee schedule,151.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4397,Not in chargemaster,L4397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4397,BCBSMN Non-RVU base fee schedule,151.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4398,Not in chargemaster,L4398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4398,BCBSMN Non-RVU base fee schedule,69.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L4631,Not in chargemaster,L4631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L4631,BCBSMN Non-RVU base fee schedule,1329.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5000,Not in chargemaster,L5000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5000,BCBSMN Non-RVU base fee schedule,517.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5010,Not in chargemaster,L5010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5010,BCBSMN Non-RVU base fee schedule,1446.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5020,Not in chargemaster,L5020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5020,BCBSMN Non-RVU base fee schedule,2266.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5050,Not in chargemaster,L5050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5050,BCBSMN Non-RVU base fee schedule,2475.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5060,Not in chargemaster,L5060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5060,BCBSMN Non-RVU base fee schedule,3051.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5100,Not in chargemaster,L5100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5100,BCBSMN Non-RVU base fee schedule,2464.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5105,Not in chargemaster,L5105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5105,BCBSMN Non-RVU base fee schedule,3478.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5150,Not in chargemaster,L5150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5150,BCBSMN Non-RVU base fee schedule,3867.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5160,Not in chargemaster,L5160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5160,BCBSMN Non-RVU base fee schedule,4245.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5200,Not in chargemaster,L5200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5200,BCBSMN Non-RVU base fee schedule,3283.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5210,Not in chargemaster,L5210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5210,BCBSMN Non-RVU base fee schedule,2607.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5220,Not in chargemaster,L5220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5220,BCBSMN Non-RVU base fee schedule,2872.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5230,Not in chargemaster,L5230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5230,BCBSMN Non-RVU base fee schedule,4307.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5250,Not in chargemaster,L5250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5250,BCBSMN Non-RVU base fee schedule,5051.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5270,Not in chargemaster,L5270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5270,BCBSMN Non-RVU base fee schedule,5627.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5280,Not in chargemaster,L5280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5280,BCBSMN Non-RVU base fee schedule,5470.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5301,Not in chargemaster,L5301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5301,BCBSMN Non-RVU base fee schedule,2420.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5312,Not in chargemaster,L5312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5312,BCBSMN Non-RVU base fee schedule,3813.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5321,Not in chargemaster,L5321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5321,BCBSMN Non-RVU base fee schedule,3227.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5331,Not in chargemaster,L5331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5331,BCBSMN Non-RVU base fee schedule,4727.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5341,Not in chargemaster,L5341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5341,BCBSMN Non-RVU base fee schedule,5024.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5400,Not in chargemaster,L5400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5400,BCBSMN Non-RVU base fee schedule,1441.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5410,Not in chargemaster,L5410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5410,BCBSMN Non-RVU base fee schedule,398.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5420,Not in chargemaster,L5420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5420,BCBSMN Non-RVU base fee schedule,1820.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5430,Not in chargemaster,L5430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5430,BCBSMN Non-RVU base fee schedule,494.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5450,Not in chargemaster,L5450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5450,BCBSMN Non-RVU base fee schedule,427.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5460,Not in chargemaster,L5460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5460,BCBSMN Non-RVU base fee schedule,560.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5500,Not in chargemaster,L5500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5500,BCBSMN Non-RVU base fee schedule,1332.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5505,Not in chargemaster,L5505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5505,BCBSMN Non-RVU base fee schedule,1874.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5510,Not in chargemaster,L5510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5510,BCBSMN Non-RVU base fee schedule,1590.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5520,Not in chargemaster,L5520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5520,BCBSMN Non-RVU base fee schedule,1426.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5530,Not in chargemaster,L5530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5530,BCBSMN Non-RVU base fee schedule,1874.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5535,Not in chargemaster,L5535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5535,BCBSMN Non-RVU base fee schedule,1747.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5540,Not in chargemaster,L5540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5540,BCBSMN Non-RVU base fee schedule,1850.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5560,Not in chargemaster,L5560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5560,BCBSMN Non-RVU base fee schedule,2108.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5570,Not in chargemaster,L5570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5570,BCBSMN Non-RVU base fee schedule,2046.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5580,Not in chargemaster,L5580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5580,BCBSMN Non-RVU base fee schedule,2540.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5585,Not in chargemaster,L5585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5585,BCBSMN Non-RVU base fee schedule,2975.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5590,Not in chargemaster,L5590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5590,BCBSMN Non-RVU base fee schedule,2648.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5595,Not in chargemaster,L5595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5595,BCBSMN Non-RVU base fee schedule,4139.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5600,Not in chargemaster,L5600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5600,BCBSMN Non-RVU base fee schedule,4711,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5610,Not in chargemaster,L5610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5610,BCBSMN Non-RVU base fee schedule,2272.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5611,Not in chargemaster,L5611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5611,BCBSMN Non-RVU base fee schedule,1447.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5613,Not in chargemaster,L5613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5613,BCBSMN Non-RVU base fee schedule,2201.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5614,Not in chargemaster,L5614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5614,BCBSMN Non-RVU base fee schedule,1524.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5616,Not in chargemaster,L5616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5616,BCBSMN Non-RVU base fee schedule,1327.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5617,Not in chargemaster,L5617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5617,BCBSMN Non-RVU base fee schedule,505.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5618,Not in chargemaster,L5618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5618,BCBSMN Non-RVU base fee schedule,301.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5620,Not in chargemaster,L5620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5620,BCBSMN Non-RVU base fee schedule,267.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5622,Not in chargemaster,L5622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5622,BCBSMN Non-RVU base fee schedule,360.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5624,Not in chargemaster,L5624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5624,BCBSMN Non-RVU base fee schedule,360.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5626,Not in chargemaster,L5626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5626,BCBSMN Non-RVU base fee schedule,570.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5628,Not in chargemaster,L5628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5628,BCBSMN Non-RVU base fee schedule,578.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5629,Not in chargemaster,L5629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5629,BCBSMN Non-RVU base fee schedule,285.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5630,Not in chargemaster,L5630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5630,BCBSMN Non-RVU base fee schedule,495.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5631,Not in chargemaster,L5631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5631,BCBSMN Non-RVU base fee schedule,394.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5632,Not in chargemaster,L5632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5632,BCBSMN Non-RVU base fee schedule,243.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5634,Not in chargemaster,L5634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5634,BCBSMN Non-RVU base fee schedule,304.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5636,Not in chargemaster,L5636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5636,BCBSMN Non-RVU base fee schedule,232.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5637,Not in chargemaster,L5637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5637,BCBSMN Non-RVU base fee schedule,345.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5638,Not in chargemaster,L5638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5638,BCBSMN Non-RVU base fee schedule,582.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5639,Not in chargemaster,L5639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5639,BCBSMN Non-RVU base fee schedule,1007.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5640,Not in chargemaster,L5640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5640,BCBSMN Non-RVU base fee schedule,661.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5642,Not in chargemaster,L5642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5642,BCBSMN Non-RVU base fee schedule,613.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5643,Not in chargemaster,L5643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5643,BCBSMN Non-RVU base fee schedule,1809.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5644,Not in chargemaster,L5644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5644,BCBSMN Non-RVU base fee schedule,530.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5645,Not in chargemaster,L5645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5645,BCBSMN Non-RVU base fee schedule,880.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5646,Not in chargemaster,L5646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5646,BCBSMN Non-RVU base fee schedule,557.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5647,Not in chargemaster,L5647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5647,BCBSMN Non-RVU base fee schedule,714.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5648,Not in chargemaster,L5648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5648,BCBSMN Non-RVU base fee schedule,659,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5649,Not in chargemaster,L5649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5649,BCBSMN Non-RVU base fee schedule,2214.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5650,Not in chargemaster,L5650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5650,BCBSMN Non-RVU base fee schedule,438.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5651,Not in chargemaster,L5651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5651,BCBSMN Non-RVU base fee schedule,1284.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5652,Not in chargemaster,L5652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5652,BCBSMN Non-RVU base fee schedule,391.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5653,Not in chargemaster,L5653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5653,BCBSMN Non-RVU base fee schedule,610.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5654,Not in chargemaster,L5654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5654,BCBSMN Non-RVU base fee schedule,354.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5655,Not in chargemaster,L5655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5655,BCBSMN Non-RVU base fee schedule,255.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5656,Not in chargemaster,L5656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5656,BCBSMN Non-RVU base fee schedule,388.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5658,Not in chargemaster,L5658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5658,BCBSMN Non-RVU base fee schedule,410.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5661,Not in chargemaster,L5661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5661,BCBSMN Non-RVU base fee schedule,588.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5665,Not in chargemaster,L5665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5665,BCBSMN Non-RVU base fee schedule,523.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5666,Not in chargemaster,L5666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5666,BCBSMN Non-RVU base fee schedule,69.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5668,Not in chargemaster,L5668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5668,BCBSMN Non-RVU base fee schedule,103.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5670,Not in chargemaster,L5670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5670,BCBSMN Non-RVU base fee schedule,243.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5671,Not in chargemaster,L5671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5671,BCBSMN Non-RVU base fee schedule,446.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5672,Not in chargemaster,L5672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5672,BCBSMN Non-RVU base fee schedule,322.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5673,Not in chargemaster,L5673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5673,BCBSMN Non-RVU base fee schedule,710.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5676,Not in chargemaster,L5676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5676,BCBSMN Non-RVU base fee schedule,325.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5677,Not in chargemaster,L5677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5677,BCBSMN Non-RVU base fee schedule,498.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5678,Not in chargemaster,L5678,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5678,BCBSMN Non-RVU base fee schedule,35.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5679,Not in chargemaster,L5679,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5679,BCBSMN Non-RVU base fee schedule,591.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5680,Not in chargemaster,L5680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5680,BCBSMN Non-RVU base fee schedule,273.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5681,Not in chargemaster,L5681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5681,BCBSMN Non-RVU base fee schedule,1188.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5682,Not in chargemaster,L5682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5682,BCBSMN Non-RVU base fee schedule,561.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5683,Not in chargemaster,L5683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5683,BCBSMN Non-RVU base fee schedule,1188.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5684,Not in chargemaster,L5684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5684,BCBSMN Non-RVU base fee schedule,43.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5685,Not in chargemaster,L5685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5685,BCBSMN Non-RVU base fee schedule,115.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5686,Not in chargemaster,L5686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5686,BCBSMN Non-RVU base fee schedule,51.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5688,Not in chargemaster,L5688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5688,BCBSMN Non-RVU base fee schedule,55.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5690,Not in chargemaster,L5690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5690,BCBSMN Non-RVU base fee schedule,112.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5692,Not in chargemaster,L5692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5692,BCBSMN Non-RVU base fee schedule,119.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5694,Not in chargemaster,L5694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5694,BCBSMN Non-RVU base fee schedule,162.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5695,Not in chargemaster,L5695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5695,BCBSMN Non-RVU base fee schedule,146.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5696,Not in chargemaster,L5696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5696,BCBSMN Non-RVU base fee schedule,176.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5697,Not in chargemaster,L5697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5697,BCBSMN Non-RVU base fee schedule,84.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5698,Not in chargemaster,L5698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5698,BCBSMN Non-RVU base fee schedule,107.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5699,Not in chargemaster,L5699,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5699,BCBSMN Non-RVU base fee schedule,184.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5700,Not in chargemaster,L5700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5700,BCBSMN Non-RVU base fee schedule,2771.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5701,Not in chargemaster,L5701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5701,BCBSMN Non-RVU base fee schedule,3437.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5702,Not in chargemaster,L5702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5702,BCBSMN Non-RVU base fee schedule,4332.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5703,Not in chargemaster,L5703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5703,BCBSMN Non-RVU base fee schedule,2279.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5704,Not in chargemaster,L5704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5704,BCBSMN Non-RVU base fee schedule,564.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5705,Not in chargemaster,L5705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5705,BCBSMN Non-RVU base fee schedule,1035.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5706,Not in chargemaster,L5706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5706,BCBSMN Non-RVU base fee schedule,1010.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5707,Not in chargemaster,L5707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5707,BCBSMN Non-RVU base fee schedule,1357.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5710,Not in chargemaster,L5710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5710,BCBSMN Non-RVU base fee schedule,323.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5711,Not in chargemaster,L5711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5711,BCBSMN Non-RVU base fee schedule,542.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5712,Not in chargemaster,L5712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5712,BCBSMN Non-RVU base fee schedule,387.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5714,Not in chargemaster,L5714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5714,BCBSMN Non-RVU base fee schedule,393.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5716,Not in chargemaster,L5716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5716,BCBSMN Non-RVU base fee schedule,778.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5718,Not in chargemaster,L5718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5718,BCBSMN Non-RVU base fee schedule,832.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5722,Not in chargemaster,L5722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5722,BCBSMN Non-RVU base fee schedule,1012.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5724,Not in chargemaster,L5724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5724,BCBSMN Non-RVU base fee schedule,1560.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5726,Not in chargemaster,L5726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5726,BCBSMN Non-RVU base fee schedule,1858.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5728,Not in chargemaster,L5728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5728,BCBSMN Non-RVU base fee schedule,2177.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5780,Not in chargemaster,L5780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5780,BCBSMN Non-RVU base fee schedule,1198.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5781,Not in chargemaster,L5781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5781,BCBSMN Non-RVU base fee schedule,3614.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5782,Not in chargemaster,L5782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5782,BCBSMN Non-RVU base fee schedule,3810.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5785,Not in chargemaster,L5785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5785,BCBSMN Non-RVU base fee schedule,466.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5790,Not in chargemaster,L5790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5790,BCBSMN Non-RVU base fee schedule,673.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5795,Not in chargemaster,L5795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5795,BCBSMN Non-RVU base fee schedule,964.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5810,Not in chargemaster,L5810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5810,BCBSMN Non-RVU base fee schedule,513.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5811,Not in chargemaster,L5811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5811,BCBSMN Non-RVU base fee schedule,709.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5812,Not in chargemaster,L5812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5812,BCBSMN Non-RVU base fee schedule,533.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5814,Not in chargemaster,L5814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5814,BCBSMN Non-RVU base fee schedule,3355.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5816,Not in chargemaster,L5816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5816,BCBSMN Non-RVU base fee schedule,763.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5818,Not in chargemaster,L5818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5818,BCBSMN Non-RVU base fee schedule,862.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5822,Not in chargemaster,L5822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5822,BCBSMN Non-RVU base fee schedule,1582.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5824,Not in chargemaster,L5824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5824,BCBSMN Non-RVU base fee schedule,1495.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5826,Not in chargemaster,L5826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5826,BCBSMN Non-RVU base fee schedule,2821.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5828,Not in chargemaster,L5828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5828,BCBSMN Non-RVU base fee schedule,2662.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5830,Not in chargemaster,L5830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5830,BCBSMN Non-RVU base fee schedule,1794.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5840,Not in chargemaster,L5840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5840,BCBSMN Non-RVU base fee schedule,3523.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5845,Not in chargemaster,L5845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5845,BCBSMN Non-RVU base fee schedule,1619.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5848,Not in chargemaster,L5848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5848,BCBSMN Non-RVU base fee schedule,971.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5850,Not in chargemaster,L5850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5850,BCBSMN Non-RVU base fee schedule,114.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5855,Not in chargemaster,L5855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5855,BCBSMN Non-RVU base fee schedule,277.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5856,Not in chargemaster,L5856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5856,BCBSMN Non-RVU base fee schedule,21686.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5857,Not in chargemaster,L5857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5857,BCBSMN Non-RVU base fee schedule,7695.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5858,Not in chargemaster,L5858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5858,BCBSMN Non-RVU base fee schedule,16789.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5859,Not in chargemaster,L5859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5859,BCBSMN Non-RVU base fee schedule,13107.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5910,Not in chargemaster,L5910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5910,BCBSMN Non-RVU base fee schedule,325.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5920,Not in chargemaster,L5920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5920,BCBSMN Non-RVU base fee schedule,476.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5925,Not in chargemaster,L5925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5925,BCBSMN Non-RVU base fee schedule,301.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5930,Not in chargemaster,L5930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5930,BCBSMN Non-RVU base fee schedule,3040.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5940,Not in chargemaster,L5940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5940,BCBSMN Non-RVU base fee schedule,450.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5950,Not in chargemaster,L5950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5950,BCBSMN Non-RVU base fee schedule,698.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5960,Not in chargemaster,L5960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5960,BCBSMN Non-RVU base fee schedule,1044.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5961,Not in chargemaster,L5961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5961,BCBSMN Non-RVU base fee schedule,4312.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5962,Not in chargemaster,L5962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5962,BCBSMN Non-RVU base fee schedule,527.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5964,Not in chargemaster,L5964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5964,BCBSMN Non-RVU base fee schedule,1012.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5966,Not in chargemaster,L5966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5966,BCBSMN Non-RVU base fee schedule,1304.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5968,Not in chargemaster,L5968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5968,BCBSMN Non-RVU base fee schedule,3282.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5969,Not in chargemaster,L5969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5969,BCBSMN Non-RVU base fee schedule,12338.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5970,Not in chargemaster,L5970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5970,BCBSMN Non-RVU base fee schedule,196.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5971,Not in chargemaster,L5971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5971,BCBSMN Non-RVU base fee schedule,196.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5972,Not in chargemaster,L5972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5972,BCBSMN Non-RVU base fee schedule,357.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5973,Not in chargemaster,L5973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5973,BCBSMN Non-RVU base fee schedule,15949.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5974,Not in chargemaster,L5974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5974,BCBSMN Non-RVU base fee schedule,209.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5975,Not in chargemaster,L5975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5975,BCBSMN Non-RVU base fee schedule,418.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5976,Not in chargemaster,L5976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5976,BCBSMN Non-RVU base fee schedule,530.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5978,Not in chargemaster,L5978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5978,BCBSMN Non-RVU base fee schedule,281.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5979,Not in chargemaster,L5979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5979,BCBSMN Non-RVU base fee schedule,2252.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5980,Not in chargemaster,L5980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5980,BCBSMN Non-RVU base fee schedule,3431.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5981,Not in chargemaster,L5981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5981,BCBSMN Non-RVU base fee schedule,3082.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5982,Not in chargemaster,L5982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5982,BCBSMN Non-RVU base fee schedule,579.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5984,Not in chargemaster,L5984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5984,BCBSMN Non-RVU base fee schedule,580.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5985,Not in chargemaster,L5985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5985,BCBSMN Non-RVU base fee schedule,255.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5986,Not in chargemaster,L5986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5986,BCBSMN Non-RVU base fee schedule,700.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5987,Not in chargemaster,L5987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5987,BCBSMN Non-RVU base fee schedule,6498.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5988,Not in chargemaster,L5988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5988,BCBSMN Non-RVU base fee schedule,1804.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L5990,Not in chargemaster,L5990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L5990,BCBSMN Non-RVU base fee schedule,1638.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6000,Not in chargemaster,L6000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6000,BCBSMN Non-RVU base fee schedule,1591.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6010,Not in chargemaster,L6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6010,BCBSMN Non-RVU base fee schedule,1770.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6020,Not in chargemaster,L6020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6020,BCBSMN Non-RVU base fee schedule,1650.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6026,Not in chargemaster,L6026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6026,BCBSMN Non-RVU base fee schedule,3929.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6050,Not in chargemaster,L6050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6050,BCBSMN Non-RVU base fee schedule,2245.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6055,Not in chargemaster,L6055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6055,BCBSMN Non-RVU base fee schedule,2864.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6100,Not in chargemaster,L6100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6100,BCBSMN Non-RVU base fee schedule,2272.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6110,Not in chargemaster,L6110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6110,BCBSMN Non-RVU base fee schedule,2404.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6120,Not in chargemaster,L6120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6120,BCBSMN Non-RVU base fee schedule,2719.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6130,Not in chargemaster,L6130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6130,BCBSMN Non-RVU base fee schedule,2868.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6200,Not in chargemaster,L6200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6200,BCBSMN Non-RVU base fee schedule,2955.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6205,Not in chargemaster,L6205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6205,BCBSMN Non-RVU base fee schedule,4076.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6250,Not in chargemaster,L6250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6250,BCBSMN Non-RVU base fee schedule,2907.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6300,Not in chargemaster,L6300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6300,BCBSMN Non-RVU base fee schedule,4009.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6310,Not in chargemaster,L6310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6310,BCBSMN Non-RVU base fee schedule,3634.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6320,Not in chargemaster,L6320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6320,BCBSMN Non-RVU base fee schedule,1894.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6350,Not in chargemaster,L6350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6350,BCBSMN Non-RVU base fee schedule,4393.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6360,Not in chargemaster,L6360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6360,BCBSMN Non-RVU base fee schedule,3814.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6370,Not in chargemaster,L6370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6370,BCBSMN Non-RVU base fee schedule,2212.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6380,Not in chargemaster,L6380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6380,BCBSMN Non-RVU base fee schedule,1279.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6382,Not in chargemaster,L6382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6382,BCBSMN Non-RVU base fee schedule,1523.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6384,Not in chargemaster,L6384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6384,BCBSMN Non-RVU base fee schedule,1926.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6386,Not in chargemaster,L6386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6386,BCBSMN Non-RVU base fee schedule,422.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6388,Not in chargemaster,L6388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6388,BCBSMN Non-RVU base fee schedule,465.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6400,Not in chargemaster,L6400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6400,BCBSMN Non-RVU base fee schedule,2458.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6450,Not in chargemaster,L6450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6450,BCBSMN Non-RVU base fee schedule,3212.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6500,Not in chargemaster,L6500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6500,BCBSMN Non-RVU base fee schedule,3154.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6550,Not in chargemaster,L6550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6550,BCBSMN Non-RVU base fee schedule,4086.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6570,Not in chargemaster,L6570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6570,BCBSMN Non-RVU base fee schedule,4561.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6580,Not in chargemaster,L6580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6580,BCBSMN Non-RVU base fee schedule,1823.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6582,Not in chargemaster,L6582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6582,BCBSMN Non-RVU base fee schedule,1531.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6584,Not in chargemaster,L6584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6584,BCBSMN Non-RVU base fee schedule,2268.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6586,Not in chargemaster,L6586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6586,BCBSMN Non-RVU base fee schedule,2021.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6588,Not in chargemaster,L6588,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6588,BCBSMN Non-RVU base fee schedule,3218.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6590,Not in chargemaster,L6590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6590,BCBSMN Non-RVU base fee schedule,2805.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6600,Not in chargemaster,L6600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6600,BCBSMN Non-RVU base fee schedule,204.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6605,Not in chargemaster,L6605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6605,BCBSMN Non-RVU base fee schedule,210.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6610,Not in chargemaster,L6610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6610,BCBSMN Non-RVU base fee schedule,199.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6611,Not in chargemaster,L6611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6611,BCBSMN Non-RVU base fee schedule,371.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6615,Not in chargemaster,L6615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6615,BCBSMN Non-RVU base fee schedule,193.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6616,Not in chargemaster,L6616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6616,BCBSMN Non-RVU base fee schedule,58.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6620,Not in chargemaster,L6620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6620,BCBSMN Non-RVU base fee schedule,338.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6621,Not in chargemaster,L6621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6621,BCBSMN Non-RVU base fee schedule,2066.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6623,Not in chargemaster,L6623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6623,BCBSMN Non-RVU base fee schedule,644.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6624,Not in chargemaster,L6624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6624,BCBSMN Non-RVU base fee schedule,3402.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6625,Not in chargemaster,L6625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6625,BCBSMN Non-RVU base fee schedule,477.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6628,Not in chargemaster,L6628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6628,BCBSMN Non-RVU base fee schedule,514.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6629,Not in chargemaster,L6629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6629,BCBSMN Non-RVU base fee schedule,175.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6630,Not in chargemaster,L6630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6630,BCBSMN Non-RVU base fee schedule,258.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6632,Not in chargemaster,L6632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6632,BCBSMN Non-RVU base fee schedule,58.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6635,Not in chargemaster,L6635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6635,BCBSMN Non-RVU base fee schedule,186.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6637,Not in chargemaster,L6637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6637,BCBSMN Non-RVU base fee schedule,365.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6638,Not in chargemaster,L6638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6638,BCBSMN Non-RVU base fee schedule,2259.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6640,Not in chargemaster,L6640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6640,BCBSMN Non-RVU base fee schedule,304.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6641,Not in chargemaster,L6641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6641,BCBSMN Non-RVU base fee schedule,177.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6642,Not in chargemaster,L6642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6642,BCBSMN Non-RVU base fee schedule,260.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6645,Not in chargemaster,L6645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6645,BCBSMN Non-RVU base fee schedule,328.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6646,Not in chargemaster,L6646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6646,BCBSMN Non-RVU base fee schedule,2849.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6647,Not in chargemaster,L6647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6647,BCBSMN Non-RVU base fee schedule,469.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6648,Not in chargemaster,L6648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6648,BCBSMN Non-RVU base fee schedule,2938.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6650,Not in chargemaster,L6650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6650,BCBSMN Non-RVU base fee schedule,356.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6655,Not in chargemaster,L6655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6655,BCBSMN Non-RVU base fee schedule,69.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6660,Not in chargemaster,L6660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6660,BCBSMN Non-RVU base fee schedule,92.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6665,Not in chargemaster,L6665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6665,BCBSMN Non-RVU base fee schedule,41.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6670,Not in chargemaster,L6670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6670,BCBSMN Non-RVU base fee schedule,43.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6672,Not in chargemaster,L6672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6672,BCBSMN Non-RVU base fee schedule,197.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6675,Not in chargemaster,L6675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6675,BCBSMN Non-RVU base fee schedule,107.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6676,Not in chargemaster,L6676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6676,BCBSMN Non-RVU base fee schedule,112.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6677,Not in chargemaster,L6677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6677,BCBSMN Non-RVU base fee schedule,267.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6680,Not in chargemaster,L6680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6680,BCBSMN Non-RVU base fee schedule,277.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6682,Not in chargemaster,L6682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6682,BCBSMN Non-RVU base fee schedule,307.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6684,Not in chargemaster,L6684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6684,BCBSMN Non-RVU base fee schedule,417.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6686,Not in chargemaster,L6686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6686,BCBSMN Non-RVU base fee schedule,619.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6687,Not in chargemaster,L6687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6687,BCBSMN Non-RVU base fee schedule,518.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6688,Not in chargemaster,L6688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6688,BCBSMN Non-RVU base fee schedule,573.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6689,Not in chargemaster,L6689,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6689,BCBSMN Non-RVU base fee schedule,683.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6690,Not in chargemaster,L6690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6690,BCBSMN Non-RVU base fee schedule,804.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6691,Not in chargemaster,L6691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6691,BCBSMN Non-RVU base fee schedule,317.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6692,Not in chargemaster,L6692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6692,BCBSMN Non-RVU base fee schedule,577.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6693,Not in chargemaster,L6693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6693,BCBSMN Non-RVU base fee schedule,2564.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6694,Not in chargemaster,L6694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6694,BCBSMN Non-RVU base fee schedule,710.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6695,Not in chargemaster,L6695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6695,BCBSMN Non-RVU base fee schedule,591.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6696,Not in chargemaster,L6696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6696,BCBSMN Non-RVU base fee schedule,1188.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6697,Not in chargemaster,L6697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6697,BCBSMN Non-RVU base fee schedule,1188.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6698,Not in chargemaster,L6698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6698,BCBSMN Non-RVU base fee schedule,446.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6703,Not in chargemaster,L6703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6703,BCBSMN Non-RVU base fee schedule,315.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6704,Not in chargemaster,L6704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6704,BCBSMN Non-RVU base fee schedule,609.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6706,Not in chargemaster,L6706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6706,BCBSMN Non-RVU base fee schedule,378.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6707,Not in chargemaster,L6707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6707,BCBSMN Non-RVU base fee schedule,1338.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6708,Not in chargemaster,L6708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6708,BCBSMN Non-RVU base fee schedule,885.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6709,Not in chargemaster,L6709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6709,BCBSMN Non-RVU base fee schedule,1256.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6711,Not in chargemaster,L6711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6711,BCBSMN Non-RVU base fee schedule,607.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6712,Not in chargemaster,L6712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6712,BCBSMN Non-RVU base fee schedule,1118.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6713,Not in chargemaster,L6713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6713,BCBSMN Non-RVU base fee schedule,1411.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6714,Not in chargemaster,L6714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6714,BCBSMN Non-RVU base fee schedule,1195.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6715,Not in chargemaster,L6715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6715,BCBSMN Non-RVU base fee schedule,2852.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6721,Not in chargemaster,L6721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6721,BCBSMN Non-RVU base fee schedule,2124.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6722,Not in chargemaster,L6722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6722,BCBSMN Non-RVU base fee schedule,1831.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6805,Not in chargemaster,L6805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6805,BCBSMN Non-RVU base fee schedule,346.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6810,Not in chargemaster,L6810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6810,BCBSMN Non-RVU base fee schedule,184.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6880,Not in chargemaster,L6880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6880,BCBSMN Non-RVU base fee schedule,21584.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6881,Not in chargemaster,L6881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6881,BCBSMN Non-RVU base fee schedule,3693.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6882,Not in chargemaster,L6882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6882,BCBSMN Non-RVU base fee schedule,2801.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6883,Not in chargemaster,L6883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6883,BCBSMN Non-RVU base fee schedule,1794.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6884,Not in chargemaster,L6884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6884,BCBSMN Non-RVU base fee schedule,2455.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6885,Not in chargemaster,L6885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6885,BCBSMN Non-RVU base fee schedule,3814.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6890,Not in chargemaster,L6890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6890,BCBSMN Non-RVU base fee schedule,180.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6895,Not in chargemaster,L6895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6895,BCBSMN Non-RVU base fee schedule,603.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6900,Not in chargemaster,L6900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6900,BCBSMN Non-RVU base fee schedule,1751.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6905,Not in chargemaster,L6905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6905,BCBSMN Non-RVU base fee schedule,1733.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6910,Not in chargemaster,L6910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6910,BCBSMN Non-RVU base fee schedule,1704.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6915,Not in chargemaster,L6915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6915,BCBSMN Non-RVU base fee schedule,732.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6920,Not in chargemaster,L6920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6920,BCBSMN Non-RVU base fee schedule,7567.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6925,Not in chargemaster,L6925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6925,BCBSMN Non-RVU base fee schedule,8084.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6930,Not in chargemaster,L6930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6930,BCBSMN Non-RVU base fee schedule,7288.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6935,Not in chargemaster,L6935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6935,BCBSMN Non-RVU base fee schedule,8046.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6940,Not in chargemaster,L6940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6940,BCBSMN Non-RVU base fee schedule,9412.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6945,Not in chargemaster,L6945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6945,BCBSMN Non-RVU base fee schedule,10500.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6950,Not in chargemaster,L6950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6950,BCBSMN Non-RVU base fee schedule,9394.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6955,Not in chargemaster,L6955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6955,BCBSMN Non-RVU base fee schedule,10894.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6960,Not in chargemaster,L6960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6960,BCBSMN Non-RVU base fee schedule,11461.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6965,Not in chargemaster,L6965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6965,BCBSMN Non-RVU base fee schedule,13577.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6970,Not in chargemaster,L6970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6970,BCBSMN Non-RVU base fee schedule,14533.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L6975,Not in chargemaster,L6975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L6975,BCBSMN Non-RVU base fee schedule,16018.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7007,Not in chargemaster,L7007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7007,BCBSMN Non-RVU base fee schedule,3299.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7008,Not in chargemaster,L7008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7008,BCBSMN Non-RVU base fee schedule,5116.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7009,Not in chargemaster,L7009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7009,BCBSMN Non-RVU base fee schedule,3375.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7040,Not in chargemaster,L7040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7040,BCBSMN Non-RVU base fee schedule,2747.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7045,Not in chargemaster,L7045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7045,BCBSMN Non-RVU base fee schedule,1451.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7170,Not in chargemaster,L7170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7170,BCBSMN Non-RVU base fee schedule,5434.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7180,Not in chargemaster,L7180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7180,BCBSMN Non-RVU base fee schedule,35157,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7181,Not in chargemaster,L7181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7181,BCBSMN Non-RVU base fee schedule,36197.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7185,Not in chargemaster,L7185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7185,BCBSMN Non-RVU base fee schedule,5713.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7186,Not in chargemaster,L7186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7186,BCBSMN Non-RVU base fee schedule,9604.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7190,Not in chargemaster,L7190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7190,BCBSMN Non-RVU base fee schedule,7580.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7191,Not in chargemaster,L7191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7191,BCBSMN Non-RVU base fee schedule,10102.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7259,Not in chargemaster,L7259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7259,BCBSMN Non-RVU base fee schedule,3702.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7360,Not in chargemaster,L7360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7360,BCBSMN Non-RVU base fee schedule,239,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7362,Not in chargemaster,L7362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7362,BCBSMN Non-RVU base fee schedule,261.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7364,Not in chargemaster,L7364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7364,BCBSMN Non-RVU base fee schedule,461.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7366,Not in chargemaster,L7366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7366,BCBSMN Non-RVU base fee schedule,635.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7367,Not in chargemaster,L7367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7367,BCBSMN Non-RVU base fee schedule,351.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7368,Not in chargemaster,L7368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7368,BCBSMN Non-RVU base fee schedule,455.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7400,Not in chargemaster,L7400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7400,BCBSMN Non-RVU base fee schedule,276.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7401,Not in chargemaster,L7401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7401,BCBSMN Non-RVU base fee schedule,309.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7402,Not in chargemaster,L7402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7402,BCBSMN Non-RVU base fee schedule,334.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7403,Not in chargemaster,L7403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7403,BCBSMN Non-RVU base fee schedule,332.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7404,Not in chargemaster,L7404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7404,BCBSMN Non-RVU base fee schedule,502.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7405,Not in chargemaster,L7405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7405,BCBSMN Non-RVU base fee schedule,656.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7520,Not in chargemaster,L7520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7520,BCBSMN Non-RVU base fee schedule,32.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7600,Not in chargemaster,L7600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7600,BCBSMN Non-RVU base fee schedule,48.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7700,Not in chargemaster,L7700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7700,BCBSMN Non-RVU base fee schedule,135.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7900,Not in chargemaster,L7900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7900,BCBSMN Non-RVU base fee schedule,503.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L7902,Not in chargemaster,L7902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L7902,BCBSMN Non-RVU base fee schedule,16.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8000,Not in chargemaster,L8000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8000,BCBSMN Non-RVU base fee schedule,38.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8001,Not in chargemaster,L8001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8001,BCBSMN Non-RVU base fee schedule,113.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8002,Not in chargemaster,L8002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8002,BCBSMN Non-RVU base fee schedule,149.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8010,Not in chargemaster,L8010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8010,BCBSMN Non-RVU base fee schedule,48.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8015,Not in chargemaster,L8015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8015,BCBSMN Non-RVU base fee schedule,54.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8020,Not in chargemaster,L8020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8020,BCBSMN Non-RVU base fee schedule,204.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8030,Not in chargemaster,L8030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8030,BCBSMN Non-RVU base fee schedule,315.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8031,Not in chargemaster,L8031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8031,BCBSMN Non-RVU base fee schedule,315.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8032,Not in chargemaster,L8032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8032,BCBSMN Non-RVU base fee schedule,35.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8035,Not in chargemaster,L8035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8035,BCBSMN Non-RVU base fee schedule,3309.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8040,Not in chargemaster,L8040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8040,BCBSMN Non-RVU base fee schedule,2239.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8041,Not in chargemaster,L8041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8041,BCBSMN Non-RVU base fee schedule,2699.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8042,Not in chargemaster,L8042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8042,BCBSMN Non-RVU base fee schedule,3032.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8043,Not in chargemaster,L8043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8043,BCBSMN Non-RVU base fee schedule,3396.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8044,Not in chargemaster,L8044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8044,BCBSMN Non-RVU base fee schedule,3760.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8045,Not in chargemaster,L8045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8045,BCBSMN Non-RVU base fee schedule,2944.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8046,Not in chargemaster,L8046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8046,BCBSMN Non-RVU base fee schedule,2426.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8047,Not in chargemaster,L8047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8047,BCBSMN Non-RVU base fee schedule,1243.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8049,Not in chargemaster,L8049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8049,BCBSMN Non-RVU base fee schedule,15.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8300,Not in chargemaster,L8300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8300,BCBSMN Non-RVU base fee schedule,75.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8310,Not in chargemaster,L8310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8310,BCBSMN Non-RVU base fee schedule,134.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8320,Not in chargemaster,L8320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8320,BCBSMN Non-RVU base fee schedule,55.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8330,Not in chargemaster,L8330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8330,BCBSMN Non-RVU base fee schedule,44.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8400,Not in chargemaster,L8400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8400,BCBSMN Non-RVU base fee schedule,14.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8410,Not in chargemaster,L8410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8410,BCBSMN Non-RVU base fee schedule,18.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8415,Not in chargemaster,L8415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8415,BCBSMN Non-RVU base fee schedule,19.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8417,Not in chargemaster,L8417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8417,BCBSMN Non-RVU base fee schedule,67.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8420,Not in chargemaster,L8420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8420,BCBSMN Non-RVU base fee schedule,18.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8430,Not in chargemaster,L8430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8430,BCBSMN Non-RVU base fee schedule,21.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8435,Not in chargemaster,L8435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8435,BCBSMN Non-RVU base fee schedule,20.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8440,Not in chargemaster,L8440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8440,BCBSMN Non-RVU base fee schedule,42.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8460,Not in chargemaster,L8460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8460,BCBSMN Non-RVU base fee schedule,59.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8465,Not in chargemaster,L8465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8465,BCBSMN Non-RVU base fee schedule,55.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8470,Not in chargemaster,L8470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8470,BCBSMN Non-RVU base fee schedule,5.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8480,Not in chargemaster,L8480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8480,BCBSMN Non-RVU base fee schedule,8.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8485,Not in chargemaster,L8485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8485,BCBSMN Non-RVU base fee schedule,11.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8500,Not in chargemaster,L8500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8500,BCBSMN Non-RVU base fee schedule,594.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8501,Not in chargemaster,L8501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8501,BCBSMN Non-RVU base fee schedule,108.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8507,Not in chargemaster,L8507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8507,BCBSMN Non-RVU base fee schedule,37.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8509,Not in chargemaster,L8509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8509,BCBSMN Non-RVU base fee schedule,98.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8510,Not in chargemaster,L8510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8510,BCBSMN Non-RVU base fee schedule,228.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8511,Not in chargemaster,L8511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8511,BCBSMN Non-RVU base fee schedule,65.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8512,Not in chargemaster,L8512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8512,BCBSMN Non-RVU base fee schedule,1.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8513,Not in chargemaster,L8513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8513,BCBSMN Non-RVU base fee schedule,4.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8514,Not in chargemaster,L8514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8514,BCBSMN Non-RVU base fee schedule,85.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8515,Not in chargemaster,L8515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8515,BCBSMN Non-RVU base fee schedule,57.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8600,Not in chargemaster,L8600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8600,BCBSMN Non-RVU base fee schedule,747.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8603,Not in chargemaster,L8603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8603,BCBSMN Non-RVU base fee schedule,393.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8604,Not in chargemaster,L8604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8604,BCBSMN Non-RVU base fee schedule,168.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8605,Not in chargemaster,L8605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8605,BCBSMN Non-RVU base fee schedule,647.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8606,Not in chargemaster,L8606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8606,BCBSMN Non-RVU base fee schedule,185.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8607,Not in chargemaster,L8607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8607,BCBSMN Non-RVU base fee schedule,38.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8609,Not in chargemaster,L8609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8609,BCBSMN Non-RVU base fee schedule,5886.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8610,Not in chargemaster,L8610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8610,BCBSMN Non-RVU base fee schedule,614.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8612,Not in chargemaster,L8612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8612,BCBSMN Non-RVU base fee schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8613,Not in chargemaster,L8613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8613,BCBSMN Non-RVU base fee schedule,307.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8614,Not in chargemaster,L8614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8614,BCBSMN Non-RVU base fee schedule,17688.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8615,Not in chargemaster,L8615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8615,BCBSMN Non-RVU base fee schedule,407.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8616,Not in chargemaster,L8616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8616,BCBSMN Non-RVU base fee schedule,94.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8617,Not in chargemaster,L8617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8617,BCBSMN Non-RVU base fee schedule,82.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8618,Not in chargemaster,L8618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8618,BCBSMN Non-RVU base fee schedule,23.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8619,Not in chargemaster,L8619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8619,BCBSMN Non-RVU base fee schedule,7593.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8621,Not in chargemaster,L8621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8621,BCBSMN Non-RVU base fee schedule,0.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8622,Not in chargemaster,L8622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8622,BCBSMN Non-RVU base fee schedule,0.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8623,Not in chargemaster,L8623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8623,BCBSMN Non-RVU base fee schedule,58.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8624,Not in chargemaster,L8624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8624,BCBSMN Non-RVU base fee schedule,145.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8625,Not in chargemaster,L8625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8625,BCBSMN Non-RVU base fee schedule,170.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8627,Not in chargemaster,L8627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8627,BCBSMN Non-RVU base fee schedule,6445.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8628,Not in chargemaster,L8628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8628,BCBSMN Non-RVU base fee schedule,1148.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8629,Not in chargemaster,L8629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8629,BCBSMN Non-RVU base fee schedule,161.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8630,Not in chargemaster,L8630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8630,BCBSMN Non-RVU base fee schedule,403.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8631,Not in chargemaster,L8631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8631,BCBSMN Non-RVU base fee schedule,1987.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8641,Not in chargemaster,L8641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8641,BCBSMN Non-RVU base fee schedule,314.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8642,Not in chargemaster,L8642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8642,BCBSMN Non-RVU base fee schedule,281.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8658,Not in chargemaster,L8658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8658,BCBSMN Non-RVU base fee schedule,274.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8659,Not in chargemaster,L8659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8659,BCBSMN Non-RVU base fee schedule,1743.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8670,Not in chargemaster,L8670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8670,BCBSMN Non-RVU base fee schedule,499.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8679,Not in chargemaster,L8679,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8679,BCBSMN Non-RVU base fee schedule,7740.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8680,Not in chargemaster,L8680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8680,BCBSMN Non-RVU base fee schedule,445.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8681,Not in chargemaster,L8681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8681,BCBSMN Non-RVU base fee schedule,1030.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8682,Not in chargemaster,L8682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8682,BCBSMN Non-RVU base fee schedule,5530.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8683,Not in chargemaster,L8683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8683,BCBSMN Non-RVU base fee schedule,4868.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8684,Not in chargemaster,L8684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8684,BCBSMN Non-RVU base fee schedule,763.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8685,Not in chargemaster,L8685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8685,BCBSMN Non-RVU base fee schedule,11839.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8686,Not in chargemaster,L8686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8686,BCBSMN Non-RVU base fee schedule,7554.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8687,Not in chargemaster,L8687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8687,BCBSMN Non-RVU base fee schedule,15408.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8688,Not in chargemaster,L8688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8688,BCBSMN Non-RVU base fee schedule,9831.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8689,Not in chargemaster,L8689,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8689,BCBSMN Non-RVU base fee schedule,1558.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8690,Not in chargemaster,L8690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8690,BCBSMN Non-RVU base fee schedule,4297.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8691,Not in chargemaster,L8691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8691,BCBSMN Non-RVU base fee schedule,1555.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8692,Not in chargemaster,L8692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8692,BCBSMN Non-RVU base fee schedule,2391.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8693,Not in chargemaster,L8693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8693,BCBSMN Non-RVU base fee schedule,1369.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8694,Not in chargemaster,L8694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8694,BCBSMN Non-RVU base fee schedule,853.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8695,Not in chargemaster,L8695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8695,BCBSMN Non-RVU base fee schedule,15.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU L8696,Not in chargemaster,L8696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,L8696,BCBSMN Non-RVU base fee schedule,195.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M0076,Not in chargemaster,M0076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M0076,BCBSMN Non-RVU base fee schedule,269.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1003,Not in chargemaster,M1003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1003,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1004,Not in chargemaster,M1004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1004,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1005,Not in chargemaster,M1005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1005,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1006,Not in chargemaster,M1006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1006,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1007,Not in chargemaster,M1007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1007,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1008,Not in chargemaster,M1008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1008,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1009,Not in chargemaster,M1009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1009,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1010,Not in chargemaster,M1010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1010,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1011,Not in chargemaster,M1011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1011,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1012,Not in chargemaster,M1012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1012,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1013,Not in chargemaster,M1013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1013,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1014,Not in chargemaster,M1014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1014,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1015,Not in chargemaster,M1015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1015,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1016,Not in chargemaster,M1016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1016,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1017,Not in chargemaster,M1017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1017,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1018,Not in chargemaster,M1018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1018,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1019,Not in chargemaster,M1019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1019,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1020,Not in chargemaster,M1020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1020,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1021,Not in chargemaster,M1021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1021,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1022,Not in chargemaster,M1022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1022,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1023,Not in chargemaster,M1023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1023,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1024,Not in chargemaster,M1024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1024,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1025,Not in chargemaster,M1025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1025,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1026,Not in chargemaster,M1026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1026,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1027,Not in chargemaster,M1027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1027,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1028,Not in chargemaster,M1028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1028,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1029,Not in chargemaster,M1029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1029,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1031,Not in chargemaster,M1031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1031,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1032,Not in chargemaster,M1032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1032,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1033,Not in chargemaster,M1033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1033,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1034,Not in chargemaster,M1034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1034,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1035,Not in chargemaster,M1035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1035,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1036,Not in chargemaster,M1036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1036,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1037,Not in chargemaster,M1037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1037,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1038,Not in chargemaster,M1038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1038,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1039,Not in chargemaster,M1039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1039,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1040,Not in chargemaster,M1040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1040,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1041,Not in chargemaster,M1041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1041,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1043,Not in chargemaster,M1043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1043,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1045,Not in chargemaster,M1045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1045,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1046,Not in chargemaster,M1046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1046,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1049,Not in chargemaster,M1049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1049,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1051,Not in chargemaster,M1051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1051,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1052,Not in chargemaster,M1052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1052,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1054,Not in chargemaster,M1054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1054,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1055,Not in chargemaster,M1055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1055,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1056,Not in chargemaster,M1056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1056,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1057,Not in chargemaster,M1057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1057,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1058,Not in chargemaster,M1058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1058,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1059,Not in chargemaster,M1059,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1059,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1060,Not in chargemaster,M1060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1060,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1061,Not in chargemaster,M1061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1061,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1062,Not in chargemaster,M1062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1062,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1063,Not in chargemaster,M1063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1063,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1064,Not in chargemaster,M1064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1064,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1065,Not in chargemaster,M1065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1065,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1066,Not in chargemaster,M1066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1066,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1067,Not in chargemaster,M1067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1067,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1068,Not in chargemaster,M1068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1068,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1069,Not in chargemaster,M1069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1069,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1070,Not in chargemaster,M1070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1070,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1071,Not in chargemaster,M1071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1071,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1106,Not in chargemaster,M1106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1106,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1107,Not in chargemaster,M1107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1107,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1108,Not in chargemaster,M1108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1108,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1109,Not in chargemaster,M1109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1109,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1110,Not in chargemaster,M1110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1110,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1111,Not in chargemaster,M1111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1111,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1112,Not in chargemaster,M1112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1112,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1113,Not in chargemaster,M1113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1113,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1114,Not in chargemaster,M1114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1114,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1115,Not in chargemaster,M1115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1115,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1116,Not in chargemaster,M1116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1116,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1117,Not in chargemaster,M1117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1117,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1118,Not in chargemaster,M1118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1118,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1119,Not in chargemaster,M1119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1119,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1120,Not in chargemaster,M1120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1120,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1121,Not in chargemaster,M1121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1121,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1122,Not in chargemaster,M1122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1122,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1123,Not in chargemaster,M1123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1123,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1124,Not in chargemaster,M1124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1124,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1125,Not in chargemaster,M1125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1125,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1126,Not in chargemaster,M1126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1126,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1127,Not in chargemaster,M1127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1127,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1128,Not in chargemaster,M1128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1128,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1129,Not in chargemaster,M1129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1129,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1130,Not in chargemaster,M1130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1130,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1131,Not in chargemaster,M1131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1131,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1132,Not in chargemaster,M1132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1132,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1133,Not in chargemaster,M1133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1133,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1134,Not in chargemaster,M1134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1134,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1135,Not in chargemaster,M1135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1135,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1136,Not in chargemaster,M1136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1136,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1137,Not in chargemaster,M1137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1137,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1138,Not in chargemaster,M1138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1138,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1139,Not in chargemaster,M1139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1139,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1140,Not in chargemaster,M1140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1140,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1141,Not in chargemaster,M1141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1141,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1142,Not in chargemaster,M1142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1142,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1143,Not in chargemaster,M1143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1143,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU M1144,Not in chargemaster,M1144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,M1144,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P2028,Not in chargemaster,P2028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P2028,BCBSMN Non-RVU base fee schedule,5.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P2029,Not in chargemaster,P2029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P2029,BCBSMN Non-RVU base fee schedule,5.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P2031,Not in chargemaster,P2031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P2031,BCBSMN Non-RVU base fee schedule,5.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P2033,Not in chargemaster,P2033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P2033,BCBSMN Non-RVU base fee schedule,5.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P2038,Not in chargemaster,P2038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P2038,BCBSMN Non-RVU base fee schedule,5.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P3000,Not in chargemaster,P3000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P3000,BCBSMN Non-RVU base fee schedule,16.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P7001,Not in chargemaster,P7001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P7001,BCBSMN Non-RVU base fee schedule,15.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9011,Not in chargemaster,P9011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9011,BCBSMN Non-RVU base fee schedule,128.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9012,Not in chargemaster,P9012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9012,BCBSMN Non-RVU base fee schedule,34.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9016,Not in chargemaster,P9016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9016,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9017,Not in chargemaster,P9017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9017,BCBSMN Non-RVU base fee schedule,111.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9019,Not in chargemaster,P9019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9019,BCBSMN Non-RVU base fee schedule,48.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9020,Not in chargemaster,P9020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9020,BCBSMN Non-RVU base fee schedule,57.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9021,Not in chargemaster,P9021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9021,BCBSMN Non-RVU base fee schedule,101.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9022,Not in chargemaster,P9022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9022,BCBSMN Non-RVU base fee schedule,188.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9031,Not in chargemaster,P9031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9031,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9033,Not in chargemaster,P9033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9033,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9035,Not in chargemaster,P9035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9035,BCBSMN Non-RVU base fee schedule,480.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9037,Not in chargemaster,P9037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9037,BCBSMN Non-RVU base fee schedule,480.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9040,Not in chargemaster,P9040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9040,BCBSMN Non-RVU base fee schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9041,Not in chargemaster,P9041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9041,BCBSMN Non-RVU base fee schedule,10.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9043,Not in chargemaster,P9043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9043,BCBSMN Non-RVU base fee schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9044,Not in chargemaster,P9044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9044,BCBSMN Non-RVU base fee schedule,42.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9045,Not in chargemaster,P9045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9045,BCBSMN Non-RVU base fee schedule,52.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9046,Not in chargemaster,P9046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9046,BCBSMN Non-RVU base fee schedule,20.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9047,Not in chargemaster,P9047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9047,BCBSMN Non-RVU base fee schedule,52.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9048,Not in chargemaster,P9048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9048,BCBSMN Non-RVU base fee schedule,84.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9051,Not in chargemaster,P9051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9051,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9052,Not in chargemaster,P9052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9052,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9053,Not in chargemaster,P9053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9053,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9054,Not in chargemaster,P9054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9054,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9055,Not in chargemaster,P9055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9055,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9056,Not in chargemaster,P9056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9056,BCBSMN Non-RVU base fee schedule,103.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9057,Not in chargemaster,P9057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9057,BCBSMN Non-RVU base fee schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9058,Not in chargemaster,P9058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9058,BCBSMN Non-RVU base fee schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9059,Not in chargemaster,P9059,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9059,BCBSMN Non-RVU base fee schedule,111.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9060,Not in chargemaster,P9060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9060,BCBSMN Non-RVU base fee schedule,111.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9071,Not in chargemaster,P9071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9071,BCBSMN Non-RVU base fee schedule,111.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9073,Not in chargemaster,P9073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9073,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9100,Not in chargemaster,P9100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9100,BCBSMN Non-RVU base fee schedule,140.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9603,Not in chargemaster,P9603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9603,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9604,Not in chargemaster,P9604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9604,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9612,Not in chargemaster,P9612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9612,BCBSMN Non-RVU base fee schedule,3.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU P9615,Not in chargemaster,P9615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,P9615,BCBSMN Non-RVU base fee schedule,3.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0081,Not in chargemaster,Q0081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0081,BCBSMN Non-RVU base fee schedule,21.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0111,Not in chargemaster,Q0111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0111,BCBSMN Non-RVU base fee schedule,16.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0112,Not in chargemaster,Q0112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0112,BCBSMN Non-RVU base fee schedule,6.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0113,Not in chargemaster,Q0113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0113,BCBSMN Non-RVU base fee schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0114,Not in chargemaster,Q0114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0114,BCBSMN Non-RVU base fee schedule,10.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0115,Not in chargemaster,Q0115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0115,BCBSMN Non-RVU base fee schedule,27.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0138,Not in chargemaster,Q0138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0138,BCBSMN Non-RVU base fee schedule,1.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0139,Not in chargemaster,Q0139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0139,BCBSMN Non-RVU base fee schedule,1.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0144,Not in chargemaster,Q0144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0144,BCBSMN Non-RVU base fee schedule,26.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0161,Not in chargemaster,Q0161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0161,BCBSMN Non-RVU base fee schedule,2.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0162,Not in chargemaster,Q0162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0162,BCBSMN Non-RVU base fee schedule,0.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0163,Not in chargemaster,Q0163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0163,BCBSMN Non-RVU base fee schedule,0.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0164,Not in chargemaster,Q0164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0164,BCBSMN Non-RVU base fee schedule,0.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0166,Not in chargemaster,Q0166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0166,BCBSMN Non-RVU base fee schedule,0.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0167,Not in chargemaster,Q0167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0167,BCBSMN Non-RVU base fee schedule,0.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0169,Not in chargemaster,Q0169,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0169,BCBSMN Non-RVU base fee schedule,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0173,Not in chargemaster,Q0173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0173,BCBSMN Non-RVU base fee schedule,0.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0174,Not in chargemaster,Q0174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0174,BCBSMN Non-RVU base fee schedule,0.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0175,Not in chargemaster,Q0175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0175,BCBSMN Non-RVU base fee schedule,0.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0177,Not in chargemaster,Q0177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0177,BCBSMN Non-RVU base fee schedule,0.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0180,Not in chargemaster,Q0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0180,BCBSMN Non-RVU base fee schedule,97.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0181,Not in chargemaster,Q0181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0181,BCBSMN Non-RVU base fee schedule,1.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0477,Not in chargemaster,Q0477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0477,BCBSMN Non-RVU base fee schedule,700.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0478,Not in chargemaster,Q0478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0478,BCBSMN Non-RVU base fee schedule,166.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0479,Not in chargemaster,Q0479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0479,BCBSMN Non-RVU base fee schedule,10844.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0480,Not in chargemaster,Q0480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0480,BCBSMN Non-RVU base fee schedule,81364.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0480 mod RR,Not in chargemaster,Q0480,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0480 mod RR,BCBSMN Non-RVU base fee schedule,8136.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0481,Not in chargemaster,Q0481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0481,BCBSMN Non-RVU base fee schedule,13127.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0481 mod RR,Not in chargemaster,Q0481,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0481 mod RR,BCBSMN Non-RVU base fee schedule,1312.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0482,Not in chargemaster,Q0482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0482,BCBSMN Non-RVU base fee schedule,4111.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0482 mod RR,Not in chargemaster,Q0482,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0482 mod RR,BCBSMN Non-RVU base fee schedule,411.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0483,Not in chargemaster,Q0483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0483,BCBSMN Non-RVU base fee schedule,16938.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0483 mod RR,Not in chargemaster,Q0483,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0483 mod RR,BCBSMN Non-RVU base fee schedule,1693.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0484,Not in chargemaster,Q0484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0484,BCBSMN Non-RVU base fee schedule,3289.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0484 mod RR,Not in chargemaster,Q0484,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0484 mod RR,BCBSMN Non-RVU base fee schedule,328.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0485,Not in chargemaster,Q0485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0485,BCBSMN Non-RVU base fee schedule,317.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0485 mod RR,Not in chargemaster,Q0485,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0485 mod RR,BCBSMN Non-RVU base fee schedule,31.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0486,Not in chargemaster,Q0486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0486,BCBSMN Non-RVU base fee schedule,264.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0486 mod RR,Not in chargemaster,Q0486,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0486 mod RR,BCBSMN Non-RVU base fee schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0487,Not in chargemaster,Q0487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0487,BCBSMN Non-RVU base fee schedule,308.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0487 mod RR,Not in chargemaster,Q0487,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0487 mod RR,BCBSMN Non-RVU base fee schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0489,Not in chargemaster,Q0489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0489,BCBSMN Non-RVU base fee schedule,14684.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0489 mod RR,Not in chargemaster,Q0489,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0489 mod RR,BCBSMN Non-RVU base fee schedule,1468.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0490,Not in chargemaster,Q0490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0490,BCBSMN Non-RVU base fee schedule,635.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0490 mod RR,Not in chargemaster,Q0490,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0490 mod RR,BCBSMN Non-RVU base fee schedule,63.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0491,Not in chargemaster,Q0491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0491,BCBSMN Non-RVU base fee schedule,998.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0491 mod RR,Not in chargemaster,Q0491,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0491 mod RR,BCBSMN Non-RVU base fee schedule,99.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0492,Not in chargemaster,Q0492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0492,BCBSMN Non-RVU base fee schedule,80.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0492 mod RR,Not in chargemaster,Q0492,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0492 mod RR,BCBSMN Non-RVU base fee schedule,8.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0493,Not in chargemaster,Q0493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0493,BCBSMN Non-RVU base fee schedule,229.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0493 mod RR,Not in chargemaster,Q0493,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0493 mod RR,BCBSMN Non-RVU base fee schedule,22.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0494,Not in chargemaster,Q0494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0494,BCBSMN Non-RVU base fee schedule,193.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0494 mod RR,Not in chargemaster,Q0494,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0494 mod RR,BCBSMN Non-RVU base fee schedule,19.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0495,Not in chargemaster,Q0495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0495,BCBSMN Non-RVU base fee schedule,3773.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0495 mod RR,Not in chargemaster,Q0495,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0495 mod RR,BCBSMN Non-RVU base fee schedule,377.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0496,Not in chargemaster,Q0496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0496,BCBSMN Non-RVU base fee schedule,1354.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0496 mod RR,Not in chargemaster,Q0496,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0496 mod RR,BCBSMN Non-RVU base fee schedule,135.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0497,Not in chargemaster,Q0497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0497,BCBSMN Non-RVU base fee schedule,422.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0497 mod RR,Not in chargemaster,Q0497,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0497 mod RR,BCBSMN Non-RVU base fee schedule,42.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0498,Not in chargemaster,Q0498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0498,BCBSMN Non-RVU base fee schedule,464.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0498 mod RR,Not in chargemaster,Q0498,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0498 mod RR,BCBSMN Non-RVU base fee schedule,46.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0499,Not in chargemaster,Q0499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0499,BCBSMN Non-RVU base fee schedule,150.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0499 mod RR,Not in chargemaster,Q0499,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0499 mod RR,BCBSMN Non-RVU base fee schedule,15.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0500,Not in chargemaster,Q0500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0500,BCBSMN Non-RVU base fee schedule,27.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0500 mod RR,Not in chargemaster,Q0500,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0500 mod RR,BCBSMN Non-RVU base fee schedule,2.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0501,Not in chargemaster,Q0501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0501,BCBSMN Non-RVU base fee schedule,461.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0501 mod RR,Not in chargemaster,Q0501,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0501 mod RR,BCBSMN Non-RVU base fee schedule,46.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0502,Not in chargemaster,Q0502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0502,BCBSMN Non-RVU base fee schedule,587.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0502 mod RR,Not in chargemaster,Q0502,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0502 mod RR,BCBSMN Non-RVU base fee schedule,58.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0503,Not in chargemaster,Q0503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0503,BCBSMN Non-RVU base fee schedule,1174.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0503 mod RR,Not in chargemaster,Q0503,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0503 mod RR,BCBSMN Non-RVU base fee schedule,117.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0504,Not in chargemaster,Q0504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0504,BCBSMN Non-RVU base fee schedule,619.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0504 mod RR,Not in chargemaster,Q0504,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0504 mod RR,BCBSMN Non-RVU base fee schedule,61.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0506,Not in chargemaster,Q0506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0506,BCBSMN Non-RVU base fee schedule,771.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0506 mod RR,Not in chargemaster,Q0506,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0506 mod RR,BCBSMN Non-RVU base fee schedule,77.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0508,Not in chargemaster,Q0508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0508,BCBSMN Non-RVU base fee schedule,63.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0508 mod RR,Not in chargemaster,Q0508,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0508 mod RR,BCBSMN Non-RVU base fee schedule,6.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0513,Not in chargemaster,Q0513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0513,BCBSMN Non-RVU base fee schedule,33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q0515,Not in chargemaster,Q0515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q0515,BCBSMN Non-RVU base fee schedule,1.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2004,Not in chargemaster,Q2004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2004,BCBSMN Non-RVU base fee schedule,97.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2009,Not in chargemaster,Q2009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2009,BCBSMN Non-RVU base fee schedule,7.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2017,Not in chargemaster,Q2017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2017,BCBSMN Non-RVU base fee schedule,2545.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2034,Not in chargemaster,Q2034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2034,BCBSMN Non-RVU base fee schedule,29.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2035,Not in chargemaster,Q2035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2035,BCBSMN Non-RVU base fee schedule,19.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2036,Not in chargemaster,Q2036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2036,BCBSMN Non-RVU base fee schedule,8.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2037,Not in chargemaster,Q2037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2037,BCBSMN Non-RVU base fee schedule,17.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2038,Not in chargemaster,Q2038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2038,BCBSMN Non-RVU base fee schedule,12.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2039,Not in chargemaster,Q2039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2039,BCBSMN Non-RVU base fee schedule,12.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2041,Not in chargemaster,Q2041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2041,BCBSMN Non-RVU base fee schedule,380460,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2042,Not in chargemaster,Q2042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2042,BCBSMN Non-RVU base fee schedule,380460,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2043,Not in chargemaster,Q2043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2043,BCBSMN Non-RVU base fee schedule,45942.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2049,Not in chargemaster,Q2049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2049,BCBSMN Non-RVU base fee schedule,494.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2050,Not in chargemaster,Q2050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2050,BCBSMN Non-RVU base fee schedule,295.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q2052,Not in chargemaster,Q2052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q2052,BCBSMN Non-RVU base fee schedule,43.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q3001,Not in chargemaster,Q3001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q3001,BCBSMN Non-RVU base fee schedule,28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q3014,Not in chargemaster,Q3014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q3014,BCBSMN Non-RVU base fee schedule,26.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q3027,Not in chargemaster,Q3027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q3027,BCBSMN Non-RVU base fee schedule,53.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q3028,Not in chargemaster,Q3028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q3028,BCBSMN Non-RVU base fee schedule,439.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q3031,Not in chargemaster,Q3031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q3031,BCBSMN Non-RVU base fee schedule,25.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4001,Not in chargemaster,Q4001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4001,BCBSMN Non-RVU base fee schedule,45.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4002,Not in chargemaster,Q4002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4002,BCBSMN Non-RVU base fee schedule,172.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4003,Not in chargemaster,Q4003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4003,BCBSMN Non-RVU base fee schedule,32.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4004,Not in chargemaster,Q4004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4004,BCBSMN Non-RVU base fee schedule,113.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4005,Not in chargemaster,Q4005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4005,BCBSMN Non-RVU base fee schedule,12.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4006,Not in chargemaster,Q4006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4006,BCBSMN Non-RVU base fee schedule,27.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4007,Not in chargemaster,Q4007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4007,BCBSMN Non-RVU base fee schedule,6.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4008,Not in chargemaster,Q4008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4008,BCBSMN Non-RVU base fee schedule,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4009,Not in chargemaster,Q4009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4009,BCBSMN Non-RVU base fee schedule,8.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4010,Not in chargemaster,Q4010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4010,BCBSMN Non-RVU base fee schedule,18.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4011,Not in chargemaster,Q4011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4011,BCBSMN Non-RVU base fee schedule,4.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4012,Not in chargemaster,Q4012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4012,BCBSMN Non-RVU base fee schedule,9.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4013,Not in chargemaster,Q4013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4013,BCBSMN Non-RVU base fee schedule,14.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4014,Not in chargemaster,Q4014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4014,BCBSMN Non-RVU base fee schedule,24.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4015,Not in chargemaster,Q4015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4015,BCBSMN Non-RVU base fee schedule,7.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4016,Not in chargemaster,Q4016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4016,BCBSMN Non-RVU base fee schedule,12.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4017,Not in chargemaster,Q4017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4017,BCBSMN Non-RVU base fee schedule,8.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4018,Not in chargemaster,Q4018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4018,BCBSMN Non-RVU base fee schedule,13.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4019,Not in chargemaster,Q4019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4019,BCBSMN Non-RVU base fee schedule,4.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4020,Not in chargemaster,Q4020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4020,BCBSMN Non-RVU base fee schedule,6.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4021,Not in chargemaster,Q4021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4021,BCBSMN Non-RVU base fee schedule,6.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4022,Not in chargemaster,Q4022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4022,BCBSMN Non-RVU base fee schedule,11.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4023,Not in chargemaster,Q4023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4023,BCBSMN Non-RVU base fee schedule,3.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4024,Not in chargemaster,Q4024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4024,BCBSMN Non-RVU base fee schedule,5.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4025,Not in chargemaster,Q4025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4025,BCBSMN Non-RVU base fee schedule,35.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4026,Not in chargemaster,Q4026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4026,BCBSMN Non-RVU base fee schedule,110.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4027,Not in chargemaster,Q4027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4027,BCBSMN Non-RVU base fee schedule,17.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4028,Not in chargemaster,Q4028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4028,BCBSMN Non-RVU base fee schedule,55.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4029,Not in chargemaster,Q4029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4029,BCBSMN Non-RVU base fee schedule,27.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4030,Not in chargemaster,Q4030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4030,BCBSMN Non-RVU base fee schedule,71.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4031,Not in chargemaster,Q4031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4031,BCBSMN Non-RVU base fee schedule,13.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4032,Not in chargemaster,Q4032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4032,BCBSMN Non-RVU base fee schedule,35.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4033,Not in chargemaster,Q4033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4033,BCBSMN Non-RVU base fee schedule,25.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4034,Not in chargemaster,Q4034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4034,BCBSMN Non-RVU base fee schedule,62.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4035,Not in chargemaster,Q4035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4035,BCBSMN Non-RVU base fee schedule,12.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4036,Not in chargemaster,Q4036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4036,BCBSMN Non-RVU base fee schedule,31.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4037,Not in chargemaster,Q4037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4037,BCBSMN Non-RVU base fee schedule,15.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4038,Not in chargemaster,Q4038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4038,BCBSMN Non-RVU base fee schedule,38.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4039,Not in chargemaster,Q4039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4039,BCBSMN Non-RVU base fee schedule,7.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4040,Not in chargemaster,Q4040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4040,BCBSMN Non-RVU base fee schedule,19.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4041,Not in chargemaster,Q4041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4041,BCBSMN Non-RVU base fee schedule,18.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4042,Not in chargemaster,Q4042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4042,BCBSMN Non-RVU base fee schedule,31.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4043,Not in chargemaster,Q4043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4043,BCBSMN Non-RVU base fee schedule,9.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4044,Not in chargemaster,Q4044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4044,BCBSMN Non-RVU base fee schedule,15.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4045,Not in chargemaster,Q4045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4045,BCBSMN Non-RVU base fee schedule,10.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4046,Not in chargemaster,Q4046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4046,BCBSMN Non-RVU base fee schedule,17.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4047,Not in chargemaster,Q4047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4047,BCBSMN Non-RVU base fee schedule,5.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4048,Not in chargemaster,Q4048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4048,BCBSMN Non-RVU base fee schedule,8.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4049,Not in chargemaster,Q4049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4049,BCBSMN Non-RVU base fee schedule,1.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4050,Not in chargemaster,Q4050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4050,BCBSMN Non-RVU base fee schedule,20.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4051,Not in chargemaster,Q4051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4051,BCBSMN Non-RVU base fee schedule,14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4074,Not in chargemaster,Q4074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4074,BCBSMN Non-RVU base fee schedule,139.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4081,Not in chargemaster,Q4081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4081,BCBSMN Non-RVU base fee schedule,1.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4101,Not in chargemaster,Q4101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4101,BCBSMN Non-RVU base fee schedule,30.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4102,Not in chargemaster,Q4102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4102,BCBSMN Non-RVU base fee schedule,11.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4103,Not in chargemaster,Q4103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4103,BCBSMN Non-RVU base fee schedule,9.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4104,Not in chargemaster,Q4104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4104,BCBSMN Non-RVU base fee schedule,32.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4105,Not in chargemaster,Q4105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4105,BCBSMN Non-RVU base fee schedule,21.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4106,Not in chargemaster,Q4106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4106,BCBSMN Non-RVU base fee schedule,32.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4107,Not in chargemaster,Q4107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4107,BCBSMN Non-RVU base fee schedule,86.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4108,Not in chargemaster,Q4108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4108,BCBSMN Non-RVU base fee schedule,35.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4110,Not in chargemaster,Q4110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4110,BCBSMN Non-RVU base fee schedule,44.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4111,Not in chargemaster,Q4111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4111,BCBSMN Non-RVU base fee schedule,7.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4112,Not in chargemaster,Q4112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4112,BCBSMN Non-RVU base fee schedule,758.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4113,Not in chargemaster,Q4113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4113,BCBSMN Non-RVU base fee schedule,758.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4114,Not in chargemaster,Q4114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4114,BCBSMN Non-RVU base fee schedule,1577.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4115,Not in chargemaster,Q4115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4115,BCBSMN Non-RVU base fee schedule,6.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4116,Not in chargemaster,Q4116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4116,BCBSMN Non-RVU base fee schedule,31.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4117,Not in chargemaster,Q4117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4117,BCBSMN Non-RVU base fee schedule,4.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4118,Not in chargemaster,Q4118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4118,BCBSMN Non-RVU base fee schedule,2.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4121,Not in chargemaster,Q4121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4121,BCBSMN Non-RVU base fee schedule,40.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4122,Not in chargemaster,Q4122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4122,BCBSMN Non-RVU base fee schedule,371.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4123,Not in chargemaster,Q4123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4123,BCBSMN Non-RVU base fee schedule,27.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4124,Not in chargemaster,Q4124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4124,BCBSMN Non-RVU base fee schedule,5.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4125,Not in chargemaster,Q4125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4125,BCBSMN Non-RVU base fee schedule,38.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4126,Not in chargemaster,Q4126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4126,BCBSMN Non-RVU base fee schedule,7.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4127,Not in chargemaster,Q4127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4127,BCBSMN Non-RVU base fee schedule,101.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4128,Not in chargemaster,Q4128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4128,BCBSMN Non-RVU base fee schedule,101.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4130,Not in chargemaster,Q4130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4130,BCBSMN Non-RVU base fee schedule,5.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4132,Not in chargemaster,Q4132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4132,BCBSMN Non-RVU base fee schedule,115.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4133,Not in chargemaster,Q4133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4133,BCBSMN Non-RVU base fee schedule,140.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4137,Not in chargemaster,Q4137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4137,BCBSMN Non-RVU base fee schedule,76.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4138,Not in chargemaster,Q4138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4138,BCBSMN Non-RVU base fee schedule,25.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4141,Not in chargemaster,Q4141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4141,BCBSMN Non-RVU base fee schedule,16.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4143,Not in chargemaster,Q4143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4143,BCBSMN Non-RVU base fee schedule,43.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4145,Not in chargemaster,Q4145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4145,BCBSMN Non-RVU base fee schedule,18.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4151,Not in chargemaster,Q4151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4151,BCBSMN Non-RVU base fee schedule,140.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4154,Not in chargemaster,Q4154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4154,BCBSMN Non-RVU base fee schedule,114.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4159,Not in chargemaster,Q4159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4159,BCBSMN Non-RVU base fee schedule,644.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4160,Not in chargemaster,Q4160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4160,BCBSMN Non-RVU base fee schedule,101.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4162,Not in chargemaster,Q4162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4162,BCBSMN Non-RVU base fee schedule,32.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4163,Not in chargemaster,Q4163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4163,BCBSMN Non-RVU base fee schedule,32.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4164,Not in chargemaster,Q4164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4164,BCBSMN Non-RVU base fee schedule,30.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4165,Not in chargemaster,Q4165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4165,BCBSMN Non-RVU base fee schedule,89.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4166,Not in chargemaster,Q4166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4166,BCBSMN Non-RVU base fee schedule,4.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4167,Not in chargemaster,Q4167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4167,BCBSMN Non-RVU base fee schedule,38.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4170,Not in chargemaster,Q4170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4170,BCBSMN Non-RVU base fee schedule,122.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4171,Not in chargemaster,Q4171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4171,BCBSMN Non-RVU base fee schedule,221.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4173,Not in chargemaster,Q4173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4173,BCBSMN Non-RVU base fee schedule,221.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4174,Not in chargemaster,Q4174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4174,BCBSMN Non-RVU base fee schedule,221.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4175,Not in chargemaster,Q4175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4175,BCBSMN Non-RVU base fee schedule,10.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4186,Not in chargemaster,Q4186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4186,BCBSMN Non-RVU base fee schedule,163.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4195,Not in chargemaster,Q4195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4195,BCBSMN Non-RVU base fee schedule,119.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q4196,Not in chargemaster,Q4196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q4196,BCBSMN Non-RVU base fee schedule,113.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5101,Not in chargemaster,Q5101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5101,BCBSMN Non-RVU base fee schedule,0.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5103,Not in chargemaster,Q5103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5103,BCBSMN Non-RVU base fee schedule,47.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5104,Not in chargemaster,Q5104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5104,BCBSMN Non-RVU base fee schedule,51.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5105,Not in chargemaster,Q5105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5105,BCBSMN Non-RVU base fee schedule,0.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5106,Not in chargemaster,Q5106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5106,BCBSMN Non-RVU base fee schedule,9.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5107,Not in chargemaster,Q5107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5107,BCBSMN Non-RVU base fee schedule,69.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5108,Not in chargemaster,Q5108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5108,BCBSMN Non-RVU base fee schedule,311.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5110,Not in chargemaster,Q5110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5110,BCBSMN Non-RVU base fee schedule,0.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5111,Not in chargemaster,Q5111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5111,BCBSMN Non-RVU base fee schedule,336.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5114,Not in chargemaster,Q5114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5114,BCBSMN Non-RVU base fee schedule,90.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5115,Not in chargemaster,Q5115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5115,BCBSMN Non-RVU base fee schedule,87.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5117,Not in chargemaster,Q5117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5117,BCBSMN Non-RVU base fee schedule,90.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5119,Not in chargemaster,Q5119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5119,BCBSMN Non-RVU base fee schedule,73.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q5120,Not in chargemaster,Q5120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q5120,BCBSMN Non-RVU base fee schedule,317.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9001,Not in chargemaster,Q9001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9001,BCBSMN Non-RVU base fee schedule,86.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9002,Not in chargemaster,Q9002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9002,BCBSMN Non-RVU base fee schedule,76.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9003,Not in chargemaster,Q9003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9003,BCBSMN Non-RVU base fee schedule,30.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9950,Not in chargemaster,Q9950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9950,BCBSMN Non-RVU base fee schedule,19.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9951,Not in chargemaster,Q9951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9951,BCBSMN Non-RVU base fee schedule,130.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9953,Not in chargemaster,Q9953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9953,BCBSMN Non-RVU base fee schedule,34.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9954,Not in chargemaster,Q9954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9954,BCBSMN Non-RVU base fee schedule,11.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9955,Not in chargemaster,Q9955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9955,BCBSMN Non-RVU base fee schedule,13.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9956,Not in chargemaster,Q9956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9956,BCBSMN Non-RVU base fee schedule,32.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9957,Not in chargemaster,Q9957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9957,BCBSMN Non-RVU base fee schedule,48.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9958,Not in chargemaster,Q9958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9958,BCBSMN Non-RVU base fee schedule,0.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9960,Not in chargemaster,Q9960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9960,BCBSMN Non-RVU base fee schedule,0.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9961,Not in chargemaster,Q9961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9961,BCBSMN Non-RVU base fee schedule,0.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9962,Not in chargemaster,Q9962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9962,BCBSMN Non-RVU base fee schedule,0.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9963,Not in chargemaster,Q9963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9963,BCBSMN Non-RVU base fee schedule,0.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9964,Not in chargemaster,Q9964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9964,BCBSMN Non-RVU base fee schedule,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9965,Not in chargemaster,Q9965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9965,BCBSMN Non-RVU base fee schedule,0.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9966,Not in chargemaster,Q9966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9966,BCBSMN Non-RVU base fee schedule,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9967,Not in chargemaster,Q9967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9967,BCBSMN Non-RVU base fee schedule,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9969,Not in chargemaster,Q9969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9969,BCBSMN Non-RVU base fee schedule,121.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9982,Not in chargemaster,Q9982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9982,BCBSMN Non-RVU base fee schedule,121.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9983,Not in chargemaster,Q9983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9983,BCBSMN Non-RVU base fee schedule,121.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9991,Not in chargemaster,Q9991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9991,BCBSMN Non-RVU base fee schedule,1672.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU Q9992,Not in chargemaster,Q9992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,Q9992,BCBSMN Non-RVU base fee schedule,1672.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU R0070,Not in chargemaster,R0070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,R0070,BCBSMN Non-RVU base fee schedule,59.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU R0075,Not in chargemaster,R0075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,R0075,BCBSMN Non-RVU base fee schedule,130.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU R0076,Not in chargemaster,R0076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,R0076,BCBSMN Non-RVU base fee schedule,39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0012,Not in chargemaster,S0012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0012,BCBSMN Non-RVU base fee schedule,81.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0014,Not in chargemaster,S0014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0014,BCBSMN Non-RVU base fee schedule,2.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0017,Not in chargemaster,S0017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0017,BCBSMN Non-RVU base fee schedule,9.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0020,Not in chargemaster,S0020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0020,BCBSMN Non-RVU base fee schedule,2.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0021,Not in chargemaster,S0021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0021,BCBSMN Non-RVU base fee schedule,14.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0023,Not in chargemaster,S0023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0023,BCBSMN Non-RVU base fee schedule,3.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0028,Not in chargemaster,S0028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0028,BCBSMN Non-RVU base fee schedule,0.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0030,Not in chargemaster,S0030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0030,BCBSMN Non-RVU base fee schedule,1.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0032,Not in chargemaster,S0032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0032,BCBSMN Non-RVU base fee schedule,31.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0034,Not in chargemaster,S0034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0034,BCBSMN Non-RVU base fee schedule,2.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0039,Not in chargemaster,S0039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0039,BCBSMN Non-RVU base fee schedule,12.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0040,Not in chargemaster,S0040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0040,BCBSMN Non-RVU base fee schedule,13.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0073,Not in chargemaster,S0073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0073,BCBSMN Non-RVU base fee schedule,14.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0074,Not in chargemaster,S0074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0074,BCBSMN Non-RVU base fee schedule,10.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0077,Not in chargemaster,S0077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0077,BCBSMN Non-RVU base fee schedule,0.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0078,Not in chargemaster,S0078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0078,BCBSMN Non-RVU base fee schedule,114.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0080,Not in chargemaster,S0080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0080,BCBSMN Non-RVU base fee schedule,161.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0081,Not in chargemaster,S0081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0081,BCBSMN Non-RVU base fee schedule,2.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0088,Not in chargemaster,S0088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0088,BCBSMN Non-RVU base fee schedule,17.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0090,Not in chargemaster,S0090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0090,BCBSMN Non-RVU base fee schedule,50.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0091,Not in chargemaster,S0091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0091,BCBSMN Non-RVU base fee schedule,50.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0092,Not in chargemaster,S0092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0092,BCBSMN Non-RVU base fee schedule,102.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0093,Not in chargemaster,S0093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0093,BCBSMN Non-RVU base fee schedule,4.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0104,Not in chargemaster,S0104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0104,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0106,Not in chargemaster,S0106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0106,BCBSMN Non-RVU base fee schedule,108.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0108,Not in chargemaster,S0108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0108,BCBSMN Non-RVU base fee schedule,5.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0109,Not in chargemaster,S0109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0109,BCBSMN Non-RVU base fee schedule,0.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0117,Not in chargemaster,S0117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0117,BCBSMN Non-RVU base fee schedule,10.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0119,Not in chargemaster,S0119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0119,BCBSMN Non-RVU base fee schedule,21.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0122,Not in chargemaster,S0122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0122,BCBSMN Non-RVU base fee schedule,48.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0126,Not in chargemaster,S0126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0126,BCBSMN Non-RVU base fee schedule,64.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0128,Not in chargemaster,S0128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0128,BCBSMN Non-RVU base fee schedule,186.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0136,Not in chargemaster,S0136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0136,BCBSMN Non-RVU base fee schedule,1.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0137,Not in chargemaster,S0137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0137,BCBSMN Non-RVU base fee schedule,0.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0138,Not in chargemaster,S0138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0138,BCBSMN Non-RVU base fee schedule,2.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0139,Not in chargemaster,S0139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0139,BCBSMN Non-RVU base fee schedule,1.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0140,Not in chargemaster,S0140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0140,BCBSMN Non-RVU base fee schedule,4.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0142,Not in chargemaster,S0142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0142,BCBSMN Non-RVU base fee schedule,0.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0145,Not in chargemaster,S0145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0145,BCBSMN Non-RVU base fee schedule,1041.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0148,Not in chargemaster,S0148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0148,BCBSMN Non-RVU base fee schedule,100.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0155,Not in chargemaster,S0155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0155,BCBSMN Non-RVU base fee schedule,14.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0156,Not in chargemaster,S0156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0156,BCBSMN Non-RVU base fee schedule,17.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0157,Not in chargemaster,S0157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0157,BCBSMN Non-RVU base fee schedule,29.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0160,Not in chargemaster,S0160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0160,BCBSMN Non-RVU base fee schedule,3.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0164,Not in chargemaster,S0164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0164,BCBSMN Non-RVU base fee schedule,5.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0166,Not in chargemaster,S0166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0166,BCBSMN Non-RVU base fee schedule,9.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0170,Not in chargemaster,S0170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0170,BCBSMN Non-RVU base fee schedule,11.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0171,Not in chargemaster,S0171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0171,BCBSMN Non-RVU base fee schedule,0.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0172,Not in chargemaster,S0172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0172,BCBSMN Non-RVU base fee schedule,24.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0174,Not in chargemaster,S0174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0174,BCBSMN Non-RVU base fee schedule,73.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0175,Not in chargemaster,S0175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0175,BCBSMN Non-RVU base fee schedule,1.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0176,Not in chargemaster,S0176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0176,BCBSMN Non-RVU base fee schedule,0.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0178,Not in chargemaster,S0178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0178,BCBSMN Non-RVU base fee schedule,92.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0179,Not in chargemaster,S0179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0179,BCBSMN Non-RVU base fee schedule,0.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0182,Not in chargemaster,S0182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0182,BCBSMN Non-RVU base fee schedule,101.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0183,Not in chargemaster,S0183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0183,BCBSMN Non-RVU base fee schedule,0.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0189,Not in chargemaster,S0189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0189,BCBSMN Non-RVU base fee schedule,107.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0190,Not in chargemaster,S0190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0190,BCBSMN Non-RVU base fee schedule,69.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0191,Not in chargemaster,S0191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0191,BCBSMN Non-RVU base fee schedule,1.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0194,Not in chargemaster,S0194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0194,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0199,Not in chargemaster,S0199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0199,BCBSMN Non-RVU base fee schedule,431.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0209,Not in chargemaster,S0209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0209,BCBSMN Non-RVU base fee schedule,1.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0215,Not in chargemaster,S0215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0215,BCBSMN Non-RVU base fee schedule,1.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0257,Not in chargemaster,S0257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0257,BCBSMN Non-RVU base fee schedule,29.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0265,Not in chargemaster,S0265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0265,BCBSMN Non-RVU base fee schedule,49.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0273,Not in chargemaster,S0273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0273,BCBSMN Non-RVU base fee schedule,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0274,Not in chargemaster,S0274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0274,BCBSMN Non-RVU base fee schedule,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0280,Not in chargemaster,S0280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0280,BCBSMN Non-RVU base fee schedule,10.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0281,Not in chargemaster,S0281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0281,BCBSMN Non-RVU base fee schedule,10.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0285,Not in chargemaster,S0285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0285,BCBSMN Non-RVU base fee schedule,79.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0302,Not in chargemaster,S0302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0302,BCBSMN Non-RVU base fee schedule,20,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0311,Not in chargemaster,S0311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0311,BCBSMN Non-RVU base fee schedule,67.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0390,Not in chargemaster,S0390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0390,BCBSMN Non-RVU base fee schedule,52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0395,Not in chargemaster,S0395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0395,BCBSMN Non-RVU base fee schedule,15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0500,Not in chargemaster,S0500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0500,BCBSMN Non-RVU base fee schedule,8.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0504,Not in chargemaster,S0504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0504,BCBSMN Non-RVU base fee schedule,29.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0516,Not in chargemaster,S0516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0516,BCBSMN Non-RVU base fee schedule,32.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0518,Not in chargemaster,S0518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0518,BCBSMN Non-RVU base fee schedule,33.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0580,Not in chargemaster,S0580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0580,BCBSMN Non-RVU base fee schedule,5.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0595,Not in chargemaster,S0595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0595,BCBSMN Non-RVU base fee schedule,5.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0601,Not in chargemaster,S0601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0601,BCBSMN Non-RVU base fee schedule,135.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0610,Not in chargemaster,S0610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0610,BCBSMN Non-RVU base fee schedule,48.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0612,Not in chargemaster,S0612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0612,BCBSMN Non-RVU base fee schedule,65.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0613,Not in chargemaster,S0613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0613,BCBSMN Non-RVU base fee schedule,50.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0618,Not in chargemaster,S0618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0618,BCBSMN Non-RVU base fee schedule,24.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0620,Not in chargemaster,S0620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0620,BCBSMN Non-RVU base fee schedule,44.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0621,Not in chargemaster,S0621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0621,BCBSMN Non-RVU base fee schedule,46.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0630,Not in chargemaster,S0630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0630,BCBSMN Non-RVU base fee schedule,53.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0800,Not in chargemaster,S0800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0800,BCBSMN Non-RVU base fee schedule,1231.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0810,Not in chargemaster,S0810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0810,BCBSMN Non-RVU base fee schedule,999.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S0812,Not in chargemaster,S0812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S0812,BCBSMN Non-RVU base fee schedule,1029.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S1016,Not in chargemaster,S1016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S1016,BCBSMN Non-RVU base fee schedule,10.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S1035,Not in chargemaster,S1035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S1035,BCBSMN Non-RVU base fee schedule,8.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S1035 mod RR,Not in chargemaster,S1035,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S1035 mod RR,BCBSMN Non-RVU base fee schedule,0.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S1036,Not in chargemaster,S1036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S1036,BCBSMN Non-RVU base fee schedule,448.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S1037,Not in chargemaster,S1037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S1037,BCBSMN Non-RVU base fee schedule,418,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S1040,Not in chargemaster,S1040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S1040,BCBSMN Non-RVU base fee schedule,2800,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2066,Not in chargemaster,S2066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2066,BCBSMN Non-RVU base fee schedule,5009.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2067,Not in chargemaster,S2067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2067,BCBSMN Non-RVU base fee schedule,5009.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2068,Not in chargemaster,S2068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2068,BCBSMN Non-RVU base fee schedule,5110.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2070,Not in chargemaster,S2070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2070,BCBSMN Non-RVU base fee schedule,546.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2079,Not in chargemaster,S2079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2079,BCBSMN Non-RVU base fee schedule,1355.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2083,Not in chargemaster,S2083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2083,BCBSMN Non-RVU base fee schedule,131.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2095,Not in chargemaster,S2095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2095,BCBSMN Non-RVU base fee schedule,1207.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2118,Not in chargemaster,S2118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2118,BCBSMN Non-RVU base fee schedule,1355.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2225,Not in chargemaster,S2225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2225,BCBSMN Non-RVU base fee schedule,213.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2325,Not in chargemaster,S2325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2325,BCBSMN Non-RVU base fee schedule,1670.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2342,Not in chargemaster,S2342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2342,BCBSMN Non-RVU base fee schedule,407.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2348,Not in chargemaster,S2348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2348,BCBSMN Non-RVU base fee schedule,723.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2404,Not in chargemaster,S2404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2404,BCBSMN Non-RVU base fee schedule,2152.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2411,Not in chargemaster,S2411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2411,BCBSMN Non-RVU base fee schedule,2990.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S2900,Not in chargemaster,S2900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S2900,BCBSMN Non-RVU base fee schedule,512.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S3000,Not in chargemaster,S3000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S3000,BCBSMN Non-RVU base fee schedule,29.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S3620,Not in chargemaster,S3620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S3620,BCBSMN Non-RVU base fee schedule,150,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S3655,Not in chargemaster,S3655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S3655,BCBSMN Non-RVU base fee schedule,6.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S3722,Not in chargemaster,S3722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S3722,BCBSMN Non-RVU base fee schedule,3371.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S3854,Not in chargemaster,S3854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S3854,BCBSMN Non-RVU base fee schedule,4186.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4013,Not in chargemaster,S4013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4013,BCBSMN Non-RVU base fee schedule,299.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4014,Not in chargemaster,S4014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4014,BCBSMN Non-RVU base fee schedule,299.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4017,Not in chargemaster,S4017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4017,BCBSMN Non-RVU base fee schedule,299.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4026,Not in chargemaster,S4026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4026,BCBSMN Non-RVU base fee schedule,992.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4035,Not in chargemaster,S4035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4035,BCBSMN Non-RVU base fee schedule,103.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4042,Not in chargemaster,S4042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4042,BCBSMN Non-RVU base fee schedule,142,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4981,Not in chargemaster,S4981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4981,BCBSMN Non-RVU base fee schedule,112.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4989,Not in chargemaster,S4989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4989,BCBSMN Non-RVU base fee schedule,406.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S4993,Not in chargemaster,S4993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S4993,BCBSMN Non-RVU base fee schedule,28.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5000,Not in chargemaster,S5000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5000,BCBSMN Non-RVU base fee schedule,31.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5010,Not in chargemaster,S5010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5010,BCBSMN Non-RVU base fee schedule,5.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5012,Not in chargemaster,S5012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5012,BCBSMN Non-RVU base fee schedule,2.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5013,Not in chargemaster,S5013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5013,BCBSMN Non-RVU base fee schedule,980.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5190,Not in chargemaster,S5190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5190,BCBSMN Non-RVU base fee schedule,30.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5497,Not in chargemaster,S5497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5497,BCBSMN Non-RVU base fee schedule,6.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5498,Not in chargemaster,S5498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5498,BCBSMN Non-RVU base fee schedule,6.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5501,Not in chargemaster,S5501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5501,BCBSMN Non-RVU base fee schedule,6.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5502,Not in chargemaster,S5502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5502,BCBSMN Non-RVU base fee schedule,6.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5517,Not in chargemaster,S5517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5517,BCBSMN Non-RVU base fee schedule,6.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5518,Not in chargemaster,S5518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5518,BCBSMN Non-RVU base fee schedule,6.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5520,Not in chargemaster,S5520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5520,BCBSMN Non-RVU base fee schedule,36.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5521,Not in chargemaster,S5521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5521,BCBSMN Non-RVU base fee schedule,36.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5522,Not in chargemaster,S5522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5522,BCBSMN Non-RVU base fee schedule,43.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5523,Not in chargemaster,S5523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5523,BCBSMN Non-RVU base fee schedule,43.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5550,Not in chargemaster,S5550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5550,BCBSMN Non-RVU base fee schedule,0.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5551,Not in chargemaster,S5551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5551,BCBSMN Non-RVU base fee schedule,1.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5552,Not in chargemaster,S5552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5552,BCBSMN Non-RVU base fee schedule,0.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S5553,Not in chargemaster,S5553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S5553,BCBSMN Non-RVU base fee schedule,1.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8085,Not in chargemaster,S8085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8085,BCBSMN Non-RVU base fee schedule,295.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8092,Not in chargemaster,S8092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8092,BCBSMN Non-RVU base fee schedule,217.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8100,Not in chargemaster,S8100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8100,BCBSMN Non-RVU base fee schedule,17.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8101,Not in chargemaster,S8101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8101,BCBSMN Non-RVU base fee schedule,30.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8110,Not in chargemaster,S8110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8110,BCBSMN Non-RVU base fee schedule,7.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8120,Not in chargemaster,S8120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8120,BCBSMN Non-RVU base fee schedule,1.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8121,Not in chargemaster,S8121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8121,BCBSMN Non-RVU base fee schedule,1.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8130,Not in chargemaster,S8130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8130,BCBSMN Non-RVU base fee schedule,299.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8130 mod RR,Not in chargemaster,S8130,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8130 mod RR,BCBSMN Non-RVU base fee schedule,29.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8131,Not in chargemaster,S8131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8131,BCBSMN Non-RVU base fee schedule,336.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8131 mod RR,Not in chargemaster,S8131,RR,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8131 mod RR,BCBSMN Non-RVU base fee schedule,33.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8185,Not in chargemaster,S8185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8185,BCBSMN Non-RVU base fee schedule,61.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8186,Not in chargemaster,S8186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8186,BCBSMN Non-RVU base fee schedule,2.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8189,Not in chargemaster,S8189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8189,BCBSMN Non-RVU base fee schedule,1.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8210,Not in chargemaster,S8210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8210,BCBSMN Non-RVU base fee schedule,1.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8265,Not in chargemaster,S8265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8265,BCBSMN Non-RVU base fee schedule,19.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8421,Not in chargemaster,S8421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8421,BCBSMN Non-RVU base fee schedule,101.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8422,Not in chargemaster,S8422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8422,BCBSMN Non-RVU base fee schedule,170.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8423,Not in chargemaster,S8423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8423,BCBSMN Non-RVU base fee schedule,150.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8424,Not in chargemaster,S8424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8424,BCBSMN Non-RVU base fee schedule,60.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8426,Not in chargemaster,S8426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8426,BCBSMN Non-RVU base fee schedule,249.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8427,Not in chargemaster,S8427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8427,BCBSMN Non-RVU base fee schedule,58.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8428,Not in chargemaster,S8428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8428,BCBSMN Non-RVU base fee schedule,56.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8429,Not in chargemaster,S8429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8429,BCBSMN Non-RVU base fee schedule,46.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8430,Not in chargemaster,S8430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8430,BCBSMN Non-RVU base fee schedule,1.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8431,Not in chargemaster,S8431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8431,BCBSMN Non-RVU base fee schedule,2.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8450,Not in chargemaster,S8450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8450,BCBSMN Non-RVU base fee schedule,2.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8451,Not in chargemaster,S8451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8451,BCBSMN Non-RVU base fee schedule,12.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8452,Not in chargemaster,S8452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8452,BCBSMN Non-RVU base fee schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8490,Not in chargemaster,S8490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8490,BCBSMN Non-RVU base fee schedule,26.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8948,Not in chargemaster,S8948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8948,BCBSMN Non-RVU base fee schedule,6.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8990,Not in chargemaster,S8990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8990,BCBSMN Non-RVU base fee schedule,21.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S8999,Not in chargemaster,S8999,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S8999,BCBSMN Non-RVU base fee schedule,50.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9001,Not in chargemaster,S9001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9001,BCBSMN Non-RVU base fee schedule,74.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9034,Not in chargemaster,S9034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9034,BCBSMN Non-RVU base fee schedule,663.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9061,Not in chargemaster,S9061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9061,BCBSMN Non-RVU base fee schedule,95.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9088,Not in chargemaster,S9088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9088,BCBSMN Non-RVU base fee schedule,10.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9090,Not in chargemaster,S9090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9090,BCBSMN Non-RVU base fee schedule,51.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9110,Not in chargemaster,S9110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9110,BCBSMN Non-RVU base fee schedule,39.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9122,Not in chargemaster,S9122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9122,BCBSMN Non-RVU base fee schedule,10.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9123,Not in chargemaster,S9123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9123,BCBSMN Non-RVU base fee schedule,61.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9128,Not in chargemaster,S9128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9128,BCBSMN Non-RVU base fee schedule,67.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9129,Not in chargemaster,S9129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9129,BCBSMN Non-RVU base fee schedule,79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9131,Not in chargemaster,S9131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9131,BCBSMN Non-RVU base fee schedule,77.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9140,Not in chargemaster,S9140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9140,BCBSMN Non-RVU base fee schedule,23.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9141,Not in chargemaster,S9141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9141,BCBSMN Non-RVU base fee schedule,23.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9152,Not in chargemaster,S9152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9152,BCBSMN Non-RVU base fee schedule,95.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9208,Not in chargemaster,S9208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9208,BCBSMN Non-RVU base fee schedule,25.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9209,Not in chargemaster,S9209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9209,BCBSMN Non-RVU base fee schedule,125.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9325,Not in chargemaster,S9325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9325,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9326,Not in chargemaster,S9326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9326,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9327,Not in chargemaster,S9327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9327,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9328,Not in chargemaster,S9328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9328,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9329,Not in chargemaster,S9329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9329,BCBSMN Non-RVU base fee schedule,110.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9330,Not in chargemaster,S9330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9330,BCBSMN Non-RVU base fee schedule,110.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9331,Not in chargemaster,S9331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9331,BCBSMN Non-RVU base fee schedule,110.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9336,Not in chargemaster,S9336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9336,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9338,Not in chargemaster,S9338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9338,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9339,Not in chargemaster,S9339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9339,BCBSMN Non-RVU base fee schedule,6.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9340,Not in chargemaster,S9340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9340,BCBSMN Non-RVU base fee schedule,44.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9341,Not in chargemaster,S9341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9341,BCBSMN Non-RVU base fee schedule,8.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9342,Not in chargemaster,S9342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9342,BCBSMN Non-RVU base fee schedule,16.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9343,Not in chargemaster,S9343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9343,BCBSMN Non-RVU base fee schedule,11.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9345,Not in chargemaster,S9345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9345,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9346,Not in chargemaster,S9346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9346,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9347,Not in chargemaster,S9347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9347,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9348,Not in chargemaster,S9348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9348,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9349,Not in chargemaster,S9349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9349,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9351,Not in chargemaster,S9351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9351,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9353,Not in chargemaster,S9353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9353,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9355,Not in chargemaster,S9355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9355,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9357,Not in chargemaster,S9357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9357,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9359,Not in chargemaster,S9359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9359,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9361,Not in chargemaster,S9361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9361,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9363,Not in chargemaster,S9363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9363,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9364,Not in chargemaster,S9364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9364,BCBSMN Non-RVU base fee schedule,141.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9365,Not in chargemaster,S9365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9365,BCBSMN Non-RVU base fee schedule,141.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9366,Not in chargemaster,S9366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9366,BCBSMN Non-RVU base fee schedule,154.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9367,Not in chargemaster,S9367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9367,BCBSMN Non-RVU base fee schedule,154.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9368,Not in chargemaster,S9368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9368,BCBSMN Non-RVU base fee schedule,154.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9370,Not in chargemaster,S9370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9370,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9372,Not in chargemaster,S9372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9372,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9373,Not in chargemaster,S9373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9373,BCBSMN Non-RVU base fee schedule,99.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9374,Not in chargemaster,S9374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9374,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9375,Not in chargemaster,S9375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9375,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9376,Not in chargemaster,S9376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9376,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9377,Not in chargemaster,S9377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9377,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9379,Not in chargemaster,S9379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9379,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9401,Not in chargemaster,S9401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9401,BCBSMN Non-RVU base fee schedule,29.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9435,Not in chargemaster,S9435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9435,BCBSMN Non-RVU base fee schedule,525,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9442,Not in chargemaster,S9442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9442,BCBSMN Non-RVU base fee schedule,31.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9443,Not in chargemaster,S9443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9443,BCBSMN Non-RVU base fee schedule,15.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9445,Not in chargemaster,S9445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9445,BCBSMN Non-RVU base fee schedule,29.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9446,Not in chargemaster,S9446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9446,BCBSMN Non-RVU base fee schedule,36.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9447,Not in chargemaster,S9447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9447,BCBSMN Non-RVU base fee schedule,22.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9449,Not in chargemaster,S9449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9449,BCBSMN Non-RVU base fee schedule,9.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9452,Not in chargemaster,S9452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9452,BCBSMN Non-RVU base fee schedule,22.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9453,Not in chargemaster,S9453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9453,BCBSMN Non-RVU base fee schedule,22.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9454,Not in chargemaster,S9454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9454,BCBSMN Non-RVU base fee schedule,22.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9455,Not in chargemaster,S9455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9455,BCBSMN Non-RVU base fee schedule,9.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9460,Not in chargemaster,S9460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9460,BCBSMN Non-RVU base fee schedule,30.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9465,Not in chargemaster,S9465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9465,BCBSMN Non-RVU base fee schedule,0.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9470,Not in chargemaster,S9470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9470,BCBSMN Non-RVU base fee schedule,80.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9476,Not in chargemaster,S9476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9476,BCBSMN Non-RVU base fee schedule,221.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9480,Not in chargemaster,S9480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9480,BCBSMN Non-RVU base fee schedule,139.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9484,Not in chargemaster,S9484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9484,BCBSMN Non-RVU base fee schedule,156.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9485,Not in chargemaster,S9485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9485,BCBSMN Non-RVU base fee schedule,245.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9490,Not in chargemaster,S9490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9490,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9494,Not in chargemaster,S9494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9494,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9497,Not in chargemaster,S9497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9497,BCBSMN Non-RVU base fee schedule,130.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9500,Not in chargemaster,S9500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9500,BCBSMN Non-RVU base fee schedule,135.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9501,Not in chargemaster,S9501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9501,BCBSMN Non-RVU base fee schedule,146.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9502,Not in chargemaster,S9502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9502,BCBSMN Non-RVU base fee schedule,152.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9503,Not in chargemaster,S9503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9503,BCBSMN Non-RVU base fee schedule,124.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9504,Not in chargemaster,S9504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9504,BCBSMN Non-RVU base fee schedule,130.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9537,Not in chargemaster,S9537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9537,BCBSMN Non-RVU base fee schedule,95.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9538,Not in chargemaster,S9538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9538,BCBSMN Non-RVU base fee schedule,90.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9542,Not in chargemaster,S9542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9542,BCBSMN Non-RVU base fee schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9558,Not in chargemaster,S9558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9558,BCBSMN Non-RVU base fee schedule,95.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9559,Not in chargemaster,S9559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9559,BCBSMN Non-RVU base fee schedule,95.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9560,Not in chargemaster,S9560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9560,BCBSMN Non-RVU base fee schedule,95.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9562,Not in chargemaster,S9562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9562,BCBSMN Non-RVU base fee schedule,95.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9590,Not in chargemaster,S9590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9590,BCBSMN Non-RVU base fee schedule,95.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9810,Not in chargemaster,S9810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9810,BCBSMN Non-RVU base fee schedule,62.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9900,Not in chargemaster,S9900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9900,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9901,Not in chargemaster,S9901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9901,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9960,Not in chargemaster,S9960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9960,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9961,Not in chargemaster,S9961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9961,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9982,Not in chargemaster,S9982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9982,BCBSMN Non-RVU base fee schedule,0.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU S9986,Not in chargemaster,S9986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,S9986,BCBSMN Non-RVU base fee schedule,779.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T1002,Not in chargemaster,T1002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T1002,BCBSMN Non-RVU base fee schedule,8.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T1013,Not in chargemaster,T1013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T1013,BCBSMN Non-RVU base fee schedule,12.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T1015,Not in chargemaster,T1015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T1015,BCBSMN Non-RVU base fee schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T1016,Not in chargemaster,T1016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T1016,BCBSMN Non-RVU base fee schedule,12.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T1017,Not in chargemaster,T1017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T1017,BCBSMN Non-RVU base fee schedule,30.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T1019,Not in chargemaster,T1019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T1019,BCBSMN Non-RVU base fee schedule,3.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T1030,Not in chargemaster,T1030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T1030,BCBSMN Non-RVU base fee schedule,75.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T2001,Not in chargemaster,T2001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T2001,BCBSMN Non-RVU base fee schedule,9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T2003,Not in chargemaster,T2003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T2003,BCBSMN Non-RVU base fee schedule,11.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T2005,Not in chargemaster,T2005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T2005,BCBSMN Non-RVU base fee schedule,60,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T2015,Not in chargemaster,T2015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T2015,BCBSMN Non-RVU base fee schedule,69.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T2022,Not in chargemaster,T2022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T2022,BCBSMN Non-RVU base fee schedule,102,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T2047,Not in chargemaster,T2047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T2047,BCBSMN Non-RVU base fee schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T2049,Not in chargemaster,T2049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T2049,BCBSMN Non-RVU base fee schedule,2.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4521,Not in chargemaster,T4521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4521,BCBSMN Non-RVU base fee schedule,0.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4522,Not in chargemaster,T4522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4522,BCBSMN Non-RVU base fee schedule,0.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4523,Not in chargemaster,T4523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4523,BCBSMN Non-RVU base fee schedule,1.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4524,Not in chargemaster,T4524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4524,BCBSMN Non-RVU base fee schedule,1.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4525,Not in chargemaster,T4525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4525,BCBSMN Non-RVU base fee schedule,0.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4526,Not in chargemaster,T4526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4526,BCBSMN Non-RVU base fee schedule,1.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4527,Not in chargemaster,T4527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4527,BCBSMN Non-RVU base fee schedule,1.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4528,Not in chargemaster,T4528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4528,BCBSMN Non-RVU base fee schedule,1.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4529,Not in chargemaster,T4529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4529,BCBSMN Non-RVU base fee schedule,0.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4530,Not in chargemaster,T4530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4530,BCBSMN Non-RVU base fee schedule,0.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4531,Not in chargemaster,T4531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4531,BCBSMN Non-RVU base fee schedule,0.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4532,Not in chargemaster,T4532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4532,BCBSMN Non-RVU base fee schedule,0.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4533,Not in chargemaster,T4533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4533,BCBSMN Non-RVU base fee schedule,0.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4534,Not in chargemaster,T4534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4534,BCBSMN Non-RVU base fee schedule,0.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4535,Not in chargemaster,T4535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4535,BCBSMN Non-RVU base fee schedule,0.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4538,Not in chargemaster,T4538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4538,BCBSMN Non-RVU base fee schedule,0.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4540,Not in chargemaster,T4540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4540,BCBSMN Non-RVU base fee schedule,1.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4541,Not in chargemaster,T4541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4541,BCBSMN Non-RVU base fee schedule,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4542,Not in chargemaster,T4542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4542,BCBSMN Non-RVU base fee schedule,0.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4543,Not in chargemaster,T4543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4543,BCBSMN Non-RVU base fee schedule,2.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4544,Not in chargemaster,T4544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4544,BCBSMN Non-RVU base fee schedule,1.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU T4545,Not in chargemaster,T4545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,T4545,BCBSMN Non-RVU base fee schedule,0.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU U0001,Not in chargemaster,U0001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,U0001,BCBSMN Non-RVU base fee schedule,35.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU U0002,Not in chargemaster,U0002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,U0002,BCBSMN Non-RVU base fee schedule,51.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU U0003,Not in chargemaster,U0003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,U0003,BCBSMN Non-RVU base fee schedule,100,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU U0004,Not in chargemaster,U0004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,U0004,BCBSMN Non-RVU base fee schedule,100,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2020,Not in chargemaster,V2020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2020,BCBSMN Non-RVU base fee schedule,130,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2025,Not in chargemaster,V2025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2025,BCBSMN Non-RVU base fee schedule,30.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2100,Not in chargemaster,V2100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2100,BCBSMN Non-RVU base fee schedule,41.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2101,Not in chargemaster,V2101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2101,BCBSMN Non-RVU base fee schedule,40.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2102,Not in chargemaster,V2102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2102,BCBSMN Non-RVU base fee schedule,69.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2103,Not in chargemaster,V2103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2103,BCBSMN Non-RVU base fee schedule,35.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2104,Not in chargemaster,V2104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2104,BCBSMN Non-RVU base fee schedule,36.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2105,Not in chargemaster,V2105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2105,BCBSMN Non-RVU base fee schedule,43.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2106,Not in chargemaster,V2106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2106,BCBSMN Non-RVU base fee schedule,47.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2107,Not in chargemaster,V2107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2107,BCBSMN Non-RVU base fee schedule,42.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2108,Not in chargemaster,V2108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2108,BCBSMN Non-RVU base fee schedule,42.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2109,Not in chargemaster,V2109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2109,BCBSMN Non-RVU base fee schedule,59.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2110,Not in chargemaster,V2110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2110,BCBSMN Non-RVU base fee schedule,47.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2111,Not in chargemaster,V2111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2111,BCBSMN Non-RVU base fee schedule,58.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2112,Not in chargemaster,V2112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2112,BCBSMN Non-RVU base fee schedule,65.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2113,Not in chargemaster,V2113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2113,BCBSMN Non-RVU base fee schedule,66.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2114,Not in chargemaster,V2114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2114,BCBSMN Non-RVU base fee schedule,78.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2115,Not in chargemaster,V2115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2115,BCBSMN Non-RVU base fee schedule,79.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2118,Not in chargemaster,V2118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2118,BCBSMN Non-RVU base fee schedule,86.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2121,Not in chargemaster,V2121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2121,BCBSMN Non-RVU base fee schedule,77.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2199,Not in chargemaster,V2199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2199,BCBSMN Non-RVU base fee schedule,40.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2200,Not in chargemaster,V2200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2200,BCBSMN Non-RVU base fee schedule,47.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2201,Not in chargemaster,V2201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2201,BCBSMN Non-RVU base fee schedule,50.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2202,Not in chargemaster,V2202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2202,BCBSMN Non-RVU base fee schedule,62.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2203,Not in chargemaster,V2203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2203,BCBSMN Non-RVU base fee schedule,48.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2204,Not in chargemaster,V2204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2204,BCBSMN Non-RVU base fee schedule,49.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2205,Not in chargemaster,V2205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2205,BCBSMN Non-RVU base fee schedule,55.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2206,Not in chargemaster,V2206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2206,BCBSMN Non-RVU base fee schedule,64.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2207,Not in chargemaster,V2207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2207,BCBSMN Non-RVU base fee schedule,54.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2208,Not in chargemaster,V2208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2208,BCBSMN Non-RVU base fee schedule,53.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2209,Not in chargemaster,V2209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2209,BCBSMN Non-RVU base fee schedule,63.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2210,Not in chargemaster,V2210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2210,BCBSMN Non-RVU base fee schedule,68.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2211,Not in chargemaster,V2211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2211,BCBSMN Non-RVU base fee schedule,66.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2212,Not in chargemaster,V2212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2212,BCBSMN Non-RVU base fee schedule,69.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2213,Not in chargemaster,V2213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2213,BCBSMN Non-RVU base fee schedule,73.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2214,Not in chargemaster,V2214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2214,BCBSMN Non-RVU base fee schedule,76.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2215,Not in chargemaster,V2215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2215,BCBSMN Non-RVU base fee schedule,95.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2218,Not in chargemaster,V2218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2218,BCBSMN Non-RVU base fee schedule,97.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2219,Not in chargemaster,V2219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2219,BCBSMN Non-RVU base fee schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2220,Not in chargemaster,V2220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2220,BCBSMN Non-RVU base fee schedule,39.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2221,Not in chargemaster,V2221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2221,BCBSMN Non-RVU base fee schedule,79.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2299,Not in chargemaster,V2299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2299,BCBSMN Non-RVU base fee schedule,21.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2300,Not in chargemaster,V2300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2300,BCBSMN Non-RVU base fee schedule,64.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2301,Not in chargemaster,V2301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2301,BCBSMN Non-RVU base fee schedule,78.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2302,Not in chargemaster,V2302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2302,BCBSMN Non-RVU base fee schedule,73.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2303,Not in chargemaster,V2303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2303,BCBSMN Non-RVU base fee schedule,61.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2304,Not in chargemaster,V2304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2304,BCBSMN Non-RVU base fee schedule,62.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2305,Not in chargemaster,V2305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2305,BCBSMN Non-RVU base fee schedule,69.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2306,Not in chargemaster,V2306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2306,BCBSMN Non-RVU base fee schedule,72.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2307,Not in chargemaster,V2307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2307,BCBSMN Non-RVU base fee schedule,68.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2308,Not in chargemaster,V2308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2308,BCBSMN Non-RVU base fee schedule,74.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2309,Not in chargemaster,V2309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2309,BCBSMN Non-RVU base fee schedule,78.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2310,Not in chargemaster,V2310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2310,BCBSMN Non-RVU base fee schedule,81.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2311,Not in chargemaster,V2311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2311,BCBSMN Non-RVU base fee schedule,94.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2312,Not in chargemaster,V2312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2312,BCBSMN Non-RVU base fee schedule,86.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2313,Not in chargemaster,V2313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2313,BCBSMN Non-RVU base fee schedule,94.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2314,Not in chargemaster,V2314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2314,BCBSMN Non-RVU base fee schedule,96.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2315,Not in chargemaster,V2315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2315,BCBSMN Non-RVU base fee schedule,107.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2318,Not in chargemaster,V2318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2318,BCBSMN Non-RVU base fee schedule,131.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2319,Not in chargemaster,V2319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2319,BCBSMN Non-RVU base fee schedule,59.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2320,Not in chargemaster,V2320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2320,BCBSMN Non-RVU base fee schedule,62.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2321,Not in chargemaster,V2321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2321,BCBSMN Non-RVU base fee schedule,105.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2399,Not in chargemaster,V2399,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2399,BCBSMN Non-RVU base fee schedule,22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2410,Not in chargemaster,V2410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2410,BCBSMN Non-RVU base fee schedule,92.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2430,Not in chargemaster,V2430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2430,BCBSMN Non-RVU base fee schedule,97.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2499,Not in chargemaster,V2499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2499,BCBSMN Non-RVU base fee schedule,1.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2500,Not in chargemaster,V2500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2500,BCBSMN Non-RVU base fee schedule,82.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2501,Not in chargemaster,V2501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2501,BCBSMN Non-RVU base fee schedule,117.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2502,Not in chargemaster,V2502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2502,BCBSMN Non-RVU base fee schedule,158.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2503,Not in chargemaster,V2503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2503,BCBSMN Non-RVU base fee schedule,153.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2510,Not in chargemaster,V2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2510,BCBSMN Non-RVU base fee schedule,110.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2511,Not in chargemaster,V2511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2511,BCBSMN Non-RVU base fee schedule,163.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2512,Not in chargemaster,V2512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2512,BCBSMN Non-RVU base fee schedule,188,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2513,Not in chargemaster,V2513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2513,BCBSMN Non-RVU base fee schedule,189.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2520,Not in chargemaster,V2520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2520,BCBSMN Non-RVU base fee schedule,109.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2521,Not in chargemaster,V2521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2521,BCBSMN Non-RVU base fee schedule,217.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2522,Not in chargemaster,V2522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2522,BCBSMN Non-RVU base fee schedule,159.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2523,Not in chargemaster,V2523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2523,BCBSMN Non-RVU base fee schedule,167.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2530,Not in chargemaster,V2530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2530,BCBSMN Non-RVU base fee schedule,267.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2531,Not in chargemaster,V2531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2531,BCBSMN Non-RVU base fee schedule,489.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2599,Not in chargemaster,V2599,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2599,BCBSMN Non-RVU base fee schedule,33.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2623,Not in chargemaster,V2623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2623,BCBSMN Non-RVU base fee schedule,1280,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2624,Not in chargemaster,V2624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2624,BCBSMN Non-RVU base fee schedule,52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2625,Not in chargemaster,V2625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2625,BCBSMN Non-RVU base fee schedule,427.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2626,Not in chargemaster,V2626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2626,BCBSMN Non-RVU base fee schedule,230.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2627,Not in chargemaster,V2627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2627,BCBSMN Non-RVU base fee schedule,1430.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2628,Not in chargemaster,V2628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2628,BCBSMN Non-RVU base fee schedule,351.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2630,Not in chargemaster,V2630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2630,BCBSMN Non-RVU base fee schedule,106.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2631,Not in chargemaster,V2631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2631,BCBSMN Non-RVU base fee schedule,106.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2632,Not in chargemaster,V2632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2632,BCBSMN Non-RVU base fee schedule,106.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2700,Not in chargemaster,V2700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2700,BCBSMN Non-RVU base fee schedule,40.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2702,Not in chargemaster,V2702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2702,BCBSMN Non-RVU base fee schedule,14.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2710,Not in chargemaster,V2710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2710,BCBSMN Non-RVU base fee schedule,66.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2715,Not in chargemaster,V2715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2715,BCBSMN Non-RVU base fee schedule,12.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2718,Not in chargemaster,V2718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2718,BCBSMN Non-RVU base fee schedule,27.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2730,Not in chargemaster,V2730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2730,BCBSMN Non-RVU base fee schedule,23.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2744,Not in chargemaster,V2744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2744,BCBSMN Non-RVU base fee schedule,16.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2745,Not in chargemaster,V2745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2745,BCBSMN Non-RVU base fee schedule,9.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2750,Not in chargemaster,V2750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2750,BCBSMN Non-RVU base fee schedule,17.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2755,Not in chargemaster,V2755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2755,BCBSMN Non-RVU base fee schedule,15.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2756,Not in chargemaster,V2756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2756,BCBSMN Non-RVU base fee schedule,2.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2760,Not in chargemaster,V2760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2760,BCBSMN Non-RVU base fee schedule,14.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2761,Not in chargemaster,V2761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2761,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2762,Not in chargemaster,V2762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2762,BCBSMN Non-RVU base fee schedule,53.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2770,Not in chargemaster,V2770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2770,BCBSMN Non-RVU base fee schedule,17.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2780,Not in chargemaster,V2780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2780,BCBSMN Non-RVU base fee schedule,11.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2781,Not in chargemaster,V2781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2781,BCBSMN Non-RVU base fee schedule,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2782,Not in chargemaster,V2782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2782,BCBSMN Non-RVU base fee schedule,58.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2783,Not in chargemaster,V2783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2783,BCBSMN Non-RVU base fee schedule,65.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2784,Not in chargemaster,V2784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2784,BCBSMN Non-RVU base fee schedule,42.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2786,Not in chargemaster,V2786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2786,BCBSMN Non-RVU base fee schedule,19.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2787,Not in chargemaster,V2787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2787,BCBSMN Non-RVU base fee schedule,477.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2788,Not in chargemaster,V2788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2788,BCBSMN Non-RVU base fee schedule,1075.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V2797,Not in chargemaster,V2797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V2797,BCBSMN Non-RVU base fee schedule,0,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5008,Not in chargemaster,V5008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5008,BCBSMN Non-RVU base fee schedule,7.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5010,Not in chargemaster,V5010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5010,BCBSMN Non-RVU base fee schedule,28.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5011,Not in chargemaster,V5011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5011,BCBSMN Non-RVU base fee schedule,11.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5014,Not in chargemaster,V5014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5014,BCBSMN Non-RVU base fee schedule,124.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5020,Not in chargemaster,V5020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5020,BCBSMN Non-RVU base fee schedule,61.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5030,Not in chargemaster,V5030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5030,BCBSMN Non-RVU base fee schedule,931.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5040,Not in chargemaster,V5040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5040,BCBSMN Non-RVU base fee schedule,887.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5050,Not in chargemaster,V5050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5050,BCBSMN Non-RVU base fee schedule,1052.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5060,Not in chargemaster,V5060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5060,BCBSMN Non-RVU base fee schedule,532.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5090,Not in chargemaster,V5090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5090,BCBSMN Non-RVU base fee schedule,182.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5100,Not in chargemaster,V5100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5100,BCBSMN Non-RVU base fee schedule,1533.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5110,Not in chargemaster,V5110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5110,BCBSMN Non-RVU base fee schedule,273.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5130,Not in chargemaster,V5130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5130,BCBSMN Non-RVU base fee schedule,1426.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5140,Not in chargemaster,V5140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5140,BCBSMN Non-RVU base fee schedule,1064.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5150,Not in chargemaster,V5150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5150,BCBSMN Non-RVU base fee schedule,1497.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5160,Not in chargemaster,V5160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5160,BCBSMN Non-RVU base fee schedule,273.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5171,Not in chargemaster,V5171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5171,BCBSMN Non-RVU base fee schedule,1078,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5172,Not in chargemaster,V5172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5172,BCBSMN Non-RVU base fee schedule,818,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5181,Not in chargemaster,V5181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5181,BCBSMN Non-RVU base fee schedule,1023.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5200,Not in chargemaster,V5200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5200,BCBSMN Non-RVU base fee schedule,182.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5211,Not in chargemaster,V5211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5211,BCBSMN Non-RVU base fee schedule,1636,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5212,Not in chargemaster,V5212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5212,BCBSMN Non-RVU base fee schedule,1636,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5213,Not in chargemaster,V5213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5213,BCBSMN Non-RVU base fee schedule,1636,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5214,Not in chargemaster,V5214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5214,BCBSMN Non-RVU base fee schedule,1636,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5215,Not in chargemaster,V5215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5215,BCBSMN Non-RVU base fee schedule,1636,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5221,Not in chargemaster,V5221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5221,BCBSMN Non-RVU base fee schedule,2046.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5240,Not in chargemaster,V5240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5240,BCBSMN Non-RVU base fee schedule,273.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5241,Not in chargemaster,V5241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5241,BCBSMN Non-RVU base fee schedule,182.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5244,Not in chargemaster,V5244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5244,BCBSMN Non-RVU base fee schedule,630.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5245,Not in chargemaster,V5245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5245,BCBSMN Non-RVU base fee schedule,1010,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5246,Not in chargemaster,V5246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5246,BCBSMN Non-RVU base fee schedule,437.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5247,Not in chargemaster,V5247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5247,BCBSMN Non-RVU base fee schedule,466.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5250,Not in chargemaster,V5250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5250,BCBSMN Non-RVU base fee schedule,1261.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5251,Not in chargemaster,V5251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5251,BCBSMN Non-RVU base fee schedule,2020,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5252,Not in chargemaster,V5252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5252,BCBSMN Non-RVU base fee schedule,874.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5253,Not in chargemaster,V5253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5253,BCBSMN Non-RVU base fee schedule,2453.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5254,Not in chargemaster,V5254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5254,BCBSMN Non-RVU base fee schedule,1456.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5255,Not in chargemaster,V5255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5255,BCBSMN Non-RVU base fee schedule,998.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5256,Not in chargemaster,V5256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5256,BCBSMN Non-RVU base fee schedule,719.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5257,Not in chargemaster,V5257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5257,BCBSMN Non-RVU base fee schedule,877.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5258,Not in chargemaster,V5258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5258,BCBSMN Non-RVU base fee schedule,2913.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5259,Not in chargemaster,V5259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5259,BCBSMN Non-RVU base fee schedule,1996.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5260,Not in chargemaster,V5260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5260,BCBSMN Non-RVU base fee schedule,1438.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5261,Not in chargemaster,V5261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5261,BCBSMN Non-RVU base fee schedule,1755.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5264,Not in chargemaster,V5264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5264,BCBSMN Non-RVU base fee schedule,48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5265,Not in chargemaster,V5265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5265,BCBSMN Non-RVU base fee schedule,1.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5266,Not in chargemaster,V5266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5266,BCBSMN Non-RVU base fee schedule,1.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5275,Not in chargemaster,V5275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5275,BCBSMN Non-RVU base fee schedule,12.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5362,Not in chargemaster,V5362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5362,BCBSMN Non-RVU base fee schedule,12.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5363,Not in chargemaster,V5363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5363,BCBSMN Non-RVU base fee schedule,12.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-RVU V5364,Not in chargemaster,V5364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota,V5364,BCBSMN Non-RVU base fee schedule,12.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Pharmacotherapy & Chemo,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield Minnesota Blue Plus,,either EAPG or 100% Non-RVU fee sched,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield Minnesota Blue Plus,,EAPG v3.13 base rate $598.98,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota Blue Plus,,% of BCBS MN fee schedule,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota Medicare Advantage,,100% of Blue Cross Medicare rates,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota Medicare Platinum,,100% of Blue Cross Medicare rates,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota Medicare Secure,,100% of Blue Cross Medicare rates,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield Minnesota MHCP,,EAPG v3.13 base rate $325.40,,,Fee schedule,,,,,,,,0
unity,Fee schedule,Pharmacotherapy & Chemo,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield Minnesota MHCP,,either EAPG or 100% Non-RVU fee sched,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield Minnesota MHCP,,% of BCBS MN fee schedule,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield ND Caring for Children,,50% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield ND Caring for Children,,lesser of 50% charge or 50% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield ND Caring for Children,,lesser of 50% charge or 50% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield ND FEP,,100% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield ND FEP,,lesser of 100% charge or 100% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield ND FEP,,lesser of 100% charge or 100% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield ND PERS,,100% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield ND PERS,,lesser of 100% charge or 100% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield ND PERS,,lesser of 95% charge or 95% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield ND Preferred,,100% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield ND Preferred,,lesser of 100% charge or 100% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield ND Preferred,,lesser of 100% charge or 100% of BCBSND payment system,,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4034,BCBSND Hospital Base OP Fee Sched Tier 3,3.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4035,BCBSND Hospital Base OP Fee Sched Tier 3,6.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4036,BCBSND Hospital Base OP Fee Sched Tier 3,4.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4081,BCBSND Hospital Base OP Fee Sched Tier 3,17.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4082,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4082,BCBSND Hospital Base OP Fee Sched Tier 3,12.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4083,BCBSND Hospital Base OP Fee Sched Tier 3,1.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4087,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4087,BCBSND Hospital Base OP Fee Sched Tier 3,28.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4088,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4088,BCBSND Hospital Base OP Fee Sched Tier 3,154.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4100,BCBSND Hospital Base OP Fee Sched Tier 3,0.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4102,BCBSND Hospital Base OP Fee Sched Tier 3,2.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4103,BCBSND Hospital Base OP Fee Sched Tier 3,2.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4104,BCBSND Hospital Base OP Fee Sched Tier 3,0.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4105,BCBSND Hospital Base OP Fee Sched Tier 3,58.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4149,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4149,BCBSND Hospital Base OP Fee Sched Tier 3,1.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4150,BCBSND Hospital Base OP Fee Sched Tier 3,0.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4152,BCBSND Hospital Base OP Fee Sched Tier 3,0.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4153,BCBSND Hospital Base OP Fee Sched Tier 3,1.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4154,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4154,BCBSND Hospital Base OP Fee Sched Tier 3,0.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4155,BCBSND Hospital Base OP Fee Sched Tier 3,0.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4157,BCBSND Hospital Base OP Fee Sched Tier 3,6.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4158,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4158,BCBSND Hospital Base OP Fee Sched Tier 3,1.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4159,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4159,BCBSND Hospital Base OP Fee Sched Tier 3,2.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4160,BCBSND Hospital Base OP Fee Sched Tier 3,0.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4161,BCBSND Hospital Base OP Fee Sched Tier 3,2.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4162,BCBSND Hospital Base OP Fee Sched Tier 3,3.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4164,BCBSND Hospital Base OP Fee Sched Tier 3,23.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4168,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4168,BCBSND Hospital Base OP Fee Sched Tier 3,34.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4176,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4176,BCBSND Hospital Base OP Fee Sched Tier 3,65.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4178,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4178,BCBSND Hospital Base OP Fee Sched Tier 3,79.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4180,BCBSND Hospital Base OP Fee Sched Tier 3,33.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4185,BCBSND Hospital Base OP Fee Sched Tier 3,15.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4189,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4189,BCBSND Hospital Base OP Fee Sched Tier 3,244.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4193,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4193,BCBSND Hospital Base OP Fee Sched Tier 3,315.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4197,BCBSND Hospital Base OP Fee Sched Tier 3,384.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4199,BCBSND Hospital Base OP Fee Sched Tier 3,439.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4216,BCBSND Hospital Base OP Fee Sched Tier 3,10.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4220,BCBSND Hospital Base OP Fee Sched Tier 3,11.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4222,BCBSND Hospital Base OP Fee Sched Tier 3,13.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,B4224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B4224,BCBSND Hospital Base OP Fee Sched Tier 3,34.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,B5000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B5000,BCBSND Hospital Base OP Fee Sched Tier 3,16.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,B5100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B5100,BCBSND Hospital Base OP Fee Sched Tier 3,6.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,B5200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B5200,BCBSND Hospital Base OP Fee Sched Tier 3,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,B9002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B9002,BCBSND Hospital Base OP Fee Sched Tier 3,708.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,B9004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B9004,BCBSND Hospital Base OP Fee Sched Tier 3,3469.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,B9006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,B9006,BCBSND Hospital Base OP Fee Sched Tier 3,3469.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,C1716,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C1716,BCBSND Hospital Base OP Fee Sched Tier 3,133.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,C1717,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C1717,BCBSND Hospital Base OP Fee Sched Tier 3,451.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,C1719,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C1719,BCBSND Hospital Base OP Fee Sched Tier 3,131.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2616,BCBSND Hospital Base OP Fee Sched Tier 3,25811.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2634,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2634,BCBSND Hospital Base OP Fee Sched Tier 3,215.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2635,BCBSND Hospital Base OP Fee Sched Tier 3,42.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2636,BCBSND Hospital Base OP Fee Sched Tier 3,76.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2638,BCBSND Hospital Base OP Fee Sched Tier 3,56.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2639,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2639,BCBSND Hospital Base OP Fee Sched Tier 3,54.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2640,BCBSND Hospital Base OP Fee Sched Tier 3,115.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2641,BCBSND Hospital Base OP Fee Sched Tier 3,93.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2642,BCBSND Hospital Base OP Fee Sched Tier 3,124.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2643,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2643,BCBSND Hospital Base OP Fee Sched Tier 3,121.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2645,BCBSND Hospital Base OP Fee Sched Tier 3,7.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2698,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2698,BCBSND Hospital Base OP Fee Sched Tier 3,56.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,C2699,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C2699,BCBSND Hospital Base OP Fee Sched Tier 3,42.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,C5271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C5271,BCBSND Hospital Base OP Fee Sched Tier 3,814.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,C5273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C5273,BCBSND Hospital Base OP Fee Sched Tier 3,2611.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,C5275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C5275,BCBSND Hospital Base OP Fee Sched Tier 3,814.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,C5277,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C5277,BCBSND Hospital Base OP Fee Sched Tier 3,814.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8900,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8901,BCBSND Hospital Base OP Fee Sched Tier 3,357.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8902,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8903,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8903,BCBSND Hospital Base OP Fee Sched Tier 3,313.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8905,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8906,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8908,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8908,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8909,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8909,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8910,BCBSND Hospital Base OP Fee Sched Tier 3,357.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8911,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8911,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8912,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8912,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8913,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8913,BCBSND Hospital Base OP Fee Sched Tier 3,357.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8914,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8914,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8918,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8918,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8919,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8919,BCBSND Hospital Base OP Fee Sched Tier 3,357.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8920,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8921,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8922,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8923,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8923,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8924,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8924,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8925,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8926,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8926,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8927,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8927,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8928,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8928,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8929,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8929,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8930,BCBSND Hospital Base OP Fee Sched Tier 3,1073.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8931,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8932,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8932,BCBSND Hospital Base OP Fee Sched Tier 3,357.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8933,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8933,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8934,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8934,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8935,BCBSND Hospital Base OP Fee Sched Tier 3,357.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8936,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8936,BCBSND Hospital Base OP Fee Sched Tier 3,599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,C8957,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C8957,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9035,BCBSND Hospital Base OP Fee Sched Tier 3,4.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9036,BCBSND Hospital Base OP Fee Sched Tier 3,134.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9037,BCBSND Hospital Base OP Fee Sched Tier 3,13.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9038,BCBSND Hospital Base OP Fee Sched Tier 3,268.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9039,BCBSND Hospital Base OP Fee Sched Tier 3,4.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9040,BCBSND Hospital Base OP Fee Sched Tier 3,3.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9041,BCBSND Hospital Base OP Fee Sched Tier 3,389.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9042,BCBSND Hospital Base OP Fee Sched Tier 3,35.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9043,BCBSND Hospital Base OP Fee Sched Tier 3,5.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9044,BCBSND Hospital Base OP Fee Sched Tier 3,36.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9045,BCBSND Hospital Base OP Fee Sched Tier 3,29.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9046,BCBSND Hospital Base OP Fee Sched Tier 3,1.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9113,BCBSND Hospital Base OP Fee Sched Tier 3,7.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9132,BCBSND Hospital Base OP Fee Sched Tier 3,3.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9141,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9141,BCBSND Hospital Base OP Fee Sched Tier 3,3.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9248,BCBSND Hospital Base OP Fee Sched Tier 3,3.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9250,BCBSND Hospital Base OP Fee Sched Tier 3,110.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9254,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9254,BCBSND Hospital Base OP Fee Sched Tier 3,0.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9257,BCBSND Hospital Base OP Fee Sched Tier 3,2.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9285,BCBSND Hospital Base OP Fee Sched Tier 3,24.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9290,BCBSND Hospital Base OP Fee Sched Tier 3,1.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9293,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9293,BCBSND Hospital Base OP Fee Sched Tier 3,427.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9358,BCBSND Hospital Base OP Fee Sched Tier 3,20.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9360,BCBSND Hospital Base OP Fee Sched Tier 3,21.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9363,BCBSND Hospital Base OP Fee Sched Tier 3,80.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9407,BCBSND Hospital Base OP Fee Sched Tier 3,428.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9408,BCBSND Hospital Base OP Fee Sched Tier 3,428.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9447,BCBSND Hospital Base OP Fee Sched Tier 3,659.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9460,BCBSND Hospital Base OP Fee Sched Tier 3,21.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9462,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9462,BCBSND Hospital Base OP Fee Sched Tier 3,0.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9482,BCBSND Hospital Base OP Fee Sched Tier 3,13.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9488,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9488,BCBSND Hospital Base OP Fee Sched Tier 3,46.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9600,BCBSND Hospital Base OP Fee Sched Tier 3,16299.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9602,BCBSND Hospital Base OP Fee Sched Tier 3,25883.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9604,BCBSND Hospital Base OP Fee Sched Tier 3,16299.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9606,BCBSND Hospital Base OP Fee Sched Tier 3,27299.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9607,BCBSND Hospital Base OP Fee Sched Tier 3,25883.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9725,BCBSND Hospital Base OP Fee Sched Tier 3,1255.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9727,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9727,BCBSND Hospital Base OP Fee Sched Tier 3,2156.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9728,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9728,BCBSND Hospital Base OP Fee Sched Tier 3,1850.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9733,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9733,BCBSND Hospital Base OP Fee Sched Tier 3,520.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9734,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9734,BCBSND Hospital Base OP Fee Sched Tier 3,18060.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9739,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9739,BCBSND Hospital Base OP Fee Sched Tier 3,6777.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9740,BCBSND Hospital Base OP Fee Sched Tier 3,12896.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9745,BCBSND Hospital Base OP Fee Sched Tier 3,7458.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9746,BCBSND Hospital Base OP Fee Sched Tier 3,27510.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9747,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9747,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9749,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9749,BCBSND Hospital Base OP Fee Sched Tier 3,7458.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9751,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9751,BCBSND Hospital Base OP Fee Sched Tier 3,12808.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9752,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9752,BCBSND Hospital Base OP Fee Sched Tier 3,18060.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9754,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9754,BCBSND Hospital Base OP Fee Sched Tier 3,16299.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,C9755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,C9755,BCBSND Hospital Base OP Fee Sched Tier 3,16299.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,D1516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D1516,BCBSND Hospital Base OP Fee Sched Tier 3,1123.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,D1517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D1517,BCBSND Hospital Base OP Fee Sched Tier 3,1123.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,D1526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D1526,BCBSND Hospital Base OP Fee Sched Tier 3,1123.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,D1527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D1527,BCBSND Hospital Base OP Fee Sched Tier 3,1123.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,D3460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D3460,BCBSND Hospital Base OP Fee Sched Tier 3,899.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,D5282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D5282,BCBSND Hospital Base OP Fee Sched Tier 3,906,,Fee schedule,,,,,,,,0
unity,Fee schedule,D5283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D5283,BCBSND Hospital Base OP Fee Sched Tier 3,906,,Fee schedule,,,,,,,,0
unity,Fee schedule,D7220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D7220,BCBSND Hospital Base OP Fee Sched Tier 3,1123.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,D7230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D7230,BCBSND Hospital Base OP Fee Sched Tier 3,1123.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,D7240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D7240,BCBSND Hospital Base OP Fee Sched Tier 3,1123.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,D7241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D7241,BCBSND Hospital Base OP Fee Sched Tier 3,1123.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,D7880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D7880,BCBSND Hospital Base OP Fee Sched Tier 3,677.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,D9944,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D9944,BCBSND Hospital Base OP Fee Sched Tier 3,899.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,D9945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D9945,BCBSND Hospital Base OP Fee Sched Tier 3,899.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,D9946,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,D9946,BCBSND Hospital Base OP Fee Sched Tier 3,899.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0100,BCBSND Hospital Base OP Fee Sched Tier 3,23.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0105,BCBSND Hospital Base OP Fee Sched Tier 3,61.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0110,BCBSND Hospital Base OP Fee Sched Tier 3,102.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0111,BCBSND Hospital Base OP Fee Sched Tier 3,65.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0112,BCBSND Hospital Base OP Fee Sched Tier 3,47.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0113,BCBSND Hospital Base OP Fee Sched Tier 3,27.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0114,BCBSND Hospital Base OP Fee Sched Tier 3,62.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0116,BCBSND Hospital Base OP Fee Sched Tier 3,36.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0117RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0117RR,BCBSND Hospital Base OP Fee Sched Tier 3,25.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0130,BCBSND Hospital Base OP Fee Sched Tier 3,51.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0135,BCBSND Hospital Base OP Fee Sched Tier 3,51.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0140RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0140RR,BCBSND Hospital Base OP Fee Sched Tier 3,32.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0141,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0141,BCBSND Hospital Base OP Fee Sched Tier 3,53.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0143,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0143,BCBSND Hospital Base OP Fee Sched Tier 3,53.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0144RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0144RR,BCBSND Hospital Base OP Fee Sched Tier 3,30.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0147,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0147,BCBSND Hospital Base OP Fee Sched Tier 3,467.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0148,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0148,BCBSND Hospital Base OP Fee Sched Tier 3,95.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0149RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0149RR,BCBSND Hospital Base OP Fee Sched Tier 3,13.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0153,BCBSND Hospital Base OP Fee Sched Tier 3,78.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0154,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0154,BCBSND Hospital Base OP Fee Sched Tier 3,57.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0155,BCBSND Hospital Base OP Fee Sched Tier 3,22.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0156,BCBSND Hospital Base OP Fee Sched Tier 3,17.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0157,BCBSND Hospital Base OP Fee Sched Tier 3,64.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0158,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0158,BCBSND Hospital Base OP Fee Sched Tier 3,23.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0159,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0159,BCBSND Hospital Base OP Fee Sched Tier 3,16.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0160,BCBSND Hospital Base OP Fee Sched Tier 3,33.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0161,BCBSND Hospital Base OP Fee Sched Tier 3,28.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0162,BCBSND Hospital Base OP Fee Sched Tier 3,192.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0163,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0163,BCBSND Hospital Base OP Fee Sched Tier 3,61.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0165RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0165RR,BCBSND Hospital Base OP Fee Sched Tier 3,14.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0167,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0167,BCBSND Hospital Base OP Fee Sched Tier 3,11.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0168,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0168,BCBSND Hospital Base OP Fee Sched Tier 3,125.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0170RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0170RR,BCBSND Hospital Base OP Fee Sched Tier 3,186.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0171RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0171RR,BCBSND Hospital Base OP Fee Sched Tier 3,35.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0172,BCBSND Hospital Base OP Fee Sched Tier 3,67.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0175,BCBSND Hospital Base OP Fee Sched Tier 3,87.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0181RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0181RR,BCBSND Hospital Base OP Fee Sched Tier 3,17.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0182RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0182RR,BCBSND Hospital Base OP Fee Sched Tier 3,24.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0184,BCBSND Hospital Base OP Fee Sched Tier 3,184.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0185,BCBSND Hospital Base OP Fee Sched Tier 3,197.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0186RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0186RR,BCBSND Hospital Base OP Fee Sched Tier 3,20.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0187RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0187RR,BCBSND Hospital Base OP Fee Sched Tier 3,23.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0188,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0188,BCBSND Hospital Base OP Fee Sched Tier 3,29.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0189,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0189,BCBSND Hospital Base OP Fee Sched Tier 3,56.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0191,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0191,BCBSND Hospital Base OP Fee Sched Tier 3,13.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0193RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0193RR,BCBSND Hospital Base OP Fee Sched Tier 3,753.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0194RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0194RR,BCBSND Hospital Base OP Fee Sched Tier 3,4308.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0196RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0196RR,BCBSND Hospital Base OP Fee Sched Tier 3,35.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0197RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0197RR,BCBSND Hospital Base OP Fee Sched Tier 3,21.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0198RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0198RR,BCBSND Hospital Base OP Fee Sched Tier 3,29.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0199,BCBSND Hospital Base OP Fee Sched Tier 3,33.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0200,BCBSND Hospital Base OP Fee Sched Tier 3,89.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0202RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0202RR,BCBSND Hospital Base OP Fee Sched Tier 3,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0203,BCBSND Hospital Base OP Fee Sched Tier 3,40.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0205,BCBSND Hospital Base OP Fee Sched Tier 3,256.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0210,BCBSND Hospital Base OP Fee Sched Tier 3,36.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0215,BCBSND Hospital Base OP Fee Sched Tier 3,93.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0217,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0217,BCBSND Hospital Base OP Fee Sched Tier 3,657.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0221,BCBSND Hospital Base OP Fee Sched Tier 3,3133.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0225,BCBSND Hospital Base OP Fee Sched Tier 3,514.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0231,BCBSND Hospital Base OP Fee Sched Tier 3,514.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0232,BCBSND Hospital Base OP Fee Sched Tier 3,514.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0235RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0235RR,BCBSND Hospital Base OP Fee Sched Tier 3,19.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0236RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0236RR,BCBSND Hospital Base OP Fee Sched Tier 3,58.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0239,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0239,BCBSND Hospital Base OP Fee Sched Tier 3,506.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0244,BCBSND Hospital Base OP Fee Sched Tier 3,49.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0249,BCBSND Hospital Base OP Fee Sched Tier 3,131.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0250RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0250RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0251RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0251RR,BCBSND Hospital Base OP Fee Sched Tier 3,66.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0255RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0255RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0256RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0256RR,BCBSND Hospital Base OP Fee Sched Tier 3,66.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0260RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0260RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0261RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0261RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0265RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0265RR,BCBSND Hospital Base OP Fee Sched Tier 3,165.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0266RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0266RR,BCBSND Hospital Base OP Fee Sched Tier 3,143.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0271,BCBSND Hospital Base OP Fee Sched Tier 3,142.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0272,BCBSND Hospital Base OP Fee Sched Tier 3,156.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0275,BCBSND Hospital Base OP Fee Sched Tier 3,14.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0276,BCBSND Hospital Base OP Fee Sched Tier 3,13.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0277RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0277RR,BCBSND Hospital Base OP Fee Sched Tier 3,231.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0280,BCBSND Hospital Base OP Fee Sched Tier 3,35.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0290RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0290RR,BCBSND Hospital Base OP Fee Sched Tier 3,64.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0291RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0291RR,BCBSND Hospital Base OP Fee Sched Tier 3,49.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0292RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0292RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0293RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0293RR,BCBSND Hospital Base OP Fee Sched Tier 3,63.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0294RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0294RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0295RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0295RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0296RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0296RR,BCBSND Hospital Base OP Fee Sched Tier 3,128.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0297RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0297RR,BCBSND Hospital Base OP Fee Sched Tier 3,113.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0300RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0300RR,BCBSND Hospital Base OP Fee Sched Tier 3,287.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0301RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0301RR,BCBSND Hospital Base OP Fee Sched Tier 3,183.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0302RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0302RR,BCBSND Hospital Base OP Fee Sched Tier 3,516.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0303RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0303RR,BCBSND Hospital Base OP Fee Sched Tier 3,186.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0304RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0304RR,BCBSND Hospital Base OP Fee Sched Tier 3,533.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0305RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0305RR,BCBSND Hospital Base OP Fee Sched Tier 3,12.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0310,BCBSND Hospital Base OP Fee Sched Tier 3,124.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0316RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0316RR,BCBSND Hospital Base OP Fee Sched Tier 3,220.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0325,BCBSND Hospital Base OP Fee Sched Tier 3,10.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0326,BCBSND Hospital Base OP Fee Sched Tier 3,10.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0328,BCBSND Hospital Base OP Fee Sched Tier 3,514.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0370,BCBSND Hospital Base OP Fee Sched Tier 3,112.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0371RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0371RR,BCBSND Hospital Base OP Fee Sched Tier 3,229.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0372RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0372RR,BCBSND Hospital Base OP Fee Sched Tier 3,231.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0373RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0373RR,BCBSND Hospital Base OP Fee Sched Tier 3,231.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0424RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0424RR,BCBSND Hospital Base OP Fee Sched Tier 3,124.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0430,BCBSND Hospital Base OP Fee Sched Tier 3,774.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0431RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0431RR,BCBSND Hospital Base OP Fee Sched Tier 3,28.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0433RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0433RR,BCBSND Hospital Base OP Fee Sched Tier 3,41.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0434RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0434RR,BCBSND Hospital Base OP Fee Sched Tier 3,61.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0435,BCBSND Hospital Base OP Fee Sched Tier 3,723.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0439RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0439RR,BCBSND Hospital Base OP Fee Sched Tier 3,124.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0440,BCBSND Hospital Base OP Fee Sched Tier 3,4599.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0441,BCBSND Hospital Base OP Fee Sched Tier 3,57.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0442,BCBSND Hospital Base OP Fee Sched Tier 3,85.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0443,BCBSND Hospital Base OP Fee Sched Tier 3,78.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0444,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0444,BCBSND Hospital Base OP Fee Sched Tier 3,53.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0447,BCBSND Hospital Base OP Fee Sched Tier 3,80.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0457,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0457,BCBSND Hospital Base OP Fee Sched Tier 3,876.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0459,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0459,BCBSND Hospital Base OP Fee Sched Tier 3,66.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0462RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0462RR,BCBSND Hospital Base OP Fee Sched Tier 3,354.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0465RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0465RR,BCBSND Hospital Base OP Fee Sched Tier 3,1868.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0466RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0466RR,BCBSND Hospital Base OP Fee Sched Tier 3,1868.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0467RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0467RR,BCBSND Hospital Base OP Fee Sched Tier 3,1457.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0470RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0470RR,BCBSND Hospital Base OP Fee Sched Tier 3,180.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0471RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0471RR,BCBSND Hospital Base OP Fee Sched Tier 3,448.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0472RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0472RR,BCBSND Hospital Base OP Fee Sched Tier 3,487.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0480RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0480RR,BCBSND Hospital Base OP Fee Sched Tier 3,58.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0481,BCBSND Hospital Base OP Fee Sched Tier 3,698.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0482RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0482RR,BCBSND Hospital Base OP Fee Sched Tier 3,757.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0483RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0483RR,BCBSND Hospital Base OP Fee Sched Tier 3,1407.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0484,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0484,BCBSND Hospital Base OP Fee Sched Tier 3,72.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0486,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0486,BCBSND Hospital Base OP Fee Sched Tier 3,1498.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0500RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0500RR,BCBSND Hospital Base OP Fee Sched Tier 3,142.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0550RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0550RR,BCBSND Hospital Base OP Fee Sched Tier 3,66.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0555,BCBSND Hospital Base OP Fee Sched Tier 3,0.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0560,BCBSND Hospital Base OP Fee Sched Tier 3,289.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0561,BCBSND Hospital Base OP Fee Sched Tier 3,115.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0562,BCBSND Hospital Base OP Fee Sched Tier 3,226.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0565RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0565RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0570RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0570RR,BCBSND Hospital Base OP Fee Sched Tier 3,9.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0572RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0572RR,BCBSND Hospital Base OP Fee Sched Tier 3,28.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0574RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0574RR,BCBSND Hospital Base OP Fee Sched Tier 3,48.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0575RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0575RR,BCBSND Hospital Base OP Fee Sched Tier 3,136.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0580,BCBSND Hospital Base OP Fee Sched Tier 3,149.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0585RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0585RR,BCBSND Hospital Base OP Fee Sched Tier 3,28.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0600RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0600RR,BCBSND Hospital Base OP Fee Sched Tier 3,54.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0601RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0601RR,BCBSND Hospital Base OP Fee Sched Tier 3,67.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0602,BCBSND Hospital Base OP Fee Sched Tier 3,57.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0605,BCBSND Hospital Base OP Fee Sched Tier 3,29.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0606RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0606RR,BCBSND Hospital Base OP Fee Sched Tier 3,29.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0607,BCBSND Hospital Base OP Fee Sched Tier 3,88.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0610,BCBSND Hospital Base OP Fee Sched Tier 3,314.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0615,BCBSND Hospital Base OP Fee Sched Tier 3,633.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0617RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0617RR,BCBSND Hospital Base OP Fee Sched Tier 3,402.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0618RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0618RR,BCBSND Hospital Base OP Fee Sched Tier 3,323.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0619,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0619,BCBSND Hospital Base OP Fee Sched Tier 3,323.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0620RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0620RR,BCBSND Hospital Base OP Fee Sched Tier 3,115.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0621,BCBSND Hospital Base OP Fee Sched Tier 3,90.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0627,BCBSND Hospital Base OP Fee Sched Tier 3,307.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0629,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0629,BCBSND Hospital Base OP Fee Sched Tier 3,301.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0630RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0630RR,BCBSND Hospital Base OP Fee Sched Tier 3,67.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0635RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0635RR,BCBSND Hospital Base OP Fee Sched Tier 3,130.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0636RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0636RR,BCBSND Hospital Base OP Fee Sched Tier 3,1151.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0637,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0637,BCBSND Hospital Base OP Fee Sched Tier 3,3121.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0639RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0639RR,BCBSND Hospital Base OP Fee Sched Tier 3,147.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0640RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0640RR,BCBSND Hospital Base OP Fee Sched Tier 3,147.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0641,BCBSND Hospital Base OP Fee Sched Tier 3,1268.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0642,BCBSND Hospital Base OP Fee Sched Tier 3,1268.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0650,BCBSND Hospital Base OP Fee Sched Tier 3,953.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0651,BCBSND Hospital Base OP Fee Sched Tier 3,1216.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0652,BCBSND Hospital Base OP Fee Sched Tier 3,6390.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0655,BCBSND Hospital Base OP Fee Sched Tier 3,142.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0656RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0656RR,BCBSND Hospital Base OP Fee Sched Tier 3,76.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0657RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0657RR,BCBSND Hospital Base OP Fee Sched Tier 3,71.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0660,BCBSND Hospital Base OP Fee Sched Tier 3,211.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0665,BCBSND Hospital Base OP Fee Sched Tier 3,181.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0666,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0666,BCBSND Hospital Base OP Fee Sched Tier 3,174.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0667,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0667,BCBSND Hospital Base OP Fee Sched Tier 3,364.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0668,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0668,BCBSND Hospital Base OP Fee Sched Tier 3,497.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0669,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0669,BCBSND Hospital Base OP Fee Sched Tier 3,242.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0670,BCBSND Hospital Base OP Fee Sched Tier 3,1414.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0671,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0671,BCBSND Hospital Base OP Fee Sched Tier 3,549.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0672,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0672,BCBSND Hospital Base OP Fee Sched Tier 3,427.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0673,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0673,BCBSND Hospital Base OP Fee Sched Tier 3,355.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0675RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0675RR,BCBSND Hospital Base OP Fee Sched Tier 3,509.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0691,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0691,BCBSND Hospital Base OP Fee Sched Tier 3,1189.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0692,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0692,BCBSND Hospital Base OP Fee Sched Tier 3,1494.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0693,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0693,BCBSND Hospital Base OP Fee Sched Tier 3,1841.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0694,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0694,BCBSND Hospital Base OP Fee Sched Tier 3,5862.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0700,BCBSND Hospital Base OP Fee Sched Tier 3,10.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0705,BCBSND Hospital Base OP Fee Sched Tier 3,51.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0720,BCBSND Hospital Base OP Fee Sched Tier 3,64.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0730,BCBSND Hospital Base OP Fee Sched Tier 3,63.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0731,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0731,BCBSND Hospital Base OP Fee Sched Tier 3,83.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0740RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0740RR,BCBSND Hospital Base OP Fee Sched Tier 3,69.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0744RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0744RR,BCBSND Hospital Base OP Fee Sched Tier 3,112.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0745RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0745RR,BCBSND Hospital Base OP Fee Sched Tier 3,100.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0747,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0747,BCBSND Hospital Base OP Fee Sched Tier 3,5185.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0748,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0748,BCBSND Hospital Base OP Fee Sched Tier 3,5151.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0760,BCBSND Hospital Base OP Fee Sched Tier 3,4280.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0762RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0762RR,BCBSND Hospital Base OP Fee Sched Tier 3,145.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0764RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0764RR,BCBSND Hospital Base OP Fee Sched Tier 3,1465.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0765,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0765,BCBSND Hospital Base OP Fee Sched Tier 3,111.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0766,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0766,BCBSND Hospital Base OP Fee Sched Tier 3,546.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0770,BCBSND Hospital Base OP Fee Sched Tier 3,1209,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0776,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0776,BCBSND Hospital Base OP Fee Sched Tier 3,143.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0779RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0779RR,BCBSND Hospital Base OP Fee Sched Tier 3,20.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0780,BCBSND Hospital Base OP Fee Sched Tier 3,13.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0781RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0781RR,BCBSND Hospital Base OP Fee Sched Tier 3,278.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0784RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0784RR,BCBSND Hospital Base OP Fee Sched Tier 3,502.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0791RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0791RR,BCBSND Hospital Base OP Fee Sched Tier 3,331.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0840,BCBSND Hospital Base OP Fee Sched Tier 3,97.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0849RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0849RR,BCBSND Hospital Base OP Fee Sched Tier 3,68.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0850,BCBSND Hospital Base OP Fee Sched Tier 3,139.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0855RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0855RR,BCBSND Hospital Base OP Fee Sched Tier 3,65.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0856RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0856RR,BCBSND Hospital Base OP Fee Sched Tier 3,20.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0860,BCBSND Hospital Base OP Fee Sched Tier 3,51.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0870,BCBSND Hospital Base OP Fee Sched Tier 3,130.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0880,BCBSND Hospital Base OP Fee Sched Tier 3,166.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0890,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0890,BCBSND Hospital Base OP Fee Sched Tier 3,159.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0900,BCBSND Hospital Base OP Fee Sched Tier 3,169.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0910RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0910RR,BCBSND Hospital Base OP Fee Sched Tier 3,12.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0911RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0911RR,BCBSND Hospital Base OP Fee Sched Tier 3,47.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0912RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0912RR,BCBSND Hospital Base OP Fee Sched Tier 3,93.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0920RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0920RR,BCBSND Hospital Base OP Fee Sched Tier 3,61.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0930RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0930RR,BCBSND Hospital Base OP Fee Sched Tier 3,52.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0935RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0935RR,BCBSND Hospital Base OP Fee Sched Tier 3,30.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0936,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0936,BCBSND Hospital Base OP Fee Sched Tier 3,361.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0940RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0940RR,BCBSND Hospital Base OP Fee Sched Tier 3,24.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0941RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0941RR,BCBSND Hospital Base OP Fee Sched Tier 3,57.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0942,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0942,BCBSND Hospital Base OP Fee Sched Tier 3,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0944,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0944,BCBSND Hospital Base OP Fee Sched Tier 3,60.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0945,BCBSND Hospital Base OP Fee Sched Tier 3,58.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0946RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0946RR,BCBSND Hospital Base OP Fee Sched Tier 3,78.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0947,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0947,BCBSND Hospital Base OP Fee Sched Tier 3,803.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0948,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0948,BCBSND Hospital Base OP Fee Sched Tier 3,776.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0950,BCBSND Hospital Base OP Fee Sched Tier 3,86.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0951,BCBSND Hospital Base OP Fee Sched Tier 3,15.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0952,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0952,BCBSND Hospital Base OP Fee Sched Tier 3,18.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0953,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0953,BCBSND Hospital Base OP Fee Sched Tier 3,88.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0954,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0954,BCBSND Hospital Base OP Fee Sched Tier 3,60.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0955RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0955RR,BCBSND Hospital Base OP Fee Sched Tier 3,16.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0956,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0956,BCBSND Hospital Base OP Fee Sched Tier 3,88.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0957,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0957,BCBSND Hospital Base OP Fee Sched Tier 3,131.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0958RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0958RR,BCBSND Hospital Base OP Fee Sched Tier 3,48.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0959,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0959,BCBSND Hospital Base OP Fee Sched Tier 3,48.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0960,BCBSND Hospital Base OP Fee Sched Tier 3,81.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0961,BCBSND Hospital Base OP Fee Sched Tier 3,22.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0966,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0966,BCBSND Hospital Base OP Fee Sched Tier 3,82.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0967,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0967,BCBSND Hospital Base OP Fee Sched Tier 3,81.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0968RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0968RR,BCBSND Hospital Base OP Fee Sched Tier 3,23.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0969,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0969,BCBSND Hospital Base OP Fee Sched Tier 3,192.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0970,BCBSND Hospital Base OP Fee Sched Tier 3,82.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0971,BCBSND Hospital Base OP Fee Sched Tier 3,33.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0973,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0973,BCBSND Hospital Base OP Fee Sched Tier 3,58.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0974,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0974,BCBSND Hospital Base OP Fee Sched Tier 3,83.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0978,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0978,BCBSND Hospital Base OP Fee Sched Tier 3,26.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0980,BCBSND Hospital Base OP Fee Sched Tier 3,43.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0981,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0981,BCBSND Hospital Base OP Fee Sched Tier 3,46.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0982,BCBSND Hospital Base OP Fee Sched Tier 3,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0983RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0983RR,BCBSND Hospital Base OP Fee Sched Tier 3,298.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0984RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0984RR,BCBSND Hospital Base OP Fee Sched Tier 3,252.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0985RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0985RR,BCBSND Hospital Base OP Fee Sched Tier 3,24.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0986RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0986RR,BCBSND Hospital Base OP Fee Sched Tier 3,644.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0988RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0988RR,BCBSND Hospital Base OP Fee Sched Tier 3,396.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0990,BCBSND Hospital Base OP Fee Sched Tier 3,79.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0992,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0992,BCBSND Hospital Base OP Fee Sched Tier 3,92.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0994,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0994,BCBSND Hospital Base OP Fee Sched Tier 3,20.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,E0995,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E0995,BCBSND Hospital Base OP Fee Sched Tier 3,29.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1002RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1002RR,BCBSND Hospital Base OP Fee Sched Tier 3,416.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1003RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1003RR,BCBSND Hospital Base OP Fee Sched Tier 3,487.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1004RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1004RR,BCBSND Hospital Base OP Fee Sched Tier 3,535.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1005RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1005RR,BCBSND Hospital Base OP Fee Sched Tier 3,585.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1006RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1006RR,BCBSND Hospital Base OP Fee Sched Tier 3,722.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1007RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1007RR,BCBSND Hospital Base OP Fee Sched Tier 3,896.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1008RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1008RR,BCBSND Hospital Base OP Fee Sched Tier 3,919.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1010RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1010RR,BCBSND Hospital Base OP Fee Sched Tier 3,124.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1012RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1012RR,BCBSND Hospital Base OP Fee Sched Tier 3,124.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1014RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1014RR,BCBSND Hospital Base OP Fee Sched Tier 3,48.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1015,BCBSND Hospital Base OP Fee Sched Tier 3,137.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1016,BCBSND Hospital Base OP Fee Sched Tier 3,124.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1020RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1020RR,BCBSND Hospital Base OP Fee Sched Tier 3,20.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1028RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1028RR,BCBSND Hospital Base OP Fee Sched Tier 3,14.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1029RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1029RR,BCBSND Hospital Base OP Fee Sched Tier 3,42.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1030RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1030RR,BCBSND Hospital Base OP Fee Sched Tier 3,131.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1031RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1031RR,BCBSND Hospital Base OP Fee Sched Tier 3,48.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1035RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1035RR,BCBSND Hospital Base OP Fee Sched Tier 3,668.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1036RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1036RR,BCBSND Hospital Base OP Fee Sched Tier 3,958.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1037RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1037RR,BCBSND Hospital Base OP Fee Sched Tier 3,123.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1038RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1038RR,BCBSND Hospital Base OP Fee Sched Tier 3,16.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1039RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1039RR,BCBSND Hospital Base OP Fee Sched Tier 3,38.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1050RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1050RR,BCBSND Hospital Base OP Fee Sched Tier 3,134.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1060RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1060RR,BCBSND Hospital Base OP Fee Sched Tier 3,166.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1070RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1070RR,BCBSND Hospital Base OP Fee Sched Tier 3,145.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1083RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1083RR,BCBSND Hospital Base OP Fee Sched Tier 3,98.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1084RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1084RR,BCBSND Hospital Base OP Fee Sched Tier 3,116.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1085,BCBSND Hospital Base OP Fee Sched Tier 3,1520.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1086,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1086,BCBSND Hospital Base OP Fee Sched Tier 3,1948.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1087RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1087RR,BCBSND Hospital Base OP Fee Sched Tier 3,167.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1088RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1088RR,BCBSND Hospital Base OP Fee Sched Tier 3,199.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1089,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1089,BCBSND Hospital Base OP Fee Sched Tier 3,2904.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1090,BCBSND Hospital Base OP Fee Sched Tier 3,3290.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1092RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1092RR,BCBSND Hospital Base OP Fee Sched Tier 3,150.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1093RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1093RR,BCBSND Hospital Base OP Fee Sched Tier 3,139.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1100RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1100RR,BCBSND Hospital Base OP Fee Sched Tier 3,137.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1110RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1110RR,BCBSND Hospital Base OP Fee Sched Tier 3,134.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1130,BCBSND Hospital Base OP Fee Sched Tier 3,959.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1140,BCBSND Hospital Base OP Fee Sched Tier 3,1475.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1150RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1150RR,BCBSND Hospital Base OP Fee Sched Tier 3,108.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1160RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1160RR,BCBSND Hospital Base OP Fee Sched Tier 3,82.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1161RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1161RR,BCBSND Hospital Base OP Fee Sched Tier 3,313.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1170RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1170RR,BCBSND Hospital Base OP Fee Sched Tier 3,118.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1171RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1171RR,BCBSND Hospital Base OP Fee Sched Tier 3,106.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1172RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1172RR,BCBSND Hospital Base OP Fee Sched Tier 3,110.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1180RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1180RR,BCBSND Hospital Base OP Fee Sched Tier 3,114.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1190RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1190RR,BCBSND Hospital Base OP Fee Sched Tier 3,155.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1195RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1195RR,BCBSND Hospital Base OP Fee Sched Tier 3,166.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1200RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1200RR,BCBSND Hospital Base OP Fee Sched Tier 3,115.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1220,BCBSND Hospital Base OP Fee Sched Tier 3,2805.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1221RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1221RR,BCBSND Hospital Base OP Fee Sched Tier 3,62.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1222RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1222RR,BCBSND Hospital Base OP Fee Sched Tier 3,89.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1223RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1223RR,BCBSND Hospital Base OP Fee Sched Tier 3,92.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1224RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1224RR,BCBSND Hospital Base OP Fee Sched Tier 3,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1225RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1225RR,BCBSND Hospital Base OP Fee Sched Tier 3,43.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1226,BCBSND Hospital Base OP Fee Sched Tier 3,432.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1227,BCBSND Hospital Base OP Fee Sched Tier 3,312.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1228RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1228RR,BCBSND Hospital Base OP Fee Sched Tier 3,37.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1230,BCBSND Hospital Base OP Fee Sched Tier 3,2994.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1232RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1232RR,BCBSND Hospital Base OP Fee Sched Tier 3,283.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1233RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1233RR,BCBSND Hospital Base OP Fee Sched Tier 3,293.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1234RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1234RR,BCBSND Hospital Base OP Fee Sched Tier 3,255.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1235RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1235RR,BCBSND Hospital Base OP Fee Sched Tier 3,245.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1236RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1236RR,BCBSND Hospital Base OP Fee Sched Tier 3,216.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1237RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1237RR,BCBSND Hospital Base OP Fee Sched Tier 3,218.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1238RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1238RR,BCBSND Hospital Base OP Fee Sched Tier 3,216.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1240RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1240RR,BCBSND Hospital Base OP Fee Sched Tier 3,115.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1250,BCBSND Hospital Base OP Fee Sched Tier 3,1836.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1260,BCBSND Hospital Base OP Fee Sched Tier 3,2026.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1270RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1270RR,BCBSND Hospital Base OP Fee Sched Tier 3,104.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1280RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1280RR,BCBSND Hospital Base OP Fee Sched Tier 3,173.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1285,BCBSND Hospital Base OP Fee Sched Tier 3,2914,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1290,BCBSND Hospital Base OP Fee Sched Tier 3,3023.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1295RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1295RR,BCBSND Hospital Base OP Fee Sched Tier 3,160.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1296,BCBSND Hospital Base OP Fee Sched Tier 3,650.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1297,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1297,BCBSND Hospital Base OP Fee Sched Tier 3,138.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1298,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1298,BCBSND Hospital Base OP Fee Sched Tier 3,476.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1300,BCBSND Hospital Base OP Fee Sched Tier 3,501.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1310,BCBSND Hospital Base OP Fee Sched Tier 3,2843.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1353,BCBSND Hospital Base OP Fee Sched Tier 3,61.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1354,BCBSND Hospital Base OP Fee Sched Tier 3,31.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1355,BCBSND Hospital Base OP Fee Sched Tier 3,31.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1356,BCBSND Hospital Base OP Fee Sched Tier 3,31.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1357,BCBSND Hospital Base OP Fee Sched Tier 3,31.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1358,BCBSND Hospital Base OP Fee Sched Tier 3,31.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1372,BCBSND Hospital Base OP Fee Sched Tier 3,125.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1390RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1390RR,BCBSND Hospital Base OP Fee Sched Tier 3,124.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1391RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1391RR,BCBSND Hospital Base OP Fee Sched Tier 3,84.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1392RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1392RR,BCBSND Hospital Base OP Fee Sched Tier 3,61.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1405RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1405RR,BCBSND Hospital Base OP Fee Sched Tier 3,112.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1406RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1406RR,BCBSND Hospital Base OP Fee Sched Tier 3,90.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1500,BCBSND Hospital Base OP Fee Sched Tier 3,160.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1700RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1700RR,BCBSND Hospital Base OP Fee Sched Tier 3,45.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1701,BCBSND Hospital Base OP Fee Sched Tier 3,14.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1702,BCBSND Hospital Base OP Fee Sched Tier 3,29.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1800RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1800RR,BCBSND Hospital Base OP Fee Sched Tier 3,162.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1801RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1801RR,BCBSND Hospital Base OP Fee Sched Tier 3,153.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1802RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1802RR,BCBSND Hospital Base OP Fee Sched Tier 3,432.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1805RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1805RR,BCBSND Hospital Base OP Fee Sched Tier 3,162.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1806RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1806RR,BCBSND Hospital Base OP Fee Sched Tier 3,126.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1810RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1810RR,BCBSND Hospital Base OP Fee Sched Tier 3,162.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1811RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1811RR,BCBSND Hospital Base OP Fee Sched Tier 3,159.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1812RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1812RR,BCBSND Hospital Base OP Fee Sched Tier 3,113.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1815RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1815RR,BCBSND Hospital Base OP Fee Sched Tier 3,162.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1816RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1816RR,BCBSND Hospital Base OP Fee Sched Tier 3,162.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1818RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1818RR,BCBSND Hospital Base OP Fee Sched Tier 3,165.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1820,BCBSND Hospital Base OP Fee Sched Tier 3,102.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1821,BCBSND Hospital Base OP Fee Sched Tier 3,139.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1825RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1825RR,BCBSND Hospital Base OP Fee Sched Tier 3,162.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1830RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1830RR,BCBSND Hospital Base OP Fee Sched Tier 3,162.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1831RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1831RR,BCBSND Hospital Base OP Fee Sched Tier 3,87.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1840RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1840RR,BCBSND Hospital Base OP Fee Sched Tier 3,470.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,E1841RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E1841RR,BCBSND Hospital Base OP Fee Sched Tier 3,599.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2000RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2000RR,BCBSND Hospital Base OP Fee Sched Tier 3,61.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2100,BCBSND Hospital Base OP Fee Sched Tier 3,851.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2101,BCBSND Hospital Base OP Fee Sched Tier 3,249.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2120RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2120RR,BCBSND Hospital Base OP Fee Sched Tier 3,375.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2201,BCBSND Hospital Base OP Fee Sched Tier 3,343.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2202,BCBSND Hospital Base OP Fee Sched Tier 3,513.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2203,BCBSND Hospital Base OP Fee Sched Tier 3,462.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2204,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2204,BCBSND Hospital Base OP Fee Sched Tier 3,825.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2205,BCBSND Hospital Base OP Fee Sched Tier 3,38.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2206,BCBSND Hospital Base OP Fee Sched Tier 3,42,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2207,BCBSND Hospital Base OP Fee Sched Tier 3,50.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2208,BCBSND Hospital Base OP Fee Sched Tier 3,87.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2209,BCBSND Hospital Base OP Fee Sched Tier 3,90.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2210,BCBSND Hospital Base OP Fee Sched Tier 3,6.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2211,BCBSND Hospital Base OP Fee Sched Tier 3,35.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2212,BCBSND Hospital Base OP Fee Sched Tier 3,6.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2213,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2213,BCBSND Hospital Base OP Fee Sched Tier 3,32.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2214,BCBSND Hospital Base OP Fee Sched Tier 3,36.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2215,BCBSND Hospital Base OP Fee Sched Tier 3,11.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2216,BCBSND Hospital Base OP Fee Sched Tier 3,60.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2217,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2217,BCBSND Hospital Base OP Fee Sched Tier 3,53.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2218,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2218,BCBSND Hospital Base OP Fee Sched Tier 3,60.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2219,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2219,BCBSND Hospital Base OP Fee Sched Tier 3,47.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2220,BCBSND Hospital Base OP Fee Sched Tier 3,31.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2221,BCBSND Hospital Base OP Fee Sched Tier 3,29.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2222,BCBSND Hospital Base OP Fee Sched Tier 3,24.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2224,BCBSND Hospital Base OP Fee Sched Tier 3,105.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2225,BCBSND Hospital Base OP Fee Sched Tier 3,21.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2226,BCBSND Hospital Base OP Fee Sched Tier 3,43.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2227RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2227RR,BCBSND Hospital Base OP Fee Sched Tier 3,247.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2228RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2228RR,BCBSND Hospital Base OP Fee Sched Tier 3,107.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2231,BCBSND Hospital Base OP Fee Sched Tier 3,152.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2310RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2310RR,BCBSND Hospital Base OP Fee Sched Tier 3,121.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2311RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2311RR,BCBSND Hospital Base OP Fee Sched Tier 3,245.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2312RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2312RR,BCBSND Hospital Base OP Fee Sched Tier 3,267.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2313RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2313RR,BCBSND Hospital Base OP Fee Sched Tier 3,42.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2321RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2321RR,BCBSND Hospital Base OP Fee Sched Tier 3,165.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2322RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2322RR,BCBSND Hospital Base OP Fee Sched Tier 3,156.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2323,BCBSND Hospital Base OP Fee Sched Tier 3,76.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2324,BCBSND Hospital Base OP Fee Sched Tier 3,50,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2325RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2325RR,BCBSND Hospital Base OP Fee Sched Tier 3,149.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2326RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2326RR,BCBSND Hospital Base OP Fee Sched Tier 3,39.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2327RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2327RR,BCBSND Hospital Base OP Fee Sched Tier 3,292.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2328RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2328RR,BCBSND Hospital Base OP Fee Sched Tier 3,552.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2329RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2329RR,BCBSND Hospital Base OP Fee Sched Tier 3,199.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2330RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2330RR,BCBSND Hospital Base OP Fee Sched Tier 3,382.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2340,BCBSND Hospital Base OP Fee Sched Tier 3,474.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2341,BCBSND Hospital Base OP Fee Sched Tier 3,711.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2342,BCBSND Hospital Base OP Fee Sched Tier 3,593.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2343,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2343,BCBSND Hospital Base OP Fee Sched Tier 3,949.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2351,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2351,BCBSND Hospital Base OP Fee Sched Tier 3,792.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2359,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2359,BCBSND Hospital Base OP Fee Sched Tier 3,192.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2360,BCBSND Hospital Base OP Fee Sched Tier 3,126.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2361,BCBSND Hospital Base OP Fee Sched Tier 3,126.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2362,BCBSND Hospital Base OP Fee Sched Tier 3,117.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2363,BCBSND Hospital Base OP Fee Sched Tier 3,161.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2364,BCBSND Hospital Base OP Fee Sched Tier 3,125.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2365,BCBSND Hospital Base OP Fee Sched Tier 3,83.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2366,BCBSND Hospital Base OP Fee Sched Tier 3,176.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2367,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2367,BCBSND Hospital Base OP Fee Sched Tier 3,420.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2368RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2368RR,BCBSND Hospital Base OP Fee Sched Tier 3,43.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2369RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2369RR,BCBSND Hospital Base OP Fee Sched Tier 3,41.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2370RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2370RR,BCBSND Hospital Base OP Fee Sched Tier 3,57.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2371,BCBSND Hospital Base OP Fee Sched Tier 3,153.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2372,BCBSND Hospital Base OP Fee Sched Tier 3,117.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2373RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2373RR,BCBSND Hospital Base OP Fee Sched Tier 3,88.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2374RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2374RR,BCBSND Hospital Base OP Fee Sched Tier 3,56.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2375RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2375RR,BCBSND Hospital Base OP Fee Sched Tier 3,74.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2376RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2376RR,BCBSND Hospital Base OP Fee Sched Tier 3,139.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2377RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2377RR,BCBSND Hospital Base OP Fee Sched Tier 3,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2378RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2378RR,BCBSND Hospital Base OP Fee Sched Tier 3,63.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2381,BCBSND Hospital Base OP Fee Sched Tier 3,65.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2382,BCBSND Hospital Base OP Fee Sched Tier 3,20.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2383,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2383,BCBSND Hospital Base OP Fee Sched Tier 3,136.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2384,BCBSND Hospital Base OP Fee Sched Tier 3,68.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2385,BCBSND Hospital Base OP Fee Sched Tier 3,49.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2386,BCBSND Hospital Base OP Fee Sched Tier 3,114.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2387,BCBSND Hospital Base OP Fee Sched Tier 3,53.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2388,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2388,BCBSND Hospital Base OP Fee Sched Tier 3,53.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2389,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2389,BCBSND Hospital Base OP Fee Sched Tier 3,29.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2390,BCBSND Hospital Base OP Fee Sched Tier 3,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2391,BCBSND Hospital Base OP Fee Sched Tier 3,18.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2392,BCBSND Hospital Base OP Fee Sched Tier 3,46.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2394,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2394,BCBSND Hospital Base OP Fee Sched Tier 3,63.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2395,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2395,BCBSND Hospital Base OP Fee Sched Tier 3,49.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2396,BCBSND Hospital Base OP Fee Sched Tier 3,55.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2397,BCBSND Hospital Base OP Fee Sched Tier 3,510.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2402RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2402RR,BCBSND Hospital Base OP Fee Sched Tier 3,107.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2500,BCBSND Hospital Base OP Fee Sched Tier 3,517.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2502,BCBSND Hospital Base OP Fee Sched Tier 3,1583.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2504,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2504,BCBSND Hospital Base OP Fee Sched Tier 3,2088.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2506,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2506,BCBSND Hospital Base OP Fee Sched Tier 3,3062.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2508,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2508,BCBSND Hospital Base OP Fee Sched Tier 3,4735.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2510,BCBSND Hospital Base OP Fee Sched Tier 3,8961.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2601,BCBSND Hospital Base OP Fee Sched Tier 3,43.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2602,BCBSND Hospital Base OP Fee Sched Tier 3,92.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2603,BCBSND Hospital Base OP Fee Sched Tier 3,117.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2604,BCBSND Hospital Base OP Fee Sched Tier 3,163.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2605,BCBSND Hospital Base OP Fee Sched Tier 3,234.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2606,BCBSND Hospital Base OP Fee Sched Tier 3,360.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2607,BCBSND Hospital Base OP Fee Sched Tier 3,218.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2608,BCBSND Hospital Base OP Fee Sched Tier 3,278.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2611,BCBSND Hospital Base OP Fee Sched Tier 3,165.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2612,BCBSND Hospital Base OP Fee Sched Tier 3,342.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2613,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2613,BCBSND Hospital Base OP Fee Sched Tier 3,346.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2614,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2614,BCBSND Hospital Base OP Fee Sched Tier 3,487.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2615,BCBSND Hospital Base OP Fee Sched Tier 3,391.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2616,BCBSND Hospital Base OP Fee Sched Tier 3,526.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2619,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2619,BCBSND Hospital Base OP Fee Sched Tier 3,55.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2620,BCBSND Hospital Base OP Fee Sched Tier 3,419.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2621,BCBSND Hospital Base OP Fee Sched Tier 3,491.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2622,BCBSND Hospital Base OP Fee Sched Tier 3,349.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2623,BCBSND Hospital Base OP Fee Sched Tier 3,441.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2624,BCBSND Hospital Base OP Fee Sched Tier 3,354.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2625,BCBSND Hospital Base OP Fee Sched Tier 3,439.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2626,BCBSND Hospital Base OP Fee Sched Tier 3,699.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2627,BCBSND Hospital Base OP Fee Sched Tier 3,1056.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2628,BCBSND Hospital Base OP Fee Sched Tier 3,832.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2629,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2629,BCBSND Hospital Base OP Fee Sched Tier 3,1043.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2630,BCBSND Hospital Base OP Fee Sched Tier 3,707.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2631,BCBSND Hospital Base OP Fee Sched Tier 3,285.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2632,BCBSND Hospital Base OP Fee Sched Tier 3,182.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,E2633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,E2633,BCBSND Hospital Base OP Fee Sched Tier 3,150.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,0001M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0001M,BCBSND Hospital Base OP Fee Sched Tier 3,308.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,0002M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0002M,BCBSND Hospital Base OP Fee Sched Tier 3,2152.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,0003M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0003M,BCBSND Hospital Base OP Fee Sched Tier 3,2152.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,0004M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0004M,BCBSND Hospital Base OP Fee Sched Tier 3,337.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,0006M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0006M,BCBSND Hospital Base OP Fee Sched Tier 3,641.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,0007M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0007M,BCBSND Hospital Base OP Fee Sched Tier 3,1603.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,0009M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0009M,BCBSND Hospital Base OP Fee Sched Tier 3,567.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,0011M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0011M,BCBSND Hospital Base OP Fee Sched Tier 3,3249,,Fee schedule,,,,,,,,0
unity,Fee schedule,0012M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0012M,BCBSND Hospital Base OP Fee Sched Tier 3,3249,,Fee schedule,,,,,,,,0
unity,Fee schedule,0013M,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0013M,BCBSND Hospital Base OP Fee Sched Tier 3,3249,,Fee schedule,,,,,,,,0
unity,Fee schedule,0058T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0058T,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,0071T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0071T,BCBSND Hospital Base OP Fee Sched Tier 3,3950.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,0072T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0072T,BCBSND Hospital Base OP Fee Sched Tier 3,3950.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,0100T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0100T,BCBSND Hospital Base OP Fee Sched Tier 3,5667.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,0101T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0101T,BCBSND Hospital Base OP Fee Sched Tier 3,4389.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,0102T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0102T,BCBSND Hospital Base OP Fee Sched Tier 3,4389.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,0106T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0106T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0107T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0107T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0108T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0108T,BCBSND Hospital Base OP Fee Sched Tier 3,94.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,0109T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0109T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0110T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0110T,BCBSND Hospital Base OP Fee Sched Tier 3,179.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,0111T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0111T,BCBSND Hospital Base OP Fee Sched Tier 3,80.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,0126T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0126T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0174T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0174T,BCBSND Hospital Base OP Fee Sched Tier 3,32.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,0175T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0175T,BCBSND Hospital Base OP Fee Sched Tier 3,32.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,0184T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0184T,BCBSND Hospital Base OP Fee Sched Tier 3,7522.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,0191T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0191T,BCBSND Hospital Base OP Fee Sched Tier 3,6090.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,0198T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0198T,BCBSND Hospital Base OP Fee Sched Tier 3,179.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,0200T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0200T,BCBSND Hospital Base OP Fee Sched Tier 3,9536.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,0201T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0201T,BCBSND Hospital Base OP Fee Sched Tier 3,9536.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,0205T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0205T,BCBSND Hospital Base OP Fee Sched Tier 3,909.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,0206T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0206T,BCBSND Hospital Base OP Fee Sched Tier 3,82.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,0207T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0207T,BCBSND Hospital Base OP Fee Sched Tier 3,94.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,0208T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0208T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0209T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0209T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0210T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0210T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0211T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0211T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0212T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0212T,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,0213T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0213T,BCBSND Hospital Base OP Fee Sched Tier 3,1279.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,0216T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0216T,BCBSND Hospital Base OP Fee Sched Tier 3,1279.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,0221T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0221T,BCBSND Hospital Base OP Fee Sched Tier 3,9536.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,0228T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0228T,BCBSND Hospital Base OP Fee Sched Tier 3,1279.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,0230T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0230T,BCBSND Hospital Base OP Fee Sched Tier 3,1279.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,0232T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0232T,BCBSND Hospital Base OP Fee Sched Tier 3,582.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,0234T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0234T,BCBSND Hospital Base OP Fee Sched Tier 3,16177.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,0236T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0236T,BCBSND Hospital Base OP Fee Sched Tier 3,16177.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,0237T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0237T,BCBSND Hospital Base OP Fee Sched Tier 3,16177.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,0238T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0238T,BCBSND Hospital Base OP Fee Sched Tier 3,25690.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,0249T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0249T,BCBSND Hospital Base OP Fee Sched Tier 3,3906.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,0253T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0253T,BCBSND Hospital Base OP Fee Sched Tier 3,6090.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,0263T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0263T,BCBSND Hospital Base OP Fee Sched Tier 3,6562.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,0264T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0264T,BCBSND Hospital Base OP Fee Sched Tier 3,6562.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,0265T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0265T,BCBSND Hospital Base OP Fee Sched Tier 3,6562.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,0266T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0266T,BCBSND Hospital Base OP Fee Sched Tier 3,31300.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0267T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0267T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0268T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0268T,BCBSND Hospital Base OP Fee Sched Tier 3,31300.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0269T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0269T,BCBSND Hospital Base OP Fee Sched Tier 3,7639.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,0270T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0270T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0271T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0271T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0272T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0272T,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,0273T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0273T,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,0274T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0274T,BCBSND Hospital Base OP Fee Sched Tier 3,9536.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,0275T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0275T,BCBSND Hospital Base OP Fee Sched Tier 3,9536.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,0278T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0278T,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,0296T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0296T,BCBSND Hospital Base OP Fee Sched Tier 3,80.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,0297T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0297T,BCBSND Hospital Base OP Fee Sched Tier 3,179.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,0308T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0308T,BCBSND Hospital Base OP Fee Sched Tier 3,27162.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,0312T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0312T,BCBSND Hospital Base OP Fee Sched Tier 3,46343.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,0313T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0313T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0314T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0314T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0315T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0315T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0316T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0316T,BCBSND Hospital Base OP Fee Sched Tier 3,31300.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0317T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0317T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0330T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0330T,BCBSND Hospital Base OP Fee Sched Tier 3,52.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0331T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0331T,BCBSND Hospital Base OP Fee Sched Tier 3,1997.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,0332T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0332T,BCBSND Hospital Base OP Fee Sched Tier 3,1997.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,0335T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0335T,BCBSND Hospital Base OP Fee Sched Tier 3,9536.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,0338T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0338T,BCBSND Hospital Base OP Fee Sched Tier 3,7827.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,0339T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0339T,BCBSND Hospital Base OP Fee Sched Tier 3,7827.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,0342T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0342T,BCBSND Hospital Base OP Fee Sched Tier 3,6562.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,0347T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0347T,BCBSND Hospital Base OP Fee Sched Tier 3,93.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,0348T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0348T,BCBSND Hospital Base OP Fee Sched Tier 3,188.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,0349T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0349T,BCBSND Hospital Base OP Fee Sched Tier 3,188.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,0350T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0350T,BCBSND Hospital Base OP Fee Sched Tier 3,104.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,0355T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0355T,BCBSND Hospital Base OP Fee Sched Tier 3,2481.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,0356T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0356T,BCBSND Hospital Base OP Fee Sched Tier 3,93.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,0357T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0357T,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,0358T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0358T,BCBSND Hospital Base OP Fee Sched Tier 3,53.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,0377T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0377T,BCBSND Hospital Base OP Fee Sched Tier 3,3906.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,0379T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0379T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0380T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0380T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0394T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0394T,BCBSND Hospital Base OP Fee Sched Tier 3,364.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,0395T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0395T,BCBSND Hospital Base OP Fee Sched Tier 3,1145.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,0398T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0398T,BCBSND Hospital Base OP Fee Sched Tier 3,21094.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,0402T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0402T,BCBSND Hospital Base OP Fee Sched Tier 3,3032.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,0404T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0404T,BCBSND Hospital Base OP Fee Sched Tier 3,10615.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,0408T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0408T,BCBSND Hospital Base OP Fee Sched Tier 3,36803.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,0409T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0409T,BCBSND Hospital Base OP Fee Sched Tier 3,36803.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,0410T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0410T,BCBSND Hospital Base OP Fee Sched Tier 3,12388.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,0411T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0411T,BCBSND Hospital Base OP Fee Sched Tier 3,12388.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,0412T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0412T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0413T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0413T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0414T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0414T,BCBSND Hospital Base OP Fee Sched Tier 3,36803.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,0415T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0415T,BCBSND Hospital Base OP Fee Sched Tier 3,1037.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0416T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0416T,BCBSND Hospital Base OP Fee Sched Tier 3,2591.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,0417T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0417T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0418T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0418T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0419T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0419T,BCBSND Hospital Base OP Fee Sched Tier 3,807.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,0420T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0420T,BCBSND Hospital Base OP Fee Sched Tier 3,807.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,0421T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0421T,BCBSND Hospital Base OP Fee Sched Tier 3,6727.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,0422T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0422T,BCBSND Hospital Base OP Fee Sched Tier 3,105.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,0424T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0424T,BCBSND Hospital Base OP Fee Sched Tier 3,46343.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,0425T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0425T,BCBSND Hospital Base OP Fee Sched Tier 3,10004.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,0426T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0426T,BCBSND Hospital Base OP Fee Sched Tier 3,31300.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0427T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0427T,BCBSND Hospital Base OP Fee Sched Tier 3,31300.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0428T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0428T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0429T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0429T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0430T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0430T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0431T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0431T,BCBSND Hospital Base OP Fee Sched Tier 3,31300.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0432T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0432T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0433T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0433T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0434T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0434T,BCBSND Hospital Base OP Fee Sched Tier 3,198.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,0435T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0435T,BCBSND Hospital Base OP Fee Sched Tier 3,198.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,0436T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0436T,BCBSND Hospital Base OP Fee Sched Tier 3,1540.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,0440T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0440T,BCBSND Hospital Base OP Fee Sched Tier 3,7639.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,0441T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0441T,BCBSND Hospital Base OP Fee Sched Tier 3,7639.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,0442T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0442T,BCBSND Hospital Base OP Fee Sched Tier 3,7639.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,0446T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0446T,BCBSND Hospital Base OP Fee Sched Tier 3,807.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,0447T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0447T,BCBSND Hospital Base OP Fee Sched Tier 3,295.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,0448T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0448T,BCBSND Hospital Base OP Fee Sched Tier 3,807.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,0449T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0449T,BCBSND Hospital Base OP Fee Sched Tier 3,6090.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,0453T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0453T,BCBSND Hospital Base OP Fee Sched Tier 3,12388.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,0454T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0454T,BCBSND Hospital Base OP Fee Sched Tier 3,12388.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,0457T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0457T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0458T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0458T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0460T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0460T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0462T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0462T,BCBSND Hospital Base OP Fee Sched Tier 3,473.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0463T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0463T,BCBSND Hospital Base OP Fee Sched Tier 3,473.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0464T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0464T,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,0465T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0465T,BCBSND Hospital Base OP Fee Sched Tier 3,482.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,0467T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0467T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0468T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0468T,BCBSND Hospital Base OP Fee Sched Tier 3,4818.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,0472T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0472T,BCBSND Hospital Base OP Fee Sched Tier 3,473.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,0473T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0473T,BCBSND Hospital Base OP Fee Sched Tier 3,198.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,0474T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0474T,BCBSND Hospital Base OP Fee Sched Tier 3,6107,,Fee schedule,,,,,,,,0
unity,Fee schedule,0476T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0476T,BCBSND Hospital Base OP Fee Sched Tier 3,179.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,0477T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0477T,BCBSND Hospital Base OP Fee Sched Tier 3,179.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,0479T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0479T,BCBSND Hospital Base OP Fee Sched Tier 3,525.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,0481T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0481T,BCBSND Hospital Base OP Fee Sched Tier 3,582.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,0485T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0485T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0486T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0486T,BCBSND Hospital Base OP Fee Sched Tier 3,54.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,0487T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0487T,BCBSND Hospital Base OP Fee Sched Tier 3,179.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,0491T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0491T,BCBSND Hospital Base OP Fee Sched Tier 3,525.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,0497T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0497T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0499T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0499T,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,0500T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0500T,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,0503T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0503T,BCBSND Hospital Base OP Fee Sched Tier 3,2447.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,0509T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0509T,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,0510T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0510T,BCBSND Hospital Base OP Fee Sched Tier 3,4389.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,0511T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0511T,BCBSND Hospital Base OP Fee Sched Tier 3,9536.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,0512T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0512T,BCBSND Hospital Base OP Fee Sched Tier 3,525.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,0515T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0515T,BCBSND Hospital Base OP Fee Sched Tier 3,36803.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,0516T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0516T,BCBSND Hospital Base OP Fee Sched Tier 3,12388.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,0517T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0517T,BCBSND Hospital Base OP Fee Sched Tier 3,12388.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,0518T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0518T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0519T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0519T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0520T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0520T,BCBSND Hospital Base OP Fee Sched Tier 3,36803.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,0521T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0521T,BCBSND Hospital Base OP Fee Sched Tier 3,28.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,0522T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0522T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0523T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0523T,BCBSND Hospital Base OP Fee Sched Tier 3,603.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,0524T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0524T,BCBSND Hospital Base OP Fee Sched Tier 3,4419.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0525T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0525T,BCBSND Hospital Base OP Fee Sched Tier 3,16529.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,0526T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0526T,BCBSND Hospital Base OP Fee Sched Tier 3,12388.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,0527T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0527T,BCBSND Hospital Base OP Fee Sched Tier 3,12388.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,0528T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0528T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0529T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0529T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0530T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0530T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0531T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0531T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0532T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0532T,BCBSND Hospital Base OP Fee Sched Tier 3,5237.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,0534T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0534T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0535T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0535T,BCBSND Hospital Base OP Fee Sched Tier 3,62.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,0540T,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,0540T,BCBSND Hospital Base OP Fee Sched Tier 3,360.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,10005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10005,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,10007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10007,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,10009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10009,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,10011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10011,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,10021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10021,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,10030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10030,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,10035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10035,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,10040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10040,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,10060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10060,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,10061,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10061,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,10080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10080,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,10081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10081,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,10120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10120,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,10121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10121,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,10140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10140,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,10160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10160,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,10180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,10180,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11000,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,11010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11010,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11011,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11012,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11042,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11043,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,11044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11044,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11055,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11056,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11056,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11057,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11057,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11102,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11104,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11106,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11200,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11300,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11301,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11302,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11303,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11305,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11306,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11307,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11308,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11310,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11311,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11312,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11313,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11400,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11401,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11402,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11403,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11404,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11404,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11406,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11420,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11421,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11422,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11422,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11423,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11423,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11424,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11424,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11426,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11440,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11441,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11442,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11443,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11444,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11444,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11446,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11450,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11451,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11451,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11462,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11462,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11463,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11463,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11470,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11471,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11600,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11601,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11602,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11603,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11604,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11606,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11620,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11621,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11622,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11623,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11624,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11626,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11640,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11641,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11642,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11643,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11643,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11644,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11644,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,11646,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11646,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11719,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11719,BCBSND Hospital Base OP Fee Sched Tier 3,80.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,11720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11720,BCBSND Hospital Base OP Fee Sched Tier 3,80.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,11721,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11721,BCBSND Hospital Base OP Fee Sched Tier 3,80.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,11730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11730,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11740,BCBSND Hospital Base OP Fee Sched Tier 3,154.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,11750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11750,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11755,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11760,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,11762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11762,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,11765,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11765,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11770,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11771,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11771,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11772,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11772,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11900,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11901,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11920,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,11921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11921,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,11950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11950,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,11951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11951,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,11952,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11952,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,11954,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11954,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,11960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11960,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,11970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11970,BCBSND Hospital Base OP Fee Sched Tier 3,8245.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11971,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,11976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11976,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,11980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11980,BCBSND Hospital Base OP Fee Sched Tier 3,503.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,11981,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11981,BCBSND Hospital Base OP Fee Sched Tier 3,154.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,11982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11982,BCBSND Hospital Base OP Fee Sched Tier 3,503.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,11983,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,11983,BCBSND Hospital Base OP Fee Sched Tier 3,503.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,12001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12001,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12002,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12004,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12005,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12006,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12007,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12011,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12013,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12014,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12015,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12016,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12017,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12018,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,12020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12020,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,12021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12021,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12031,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12032,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12034,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12035,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12036,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,12037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12037,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,12041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12041,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12042,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12044,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,12045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12045,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,12046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12046,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12047,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,12051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12051,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12052,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12052,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12053,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12053,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12054,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12054,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12055,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12056,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12056,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,12057,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,12057,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,13100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13100,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,13101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13101,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,13120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13120,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,13121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13121,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,13131,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13131,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,13132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13132,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,13151,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13151,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,13152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13152,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,13160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,13160,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14000,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14001,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14020,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14021,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14040,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14041,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14060,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14061,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14061,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,14301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14301,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,14350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,14350,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15002,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15004,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,15040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15040,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15050,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,15100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15100,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15110,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15115,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15120,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15130,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15135,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15150,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15155,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15200,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15220,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15240,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15260,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15271,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15273,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15275,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15277,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15277,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15570,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15572,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15574,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15574,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15576,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15600,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15610,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15620,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15630,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15650,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15730,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15731,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15731,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15733,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15733,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15734,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15734,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15736,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15736,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15738,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15738,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15740,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15750,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15760,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15770,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15775,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,15776,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15776,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,15780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15780,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15781,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15781,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,15782,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15782,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,15783,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15783,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,15786,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15786,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,15788,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15788,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,15789,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15789,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,15792,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15792,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,15793,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15793,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,15819,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15819,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15820,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15821,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15822,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15823,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15823,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15824,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15824,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15825,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15826,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15826,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15828,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15828,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15829,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15829,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15830,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,15832,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15832,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15833,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15833,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15834,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15834,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15835,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15835,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15836,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15836,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15837,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15837,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15838,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15838,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15839,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15839,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15840,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15841,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15841,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15842,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15842,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15845,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15845,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15850,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,15851,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15851,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15852,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15852,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,15860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15860,BCBSND Hospital Base OP Fee Sched Tier 3,503.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,15876,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15876,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15877,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15877,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15878,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15878,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15879,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15879,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15920,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15922,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15931,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,15933,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15933,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15934,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15934,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15935,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15936,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15936,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15937,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15937,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15940,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15941,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15941,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15944,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15944,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15945,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15946,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15946,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15950,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,15951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15951,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,15952,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15952,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15953,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15953,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15956,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15956,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,15958,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15958,BCBSND Hospital Base OP Fee Sched Tier 3,4001.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,15999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,15999,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,16000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,16000,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,16020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,16020,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,16025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,16025,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,16030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,16030,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,16035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,16035,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17000,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17004,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17106,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17107,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,17108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17108,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,17110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17110,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17111,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17250,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17260,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17261,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17262,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17263,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17264,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17266,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17266,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17270,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17271,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17272,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17273,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17274,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17276,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17280,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17281,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17282,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17283,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,17284,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17284,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,17286,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17286,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,17311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17311,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,17313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17313,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,17340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17340,BCBSND Hospital Base OP Fee Sched Tier 3,46.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,17360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17360,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,17380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17380,BCBSND Hospital Base OP Fee Sched Tier 3,698.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,17999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,17999,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,19000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19000,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,19020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19020,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,19081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19081,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,19083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19083,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,19085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19085,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,19100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19100,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,19101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19101,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19105,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19110,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19112,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19120,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19125,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19260,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,19281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19281,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,19283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19283,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,19285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19285,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,19287,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19287,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,19296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19296,BCBSND Hospital Base OP Fee Sched Tier 3,10776.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,19298,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19298,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19300,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19301,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19302,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19303,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19304,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19307,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19316,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19318,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19324,BCBSND Hospital Base OP Fee Sched Tier 3,10776.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,19325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19325,BCBSND Hospital Base OP Fee Sched Tier 3,10776.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,19328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19328,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19330,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19340,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19342,BCBSND Hospital Base OP Fee Sched Tier 3,10776.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,19350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19350,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19355,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19357,BCBSND Hospital Base OP Fee Sched Tier 3,17544.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,19366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19366,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19370,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19371,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19380,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,19396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19396,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,19499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,19499,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,20100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20100,BCBSND Hospital Base OP Fee Sched Tier 3,753.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,20101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20101,BCBSND Hospital Base OP Fee Sched Tier 3,2396.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,20102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20102,BCBSND Hospital Base OP Fee Sched Tier 3,2396.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,20103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20103,BCBSND Hospital Base OP Fee Sched Tier 3,896.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,20150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20150,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,20200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20200,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,20205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20205,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,20206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20206,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,20220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20220,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,20225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20225,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,20240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20240,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,20245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20245,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,20250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20250,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,20251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20251,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20500,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,20520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20520,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,20525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20525,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,20526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20526,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20527,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20550,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20551,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20552,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20553,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20555,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,20600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20600,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20604,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20605,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20606,BCBSND Hospital Base OP Fee Sched Tier 3,926.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,20610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20610,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20611,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20612,BCBSND Hospital Base OP Fee Sched Tier 3,382.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,20615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20615,BCBSND Hospital Base OP Fee Sched Tier 3,896.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,20650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20650,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,20660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20660,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,20662,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20662,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,20663,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20663,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,20665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20665,BCBSND Hospital Base OP Fee Sched Tier 3,538.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,20670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20670,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,20680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20680,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,20690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20690,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20692,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20692,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,20693,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20693,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20694,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20694,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,20696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20696,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,20697,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20697,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,20822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20822,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,20900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20900,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20902,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20910,BCBSND Hospital Base OP Fee Sched Tier 3,747.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,20912,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20912,BCBSND Hospital Base OP Fee Sched Tier 3,4280.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,20920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20920,BCBSND Hospital Base OP Fee Sched Tier 3,2396.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,20922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20922,BCBSND Hospital Base OP Fee Sched Tier 3,2396.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,20924,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20924,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20926,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20926,BCBSND Hospital Base OP Fee Sched Tier 3,4280.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,20950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20950,BCBSND Hospital Base OP Fee Sched Tier 3,896.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,20972,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20972,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20973,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20973,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20979,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20979,BCBSND Hospital Base OP Fee Sched Tier 3,26.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,20982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20982,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20983,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20983,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,20999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,20999,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,21010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21010,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21011,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21012,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21013,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21014,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21015,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21016,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21025,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21026,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21026,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21029,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21029,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21030,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21031,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21032,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21034,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21040,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21044,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21046,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21047,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21048,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21049,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21049,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21050,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21060,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21070,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21073,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21076,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21077,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21079,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21079,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21080,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21081,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21082,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21082,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21083,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21084,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21084,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21085,BCBSND Hospital Base OP Fee Sched Tier 3,318.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,21086,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21086,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21087,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21087,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21088,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21088,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21089,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21089,BCBSND Hospital Base OP Fee Sched Tier 3,318.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,21100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21100,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21110,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21120,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21121,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21122,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21122,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21123,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21123,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21125,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21127,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21127,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21137,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21137,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21138,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21138,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21139,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21139,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21150,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21172,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21175,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21181,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21181,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21193,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21193,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21195,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21198,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21198,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21199,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21206,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21208,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21209,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21210,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21215,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21230,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21235,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21240,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21242,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21242,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21243,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21243,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,21244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21244,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21245,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21246,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21248,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21249,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21256,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21256,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21260,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21261,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21263,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21267,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21270,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21275,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21280,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21282,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21295,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21296,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21299,BCBSND Hospital Base OP Fee Sched Tier 3,318.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,21310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21310,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,21315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21315,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21320,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21325,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21330,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21335,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21336,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21337,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21338,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21338,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21339,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21339,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21340,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21345,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21346,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21355,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21356,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21360,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21365,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21385,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21386,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21387,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21390,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21395,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21395,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21400,BCBSND Hospital Base OP Fee Sched Tier 3,753.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,21401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21401,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21406,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21407,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21408,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21421,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21440,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21445,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21450,BCBSND Hospital Base OP Fee Sched Tier 3,753.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,21451,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21451,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21452,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21453,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21453,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21454,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21454,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21461,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21461,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21462,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21462,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21465,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21470,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21480,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,21485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21485,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21490,BCBSND Hospital Base OP Fee Sched Tier 3,3452.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,21497,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21497,BCBSND Hospital Base OP Fee Sched Tier 3,1979.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,21499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21499,BCBSND Hospital Base OP Fee Sched Tier 3,318.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,21501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21501,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21502,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21550,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21552,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21554,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21555,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21556,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21557,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21558,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21600,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,21610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21610,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21685,BCBSND Hospital Base OP Fee Sched Tier 3,6845.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,21700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21700,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21720,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21725,BCBSND Hospital Base OP Fee Sched Tier 3,896.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,21742,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21742,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21743,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21743,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21811,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21811,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21812,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,21813,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21813,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,21820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21820,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,21899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21899,BCBSND Hospital Base OP Fee Sched Tier 3,318.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,21920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21920,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21925,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21930,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21931,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,21932,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21932,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21933,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21933,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21935,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,21936,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,21936,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,22100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22100,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,22101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22101,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,22102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22102,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,22310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22310,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,22315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22315,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,22505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22505,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,22510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22510,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,22511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22511,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,22513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22513,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,22514,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22514,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,22526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22526,BCBSND Hospital Base OP Fee Sched Tier 3,3692.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,22527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22527,BCBSND Hospital Base OP Fee Sched Tier 3,3692.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,22551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22551,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,22554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22554,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,22612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22612,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,22856,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22856,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,22867,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22867,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,22869,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22869,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,22899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22899,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,22900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22900,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,22901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22901,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,22902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22902,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,22903,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22903,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,22904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22904,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,22905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22905,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,22999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,22999,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23000,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,23020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23020,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23030,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,23031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23031,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,23035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23035,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23040,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23044,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23065,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,23066,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23066,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,23071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23071,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,23073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23073,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,23075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23075,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,23076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23076,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,23077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23077,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,23078,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23078,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,23100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23100,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23101,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23105,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23106,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23107,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23120,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23125,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23130,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23140,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23145,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23146,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23146,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23150,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23155,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23156,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23170,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23172,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23174,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23174,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23180,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23182,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23184,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23190,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23195,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23330,BCBSND Hospital Base OP Fee Sched Tier 3,896.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,23333,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23333,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,23334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23334,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,23395,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23395,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23397,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23400,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23405,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23406,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23410,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23412,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23415,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23420,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23430,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23440,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23450,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23455,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23460,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23462,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23462,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23465,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23466,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23466,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23470,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23473,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23473,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23480,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23485,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23490,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23491,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23500,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23505,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23515,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23520,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23525,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23530,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23532,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23532,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23540,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23545,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23550,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23552,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23570,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23575,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23585,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23600,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23605,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23615,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23616,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23620,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23625,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23630,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23650,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23655,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23660,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23665,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23670,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23675,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23680,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23700,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,23800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23800,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,23802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23802,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,23921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23921,BCBSND Hospital Base OP Fee Sched Tier 3,2396.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,23929,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23929,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,23930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23930,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,23931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23931,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,23935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,23935,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24000,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24006,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24065,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,24066,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24066,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,24071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24071,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,24073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24073,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,24075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24075,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,24076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24076,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,24077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24077,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,24079,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24079,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,24100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24100,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24101,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24102,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24105,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24110,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24115,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24116,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24120,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24125,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24126,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24130,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24134,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24134,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24136,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24136,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24138,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24138,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24140,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24145,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24147,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24147,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24149,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24149,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24150,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24152,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24155,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24160,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24164,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24200,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,24201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24201,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,24300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24300,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24301,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24305,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24310,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24320,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24330,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24331,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24332,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24340,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24341,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24342,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24343,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24343,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24344,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24345,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24346,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24357,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24358,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24359,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24359,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24360,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24361,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24362,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24363,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24365,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24366,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24370,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24371,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24400,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24410,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24420,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24430,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24435,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24470,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24495,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24498,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24500,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,24505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24505,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24515,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24516,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24530,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,24535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24535,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24538,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24538,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24545,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24546,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24546,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24560,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,24565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24565,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24566,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24566,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24575,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24576,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,24577,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24577,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24579,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24579,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24582,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24586,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24586,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24587,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24587,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24600,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,24605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24605,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24615,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24620,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24635,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24640,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,24650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24650,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,24655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24655,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24665,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24666,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24666,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24670,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,24675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24675,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,24685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24685,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24800,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24802,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24925,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,24935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24935,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,24999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,24999,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25000,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25001,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25020,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25023,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25023,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25024,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25024,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25025,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25028,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25028,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25031,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25035,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25040,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25065,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,25066,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25066,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,25071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25071,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,25073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25073,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,25075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25075,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,25076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25076,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,25077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25077,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,25078,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25078,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,25085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25085,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25100,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25101,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25105,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25107,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25109,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25109,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25110,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25111,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25112,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25115,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25116,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25118,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25118,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25119,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25119,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25120,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25125,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25126,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25130,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25135,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25136,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25136,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25145,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25150,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25151,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25151,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25170,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25210,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25215,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25230,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25240,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25248,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25250,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25251,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25259,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25259,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25260,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25263,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25265,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25270,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25272,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25274,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25275,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25280,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25290,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25295,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25300,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25301,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25310,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25312,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25315,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25316,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25320,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25332,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25335,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25337,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25350,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25355,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25360,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25365,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25370,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25375,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25390,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25391,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25392,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25393,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25393,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25394,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25394,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25400,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25405,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25415,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25420,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25425,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25426,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25430,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25431,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25440,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25441,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25442,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25443,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25444,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25444,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25445,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25446,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25447,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25449,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25449,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25450,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25455,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25490,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25491,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25492,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25500,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25505,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25515,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25520,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25525,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25526,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25530,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25535,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25545,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25560,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25565,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25574,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25574,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25575,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25600,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25605,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25606,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25607,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25608,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25609,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25609,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25622,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25624,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25628,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25630,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25635,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25645,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25650,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25651,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25652,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25660,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25670,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25671,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25671,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25675,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25676,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25676,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25680,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,25685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25685,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25690,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25695,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25800,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25805,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25810,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25820,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25825,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25830,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,25907,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25907,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25909,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25909,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25922,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,25929,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25929,BCBSND Hospital Base OP Fee Sched Tier 3,2396.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,25931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25931,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,25999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,25999,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26010,BCBSND Hospital Base OP Fee Sched Tier 3,273.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,26011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26011,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,26020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26020,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26025,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26030,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26034,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26035,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26037,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26040,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26045,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26055,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26060,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26070,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26075,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26080,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26100,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26105,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26110,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26111,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,26113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26113,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,26115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26115,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,26116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26116,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,26117,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26117,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,26118,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26118,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,26121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26121,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26123,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26123,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26130,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26135,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26140,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26145,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26160,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26170,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26180,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26185,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26200,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26205,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26210,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26215,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26230,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26235,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26236,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26236,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26250,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26260,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26262,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26320,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,26340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26340,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26341,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26350,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26352,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26356,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26357,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26358,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26370,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26372,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26373,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26390,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26392,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26410,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26412,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26415,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26416,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26418,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26418,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26420,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26426,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26428,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26428,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26432,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26432,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26433,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26433,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26434,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26434,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26437,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26437,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26440,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26442,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26445,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26449,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26449,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26450,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26455,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26460,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26471,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26474,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26474,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26476,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26476,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26477,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26477,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26478,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26478,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26479,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26479,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26480,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26483,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26483,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26485,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26489,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26489,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26490,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26492,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26494,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26494,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26496,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26497,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26497,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26498,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26499,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26500,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26502,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26508,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26508,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26510,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26516,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26517,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26518,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26518,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26520,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26525,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26530,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26531,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26535,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26536,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26536,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26540,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26541,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26542,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26545,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26546,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26546,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26548,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26548,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26550,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26555,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26560,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26561,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26562,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26565,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26567,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26567,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26568,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26568,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26580,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26587,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26587,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26590,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26591,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26591,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26593,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26593,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26596,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26596,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26600,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26605,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26607,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26608,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26615,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26641,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26645,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26650,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26665,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26670,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26675,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26676,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26676,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26685,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26686,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26686,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26700,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26705,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26706,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26715,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26720,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26725,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26727,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26727,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26735,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26735,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26740,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26742,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26742,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,26746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26746,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26750,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26755,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26756,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26756,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26765,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26765,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26770,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26775,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,26776,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26776,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26785,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26820,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26841,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26841,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26842,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26842,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26843,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26843,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26844,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26844,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26850,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26852,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26852,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,26860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26860,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26862,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26862,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26910,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26951,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26952,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26952,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26989,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26989,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,26990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26990,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,26991,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,26991,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27000,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27001,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27003,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27006,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27027,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27033,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27033,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27035,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27040,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,27041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27041,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,27043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27043,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27045,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27047,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27048,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27049,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27049,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27050,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27052,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27052,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27057,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27057,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27059,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27059,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27060,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27062,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27062,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27065,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27066,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27066,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27067,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27067,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27080,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27086,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27086,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,27087,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27087,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27096,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27096,BCBSND Hospital Base OP Fee Sched Tier 3,197.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,27097,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27097,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27098,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27098,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27100,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27105,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27110,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27111,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27130,BCBSND Hospital Base OP Fee Sched Tier 3,16977.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,27179,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27179,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27197,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27198,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27198,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27200,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27202,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27215,BCBSND Hospital Base OP Fee Sched Tier 3,5340.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,27216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27216,BCBSND Hospital Base OP Fee Sched Tier 3,3692.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,27217,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27217,BCBSND Hospital Base OP Fee Sched Tier 3,5340.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,27218,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27218,BCBSND Hospital Base OP Fee Sched Tier 3,5340.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,27220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27220,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27222,BCBSND Hospital Base OP Fee Sched Tier 3,1829.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,27230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27230,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27235,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27238,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27246,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27250,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27252,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27256,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27256,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27257,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27265,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27266,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27266,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27267,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27275,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27279,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27279,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27299,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27301,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27303,BCBSND Hospital Base OP Fee Sched Tier 3,2427.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,27305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27305,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27306,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27307,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27310,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27323,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,27324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27324,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27325,BCBSND Hospital Base OP Fee Sched Tier 3,2524.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,27326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27326,BCBSND Hospital Base OP Fee Sched Tier 3,2524.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,27327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27327,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,27328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27328,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27329,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27330,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27331,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27332,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27333,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27333,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27334,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27335,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27337,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27339,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27339,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27340,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27345,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27347,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27347,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27350,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27355,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27356,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27357,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27360,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27364,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27372,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27380,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27381,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27385,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27386,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27390,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27391,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27392,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27393,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27393,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27394,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27394,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27395,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27395,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27396,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27397,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27400,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27403,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27405,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27407,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27409,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27409,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27412,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27415,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27416,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27418,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27418,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27420,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27422,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27422,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27424,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27424,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27425,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27427,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27427,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27428,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27428,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27429,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27429,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27430,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27435,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27437,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27437,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27438,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27438,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27440,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27441,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27442,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27443,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27446,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27447,BCBSND Hospital Base OP Fee Sched Tier 3,15881.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,27472,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27472,BCBSND Hospital Base OP Fee Sched Tier 3,3996.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,27475,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27475,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27477,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27477,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27479,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27479,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27485,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27496,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27497,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27497,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27498,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27499,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27500,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27501,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27502,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27503,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27508,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27508,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27509,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27509,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27510,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27516,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27517,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27520,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27524,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27524,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27530,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27532,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27532,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27535,BCBSND Hospital Base OP Fee Sched Tier 3,3996.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,27538,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27538,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27540,BCBSND Hospital Base OP Fee Sched Tier 3,3996.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,27550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27550,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27552,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27556,BCBSND Hospital Base OP Fee Sched Tier 3,3996.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,27560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27560,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27562,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27566,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27566,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27570,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27594,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27594,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27599,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27599,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27600,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27601,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27602,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27603,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27604,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27605,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27606,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27607,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27610,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27612,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27613,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27613,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,27614,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27614,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27615,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27616,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27618,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,27619,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27619,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27620,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27625,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27626,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27630,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27632,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27634,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27634,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,27635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27635,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27637,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27637,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27638,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27640,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27641,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27647,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27650,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27652,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27654,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27654,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27656,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27656,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27658,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27658,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27659,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27659,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27664,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27664,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27665,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27675,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27676,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27676,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27680,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27681,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27681,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27685,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27686,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27686,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27687,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27687,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27690,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27691,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27691,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27695,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27696,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27698,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27698,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27700,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27704,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27704,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27705,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27707,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27707,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27709,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27709,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27720,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27722,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27722,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27726,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27726,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27730,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27732,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27732,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27734,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27734,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27740,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27742,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27742,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27745,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27750,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27752,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27752,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27756,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27756,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27758,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27758,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27759,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27759,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27760,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27762,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27766,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27766,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27767,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27767,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27768,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27768,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27769,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27769,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27780,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27781,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27781,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27784,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27784,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27786,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27786,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27788,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27788,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27792,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27792,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27808,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27810,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27814,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27814,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27816,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27816,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27818,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27818,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27822,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27823,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27823,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27824,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27824,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27825,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27826,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27826,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27827,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27827,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27828,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27828,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27829,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27829,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27830,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27831,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27832,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27832,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27840,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,27842,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27842,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,27846,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27846,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27848,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27848,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27860,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27870,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27871,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27871,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27884,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27884,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27889,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27889,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27892,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27892,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27893,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27893,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,27894,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27894,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,27899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,27899,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28001,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,28002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28002,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28003,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28005,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28008,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28008,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28010,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28011,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28020,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28022,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28024,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28024,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28035,BCBSND Hospital Base OP Fee Sched Tier 3,2524.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,28039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28039,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,28041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28041,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,28043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28043,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,28045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28045,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,28046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28046,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,28047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28047,BCBSND Hospital Base OP Fee Sched Tier 3,3680.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,28050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28050,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28052,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28052,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28054,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28054,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28055,BCBSND Hospital Base OP Fee Sched Tier 3,2524.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,28060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28060,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28062,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28062,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28070,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28072,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28072,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28080,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28086,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28086,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28088,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28088,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28090,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28092,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28092,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28100,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28102,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28103,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28104,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28106,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28107,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28108,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28110,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28111,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28112,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28113,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28114,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28116,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28118,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28118,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28119,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28119,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28120,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28122,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28122,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28124,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28124,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28126,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28130,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28140,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28150,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28153,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28160,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28171,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28171,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28173,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28173,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28175,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28190,BCBSND Hospital Base OP Fee Sched Tier 3,896.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,28192,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28192,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,28193,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28193,BCBSND Hospital Base OP Fee Sched Tier 3,2128.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,28200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28200,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28202,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28208,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28210,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28220,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28222,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28225,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28226,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28230,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28232,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28234,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28234,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28238,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28240,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28250,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28260,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28261,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28262,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28264,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28270,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28272,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28280,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28285,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28286,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28286,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28288,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28288,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28289,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28289,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28291,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28292,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28292,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28295,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28296,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28297,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28297,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28298,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28298,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28299,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28300,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28302,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28304,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28305,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28306,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28307,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28308,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28309,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28309,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28310,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28312,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28313,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28315,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28320,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28322,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28340,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28341,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28344,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28345,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28360,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28400,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28405,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28406,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28415,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28420,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28430,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28435,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28436,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28445,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28446,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28450,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28455,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28456,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28465,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28470,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28475,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28475,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28476,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28476,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28485,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28490,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28495,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28496,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28505,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28510,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28515,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28525,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28530,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28531,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28540,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28545,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28546,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28546,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28555,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28570,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28575,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28576,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28585,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28600,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28605,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28606,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28615,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28630,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28635,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28636,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28645,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28660,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,28665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28665,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,28666,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28666,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28675,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28705,BCBSND Hospital Base OP Fee Sched Tier 3,23833.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28715,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28725,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28730,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28735,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28735,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28737,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28737,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28740,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28750,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28755,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28760,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,28805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28805,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28810,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28820,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28825,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,28890,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28890,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,28899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,28899,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,29000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29000,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29010,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29015,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29035,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29040,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29044,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29046,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29049,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29049,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29055,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29058,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29058,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29065,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29075,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29085,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29086,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29086,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29105,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29125,BCBSND Hospital Base OP Fee Sched Tier 3,164.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,29126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29126,BCBSND Hospital Base OP Fee Sched Tier 3,164.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,29130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29130,BCBSND Hospital Base OP Fee Sched Tier 3,86.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,29131,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29131,BCBSND Hospital Base OP Fee Sched Tier 3,86.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,29200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29200,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29240,BCBSND Hospital Base OP Fee Sched Tier 3,164.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,29260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29260,BCBSND Hospital Base OP Fee Sched Tier 3,49.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,29280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29280,BCBSND Hospital Base OP Fee Sched Tier 3,49.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,29305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29305,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29325,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29345,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29355,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29358,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29365,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29405,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29425,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29435,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29440,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29445,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29450,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29505,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29515,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29520,BCBSND Hospital Base OP Fee Sched Tier 3,86.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,29530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29530,BCBSND Hospital Base OP Fee Sched Tier 3,164.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,29540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29540,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29550,BCBSND Hospital Base OP Fee Sched Tier 3,86.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,29580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29580,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29581,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29581,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29584,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29584,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29700,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29705,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29710,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29720,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29730,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29740,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29750,BCBSND Hospital Base OP Fee Sched Tier 3,364.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,29799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29799,BCBSND Hospital Base OP Fee Sched Tier 3,208.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,29800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29800,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29804,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29804,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29805,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29806,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29807,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29807,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29819,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29819,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29820,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29821,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29822,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29823,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29823,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29824,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29824,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29825,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29827,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29827,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29828,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29828,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29830,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29834,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29834,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29835,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29835,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29836,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29836,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29837,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29837,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29838,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29838,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29840,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29843,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29843,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29844,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29844,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29845,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29845,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29846,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29846,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29847,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29847,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29848,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29848,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,29850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29850,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,29851,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29851,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,29855,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29855,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29856,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29856,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29860,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29861,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29861,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29862,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29862,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29863,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29863,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29866,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29866,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29867,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29867,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29868,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29868,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29870,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29871,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29871,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29873,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29873,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29874,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29874,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29875,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29875,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29876,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29876,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29877,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29877,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29879,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29879,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29880,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29881,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29881,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29882,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29882,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29883,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29883,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29884,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29884,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29885,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29886,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29886,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29887,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29887,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29888,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29888,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29889,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29889,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29891,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29891,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29892,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29892,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29893,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29893,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29894,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29894,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29895,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29895,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29897,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29897,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29898,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29898,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29899,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29900,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29901,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29902,BCBSND Hospital Base OP Fee Sched Tier 3,2032.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,29904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29904,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29905,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29906,BCBSND Hospital Base OP Fee Sched Tier 3,4059.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29907,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29907,BCBSND Hospital Base OP Fee Sched Tier 3,16578.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,29914,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29914,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29915,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29915,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29916,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29916,BCBSND Hospital Base OP Fee Sched Tier 3,8819.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,29999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,29999,BCBSND Hospital Base OP Fee Sched Tier 3,348.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,30000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30000,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,30020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30020,BCBSND Hospital Base OP Fee Sched Tier 3,674.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,30100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30100,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,30110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30110,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,30115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30115,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30117,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30117,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30118,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30118,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30120,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30124,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30124,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,30125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30125,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30130,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30140,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30150,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30160,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30200,BCBSND Hospital Base OP Fee Sched Tier 3,674.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,30210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30210,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,30220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30220,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,30300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30300,BCBSND Hospital Base OP Fee Sched Tier 3,147.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,30310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30310,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30320,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,30400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30400,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30410,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30420,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30430,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30435,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30450,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30460,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30462,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30462,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30465,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30520,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30540,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30545,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30560,BCBSND Hospital Base OP Fee Sched Tier 3,674.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,30580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30580,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30600,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30620,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,30630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30630,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30801,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,30802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30802,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,30901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30901,BCBSND Hospital Base OP Fee Sched Tier 3,147.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,30903,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30903,BCBSND Hospital Base OP Fee Sched Tier 3,147.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,30905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30905,BCBSND Hospital Base OP Fee Sched Tier 3,147.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,30906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30906,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,30915,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30915,BCBSND Hospital Base OP Fee Sched Tier 3,3655.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,30920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30920,BCBSND Hospital Base OP Fee Sched Tier 3,3655.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,30930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30930,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,30999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,30999,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,31000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31000,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,31002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31002,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,31020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31020,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31030,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31032,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31040,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31050,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31051,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31070,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31075,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31080,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31081,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31084,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31084,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31085,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31086,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31086,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31087,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31087,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31090,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31200,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31201,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31205,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31225,BCBSND Hospital Base OP Fee Sched Tier 3,2412.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,31231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31231,BCBSND Hospital Base OP Fee Sched Tier 3,226.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,31233,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31233,BCBSND Hospital Base OP Fee Sched Tier 3,534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,31235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31235,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31237,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31237,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31238,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31239,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31239,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31240,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31241,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31253,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31253,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31254,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31254,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31255,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31256,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31256,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31257,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31259,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31259,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31267,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31276,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31287,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31287,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31288,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31288,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31290,BCBSND Hospital Base OP Fee Sched Tier 3,4575.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,31292,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31292,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31293,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31293,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31294,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31294,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31295,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31296,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31297,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31297,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31298,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31298,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31299,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,31300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31300,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31400,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31420,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31500,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,31502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31502,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,31505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31505,BCBSND Hospital Base OP Fee Sched Tier 3,226.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,31510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31510,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31511,BCBSND Hospital Base OP Fee Sched Tier 3,226.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,31512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31512,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31513,BCBSND Hospital Base OP Fee Sched Tier 3,534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,31515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31515,BCBSND Hospital Base OP Fee Sched Tier 3,534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,31520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31520,BCBSND Hospital Base OP Fee Sched Tier 3,534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,31525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31525,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31526,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31527,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31528,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31528,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31529,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31529,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31530,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31531,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31535,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31536,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31536,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31540,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31541,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31545,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31546,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31546,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31551,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31552,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31553,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31554,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31560,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31561,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31570,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31571,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31572,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31573,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31573,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31574,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31574,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31575,BCBSND Hospital Base OP Fee Sched Tier 3,226.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,31576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31576,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31577,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31577,BCBSND Hospital Base OP Fee Sched Tier 3,534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,31578,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31578,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31579,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31579,BCBSND Hospital Base OP Fee Sched Tier 3,534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,31580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31580,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31584,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31584,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31587,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31587,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31590,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31591,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31591,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31592,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31592,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31599,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31599,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,31600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31600,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31601,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31603,BCBSND Hospital Base OP Fee Sched Tier 3,1770.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,31605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31605,BCBSND Hospital Base OP Fee Sched Tier 3,285.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,31610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31610,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31611,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31612,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31613,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31613,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31614,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31614,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31615,BCBSND Hospital Base OP Fee Sched Tier 3,674.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,31622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31622,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31623,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31624,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31625,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31626,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31628,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31629,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31629,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31630,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31631,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31634,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31634,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31635,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31636,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31638,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31640,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31641,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31643,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31643,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31645,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31646,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31646,BCBSND Hospital Base OP Fee Sched Tier 3,534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,31647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31647,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31648,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31648,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31649,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31649,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31652,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31653,BCBSND Hospital Base OP Fee Sched Tier 3,3792.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,31660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31660,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31661,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31661,BCBSND Hospital Base OP Fee Sched Tier 3,7123.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,31717,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31717,BCBSND Hospital Base OP Fee Sched Tier 3,534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,31720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31720,BCBSND Hospital Base OP Fee Sched Tier 3,265.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,31730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31730,BCBSND Hospital Base OP Fee Sched Tier 3,1894.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,31750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31750,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31755,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31785,BCBSND Hospital Base OP Fee Sched Tier 3,6122.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,31820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31820,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31825,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31830,BCBSND Hospital Base OP Fee Sched Tier 3,3087.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,31899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,31899,BCBSND Hospital Base OP Fee Sched Tier 3,226.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,32400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32400,BCBSND Hospital Base OP Fee Sched Tier 3,1903.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,32405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32405,BCBSND Hospital Base OP Fee Sched Tier 3,1903.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,32550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32550,BCBSND Hospital Base OP Fee Sched Tier 3,4078.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,32551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32551,BCBSND Hospital Base OP Fee Sched Tier 3,1513.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,32552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32552,BCBSND Hospital Base OP Fee Sched Tier 3,857.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,32553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32553,BCBSND Hospital Base OP Fee Sched Tier 3,1649.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,32554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32554,BCBSND Hospital Base OP Fee Sched Tier 3,857.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,32555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32555,BCBSND Hospital Base OP Fee Sched Tier 3,857.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,32556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32556,BCBSND Hospital Base OP Fee Sched Tier 3,2052.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,32557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32557,BCBSND Hospital Base OP Fee Sched Tier 3,1513.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,32560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32560,BCBSND Hospital Base OP Fee Sched Tier 3,857.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,32561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32561,BCBSND Hospital Base OP Fee Sched Tier 3,857.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,32562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32562,BCBSND Hospital Base OP Fee Sched Tier 3,857.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,32601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32601,BCBSND Hospital Base OP Fee Sched Tier 3,6359.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,32604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32604,BCBSND Hospital Base OP Fee Sched Tier 3,6359.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,32606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32606,BCBSND Hospital Base OP Fee Sched Tier 3,6359.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,32607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32607,BCBSND Hospital Base OP Fee Sched Tier 3,6359.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,32608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32608,BCBSND Hospital Base OP Fee Sched Tier 3,6359.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,32609,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32609,BCBSND Hospital Base OP Fee Sched Tier 3,6359.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,32664,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32664,BCBSND Hospital Base OP Fee Sched Tier 3,11067.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,32960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32960,BCBSND Hospital Base OP Fee Sched Tier 3,857.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,32994,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32994,BCBSND Hospital Base OP Fee Sched Tier 3,6359.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,32998,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32998,BCBSND Hospital Base OP Fee Sched Tier 3,6359.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,32999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,32999,BCBSND Hospital Base OP Fee Sched Tier 3,857.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,33010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33010,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,33011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33011,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,33206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33206,BCBSND Hospital Base OP Fee Sched Tier 3,17089.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,33207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33207,BCBSND Hospital Base OP Fee Sched Tier 3,17089.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,33208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33208,BCBSND Hospital Base OP Fee Sched Tier 3,17089.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,33210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33210,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33211,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33212,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33213,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33213,BCBSND Hospital Base OP Fee Sched Tier 3,17089.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,33214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33214,BCBSND Hospital Base OP Fee Sched Tier 3,17089.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,33215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33215,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,33216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33216,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33217,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33217,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33218,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33218,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,33220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33220,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,33221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33221,BCBSND Hospital Base OP Fee Sched Tier 3,30580.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,33222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33222,BCBSND Hospital Base OP Fee Sched Tier 3,2679.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,33223,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33223,BCBSND Hospital Base OP Fee Sched Tier 3,2679.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,33224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33224,BCBSND Hospital Base OP Fee Sched Tier 3,17089.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,33226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33226,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,33227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33227,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33228,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33228,BCBSND Hospital Base OP Fee Sched Tier 3,17089.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,33229,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33229,BCBSND Hospital Base OP Fee Sched Tier 3,30580.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,33230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33230,BCBSND Hospital Base OP Fee Sched Tier 3,38048.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,33231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33231,BCBSND Hospital Base OP Fee Sched Tier 3,53028.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,33233,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33233,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33234,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33234,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,33235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33235,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,33240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33240,BCBSND Hospital Base OP Fee Sched Tier 3,38048.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,33241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33241,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,33244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33244,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,33249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33249,BCBSND Hospital Base OP Fee Sched Tier 3,53028.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,33262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33262,BCBSND Hospital Base OP Fee Sched Tier 3,38048.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,33263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33263,BCBSND Hospital Base OP Fee Sched Tier 3,38048.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,33264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33264,BCBSND Hospital Base OP Fee Sched Tier 3,53028.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,33270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33270,BCBSND Hospital Base OP Fee Sched Tier 3,53028.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,33271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33271,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33272,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,33273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33273,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,33274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33274,BCBSND Hospital Base OP Fee Sched Tier 3,26559.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,33275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33275,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,33285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33285,BCBSND Hospital Base OP Fee Sched Tier 3,12807.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,33286,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33286,BCBSND Hospital Base OP Fee Sched Tier 3,1002.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,33289,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33289,BCBSND Hospital Base OP Fee Sched Tier 3,50752.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,33999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,33999,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,34101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34101,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,34111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34111,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,34201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34201,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,34203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34203,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,34421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34421,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,34471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34471,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,34490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34490,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,34501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34501,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,34510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34510,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,34520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34520,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,34530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,34530,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,35011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35011,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35045,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35180,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,35184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35184,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,35188,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35188,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35190,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35201,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35206,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,35207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35207,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,35226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35226,BCBSND Hospital Base OP Fee Sched Tier 3,1002.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,35231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35231,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,35236,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35236,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35256,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35256,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35261,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,35266,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35266,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35286,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35286,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35321,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35761,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,35860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35860,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,35875,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35875,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35876,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35876,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35879,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35879,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35881,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35881,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35883,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35883,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35884,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35884,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,35903,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,35903,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36002,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,36221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36221,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36222,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36223,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36223,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36224,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36225,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36226,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36251,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36252,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36253,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36253,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36254,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36254,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36260,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36261,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,36262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36262,BCBSND Hospital Base OP Fee Sched Tier 3,5415.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,36400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36400,BCBSND Hospital Base OP Fee Sched Tier 3,67.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,36405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36405,BCBSND Hospital Base OP Fee Sched Tier 3,59.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,36406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36406,BCBSND Hospital Base OP Fee Sched Tier 3,42.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,36415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36415,BCBSND Hospital Base OP Fee Sched Tier 3,11.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,36420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36420,BCBSND Hospital Base OP Fee Sched Tier 3,96.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,36425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36425,BCBSND Hospital Base OP Fee Sched Tier 3,602.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,36430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36430,BCBSND Hospital Base OP Fee Sched Tier 3,662.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,36440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36440,BCBSND Hospital Base OP Fee Sched Tier 3,662.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,36450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36450,BCBSND Hospital Base OP Fee Sched Tier 3,662.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,36455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36455,BCBSND Hospital Base OP Fee Sched Tier 3,662.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,36456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36456,BCBSND Hospital Base OP Fee Sched Tier 3,662.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,36460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36460,BCBSND Hospital Base OP Fee Sched Tier 3,662.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,36465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36465,BCBSND Hospital Base OP Fee Sched Tier 3,2679.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,36466,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36466,BCBSND Hospital Base OP Fee Sched Tier 3,2679.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,36468,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36468,BCBSND Hospital Base OP Fee Sched Tier 3,305.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,36470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36470,BCBSND Hospital Base OP Fee Sched Tier 3,543.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,36471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36471,BCBSND Hospital Base OP Fee Sched Tier 3,543.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,36473,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36473,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36475,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36475,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36478,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36478,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36482,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36511,BCBSND Hospital Base OP Fee Sched Tier 3,2157.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,36512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36512,BCBSND Hospital Base OP Fee Sched Tier 3,2157.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,36513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36513,BCBSND Hospital Base OP Fee Sched Tier 3,662.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,36514,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36514,BCBSND Hospital Base OP Fee Sched Tier 3,2157.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,36516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36516,BCBSND Hospital Base OP Fee Sched Tier 3,6785.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,36522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36522,BCBSND Hospital Base OP Fee Sched Tier 3,6785.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,36555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36555,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36556,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36557,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36558,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36560,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36561,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36563,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36563,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36565,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36566,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36566,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36568,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36568,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,36569,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36569,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36570,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36571,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36572,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,36573,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36573,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36575,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,36576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36576,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36578,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36578,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36580,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36581,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36581,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36582,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36583,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36583,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36584,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36584,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36585,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36589,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36589,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,36590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36590,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,36591,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36591,BCBSND Hospital Base OP Fee Sched Tier 3,133.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,36592,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36592,BCBSND Hospital Base OP Fee Sched Tier 3,133.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,36593,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36593,BCBSND Hospital Base OP Fee Sched Tier 3,498.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,36595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36595,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36596,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36596,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36597,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36597,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36598,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36598,BCBSND Hospital Base OP Fee Sched Tier 3,323.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,36600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36600,BCBSND Hospital Base OP Fee Sched Tier 3,184.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,36640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36640,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36680,BCBSND Hospital Base OP Fee Sched Tier 3,602.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,36800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36800,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36810,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36815,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36815,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36818,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36818,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36819,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36819,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36820,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36821,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36825,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36830,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36831,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36832,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36832,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36833,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36833,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36835,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36835,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,36838,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36838,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36860,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,36861,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36861,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,36901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36901,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,36902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36902,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,36903,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36903,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,36904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36904,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,36905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36905,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,36906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,36906,BCBSND Hospital Base OP Fee Sched Tier 3,26559.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,37183,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37183,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,37184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37184,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,37187,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37187,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,37188,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37188,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37191,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37191,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,37192,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37192,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37193,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37193,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37195,BCBSND Hospital Base OP Fee Sched Tier 3,498.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,37197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37197,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37200,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,37211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37211,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,37212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37212,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37213,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37213,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,37214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37214,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,37220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37220,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,37221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37221,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37224,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,37225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37225,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37226,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37227,BCBSND Hospital Base OP Fee Sched Tier 3,26559.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,37228,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37228,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37229,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37229,BCBSND Hospital Base OP Fee Sched Tier 3,26559.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,37230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37230,BCBSND Hospital Base OP Fee Sched Tier 3,26559.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,37231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37231,BCBSND Hospital Base OP Fee Sched Tier 3,26559.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,37236,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37236,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37238,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37241,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37242,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37242,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37243,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37243,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37244,BCBSND Hospital Base OP Fee Sched Tier 3,16725.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,37246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37246,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,37248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37248,BCBSND Hospital Base OP Fee Sched Tier 3,8092.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,37500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37500,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,37501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37501,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,37565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37565,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,37600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37600,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37605,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37606,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37607,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37609,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37609,BCBSND Hospital Base OP Fee Sched Tier 3,2379.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,37615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37615,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,37618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37618,BCBSND Hospital Base OP Fee Sched Tier 3,4191.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,37619,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37619,BCBSND Hospital Base OP Fee Sched Tier 3,7570.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,37650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37650,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37660,BCBSND Hospital Base OP Fee Sched Tier 3,4191.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,37700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37700,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37718,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37718,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37722,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37722,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37735,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37735,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37760,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37761,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,37765,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37765,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37766,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37766,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37780,BCBSND Hospital Base OP Fee Sched Tier 3,1891.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,37785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37785,BCBSND Hospital Base OP Fee Sched Tier 3,4569.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,37790,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37790,BCBSND Hospital Base OP Fee Sched Tier 3,5062.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,37799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,37799,BCBSND Hospital Base OP Fee Sched Tier 3,1072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,38120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38120,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,38129,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38129,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,38206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38206,BCBSND Hospital Base OP Fee Sched Tier 3,1804.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,38207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38207,BCBSND Hospital Base OP Fee Sched Tier 3,478.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,38208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38208,BCBSND Hospital Base OP Fee Sched Tier 3,478.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,38209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38209,BCBSND Hospital Base OP Fee Sched Tier 3,478.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,38210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38210,BCBSND Hospital Base OP Fee Sched Tier 3,553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38211,BCBSND Hospital Base OP Fee Sched Tier 3,553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38212,BCBSND Hospital Base OP Fee Sched Tier 3,553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38213,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38213,BCBSND Hospital Base OP Fee Sched Tier 3,553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38214,BCBSND Hospital Base OP Fee Sched Tier 3,553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38215,BCBSND Hospital Base OP Fee Sched Tier 3,553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38220,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,38221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38221,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,38222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38222,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,38230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38230,BCBSND Hospital Base OP Fee Sched Tier 3,1804.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,38232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38232,BCBSND Hospital Base OP Fee Sched Tier 3,5674.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,38240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38240,BCBSND Hospital Base OP Fee Sched Tier 3,54820.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,38241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38241,BCBSND Hospital Base OP Fee Sched Tier 3,1804.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,38242,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38242,BCBSND Hospital Base OP Fee Sched Tier 3,1804.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,38243,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38243,BCBSND Hospital Base OP Fee Sched Tier 3,1804.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,38300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38300,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,38305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38305,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,38308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38308,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,38500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38500,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,38505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38505,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,38510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38510,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,38520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38520,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,38525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38525,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,38530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38530,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,38531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38531,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,38542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38542,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,38550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38550,BCBSND Hospital Base OP Fee Sched Tier 3,4073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,38555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38555,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38570,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,38571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38571,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,38572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38572,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,38573,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38573,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,38589,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38589,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,38700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38700,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38720,BCBSND Hospital Base OP Fee Sched Tier 3,10776.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,38740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38740,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,38745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38745,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,38760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38760,BCBSND Hospital Base OP Fee Sched Tier 3,7110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,38792,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38792,BCBSND Hospital Base OP Fee Sched Tier 3,511.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,38999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,38999,BCBSND Hospital Base OP Fee Sched Tier 3,553.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,39401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,39401,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,39402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,39402,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,40490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40490,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,40500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40500,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40510,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40520,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40525,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40527,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40530,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40650,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,40652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40652,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,40654,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40654,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,40700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40700,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40701,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40702,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40720,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40761,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40799,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,40800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40800,BCBSND Hospital Base OP Fee Sched Tier 3,925.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,40801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40801,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,40804,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40804,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,40805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40805,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,40806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40806,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,40808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40808,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,40810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40810,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40812,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40814,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40814,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40816,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40816,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40818,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40818,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,40819,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40819,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,40820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40820,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,40830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40830,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,40831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40831,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,40840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40840,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40842,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40842,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40843,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40843,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40844,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40844,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40845,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40845,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,40899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,40899,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,41000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41000,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,41005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41005,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,41006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41006,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41007,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41008,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41008,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41009,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,41010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41010,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41015,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,41016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41016,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,41017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41017,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41018,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41019,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41019,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,41100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41100,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,41105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41105,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41108,BCBSND Hospital Base OP Fee Sched Tier 3,2197.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,41110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41110,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41112,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41113,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41114,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41115,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41116,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41120,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,41250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41250,BCBSND Hospital Base OP Fee Sched Tier 3,170.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,41251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41251,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,41252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41252,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,41510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41510,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41512,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,41520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41520,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41530,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41599,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41599,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,41800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41800,BCBSND Hospital Base OP Fee Sched Tier 3,170.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,41805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41805,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41806,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41820,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41821,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41822,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41823,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41823,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,41825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41825,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41826,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41826,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41827,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41827,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,41828,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41828,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41830,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41850,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,41870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41870,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41872,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41872,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41874,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41874,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,41899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,41899,BCBSND Hospital Base OP Fee Sched Tier 3,2243.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,42000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42000,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,42100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42100,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,42104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42104,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42106,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42107,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42120,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42140,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42145,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42160,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42180,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,42182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42182,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42200,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42205,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42210,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42215,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42220,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42225,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42226,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42227,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42235,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42260,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42280,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,42281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42281,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42299,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,42300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42300,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,42305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42305,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42310,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,42320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42320,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,42330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42330,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42335,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42340,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42400,BCBSND Hospital Base OP Fee Sched Tier 3,925.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,42405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42405,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42408,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42409,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42409,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42410,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42415,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42420,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42425,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42440,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42450,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42500,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42505,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42507,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42509,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42509,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42510,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42600,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42650,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,42660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42660,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,42665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42665,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42699,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42699,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,42700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42700,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,42720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42720,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42725,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42800,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42804,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42804,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42806,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42808,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42809,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42809,BCBSND Hospital Base OP Fee Sched Tier 3,556.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,42810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42810,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42815,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42815,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42820,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42821,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42825,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42826,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42826,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42830,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42831,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42835,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42835,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42836,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42836,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42842,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42842,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42844,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42844,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42860,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42870,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42890,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42890,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42892,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42892,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42900,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,42950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42950,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,42955,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42955,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,42960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42960,BCBSND Hospital Base OP Fee Sched Tier 3,778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,42961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42961,BCBSND Hospital Base OP Fee Sched Tier 3,3906.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,42962,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42962,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42970,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,42972,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42972,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,42999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,42999,BCBSND Hospital Base OP Fee Sched Tier 3,329.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,43020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43020,BCBSND Hospital Base OP Fee Sched Tier 3,2043.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,43030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43030,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,43130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43130,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,43180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43180,BCBSND Hospital Base OP Fee Sched Tier 3,7068.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,43191,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43191,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43192,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43192,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43193,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43193,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43194,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43194,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43195,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43196,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43196,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43197,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43198,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43198,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43200,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43201,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43202,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43204,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43204,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43205,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43206,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43210,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,43211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43211,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43212,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,43213,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43213,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43214,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43215,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43216,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43217,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43217,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43220,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43226,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43227,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43229,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43229,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43231,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43232,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43233,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43233,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43235,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43236,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43236,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43237,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43237,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43238,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43239,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43239,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43240,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43241,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43242,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43242,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43243,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43243,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43244,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43245,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43246,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43247,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43247,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43248,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43249,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43250,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43251,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43252,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43253,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43253,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43254,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43254,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43255,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43257,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43259,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43259,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43260,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43261,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43262,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43263,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43264,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43265,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,43266,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43266,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,43270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43270,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43274,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,43275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43275,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43276,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,43277,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43277,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43278,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43278,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43280,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,43281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43281,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,43282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43282,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,43284,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43284,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,43285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43285,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43289,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43289,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43420,BCBSND Hospital Base OP Fee Sched Tier 3,3564.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,43450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43450,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43453,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43453,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43499,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43510,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43647,BCBSND Hospital Base OP Fee Sched Tier 3,9553.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,43648,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43648,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43651,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43652,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43653,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43659,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43659,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43752,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43752,BCBSND Hospital Base OP Fee Sched Tier 3,556.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,43753,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43753,BCBSND Hospital Base OP Fee Sched Tier 3,403.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,43754,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43754,BCBSND Hospital Base OP Fee Sched Tier 3,403.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,43755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43755,BCBSND Hospital Base OP Fee Sched Tier 3,217.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,43756,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43756,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43757,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43757,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43761,BCBSND Hospital Base OP Fee Sched Tier 3,369.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,43762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43762,BCBSND Hospital Base OP Fee Sched Tier 3,369.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,43763,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43763,BCBSND Hospital Base OP Fee Sched Tier 3,369.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,43770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43770,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,43771,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43771,BCBSND Hospital Base OP Fee Sched Tier 3,6892.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,43772,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43772,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43773,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43773,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43774,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43774,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43830,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,43831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43831,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,43870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43870,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,43886,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43886,BCBSND Hospital Base OP Fee Sched Tier 3,4419.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,43887,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43887,BCBSND Hospital Base OP Fee Sched Tier 3,2474.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,43888,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43888,BCBSND Hospital Base OP Fee Sched Tier 3,4419.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,43999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,43999,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44100,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44180,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44186,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44238,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44312,BCBSND Hospital Base OP Fee Sched Tier 3,4419.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,44340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44340,BCBSND Hospital Base OP Fee Sched Tier 3,4419.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,44346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44346,BCBSND Hospital Base OP Fee Sched Tier 3,7528.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,44360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44360,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44361,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44363,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44364,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44365,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44366,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44369,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44369,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44370,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,44372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44372,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44373,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44376,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44377,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44377,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44378,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44378,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44379,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,44380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44380,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44381,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,44382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44382,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44384,BCBSND Hospital Base OP Fee Sched Tier 3,4512.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,44385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44385,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,44386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44386,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,44388,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44388,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,44389,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44389,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44390,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44391,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44392,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44394,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44394,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44401,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44402,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,44403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44403,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44404,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44404,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44405,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44406,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44407,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,44408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44408,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,44500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44500,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44799,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44950,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,44970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44970,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,44979,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,44979,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,45000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45000,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45005,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45020,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45100,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45108,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45150,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45160,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45171,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45171,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45172,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45190,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45300,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45303,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45305,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45307,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45308,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45309,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45309,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45315,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45317,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45317,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45320,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45321,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45327,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,45330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45330,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45331,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45332,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45333,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45333,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45334,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45335,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45337,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45338,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45338,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45340,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45341,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45342,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45346,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45347,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45347,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,45349,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45349,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45350,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45378,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45378,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45379,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45380,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45381,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45382,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45384,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45385,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45386,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45388,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45388,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45389,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45389,BCBSND Hospital Base OP Fee Sched Tier 3,7183.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,45390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45390,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45391,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45392,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45393,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45393,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45398,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45398,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45399,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45499,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,45500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45500,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45505,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45520,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45541,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45560,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45900,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,45905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45905,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45910,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45915,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45915,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,45990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45990,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,45999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,45999,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,46020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46020,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46030,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46040,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46045,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46050,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,46060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46060,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46070,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46080,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46083,BCBSND Hospital Base OP Fee Sched Tier 3,369.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,46200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46200,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46220,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46221,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,46230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46230,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46250,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46255,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46257,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46258,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46258,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46260,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46261,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46262,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46270,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46275,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46280,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46285,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46288,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46288,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46320,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46500,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,46505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46505,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46600,BCBSND Hospital Base OP Fee Sched Tier 3,170.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,46601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46601,BCBSND Hospital Base OP Fee Sched Tier 3,170.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,46604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46604,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46606,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46607,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46608,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,46610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46610,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46611,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,46612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46612,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46614,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46614,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46615,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46700,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46706,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46707,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46707,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46750,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46753,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46753,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46754,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46754,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46760,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46761,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46900,BCBSND Hospital Base OP Fee Sched Tier 3,501.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,46910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46910,BCBSND Hospital Base OP Fee Sched Tier 3,2474.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,46916,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46916,BCBSND Hospital Base OP Fee Sched Tier 3,281.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,46917,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46917,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46922,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46924,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46924,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46930,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,46940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46940,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46942,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46942,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,46945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46945,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46946,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46946,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46947,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46947,BCBSND Hospital Base OP Fee Sched Tier 3,3729.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,46999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,46999,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,47000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47000,BCBSND Hospital Base OP Fee Sched Tier 3,2197.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,47370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47370,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,47371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47371,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,47379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47379,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47382,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47383,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47383,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47399,BCBSND Hospital Base OP Fee Sched Tier 3,925.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,47490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47490,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47531,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47532,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47532,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47533,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47533,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47534,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47534,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47535,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47536,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47536,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47537,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47537,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47538,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47538,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47539,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47539,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47540,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47541,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47552,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47553,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47554,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47555,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,47556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47556,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47562,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47563,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47563,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47564,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47564,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47570,BCBSND Hospital Base OP Fee Sched Tier 3,6966.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,47579,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47579,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,47600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47600,BCBSND Hospital Base OP Fee Sched Tier 3,6772.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,47999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,47999,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,48102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,48102,BCBSND Hospital Base OP Fee Sched Tier 3,2197.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,48999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,48999,BCBSND Hospital Base OP Fee Sched Tier 3,925.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,49082,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49082,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49083,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49084,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49084,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49180,BCBSND Hospital Base OP Fee Sched Tier 3,2197.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,49185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49185,BCBSND Hospital Base OP Fee Sched Tier 3,925.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,49250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49250,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49320,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49321,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49322,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49323,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49324,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49325,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49329,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49402,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49405,BCBSND Hospital Base OP Fee Sched Tier 3,2197.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,49406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49406,BCBSND Hospital Base OP Fee Sched Tier 3,2197.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,49407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49407,BCBSND Hospital Base OP Fee Sched Tier 3,2197.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,49411,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49411,BCBSND Hospital Base OP Fee Sched Tier 3,1904.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,49412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49412,BCBSND Hospital Base OP Fee Sched Tier 3,1535.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,49418,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49418,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49419,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49419,BCBSND Hospital Base OP Fee Sched Tier 3,6992.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,49421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49421,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49422,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49422,BCBSND Hospital Base OP Fee Sched Tier 3,4220.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,49423,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49423,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,49426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49426,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49429,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49429,BCBSND Hospital Base OP Fee Sched Tier 3,4220.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,49436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49436,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,49440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49440,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,49441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49441,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,49442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49442,BCBSND Hospital Base OP Fee Sched Tier 3,1565.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,49446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49446,BCBSND Hospital Base OP Fee Sched Tier 3,2369.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,49450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49450,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49451,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49451,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49452,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49460,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49465,BCBSND Hospital Base OP Fee Sched Tier 3,368.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,49491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49491,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49492,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49495,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49496,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49500,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49501,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49505,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49507,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49520,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49521,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49525,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49540,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49550,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49553,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49555,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49557,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49560,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49561,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49565,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49566,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49566,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49570,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49572,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49580,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49582,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49585,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49587,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49587,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49590,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49600,BCBSND Hospital Base OP Fee Sched Tier 3,4708.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,49650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49650,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49651,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49652,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49653,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49654,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49654,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,49655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49655,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,49656,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49656,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,49657,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49657,BCBSND Hospital Base OP Fee Sched Tier 3,12368.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,49659,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49659,BCBSND Hospital Base OP Fee Sched Tier 3,7342.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,49999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,49999,BCBSND Hospital Base OP Fee Sched Tier 3,1216.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,50020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50020,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50080,BCBSND Hospital Base OP Fee Sched Tier 3,11549.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,50081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50081,BCBSND Hospital Base OP Fee Sched Tier 3,11549.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,50200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50200,BCBSND Hospital Base OP Fee Sched Tier 3,2076.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,50382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50382,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50384,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50385,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50386,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50387,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50389,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50389,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,50390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50390,BCBSND Hospital Base OP Fee Sched Tier 3,874.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,50391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50391,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,50396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50396,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,50430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50430,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,50431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50431,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,50432,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50432,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50433,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50433,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50434,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50434,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50435,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50436,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50437,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50437,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,50541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50541,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,50542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50542,BCBSND Hospital Base OP Fee Sched Tier 3,11686.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,50543,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50543,BCBSND Hospital Base OP Fee Sched Tier 3,11686.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,50544,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50544,BCBSND Hospital Base OP Fee Sched Tier 3,11686.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,50547,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50547,BCBSND Hospital Base OP Fee Sched Tier 3,11167.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,50548,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50548,BCBSND Hospital Base OP Fee Sched Tier 3,11167.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,50549,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50549,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,50551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50551,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50553,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50555,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50557,BCBSND Hospital Base OP Fee Sched Tier 3,11549.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,50561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50561,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50562,BCBSND Hospital Base OP Fee Sched Tier 3,11549.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,50570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50570,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,50572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50572,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,50574,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50574,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50575,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50576,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50580,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50590,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,50592,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50592,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,50593,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50593,BCBSND Hospital Base OP Fee Sched Tier 3,11686.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,50686,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50686,BCBSND Hospital Base OP Fee Sched Tier 3,205.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,50688,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50688,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50693,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50693,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50694,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50694,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,50695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50695,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,50727,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50727,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,50945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50945,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,50947,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50947,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,50948,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50948,BCBSND Hospital Base OP Fee Sched Tier 3,11686.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,50949,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50949,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,50951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50951,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50953,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50953,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,50955,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50955,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50957,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50957,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50961,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50970,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,50972,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50972,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,50974,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50974,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50976,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,50980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,50980,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,51020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51020,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,51030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51030,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,51040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51040,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,51045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51045,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,51050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51050,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,51060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51060,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,51065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51065,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,51080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51080,BCBSND Hospital Base OP Fee Sched Tier 3,3590.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,51100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51100,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,51101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51101,BCBSND Hospital Base OP Fee Sched Tier 3,1377.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,51102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51102,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,51500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51500,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,51520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51520,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,51535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51535,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,51700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51700,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,51701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51701,BCBSND Hospital Base OP Fee Sched Tier 3,160.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,51702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51702,BCBSND Hospital Base OP Fee Sched Tier 3,160.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,51703,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51703,BCBSND Hospital Base OP Fee Sched Tier 3,205.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,51705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51705,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,51710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51710,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,51715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51715,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,51720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51720,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,51725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51725,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,51726,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51726,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,51727,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51727,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,51728,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51728,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,51729,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51729,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,51736,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51736,BCBSND Hospital Base OP Fee Sched Tier 3,160.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,51741,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51741,BCBSND Hospital Base OP Fee Sched Tier 3,205.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,51784,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51784,BCBSND Hospital Base OP Fee Sched Tier 3,205.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,51785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51785,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,51792,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51792,BCBSND Hospital Base OP Fee Sched Tier 3,84.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,51798,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51798,BCBSND Hospital Base OP Fee Sched Tier 3,84.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,51845,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51845,BCBSND Hospital Base OP Fee Sched Tier 3,6228.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,51860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51860,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,51880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51880,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,51990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51990,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,51992,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51992,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,51999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,51999,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,52000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52000,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,52001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52001,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52005,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52007,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52010,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,52204,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52204,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52214,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52224,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52234,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52234,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52235,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52240,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52250,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52260,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52265,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52270,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52275,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52276,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52277,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52277,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52281,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52282,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52283,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52285,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,52287,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52287,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52290,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52300,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52301,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52305,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52310,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52315,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52317,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52317,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52318,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52320,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52325,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52327,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52330,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52332,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52334,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52341,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52342,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52343,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52343,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52344,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52345,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52346,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52351,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52351,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,52352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52352,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52353,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52354,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52355,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52356,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52400,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52402,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52450,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52500,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52601,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52630,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52640,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,52647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52647,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52648,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52648,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52649,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52649,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,52700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,52700,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,53000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53000,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53010,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53020,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53025,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53040,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53060,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53080,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,53085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53085,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53200,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53210,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,53215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53215,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53220,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,53230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53230,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53235,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53240,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53250,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,53260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53260,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53265,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53270,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53275,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53400,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53405,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53410,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53420,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53425,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53430,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53431,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53440,BCBSND Hospital Base OP Fee Sched Tier 3,11549.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,53442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53442,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53444,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53444,BCBSND Hospital Base OP Fee Sched Tier 3,24636.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,53445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53445,BCBSND Hospital Base OP Fee Sched Tier 3,24636.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,53446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53446,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53447,BCBSND Hospital Base OP Fee Sched Tier 3,24636.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,53448,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53448,BCBSND Hospital Base OP Fee Sched Tier 3,22930.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,53449,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53449,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53450,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53460,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53500,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,53502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53502,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,53505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53505,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53510,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53515,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53520,BCBSND Hospital Base OP Fee Sched Tier 3,6069.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,53600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53600,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,53601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53601,BCBSND Hospital Base OP Fee Sched Tier 3,160.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,53605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53605,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53620,BCBSND Hospital Base OP Fee Sched Tier 3,848.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,53621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53621,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,53660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53660,BCBSND Hospital Base OP Fee Sched Tier 3,205.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,53661,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53661,BCBSND Hospital Base OP Fee Sched Tier 3,160.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,53665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53665,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53850,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,53852,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53852,BCBSND Hospital Base OP Fee Sched Tier 3,4418.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,53854,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53854,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53855,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53855,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53860,BCBSND Hospital Base OP Fee Sched Tier 3,2626.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,53899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,53899,BCBSND Hospital Base OP Fee Sched Tier 3,349.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54000,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54001,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54015,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,54050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54050,BCBSND Hospital Base OP Fee Sched Tier 3,454.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,54055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54055,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,54056,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54056,BCBSND Hospital Base OP Fee Sched Tier 3,255.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,54057,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54057,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,54060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54060,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,54065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54065,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,54100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54100,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,54105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54105,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,54110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54110,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54111,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54112,BCBSND Hospital Base OP Fee Sched Tier 3,11068.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,54115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54115,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,54120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54120,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54150,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54160,BCBSND Hospital Base OP Fee Sched Tier 3,813.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,54161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54161,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54162,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54163,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54163,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54164,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54200,BCBSND Hospital Base OP Fee Sched Tier 3,334.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,54205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54205,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54220,BCBSND Hospital Base OP Fee Sched Tier 3,334.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,54231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54231,BCBSND Hospital Base OP Fee Sched Tier 3,334.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,54235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54235,BCBSND Hospital Base OP Fee Sched Tier 3,334.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,54240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54240,BCBSND Hospital Base OP Fee Sched Tier 3,196.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,54250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54250,BCBSND Hospital Base OP Fee Sched Tier 3,334.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,54300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54300,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54304,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54308,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54312,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54316,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54318,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54322,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54324,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54326,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54328,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54332,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54336,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54340,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54344,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54348,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54348,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54352,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54360,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54380,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54385,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54400,BCBSND Hospital Base OP Fee Sched Tier 3,23609.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,54401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54401,BCBSND Hospital Base OP Fee Sched Tier 3,23609.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,54405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54405,BCBSND Hospital Base OP Fee Sched Tier 3,23609.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,54406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54406,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54408,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54410,BCBSND Hospital Base OP Fee Sched Tier 3,23609.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,54411,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54411,BCBSND Hospital Base OP Fee Sched Tier 3,23609.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,54415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54415,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54416,BCBSND Hospital Base OP Fee Sched Tier 3,23609.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,54417,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54417,BCBSND Hospital Base OP Fee Sched Tier 3,23609.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,54420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54420,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54435,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54437,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54437,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54440,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54450,BCBSND Hospital Base OP Fee Sched Tier 3,334.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,54500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54500,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,54505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54505,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54512,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54520,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54522,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54530,BCBSND Hospital Base OP Fee Sched Tier 3,4263.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,54535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54535,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54550,BCBSND Hospital Base OP Fee Sched Tier 3,4263.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,54560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54560,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54600,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54620,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54640,BCBSND Hospital Base OP Fee Sched Tier 3,4263.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,54650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54650,BCBSND Hospital Base OP Fee Sched Tier 3,4263.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,54660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54660,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,54670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54670,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54680,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54690,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,54692,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54692,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,54699,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54699,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,54700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54700,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54800,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,54830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54830,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54840,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54860,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54861,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54861,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,54865,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54865,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54900,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,54901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,54901,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,55000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55000,BCBSND Hospital Base OP Fee Sched Tier 3,838.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,55040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55040,BCBSND Hospital Base OP Fee Sched Tier 3,4263.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,55041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55041,BCBSND Hospital Base OP Fee Sched Tier 3,4263.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,55060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55060,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55100,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,55110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55110,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,55120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55120,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55150,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55175,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,55180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55180,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,55200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55200,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55250,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55400,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,55500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55500,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55520,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55530,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,55535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55535,BCBSND Hospital Base OP Fee Sched Tier 3,4263.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,55540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55540,BCBSND Hospital Base OP Fee Sched Tier 3,4263.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,55550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55550,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,55559,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55559,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,55600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55600,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55605,BCBSND Hospital Base OP Fee Sched Tier 3,3499.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,55650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55650,BCBSND Hospital Base OP Fee Sched Tier 3,3499.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,55680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55680,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,55700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55700,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55705,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55706,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55720,BCBSND Hospital Base OP Fee Sched Tier 3,2516.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,55725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55725,BCBSND Hospital Base OP Fee Sched Tier 3,4234.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,55860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55860,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,55866,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55866,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,55870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55870,BCBSND Hospital Base OP Fee Sched Tier 3,807.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,55873,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55873,BCBSND Hospital Base OP Fee Sched Tier 3,11068.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,55874,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55874,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,55875,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55875,BCBSND Hospital Base OP Fee Sched Tier 3,5816.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,55876,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55876,BCBSND Hospital Base OP Fee Sched Tier 3,1724.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,55899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55899,BCBSND Hospital Base OP Fee Sched Tier 3,334.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,55920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55920,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,55970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55970,BCBSND Hospital Base OP Fee Sched Tier 3,10821.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,55980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,55980,BCBSND Hospital Base OP Fee Sched Tier 3,10821.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56405,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,56420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56420,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,56440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56440,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56441,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56442,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56501,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,56515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56515,BCBSND Hospital Base OP Fee Sched Tier 3,2240.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,56605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56605,BCBSND Hospital Base OP Fee Sched Tier 3,807.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,56620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56620,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56625,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56700,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56740,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56800,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56805,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56810,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,56820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56820,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,56821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,56821,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,57000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57000,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57010,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57020,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57022,BCBSND Hospital Base OP Fee Sched Tier 3,1989.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,57023,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57023,BCBSND Hospital Base OP Fee Sched Tier 3,3440.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,57061,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57061,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57065,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57100,BCBSND Hospital Base OP Fee Sched Tier 3,807.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,57105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57105,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57106,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57107,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57109,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57109,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57120,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57130,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57135,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57150,BCBSND Hospital Base OP Fee Sched Tier 3,154.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,57155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57155,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57156,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,57160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57160,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,57170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57170,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,57180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57180,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,57200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57200,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57210,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57220,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57230,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57240,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57250,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57260,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57265,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57268,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57268,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57282,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,57283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57283,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,57284,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57284,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57285,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,57287,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57287,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57288,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57288,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57289,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57289,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,57291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57291,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57292,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57292,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57295,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57300,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57310,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,57320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57320,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57330,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,57335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57335,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57400,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57410,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57415,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57420,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,57421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57421,BCBSND Hospital Base OP Fee Sched Tier 3,807.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,57423,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57423,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,57425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57425,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,57426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57426,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,57452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57452,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,57454,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57454,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,57455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57455,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,57456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57456,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,57460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57460,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57461,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57461,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57500,BCBSND Hospital Base OP Fee Sched Tier 3,807.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,57505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57505,BCBSND Hospital Base OP Fee Sched Tier 3,807.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,57510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57510,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57511,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,57513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57513,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57520,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57522,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57530,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57550,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57555,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57556,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,57558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57558,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57700,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57720,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,57800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,57800,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58100,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,58120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58120,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58145,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58260,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58262,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58263,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58270,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58290,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,58291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58291,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58292,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58292,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,58294,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58294,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58300,BCBSND Hospital Base OP Fee Sched Tier 3,160.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,58301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58301,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,58321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58321,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,58322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58322,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,58323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58323,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,58345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58345,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58346,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58350,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58353,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58356,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58541,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58542,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58543,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58543,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58544,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58544,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58545,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58546,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58546,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58550,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58552,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58553,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58554,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58555,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58558,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58559,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58559,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58560,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58561,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58562,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58563,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58563,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58565,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58570,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58571,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58572,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58573,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58573,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58578,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58578,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58579,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58579,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,58600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58600,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58605,BCBSND Hospital Base OP Fee Sched Tier 3,2903.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,58615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58615,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58660,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58661,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58661,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58662,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58662,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58670,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58671,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58671,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58672,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58672,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58673,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58673,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58674,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58674,BCBSND Hospital Base OP Fee Sched Tier 3,11200,,Fee schedule,,,,,,,,0
unity,Fee schedule,58679,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58679,BCBSND Hospital Base OP Fee Sched Tier 3,6648.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,58700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58700,BCBSND Hospital Base OP Fee Sched Tier 3,6241.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,58720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58720,BCBSND Hospital Base OP Fee Sched Tier 3,6241.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,58760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58760,BCBSND Hospital Base OP Fee Sched Tier 3,6241.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,58770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58770,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58800,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58805,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58820,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58822,BCBSND Hospital Base OP Fee Sched Tier 3,2903.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,58825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58825,BCBSND Hospital Base OP Fee Sched Tier 3,4691.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58900,BCBSND Hospital Base OP Fee Sched Tier 3,3416.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,58920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58920,BCBSND Hospital Base OP Fee Sched Tier 3,9178.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,58925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58925,BCBSND Hospital Base OP Fee Sched Tier 3,5968.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,58940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58940,BCBSND Hospital Base OP Fee Sched Tier 3,8889.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,58970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58970,BCBSND Hospital Base OP Fee Sched Tier 3,807.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,58974,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58974,BCBSND Hospital Base OP Fee Sched Tier 3,807.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,58976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58976,BCBSND Hospital Base OP Fee Sched Tier 3,394.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,58999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,58999,BCBSND Hospital Base OP Fee Sched Tier 3,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,59000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59000,BCBSND Hospital Base OP Fee Sched Tier 3,842.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,59001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59001,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59012,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59015,BCBSND Hospital Base OP Fee Sched Tier 3,842.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,59020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59020,BCBSND Hospital Base OP Fee Sched Tier 3,250.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,59025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59025,BCBSND Hospital Base OP Fee Sched Tier 3,250.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,59030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59030,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59070,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59072,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59072,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59074,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59074,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59076,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59100,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59150,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,59151,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59151,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,59160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59160,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59200,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59300,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59320,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59325,BCBSND Hospital Base OP Fee Sched Tier 3,3029.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,59409,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59409,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59412,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59414,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59414,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59612,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59812,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59820,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59821,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59830,BCBSND Hospital Base OP Fee Sched Tier 3,3029.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,59840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59840,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59841,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59841,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59866,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59866,BCBSND Hospital Base OP Fee Sched Tier 3,412.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,59870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59870,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59871,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59871,BCBSND Hospital Base OP Fee Sched Tier 3,3564.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,59897,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59897,BCBSND Hospital Base OP Fee Sched Tier 3,250.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,59898,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59898,BCBSND Hospital Base OP Fee Sched Tier 3,6938,,Fee schedule,,,,,,,,0
unity,Fee schedule,59899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,59899,BCBSND Hospital Base OP Fee Sched Tier 3,250.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,60000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60000,BCBSND Hospital Base OP Fee Sched Tier 3,2067.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,60100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60100,BCBSND Hospital Base OP Fee Sched Tier 3,936.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,60200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60200,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60210,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60212,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60220,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60225,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60240,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60252,BCBSND Hospital Base OP Fee Sched Tier 3,7152.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,60260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60260,BCBSND Hospital Base OP Fee Sched Tier 3,7152.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,60271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60271,BCBSND Hospital Base OP Fee Sched Tier 3,7152.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,60280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60280,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60281,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60300,BCBSND Hospital Base OP Fee Sched Tier 3,936.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,60500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60500,BCBSND Hospital Base OP Fee Sched Tier 3,7152.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,60502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60502,BCBSND Hospital Base OP Fee Sched Tier 3,7152.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,60520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60520,BCBSND Hospital Base OP Fee Sched Tier 3,7152.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,60650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60650,BCBSND Hospital Base OP Fee Sched Tier 3,6973.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,60659,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60659,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,60699,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,60699,BCBSND Hospital Base OP Fee Sched Tier 3,7429.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,61000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61000,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,61001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61001,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,61020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61020,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,61026,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61026,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,61050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61050,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,61055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61055,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,61070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61070,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,61215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61215,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,61330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61330,BCBSND Hospital Base OP Fee Sched Tier 3,3943.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,61623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61623,BCBSND Hospital Base OP Fee Sched Tier 3,17090.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,61626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61626,BCBSND Hospital Base OP Fee Sched Tier 3,17090.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,61630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61630,BCBSND Hospital Base OP Fee Sched Tier 3,1668.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,61635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61635,BCBSND Hospital Base OP Fee Sched Tier 3,1668.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,61640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61640,BCBSND Hospital Base OP Fee Sched Tier 3,1668.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,61641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61641,BCBSND Hospital Base OP Fee Sched Tier 3,1668.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,61642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61642,BCBSND Hospital Base OP Fee Sched Tier 3,1668.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,61720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61720,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,61770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61770,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,61790,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61790,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,61791,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61791,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,61880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61880,BCBSND Hospital Base OP Fee Sched Tier 3,5090.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,61885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61885,BCBSND Hospital Base OP Fee Sched Tier 3,33065.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,61886,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61886,BCBSND Hospital Base OP Fee Sched Tier 3,48956.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,61888,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,61888,BCBSND Hospital Base OP Fee Sched Tier 3,10568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,62000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62000,BCBSND Hospital Base OP Fee Sched Tier 3,3943.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,62194,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62194,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,62225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62225,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,62230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62230,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,62252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62252,BCBSND Hospital Base OP Fee Sched Tier 3,495.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,62263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62263,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62264,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62267,BCBSND Hospital Base OP Fee Sched Tier 3,1023.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,62268,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62268,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62269,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62269,BCBSND Hospital Base OP Fee Sched Tier 3,2431.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,62270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62270,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62272,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62273,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62280,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62281,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62282,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62287,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62287,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,62292,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62292,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,62294,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62294,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62302,BCBSND Hospital Base OP Fee Sched Tier 3,1222.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,62303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62303,BCBSND Hospital Base OP Fee Sched Tier 3,1222.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,62304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62304,BCBSND Hospital Base OP Fee Sched Tier 3,1222.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,62305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62305,BCBSND Hospital Base OP Fee Sched Tier 3,1222.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,62320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62320,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62321,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62322,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62323,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62324,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62325,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62326,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62327,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,62350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62350,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,62351,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62351,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,62355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62355,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,62360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62360,BCBSND Hospital Base OP Fee Sched Tier 3,28399.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62361,BCBSND Hospital Base OP Fee Sched Tier 3,28399.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62362,BCBSND Hospital Base OP Fee Sched Tier 3,28399.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,62365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62365,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,62367,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62367,BCBSND Hospital Base OP Fee Sched Tier 3,495.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,62368,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62368,BCBSND Hospital Base OP Fee Sched Tier 3,495.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,62369,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62369,BCBSND Hospital Base OP Fee Sched Tier 3,495.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,62370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62370,BCBSND Hospital Base OP Fee Sched Tier 3,495.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,62380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,62380,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63001,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63003,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63005,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63011,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63012,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63015,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63016,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63017,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63020,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63030,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63040,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63042,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63045,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63046,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63047,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63055,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63056,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63056,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63064,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63064,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63075,BCBSND Hospital Base OP Fee Sched Tier 3,10074.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,63267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63267,BCBSND Hospital Base OP Fee Sched Tier 3,9470.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,63600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63600,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,63610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63610,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,63650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63650,BCBSND Hospital Base OP Fee Sched Tier 3,10568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,63655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63655,BCBSND Hospital Base OP Fee Sched Tier 3,33065.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,63661,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63661,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,63662,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63662,BCBSND Hospital Base OP Fee Sched Tier 3,5090.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,63663,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63663,BCBSND Hospital Base OP Fee Sched Tier 3,10568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,63664,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63664,BCBSND Hospital Base OP Fee Sched Tier 3,33065.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,63685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63685,BCBSND Hospital Base OP Fee Sched Tier 3,48956.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,63688,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63688,BCBSND Hospital Base OP Fee Sched Tier 3,5090.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,63741,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63741,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,63744,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63744,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,63746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,63746,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64400,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64402,BCBSND Hospital Base OP Fee Sched Tier 3,188.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,64405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64405,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64408,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64410,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64413,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64413,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64415,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64416,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64417,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64417,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64418,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64418,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64420,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64421,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64425,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64430,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64435,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64445,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64446,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64447,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64448,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64448,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64449,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64449,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64450,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64455,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64461,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64461,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64463,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64463,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64479,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64479,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64483,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64483,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64490,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64493,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64493,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64505,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64510,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64517,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64520,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64530,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64553,BCBSND Hospital Base OP Fee Sched Tier 3,10568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,64555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64555,BCBSND Hospital Base OP Fee Sched Tier 3,10568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,64561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64561,BCBSND Hospital Base OP Fee Sched Tier 3,10568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,64566,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64566,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64568,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64568,BCBSND Hospital Base OP Fee Sched Tier 3,48956.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,64569,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64569,BCBSND Hospital Base OP Fee Sched Tier 3,10568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,64570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64570,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64575,BCBSND Hospital Base OP Fee Sched Tier 3,33065.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,64580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64580,BCBSND Hospital Base OP Fee Sched Tier 3,33065.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,64581,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64581,BCBSND Hospital Base OP Fee Sched Tier 3,10568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,64585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64585,BCBSND Hospital Base OP Fee Sched Tier 3,5090.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,64590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64590,BCBSND Hospital Base OP Fee Sched Tier 3,33065.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,64595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64595,BCBSND Hospital Base OP Fee Sched Tier 3,5090.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,64600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64600,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64605,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64610,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64611,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64612,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64615,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64616,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64617,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64617,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64620,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64630,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64632,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64633,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64635,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64640,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64642,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64644,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64644,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64646,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64646,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64647,BCBSND Hospital Base OP Fee Sched Tier 3,1058.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,64650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64650,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64653,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,64680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64680,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64681,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64681,BCBSND Hospital Base OP Fee Sched Tier 3,1351.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,64702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64702,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64704,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64704,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64708,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64708,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64712,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64712,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64713,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64713,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64714,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64714,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64716,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64716,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64718,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64718,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64719,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64719,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64721,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64721,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64722,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64722,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64726,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64726,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64732,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64732,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64734,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64734,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64736,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64736,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64738,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64738,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64740,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64742,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64742,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64744,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64744,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64746,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64763,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64763,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64766,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64766,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64771,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64771,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64772,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64772,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64774,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64774,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64776,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64776,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64782,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64782,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64784,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64784,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64786,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64786,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64788,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64788,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64790,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64790,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64792,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64792,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64795,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64795,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64802,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64804,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64804,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64820,BCBSND Hospital Base OP Fee Sched Tier 3,2883.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,64821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64821,BCBSND Hospital Base OP Fee Sched Tier 3,4636.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,64822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64822,BCBSND Hospital Base OP Fee Sched Tier 3,4636.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,64823,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64823,BCBSND Hospital Base OP Fee Sched Tier 3,4636.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,64831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64831,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64834,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64834,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64835,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64835,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64836,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64836,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64840,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64856,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64856,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64857,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64857,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64858,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64858,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64861,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64861,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64862,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64862,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64864,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64864,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64865,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64865,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64885,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64886,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64886,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64890,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64890,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64891,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64891,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64892,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64892,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64893,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64893,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64895,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64895,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64896,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64896,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64897,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64897,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64898,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64898,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64905,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64907,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64907,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64910,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64911,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64911,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64912,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64912,BCBSND Hospital Base OP Fee Sched Tier 3,8070.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,64999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,64999,BCBSND Hospital Base OP Fee Sched Tier 3,437.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,65091,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65091,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65093,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65093,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65101,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65103,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65105,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65110,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65112,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65114,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65125,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65130,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65135,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65140,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65150,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65155,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65175,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65205,BCBSND Hospital Base OP Fee Sched Tier 3,194.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,65210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65210,BCBSND Hospital Base OP Fee Sched Tier 3,637.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,65220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65220,BCBSND Hospital Base OP Fee Sched Tier 3,637.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,65222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65222,BCBSND Hospital Base OP Fee Sched Tier 3,194.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,65235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65235,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65260,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65265,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65270,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65272,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65273,BCBSND Hospital Base OP Fee Sched Tier 3,2753.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,65275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65275,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65280,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65285,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65286,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65286,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65290,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65400,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,65410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65410,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65420,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65426,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65430,BCBSND Hospital Base OP Fee Sched Tier 3,637.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,65435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65435,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,65436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65436,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65450,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,65600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65600,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65710,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65730,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65750,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65755,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65756,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65756,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65770,BCBSND Hospital Base OP Fee Sched Tier 3,18004.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,65772,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65772,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,65775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65775,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,65778,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65778,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,65779,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65779,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65780,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65781,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65781,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65782,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65782,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,65785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65785,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65800,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65810,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65815,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65815,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65820,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65850,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65855,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65855,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,65860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65860,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,65865,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65865,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65870,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65875,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65875,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65880,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65900,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65920,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,65930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,65930,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66020,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66030,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66130,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,66150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66150,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66155,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66160,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66170,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66172,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66174,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66174,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66175,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66179,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66179,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66180,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66183,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66183,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66184,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66185,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66225,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66250,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,66500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66500,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66505,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66600,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66605,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66625,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66630,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66635,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66680,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66682,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66682,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66700,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66710,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,66711,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66711,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66720,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,66740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66740,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,66761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66761,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,66762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66762,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,66770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66770,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,66820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66820,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66821,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,66825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66825,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66830,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66840,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66850,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66852,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66852,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66920,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66930,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66940,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66982,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66983,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66983,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66984,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66984,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66985,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66985,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66986,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66986,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,66999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,66999,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67005,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67010,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67015,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67025,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67027,BCBSND Hospital Base OP Fee Sched Tier 3,29715.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,67028,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67028,BCBSND Hospital Base OP Fee Sched Tier 3,527.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,67030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67030,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67031,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,67036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67036,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67039,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67040,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67041,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67042,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67043,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67101,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67105,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,67107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67107,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67108,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67110,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67113,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67115,BCBSND Hospital Base OP Fee Sched Tier 3,6663.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67120,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67121,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67141,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67141,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67145,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,67208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67208,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67210,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,67218,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67218,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67220,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,67221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67221,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,67227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67227,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67228,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67228,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,67229,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67229,BCBSND Hospital Base OP Fee Sched Tier 3,908.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,67250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67250,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67255,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67299,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,67311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67311,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67312,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67314,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67314,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67316,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67318,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67343,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67343,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67345,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67346,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67399,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67400,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67405,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67412,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67413,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67413,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67414,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67414,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67415,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67420,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67430,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67440,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67445,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67450,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67500,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67505,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67515,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67550,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67560,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67570,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67599,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67599,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67700,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67710,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,67715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67715,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67800,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67801,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,67805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67805,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67808,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67810,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67820,BCBSND Hospital Base OP Fee Sched Tier 3,194.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,67825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67825,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67830,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,67835,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67835,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67840,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,67850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67850,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,67875,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67875,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,67880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67880,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67882,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67882,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67900,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67901,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67902,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67903,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67903,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67904,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67906,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67908,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67908,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67909,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67909,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67911,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67911,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67912,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67912,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67914,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67914,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67915,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67915,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67916,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67916,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67917,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67917,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67921,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67922,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67923,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67923,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67924,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67924,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67930,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67935,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67938,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67938,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,67950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67950,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67961,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67966,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67966,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67971,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67973,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67973,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67974,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67974,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,67975,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67975,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,67999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,67999,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68020,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,68040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68040,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68100,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68110,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68115,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68130,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68135,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68200,BCBSND Hospital Base OP Fee Sched Tier 3,194.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,68320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68320,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68325,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68326,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68328,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68330,BCBSND Hospital Base OP Fee Sched Tier 3,3509.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,68335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68335,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68340,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68360,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68362,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68371,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68399,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68400,BCBSND Hospital Base OP Fee Sched Tier 3,1477.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,68420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68420,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68440,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68500,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68505,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68510,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68520,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68525,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68530,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68540,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68550,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68700,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68705,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68720,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68745,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68750,BCBSND Hospital Base OP Fee Sched Tier 3,5445.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,68760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68760,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68761,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68770,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68801,BCBSND Hospital Base OP Fee Sched Tier 3,637.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,68810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68810,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68811,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68811,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68815,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68815,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68816,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68816,BCBSND Hospital Base OP Fee Sched Tier 3,3317.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,68840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68840,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,68899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,68899,BCBSND Hospital Base OP Fee Sched Tier 3,518.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,69000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69000,BCBSND Hospital Base OP Fee Sched Tier 3,1027.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,69005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69005,BCBSND Hospital Base OP Fee Sched Tier 3,2439.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,69020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69020,BCBSND Hospital Base OP Fee Sched Tier 3,1027.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,69100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69100,BCBSND Hospital Base OP Fee Sched Tier 3,365.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,69105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69105,BCBSND Hospital Base OP Fee Sched Tier 3,2268.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,69110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69110,BCBSND Hospital Base OP Fee Sched Tier 3,4218.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,69120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69120,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69140,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69145,BCBSND Hospital Base OP Fee Sched Tier 3,4218.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,69150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69150,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69200,BCBSND Hospital Base OP Fee Sched Tier 3,188.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,69205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69205,BCBSND Hospital Base OP Fee Sched Tier 3,2439.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,69209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69209,BCBSND Hospital Base OP Fee Sched Tier 3,99.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,69210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69210,BCBSND Hospital Base OP Fee Sched Tier 3,99.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,69220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69220,BCBSND Hospital Base OP Fee Sched Tier 3,312.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,69222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69222,BCBSND Hospital Base OP Fee Sched Tier 3,864.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,69300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69300,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69310,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69320,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69399,BCBSND Hospital Base OP Fee Sched Tier 3,365.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,69420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69420,BCBSND Hospital Base OP Fee Sched Tier 3,365.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,69421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69421,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69424,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69424,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69433,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69433,BCBSND Hospital Base OP Fee Sched Tier 3,864.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,69436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69436,BCBSND Hospital Base OP Fee Sched Tier 3,2268.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,69440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69440,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69450,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69501,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69502,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69505,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69511,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69530,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69535,BCBSND Hospital Base OP Fee Sched Tier 3,10025.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,69540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69540,BCBSND Hospital Base OP Fee Sched Tier 3,2268.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,69550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69550,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69552,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69601,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69602,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69603,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69604,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69605,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69610,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69620,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69631,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69632,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69633,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69635,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69636,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69637,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69637,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69641,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69642,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69643,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69643,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69644,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69644,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69645,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69646,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69646,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69650,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69660,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69661,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69661,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69662,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69662,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69666,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69666,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69667,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69667,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69670,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69676,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69676,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69700,BCBSND Hospital Base OP Fee Sched Tier 3,2268.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,69711,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69711,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69714,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69714,BCBSND Hospital Base OP Fee Sched Tier 3,19004.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,69715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69715,BCBSND Hospital Base OP Fee Sched Tier 3,27321.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,69717,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69717,BCBSND Hospital Base OP Fee Sched Tier 3,10109.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,69718,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69718,BCBSND Hospital Base OP Fee Sched Tier 3,19004.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,69720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69720,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69725,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69740,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69745,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69799,BCBSND Hospital Base OP Fee Sched Tier 3,365.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,69801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69801,BCBSND Hospital Base OP Fee Sched Tier 3,2268.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,69805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69805,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69806,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69905,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69910,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69915,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69915,BCBSND Hospital Base OP Fee Sched Tier 3,3957.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,69930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69930,BCBSND Hospital Base OP Fee Sched Tier 3,56704.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,69949,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69949,BCBSND Hospital Base OP Fee Sched Tier 3,365.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,69955,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69955,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69960,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69970,BCBSND Hospital Base OP Fee Sched Tier 3,7847.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,69979,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,69979,BCBSND Hospital Base OP Fee Sched Tier 3,365.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,70010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70010,BCBSND Hospital Base OP Fee Sched Tier 3,233.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,70015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70015,BCBSND Hospital Base OP Fee Sched Tier 3,357.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,70030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70030,BCBSND Hospital Base OP Fee Sched Tier 3,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70100,BCBSND Hospital Base OP Fee Sched Tier 3,95.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,70110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70110,BCBSND Hospital Base OP Fee Sched Tier 3,103.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,70120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70120,BCBSND Hospital Base OP Fee Sched Tier 3,95.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,70130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70130,BCBSND Hospital Base OP Fee Sched Tier 3,150.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,70134,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70134,BCBSND Hospital Base OP Fee Sched Tier 3,136.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,70140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70140,BCBSND Hospital Base OP Fee Sched Tier 3,76.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,70150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70150,BCBSND Hospital Base OP Fee Sched Tier 3,114.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,70160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70160,BCBSND Hospital Base OP Fee Sched Tier 3,97.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,70170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70170,BCBSND Hospital Base OP Fee Sched Tier 3,156.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,70190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70190,BCBSND Hospital Base OP Fee Sched Tier 3,97.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,70200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70200,BCBSND Hospital Base OP Fee Sched Tier 3,113.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,70210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70210,BCBSND Hospital Base OP Fee Sched Tier 3,86.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,70220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70220,BCBSND Hospital Base OP Fee Sched Tier 3,99.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,70240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70240,BCBSND Hospital Base OP Fee Sched Tier 3,82.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,70250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70250,BCBSND Hospital Base OP Fee Sched Tier 3,95.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,70260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70260,BCBSND Hospital Base OP Fee Sched Tier 3,113.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,70300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70300,BCBSND Hospital Base OP Fee Sched Tier 3,32.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,70310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70310,BCBSND Hospital Base OP Fee Sched Tier 3,113.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,70320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70320,BCBSND Hospital Base OP Fee Sched Tier 3,159.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,70328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70328,BCBSND Hospital Base OP Fee Sched Tier 3,84.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,70330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70330,BCBSND Hospital Base OP Fee Sched Tier 3,140.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,70332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70332,BCBSND Hospital Base OP Fee Sched Tier 3,185.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,70336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70336,BCBSND Hospital Base OP Fee Sched Tier 3,1692.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70350,BCBSND Hospital Base OP Fee Sched Tier 3,33.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,70355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70355,BCBSND Hospital Base OP Fee Sched Tier 3,33.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,70360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70360,BCBSND Hospital Base OP Fee Sched Tier 3,82.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,70370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70370,BCBSND Hospital Base OP Fee Sched Tier 3,249.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,70371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70371,BCBSND Hospital Base OP Fee Sched Tier 3,210.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,70380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70380,BCBSND Hospital Base OP Fee Sched Tier 3,95.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,70390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70390,BCBSND Hospital Base OP Fee Sched Tier 3,318.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,70450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70450,BCBSND Hospital Base OP Fee Sched Tier 3,512.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70460,BCBSND Hospital Base OP Fee Sched Tier 3,747.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70470,BCBSND Hospital Base OP Fee Sched Tier 3,895,,Fee schedule,,,,,,,,0
unity,Fee schedule,70480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70480,BCBSND Hospital Base OP Fee Sched Tier 3,1182.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70481,BCBSND Hospital Base OP Fee Sched Tier 3,1447.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70482,BCBSND Hospital Base OP Fee Sched Tier 3,1597.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70486,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70486,BCBSND Hospital Base OP Fee Sched Tier 3,675,,Fee schedule,,,,,,,,0
unity,Fee schedule,70487,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70487,BCBSND Hospital Base OP Fee Sched Tier 3,777.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70488,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70488,BCBSND Hospital Base OP Fee Sched Tier 3,982.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70490,BCBSND Hospital Base OP Fee Sched Tier 3,702.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70491,BCBSND Hospital Base OP Fee Sched Tier 3,935,,Fee schedule,,,,,,,,0
unity,Fee schedule,70492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70492,BCBSND Hospital Base OP Fee Sched Tier 3,1145,,Fee schedule,,,,,,,,0
unity,Fee schedule,70496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70496,BCBSND Hospital Base OP Fee Sched Tier 3,1455,,Fee schedule,,,,,,,,0
unity,Fee schedule,70498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70498,BCBSND Hospital Base OP Fee Sched Tier 3,1450,,Fee schedule,,,,,,,,0
unity,Fee schedule,70540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70540,BCBSND Hospital Base OP Fee Sched Tier 3,1390,,Fee schedule,,,,,,,,0
unity,Fee schedule,70542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70542,BCBSND Hospital Base OP Fee Sched Tier 3,1645,,Fee schedule,,,,,,,,0
unity,Fee schedule,70543,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70543,BCBSND Hospital Base OP Fee Sched Tier 3,2032.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70544,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70544,BCBSND Hospital Base OP Fee Sched Tier 3,1532.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70545,BCBSND Hospital Base OP Fee Sched Tier 3,1517.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70546,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70546,BCBSND Hospital Base OP Fee Sched Tier 3,2350,,Fee schedule,,,,,,,,0
unity,Fee schedule,70547,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70547,BCBSND Hospital Base OP Fee Sched Tier 3,1540,,Fee schedule,,,,,,,,0
unity,Fee schedule,70548,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70548,BCBSND Hospital Base OP Fee Sched Tier 3,1630,,Fee schedule,,,,,,,,0
unity,Fee schedule,70549,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70549,BCBSND Hospital Base OP Fee Sched Tier 3,2365,,Fee schedule,,,,,,,,0
unity,Fee schedule,70551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70551,BCBSND Hospital Base OP Fee Sched Tier 3,1067.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70552,BCBSND Hospital Base OP Fee Sched Tier 3,1580,,Fee schedule,,,,,,,,0
unity,Fee schedule,70553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70553,BCBSND Hospital Base OP Fee Sched Tier 3,1800,,Fee schedule,,,,,,,,0
unity,Fee schedule,70554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70554,BCBSND Hospital Base OP Fee Sched Tier 3,2350,,Fee schedule,,,,,,,,0
unity,Fee schedule,70555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70555,BCBSND Hospital Base OP Fee Sched Tier 3,2350,,Fee schedule,,,,,,,,0
unity,Fee schedule,70557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70557,BCBSND Hospital Base OP Fee Sched Tier 3,1067.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,70558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70558,BCBSND Hospital Base OP Fee Sched Tier 3,1580,,Fee schedule,,,,,,,,0
unity,Fee schedule,70559,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,70559,BCBSND Hospital Base OP Fee Sched Tier 3,1800,,Fee schedule,,,,,,,,0
unity,Fee schedule,71045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71045,BCBSND Hospital Base OP Fee Sched Tier 3,59.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,71046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71046,BCBSND Hospital Base OP Fee Sched Tier 3,78.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,71047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71047,BCBSND Hospital Base OP Fee Sched Tier 3,97.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,71048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71048,BCBSND Hospital Base OP Fee Sched Tier 3,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,71100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71100,BCBSND Hospital Base OP Fee Sched Tier 3,87.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,71101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71101,BCBSND Hospital Base OP Fee Sched Tier 3,97.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,71110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71110,BCBSND Hospital Base OP Fee Sched Tier 3,99.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,71111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71111,BCBSND Hospital Base OP Fee Sched Tier 3,122.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,71120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71120,BCBSND Hospital Base OP Fee Sched Tier 3,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,71130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71130,BCBSND Hospital Base OP Fee Sched Tier 3,99.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,71250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71250,BCBSND Hospital Base OP Fee Sched Tier 3,702.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,71260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71260,BCBSND Hospital Base OP Fee Sched Tier 3,940,,Fee schedule,,,,,,,,0
unity,Fee schedule,71270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71270,BCBSND Hospital Base OP Fee Sched Tier 3,1147.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,71275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71275,BCBSND Hospital Base OP Fee Sched Tier 3,1477.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,71550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71550,BCBSND Hospital Base OP Fee Sched Tier 3,2335,,Fee schedule,,,,,,,,0
unity,Fee schedule,71551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71551,BCBSND Hospital Base OP Fee Sched Tier 3,2542.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,71552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71552,BCBSND Hospital Base OP Fee Sched Tier 3,3185,,Fee schedule,,,,,,,,0
unity,Fee schedule,71555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,71555,BCBSND Hospital Base OP Fee Sched Tier 3,2122.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72020,BCBSND Hospital Base OP Fee Sched Tier 3,57.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,72040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72040,BCBSND Hospital Base OP Fee Sched Tier 3,95.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,72050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72050,BCBSND Hospital Base OP Fee Sched Tier 3,130.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,72052,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72052,BCBSND Hospital Base OP Fee Sched Tier 3,157.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,72070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72070,BCBSND Hospital Base OP Fee Sched Tier 3,86.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,72072,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72072,BCBSND Hospital Base OP Fee Sched Tier 3,95.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,72074,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72074,BCBSND Hospital Base OP Fee Sched Tier 3,109.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,72080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72080,BCBSND Hospital Base OP Fee Sched Tier 3,84.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,72081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72081,BCBSND Hospital Base OP Fee Sched Tier 3,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,72082,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72082,BCBSND Hospital Base OP Fee Sched Tier 3,184.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,72083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72083,BCBSND Hospital Base OP Fee Sched Tier 3,220.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,72084,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72084,BCBSND Hospital Base OP Fee Sched Tier 3,258.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,72100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72100,BCBSND Hospital Base OP Fee Sched Tier 3,95.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,72110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72110,BCBSND Hospital Base OP Fee Sched Tier 3,133.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,72114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72114,BCBSND Hospital Base OP Fee Sched Tier 3,157.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,72120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72120,BCBSND Hospital Base OP Fee Sched Tier 3,119.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,72125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72125,BCBSND Hospital Base OP Fee Sched Tier 3,915,,Fee schedule,,,,,,,,0
unity,Fee schedule,72126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72126,BCBSND Hospital Base OP Fee Sched Tier 3,1165,,Fee schedule,,,,,,,,0
unity,Fee schedule,72127,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72127,BCBSND Hospital Base OP Fee Sched Tier 3,1445,,Fee schedule,,,,,,,,0
unity,Fee schedule,72128,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72128,BCBSND Hospital Base OP Fee Sched Tier 3,912.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72129,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72129,BCBSND Hospital Base OP Fee Sched Tier 3,1175,,Fee schedule,,,,,,,,0
unity,Fee schedule,72130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72130,BCBSND Hospital Base OP Fee Sched Tier 3,1447.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72131,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72131,BCBSND Hospital Base OP Fee Sched Tier 3,907.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72132,BCBSND Hospital Base OP Fee Sched Tier 3,1167.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72133,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72133,BCBSND Hospital Base OP Fee Sched Tier 3,1437.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72141,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72141,BCBSND Hospital Base OP Fee Sched Tier 3,1025,,Fee schedule,,,,,,,,0
unity,Fee schedule,72142,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72142,BCBSND Hospital Base OP Fee Sched Tier 3,1620,,Fee schedule,,,,,,,,0
unity,Fee schedule,72146,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72146,BCBSND Hospital Base OP Fee Sched Tier 3,1027.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72147,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72147,BCBSND Hospital Base OP Fee Sched Tier 3,1610,,Fee schedule,,,,,,,,0
unity,Fee schedule,72148,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72148,BCBSND Hospital Base OP Fee Sched Tier 3,1027.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72149,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72149,BCBSND Hospital Base OP Fee Sched Tier 3,1592.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72156,BCBSND Hospital Base OP Fee Sched Tier 3,1817.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72157,BCBSND Hospital Base OP Fee Sched Tier 3,1825,,Fee schedule,,,,,,,,0
unity,Fee schedule,72158,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72158,BCBSND Hospital Base OP Fee Sched Tier 3,1812.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72159,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72159,BCBSND Hospital Base OP Fee Sched Tier 3,2217.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72170,BCBSND Hospital Base OP Fee Sched Tier 3,91.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,72190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72190,BCBSND Hospital Base OP Fee Sched Tier 3,109.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,72191,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72191,BCBSND Hospital Base OP Fee Sched Tier 3,1572.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72192,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72192,BCBSND Hospital Base OP Fee Sched Tier 3,637.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72193,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72193,BCBSND Hospital Base OP Fee Sched Tier 3,1232.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72194,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72194,BCBSND Hospital Base OP Fee Sched Tier 3,1437.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72195,BCBSND Hospital Base OP Fee Sched Tier 3,1385,,Fee schedule,,,,,,,,0
unity,Fee schedule,72196,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72196,BCBSND Hospital Base OP Fee Sched Tier 3,1607.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72197,BCBSND Hospital Base OP Fee Sched Tier 3,2027.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,72198,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72198,BCBSND Hospital Base OP Fee Sched Tier 3,2140,,Fee schedule,,,,,,,,0
unity,Fee schedule,72200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72200,BCBSND Hospital Base OP Fee Sched Tier 3,83.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,72202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72202,BCBSND Hospital Base OP Fee Sched Tier 3,95.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,72220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72220,BCBSND Hospital Base OP Fee Sched Tier 3,82.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,72240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72240,BCBSND Hospital Base OP Fee Sched Tier 3,222.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,72255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72255,BCBSND Hospital Base OP Fee Sched Tier 3,220.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,72265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72265,BCBSND Hospital Base OP Fee Sched Tier 3,214.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,72270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72270,BCBSND Hospital Base OP Fee Sched Tier 3,256.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,72275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72275,BCBSND Hospital Base OP Fee Sched Tier 3,319.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,72285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72285,BCBSND Hospital Base OP Fee Sched Tier 3,219.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,72295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,72295,BCBSND Hospital Base OP Fee Sched Tier 3,225.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,73000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73000,BCBSND Hospital Base OP Fee Sched Tier 3,78.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,73010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73010,BCBSND Hospital Base OP Fee Sched Tier 3,86.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,73020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73020,BCBSND Hospital Base OP Fee Sched Tier 3,59.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,73030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73030,BCBSND Hospital Base OP Fee Sched Tier 3,78.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,73040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73040,BCBSND Hospital Base OP Fee Sched Tier 3,315.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,73050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73050,BCBSND Hospital Base OP Fee Sched Tier 3,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,73060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73060,BCBSND Hospital Base OP Fee Sched Tier 3,82.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,73070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73070,BCBSND Hospital Base OP Fee Sched Tier 3,71.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,73080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73080,BCBSND Hospital Base OP Fee Sched Tier 3,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73085,BCBSND Hospital Base OP Fee Sched Tier 3,292.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,73090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73090,BCBSND Hospital Base OP Fee Sched Tier 3,74.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,73092,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73092,BCBSND Hospital Base OP Fee Sched Tier 3,78.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,73100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73100,BCBSND Hospital Base OP Fee Sched Tier 3,88.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,73110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73110,BCBSND Hospital Base OP Fee Sched Tier 3,105.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,73115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73115,BCBSND Hospital Base OP Fee Sched Tier 3,339.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,73120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73120,BCBSND Hospital Base OP Fee Sched Tier 3,78.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,73130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73130,BCBSND Hospital Base OP Fee Sched Tier 3,92.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,73140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73140,BCBSND Hospital Base OP Fee Sched Tier 3,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,73200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73200,BCBSND Hospital Base OP Fee Sched Tier 3,905,,Fee schedule,,,,,,,,0
unity,Fee schedule,73201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73201,BCBSND Hospital Base OP Fee Sched Tier 3,1155,,Fee schedule,,,,,,,,0
unity,Fee schedule,73202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73202,BCBSND Hospital Base OP Fee Sched Tier 3,1520,,Fee schedule,,,,,,,,0
unity,Fee schedule,73206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73206,BCBSND Hospital Base OP Fee Sched Tier 3,1672.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73218,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73218,BCBSND Hospital Base OP Fee Sched Tier 3,2047.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73219,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73219,BCBSND Hospital Base OP Fee Sched Tier 3,2200,,Fee schedule,,,,,,,,0
unity,Fee schedule,73220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73220,BCBSND Hospital Base OP Fee Sched Tier 3,2675,,Fee schedule,,,,,,,,0
unity,Fee schedule,73221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73221,BCBSND Hospital Base OP Fee Sched Tier 3,1157.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73222,BCBSND Hospital Base OP Fee Sched Tier 3,2037.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73223,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73223,BCBSND Hospital Base OP Fee Sched Tier 3,2482.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73225,BCBSND Hospital Base OP Fee Sched Tier 3,2135,,Fee schedule,,,,,,,,0
unity,Fee schedule,73501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73501,BCBSND Hospital Base OP Fee Sched Tier 3,80.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,73502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73502,BCBSND Hospital Base OP Fee Sched Tier 3,119.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,73503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73503,BCBSND Hospital Base OP Fee Sched Tier 3,149.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,73521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73521,BCBSND Hospital Base OP Fee Sched Tier 3,102.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,73522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73522,BCBSND Hospital Base OP Fee Sched Tier 3,132.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,73523,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73523,BCBSND Hospital Base OP Fee Sched Tier 3,160.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,73525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73525,BCBSND Hospital Base OP Fee Sched Tier 3,316.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,73551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73551,BCBSND Hospital Base OP Fee Sched Tier 3,75.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,73552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73552,BCBSND Hospital Base OP Fee Sched Tier 3,91.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,73560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73560,BCBSND Hospital Base OP Fee Sched Tier 3,90.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,73562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73562,BCBSND Hospital Base OP Fee Sched Tier 3,105.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,73564,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73564,BCBSND Hospital Base OP Fee Sched Tier 3,114.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,73565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73565,BCBSND Hospital Base OP Fee Sched Tier 3,107.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,73580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73580,BCBSND Hospital Base OP Fee Sched Tier 3,373.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,73590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73590,BCBSND Hospital Base OP Fee Sched Tier 3,80.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,73592,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73592,BCBSND Hospital Base OP Fee Sched Tier 3,78.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,73600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73600,BCBSND Hospital Base OP Fee Sched Tier 3,84.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,73610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73610,BCBSND Hospital Base OP Fee Sched Tier 3,92.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,73615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73615,BCBSND Hospital Base OP Fee Sched Tier 3,338.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,73620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73620,BCBSND Hospital Base OP Fee Sched Tier 3,72.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,73630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73630,BCBSND Hospital Base OP Fee Sched Tier 3,86.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,73650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73650,BCBSND Hospital Base OP Fee Sched Tier 3,71.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,73660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73660,BCBSND Hospital Base OP Fee Sched Tier 3,83.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,73700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73700,BCBSND Hospital Base OP Fee Sched Tier 3,907.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73701,BCBSND Hospital Base OP Fee Sched Tier 3,1175,,Fee schedule,,,,,,,,0
unity,Fee schedule,73702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73702,BCBSND Hospital Base OP Fee Sched Tier 3,1492.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73706,BCBSND Hospital Base OP Fee Sched Tier 3,1832.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73718,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73718,BCBSND Hospital Base OP Fee Sched Tier 3,1367.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73719,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73719,BCBSND Hospital Base OP Fee Sched Tier 3,1607.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73720,BCBSND Hospital Base OP Fee Sched Tier 3,2040,,Fee schedule,,,,,,,,0
unity,Fee schedule,73721,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73721,BCBSND Hospital Base OP Fee Sched Tier 3,1157.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73722,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73722,BCBSND Hospital Base OP Fee Sched Tier 3,2050,,Fee schedule,,,,,,,,0
unity,Fee schedule,73723,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73723,BCBSND Hospital Base OP Fee Sched Tier 3,2477.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,73725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,73725,BCBSND Hospital Base OP Fee Sched Tier 3,2137.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74018,BCBSND Hospital Base OP Fee Sched Tier 3,72.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,74019,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74019,BCBSND Hospital Base OP Fee Sched Tier 3,87.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,74021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74021,BCBSND Hospital Base OP Fee Sched Tier 3,99.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,74022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74022,BCBSND Hospital Base OP Fee Sched Tier 3,114.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,74150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74150,BCBSND Hospital Base OP Fee Sched Tier 3,630,,Fee schedule,,,,,,,,0
unity,Fee schedule,74160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74160,BCBSND Hospital Base OP Fee Sched Tier 3,1227.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74170,BCBSND Hospital Base OP Fee Sched Tier 3,1407.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74174,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74174,BCBSND Hospital Base OP Fee Sched Tier 3,2015,,Fee schedule,,,,,,,,0
unity,Fee schedule,74175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74175,BCBSND Hospital Base OP Fee Sched Tier 3,1575,,Fee schedule,,,,,,,,0
unity,Fee schedule,74176,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74176,BCBSND Hospital Base OP Fee Sched Tier 3,792.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74177,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74177,BCBSND Hospital Base OP Fee Sched Tier 3,1597.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74178,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74178,BCBSND Hospital Base OP Fee Sched Tier 3,1825,,Fee schedule,,,,,,,,0
unity,Fee schedule,74181,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74181,BCBSND Hospital Base OP Fee Sched Tier 3,1200,,Fee schedule,,,,,,,,0
unity,Fee schedule,74182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74182,BCBSND Hospital Base OP Fee Sched Tier 3,1910,,Fee schedule,,,,,,,,0
unity,Fee schedule,74183,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74183,BCBSND Hospital Base OP Fee Sched Tier 3,2030,,Fee schedule,,,,,,,,0
unity,Fee schedule,74185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74185,BCBSND Hospital Base OP Fee Sched Tier 3,2147.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74190,BCBSND Hospital Base OP Fee Sched Tier 3,212.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,74210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74210,BCBSND Hospital Base OP Fee Sched Tier 3,222.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,74220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74220,BCBSND Hospital Base OP Fee Sched Tier 3,238.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,74230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74230,BCBSND Hospital Base OP Fee Sched Tier 3,381.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,74235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74235,BCBSND Hospital Base OP Fee Sched Tier 3,425.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,74240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74240,BCBSND Hospital Base OP Fee Sched Tier 3,331.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,74241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74241,BCBSND Hospital Base OP Fee Sched Tier 3,351.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,74245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74245,BCBSND Hospital Base OP Fee Sched Tier 3,532.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,74246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74246,BCBSND Hospital Base OP Fee Sched Tier 3,385.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,74247,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74247,BCBSND Hospital Base OP Fee Sched Tier 3,450.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,74249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74249,BCBSND Hospital Base OP Fee Sched Tier 3,583.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,74250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74250,BCBSND Hospital Base OP Fee Sched Tier 3,338.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,74251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74251,BCBSND Hospital Base OP Fee Sched Tier 3,1506.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,74260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74260,BCBSND Hospital Base OP Fee Sched Tier 3,1239.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,74261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74261,BCBSND Hospital Base OP Fee Sched Tier 3,2540,,Fee schedule,,,,,,,,0
unity,Fee schedule,74262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74262,BCBSND Hospital Base OP Fee Sched Tier 3,2922.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74263,BCBSND Hospital Base OP Fee Sched Tier 3,4520,,Fee schedule,,,,,,,,0
unity,Fee schedule,74270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74270,BCBSND Hospital Base OP Fee Sched Tier 3,479.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,74280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74280,BCBSND Hospital Base OP Fee Sched Tier 3,673.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,74283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74283,BCBSND Hospital Base OP Fee Sched Tier 3,494.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,74290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74290,BCBSND Hospital Base OP Fee Sched Tier 3,227.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,74328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74328,BCBSND Hospital Base OP Fee Sched Tier 3,514.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,74329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74329,BCBSND Hospital Base OP Fee Sched Tier 3,513.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,74330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74330,BCBSND Hospital Base OP Fee Sched Tier 3,514.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,74340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74340,BCBSND Hospital Base OP Fee Sched Tier 3,427.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,74355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74355,BCBSND Hospital Base OP Fee Sched Tier 3,427.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,74360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74360,BCBSND Hospital Base OP Fee Sched Tier 3,514.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,74363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74363,BCBSND Hospital Base OP Fee Sched Tier 3,993.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,74400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74400,BCBSND Hospital Base OP Fee Sched Tier 3,358.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,74410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74410,BCBSND Hospital Base OP Fee Sched Tier 3,366.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,74415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74415,BCBSND Hospital Base OP Fee Sched Tier 3,454.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,74420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74420,BCBSND Hospital Base OP Fee Sched Tier 3,173.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,74425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74425,BCBSND Hospital Base OP Fee Sched Tier 3,212.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,74430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74430,BCBSND Hospital Base OP Fee Sched Tier 3,87.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,74440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74440,BCBSND Hospital Base OP Fee Sched Tier 3,258.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,74445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74445,BCBSND Hospital Base OP Fee Sched Tier 3,183.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,74450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74450,BCBSND Hospital Base OP Fee Sched Tier 3,238.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,74455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74455,BCBSND Hospital Base OP Fee Sched Tier 3,280.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,74470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74470,BCBSND Hospital Base OP Fee Sched Tier 3,203.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,74485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74485,BCBSND Hospital Base OP Fee Sched Tier 3,253.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,74710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74710,BCBSND Hospital Base OP Fee Sched Tier 3,79.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74712,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74712,BCBSND Hospital Base OP Fee Sched Tier 3,2322.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,74740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74740,BCBSND Hospital Base OP Fee Sched Tier 3,239.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,74742,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74742,BCBSND Hospital Base OP Fee Sched Tier 3,513.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,74775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,74775,BCBSND Hospital Base OP Fee Sched Tier 3,238.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,75557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75557,BCBSND Hospital Base OP Fee Sched Tier 3,1467.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,75559,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75559,BCBSND Hospital Base OP Fee Sched Tier 3,2180,,Fee schedule,,,,,,,,0
unity,Fee schedule,75561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75561,BCBSND Hospital Base OP Fee Sched Tier 3,2100,,Fee schedule,,,,,,,,0
unity,Fee schedule,75563,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75563,BCBSND Hospital Base OP Fee Sched Tier 3,2525,,Fee schedule,,,,,,,,0
unity,Fee schedule,75565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75565,BCBSND Hospital Base OP Fee Sched Tier 3,290,,Fee schedule,,,,,,,,0
unity,Fee schedule,75571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75571,BCBSND Hospital Base OP Fee Sched Tier 3,525,,Fee schedule,,,,,,,,0
unity,Fee schedule,75572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75572,BCBSND Hospital Base OP Fee Sched Tier 3,1262.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,75573,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75573,BCBSND Hospital Base OP Fee Sched Tier 3,1647.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,75574,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75574,BCBSND Hospital Base OP Fee Sched Tier 3,1920,,Fee schedule,,,,,,,,0
unity,Fee schedule,75600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75600,BCBSND Hospital Base OP Fee Sched Tier 3,665.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,75605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75605,BCBSND Hospital Base OP Fee Sched Tier 3,296.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,75625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75625,BCBSND Hospital Base OP Fee Sched Tier 3,289.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,75630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75630,BCBSND Hospital Base OP Fee Sched Tier 3,295.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,75635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75635,BCBSND Hospital Base OP Fee Sched Tier 3,2270,,Fee schedule,,,,,,,,0
unity,Fee schedule,75705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75705,BCBSND Hospital Base OP Fee Sched Tier 3,513.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,75710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75710,BCBSND Hospital Base OP Fee Sched Tier 3,307.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,75716,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75716,BCBSND Hospital Base OP Fee Sched Tier 3,311.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,75726,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75726,BCBSND Hospital Base OP Fee Sched Tier 3,339.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,75731,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75731,BCBSND Hospital Base OP Fee Sched Tier 3,417.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,75733,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75733,BCBSND Hospital Base OP Fee Sched Tier 3,441.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,75736,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75736,BCBSND Hospital Base OP Fee Sched Tier 3,380,,Fee schedule,,,,,,,,0
unity,Fee schedule,75741,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75741,BCBSND Hospital Base OP Fee Sched Tier 3,313.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,75743,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75743,BCBSND Hospital Base OP Fee Sched Tier 3,318.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,75746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75746,BCBSND Hospital Base OP Fee Sched Tier 3,347.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,75756,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75756,BCBSND Hospital Base OP Fee Sched Tier 3,427.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,75774,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75774,BCBSND Hospital Base OP Fee Sched Tier 3,247.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,75801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75801,BCBSND Hospital Base OP Fee Sched Tier 3,883.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,75803,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75803,BCBSND Hospital Base OP Fee Sched Tier 3,883.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,75805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75805,BCBSND Hospital Base OP Fee Sched Tier 3,995.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,75807,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75807,BCBSND Hospital Base OP Fee Sched Tier 3,993.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,75809,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75809,BCBSND Hospital Base OP Fee Sched Tier 3,270.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,75810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75810,BCBSND Hospital Base OP Fee Sched Tier 3,2052.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,75820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75820,BCBSND Hospital Base OP Fee Sched Tier 3,291.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,75822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75822,BCBSND Hospital Base OP Fee Sched Tier 3,297.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,75825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75825,BCBSND Hospital Base OP Fee Sched Tier 3,282.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,75827,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75827,BCBSND Hospital Base OP Fee Sched Tier 3,299.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,75831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75831,BCBSND Hospital Base OP Fee Sched Tier 3,307.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,75833,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75833,BCBSND Hospital Base OP Fee Sched Tier 3,334.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,75840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75840,BCBSND Hospital Base OP Fee Sched Tier 3,330.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,75842,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75842,BCBSND Hospital Base OP Fee Sched Tier 3,380,,Fee schedule,,,,,,,,0
unity,Fee schedule,75860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75860,BCBSND Hospital Base OP Fee Sched Tier 3,322.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,75870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75870,BCBSND Hospital Base OP Fee Sched Tier 3,467.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,75872,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75872,BCBSND Hospital Base OP Fee Sched Tier 3,330.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,75880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75880,BCBSND Hospital Base OP Fee Sched Tier 3,328.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,75885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75885,BCBSND Hospital Base OP Fee Sched Tier 3,319.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,75887,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75887,BCBSND Hospital Base OP Fee Sched Tier 3,320.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,75889,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75889,BCBSND Hospital Base OP Fee Sched Tier 3,320.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,75891,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75891,BCBSND Hospital Base OP Fee Sched Tier 3,324.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,75893,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75893,BCBSND Hospital Base OP Fee Sched Tier 3,343.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,75894,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75894,BCBSND Hospital Base OP Fee Sched Tier 3,3933.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,75898,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75898,BCBSND Hospital Base OP Fee Sched Tier 3,171.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,75901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75901,BCBSND Hospital Base OP Fee Sched Tier 3,667.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,75902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75902,BCBSND Hospital Base OP Fee Sched Tier 3,226.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,75970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75970,BCBSND Hospital Base OP Fee Sched Tier 3,1879.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,75984,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75984,BCBSND Hospital Base OP Fee Sched Tier 3,256.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,75989,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,75989,BCBSND Hospital Base OP Fee Sched Tier 3,238.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,76010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76010,BCBSND Hospital Base OP Fee Sched Tier 3,68.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,76080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76080,BCBSND Hospital Base OP Fee Sched Tier 3,117.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,76098,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76098,BCBSND Hospital Base OP Fee Sched Tier 3,32.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,76100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76100,BCBSND Hospital Base OP Fee Sched Tier 3,239.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,76101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76101,BCBSND Hospital Base OP Fee Sched Tier 3,249.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,76102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76102,BCBSND Hospital Base OP Fee Sched Tier 3,528.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,76120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76120,BCBSND Hospital Base OP Fee Sched Tier 3,316.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,76125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76125,BCBSND Hospital Base OP Fee Sched Tier 3,128.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,76376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76376,BCBSND Hospital Base OP Fee Sched Tier 3,49.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,76377,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76377,BCBSND Hospital Base OP Fee Sched Tier 3,118.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,76380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76380,BCBSND Hospital Base OP Fee Sched Tier 3,672.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,76390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76390,BCBSND Hospital Base OP Fee Sched Tier 3,2582.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,76391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76391,BCBSND Hospital Base OP Fee Sched Tier 3,1270,,Fee schedule,,,,,,,,0
unity,Fee schedule,76496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76496,BCBSND Hospital Base OP Fee Sched Tier 3,101.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,76497,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76497,BCBSND Hospital Base OP Fee Sched Tier 3,101.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,76498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76498,BCBSND Hospital Base OP Fee Sched Tier 3,101.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,76499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76499,BCBSND Hospital Base OP Fee Sched Tier 3,101.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,76506,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76506,BCBSND Hospital Base OP Fee Sched Tier 3,316.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,76510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76510,BCBSND Hospital Base OP Fee Sched Tier 3,202.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,76511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76511,BCBSND Hospital Base OP Fee Sched Tier 3,121.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,76512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76512,BCBSND Hospital Base OP Fee Sched Tier 3,99.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,76513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76513,BCBSND Hospital Base OP Fee Sched Tier 3,237.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,76514,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76514,BCBSND Hospital Base OP Fee Sched Tier 3,17.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,76516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76516,BCBSND Hospital Base OP Fee Sched Tier 3,118.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,76519,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76519,BCBSND Hospital Base OP Fee Sched Tier 3,132.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,76529,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76529,BCBSND Hospital Base OP Fee Sched Tier 3,187.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,76536,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76536,BCBSND Hospital Base OP Fee Sched Tier 3,330.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,76604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76604,BCBSND Hospital Base OP Fee Sched Tier 3,234.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,76641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76641,BCBSND Hospital Base OP Fee Sched Tier 3,266.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,76642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76642,BCBSND Hospital Base OP Fee Sched Tier 3,202.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,76700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76700,BCBSND Hospital Base OP Fee Sched Tier 3,307.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,76705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76705,BCBSND Hospital Base OP Fee Sched Tier 3,233.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,76706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76706,BCBSND Hospital Base OP Fee Sched Tier 3,326.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,76770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76770,BCBSND Hospital Base OP Fee Sched Tier 3,287.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,76775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76775,BCBSND Hospital Base OP Fee Sched Tier 3,111.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,76776,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76776,BCBSND Hospital Base OP Fee Sched Tier 3,444.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,76800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76800,BCBSND Hospital Base OP Fee Sched Tier 3,318.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,76801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76801,BCBSND Hospital Base OP Fee Sched Tier 3,274.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,76802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76802,BCBSND Hospital Base OP Fee Sched Tier 3,82.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,76805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76805,BCBSND Hospital Base OP Fee Sched Tier 3,342.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,76810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76810,BCBSND Hospital Base OP Fee Sched Tier 3,161.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,76811,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76811,BCBSND Hospital Base OP Fee Sched Tier 3,316.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,76812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76812,BCBSND Hospital Base OP Fee Sched Tier 3,417.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,76813,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76813,BCBSND Hospital Base OP Fee Sched Tier 3,231.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,76814,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76814,BCBSND Hospital Base OP Fee Sched Tier 3,109.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,76815,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76815,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,76816,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76816,BCBSND Hospital Base OP Fee Sched Tier 3,268.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,76817,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76817,BCBSND Hospital Base OP Fee Sched Tier 3,222.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,76818,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76818,BCBSND Hospital Base OP Fee Sched Tier 3,256.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,76819,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76819,BCBSND Hospital Base OP Fee Sched Tier 3,188.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,76820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76820,BCBSND Hospital Base OP Fee Sched Tier 3,83.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,76821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76821,BCBSND Hospital Base OP Fee Sched Tier 3,212.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,76825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76825,BCBSND Hospital Base OP Fee Sched Tier 3,729,,Fee schedule,,,,,,,,0
unity,Fee schedule,76826,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76826,BCBSND Hospital Base OP Fee Sched Tier 3,464.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,76827,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76827,BCBSND Hospital Base OP Fee Sched Tier 3,173.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,76828,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76828,BCBSND Hospital Base OP Fee Sched Tier 3,94.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,76830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76830,BCBSND Hospital Base OP Fee Sched Tier 3,330.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,76831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76831,BCBSND Hospital Base OP Fee Sched Tier 3,311.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,76856,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76856,BCBSND Hospital Base OP Fee Sched Tier 3,284.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,76857,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76857,BCBSND Hospital Base OP Fee Sched Tier 3,90.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,76870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76870,BCBSND Hospital Base OP Fee Sched Tier 3,277.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,76872,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76872,BCBSND Hospital Base OP Fee Sched Tier 3,359.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,76873,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76873,BCBSND Hospital Base OP Fee Sched Tier 3,362.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,76881,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76881,BCBSND Hospital Base OP Fee Sched Tier 3,216.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,76882,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76882,BCBSND Hospital Base OP Fee Sched Tier 3,123.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,76885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76885,BCBSND Hospital Base OP Fee Sched Tier 3,402.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,76886,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76886,BCBSND Hospital Base OP Fee Sched Tier 3,280.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,76930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76930,BCBSND Hospital Base OP Fee Sched Tier 3,207.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,76932,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76932,BCBSND Hospital Base OP Fee Sched Tier 3,250.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,76936,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76936,BCBSND Hospital Base OP Fee Sched Tier 3,650.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,76937,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76937,BCBSND Hospital Base OP Fee Sched Tier 3,74.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,76940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76940,BCBSND Hospital Base OP Fee Sched Tier 3,278.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,76941,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76941,BCBSND Hospital Base OP Fee Sched Tier 3,249.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,76942,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76942,BCBSND Hospital Base OP Fee Sched Tier 3,94.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,76945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76945,BCBSND Hospital Base OP Fee Sched Tier 3,249.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,76946,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76946,BCBSND Hospital Base OP Fee Sched Tier 3,49.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,76948,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76948,BCBSND Hospital Base OP Fee Sched Tier 3,152.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,76965,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76965,BCBSND Hospital Base OP Fee Sched Tier 3,94.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,76970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76970,BCBSND Hospital Base OP Fee Sched Tier 3,268.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,76975,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76975,BCBSND Hospital Base OP Fee Sched Tier 3,250.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,76977,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76977,BCBSND Hospital Base OP Fee Sched Tier 3,17.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,76978,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76978,BCBSND Hospital Base OP Fee Sched Tier 3,927.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,76979,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76979,BCBSND Hospital Base OP Fee Sched Tier 3,676.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,76981,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76981,BCBSND Hospital Base OP Fee Sched Tier 3,295.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,76982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76982,BCBSND Hospital Base OP Fee Sched Tier 3,251.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,76983,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76983,BCBSND Hospital Base OP Fee Sched Tier 3,128.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,76999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,76999,BCBSND Hospital Base OP Fee Sched Tier 3,101.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,77011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77011,BCBSND Hospital Base OP Fee Sched Tier 3,1170,,Fee schedule,,,,,,,,0
unity,Fee schedule,77012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77012,BCBSND Hospital Base OP Fee Sched Tier 3,542.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,77013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77013,BCBSND Hospital Base OP Fee Sched Tier 3,2790,,Fee schedule,,,,,,,,0
unity,Fee schedule,77014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77014,BCBSND Hospital Base OP Fee Sched Tier 3,535,,Fee schedule,,,,,,,,0
unity,Fee schedule,77021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77021,BCBSND Hospital Base OP Fee Sched Tier 3,2840,,Fee schedule,,,,,,,,0
unity,Fee schedule,77022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77022,BCBSND Hospital Base OP Fee Sched Tier 3,3667.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,77046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77046,BCBSND Hospital Base OP Fee Sched Tier 3,1240,,Fee schedule,,,,,,,,0
unity,Fee schedule,77047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77047,BCBSND Hospital Base OP Fee Sched Tier 3,1232.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,77048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77048,BCBSND Hospital Base OP Fee Sched Tier 3,2042.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,77049,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77049,BCBSND Hospital Base OP Fee Sched Tier 3,2032.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,77053,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77053,BCBSND Hospital Base OP Fee Sched Tier 3,149.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,77054,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77054,BCBSND Hospital Base OP Fee Sched Tier 3,198.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,77061,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77061,BCBSND Hospital Base OP Fee Sched Tier 3,75.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,77062,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77062,BCBSND Hospital Base OP Fee Sched Tier 3,94.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,77063,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77063,BCBSND Hospital Base OP Fee Sched Tier 3,94.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,77065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77065,BCBSND Hospital Base OP Fee Sched Tier 3,351.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,77066,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77066,BCBSND Hospital Base OP Fee Sched Tier 3,450.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,77067,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77067,BCBSND Hospital Base OP Fee Sched Tier 3,371.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,77072,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77072,BCBSND Hospital Base OP Fee Sched Tier 3,55.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,77073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77073,BCBSND Hospital Base OP Fee Sched Tier 3,87.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,77074,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77074,BCBSND Hospital Base OP Fee Sched Tier 3,169.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,77075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77075,BCBSND Hospital Base OP Fee Sched Tier 3,246.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,77076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77076,BCBSND Hospital Base OP Fee Sched Tier 3,249.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,77077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77077,BCBSND Hospital Base OP Fee Sched Tier 3,84.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,77078,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77078,BCBSND Hospital Base OP Fee Sched Tier 3,722.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,77080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77080,BCBSND Hospital Base OP Fee Sched Tier 3,114.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,77081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77081,BCBSND Hospital Base OP Fee Sched Tier 3,87.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,77084,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77084,BCBSND Hospital Base OP Fee Sched Tier 3,2107.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,77085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77085,BCBSND Hospital Base OP Fee Sched Tier 3,149.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,77086,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77086,BCBSND Hospital Base OP Fee Sched Tier 3,101.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,77280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77280,BCBSND Hospital Base OP Fee Sched Tier 3,1142.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,77285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77285,BCBSND Hospital Base OP Fee Sched Tier 3,1913.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,77290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77290,BCBSND Hospital Base OP Fee Sched Tier 3,2038.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,77295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77295,BCBSND Hospital Base OP Fee Sched Tier 3,1270.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,77299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77299,BCBSND Hospital Base OP Fee Sched Tier 3,201.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,77300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77300,BCBSND Hospital Base OP Fee Sched Tier 3,161.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,77301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77301,BCBSND Hospital Base OP Fee Sched Tier 3,7264.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,77306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77306,BCBSND Hospital Base OP Fee Sched Tier 3,291.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,77307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77307,BCBSND Hospital Base OP Fee Sched Tier 3,525.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,77316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77316,BCBSND Hospital Base OP Fee Sched Tier 3,495.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,77317,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77317,BCBSND Hospital Base OP Fee Sched Tier 3,652.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,77318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77318,BCBSND Hospital Base OP Fee Sched Tier 3,883.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,77321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77321,BCBSND Hospital Base OP Fee Sched Tier 3,208.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,77331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77331,BCBSND Hospital Base OP Fee Sched Tier 3,91.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,77332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77332,BCBSND Hospital Base OP Fee Sched Tier 3,136.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,77333,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77333,BCBSND Hospital Base OP Fee Sched Tier 3,334.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,77334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77334,BCBSND Hospital Base OP Fee Sched Tier 3,323.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,77336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77336,BCBSND Hospital Base OP Fee Sched Tier 3,381.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,77338,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77338,BCBSND Hospital Base OP Fee Sched Tier 3,1307.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,77370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77370,BCBSND Hospital Base OP Fee Sched Tier 3,592.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,77371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77371,BCBSND Hospital Base OP Fee Sched Tier 3,5547.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,77372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77372,BCBSND Hospital Base OP Fee Sched Tier 3,5093.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,77373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77373,BCBSND Hospital Base OP Fee Sched Tier 3,6166.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,77385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77385,BCBSND Hospital Base OP Fee Sched Tier 3,844.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,77386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77386,BCBSND Hospital Base OP Fee Sched Tier 3,844.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,77387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77387,BCBSND Hospital Base OP Fee Sched Tier 3,257.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,77399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77399,BCBSND Hospital Base OP Fee Sched Tier 3,201.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,77401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77401,BCBSND Hospital Base OP Fee Sched Tier 3,118.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,77402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77402,BCBSND Hospital Base OP Fee Sched Tier 3,447.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,77407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77407,BCBSND Hospital Base OP Fee Sched Tier 3,1075.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,77412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77412,BCBSND Hospital Base OP Fee Sched Tier 3,800.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,77417,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77417,BCBSND Hospital Base OP Fee Sched Tier 3,53.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,77423,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77423,BCBSND Hospital Base OP Fee Sched Tier 3,308.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,77424,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77424,BCBSND Hospital Base OP Fee Sched Tier 3,12421.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,77425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77425,BCBSND Hospital Base OP Fee Sched Tier 3,12421.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,77435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77435,BCBSND Hospital Base OP Fee Sched Tier 3,2448.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,77469,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77469,BCBSND Hospital Base OP Fee Sched Tier 3,1212.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,77470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77470,BCBSND Hospital Base OP Fee Sched Tier 3,121.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,77520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77520,BCBSND Hospital Base OP Fee Sched Tier 3,844.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,77522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77522,BCBSND Hospital Base OP Fee Sched Tier 3,1753.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,77523,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77523,BCBSND Hospital Base OP Fee Sched Tier 3,1753.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,77525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77525,BCBSND Hospital Base OP Fee Sched Tier 3,1753.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,77600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77600,BCBSND Hospital Base OP Fee Sched Tier 3,1809.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,77605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77605,BCBSND Hospital Base OP Fee Sched Tier 3,3221.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,77610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77610,BCBSND Hospital Base OP Fee Sched Tier 3,2975.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,77615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77615,BCBSND Hospital Base OP Fee Sched Tier 3,4608.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,77620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77620,BCBSND Hospital Base OP Fee Sched Tier 3,2056.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,77750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77750,BCBSND Hospital Base OP Fee Sched Tier 3,563.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,77761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77761,BCBSND Hospital Base OP Fee Sched Tier 3,940.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,77762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77762,BCBSND Hospital Base OP Fee Sched Tier 3,1076.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,77763,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77763,BCBSND Hospital Base OP Fee Sched Tier 3,1414.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,77767,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77767,BCBSND Hospital Base OP Fee Sched Tier 3,677.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,77768,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77768,BCBSND Hospital Base OP Fee Sched Tier 3,1083.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,77770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77770,BCBSND Hospital Base OP Fee Sched Tier 3,870.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,77771,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77771,BCBSND Hospital Base OP Fee Sched Tier 3,1536.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,77772,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77772,BCBSND Hospital Base OP Fee Sched Tier 3,2403.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,77778,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77778,BCBSND Hospital Base OP Fee Sched Tier 3,1852.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,77789,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77789,BCBSND Hospital Base OP Fee Sched Tier 3,300.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,77790,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77790,BCBSND Hospital Base OP Fee Sched Tier 3,57.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,77799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,77799,BCBSND Hospital Base OP Fee Sched Tier 3,190.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,78012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78012,BCBSND Hospital Base OP Fee Sched Tier 3,278.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,78013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78013,BCBSND Hospital Base OP Fee Sched Tier 3,676.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,78014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78014,BCBSND Hospital Base OP Fee Sched Tier 3,842.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,78015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78015,BCBSND Hospital Base OP Fee Sched Tier 3,743.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,78016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78016,BCBSND Hospital Base OP Fee Sched Tier 3,963.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,78018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78018,BCBSND Hospital Base OP Fee Sched Tier 3,1059.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78020,BCBSND Hospital Base OP Fee Sched Tier 3,218.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,78070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78070,BCBSND Hospital Base OP Fee Sched Tier 3,1010.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,78071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78071,BCBSND Hospital Base OP Fee Sched Tier 3,1158.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,78072,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78072,BCBSND Hospital Base OP Fee Sched Tier 3,1215.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,78075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78075,BCBSND Hospital Base OP Fee Sched Tier 3,1608.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,78099,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78099,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78102,BCBSND Hospital Base OP Fee Sched Tier 3,557.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,78103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78103,BCBSND Hospital Base OP Fee Sched Tier 3,710.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,78104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78104,BCBSND Hospital Base OP Fee Sched Tier 3,815.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,78110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78110,BCBSND Hospital Base OP Fee Sched Tier 3,237.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,78111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78111,BCBSND Hospital Base OP Fee Sched Tier 3,247.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,78120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78120,BCBSND Hospital Base OP Fee Sched Tier 3,237.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,78121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78121,BCBSND Hospital Base OP Fee Sched Tier 3,247.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,78122,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78122,BCBSND Hospital Base OP Fee Sched Tier 3,287.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,78130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78130,BCBSND Hospital Base OP Fee Sched Tier 3,382.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,78135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78135,BCBSND Hospital Base OP Fee Sched Tier 3,978.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,78140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78140,BCBSND Hospital Base OP Fee Sched Tier 3,326.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,78185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78185,BCBSND Hospital Base OP Fee Sched Tier 3,591.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,78191,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78191,BCBSND Hospital Base OP Fee Sched Tier 3,382.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,78195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78195,BCBSND Hospital Base OP Fee Sched Tier 3,1158.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,78199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78199,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78201,BCBSND Hospital Base OP Fee Sched Tier 3,658.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,78202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78202,BCBSND Hospital Base OP Fee Sched Tier 3,693.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,78205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78205,BCBSND Hospital Base OP Fee Sched Tier 3,691.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,78206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78206,BCBSND Hospital Base OP Fee Sched Tier 3,1139.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,78215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78215,BCBSND Hospital Base OP Fee Sched Tier 3,662.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,78216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78216,BCBSND Hospital Base OP Fee Sched Tier 3,390.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,78226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78226,BCBSND Hospital Base OP Fee Sched Tier 3,1142.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,78227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78227,BCBSND Hospital Base OP Fee Sched Tier 3,1563.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,78230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78230,BCBSND Hospital Base OP Fee Sched Tier 3,590.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,78231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78231,BCBSND Hospital Base OP Fee Sched Tier 3,318.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,78232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78232,BCBSND Hospital Base OP Fee Sched Tier 3,318.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,78258,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78258,BCBSND Hospital Base OP Fee Sched Tier 3,712.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,78261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78261,BCBSND Hospital Base OP Fee Sched Tier 3,675.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,78262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78262,BCBSND Hospital Base OP Fee Sched Tier 3,809.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,78264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78264,BCBSND Hospital Base OP Fee Sched Tier 3,1152.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,78265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78265,BCBSND Hospital Base OP Fee Sched Tier 3,1358.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,78266,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78266,BCBSND Hospital Base OP Fee Sched Tier 3,1626.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78267,BCBSND Hospital Base OP Fee Sched Tier 3,47.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,78268,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78268,BCBSND Hospital Base OP Fee Sched Tier 3,403.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,78278,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78278,BCBSND Hospital Base OP Fee Sched Tier 3,1168.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,78282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78282,BCBSND Hospital Base OP Fee Sched Tier 3,61.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,78290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78290,BCBSND Hospital Base OP Fee Sched Tier 3,1156.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,78291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78291,BCBSND Hospital Base OP Fee Sched Tier 3,832.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,78299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78299,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78300,BCBSND Hospital Base OP Fee Sched Tier 3,774.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,78305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78305,BCBSND Hospital Base OP Fee Sched Tier 3,931.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,78306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78306,BCBSND Hospital Base OP Fee Sched Tier 3,1011.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,78315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78315,BCBSND Hospital Base OP Fee Sched Tier 3,1153.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,78320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78320,BCBSND Hospital Base OP Fee Sched Tier 3,693.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,78350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78350,BCBSND Hospital Base OP Fee Sched Tier 3,82.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,78351,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78351,BCBSND Hospital Base OP Fee Sched Tier 3,59.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,78399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78399,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78414,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78414,BCBSND Hospital Base OP Fee Sched Tier 3,84.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,78428,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78428,BCBSND Hospital Base OP Fee Sched Tier 3,568.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,78445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78445,BCBSND Hospital Base OP Fee Sched Tier 3,629.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,78451,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78451,BCBSND Hospital Base OP Fee Sched Tier 3,1059.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78452,BCBSND Hospital Base OP Fee Sched Tier 3,1530.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,78453,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78453,BCBSND Hospital Base OP Fee Sched Tier 3,993.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,78454,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78454,BCBSND Hospital Base OP Fee Sched Tier 3,1437.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,78456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78456,BCBSND Hospital Base OP Fee Sched Tier 3,1017.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,78457,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78457,BCBSND Hospital Base OP Fee Sched Tier 3,594.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,78458,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78458,BCBSND Hospital Base OP Fee Sched Tier 3,625.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,78459,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78459,BCBSND Hospital Base OP Fee Sched Tier 3,2305.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,78466,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78466,BCBSND Hospital Base OP Fee Sched Tier 3,630.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,78468,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78468,BCBSND Hospital Base OP Fee Sched Tier 3,641.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,78469,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78469,BCBSND Hospital Base OP Fee Sched Tier 3,702.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,78472,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78472,BCBSND Hospital Base OP Fee Sched Tier 3,703.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,78473,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78473,BCBSND Hospital Base OP Fee Sched Tier 3,848.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,78481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78481,BCBSND Hospital Base OP Fee Sched Tier 3,497.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,78483,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78483,BCBSND Hospital Base OP Fee Sched Tier 3,649.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,78491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78491,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78492,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78494,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78494,BCBSND Hospital Base OP Fee Sched Tier 3,654.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,78496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78496,BCBSND Hospital Base OP Fee Sched Tier 3,75.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,78499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78499,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78579,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78579,BCBSND Hospital Base OP Fee Sched Tier 3,630.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,78580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78580,BCBSND Hospital Base OP Fee Sched Tier 3,785.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,78582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78582,BCBSND Hospital Base OP Fee Sched Tier 3,1096.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,78597,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78597,BCBSND Hospital Base OP Fee Sched Tier 3,644.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,78598,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78598,BCBSND Hospital Base OP Fee Sched Tier 3,1028.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78599,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78599,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78600,BCBSND Hospital Base OP Fee Sched Tier 3,631.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,78601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78601,BCBSND Hospital Base OP Fee Sched Tier 3,745.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,78605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78605,BCBSND Hospital Base OP Fee Sched Tier 3,671.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,78606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78606,BCBSND Hospital Base OP Fee Sched Tier 3,1160.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,78607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78607,BCBSND Hospital Base OP Fee Sched Tier 3,1119.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,78608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78608,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78609,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78609,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78610,BCBSND Hospital Base OP Fee Sched Tier 3,621.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,78630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78630,BCBSND Hospital Base OP Fee Sched Tier 3,1183.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,78635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78635,BCBSND Hospital Base OP Fee Sched Tier 3,1197.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,78645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78645,BCBSND Hospital Base OP Fee Sched Tier 3,1156.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,78647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78647,BCBSND Hospital Base OP Fee Sched Tier 3,1179.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,78650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78650,BCBSND Hospital Base OP Fee Sched Tier 3,966.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,78660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78660,BCBSND Hospital Base OP Fee Sched Tier 3,607.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,78699,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78699,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78700,BCBSND Hospital Base OP Fee Sched Tier 3,579.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78701,BCBSND Hospital Base OP Fee Sched Tier 3,750.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,78707,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78707,BCBSND Hospital Base OP Fee Sched Tier 3,723.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,78708,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78708,BCBSND Hospital Base OP Fee Sched Tier 3,459.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,78709,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78709,BCBSND Hospital Base OP Fee Sched Tier 3,1166.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,78710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78710,BCBSND Hospital Base OP Fee Sched Tier 3,583.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,78725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78725,BCBSND Hospital Base OP Fee Sched Tier 3,349,,Fee schedule,,,,,,,,0
unity,Fee schedule,78730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78730,BCBSND Hospital Base OP Fee Sched Tier 3,268.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,78740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78740,BCBSND Hospital Base OP Fee Sched Tier 3,742.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,78761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78761,BCBSND Hospital Base OP Fee Sched Tier 3,683.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,78799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78799,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,78800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78800,BCBSND Hospital Base OP Fee Sched Tier 3,626.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,78801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78801,BCBSND Hospital Base OP Fee Sched Tier 3,848.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,78802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78802,BCBSND Hospital Base OP Fee Sched Tier 3,1092.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,78803,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78803,BCBSND Hospital Base OP Fee Sched Tier 3,1122.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,78804,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78804,BCBSND Hospital Base OP Fee Sched Tier 3,2007.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,78805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78805,BCBSND Hospital Base OP Fee Sched Tier 3,576.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,78806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78806,BCBSND Hospital Base OP Fee Sched Tier 3,1131.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,78807,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78807,BCBSND Hospital Base OP Fee Sched Tier 3,1122.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,78808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78808,BCBSND Hospital Base OP Fee Sched Tier 3,150.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,78811,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78811,BCBSND Hospital Base OP Fee Sched Tier 3,2305.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,78812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78812,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78813,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78813,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78814,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78814,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78815,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78815,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78816,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78816,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,78999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,78999,BCBSND Hospital Base OP Fee Sched Tier 3,574.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,79005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,79005,BCBSND Hospital Base OP Fee Sched Tier 3,237.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,79101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,79101,BCBSND Hospital Base OP Fee Sched Tier 3,235.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,79200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,79200,BCBSND Hospital Base OP Fee Sched Tier 3,247.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,79300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,79300,BCBSND Hospital Base OP Fee Sched Tier 3,257.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,79403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,79403,BCBSND Hospital Base OP Fee Sched Tier 3,392.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,79440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,79440,BCBSND Hospital Base OP Fee Sched Tier 3,183.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,79445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,79445,BCBSND Hospital Base OP Fee Sched Tier 3,536.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,79999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,79999,BCBSND Hospital Base OP Fee Sched Tier 3,375.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,80047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80047,BCBSND Hospital Base OP Fee Sched Tier 3,58.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,80048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80048,BCBSND Hospital Base OP Fee Sched Tier 3,40.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,80050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80050,BCBSND Hospital Base OP Fee Sched Tier 3,160.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,80051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80051,BCBSND Hospital Base OP Fee Sched Tier 3,33.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,80053,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80053,BCBSND Hospital Base OP Fee Sched Tier 3,50.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,80055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80055,BCBSND Hospital Base OP Fee Sched Tier 3,227.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,80061,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80061,BCBSND Hospital Base OP Fee Sched Tier 3,63.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,80069,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80069,BCBSND Hospital Base OP Fee Sched Tier 3,41.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,80074,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80074,BCBSND Hospital Base OP Fee Sched Tier 3,226.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,80076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80076,BCBSND Hospital Base OP Fee Sched Tier 3,38.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,80081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80081,BCBSND Hospital Base OP Fee Sched Tier 3,355.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,80150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80150,BCBSND Hospital Base OP Fee Sched Tier 3,71.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,80155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80155,BCBSND Hospital Base OP Fee Sched Tier 3,164.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,80156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80156,BCBSND Hospital Base OP Fee Sched Tier 3,69.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,80157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80157,BCBSND Hospital Base OP Fee Sched Tier 3,62.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,80158,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80158,BCBSND Hospital Base OP Fee Sched Tier 3,85.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,80159,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80159,BCBSND Hospital Base OP Fee Sched Tier 3,87.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,80162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80162,BCBSND Hospital Base OP Fee Sched Tier 3,63.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,80163,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80163,BCBSND Hospital Base OP Fee Sched Tier 3,63.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,80164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80164,BCBSND Hospital Base OP Fee Sched Tier 3,64.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,80165,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80165,BCBSND Hospital Base OP Fee Sched Tier 3,64.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,80168,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80168,BCBSND Hospital Base OP Fee Sched Tier 3,77.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,80169,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80169,BCBSND Hospital Base OP Fee Sched Tier 3,65.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,80170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80170,BCBSND Hospital Base OP Fee Sched Tier 3,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,80171,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80171,BCBSND Hospital Base OP Fee Sched Tier 3,92.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,80173,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80173,BCBSND Hospital Base OP Fee Sched Tier 3,69.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,80175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80175,BCBSND Hospital Base OP Fee Sched Tier 3,62.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,80176,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80176,BCBSND Hospital Base OP Fee Sched Tier 3,69.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,80177,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80177,BCBSND Hospital Base OP Fee Sched Tier 3,62.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,80178,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80178,BCBSND Hospital Base OP Fee Sched Tier 3,31.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,80180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80180,BCBSND Hospital Base OP Fee Sched Tier 3,85.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,80183,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80183,BCBSND Hospital Base OP Fee Sched Tier 3,62.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,80184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80184,BCBSND Hospital Base OP Fee Sched Tier 3,65.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,80185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80185,BCBSND Hospital Base OP Fee Sched Tier 3,62.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,80186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80186,BCBSND Hospital Base OP Fee Sched Tier 3,65.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,80188,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80188,BCBSND Hospital Base OP Fee Sched Tier 3,78.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,80190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80190,BCBSND Hospital Base OP Fee Sched Tier 3,256.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,80192,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80192,BCBSND Hospital Base OP Fee Sched Tier 3,79.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,80194,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80194,BCBSND Hospital Base OP Fee Sched Tier 3,69.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,80195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80195,BCBSND Hospital Base OP Fee Sched Tier 3,65.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,80197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80197,BCBSND Hospital Base OP Fee Sched Tier 3,65.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,80198,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80198,BCBSND Hospital Base OP Fee Sched Tier 3,67.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,80199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80199,BCBSND Hospital Base OP Fee Sched Tier 3,115.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,80200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80200,BCBSND Hospital Base OP Fee Sched Tier 3,76.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,80201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80201,BCBSND Hospital Base OP Fee Sched Tier 3,56.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,80202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80202,BCBSND Hospital Base OP Fee Sched Tier 3,64.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,80203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80203,BCBSND Hospital Base OP Fee Sched Tier 3,62.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,80299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80299,BCBSND Hospital Base OP Fee Sched Tier 3,79.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,80305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80305,BCBSND Hospital Base OP Fee Sched Tier 3,53.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,80306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80306,BCBSND Hospital Base OP Fee Sched Tier 3,73.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,80307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80307,BCBSND Hospital Base OP Fee Sched Tier 3,276.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,80320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80320,BCBSND Hospital Base OP Fee Sched Tier 3,52.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,80321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80321,BCBSND Hospital Base OP Fee Sched Tier 3,52.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,80322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80322,BCBSND Hospital Base OP Fee Sched Tier 3,52.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,80323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80323,BCBSND Hospital Base OP Fee Sched Tier 3,116.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,80324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80324,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80325,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80326,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80327,BCBSND Hospital Base OP Fee Sched Tier 3,126.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,80328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80328,BCBSND Hospital Base OP Fee Sched Tier 3,126.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,80329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80329,BCBSND Hospital Base OP Fee Sched Tier 3,34.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,80330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80330,BCBSND Hospital Base OP Fee Sched Tier 3,34.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,80331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80331,BCBSND Hospital Base OP Fee Sched Tier 3,34.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,80332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80332,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80333,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80333,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80334,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80335,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80336,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80337,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80338,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80338,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80339,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80339,BCBSND Hospital Base OP Fee Sched Tier 3,67.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,80340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80340,BCBSND Hospital Base OP Fee Sched Tier 3,67.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,80341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80341,BCBSND Hospital Base OP Fee Sched Tier 3,67.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,80342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80342,BCBSND Hospital Base OP Fee Sched Tier 3,76.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,80343,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80343,BCBSND Hospital Base OP Fee Sched Tier 3,76.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,80344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80344,BCBSND Hospital Base OP Fee Sched Tier 3,76.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,80345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80345,BCBSND Hospital Base OP Fee Sched Tier 3,56.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,80346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80346,BCBSND Hospital Base OP Fee Sched Tier 3,97.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,80347,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80347,BCBSND Hospital Base OP Fee Sched Tier 3,97.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,80348,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80348,BCBSND Hospital Base OP Fee Sched Tier 3,97.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,80349,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80349,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80350,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80351,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80351,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80352,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80353,BCBSND Hospital Base OP Fee Sched Tier 3,74.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,80354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80354,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80355,BCBSND Hospital Base OP Fee Sched Tier 3,76.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,80356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80356,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80357,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80358,BCBSND Hospital Base OP Fee Sched Tier 3,80.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,80359,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80359,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80360,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80361,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80362,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80363,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80364,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80365,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80366,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80367,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80367,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80368,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80368,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80369,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80369,BCBSND Hospital Base OP Fee Sched Tier 3,86.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,80370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80370,BCBSND Hospital Base OP Fee Sched Tier 3,86.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,80371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80371,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80372,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80373,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80374,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80374,BCBSND Hospital Base OP Fee Sched Tier 3,95.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,80375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80375,BCBSND Hospital Base OP Fee Sched Tier 3,79.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,80376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80376,BCBSND Hospital Base OP Fee Sched Tier 3,79.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,80377,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80377,BCBSND Hospital Base OP Fee Sched Tier 3,79.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,80400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80400,BCBSND Hospital Base OP Fee Sched Tier 3,154.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,80402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80402,BCBSND Hospital Base OP Fee Sched Tier 3,413.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,80406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80406,BCBSND Hospital Base OP Fee Sched Tier 3,371.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,80408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80408,BCBSND Hospital Base OP Fee Sched Tier 3,596.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,80410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80410,BCBSND Hospital Base OP Fee Sched Tier 3,381.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,80412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80412,BCBSND Hospital Base OP Fee Sched Tier 3,3426.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,80414,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80414,BCBSND Hospital Base OP Fee Sched Tier 3,245.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,80415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80415,BCBSND Hospital Base OP Fee Sched Tier 3,265.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,80416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80416,BCBSND Hospital Base OP Fee Sched Tier 3,894.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,80417,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80417,BCBSND Hospital Base OP Fee Sched Tier 3,208.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,80418,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80418,BCBSND Hospital Base OP Fee Sched Tier 3,2752.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,80420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80420,BCBSND Hospital Base OP Fee Sched Tier 3,692.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,80422,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80422,BCBSND Hospital Base OP Fee Sched Tier 3,218.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,80424,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80424,BCBSND Hospital Base OP Fee Sched Tier 3,239.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,80426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80426,BCBSND Hospital Base OP Fee Sched Tier 3,704.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,80428,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80428,BCBSND Hospital Base OP Fee Sched Tier 3,316.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,80430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80430,BCBSND Hospital Base OP Fee Sched Tier 3,552.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,80432,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80432,BCBSND Hospital Base OP Fee Sched Tier 3,707.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,80434,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80434,BCBSND Hospital Base OP Fee Sched Tier 3,1218.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,80435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80435,BCBSND Hospital Base OP Fee Sched Tier 3,489.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,80436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80436,BCBSND Hospital Base OP Fee Sched Tier 3,433.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,80438,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80438,BCBSND Hospital Base OP Fee Sched Tier 3,239.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,80439,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80439,BCBSND Hospital Base OP Fee Sched Tier 3,319.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,80500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80500,BCBSND Hospital Base OP Fee Sched Tier 3,8.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,80502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,80502,BCBSND Hospital Base OP Fee Sched Tier 3,8.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,81000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81000,BCBSND Hospital Base OP Fee Sched Tier 3,17.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,81001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81001,BCBSND Hospital Base OP Fee Sched Tier 3,15.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,81002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81002,BCBSND Hospital Base OP Fee Sched Tier 3,14.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,81003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81003,BCBSND Hospital Base OP Fee Sched Tier 3,10.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,81005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81005,BCBSND Hospital Base OP Fee Sched Tier 3,10.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,81007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81007,BCBSND Hospital Base OP Fee Sched Tier 3,128.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,81015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81015,BCBSND Hospital Base OP Fee Sched Tier 3,14.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,81020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81020,BCBSND Hospital Base OP Fee Sched Tier 3,20.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,81025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81025,BCBSND Hospital Base OP Fee Sched Tier 3,36.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,81050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81050,BCBSND Hospital Base OP Fee Sched Tier 3,15.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,81105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81105,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81106,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81107,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81108,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81109,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81109,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81110,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81111,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81112,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81120,BCBSND Hospital Base OP Fee Sched Tier 3,826.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,81121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81121,BCBSND Hospital Base OP Fee Sched Tier 3,1264.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,81161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81161,BCBSND Hospital Base OP Fee Sched Tier 3,1192.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,81162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81162,BCBSND Hospital Base OP Fee Sched Tier 3,8668.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,81163,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81163,BCBSND Hospital Base OP Fee Sched Tier 3,2000.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,81164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81164,BCBSND Hospital Base OP Fee Sched Tier 3,2497.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,81165,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81165,BCBSND Hospital Base OP Fee Sched Tier 3,1209.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81166,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81166,BCBSND Hospital Base OP Fee Sched Tier 3,1288.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,81167,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81167,BCBSND Hospital Base OP Fee Sched Tier 3,1209.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81170,BCBSND Hospital Base OP Fee Sched Tier 3,1282.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,81171,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81171,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81172,BCBSND Hospital Base OP Fee Sched Tier 3,1174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81173,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81173,BCBSND Hospital Base OP Fee Sched Tier 3,1288.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,81174,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81174,BCBSND Hospital Base OP Fee Sched Tier 3,791.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,81175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81175,BCBSND Hospital Base OP Fee Sched Tier 3,2892.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,81176,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81176,BCBSND Hospital Base OP Fee Sched Tier 3,1148.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,81177,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81177,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81178,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81178,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81179,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81179,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81180,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81181,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81181,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81182,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81183,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81183,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81184,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81185,BCBSND Hospital Base OP Fee Sched Tier 3,3617.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,81186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81186,BCBSND Hospital Base OP Fee Sched Tier 3,791.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,81187,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81187,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81188,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81188,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81189,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81189,BCBSND Hospital Base OP Fee Sched Tier 3,1174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81190,BCBSND Hospital Base OP Fee Sched Tier 3,791.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,81200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81200,BCBSND Hospital Base OP Fee Sched Tier 3,201.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,81201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81201,BCBSND Hospital Base OP Fee Sched Tier 3,3334.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,81202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81202,BCBSND Hospital Base OP Fee Sched Tier 3,1197,,Fee schedule,,,,,,,,0
unity,Fee schedule,81203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81203,BCBSND Hospital Base OP Fee Sched Tier 3,855,,Fee schedule,,,,,,,,0
unity,Fee schedule,81204,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81204,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81205,BCBSND Hospital Base OP Fee Sched Tier 3,406.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,81206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81206,BCBSND Hospital Base OP Fee Sched Tier 3,778.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,81207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81207,BCBSND Hospital Base OP Fee Sched Tier 3,687.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,81208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81208,BCBSND Hospital Base OP Fee Sched Tier 3,917.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,81209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81209,BCBSND Hospital Base OP Fee Sched Tier 3,168.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,81210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81210,BCBSND Hospital Base OP Fee Sched Tier 3,749.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,81212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81212,BCBSND Hospital Base OP Fee Sched Tier 3,1881,,Fee schedule,,,,,,,,0
unity,Fee schedule,81215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81215,BCBSND Hospital Base OP Fee Sched Tier 3,1604.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,81216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81216,BCBSND Hospital Base OP Fee Sched Tier 3,791.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,81217,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81217,BCBSND Hospital Base OP Fee Sched Tier 3,1604.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,81218,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81218,BCBSND Hospital Base OP Fee Sched Tier 3,1148.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,81219,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81219,BCBSND Hospital Base OP Fee Sched Tier 3,577.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,81220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81220,BCBSND Hospital Base OP Fee Sched Tier 3,2379.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,81221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81221,BCBSND Hospital Base OP Fee Sched Tier 3,415.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,81222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81222,BCBSND Hospital Base OP Fee Sched Tier 3,1859.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,81223,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81223,BCBSND Hospital Base OP Fee Sched Tier 3,2133.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,81224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81224,BCBSND Hospital Base OP Fee Sched Tier 3,721.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,81225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81225,BCBSND Hospital Base OP Fee Sched Tier 3,1245.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,81226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81226,BCBSND Hospital Base OP Fee Sched Tier 3,1927.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,81227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81227,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81228,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81228,BCBSND Hospital Base OP Fee Sched Tier 3,3847.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,81229,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81229,BCBSND Hospital Base OP Fee Sched Tier 3,4959,,Fee schedule,,,,,,,,0
unity,Fee schedule,81230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81230,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81231,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81232,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81233,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81233,BCBSND Hospital Base OP Fee Sched Tier 3,749.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,81234,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81234,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81235,BCBSND Hospital Base OP Fee Sched Tier 3,1387.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,81236,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81236,BCBSND Hospital Base OP Fee Sched Tier 3,1209.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81237,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81237,BCBSND Hospital Base OP Fee Sched Tier 3,749.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,81238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81238,BCBSND Hospital Base OP Fee Sched Tier 3,2565,,Fee schedule,,,,,,,,0
unity,Fee schedule,81239,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81239,BCBSND Hospital Base OP Fee Sched Tier 3,1174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81240,BCBSND Hospital Base OP Fee Sched Tier 3,280.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,81241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81241,BCBSND Hospital Base OP Fee Sched Tier 3,313.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,81242,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81242,BCBSND Hospital Base OP Fee Sched Tier 3,156.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81243,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81243,BCBSND Hospital Base OP Fee Sched Tier 3,243.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,81244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81244,BCBSND Hospital Base OP Fee Sched Tier 3,191.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81245,BCBSND Hospital Base OP Fee Sched Tier 3,707.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,81246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81246,BCBSND Hospital Base OP Fee Sched Tier 3,354.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,81247,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81247,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81248,BCBSND Hospital Base OP Fee Sched Tier 3,1604.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,81249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81249,BCBSND Hospital Base OP Fee Sched Tier 3,2565,,Fee schedule,,,,,,,,0
unity,Fee schedule,81250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81250,BCBSND Hospital Base OP Fee Sched Tier 3,250.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,81251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81251,BCBSND Hospital Base OP Fee Sched Tier 3,201.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,81252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81252,BCBSND Hospital Base OP Fee Sched Tier 3,432.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,81253,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81253,BCBSND Hospital Base OP Fee Sched Tier 3,263,,Fee schedule,,,,,,,,0
unity,Fee schedule,81254,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81254,BCBSND Hospital Base OP Fee Sched Tier 3,149.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,81255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81255,BCBSND Hospital Base OP Fee Sched Tier 3,219.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,81256,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81256,BCBSND Hospital Base OP Fee Sched Tier 3,310.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,81257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81257,BCBSND Hospital Base OP Fee Sched Tier 3,437.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,81258,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81258,BCBSND Hospital Base OP Fee Sched Tier 3,1604.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,81259,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81259,BCBSND Hospital Base OP Fee Sched Tier 3,2565,,Fee schedule,,,,,,,,0
unity,Fee schedule,81260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81260,BCBSND Hospital Base OP Fee Sched Tier 3,168.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,81261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81261,BCBSND Hospital Base OP Fee Sched Tier 3,940.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,81262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81262,BCBSND Hospital Base OP Fee Sched Tier 3,293.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,81263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81263,BCBSND Hospital Base OP Fee Sched Tier 3,1398.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,81264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81264,BCBSND Hospital Base OP Fee Sched Tier 3,738.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,81265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81265,BCBSND Hospital Base OP Fee Sched Tier 3,1021.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,81266,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81266,BCBSND Hospital Base OP Fee Sched Tier 3,1303.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,81267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81267,BCBSND Hospital Base OP Fee Sched Tier 3,985.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,81268,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81268,BCBSND Hospital Base OP Fee Sched Tier 3,1238.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,81269,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81269,BCBSND Hospital Base OP Fee Sched Tier 3,865.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,81270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81270,BCBSND Hospital Base OP Fee Sched Tier 3,435.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,81271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81271,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81272,BCBSND Hospital Base OP Fee Sched Tier 3,1408.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,81273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81273,BCBSND Hospital Base OP Fee Sched Tier 3,533.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,81274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81274,BCBSND Hospital Base OP Fee Sched Tier 3,1174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81275,BCBSND Hospital Base OP Fee Sched Tier 3,826.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,81276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81276,BCBSND Hospital Base OP Fee Sched Tier 3,826.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,81283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81283,BCBSND Hospital Base OP Fee Sched Tier 3,313.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,81284,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81284,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81285,BCBSND Hospital Base OP Fee Sched Tier 3,1174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81286,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81286,BCBSND Hospital Base OP Fee Sched Tier 3,1174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81287,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81287,BCBSND Hospital Base OP Fee Sched Tier 3,532.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,81288,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81288,BCBSND Hospital Base OP Fee Sched Tier 3,822.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,81289,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81289,BCBSND Hospital Base OP Fee Sched Tier 3,791.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,81290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81290,BCBSND Hospital Base OP Fee Sched Tier 3,168.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,81291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81291,BCBSND Hospital Base OP Fee Sched Tier 3,279.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,81292,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81292,BCBSND Hospital Base OP Fee Sched Tier 3,2887.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,81293,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81293,BCBSND Hospital Base OP Fee Sched Tier 3,1415.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,81294,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81294,BCBSND Hospital Base OP Fee Sched Tier 3,865.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,81295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81295,BCBSND Hospital Base OP Fee Sched Tier 3,1631.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,81296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81296,BCBSND Hospital Base OP Fee Sched Tier 3,1443.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,81297,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81297,BCBSND Hospital Base OP Fee Sched Tier 3,911.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,81298,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81298,BCBSND Hospital Base OP Fee Sched Tier 3,2743.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,81299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81299,BCBSND Hospital Base OP Fee Sched Tier 3,1316.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,81300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81300,BCBSND Hospital Base OP Fee Sched Tier 3,1017.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,81301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81301,BCBSND Hospital Base OP Fee Sched Tier 3,1490.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,81302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81302,BCBSND Hospital Base OP Fee Sched Tier 3,2256.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,81303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81303,BCBSND Hospital Base OP Fee Sched Tier 3,513,,Fee schedule,,,,,,,,0
unity,Fee schedule,81304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81304,BCBSND Hospital Base OP Fee Sched Tier 3,641.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,81305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81305,BCBSND Hospital Base OP Fee Sched Tier 3,749.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,81306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81306,BCBSND Hospital Base OP Fee Sched Tier 3,1245.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,81310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81310,BCBSND Hospital Base OP Fee Sched Tier 3,1053.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,81311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81311,BCBSND Hospital Base OP Fee Sched Tier 3,1264.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,81312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81312,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81313,BCBSND Hospital Base OP Fee Sched Tier 3,1090.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,81314,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81314,BCBSND Hospital Base OP Fee Sched Tier 3,1408.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,81315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81315,BCBSND Hospital Base OP Fee Sched Tier 3,984.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,81316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81316,BCBSND Hospital Base OP Fee Sched Tier 3,984.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,81317,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81317,BCBSND Hospital Base OP Fee Sched Tier 3,2892.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,81318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81318,BCBSND Hospital Base OP Fee Sched Tier 3,1415.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,81319,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81319,BCBSND Hospital Base OP Fee Sched Tier 3,869.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,81320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81320,BCBSND Hospital Base OP Fee Sched Tier 3,1245.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,81321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81321,BCBSND Hospital Base OP Fee Sched Tier 3,2565,,Fee schedule,,,,,,,,0
unity,Fee schedule,81322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81322,BCBSND Hospital Base OP Fee Sched Tier 3,203.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,81323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81323,BCBSND Hospital Base OP Fee Sched Tier 3,1282.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,81324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81324,BCBSND Hospital Base OP Fee Sched Tier 3,3241.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,81325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81325,BCBSND Hospital Base OP Fee Sched Tier 3,3289.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,81326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81326,BCBSND Hospital Base OP Fee Sched Tier 3,203.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,81327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81327,BCBSND Hospital Base OP Fee Sched Tier 3,820.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,81328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81328,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81329,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81330,BCBSND Hospital Base OP Fee Sched Tier 3,200.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,81331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81331,BCBSND Hospital Base OP Fee Sched Tier 3,218.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,81332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81332,BCBSND Hospital Base OP Fee Sched Tier 3,207.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,81333,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81333,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81334,BCBSND Hospital Base OP Fee Sched Tier 3,1408.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,81335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81335,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81336,BCBSND Hospital Base OP Fee Sched Tier 3,1288.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,81337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81337,BCBSND Hospital Base OP Fee Sched Tier 3,791.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,81340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81340,BCBSND Hospital Base OP Fee Sched Tier 3,992.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,81341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81341,BCBSND Hospital Base OP Fee Sched Tier 3,235.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81342,BCBSND Hospital Base OP Fee Sched Tier 3,957.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,81343,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81343,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81344,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81345,BCBSND Hospital Base OP Fee Sched Tier 3,791.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,81346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81346,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81350,BCBSND Hospital Base OP Fee Sched Tier 3,1000.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,81355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81355,BCBSND Hospital Base OP Fee Sched Tier 3,377.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,81361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81361,BCBSND Hospital Base OP Fee Sched Tier 3,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81362,BCBSND Hospital Base OP Fee Sched Tier 3,1604.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,81363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81363,BCBSND Hospital Base OP Fee Sched Tier 3,865.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,81364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81364,BCBSND Hospital Base OP Fee Sched Tier 3,1387.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,81370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81370,BCBSND Hospital Base OP Fee Sched Tier 3,1910.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,81371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81371,BCBSND Hospital Base OP Fee Sched Tier 3,1729.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,81372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81372,BCBSND Hospital Base OP Fee Sched Tier 3,1725.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,81373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81373,BCBSND Hospital Base OP Fee Sched Tier 3,544.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,81374,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81374,BCBSND Hospital Base OP Fee Sched Tier 3,345.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81375,BCBSND Hospital Base OP Fee Sched Tier 3,1048.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,81376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81376,BCBSND Hospital Base OP Fee Sched Tier 3,580.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,81377,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81377,BCBSND Hospital Base OP Fee Sched Tier 3,436.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,81378,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81378,BCBSND Hospital Base OP Fee Sched Tier 3,1641.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,81379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81379,BCBSND Hospital Base OP Fee Sched Tier 3,1593.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,81380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81380,BCBSND Hospital Base OP Fee Sched Tier 3,841.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,81381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81381,BCBSND Hospital Base OP Fee Sched Tier 3,726.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,81382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81382,BCBSND Hospital Base OP Fee Sched Tier 3,587.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,81383,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81383,BCBSND Hospital Base OP Fee Sched Tier 3,518.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,81400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81400,BCBSND Hospital Base OP Fee Sched Tier 3,273.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,81401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81401,BCBSND Hospital Base OP Fee Sched Tier 3,585.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81402,BCBSND Hospital Base OP Fee Sched Tier 3,642.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,81403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81403,BCBSND Hospital Base OP Fee Sched Tier 3,791.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,81404,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81404,BCBSND Hospital Base OP Fee Sched Tier 3,1174.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81405,BCBSND Hospital Base OP Fee Sched Tier 3,1288.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,81406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81406,BCBSND Hospital Base OP Fee Sched Tier 3,1209.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,81407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81407,BCBSND Hospital Base OP Fee Sched Tier 3,3617.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,81408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81408,BCBSND Hospital Base OP Fee Sched Tier 3,8550,,Fee schedule,,,,,,,,0
unity,Fee schedule,81410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81410,BCBSND Hospital Base OP Fee Sched Tier 3,2154.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,81411,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81411,BCBSND Hospital Base OP Fee Sched Tier 3,5772.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,81412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81412,BCBSND Hospital Base OP Fee Sched Tier 3,10467.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,81413,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81413,BCBSND Hospital Base OP Fee Sched Tier 3,2778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,81414,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81414,BCBSND Hospital Base OP Fee Sched Tier 3,2778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,81415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81415,BCBSND Hospital Base OP Fee Sched Tier 3,20434.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,81416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81416,BCBSND Hospital Base OP Fee Sched Tier 3,51300,,Fee schedule,,,,,,,,0
unity,Fee schedule,81417,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81417,BCBSND Hospital Base OP Fee Sched Tier 3,1368,,Fee schedule,,,,,,,,0
unity,Fee schedule,81420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81420,BCBSND Hospital Base OP Fee Sched Tier 3,3244.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,81422,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81422,BCBSND Hospital Base OP Fee Sched Tier 3,3244.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,81425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81425,BCBSND Hospital Base OP Fee Sched Tier 3,21508.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,81426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81426,BCBSND Hospital Base OP Fee Sched Tier 3,11585.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,81427,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81427,BCBSND Hospital Base OP Fee Sched Tier 3,9993.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,81430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81430,BCBSND Hospital Base OP Fee Sched Tier 3,6946.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,81431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81431,BCBSND Hospital Base OP Fee Sched Tier 3,2905.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,81432,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81432,BCBSND Hospital Base OP Fee Sched Tier 3,3225.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,81433,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81433,BCBSND Hospital Base OP Fee Sched Tier 3,2084.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,81434,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81434,BCBSND Hospital Base OP Fee Sched Tier 3,2556.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,81435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81435,BCBSND Hospital Base OP Fee Sched Tier 3,2778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,81436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81436,BCBSND Hospital Base OP Fee Sched Tier 3,2778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,81437,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81437,BCBSND Hospital Base OP Fee Sched Tier 3,2084.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,81438,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81438,BCBSND Hospital Base OP Fee Sched Tier 3,2084.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,81439,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81439,BCBSND Hospital Base OP Fee Sched Tier 3,2778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,81440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81440,BCBSND Hospital Base OP Fee Sched Tier 3,14210.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,81442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81442,BCBSND Hospital Base OP Fee Sched Tier 3,9163.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,81443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81443,BCBSND Hospital Base OP Fee Sched Tier 3,10467.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,81445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81445,BCBSND Hospital Base OP Fee Sched Tier 3,2556.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,81448,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81448,BCBSND Hospital Base OP Fee Sched Tier 3,2778.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,81450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81450,BCBSND Hospital Base OP Fee Sched Tier 3,3246.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,81455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81455,BCBSND Hospital Base OP Fee Sched Tier 3,12481.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,81460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81460,BCBSND Hospital Base OP Fee Sched Tier 3,5501.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,81465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81465,BCBSND Hospital Base OP Fee Sched Tier 3,4001.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,81470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81470,BCBSND Hospital Base OP Fee Sched Tier 3,3907.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,81471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81471,BCBSND Hospital Base OP Fee Sched Tier 3,3907.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,81490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81490,BCBSND Hospital Base OP Fee Sched Tier 3,3593.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,81493,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81493,BCBSND Hospital Base OP Fee Sched Tier 3,4488.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,81500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81500,BCBSND Hospital Base OP Fee Sched Tier 3,1113.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,81503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81503,BCBSND Hospital Base OP Fee Sched Tier 3,3834.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81504,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81504,BCBSND Hospital Base OP Fee Sched Tier 3,2223,,Fee schedule,,,,,,,,0
unity,Fee schedule,81506,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81506,BCBSND Hospital Base OP Fee Sched Tier 3,319.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,81507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81507,BCBSND Hospital Base OP Fee Sched Tier 3,3398.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,81508,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81508,BCBSND Hospital Base OP Fee Sched Tier 3,232.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,81509,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81509,BCBSND Hospital Base OP Fee Sched Tier 3,6358.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,81510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81510,BCBSND Hospital Base OP Fee Sched Tier 3,237.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,81511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81511,BCBSND Hospital Base OP Fee Sched Tier 3,314.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,81512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81512,BCBSND Hospital Base OP Fee Sched Tier 3,297.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,81518,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81518,BCBSND Hospital Base OP Fee Sched Tier 3,16557.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,81519,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81519,BCBSND Hospital Base OP Fee Sched Tier 3,16557.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,81520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81520,BCBSND Hospital Base OP Fee Sched Tier 3,11923.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,81521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81521,BCBSND Hospital Base OP Fee Sched Tier 3,16557.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,81525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81525,BCBSND Hospital Base OP Fee Sched Tier 3,13320.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,81528,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81528,BCBSND Hospital Base OP Fee Sched Tier 3,2175.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,81535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81535,BCBSND Hospital Base OP Fee Sched Tier 3,2477.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,81536,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81536,BCBSND Hospital Base OP Fee Sched Tier 3,759.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,81538,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81538,BCBSND Hospital Base OP Fee Sched Tier 3,12273.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,81539,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81539,BCBSND Hospital Base OP Fee Sched Tier 3,3249,,Fee schedule,,,,,,,,0
unity,Fee schedule,81540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81540,BCBSND Hospital Base OP Fee Sched Tier 3,16031.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,81541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81541,BCBSND Hospital Base OP Fee Sched Tier 3,16557.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,81545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81545,BCBSND Hospital Base OP Fee Sched Tier 3,15390,,Fee schedule,,,,,,,,0
unity,Fee schedule,81551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81551,BCBSND Hospital Base OP Fee Sched Tier 3,8678.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,81595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81595,BCBSND Hospital Base OP Fee Sched Tier 3,13851,,Fee schedule,,,,,,,,0
unity,Fee schedule,81596,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,81596,BCBSND Hospital Base OP Fee Sched Tier 3,308.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,82009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82009,BCBSND Hospital Base OP Fee Sched Tier 3,21.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,82010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82010,BCBSND Hospital Base OP Fee Sched Tier 3,38.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,82013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82013,BCBSND Hospital Base OP Fee Sched Tier 3,53.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,82016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82016,BCBSND Hospital Base OP Fee Sched Tier 3,70.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,82017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82017,BCBSND Hospital Base OP Fee Sched Tier 3,80.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,82024,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82024,BCBSND Hospital Base OP Fee Sched Tier 3,183.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,82030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82030,BCBSND Hospital Base OP Fee Sched Tier 3,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,82040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82040,BCBSND Hospital Base OP Fee Sched Tier 3,23.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,82042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82042,BCBSND Hospital Base OP Fee Sched Tier 3,33.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,82043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82043,BCBSND Hospital Base OP Fee Sched Tier 3,27.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,82044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82044,BCBSND Hospital Base OP Fee Sched Tier 3,26.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,82045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82045,BCBSND Hospital Base OP Fee Sched Tier 3,161.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,82075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82075,BCBSND Hospital Base OP Fee Sched Tier 3,128.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,82085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82085,BCBSND Hospital Base OP Fee Sched Tier 3,46.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,82088,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82088,BCBSND Hospital Base OP Fee Sched Tier 3,193.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,82103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82103,BCBSND Hospital Base OP Fee Sched Tier 3,63.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,82104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82104,BCBSND Hospital Base OP Fee Sched Tier 3,68.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,82105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82105,BCBSND Hospital Base OP Fee Sched Tier 3,79.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,82106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82106,BCBSND Hospital Base OP Fee Sched Tier 3,79.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,82107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82107,BCBSND Hospital Base OP Fee Sched Tier 3,305.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,82108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82108,BCBSND Hospital Base OP Fee Sched Tier 3,121.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,82120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82120,BCBSND Hospital Base OP Fee Sched Tier 3,25.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,82127,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82127,BCBSND Hospital Base OP Fee Sched Tier 3,65.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,82128,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82128,BCBSND Hospital Base OP Fee Sched Tier 3,65.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,82131,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82131,BCBSND Hospital Base OP Fee Sched Tier 3,98.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,82135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82135,BCBSND Hospital Base OP Fee Sched Tier 3,78.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,82136,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82136,BCBSND Hospital Base OP Fee Sched Tier 3,83.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,82139,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82139,BCBSND Hospital Base OP Fee Sched Tier 3,80.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,82140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82140,BCBSND Hospital Base OP Fee Sched Tier 3,69.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,82143,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82143,BCBSND Hospital Base OP Fee Sched Tier 3,39.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,82150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82150,BCBSND Hospital Base OP Fee Sched Tier 3,30.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,82154,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82154,BCBSND Hospital Base OP Fee Sched Tier 3,136.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,82157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82157,BCBSND Hospital Base OP Fee Sched Tier 3,139.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,82160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82160,BCBSND Hospital Base OP Fee Sched Tier 3,118.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,82163,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82163,BCBSND Hospital Base OP Fee Sched Tier 3,97.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,82164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82164,BCBSND Hospital Base OP Fee Sched Tier 3,69.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,82172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82172,BCBSND Hospital Base OP Fee Sched Tier 3,90.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,82175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82175,BCBSND Hospital Base OP Fee Sched Tier 3,90.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,82180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82180,BCBSND Hospital Base OP Fee Sched Tier 3,46.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,82190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82190,BCBSND Hospital Base OP Fee Sched Tier 3,70.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,82232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82232,BCBSND Hospital Base OP Fee Sched Tier 3,76.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,82239,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82239,BCBSND Hospital Base OP Fee Sched Tier 3,81.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,82240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82240,BCBSND Hospital Base OP Fee Sched Tier 3,126.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,82247,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82247,BCBSND Hospital Base OP Fee Sched Tier 3,23.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,82248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82248,BCBSND Hospital Base OP Fee Sched Tier 3,23.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,82252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82252,BCBSND Hospital Base OP Fee Sched Tier 3,21.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,82261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82261,BCBSND Hospital Base OP Fee Sched Tier 3,80.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,82270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82270,BCBSND Hospital Base OP Fee Sched Tier 3,18.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,82271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82271,BCBSND Hospital Base OP Fee Sched Tier 3,22.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,82272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82272,BCBSND Hospital Base OP Fee Sched Tier 3,18.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,82274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82274,BCBSND Hospital Base OP Fee Sched Tier 3,75.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,82286,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82286,BCBSND Hospital Base OP Fee Sched Tier 3,24.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,82300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82300,BCBSND Hospital Base OP Fee Sched Tier 3,109.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,82306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82306,BCBSND Hospital Base OP Fee Sched Tier 3,140.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,82308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82308,BCBSND Hospital Base OP Fee Sched Tier 3,127.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,82310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82310,BCBSND Hospital Base OP Fee Sched Tier 3,24.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,82330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82330,BCBSND Hospital Base OP Fee Sched Tier 3,64.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,82331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82331,BCBSND Hospital Base OP Fee Sched Tier 3,57.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,82340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82340,BCBSND Hospital Base OP Fee Sched Tier 3,28.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,82355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82355,BCBSND Hospital Base OP Fee Sched Tier 3,54.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,82360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82360,BCBSND Hospital Base OP Fee Sched Tier 3,61.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,82365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82365,BCBSND Hospital Base OP Fee Sched Tier 3,61.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,82370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82370,BCBSND Hospital Base OP Fee Sched Tier 3,59.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,82373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82373,BCBSND Hospital Base OP Fee Sched Tier 3,85.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,82374,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82374,BCBSND Hospital Base OP Fee Sched Tier 3,23.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,82375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82375,BCBSND Hospital Base OP Fee Sched Tier 3,58.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,82376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82376,BCBSND Hospital Base OP Fee Sched Tier 3,60.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,82378,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82378,BCBSND Hospital Base OP Fee Sched Tier 3,90.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,82379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82379,BCBSND Hospital Base OP Fee Sched Tier 3,80.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,82380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82380,BCBSND Hospital Base OP Fee Sched Tier 3,43.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,82382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82382,BCBSND Hospital Base OP Fee Sched Tier 3,116.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,82383,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82383,BCBSND Hospital Base OP Fee Sched Tier 3,124.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,82384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82384,BCBSND Hospital Base OP Fee Sched Tier 3,119.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,82387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82387,BCBSND Hospital Base OP Fee Sched Tier 3,85.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,82390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82390,BCBSND Hospital Base OP Fee Sched Tier 3,51,,Fee schedule,,,,,,,,0
unity,Fee schedule,82397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82397,BCBSND Hospital Base OP Fee Sched Tier 3,67.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,82415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82415,BCBSND Hospital Base OP Fee Sched Tier 3,60.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,82435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82435,BCBSND Hospital Base OP Fee Sched Tier 3,21.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,82436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82436,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,82438,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82438,BCBSND Hospital Base OP Fee Sched Tier 3,23.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,82441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82441,BCBSND Hospital Base OP Fee Sched Tier 3,28.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,82465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82465,BCBSND Hospital Base OP Fee Sched Tier 3,20.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,82480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82480,BCBSND Hospital Base OP Fee Sched Tier 3,37.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,82482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82482,BCBSND Hospital Base OP Fee Sched Tier 3,41.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,82485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82485,BCBSND Hospital Base OP Fee Sched Tier 3,98.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,82495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82495,BCBSND Hospital Base OP Fee Sched Tier 3,96.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,82507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82507,BCBSND Hospital Base OP Fee Sched Tier 3,132.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,82523,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82523,BCBSND Hospital Base OP Fee Sched Tier 3,88.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,82525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82525,BCBSND Hospital Base OP Fee Sched Tier 3,58.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,82528,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82528,BCBSND Hospital Base OP Fee Sched Tier 3,106.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,82530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82530,BCBSND Hospital Base OP Fee Sched Tier 3,79.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,82533,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82533,BCBSND Hospital Base OP Fee Sched Tier 3,77.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,82540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82540,BCBSND Hospital Base OP Fee Sched Tier 3,22.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,82542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82542,BCBSND Hospital Base OP Fee Sched Tier 3,102.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,82550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82550,BCBSND Hospital Base OP Fee Sched Tier 3,30.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,82552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82552,BCBSND Hospital Base OP Fee Sched Tier 3,63.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,82553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82553,BCBSND Hospital Base OP Fee Sched Tier 3,54.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,82554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82554,BCBSND Hospital Base OP Fee Sched Tier 3,56.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,82565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82565,BCBSND Hospital Base OP Fee Sched Tier 3,24.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,82570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82570,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,82575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82575,BCBSND Hospital Base OP Fee Sched Tier 3,44.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,82585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82585,BCBSND Hospital Base OP Fee Sched Tier 3,60.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,82595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82595,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,82600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82600,BCBSND Hospital Base OP Fee Sched Tier 3,92.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,82607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82607,BCBSND Hospital Base OP Fee Sched Tier 3,71.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,82608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82608,BCBSND Hospital Base OP Fee Sched Tier 3,68.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,82610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82610,BCBSND Hospital Base OP Fee Sched Tier 3,79.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,82615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82615,BCBSND Hospital Base OP Fee Sched Tier 3,40.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,82626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82626,BCBSND Hospital Base OP Fee Sched Tier 3,120.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,82627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82627,BCBSND Hospital Base OP Fee Sched Tier 3,105.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,82633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82633,BCBSND Hospital Base OP Fee Sched Tier 3,147.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,82634,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82634,BCBSND Hospital Base OP Fee Sched Tier 3,139.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,82638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82638,BCBSND Hospital Base OP Fee Sched Tier 3,58.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,82642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82642,BCBSND Hospital Base OP Fee Sched Tier 3,139.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,82652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82652,BCBSND Hospital Base OP Fee Sched Tier 3,182.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,82656,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82656,BCBSND Hospital Base OP Fee Sched Tier 3,54.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,82657,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82657,BCBSND Hospital Base OP Fee Sched Tier 3,94.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,82658,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82658,BCBSND Hospital Base OP Fee Sched Tier 3,188.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,82664,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82664,BCBSND Hospital Base OP Fee Sched Tier 3,262.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,82668,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82668,BCBSND Hospital Base OP Fee Sched Tier 3,89.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,82670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82670,BCBSND Hospital Base OP Fee Sched Tier 3,132.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,82671,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82671,BCBSND Hospital Base OP Fee Sched Tier 3,153.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,82672,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82672,BCBSND Hospital Base OP Fee Sched Tier 3,103.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,82677,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82677,BCBSND Hospital Base OP Fee Sched Tier 3,114.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,82679,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82679,BCBSND Hospital Base OP Fee Sched Tier 3,118.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,82693,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82693,BCBSND Hospital Base OP Fee Sched Tier 3,70.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,82696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82696,BCBSND Hospital Base OP Fee Sched Tier 3,112.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,82705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82705,BCBSND Hospital Base OP Fee Sched Tier 3,24.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,82710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82710,BCBSND Hospital Base OP Fee Sched Tier 3,79.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,82715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82715,BCBSND Hospital Base OP Fee Sched Tier 3,98.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,82725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82725,BCBSND Hospital Base OP Fee Sched Tier 3,80.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,82726,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82726,BCBSND Hospital Base OP Fee Sched Tier 3,85.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,82728,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82728,BCBSND Hospital Base OP Fee Sched Tier 3,64.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,82731,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82731,BCBSND Hospital Base OP Fee Sched Tier 3,305.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,82735,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82735,BCBSND Hospital Base OP Fee Sched Tier 3,88.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,82746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82746,BCBSND Hospital Base OP Fee Sched Tier 3,69.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,82747,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82747,BCBSND Hospital Base OP Fee Sched Tier 3,82.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,82757,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82757,BCBSND Hospital Base OP Fee Sched Tier 3,82.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,82759,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82759,BCBSND Hospital Base OP Fee Sched Tier 3,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,82760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82760,BCBSND Hospital Base OP Fee Sched Tier 3,53.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,82775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82775,BCBSND Hospital Base OP Fee Sched Tier 3,100.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,82776,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82776,BCBSND Hospital Base OP Fee Sched Tier 3,50.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,82777,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82777,BCBSND Hospital Base OP Fee Sched Tier 3,189.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,82784,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82784,BCBSND Hospital Base OP Fee Sched Tier 3,44.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,82785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82785,BCBSND Hospital Base OP Fee Sched Tier 3,78.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,82787,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82787,BCBSND Hospital Base OP Fee Sched Tier 3,38.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,82800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82800,BCBSND Hospital Base OP Fee Sched Tier 3,47.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,82803,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82803,BCBSND Hospital Base OP Fee Sched Tier 3,111.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,82805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82805,BCBSND Hospital Base OP Fee Sched Tier 3,336.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,82810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82810,BCBSND Hospital Base OP Fee Sched Tier 3,41.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,82820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82820,BCBSND Hospital Base OP Fee Sched Tier 3,57.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,82930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82930,BCBSND Hospital Base OP Fee Sched Tier 3,28.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,82938,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82938,BCBSND Hospital Base OP Fee Sched Tier 3,84.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,82941,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82941,BCBSND Hospital Base OP Fee Sched Tier 3,83.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,82943,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82943,BCBSND Hospital Base OP Fee Sched Tier 3,67.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,82945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82945,BCBSND Hospital Base OP Fee Sched Tier 3,18.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,82946,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82946,BCBSND Hospital Base OP Fee Sched Tier 3,75.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,82947,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82947,BCBSND Hospital Base OP Fee Sched Tier 3,18.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,82948,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82948,BCBSND Hospital Base OP Fee Sched Tier 3,21.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,82950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82950,BCBSND Hospital Base OP Fee Sched Tier 3,22.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,82951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82951,BCBSND Hospital Base OP Fee Sched Tier 3,61.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,82952,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82952,BCBSND Hospital Base OP Fee Sched Tier 3,18.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,82955,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82955,BCBSND Hospital Base OP Fee Sched Tier 3,46.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,82960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82960,BCBSND Hospital Base OP Fee Sched Tier 3,28.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,82962,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82962,BCBSND Hospital Base OP Fee Sched Tier 3,14.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,82963,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82963,BCBSND Hospital Base OP Fee Sched Tier 3,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,82965,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82965,BCBSND Hospital Base OP Fee Sched Tier 3,56.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,82977,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82977,BCBSND Hospital Base OP Fee Sched Tier 3,34.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,82978,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82978,BCBSND Hospital Base OP Fee Sched Tier 3,67.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,82979,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82979,BCBSND Hospital Base OP Fee Sched Tier 3,44.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,82985,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,82985,BCBSND Hospital Base OP Fee Sched Tier 3,71.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,83001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83001,BCBSND Hospital Base OP Fee Sched Tier 3,88.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,83002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83002,BCBSND Hospital Base OP Fee Sched Tier 3,87.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,83003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83003,BCBSND Hospital Base OP Fee Sched Tier 3,79.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,83006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83006,BCBSND Hospital Base OP Fee Sched Tier 3,323.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,83009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83009,BCBSND Hospital Base OP Fee Sched Tier 3,319.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,83010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83010,BCBSND Hospital Base OP Fee Sched Tier 3,59.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,83012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83012,BCBSND Hospital Base OP Fee Sched Tier 3,114.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,83013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83013,BCBSND Hospital Base OP Fee Sched Tier 3,319.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,83014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83014,BCBSND Hospital Base OP Fee Sched Tier 3,37.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,83015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83015,BCBSND Hospital Base OP Fee Sched Tier 3,89.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,83018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83018,BCBSND Hospital Base OP Fee Sched Tier 3,104.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,83020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83020,BCBSND Hospital Base OP Fee Sched Tier 3,61.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,83021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83021,BCBSND Hospital Base OP Fee Sched Tier 3,85.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,83026,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83026,BCBSND Hospital Base OP Fee Sched Tier 3,17.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,83030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83030,BCBSND Hospital Base OP Fee Sched Tier 3,45.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,83033,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83033,BCBSND Hospital Base OP Fee Sched Tier 3,34.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,83036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83036,BCBSND Hospital Base OP Fee Sched Tier 3,46.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,83037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83037,BCBSND Hospital Base OP Fee Sched Tier 3,46.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,83045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83045,BCBSND Hospital Base OP Fee Sched Tier 3,27.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,83050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83050,BCBSND Hospital Base OP Fee Sched Tier 3,35.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,83051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83051,BCBSND Hospital Base OP Fee Sched Tier 3,34.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,83060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83060,BCBSND Hospital Base OP Fee Sched Tier 3,39.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,83065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83065,BCBSND Hospital Base OP Fee Sched Tier 3,38.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,83068,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83068,BCBSND Hospital Base OP Fee Sched Tier 3,40.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,83069,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83069,BCBSND Hospital Base OP Fee Sched Tier 3,18.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,83070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83070,BCBSND Hospital Base OP Fee Sched Tier 3,22.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,83080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83080,BCBSND Hospital Base OP Fee Sched Tier 3,80.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,83088,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83088,BCBSND Hospital Base OP Fee Sched Tier 3,140.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,83090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83090,BCBSND Hospital Base OP Fee Sched Tier 3,80.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,83150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83150,BCBSND Hospital Base OP Fee Sched Tier 3,95.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,83491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83491,BCBSND Hospital Base OP Fee Sched Tier 3,83.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,83497,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83497,BCBSND Hospital Base OP Fee Sched Tier 3,61.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,83498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83498,BCBSND Hospital Base OP Fee Sched Tier 3,129.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,83500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83500,BCBSND Hospital Base OP Fee Sched Tier 3,107.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,83505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83505,BCBSND Hospital Base OP Fee Sched Tier 3,115.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,83516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83516,BCBSND Hospital Base OP Fee Sched Tier 3,54.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,83518,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83518,BCBSND Hospital Base OP Fee Sched Tier 3,41.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,83519,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83519,BCBSND Hospital Base OP Fee Sched Tier 3,78.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,83520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83520,BCBSND Hospital Base OP Fee Sched Tier 3,73.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,83525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83525,BCBSND Hospital Base OP Fee Sched Tier 3,54.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,83527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83527,BCBSND Hospital Base OP Fee Sched Tier 3,61.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,83528,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83528,BCBSND Hospital Base OP Fee Sched Tier 3,84.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,83540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83540,BCBSND Hospital Base OP Fee Sched Tier 3,30.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,83550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83550,BCBSND Hospital Base OP Fee Sched Tier 3,41.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,83570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83570,BCBSND Hospital Base OP Fee Sched Tier 3,42.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,83582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83582,BCBSND Hospital Base OP Fee Sched Tier 3,67.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,83586,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83586,BCBSND Hospital Base OP Fee Sched Tier 3,60.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,83593,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83593,BCBSND Hospital Base OP Fee Sched Tier 3,124.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,83605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83605,BCBSND Hospital Base OP Fee Sched Tier 3,50.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,83615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83615,BCBSND Hospital Base OP Fee Sched Tier 3,28.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,83625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83625,BCBSND Hospital Base OP Fee Sched Tier 3,60.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,83630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83630,BCBSND Hospital Base OP Fee Sched Tier 3,93.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,83631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83631,BCBSND Hospital Base OP Fee Sched Tier 3,93.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,83632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83632,BCBSND Hospital Base OP Fee Sched Tier 3,96.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,83633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83633,BCBSND Hospital Base OP Fee Sched Tier 3,48.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,83655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83655,BCBSND Hospital Base OP Fee Sched Tier 3,57.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,83661,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83661,BCBSND Hospital Base OP Fee Sched Tier 3,104.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,83662,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83662,BCBSND Hospital Base OP Fee Sched Tier 3,89.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,83663,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83663,BCBSND Hospital Base OP Fee Sched Tier 3,89.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,83664,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83664,BCBSND Hospital Base OP Fee Sched Tier 3,89.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,83670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83670,BCBSND Hospital Base OP Fee Sched Tier 3,43.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,83690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83690,BCBSND Hospital Base OP Fee Sched Tier 3,32.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,83695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83695,BCBSND Hospital Base OP Fee Sched Tier 3,61.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,83698,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83698,BCBSND Hospital Base OP Fee Sched Tier 3,197.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,83700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83700,BCBSND Hospital Base OP Fee Sched Tier 3,53.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,83701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83701,BCBSND Hospital Base OP Fee Sched Tier 3,144.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,83704,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83704,BCBSND Hospital Base OP Fee Sched Tier 3,149.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,83718,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83718,BCBSND Hospital Base OP Fee Sched Tier 3,38.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,83719,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83719,BCBSND Hospital Base OP Fee Sched Tier 3,55.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,83721,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83721,BCBSND Hospital Base OP Fee Sched Tier 3,45.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,83722,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83722,BCBSND Hospital Base OP Fee Sched Tier 3,149.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,83727,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83727,BCBSND Hospital Base OP Fee Sched Tier 3,81.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,83735,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83735,BCBSND Hospital Base OP Fee Sched Tier 3,31.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,83775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83775,BCBSND Hospital Base OP Fee Sched Tier 3,35.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,83785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83785,BCBSND Hospital Base OP Fee Sched Tier 3,116.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,83789,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83789,BCBSND Hospital Base OP Fee Sched Tier 3,103.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,83825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83825,BCBSND Hospital Base OP Fee Sched Tier 3,77.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,83835,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83835,BCBSND Hospital Base OP Fee Sched Tier 3,80.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,83857,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83857,BCBSND Hospital Base OP Fee Sched Tier 3,51,,Fee schedule,,,,,,,,0
unity,Fee schedule,83861,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83861,BCBSND Hospital Base OP Fee Sched Tier 3,96.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,83864,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83864,BCBSND Hospital Base OP Fee Sched Tier 3,121.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,83872,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83872,BCBSND Hospital Base OP Fee Sched Tier 3,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,83873,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83873,BCBSND Hospital Base OP Fee Sched Tier 3,81.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,83874,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83874,BCBSND Hospital Base OP Fee Sched Tier 3,61.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,83876,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83876,BCBSND Hospital Base OP Fee Sched Tier 3,217.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,83880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83880,BCBSND Hospital Base OP Fee Sched Tier 3,167.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,83883,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83883,BCBSND Hospital Base OP Fee Sched Tier 3,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,83885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83885,BCBSND Hospital Base OP Fee Sched Tier 3,116.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,83915,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83915,BCBSND Hospital Base OP Fee Sched Tier 3,52.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,83916,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83916,BCBSND Hospital Base OP Fee Sched Tier 3,117.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,83918,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83918,BCBSND Hospital Base OP Fee Sched Tier 3,100.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,83919,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83919,BCBSND Hospital Base OP Fee Sched Tier 3,78.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,83921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83921,BCBSND Hospital Base OP Fee Sched Tier 3,90.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,83930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83930,BCBSND Hospital Base OP Fee Sched Tier 3,31.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,83935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83935,BCBSND Hospital Base OP Fee Sched Tier 3,32.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,83937,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83937,BCBSND Hospital Base OP Fee Sched Tier 3,141.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,83945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83945,BCBSND Hospital Base OP Fee Sched Tier 3,61.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,83950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83950,BCBSND Hospital Base OP Fee Sched Tier 3,305.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,83951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83951,BCBSND Hospital Base OP Fee Sched Tier 3,305.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,83970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83970,BCBSND Hospital Base OP Fee Sched Tier 3,196.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,83986,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83986,BCBSND Hospital Base OP Fee Sched Tier 3,17.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,83987,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83987,BCBSND Hospital Base OP Fee Sched Tier 3,17.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,83992,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83992,BCBSND Hospital Base OP Fee Sched Tier 3,64.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,83993,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,83993,BCBSND Hospital Base OP Fee Sched Tier 3,93.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,84030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84030,BCBSND Hospital Base OP Fee Sched Tier 3,26.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,84035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84035,BCBSND Hospital Base OP Fee Sched Tier 3,17.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,84060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84060,BCBSND Hospital Base OP Fee Sched Tier 3,35.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,84066,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84066,BCBSND Hospital Base OP Fee Sched Tier 3,45.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,84075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84075,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,84078,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84078,BCBSND Hospital Base OP Fee Sched Tier 3,35.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,84080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84080,BCBSND Hospital Base OP Fee Sched Tier 3,70.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,84081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84081,BCBSND Hospital Base OP Fee Sched Tier 3,78.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,84085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84085,BCBSND Hospital Base OP Fee Sched Tier 3,44.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,84087,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84087,BCBSND Hospital Base OP Fee Sched Tier 3,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,84100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84100,BCBSND Hospital Base OP Fee Sched Tier 3,22.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,84105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84105,BCBSND Hospital Base OP Fee Sched Tier 3,24.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,84106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84106,BCBSND Hospital Base OP Fee Sched Tier 3,24.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,84110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84110,BCBSND Hospital Base OP Fee Sched Tier 3,40.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,84112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84112,BCBSND Hospital Base OP Fee Sched Tier 3,419.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,84119,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84119,BCBSND Hospital Base OP Fee Sched Tier 3,57.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,84120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84120,BCBSND Hospital Base OP Fee Sched Tier 3,69.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,84126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84126,BCBSND Hospital Base OP Fee Sched Tier 3,167.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,84132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84132,BCBSND Hospital Base OP Fee Sched Tier 3,21.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,84133,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84133,BCBSND Hospital Base OP Fee Sched Tier 3,20.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,84134,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84134,BCBSND Hospital Base OP Fee Sched Tier 3,69.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,84135,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84135,BCBSND Hospital Base OP Fee Sched Tier 3,90.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,84138,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84138,BCBSND Hospital Base OP Fee Sched Tier 3,89.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,84140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84140,BCBSND Hospital Base OP Fee Sched Tier 3,98.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,84143,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84143,BCBSND Hospital Base OP Fee Sched Tier 3,108.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,84144,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84144,BCBSND Hospital Base OP Fee Sched Tier 3,99.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,84145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84145,BCBSND Hospital Base OP Fee Sched Tier 3,127.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,84146,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84146,BCBSND Hospital Base OP Fee Sched Tier 3,92.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,84150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84150,BCBSND Hospital Base OP Fee Sched Tier 3,178.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,84152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84152,BCBSND Hospital Base OP Fee Sched Tier 3,87.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,84153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84153,BCBSND Hospital Base OP Fee Sched Tier 3,87.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,84154,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84154,BCBSND Hospital Base OP Fee Sched Tier 3,87.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,84155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84155,BCBSND Hospital Base OP Fee Sched Tier 3,17.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,84156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84156,BCBSND Hospital Base OP Fee Sched Tier 3,17.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,84157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84157,BCBSND Hospital Base OP Fee Sched Tier 3,17.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,84160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84160,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,84163,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84163,BCBSND Hospital Base OP Fee Sched Tier 3,71.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,84165,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84165,BCBSND Hospital Base OP Fee Sched Tier 3,51,,Fee schedule,,,,,,,,0
unity,Fee schedule,84166,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84166,BCBSND Hospital Base OP Fee Sched Tier 3,84.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,84181,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84181,BCBSND Hospital Base OP Fee Sched Tier 3,80.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,84182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84182,BCBSND Hospital Base OP Fee Sched Tier 3,124.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,84202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84202,BCBSND Hospital Base OP Fee Sched Tier 3,68.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,84203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84203,BCBSND Hospital Base OP Fee Sched Tier 3,41.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,84206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84206,BCBSND Hospital Base OP Fee Sched Tier 3,114.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,84207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84207,BCBSND Hospital Base OP Fee Sched Tier 3,133.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,84210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84210,BCBSND Hospital Base OP Fee Sched Tier 3,61.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,84220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84220,BCBSND Hospital Base OP Fee Sched Tier 3,44.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,84228,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84228,BCBSND Hospital Base OP Fee Sched Tier 3,55.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,84233,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84233,BCBSND Hospital Base OP Fee Sched Tier 3,375.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,84234,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84234,BCBSND Hospital Base OP Fee Sched Tier 3,308.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,84235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84235,BCBSND Hospital Base OP Fee Sched Tier 3,304.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,84238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84238,BCBSND Hospital Base OP Fee Sched Tier 3,173.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,84244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84244,BCBSND Hospital Base OP Fee Sched Tier 3,104.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,84252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84252,BCBSND Hospital Base OP Fee Sched Tier 3,96.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,84255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84255,BCBSND Hospital Base OP Fee Sched Tier 3,121.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,84260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84260,BCBSND Hospital Base OP Fee Sched Tier 3,147.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,84270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84270,BCBSND Hospital Base OP Fee Sched Tier 3,103.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,84275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84275,BCBSND Hospital Base OP Fee Sched Tier 3,63.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,84285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84285,BCBSND Hospital Base OP Fee Sched Tier 3,111.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,84295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84295,BCBSND Hospital Base OP Fee Sched Tier 3,22.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,84300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84300,BCBSND Hospital Base OP Fee Sched Tier 3,23.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,84302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84302,BCBSND Hospital Base OP Fee Sched Tier 3,23.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,84305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84305,BCBSND Hospital Base OP Fee Sched Tier 3,101.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,84307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84307,BCBSND Hospital Base OP Fee Sched Tier 3,86.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,84311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84311,BCBSND Hospital Base OP Fee Sched Tier 3,34.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,84315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84315,BCBSND Hospital Base OP Fee Sched Tier 3,14.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,84375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84375,BCBSND Hospital Base OP Fee Sched Tier 3,166.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,84376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84376,BCBSND Hospital Base OP Fee Sched Tier 3,26.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,84377,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84377,BCBSND Hospital Base OP Fee Sched Tier 3,26.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,84378,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84378,BCBSND Hospital Base OP Fee Sched Tier 3,54.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,84379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84379,BCBSND Hospital Base OP Fee Sched Tier 3,54.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,84392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84392,BCBSND Hospital Base OP Fee Sched Tier 3,23.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,84402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84402,BCBSND Hospital Base OP Fee Sched Tier 3,120.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,84403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84403,BCBSND Hospital Base OP Fee Sched Tier 3,122.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,84410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84410,BCBSND Hospital Base OP Fee Sched Tier 3,243.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,84425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84425,BCBSND Hospital Base OP Fee Sched Tier 3,100.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,84430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84430,BCBSND Hospital Base OP Fee Sched Tier 3,55.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,84431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84431,BCBSND Hospital Base OP Fee Sched Tier 3,150.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,84432,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84432,BCBSND Hospital Base OP Fee Sched Tier 3,76.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,84436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84436,BCBSND Hospital Base OP Fee Sched Tier 3,32.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,84437,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84437,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,84439,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84439,BCBSND Hospital Base OP Fee Sched Tier 3,42.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,84442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84442,BCBSND Hospital Base OP Fee Sched Tier 3,70.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,84443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84443,BCBSND Hospital Base OP Fee Sched Tier 3,79.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,84445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84445,BCBSND Hospital Base OP Fee Sched Tier 3,241.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,84446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84446,BCBSND Hospital Base OP Fee Sched Tier 3,67.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,84449,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84449,BCBSND Hospital Base OP Fee Sched Tier 3,85.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,84450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84450,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,84460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84460,BCBSND Hospital Base OP Fee Sched Tier 3,25.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,84466,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84466,BCBSND Hospital Base OP Fee Sched Tier 3,60.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,84478,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84478,BCBSND Hospital Base OP Fee Sched Tier 3,27.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,84479,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84479,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,84480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84480,BCBSND Hospital Base OP Fee Sched Tier 3,67.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,84481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84481,BCBSND Hospital Base OP Fee Sched Tier 3,80.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,84482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84482,BCBSND Hospital Base OP Fee Sched Tier 3,74.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,84484,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84484,BCBSND Hospital Base OP Fee Sched Tier 3,53.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,84485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84485,BCBSND Hospital Base OP Fee Sched Tier 3,34.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,84488,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84488,BCBSND Hospital Base OP Fee Sched Tier 3,34.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,84490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84490,BCBSND Hospital Base OP Fee Sched Tier 3,42.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,84510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84510,BCBSND Hospital Base OP Fee Sched Tier 3,49.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,84512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84512,BCBSND Hospital Base OP Fee Sched Tier 3,43.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,84520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84520,BCBSND Hospital Base OP Fee Sched Tier 3,18.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,84525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84525,BCBSND Hospital Base OP Fee Sched Tier 3,21.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,84540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84540,BCBSND Hospital Base OP Fee Sched Tier 3,23.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,84545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84545,BCBSND Hospital Base OP Fee Sched Tier 3,31.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,84550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84550,BCBSND Hospital Base OP Fee Sched Tier 3,21.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,84560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84560,BCBSND Hospital Base OP Fee Sched Tier 3,22.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,84577,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84577,BCBSND Hospital Base OP Fee Sched Tier 3,79.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,84578,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84578,BCBSND Hospital Base OP Fee Sched Tier 3,19.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,84580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84580,BCBSND Hospital Base OP Fee Sched Tier 3,40.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,84583,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84583,BCBSND Hospital Base OP Fee Sched Tier 3,25.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,84585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84585,BCBSND Hospital Base OP Fee Sched Tier 3,73.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,84586,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84586,BCBSND Hospital Base OP Fee Sched Tier 3,167.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,84588,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84588,BCBSND Hospital Base OP Fee Sched Tier 3,161.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,84590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84590,BCBSND Hospital Base OP Fee Sched Tier 3,55.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,84591,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84591,BCBSND Hospital Base OP Fee Sched Tier 3,72.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,84597,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84597,BCBSND Hospital Base OP Fee Sched Tier 3,65.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,84600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84600,BCBSND Hospital Base OP Fee Sched Tier 3,76.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,84620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84620,BCBSND Hospital Base OP Fee Sched Tier 3,56.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,84630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84630,BCBSND Hospital Base OP Fee Sched Tier 3,54.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,84681,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84681,BCBSND Hospital Base OP Fee Sched Tier 3,98.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,84702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84702,BCBSND Hospital Base OP Fee Sched Tier 3,71.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,84703,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84703,BCBSND Hospital Base OP Fee Sched Tier 3,35.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,84704,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84704,BCBSND Hospital Base OP Fee Sched Tier 3,71.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,84830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,84830,BCBSND Hospital Base OP Fee Sched Tier 3,54.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,85002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85002,BCBSND Hospital Base OP Fee Sched Tier 3,21.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,85004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85004,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,85007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85007,BCBSND Hospital Base OP Fee Sched Tier 3,16.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,85008,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85008,BCBSND Hospital Base OP Fee Sched Tier 3,16.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,85009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85009,BCBSND Hospital Base OP Fee Sched Tier 3,21.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,85013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85013,BCBSND Hospital Base OP Fee Sched Tier 3,29.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,85014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85014,BCBSND Hospital Base OP Fee Sched Tier 3,11.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,85018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85018,BCBSND Hospital Base OP Fee Sched Tier 3,11.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,85025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85025,BCBSND Hospital Base OP Fee Sched Tier 3,36.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,85027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85027,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,85032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85032,BCBSND Hospital Base OP Fee Sched Tier 3,20.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,85041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85041,BCBSND Hospital Base OP Fee Sched Tier 3,14.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,85044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85044,BCBSND Hospital Base OP Fee Sched Tier 3,20.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,85045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85045,BCBSND Hospital Base OP Fee Sched Tier 3,18.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,85046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85046,BCBSND Hospital Base OP Fee Sched Tier 3,26.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,85048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85048,BCBSND Hospital Base OP Fee Sched Tier 3,12.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,85049,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85049,BCBSND Hospital Base OP Fee Sched Tier 3,21.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,85055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85055,BCBSND Hospital Base OP Fee Sched Tier 3,152.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,85097,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85097,BCBSND Hospital Base OP Fee Sched Tier 3,62.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,85130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85130,BCBSND Hospital Base OP Fee Sched Tier 3,56.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,85170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85170,BCBSND Hospital Base OP Fee Sched Tier 3,69.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,85175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85175,BCBSND Hospital Base OP Fee Sched Tier 3,87.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,85210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85210,BCBSND Hospital Base OP Fee Sched Tier 3,61.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,85220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85220,BCBSND Hospital Base OP Fee Sched Tier 3,83.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,85230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85230,BCBSND Hospital Base OP Fee Sched Tier 3,85.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,85240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85240,BCBSND Hospital Base OP Fee Sched Tier 3,85.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,85244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85244,BCBSND Hospital Base OP Fee Sched Tier 3,97,,Fee schedule,,,,,,,,0
unity,Fee schedule,85245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85245,BCBSND Hospital Base OP Fee Sched Tier 3,108.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,85246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85246,BCBSND Hospital Base OP Fee Sched Tier 3,108.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,85247,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85247,BCBSND Hospital Base OP Fee Sched Tier 3,108.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,85250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85250,BCBSND Hospital Base OP Fee Sched Tier 3,90.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,85260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85260,BCBSND Hospital Base OP Fee Sched Tier 3,85.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,85270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85270,BCBSND Hospital Base OP Fee Sched Tier 3,85.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,85280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85280,BCBSND Hospital Base OP Fee Sched Tier 3,91.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,85290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85290,BCBSND Hospital Base OP Fee Sched Tier 3,77.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,85291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85291,BCBSND Hospital Base OP Fee Sched Tier 3,42.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,85292,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85292,BCBSND Hospital Base OP Fee Sched Tier 3,89.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,85293,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85293,BCBSND Hospital Base OP Fee Sched Tier 3,89.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,85300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85300,BCBSND Hospital Base OP Fee Sched Tier 3,56.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,85301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85301,BCBSND Hospital Base OP Fee Sched Tier 3,51.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,85302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85302,BCBSND Hospital Base OP Fee Sched Tier 3,57.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,85303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85303,BCBSND Hospital Base OP Fee Sched Tier 3,65.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,85305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85305,BCBSND Hospital Base OP Fee Sched Tier 3,55.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,85306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85306,BCBSND Hospital Base OP Fee Sched Tier 3,72.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,85307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85307,BCBSND Hospital Base OP Fee Sched Tier 3,72.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,85335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85335,BCBSND Hospital Base OP Fee Sched Tier 3,61.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,85337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85337,BCBSND Hospital Base OP Fee Sched Tier 3,73.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,85345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85345,BCBSND Hospital Base OP Fee Sched Tier 3,20.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,85347,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85347,BCBSND Hospital Base OP Fee Sched Tier 3,20.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,85348,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85348,BCBSND Hospital Base OP Fee Sched Tier 3,19.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,85360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85360,BCBSND Hospital Base OP Fee Sched Tier 3,39.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,85362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85362,BCBSND Hospital Base OP Fee Sched Tier 3,32.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,85366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85366,BCBSND Hospital Base OP Fee Sched Tier 3,343.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,85370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85370,BCBSND Hospital Base OP Fee Sched Tier 3,53.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,85378,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85378,BCBSND Hospital Base OP Fee Sched Tier 3,41.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,85379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85379,BCBSND Hospital Base OP Fee Sched Tier 3,48.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,85380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85380,BCBSND Hospital Base OP Fee Sched Tier 3,48.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,85384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85384,BCBSND Hospital Base OP Fee Sched Tier 3,41.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,85385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85385,BCBSND Hospital Base OP Fee Sched Tier 3,61.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,85390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85390,BCBSND Hospital Base OP Fee Sched Tier 3,66.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,85397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85397,BCBSND Hospital Base OP Fee Sched Tier 3,131.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,85400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85400,BCBSND Hospital Base OP Fee Sched Tier 3,36.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,85410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85410,BCBSND Hospital Base OP Fee Sched Tier 3,36.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,85415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85415,BCBSND Hospital Base OP Fee Sched Tier 3,81.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,85420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85420,BCBSND Hospital Base OP Fee Sched Tier 3,31.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,85421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85421,BCBSND Hospital Base OP Fee Sched Tier 3,48.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,85441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85441,BCBSND Hospital Base OP Fee Sched Tier 3,19.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,85445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85445,BCBSND Hospital Base OP Fee Sched Tier 3,32.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,85460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85460,BCBSND Hospital Base OP Fee Sched Tier 3,36.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,85461,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85461,BCBSND Hospital Base OP Fee Sched Tier 3,40.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,85475,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85475,BCBSND Hospital Base OP Fee Sched Tier 3,42.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,85520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85520,BCBSND Hospital Base OP Fee Sched Tier 3,62.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,85525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85525,BCBSND Hospital Base OP Fee Sched Tier 3,56.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,85530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85530,BCBSND Hospital Base OP Fee Sched Tier 3,62.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,85536,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85536,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,85540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85540,BCBSND Hospital Base OP Fee Sched Tier 3,40.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,85547,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85547,BCBSND Hospital Base OP Fee Sched Tier 3,40.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,85549,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85549,BCBSND Hospital Base OP Fee Sched Tier 3,89.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,85555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85555,BCBSND Hospital Base OP Fee Sched Tier 3,31.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,85557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85557,BCBSND Hospital Base OP Fee Sched Tier 3,63.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,85576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85576,BCBSND Hospital Base OP Fee Sched Tier 3,106.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,85597,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85597,BCBSND Hospital Base OP Fee Sched Tier 3,85.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,85598,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85598,BCBSND Hospital Base OP Fee Sched Tier 3,85.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,85610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85610,BCBSND Hospital Base OP Fee Sched Tier 3,18.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,85611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85611,BCBSND Hospital Base OP Fee Sched Tier 3,18.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,85612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85612,BCBSND Hospital Base OP Fee Sched Tier 3,74.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,85613,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85613,BCBSND Hospital Base OP Fee Sched Tier 3,45.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,85635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85635,BCBSND Hospital Base OP Fee Sched Tier 3,46.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,85651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85651,BCBSND Hospital Base OP Fee Sched Tier 3,18.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,85652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85652,BCBSND Hospital Base OP Fee Sched Tier 3,12.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,85660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85660,BCBSND Hospital Base OP Fee Sched Tier 3,26.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,85670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85670,BCBSND Hospital Base OP Fee Sched Tier 3,27.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,85675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85675,BCBSND Hospital Base OP Fee Sched Tier 3,32.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,85705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85705,BCBSND Hospital Base OP Fee Sched Tier 3,45.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,85730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85730,BCBSND Hospital Base OP Fee Sched Tier 3,28.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,85732,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85732,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,85810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,85810,BCBSND Hospital Base OP Fee Sched Tier 3,55.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,86000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86000,BCBSND Hospital Base OP Fee Sched Tier 3,33.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,86001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86001,BCBSND Hospital Base OP Fee Sched Tier 3,33.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,86003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86003,BCBSND Hospital Base OP Fee Sched Tier 3,24.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,86005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86005,BCBSND Hospital Base OP Fee Sched Tier 3,37.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,86008,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86008,BCBSND Hospital Base OP Fee Sched Tier 3,85.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,86021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86021,BCBSND Hospital Base OP Fee Sched Tier 3,71.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,86022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86022,BCBSND Hospital Base OP Fee Sched Tier 3,87.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,86023,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86023,BCBSND Hospital Base OP Fee Sched Tier 3,59.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,86038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86038,BCBSND Hospital Base OP Fee Sched Tier 3,57.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,86039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86039,BCBSND Hospital Base OP Fee Sched Tier 3,53.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,86060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86060,BCBSND Hospital Base OP Fee Sched Tier 3,34.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,86063,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86063,BCBSND Hospital Base OP Fee Sched Tier 3,27.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,86077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86077,BCBSND Hospital Base OP Fee Sched Tier 3,9.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,86078,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86078,BCBSND Hospital Base OP Fee Sched Tier 3,9.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,86079,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86079,BCBSND Hospital Base OP Fee Sched Tier 3,9.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,86140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86140,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,86141,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86141,BCBSND Hospital Base OP Fee Sched Tier 3,61.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,86146,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86146,BCBSND Hospital Base OP Fee Sched Tier 3,120.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,86147,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86147,BCBSND Hospital Base OP Fee Sched Tier 3,120.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,86148,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86148,BCBSND Hospital Base OP Fee Sched Tier 3,76.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,86152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86152,BCBSND Hospital Base OP Fee Sched Tier 3,1167.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,86155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86155,BCBSND Hospital Base OP Fee Sched Tier 3,75.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,86156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86156,BCBSND Hospital Base OP Fee Sched Tier 3,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,86157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86157,BCBSND Hospital Base OP Fee Sched Tier 3,38.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,86160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86160,BCBSND Hospital Base OP Fee Sched Tier 3,56.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,86161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86161,BCBSND Hospital Base OP Fee Sched Tier 3,56.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,86162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86162,BCBSND Hospital Base OP Fee Sched Tier 3,96.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,86171,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86171,BCBSND Hospital Base OP Fee Sched Tier 3,47.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,86200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86200,BCBSND Hospital Base OP Fee Sched Tier 3,61.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,86215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86215,BCBSND Hospital Base OP Fee Sched Tier 3,62.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,86225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86225,BCBSND Hospital Base OP Fee Sched Tier 3,65.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,86226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86226,BCBSND Hospital Base OP Fee Sched Tier 3,57.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,86235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86235,BCBSND Hospital Base OP Fee Sched Tier 3,85.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,86255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86255,BCBSND Hospital Base OP Fee Sched Tier 3,57.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,86256,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86256,BCBSND Hospital Base OP Fee Sched Tier 3,57.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,86277,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86277,BCBSND Hospital Base OP Fee Sched Tier 3,74.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,86280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86280,BCBSND Hospital Base OP Fee Sched Tier 3,38.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,86294,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86294,BCBSND Hospital Base OP Fee Sched Tier 3,109.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,86300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86300,BCBSND Hospital Base OP Fee Sched Tier 3,98.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,86301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86301,BCBSND Hospital Base OP Fee Sched Tier 3,98.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,86304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86304,BCBSND Hospital Base OP Fee Sched Tier 3,98.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,86305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86305,BCBSND Hospital Base OP Fee Sched Tier 3,98.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,86308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86308,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,86309,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86309,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,86310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86310,BCBSND Hospital Base OP Fee Sched Tier 3,35.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,86316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86316,BCBSND Hospital Base OP Fee Sched Tier 3,98.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,86317,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86317,BCBSND Hospital Base OP Fee Sched Tier 3,71.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86318,BCBSND Hospital Base OP Fee Sched Tier 3,77.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,86320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86320,BCBSND Hospital Base OP Fee Sched Tier 3,127.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,86325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86325,BCBSND Hospital Base OP Fee Sched Tier 3,106.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,86327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86327,BCBSND Hospital Base OP Fee Sched Tier 3,127.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,86329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86329,BCBSND Hospital Base OP Fee Sched Tier 3,66.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,86331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86331,BCBSND Hospital Base OP Fee Sched Tier 3,56.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,86332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86332,BCBSND Hospital Base OP Fee Sched Tier 3,115.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,86334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86334,BCBSND Hospital Base OP Fee Sched Tier 3,106.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,86335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86335,BCBSND Hospital Base OP Fee Sched Tier 3,139.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,86336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86336,BCBSND Hospital Base OP Fee Sched Tier 3,74.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,86337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86337,BCBSND Hospital Base OP Fee Sched Tier 3,101.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,86340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86340,BCBSND Hospital Base OP Fee Sched Tier 3,71.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,86341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86341,BCBSND Hospital Base OP Fee Sched Tier 3,100.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,86343,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86343,BCBSND Hospital Base OP Fee Sched Tier 3,59.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,86344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86344,BCBSND Hospital Base OP Fee Sched Tier 3,44.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,86352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86352,BCBSND Hospital Base OP Fee Sched Tier 3,645.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,86353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86353,BCBSND Hospital Base OP Fee Sched Tier 3,232.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,86355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86355,BCBSND Hospital Base OP Fee Sched Tier 3,179.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,86356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86356,BCBSND Hospital Base OP Fee Sched Tier 3,127.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86357,BCBSND Hospital Base OP Fee Sched Tier 3,179.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,86359,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86359,BCBSND Hospital Base OP Fee Sched Tier 3,179.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,86360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86360,BCBSND Hospital Base OP Fee Sched Tier 3,223.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,86361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86361,BCBSND Hospital Base OP Fee Sched Tier 3,127.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86367,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86367,BCBSND Hospital Base OP Fee Sched Tier 3,332.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,86376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86376,BCBSND Hospital Base OP Fee Sched Tier 3,69.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,86382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86382,BCBSND Hospital Base OP Fee Sched Tier 3,80.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,86384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86384,BCBSND Hospital Base OP Fee Sched Tier 3,58.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86386,BCBSND Hospital Base OP Fee Sched Tier 3,93.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,86403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86403,BCBSND Hospital Base OP Fee Sched Tier 3,49.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,86406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86406,BCBSND Hospital Base OP Fee Sched Tier 3,50.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,86430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86430,BCBSND Hospital Base OP Fee Sched Tier 3,26.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,86431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86431,BCBSND Hospital Base OP Fee Sched Tier 3,26.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,86480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86480,BCBSND Hospital Base OP Fee Sched Tier 3,294.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,86481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86481,BCBSND Hospital Base OP Fee Sched Tier 3,427.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,86485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86485,BCBSND Hospital Base OP Fee Sched Tier 3,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,86486,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86486,BCBSND Hospital Base OP Fee Sched Tier 3,13.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,86490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86490,BCBSND Hospital Base OP Fee Sched Tier 3,225.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,86510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86510,BCBSND Hospital Base OP Fee Sched Tier 3,17.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,86580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86580,BCBSND Hospital Base OP Fee Sched Tier 3,21.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,86590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86590,BCBSND Hospital Base OP Fee Sched Tier 3,54.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,86592,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86592,BCBSND Hospital Base OP Fee Sched Tier 3,20.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,86593,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86593,BCBSND Hospital Base OP Fee Sched Tier 3,20.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,86602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86602,BCBSND Hospital Base OP Fee Sched Tier 3,48.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,86603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86603,BCBSND Hospital Base OP Fee Sched Tier 3,61.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,86606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86606,BCBSND Hospital Base OP Fee Sched Tier 3,71.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,86609,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86609,BCBSND Hospital Base OP Fee Sched Tier 3,61.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86611,BCBSND Hospital Base OP Fee Sched Tier 3,48.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,86612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86612,BCBSND Hospital Base OP Fee Sched Tier 3,61.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,86615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86615,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86617,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86617,BCBSND Hospital Base OP Fee Sched Tier 3,73.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,86618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86618,BCBSND Hospital Base OP Fee Sched Tier 3,80.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,86619,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86619,BCBSND Hospital Base OP Fee Sched Tier 3,63.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,86622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86622,BCBSND Hospital Base OP Fee Sched Tier 3,42.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,86625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86625,BCBSND Hospital Base OP Fee Sched Tier 3,62.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,86628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86628,BCBSND Hospital Base OP Fee Sched Tier 3,57.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,86631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86631,BCBSND Hospital Base OP Fee Sched Tier 3,56.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,86632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86632,BCBSND Hospital Base OP Fee Sched Tier 3,60.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,86635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86635,BCBSND Hospital Base OP Fee Sched Tier 3,54.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,86638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86638,BCBSND Hospital Base OP Fee Sched Tier 3,57.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,86641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86641,BCBSND Hospital Base OP Fee Sched Tier 3,68.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,86644,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86644,BCBSND Hospital Base OP Fee Sched Tier 3,68.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86645,BCBSND Hospital Base OP Fee Sched Tier 3,80.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,86648,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86648,BCBSND Hospital Base OP Fee Sched Tier 3,72.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,86651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86651,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86652,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86653,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86654,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86654,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86658,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86658,BCBSND Hospital Base OP Fee Sched Tier 3,61.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,86663,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86663,BCBSND Hospital Base OP Fee Sched Tier 3,62.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,86664,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86664,BCBSND Hospital Base OP Fee Sched Tier 3,72.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86665,BCBSND Hospital Base OP Fee Sched Tier 3,86.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86666,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86666,BCBSND Hospital Base OP Fee Sched Tier 3,48.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,86668,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86668,BCBSND Hospital Base OP Fee Sched Tier 3,60.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,86671,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86671,BCBSND Hospital Base OP Fee Sched Tier 3,58.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,86674,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86674,BCBSND Hospital Base OP Fee Sched Tier 3,69.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,86677,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86677,BCBSND Hospital Base OP Fee Sched Tier 3,72.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,86682,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86682,BCBSND Hospital Base OP Fee Sched Tier 3,61.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,86684,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86684,BCBSND Hospital Base OP Fee Sched Tier 3,75.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,86687,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86687,BCBSND Hospital Base OP Fee Sched Tier 3,39.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,86688,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86688,BCBSND Hospital Base OP Fee Sched Tier 3,66.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,86689,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86689,BCBSND Hospital Base OP Fee Sched Tier 3,91.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,86692,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86692,BCBSND Hospital Base OP Fee Sched Tier 3,81.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,86694,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86694,BCBSND Hospital Base OP Fee Sched Tier 3,68.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86695,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86696,BCBSND Hospital Base OP Fee Sched Tier 3,91.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,86698,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86698,BCBSND Hospital Base OP Fee Sched Tier 3,59.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,86701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86701,BCBSND Hospital Base OP Fee Sched Tier 3,42.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,86702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86702,BCBSND Hospital Base OP Fee Sched Tier 3,64.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,86703,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86703,BCBSND Hospital Base OP Fee Sched Tier 3,65.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,86704,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86704,BCBSND Hospital Base OP Fee Sched Tier 3,57.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,86705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86705,BCBSND Hospital Base OP Fee Sched Tier 3,55.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,86706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86706,BCBSND Hospital Base OP Fee Sched Tier 3,51,,Fee schedule,,,,,,,,0
unity,Fee schedule,86707,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86707,BCBSND Hospital Base OP Fee Sched Tier 3,54.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,86708,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86708,BCBSND Hospital Base OP Fee Sched Tier 3,58.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,86709,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86709,BCBSND Hospital Base OP Fee Sched Tier 3,53.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,86710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86710,BCBSND Hospital Base OP Fee Sched Tier 3,64.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,86711,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86711,BCBSND Hospital Base OP Fee Sched Tier 3,72.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,86713,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86713,BCBSND Hospital Base OP Fee Sched Tier 3,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,86717,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86717,BCBSND Hospital Base OP Fee Sched Tier 3,58.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86720,BCBSND Hospital Base OP Fee Sched Tier 3,69.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,86723,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86723,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86727,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86727,BCBSND Hospital Base OP Fee Sched Tier 3,61.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,86732,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86732,BCBSND Hospital Base OP Fee Sched Tier 3,64.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,86735,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86735,BCBSND Hospital Base OP Fee Sched Tier 3,61.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,86738,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86738,BCBSND Hospital Base OP Fee Sched Tier 3,62.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,86741,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86741,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86744,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86744,BCBSND Hospital Base OP Fee Sched Tier 3,68.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86747,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86747,BCBSND Hospital Base OP Fee Sched Tier 3,71.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86750,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86753,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86753,BCBSND Hospital Base OP Fee Sched Tier 3,58.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,86756,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86756,BCBSND Hospital Base OP Fee Sched Tier 3,67.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,86757,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86757,BCBSND Hospital Base OP Fee Sched Tier 3,91.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,86759,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86759,BCBSND Hospital Base OP Fee Sched Tier 3,77.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,86762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86762,BCBSND Hospital Base OP Fee Sched Tier 3,68.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86765,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86765,BCBSND Hospital Base OP Fee Sched Tier 3,61.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86768,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86768,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86771,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86771,BCBSND Hospital Base OP Fee Sched Tier 3,104.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,86774,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86774,BCBSND Hospital Base OP Fee Sched Tier 3,70.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,86777,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86777,BCBSND Hospital Base OP Fee Sched Tier 3,68.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86778,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86778,BCBSND Hospital Base OP Fee Sched Tier 3,68.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,86780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86780,BCBSND Hospital Base OP Fee Sched Tier 3,62.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,86784,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86784,BCBSND Hospital Base OP Fee Sched Tier 3,59.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,86787,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86787,BCBSND Hospital Base OP Fee Sched Tier 3,61.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86788,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86788,BCBSND Hospital Base OP Fee Sched Tier 3,80.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,86789,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86789,BCBSND Hospital Base OP Fee Sched Tier 3,68.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86790,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86790,BCBSND Hospital Base OP Fee Sched Tier 3,61.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86793,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86793,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,86794,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86794,BCBSND Hospital Base OP Fee Sched Tier 3,80.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,86800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86800,BCBSND Hospital Base OP Fee Sched Tier 3,75.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,86803,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86803,BCBSND Hospital Base OP Fee Sched Tier 3,67.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,86804,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86804,BCBSND Hospital Base OP Fee Sched Tier 3,73.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,86805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86805,BCBSND Hospital Base OP Fee Sched Tier 3,810.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,86806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86806,BCBSND Hospital Base OP Fee Sched Tier 3,226.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,86807,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86807,BCBSND Hospital Base OP Fee Sched Tier 3,336.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,86808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86808,BCBSND Hospital Base OP Fee Sched Tier 3,140.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,86812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86812,BCBSND Hospital Base OP Fee Sched Tier 3,122.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,86813,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86813,BCBSND Hospital Base OP Fee Sched Tier 3,275.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,86816,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86816,BCBSND Hospital Base OP Fee Sched Tier 3,132.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,86817,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86817,BCBSND Hospital Base OP Fee Sched Tier 3,453.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,86821,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86821,BCBSND Hospital Base OP Fee Sched Tier 3,173.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,86825,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86825,BCBSND Hospital Base OP Fee Sched Tier 3,468.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,86826,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86826,BCBSND Hospital Base OP Fee Sched Tier 3,156.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,86828,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86828,BCBSND Hospital Base OP Fee Sched Tier 3,274.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,86829,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86829,BCBSND Hospital Base OP Fee Sched Tier 3,274.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,86830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86830,BCBSND Hospital Base OP Fee Sched Tier 3,408.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,86831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86831,BCBSND Hospital Base OP Fee Sched Tier 3,350.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,86832,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86832,BCBSND Hospital Base OP Fee Sched Tier 3,1384.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,86833,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86833,BCBSND Hospital Base OP Fee Sched Tier 3,1392.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,86834,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86834,BCBSND Hospital Base OP Fee Sched Tier 3,1698.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,86835,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86835,BCBSND Hospital Base OP Fee Sched Tier 3,1534.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,86850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86850,BCBSND Hospital Base OP Fee Sched Tier 3,68.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,86860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86860,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86870,BCBSND Hospital Base OP Fee Sched Tier 3,370.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,86880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86880,BCBSND Hospital Base OP Fee Sched Tier 3,25.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,86885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86885,BCBSND Hospital Base OP Fee Sched Tier 3,27.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,86886,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86886,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,86890,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86890,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86891,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86891,BCBSND Hospital Base OP Fee Sched Tier 3,753.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,86900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86900,BCBSND Hospital Base OP Fee Sched Tier 3,14.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,86901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86901,BCBSND Hospital Base OP Fee Sched Tier 3,14.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,86902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86902,BCBSND Hospital Base OP Fee Sched Tier 3,27.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,86904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86904,BCBSND Hospital Base OP Fee Sched Tier 3,69.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,86905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86905,BCBSND Hospital Base OP Fee Sched Tier 3,18.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,86906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86906,BCBSND Hospital Base OP Fee Sched Tier 3,36.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,86910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86910,BCBSND Hospital Base OP Fee Sched Tier 3,124.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,86911,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86911,BCBSND Hospital Base OP Fee Sched Tier 3,35.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,86920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86920,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,86921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86921,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,86922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86922,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,86923,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86923,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,86927,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86927,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86930,BCBSND Hospital Base OP Fee Sched Tier 3,370.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,86931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86931,BCBSND Hospital Base OP Fee Sched Tier 3,370.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,86932,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86932,BCBSND Hospital Base OP Fee Sched Tier 3,43.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86940,BCBSND Hospital Base OP Fee Sched Tier 3,38.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,86941,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86941,BCBSND Hospital Base OP Fee Sched Tier 3,57.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,86945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86945,BCBSND Hospital Base OP Fee Sched Tier 3,43.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86950,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86960,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86965,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86965,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86970,BCBSND Hospital Base OP Fee Sched Tier 3,43.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86971,BCBSND Hospital Base OP Fee Sched Tier 3,370.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,86972,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86972,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86975,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86975,BCBSND Hospital Base OP Fee Sched Tier 3,43.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86976,BCBSND Hospital Base OP Fee Sched Tier 3,23.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,86977,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86977,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86978,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86978,BCBSND Hospital Base OP Fee Sched Tier 3,43.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,86985,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86985,BCBSND Hospital Base OP Fee Sched Tier 3,195.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,86999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,86999,BCBSND Hospital Base OP Fee Sched Tier 3,23.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,87003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87003,BCBSND Hospital Base OP Fee Sched Tier 3,79.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,87015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87015,BCBSND Hospital Base OP Fee Sched Tier 3,31.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,87040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87040,BCBSND Hospital Base OP Fee Sched Tier 3,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,87045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87045,BCBSND Hospital Base OP Fee Sched Tier 3,44.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,87046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87046,BCBSND Hospital Base OP Fee Sched Tier 3,44.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,87070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87070,BCBSND Hospital Base OP Fee Sched Tier 3,40.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,87071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87071,BCBSND Hospital Base OP Fee Sched Tier 3,44.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,87073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87073,BCBSND Hospital Base OP Fee Sched Tier 3,44.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,87075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87075,BCBSND Hospital Base OP Fee Sched Tier 3,44.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,87076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87076,BCBSND Hospital Base OP Fee Sched Tier 3,38.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,87077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87077,BCBSND Hospital Base OP Fee Sched Tier 3,38.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,87081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87081,BCBSND Hospital Base OP Fee Sched Tier 3,31.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,87084,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87084,BCBSND Hospital Base OP Fee Sched Tier 3,115.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,87086,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87086,BCBSND Hospital Base OP Fee Sched Tier 3,38.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,87088,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87088,BCBSND Hospital Base OP Fee Sched Tier 3,38.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,87101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87101,BCBSND Hospital Base OP Fee Sched Tier 3,36.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,87102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87102,BCBSND Hospital Base OP Fee Sched Tier 3,39.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,87103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87103,BCBSND Hospital Base OP Fee Sched Tier 3,87.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,87106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87106,BCBSND Hospital Base OP Fee Sched Tier 3,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,87107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87107,BCBSND Hospital Base OP Fee Sched Tier 3,49.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,87109,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87109,BCBSND Hospital Base OP Fee Sched Tier 3,73.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,87110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87110,BCBSND Hospital Base OP Fee Sched Tier 3,93.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,87116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87116,BCBSND Hospital Base OP Fee Sched Tier 3,51.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,87118,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87118,BCBSND Hospital Base OP Fee Sched Tier 3,62.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,87140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87140,BCBSND Hospital Base OP Fee Sched Tier 3,26.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,87143,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87143,BCBSND Hospital Base OP Fee Sched Tier 3,59.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,87147,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87147,BCBSND Hospital Base OP Fee Sched Tier 3,24.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,87149,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87149,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87150,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87152,BCBSND Hospital Base OP Fee Sched Tier 3,33.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,87153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87153,BCBSND Hospital Base OP Fee Sched Tier 3,547.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,87158,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87158,BCBSND Hospital Base OP Fee Sched Tier 3,33.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,87164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87164,BCBSND Hospital Base OP Fee Sched Tier 3,51,,Fee schedule,,,,,,,,0
unity,Fee schedule,87166,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87166,BCBSND Hospital Base OP Fee Sched Tier 3,53.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,87168,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87168,BCBSND Hospital Base OP Fee Sched Tier 3,20.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,87169,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87169,BCBSND Hospital Base OP Fee Sched Tier 3,20.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,87172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87172,BCBSND Hospital Base OP Fee Sched Tier 3,20.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,87176,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87176,BCBSND Hospital Base OP Fee Sched Tier 3,27.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,87177,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87177,BCBSND Hospital Base OP Fee Sched Tier 3,42.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,87181,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87181,BCBSND Hospital Base OP Fee Sched Tier 3,22.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,87184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87184,BCBSND Hospital Base OP Fee Sched Tier 3,32.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,87185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87185,BCBSND Hospital Base OP Fee Sched Tier 3,22.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,87186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87186,BCBSND Hospital Base OP Fee Sched Tier 3,41.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,87187,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87187,BCBSND Hospital Base OP Fee Sched Tier 3,171.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,87188,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87188,BCBSND Hospital Base OP Fee Sched Tier 3,31.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,87190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87190,BCBSND Hospital Base OP Fee Sched Tier 3,31.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87197,BCBSND Hospital Base OP Fee Sched Tier 3,71.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,87205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87205,BCBSND Hospital Base OP Fee Sched Tier 3,20.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,87206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87206,BCBSND Hospital Base OP Fee Sched Tier 3,25.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,87207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87207,BCBSND Hospital Base OP Fee Sched Tier 3,28.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,87209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87209,BCBSND Hospital Base OP Fee Sched Tier 3,85.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,87210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87210,BCBSND Hospital Base OP Fee Sched Tier 3,24.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,87220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87220,BCBSND Hospital Base OP Fee Sched Tier 3,20.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,87230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87230,BCBSND Hospital Base OP Fee Sched Tier 3,93.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,87250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87250,BCBSND Hospital Base OP Fee Sched Tier 3,92.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,87252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87252,BCBSND Hospital Base OP Fee Sched Tier 3,123.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,87253,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87253,BCBSND Hospital Base OP Fee Sched Tier 3,95.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,87254,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87254,BCBSND Hospital Base OP Fee Sched Tier 3,92.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,87255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87255,BCBSND Hospital Base OP Fee Sched Tier 3,160.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,87260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87260,BCBSND Hospital Base OP Fee Sched Tier 3,61.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,87265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87265,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87267,BCBSND Hospital Base OP Fee Sched Tier 3,57.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,87269,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87269,BCBSND Hospital Base OP Fee Sched Tier 3,58.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,87270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87270,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87271,BCBSND Hospital Base OP Fee Sched Tier 3,57.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,87272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87272,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87273,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87274,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87275,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87276,BCBSND Hospital Base OP Fee Sched Tier 3,68.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,87278,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87278,BCBSND Hospital Base OP Fee Sched Tier 3,66.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,87279,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87279,BCBSND Hospital Base OP Fee Sched Tier 3,70.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,87280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87280,BCBSND Hospital Base OP Fee Sched Tier 3,57.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,87281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87281,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87283,BCBSND Hospital Base OP Fee Sched Tier 3,259.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,87285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87285,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87290,BCBSND Hospital Base OP Fee Sched Tier 3,57.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,87299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87299,BCBSND Hospital Base OP Fee Sched Tier 3,68.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,87300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87300,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87301,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87305,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87320,BCBSND Hospital Base OP Fee Sched Tier 3,64.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,87324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87324,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87327,BCBSND Hospital Base OP Fee Sched Tier 3,57.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,87328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87328,BCBSND Hospital Base OP Fee Sched Tier 3,59.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,87329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87329,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87332,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87335,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87336,BCBSND Hospital Base OP Fee Sched Tier 3,68.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,87337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87337,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87338,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87338,BCBSND Hospital Base OP Fee Sched Tier 3,68.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,87339,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87339,BCBSND Hospital Base OP Fee Sched Tier 3,68.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,87340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87340,BCBSND Hospital Base OP Fee Sched Tier 3,49.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,87341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87341,BCBSND Hospital Base OP Fee Sched Tier 3,49.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,87350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87350,BCBSND Hospital Base OP Fee Sched Tier 3,54.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,87380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87380,BCBSND Hospital Base OP Fee Sched Tier 3,78.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87385,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87389,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87389,BCBSND Hospital Base OP Fee Sched Tier 3,114.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,87390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87390,BCBSND Hospital Base OP Fee Sched Tier 3,102.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,87391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87391,BCBSND Hospital Base OP Fee Sched Tier 3,93.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,87400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87400,BCBSND Hospital Base OP Fee Sched Tier 3,60.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,87420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87420,BCBSND Hospital Base OP Fee Sched Tier 3,59.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,87425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87425,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87427,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87427,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87430,BCBSND Hospital Base OP Fee Sched Tier 3,71.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,87449,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87449,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87450,BCBSND Hospital Base OP Fee Sched Tier 3,45.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,87451,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87451,BCBSND Hospital Base OP Fee Sched Tier 3,45.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,87471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87471,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87472,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87472,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87475,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87475,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87476,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87476,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87480,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87481,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87482,BCBSND Hospital Base OP Fee Sched Tier 3,238.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,87483,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87483,BCBSND Hospital Base OP Fee Sched Tier 3,1979.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,87485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87485,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87486,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87486,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87487,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87487,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87490,BCBSND Hospital Base OP Fee Sched Tier 3,97.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,87491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87491,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87492,BCBSND Hospital Base OP Fee Sched Tier 3,228.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,87493,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87493,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87495,BCBSND Hospital Base OP Fee Sched Tier 3,128.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,87496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87496,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87497,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87497,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87498,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87500,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87501,BCBSND Hospital Base OP Fee Sched Tier 3,243.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,87502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87502,BCBSND Hospital Base OP Fee Sched Tier 3,409.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,87503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87503,BCBSND Hospital Base OP Fee Sched Tier 3,124.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,87505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87505,BCBSND Hospital Base OP Fee Sched Tier 3,609.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,87506,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87506,BCBSND Hospital Base OP Fee Sched Tier 3,1124.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,87507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87507,BCBSND Hospital Base OP Fee Sched Tier 3,1979.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,87510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87510,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87511,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87512,BCBSND Hospital Base OP Fee Sched Tier 3,198.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,87516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87516,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87517,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87520,BCBSND Hospital Base OP Fee Sched Tier 3,133.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,87521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87521,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87522,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87525,BCBSND Hospital Base OP Fee Sched Tier 3,127.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,87526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87526,BCBSND Hospital Base OP Fee Sched Tier 3,167.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,87527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87527,BCBSND Hospital Base OP Fee Sched Tier 3,198.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,87528,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87528,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87529,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87529,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87530,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87531,BCBSND Hospital Base OP Fee Sched Tier 3,247.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,87532,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87532,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87533,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87533,BCBSND Hospital Base OP Fee Sched Tier 3,198.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,87534,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87534,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87535,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87536,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87536,BCBSND Hospital Base OP Fee Sched Tier 3,404.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,87537,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87537,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87538,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87538,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87539,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87539,BCBSND Hospital Base OP Fee Sched Tier 3,250.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,87540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87540,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87541,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87542,BCBSND Hospital Base OP Fee Sched Tier 3,198.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,87550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87550,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87551,BCBSND Hospital Base OP Fee Sched Tier 3,206.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,87552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87552,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87555,BCBSND Hospital Base OP Fee Sched Tier 3,114.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,87556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87556,BCBSND Hospital Base OP Fee Sched Tier 3,178.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,87557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87557,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87560,BCBSND Hospital Base OP Fee Sched Tier 3,116.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,87561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87561,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87562,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87580,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87581,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87581,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87582,BCBSND Hospital Base OP Fee Sched Tier 3,1293.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,87590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87590,BCBSND Hospital Base OP Fee Sched Tier 3,114.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,87591,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87591,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87592,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87592,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87623,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87624,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87625,BCBSND Hospital Base OP Fee Sched Tier 3,173.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,87631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87631,BCBSND Hospital Base OP Fee Sched Tier 3,609.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,87632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87632,BCBSND Hospital Base OP Fee Sched Tier 3,1013.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,87633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87633,BCBSND Hospital Base OP Fee Sched Tier 3,1979.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,87634,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87634,BCBSND Hospital Base OP Fee Sched Tier 3,333.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,87640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87640,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87641,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87650,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87651,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87652,BCBSND Hospital Base OP Fee Sched Tier 3,198.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,87653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87653,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87660,BCBSND Hospital Base OP Fee Sched Tier 3,95.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,87661,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87661,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87662,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87662,BCBSND Hospital Base OP Fee Sched Tier 3,243.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,87797,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87797,BCBSND Hospital Base OP Fee Sched Tier 3,128.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,87798,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87798,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,87799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87799,BCBSND Hospital Base OP Fee Sched Tier 3,203.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,87800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87800,BCBSND Hospital Base OP Fee Sched Tier 3,190.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,87801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87801,BCBSND Hospital Base OP Fee Sched Tier 3,333.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,87802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87802,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87803,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87803,BCBSND Hospital Base OP Fee Sched Tier 3,68.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,87804,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87804,BCBSND Hospital Base OP Fee Sched Tier 3,70.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,87806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87806,BCBSND Hospital Base OP Fee Sched Tier 3,140.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,87807,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87807,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,87808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87808,BCBSND Hospital Base OP Fee Sched Tier 3,65.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,87809,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87809,BCBSND Hospital Base OP Fee Sched Tier 3,93.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,87810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87810,BCBSND Hospital Base OP Fee Sched Tier 3,150.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,87850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87850,BCBSND Hospital Base OP Fee Sched Tier 3,104.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,87880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87880,BCBSND Hospital Base OP Fee Sched Tier 3,70.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,87899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87899,BCBSND Hospital Base OP Fee Sched Tier 3,68.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,87900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87900,BCBSND Hospital Base OP Fee Sched Tier 3,619.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,87901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87901,BCBSND Hospital Base OP Fee Sched Tier 3,1222.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,87902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87902,BCBSND Hospital Base OP Fee Sched Tier 3,1222.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,87903,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87903,BCBSND Hospital Base OP Fee Sched Tier 3,2321.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,87904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87904,BCBSND Hospital Base OP Fee Sched Tier 3,123.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,87905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87905,BCBSND Hospital Base OP Fee Sched Tier 3,58.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,87906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87906,BCBSND Hospital Base OP Fee Sched Tier 3,611.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,87910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87910,BCBSND Hospital Base OP Fee Sched Tier 3,1222.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,87912,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,87912,BCBSND Hospital Base OP Fee Sched Tier 3,1222.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,88104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88104,BCBSND Hospital Base OP Fee Sched Tier 3,104.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,88106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88106,BCBSND Hospital Base OP Fee Sched Tier 3,113.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,88108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88108,BCBSND Hospital Base OP Fee Sched Tier 3,95.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,88112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88112,BCBSND Hospital Base OP Fee Sched Tier 3,98.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,88120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88120,BCBSND Hospital Base OP Fee Sched Tier 3,1377.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,88121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88121,BCBSND Hospital Base OP Fee Sched Tier 3,1097.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,88125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88125,BCBSND Hospital Base OP Fee Sched Tier 3,31.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,88130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88130,BCBSND Hospital Base OP Fee Sched Tier 3,85.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,88140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88140,BCBSND Hospital Base OP Fee Sched Tier 3,37.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,88142,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88142,BCBSND Hospital Base OP Fee Sched Tier 3,96.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,88143,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88143,BCBSND Hospital Base OP Fee Sched Tier 3,98.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,88147,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88147,BCBSND Hospital Base OP Fee Sched Tier 3,216.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,88148,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88148,BCBSND Hospital Base OP Fee Sched Tier 3,72.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,88150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88150,BCBSND Hospital Base OP Fee Sched Tier 3,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,88152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88152,BCBSND Hospital Base OP Fee Sched Tier 3,118.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,88153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88153,BCBSND Hospital Base OP Fee Sched Tier 3,102.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88155,BCBSND Hospital Base OP Fee Sched Tier 3,62.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,88160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88160,BCBSND Hospital Base OP Fee Sched Tier 3,114.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,88161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88161,BCBSND Hospital Base OP Fee Sched Tier 3,103.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,88162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88162,BCBSND Hospital Base OP Fee Sched Tier 3,143.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,88164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88164,BCBSND Hospital Base OP Fee Sched Tier 3,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,88165,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88165,BCBSND Hospital Base OP Fee Sched Tier 3,180.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,88166,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88166,BCBSND Hospital Base OP Fee Sched Tier 3,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,88167,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88167,BCBSND Hospital Base OP Fee Sched Tier 3,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,88172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88172,BCBSND Hospital Base OP Fee Sched Tier 3,49.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,88173,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88173,BCBSND Hospital Base OP Fee Sched Tier 3,205.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,88174,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88174,BCBSND Hospital Base OP Fee Sched Tier 3,108.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,88175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88175,BCBSND Hospital Base OP Fee Sched Tier 3,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,88177,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88177,BCBSND Hospital Base OP Fee Sched Tier 3,18.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,88182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88182,BCBSND Hospital Base OP Fee Sched Tier 3,241.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,88184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88184,BCBSND Hospital Base OP Fee Sched Tier 3,170.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,88185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88185,BCBSND Hospital Base OP Fee Sched Tier 3,62.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,88199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88199,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88230,BCBSND Hospital Base OP Fee Sched Tier 3,553.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,88233,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88233,BCBSND Hospital Base OP Fee Sched Tier 3,668.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,88235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88235,BCBSND Hospital Base OP Fee Sched Tier 3,699.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,88237,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88237,BCBSND Hospital Base OP Fee Sched Tier 3,614.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,88239,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88239,BCBSND Hospital Base OP Fee Sched Tier 3,700.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,88240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88240,BCBSND Hospital Base OP Fee Sched Tier 3,55.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,88241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88241,BCBSND Hospital Base OP Fee Sched Tier 3,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,88245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88245,BCBSND Hospital Base OP Fee Sched Tier 3,822.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,88248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88248,BCBSND Hospital Base OP Fee Sched Tier 3,822.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,88249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88249,BCBSND Hospital Base OP Fee Sched Tier 3,822.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,88261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88261,BCBSND Hospital Base OP Fee Sched Tier 3,1130.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,88262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88262,BCBSND Hospital Base OP Fee Sched Tier 3,592.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,88263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88263,BCBSND Hospital Base OP Fee Sched Tier 3,713.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,88264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88264,BCBSND Hospital Base OP Fee Sched Tier 3,618.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,88267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88267,BCBSND Hospital Base OP Fee Sched Tier 3,853.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,88269,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88269,BCBSND Hospital Base OP Fee Sched Tier 3,790.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,88271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88271,BCBSND Hospital Base OP Fee Sched Tier 3,101.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,88272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88272,BCBSND Hospital Base OP Fee Sched Tier 3,173.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,88273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88273,BCBSND Hospital Base OP Fee Sched Tier 3,152.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,88274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88274,BCBSND Hospital Base OP Fee Sched Tier 3,181.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,88275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88275,BCBSND Hospital Base OP Fee Sched Tier 3,218.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,88280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88280,BCBSND Hospital Base OP Fee Sched Tier 3,143.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,88283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88283,BCBSND Hospital Base OP Fee Sched Tier 3,325.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,88285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88285,BCBSND Hospital Base OP Fee Sched Tier 3,115.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,88289,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88289,BCBSND Hospital Base OP Fee Sched Tier 3,163.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,88291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88291,BCBSND Hospital Base OP Fee Sched Tier 3,85.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,88299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88299,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88300,BCBSND Hospital Base OP Fee Sched Tier 3,21.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,88302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88302,BCBSND Hospital Base OP Fee Sched Tier 3,60.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,88304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88304,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88305,BCBSND Hospital Base OP Fee Sched Tier 3,76.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,88307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88307,BCBSND Hospital Base OP Fee Sched Tier 3,468.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88309,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88309,BCBSND Hospital Base OP Fee Sched Tier 3,657.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,88311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88311,BCBSND Hospital Base OP Fee Sched Tier 3,22.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,88312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88312,BCBSND Hospital Base OP Fee Sched Tier 3,186.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,88313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88313,BCBSND Hospital Base OP Fee Sched Tier 3,153.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,88314,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88314,BCBSND Hospital Base OP Fee Sched Tier 3,176.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,88319,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88319,BCBSND Hospital Base OP Fee Sched Tier 3,178.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,88321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88321,BCBSND Hospital Base OP Fee Sched Tier 3,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,88323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88323,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88325,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88329,BCBSND Hospital Base OP Fee Sched Tier 3,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,88331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88331,BCBSND Hospital Base OP Fee Sched Tier 3,84.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,88332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88332,BCBSND Hospital Base OP Fee Sched Tier 3,55.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,88333,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88333,BCBSND Hospital Base OP Fee Sched Tier 3,64.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,88334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88334,BCBSND Hospital Base OP Fee Sched Tier 3,42.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,88341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88341,BCBSND Hospital Base OP Fee Sched Tier 3,161.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,88342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88342,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,88344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88344,BCBSND Hospital Base OP Fee Sched Tier 3,342.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,88346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88346,BCBSND Hospital Base OP Fee Sched Tier 3,186.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,88348,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88348,BCBSND Hospital Base OP Fee Sched Tier 3,718.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,88350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88350,BCBSND Hospital Base OP Fee Sched Tier 3,122.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,88355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88355,BCBSND Hospital Base OP Fee Sched Tier 3,124.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,88356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88356,BCBSND Hospital Base OP Fee Sched Tier 3,245.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,88358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88358,BCBSND Hospital Base OP Fee Sched Tier 3,195.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,88360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88360,BCBSND Hospital Base OP Fee Sched Tier 3,214.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,88361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88361,BCBSND Hospital Base OP Fee Sched Tier 3,217.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,88362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88362,BCBSND Hospital Base OP Fee Sched Tier 3,244.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,88363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88363,BCBSND Hospital Base OP Fee Sched Tier 3,9.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,88364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88364,BCBSND Hospital Base OP Fee Sched Tier 3,247.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,88365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88365,BCBSND Hospital Base OP Fee Sched Tier 3,336.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,88366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88366,BCBSND Hospital Base OP Fee Sched Tier 3,510.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,88367,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88367,BCBSND Hospital Base OP Fee Sched Tier 3,188.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,88368,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88368,BCBSND Hospital Base OP Fee Sched Tier 3,215.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,88369,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88369,BCBSND Hospital Base OP Fee Sched Tier 3,199.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,88371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88371,BCBSND Hospital Base OP Fee Sched Tier 3,105.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,88372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88372,BCBSND Hospital Base OP Fee Sched Tier 3,112.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,88373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88373,BCBSND Hospital Base OP Fee Sched Tier 3,120.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,88374,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88374,BCBSND Hospital Base OP Fee Sched Tier 3,714.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,88375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88375,BCBSND Hospital Base OP Fee Sched Tier 3,128.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,88377,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88377,BCBSND Hospital Base OP Fee Sched Tier 3,820.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88380,BCBSND Hospital Base OP Fee Sched Tier 3,198.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,88381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88381,BCBSND Hospital Base OP Fee Sched Tier 3,326.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,88387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88387,BCBSND Hospital Base OP Fee Sched Tier 3,17.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,88388,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88388,BCBSND Hospital Base OP Fee Sched Tier 3,28.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,88399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88399,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,88720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88720,BCBSND Hospital Base OP Fee Sched Tier 3,23.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,88738,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88738,BCBSND Hospital Base OP Fee Sched Tier 3,23.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,88740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88740,BCBSND Hospital Base OP Fee Sched Tier 3,40.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,88741,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,88741,BCBSND Hospital Base OP Fee Sched Tier 3,40.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,89049,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89049,BCBSND Hospital Base OP Fee Sched Tier 3,638.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,89050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89050,BCBSND Hospital Base OP Fee Sched Tier 3,22.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,89051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89051,BCBSND Hospital Base OP Fee Sched Tier 3,26.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,89055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89055,BCBSND Hospital Base OP Fee Sched Tier 3,20.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,89060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89060,BCBSND Hospital Base OP Fee Sched Tier 3,33.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,89125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89125,BCBSND Hospital Base OP Fee Sched Tier 3,25.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,89160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89160,BCBSND Hospital Base OP Fee Sched Tier 3,20.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,89190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89190,BCBSND Hospital Base OP Fee Sched Tier 3,24.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,89220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89220,BCBSND Hospital Base OP Fee Sched Tier 3,41.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,89230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89230,BCBSND Hospital Base OP Fee Sched Tier 3,7.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,89240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89240,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,89250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89250,BCBSND Hospital Base OP Fee Sched Tier 3,1050,,Fee schedule,,,,,,,,0
unity,Fee schedule,89251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89251,BCBSND Hospital Base OP Fee Sched Tier 3,342.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,89253,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89253,BCBSND Hospital Base OP Fee Sched Tier 3,1025,,Fee schedule,,,,,,,,0
unity,Fee schedule,89254,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89254,BCBSND Hospital Base OP Fee Sched Tier 3,1000,,Fee schedule,,,,,,,,0
unity,Fee schedule,89255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89255,BCBSND Hospital Base OP Fee Sched Tier 3,650,,Fee schedule,,,,,,,,0
unity,Fee schedule,89257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89257,BCBSND Hospital Base OP Fee Sched Tier 3,600,,Fee schedule,,,,,,,,0
unity,Fee schedule,89258,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89258,BCBSND Hospital Base OP Fee Sched Tier 3,864.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,89259,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89259,BCBSND Hospital Base OP Fee Sched Tier 3,300,,Fee schedule,,,,,,,,0
unity,Fee schedule,89260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89260,BCBSND Hospital Base OP Fee Sched Tier 3,116.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,89261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89261,BCBSND Hospital Base OP Fee Sched Tier 3,367.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,89264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89264,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,89268,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89268,BCBSND Hospital Base OP Fee Sched Tier 3,270,,Fee schedule,,,,,,,,0
unity,Fee schedule,89272,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89272,BCBSND Hospital Base OP Fee Sched Tier 3,520,,Fee schedule,,,,,,,,0
unity,Fee schedule,89280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89280,BCBSND Hospital Base OP Fee Sched Tier 3,1605,,Fee schedule,,,,,,,,0
unity,Fee schedule,89281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89281,BCBSND Hospital Base OP Fee Sched Tier 3,2025,,Fee schedule,,,,,,,,0
unity,Fee schedule,89290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89290,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,89291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89291,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,89300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89300,BCBSND Hospital Base OP Fee Sched Tier 3,42.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,89310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89310,BCBSND Hospital Base OP Fee Sched Tier 3,40.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,89320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89320,BCBSND Hospital Base OP Fee Sched Tier 3,57.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,89321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89321,BCBSND Hospital Base OP Fee Sched Tier 3,57.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,89322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89322,BCBSND Hospital Base OP Fee Sched Tier 3,73.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,89325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89325,BCBSND Hospital Base OP Fee Sched Tier 3,50.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,89329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89329,BCBSND Hospital Base OP Fee Sched Tier 3,93.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,89330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89330,BCBSND Hospital Base OP Fee Sched Tier 3,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,89331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89331,BCBSND Hospital Base OP Fee Sched Tier 3,93.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,89335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89335,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,89337,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89337,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,89342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89342,BCBSND Hospital Base OP Fee Sched Tier 3,400,,Fee schedule,,,,,,,,0
unity,Fee schedule,89343,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89343,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,89344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89344,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,89346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89346,BCBSND Hospital Base OP Fee Sched Tier 3,342.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,89352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89352,BCBSND Hospital Base OP Fee Sched Tier 3,750,,Fee schedule,,,,,,,,0
unity,Fee schedule,89353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89353,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,89354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89354,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,89356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89356,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,89398,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,89398,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,90284,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90284,BCBSND Hospital Base OP Fee Sched Tier 3,16.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,90371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90371,BCBSND Hospital Base OP Fee Sched Tier 3,183.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,90375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90375,BCBSND Hospital Base OP Fee Sched Tier 3,457.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,90376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90376,BCBSND Hospital Base OP Fee Sched Tier 3,408.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,90384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90384,BCBSND Hospital Base OP Fee Sched Tier 3,107.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,90385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90385,BCBSND Hospital Base OP Fee Sched Tier 3,41.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,90396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90396,BCBSND Hospital Base OP Fee Sched Tier 3,2327,,Fee schedule,,,,,,,,0
unity,Fee schedule,90460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90460,BCBSND Hospital Base OP Fee Sched Tier 3,34.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,90461,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90461,BCBSND Hospital Base OP Fee Sched Tier 3,26.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,90471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90471,BCBSND Hospital Base OP Fee Sched Tier 3,34.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,90472,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90472,BCBSND Hospital Base OP Fee Sched Tier 3,26.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,90473,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90473,BCBSND Hospital Base OP Fee Sched Tier 3,34.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,90474,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90474,BCBSND Hospital Base OP Fee Sched Tier 3,26.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,90581,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90581,BCBSND Hospital Base OP Fee Sched Tier 3,143.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,90585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90585,BCBSND Hospital Base OP Fee Sched Tier 3,207.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,90586,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90586,BCBSND Hospital Base OP Fee Sched Tier 3,207.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,90620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90620,BCBSND Hospital Base OP Fee Sched Tier 3,247.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,90621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90621,BCBSND Hospital Base OP Fee Sched Tier 3,203.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,90625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90625,BCBSND Hospital Base OP Fee Sched Tier 3,326.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,90632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90632,BCBSND Hospital Base OP Fee Sched Tier 3,87.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,90633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90633,BCBSND Hospital Base OP Fee Sched Tier 3,47.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,90636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90636,BCBSND Hospital Base OP Fee Sched Tier 3,150.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,90647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90647,BCBSND Hospital Base OP Fee Sched Tier 3,38.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,90648,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90648,BCBSND Hospital Base OP Fee Sched Tier 3,15.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,90649,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90649,BCBSND Hospital Base OP Fee Sched Tier 3,232.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,90651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90651,BCBSND Hospital Base OP Fee Sched Tier 3,315.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,90653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90653,BCBSND Hospital Base OP Fee Sched Tier 3,69.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,90656,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90656,BCBSND Hospital Base OP Fee Sched Tier 3,25.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,90658,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90658,BCBSND Hospital Base OP Fee Sched Tier 3,23.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,90662,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90662,BCBSND Hospital Base OP Fee Sched Tier 3,68.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,90670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90670,BCBSND Hospital Base OP Fee Sched Tier 3,274.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,90672,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90672,BCBSND Hospital Base OP Fee Sched Tier 3,33.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,90674,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90674,BCBSND Hospital Base OP Fee Sched Tier 3,30.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,90675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90675,BCBSND Hospital Base OP Fee Sched Tier 3,415.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,90680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90680,BCBSND Hospital Base OP Fee Sched Tier 3,120.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,90681,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90681,BCBSND Hospital Base OP Fee Sched Tier 3,175.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,90682,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90682,BCBSND Hospital Base OP Fee Sched Tier 3,68.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,90685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90685,BCBSND Hospital Base OP Fee Sched Tier 3,27.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,90686,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90686,BCBSND Hospital Base OP Fee Sched Tier 3,24.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,90687,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90687,BCBSND Hospital Base OP Fee Sched Tier 3,12.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,90688,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90688,BCBSND Hospital Base OP Fee Sched Tier 3,22.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,90690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90690,BCBSND Hospital Base OP Fee Sched Tier 3,113.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,90691,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90691,BCBSND Hospital Base OP Fee Sched Tier 3,136.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,90696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90696,BCBSND Hospital Base OP Fee Sched Tier 3,75.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,90698,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90698,BCBSND Hospital Base OP Fee Sched Tier 3,139.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,90700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90700,BCBSND Hospital Base OP Fee Sched Tier 3,35.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,90702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90702,BCBSND Hospital Base OP Fee Sched Tier 3,79.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,90707,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90707,BCBSND Hospital Base OP Fee Sched Tier 3,108.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,90710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90710,BCBSND Hospital Base OP Fee Sched Tier 3,311.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,90713,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90713,BCBSND Hospital Base OP Fee Sched Tier 3,48.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,90714,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90714,BCBSND Hospital Base OP Fee Sched Tier 3,33.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,90715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90715,BCBSND Hospital Base OP Fee Sched Tier 3,46.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,90716,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90716,BCBSND Hospital Base OP Fee Sched Tier 3,187.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,90717,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90717,BCBSND Hospital Base OP Fee Sched Tier 3,204.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,90723,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90723,BCBSND Hospital Base OP Fee Sched Tier 3,114.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,90732,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90732,BCBSND Hospital Base OP Fee Sched Tier 3,145.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,90734,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90734,BCBSND Hospital Base OP Fee Sched Tier 3,177.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,90736,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90736,BCBSND Hospital Base OP Fee Sched Tier 3,308.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,90738,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90738,BCBSND Hospital Base OP Fee Sched Tier 3,360.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,90739,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90739,BCBSND Hospital Base OP Fee Sched Tier 3,166.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,90740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90740,BCBSND Hospital Base OP Fee Sched Tier 3,240.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,90743,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90743,BCBSND Hospital Base OP Fee Sched Tier 3,88.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,90744,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90744,BCBSND Hospital Base OP Fee Sched Tier 3,34.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,90746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90746,BCBSND Hospital Base OP Fee Sched Tier 3,85.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,90747,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90747,BCBSND Hospital Base OP Fee Sched Tier 3,171.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,90750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90750,BCBSND Hospital Base OP Fee Sched Tier 3,209.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,90756,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90756,BCBSND Hospital Base OP Fee Sched Tier 3,29.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,90785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90785,BCBSND Hospital Base OP Fee Sched Tier 3,38,,Fee schedule,,,,,,,,0
unity,Fee schedule,90791,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90791,BCBSND Hospital Base OP Fee Sched Tier 3,31.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,90792,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90792,BCBSND Hospital Base OP Fee Sched Tier 3,32.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,90832,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90832,BCBSND Hospital Base OP Fee Sched Tier 3,12.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,90833,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90833,BCBSND Hospital Base OP Fee Sched Tier 3,11.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,90834,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90834,BCBSND Hospital Base OP Fee Sched Tier 3,16.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,90836,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90836,BCBSND Hospital Base OP Fee Sched Tier 3,14.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,90837,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90837,BCBSND Hospital Base OP Fee Sched Tier 3,24.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,90838,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90838,BCBSND Hospital Base OP Fee Sched Tier 3,19,,Fee schedule,,,,,,,,0
unity,Fee schedule,90839,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90839,BCBSND Hospital Base OP Fee Sched Tier 3,24.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,90840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90840,BCBSND Hospital Base OP Fee Sched Tier 3,12.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,90845,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90845,BCBSND Hospital Base OP Fee Sched Tier 3,16.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,90846,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90846,BCBSND Hospital Base OP Fee Sched Tier 3,19,,Fee schedule,,,,,,,,0
unity,Fee schedule,90847,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90847,BCBSND Hospital Base OP Fee Sched Tier 3,19.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,90849,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90849,BCBSND Hospital Base OP Fee Sched Tier 3,27.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,90853,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90853,BCBSND Hospital Base OP Fee Sched Tier 3,5.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,90867,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90867,BCBSND Hospital Base OP Fee Sched Tier 3,425.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,90868,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90868,BCBSND Hospital Base OP Fee Sched Tier 3,526.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,90869,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90869,BCBSND Hospital Base OP Fee Sched Tier 3,1309.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,90870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90870,BCBSND Hospital Base OP Fee Sched Tier 3,770.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,90875,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90875,BCBSND Hospital Base OP Fee Sched Tier 3,18.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,90876,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90876,BCBSND Hospital Base OP Fee Sched Tier 3,28.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,90880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90880,BCBSND Hospital Base OP Fee Sched Tier 3,36.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,90887,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90887,BCBSND Hospital Base OP Fee Sched Tier 3,30.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,90899,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90899,BCBSND Hospital Base OP Fee Sched Tier 3,41.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,90901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90901,BCBSND Hospital Base OP Fee Sched Tier 3,102.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,90911,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90911,BCBSND Hospital Base OP Fee Sched Tier 3,169.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,90935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90935,BCBSND Hospital Base OP Fee Sched Tier 3,497.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,90937,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90937,BCBSND Hospital Base OP Fee Sched Tier 3,497.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,90945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90945,BCBSND Hospital Base OP Fee Sched Tier 3,213.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,90947,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90947,BCBSND Hospital Base OP Fee Sched Tier 3,213.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,90989,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90989,BCBSND Hospital Base OP Fee Sched Tier 3,1092.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,90993,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90993,BCBSND Hospital Base OP Fee Sched Tier 3,43.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,90997,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90997,BCBSND Hospital Base OP Fee Sched Tier 3,247.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,90999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,90999,BCBSND Hospital Base OP Fee Sched Tier 3,497.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,91010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91010,BCBSND Hospital Base OP Fee Sched Tier 3,457.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,91013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91013,BCBSND Hospital Base OP Fee Sched Tier 3,50.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,91020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91020,BCBSND Hospital Base OP Fee Sched Tier 3,643.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,91022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91022,BCBSND Hospital Base OP Fee Sched Tier 3,350.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,91030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91030,BCBSND Hospital Base OP Fee Sched Tier 3,337.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,91034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91034,BCBSND Hospital Base OP Fee Sched Tier 3,519.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,91035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91035,BCBSND Hospital Base OP Fee Sched Tier 3,1490.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,91037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91037,BCBSND Hospital Base OP Fee Sched Tier 3,423.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,91038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91038,BCBSND Hospital Base OP Fee Sched Tier 3,1442,,Fee schedule,,,,,,,,0
unity,Fee schedule,91040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91040,BCBSND Hospital Base OP Fee Sched Tier 3,1596.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,91065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91065,BCBSND Hospital Base OP Fee Sched Tier 3,242.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,91110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91110,BCBSND Hospital Base OP Fee Sched Tier 3,2810.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,91111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91111,BCBSND Hospital Base OP Fee Sched Tier 3,2822,,Fee schedule,,,,,,,,0
unity,Fee schedule,91112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91112,BCBSND Hospital Base OP Fee Sched Tier 3,3596.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,91117,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91117,BCBSND Hospital Base OP Fee Sched Tier 3,435.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,91120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91120,BCBSND Hospital Base OP Fee Sched Tier 3,1519.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,91122,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91122,BCBSND Hospital Base OP Fee Sched Tier 3,563.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,91132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91132,BCBSND Hospital Base OP Fee Sched Tier 3,662.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,91133,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91133,BCBSND Hospital Base OP Fee Sched Tier 3,710.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,91200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91200,BCBSND Hospital Base OP Fee Sched Tier 3,76.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,91299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,91299,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,92002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92002,BCBSND Hospital Base OP Fee Sched Tier 3,98.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,92004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92004,BCBSND Hospital Base OP Fee Sched Tier 3,141.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,92012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92012,BCBSND Hospital Base OP Fee Sched Tier 3,97.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,92014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92014,BCBSND Hospital Base OP Fee Sched Tier 3,128.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,92015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92015,BCBSND Hospital Base OP Fee Sched Tier 3,61.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,92018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92018,BCBSND Hospital Base OP Fee Sched Tier 3,3067.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,92019,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92019,BCBSND Hospital Base OP Fee Sched Tier 3,3067.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,92020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92020,BCBSND Hospital Base OP Fee Sched Tier 3,85.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,92025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92025,BCBSND Hospital Base OP Fee Sched Tier 3,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,92060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92060,BCBSND Hospital Base OP Fee Sched Tier 3,81.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92065,BCBSND Hospital Base OP Fee Sched Tier 3,109.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,92081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92081,BCBSND Hospital Base OP Fee Sched Tier 3,54.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,92082,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92082,BCBSND Hospital Base OP Fee Sched Tier 3,81.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92083,BCBSND Hospital Base OP Fee Sched Tier 3,112.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,92100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92100,BCBSND Hospital Base OP Fee Sched Tier 3,255.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,92132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92132,BCBSND Hospital Base OP Fee Sched Tier 3,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,92133,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92133,BCBSND Hospital Base OP Fee Sched Tier 3,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,92134,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92134,BCBSND Hospital Base OP Fee Sched Tier 3,47.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,92136,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92136,BCBSND Hospital Base OP Fee Sched Tier 3,119.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,92145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92145,BCBSND Hospital Base OP Fee Sched Tier 3,24.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,92225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92225,BCBSND Hospital Base OP Fee Sched Tier 3,85.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,92226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92226,BCBSND Hospital Base OP Fee Sched Tier 3,79.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,92227,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92227,BCBSND Hospital Base OP Fee Sched Tier 3,43.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,92228,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92228,BCBSND Hospital Base OP Fee Sched Tier 3,41.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,92230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92230,BCBSND Hospital Base OP Fee Sched Tier 3,201.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,92235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92235,BCBSND Hospital Base OP Fee Sched Tier 3,149.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,92240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92240,BCBSND Hospital Base OP Fee Sched Tier 3,492.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,92242,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92242,BCBSND Hospital Base OP Fee Sched Tier 3,544.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,92250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92250,BCBSND Hospital Base OP Fee Sched Tier 3,89.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,92260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92260,BCBSND Hospital Base OP Fee Sched Tier 3,60.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,92265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92265,BCBSND Hospital Base OP Fee Sched Tier 3,126.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,92270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92270,BCBSND Hospital Base OP Fee Sched Tier 3,164.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,92273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92273,BCBSND Hospital Base OP Fee Sched Tier 3,415.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,92274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92274,BCBSND Hospital Base OP Fee Sched Tier 3,281.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,92283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92283,BCBSND Hospital Base OP Fee Sched Tier 3,138.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,92284,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92284,BCBSND Hospital Base OP Fee Sched Tier 3,151.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,92285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92285,BCBSND Hospital Base OP Fee Sched Tier 3,57.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,92286,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92286,BCBSND Hospital Base OP Fee Sched Tier 3,51.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,92287,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92287,BCBSND Hospital Base OP Fee Sched Tier 3,307.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,92310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92310,BCBSND Hospital Base OP Fee Sched Tier 3,307.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,92311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92311,BCBSND Hospital Base OP Fee Sched Tier 3,323.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,92312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92312,BCBSND Hospital Base OP Fee Sched Tier 3,373.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,92313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92313,BCBSND Hospital Base OP Fee Sched Tier 3,305.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,92314,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92314,BCBSND Hospital Base OP Fee Sched Tier 3,259.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,92315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92315,BCBSND Hospital Base OP Fee Sched Tier 3,240.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,92316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92316,BCBSND Hospital Base OP Fee Sched Tier 3,299.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,92317,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92317,BCBSND Hospital Base OP Fee Sched Tier 3,251.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,92325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92325,BCBSND Hospital Base OP Fee Sched Tier 3,136.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,92326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92326,BCBSND Hospital Base OP Fee Sched Tier 3,115.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,92340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92340,BCBSND Hospital Base OP Fee Sched Tier 3,108.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,92341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92341,BCBSND Hospital Base OP Fee Sched Tier 3,125.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,92342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92342,BCBSND Hospital Base OP Fee Sched Tier 3,135.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,92352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92352,BCBSND Hospital Base OP Fee Sched Tier 3,128.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,92353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92353,BCBSND Hospital Base OP Fee Sched Tier 3,149.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,92354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92354,BCBSND Hospital Base OP Fee Sched Tier 3,41.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,92355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92355,BCBSND Hospital Base OP Fee Sched Tier 3,64.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,92358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92358,BCBSND Hospital Base OP Fee Sched Tier 3,35.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,92370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92370,BCBSND Hospital Base OP Fee Sched Tier 3,96.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,92371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92371,BCBSND Hospital Base OP Fee Sched Tier 3,36.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,92499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92499,BCBSND Hospital Base OP Fee Sched Tier 3,28.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,92502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92502,BCBSND Hospital Base OP Fee Sched Tier 3,824.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,92504,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92504,BCBSND Hospital Base OP Fee Sched Tier 3,91.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,92507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92507,BCBSND Hospital Base OP Fee Sched Tier 3,245.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,92508,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92508,BCBSND Hospital Base OP Fee Sched Tier 3,73.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,92511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92511,BCBSND Hospital Base OP Fee Sched Tier 3,277.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,92512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92512,BCBSND Hospital Base OP Fee Sched Tier 3,184.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,92516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92516,BCBSND Hospital Base OP Fee Sched Tier 3,213.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,92520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92520,BCBSND Hospital Base OP Fee Sched Tier 3,245.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,92521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92521,BCBSND Hospital Base OP Fee Sched Tier 3,352.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,92522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92522,BCBSND Hospital Base OP Fee Sched Tier 3,285.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,92523,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92523,BCBSND Hospital Base OP Fee Sched Tier 3,609.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,92524,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92524,BCBSND Hospital Base OP Fee Sched Tier 3,275.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,92526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92526,BCBSND Hospital Base OP Fee Sched Tier 3,268.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,92531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92531,BCBSND Hospital Base OP Fee Sched Tier 3,76.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,92532,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92532,BCBSND Hospital Base OP Fee Sched Tier 3,128.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,92533,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92533,BCBSND Hospital Base OP Fee Sched Tier 3,201.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,92534,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92534,BCBSND Hospital Base OP Fee Sched Tier 3,76.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,92537,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92537,BCBSND Hospital Base OP Fee Sched Tier 3,28.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,92538,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92538,BCBSND Hospital Base OP Fee Sched Tier 3,16.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,92540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92540,BCBSND Hospital Base OP Fee Sched Tier 3,76.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,92541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92541,BCBSND Hospital Base OP Fee Sched Tier 3,12.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,92542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92542,BCBSND Hospital Base OP Fee Sched Tier 3,11,,Fee schedule,,,,,,,,0
unity,Fee schedule,92544,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92544,BCBSND Hospital Base OP Fee Sched Tier 3,8.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,92545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92545,BCBSND Hospital Base OP Fee Sched Tier 3,8.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,92546,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92546,BCBSND Hospital Base OP Fee Sched Tier 3,277.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,92547,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92547,BCBSND Hospital Base OP Fee Sched Tier 3,23.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,92548,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92548,BCBSND Hospital Base OP Fee Sched Tier 3,217.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,92550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92550,BCBSND Hospital Base OP Fee Sched Tier 3,68.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,92551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92551,BCBSND Hospital Base OP Fee Sched Tier 3,36.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,92552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92552,BCBSND Hospital Base OP Fee Sched Tier 3,97.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,92553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92553,BCBSND Hospital Base OP Fee Sched Tier 3,118.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,92555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92555,BCBSND Hospital Base OP Fee Sched Tier 3,74.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,92556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92556,BCBSND Hospital Base OP Fee Sched Tier 3,117.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,92557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92557,BCBSND Hospital Base OP Fee Sched Tier 3,118.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,92558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92558,BCBSND Hospital Base OP Fee Sched Tier 3,30.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,92559,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92559,BCBSND Hospital Base OP Fee Sched Tier 3,69.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,92560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92560,BCBSND Hospital Base OP Fee Sched Tier 3,129.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,92561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92561,BCBSND Hospital Base OP Fee Sched Tier 3,120.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,92562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92562,BCBSND Hospital Base OP Fee Sched Tier 3,140.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,92563,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92563,BCBSND Hospital Base OP Fee Sched Tier 3,95.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,92564,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92564,BCBSND Hospital Base OP Fee Sched Tier 3,78.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,92565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92565,BCBSND Hospital Base OP Fee Sched Tier 3,47.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,92567,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92567,BCBSND Hospital Base OP Fee Sched Tier 3,47.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,92568,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92568,BCBSND Hospital Base OP Fee Sched Tier 3,49.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,92570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92570,BCBSND Hospital Base OP Fee Sched Tier 3,101.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,92571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92571,BCBSND Hospital Base OP Fee Sched Tier 3,83.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,92572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92572,BCBSND Hospital Base OP Fee Sched Tier 3,133.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,92575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92575,BCBSND Hospital Base OP Fee Sched Tier 3,196.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,92576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92576,BCBSND Hospital Base OP Fee Sched Tier 3,113.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,92577,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92577,BCBSND Hospital Base OP Fee Sched Tier 3,42.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,92579,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92579,BCBSND Hospital Base OP Fee Sched Tier 3,144.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,92582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92582,BCBSND Hospital Base OP Fee Sched Tier 3,226.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,92583,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92583,BCBSND Hospital Base OP Fee Sched Tier 3,148.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,92584,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92584,BCBSND Hospital Base OP Fee Sched Tier 3,229.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,92585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92585,BCBSND Hospital Base OP Fee Sched Tier 3,335.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,92586,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92586,BCBSND Hospital Base OP Fee Sched Tier 3,286.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,92587,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92587,BCBSND Hospital Base OP Fee Sched Tier 3,11,,Fee schedule,,,,,,,,0
unity,Fee schedule,92588,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92588,BCBSND Hospital Base OP Fee Sched Tier 3,13.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,92591,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92591,BCBSND Hospital Base OP Fee Sched Tier 3,169.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,92596,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92596,BCBSND Hospital Base OP Fee Sched Tier 3,207.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,92597,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92597,BCBSND Hospital Base OP Fee Sched Tier 3,226.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,92601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92601,BCBSND Hospital Base OP Fee Sched Tier 3,514.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,92602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92602,BCBSND Hospital Base OP Fee Sched Tier 3,321.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,92603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92603,BCBSND Hospital Base OP Fee Sched Tier 3,480.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,92604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92604,BCBSND Hospital Base OP Fee Sched Tier 3,285.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,92605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92605,BCBSND Hospital Base OP Fee Sched Tier 3,291.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,92606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92606,BCBSND Hospital Base OP Fee Sched Tier 3,258.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,92607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92607,BCBSND Hospital Base OP Fee Sched Tier 3,405.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,92608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92608,BCBSND Hospital Base OP Fee Sched Tier 3,161.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,92609,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92609,BCBSND Hospital Base OP Fee Sched Tier 3,338.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,92610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92610,BCBSND Hospital Base OP Fee Sched Tier 3,269.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,92611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92611,BCBSND Hospital Base OP Fee Sched Tier 3,280.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,92612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92612,BCBSND Hospital Base OP Fee Sched Tier 3,595.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,92614,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92614,BCBSND Hospital Base OP Fee Sched Tier 3,208.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,92616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92616,BCBSND Hospital Base OP Fee Sched Tier 3,294.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,92618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92618,BCBSND Hospital Base OP Fee Sched Tier 3,105.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,92620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92620,BCBSND Hospital Base OP Fee Sched Tier 3,293.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,92621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92621,BCBSND Hospital Base OP Fee Sched Tier 3,70.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92625,BCBSND Hospital Base OP Fee Sched Tier 3,218.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,92626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92626,BCBSND Hospital Base OP Fee Sched Tier 3,280.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,92627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92627,BCBSND Hospital Base OP Fee Sched Tier 3,70.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92630,BCBSND Hospital Base OP Fee Sched Tier 3,245.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,92633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92633,BCBSND Hospital Base OP Fee Sched Tier 3,245.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,92640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92640,BCBSND Hospital Base OP Fee Sched Tier 3,357.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,92700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92700,BCBSND Hospital Base OP Fee Sched Tier 3,28.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,92920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92920,BCBSND Hospital Base OP Fee Sched Tier 3,7916.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,92924,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92924,BCBSND Hospital Base OP Fee Sched Tier 3,16360.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92928,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92928,BCBSND Hospital Base OP Fee Sched Tier 3,16360.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92933,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92933,BCBSND Hospital Base OP Fee Sched Tier 3,25980.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,92937,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92937,BCBSND Hospital Base OP Fee Sched Tier 3,16360.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92941,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92941,BCBSND Hospital Base OP Fee Sched Tier 3,17489.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,92943,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92943,BCBSND Hospital Base OP Fee Sched Tier 3,16360.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92950,BCBSND Hospital Base OP Fee Sched Tier 3,980.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,92953,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92953,BCBSND Hospital Base OP Fee Sched Tier 3,3.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,92960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92960,BCBSND Hospital Base OP Fee Sched Tier 3,495.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,92961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92961,BCBSND Hospital Base OP Fee Sched Tier 3,794.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,92970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92970,BCBSND Hospital Base OP Fee Sched Tier 3,606.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,92971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92971,BCBSND Hospital Base OP Fee Sched Tier 3,319.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,92975,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92975,BCBSND Hospital Base OP Fee Sched Tier 3,1207.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,92977,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92977,BCBSND Hospital Base OP Fee Sched Tier 3,487.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,92986,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92986,BCBSND Hospital Base OP Fee Sched Tier 3,7916.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,92987,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92987,BCBSND Hospital Base OP Fee Sched Tier 3,16360.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92990,BCBSND Hospital Base OP Fee Sched Tier 3,16360.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,92997,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,92997,BCBSND Hospital Base OP Fee Sched Tier 3,16360.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,93005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93005,BCBSND Hospital Base OP Fee Sched Tier 3,26.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,93017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93017,BCBSND Hospital Base OP Fee Sched Tier 3,105.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,93024,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93024,BCBSND Hospital Base OP Fee Sched Tier 3,164.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,93041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93041,BCBSND Hospital Base OP Fee Sched Tier 3,17.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,93050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93050,BCBSND Hospital Base OP Fee Sched Tier 3,24.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,93225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93225,BCBSND Hospital Base OP Fee Sched Tier 3,80.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,93226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93226,BCBSND Hospital Base OP Fee Sched Tier 3,113.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,93228,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93228,BCBSND Hospital Base OP Fee Sched Tier 3,97.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,93229,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93229,BCBSND Hospital Base OP Fee Sched Tier 3,2632.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,93260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93260,BCBSND Hospital Base OP Fee Sched Tier 3,93.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,93261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93261,BCBSND Hospital Base OP Fee Sched Tier 3,93.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,93264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93264,BCBSND Hospital Base OP Fee Sched Tier 3,158.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93268,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93268,BCBSND Hospital Base OP Fee Sched Tier 3,626.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,93270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93270,BCBSND Hospital Base OP Fee Sched Tier 3,28.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,93271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93271,BCBSND Hospital Base OP Fee Sched Tier 3,518.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,93278,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93278,BCBSND Hospital Base OP Fee Sched Tier 3,56.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,93279,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93279,BCBSND Hospital Base OP Fee Sched Tier 3,84.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,93280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93280,BCBSND Hospital Base OP Fee Sched Tier 3,97.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,93281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93281,BCBSND Hospital Base OP Fee Sched Tier 3,98.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,93282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93282,BCBSND Hospital Base OP Fee Sched Tier 3,91.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,93283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93283,BCBSND Hospital Base OP Fee Sched Tier 3,98.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,93284,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93284,BCBSND Hospital Base OP Fee Sched Tier 3,105.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,93285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93285,BCBSND Hospital Base OP Fee Sched Tier 3,81.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,93288,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93288,BCBSND Hospital Base OP Fee Sched Tier 3,84.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,93289,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93289,BCBSND Hospital Base OP Fee Sched Tier 3,84.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,93290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93290,BCBSND Hospital Base OP Fee Sched Tier 3,75.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,93291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93291,BCBSND Hospital Base OP Fee Sched Tier 3,72.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,93292,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93292,BCBSND Hospital Base OP Fee Sched Tier 3,69.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,93293,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93293,BCBSND Hospital Base OP Fee Sched Tier 3,138.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,93294,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93294,BCBSND Hospital Base OP Fee Sched Tier 3,95.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,93295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93295,BCBSND Hospital Base OP Fee Sched Tier 3,138.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,93296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93296,BCBSND Hospital Base OP Fee Sched Tier 3,94.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,93297,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93297,BCBSND Hospital Base OP Fee Sched Tier 3,82.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,93298,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93298,BCBSND Hospital Base OP Fee Sched Tier 3,82.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,93299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93299,BCBSND Hospital Base OP Fee Sched Tier 3,66.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,93303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93303,BCBSND Hospital Base OP Fee Sched Tier 3,532.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,93304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93304,BCBSND Hospital Base OP Fee Sched Tier 3,383.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,93306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93306,BCBSND Hospital Base OP Fee Sched Tier 3,496.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,93307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93307,BCBSND Hospital Base OP Fee Sched Tier 3,295.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,93308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93308,BCBSND Hospital Base OP Fee Sched Tier 3,225.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,93312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93312,BCBSND Hospital Base OP Fee Sched Tier 3,424.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,93313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93313,BCBSND Hospital Base OP Fee Sched Tier 3,36.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,93315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93315,BCBSND Hospital Base OP Fee Sched Tier 3,839.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,93316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93316,BCBSND Hospital Base OP Fee Sched Tier 3,86.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,93318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93318,BCBSND Hospital Base OP Fee Sched Tier 3,839.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,93320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93320,BCBSND Hospital Base OP Fee Sched Tier 3,108.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,93321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93321,BCBSND Hospital Base OP Fee Sched Tier 3,60.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,93325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93325,BCBSND Hospital Base OP Fee Sched Tier 3,68.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,93350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93350,BCBSND Hospital Base OP Fee Sched Tier 3,361.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,93351,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93351,BCBSND Hospital Base OP Fee Sched Tier 3,547.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,93352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93352,BCBSND Hospital Base OP Fee Sched Tier 3,125.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,93451,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93451,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93452,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93453,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93453,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93454,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93454,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93455,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93456,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93457,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93457,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93458,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93458,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93459,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93459,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93460,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93461,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93461,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93503,BCBSND Hospital Base OP Fee Sched Tier 3,1850.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,93505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93505,BCBSND Hospital Base OP Fee Sched Tier 3,4469.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,93530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93530,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93531,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93532,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93532,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93533,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93533,BCBSND Hospital Base OP Fee Sched Tier 3,4755.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,93561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93561,BCBSND Hospital Base OP Fee Sched Tier 3,72.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,93562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93562,BCBSND Hospital Base OP Fee Sched Tier 3,45.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,93571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93571,BCBSND Hospital Base OP Fee Sched Tier 3,603.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,93572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93572,BCBSND Hospital Base OP Fee Sched Tier 3,303.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,93580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93580,BCBSND Hospital Base OP Fee Sched Tier 3,25980.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,93581,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93581,BCBSND Hospital Base OP Fee Sched Tier 3,25980.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,93582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93582,BCBSND Hospital Base OP Fee Sched Tier 3,25980.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,93590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93590,BCBSND Hospital Base OP Fee Sched Tier 3,25980.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,93591,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93591,BCBSND Hospital Base OP Fee Sched Tier 3,25980.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,93600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93600,BCBSND Hospital Base OP Fee Sched Tier 3,8624.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93602,BCBSND Hospital Base OP Fee Sched Tier 3,8624.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93603,BCBSND Hospital Base OP Fee Sched Tier 3,1555.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,93610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93610,BCBSND Hospital Base OP Fee Sched Tier 3,8624.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93612,BCBSND Hospital Base OP Fee Sched Tier 3,8624.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93615,BCBSND Hospital Base OP Fee Sched Tier 3,1555.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,93616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93616,BCBSND Hospital Base OP Fee Sched Tier 3,1555.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,93618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93618,BCBSND Hospital Base OP Fee Sched Tier 3,1555.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,93619,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93619,BCBSND Hospital Base OP Fee Sched Tier 3,8624.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93620,BCBSND Hospital Base OP Fee Sched Tier 3,8624.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93624,BCBSND Hospital Base OP Fee Sched Tier 3,8624.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93642,BCBSND Hospital Base OP Fee Sched Tier 3,1555.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,93650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93650,BCBSND Hospital Base OP Fee Sched Tier 3,8624.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93653,BCBSND Hospital Base OP Fee Sched Tier 3,32510.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,93654,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93654,BCBSND Hospital Base OP Fee Sched Tier 3,32510.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,93656,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93656,BCBSND Hospital Base OP Fee Sched Tier 3,32510.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,93660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93660,BCBSND Hospital Base OP Fee Sched Tier 3,770.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,93701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93701,BCBSND Hospital Base OP Fee Sched Tier 3,78.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,93702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93702,BCBSND Hospital Base OP Fee Sched Tier 3,392.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,93724,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93724,BCBSND Hospital Base OP Fee Sched Tier 3,103.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,93740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93740,BCBSND Hospital Base OP Fee Sched Tier 3,25.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,93745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93745,BCBSND Hospital Base OP Fee Sched Tier 3,84.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,93750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93750,BCBSND Hospital Base OP Fee Sched Tier 3,25.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,93784,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93784,BCBSND Hospital Base OP Fee Sched Tier 3,166.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,93786,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93786,BCBSND Hospital Base OP Fee Sched Tier 3,91.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,93788,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93788,BCBSND Hospital Base OP Fee Sched Tier 3,16.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,93792,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93792,BCBSND Hospital Base OP Fee Sched Tier 3,162.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,93793,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93793,BCBSND Hospital Base OP Fee Sched Tier 3,37.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,93797,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93797,BCBSND Hospital Base OP Fee Sched Tier 3,50.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,93798,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93798,BCBSND Hospital Base OP Fee Sched Tier 3,79.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,93799,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93799,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,93880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93880,BCBSND Hospital Base OP Fee Sched Tier 3,501.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,93882,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93882,BCBSND Hospital Base OP Fee Sched Tier 3,322.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,93886,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93886,BCBSND Hospital Base OP Fee Sched Tier 3,695.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,93888,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93888,BCBSND Hospital Base OP Fee Sched Tier 3,410.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,93890,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93890,BCBSND Hospital Base OP Fee Sched Tier 3,699.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,93892,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93892,BCBSND Hospital Base OP Fee Sched Tier 3,780.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,93893,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93893,BCBSND Hospital Base OP Fee Sched Tier 3,890.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,93922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93922,BCBSND Hospital Base OP Fee Sched Tier 3,228.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,93923,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93923,BCBSND Hospital Base OP Fee Sched Tier 3,346.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,93924,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93924,BCBSND Hospital Base OP Fee Sched Tier 3,436.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,93925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93925,BCBSND Hospital Base OP Fee Sched Tier 3,673.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,93926,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93926,BCBSND Hospital Base OP Fee Sched Tier 3,392.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,93930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93930,BCBSND Hospital Base OP Fee Sched Tier 3,515.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,93931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93931,BCBSND Hospital Base OP Fee Sched Tier 3,322.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,93970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93970,BCBSND Hospital Base OP Fee Sched Tier 3,499.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,93971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93971,BCBSND Hospital Base OP Fee Sched Tier 3,305.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,93975,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93975,BCBSND Hospital Base OP Fee Sched Tier 3,686.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,93976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93976,BCBSND Hospital Base OP Fee Sched Tier 3,385.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,93978,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93978,BCBSND Hospital Base OP Fee Sched Tier 3,463.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,93979,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93979,BCBSND Hospital Base OP Fee Sched Tier 3,296.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,93980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93980,BCBSND Hospital Base OP Fee Sched Tier 3,194.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,93981,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93981,BCBSND Hospital Base OP Fee Sched Tier 3,168.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,93990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93990,BCBSND Hospital Base OP Fee Sched Tier 3,408.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,93998,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,93998,BCBSND Hospital Base OP Fee Sched Tier 3,28.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,94002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94002,BCBSND Hospital Base OP Fee Sched Tier 3,290.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,94003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94003,BCBSND Hospital Base OP Fee Sched Tier 3,207.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,94004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94004,BCBSND Hospital Base OP Fee Sched Tier 3,153.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,94005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94005,BCBSND Hospital Base OP Fee Sched Tier 3,286.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,94010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94010,BCBSND Hospital Base OP Fee Sched Tier 3,83.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,94011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94011,BCBSND Hospital Base OP Fee Sched Tier 3,272.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,94012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94012,BCBSND Hospital Base OP Fee Sched Tier 3,441.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,94013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94013,BCBSND Hospital Base OP Fee Sched Tier 3,60.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,94014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94014,BCBSND Hospital Base OP Fee Sched Tier 3,173.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,94015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94015,BCBSND Hospital Base OP Fee Sched Tier 3,94.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,94016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94016,BCBSND Hospital Base OP Fee Sched Tier 3,79.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,94060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94060,BCBSND Hospital Base OP Fee Sched Tier 3,144.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,94070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94070,BCBSND Hospital Base OP Fee Sched Tier 3,95.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,94150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94150,BCBSND Hospital Base OP Fee Sched Tier 3,67.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,94200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94200,BCBSND Hospital Base OP Fee Sched Tier 3,68.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,94250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94250,BCBSND Hospital Base OP Fee Sched Tier 3,68.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,94375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94375,BCBSND Hospital Base OP Fee Sched Tier 3,76.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,94400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94400,BCBSND Hospital Base OP Fee Sched Tier 3,115.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,94450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94450,BCBSND Hospital Base OP Fee Sched Tier 3,163.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,94452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94452,BCBSND Hospital Base OP Fee Sched Tier 3,125.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,94453,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94453,BCBSND Hospital Base OP Fee Sched Tier 3,175.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,94610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94610,BCBSND Hospital Base OP Fee Sched Tier 3,174.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,94617,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94617,BCBSND Hospital Base OP Fee Sched Tier 3,188,,Fee schedule,,,,,,,,0
unity,Fee schedule,94618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94618,BCBSND Hospital Base OP Fee Sched Tier 3,34.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,94621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94621,BCBSND Hospital Base OP Fee Sched Tier 3,283.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,94640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94640,BCBSND Hospital Base OP Fee Sched Tier 3,56.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,94642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94642,BCBSND Hospital Base OP Fee Sched Tier 3,323.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,94644,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94644,BCBSND Hospital Base OP Fee Sched Tier 3,153.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,94645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94645,BCBSND Hospital Base OP Fee Sched Tier 3,51.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,94660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94660,BCBSND Hospital Base OP Fee Sched Tier 3,199,,Fee schedule,,,,,,,,0
unity,Fee schedule,94664,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94664,BCBSND Hospital Base OP Fee Sched Tier 3,52.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,94667,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94667,BCBSND Hospital Base OP Fee Sched Tier 3,78.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,94668,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94668,BCBSND Hospital Base OP Fee Sched Tier 3,101.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,94669,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94669,BCBSND Hospital Base OP Fee Sched Tier 3,98.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,94680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94680,BCBSND Hospital Base OP Fee Sched Tier 3,133.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,94681,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94681,BCBSND Hospital Base OP Fee Sched Tier 3,138.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,94690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94690,BCBSND Hospital Base OP Fee Sched Tier 3,151.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,94726,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94726,BCBSND Hospital Base OP Fee Sched Tier 3,128.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,94727,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94727,BCBSND Hospital Base OP Fee Sched Tier 3,96.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,94728,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94728,BCBSND Hospital Base OP Fee Sched Tier 3,86.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,94729,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94729,BCBSND Hospital Base OP Fee Sched Tier 3,142.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,94762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94762,BCBSND Hospital Base OP Fee Sched Tier 3,78.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,94770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94770,BCBSND Hospital Base OP Fee Sched Tier 3,23.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,94772,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94772,BCBSND Hospital Base OP Fee Sched Tier 3,273.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,94774,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94774,BCBSND Hospital Base OP Fee Sched Tier 3,626.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,94775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94775,BCBSND Hospital Base OP Fee Sched Tier 3,28.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,94776,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94776,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,94777,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,94777,BCBSND Hospital Base OP Fee Sched Tier 3,79.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,95004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95004,BCBSND Hospital Base OP Fee Sched Tier 3,13.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,95012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95012,BCBSND Hospital Base OP Fee Sched Tier 3,62.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,95017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95017,BCBSND Hospital Base OP Fee Sched Tier 3,25.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,95018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95018,BCBSND Hospital Base OP Fee Sched Tier 3,67.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,95024,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95024,BCBSND Hospital Base OP Fee Sched Tier 3,25.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,95027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95027,BCBSND Hospital Base OP Fee Sched Tier 3,14.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,95028,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95028,BCBSND Hospital Base OP Fee Sched Tier 3,40.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,95044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95044,BCBSND Hospital Base OP Fee Sched Tier 3,17.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,95052,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95052,BCBSND Hospital Base OP Fee Sched Tier 3,20.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,95056,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95056,BCBSND Hospital Base OP Fee Sched Tier 3,144.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,95060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95060,BCBSND Hospital Base OP Fee Sched Tier 3,108.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,95065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95065,BCBSND Hospital Base OP Fee Sched Tier 3,81.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,95070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95070,BCBSND Hospital Base OP Fee Sched Tier 3,98.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,95071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95071,BCBSND Hospital Base OP Fee Sched Tier 3,115.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,95076,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95076,BCBSND Hospital Base OP Fee Sched Tier 3,377.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,95079,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95079,BCBSND Hospital Base OP Fee Sched Tier 3,266.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,95115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95115,BCBSND Hospital Base OP Fee Sched Tier 3,28.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,95117,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95117,BCBSND Hospital Base OP Fee Sched Tier 3,32.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,95120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95120,BCBSND Hospital Base OP Fee Sched Tier 3,72.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,95125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95125,BCBSND Hospital Base OP Fee Sched Tier 3,76.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,95144,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95144,BCBSND Hospital Base OP Fee Sched Tier 3,45.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,95145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95145,BCBSND Hospital Base OP Fee Sched Tier 3,89.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,95146,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95146,BCBSND Hospital Base OP Fee Sched Tier 3,164.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,95147,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95147,BCBSND Hospital Base OP Fee Sched Tier 3,170.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,95148,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95148,BCBSND Hospital Base OP Fee Sched Tier 3,245.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,95149,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95149,BCBSND Hospital Base OP Fee Sched Tier 3,326.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,95165,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95165,BCBSND Hospital Base OP Fee Sched Tier 3,43.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,95170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95170,BCBSND Hospital Base OP Fee Sched Tier 3,32.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,95180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95180,BCBSND Hospital Base OP Fee Sched Tier 3,430.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,95199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95199,BCBSND Hospital Base OP Fee Sched Tier 3,28.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,95249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95249,BCBSND Hospital Base OP Fee Sched Tier 3,171.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,95250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95250,BCBSND Hospital Base OP Fee Sched Tier 3,468.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,95782,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95782,BCBSND Hospital Base OP Fee Sched Tier 3,2426.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,95783,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95783,BCBSND Hospital Base OP Fee Sched Tier 3,2573.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,95800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95800,BCBSND Hospital Base OP Fee Sched Tier 3,394.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,95801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95801,BCBSND Hospital Base OP Fee Sched Tier 3,151.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,95803,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95803,BCBSND Hospital Base OP Fee Sched Tier 3,370.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,95805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95805,BCBSND Hospital Base OP Fee Sched Tier 3,1120.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,95806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95806,BCBSND Hospital Base OP Fee Sched Tier 3,273.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,95807,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95807,BCBSND Hospital Base OP Fee Sched Tier 3,1142.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,95808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95808,BCBSND Hospital Base OP Fee Sched Tier 3,1809.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,95810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95810,BCBSND Hospital Base OP Fee Sched Tier 3,1528.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,95811,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95811,BCBSND Hospital Base OP Fee Sched Tier 3,1606.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,95812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95812,BCBSND Hospital Base OP Fee Sched Tier 3,828.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,95813,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95813,BCBSND Hospital Base OP Fee Sched Tier 3,982.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,95816,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95816,BCBSND Hospital Base OP Fee Sched Tier 3,947.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,95819,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95819,BCBSND Hospital Base OP Fee Sched Tier 3,1146.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,95822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95822,BCBSND Hospital Base OP Fee Sched Tier 3,1015.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,95824,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95824,BCBSND Hospital Base OP Fee Sched Tier 3,124.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,95827,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95827,BCBSND Hospital Base OP Fee Sched Tier 3,1714,,Fee schedule,,,,,,,,0
unity,Fee schedule,95830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95830,BCBSND Hospital Base OP Fee Sched Tier 3,1206.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,95831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95831,BCBSND Hospital Base OP Fee Sched Tier 3,101.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,95832,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95832,BCBSND Hospital Base OP Fee Sched Tier 3,100.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,95833,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95833,BCBSND Hospital Base OP Fee Sched Tier 3,131.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,95834,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95834,BCBSND Hospital Base OP Fee Sched Tier 3,172.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,95836,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95836,BCBSND Hospital Base OP Fee Sched Tier 3,345.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,95851,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95851,BCBSND Hospital Base OP Fee Sched Tier 3,64.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,95852,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95852,BCBSND Hospital Base OP Fee Sched Tier 3,58.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,95857,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95857,BCBSND Hospital Base OP Fee Sched Tier 3,169.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,95860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95860,BCBSND Hospital Base OP Fee Sched Tier 3,215.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,95861,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95861,BCBSND Hospital Base OP Fee Sched Tier 3,279.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,95863,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95863,BCBSND Hospital Base OP Fee Sched Tier 3,362.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,95864,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95864,BCBSND Hospital Base OP Fee Sched Tier 3,441.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,95865,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95865,BCBSND Hospital Base OP Fee Sched Tier 3,205.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,95866,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95866,BCBSND Hospital Base OP Fee Sched Tier 3,215.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,95867,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95867,BCBSND Hospital Base OP Fee Sched Tier 3,196.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,95868,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95868,BCBSND Hospital Base OP Fee Sched Tier 3,233.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,95869,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95869,BCBSND Hospital Base OP Fee Sched Tier 3,230.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,95870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95870,BCBSND Hospital Base OP Fee Sched Tier 3,220.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,95872,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95872,BCBSND Hospital Base OP Fee Sched Tier 3,135.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,95875,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95875,BCBSND Hospital Base OP Fee Sched Tier 3,226.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,95885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95885,BCBSND Hospital Base OP Fee Sched Tier 3,130.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,95886,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95886,BCBSND Hospital Base OP Fee Sched Tier 3,149.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,95887,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95887,BCBSND Hospital Base OP Fee Sched Tier 3,137.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,95905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95905,BCBSND Hospital Base OP Fee Sched Tier 3,189.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,95907,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95907,BCBSND Hospital Base OP Fee Sched Tier 3,130.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,95908,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95908,BCBSND Hospital Base OP Fee Sched Tier 3,174.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,95909,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95909,BCBSND Hospital Base OP Fee Sched Tier 3,208.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,95910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95910,BCBSND Hospital Base OP Fee Sched Tier 3,268.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,95911,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95911,BCBSND Hospital Base OP Fee Sched Tier 3,306.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,95912,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95912,BCBSND Hospital Base OP Fee Sched Tier 3,316.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,95913,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95913,BCBSND Hospital Base OP Fee Sched Tier 3,350.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,95921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95921,BCBSND Hospital Base OP Fee Sched Tier 3,117.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,95922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95922,BCBSND Hospital Base OP Fee Sched Tier 3,146.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,95923,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95923,BCBSND Hospital Base OP Fee Sched Tier 3,256.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,95924,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95924,BCBSND Hospital Base OP Fee Sched Tier 3,188,,Fee schedule,,,,,,,,0
unity,Fee schedule,95925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95925,BCBSND Hospital Base OP Fee Sched Tier 3,323.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,95926,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95926,BCBSND Hospital Base OP Fee Sched Tier 3,311.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,95927,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95927,BCBSND Hospital Base OP Fee Sched Tier 3,325.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,95928,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95928,BCBSND Hospital Base OP Fee Sched Tier 3,432.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,95929,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95929,BCBSND Hospital Base OP Fee Sched Tier 3,447.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,95930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95930,BCBSND Hospital Base OP Fee Sched Tier 3,153.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,95933,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95933,BCBSND Hospital Base OP Fee Sched Tier 3,153.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,95937,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95937,BCBSND Hospital Base OP Fee Sched Tier 3,164.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,95938,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95938,BCBSND Hospital Base OP Fee Sched Tier 3,931.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,95939,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95939,BCBSND Hospital Base OP Fee Sched Tier 3,1223.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,95943,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95943,BCBSND Hospital Base OP Fee Sched Tier 3,263.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,95950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95950,BCBSND Hospital Base OP Fee Sched Tier 3,662.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,95951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95951,BCBSND Hospital Base OP Fee Sched Tier 3,1540.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,95953,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95953,BCBSND Hospital Base OP Fee Sched Tier 3,866.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,95954,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95954,BCBSND Hospital Base OP Fee Sched Tier 3,881.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,95956,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95956,BCBSND Hospital Base OP Fee Sched Tier 3,3933.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,95957,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95957,BCBSND Hospital Base OP Fee Sched Tier 3,513.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,95958,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95958,BCBSND Hospital Base OP Fee Sched Tier 3,1084.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,95961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95961,BCBSND Hospital Base OP Fee Sched Tier 3,445.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,95962,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95962,BCBSND Hospital Base OP Fee Sched Tier 3,275.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,95965,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95965,BCBSND Hospital Base OP Fee Sched Tier 3,1540.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,95970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95970,BCBSND Hospital Base OP Fee Sched Tier 3,59.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,95971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95971,BCBSND Hospital Base OP Fee Sched Tier 3,158.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,95972,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95972,BCBSND Hospital Base OP Fee Sched Tier 3,178.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,95976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95976,BCBSND Hospital Base OP Fee Sched Tier 3,127.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,95977,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95977,BCBSND Hospital Base OP Fee Sched Tier 3,169.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,95981,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95981,BCBSND Hospital Base OP Fee Sched Tier 3,106.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,95982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95982,BCBSND Hospital Base OP Fee Sched Tier 3,170.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,95983,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95983,BCBSND Hospital Base OP Fee Sched Tier 3,160.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,95984,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95984,BCBSND Hospital Base OP Fee Sched Tier 3,139.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,95990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95990,BCBSND Hospital Base OP Fee Sched Tier 3,487.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,95991,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95991,BCBSND Hospital Base OP Fee Sched Tier 3,418.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,95992,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95992,BCBSND Hospital Base OP Fee Sched Tier 3,164.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,95999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,95999,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,96000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96000,BCBSND Hospital Base OP Fee Sched Tier 3,299.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,96001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96001,BCBSND Hospital Base OP Fee Sched Tier 3,401.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,96002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96002,BCBSND Hospital Base OP Fee Sched Tier 3,69.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,96003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96003,BCBSND Hospital Base OP Fee Sched Tier 3,53.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96004,BCBSND Hospital Base OP Fee Sched Tier 3,286.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,96020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96020,BCBSND Hospital Base OP Fee Sched Tier 3,234.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,96040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96040,BCBSND Hospital Base OP Fee Sched Tier 3,142.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,96105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96105,BCBSND Hospital Base OP Fee Sched Tier 3,325.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,96110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96110,BCBSND Hospital Base OP Fee Sched Tier 3,30.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,96112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96112,BCBSND Hospital Base OP Fee Sched Tier 3,421.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,96113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96113,BCBSND Hospital Base OP Fee Sched Tier 3,188,,Fee schedule,,,,,,,,0
unity,Fee schedule,96116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96116,BCBSND Hospital Base OP Fee Sched Tier 3,296.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,96121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96121,BCBSND Hospital Base OP Fee Sched Tier 3,236.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,96125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96125,BCBSND Hospital Base OP Fee Sched Tier 3,343.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,96127,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96127,BCBSND Hospital Base OP Fee Sched Tier 3,16.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96130,BCBSND Hospital Base OP Fee Sched Tier 3,362.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,96131,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96131,BCBSND Hospital Base OP Fee Sched Tier 3,255.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,96132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96132,BCBSND Hospital Base OP Fee Sched Tier 3,407.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,96133,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96133,BCBSND Hospital Base OP Fee Sched Tier 3,288.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,96136,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96136,BCBSND Hospital Base OP Fee Sched Tier 3,146.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,96137,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96137,BCBSND Hospital Base OP Fee Sched Tier 3,125.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,96138,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96138,BCBSND Hospital Base OP Fee Sched Tier 3,118.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,96139,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96139,BCBSND Hospital Base OP Fee Sched Tier 3,109.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,96146,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96146,BCBSND Hospital Base OP Fee Sched Tier 3,6.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,96150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96150,BCBSND Hospital Base OP Fee Sched Tier 3,71.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,96151,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96151,BCBSND Hospital Base OP Fee Sched Tier 3,70.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,96152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96152,BCBSND Hospital Base OP Fee Sched Tier 3,64.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96153,BCBSND Hospital Base OP Fee Sched Tier 3,15.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,96154,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96154,BCBSND Hospital Base OP Fee Sched Tier 3,63.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,96155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96155,BCBSND Hospital Base OP Fee Sched Tier 3,70.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,96160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96160,BCBSND Hospital Base OP Fee Sched Tier 3,9.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,96161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96161,BCBSND Hospital Base OP Fee Sched Tier 3,9.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,96360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96360,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96361,BCBSND Hospital Base OP Fee Sched Tier 3,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,96365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96365,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96366,BCBSND Hospital Base OP Fee Sched Tier 3,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,96367,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96367,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96369,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96369,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96370,BCBSND Hospital Base OP Fee Sched Tier 3,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,96371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96371,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96372,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96373,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96374,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96374,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96375,BCBSND Hospital Base OP Fee Sched Tier 3,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,96377,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96377,BCBSND Hospital Base OP Fee Sched Tier 3,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,96379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96379,BCBSND Hospital Base OP Fee Sched Tier 3,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,96401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96401,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96402,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96405,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96406,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96409,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96409,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96411,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96411,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96413,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96413,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96415,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96416,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96417,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96417,BCBSND Hospital Base OP Fee Sched Tier 3,104.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96420,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96422,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96422,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96423,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96423,BCBSND Hospital Base OP Fee Sched Tier 3,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,96425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96425,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96440,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96446,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96450,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96521,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96522,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96523,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96523,BCBSND Hospital Base OP Fee Sched Tier 3,98.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96542,BCBSND Hospital Base OP Fee Sched Tier 3,328.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,96549,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96549,BCBSND Hospital Base OP Fee Sched Tier 3,66.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,96567,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96567,BCBSND Hospital Base OP Fee Sched Tier 3,384.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,96570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96570,BCBSND Hospital Base OP Fee Sched Tier 3,162.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,96571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96571,BCBSND Hospital Base OP Fee Sched Tier 3,91.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,96573,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96573,BCBSND Hospital Base OP Fee Sched Tier 3,626.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,96574,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96574,BCBSND Hospital Base OP Fee Sched Tier 3,797.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,96900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96900,BCBSND Hospital Base OP Fee Sched Tier 3,67.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,96902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96902,BCBSND Hospital Base OP Fee Sched Tier 3,68.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,96904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96904,BCBSND Hospital Base OP Fee Sched Tier 3,200.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,96910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96910,BCBSND Hospital Base OP Fee Sched Tier 3,356.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,96912,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96912,BCBSND Hospital Base OP Fee Sched Tier 3,302.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,96913,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96913,BCBSND Hospital Base OP Fee Sched Tier 3,429.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,96920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96920,BCBSND Hospital Base OP Fee Sched Tier 3,298.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,96921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96921,BCBSND Hospital Base OP Fee Sched Tier 3,298.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,96922,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96922,BCBSND Hospital Base OP Fee Sched Tier 3,531.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,96932,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96932,BCBSND Hospital Base OP Fee Sched Tier 3,385.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,96999,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,96999,BCBSND Hospital Base OP Fee Sched Tier 3,298.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,97010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97010,BCBSND Hospital Base OP Fee Sched Tier 3,19.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,97012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97012,BCBSND Hospital Base OP Fee Sched Tier 3,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,97014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97014,BCBSND Hospital Base OP Fee Sched Tier 3,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,97016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97016,BCBSND Hospital Base OP Fee Sched Tier 3,39.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,97018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97018,BCBSND Hospital Base OP Fee Sched Tier 3,21.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,97022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97022,BCBSND Hospital Base OP Fee Sched Tier 3,56.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,97024,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97024,BCBSND Hospital Base OP Fee Sched Tier 3,21.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,97026,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97026,BCBSND Hospital Base OP Fee Sched Tier 3,19.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,97028,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97028,BCBSND Hospital Base OP Fee Sched Tier 3,25.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,97032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97032,BCBSND Hospital Base OP Fee Sched Tier 3,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,97033,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97033,BCBSND Hospital Base OP Fee Sched Tier 3,64.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,97034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97034,BCBSND Hospital Base OP Fee Sched Tier 3,47.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,97035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97035,BCBSND Hospital Base OP Fee Sched Tier 3,42.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,97036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97036,BCBSND Hospital Base OP Fee Sched Tier 3,108.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,97039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97039,BCBSND Hospital Base OP Fee Sched Tier 3,39.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,97110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97110,BCBSND Hospital Base OP Fee Sched Tier 3,95.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,97112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97112,BCBSND Hospital Base OP Fee Sched Tier 3,108.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,97113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97113,BCBSND Hospital Base OP Fee Sched Tier 3,120.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,97116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97116,BCBSND Hospital Base OP Fee Sched Tier 3,94.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,97124,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97124,BCBSND Hospital Base OP Fee Sched Tier 3,89.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,97127,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97127,BCBSND Hospital Base OP Fee Sched Tier 3,270.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,97139,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97139,BCBSND Hospital Base OP Fee Sched Tier 3,52.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,97140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97140,BCBSND Hospital Base OP Fee Sched Tier 3,86.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,97150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97150,BCBSND Hospital Base OP Fee Sched Tier 3,57.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,97151,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97151,BCBSND Hospital Base OP Fee Sched Tier 3,71.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,97152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97152,BCBSND Hospital Base OP Fee Sched Tier 3,52.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,97153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97153,BCBSND Hospital Base OP Fee Sched Tier 3,21.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,97154,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97154,BCBSND Hospital Base OP Fee Sched Tier 3,4.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,97155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97155,BCBSND Hospital Base OP Fee Sched Tier 3,45.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,97156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97156,BCBSND Hospital Base OP Fee Sched Tier 3,44.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,97157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97157,BCBSND Hospital Base OP Fee Sched Tier 3,44.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,97161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97161,BCBSND Hospital Base OP Fee Sched Tier 3,263.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,97162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97162,BCBSND Hospital Base OP Fee Sched Tier 3,263.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,97163,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97163,BCBSND Hospital Base OP Fee Sched Tier 3,263.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,97164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97164,BCBSND Hospital Base OP Fee Sched Tier 3,179.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,97165,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97165,BCBSND Hospital Base OP Fee Sched Tier 3,283.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,97166,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97166,BCBSND Hospital Base OP Fee Sched Tier 3,283.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,97167,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97167,BCBSND Hospital Base OP Fee Sched Tier 3,283.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,97168,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97168,BCBSND Hospital Base OP Fee Sched Tier 3,194.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,97530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97530,BCBSND Hospital Base OP Fee Sched Tier 3,124.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,97533,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97533,BCBSND Hospital Base OP Fee Sched Tier 3,133.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,97535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97535,BCBSND Hospital Base OP Fee Sched Tier 3,106.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,97537,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97537,BCBSND Hospital Base OP Fee Sched Tier 3,102.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,97542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97542,BCBSND Hospital Base OP Fee Sched Tier 3,103.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,97597,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97597,BCBSND Hospital Base OP Fee Sched Tier 3,277.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,97598,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97598,BCBSND Hospital Base OP Fee Sched Tier 3,86.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,97602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97602,BCBSND Hospital Base OP Fee Sched Tier 3,297.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,97605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97605,BCBSND Hospital Base OP Fee Sched Tier 3,136.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,97606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97606,BCBSND Hospital Base OP Fee Sched Tier 3,160.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,97607,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97607,BCBSND Hospital Base OP Fee Sched Tier 3,136.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,97608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97608,BCBSND Hospital Base OP Fee Sched Tier 3,160.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,97610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97610,BCBSND Hospital Base OP Fee Sched Tier 3,702.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,97750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97750,BCBSND Hospital Base OP Fee Sched Tier 3,108.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,97755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97755,BCBSND Hospital Base OP Fee Sched Tier 3,118.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,97760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97760,BCBSND Hospital Base OP Fee Sched Tier 3,148.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,97761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97761,BCBSND Hospital Base OP Fee Sched Tier 3,127.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,97763,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97763,BCBSND Hospital Base OP Fee Sched Tier 3,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,97802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97802,BCBSND Hospital Base OP Fee Sched Tier 3,115.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,97803,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97803,BCBSND Hospital Base OP Fee Sched Tier 3,100.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,97804,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97804,BCBSND Hospital Base OP Fee Sched Tier 3,52.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,97810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97810,BCBSND Hospital Base OP Fee Sched Tier 3,101.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,97811,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97811,BCBSND Hospital Base OP Fee Sched Tier 3,76.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,97813,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97813,BCBSND Hospital Base OP Fee Sched Tier 3,111.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,97814,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,97814,BCBSND Hospital Base OP Fee Sched Tier 3,89.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,98925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98925,BCBSND Hospital Base OP Fee Sched Tier 3,18.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,98926,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98926,BCBSND Hospital Base OP Fee Sched Tier 3,22.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,98927,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98927,BCBSND Hospital Base OP Fee Sched Tier 3,28.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,98928,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98928,BCBSND Hospital Base OP Fee Sched Tier 3,30.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,98929,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98929,BCBSND Hospital Base OP Fee Sched Tier 3,34.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,98940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98940,BCBSND Hospital Base OP Fee Sched Tier 3,14.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,98941,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98941,BCBSND Hospital Base OP Fee Sched Tier 3,15.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,98942,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98942,BCBSND Hospital Base OP Fee Sched Tier 3,14.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,98943,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98943,BCBSND Hospital Base OP Fee Sched Tier 3,8.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,98960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98960,BCBSND Hospital Base OP Fee Sched Tier 3,84.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,98961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98961,BCBSND Hospital Base OP Fee Sched Tier 3,41.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,98962,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98962,BCBSND Hospital Base OP Fee Sched Tier 3,30.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,98966,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98966,BCBSND Hospital Base OP Fee Sched Tier 3,42.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,98967,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98967,BCBSND Hospital Base OP Fee Sched Tier 3,83.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,98968,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,98968,BCBSND Hospital Base OP Fee Sched Tier 3,123.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,99170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99170,BCBSND Hospital Base OP Fee Sched Tier 3,280.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,99172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99172,BCBSND Hospital Base OP Fee Sched Tier 3,8.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,99173,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99173,BCBSND Hospital Base OP Fee Sched Tier 3,8.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,99174,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99174,BCBSND Hospital Base OP Fee Sched Tier 3,17.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,99175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99175,BCBSND Hospital Base OP Fee Sched Tier 3,80.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,99177,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99177,BCBSND Hospital Base OP Fee Sched Tier 3,14.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,99183,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99183,BCBSND Hospital Base OP Fee Sched Tier 3,343.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,99184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99184,BCBSND Hospital Base OP Fee Sched Tier 3,695.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,99190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99190,BCBSND Hospital Base OP Fee Sched Tier 3,485.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,99191,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99191,BCBSND Hospital Base OP Fee Sched Tier 3,300.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,99192,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99192,BCBSND Hospital Base OP Fee Sched Tier 3,222.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,99195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99195,BCBSND Hospital Base OP Fee Sched Tier 3,314.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,99201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99201,BCBSND Hospital Base OP Fee Sched Tier 3,47.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,99202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99202,BCBSND Hospital Base OP Fee Sched Tier 3,65.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,99203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99203,BCBSND Hospital Base OP Fee Sched Tier 3,81.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,99204,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99204,BCBSND Hospital Base OP Fee Sched Tier 3,89.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,99205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99205,BCBSND Hospital Base OP Fee Sched Tier 3,96.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,99211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99211,BCBSND Hospital Base OP Fee Sched Tier 3,34.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,99212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99212,BCBSND Hospital Base OP Fee Sched Tier 3,49.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,99213,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99213,BCBSND Hospital Base OP Fee Sched Tier 3,58.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,99214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99214,BCBSND Hospital Base OP Fee Sched Tier 3,76,,Fee schedule,,,,,,,,0
unity,Fee schedule,99215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99215,BCBSND Hospital Base OP Fee Sched Tier 3,87.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,99241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99241,BCBSND Hospital Base OP Fee Sched Tier 3,38,,Fee schedule,,,,,,,,0
unity,Fee schedule,99242,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99242,BCBSND Hospital Base OP Fee Sched Tier 3,53.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,99243,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99243,BCBSND Hospital Base OP Fee Sched Tier 3,67.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,99244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99244,BCBSND Hospital Base OP Fee Sched Tier 3,74.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,99245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99245,BCBSND Hospital Base OP Fee Sched Tier 3,83.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,99281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99281,BCBSND Hospital Base OP Fee Sched Tier 3,115.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,99282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99282,BCBSND Hospital Base OP Fee Sched Tier 3,211.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,99283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99283,BCBSND Hospital Base OP Fee Sched Tier 3,367.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,99284,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99284,BCBSND Hospital Base OP Fee Sched Tier 3,594.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,99285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99285,BCBSND Hospital Base OP Fee Sched Tier 3,866.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,99291,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99291,BCBSND Hospital Base OP Fee Sched Tier 3,1591.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,99354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99354,BCBSND Hospital Base OP Fee Sched Tier 3,22.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,99355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99355,BCBSND Hospital Base OP Fee Sched Tier 3,19.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,99356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99356,BCBSND Hospital Base OP Fee Sched Tier 3,22.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,99357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99357,BCBSND Hospital Base OP Fee Sched Tier 3,19.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,99381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99381,BCBSND Hospital Base OP Fee Sched Tier 3,93.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,99382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99382,BCBSND Hospital Base OP Fee Sched Tier 3,93.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,99383,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99383,BCBSND Hospital Base OP Fee Sched Tier 3,92.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,99384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99384,BCBSND Hospital Base OP Fee Sched Tier 3,94.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,99385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99385,BCBSND Hospital Base OP Fee Sched Tier 3,93.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,99386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99386,BCBSND Hospital Base OP Fee Sched Tier 3,93.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,99387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99387,BCBSND Hospital Base OP Fee Sched Tier 3,104.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,99391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99391,BCBSND Hospital Base OP Fee Sched Tier 3,82.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,99392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99392,BCBSND Hospital Base OP Fee Sched Tier 3,82.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,99393,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99393,BCBSND Hospital Base OP Fee Sched Tier 3,81.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,99394,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99394,BCBSND Hospital Base OP Fee Sched Tier 3,81.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,99395,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99395,BCBSND Hospital Base OP Fee Sched Tier 3,81.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,99396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99396,BCBSND Hospital Base OP Fee Sched Tier 3,82.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,99397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99397,BCBSND Hospital Base OP Fee Sched Tier 3,94.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,99401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99401,BCBSND Hospital Base OP Fee Sched Tier 3,39.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,99402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99402,BCBSND Hospital Base OP Fee Sched Tier 3,38.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,99403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99403,BCBSND Hospital Base OP Fee Sched Tier 3,38.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,99404,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99404,BCBSND Hospital Base OP Fee Sched Tier 3,39.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,99406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99406,BCBSND Hospital Base OP Fee Sched Tier 3,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,99407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99407,BCBSND Hospital Base OP Fee Sched Tier 3,87.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,99408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99408,BCBSND Hospital Base OP Fee Sched Tier 3,6.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,99409,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99409,BCBSND Hospital Base OP Fee Sched Tier 3,6.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,99411,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99411,BCBSND Hospital Base OP Fee Sched Tier 3,32.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,99412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99412,BCBSND Hospital Base OP Fee Sched Tier 3,32.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,99441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99441,BCBSND Hospital Base OP Fee Sched Tier 3,42.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,99442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99442,BCBSND Hospital Base OP Fee Sched Tier 3,83.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,99443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99443,BCBSND Hospital Base OP Fee Sched Tier 3,123.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,99444,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99444,BCBSND Hospital Base OP Fee Sched Tier 3,74.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,99483,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99483,BCBSND Hospital Base OP Fee Sched Tier 3,804.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,99484,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99484,BCBSND Hospital Base OP Fee Sched Tier 3,148.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,99485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99485,BCBSND Hospital Base OP Fee Sched Tier 3,238.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,99486,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99486,BCBSND Hospital Base OP Fee Sched Tier 3,206.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,99487,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99487,BCBSND Hospital Base OP Fee Sched Tier 3,283.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,99489,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99489,BCBSND Hospital Base OP Fee Sched Tier 3,141.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,99490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99490,BCBSND Hospital Base OP Fee Sched Tier 3,128.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,99492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99492,BCBSND Hospital Base OP Fee Sched Tier 3,494.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,99493,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99493,BCBSND Hospital Base OP Fee Sched Tier 3,394.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,99494,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99494,BCBSND Hospital Base OP Fee Sched Tier 3,204.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,99495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99495,BCBSND Hospital Base OP Fee Sched Tier 3,507.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,99496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,99496,BCBSND Hospital Base OP Fee Sched Tier 3,716.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0425,BCBSND Hospital Base OP Fee Sched Tier 3,24.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0426,BCBSND Hospital Base OP Fee Sched Tier 3,815.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0427,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0427,BCBSND Hospital Base OP Fee Sched Tier 3,1290.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0428,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0428,BCBSND Hospital Base OP Fee Sched Tier 3,679.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0429,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0429,BCBSND Hospital Base OP Fee Sched Tier 3,1086.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0430,BCBSND Hospital Base OP Fee Sched Tier 3,12947.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0431,BCBSND Hospital Base OP Fee Sched Tier 3,15053.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0433,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0433,BCBSND Hospital Base OP Fee Sched Tier 3,1868.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0434,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0434,BCBSND Hospital Base OP Fee Sched Tier 3,2207.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0435,BCBSND Hospital Base OP Fee Sched Tier 3,37.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0436,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0436,BCBSND Hospital Base OP Fee Sched Tier 3,99.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,A0998,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A0998,BCBSND Hospital Base OP Fee Sched Tier 3,667.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4210,BCBSND Hospital Base OP Fee Sched Tier 3,262.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4221,BCBSND Hospital Base OP Fee Sched Tier 3,23.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4222,BCBSND Hospital Base OP Fee Sched Tier 3,44.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4224,BCBSND Hospital Base OP Fee Sched Tier 3,23.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4225,BCBSND Hospital Base OP Fee Sched Tier 3,3.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4232,BCBSND Hospital Base OP Fee Sched Tier 3,3.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4233,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4233,BCBSND Hospital Base OP Fee Sched Tier 3,0.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4234,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4234,BCBSND Hospital Base OP Fee Sched Tier 3,2.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4235,BCBSND Hospital Base OP Fee Sched Tier 3,1.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4236,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4236,BCBSND Hospital Base OP Fee Sched Tier 3,1.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4250,BCBSND Hospital Base OP Fee Sched Tier 3,36,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4252,BCBSND Hospital Base OP Fee Sched Tier 3,1.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4253,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4253,BCBSND Hospital Base OP Fee Sched Tier 3,30.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4255,BCBSND Hospital Base OP Fee Sched Tier 3,5.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4256,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4256,BCBSND Hospital Base OP Fee Sched Tier 3,3.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4257,BCBSND Hospital Base OP Fee Sched Tier 3,16.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4258,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4258,BCBSND Hospital Base OP Fee Sched Tier 3,2.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4259,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4259,BCBSND Hospital Base OP Fee Sched Tier 3,1.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4265,BCBSND Hospital Base OP Fee Sched Tier 3,4.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4280,BCBSND Hospital Base OP Fee Sched Tier 3,7.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4310,BCBSND Hospital Base OP Fee Sched Tier 3,10.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4311,BCBSND Hospital Base OP Fee Sched Tier 3,19.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4312,BCBSND Hospital Base OP Fee Sched Tier 3,21.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4313,BCBSND Hospital Base OP Fee Sched Tier 3,21.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4314,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4314,BCBSND Hospital Base OP Fee Sched Tier 3,33.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4315,BCBSND Hospital Base OP Fee Sched Tier 3,34.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4316,BCBSND Hospital Base OP Fee Sched Tier 3,36.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4320,BCBSND Hospital Base OP Fee Sched Tier 3,7.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4322,BCBSND Hospital Base OP Fee Sched Tier 3,4.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4326,BCBSND Hospital Base OP Fee Sched Tier 3,12.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4327,BCBSND Hospital Base OP Fee Sched Tier 3,59.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4328,BCBSND Hospital Base OP Fee Sched Tier 3,13.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4330,BCBSND Hospital Base OP Fee Sched Tier 3,9.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4331,BCBSND Hospital Base OP Fee Sched Tier 3,4.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4332,BCBSND Hospital Base OP Fee Sched Tier 3,0.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4333,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4333,BCBSND Hospital Base OP Fee Sched Tier 3,2.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4334,BCBSND Hospital Base OP Fee Sched Tier 3,6.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4336,BCBSND Hospital Base OP Fee Sched Tier 3,1.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4338,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4338,BCBSND Hospital Base OP Fee Sched Tier 3,16.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4340,BCBSND Hospital Base OP Fee Sched Tier 3,42.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4344,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4344,BCBSND Hospital Base OP Fee Sched Tier 3,21.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4346,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4346,BCBSND Hospital Base OP Fee Sched Tier 3,25.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4349,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4349,BCBSND Hospital Base OP Fee Sched Tier 3,2.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4351,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4351,BCBSND Hospital Base OP Fee Sched Tier 3,2.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4352,BCBSND Hospital Base OP Fee Sched Tier 3,7.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4353,BCBSND Hospital Base OP Fee Sched Tier 3,9.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4354,BCBSND Hospital Base OP Fee Sched Tier 3,13.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4355,BCBSND Hospital Base OP Fee Sched Tier 3,10.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4356,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4356,BCBSND Hospital Base OP Fee Sched Tier 3,60.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4357,BCBSND Hospital Base OP Fee Sched Tier 3,12.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4358,BCBSND Hospital Base OP Fee Sched Tier 3,8.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4360,BCBSND Hospital Base OP Fee Sched Tier 3,0.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4361,BCBSND Hospital Base OP Fee Sched Tier 3,24.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4362,BCBSND Hospital Base OP Fee Sched Tier 3,4.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4363,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4363,BCBSND Hospital Base OP Fee Sched Tier 3,2.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4364,BCBSND Hospital Base OP Fee Sched Tier 3,3.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4366,BCBSND Hospital Base OP Fee Sched Tier 3,1.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4367,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4367,BCBSND Hospital Base OP Fee Sched Tier 3,9.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4368,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4368,BCBSND Hospital Base OP Fee Sched Tier 3,0.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4369,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4369,BCBSND Hospital Base OP Fee Sched Tier 3,2.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4371,BCBSND Hospital Base OP Fee Sched Tier 3,4.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4372,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4372,BCBSND Hospital Base OP Fee Sched Tier 3,5.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4373,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4373,BCBSND Hospital Base OP Fee Sched Tier 3,8.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4375,BCBSND Hospital Base OP Fee Sched Tier 3,22.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4376,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4376,BCBSND Hospital Base OP Fee Sched Tier 3,63.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4377,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4377,BCBSND Hospital Base OP Fee Sched Tier 3,5.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4378,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4378,BCBSND Hospital Base OP Fee Sched Tier 3,40.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4379,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4379,BCBSND Hospital Base OP Fee Sched Tier 3,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4380,BCBSND Hospital Base OP Fee Sched Tier 3,49.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4381,BCBSND Hospital Base OP Fee Sched Tier 3,6.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4382,BCBSND Hospital Base OP Fee Sched Tier 3,32.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4383,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4383,BCBSND Hospital Base OP Fee Sched Tier 3,37.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4384,BCBSND Hospital Base OP Fee Sched Tier 3,12.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4385,BCBSND Hospital Base OP Fee Sched Tier 3,6.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4387,BCBSND Hospital Base OP Fee Sched Tier 3,2.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4388,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4388,BCBSND Hospital Base OP Fee Sched Tier 3,5.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4389,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4389,BCBSND Hospital Base OP Fee Sched Tier 3,8.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4390,BCBSND Hospital Base OP Fee Sched Tier 3,12.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4391,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4391,BCBSND Hospital Base OP Fee Sched Tier 3,9.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4392,BCBSND Hospital Base OP Fee Sched Tier 3,10.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4393,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4393,BCBSND Hospital Base OP Fee Sched Tier 3,11.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4394,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4394,BCBSND Hospital Base OP Fee Sched Tier 3,3.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4395,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4395,BCBSND Hospital Base OP Fee Sched Tier 3,0.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4396,BCBSND Hospital Base OP Fee Sched Tier 3,53.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4397,BCBSND Hospital Base OP Fee Sched Tier 3,6.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4398,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4398,BCBSND Hospital Base OP Fee Sched Tier 3,16.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4399,BCBSND Hospital Base OP Fee Sched Tier 3,16.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4400,BCBSND Hospital Base OP Fee Sched Tier 3,64.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4402,BCBSND Hospital Base OP Fee Sched Tier 3,2.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4404,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4404,BCBSND Hospital Base OP Fee Sched Tier 3,2.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4405,BCBSND Hospital Base OP Fee Sched Tier 3,4.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4406,BCBSND Hospital Base OP Fee Sched Tier 3,7.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4407,BCBSND Hospital Base OP Fee Sched Tier 3,11.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4408,BCBSND Hospital Base OP Fee Sched Tier 3,13.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4409,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4409,BCBSND Hospital Base OP Fee Sched Tier 3,8.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4410,BCBSND Hospital Base OP Fee Sched Tier 3,11.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4411,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4411,BCBSND Hospital Base OP Fee Sched Tier 3,6.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4412,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4412,BCBSND Hospital Base OP Fee Sched Tier 3,3.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4413,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4413,BCBSND Hospital Base OP Fee Sched Tier 3,7.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4414,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4414,BCBSND Hospital Base OP Fee Sched Tier 3,6.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4415,BCBSND Hospital Base OP Fee Sched Tier 3,7.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4416,BCBSND Hospital Base OP Fee Sched Tier 3,3.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4417,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4417,BCBSND Hospital Base OP Fee Sched Tier 3,4.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4418,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4418,BCBSND Hospital Base OP Fee Sched Tier 3,2.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4419,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4419,BCBSND Hospital Base OP Fee Sched Tier 3,2.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4422,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4422,BCBSND Hospital Base OP Fee Sched Tier 3,0.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4423,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4423,BCBSND Hospital Base OP Fee Sched Tier 3,2.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4424,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4424,BCBSND Hospital Base OP Fee Sched Tier 3,6.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4425,BCBSND Hospital Base OP Fee Sched Tier 3,4.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4426,BCBSND Hospital Base OP Fee Sched Tier 3,3.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4427,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4427,BCBSND Hospital Base OP Fee Sched Tier 3,3.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4428,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4428,BCBSND Hospital Base OP Fee Sched Tier 3,8.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4429,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4429,BCBSND Hospital Base OP Fee Sched Tier 3,10.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4430,BCBSND Hospital Base OP Fee Sched Tier 3,11.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4431,BCBSND Hospital Base OP Fee Sched Tier 3,8.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4432,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4432,BCBSND Hospital Base OP Fee Sched Tier 3,4.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4433,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4433,BCBSND Hospital Base OP Fee Sched Tier 3,4.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4434,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4434,BCBSND Hospital Base OP Fee Sched Tier 3,4.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4435,BCBSND Hospital Base OP Fee Sched Tier 3,7.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4450,BCBSND Hospital Base OP Fee Sched Tier 3,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4452,BCBSND Hospital Base OP Fee Sched Tier 3,0.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4455,BCBSND Hospital Base OP Fee Sched Tier 3,1.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4456,BCBSND Hospital Base OP Fee Sched Tier 3,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4461,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4461,BCBSND Hospital Base OP Fee Sched Tier 3,4.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4463,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4463,BCBSND Hospital Base OP Fee Sched Tier 3,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4481,BCBSND Hospital Base OP Fee Sched Tier 3,0.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4490,BCBSND Hospital Base OP Fee Sched Tier 3,37.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4495,BCBSND Hospital Base OP Fee Sched Tier 3,24.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4500,BCBSND Hospital Base OP Fee Sched Tier 3,18.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4510,BCBSND Hospital Base OP Fee Sched Tier 3,46.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4554,BCBSND Hospital Base OP Fee Sched Tier 3,0.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4556,BCBSND Hospital Base OP Fee Sched Tier 3,16.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4557,BCBSND Hospital Base OP Fee Sched Tier 3,10.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4558,BCBSND Hospital Base OP Fee Sched Tier 3,6.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4559,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4559,BCBSND Hospital Base OP Fee Sched Tier 3,0.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4561,BCBSND Hospital Base OP Fee Sched Tier 3,27.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4562,BCBSND Hospital Base OP Fee Sched Tier 3,68.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4563,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4563,BCBSND Hospital Base OP Fee Sched Tier 3,148.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4565,BCBSND Hospital Base OP Fee Sched Tier 3,10.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4566,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4566,BCBSND Hospital Base OP Fee Sched Tier 3,134.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4570,BCBSND Hospital Base OP Fee Sched Tier 3,24.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4580,BCBSND Hospital Base OP Fee Sched Tier 3,112.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4590,BCBSND Hospital Base OP Fee Sched Tier 3,167.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4595,BCBSND Hospital Base OP Fee Sched Tier 3,10.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4601,BCBSND Hospital Base OP Fee Sched Tier 3,450.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4604,BCBSND Hospital Base OP Fee Sched Tier 3,44.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4605,BCBSND Hospital Base OP Fee Sched Tier 3,21.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4608,BCBSND Hospital Base OP Fee Sched Tier 3,66.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4611,BCBSND Hospital Base OP Fee Sched Tier 3,280.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4612,BCBSND Hospital Base OP Fee Sched Tier 3,114.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4613,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4613,BCBSND Hospital Base OP Fee Sched Tier 3,174.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4614,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4614,BCBSND Hospital Base OP Fee Sched Tier 3,31.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4615,BCBSND Hospital Base OP Fee Sched Tier 3,0.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4616,BCBSND Hospital Base OP Fee Sched Tier 3,0.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4617,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4617,BCBSND Hospital Base OP Fee Sched Tier 3,4.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4618,BCBSND Hospital Base OP Fee Sched Tier 3,11.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4619,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4619,BCBSND Hospital Base OP Fee Sched Tier 3,2.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4620,BCBSND Hospital Base OP Fee Sched Tier 3,0.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4623,BCBSND Hospital Base OP Fee Sched Tier 3,8.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4624,BCBSND Hospital Base OP Fee Sched Tier 3,2.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4625,BCBSND Hospital Base OP Fee Sched Tier 3,7.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4626,BCBSND Hospital Base OP Fee Sched Tier 3,3.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4627,BCBSND Hospital Base OP Fee Sched Tier 3,16.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4628,BCBSND Hospital Base OP Fee Sched Tier 3,4.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4629,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4629,BCBSND Hospital Base OP Fee Sched Tier 3,6.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4630,BCBSND Hospital Base OP Fee Sched Tier 3,8.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4633,BCBSND Hospital Base OP Fee Sched Tier 3,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4635,BCBSND Hospital Base OP Fee Sched Tier 3,6.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4636,BCBSND Hospital Base OP Fee Sched Tier 3,3.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4637,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4637,BCBSND Hospital Base OP Fee Sched Tier 3,1.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4639RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4639RR,BCBSND Hospital Base OP Fee Sched Tier 3,38.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4640,BCBSND Hospital Base OP Fee Sched Tier 3,60.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4657,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4657,BCBSND Hospital Base OP Fee Sched Tier 3,0.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4670,BCBSND Hospital Base OP Fee Sched Tier 3,109.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,A4802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A4802,BCBSND Hospital Base OP Fee Sched Tier 3,13.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5051,BCBSND Hospital Base OP Fee Sched Tier 3,2.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5052,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5052,BCBSND Hospital Base OP Fee Sched Tier 3,1.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5053,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5053,BCBSND Hospital Base OP Fee Sched Tier 3,1.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5054,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5054,BCBSND Hospital Base OP Fee Sched Tier 3,2.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5055,BCBSND Hospital Base OP Fee Sched Tier 3,1.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5056,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5056,BCBSND Hospital Base OP Fee Sched Tier 3,6.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5057,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5057,BCBSND Hospital Base OP Fee Sched Tier 3,12.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5061,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5061,BCBSND Hospital Base OP Fee Sched Tier 3,4.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5062,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5062,BCBSND Hospital Base OP Fee Sched Tier 3,2.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5063,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5063,BCBSND Hospital Base OP Fee Sched Tier 3,3.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5071,BCBSND Hospital Base OP Fee Sched Tier 3,7.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5072,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5072,BCBSND Hospital Base OP Fee Sched Tier 3,4.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5073,BCBSND Hospital Base OP Fee Sched Tier 3,4.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5081,BCBSND Hospital Base OP Fee Sched Tier 3,3.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5082,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5082,BCBSND Hospital Base OP Fee Sched Tier 3,15.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5083,BCBSND Hospital Base OP Fee Sched Tier 3,0.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5093,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5093,BCBSND Hospital Base OP Fee Sched Tier 3,2.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5102,BCBSND Hospital Base OP Fee Sched Tier 3,29.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5105,BCBSND Hospital Base OP Fee Sched Tier 3,53.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5112,BCBSND Hospital Base OP Fee Sched Tier 3,45.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5113,BCBSND Hospital Base OP Fee Sched Tier 3,5.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5114,BCBSND Hospital Base OP Fee Sched Tier 3,11.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5120,BCBSND Hospital Base OP Fee Sched Tier 3,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5121,BCBSND Hospital Base OP Fee Sched Tier 3,9.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5122,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5122,BCBSND Hospital Base OP Fee Sched Tier 3,17.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5126,BCBSND Hospital Base OP Fee Sched Tier 3,1.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5131,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5131,BCBSND Hospital Base OP Fee Sched Tier 3,20.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5200,BCBSND Hospital Base OP Fee Sched Tier 3,14.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5500,BCBSND Hospital Base OP Fee Sched Tier 3,84.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5501,BCBSND Hospital Base OP Fee Sched Tier 3,252.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5503,BCBSND Hospital Base OP Fee Sched Tier 3,41.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5504,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5504,BCBSND Hospital Base OP Fee Sched Tier 3,41.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5505,BCBSND Hospital Base OP Fee Sched Tier 3,41.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5506,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5506,BCBSND Hospital Base OP Fee Sched Tier 3,41.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5507,BCBSND Hospital Base OP Fee Sched Tier 3,41.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5512,BCBSND Hospital Base OP Fee Sched Tier 3,34.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5513,BCBSND Hospital Base OP Fee Sched Tier 3,51.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A5514,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A5514,BCBSND Hospital Base OP Fee Sched Tier 3,51.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6010,BCBSND Hospital Base OP Fee Sched Tier 3,41.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6011,BCBSND Hospital Base OP Fee Sched Tier 3,3.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6021,BCBSND Hospital Base OP Fee Sched Tier 3,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6022,BCBSND Hospital Base OP Fee Sched Tier 3,27.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6023,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6023,BCBSND Hospital Base OP Fee Sched Tier 3,251.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6024,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6024,BCBSND Hospital Base OP Fee Sched Tier 3,8.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6154,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6154,BCBSND Hospital Base OP Fee Sched Tier 3,19.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6196,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6196,BCBSND Hospital Base OP Fee Sched Tier 3,9.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6197,BCBSND Hospital Base OP Fee Sched Tier 3,21.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6199,BCBSND Hospital Base OP Fee Sched Tier 3,7,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6203,BCBSND Hospital Base OP Fee Sched Tier 3,4.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6204,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6204,BCBSND Hospital Base OP Fee Sched Tier 3,8.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6207,BCBSND Hospital Base OP Fee Sched Tier 3,9.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6209,BCBSND Hospital Base OP Fee Sched Tier 3,9.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6210,BCBSND Hospital Base OP Fee Sched Tier 3,26.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6211,BCBSND Hospital Base OP Fee Sched Tier 3,38.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6212,BCBSND Hospital Base OP Fee Sched Tier 3,12.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6214,BCBSND Hospital Base OP Fee Sched Tier 3,13.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6216,BCBSND Hospital Base OP Fee Sched Tier 3,0.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6219,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6219,BCBSND Hospital Base OP Fee Sched Tier 3,1.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6220,BCBSND Hospital Base OP Fee Sched Tier 3,3.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6222,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6222,BCBSND Hospital Base OP Fee Sched Tier 3,2.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6223,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6223,BCBSND Hospital Base OP Fee Sched Tier 3,3.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6224,BCBSND Hospital Base OP Fee Sched Tier 3,4.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6229,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6229,BCBSND Hospital Base OP Fee Sched Tier 3,4.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6231,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6231,BCBSND Hospital Base OP Fee Sched Tier 3,6.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6232,BCBSND Hospital Base OP Fee Sched Tier 3,9.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6233,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6233,BCBSND Hospital Base OP Fee Sched Tier 3,25.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6234,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6234,BCBSND Hospital Base OP Fee Sched Tier 3,8.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6235,BCBSND Hospital Base OP Fee Sched Tier 3,22.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6236,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6236,BCBSND Hospital Base OP Fee Sched Tier 3,36.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6237,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6237,BCBSND Hospital Base OP Fee Sched Tier 3,10.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6238,BCBSND Hospital Base OP Fee Sched Tier 3,30.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6240,BCBSND Hospital Base OP Fee Sched Tier 3,16.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6241,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6241,BCBSND Hospital Base OP Fee Sched Tier 3,3.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6242,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6242,BCBSND Hospital Base OP Fee Sched Tier 3,8.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6243,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6243,BCBSND Hospital Base OP Fee Sched Tier 3,16.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6244,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6244,BCBSND Hospital Base OP Fee Sched Tier 3,52.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6245,BCBSND Hospital Base OP Fee Sched Tier 3,9.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6246,BCBSND Hospital Base OP Fee Sched Tier 3,13.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6247,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6247,BCBSND Hospital Base OP Fee Sched Tier 3,31.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6248,BCBSND Hospital Base OP Fee Sched Tier 3,21.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6251,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6251,BCBSND Hospital Base OP Fee Sched Tier 3,2.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6252,BCBSND Hospital Base OP Fee Sched Tier 3,4.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6253,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6253,BCBSND Hospital Base OP Fee Sched Tier 3,8.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6254,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6254,BCBSND Hospital Base OP Fee Sched Tier 3,1.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6255,BCBSND Hospital Base OP Fee Sched Tier 3,4.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6257,BCBSND Hospital Base OP Fee Sched Tier 3,2.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6258,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6258,BCBSND Hospital Base OP Fee Sched Tier 3,5.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6259,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6259,BCBSND Hospital Base OP Fee Sched Tier 3,14.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6266,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6266,BCBSND Hospital Base OP Fee Sched Tier 3,2.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6402,BCBSND Hospital Base OP Fee Sched Tier 3,0.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6403,BCBSND Hospital Base OP Fee Sched Tier 3,0.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6407,BCBSND Hospital Base OP Fee Sched Tier 3,2.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6410,BCBSND Hospital Base OP Fee Sched Tier 3,0.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6413,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6413,BCBSND Hospital Base OP Fee Sched Tier 3,0.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6441,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6441,BCBSND Hospital Base OP Fee Sched Tier 3,0.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6442,BCBSND Hospital Base OP Fee Sched Tier 3,0.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6443,BCBSND Hospital Base OP Fee Sched Tier 3,0.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6444,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6444,BCBSND Hospital Base OP Fee Sched Tier 3,0.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6445,BCBSND Hospital Base OP Fee Sched Tier 3,0.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6446,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6446,BCBSND Hospital Base OP Fee Sched Tier 3,0.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6447,BCBSND Hospital Base OP Fee Sched Tier 3,0.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6448,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6448,BCBSND Hospital Base OP Fee Sched Tier 3,1.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6449,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6449,BCBSND Hospital Base OP Fee Sched Tier 3,2.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6452,BCBSND Hospital Base OP Fee Sched Tier 3,7.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6453,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6453,BCBSND Hospital Base OP Fee Sched Tier 3,0.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6454,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6454,BCBSND Hospital Base OP Fee Sched Tier 3,1.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6455,BCBSND Hospital Base OP Fee Sched Tier 3,1.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6456,BCBSND Hospital Base OP Fee Sched Tier 3,1.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6457,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6457,BCBSND Hospital Base OP Fee Sched Tier 3,1.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6530,BCBSND Hospital Base OP Fee Sched Tier 3,38.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6531,BCBSND Hospital Base OP Fee Sched Tier 3,57.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6532,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6532,BCBSND Hospital Base OP Fee Sched Tier 3,80.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6533,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6533,BCBSND Hospital Base OP Fee Sched Tier 3,60.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6534,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6534,BCBSND Hospital Base OP Fee Sched Tier 3,51.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6535,BCBSND Hospital Base OP Fee Sched Tier 3,116.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6536,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6536,BCBSND Hospital Base OP Fee Sched Tier 3,97.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6537,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6537,BCBSND Hospital Base OP Fee Sched Tier 3,140.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6538,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6538,BCBSND Hospital Base OP Fee Sched Tier 3,308.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6539,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6539,BCBSND Hospital Base OP Fee Sched Tier 3,48.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6540,BCBSND Hospital Base OP Fee Sched Tier 3,83.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6541,BCBSND Hospital Base OP Fee Sched Tier 3,280.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6544,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6544,BCBSND Hospital Base OP Fee Sched Tier 3,18.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6545,BCBSND Hospital Base OP Fee Sched Tier 3,82.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A6550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A6550,BCBSND Hospital Base OP Fee Sched Tier 3,28.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7000,BCBSND Hospital Base OP Fee Sched Tier 3,13.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7001,BCBSND Hospital Base OP Fee Sched Tier 3,64.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7002,BCBSND Hospital Base OP Fee Sched Tier 3,7.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7003,BCBSND Hospital Base OP Fee Sched Tier 3,2.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7004,BCBSND Hospital Base OP Fee Sched Tier 3,2.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7005,BCBSND Hospital Base OP Fee Sched Tier 3,19.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7006,BCBSND Hospital Base OP Fee Sched Tier 3,7.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7007,BCBSND Hospital Base OP Fee Sched Tier 3,3.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7008,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7008,BCBSND Hospital Base OP Fee Sched Tier 3,14.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7009,BCBSND Hospital Base OP Fee Sched Tier 3,55.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7010,BCBSND Hospital Base OP Fee Sched Tier 3,16.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7012,BCBSND Hospital Base OP Fee Sched Tier 3,3.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7013,BCBSND Hospital Base OP Fee Sched Tier 3,0.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7014,BCBSND Hospital Base OP Fee Sched Tier 3,3.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7015,BCBSND Hospital Base OP Fee Sched Tier 3,1.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7016,BCBSND Hospital Base OP Fee Sched Tier 3,9.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7017,BCBSND Hospital Base OP Fee Sched Tier 3,119.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7018,BCBSND Hospital Base OP Fee Sched Tier 3,0.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7020,BCBSND Hospital Base OP Fee Sched Tier 3,28.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7025RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7025RR,BCBSND Hospital Base OP Fee Sched Tier 3,57.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7026,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7026,BCBSND Hospital Base OP Fee Sched Tier 3,38.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7027,BCBSND Hospital Base OP Fee Sched Tier 3,203.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7028,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7028,BCBSND Hospital Base OP Fee Sched Tier 3,57.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7029,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7029,BCBSND Hospital Base OP Fee Sched Tier 3,25.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7030,BCBSND Hospital Base OP Fee Sched Tier 3,147.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7031,BCBSND Hospital Base OP Fee Sched Tier 3,56.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7032,BCBSND Hospital Base OP Fee Sched Tier 3,31.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7033,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7033,BCBSND Hospital Base OP Fee Sched Tier 3,25.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7034,BCBSND Hospital Base OP Fee Sched Tier 3,94.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7035,BCBSND Hospital Base OP Fee Sched Tier 3,30.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7036,BCBSND Hospital Base OP Fee Sched Tier 3,17.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7037,BCBSND Hospital Base OP Fee Sched Tier 3,18.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7038,BCBSND Hospital Base OP Fee Sched Tier 3,3.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7039,BCBSND Hospital Base OP Fee Sched Tier 3,9.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7040,BCBSND Hospital Base OP Fee Sched Tier 3,54.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7041,BCBSND Hospital Base OP Fee Sched Tier 3,101.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7044,BCBSND Hospital Base OP Fee Sched Tier 3,92.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7045,BCBSND Hospital Base OP Fee Sched Tier 3,13.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7046,BCBSND Hospital Base OP Fee Sched Tier 3,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7047,BCBSND Hospital Base OP Fee Sched Tier 3,160.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7048,BCBSND Hospital Base OP Fee Sched Tier 3,90,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7501,BCBSND Hospital Base OP Fee Sched Tier 3,139.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7502,BCBSND Hospital Base OP Fee Sched Tier 3,66.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7503,BCBSND Hospital Base OP Fee Sched Tier 3,15.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7504,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7504,BCBSND Hospital Base OP Fee Sched Tier 3,0.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7505,BCBSND Hospital Base OP Fee Sched Tier 3,6.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7506,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7506,BCBSND Hospital Base OP Fee Sched Tier 3,0.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7507,BCBSND Hospital Base OP Fee Sched Tier 3,3.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7508,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7508,BCBSND Hospital Base OP Fee Sched Tier 3,3.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7509,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7509,BCBSND Hospital Base OP Fee Sched Tier 3,1.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7520,BCBSND Hospital Base OP Fee Sched Tier 3,62.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7522,BCBSND Hospital Base OP Fee Sched Tier 3,59.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7524,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7524,BCBSND Hospital Base OP Fee Sched Tier 3,102.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7525,BCBSND Hospital Base OP Fee Sched Tier 3,2.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7526,BCBSND Hospital Base OP Fee Sched Tier 3,4.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,A7527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A7527,BCBSND Hospital Base OP Fee Sched Tier 3,4.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A8000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A8000,BCBSND Hospital Base OP Fee Sched Tier 3,203.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,A8001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A8001,BCBSND Hospital Base OP Fee Sched Tier 3,203.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,A8002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A8002,BCBSND Hospital Base OP Fee Sched Tier 3,228.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,A8003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A8003,BCBSND Hospital Base OP Fee Sched Tier 3,228.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,A8004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A8004,BCBSND Hospital Base OP Fee Sched Tier 3,228.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9155,BCBSND Hospital Base OP Fee Sched Tier 3,7.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9180,BCBSND Hospital Base OP Fee Sched Tier 3,2.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9273,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9273,BCBSND Hospital Base OP Fee Sched Tier 3,12.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9275,BCBSND Hospital Base OP Fee Sched Tier 3,993.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9276,BCBSND Hospital Base OP Fee Sched Tier 3,12.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9277,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9277,BCBSND Hospital Base OP Fee Sched Tier 3,702.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9278,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9278,BCBSND Hospital Base OP Fee Sched Tier 3,595.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9283,BCBSND Hospital Base OP Fee Sched Tier 3,13.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9500,BCBSND Hospital Base OP Fee Sched Tier 3,171.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9502,BCBSND Hospital Base OP Fee Sched Tier 3,138.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9503,BCBSND Hospital Base OP Fee Sched Tier 3,18.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9505,BCBSND Hospital Base OP Fee Sched Tier 3,216.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9507,BCBSND Hospital Base OP Fee Sched Tier 3,6231.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9508,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9508,BCBSND Hospital Base OP Fee Sched Tier 3,1047.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9509,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9509,BCBSND Hospital Base OP Fee Sched Tier 3,2563.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9510,BCBSND Hospital Base OP Fee Sched Tier 3,99.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9512,BCBSND Hospital Base OP Fee Sched Tier 3,14.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9513,BCBSND Hospital Base OP Fee Sched Tier 3,346.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9515,BCBSND Hospital Base OP Fee Sched Tier 3,7087.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9516,BCBSND Hospital Base OP Fee Sched Tier 3,256.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9517,BCBSND Hospital Base OP Fee Sched Tier 3,50.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9520,BCBSND Hospital Base OP Fee Sched Tier 3,665.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9521,BCBSND Hospital Base OP Fee Sched Tier 3,2063.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9524,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9524,BCBSND Hospital Base OP Fee Sched Tier 3,109.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9526,BCBSND Hospital Base OP Fee Sched Tier 3,271.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9527,BCBSND Hospital Base OP Fee Sched Tier 3,20.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9528,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9528,BCBSND Hospital Base OP Fee Sched Tier 3,42.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9529,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9529,BCBSND Hospital Base OP Fee Sched Tier 3,34.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9530,BCBSND Hospital Base OP Fee Sched Tier 3,18.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9531,BCBSND Hospital Base OP Fee Sched Tier 3,11.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9537,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9537,BCBSND Hospital Base OP Fee Sched Tier 3,75.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9538,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9538,BCBSND Hospital Base OP Fee Sched Tier 3,37.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9539,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9539,BCBSND Hospital Base OP Fee Sched Tier 3,43.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9540,BCBSND Hospital Base OP Fee Sched Tier 3,42.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9541,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9541,BCBSND Hospital Base OP Fee Sched Tier 3,75.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9542,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9542,BCBSND Hospital Base OP Fee Sched Tier 3,4961.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9543,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9543,BCBSND Hospital Base OP Fee Sched Tier 3,68187.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9547,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9547,BCBSND Hospital Base OP Fee Sched Tier 3,2534.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9548,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9548,BCBSND Hospital Base OP Fee Sched Tier 3,585.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9551,BCBSND Hospital Base OP Fee Sched Tier 3,849.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9552,BCBSND Hospital Base OP Fee Sched Tier 3,397.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9553,BCBSND Hospital Base OP Fee Sched Tier 3,799.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9554,BCBSND Hospital Base OP Fee Sched Tier 3,45.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9555,BCBSND Hospital Base OP Fee Sched Tier 3,332.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9556,BCBSND Hospital Base OP Fee Sched Tier 3,154.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9557,BCBSND Hospital Base OP Fee Sched Tier 3,512.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9558,BCBSND Hospital Base OP Fee Sched Tier 3,54.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9560,BCBSND Hospital Base OP Fee Sched Tier 3,141.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9561,BCBSND Hospital Base OP Fee Sched Tier 3,62.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9562,BCBSND Hospital Base OP Fee Sched Tier 3,1098.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9563,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9563,BCBSND Hospital Base OP Fee Sched Tier 3,432.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9564,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9564,BCBSND Hospital Base OP Fee Sched Tier 3,411.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9567,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9567,BCBSND Hospital Base OP Fee Sched Tier 3,65.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9569,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9569,BCBSND Hospital Base OP Fee Sched Tier 3,2063.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9570,BCBSND Hospital Base OP Fee Sched Tier 3,5069.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9571,BCBSND Hospital Base OP Fee Sched Tier 3,5069.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9572,BCBSND Hospital Base OP Fee Sched Tier 3,7815.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9575,BCBSND Hospital Base OP Fee Sched Tier 3,0.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9576,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9576,BCBSND Hospital Base OP Fee Sched Tier 3,2.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9577,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9577,BCBSND Hospital Base OP Fee Sched Tier 3,2.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9578,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9578,BCBSND Hospital Base OP Fee Sched Tier 3,2.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9579,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9579,BCBSND Hospital Base OP Fee Sched Tier 3,2.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9580,BCBSND Hospital Base OP Fee Sched Tier 3,237.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9581,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9581,BCBSND Hospital Base OP Fee Sched Tier 3,21.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9582,BCBSND Hospital Base OP Fee Sched Tier 3,8369.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9583,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9583,BCBSND Hospital Base OP Fee Sched Tier 3,24.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9584,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9584,BCBSND Hospital Base OP Fee Sched Tier 3,3498.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9585,BCBSND Hospital Base OP Fee Sched Tier 3,0.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9586,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9586,BCBSND Hospital Base OP Fee Sched Tier 3,4050.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9587,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9587,BCBSND Hospital Base OP Fee Sched Tier 3,91.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9588,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9588,BCBSND Hospital Base OP Fee Sched Tier 3,567.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9589,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9589,BCBSND Hospital Base OP Fee Sched Tier 3,1668.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9600,BCBSND Hospital Base OP Fee Sched Tier 3,2735.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9604,BCBSND Hospital Base OP Fee Sched Tier 3,21571,,Fee schedule,,,,,,,,0
unity,Fee schedule,A9606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,A9606,BCBSND Hospital Base OP Fee Sched Tier 3,190.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0129,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0129,BCBSND Hospital Base OP Fee Sched Tier 3,76.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0130,BCBSND Hospital Base OP Fee Sched Tier 3,2093.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0131,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0131,BCBSND Hospital Base OP Fee Sched Tier 3,0.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0132,BCBSND Hospital Base OP Fee Sched Tier 3,1.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0133,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0133,BCBSND Hospital Base OP Fee Sched Tier 3,0.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0153,BCBSND Hospital Base OP Fee Sched Tier 3,1.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0171,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0171,BCBSND Hospital Base OP Fee Sched Tier 3,1.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0178,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0178,BCBSND Hospital Base OP Fee Sched Tier 3,1406.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0180,BCBSND Hospital Base OP Fee Sched Tier 3,261,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0185,BCBSND Hospital Base OP Fee Sched Tier 3,3.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0202,BCBSND Hospital Base OP Fee Sched Tier 3,2743.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0207,BCBSND Hospital Base OP Fee Sched Tier 3,1450.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0221,BCBSND Hospital Base OP Fee Sched Tier 3,243.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0256,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0256,BCBSND Hospital Base OP Fee Sched Tier 3,6.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0257,BCBSND Hospital Base OP Fee Sched Tier 3,6.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0270,BCBSND Hospital Base OP Fee Sched Tier 3,11.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0278,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0278,BCBSND Hospital Base OP Fee Sched Tier 3,1.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0280,BCBSND Hospital Base OP Fee Sched Tier 3,10.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0282,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0282,BCBSND Hospital Base OP Fee Sched Tier 3,0.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0285,BCBSND Hospital Base OP Fee Sched Tier 3,54.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0287,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0287,BCBSND Hospital Base OP Fee Sched Tier 3,9.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0289,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0289,BCBSND Hospital Base OP Fee Sched Tier 3,35.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0290,BCBSND Hospital Base OP Fee Sched Tier 3,1.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0295,BCBSND Hospital Base OP Fee Sched Tier 3,4.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0300,BCBSND Hospital Base OP Fee Sched Tier 3,259.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0330,BCBSND Hospital Base OP Fee Sched Tier 3,2.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0348,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0348,BCBSND Hospital Base OP Fee Sched Tier 3,0.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0360,BCBSND Hospital Base OP Fee Sched Tier 3,3.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0364,BCBSND Hospital Base OP Fee Sched Tier 3,49.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0401,BCBSND Hospital Base OP Fee Sched Tier 3,7.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0456,BCBSND Hospital Base OP Fee Sched Tier 3,3.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0461,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0461,BCBSND Hospital Base OP Fee Sched Tier 3,0.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0470,BCBSND Hospital Base OP Fee Sched Tier 3,79.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0475,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0475,BCBSND Hospital Base OP Fee Sched Tier 3,255.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0476,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0476,BCBSND Hospital Base OP Fee Sched Tier 3,73.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0480,BCBSND Hospital Base OP Fee Sched Tier 3,5400.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0485,BCBSND Hospital Base OP Fee Sched Tier 3,5.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0490,BCBSND Hospital Base OP Fee Sched Tier 3,64.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0500,BCBSND Hospital Base OP Fee Sched Tier 3,120.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0515,BCBSND Hospital Base OP Fee Sched Tier 3,27.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0517,BCBSND Hospital Base OP Fee Sched Tier 3,244.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0558,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0558,BCBSND Hospital Base OP Fee Sched Tier 3,16.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0561,BCBSND Hospital Base OP Fee Sched Tier 3,20.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0565,BCBSND Hospital Base OP Fee Sched Tier 3,58.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0567,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0567,BCBSND Hospital Base OP Fee Sched Tier 3,127.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0570,BCBSND Hospital Base OP Fee Sched Tier 3,1850.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0571,BCBSND Hospital Base OP Fee Sched Tier 3,1.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0583,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0583,BCBSND Hospital Base OP Fee Sched Tier 3,1.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0584,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0584,BCBSND Hospital Base OP Fee Sched Tier 3,481.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0585,BCBSND Hospital Base OP Fee Sched Tier 3,8.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0586,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0586,BCBSND Hospital Base OP Fee Sched Tier 3,12.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0587,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0587,BCBSND Hospital Base OP Fee Sched Tier 3,17.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0588,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0588,BCBSND Hospital Base OP Fee Sched Tier 3,7.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0592,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0592,BCBSND Hospital Base OP Fee Sched Tier 3,6.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0594,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0594,BCBSND Hospital Base OP Fee Sched Tier 3,9.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0595,BCBSND Hospital Base OP Fee Sched Tier 3,3.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0596,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0596,BCBSND Hospital Base OP Fee Sched Tier 3,40.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0597,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0597,BCBSND Hospital Base OP Fee Sched Tier 3,71.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0598,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0598,BCBSND Hospital Base OP Fee Sched Tier 3,80.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0599,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0599,BCBSND Hospital Base OP Fee Sched Tier 3,13.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0600,BCBSND Hospital Base OP Fee Sched Tier 3,8193.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0604,BCBSND Hospital Base OP Fee Sched Tier 3,1.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0606,BCBSND Hospital Base OP Fee Sched Tier 3,4.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0610,BCBSND Hospital Base OP Fee Sched Tier 3,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0630,BCBSND Hospital Base OP Fee Sched Tier 3,3892.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0636,BCBSND Hospital Base OP Fee Sched Tier 3,0.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0637,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0637,BCBSND Hospital Base OP Fee Sched Tier 3,15.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0638,BCBSND Hospital Base OP Fee Sched Tier 3,162.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0640,BCBSND Hospital Base OP Fee Sched Tier 3,4.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0641,BCBSND Hospital Base OP Fee Sched Tier 3,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0670,BCBSND Hospital Base OP Fee Sched Tier 3,2.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0690,BCBSND Hospital Base OP Fee Sched Tier 3,1.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0692,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0692,BCBSND Hospital Base OP Fee Sched Tier 3,2.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0694,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0694,BCBSND Hospital Base OP Fee Sched Tier 3,6.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0695,BCBSND Hospital Base OP Fee Sched Tier 3,7.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0696,BCBSND Hospital Base OP Fee Sched Tier 3,0.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0697,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0697,BCBSND Hospital Base OP Fee Sched Tier 3,3.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0698,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0698,BCBSND Hospital Base OP Fee Sched Tier 3,5.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0702,BCBSND Hospital Base OP Fee Sched Tier 3,9.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0706,BCBSND Hospital Base OP Fee Sched Tier 3,2.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0712,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0712,BCBSND Hospital Base OP Fee Sched Tier 3,4.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0713,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0713,BCBSND Hospital Base OP Fee Sched Tier 3,2.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0714,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0714,BCBSND Hospital Base OP Fee Sched Tier 3,127.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0716,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0716,BCBSND Hospital Base OP Fee Sched Tier 3,6580.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0717,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0717,BCBSND Hospital Base OP Fee Sched Tier 3,11.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0720,BCBSND Hospital Base OP Fee Sched Tier 3,57.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0725,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0725,BCBSND Hospital Base OP Fee Sched Tier 3,32.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0735,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0735,BCBSND Hospital Base OP Fee Sched Tier 3,22.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0740,BCBSND Hospital Base OP Fee Sched Tier 3,849.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0743,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0743,BCBSND Hospital Base OP Fee Sched Tier 3,9.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0744,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0744,BCBSND Hospital Base OP Fee Sched Tier 3,1.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0770,BCBSND Hospital Base OP Fee Sched Tier 3,19.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0775,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0775,BCBSND Hospital Base OP Fee Sched Tier 3,68.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0780,BCBSND Hospital Base OP Fee Sched Tier 3,14.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0795,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0795,BCBSND Hospital Base OP Fee Sched Tier 3,13.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0800,BCBSND Hospital Base OP Fee Sched Tier 3,5825.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0834,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0834,BCBSND Hospital Base OP Fee Sched Tier 3,60.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0840,BCBSND Hospital Base OP Fee Sched Tier 3,4865.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0841,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0841,BCBSND Hospital Base OP Fee Sched Tier 3,1729.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0850,BCBSND Hospital Base OP Fee Sched Tier 3,1653.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0875,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0875,BCBSND Hospital Base OP Fee Sched Tier 3,21.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0878,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0878,BCBSND Hospital Base OP Fee Sched Tier 3,0.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0881,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0881,BCBSND Hospital Base OP Fee Sched Tier 3,5.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0882,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0882,BCBSND Hospital Base OP Fee Sched Tier 3,5.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0883,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0883,BCBSND Hospital Base OP Fee Sched Tier 3,6.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0884,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0884,BCBSND Hospital Base OP Fee Sched Tier 3,6.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0885,BCBSND Hospital Base OP Fee Sched Tier 3,17.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0887,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0887,BCBSND Hospital Base OP Fee Sched Tier 3,2.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0888,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0888,BCBSND Hospital Base OP Fee Sched Tier 3,2.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0894,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0894,BCBSND Hospital Base OP Fee Sched Tier 3,12.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0895,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0895,BCBSND Hospital Base OP Fee Sched Tier 3,11.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,J0897,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J0897,BCBSND Hospital Base OP Fee Sched Tier 3,27.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1000,BCBSND Hospital Base OP Fee Sched Tier 3,32.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1020,BCBSND Hospital Base OP Fee Sched Tier 3,5.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1030,BCBSND Hospital Base OP Fee Sched Tier 3,9.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1040,BCBSND Hospital Base OP Fee Sched Tier 3,18.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1050,BCBSND Hospital Base OP Fee Sched Tier 3,0.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1071,BCBSND Hospital Base OP Fee Sched Tier 3,0.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1095,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1095,BCBSND Hospital Base OP Fee Sched Tier 3,1.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1100,BCBSND Hospital Base OP Fee Sched Tier 3,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1110,BCBSND Hospital Base OP Fee Sched Tier 3,85.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1120,BCBSND Hospital Base OP Fee Sched Tier 3,20.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1160,BCBSND Hospital Base OP Fee Sched Tier 3,8.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1162,BCBSND Hospital Base OP Fee Sched Tier 3,5536.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1165,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1165,BCBSND Hospital Base OP Fee Sched Tier 3,0.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1170,BCBSND Hospital Base OP Fee Sched Tier 3,4.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1190,BCBSND Hospital Base OP Fee Sched Tier 3,309.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1200,BCBSND Hospital Base OP Fee Sched Tier 3,0.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1205,BCBSND Hospital Base OP Fee Sched Tier 3,94.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1212,BCBSND Hospital Base OP Fee Sched Tier 3,806.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1230,BCBSND Hospital Base OP Fee Sched Tier 3,27.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1240,BCBSND Hospital Base OP Fee Sched Tier 3,11.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1245,BCBSND Hospital Base OP Fee Sched Tier 3,3.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1250,BCBSND Hospital Base OP Fee Sched Tier 3,12.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1265,BCBSND Hospital Base OP Fee Sched Tier 3,1.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1267,BCBSND Hospital Base OP Fee Sched Tier 3,1.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1270,BCBSND Hospital Base OP Fee Sched Tier 3,0.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1290,BCBSND Hospital Base OP Fee Sched Tier 3,703.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1300,BCBSND Hospital Base OP Fee Sched Tier 3,337.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1301,BCBSND Hospital Base OP Fee Sched Tier 3,28.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1322,BCBSND Hospital Base OP Fee Sched Tier 3,346.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1324,BCBSND Hospital Base OP Fee Sched Tier 3,0.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1325,BCBSND Hospital Base OP Fee Sched Tier 3,23.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1327,BCBSND Hospital Base OP Fee Sched Tier 3,41.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1335,BCBSND Hospital Base OP Fee Sched Tier 3,71.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1364,BCBSND Hospital Base OP Fee Sched Tier 3,115.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1380,BCBSND Hospital Base OP Fee Sched Tier 3,17.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1410,BCBSND Hospital Base OP Fee Sched Tier 3,452.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1428,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1428,BCBSND Hospital Base OP Fee Sched Tier 3,226.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1430,BCBSND Hospital Base OP Fee Sched Tier 3,650.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1438,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1438,BCBSND Hospital Base OP Fee Sched Tier 3,916.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1439,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1439,BCBSND Hospital Base OP Fee Sched Tier 3,1.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1442,BCBSND Hospital Base OP Fee Sched Tier 3,1.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1447,BCBSND Hospital Base OP Fee Sched Tier 3,0.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1450,BCBSND Hospital Base OP Fee Sched Tier 3,6.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1451,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1451,BCBSND Hospital Base OP Fee Sched Tier 3,15.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1453,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1453,BCBSND Hospital Base OP Fee Sched Tier 3,3.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1454,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1454,BCBSND Hospital Base OP Fee Sched Tier 3,774.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1455,BCBSND Hospital Base OP Fee Sched Tier 3,111.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1458,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1458,BCBSND Hospital Base OP Fee Sched Tier 3,571.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1459,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1459,BCBSND Hospital Base OP Fee Sched Tier 3,59.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1460,BCBSND Hospital Base OP Fee Sched Tier 3,57.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1555,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1555,BCBSND Hospital Base OP Fee Sched Tier 3,19.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1556,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1556,BCBSND Hospital Base OP Fee Sched Tier 3,103.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1557,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1557,BCBSND Hospital Base OP Fee Sched Tier 3,64.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1559,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1559,BCBSND Hospital Base OP Fee Sched Tier 3,14.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1560,BCBSND Hospital Base OP Fee Sched Tier 3,574.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1561,BCBSND Hospital Base OP Fee Sched Tier 3,56.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1566,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1566,BCBSND Hospital Base OP Fee Sched Tier 3,87.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1568,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1568,BCBSND Hospital Base OP Fee Sched Tier 3,47.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1569,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1569,BCBSND Hospital Base OP Fee Sched Tier 3,61.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1570,BCBSND Hospital Base OP Fee Sched Tier 3,73.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1571,BCBSND Hospital Base OP Fee Sched Tier 3,94.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1572,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1572,BCBSND Hospital Base OP Fee Sched Tier 3,53.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1573,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1573,BCBSND Hospital Base OP Fee Sched Tier 3,120.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1575,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1575,BCBSND Hospital Base OP Fee Sched Tier 3,20.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1580,BCBSND Hospital Base OP Fee Sched Tier 3,2.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1595,BCBSND Hospital Base OP Fee Sched Tier 3,168.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1602,BCBSND Hospital Base OP Fee Sched Tier 3,32.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1610,BCBSND Hospital Base OP Fee Sched Tier 3,303.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1626,BCBSND Hospital Base OP Fee Sched Tier 3,0.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1627,BCBSND Hospital Base OP Fee Sched Tier 3,4.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1628,BCBSND Hospital Base OP Fee Sched Tier 3,153.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1630,BCBSND Hospital Base OP Fee Sched Tier 3,1.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1631,BCBSND Hospital Base OP Fee Sched Tier 3,24.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1640,BCBSND Hospital Base OP Fee Sched Tier 3,33.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1642,BCBSND Hospital Base OP Fee Sched Tier 3,0.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1644,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1644,BCBSND Hospital Base OP Fee Sched Tier 3,0.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1645,BCBSND Hospital Base OP Fee Sched Tier 3,19.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1650,BCBSND Hospital Base OP Fee Sched Tier 3,1.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1652,BCBSND Hospital Base OP Fee Sched Tier 3,3.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1670,BCBSND Hospital Base OP Fee Sched Tier 3,598.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1720,BCBSND Hospital Base OP Fee Sched Tier 3,19.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1726,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1726,BCBSND Hospital Base OP Fee Sched Tier 3,40.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1729,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1729,BCBSND Hospital Base OP Fee Sched Tier 3,19.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1740,BCBSND Hospital Base OP Fee Sched Tier 3,65.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1741,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1741,BCBSND Hospital Base OP Fee Sched Tier 3,2.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1742,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1742,BCBSND Hospital Base OP Fee Sched Tier 3,192.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1743,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1743,BCBSND Hospital Base OP Fee Sched Tier 3,795.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1744,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1744,BCBSND Hospital Base OP Fee Sched Tier 3,511.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1745,BCBSND Hospital Base OP Fee Sched Tier 3,105.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1746,BCBSND Hospital Base OP Fee Sched Tier 3,80.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1750,BCBSND Hospital Base OP Fee Sched Tier 3,19.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1756,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1756,BCBSND Hospital Base OP Fee Sched Tier 3,0.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1786,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1786,BCBSND Hospital Base OP Fee Sched Tier 3,61.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1790,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1790,BCBSND Hospital Base OP Fee Sched Tier 3,6.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1800,BCBSND Hospital Base OP Fee Sched Tier 3,5.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1815,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1815,BCBSND Hospital Base OP Fee Sched Tier 3,1.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1817,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1817,BCBSND Hospital Base OP Fee Sched Tier 3,16.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1826,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1826,BCBSND Hospital Base OP Fee Sched Tier 3,2454.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1830,BCBSND Hospital Base OP Fee Sched Tier 3,631.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1833,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1833,BCBSND Hospital Base OP Fee Sched Tier 3,1.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1885,BCBSND Hospital Base OP Fee Sched Tier 3,0.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1930,BCBSND Hospital Base OP Fee Sched Tier 3,86.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1931,BCBSND Hospital Base OP Fee Sched Tier 3,45.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1940,BCBSND Hospital Base OP Fee Sched Tier 3,1.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1942,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1942,BCBSND Hospital Base OP Fee Sched Tier 3,3.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1950,BCBSND Hospital Base OP Fee Sched Tier 3,1743.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1953,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1953,BCBSND Hospital Base OP Fee Sched Tier 3,0.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1955,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1955,BCBSND Hospital Base OP Fee Sched Tier 3,29.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1956,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1956,BCBSND Hospital Base OP Fee Sched Tier 3,1.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,J1980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J1980,BCBSND Hospital Base OP Fee Sched Tier 3,44.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2001,BCBSND Hospital Base OP Fee Sched Tier 3,0.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2010,BCBSND Hospital Base OP Fee Sched Tier 3,18.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2020,BCBSND Hospital Base OP Fee Sched Tier 3,13.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2060,BCBSND Hospital Base OP Fee Sched Tier 3,1.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2062,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2062,BCBSND Hospital Base OP Fee Sched Tier 3,21.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2150,BCBSND Hospital Base OP Fee Sched Tier 3,5.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2170,BCBSND Hospital Base OP Fee Sched Tier 3,158.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2175,BCBSND Hospital Base OP Fee Sched Tier 3,7.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2182,BCBSND Hospital Base OP Fee Sched Tier 3,43.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2185,BCBSND Hospital Base OP Fee Sched Tier 3,1.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2186,BCBSND Hospital Base OP Fee Sched Tier 3,2.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2210,BCBSND Hospital Base OP Fee Sched Tier 3,24.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2212,BCBSND Hospital Base OP Fee Sched Tier 3,1.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2248,BCBSND Hospital Base OP Fee Sched Tier 3,1.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2250,BCBSND Hospital Base OP Fee Sched Tier 3,0.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2260,BCBSND Hospital Base OP Fee Sched Tier 3,2.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2265,BCBSND Hospital Base OP Fee Sched Tier 3,2.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2270,BCBSND Hospital Base OP Fee Sched Tier 3,3.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2274,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2274,BCBSND Hospital Base OP Fee Sched Tier 3,11.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2278,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2278,BCBSND Hospital Base OP Fee Sched Tier 3,11.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2280,BCBSND Hospital Base OP Fee Sched Tier 3,13.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2300,BCBSND Hospital Base OP Fee Sched Tier 3,4.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2310,BCBSND Hospital Base OP Fee Sched Tier 3,21.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2315,BCBSND Hospital Base OP Fee Sched Tier 3,4.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2323,BCBSND Hospital Base OP Fee Sched Tier 3,28.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2325,BCBSND Hospital Base OP Fee Sched Tier 3,100.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2326,BCBSND Hospital Base OP Fee Sched Tier 3,1476.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2350,BCBSND Hospital Base OP Fee Sched Tier 3,84.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2353,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2353,BCBSND Hospital Base OP Fee Sched Tier 3,289.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2354,BCBSND Hospital Base OP Fee Sched Tier 3,1.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2357,BCBSND Hospital Base OP Fee Sched Tier 3,54.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2358,BCBSND Hospital Base OP Fee Sched Tier 3,4.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2360,BCBSND Hospital Base OP Fee Sched Tier 3,7.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2370,BCBSND Hospital Base OP Fee Sched Tier 3,5.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2400,BCBSND Hospital Base OP Fee Sched Tier 3,40.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2405,BCBSND Hospital Base OP Fee Sched Tier 3,0.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2407,BCBSND Hospital Base OP Fee Sched Tier 3,35.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2425,BCBSND Hospital Base OP Fee Sched Tier 3,29.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2426,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2426,BCBSND Hospital Base OP Fee Sched Tier 3,15.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2430,BCBSND Hospital Base OP Fee Sched Tier 3,23.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2440,BCBSND Hospital Base OP Fee Sched Tier 3,48.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2469,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2469,BCBSND Hospital Base OP Fee Sched Tier 3,17.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2501,BCBSND Hospital Base OP Fee Sched Tier 3,1.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2502,BCBSND Hospital Base OP Fee Sched Tier 3,599.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2503,BCBSND Hospital Base OP Fee Sched Tier 3,1045.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2504,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2504,BCBSND Hospital Base OP Fee Sched Tier 3,538.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2505,BCBSND Hospital Base OP Fee Sched Tier 3,6818.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2507,BCBSND Hospital Base OP Fee Sched Tier 3,3519.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2510,BCBSND Hospital Base OP Fee Sched Tier 3,43.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2515,BCBSND Hospital Base OP Fee Sched Tier 3,65.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2540,BCBSND Hospital Base OP Fee Sched Tier 3,1.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2543,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2543,BCBSND Hospital Base OP Fee Sched Tier 3,2.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2545,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2545,BCBSND Hospital Base OP Fee Sched Tier 3,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2547,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2547,BCBSND Hospital Base OP Fee Sched Tier 3,2.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2550,BCBSND Hospital Base OP Fee Sched Tier 3,3.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2560,BCBSND Hospital Base OP Fee Sched Tier 3,57.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2562,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2562,BCBSND Hospital Base OP Fee Sched Tier 3,484.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2590,BCBSND Hospital Base OP Fee Sched Tier 3,1.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2597,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2597,BCBSND Hospital Base OP Fee Sched Tier 3,18.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2675,BCBSND Hospital Base OP Fee Sched Tier 3,2.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2680,BCBSND Hospital Base OP Fee Sched Tier 3,18.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2690,BCBSND Hospital Base OP Fee Sched Tier 3,120.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2700,BCBSND Hospital Base OP Fee Sched Tier 3,2.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2704,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2704,BCBSND Hospital Base OP Fee Sched Tier 3,0.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2710,BCBSND Hospital Base OP Fee Sched Tier 3,2.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2720,BCBSND Hospital Base OP Fee Sched Tier 3,1.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2724,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2724,BCBSND Hospital Base OP Fee Sched Tier 3,22.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2730,BCBSND Hospital Base OP Fee Sched Tier 3,122.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2760,BCBSND Hospital Base OP Fee Sched Tier 3,613.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2765,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2765,BCBSND Hospital Base OP Fee Sched Tier 3,1.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2770,BCBSND Hospital Base OP Fee Sched Tier 3,610.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2778,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2778,BCBSND Hospital Base OP Fee Sched Tier 3,533.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2780,BCBSND Hospital Base OP Fee Sched Tier 3,7.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2783,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2783,BCBSND Hospital Base OP Fee Sched Tier 3,408.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2785,BCBSND Hospital Base OP Fee Sched Tier 3,84.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2786,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2786,BCBSND Hospital Base OP Fee Sched Tier 3,13.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2787,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2787,BCBSND Hospital Base OP Fee Sched Tier 3,2019.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2788,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2788,BCBSND Hospital Base OP Fee Sched Tier 3,37.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2790,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2790,BCBSND Hospital Base OP Fee Sched Tier 3,114.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2791,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2791,BCBSND Hospital Base OP Fee Sched Tier 3,7.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2792,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2792,BCBSND Hospital Base OP Fee Sched Tier 3,41.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2793,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2793,BCBSND Hospital Base OP Fee Sched Tier 3,32.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2794,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2794,BCBSND Hospital Base OP Fee Sched Tier 3,13.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2795,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2795,BCBSND Hospital Base OP Fee Sched Tier 3,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2796,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2796,BCBSND Hospital Base OP Fee Sched Tier 3,105.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2797,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2797,BCBSND Hospital Base OP Fee Sched Tier 3,1.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2800,BCBSND Hospital Base OP Fee Sched Tier 3,22.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2805,BCBSND Hospital Base OP Fee Sched Tier 3,152.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2810,BCBSND Hospital Base OP Fee Sched Tier 3,0.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2820,BCBSND Hospital Base OP Fee Sched Tier 3,58.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2840,BCBSND Hospital Base OP Fee Sched Tier 3,723.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2850,BCBSND Hospital Base OP Fee Sched Tier 3,46.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2860,BCBSND Hospital Base OP Fee Sched Tier 3,140.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2916,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2916,BCBSND Hospital Base OP Fee Sched Tier 3,2.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2920,BCBSND Hospital Base OP Fee Sched Tier 3,6.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2930,BCBSND Hospital Base OP Fee Sched Tier 3,9.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2941,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2941,BCBSND Hospital Base OP Fee Sched Tier 3,196.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,J2997,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J2997,BCBSND Hospital Base OP Fee Sched Tier 3,128.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3000,BCBSND Hospital Base OP Fee Sched Tier 3,44.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3010,BCBSND Hospital Base OP Fee Sched Tier 3,1.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3030,BCBSND Hospital Base OP Fee Sched Tier 3,78.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3060,BCBSND Hospital Base OP Fee Sched Tier 3,59.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3090,BCBSND Hospital Base OP Fee Sched Tier 3,2.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3095,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3095,BCBSND Hospital Base OP Fee Sched Tier 3,8.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3101,BCBSND Hospital Base OP Fee Sched Tier 3,178.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3105,BCBSND Hospital Base OP Fee Sched Tier 3,4.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3110,BCBSND Hospital Base OP Fee Sched Tier 3,80.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3121,BCBSND Hospital Base OP Fee Sched Tier 3,0.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3145,BCBSND Hospital Base OP Fee Sched Tier 3,2.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3230,BCBSND Hospital Base OP Fee Sched Tier 3,42.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3240,BCBSND Hospital Base OP Fee Sched Tier 3,2419.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3243,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3243,BCBSND Hospital Base OP Fee Sched Tier 3,2.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3245,BCBSND Hospital Base OP Fee Sched Tier 3,199,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3246,BCBSND Hospital Base OP Fee Sched Tier 3,21.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3250,BCBSND Hospital Base OP Fee Sched Tier 3,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3260,BCBSND Hospital Base OP Fee Sched Tier 3,5.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3262,BCBSND Hospital Base OP Fee Sched Tier 3,7.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3285,BCBSND Hospital Base OP Fee Sched Tier 3,96.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3300,BCBSND Hospital Base OP Fee Sched Tier 3,5.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3301,BCBSND Hospital Base OP Fee Sched Tier 3,2.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3304,BCBSND Hospital Base OP Fee Sched Tier 3,27.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3315,BCBSND Hospital Base OP Fee Sched Tier 3,352.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3316,BCBSND Hospital Base OP Fee Sched Tier 3,3874.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3355,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3355,BCBSND Hospital Base OP Fee Sched Tier 3,177.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3357,BCBSND Hospital Base OP Fee Sched Tier 3,264.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3358,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3358,BCBSND Hospital Base OP Fee Sched Tier 3,17.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3360,BCBSND Hospital Base OP Fee Sched Tier 3,10.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3370,BCBSND Hospital Base OP Fee Sched Tier 3,6.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3380,BCBSND Hospital Base OP Fee Sched Tier 3,28.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3385,BCBSND Hospital Base OP Fee Sched Tier 3,506.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3396,BCBSND Hospital Base OP Fee Sched Tier 3,16.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3397,BCBSND Hospital Base OP Fee Sched Tier 3,299.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3398,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3398,BCBSND Hospital Base OP Fee Sched Tier 3,4016.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3410,BCBSND Hospital Base OP Fee Sched Tier 3,10.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3411,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3411,BCBSND Hospital Base OP Fee Sched Tier 3,4.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3415,BCBSND Hospital Base OP Fee Sched Tier 3,14.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3420,BCBSND Hospital Base OP Fee Sched Tier 3,2.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3430,BCBSND Hospital Base OP Fee Sched Tier 3,6.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3465,BCBSND Hospital Base OP Fee Sched Tier 3,2.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3470,BCBSND Hospital Base OP Fee Sched Tier 3,79.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3471,BCBSND Hospital Base OP Fee Sched Tier 3,0.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3473,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3473,BCBSND Hospital Base OP Fee Sched Tier 3,0.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3475,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3475,BCBSND Hospital Base OP Fee Sched Tier 3,0.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3480,BCBSND Hospital Base OP Fee Sched Tier 3,0.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3485,BCBSND Hospital Base OP Fee Sched Tier 3,2.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3486,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3486,BCBSND Hospital Base OP Fee Sched Tier 3,26.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J3489,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J3489,BCBSND Hospital Base OP Fee Sched Tier 3,15.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7030,BCBSND Hospital Base OP Fee Sched Tier 3,3.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7040,BCBSND Hospital Base OP Fee Sched Tier 3,1.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7042,BCBSND Hospital Base OP Fee Sched Tier 3,1.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7050,BCBSND Hospital Base OP Fee Sched Tier 3,0.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7060,BCBSND Hospital Base OP Fee Sched Tier 3,3.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7070,BCBSND Hospital Base OP Fee Sched Tier 3,6.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7100,BCBSND Hospital Base OP Fee Sched Tier 3,37.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7120,BCBSND Hospital Base OP Fee Sched Tier 3,3.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7121,BCBSND Hospital Base OP Fee Sched Tier 3,7.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7131,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7131,BCBSND Hospital Base OP Fee Sched Tier 3,0.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7170,BCBSND Hospital Base OP Fee Sched Tier 3,70.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7175,BCBSND Hospital Base OP Fee Sched Tier 3,10.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7177,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7177,BCBSND Hospital Base OP Fee Sched Tier 3,1.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7178,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7178,BCBSND Hospital Base OP Fee Sched Tier 3,1.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7179,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7179,BCBSND Hospital Base OP Fee Sched Tier 3,2.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7180,BCBSND Hospital Base OP Fee Sched Tier 3,12.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7181,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7181,BCBSND Hospital Base OP Fee Sched Tier 3,21.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7182,BCBSND Hospital Base OP Fee Sched Tier 3,1.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7183,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7183,BCBSND Hospital Base OP Fee Sched Tier 3,1.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7185,BCBSND Hospital Base OP Fee Sched Tier 3,1.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7186,BCBSND Hospital Base OP Fee Sched Tier 3,1.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7187,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7187,BCBSND Hospital Base OP Fee Sched Tier 3,1.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7188,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7188,BCBSND Hospital Base OP Fee Sched Tier 3,4.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7189,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7189,BCBSND Hospital Base OP Fee Sched Tier 3,3.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7190,BCBSND Hospital Base OP Fee Sched Tier 3,1.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7192,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7192,BCBSND Hospital Base OP Fee Sched Tier 3,1.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7193,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7193,BCBSND Hospital Base OP Fee Sched Tier 3,1.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7194,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7194,BCBSND Hospital Base OP Fee Sched Tier 3,2.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7195,BCBSND Hospital Base OP Fee Sched Tier 3,2.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7196,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7196,BCBSND Hospital Base OP Fee Sched Tier 3,199.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7197,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7197,BCBSND Hospital Base OP Fee Sched Tier 3,4.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7198,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7198,BCBSND Hospital Base OP Fee Sched Tier 3,2.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7200,BCBSND Hospital Base OP Fee Sched Tier 3,1.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7201,BCBSND Hospital Base OP Fee Sched Tier 3,4.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7202,BCBSND Hospital Base OP Fee Sched Tier 3,6.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7203,BCBSND Hospital Base OP Fee Sched Tier 3,5.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7205,BCBSND Hospital Base OP Fee Sched Tier 3,2.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7207,BCBSND Hospital Base OP Fee Sched Tier 3,2.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7209,BCBSND Hospital Base OP Fee Sched Tier 3,1.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7210,BCBSND Hospital Base OP Fee Sched Tier 3,2.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7211,BCBSND Hospital Base OP Fee Sched Tier 3,2.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7296,BCBSND Hospital Base OP Fee Sched Tier 3,1351.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7297,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7297,BCBSND Hospital Base OP Fee Sched Tier 3,1062.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7298,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7298,BCBSND Hospital Base OP Fee Sched Tier 3,1351.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7300,BCBSND Hospital Base OP Fee Sched Tier 3,1146.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7301,BCBSND Hospital Base OP Fee Sched Tier 3,1125.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7303,BCBSND Hospital Base OP Fee Sched Tier 3,230.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7304,BCBSND Hospital Base OP Fee Sched Tier 3,57.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7307,BCBSND Hospital Base OP Fee Sched Tier 3,1262.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7308,BCBSND Hospital Base OP Fee Sched Tier 3,580.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7311,BCBSND Hospital Base OP Fee Sched Tier 3,29484.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7312,BCBSND Hospital Base OP Fee Sched Tier 3,293.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7313,BCBSND Hospital Base OP Fee Sched Tier 3,718.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7315,BCBSND Hospital Base OP Fee Sched Tier 3,508.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7316,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7316,BCBSND Hospital Base OP Fee Sched Tier 3,1526.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7318,BCBSND Hospital Base OP Fee Sched Tier 3,23.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7320,BCBSND Hospital Base OP Fee Sched Tier 3,9.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7321,BCBSND Hospital Base OP Fee Sched Tier 3,122.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7322,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7322,BCBSND Hospital Base OP Fee Sched Tier 3,25.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7323,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7323,BCBSND Hospital Base OP Fee Sched Tier 3,212.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7324,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7324,BCBSND Hospital Base OP Fee Sched Tier 3,215.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7325,BCBSND Hospital Base OP Fee Sched Tier 3,16.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7326,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7326,BCBSND Hospital Base OP Fee Sched Tier 3,787.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7327,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7327,BCBSND Hospital Base OP Fee Sched Tier 3,1158.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7328,BCBSND Hospital Base OP Fee Sched Tier 3,2.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7329,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7329,BCBSND Hospital Base OP Fee Sched Tier 3,9.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7336,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7336,BCBSND Hospital Base OP Fee Sched Tier 3,4.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7340,BCBSND Hospital Base OP Fee Sched Tier 3,310.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7342,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7342,BCBSND Hospital Base OP Fee Sched Tier 3,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7345,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7345,BCBSND Hospital Base OP Fee Sched Tier 3,2.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7500,BCBSND Hospital Base OP Fee Sched Tier 3,1.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7501,BCBSND Hospital Base OP Fee Sched Tier 3,354.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7502,BCBSND Hospital Base OP Fee Sched Tier 3,3.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7503,BCBSND Hospital Base OP Fee Sched Tier 3,1.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7504,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7504,BCBSND Hospital Base OP Fee Sched Tier 3,3034.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7507,BCBSND Hospital Base OP Fee Sched Tier 3,0.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7508,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7508,BCBSND Hospital Base OP Fee Sched Tier 3,0.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7509,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7509,BCBSND Hospital Base OP Fee Sched Tier 3,1.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7510,BCBSND Hospital Base OP Fee Sched Tier 3,0.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7511,BCBSND Hospital Base OP Fee Sched Tier 3,1083.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7512,BCBSND Hospital Base OP Fee Sched Tier 3,0.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7515,BCBSND Hospital Base OP Fee Sched Tier 3,1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7516,BCBSND Hospital Base OP Fee Sched Tier 3,83.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7517,BCBSND Hospital Base OP Fee Sched Tier 3,1.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7518,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7518,BCBSND Hospital Base OP Fee Sched Tier 3,4.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7520,BCBSND Hospital Base OP Fee Sched Tier 3,10.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7525,BCBSND Hospital Base OP Fee Sched Tier 3,301.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7527,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7527,BCBSND Hospital Base OP Fee Sched Tier 3,12.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7605,BCBSND Hospital Base OP Fee Sched Tier 3,14.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7606,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7606,BCBSND Hospital Base OP Fee Sched Tier 3,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7608,BCBSND Hospital Base OP Fee Sched Tier 3,9.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7609,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7609,BCBSND Hospital Base OP Fee Sched Tier 3,0.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7611,BCBSND Hospital Base OP Fee Sched Tier 3,0.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7612,BCBSND Hospital Base OP Fee Sched Tier 3,0.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7613,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7613,BCBSND Hospital Base OP Fee Sched Tier 3,0.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7614,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7614,BCBSND Hospital Base OP Fee Sched Tier 3,0.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7620,BCBSND Hospital Base OP Fee Sched Tier 3,0.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7626,BCBSND Hospital Base OP Fee Sched Tier 3,3.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7627,BCBSND Hospital Base OP Fee Sched Tier 3,0.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7628,BCBSND Hospital Base OP Fee Sched Tier 3,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7631,BCBSND Hospital Base OP Fee Sched Tier 3,8.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7639,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7639,BCBSND Hospital Base OP Fee Sched Tier 3,69.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7643,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7643,BCBSND Hospital Base OP Fee Sched Tier 3,1.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7644,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7644,BCBSND Hospital Base OP Fee Sched Tier 3,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7674,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7674,BCBSND Hospital Base OP Fee Sched Tier 3,1,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7682,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7682,BCBSND Hospital Base OP Fee Sched Tier 3,51.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J7686,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J7686,BCBSND Hospital Base OP Fee Sched Tier 3,855.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8501,BCBSND Hospital Base OP Fee Sched Tier 3,7.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8510,BCBSND Hospital Base OP Fee Sched Tier 3,35.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8515,BCBSND Hospital Base OP Fee Sched Tier 3,8.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8520,BCBSND Hospital Base OP Fee Sched Tier 3,2.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8521,BCBSND Hospital Base OP Fee Sched Tier 3,5.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8530,BCBSND Hospital Base OP Fee Sched Tier 3,5.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8540,BCBSND Hospital Base OP Fee Sched Tier 3,0.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8560,BCBSND Hospital Base OP Fee Sched Tier 3,111.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8565,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8565,BCBSND Hospital Base OP Fee Sched Tier 3,364.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8600,BCBSND Hospital Base OP Fee Sched Tier 3,17.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8610,BCBSND Hospital Base OP Fee Sched Tier 3,0.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8650,BCBSND Hospital Base OP Fee Sched Tier 3,55.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8655,BCBSND Hospital Base OP Fee Sched Tier 3,380.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8670,BCBSND Hospital Base OP Fee Sched Tier 3,2.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8700,BCBSND Hospital Base OP Fee Sched Tier 3,1.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,J8705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J8705,BCBSND Hospital Base OP Fee Sched Tier 3,151.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9000,BCBSND Hospital Base OP Fee Sched Tier 3,4.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9015,BCBSND Hospital Base OP Fee Sched Tier 3,5533.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9017,BCBSND Hospital Base OP Fee Sched Tier 3,92.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9019,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9019,BCBSND Hospital Base OP Fee Sched Tier 3,607.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9022,BCBSND Hospital Base OP Fee Sched Tier 3,113.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9023,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9023,BCBSND Hospital Base OP Fee Sched Tier 3,119.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9025,BCBSND Hospital Base OP Fee Sched Tier 3,1.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9027,BCBSND Hospital Base OP Fee Sched Tier 3,96.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9031,BCBSND Hospital Base OP Fee Sched Tier 3,207.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9032,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9033,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9033,BCBSND Hospital Base OP Fee Sched Tier 3,43.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9034,BCBSND Hospital Base OP Fee Sched Tier 3,35.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9035,BCBSND Hospital Base OP Fee Sched Tier 3,118.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9039,BCBSND Hospital Base OP Fee Sched Tier 3,161.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9040,BCBSND Hospital Base OP Fee Sched Tier 3,36.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9041,BCBSND Hospital Base OP Fee Sched Tier 3,65.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9042,BCBSND Hospital Base OP Fee Sched Tier 3,229.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9043,BCBSND Hospital Base OP Fee Sched Tier 3,247.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9044,BCBSND Hospital Base OP Fee Sched Tier 3,45.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9045,BCBSND Hospital Base OP Fee Sched Tier 3,4.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9047,BCBSND Hospital Base OP Fee Sched Tier 3,53.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9050,BCBSND Hospital Base OP Fee Sched Tier 3,5687.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9055,BCBSND Hospital Base OP Fee Sched Tier 3,88.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9057,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9057,BCBSND Hospital Base OP Fee Sched Tier 3,108.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9060,BCBSND Hospital Base OP Fee Sched Tier 3,2.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9065,BCBSND Hospital Base OP Fee Sched Tier 3,32.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9070,BCBSND Hospital Base OP Fee Sched Tier 3,54.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9100,BCBSND Hospital Base OP Fee Sched Tier 3,0.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9120,BCBSND Hospital Base OP Fee Sched Tier 3,1836.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9130,BCBSND Hospital Base OP Fee Sched Tier 3,7.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9145,BCBSND Hospital Base OP Fee Sched Tier 3,76.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9150,BCBSND Hospital Base OP Fee Sched Tier 3,69.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9153,BCBSND Hospital Base OP Fee Sched Tier 3,281.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9155,BCBSND Hospital Base OP Fee Sched Tier 3,8.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9171,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9171,BCBSND Hospital Base OP Fee Sched Tier 3,1.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9173,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9173,BCBSND Hospital Base OP Fee Sched Tier 3,108.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9175,BCBSND Hospital Base OP Fee Sched Tier 3,12.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9176,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9176,BCBSND Hospital Base OP Fee Sched Tier 3,9.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9178,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9178,BCBSND Hospital Base OP Fee Sched Tier 3,1.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9179,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9179,BCBSND Hospital Base OP Fee Sched Tier 3,168.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9181,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9181,BCBSND Hospital Base OP Fee Sched Tier 3,1.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9185,BCBSND Hospital Base OP Fee Sched Tier 3,101.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9190,BCBSND Hospital Base OP Fee Sched Tier 3,2.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9200,BCBSND Hospital Base OP Fee Sched Tier 3,110.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9201,BCBSND Hospital Base OP Fee Sched Tier 3,7.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9202,BCBSND Hospital Base OP Fee Sched Tier 3,715.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9203,BCBSND Hospital Base OP Fee Sched Tier 3,266.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9205,BCBSND Hospital Base OP Fee Sched Tier 3,67,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9206,BCBSND Hospital Base OP Fee Sched Tier 3,4.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9207,BCBSND Hospital Base OP Fee Sched Tier 3,123.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9208,BCBSND Hospital Base OP Fee Sched Tier 3,39.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9209,BCBSND Hospital Base OP Fee Sched Tier 3,2.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9211,BCBSND Hospital Base OP Fee Sched Tier 3,52.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9214,BCBSND Hospital Base OP Fee Sched Tier 3,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9215,BCBSND Hospital Base OP Fee Sched Tier 3,42.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9216,BCBSND Hospital Base OP Fee Sched Tier 3,9725.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9217,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9217,BCBSND Hospital Base OP Fee Sched Tier 3,328.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9218,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9218,BCBSND Hospital Base OP Fee Sched Tier 3,20.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9225,BCBSND Hospital Base OP Fee Sched Tier 3,5665.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9226,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9226,BCBSND Hospital Base OP Fee Sched Tier 3,51218.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9228,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9228,BCBSND Hospital Base OP Fee Sched Tier 3,221.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9229,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9229,BCBSND Hospital Base OP Fee Sched Tier 3,3033.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9230,BCBSND Hospital Base OP Fee Sched Tier 3,471.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9245,BCBSND Hospital Base OP Fee Sched Tier 3,1021.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9250,BCBSND Hospital Base OP Fee Sched Tier 3,0.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9260,BCBSND Hospital Base OP Fee Sched Tier 3,3.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9261,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9261,BCBSND Hospital Base OP Fee Sched Tier 3,222.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9262,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9262,BCBSND Hospital Base OP Fee Sched Tier 3,4.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9263,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9263,BCBSND Hospital Base OP Fee Sched Tier 3,0.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9264,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9264,BCBSND Hospital Base OP Fee Sched Tier 3,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9266,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9266,BCBSND Hospital Base OP Fee Sched Tier 3,22997.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9267,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9267,BCBSND Hospital Base OP Fee Sched Tier 3,0.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9268,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9268,BCBSND Hospital Base OP Fee Sched Tier 3,2906.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9271,BCBSND Hospital Base OP Fee Sched Tier 3,72.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9280,BCBSND Hospital Base OP Fee Sched Tier 3,169.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9285,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9285,BCBSND Hospital Base OP Fee Sched Tier 3,74.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9293,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9293,BCBSND Hospital Base OP Fee Sched Tier 3,48.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9295,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9295,BCBSND Hospital Base OP Fee Sched Tier 3,8.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9299,BCBSND Hospital Base OP Fee Sched Tier 3,40.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9301,BCBSND Hospital Base OP Fee Sched Tier 3,93.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9302,BCBSND Hospital Base OP Fee Sched Tier 3,85.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9303,BCBSND Hospital Base OP Fee Sched Tier 3,168.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9305,BCBSND Hospital Base OP Fee Sched Tier 3,100.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9306,BCBSND Hospital Base OP Fee Sched Tier 3,17.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9307,BCBSND Hospital Base OP Fee Sched Tier 3,412.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9308,BCBSND Hospital Base OP Fee Sched Tier 3,84.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9311,BCBSND Hospital Base OP Fee Sched Tier 3,66.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9312,BCBSND Hospital Base OP Fee Sched Tier 3,139.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9315,BCBSND Hospital Base OP Fee Sched Tier 3,459.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9320,BCBSND Hospital Base OP Fee Sched Tier 3,505.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9325,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9325,BCBSND Hospital Base OP Fee Sched Tier 3,73.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9328,BCBSND Hospital Base OP Fee Sched Tier 3,15.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9330,BCBSND Hospital Base OP Fee Sched Tier 3,90.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9340,BCBSND Hospital Base OP Fee Sched Tier 3,1063.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9351,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9351,BCBSND Hospital Base OP Fee Sched Tier 3,1.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9352,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9352,BCBSND Hospital Base OP Fee Sched Tier 3,440.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9354,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9354,BCBSND Hospital Base OP Fee Sched Tier 3,45.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9357,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9357,BCBSND Hospital Base OP Fee Sched Tier 3,2021.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9360,BCBSND Hospital Base OP Fee Sched Tier 3,5.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9370,BCBSND Hospital Base OP Fee Sched Tier 3,7.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9371,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9371,BCBSND Hospital Base OP Fee Sched Tier 3,4438.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9390,BCBSND Hospital Base OP Fee Sched Tier 3,13.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9395,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9395,BCBSND Hospital Base OP Fee Sched Tier 3,142.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9400,BCBSND Hospital Base OP Fee Sched Tier 3,12.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,J9600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,J9600,BCBSND Hospital Base OP Fee Sched Tier 3,28955.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0001RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0001RR,BCBSND Hospital Base OP Fee Sched Tier 3,25.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0002RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0002RR,BCBSND Hospital Base OP Fee Sched Tier 3,42.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0003RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0003RR,BCBSND Hospital Base OP Fee Sched Tier 3,40.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0004RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0004RR,BCBSND Hospital Base OP Fee Sched Tier 3,47.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0005,BCBSND Hospital Base OP Fee Sched Tier 3,2406.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0006RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0006RR,BCBSND Hospital Base OP Fee Sched Tier 3,65.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0007RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0007RR,BCBSND Hospital Base OP Fee Sched Tier 3,91.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0009RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0009RR,BCBSND Hospital Base OP Fee Sched Tier 3,94.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0010RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0010RR,BCBSND Hospital Base OP Fee Sched Tier 3,564.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0011RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0011RR,BCBSND Hospital Base OP Fee Sched Tier 3,631.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0012RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0012RR,BCBSND Hospital Base OP Fee Sched Tier 3,387.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0015RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0015RR,BCBSND Hospital Base OP Fee Sched Tier 3,16.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0017,BCBSND Hospital Base OP Fee Sched Tier 3,52.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0018,BCBSND Hospital Base OP Fee Sched Tier 3,29.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0019,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0019,BCBSND Hospital Base OP Fee Sched Tier 3,14.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0020,BCBSND Hospital Base OP Fee Sched Tier 3,51.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0037,BCBSND Hospital Base OP Fee Sched Tier 3,46.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0038,BCBSND Hospital Base OP Fee Sched Tier 3,26.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0039,BCBSND Hospital Base OP Fee Sched Tier 3,56.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0040,BCBSND Hospital Base OP Fee Sched Tier 3,57.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0041,BCBSND Hospital Base OP Fee Sched Tier 3,54.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0042,BCBSND Hospital Base OP Fee Sched Tier 3,34.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0043,BCBSND Hospital Base OP Fee Sched Tier 3,21.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0044,BCBSND Hospital Base OP Fee Sched Tier 3,18.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0045,BCBSND Hospital Base OP Fee Sched Tier 3,54.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0046,BCBSND Hospital Base OP Fee Sched Tier 3,21.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0047,BCBSND Hospital Base OP Fee Sched Tier 3,76.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0050,BCBSND Hospital Base OP Fee Sched Tier 3,35.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0051,BCBSND Hospital Base OP Fee Sched Tier 3,56.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0052,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0052,BCBSND Hospital Base OP Fee Sched Tier 3,80.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0053,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0053,BCBSND Hospital Base OP Fee Sched Tier 3,90.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0056,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0056,BCBSND Hospital Base OP Fee Sched Tier 3,105.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0065,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0065,BCBSND Hospital Base OP Fee Sched Tier 3,53.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0069,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0069,BCBSND Hospital Base OP Fee Sched Tier 3,102.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0070RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0070RR,BCBSND Hospital Base OP Fee Sched Tier 3,17.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0071,BCBSND Hospital Base OP Fee Sched Tier 3,121.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0072,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0072,BCBSND Hospital Base OP Fee Sched Tier 3,73.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0073,BCBSND Hospital Base OP Fee Sched Tier 3,39.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0077,BCBSND Hospital Base OP Fee Sched Tier 3,59.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0098,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0098,BCBSND Hospital Base OP Fee Sched Tier 3,27.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0105,BCBSND Hospital Base OP Fee Sched Tier 3,109.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0195RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0195RR,BCBSND Hospital Base OP Fee Sched Tier 3,12.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0455RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0455RR,BCBSND Hospital Base OP Fee Sched Tier 3,315.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0552,BCBSND Hospital Base OP Fee Sched Tier 3,3.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0553,BCBSND Hospital Base OP Fee Sched Tier 3,295.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0554,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0554,BCBSND Hospital Base OP Fee Sched Tier 3,310.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0601,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0601,BCBSND Hospital Base OP Fee Sched Tier 3,1.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0602,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0602,BCBSND Hospital Base OP Fee Sched Tier 3,7.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0603,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0603,BCBSND Hospital Base OP Fee Sched Tier 3,0.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0604,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0604,BCBSND Hospital Base OP Fee Sched Tier 3,7.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0605,BCBSND Hospital Base OP Fee Sched Tier 3,18.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0606RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0606RR,BCBSND Hospital Base OP Fee Sched Tier 3,3334.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0607RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0607RR,BCBSND Hospital Base OP Fee Sched Tier 3,25.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0608,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0608,BCBSND Hospital Base OP Fee Sched Tier 3,160.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0609,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0609,BCBSND Hospital Base OP Fee Sched Tier 3,1067.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0672,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0672,BCBSND Hospital Base OP Fee Sched Tier 3,97.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0730RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0730RR,BCBSND Hospital Base OP Fee Sched Tier 3,228.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0733,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0733,BCBSND Hospital Base OP Fee Sched Tier 3,31.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0738RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0738RR,BCBSND Hospital Base OP Fee Sched Tier 3,41.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0739,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0739,BCBSND Hospital Base OP Fee Sched Tier 3,22.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0740,BCBSND Hospital Base OP Fee Sched Tier 3,22.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0744,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0744,BCBSND Hospital Base OP Fee Sched Tier 3,2.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0745,BCBSND Hospital Base OP Fee Sched Tier 3,4.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0746,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0746,BCBSND Hospital Base OP Fee Sched Tier 3,8.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0800,BCBSND Hospital Base OP Fee Sched Tier 3,914.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0801,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0801,BCBSND Hospital Base OP Fee Sched Tier 3,1709.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0802,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0802,BCBSND Hospital Base OP Fee Sched Tier 3,2252.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0806,BCBSND Hospital Base OP Fee Sched Tier 3,1570.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0807,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0807,BCBSND Hospital Base OP Fee Sched Tier 3,2433.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0808,BCBSND Hospital Base OP Fee Sched Tier 3,3762.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0812,BCBSND Hospital Base OP Fee Sched Tier 3,2994.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0813RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0813RR,BCBSND Hospital Base OP Fee Sched Tier 3,299.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0814RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0814RR,BCBSND Hospital Base OP Fee Sched Tier 3,316.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0815RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0815RR,BCBSND Hospital Base OP Fee Sched Tier 3,359.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0816RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0816RR,BCBSND Hospital Base OP Fee Sched Tier 3,317.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0820RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0820RR,BCBSND Hospital Base OP Fee Sched Tier 3,317.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0821RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0821RR,BCBSND Hospital Base OP Fee Sched Tier 3,317.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0822RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0822RR,BCBSND Hospital Base OP Fee Sched Tier 3,347.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0823RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0823RR,BCBSND Hospital Base OP Fee Sched Tier 3,317.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0824RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0824RR,BCBSND Hospital Base OP Fee Sched Tier 3,506.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0825RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0825RR,BCBSND Hospital Base OP Fee Sched Tier 3,457.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0826RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0826RR,BCBSND Hospital Base OP Fee Sched Tier 3,856.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0827RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0827RR,BCBSND Hospital Base OP Fee Sched Tier 3,750.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0828RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0828RR,BCBSND Hospital Base OP Fee Sched Tier 3,1035,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0829RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0829RR,BCBSND Hospital Base OP Fee Sched Tier 3,1005.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0830RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0830RR,BCBSND Hospital Base OP Fee Sched Tier 3,713.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0831RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0831RR,BCBSND Hospital Base OP Fee Sched Tier 3,673.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0835RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0835RR,BCBSND Hospital Base OP Fee Sched Tier 3,403.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0836RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0836RR,BCBSND Hospital Base OP Fee Sched Tier 3,418.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0837RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0837RR,BCBSND Hospital Base OP Fee Sched Tier 3,517.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0838RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0838RR,BCBSND Hospital Base OP Fee Sched Tier 3,458.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0839RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0839RR,BCBSND Hospital Base OP Fee Sched Tier 3,687.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0840RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0840RR,BCBSND Hospital Base OP Fee Sched Tier 3,1055.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0841RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0841RR,BCBSND Hospital Base OP Fee Sched Tier 3,454.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0842RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0842RR,BCBSND Hospital Base OP Fee Sched Tier 3,454.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0843RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0843RR,BCBSND Hospital Base OP Fee Sched Tier 3,539.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0848RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0848RR,BCBSND Hospital Base OP Fee Sched Tier 3,904.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0849RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0849RR,BCBSND Hospital Base OP Fee Sched Tier 3,869.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0850RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0850RR,BCBSND Hospital Base OP Fee Sched Tier 3,1049.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0851RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0851RR,BCBSND Hospital Base OP Fee Sched Tier 3,1008.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0852RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0852RR,BCBSND Hospital Base OP Fee Sched Tier 3,1212.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0853RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0853RR,BCBSND Hospital Base OP Fee Sched Tier 3,1245.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0854RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0854RR,BCBSND Hospital Base OP Fee Sched Tier 3,1649.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0855RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0855RR,BCBSND Hospital Base OP Fee Sched Tier 3,1558.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0856RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0856RR,BCBSND Hospital Base OP Fee Sched Tier 3,970.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0857RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0857RR,BCBSND Hospital Base OP Fee Sched Tier 3,990.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0858RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0858RR,BCBSND Hospital Base OP Fee Sched Tier 3,1204.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0859RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0859RR,BCBSND Hospital Base OP Fee Sched Tier 3,1148.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0860RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0860RR,BCBSND Hospital Base OP Fee Sched Tier 3,1721.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0861RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0861RR,BCBSND Hospital Base OP Fee Sched Tier 3,972.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0862RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0862RR,BCBSND Hospital Base OP Fee Sched Tier 3,1204.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0863RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0863RR,BCBSND Hospital Base OP Fee Sched Tier 3,1721.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0864RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0864RR,BCBSND Hospital Base OP Fee Sched Tier 3,2048.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0868RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0868RR,BCBSND Hospital Base OP Fee Sched Tier 3,678.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0869RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0869RR,BCBSND Hospital Base OP Fee Sched Tier 3,678.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0870RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0870RR,BCBSND Hospital Base OP Fee Sched Tier 3,631.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0871RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0871RR,BCBSND Hospital Base OP Fee Sched Tier 3,631.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0877RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0877RR,BCBSND Hospital Base OP Fee Sched Tier 3,595.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0878RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0878RR,BCBSND Hospital Base OP Fee Sched Tier 3,631.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0879RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0879RR,BCBSND Hospital Base OP Fee Sched Tier 3,804.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0880RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0880RR,BCBSND Hospital Base OP Fee Sched Tier 3,1258.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0884RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0884RR,BCBSND Hospital Base OP Fee Sched Tier 3,909.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0885RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0885RR,BCBSND Hospital Base OP Fee Sched Tier 3,898.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0886RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0886RR,BCBSND Hospital Base OP Fee Sched Tier 3,829.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0890RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0890RR,BCBSND Hospital Base OP Fee Sched Tier 3,1368.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0891RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0891RR,BCBSND Hospital Base OP Fee Sched Tier 3,1812.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0898RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0898RR,BCBSND Hospital Base OP Fee Sched Tier 3,631.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,K0899RR,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,K0899RR,BCBSND Hospital Base OP Fee Sched Tier 3,631.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0112,BCBSND Hospital Base OP Fee Sched Tier 3,1615.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0113,BCBSND Hospital Base OP Fee Sched Tier 3,329.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0120,BCBSND Hospital Base OP Fee Sched Tier 3,28.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0130,BCBSND Hospital Base OP Fee Sched Tier 3,174.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0140,BCBSND Hospital Base OP Fee Sched Tier 3,77.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0150,BCBSND Hospital Base OP Fee Sched Tier 3,115.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0160,BCBSND Hospital Base OP Fee Sched Tier 3,167.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0170,BCBSND Hospital Base OP Fee Sched Tier 3,688.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0172,BCBSND Hospital Base OP Fee Sched Tier 3,140.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0174,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0174,BCBSND Hospital Base OP Fee Sched Tier 3,343.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0180,BCBSND Hospital Base OP Fee Sched Tier 3,395.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0190,BCBSND Hospital Base OP Fee Sched Tier 3,549.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0200,BCBSND Hospital Base OP Fee Sched Tier 3,596.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0220,BCBSND Hospital Base OP Fee Sched Tier 3,130.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0450,BCBSND Hospital Base OP Fee Sched Tier 3,185.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0454,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0454,BCBSND Hospital Base OP Fee Sched Tier 3,400.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0455,BCBSND Hospital Base OP Fee Sched Tier 3,400.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0456,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0456,BCBSND Hospital Base OP Fee Sched Tier 3,1148.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0457,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0457,BCBSND Hospital Base OP Fee Sched Tier 3,1148.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0458,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0458,BCBSND Hospital Base OP Fee Sched Tier 3,1029.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0460,BCBSND Hospital Base OP Fee Sched Tier 3,1158.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0462,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0462,BCBSND Hospital Base OP Fee Sched Tier 3,1441.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0464,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0464,BCBSND Hospital Base OP Fee Sched Tier 3,1715.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0466,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0466,BCBSND Hospital Base OP Fee Sched Tier 3,416.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0467,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0467,BCBSND Hospital Base OP Fee Sched Tier 3,416.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0468,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0468,BCBSND Hospital Base OP Fee Sched Tier 3,489.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0469,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0469,BCBSND Hospital Base OP Fee Sched Tier 3,489.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0470,BCBSND Hospital Base OP Fee Sched Tier 3,680.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0472,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0472,BCBSND Hospital Base OP Fee Sched Tier 3,431.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0480,BCBSND Hospital Base OP Fee Sched Tier 3,1889.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0482,BCBSND Hospital Base OP Fee Sched Tier 3,2112.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0484,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0484,BCBSND Hospital Base OP Fee Sched Tier 3,2279.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0486,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0486,BCBSND Hospital Base OP Fee Sched Tier 3,2309.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0488,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0488,BCBSND Hospital Base OP Fee Sched Tier 3,1158.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0490,BCBSND Hospital Base OP Fee Sched Tier 3,326.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0491,BCBSND Hospital Base OP Fee Sched Tier 3,886.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0492,BCBSND Hospital Base OP Fee Sched Tier 3,558.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0621,BCBSND Hospital Base OP Fee Sched Tier 3,121.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0622,BCBSND Hospital Base OP Fee Sched Tier 3,275.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0623,BCBSND Hospital Base OP Fee Sched Tier 3,96.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0625,BCBSND Hospital Base OP Fee Sched Tier 3,63.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0626,BCBSND Hospital Base OP Fee Sched Tier 3,90.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0627,BCBSND Hospital Base OP Fee Sched Tier 3,475.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0628,BCBSND Hospital Base OP Fee Sched Tier 3,97.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0630,BCBSND Hospital Base OP Fee Sched Tier 3,187.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0631,BCBSND Hospital Base OP Fee Sched Tier 3,1187.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0633,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0633,BCBSND Hospital Base OP Fee Sched Tier 3,331.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0635,BCBSND Hospital Base OP Fee Sched Tier 3,1021.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0636,BCBSND Hospital Base OP Fee Sched Tier 3,1778.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0637,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0637,BCBSND Hospital Base OP Fee Sched Tier 3,1197.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0638,BCBSND Hospital Base OP Fee Sched Tier 3,1522.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0639,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0639,BCBSND Hospital Base OP Fee Sched Tier 3,1197.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0640,BCBSND Hospital Base OP Fee Sched Tier 3,1207.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0641,BCBSND Hospital Base OP Fee Sched Tier 3,90.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0642,BCBSND Hospital Base OP Fee Sched Tier 3,475.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0643,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0643,BCBSND Hospital Base OP Fee Sched Tier 3,187.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0648,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0648,BCBSND Hospital Base OP Fee Sched Tier 3,1187.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0649,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0649,BCBSND Hospital Base OP Fee Sched Tier 3,331.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0650,BCBSND Hospital Base OP Fee Sched Tier 3,1197.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0651,BCBSND Hospital Base OP Fee Sched Tier 3,1197.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0700,BCBSND Hospital Base OP Fee Sched Tier 3,2183.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0710,BCBSND Hospital Base OP Fee Sched Tier 3,2548.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0810,BCBSND Hospital Base OP Fee Sched Tier 3,2877.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0820,BCBSND Hospital Base OP Fee Sched Tier 3,2489.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0830,BCBSND Hospital Base OP Fee Sched Tier 3,3347.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0859,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0859,BCBSND Hospital Base OP Fee Sched Tier 3,1734.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0861,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0861,BCBSND Hospital Base OP Fee Sched Tier 3,248.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0970,BCBSND Hospital Base OP Fee Sched Tier 3,162.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0972,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0972,BCBSND Hospital Base OP Fee Sched Tier 3,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0974,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0974,BCBSND Hospital Base OP Fee Sched Tier 3,191.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0976,BCBSND Hospital Base OP Fee Sched Tier 3,216.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0978,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0978,BCBSND Hospital Base OP Fee Sched Tier 3,205.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0980,BCBSND Hospital Base OP Fee Sched Tier 3,18.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0982,BCBSND Hospital Base OP Fee Sched Tier 3,17.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L0984,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L0984,BCBSND Hospital Base OP Fee Sched Tier 3,71.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1000,BCBSND Hospital Base OP Fee Sched Tier 3,2525.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1001,BCBSND Hospital Base OP Fee Sched Tier 3,2183.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1005,BCBSND Hospital Base OP Fee Sched Tier 3,3694.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1010,BCBSND Hospital Base OP Fee Sched Tier 3,71.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1020,BCBSND Hospital Base OP Fee Sched Tier 3,92.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1025,BCBSND Hospital Base OP Fee Sched Tier 3,133.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1030,BCBSND Hospital Base OP Fee Sched Tier 3,67.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1040,BCBSND Hospital Base OP Fee Sched Tier 3,83.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1050,BCBSND Hospital Base OP Fee Sched Tier 3,88.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1060,BCBSND Hospital Base OP Fee Sched Tier 3,102.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1070,BCBSND Hospital Base OP Fee Sched Tier 3,96.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1080,BCBSND Hospital Base OP Fee Sched Tier 3,75.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1085,BCBSND Hospital Base OP Fee Sched Tier 3,164.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1090,BCBSND Hospital Base OP Fee Sched Tier 3,105.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1100,BCBSND Hospital Base OP Fee Sched Tier 3,169.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1110,BCBSND Hospital Base OP Fee Sched Tier 3,272.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1120,BCBSND Hospital Base OP Fee Sched Tier 3,45.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1200,BCBSND Hospital Base OP Fee Sched Tier 3,2006.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1210,BCBSND Hospital Base OP Fee Sched Tier 3,372.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1220,BCBSND Hospital Base OP Fee Sched Tier 3,246.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1230,BCBSND Hospital Base OP Fee Sched Tier 3,806.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1240,BCBSND Hospital Base OP Fee Sched Tier 3,82.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1250,BCBSND Hospital Base OP Fee Sched Tier 3,77.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1260,BCBSND Hospital Base OP Fee Sched Tier 3,80.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1270,BCBSND Hospital Base OP Fee Sched Tier 3,82.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1280,BCBSND Hospital Base OP Fee Sched Tier 3,92.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1290,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1290,BCBSND Hospital Base OP Fee Sched Tier 3,83.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1300,BCBSND Hospital Base OP Fee Sched Tier 3,2216.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1310,BCBSND Hospital Base OP Fee Sched Tier 3,2346.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1600,BCBSND Hospital Base OP Fee Sched Tier 3,140.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1610,BCBSND Hospital Base OP Fee Sched Tier 3,46.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1620,BCBSND Hospital Base OP Fee Sched Tier 3,143.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1630,BCBSND Hospital Base OP Fee Sched Tier 3,180.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1640,BCBSND Hospital Base OP Fee Sched Tier 3,604.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1650,BCBSND Hospital Base OP Fee Sched Tier 3,278.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1652,BCBSND Hospital Base OP Fee Sched Tier 3,411.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1660,BCBSND Hospital Base OP Fee Sched Tier 3,182.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1680,BCBSND Hospital Base OP Fee Sched Tier 3,1300.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1685,BCBSND Hospital Base OP Fee Sched Tier 3,1269.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1686,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1686,BCBSND Hospital Base OP Fee Sched Tier 3,1097.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1690,BCBSND Hospital Base OP Fee Sched Tier 3,2232.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1700,BCBSND Hospital Base OP Fee Sched Tier 3,1630.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1710,BCBSND Hospital Base OP Fee Sched Tier 3,1908.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1720,BCBSND Hospital Base OP Fee Sched Tier 3,1406.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1730,BCBSND Hospital Base OP Fee Sched Tier 3,1210.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1755,BCBSND Hospital Base OP Fee Sched Tier 3,1690.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1810,BCBSND Hospital Base OP Fee Sched Tier 3,107.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1812,BCBSND Hospital Base OP Fee Sched Tier 3,107.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1820,BCBSND Hospital Base OP Fee Sched Tier 3,151.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1830,BCBSND Hospital Base OP Fee Sched Tier 3,98.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1831,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1831,BCBSND Hospital Base OP Fee Sched Tier 3,339.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1832,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1832,BCBSND Hospital Base OP Fee Sched Tier 3,649.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1833,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1833,BCBSND Hospital Base OP Fee Sched Tier 3,649.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1834,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1834,BCBSND Hospital Base OP Fee Sched Tier 3,875.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1836,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1836,BCBSND Hospital Base OP Fee Sched Tier 3,154.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1840,BCBSND Hospital Base OP Fee Sched Tier 3,981.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1843,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1843,BCBSND Hospital Base OP Fee Sched Tier 3,1035.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1844,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1844,BCBSND Hospital Base OP Fee Sched Tier 3,1916.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1845,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1845,BCBSND Hospital Base OP Fee Sched Tier 3,901.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1846,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1846,BCBSND Hospital Base OP Fee Sched Tier 3,1198.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1847,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1847,BCBSND Hospital Base OP Fee Sched Tier 3,663.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1848,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1848,BCBSND Hospital Base OP Fee Sched Tier 3,663.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1850,BCBSND Hospital Base OP Fee Sched Tier 3,349.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1851,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1851,BCBSND Hospital Base OP Fee Sched Tier 3,1035.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1852,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1852,BCBSND Hospital Base OP Fee Sched Tier 3,901.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1860,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1860,BCBSND Hospital Base OP Fee Sched Tier 3,1145.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1900,BCBSND Hospital Base OP Fee Sched Tier 3,314.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1902,BCBSND Hospital Base OP Fee Sched Tier 3,85.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1904,BCBSND Hospital Base OP Fee Sched Tier 3,502.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1906,BCBSND Hospital Base OP Fee Sched Tier 3,171.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1907,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1907,BCBSND Hospital Base OP Fee Sched Tier 3,649.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1910,BCBSND Hospital Base OP Fee Sched Tier 3,288.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1920,BCBSND Hospital Base OP Fee Sched Tier 3,469.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1930,BCBSND Hospital Base OP Fee Sched Tier 3,275.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1932,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1932,BCBSND Hospital Base OP Fee Sched Tier 3,1030.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1940,BCBSND Hospital Base OP Fee Sched Tier 3,528,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1945,BCBSND Hospital Base OP Fee Sched Tier 3,1016.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1950,BCBSND Hospital Base OP Fee Sched Tier 3,860.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1951,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1951,BCBSND Hospital Base OP Fee Sched Tier 3,969.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1960,BCBSND Hospital Base OP Fee Sched Tier 3,591.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1970,BCBSND Hospital Base OP Fee Sched Tier 3,798.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1971,BCBSND Hospital Base OP Fee Sched Tier 3,541.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1980,BCBSND Hospital Base OP Fee Sched Tier 3,422.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L1990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L1990,BCBSND Hospital Base OP Fee Sched Tier 3,475.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2000,BCBSND Hospital Base OP Fee Sched Tier 3,1121.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2005,BCBSND Hospital Base OP Fee Sched Tier 3,4739.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2010,BCBSND Hospital Base OP Fee Sched Tier 3,1155.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2020,BCBSND Hospital Base OP Fee Sched Tier 3,1246.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2030,BCBSND Hospital Base OP Fee Sched Tier 3,1081.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2034,BCBSND Hospital Base OP Fee Sched Tier 3,2402.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2035,BCBSND Hospital Base OP Fee Sched Tier 3,199.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2036,BCBSND Hospital Base OP Fee Sched Tier 3,2174.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2037,BCBSND Hospital Base OP Fee Sched Tier 3,1778.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2038,BCBSND Hospital Base OP Fee Sched Tier 3,1526.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2040,BCBSND Hospital Base OP Fee Sched Tier 3,246.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2050,BCBSND Hospital Base OP Fee Sched Tier 3,562.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2060,BCBSND Hospital Base OP Fee Sched Tier 3,631.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2070,BCBSND Hospital Base OP Fee Sched Tier 3,143.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2080,BCBSND Hospital Base OP Fee Sched Tier 3,384.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2090,BCBSND Hospital Base OP Fee Sched Tier 3,520.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2106,BCBSND Hospital Base OP Fee Sched Tier 3,725.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2108,BCBSND Hospital Base OP Fee Sched Tier 3,1298.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2112,BCBSND Hospital Base OP Fee Sched Tier 3,498.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2114,BCBSND Hospital Base OP Fee Sched Tier 3,624.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2116,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2116,BCBSND Hospital Base OP Fee Sched Tier 3,760.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2126,BCBSND Hospital Base OP Fee Sched Tier 3,1435.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2128,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2128,BCBSND Hospital Base OP Fee Sched Tier 3,1830.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2132,BCBSND Hospital Base OP Fee Sched Tier 3,1113.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2134,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2134,BCBSND Hospital Base OP Fee Sched Tier 3,1032.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2136,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2136,BCBSND Hospital Base OP Fee Sched Tier 3,1419.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2180,BCBSND Hospital Base OP Fee Sched Tier 3,162.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2182,BCBSND Hospital Base OP Fee Sched Tier 3,104.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2184,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2184,BCBSND Hospital Base OP Fee Sched Tier 3,144.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2186,BCBSND Hospital Base OP Fee Sched Tier 3,192.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2188,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2188,BCBSND Hospital Base OP Fee Sched Tier 3,319.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2190,BCBSND Hospital Base OP Fee Sched Tier 3,96.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2192,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2192,BCBSND Hospital Base OP Fee Sched Tier 3,380.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2200,BCBSND Hospital Base OP Fee Sched Tier 3,67.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2210,BCBSND Hospital Base OP Fee Sched Tier 3,95.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2220,BCBSND Hospital Base OP Fee Sched Tier 3,113.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2230,BCBSND Hospital Base OP Fee Sched Tier 3,89.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2232,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2232,BCBSND Hospital Base OP Fee Sched Tier 3,110.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2240,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2240,BCBSND Hospital Base OP Fee Sched Tier 3,89.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2250,BCBSND Hospital Base OP Fee Sched Tier 3,449.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2260,BCBSND Hospital Base OP Fee Sched Tier 3,244.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2265,BCBSND Hospital Base OP Fee Sched Tier 3,125.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2270,BCBSND Hospital Base OP Fee Sched Tier 3,62.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2275,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2275,BCBSND Hospital Base OP Fee Sched Tier 3,159.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2280,BCBSND Hospital Base OP Fee Sched Tier 3,483.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2300,BCBSND Hospital Base OP Fee Sched Tier 3,287.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2310,BCBSND Hospital Base OP Fee Sched Tier 3,142.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2320,BCBSND Hospital Base OP Fee Sched Tier 3,280.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2330,BCBSND Hospital Base OP Fee Sched Tier 3,462.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2335,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2335,BCBSND Hospital Base OP Fee Sched Tier 3,254.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2340,BCBSND Hospital Base OP Fee Sched Tier 3,477.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2350,BCBSND Hospital Base OP Fee Sched Tier 3,1111.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2360,BCBSND Hospital Base OP Fee Sched Tier 3,61.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2370,BCBSND Hospital Base OP Fee Sched Tier 3,274.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2375,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2375,BCBSND Hospital Base OP Fee Sched Tier 3,120.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2380,BCBSND Hospital Base OP Fee Sched Tier 3,175.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2385,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2385,BCBSND Hospital Base OP Fee Sched Tier 3,190.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2387,BCBSND Hospital Base OP Fee Sched Tier 3,176.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2390,BCBSND Hospital Base OP Fee Sched Tier 3,155.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2395,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2395,BCBSND Hospital Base OP Fee Sched Tier 3,198.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2397,BCBSND Hospital Base OP Fee Sched Tier 3,137.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2405,BCBSND Hospital Base OP Fee Sched Tier 3,100.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2415,BCBSND Hospital Base OP Fee Sched Tier 3,140.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2425,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2425,BCBSND Hospital Base OP Fee Sched Tier 3,165.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2430,BCBSND Hospital Base OP Fee Sched Tier 3,165.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2492,BCBSND Hospital Base OP Fee Sched Tier 3,136.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2500,BCBSND Hospital Base OP Fee Sched Tier 3,336.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2510,BCBSND Hospital Base OP Fee Sched Tier 3,775.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2520,BCBSND Hospital Base OP Fee Sched Tier 3,526.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2525,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2525,BCBSND Hospital Base OP Fee Sched Tier 3,1463.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2526,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2526,BCBSND Hospital Base OP Fee Sched Tier 3,947.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2530,BCBSND Hospital Base OP Fee Sched Tier 3,334.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2540,BCBSND Hospital Base OP Fee Sched Tier 3,512.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2550,BCBSND Hospital Base OP Fee Sched Tier 3,408.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2570,BCBSND Hospital Base OP Fee Sched Tier 3,508.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2580,BCBSND Hospital Base OP Fee Sched Tier 3,648.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2600,BCBSND Hospital Base OP Fee Sched Tier 3,238.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2610,BCBSND Hospital Base OP Fee Sched Tier 3,271.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2620,BCBSND Hospital Base OP Fee Sched Tier 3,285.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2622,BCBSND Hospital Base OP Fee Sched Tier 3,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2624,BCBSND Hospital Base OP Fee Sched Tier 3,353.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2627,BCBSND Hospital Base OP Fee Sched Tier 3,2440.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2628,BCBSND Hospital Base OP Fee Sched Tier 3,2384.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2630,BCBSND Hospital Base OP Fee Sched Tier 3,352.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2640,BCBSND Hospital Base OP Fee Sched Tier 3,358.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2650,BCBSND Hospital Base OP Fee Sched Tier 3,128.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2660,BCBSND Hospital Base OP Fee Sched Tier 3,265.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2670,BCBSND Hospital Base OP Fee Sched Tier 3,242.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2680,BCBSND Hospital Base OP Fee Sched Tier 3,222.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2750,BCBSND Hospital Base OP Fee Sched Tier 3,89.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2755,BCBSND Hospital Base OP Fee Sched Tier 3,150.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2760,BCBSND Hospital Base OP Fee Sched Tier 3,86.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2768,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2768,BCBSND Hospital Base OP Fee Sched Tier 3,150.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2780,BCBSND Hospital Base OP Fee Sched Tier 3,72.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2785,BCBSND Hospital Base OP Fee Sched Tier 3,33.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2795,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2795,BCBSND Hospital Base OP Fee Sched Tier 3,90.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2800,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2800,BCBSND Hospital Base OP Fee Sched Tier 3,124.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2810,BCBSND Hospital Base OP Fee Sched Tier 3,83.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2820,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2820,BCBSND Hospital Base OP Fee Sched Tier 3,123.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2830,BCBSND Hospital Base OP Fee Sched Tier 3,133.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2840,BCBSND Hospital Base OP Fee Sched Tier 3,46.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L2850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L2850,BCBSND Hospital Base OP Fee Sched Tier 3,84.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3000,BCBSND Hospital Base OP Fee Sched Tier 3,362.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3001,BCBSND Hospital Base OP Fee Sched Tier 3,152.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3002,BCBSND Hospital Base OP Fee Sched Tier 3,186.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3003,BCBSND Hospital Base OP Fee Sched Tier 3,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3010,BCBSND Hospital Base OP Fee Sched Tier 3,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3020,BCBSND Hospital Base OP Fee Sched Tier 3,229.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3030,BCBSND Hospital Base OP Fee Sched Tier 3,88.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3031,BCBSND Hospital Base OP Fee Sched Tier 3,141.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3040,BCBSND Hospital Base OP Fee Sched Tier 3,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3050,BCBSND Hospital Base OP Fee Sched Tier 3,54.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3060,BCBSND Hospital Base OP Fee Sched Tier 3,85.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3070,BCBSND Hospital Base OP Fee Sched Tier 3,36.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3080,BCBSND Hospital Base OP Fee Sched Tier 3,36.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3090,BCBSND Hospital Base OP Fee Sched Tier 3,46.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3100,BCBSND Hospital Base OP Fee Sched Tier 3,49.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3140,BCBSND Hospital Base OP Fee Sched Tier 3,102.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3150,BCBSND Hospital Base OP Fee Sched Tier 3,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3170,BCBSND Hospital Base OP Fee Sched Tier 3,58.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3201,BCBSND Hospital Base OP Fee Sched Tier 3,75.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3202,BCBSND Hospital Base OP Fee Sched Tier 3,75.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3204,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3204,BCBSND Hospital Base OP Fee Sched Tier 3,75.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3206,BCBSND Hospital Base OP Fee Sched Tier 3,75.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3208,BCBSND Hospital Base OP Fee Sched Tier 3,65.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3209,BCBSND Hospital Base OP Fee Sched Tier 3,72.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3211,BCBSND Hospital Base OP Fee Sched Tier 3,84.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3212,BCBSND Hospital Base OP Fee Sched Tier 3,99.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3213,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3213,BCBSND Hospital Base OP Fee Sched Tier 3,112.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3214,BCBSND Hospital Base OP Fee Sched Tier 3,129.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3215,BCBSND Hospital Base OP Fee Sched Tier 3,121.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3216,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3216,BCBSND Hospital Base OP Fee Sched Tier 3,155.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3221,BCBSND Hospital Base OP Fee Sched Tier 3,146.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3224,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3224,BCBSND Hospital Base OP Fee Sched Tier 3,65.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3225,BCBSND Hospital Base OP Fee Sched Tier 3,87.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3260,BCBSND Hospital Base OP Fee Sched Tier 3,31.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3265,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3265,BCBSND Hospital Base OP Fee Sched Tier 3,17.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3300,BCBSND Hospital Base OP Fee Sched Tier 3,60.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3310,BCBSND Hospital Base OP Fee Sched Tier 3,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3330,BCBSND Hospital Base OP Fee Sched Tier 3,653.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3332,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3332,BCBSND Hospital Base OP Fee Sched Tier 3,85.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3334,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3334,BCBSND Hospital Base OP Fee Sched Tier 3,44.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3340,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3340,BCBSND Hospital Base OP Fee Sched Tier 3,98.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3350,BCBSND Hospital Base OP Fee Sched Tier 3,26.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3360,BCBSND Hospital Base OP Fee Sched Tier 3,41.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3370,BCBSND Hospital Base OP Fee Sched Tier 3,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3380,BCBSND Hospital Base OP Fee Sched Tier 3,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3390,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3390,BCBSND Hospital Base OP Fee Sched Tier 3,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3400,BCBSND Hospital Base OP Fee Sched Tier 3,46.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3410,BCBSND Hospital Base OP Fee Sched Tier 3,107.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3420,BCBSND Hospital Base OP Fee Sched Tier 3,63.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3430,BCBSND Hospital Base OP Fee Sched Tier 3,185,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3440,BCBSND Hospital Base OP Fee Sched Tier 3,88.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3450,BCBSND Hospital Base OP Fee Sched Tier 3,121.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3455,BCBSND Hospital Base OP Fee Sched Tier 3,46.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3460,BCBSND Hospital Base OP Fee Sched Tier 3,39.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3465,BCBSND Hospital Base OP Fee Sched Tier 3,67.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3470,BCBSND Hospital Base OP Fee Sched Tier 3,71.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3480,BCBSND Hospital Base OP Fee Sched Tier 3,71.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3485,BCBSND Hospital Base OP Fee Sched Tier 3,18.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3500,BCBSND Hospital Base OP Fee Sched Tier 3,33.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3510,BCBSND Hospital Base OP Fee Sched Tier 3,33.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3520,BCBSND Hospital Base OP Fee Sched Tier 3,36.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3530,BCBSND Hospital Base OP Fee Sched Tier 3,36.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3540,BCBSND Hospital Base OP Fee Sched Tier 3,58.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3550,BCBSND Hospital Base OP Fee Sched Tier 3,10.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3560,BCBSND Hospital Base OP Fee Sched Tier 3,26.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3570,BCBSND Hospital Base OP Fee Sched Tier 3,98.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3580,BCBSND Hospital Base OP Fee Sched Tier 3,74.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3590,BCBSND Hospital Base OP Fee Sched Tier 3,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3595,BCBSND Hospital Base OP Fee Sched Tier 3,48.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3600,BCBSND Hospital Base OP Fee Sched Tier 3,88.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3610,BCBSND Hospital Base OP Fee Sched Tier 3,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3620,BCBSND Hospital Base OP Fee Sched Tier 3,88.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3630,BCBSND Hospital Base OP Fee Sched Tier 3,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3640,BCBSND Hospital Base OP Fee Sched Tier 3,49.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3650,BCBSND Hospital Base OP Fee Sched Tier 3,61.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3660,BCBSND Hospital Base OP Fee Sched Tier 3,140.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3670,BCBSND Hospital Base OP Fee Sched Tier 3,118.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3671,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3671,BCBSND Hospital Base OP Fee Sched Tier 3,946.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3674,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3674,BCBSND Hospital Base OP Fee Sched Tier 3,1241.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3675,BCBSND Hospital Base OP Fee Sched Tier 3,184.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3677,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3677,BCBSND Hospital Base OP Fee Sched Tier 3,61.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3702,BCBSND Hospital Base OP Fee Sched Tier 3,303.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3710,BCBSND Hospital Base OP Fee Sched Tier 3,129.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3720,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3720,BCBSND Hospital Base OP Fee Sched Tier 3,683.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3730,BCBSND Hospital Base OP Fee Sched Tier 3,941.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3740,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3740,BCBSND Hospital Base OP Fee Sched Tier 3,1116.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3760,BCBSND Hospital Base OP Fee Sched Tier 3,525.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3761,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3761,BCBSND Hospital Base OP Fee Sched Tier 3,1050.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3762,BCBSND Hospital Base OP Fee Sched Tier 3,112.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3763,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3763,BCBSND Hospital Base OP Fee Sched Tier 3,705.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3764,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3764,BCBSND Hospital Base OP Fee Sched Tier 3,806.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3765,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3765,BCBSND Hospital Base OP Fee Sched Tier 3,1347.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3766,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3766,BCBSND Hospital Base OP Fee Sched Tier 3,1426.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3806,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3806,BCBSND Hospital Base OP Fee Sched Tier 3,477.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3807,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3807,BCBSND Hospital Base OP Fee Sched Tier 3,262.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3808,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3808,BCBSND Hospital Base OP Fee Sched Tier 3,381.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3809,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3809,BCBSND Hospital Base OP Fee Sched Tier 3,262.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3900,BCBSND Hospital Base OP Fee Sched Tier 3,1351.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3901,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3901,BCBSND Hospital Base OP Fee Sched Tier 3,2151.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3904,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3904,BCBSND Hospital Base OP Fee Sched Tier 3,4079.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3905,BCBSND Hospital Base OP Fee Sched Tier 3,1041.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3906,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3906,BCBSND Hospital Base OP Fee Sched Tier 3,427.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3908,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3908,BCBSND Hospital Base OP Fee Sched Tier 3,62.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3912,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3912,BCBSND Hospital Base OP Fee Sched Tier 3,99.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3913,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3913,BCBSND Hospital Base OP Fee Sched Tier 3,284.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3915,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3915,BCBSND Hospital Base OP Fee Sched Tier 3,558.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3916,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3916,BCBSND Hospital Base OP Fee Sched Tier 3,558.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3917,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3917,BCBSND Hospital Base OP Fee Sched Tier 3,110.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3918,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3918,BCBSND Hospital Base OP Fee Sched Tier 3,110.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3919,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3919,BCBSND Hospital Base OP Fee Sched Tier 3,284.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3921,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3921,BCBSND Hospital Base OP Fee Sched Tier 3,337.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3923,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3923,BCBSND Hospital Base OP Fee Sched Tier 3,90.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3924,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3924,BCBSND Hospital Base OP Fee Sched Tier 3,90.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3925,BCBSND Hospital Base OP Fee Sched Tier 3,51.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3927,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3927,BCBSND Hospital Base OP Fee Sched Tier 3,36.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3929,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3929,BCBSND Hospital Base OP Fee Sched Tier 3,81.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3930,BCBSND Hospital Base OP Fee Sched Tier 3,81.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3931,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3931,BCBSND Hospital Base OP Fee Sched Tier 3,201.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3933,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3933,BCBSND Hospital Base OP Fee Sched Tier 3,224.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3935,BCBSND Hospital Base OP Fee Sched Tier 3,232.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3960,BCBSND Hospital Base OP Fee Sched Tier 3,767.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3961,BCBSND Hospital Base OP Fee Sched Tier 3,1765.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3962,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3962,BCBSND Hospital Base OP Fee Sched Tier 3,749.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3967,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3967,BCBSND Hospital Base OP Fee Sched Tier 3,2083.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3971,BCBSND Hospital Base OP Fee Sched Tier 3,1978.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3973,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3973,BCBSND Hospital Base OP Fee Sched Tier 3,2083.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3975,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3975,BCBSND Hospital Base OP Fee Sched Tier 3,1765.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3976,BCBSND Hospital Base OP Fee Sched Tier 3,1765.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3977,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3977,BCBSND Hospital Base OP Fee Sched Tier 3,1978.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3978,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3978,BCBSND Hospital Base OP Fee Sched Tier 3,2083.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3980,BCBSND Hospital Base OP Fee Sched Tier 3,322.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3981,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3981,BCBSND Hospital Base OP Fee Sched Tier 3,1059.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3982,BCBSND Hospital Base OP Fee Sched Tier 3,399.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3984,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3984,BCBSND Hospital Base OP Fee Sched Tier 3,413.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,L3995,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L3995,BCBSND Hospital Base OP Fee Sched Tier 3,34.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4000,BCBSND Hospital Base OP Fee Sched Tier 3,1543.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4002,BCBSND Hospital Base OP Fee Sched Tier 3,21.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4010,BCBSND Hospital Base OP Fee Sched Tier 3,776.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4020,BCBSND Hospital Base OP Fee Sched Tier 3,919.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4030,BCBSND Hospital Base OP Fee Sched Tier 3,539.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4040,BCBSND Hospital Base OP Fee Sched Tier 3,454.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4045,BCBSND Hospital Base OP Fee Sched Tier 3,421.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4050,BCBSND Hospital Base OP Fee Sched Tier 3,440.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4055,BCBSND Hospital Base OP Fee Sched Tier 3,285.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4060,BCBSND Hospital Base OP Fee Sched Tier 3,452.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4070,BCBSND Hospital Base OP Fee Sched Tier 3,300.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4080,BCBSND Hospital Base OP Fee Sched Tier 3,107.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4090,BCBSND Hospital Base OP Fee Sched Tier 3,96.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4100,BCBSND Hospital Base OP Fee Sched Tier 3,111.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4110,BCBSND Hospital Base OP Fee Sched Tier 3,91.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4130,BCBSND Hospital Base OP Fee Sched Tier 3,608.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4205,BCBSND Hospital Base OP Fee Sched Tier 3,25.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4210,BCBSND Hospital Base OP Fee Sched Tier 3,34.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4350,BCBSND Hospital Base OP Fee Sched Tier 3,95.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4360,BCBSND Hospital Base OP Fee Sched Tier 3,319.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4361,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4361,BCBSND Hospital Base OP Fee Sched Tier 3,319.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4370,BCBSND Hospital Base OP Fee Sched Tier 3,221.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4386,BCBSND Hospital Base OP Fee Sched Tier 3,183.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4387,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4387,BCBSND Hospital Base OP Fee Sched Tier 3,183.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4392,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4392,BCBSND Hospital Base OP Fee Sched Tier 3,26.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4394,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4394,BCBSND Hospital Base OP Fee Sched Tier 3,19.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4396,BCBSND Hospital Base OP Fee Sched Tier 3,190.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4397,BCBSND Hospital Base OP Fee Sched Tier 3,190.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4398,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4398,BCBSND Hospital Base OP Fee Sched Tier 3,87.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,L4631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L4631,BCBSND Hospital Base OP Fee Sched Tier 3,1588.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5000,BCBSND Hospital Base OP Fee Sched Tier 3,574.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5010,BCBSND Hospital Base OP Fee Sched Tier 3,1519.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5020,BCBSND Hospital Base OP Fee Sched Tier 3,2665.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5050,BCBSND Hospital Base OP Fee Sched Tier 3,2831.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5060,BCBSND Hospital Base OP Fee Sched Tier 3,3838.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5100,BCBSND Hospital Base OP Fee Sched Tier 3,2643.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5105,BCBSND Hospital Base OP Fee Sched Tier 3,4334.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5150,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5150,BCBSND Hospital Base OP Fee Sched Tier 3,4424.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5160,BCBSND Hospital Base OP Fee Sched Tier 3,4872.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5200,BCBSND Hospital Base OP Fee Sched Tier 3,3757.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5210,BCBSND Hospital Base OP Fee Sched Tier 3,2975.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5220,BCBSND Hospital Base OP Fee Sched Tier 3,3427.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5230,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5230,BCBSND Hospital Base OP Fee Sched Tier 3,5769.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5250,BCBSND Hospital Base OP Fee Sched Tier 3,7413.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5270,BCBSND Hospital Base OP Fee Sched Tier 3,6762.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5280,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5280,BCBSND Hospital Base OP Fee Sched Tier 3,7681.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5301,BCBSND Hospital Base OP Fee Sched Tier 3,2633.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5312,BCBSND Hospital Base OP Fee Sched Tier 3,4148.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5321,BCBSND Hospital Base OP Fee Sched Tier 3,3738.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5331,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5331,BCBSND Hospital Base OP Fee Sched Tier 3,6372.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5341,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5341,BCBSND Hospital Base OP Fee Sched Tier 3,6899.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5400,BCBSND Hospital Base OP Fee Sched Tier 3,1395.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5410,BCBSND Hospital Base OP Fee Sched Tier 3,475.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5420,BCBSND Hospital Base OP Fee Sched Tier 3,1944.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5430,BCBSND Hospital Base OP Fee Sched Tier 3,572.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5450,BCBSND Hospital Base OP Fee Sched Tier 3,557.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5460,BCBSND Hospital Base OP Fee Sched Tier 3,652.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5500,BCBSND Hospital Base OP Fee Sched Tier 3,1924.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5505,BCBSND Hospital Base OP Fee Sched Tier 3,2240.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5510,BCBSND Hospital Base OP Fee Sched Tier 3,1917.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5520,BCBSND Hospital Base OP Fee Sched Tier 3,1635.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5530,BCBSND Hospital Base OP Fee Sched Tier 3,2152.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5535,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5535,BCBSND Hospital Base OP Fee Sched Tier 3,1928.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5540,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5540,BCBSND Hospital Base OP Fee Sched Tier 3,2310.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5560,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5560,BCBSND Hospital Base OP Fee Sched Tier 3,2701.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5570,BCBSND Hospital Base OP Fee Sched Tier 3,2923.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5580,BCBSND Hospital Base OP Fee Sched Tier 3,3283.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5585,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5585,BCBSND Hospital Base OP Fee Sched Tier 3,3292.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5590,BCBSND Hospital Base OP Fee Sched Tier 3,3492.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5595,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5595,BCBSND Hospital Base OP Fee Sched Tier 3,4579.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5600,BCBSND Hospital Base OP Fee Sched Tier 3,5057.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5610,BCBSND Hospital Base OP Fee Sched Tier 3,3049.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5611,BCBSND Hospital Base OP Fee Sched Tier 3,2443.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5613,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5613,BCBSND Hospital Base OP Fee Sched Tier 3,3494.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5614,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5614,BCBSND Hospital Base OP Fee Sched Tier 3,1951.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5616,BCBSND Hospital Base OP Fee Sched Tier 3,2028.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5617,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5617,BCBSND Hospital Base OP Fee Sched Tier 3,645.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5618,BCBSND Hospital Base OP Fee Sched Tier 3,319.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5620,BCBSND Hospital Base OP Fee Sched Tier 3,316.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5622,BCBSND Hospital Base OP Fee Sched Tier 3,412.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5624,BCBSND Hospital Base OP Fee Sched Tier 3,414.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5626,BCBSND Hospital Base OP Fee Sched Tier 3,542.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5628,BCBSND Hospital Base OP Fee Sched Tier 3,549.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5629,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5629,BCBSND Hospital Base OP Fee Sched Tier 3,361.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5630,BCBSND Hospital Base OP Fee Sched Tier 3,557.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5631,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5631,BCBSND Hospital Base OP Fee Sched Tier 3,499.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5632,BCBSND Hospital Base OP Fee Sched Tier 3,310.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5634,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5634,BCBSND Hospital Base OP Fee Sched Tier 3,461.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5636,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5636,BCBSND Hospital Base OP Fee Sched Tier 3,386.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5637,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5637,BCBSND Hospital Base OP Fee Sched Tier 3,328.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5638,BCBSND Hospital Base OP Fee Sched Tier 3,738.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5639,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5639,BCBSND Hospital Base OP Fee Sched Tier 3,1700.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5640,BCBSND Hospital Base OP Fee Sched Tier 3,969.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5642,BCBSND Hospital Base OP Fee Sched Tier 3,939.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5643,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5643,BCBSND Hospital Base OP Fee Sched Tier 3,2360.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5644,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5644,BCBSND Hospital Base OP Fee Sched Tier 3,895.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5645,BCBSND Hospital Base OP Fee Sched Tier 3,1210.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5646,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5646,BCBSND Hospital Base OP Fee Sched Tier 3,807.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5647,BCBSND Hospital Base OP Fee Sched Tier 3,1104.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5648,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5648,BCBSND Hospital Base OP Fee Sched Tier 3,998.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5649,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5649,BCBSND Hospital Base OP Fee Sched Tier 3,2411.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5650,BCBSND Hospital Base OP Fee Sched Tier 3,740.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5651,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5651,BCBSND Hospital Base OP Fee Sched Tier 3,1821.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5652,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5652,BCBSND Hospital Base OP Fee Sched Tier 3,661.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5653,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5653,BCBSND Hospital Base OP Fee Sched Tier 3,882.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5654,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5654,BCBSND Hospital Base OP Fee Sched Tier 3,379.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5655,BCBSND Hospital Base OP Fee Sched Tier 3,301.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5656,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5656,BCBSND Hospital Base OP Fee Sched Tier 3,435.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5658,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5658,BCBSND Hospital Base OP Fee Sched Tier 3,474.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5661,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5661,BCBSND Hospital Base OP Fee Sched Tier 3,692.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5665,BCBSND Hospital Base OP Fee Sched Tier 3,582.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5666,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5666,BCBSND Hospital Base OP Fee Sched Tier 3,79.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5668,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5668,BCBSND Hospital Base OP Fee Sched Tier 3,114.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5670,BCBSND Hospital Base OP Fee Sched Tier 3,411.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5671,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5671,BCBSND Hospital Base OP Fee Sched Tier 3,754.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5672,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5672,BCBSND Hospital Base OP Fee Sched Tier 3,452.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5673,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5673,BCBSND Hospital Base OP Fee Sched Tier 3,861.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5676,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5676,BCBSND Hospital Base OP Fee Sched Tier 3,509.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5677,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5677,BCBSND Hospital Base OP Fee Sched Tier 3,560.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5678,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5678,BCBSND Hospital Base OP Fee Sched Tier 3,58.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5679,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5679,BCBSND Hospital Base OP Fee Sched Tier 3,718.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5680,BCBSND Hospital Base OP Fee Sched Tier 3,422.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5681,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5681,BCBSND Hospital Base OP Fee Sched Tier 3,1524.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5682,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5682,BCBSND Hospital Base OP Fee Sched Tier 3,711.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5683,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5683,BCBSND Hospital Base OP Fee Sched Tier 3,1524.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5684,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5684,BCBSND Hospital Base OP Fee Sched Tier 3,55.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5685,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5685,BCBSND Hospital Base OP Fee Sched Tier 3,148.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5686,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5686,BCBSND Hospital Base OP Fee Sched Tier 3,68.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5688,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5688,BCBSND Hospital Base OP Fee Sched Tier 3,69.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5690,BCBSND Hospital Base OP Fee Sched Tier 3,111.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5692,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5692,BCBSND Hospital Base OP Fee Sched Tier 3,156.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5694,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5694,BCBSND Hospital Base OP Fee Sched Tier 3,230.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5695,BCBSND Hospital Base OP Fee Sched Tier 3,225.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5696,BCBSND Hospital Base OP Fee Sched Tier 3,210.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5697,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5697,BCBSND Hospital Base OP Fee Sched Tier 3,99.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5698,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5698,BCBSND Hospital Base OP Fee Sched Tier 3,118.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5699,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5699,BCBSND Hospital Base OP Fee Sched Tier 3,212.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5700,BCBSND Hospital Base OP Fee Sched Tier 3,3227.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5701,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5701,BCBSND Hospital Base OP Fee Sched Tier 3,4307.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5702,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5702,BCBSND Hospital Base OP Fee Sched Tier 3,5937.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5703,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5703,BCBSND Hospital Base OP Fee Sched Tier 3,2573.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5704,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5704,BCBSND Hospital Base OP Fee Sched Tier 3,673.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5705,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5705,BCBSND Hospital Base OP Fee Sched Tier 3,1143.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5706,BCBSND Hospital Base OP Fee Sched Tier 3,1128.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5707,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5707,BCBSND Hospital Base OP Fee Sched Tier 3,1556.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5710,BCBSND Hospital Base OP Fee Sched Tier 3,482.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5711,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5711,BCBSND Hospital Base OP Fee Sched Tier 3,593.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5712,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5712,BCBSND Hospital Base OP Fee Sched Tier 3,490.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5714,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5714,BCBSND Hospital Base OP Fee Sched Tier 3,577.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5716,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5716,BCBSND Hospital Base OP Fee Sched Tier 3,1105.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5718,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5718,BCBSND Hospital Base OP Fee Sched Tier 3,1381.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5722,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5722,BCBSND Hospital Base OP Fee Sched Tier 3,1142.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5724,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5724,BCBSND Hospital Base OP Fee Sched Tier 3,1794.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5726,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5726,BCBSND Hospital Base OP Fee Sched Tier 3,1978.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5728,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5728,BCBSND Hospital Base OP Fee Sched Tier 3,3257.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5780,BCBSND Hospital Base OP Fee Sched Tier 3,1307.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5781,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5781,BCBSND Hospital Base OP Fee Sched Tier 3,4627.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5782,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5782,BCBSND Hospital Base OP Fee Sched Tier 3,4878.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5785,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5785,BCBSND Hospital Base OP Fee Sched Tier 3,590.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5790,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5790,BCBSND Hospital Base OP Fee Sched Tier 3,817.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5795,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5795,BCBSND Hospital Base OP Fee Sched Tier 3,1221.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5810,BCBSND Hospital Base OP Fee Sched Tier 3,614.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5811,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5811,BCBSND Hospital Base OP Fee Sched Tier 3,1074.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5812,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5812,BCBSND Hospital Base OP Fee Sched Tier 3,790.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5814,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5814,BCBSND Hospital Base OP Fee Sched Tier 3,4295.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5816,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5816,BCBSND Hospital Base OP Fee Sched Tier 3,1289.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5818,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5818,BCBSND Hospital Base OP Fee Sched Tier 3,1456.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5822,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5822,BCBSND Hospital Base OP Fee Sched Tier 3,2142.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5824,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5824,BCBSND Hospital Base OP Fee Sched Tier 3,2325.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5826,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5826,BCBSND Hospital Base OP Fee Sched Tier 3,3611.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5828,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5828,BCBSND Hospital Base OP Fee Sched Tier 3,3612,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5830,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5830,BCBSND Hospital Base OP Fee Sched Tier 3,2158.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5840,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5840,BCBSND Hospital Base OP Fee Sched Tier 3,4438.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5845,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5845,BCBSND Hospital Base OP Fee Sched Tier 3,2073.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5848,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5848,BCBSND Hospital Base OP Fee Sched Tier 3,1243.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5850,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5850,BCBSND Hospital Base OP Fee Sched Tier 3,194.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5855,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5855,BCBSND Hospital Base OP Fee Sched Tier 3,465.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5856,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5856,BCBSND Hospital Base OP Fee Sched Tier 3,27745.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5857,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5857,BCBSND Hospital Base OP Fee Sched Tier 3,9832.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5858,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5858,BCBSND Hospital Base OP Fee Sched Tier 3,21495.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5859,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5859,BCBSND Hospital Base OP Fee Sched Tier 3,16781.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5910,BCBSND Hospital Base OP Fee Sched Tier 3,549.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5920,BCBSND Hospital Base OP Fee Sched Tier 3,799.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5925,BCBSND Hospital Base OP Fee Sched Tier 3,509.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5930,BCBSND Hospital Base OP Fee Sched Tier 3,3880.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5940,BCBSND Hospital Base OP Fee Sched Tier 3,760.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5950,BCBSND Hospital Base OP Fee Sched Tier 3,919.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5960,BCBSND Hospital Base OP Fee Sched Tier 3,1096.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5961,BCBSND Hospital Base OP Fee Sched Tier 3,5832.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5962,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5962,BCBSND Hospital Base OP Fee Sched Tier 3,851.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5964,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5964,BCBSND Hospital Base OP Fee Sched Tier 3,1203.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5966,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5966,BCBSND Hospital Base OP Fee Sched Tier 3,1530.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5968,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5968,BCBSND Hospital Base OP Fee Sched Tier 3,4202.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5969,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5969,BCBSND Hospital Base OP Fee Sched Tier 3,17789.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5970,BCBSND Hospital Base OP Fee Sched Tier 3,258.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5971,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5971,BCBSND Hospital Base OP Fee Sched Tier 3,258.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5972,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5972,BCBSND Hospital Base OP Fee Sched Tier 3,500.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5973,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5973,BCBSND Hospital Base OP Fee Sched Tier 3,20172.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5974,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5974,BCBSND Hospital Base OP Fee Sched Tier 3,268.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5975,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5975,BCBSND Hospital Base OP Fee Sched Tier 3,536.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5976,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5976,BCBSND Hospital Base OP Fee Sched Tier 3,687.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5978,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5978,BCBSND Hospital Base OP Fee Sched Tier 3,331.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5979,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5979,BCBSND Hospital Base OP Fee Sched Tier 3,3141.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5980,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5980,BCBSND Hospital Base OP Fee Sched Tier 3,5623.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5981,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5981,BCBSND Hospital Base OP Fee Sched Tier 3,3674.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5982,BCBSND Hospital Base OP Fee Sched Tier 3,876.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5984,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5984,BCBSND Hospital Base OP Fee Sched Tier 3,686.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5985,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5985,BCBSND Hospital Base OP Fee Sched Tier 3,325.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5986,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5986,BCBSND Hospital Base OP Fee Sched Tier 3,961.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5987,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5987,BCBSND Hospital Base OP Fee Sched Tier 3,8320.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5988,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5988,BCBSND Hospital Base OP Fee Sched Tier 3,2310.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L5990,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L5990,BCBSND Hospital Base OP Fee Sched Tier 3,2098.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6000,BCBSND Hospital Base OP Fee Sched Tier 3,1511.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6010,BCBSND Hospital Base OP Fee Sched Tier 3,1790.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6020,BCBSND Hospital Base OP Fee Sched Tier 3,1594.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6026,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6026,BCBSND Hospital Base OP Fee Sched Tier 3,5417.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6050,BCBSND Hospital Base OP Fee Sched Tier 3,2325.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6055,BCBSND Hospital Base OP Fee Sched Tier 3,3219.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6100,BCBSND Hospital Base OP Fee Sched Tier 3,2301.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6110,BCBSND Hospital Base OP Fee Sched Tier 3,2375.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6120,BCBSND Hospital Base OP Fee Sched Tier 3,2982.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6130,BCBSND Hospital Base OP Fee Sched Tier 3,3217.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6200,BCBSND Hospital Base OP Fee Sched Tier 3,3468.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6205,BCBSND Hospital Base OP Fee Sched Tier 3,4247.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6250,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6250,BCBSND Hospital Base OP Fee Sched Tier 3,3088.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6300,BCBSND Hospital Base OP Fee Sched Tier 3,4528.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6310,BCBSND Hospital Base OP Fee Sched Tier 3,3451.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6320,BCBSND Hospital Base OP Fee Sched Tier 3,2072.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6350,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6350,BCBSND Hospital Base OP Fee Sched Tier 3,5202.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6360,BCBSND Hospital Base OP Fee Sched Tier 3,3622.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6370,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6370,BCBSND Hospital Base OP Fee Sched Tier 3,2310.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6380,BCBSND Hospital Base OP Fee Sched Tier 3,1324.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6382,BCBSND Hospital Base OP Fee Sched Tier 3,1800.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6384,BCBSND Hospital Base OP Fee Sched Tier 3,2496.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6386,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6386,BCBSND Hospital Base OP Fee Sched Tier 3,456.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6388,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6388,BCBSND Hospital Base OP Fee Sched Tier 3,575.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6400,BCBSND Hospital Base OP Fee Sched Tier 3,3519.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6450,BCBSND Hospital Base OP Fee Sched Tier 3,4675.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6500,BCBSND Hospital Base OP Fee Sched Tier 3,4598.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6550,BCBSND Hospital Base OP Fee Sched Tier 3,5751.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6570,BCBSND Hospital Base OP Fee Sched Tier 3,5984.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6580,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6580,BCBSND Hospital Base OP Fee Sched Tier 3,2139.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6582,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6582,BCBSND Hospital Base OP Fee Sched Tier 3,2087.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6584,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6584,BCBSND Hospital Base OP Fee Sched Tier 3,2328.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6586,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6586,BCBSND Hospital Base OP Fee Sched Tier 3,2422.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6588,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6588,BCBSND Hospital Base OP Fee Sched Tier 3,3214.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6590,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6590,BCBSND Hospital Base OP Fee Sched Tier 3,3224.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6600,BCBSND Hospital Base OP Fee Sched Tier 3,213.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6605,BCBSND Hospital Base OP Fee Sched Tier 3,210.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6610,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6610,BCBSND Hospital Base OP Fee Sched Tier 3,192.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6611,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6611,BCBSND Hospital Base OP Fee Sched Tier 3,476.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6615,BCBSND Hospital Base OP Fee Sched Tier 3,222.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6616,BCBSND Hospital Base OP Fee Sched Tier 3,73.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6620,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6620,BCBSND Hospital Base OP Fee Sched Tier 3,386.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6621,BCBSND Hospital Base OP Fee Sched Tier 3,2645.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6623,BCBSND Hospital Base OP Fee Sched Tier 3,729.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6624,BCBSND Hospital Base OP Fee Sched Tier 3,4355.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6625,BCBSND Hospital Base OP Fee Sched Tier 3,604.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6628,BCBSND Hospital Base OP Fee Sched Tier 3,726.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6629,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6629,BCBSND Hospital Base OP Fee Sched Tier 3,208.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6630,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6630,BCBSND Hospital Base OP Fee Sched Tier 3,245.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6632,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6632,BCBSND Hospital Base OP Fee Sched Tier 3,98.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6635,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6635,BCBSND Hospital Base OP Fee Sched Tier 3,235.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6637,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6637,BCBSND Hospital Base OP Fee Sched Tier 3,417.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6638,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6638,BCBSND Hospital Base OP Fee Sched Tier 3,2892.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6640,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6640,BCBSND Hospital Base OP Fee Sched Tier 3,333.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6641,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6641,BCBSND Hospital Base OP Fee Sched Tier 3,183.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6642,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6642,BCBSND Hospital Base OP Fee Sched Tier 3,247.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6645,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6645,BCBSND Hospital Base OP Fee Sched Tier 3,363.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6646,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6646,BCBSND Hospital Base OP Fee Sched Tier 3,3647.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6647,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6647,BCBSND Hospital Base OP Fee Sched Tier 3,600.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6648,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6648,BCBSND Hospital Base OP Fee Sched Tier 3,3762.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6650,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6650,BCBSND Hospital Base OP Fee Sched Tier 3,385.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6655,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6655,BCBSND Hospital Base OP Fee Sched Tier 3,85.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6660,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6660,BCBSND Hospital Base OP Fee Sched Tier 3,106.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6665,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6665,BCBSND Hospital Base OP Fee Sched Tier 3,52.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6670,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6670,BCBSND Hospital Base OP Fee Sched Tier 3,54.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6672,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6672,BCBSND Hospital Base OP Fee Sched Tier 3,230.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6675,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6675,BCBSND Hospital Base OP Fee Sched Tier 3,136.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6676,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6676,BCBSND Hospital Base OP Fee Sched Tier 3,161.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6677,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6677,BCBSND Hospital Base OP Fee Sched Tier 3,343.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6680,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6680,BCBSND Hospital Base OP Fee Sched Tier 3,279.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6682,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6682,BCBSND Hospital Base OP Fee Sched Tier 3,304.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6684,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6684,BCBSND Hospital Base OP Fee Sched Tier 3,433.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6686,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6686,BCBSND Hospital Base OP Fee Sched Tier 3,671.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6687,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6687,BCBSND Hospital Base OP Fee Sched Tier 3,874.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6688,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6688,BCBSND Hospital Base OP Fee Sched Tier 3,602.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6689,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6689,BCBSND Hospital Base OP Fee Sched Tier 3,1021.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6690,BCBSND Hospital Base OP Fee Sched Tier 3,782.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6691,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6691,BCBSND Hospital Base OP Fee Sched Tier 3,392.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6692,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6692,BCBSND Hospital Base OP Fee Sched Tier 3,795.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6693,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6693,BCBSND Hospital Base OP Fee Sched Tier 3,3283.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6694,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6694,BCBSND Hospital Base OP Fee Sched Tier 3,861.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6695,BCBSND Hospital Base OP Fee Sched Tier 3,718.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6696,BCBSND Hospital Base OP Fee Sched Tier 3,1524.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6697,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6697,BCBSND Hospital Base OP Fee Sched Tier 3,1524.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6698,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6698,BCBSND Hospital Base OP Fee Sched Tier 3,754.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6703,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6703,BCBSND Hospital Base OP Fee Sched Tier 3,420.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6704,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6704,BCBSND Hospital Base OP Fee Sched Tier 3,818.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6706,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6706,BCBSND Hospital Base OP Fee Sched Tier 3,526.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6707,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6707,BCBSND Hospital Base OP Fee Sched Tier 3,1625.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6708,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6708,BCBSND Hospital Base OP Fee Sched Tier 3,1132.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6709,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6709,BCBSND Hospital Base OP Fee Sched Tier 3,1756.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6711,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6711,BCBSND Hospital Base OP Fee Sched Tier 3,777.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6712,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6712,BCBSND Hospital Base OP Fee Sched Tier 3,1431.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6713,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6713,BCBSND Hospital Base OP Fee Sched Tier 3,1806.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6714,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6714,BCBSND Hospital Base OP Fee Sched Tier 3,1530.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6715,BCBSND Hospital Base OP Fee Sched Tier 3,3658.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6721,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6721,BCBSND Hospital Base OP Fee Sched Tier 3,2720.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6722,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6722,BCBSND Hospital Base OP Fee Sched Tier 3,2345.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6805,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6805,BCBSND Hospital Base OP Fee Sched Tier 3,405.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6810,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6810,BCBSND Hospital Base OP Fee Sched Tier 3,250.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6880,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6880,BCBSND Hospital Base OP Fee Sched Tier 3,27689.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6881,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6881,BCBSND Hospital Base OP Fee Sched Tier 3,4728.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6882,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6882,BCBSND Hospital Base OP Fee Sched Tier 3,3586.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6883,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6883,BCBSND Hospital Base OP Fee Sched Tier 3,1949.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6884,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6884,BCBSND Hospital Base OP Fee Sched Tier 3,2539.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6885,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6885,BCBSND Hospital Base OP Fee Sched Tier 3,3622.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6890,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6890,BCBSND Hospital Base OP Fee Sched Tier 3,206.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6895,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6895,BCBSND Hospital Base OP Fee Sched Tier 3,649.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6900,BCBSND Hospital Base OP Fee Sched Tier 3,1718.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6905,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6905,BCBSND Hospital Base OP Fee Sched Tier 3,1670.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6910,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6910,BCBSND Hospital Base OP Fee Sched Tier 3,1626.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6915,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6915,BCBSND Hospital Base OP Fee Sched Tier 3,712.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6920,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6920,BCBSND Hospital Base OP Fee Sched Tier 3,9227.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6925,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6925,BCBSND Hospital Base OP Fee Sched Tier 3,9952.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6930,BCBSND Hospital Base OP Fee Sched Tier 3,9695.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6935,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6935,BCBSND Hospital Base OP Fee Sched Tier 3,10408.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6940,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6940,BCBSND Hospital Base OP Fee Sched Tier 3,13306.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6945,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6945,BCBSND Hospital Base OP Fee Sched Tier 3,15480.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6950,BCBSND Hospital Base OP Fee Sched Tier 3,15124.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6955,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6955,BCBSND Hospital Base OP Fee Sched Tier 3,18113.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6960,BCBSND Hospital Base OP Fee Sched Tier 3,18268.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6965,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6965,BCBSND Hospital Base OP Fee Sched Tier 3,19793.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6970,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6970,BCBSND Hospital Base OP Fee Sched Tier 3,20037.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L6975,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L6975,BCBSND Hospital Base OP Fee Sched Tier 3,21468.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7007,BCBSND Hospital Base OP Fee Sched Tier 3,3914,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7008,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7008,BCBSND Hospital Base OP Fee Sched Tier 3,6586.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7009,BCBSND Hospital Base OP Fee Sched Tier 3,4098.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7040,BCBSND Hospital Base OP Fee Sched Tier 3,3206.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7045,BCBSND Hospital Base OP Fee Sched Tier 3,1838.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7170,BCBSND Hospital Base OP Fee Sched Tier 3,6997.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7180,BCBSND Hospital Base OP Fee Sched Tier 3,40611.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7181,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7181,BCBSND Hospital Base OP Fee Sched Tier 3,46342.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7185,BCBSND Hospital Base OP Fee Sched Tier 3,7260.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7186,BCBSND Hospital Base OP Fee Sched Tier 3,13158.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7190,BCBSND Hospital Base OP Fee Sched Tier 3,9185.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7191,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7191,BCBSND Hospital Base OP Fee Sched Tier 3,13481.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7259,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7259,BCBSND Hospital Base OP Fee Sched Tier 3,4386.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7360,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7360,BCBSND Hospital Base OP Fee Sched Tier 3,258.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7362,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7362,BCBSND Hospital Base OP Fee Sched Tier 3,379.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7364,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7364,BCBSND Hospital Base OP Fee Sched Tier 3,453.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7366,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7366,BCBSND Hospital Base OP Fee Sched Tier 3,610.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7367,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7367,BCBSND Hospital Base OP Fee Sched Tier 3,450.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7368,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7368,BCBSND Hospital Base OP Fee Sched Tier 3,583.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7400,BCBSND Hospital Base OP Fee Sched Tier 3,354.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7401,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7401,BCBSND Hospital Base OP Fee Sched Tier 3,396.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7402,BCBSND Hospital Base OP Fee Sched Tier 3,428.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7403,BCBSND Hospital Base OP Fee Sched Tier 3,425.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7404,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7404,BCBSND Hospital Base OP Fee Sched Tier 3,642.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7405,BCBSND Hospital Base OP Fee Sched Tier 3,840.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7520,BCBSND Hospital Base OP Fee Sched Tier 3,38.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7600,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7600,BCBSND Hospital Base OP Fee Sched Tier 3,425.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7700,BCBSND Hospital Base OP Fee Sched Tier 3,136,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7900,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7900,BCBSND Hospital Base OP Fee Sched Tier 3,599.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L7902,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L7902,BCBSND Hospital Base OP Fee Sched Tier 3,20.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8000,BCBSND Hospital Base OP Fee Sched Tier 3,42.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8001,BCBSND Hospital Base OP Fee Sched Tier 3,145.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8002,BCBSND Hospital Base OP Fee Sched Tier 3,190.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8010,BCBSND Hospital Base OP Fee Sched Tier 3,99.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8015,BCBSND Hospital Base OP Fee Sched Tier 3,69.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8020,BCBSND Hospital Base OP Fee Sched Tier 3,228.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8030,BCBSND Hospital Base OP Fee Sched Tier 3,404.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8031,BCBSND Hospital Base OP Fee Sched Tier 3,404.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8032,BCBSND Hospital Base OP Fee Sched Tier 3,45.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8035,BCBSND Hospital Base OP Fee Sched Tier 3,4237.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8040,BCBSND Hospital Base OP Fee Sched Tier 3,2671.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8041,BCBSND Hospital Base OP Fee Sched Tier 3,3220.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8042,BCBSND Hospital Base OP Fee Sched Tier 3,3618.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8043,BCBSND Hospital Base OP Fee Sched Tier 3,4052.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8044,BCBSND Hospital Base OP Fee Sched Tier 3,4486.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8045,BCBSND Hospital Base OP Fee Sched Tier 3,2809.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8046,BCBSND Hospital Base OP Fee Sched Tier 3,2894.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8047,BCBSND Hospital Base OP Fee Sched Tier 3,1483.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8049,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8049,BCBSND Hospital Base OP Fee Sched Tier 3,42.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8300,BCBSND Hospital Base OP Fee Sched Tier 3,109.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8310,BCBSND Hospital Base OP Fee Sched Tier 3,176.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8320,BCBSND Hospital Base OP Fee Sched Tier 3,60.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8330,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8330,BCBSND Hospital Base OP Fee Sched Tier 3,56.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8400,BCBSND Hospital Base OP Fee Sched Tier 3,17.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8410,BCBSND Hospital Base OP Fee Sched Tier 3,24.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8415,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8415,BCBSND Hospital Base OP Fee Sched Tier 3,26.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8417,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8417,BCBSND Hospital Base OP Fee Sched Tier 3,86.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8420,BCBSND Hospital Base OP Fee Sched Tier 3,22.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8430,BCBSND Hospital Base OP Fee Sched Tier 3,27.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8435,BCBSND Hospital Base OP Fee Sched Tier 3,23.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8440,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8440,BCBSND Hospital Base OP Fee Sched Tier 3,47.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8460,BCBSND Hospital Base OP Fee Sched Tier 3,75.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8465,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8465,BCBSND Hospital Base OP Fee Sched Tier 3,55.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8470,BCBSND Hospital Base OP Fee Sched Tier 3,10.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8480,BCBSND Hospital Base OP Fee Sched Tier 3,13.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8485,BCBSND Hospital Base OP Fee Sched Tier 3,15.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8500,BCBSND Hospital Base OP Fee Sched Tier 3,750.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8501,BCBSND Hospital Base OP Fee Sched Tier 3,137.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8505,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8505,BCBSND Hospital Base OP Fee Sched Tier 3,11.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8507,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8507,BCBSND Hospital Base OP Fee Sched Tier 3,48.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8509,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8509,BCBSND Hospital Base OP Fee Sched Tier 3,126.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8510,BCBSND Hospital Base OP Fee Sched Tier 3,292.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8511,BCBSND Hospital Base OP Fee Sched Tier 3,84.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8512,BCBSND Hospital Base OP Fee Sched Tier 3,2.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8513,BCBSND Hospital Base OP Fee Sched Tier 3,6.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8514,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8514,BCBSND Hospital Base OP Fee Sched Tier 3,109.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8515,BCBSND Hospital Base OP Fee Sched Tier 3,73.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8605,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8605,BCBSND Hospital Base OP Fee Sched Tier 3,830.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8615,BCBSND Hospital Base OP Fee Sched Tier 3,522.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8616,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8616,BCBSND Hospital Base OP Fee Sched Tier 3,121.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8617,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8617,BCBSND Hospital Base OP Fee Sched Tier 3,106.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8618,BCBSND Hospital Base OP Fee Sched Tier 3,30.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8619,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8619,BCBSND Hospital Base OP Fee Sched Tier 3,9480.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8621,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8621,BCBSND Hospital Base OP Fee Sched Tier 3,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8622,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8622,BCBSND Hospital Base OP Fee Sched Tier 3,0.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8623,BCBSND Hospital Base OP Fee Sched Tier 3,74.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8624,BCBSND Hospital Base OP Fee Sched Tier 3,186.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8625,BCBSND Hospital Base OP Fee Sched Tier 3,218.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8627,BCBSND Hospital Base OP Fee Sched Tier 3,8030.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8628,BCBSND Hospital Base OP Fee Sched Tier 3,1449.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8629,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8629,BCBSND Hospital Base OP Fee Sched Tier 3,207.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8679,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8679,BCBSND Hospital Base OP Fee Sched Tier 3,9774.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8681,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8681,BCBSND Hospital Base OP Fee Sched Tier 3,1227.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8683,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8683,BCBSND Hospital Base OP Fee Sched Tier 3,6147.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8684,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8684,BCBSND Hospital Base OP Fee Sched Tier 3,908.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8689,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8689,BCBSND Hospital Base OP Fee Sched Tier 3,1999.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8690,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8690,BCBSND Hospital Base OP Fee Sched Tier 3,5513.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8691,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8691,BCBSND Hospital Base OP Fee Sched Tier 3,1995.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8692,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8692,BCBSND Hospital Base OP Fee Sched Tier 3,6504.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8693,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8693,BCBSND Hospital Base OP Fee Sched Tier 3,1757.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8694,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8694,BCBSND Hospital Base OP Fee Sched Tier 3,1094.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8695,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8695,BCBSND Hospital Base OP Fee Sched Tier 3,19.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,L8696,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,L8696,BCBSND Hospital Base OP Fee Sched Tier 3,251.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0027,BCBSND Hospital Base OP Fee Sched Tier 3,30.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0101,BCBSND Hospital Base OP Fee Sched Tier 3,95.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0103,BCBSND Hospital Base OP Fee Sched Tier 3,87.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0104,BCBSND Hospital Base OP Fee Sched Tier 3,1255.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0105,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0106,BCBSND Hospital Base OP Fee Sched Tier 3,549.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0108,BCBSND Hospital Base OP Fee Sched Tier 3,141.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0109,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0109,BCBSND Hospital Base OP Fee Sched Tier 3,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0117,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0117,BCBSND Hospital Base OP Fee Sched Tier 3,173.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0118,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0118,BCBSND Hospital Base OP Fee Sched Tier 3,129.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0120,BCBSND Hospital Base OP Fee Sched Tier 3,549.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0121,BCBSND Hospital Base OP Fee Sched Tier 3,1190.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0122,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0122,BCBSND Hospital Base OP Fee Sched Tier 3,746.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0123,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0123,BCBSND Hospital Base OP Fee Sched Tier 3,96.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0124,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0124,BCBSND Hospital Base OP Fee Sched Tier 3,81.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0127,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0127,BCBSND Hospital Base OP Fee Sched Tier 3,94.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0130,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0130,BCBSND Hospital Base OP Fee Sched Tier 3,90.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0141,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0141,BCBSND Hospital Base OP Fee Sched Tier 3,81.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0143,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0143,BCBSND Hospital Base OP Fee Sched Tier 3,115.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0144,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0144,BCBSND Hospital Base OP Fee Sched Tier 3,187.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0145,BCBSND Hospital Base OP Fee Sched Tier 3,125.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0147,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0147,BCBSND Hospital Base OP Fee Sched Tier 3,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0148,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0148,BCBSND Hospital Base OP Fee Sched Tier 3,136.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0151,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0151,BCBSND Hospital Base OP Fee Sched Tier 3,83.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0152,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0152,BCBSND Hospital Base OP Fee Sched Tier 3,84.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0153,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0153,BCBSND Hospital Base OP Fee Sched Tier 3,91.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0155,BCBSND Hospital Base OP Fee Sched Tier 3,122.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0156,BCBSND Hospital Base OP Fee Sched Tier 3,34.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0157,BCBSND Hospital Base OP Fee Sched Tier 3,62.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0158,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0158,BCBSND Hospital Base OP Fee Sched Tier 3,63.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0159,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0159,BCBSND Hospital Base OP Fee Sched Tier 3,83.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0160,BCBSND Hospital Base OP Fee Sched Tier 3,84.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0161,BCBSND Hospital Base OP Fee Sched Tier 3,91.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0162,BCBSND Hospital Base OP Fee Sched Tier 3,76.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0166,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0166,BCBSND Hospital Base OP Fee Sched Tier 3,354.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0175,BCBSND Hospital Base OP Fee Sched Tier 3,608.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0186,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0186,BCBSND Hospital Base OP Fee Sched Tier 3,836.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0219,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0219,BCBSND Hospital Base OP Fee Sched Tier 3,2579.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0235,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0235,BCBSND Hospital Base OP Fee Sched Tier 3,2305.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0237,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0237,BCBSND Hospital Base OP Fee Sched Tier 3,29.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0238,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0238,BCBSND Hospital Base OP Fee Sched Tier 3,30.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0239,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0239,BCBSND Hospital Base OP Fee Sched Tier 3,38.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0245,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0245,BCBSND Hospital Base OP Fee Sched Tier 3,64.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0246,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0246,BCBSND Hospital Base OP Fee Sched Tier 3,49.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0247,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0247,BCBSND Hospital Base OP Fee Sched Tier 3,148.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0248,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0248,BCBSND Hospital Base OP Fee Sched Tier 3,222.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0249,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0249,BCBSND Hospital Base OP Fee Sched Tier 3,223.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0252,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0252,BCBSND Hospital Base OP Fee Sched Tier 3,2305.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0255,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0255,BCBSND Hospital Base OP Fee Sched Tier 3,59.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0257,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0257,BCBSND Hospital Base OP Fee Sched Tier 3,497.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0260,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0260,BCBSND Hospital Base OP Fee Sched Tier 3,926.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0270,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0270,BCBSND Hospital Base OP Fee Sched Tier 3,100.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0271,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0271,BCBSND Hospital Base OP Fee Sched Tier 3,52.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0276,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0276,BCBSND Hospital Base OP Fee Sched Tier 3,9608.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0277,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0277,BCBSND Hospital Base OP Fee Sched Tier 3,340.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0279,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0279,BCBSND Hospital Base OP Fee Sched Tier 3,94.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0281,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0281,BCBSND Hospital Base OP Fee Sched Tier 3,43.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0283,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0283,BCBSND Hospital Base OP Fee Sched Tier 3,43.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0288,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0288,BCBSND Hospital Base OP Fee Sched Tier 3,111.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0293,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0293,BCBSND Hospital Base OP Fee Sched Tier 3,54.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0296,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0296,BCBSND Hospital Base OP Fee Sched Tier 3,89.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0297,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0297,BCBSND Hospital Base OP Fee Sched Tier 3,575.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0299,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0299,BCBSND Hospital Base OP Fee Sched Tier 3,76.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0300,BCBSND Hospital Base OP Fee Sched Tier 3,76.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0302,BCBSND Hospital Base OP Fee Sched Tier 3,768.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0303,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0304,BCBSND Hospital Base OP Fee Sched Tier 3,768.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0305,BCBSND Hospital Base OP Fee Sched Tier 3,768.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0306,BCBSND Hospital Base OP Fee Sched Tier 3,36.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0307,BCBSND Hospital Base OP Fee Sched Tier 3,30.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0328,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0328,BCBSND Hospital Base OP Fee Sched Tier 3,77.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0365,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0365,BCBSND Hospital Base OP Fee Sched Tier 3,151.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0380,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0380,BCBSND Hospital Base OP Fee Sched Tier 3,47.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0381,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0381,BCBSND Hospital Base OP Fee Sched Tier 3,65.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0382,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0382,BCBSND Hospital Base OP Fee Sched Tier 3,81.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0383,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0383,BCBSND Hospital Base OP Fee Sched Tier 3,89.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0384,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0384,BCBSND Hospital Base OP Fee Sched Tier 3,96.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0396,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0396,BCBSND Hospital Base OP Fee Sched Tier 3,111.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0397,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0397,BCBSND Hospital Base OP Fee Sched Tier 3,207.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0398,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0398,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0399,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0399,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0400,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0400,BCBSND Hospital Base OP Fee Sched Tier 3,229.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0402,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0402,BCBSND Hospital Base OP Fee Sched Tier 3,515.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0403,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0403,BCBSND Hospital Base OP Fee Sched Tier 3,52.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0404,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0404,BCBSND Hospital Base OP Fee Sched Tier 3,26.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0405,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0405,BCBSND Hospital Base OP Fee Sched Tier 3,26.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0406,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0406,BCBSND Hospital Base OP Fee Sched Tier 3,119.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0407,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0407,BCBSND Hospital Base OP Fee Sched Tier 3,223.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0408,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0408,BCBSND Hospital Base OP Fee Sched Tier 3,321.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0409,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0409,BCBSND Hospital Base OP Fee Sched Tier 3,50.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0413,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0413,BCBSND Hospital Base OP Fee Sched Tier 3,4422.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0416,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0416,BCBSND Hospital Base OP Fee Sched Tier 3,504.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0420,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0420,BCBSND Hospital Base OP Fee Sched Tier 3,343.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0421,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0421,BCBSND Hospital Base OP Fee Sched Tier 3,80.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0424,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0424,BCBSND Hospital Base OP Fee Sched Tier 3,91.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0432,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0432,BCBSND Hospital Base OP Fee Sched Tier 3,83.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0433,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0433,BCBSND Hospital Base OP Fee Sched Tier 3,78.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0435,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0435,BCBSND Hospital Base OP Fee Sched Tier 3,56.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0438,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0438,BCBSND Hospital Base OP Fee Sched Tier 3,532.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0439,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0439,BCBSND Hospital Base OP Fee Sched Tier 3,360.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0442,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0442,BCBSND Hospital Base OP Fee Sched Tier 3,23.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0443,BCBSND Hospital Base OP Fee Sched Tier 3,6.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0444,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0444,BCBSND Hospital Base OP Fee Sched Tier 3,23.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0445,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0445,BCBSND Hospital Base OP Fee Sched Tier 3,10.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0447,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0447,BCBSND Hospital Base OP Fee Sched Tier 3,5.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0452,BCBSND Hospital Base OP Fee Sched Tier 3,47.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0454,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0454,BCBSND Hospital Base OP Fee Sched Tier 3,28.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0455,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0455,BCBSND Hospital Base OP Fee Sched Tier 3,1283.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0458,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0458,BCBSND Hospital Base OP Fee Sched Tier 3,3161.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0459,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0459,BCBSND Hospital Base OP Fee Sched Tier 3,127.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0460,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0460,BCBSND Hospital Base OP Fee Sched Tier 3,2613.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0463,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0463,BCBSND Hospital Base OP Fee Sched Tier 3,65.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0471,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0471,BCBSND Hospital Base OP Fee Sched Tier 3,21.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0472,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0472,BCBSND Hospital Base OP Fee Sched Tier 3,198.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0473,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0473,BCBSND Hospital Base OP Fee Sched Tier 3,39.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0475,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0475,BCBSND Hospital Base OP Fee Sched Tier 3,114.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0476,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0476,BCBSND Hospital Base OP Fee Sched Tier 3,166.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0480,BCBSND Hospital Base OP Fee Sched Tier 3,489.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0481,BCBSND Hospital Base OP Fee Sched Tier 3,669.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0482,BCBSND Hospital Base OP Fee Sched Tier 3,849.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0483,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0483,BCBSND Hospital Base OP Fee Sched Tier 3,1055.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0493,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0493,BCBSND Hospital Base OP Fee Sched Tier 3,76.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0494,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0494,BCBSND Hospital Base OP Fee Sched Tier 3,76.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0495,BCBSND Hospital Base OP Fee Sched Tier 3,76.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0496,BCBSND Hospital Base OP Fee Sched Tier 3,76.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0498,BCBSND Hospital Base OP Fee Sched Tier 3,506.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0499,BCBSND Hospital Base OP Fee Sched Tier 3,134.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0513,BCBSND Hospital Base OP Fee Sched Tier 3,201.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0514,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0514,BCBSND Hospital Base OP Fee Sched Tier 3,201.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0515,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0515,BCBSND Hospital Base OP Fee Sched Tier 3,120.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0516,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0516,BCBSND Hospital Base OP Fee Sched Tier 3,586.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0517,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0517,BCBSND Hospital Base OP Fee Sched Tier 3,586.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0518,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0518,BCBSND Hospital Base OP Fee Sched Tier 3,586.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,G0659,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G0659,BCBSND Hospital Base OP Fee Sched Tier 3,276.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,G2000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G2000,BCBSND Hospital Base OP Fee Sched Tier 3,770.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,G2010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G2010,BCBSND Hospital Base OP Fee Sched Tier 3,38.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,G2011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G2011,BCBSND Hospital Base OP Fee Sched Tier 3,51.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,G2012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G2012,BCBSND Hospital Base OP Fee Sched Tier 3,45.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6001,BCBSND Hospital Base OP Fee Sched Tier 3,194.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6002,BCBSND Hospital Base OP Fee Sched Tier 3,210.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6003,BCBSND Hospital Base OP Fee Sched Tier 3,745.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6004,BCBSND Hospital Base OP Fee Sched Tier 3,545.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6005,BCBSND Hospital Base OP Fee Sched Tier 3,545.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6006,BCBSND Hospital Base OP Fee Sched Tier 3,544.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6007,BCBSND Hospital Base OP Fee Sched Tier 3,1032.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6008,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6008,BCBSND Hospital Base OP Fee Sched Tier 3,753.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6009,BCBSND Hospital Base OP Fee Sched Tier 3,749.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6010,BCBSND Hospital Base OP Fee Sched Tier 3,749.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6011,BCBSND Hospital Base OP Fee Sched Tier 3,1018.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6012,BCBSND Hospital Base OP Fee Sched Tier 3,998.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6013,BCBSND Hospital Base OP Fee Sched Tier 3,999.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6014,BCBSND Hospital Base OP Fee Sched Tier 3,999.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6015,BCBSND Hospital Base OP Fee Sched Tier 3,1355.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6016,BCBSND Hospital Base OP Fee Sched Tier 3,1351.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,G6017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G6017,BCBSND Hospital Base OP Fee Sched Tier 3,320.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9017,BCBSND Hospital Base OP Fee Sched Tier 3,2.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9018,BCBSND Hospital Base OP Fee Sched Tier 3,8.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9019,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9019,BCBSND Hospital Base OP Fee Sched Tier 3,12.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9020,BCBSND Hospital Base OP Fee Sched Tier 3,3.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9034,BCBSND Hospital Base OP Fee Sched Tier 3,8.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9035,BCBSND Hospital Base OP Fee Sched Tier 3,21.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9036,BCBSND Hospital Base OP Fee Sched Tier 3,3.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9143,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9143,BCBSND Hospital Base OP Fee Sched Tier 3,573.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9187,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9187,BCBSND Hospital Base OP Fee Sched Tier 3,136.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9868,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9868,BCBSND Hospital Base OP Fee Sched Tier 3,87.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9869,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9869,BCBSND Hospital Base OP Fee Sched Tier 3,117.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,G9870,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,G9870,BCBSND Hospital Base OP Fee Sched Tier 3,147.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,H0004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,H0004,BCBSND Hospital Base OP Fee Sched Tier 3,53.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,H0005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,H0005,BCBSND Hospital Base OP Fee Sched Tier 3,77.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0035,BCBSND Hospital Base OP Fee Sched Tier 3,35.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0092,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0092,BCBSND Hospital Base OP Fee Sched Tier 3,74.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0111,BCBSND Hospital Base OP Fee Sched Tier 3,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0112,BCBSND Hospital Base OP Fee Sched Tier 3,24.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0113,BCBSND Hospital Base OP Fee Sched Tier 3,20.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0114,BCBSND Hospital Base OP Fee Sched Tier 3,41.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0115,BCBSND Hospital Base OP Fee Sched Tier 3,106.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0138,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0138,BCBSND Hospital Base OP Fee Sched Tier 3,1.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0139,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0139,BCBSND Hospital Base OP Fee Sched Tier 3,1.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0144,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0144,BCBSND Hospital Base OP Fee Sched Tier 3,34.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0161,BCBSND Hospital Base OP Fee Sched Tier 3,2.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0162,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0162,BCBSND Hospital Base OP Fee Sched Tier 3,0.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0163,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0163,BCBSND Hospital Base OP Fee Sched Tier 3,0.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0164,BCBSND Hospital Base OP Fee Sched Tier 3,0.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0166,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0166,BCBSND Hospital Base OP Fee Sched Tier 3,5.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0167,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0167,BCBSND Hospital Base OP Fee Sched Tier 3,1.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0169,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0169,BCBSND Hospital Base OP Fee Sched Tier 3,0.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0175,BCBSND Hospital Base OP Fee Sched Tier 3,1.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0177,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0177,BCBSND Hospital Base OP Fee Sched Tier 3,0.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0180,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0180,BCBSND Hospital Base OP Fee Sched Tier 3,135.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0477,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0477,BCBSND Hospital Base OP Fee Sched Tier 3,899.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0478,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0478,BCBSND Hospital Base OP Fee Sched Tier 3,212.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0479,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0479,BCBSND Hospital Base OP Fee Sched Tier 3,13883.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0480,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0480,BCBSND Hospital Base OP Fee Sched Tier 3,104376.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0481,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0481,BCBSND Hospital Base OP Fee Sched Tier 3,16839.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0482,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0482,BCBSND Hospital Base OP Fee Sched Tier 3,5274.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0483,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0483,BCBSND Hospital Base OP Fee Sched Tier 3,21728.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0484,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0484,BCBSND Hospital Base OP Fee Sched Tier 3,4219.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0485,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0485,BCBSND Hospital Base OP Fee Sched Tier 3,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0486,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0486,BCBSND Hospital Base OP Fee Sched Tier 3,339.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0487,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0487,BCBSND Hospital Base OP Fee Sched Tier 3,395.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0489,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0489,BCBSND Hospital Base OP Fee Sched Tier 3,18837.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0490,BCBSND Hospital Base OP Fee Sched Tier 3,814.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0491,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0491,BCBSND Hospital Base OP Fee Sched Tier 3,1281.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0492,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0492,BCBSND Hospital Base OP Fee Sched Tier 3,103.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0493,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0493,BCBSND Hospital Base OP Fee Sched Tier 3,293.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0494,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0494,BCBSND Hospital Base OP Fee Sched Tier 3,248.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0495,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0495,BCBSND Hospital Base OP Fee Sched Tier 3,4840.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0496,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0496,BCBSND Hospital Base OP Fee Sched Tier 3,1737.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0497,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0497,BCBSND Hospital Base OP Fee Sched Tier 3,542.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0498,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0498,BCBSND Hospital Base OP Fee Sched Tier 3,595.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0499,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0499,BCBSND Hospital Base OP Fee Sched Tier 3,193.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0500,BCBSND Hospital Base OP Fee Sched Tier 3,35.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0501,BCBSND Hospital Base OP Fee Sched Tier 3,591.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0502,BCBSND Hospital Base OP Fee Sched Tier 3,753.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0503,BCBSND Hospital Base OP Fee Sched Tier 3,1507.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0504,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0504,BCBSND Hospital Base OP Fee Sched Tier 3,795.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q0506,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q0506,BCBSND Hospital Base OP Fee Sched Tier 3,989.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q2004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q2004,BCBSND Hospital Base OP Fee Sched Tier 3,120.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q2009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q2009,BCBSND Hospital Base OP Fee Sched Tier 3,6.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q2017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q2017,BCBSND Hospital Base OP Fee Sched Tier 3,3538.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q2035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q2035,BCBSND Hospital Base OP Fee Sched Tier 3,23.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q2039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q2039,BCBSND Hospital Base OP Fee Sched Tier 3,29.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q2043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q2043,BCBSND Hospital Base OP Fee Sched Tier 3,65948.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q2050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q2050,BCBSND Hospital Base OP Fee Sched Tier 3,529.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q3014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q3014,BCBSND Hospital Base OP Fee Sched Tier 3,56.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q3027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q3027,BCBSND Hospital Base OP Fee Sched Tier 3,78.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q3028,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q3028,BCBSND Hospital Base OP Fee Sched Tier 3,40.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4001,BCBSND Hospital Base OP Fee Sched Tier 3,57.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4002,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4002,BCBSND Hospital Base OP Fee Sched Tier 3,218.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4003,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4003,BCBSND Hospital Base OP Fee Sched Tier 3,41.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4004,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4004,BCBSND Hospital Base OP Fee Sched Tier 3,144.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4005,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4005,BCBSND Hospital Base OP Fee Sched Tier 3,15.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4006,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4006,BCBSND Hospital Base OP Fee Sched Tier 3,34.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4007,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4007,BCBSND Hospital Base OP Fee Sched Tier 3,7.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4008,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4008,BCBSND Hospital Base OP Fee Sched Tier 3,17.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4009,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4009,BCBSND Hospital Base OP Fee Sched Tier 3,10.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4010,BCBSND Hospital Base OP Fee Sched Tier 3,23.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4011,BCBSND Hospital Base OP Fee Sched Tier 3,5.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4012,BCBSND Hospital Base OP Fee Sched Tier 3,11.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4013,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4013,BCBSND Hospital Base OP Fee Sched Tier 3,18.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4014,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4014,BCBSND Hospital Base OP Fee Sched Tier 3,31.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4015,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4015,BCBSND Hospital Base OP Fee Sched Tier 3,9.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4016,BCBSND Hospital Base OP Fee Sched Tier 3,15.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4017,BCBSND Hospital Base OP Fee Sched Tier 3,10.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4018,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4018,BCBSND Hospital Base OP Fee Sched Tier 3,17.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4019,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4019,BCBSND Hospital Base OP Fee Sched Tier 3,5.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4020,BCBSND Hospital Base OP Fee Sched Tier 3,8.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4021,BCBSND Hospital Base OP Fee Sched Tier 3,7.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4022,BCBSND Hospital Base OP Fee Sched Tier 3,14.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4023,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4023,BCBSND Hospital Base OP Fee Sched Tier 3,4.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4024,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4024,BCBSND Hospital Base OP Fee Sched Tier 3,7.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4025,BCBSND Hospital Base OP Fee Sched Tier 3,44.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4026,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4026,BCBSND Hospital Base OP Fee Sched Tier 3,139.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4027,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4027,BCBSND Hospital Base OP Fee Sched Tier 3,22.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4028,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4028,BCBSND Hospital Base OP Fee Sched Tier 3,69.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4029,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4029,BCBSND Hospital Base OP Fee Sched Tier 3,34.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4030,BCBSND Hospital Base OP Fee Sched Tier 3,90.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4031,BCBSND Hospital Base OP Fee Sched Tier 3,17.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4032,BCBSND Hospital Base OP Fee Sched Tier 3,45.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4033,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4033,BCBSND Hospital Base OP Fee Sched Tier 3,31.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4034,BCBSND Hospital Base OP Fee Sched Tier 3,79.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4035,BCBSND Hospital Base OP Fee Sched Tier 3,15.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4036,BCBSND Hospital Base OP Fee Sched Tier 3,39.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4037,BCBSND Hospital Base OP Fee Sched Tier 3,19.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4038,BCBSND Hospital Base OP Fee Sched Tier 3,48.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4039,BCBSND Hospital Base OP Fee Sched Tier 3,9.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4040,BCBSND Hospital Base OP Fee Sched Tier 3,24.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4041,BCBSND Hospital Base OP Fee Sched Tier 3,23.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4042,BCBSND Hospital Base OP Fee Sched Tier 3,40.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4043,BCBSND Hospital Base OP Fee Sched Tier 3,11.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4044,BCBSND Hospital Base OP Fee Sched Tier 3,20.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4045,BCBSND Hospital Base OP Fee Sched Tier 3,13.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4046,BCBSND Hospital Base OP Fee Sched Tier 3,22.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4047,BCBSND Hospital Base OP Fee Sched Tier 3,6.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4048,BCBSND Hospital Base OP Fee Sched Tier 3,11.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4049,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4049,BCBSND Hospital Base OP Fee Sched Tier 3,2.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4051,BCBSND Hospital Base OP Fee Sched Tier 3,19.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4074,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4074,BCBSND Hospital Base OP Fee Sched Tier 3,207.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4081,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4081,BCBSND Hospital Base OP Fee Sched Tier 3,1.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4195,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4195,BCBSND Hospital Base OP Fee Sched Tier 3,108.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q4196,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q4196,BCBSND Hospital Base OP Fee Sched Tier 3,117.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q5101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q5101,BCBSND Hospital Base OP Fee Sched Tier 3,0.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q5103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q5103,BCBSND Hospital Base OP Fee Sched Tier 3,79.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q5104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q5104,BCBSND Hospital Base OP Fee Sched Tier 3,86.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q5105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q5105,BCBSND Hospital Base OP Fee Sched Tier 3,1.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q5106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q5106,BCBSND Hospital Base OP Fee Sched Tier 3,16.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q5108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q5108,BCBSND Hospital Base OP Fee Sched Tier 3,512.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q5110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q5110,BCBSND Hospital Base OP Fee Sched Tier 3,1.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q5111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q5111,BCBSND Hospital Base OP Fee Sched Tier 3,524.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9950,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9950,BCBSND Hospital Base OP Fee Sched Tier 3,29.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9956,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9956,BCBSND Hospital Base OP Fee Sched Tier 3,47.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9957,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9957,BCBSND Hospital Base OP Fee Sched Tier 3,70.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9958,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9958,BCBSND Hospital Base OP Fee Sched Tier 3,0.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9960,BCBSND Hospital Base OP Fee Sched Tier 3,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9961,BCBSND Hospital Base OP Fee Sched Tier 3,0.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9963,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9963,BCBSND Hospital Base OP Fee Sched Tier 3,0.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9965,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9965,BCBSND Hospital Base OP Fee Sched Tier 3,1.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9966,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9966,BCBSND Hospital Base OP Fee Sched Tier 3,0.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9967,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9967,BCBSND Hospital Base OP Fee Sched Tier 3,0.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9968,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9968,BCBSND Hospital Base OP Fee Sched Tier 3,25.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9982,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9982,BCBSND Hospital Base OP Fee Sched Tier 3,4677.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9983,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9983,BCBSND Hospital Base OP Fee Sched Tier 3,3969,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9991,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9991,BCBSND Hospital Base OP Fee Sched Tier 3,2452.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Q9992,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,Q9992,BCBSND Hospital Base OP Fee Sched Tier 3,2452.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,R0070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,R0070,BCBSND Hospital Base OP Fee Sched Tier 3,270.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,R0075,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,R0075,BCBSND Hospital Base OP Fee Sched Tier 3,114.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0012,BCBSND Hospital Base OP Fee Sched Tier 3,79.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0017,BCBSND Hospital Base OP Fee Sched Tier 3,9.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0020,BCBSND Hospital Base OP Fee Sched Tier 3,4.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0028,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0028,BCBSND Hospital Base OP Fee Sched Tier 3,1.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0030,BCBSND Hospital Base OP Fee Sched Tier 3,2.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0032,BCBSND Hospital Base OP Fee Sched Tier 3,32.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0039,BCBSND Hospital Base OP Fee Sched Tier 3,17.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0073,BCBSND Hospital Base OP Fee Sched Tier 3,20.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0074,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0074,BCBSND Hospital Base OP Fee Sched Tier 3,13.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0077,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0077,BCBSND Hospital Base OP Fee Sched Tier 3,1.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0078,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0078,BCBSND Hospital Base OP Fee Sched Tier 3,100.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0080,BCBSND Hospital Base OP Fee Sched Tier 3,204.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0088,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0088,BCBSND Hospital Base OP Fee Sched Tier 3,17.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0090,BCBSND Hospital Base OP Fee Sched Tier 3,1.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0091,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0091,BCBSND Hospital Base OP Fee Sched Tier 3,9.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0092,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0092,BCBSND Hospital Base OP Fee Sched Tier 3,92.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0093,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0093,BCBSND Hospital Base OP Fee Sched Tier 3,7.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0104,BCBSND Hospital Base OP Fee Sched Tier 3,1.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0106,BCBSND Hospital Base OP Fee Sched Tier 3,25.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0108,BCBSND Hospital Base OP Fee Sched Tier 3,4.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0109,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0109,BCBSND Hospital Base OP Fee Sched Tier 3,0.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0117,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0117,BCBSND Hospital Base OP Fee Sched Tier 3,14.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0119,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0119,BCBSND Hospital Base OP Fee Sched Tier 3,0.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0122,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0122,BCBSND Hospital Base OP Fee Sched Tier 3,264.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0126,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0126,BCBSND Hospital Base OP Fee Sched Tier 3,259.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0128,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0128,BCBSND Hospital Base OP Fee Sched Tier 3,267.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0132,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0132,BCBSND Hospital Base OP Fee Sched Tier 3,260.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0136,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0136,BCBSND Hospital Base OP Fee Sched Tier 3,1.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0137,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0137,BCBSND Hospital Base OP Fee Sched Tier 3,1.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0138,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0138,BCBSND Hospital Base OP Fee Sched Tier 3,0.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0139,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0139,BCBSND Hospital Base OP Fee Sched Tier 3,0.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0145,BCBSND Hospital Base OP Fee Sched Tier 3,1447.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0148,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0148,BCBSND Hospital Base OP Fee Sched Tier 3,213.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0155,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0155,BCBSND Hospital Base OP Fee Sched Tier 3,16.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0156,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0156,BCBSND Hospital Base OP Fee Sched Tier 3,12.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0157,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0157,BCBSND Hospital Base OP Fee Sched Tier 3,52.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0160,BCBSND Hospital Base OP Fee Sched Tier 3,1.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0164,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0164,BCBSND Hospital Base OP Fee Sched Tier 3,7.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0166,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0166,BCBSND Hospital Base OP Fee Sched Tier 3,11.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0169,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0169,BCBSND Hospital Base OP Fee Sched Tier 3,1.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0170,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0170,BCBSND Hospital Base OP Fee Sched Tier 3,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0171,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0171,BCBSND Hospital Base OP Fee Sched Tier 3,1.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0172,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0172,BCBSND Hospital Base OP Fee Sched Tier 3,34.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0175,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0175,BCBSND Hospital Base OP Fee Sched Tier 3,2.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0176,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0176,BCBSND Hospital Base OP Fee Sched Tier 3,1.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0178,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0178,BCBSND Hospital Base OP Fee Sched Tier 3,128.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0179,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0179,BCBSND Hospital Base OP Fee Sched Tier 3,0.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0182,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0182,BCBSND Hospital Base OP Fee Sched Tier 3,140.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0183,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0183,BCBSND Hospital Base OP Fee Sched Tier 3,0.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0187,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0187,BCBSND Hospital Base OP Fee Sched Tier 3,0.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0189,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0189,BCBSND Hospital Base OP Fee Sched Tier 3,140.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0190,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0190,BCBSND Hospital Base OP Fee Sched Tier 3,94.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0191,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0191,BCBSND Hospital Base OP Fee Sched Tier 3,1.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0194,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0194,BCBSND Hospital Base OP Fee Sched Tier 3,55.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,S0618,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S0618,BCBSND Hospital Base OP Fee Sched Tier 3,97.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,S1030,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S1030,BCBSND Hospital Base OP Fee Sched Tier 3,88.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,S1031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S1031,BCBSND Hospital Base OP Fee Sched Tier 3,8.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,S1034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S1034,BCBSND Hospital Base OP Fee Sched Tier 3,6031.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,S1035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S1035,BCBSND Hospital Base OP Fee Sched Tier 3,12.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,S1036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S1036,BCBSND Hospital Base OP Fee Sched Tier 3,702.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,S1040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S1040,BCBSND Hospital Base OP Fee Sched Tier 3,2225.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,S1090,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S1090,BCBSND Hospital Base OP Fee Sched Tier 3,866.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,S2083,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S2083,BCBSND Hospital Base OP Fee Sched Tier 3,214.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,S2095,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S2095,BCBSND Hospital Base OP Fee Sched Tier 3,8276.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,S2117,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S2117,BCBSND Hospital Base OP Fee Sched Tier 3,12839.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,S2120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S2120,BCBSND Hospital Base OP Fee Sched Tier 3,5567.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,S2225,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S2225,BCBSND Hospital Base OP Fee Sched Tier 3,594.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,S2300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S2300,BCBSND Hospital Base OP Fee Sched Tier 3,4354.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5010,BCBSND Hospital Base OP Fee Sched Tier 3,9.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5012,BCBSND Hospital Base OP Fee Sched Tier 3,3.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5160,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5160,BCBSND Hospital Base OP Fee Sched Tier 3,22.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5161,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5161,BCBSND Hospital Base OP Fee Sched Tier 3,22.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5165,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5165,BCBSND Hospital Base OP Fee Sched Tier 3,22.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5550,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5550,BCBSND Hospital Base OP Fee Sched Tier 3,1.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5551,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5551,BCBSND Hospital Base OP Fee Sched Tier 3,1.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5552,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5552,BCBSND Hospital Base OP Fee Sched Tier 3,1.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5553,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5553,BCBSND Hospital Base OP Fee Sched Tier 3,2.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5561,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5561,BCBSND Hospital Base OP Fee Sched Tier 3,42.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5566,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5566,BCBSND Hospital Base OP Fee Sched Tier 3,148.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5570,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5570,BCBSND Hospital Base OP Fee Sched Tier 3,183.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,S5571,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S5571,BCBSND Hospital Base OP Fee Sched Tier 3,150.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8080,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8080,BCBSND Hospital Base OP Fee Sched Tier 3,134.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8085,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8085,BCBSND Hospital Base OP Fee Sched Tier 3,2305.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8100,BCBSND Hospital Base OP Fee Sched Tier 3,16.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8101,BCBSND Hospital Base OP Fee Sched Tier 3,16.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8120,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8120,BCBSND Hospital Base OP Fee Sched Tier 3,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8121,BCBSND Hospital Base OP Fee Sched Tier 3,33.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8185,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8185,BCBSND Hospital Base OP Fee Sched Tier 3,74.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8189,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8189,BCBSND Hospital Base OP Fee Sched Tier 3,109.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8427,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8427,BCBSND Hospital Base OP Fee Sched Tier 3,41.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8428,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8428,BCBSND Hospital Base OP Fee Sched Tier 3,45.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8429,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8429,BCBSND Hospital Base OP Fee Sched Tier 3,41.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8430,BCBSND Hospital Base OP Fee Sched Tier 3,1.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8431,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8431,BCBSND Hospital Base OP Fee Sched Tier 3,2.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8450,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8450,BCBSND Hospital Base OP Fee Sched Tier 3,39.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8451,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8451,BCBSND Hospital Base OP Fee Sched Tier 3,52.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8452,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8452,BCBSND Hospital Base OP Fee Sched Tier 3,24.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8490,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8490,BCBSND Hospital Base OP Fee Sched Tier 3,25.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8930,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8930,BCBSND Hospital Base OP Fee Sched Tier 3,111.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,S8948,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S8948,BCBSND Hospital Base OP Fee Sched Tier 3,39.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9123,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9123,BCBSND Hospital Base OP Fee Sched Tier 3,89.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9124,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9124,BCBSND Hospital Base OP Fee Sched Tier 3,67.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9125,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9125,BCBSND Hospital Base OP Fee Sched Tier 3,1165.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9145,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9145,BCBSND Hospital Base OP Fee Sched Tier 3,343.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9443,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9443,BCBSND Hospital Base OP Fee Sched Tier 3,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9470,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9470,BCBSND Hospital Base OP Fee Sched Tier 3,54,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9473,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9473,BCBSND Hospital Base OP Fee Sched Tier 3,208.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9529,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9529,BCBSND Hospital Base OP Fee Sched Tier 3,11.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9960,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9960,BCBSND Hospital Base OP Fee Sched Tier 3,12947.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,S9961,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,S9961,BCBSND Hospital Base OP Fee Sched Tier 3,15053.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,T2042,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,T2042,BCBSND Hospital Base OP Fee Sched Tier 3,294.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,T2043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,T2043,BCBSND Hospital Base OP Fee Sched Tier 3,62.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,T2044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,T2044,BCBSND Hospital Base OP Fee Sched Tier 3,264.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,T2045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,T2045,BCBSND Hospital Base OP Fee Sched Tier 3,1137.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2020,BCBSND Hospital Base OP Fee Sched Tier 3,83.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2025,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2025,BCBSND Hospital Base OP Fee Sched Tier 3,188.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2100,BCBSND Hospital Base OP Fee Sched Tier 3,59.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2101,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2101,BCBSND Hospital Base OP Fee Sched Tier 3,62.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2102,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2102,BCBSND Hospital Base OP Fee Sched Tier 3,88.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2103,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2103,BCBSND Hospital Base OP Fee Sched Tier 3,47.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2104,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2104,BCBSND Hospital Base OP Fee Sched Tier 3,54.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2105,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2105,BCBSND Hospital Base OP Fee Sched Tier 3,46.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2106,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2106,BCBSND Hospital Base OP Fee Sched Tier 3,51.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2107,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2107,BCBSND Hospital Base OP Fee Sched Tier 3,53.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2108,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2108,BCBSND Hospital Base OP Fee Sched Tier 3,64.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2109,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2109,BCBSND Hospital Base OP Fee Sched Tier 3,56.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2110,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2110,BCBSND Hospital Base OP Fee Sched Tier 3,55.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2111,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2111,BCBSND Hospital Base OP Fee Sched Tier 3,58.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2112,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2112,BCBSND Hospital Base OP Fee Sched Tier 3,63.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2113,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2113,BCBSND Hospital Base OP Fee Sched Tier 3,72.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2114,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2114,BCBSND Hospital Base OP Fee Sched Tier 3,94.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2115,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2115,BCBSND Hospital Base OP Fee Sched Tier 3,100.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2118,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2118,BCBSND Hospital Base OP Fee Sched Tier 3,83.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2121,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2121,BCBSND Hospital Base OP Fee Sched Tier 3,88.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2199,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2199,BCBSND Hospital Base OP Fee Sched Tier 3,134.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2200,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2200,BCBSND Hospital Base OP Fee Sched Tier 3,62.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2201,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2201,BCBSND Hospital Base OP Fee Sched Tier 3,73.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2202,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2202,BCBSND Hospital Base OP Fee Sched Tier 3,96.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2203,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2203,BCBSND Hospital Base OP Fee Sched Tier 3,62.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2204,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2204,BCBSND Hospital Base OP Fee Sched Tier 3,64.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2205,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2205,BCBSND Hospital Base OP Fee Sched Tier 3,75.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2206,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2206,BCBSND Hospital Base OP Fee Sched Tier 3,71.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2207,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2207,BCBSND Hospital Base OP Fee Sched Tier 3,72.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2208,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2208,BCBSND Hospital Base OP Fee Sched Tier 3,78.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2209,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2209,BCBSND Hospital Base OP Fee Sched Tier 3,79.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2210,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2210,BCBSND Hospital Base OP Fee Sched Tier 3,84.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2211,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2211,BCBSND Hospital Base OP Fee Sched Tier 3,112,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2212,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2212,BCBSND Hospital Base OP Fee Sched Tier 3,115.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2213,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2213,BCBSND Hospital Base OP Fee Sched Tier 3,116.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2214,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2214,BCBSND Hospital Base OP Fee Sched Tier 3,111.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2215,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2215,BCBSND Hospital Base OP Fee Sched Tier 3,98.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2218,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2218,BCBSND Hospital Base OP Fee Sched Tier 3,115.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2219,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2219,BCBSND Hospital Base OP Fee Sched Tier 3,67.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2220,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2220,BCBSND Hospital Base OP Fee Sched Tier 3,42.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2221,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2221,BCBSND Hospital Base OP Fee Sched Tier 3,103.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2300,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2300,BCBSND Hospital Base OP Fee Sched Tier 3,82.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2301,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2301,BCBSND Hospital Base OP Fee Sched Tier 3,87.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2302,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2302,BCBSND Hospital Base OP Fee Sched Tier 3,93.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2303,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2303,BCBSND Hospital Base OP Fee Sched Tier 3,78.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2304,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2304,BCBSND Hospital Base OP Fee Sched Tier 3,83.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2305,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2305,BCBSND Hospital Base OP Fee Sched Tier 3,93.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2306,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2306,BCBSND Hospital Base OP Fee Sched Tier 3,105.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2307,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2307,BCBSND Hospital Base OP Fee Sched Tier 3,89.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2308,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2308,BCBSND Hospital Base OP Fee Sched Tier 3,93.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2309,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2309,BCBSND Hospital Base OP Fee Sched Tier 3,98.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2310,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2310,BCBSND Hospital Base OP Fee Sched Tier 3,97.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2311,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2311,BCBSND Hospital Base OP Fee Sched Tier 3,101.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2312,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2312,BCBSND Hospital Base OP Fee Sched Tier 3,101.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2313,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2313,BCBSND Hospital Base OP Fee Sched Tier 3,113.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2314,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2314,BCBSND Hospital Base OP Fee Sched Tier 3,122.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2315,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2315,BCBSND Hospital Base OP Fee Sched Tier 3,135.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2318,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2318,BCBSND Hospital Base OP Fee Sched Tier 3,166.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2319,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2319,BCBSND Hospital Base OP Fee Sched Tier 3,56.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2320,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2320,BCBSND Hospital Base OP Fee Sched Tier 3,59.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2321,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2321,BCBSND Hospital Base OP Fee Sched Tier 3,133.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2410,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2410,BCBSND Hospital Base OP Fee Sched Tier 3,135.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2430,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2430,BCBSND Hospital Base OP Fee Sched Tier 3,139.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2500,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2500,BCBSND Hospital Base OP Fee Sched Tier 3,97.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2501,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2501,BCBSND Hospital Base OP Fee Sched Tier 3,172.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2502,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2502,BCBSND Hospital Base OP Fee Sched Tier 3,194.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2503,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2503,BCBSND Hospital Base OP Fee Sched Tier 3,159.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2510,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2510,BCBSND Hospital Base OP Fee Sched Tier 3,140.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2511,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2511,BCBSND Hospital Base OP Fee Sched Tier 3,181.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2512,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2512,BCBSND Hospital Base OP Fee Sched Tier 3,214.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2513,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2513,BCBSND Hospital Base OP Fee Sched Tier 3,179.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2520,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2520,BCBSND Hospital Base OP Fee Sched Tier 3,118.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2521,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2521,BCBSND Hospital Base OP Fee Sched Tier 3,229.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2522,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2522,BCBSND Hospital Base OP Fee Sched Tier 3,200.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2523,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2523,BCBSND Hospital Base OP Fee Sched Tier 3,171.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2530,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2530,BCBSND Hospital Base OP Fee Sched Tier 3,276.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2531,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2531,BCBSND Hospital Base OP Fee Sched Tier 3,624.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2623,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2623,BCBSND Hospital Base OP Fee Sched Tier 3,1080.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2624,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2624,BCBSND Hospital Base OP Fee Sched Tier 3,88.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2625,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2625,BCBSND Hospital Base OP Fee Sched Tier 3,555.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2626,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2626,BCBSND Hospital Base OP Fee Sched Tier 3,226.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2627,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2627,BCBSND Hospital Base OP Fee Sched Tier 3,1904.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2628,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2628,BCBSND Hospital Base OP Fee Sched Tier 3,461.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2700,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2700,BCBSND Hospital Base OP Fee Sched Tier 3,58.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2710,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2710,BCBSND Hospital Base OP Fee Sched Tier 3,87.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2715,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2715,BCBSND Hospital Base OP Fee Sched Tier 3,13.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2718,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2718,BCBSND Hospital Base OP Fee Sched Tier 3,32.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2730,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2730,BCBSND Hospital Base OP Fee Sched Tier 3,23.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2744,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2744,BCBSND Hospital Base OP Fee Sched Tier 3,18.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2745,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2745,BCBSND Hospital Base OP Fee Sched Tier 3,11.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2750,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2750,BCBSND Hospital Base OP Fee Sched Tier 3,21.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2755,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2755,BCBSND Hospital Base OP Fee Sched Tier 3,19.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2760,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2760,BCBSND Hospital Base OP Fee Sched Tier 3,24.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2762,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2762,BCBSND Hospital Base OP Fee Sched Tier 3,68.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2770,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2770,BCBSND Hospital Base OP Fee Sched Tier 3,22.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2780,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2780,BCBSND Hospital Base OP Fee Sched Tier 3,14.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2781,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2781,BCBSND Hospital Base OP Fee Sched Tier 3,118.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2782,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2782,BCBSND Hospital Base OP Fee Sched Tier 3,74.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2783,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2783,BCBSND Hospital Base OP Fee Sched Tier 3,83.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,V2784,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V2784,BCBSND Hospital Base OP Fee Sched Tier 3,54.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,V5095,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V5095,BCBSND Hospital Base OP Fee Sched Tier 3,24162.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,V5140,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,V5140,BCBSND Hospital Base OP Fee Sched Tier 3,3832.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,P2038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P2038,BCBSND Hospital Base OP Fee Sched Tier 3,23.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,P3000,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P3000,BCBSND Hospital Base OP Fee Sched Tier 3,64.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,P3001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P3001,BCBSND Hospital Base OP Fee Sched Tier 3,81.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,P7001,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P7001,BCBSND Hospital Base OP Fee Sched Tier 3,37.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9010,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9010,BCBSND Hospital Base OP Fee Sched Tier 3,150.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9011,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9011,BCBSND Hospital Base OP Fee Sched Tier 3,170.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9012,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9012,BCBSND Hospital Base OP Fee Sched Tier 3,66.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9016,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9016,BCBSND Hospital Base OP Fee Sched Tier 3,249.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9017,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9017,BCBSND Hospital Base OP Fee Sched Tier 3,96.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9019,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9019,BCBSND Hospital Base OP Fee Sched Tier 3,145.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9020,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9020,BCBSND Hospital Base OP Fee Sched Tier 3,169.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9021,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9021,BCBSND Hospital Base OP Fee Sched Tier 3,189.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9022,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9022,BCBSND Hospital Base OP Fee Sched Tier 3,480.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9023,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9023,BCBSND Hospital Base OP Fee Sched Tier 3,102.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9031,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9031,BCBSND Hospital Base OP Fee Sched Tier 3,184.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9032,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9032,BCBSND Hospital Base OP Fee Sched Tier 3,232.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9033,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9033,BCBSND Hospital Base OP Fee Sched Tier 3,225.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9034,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9034,BCBSND Hospital Base OP Fee Sched Tier 3,455.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9035,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9035,BCBSND Hospital Base OP Fee Sched Tier 3,656.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9036,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9036,BCBSND Hospital Base OP Fee Sched Tier 3,746.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9037,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9037,BCBSND Hospital Base OP Fee Sched Tier 3,843.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9038,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9038,BCBSND Hospital Base OP Fee Sched Tier 3,298.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9039,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9039,BCBSND Hospital Base OP Fee Sched Tier 3,447.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9040,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9040,BCBSND Hospital Base OP Fee Sched Tier 3,345.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9041,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9041,BCBSND Hospital Base OP Fee Sched Tier 3,46.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9043,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9043,BCBSND Hospital Base OP Fee Sched Tier 3,31.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9044,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9044,BCBSND Hospital Base OP Fee Sched Tier 3,119.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9045,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9045,BCBSND Hospital Base OP Fee Sched Tier 3,65.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9046,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9046,BCBSND Hospital Base OP Fee Sched Tier 3,38.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9047,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9047,BCBSND Hospital Base OP Fee Sched Tier 3,65.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9048,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9048,BCBSND Hospital Base OP Fee Sched Tier 3,74.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9050,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9050,BCBSND Hospital Base OP Fee Sched Tier 3,2372.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9051,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9051,BCBSND Hospital Base OP Fee Sched Tier 3,237.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9052,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9052,BCBSND Hospital Base OP Fee Sched Tier 3,1140.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9053,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9053,BCBSND Hospital Base OP Fee Sched Tier 3,664.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9054,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9054,BCBSND Hospital Base OP Fee Sched Tier 3,402.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9055,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9055,BCBSND Hospital Base OP Fee Sched Tier 3,600.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9056,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9056,BCBSND Hospital Base OP Fee Sched Tier 3,304.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9057,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9057,BCBSND Hospital Base OP Fee Sched Tier 3,303.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9058,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9058,BCBSND Hospital Base OP Fee Sched Tier 3,309.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9059,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9059,BCBSND Hospital Base OP Fee Sched Tier 3,103.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9060,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9060,BCBSND Hospital Base OP Fee Sched Tier 3,84.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9070,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9070,BCBSND Hospital Base OP Fee Sched Tier 3,55.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9071,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9071,BCBSND Hospital Base OP Fee Sched Tier 3,105.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9073,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9073,BCBSND Hospital Base OP Fee Sched Tier 3,843.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9100,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9100,BCBSND Hospital Base OP Fee Sched Tier 3,34.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9612,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9612,BCBSND Hospital Base OP Fee Sched Tier 3,12.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,P9615,Not in chargemaster,N/A,N/A,N/A,N/A,N/A,Outpatient,N/A,Blue Cross Blue Shield North Dakota,P9615,BCBSND Hospital Base OP Fee Sched Tier 3,12.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92352,Not in chargemaster,92352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92352,BCBSND Base Physician Payment Schedule,91.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92342,Not in chargemaster,92342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92342,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92341,Not in chargemaster,92341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92341,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92340,Not in chargemaster,92340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92340,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92326,Not in chargemaster,92326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92326,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92325,Not in chargemaster,92325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92325,BCBSND Base Physician Payment Schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92317,Not in chargemaster,92317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92317,BCBSND Base Physician Payment Schedule,170.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92316,Not in chargemaster,92316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92316,BCBSND Base Physician Payment Schedule,202.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92315,Not in chargemaster,92315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92315,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92314,Not in chargemaster,92314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92314,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92313,Not in chargemaster,92313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92313,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92312,Not in chargemaster,92312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92312,BCBSND Base Physician Payment Schedule,251.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92311,Not in chargemaster,92311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92311,BCBSND Base Physician Payment Schedule,216.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92310,Not in chargemaster,92310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92310,BCBSND Base Physician Payment Schedule,209.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9228726,Not in chargemaster,92287,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9228726,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92287TC,Not in chargemaster,92287TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92287TC,BCBSND Base Physician Payment Schedule,230.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92287,Not in chargemaster,92287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92287,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92286,Not in chargemaster,92286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92286,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9228626,Not in chargemaster,92286,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9228626,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92286TC,Not in chargemaster,92286TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92286TC,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9228526,Not in chargemaster,92285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9228526,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92285TC,Not in chargemaster,92285TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92285TC,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92285,Not in chargemaster,92285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92285,BCBSND Base Physician Payment Schedule,45.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92284,Not in chargemaster,92284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92284,BCBSND Base Physician Payment Schedule,123.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9228426,Not in chargemaster,92284,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9228426,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92284TC,Not in chargemaster,92284TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92284TC,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9228326,Not in chargemaster,92283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9228326,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92283TC,Not in chargemaster,92283TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92283TC,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92283,Not in chargemaster,92283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92283,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92274,Not in chargemaster,92274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92274,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9227426,Not in chargemaster,92274,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9227426,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92274TC,Not in chargemaster,92274TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92274TC,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9227326,Not in chargemaster,92273,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9227326,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92273TC,Not in chargemaster,92273TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92273TC,BCBSND Base Physician Payment Schedule,193.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92273,Not in chargemaster,92273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92273,BCBSND Base Physician Payment Schedule,270.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92270,Not in chargemaster,92270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92270,BCBSND Base Physician Payment Schedule,200.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9227026,Not in chargemaster,92270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9227026,BCBSND Base Physician Payment Schedule,88.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92270TC,Not in chargemaster,92270TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92270TC,BCBSND Base Physician Payment Schedule,111.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9226526,Not in chargemaster,92265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9226526,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92265TC,Not in chargemaster,92265TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92265TC,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92265,Not in chargemaster,92265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92265,BCBSND Base Physician Payment Schedule,179.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92260,Not in chargemaster,92260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92260,BCBSND Base Physician Payment Schedule,40.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9225026,Not in chargemaster,92250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9225026,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92250TC,Not in chargemaster,92250TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92250TC,BCBSND Base Physician Payment Schedule,48.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92250,Not in chargemaster,92250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92250,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92242,Not in chargemaster,92242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92242,BCBSND Base Physician Payment Schedule,492.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9224226,Not in chargemaster,92242,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9224226,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92242TC,Not in chargemaster,92242TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92242TC,BCBSND Base Physician Payment Schedule,379.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9224026,Not in chargemaster,92240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9224026,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92240TC,Not in chargemaster,92240TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92240TC,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92240,Not in chargemaster,92240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92240,BCBSND Base Physician Payment Schedule,417.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92235,Not in chargemaster,92235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92235,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9223526,Not in chargemaster,92235,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9223526,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92235TC,Not in chargemaster,92235TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92235TC,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92230,Not in chargemaster,92230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92230,BCBSND Base Physician Payment Schedule,160.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92228,Not in chargemaster,92228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92228,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9222826,Not in chargemaster,92228,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9222826,BCBSND Base Physician Payment Schedule,43.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92228TC,Not in chargemaster,92228TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92228TC,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92227,Not in chargemaster,92227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92227,BCBSND Base Physician Payment Schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92202,Not in chargemaster,92202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92202,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92201,Not in chargemaster,92201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92201,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92145,Not in chargemaster,92145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92145,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9214526,Not in chargemaster,92145,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9214526,BCBSND Base Physician Payment Schedule,16.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92145TC,Not in chargemaster,92145TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92145TC,BCBSND Base Physician Payment Schedule,14.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9213626,Not in chargemaster,92136,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9213626,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92136TC,Not in chargemaster,92136TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92136TC,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92136,Not in chargemaster,92136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92136,BCBSND Base Physician Payment Schedule,129.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92134,Not in chargemaster,92134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92134,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9213426,Not in chargemaster,92134,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9213426,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92134TC,Not in chargemaster,92134TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92134TC,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9213326,Not in chargemaster,92133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9213326,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92133TC,Not in chargemaster,92133TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92133TC,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92133,Not in chargemaster,92133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92133,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92132,Not in chargemaster,92132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92132,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9213226,Not in chargemaster,92132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9213226,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92132TC,Not in chargemaster,92132TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92132TC,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92100,Not in chargemaster,92100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92100,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92083,Not in chargemaster,92083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92083,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9208326,Not in chargemaster,92083,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9208326,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92083TC,Not in chargemaster,92083TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92083TC,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9208226,Not in chargemaster,92082,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9208226,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92082TC,Not in chargemaster,92082TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92082TC,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92082,Not in chargemaster,92082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92082,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92081,Not in chargemaster,92081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92081,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9208126,Not in chargemaster,92081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9208126,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92081TC,Not in chargemaster,92081TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92081TC,BCBSND Base Physician Payment Schedule,35.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92072,Not in chargemaster,92072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92072,BCBSND Base Physician Payment Schedule,265.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92071,Not in chargemaster,92071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92071,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9206526,Not in chargemaster,92065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9206526,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92065TC,Not in chargemaster,92065TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92065TC,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92065,Not in chargemaster,92065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92065,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92060,Not in chargemaster,92060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92060,BCBSND Base Physician Payment Schedule,131.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9206026,Not in chargemaster,92060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9206026,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92060TC,Not in chargemaster,92060TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92060TC,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9202526,Not in chargemaster,92025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9202526,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92025TC,Not in chargemaster,92025TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92025TC,BCBSND Base Physician Payment Schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92025,Not in chargemaster,92025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92025,BCBSND Base Physician Payment Schedule,76.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92020,Not in chargemaster,92020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92020,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92019,Not in chargemaster,92019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92019,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92018,Not in chargemaster,92018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92018,BCBSND Base Physician Payment Schedule,298.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92015,Not in chargemaster,92015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92015,BCBSND Base Physician Payment Schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92014,Not in chargemaster,92014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92014,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92012,Not in chargemaster,92012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92012,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92004,Not in chargemaster,92004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92004,BCBSND Base Physician Payment Schedule,310.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92002,Not in chargemaster,92002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92002,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91200,Not in chargemaster,91200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91200,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9120026,Not in chargemaster,91200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9120026,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91200TC,Not in chargemaster,91200TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91200TC,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9113326,Not in chargemaster,91133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9113326,BCBSND Base Physician Payment Schedule,71.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91133TC,Not in chargemaster,91133TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91133TC,BCBSND Base Physician Payment Schedule,649.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91133,Not in chargemaster,91133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91133,BCBSND Base Physician Payment Schedule,720.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91132,Not in chargemaster,91132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91132,BCBSND Base Physician Payment Schedule,672.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9113226,Not in chargemaster,91132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9113226,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91132TC,Not in chargemaster,91132TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91132TC,BCBSND Base Physician Payment Schedule,615.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9112226,Not in chargemaster,91122,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9112226,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91122TC,Not in chargemaster,91122TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91122TC,BCBSND Base Physician Payment Schedule,336.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91122,Not in chargemaster,91122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91122,BCBSND Base Physician Payment Schedule,523.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91120,Not in chargemaster,91120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91120,BCBSND Base Physician Payment Schedule,1012.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9112026,Not in chargemaster,91120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9112026,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91120TC,Not in chargemaster,91120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91120TC,BCBSND Base Physician Payment Schedule,908.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91117,Not in chargemaster,91117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91117,BCBSND Base Physician Payment Schedule,287.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91112,Not in chargemaster,91112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91112,BCBSND Base Physician Payment Schedule,3009.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9111226,Not in chargemaster,91112,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9111226,BCBSND Base Physician Payment Schedule,226.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91112TC,Not in chargemaster,91112TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91112TC,BCBSND Base Physician Payment Schedule,2782.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9111126,Not in chargemaster,91111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9111126,BCBSND Base Physician Payment Schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91111TC,Not in chargemaster,91111TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91111TC,BCBSND Base Physician Payment Schedule,1688.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91111,Not in chargemaster,91111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91111,BCBSND Base Physician Payment Schedule,1797.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91110,Not in chargemaster,91110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91110,BCBSND Base Physician Payment Schedule,1789,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9111026,Not in chargemaster,91110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9111026,BCBSND Base Physician Payment Schedule,268.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91110TC,Not in chargemaster,91110TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91110TC,BCBSND Base Physician Payment Schedule,1520.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9106526,Not in chargemaster,91065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9106526,BCBSND Base Physician Payment Schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91065TC,Not in chargemaster,91065TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91065TC,BCBSND Base Physician Payment Schedule,144.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91065,Not in chargemaster,91065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91065,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91040,Not in chargemaster,91040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91040,BCBSND Base Physician Payment Schedule,1057.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9104026,Not in chargemaster,91040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9104026,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91040TC,Not in chargemaster,91040TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91040TC,BCBSND Base Physician Payment Schedule,949.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9103826,Not in chargemaster,91038,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9103826,BCBSND Base Physician Payment Schedule,118.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91038TC,Not in chargemaster,91038TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91038TC,BCBSND Base Physician Payment Schedule,795.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91038,Not in chargemaster,91038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91038,BCBSND Base Physician Payment Schedule,913.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91037,Not in chargemaster,91037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91037,BCBSND Base Physician Payment Schedule,345.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9103726,Not in chargemaster,91037,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9103726,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91037TC,Not in chargemaster,91037TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91037TC,BCBSND Base Physician Payment Schedule,240.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9103526,Not in chargemaster,91035,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9103526,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91035TC,Not in chargemaster,91035TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91035TC,BCBSND Base Physician Payment Schedule,832.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91035,Not in chargemaster,91035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91035,BCBSND Base Physician Payment Schedule,1006.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91034,Not in chargemaster,91034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91034,BCBSND Base Physician Payment Schedule,397.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9103426,Not in chargemaster,91034,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9103426,BCBSND Base Physician Payment Schedule,105.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91034TC,Not in chargemaster,91034TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91034TC,BCBSND Base Physician Payment Schedule,291.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9103026,Not in chargemaster,91030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9103026,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91030TC,Not in chargemaster,91030TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91030TC,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91030,Not in chargemaster,91030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91030,BCBSND Base Physician Payment Schedule,289.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91022,Not in chargemaster,91022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91022,BCBSND Base Physician Payment Schedule,350.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9102226,Not in chargemaster,91022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9102226,BCBSND Base Physician Payment Schedule,155.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91022TC,Not in chargemaster,91022TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91022TC,BCBSND Base Physician Payment Schedule,194.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9102026,Not in chargemaster,91020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9102026,BCBSND Base Physician Payment Schedule,155.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91020TC,Not in chargemaster,91020TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91020TC,BCBSND Base Physician Payment Schedule,383.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91020,Not in chargemaster,91020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91020,BCBSND Base Physician Payment Schedule,539.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91013,Not in chargemaster,91013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91013,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9101326,Not in chargemaster,91013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9101326,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91013TC,Not in chargemaster,91013TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91013TC,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9101026,Not in chargemaster,91010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9101026,BCBSND Base Physician Payment Schedule,138.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91010TC,Not in chargemaster,91010TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91010TC,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 91010,Not in chargemaster,91010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,91010,BCBSND Base Physician Payment Schedule,418.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90997,Not in chargemaster,90997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90997,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90970,Not in chargemaster,90970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90970,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90989,Not in chargemaster,90989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90989,BCBSND Base Physician Payment Schedule,759.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90993,Not in chargemaster,90993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90993,BCBSND Base Physician Payment Schedule,30.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90969,Not in chargemaster,90969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90969,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90968,Not in chargemaster,90968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90968,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90967,Not in chargemaster,90967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90967,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90966,Not in chargemaster,90966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90966,BCBSND Base Physician Payment Schedule,496.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90965,Not in chargemaster,90965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90965,BCBSND Base Physician Payment Schedule,948.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90964,Not in chargemaster,90964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90964,BCBSND Base Physician Payment Schedule,992.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90963,Not in chargemaster,90963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90963,BCBSND Base Physician Payment Schedule,1134.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90962,Not in chargemaster,90962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90962,BCBSND Base Physician Payment Schedule,383.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90961,Not in chargemaster,90961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90961,BCBSND Base Physician Payment Schedule,497.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90960,Not in chargemaster,90960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90960,BCBSND Base Physician Payment Schedule,592.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90959,Not in chargemaster,90959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90959,BCBSND Base Physician Payment Schedule,617.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90958,Not in chargemaster,90958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90958,BCBSND Base Physician Payment Schedule,912.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90957,Not in chargemaster,90957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90957,BCBSND Base Physician Payment Schedule,1343.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90956,Not in chargemaster,90956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90956,BCBSND Base Physician Payment Schedule,664.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90955,Not in chargemaster,90955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90955,BCBSND Base Physician Payment Schedule,954.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90954,Not in chargemaster,90954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90954,BCBSND Base Physician Payment Schedule,1693.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90951,Not in chargemaster,90951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90951,BCBSND Base Physician Payment Schedule,1952.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90952,Not in chargemaster,90952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90952,BCBSND Base Physician Payment Schedule,1113.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90953,Not in chargemaster,90953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90953,BCBSND Base Physician Payment Schedule,761.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90947,Not in chargemaster,90947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90947,BCBSND Base Physician Payment Schedule,259.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90945,Not in chargemaster,90945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90945,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90937,Not in chargemaster,90937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90937,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90935,Not in chargemaster,90935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90935,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90913,Not in chargemaster,90913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90913,BCBSND Base Physician Payment Schedule,67.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90912,Not in chargemaster,90912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90912,BCBSND Base Physician Payment Schedule,166.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90901,Not in chargemaster,90901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90901,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90887,Not in chargemaster,90887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90887,BCBSND Base Physician Payment Schedule,183.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90889,Not in chargemaster,90889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90889,BCBSND Base Physician Payment Schedule,115.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90885,Not in chargemaster,90885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90885,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90880,Not in chargemaster,90880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90880,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90876,Not in chargemaster,90876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90876,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90875,Not in chargemaster,90875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90875,BCBSND Base Physician Payment Schedule,129.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90870,Not in chargemaster,90870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90870,BCBSND Base Physician Payment Schedule,366.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90863,Not in chargemaster,90863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90863,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90865,Not in chargemaster,90865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90865,BCBSND Base Physician Payment Schedule,352.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90867,Not in chargemaster,90867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90867,BCBSND Base Physician Payment Schedule,721.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90868,Not in chargemaster,90868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90868,BCBSND Base Physician Payment Schedule,353.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90869,Not in chargemaster,90869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90869,BCBSND Base Physician Payment Schedule,879.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90853,Not in chargemaster,90853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90853,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90849,Not in chargemaster,90849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90849,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90847,Not in chargemaster,90847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90847,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90846,Not in chargemaster,90846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90846,BCBSND Base Physician Payment Schedule,210.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90845,Not in chargemaster,90845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90845,BCBSND Base Physician Payment Schedule,204.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90840,Not in chargemaster,90840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90840,BCBSND Base Physician Payment Schedule,143.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90839,Not in chargemaster,90839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90839,BCBSND Base Physician Payment Schedule,300.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90791,Not in chargemaster,90791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90791,BCBSND Base Physician Payment Schedule,295.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90792,Not in chargemaster,90792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90792,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90832,Not in chargemaster,90832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90832,BCBSND Base Physician Payment Schedule,144.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90833,Not in chargemaster,90833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90833,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90834,Not in chargemaster,90834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90834,BCBSND Base Physician Payment Schedule,192.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90836,Not in chargemaster,90836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90836,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90837,Not in chargemaster,90837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90837,BCBSND Base Physician Payment Schedule,287.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90838,Not in chargemaster,90838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90838,BCBSND Base Physician Payment Schedule,246.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90785,Not in chargemaster,90785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90785,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90474,Not in chargemaster,90474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90474,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90473,90473,90473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90473,BCBSND Base Physician Payment Schedule,29.36,40.47,Fee schedule,,29.36,29.36,29.36,29.36,,,0
unity,Fee schedule,Non-facility 90472,90472,90472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90472,BCBSND Base Physician Payment Schedule,26.43,21,Fee schedule,,21,21,21,21,,,0
unity,Fee schedule,Non-facility 90471,90471,90471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90471,BCBSND Base Physician Payment Schedule,29.36,33.57,Fee schedule,,29.36,29.36,29.36,29.36,,,0
unity,Fee schedule,Non-facility 90461,Not in chargemaster,90461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90461,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 90460,Not in chargemaster,90460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90460,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 89230,Not in chargemaster,89230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,89230,BCBSND Base Physician Payment Schedule,5.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 89220,Not in chargemaster,89220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,89220,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8906026,Not in chargemaster,89060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8906026,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 89049,Not in chargemaster,89049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,89049,BCBSND Base Physician Payment Schedule,523.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88388,Not in chargemaster,88388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88388,BCBSND Base Physician Payment Schedule,76.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8838826,Not in chargemaster,88388,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8838826,BCBSND Base Physician Payment Schedule,50.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88388TC,Not in chargemaster,88388TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88388TC,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8838726,Not in chargemaster,88387,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8838726,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88387TC,Not in chargemaster,88387TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88387TC,BCBSND Base Physician Payment Schedule,14.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88387,Not in chargemaster,88387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88387,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88381,Not in chargemaster,88381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88381,BCBSND Base Physician Payment Schedule,372.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8838126,Not in chargemaster,88381,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8838126,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88381TC,Not in chargemaster,88381TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88381TC,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8838026,Not in chargemaster,88380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8838026,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88380TC,Not in chargemaster,88380TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88380TC,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88380,Not in chargemaster,88380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88380,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88377,Not in chargemaster,88377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88377,BCBSND Base Physician Payment Schedule,837.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8837726,Not in chargemaster,88377,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8837726,BCBSND Base Physician Payment Schedule,137.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88377TC,Not in chargemaster,88377TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88377TC,BCBSND Base Physician Payment Schedule,700.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88375,Not in chargemaster,88375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88375,BCBSND Base Physician Payment Schedule,104.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88374,Not in chargemaster,88374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88374,BCBSND Base Physician Payment Schedule,708.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8837426,Not in chargemaster,88374,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8837426,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88374TC,Not in chargemaster,88374TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88374TC,BCBSND Base Physician Payment Schedule,614.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8837326,Not in chargemaster,88373,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8837326,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88373TC,Not in chargemaster,88373TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88373TC,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88373,Not in chargemaster,88373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88373,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8837226,Not in chargemaster,88372,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8837226,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8837126,Not in chargemaster,88371,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8837126,BCBSND Base Physician Payment Schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88369,Not in chargemaster,88369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88369,BCBSND Base Physician Payment Schedule,237.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836926,Not in chargemaster,88369,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836926,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88369TC,Not in chargemaster,88369TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88369TC,BCBSND Base Physician Payment Schedule,168.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836826,Not in chargemaster,88368,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836826,BCBSND Base Physician Payment Schedule,88.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88368TC,Not in chargemaster,88368TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88368TC,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88368,Not in chargemaster,88368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88368,BCBSND Base Physician Payment Schedule,272.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88367,Not in chargemaster,88367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88367,BCBSND Base Physician Payment Schedule,234.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836726,Not in chargemaster,88367,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836726,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88367TC,Not in chargemaster,88367TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88367TC,BCBSND Base Physician Payment Schedule,161.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836626,Not in chargemaster,88366,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836626,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88366TC,Not in chargemaster,88366TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88366TC,BCBSND Base Physician Payment Schedule,440.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88366,Not in chargemaster,88366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88366,BCBSND Base Physician Payment Schedule,572.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88365,Not in chargemaster,88365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88365,BCBSND Base Physician Payment Schedule,374.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836526,Not in chargemaster,88365,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836526,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88365TC,Not in chargemaster,88365TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88365TC,BCBSND Base Physician Payment Schedule,281.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836426,Not in chargemaster,88364,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836426,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88364TC,Not in chargemaster,88364TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88364TC,BCBSND Base Physician Payment Schedule,212.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88364,Not in chargemaster,88364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88364,BCBSND Base Physician Payment Schedule,285.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88363,Not in chargemaster,88363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88363,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836226,Not in chargemaster,88362,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836226,BCBSND Base Physician Payment Schedule,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88362TC,Not in chargemaster,88362TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88362TC,BCBSND Base Physician Payment Schedule,232.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88362,Not in chargemaster,88362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88362,BCBSND Base Physician Payment Schedule,472.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88361,Not in chargemaster,88361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88361,BCBSND Base Physician Payment Schedule,262.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836126,Not in chargemaster,88361,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836126,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88361TC,Not in chargemaster,88361TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88361TC,BCBSND Base Physician Payment Schedule,168.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8836026,Not in chargemaster,88360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8836026,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88360TC,Not in chargemaster,88360TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88360TC,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88360,Not in chargemaster,88360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88360,BCBSND Base Physician Payment Schedule,259.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88358,Not in chargemaster,88358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88358,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8835826,Not in chargemaster,88358,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8835826,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88358TC,Not in chargemaster,88358TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88358TC,BCBSND Base Physician Payment Schedule,170.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8835626,Not in chargemaster,88356,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8835626,BCBSND Base Physician Payment Schedule,272.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88356TC,Not in chargemaster,88356TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88356TC,BCBSND Base Physician Payment Schedule,216.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88356,Not in chargemaster,88356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88356,BCBSND Base Physician Payment Schedule,488.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88355,Not in chargemaster,88355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88355,BCBSND Base Physician Payment Schedule,284.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8835526,Not in chargemaster,88355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8835526,BCBSND Base Physician Payment Schedule,174.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88355TC,Not in chargemaster,88355TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88355TC,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8835026,Not in chargemaster,88350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8835026,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88350TC,Not in chargemaster,88350TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88350TC,BCBSND Base Physician Payment Schedule,129.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88350,Not in chargemaster,88350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88350,BCBSND Base Physician Payment Schedule,191.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88348,Not in chargemaster,88348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88348,BCBSND Base Physician Payment Schedule,801.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8834826,Not in chargemaster,88348,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8834826,BCBSND Base Physician Payment Schedule,162.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88348TC,Not in chargemaster,88348TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88348TC,BCBSND Base Physician Payment Schedule,639.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8834626,Not in chargemaster,88346,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8834626,BCBSND Base Physician Payment Schedule,76.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88346TC,Not in chargemaster,88346TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88346TC,BCBSND Base Physician Payment Schedule,184.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88346,Not in chargemaster,88346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88346,BCBSND Base Physician Payment Schedule,261.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88344,Not in chargemaster,88344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88344,BCBSND Base Physician Payment Schedule,356.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8834426,Not in chargemaster,88344,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8834426,BCBSND Base Physician Payment Schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88344TC,Not in chargemaster,88344TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88344TC,BCBSND Base Physician Payment Schedule,275.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8834226,Not in chargemaster,88342,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8834226,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88342TC,Not in chargemaster,88342TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88342TC,BCBSND Base Physician Payment Schedule,143.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88342,Not in chargemaster,88342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88342,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88341,Not in chargemaster,88341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88341,BCBSND Base Physician Payment Schedule,191.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8834126,Not in chargemaster,88341,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8834126,BCBSND Base Physician Payment Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88341TC,Not in chargemaster,88341TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88341TC,BCBSND Base Physician Payment Schedule,131.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8833426,Not in chargemaster,88334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8833426,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88334TC,Not in chargemaster,88334TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88334TC,BCBSND Base Physician Payment Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88334,Not in chargemaster,88334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88334,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88333,Not in chargemaster,88333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88333,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8833326,Not in chargemaster,88333,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8833326,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88333TC,Not in chargemaster,88333TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88333TC,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8833226,Not in chargemaster,88332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8833226,BCBSND Base Physician Payment Schedule,66.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88332TC,Not in chargemaster,88332TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88332TC,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88332,Not in chargemaster,88332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88332,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88331,Not in chargemaster,88331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88331,BCBSND Base Physician Payment Schedule,204.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8833126,Not in chargemaster,88331,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8833126,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88331TC,Not in chargemaster,88331TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88331TC,BCBSND Base Physician Payment Schedule,71.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88329,Not in chargemaster,88329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88329,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88325,Not in chargemaster,88325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88325,BCBSND Base Physician Payment Schedule,364.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8832326,Not in chargemaster,88323,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8832326,BCBSND Base Physician Payment Schedule,184.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88323TC,Not in chargemaster,88323TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88323TC,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88323,Not in chargemaster,88323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88323,BCBSND Base Physician Payment Schedule,239.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88321,Not in chargemaster,88321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88321,BCBSND Base Physician Payment Schedule,208.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8831926,Not in chargemaster,88319,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8831926,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88319TC,Not in chargemaster,88319TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88319TC,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88319,Not in chargemaster,88319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88319,BCBSND Base Physician Payment Schedule,231.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88314,Not in chargemaster,88314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88314,BCBSND Base Physician Payment Schedule,200.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8831426,Not in chargemaster,88314,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8831426,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88314TC,Not in chargemaster,88314TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88314TC,BCBSND Base Physician Payment Schedule,153.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8831326,Not in chargemaster,88313,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8831326,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88313TC,Not in chargemaster,88313TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88313TC,BCBSND Base Physician Payment Schedule,131.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88313,Not in chargemaster,88313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88313,BCBSND Base Physician Payment Schedule,157.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88312,Not in chargemaster,88312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88312,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8831226,Not in chargemaster,88312,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8831226,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88312TC,Not in chargemaster,88312TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88312TC,BCBSND Base Physician Payment Schedule,161.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8831126,Not in chargemaster,88311,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8831126,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88311TC,Not in chargemaster,88311TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88311TC,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88311,Not in chargemaster,88311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88311,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88309,Not in chargemaster,88309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88309,BCBSND Base Physician Payment Schedule,869.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8830926,Not in chargemaster,88309,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8830926,BCBSND Base Physician Payment Schedule,310.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88309TC,Not in chargemaster,88309TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88309TC,BCBSND Base Physician Payment Schedule,559.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8830726,Not in chargemaster,88307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8830726,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88307TC,Not in chargemaster,88307TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88307TC,BCBSND Base Physician Payment Schedule,396.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88307,Not in chargemaster,88307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88307,BCBSND Base Physician Payment Schedule,572.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88305,Not in chargemaster,88305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88305,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8830526,Not in chargemaster,88305,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8830526,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88305TC,Not in chargemaster,88305TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88305TC,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8830426,Not in chargemaster,88304,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8830426,BCBSND Base Physician Payment Schedule,24.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88304TC,Not in chargemaster,88304TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88304TC,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88304,Not in chargemaster,88304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88304,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88302,Not in chargemaster,88302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88302,BCBSND Base Physician Payment Schedule,63.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8830226,Not in chargemaster,88302,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8830226,BCBSND Base Physician Payment Schedule,14.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88302TC,Not in chargemaster,88302TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88302TC,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8830026,Not in chargemaster,88300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8830026,BCBSND Base Physician Payment Schedule,9.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88300TC,Not in chargemaster,88300TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88300TC,BCBSND Base Physician Payment Schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88300,Not in chargemaster,88300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88300,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88291,Not in chargemaster,88291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88291,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88189,Not in chargemaster,88189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88189,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88188,Not in chargemaster,88188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88188,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88187,Not in chargemaster,88187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88187,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88185,Not in chargemaster,88185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88185,BCBSND Base Physician Payment Schedule,45.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88184,Not in chargemaster,88184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88184,BCBSND Base Physician Payment Schedule,138.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88182,Not in chargemaster,88182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88182,BCBSND Base Physician Payment Schedule,285.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8818226,Not in chargemaster,88182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8818226,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88182TC,Not in chargemaster,88182TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88182TC,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8817726,Not in chargemaster,88177,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8817726,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88177TC,Not in chargemaster,88177TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88177TC,BCBSND Base Physician Payment Schedule,14.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88177,Not in chargemaster,88177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88177,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88173,Not in chargemaster,88173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88173,BCBSND Base Physician Payment Schedule,320.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8817326,Not in chargemaster,88173,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8817326,BCBSND Base Physician Payment Schedule,150.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88173TC,Not in chargemaster,88173TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88173TC,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8817226,Not in chargemaster,88172,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8817226,BCBSND Base Physician Payment Schedule,76.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88172TC,Not in chargemaster,88172TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88172TC,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88172,Not in chargemaster,88172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88172,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88162,Not in chargemaster,88162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88162,BCBSND Base Physician Payment Schedule,205.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8816226,Not in chargemaster,88162,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8816226,BCBSND Base Physician Payment Schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88162TC,Not in chargemaster,88162TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88162TC,BCBSND Base Physician Payment Schedule,124.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8816126,Not in chargemaster,88161,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8816126,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88161TC,Not in chargemaster,88161TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88161TC,BCBSND Base Physician Payment Schedule,88.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88161,Not in chargemaster,88161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88161,BCBSND Base Physician Payment Schedule,141.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88160,Not in chargemaster,88160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88160,BCBSND Base Physician Payment Schedule,147.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8816026,Not in chargemaster,88160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8816026,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88160TC,Not in chargemaster,88160TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88160TC,BCBSND Base Physician Payment Schedule,92.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88141,Not in chargemaster,88141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88141,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88125,Not in chargemaster,88125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88125,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8812526,Not in chargemaster,88125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8812526,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88125TC,Not in chargemaster,88125TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88125TC,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8812126,Not in chargemaster,88121,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8812126,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88121TC,Not in chargemaster,88121TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88121TC,BCBSND Base Physician Payment Schedule,812.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88121,Not in chargemaster,88121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88121,BCBSND Base Physician Payment Schedule,916.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88120,Not in chargemaster,88120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88120,BCBSND Base Physician Payment Schedule,1198.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8812026,Not in chargemaster,88120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8812026,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88120TC,Not in chargemaster,88120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88120TC,BCBSND Base Physician Payment Schedule,1076.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8811226,Not in chargemaster,88112,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8811226,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88112TC,Not in chargemaster,88112TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88112TC,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88112,Not in chargemaster,88112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88112,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88108,Not in chargemaster,88108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88108,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8810826,Not in chargemaster,88108,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8810826,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88108TC,Not in chargemaster,88108TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88108TC,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8810626,Not in chargemaster,88106,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8810626,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88106TC,Not in chargemaster,88106TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88106TC,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88106,Not in chargemaster,88106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88106,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88104,Not in chargemaster,88104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88104,BCBSND Base Physician Payment Schedule,141.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8810426,Not in chargemaster,88104,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8810426,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 88104TC,Not in chargemaster,88104TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88104TC,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8720726,Not in chargemaster,87207,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8720726,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8716426,Not in chargemaster,87164,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8716426,BCBSND Base Physician Payment Schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86580,Not in chargemaster,86580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86580,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86510,Not in chargemaster,86510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86510,BCBSND Base Physician Payment Schedule,13.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86490,Not in chargemaster,86490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86490,BCBSND Base Physician Payment Schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86486,Not in chargemaster,86486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86486,BCBSND Base Physician Payment Schedule,11.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8633526,Not in chargemaster,86335,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8633526,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8633426,Not in chargemaster,86334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8633426,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8632726,Not in chargemaster,86327,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8632726,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8632526,Not in chargemaster,86325,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8632526,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8632026,Not in chargemaster,86320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8632026,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8625626,Not in chargemaster,86256,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8625626,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8625526,Not in chargemaster,86255,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8625526,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8615326,Not in chargemaster,86153,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8615326,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86079,Not in chargemaster,86079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86079,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86078,Not in chargemaster,86078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86078,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 86077,Not in chargemaster,86077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86077,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8557626,Not in chargemaster,85576,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8557626,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85396,Not in chargemaster,85396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,85396,BCBSND Base Physician Payment Schedule,42.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8539026,Not in chargemaster,85390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8539026,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85097,Not in chargemaster,85097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,85097,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 85060,Not in chargemaster,85060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,85060,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8418226,Not in chargemaster,84182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8418226,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8418126,Not in chargemaster,84181,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8418126,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8416626,Not in chargemaster,84166,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8416626,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8416526,Not in chargemaster,84165,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8416526,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 8302026,Not in chargemaster,83020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,8302026,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 80502,Not in chargemaster,80502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,80502,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 80500,Not in chargemaster,80500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,80500,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7944526,Not in chargemaster,79445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7944526,BCBSND Base Physician Payment Schedule,237.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79445TC,Not in chargemaster,79445TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79445TC,BCBSND Base Physician Payment Schedule,328.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79445,Not in chargemaster,79445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79445,BCBSND Base Physician Payment Schedule,566.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79440,Not in chargemaster,79440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79440,BCBSND Base Physician Payment Schedule,285.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7944026,Not in chargemaster,79440,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7944026,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79440TC,Not in chargemaster,79440TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79440TC,BCBSND Base Physician Payment Schedule,112.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7940326,Not in chargemaster,79403,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7940326,BCBSND Base Physician Payment Schedule,226.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79403TC,Not in chargemaster,79403TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79403TC,BCBSND Base Physician Payment Schedule,231.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79403,Not in chargemaster,79403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79403,BCBSND Base Physician Payment Schedule,458.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7930026,Not in chargemaster,79300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7930026,BCBSND Base Physician Payment Schedule,138.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7920026,Not in chargemaster,79200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7920026,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79200TC,Not in chargemaster,79200TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79200TC,BCBSND Base Physician Payment Schedule,150.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79200,Not in chargemaster,79200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79200,BCBSND Base Physician Payment Schedule,324.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79101,Not in chargemaster,79101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79101,BCBSND Base Physician Payment Schedule,349.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7910126,Not in chargemaster,79101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7910126,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79101TC,Not in chargemaster,79101TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79101TC,BCBSND Base Physician Payment Schedule,144.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7900526,Not in chargemaster,79005,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7900526,BCBSND Base Physician Payment Schedule,183.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79005TC,Not in chargemaster,79005TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79005TC,BCBSND Base Physician Payment Schedule,142.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 79005,Not in chargemaster,79005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,79005,BCBSND Base Physician Payment Schedule,326.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78835,Not in chargemaster,78835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78835,BCBSND Base Physician Payment Schedule,237.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7883526,Not in chargemaster,78835,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7883526,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78835TC,Not in chargemaster,78835TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78835TC,BCBSND Base Physician Payment Schedule,190.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7883226,Not in chargemaster,78832,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7883226,BCBSND Base Physician Payment Schedule,212.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78832TC,Not in chargemaster,78832TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78832TC,BCBSND Base Physician Payment Schedule,1946.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78832,Not in chargemaster,78832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78832,BCBSND Base Physician Payment Schedule,2159.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78831,Not in chargemaster,78831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78831,BCBSND Base Physician Payment Schedule,1657.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7883126,Not in chargemaster,78831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7883126,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78831TC,Not in chargemaster,78831TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78831TC,BCBSND Base Physician Payment Schedule,1474.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7883026,Not in chargemaster,78830,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7883026,BCBSND Base Physician Payment Schedule,149.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78830TC,Not in chargemaster,78830TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78830TC,BCBSND Base Physician Payment Schedule,993.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78830,Not in chargemaster,78830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78830,BCBSND Base Physician Payment Schedule,1142.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78816,Not in chargemaster,78816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78816,BCBSND Base Physician Payment Schedule,2354.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7881626,Not in chargemaster,78816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7881626,BCBSND Base Physician Payment Schedule,249.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78816TC,Not in chargemaster,78816TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78816TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7881526,Not in chargemaster,78815,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7881526,BCBSND Base Physician Payment Schedule,247.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78815TC,Not in chargemaster,78815TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78815TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78815,Not in chargemaster,78815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78815,BCBSND Base Physician Payment Schedule,2351.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7881426,Not in chargemaster,78814,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7881426,BCBSND Base Physician Payment Schedule,220.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78814TC,Not in chargemaster,78814TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78814TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78814,Not in chargemaster,78814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78814,BCBSND Base Physician Payment Schedule,2325.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7881326,Not in chargemaster,78813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7881326,BCBSND Base Physician Payment Schedule,193.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78813TC,Not in chargemaster,78813TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78813TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78813,Not in chargemaster,78813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78813,BCBSND Base Physician Payment Schedule,2298.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7881226,Not in chargemaster,78812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7881226,BCBSND Base Physician Payment Schedule,193.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78812TC,Not in chargemaster,78812TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78812TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78812,Not in chargemaster,78812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78812,BCBSND Base Physician Payment Schedule,2297.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7881126,Not in chargemaster,78811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7881126,BCBSND Base Physician Payment Schedule,157.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78811TC,Not in chargemaster,78811TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78811TC,BCBSND Base Physician Payment Schedule,1880.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78811,Not in chargemaster,78811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78811,BCBSND Base Physician Payment Schedule,2038.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78808,Not in chargemaster,78808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78808,BCBSND Base Physician Payment Schedule,94.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7880426,Not in chargemaster,78804,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7880426,BCBSND Base Physician Payment Schedule,102.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78804TC,Not in chargemaster,78804TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78804TC,BCBSND Base Physician Payment Schedule,1442.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78804,Not in chargemaster,78804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78804,BCBSND Base Physician Payment Schedule,1544.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78803,Not in chargemaster,78803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78803,BCBSND Base Physician Payment Schedule,904.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7880326,Not in chargemaster,78803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7880326,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78803TC,Not in chargemaster,78803TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78803TC,BCBSND Base Physician Payment Schedule,794.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7880226,Not in chargemaster,78802,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7880226,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78802TC,Not in chargemaster,78802TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78802TC,BCBSND Base Physician Payment Schedule,647.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78802,Not in chargemaster,78802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78802,BCBSND Base Physician Payment Schedule,727.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78801,Not in chargemaster,78801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78801,BCBSND Base Physician Payment Schedule,661.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7880126,Not in chargemaster,78801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7880126,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78801TC,Not in chargemaster,78801TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78801TC,BCBSND Base Physician Payment Schedule,586.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7880026,Not in chargemaster,78800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7880026,BCBSND Base Physician Payment Schedule,66.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78800TC,Not in chargemaster,78800TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78800TC,BCBSND Base Physician Payment Schedule,535.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78800,Not in chargemaster,78800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78800,BCBSND Base Physician Payment Schedule,602.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78761,Not in chargemaster,78761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78761,BCBSND Base Physician Payment Schedule,491.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7876126,Not in chargemaster,78761,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7876126,BCBSND Base Physician Payment Schedule,74.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78761TC,Not in chargemaster,78761TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78761TC,BCBSND Base Physician Payment Schedule,416.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7874026,Not in chargemaster,78740,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7874026,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78740TC,Not in chargemaster,78740TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78740TC,BCBSND Base Physician Payment Schedule,449.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78740,Not in chargemaster,78740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78740,BCBSND Base Physician Payment Schedule,505.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78730,Not in chargemaster,78730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78730,BCBSND Base Physician Payment Schedule,177.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7873026,Not in chargemaster,78730,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7873026,BCBSND Base Physician Payment Schedule,16.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78730TC,Not in chargemaster,78730TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78730TC,BCBSND Base Physician Payment Schedule,160.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7872526,Not in chargemaster,78725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7872526,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78725TC,Not in chargemaster,78725TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78725TC,BCBSND Base Physician Payment Schedule,213.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78725,Not in chargemaster,78725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78725,BCBSND Base Physician Payment Schedule,251.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78709,Not in chargemaster,78709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78709,BCBSND Base Physician Payment Schedule,849.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7870926,Not in chargemaster,78709,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7870926,BCBSND Base Physician Payment Schedule,141.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78709TC,Not in chargemaster,78709TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78709TC,BCBSND Base Physician Payment Schedule,707.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7870826,Not in chargemaster,78708,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7870826,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78708TC,Not in chargemaster,78708TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78708TC,BCBSND Base Physician Payment Schedule,279.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78708,Not in chargemaster,78708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78708,BCBSND Base Physician Payment Schedule,402.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78707,Not in chargemaster,78707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78707,BCBSND Base Physician Payment Schedule,537.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7870726,Not in chargemaster,78707,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7870726,BCBSND Base Physician Payment Schedule,97.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78707TC,Not in chargemaster,78707TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78707TC,BCBSND Base Physician Payment Schedule,439.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7870126,Not in chargemaster,78701,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7870126,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78701TC,Not in chargemaster,78701TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78701TC,BCBSND Base Physician Payment Schedule,459.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78701,Not in chargemaster,78701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78701,BCBSND Base Physician Payment Schedule,509.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78700,Not in chargemaster,78700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78700,BCBSND Base Physician Payment Schedule,398,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7870026,Not in chargemaster,78700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7870026,BCBSND Base Physician Payment Schedule,45.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78700TC,Not in chargemaster,78700TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78700TC,BCBSND Base Physician Payment Schedule,352.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7866026,Not in chargemaster,78660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7866026,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78660TC,Not in chargemaster,78660TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78660TC,BCBSND Base Physician Payment Schedule,373.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78660,Not in chargemaster,78660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78660,BCBSND Base Physician Payment Schedule,428.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78650,Not in chargemaster,78650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78650,BCBSND Base Physician Payment Schedule,644.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7865026,Not in chargemaster,78650,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7865026,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78650TC,Not in chargemaster,78650TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78650TC,BCBSND Base Physician Payment Schedule,591.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7864526,Not in chargemaster,78645,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7864526,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78645TC,Not in chargemaster,78645TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78645TC,BCBSND Base Physician Payment Schedule,701.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78645,Not in chargemaster,78645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78645,BCBSND Base Physician Payment Schedule,758.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78635,Not in chargemaster,78635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78635,BCBSND Base Physician Payment Schedule,789.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7863526,Not in chargemaster,78635,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7863526,BCBSND Base Physician Payment Schedule,63.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78635TC,Not in chargemaster,78635TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78635TC,BCBSND Base Physician Payment Schedule,725.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7863026,Not in chargemaster,78630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7863026,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78630TC,Not in chargemaster,78630TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78630TC,BCBSND Base Physician Payment Schedule,719.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78630,Not in chargemaster,78630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78630,BCBSND Base Physician Payment Schedule,788.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78610,Not in chargemaster,78610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78610,BCBSND Base Physician Payment Schedule,406.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7861026,Not in chargemaster,78610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7861026,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78610TC,Not in chargemaster,78610TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78610TC,BCBSND Base Physician Payment Schedule,375.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7860926,Not in chargemaster,78609,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7860926,BCBSND Base Physician Payment Schedule,158.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78609TC,Not in chargemaster,78609TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78609TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78609,Not in chargemaster,78609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78609,BCBSND Base Physician Payment Schedule,2263.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7860826,Not in chargemaster,78608,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7860826,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78608TC,Not in chargemaster,78608TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78608TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78608,Not in chargemaster,78608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78608,BCBSND Base Physician Payment Schedule,2253.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7860626,Not in chargemaster,78606,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7860626,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78606TC,Not in chargemaster,78606TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78606TC,BCBSND Base Physician Payment Schedule,706.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78606,Not in chargemaster,78606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78606,BCBSND Base Physician Payment Schedule,771.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78605,Not in chargemaster,78605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78605,BCBSND Base Physician Payment Schedule,464.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7860526,Not in chargemaster,78605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7860526,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78605TC,Not in chargemaster,78605TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78605TC,BCBSND Base Physician Payment Schedule,409.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7860126,Not in chargemaster,78601,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7860126,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78601TC,Not in chargemaster,78601TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78601TC,BCBSND Base Physician Payment Schedule,453.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78601,Not in chargemaster,78601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78601,BCBSND Base Physician Payment Schedule,505.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78600,Not in chargemaster,78600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78600,BCBSND Base Physician Payment Schedule,428.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7860026,Not in chargemaster,78600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7860026,BCBSND Base Physician Payment Schedule,45.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78600TC,Not in chargemaster,78600TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78600TC,BCBSND Base Physician Payment Schedule,383.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7859826,Not in chargemaster,78598,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7859826,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78598TC,Not in chargemaster,78598TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78598TC,BCBSND Base Physician Payment Schedule,622.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78598,Not in chargemaster,78598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78598,BCBSND Base Physician Payment Schedule,707.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78597,Not in chargemaster,78597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78597,BCBSND Base Physician Payment Schedule,464.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7859726,Not in chargemaster,78597,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7859726,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78597TC,Not in chargemaster,78597TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78597TC,BCBSND Base Physician Payment Schedule,391.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7858226,Not in chargemaster,78582,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7858226,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78582TC,Not in chargemaster,78582TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78582TC,BCBSND Base Physician Payment Schedule,664.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78582,Not in chargemaster,78582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78582,BCBSND Base Physician Payment Schedule,773.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78580,Not in chargemaster,78580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78580,BCBSND Base Physician Payment Schedule,549.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7858026,78580,78580,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7858026,BCBSND Base Physician Payment Schedule,75.61,93.14,Fee schedule,,75.61,75.61,75.61,75.61,,,0
unity,Fee schedule,Non-facility 78580TC,Not in chargemaster,78580TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78580TC,BCBSND Base Physician Payment Schedule,473.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7857926,Not in chargemaster,78579,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7857926,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78579TC,Not in chargemaster,78579TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78579TC,BCBSND Base Physician Payment Schedule,386.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78579,Not in chargemaster,78579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78579,BCBSND Base Physician Payment Schedule,436.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78496,Not in chargemaster,78496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78496,BCBSND Base Physician Payment Schedule,95.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7849626,Not in chargemaster,78496,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7849626,BCBSND Base Physician Payment Schedule,50.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78496TC,Not in chargemaster,78496TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78496TC,BCBSND Base Physician Payment Schedule,44.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7849426,Not in chargemaster,78494,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7849426,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78494TC,Not in chargemaster,78494TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78494TC,BCBSND Base Physician Payment Schedule,397.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78494,Not in chargemaster,78494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78494,BCBSND Base Physician Payment Schedule,519.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7849226,Not in chargemaster,78492,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7849226,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78492TC,Not in chargemaster,78492TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78492TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78492,Not in chargemaster,78492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78492,BCBSND Base Physician Payment Schedule,2285.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7849126,Not in chargemaster,78491,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7849126,BCBSND Base Physician Payment Schedule,153.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78491TC,Not in chargemaster,78491TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78491TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78491,Not in chargemaster,78491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78491,BCBSND Base Physician Payment Schedule,2258.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78483,Not in chargemaster,78483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78483,BCBSND Base Physician Payment Schedule,550.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7848326,Not in chargemaster,78483,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7848326,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78483TC,Not in chargemaster,78483TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78483TC,BCBSND Base Physician Payment Schedule,401.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7848126,Not in chargemaster,78481,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7848126,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78481TC,Not in chargemaster,78481TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78481TC,BCBSND Base Physician Payment Schedule,302.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78481,Not in chargemaster,78481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78481,BCBSND Base Physician Payment Schedule,402.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78473,Not in chargemaster,78473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78473,BCBSND Base Physician Payment Schedule,663.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7847326,Not in chargemaster,78473,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7847326,BCBSND Base Physician Payment Schedule,147.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78473TC,Not in chargemaster,78473TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78473TC,BCBSND Base Physician Payment Schedule,515.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7847226,Not in chargemaster,78472,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7847226,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78472TC,Not in chargemaster,78472TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78472TC,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78472,Not in chargemaster,78472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78472,BCBSND Base Physician Payment Schedule,524.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78469,Not in chargemaster,78469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78469,BCBSND Base Physician Payment Schedule,515.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7846926,Not in chargemaster,78469,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7846926,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78469TC,Not in chargemaster,78469TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78469TC,BCBSND Base Physician Payment Schedule,421.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7846826,Not in chargemaster,78468,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7846826,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78468TC,Not in chargemaster,78468TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78468TC,BCBSND Base Physician Payment Schedule,364.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78468,Not in chargemaster,78468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78468,BCBSND Base Physician Payment Schedule,444.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78466,Not in chargemaster,78466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78466,BCBSND Base Physician Payment Schedule,463.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7846626,Not in chargemaster,78466,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7846626,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78466TC,Not in chargemaster,78466TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78466TC,BCBSND Base Physician Payment Schedule,389.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7845926,Not in chargemaster,78459,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7845926,BCBSND Base Physician Payment Schedule,157.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78459TC,Not in chargemaster,78459TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78459TC,BCBSND Base Physician Payment Schedule,1880.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78459,Not in chargemaster,78459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78459,BCBSND Base Physician Payment Schedule,2038.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7845826,Not in chargemaster,78458,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7845826,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78458TC,Not in chargemaster,78458TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78458TC,BCBSND Base Physician Payment Schedule,378.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78458,Not in chargemaster,78458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78458,BCBSND Base Physician Payment Schedule,473.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78457,Not in chargemaster,78457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78457,BCBSND Base Physician Payment Schedule,404.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7845726,Not in chargemaster,78457,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7845726,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78457TC,Not in chargemaster,78457TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78457TC,BCBSND Base Physician Payment Schedule,326.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7845626,Not in chargemaster,78456,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7845626,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78456TC,Not in chargemaster,78456TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78456TC,BCBSND Base Physician Payment Schedule,615,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78456,Not in chargemaster,78456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78456,BCBSND Base Physician Payment Schedule,715.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78454,Not in chargemaster,78454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78454,BCBSND Base Physician Payment Schedule,1007.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7845426,Not in chargemaster,78454,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7845426,BCBSND Base Physician Payment Schedule,138.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78454TC,Not in chargemaster,78454TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78454TC,BCBSND Base Physician Payment Schedule,869.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7845326,Not in chargemaster,78453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7845326,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78453TC,Not in chargemaster,78453TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78453TC,BCBSND Base Physician Payment Schedule,598.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78453,Not in chargemaster,78453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78453,BCBSND Base Physician Payment Schedule,702,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78452,Not in chargemaster,78452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78452,BCBSND Base Physician Payment Schedule,1088.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7845226,Not in chargemaster,78452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7845226,BCBSND Base Physician Payment Schedule,164.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78452TC,Not in chargemaster,78452TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78452TC,BCBSND Base Physician Payment Schedule,923.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7845126,Not in chargemaster,78451,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7845126,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78451TC,Not in chargemaster,78451TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78451TC,BCBSND Base Physician Payment Schedule,638.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78451,Not in chargemaster,78451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78451,BCBSND Base Physician Payment Schedule,777.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78445,Not in chargemaster,78445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78445,BCBSND Base Physician Payment Schedule,455.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7844526,Not in chargemaster,78445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7844526,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78445TC,Not in chargemaster,78445TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78445TC,BCBSND Base Physician Payment Schedule,402.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7843426,Not in chargemaster,78434,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7843426,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7843326,Not in chargemaster,78433,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7843326,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78433TC,Not in chargemaster,78433TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78433TC,BCBSND Base Physician Payment Schedule,4208.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78433,Not in chargemaster,78433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78433,BCBSND Base Physician Payment Schedule,4432.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7843226,Not in chargemaster,78432,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7843226,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78432TC,Not in chargemaster,78432TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78432TC,BCBSND Base Physician Payment Schedule,4208.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78432,Not in chargemaster,78432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78432,BCBSND Base Physician Payment Schedule,4413.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7843126,Not in chargemaster,78431,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7843126,BCBSND Base Physician Payment Schedule,192.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78431TC,Not in chargemaster,78431TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78431TC,BCBSND Base Physician Payment Schedule,3443.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78431,Not in chargemaster,78431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78431,BCBSND Base Physician Payment Schedule,3635.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7843026,Not in chargemaster,78430,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7843026,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78430TC,Not in chargemaster,78430TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78430TC,BCBSND Base Physician Payment Schedule,2207.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78430,Not in chargemaster,78430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78430,BCBSND Base Physician Payment Schedule,2372.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7842926,Not in chargemaster,78429,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7842926,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78429TC,Not in chargemaster,78429TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78429TC,BCBSND Base Physician Payment Schedule,2207.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78429,Not in chargemaster,78429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78429,BCBSND Base Physician Payment Schedule,2381.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78428,Not in chargemaster,78428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78428,BCBSND Base Physician Payment Schedule,427.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7842826,Not in chargemaster,78428,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7842826,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78428TC,Not in chargemaster,78428TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78428TC,BCBSND Base Physician Payment Schedule,349.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7841426,Not in chargemaster,78414,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7841426,BCBSND Base Physician Payment Schedule,45.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78351,Not in chargemaster,78351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78351,BCBSND Base Physician Payment Schedule,36.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7835026,Not in chargemaster,78350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7835026,BCBSND Base Physician Payment Schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78350TC,Not in chargemaster,78350TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78350TC,BCBSND Base Physician Payment Schedule,49.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78350,Not in chargemaster,78350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78350,BCBSND Base Physician Payment Schedule,72.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78315,Not in chargemaster,78315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78315,BCBSND Base Physician Payment Schedule,805,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7831526,Not in chargemaster,78315,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7831526,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78315TC,Not in chargemaster,78315TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78315TC,BCBSND Base Physician Payment Schedule,700.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7830626,78306,78306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7830626,BCBSND Base Physician Payment Schedule,88.83,108.37,Fee schedule,,88.83,88.83,88.83,88.83,,,0
unity,Fee schedule,Non-facility 78306TC,Not in chargemaster,78306TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78306TC,BCBSND Base Physician Payment Schedule,611.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78306,Not in chargemaster,78306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78306,BCBSND Base Physician Payment Schedule,700.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78305,Not in chargemaster,78305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78305,BCBSND Base Physician Payment Schedule,645.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7830526,78305,78305,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7830526,BCBSND Base Physician Payment Schedule,85.89,104.8,Fee schedule,,85.89,85.89,85.89,85.89,,,0
unity,Fee schedule,Non-facility 78305TC,Not in chargemaster,78305TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78305TC,BCBSND Base Physician Payment Schedule,559.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7830026,78300,78300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7830026,BCBSND Base Physician Payment Schedule,64.6,79.71,Fee schedule,,64.6,64.6,64.6,64.6,,,0
unity,Fee schedule,Non-facility 78300TC,Not in chargemaster,78300TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78300TC,BCBSND Base Physician Payment Schedule,468.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78300,Not in chargemaster,78300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78300,BCBSND Base Physician Payment Schedule,533.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78291,Not in chargemaster,78291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78291,BCBSND Base Physician Payment Schedule,591.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7829126,Not in chargemaster,78291,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7829126,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78291TC,Not in chargemaster,78291TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78291TC,BCBSND Base Physician Payment Schedule,501.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7829026,Not in chargemaster,78290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7829026,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78290TC,Not in chargemaster,78290TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78290TC,BCBSND Base Physician Payment Schedule,701.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78290,Not in chargemaster,78290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78290,BCBSND Base Physician Payment Schedule,770.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7828226,Not in chargemaster,78282,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7828226,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7827826,Not in chargemaster,78278,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7827826,BCBSND Base Physician Payment Schedule,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78278TC,Not in chargemaster,78278TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78278TC,BCBSND Base Physician Payment Schedule,708.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78278,Not in chargemaster,78278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78278,BCBSND Base Physician Payment Schedule,810.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78266,Not in chargemaster,78266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78266,BCBSND Base Physician Payment Schedule,1003.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7826626,Not in chargemaster,78266,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7826626,BCBSND Base Physician Payment Schedule,102.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78266TC,Not in chargemaster,78266TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78266TC,BCBSND Base Physician Payment Schedule,900.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7826526,Not in chargemaster,78265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7826526,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78265TC,Not in chargemaster,78265TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78265TC,BCBSND Base Physician Payment Schedule,816.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78265,Not in chargemaster,78265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78265,BCBSND Base Physician Payment Schedule,916.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78264,Not in chargemaster,78264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78264,BCBSND Base Physician Payment Schedule,775.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7826426,Not in chargemaster,78264,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7826426,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78264TC,Not in chargemaster,78264TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78264TC,BCBSND Base Physician Payment Schedule,695.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7826226,Not in chargemaster,78262,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7826226,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78262TC,Not in chargemaster,78262TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78262TC,BCBSND Base Physician Payment Schedule,487.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78262,Not in chargemaster,78262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78262,BCBSND Base Physician Payment Schedule,557.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78261,Not in chargemaster,78261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78261,BCBSND Base Physician Payment Schedule,474.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7826126,Not in chargemaster,78261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7826126,BCBSND Base Physician Payment Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78261TC,Not in chargemaster,78261TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78261TC,BCBSND Base Physician Payment Schedule,414.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7825826,Not in chargemaster,78258,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7825826,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78258TC,Not in chargemaster,78258TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78258TC,BCBSND Base Physician Payment Schedule,429.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78258,Not in chargemaster,78258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78258,BCBSND Base Physician Payment Schedule,501.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78232,Not in chargemaster,78232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78232,BCBSND Base Physician Payment Schedule,239.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7823226,Not in chargemaster,78232,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7823226,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78232TC,Not in chargemaster,78232TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78232TC,BCBSND Base Physician Payment Schedule,198.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7823126,Not in chargemaster,78231,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7823126,BCBSND Base Physician Payment Schedule,45.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78231TC,Not in chargemaster,78231TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78231TC,BCBSND Base Physician Payment Schedule,198.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78231,Not in chargemaster,78231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78231,BCBSND Base Physician Payment Schedule,243.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78230,Not in chargemaster,78230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78230,BCBSND Base Physician Payment Schedule,406.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7823026,Not in chargemaster,78230,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7823026,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78230TC,Not in chargemaster,78230TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78230TC,BCBSND Base Physician Payment Schedule,359.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7822726,Not in chargemaster,78227,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7822726,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78227TC,Not in chargemaster,78227TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78227TC,BCBSND Base Physician Payment Schedule,941.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78227,Not in chargemaster,78227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78227,BCBSND Base Physician Payment Schedule,1034.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78226,Not in chargemaster,78226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78226,BCBSND Base Physician Payment Schedule,764.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7822626,Not in chargemaster,78226,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7822626,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78226TC,Not in chargemaster,78226TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78226TC,BCBSND Base Physician Payment Schedule,689.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7821626,Not in chargemaster,78216,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7821626,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78216TC,Not in chargemaster,78216TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78216TC,BCBSND Base Physician Payment Schedule,241.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78216,Not in chargemaster,78216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78216,BCBSND Base Physician Payment Schedule,297.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78215,Not in chargemaster,78215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78215,BCBSND Base Physician Payment Schedule,455.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7821526,Not in chargemaster,78215,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7821526,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78215TC,Not in chargemaster,78215TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78215TC,BCBSND Base Physician Payment Schedule,405.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7820226,Not in chargemaster,78202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7820226,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78202TC,Not in chargemaster,78202TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78202TC,BCBSND Base Physician Payment Schedule,429.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78202,Not in chargemaster,78202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78202,BCBSND Base Physician Payment Schedule,479.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78201,Not in chargemaster,78201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78201,BCBSND Base Physician Payment Schedule,445.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7820126,Not in chargemaster,78201,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7820126,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78201TC,Not in chargemaster,78201TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78201TC,BCBSND Base Physician Payment Schedule,401.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7819526,Not in chargemaster,78195,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7819526,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78195TC,Not in chargemaster,78195TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78195TC,BCBSND Base Physician Payment Schedule,701.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78195,Not in chargemaster,78195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78195,BCBSND Base Physician Payment Schedule,822.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78191,Not in chargemaster,78191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78191,BCBSND Base Physician Payment Schedule,289.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7819126,Not in chargemaster,78191,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7819126,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78191TC,Not in chargemaster,78191TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78191TC,BCBSND Base Physician Payment Schedule,236.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7818526,Not in chargemaster,78185,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7818526,BCBSND Base Physician Payment Schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78185TC,Not in chargemaster,78185TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78185TC,BCBSND Base Physician Payment Schedule,363.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78185,Not in chargemaster,78185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78185,BCBSND Base Physician Payment Schedule,398.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78140,Not in chargemaster,78140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78140,BCBSND Base Physician Payment Schedule,256.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7814026,Not in chargemaster,78140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7814026,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78140TC,Not in chargemaster,78140TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78140TC,BCBSND Base Physician Payment Schedule,203.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7813526,Not in chargemaster,78135,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7813526,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78135TC,Not in chargemaster,78135TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78135TC,BCBSND Base Physician Payment Schedule,597.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78135,Not in chargemaster,78135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78135,BCBSND Base Physician Payment Schedule,653.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78130,Not in chargemaster,78130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78130,BCBSND Base Physician Payment Schedule,289.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7813026,Not in chargemaster,78130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7813026,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78130TC,Not in chargemaster,78130TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78130TC,BCBSND Base Physician Payment Schedule,236.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7812226,Not in chargemaster,78122,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7812226,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78122TC,Not in chargemaster,78122TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78122TC,BCBSND Base Physician Payment Schedule,177.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78122,Not in chargemaster,78122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78122,BCBSND Base Physician Payment Schedule,221.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78121,Not in chargemaster,78121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78121,BCBSND Base Physician Payment Schedule,180.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7812126,Not in chargemaster,78121,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7812126,BCBSND Base Physician Payment Schedule,28.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78121TC,Not in chargemaster,78121TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78121TC,BCBSND Base Physician Payment Schedule,151.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7812026,Not in chargemaster,78120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7812026,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78120TC,Not in chargemaster,78120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78120TC,BCBSND Base Physician Payment Schedule,145.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78120,Not in chargemaster,78120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78120,BCBSND Base Physician Payment Schedule,165.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78111,Not in chargemaster,78111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78111,BCBSND Base Physician Payment Schedule,171.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7811126,Not in chargemaster,78111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7811126,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78111TC,Not in chargemaster,78111TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78111TC,BCBSND Base Physician Payment Schedule,151.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7811026,Not in chargemaster,78110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7811026,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78110TC,Not in chargemaster,78110TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78110TC,BCBSND Base Physician Payment Schedule,145.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78110,Not in chargemaster,78110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78110,BCBSND Base Physician Payment Schedule,162.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78104,Not in chargemaster,78104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78104,BCBSND Base Physician Payment Schedule,579.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7810426,Not in chargemaster,78104,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7810426,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78104TC,Not in chargemaster,78104TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78104TC,BCBSND Base Physician Payment Schedule,498.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7810326,Not in chargemaster,78103,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7810326,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78103TC,Not in chargemaster,78103TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78103TC,BCBSND Base Physician Payment Schedule,430.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78103,Not in chargemaster,78103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78103,BCBSND Base Physician Payment Schedule,502.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78102,Not in chargemaster,78102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78102,BCBSND Base Physician Payment Schedule,395.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7810226,Not in chargemaster,78102,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7810226,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78102TC,Not in chargemaster,78102TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78102TC,BCBSND Base Physician Payment Schedule,340.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7807526,Not in chargemaster,78075,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7807526,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78075TC,Not in chargemaster,78075TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78075TC,BCBSND Base Physician Payment Schedule,971.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78075,Not in chargemaster,78075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78075,BCBSND Base Physician Payment Schedule,1048.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78072,Not in chargemaster,78072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78072,BCBSND Base Physician Payment Schedule,1033.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7807226,Not in chargemaster,78072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7807226,BCBSND Base Physician Payment Schedule,160.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78072TC,Not in chargemaster,78072TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78072TC,BCBSND Base Physician Payment Schedule,873.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7807126,Not in chargemaster,78071,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7807126,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78071TC,Not in chargemaster,78071TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78071TC,BCBSND Base Physician Payment Schedule,698.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78071,Not in chargemaster,78071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78071,BCBSND Base Physician Payment Schedule,820.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78070,Not in chargemaster,78070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78070,BCBSND Base Physician Payment Schedule,689.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7807026,Not in chargemaster,78070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7807026,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78070TC,Not in chargemaster,78070TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78070TC,BCBSND Base Physician Payment Schedule,609.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7802026,Not in chargemaster,78020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7802026,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78020TC,Not in chargemaster,78020TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78020TC,BCBSND Base Physician Payment Schedule,130.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78020,Not in chargemaster,78020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78020,BCBSND Base Physician Payment Schedule,188.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78018,Not in chargemaster,78018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78018,BCBSND Base Physician Payment Schedule,728.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7801826,Not in chargemaster,78018,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7801826,BCBSND Base Physician Payment Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78018TC,Not in chargemaster,78018TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78018TC,BCBSND Base Physician Payment Schedule,643.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7801626,Not in chargemaster,78016,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7801626,BCBSND Base Physician Payment Schedule,71.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78016TC,Not in chargemaster,78016TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78016TC,BCBSND Base Physician Payment Schedule,586.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78016,Not in chargemaster,78016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78016,BCBSND Base Physician Payment Schedule,658.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78015,Not in chargemaster,78015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78015,BCBSND Base Physician Payment Schedule,522.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7801526,Not in chargemaster,78015,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7801526,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78015TC,Not in chargemaster,78015TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78015TC,BCBSND Base Physician Payment Schedule,453.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7801426,Not in chargemaster,78014,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7801426,BCBSND Base Physician Payment Schedule,50.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78014TC,Not in chargemaster,78014TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78014TC,BCBSND Base Physician Payment Schedule,509.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78014,Not in chargemaster,78014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78014,BCBSND Base Physician Payment Schedule,559.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78013,Not in chargemaster,78013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78013,BCBSND Base Physician Payment Schedule,448.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7801326,Not in chargemaster,78013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7801326,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78013TC,Not in chargemaster,78013TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78013TC,BCBSND Base Physician Payment Schedule,411.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7801226,Not in chargemaster,78012,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7801226,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78012TC,Not in chargemaster,78012TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78012TC,BCBSND Base Physician Payment Schedule,170.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 78012,Not in chargemaster,78012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,78012,BCBSND Base Physician Payment Schedule,189.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77790,Not in chargemaster,77790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77790,BCBSND Base Physician Payment Schedule,35.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7778926,Not in chargemaster,77789,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7778926,BCBSND Base Physician Payment Schedule,127.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77789TC,Not in chargemaster,77789TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77789TC,BCBSND Base Physician Payment Schedule,190.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77789,Not in chargemaster,77789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77789,BCBSND Base Physician Payment Schedule,317.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77778,Not in chargemaster,77778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77778,BCBSND Base Physician Payment Schedule,2113.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7777826,Not in chargemaster,77778,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7777826,BCBSND Base Physician Payment Schedule,965.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77778TC,Not in chargemaster,77778TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77778TC,BCBSND Base Physician Payment Schedule,1147.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7777226,Not in chargemaster,77772,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7777226,BCBSND Base Physician Payment Schedule,591.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77772TC,Not in chargemaster,77772TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77772TC,BCBSND Base Physician Payment Schedule,1444.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77772,Not in chargemaster,77772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77772,BCBSND Base Physician Payment Schedule,2036.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77771,Not in chargemaster,77771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77771,BCBSND Base Physician Payment Schedule,1348.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7777126,Not in chargemaster,77771,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7777126,BCBSND Base Physician Payment Schedule,418.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77771TC,Not in chargemaster,77771TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77771TC,BCBSND Base Physician Payment Schedule,930.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7777026,Not in chargemaster,77770,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7777026,BCBSND Base Physician Payment Schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77770TC,Not in chargemaster,77770TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77770TC,BCBSND Base Physician Payment Schedule,542.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77770,Not in chargemaster,77770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77770,BCBSND Base Physician Payment Schedule,758.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77768,Not in chargemaster,77768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77768,BCBSND Base Physician Payment Schedule,819.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7776826,Not in chargemaster,77768,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7776826,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77768TC,Not in chargemaster,77768TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77768TC,BCBSND Base Physician Payment Schedule,664.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7776726,Not in chargemaster,77767,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7776726,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77767TC,Not in chargemaster,77767TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77767TC,BCBSND Base Physician Payment Schedule,428.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77767,Not in chargemaster,77767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77767,BCBSND Base Physician Payment Schedule,545.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77763,Not in chargemaster,77763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77763,BCBSND Base Physician Payment Schedule,1798.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7776326,Not in chargemaster,77763,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7776326,BCBSND Base Physician Payment Schedule,955.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77763TC,Not in chargemaster,77763TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77763TC,BCBSND Base Physician Payment Schedule,843.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7776226,Not in chargemaster,77762,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7776226,BCBSND Base Physician Payment Schedule,636.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77762TC,Not in chargemaster,77762TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77762TC,BCBSND Base Physician Payment Schedule,652.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77762,Not in chargemaster,77762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77762,BCBSND Base Physician Payment Schedule,1289.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77761,Not in chargemaster,77761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77761,BCBSND Base Physician Payment Schedule,993.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7776126,Not in chargemaster,77761,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7776126,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77761TC,Not in chargemaster,77761TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77761TC,BCBSND Base Physician Payment Schedule,569.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7775026,Not in chargemaster,77750,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7775026,BCBSND Base Physician Payment Schedule,550.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77750TC,Not in chargemaster,77750TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77750TC,BCBSND Base Physician Payment Schedule,342.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77750,Not in chargemaster,77750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77750,BCBSND Base Physician Payment Schedule,892.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77620,Not in chargemaster,77620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77620,BCBSND Base Physician Payment Schedule,1675.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7762026,Not in chargemaster,77620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7762026,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77620TC,Not in chargemaster,77620TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77620TC,BCBSND Base Physician Payment Schedule,1496.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7761526,Not in chargemaster,77615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7761526,BCBSND Base Physician Payment Schedule,204.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77615TC,Not in chargemaster,77615TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77615TC,BCBSND Base Physician Payment Schedule,2756.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77615,Not in chargemaster,77615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77615,BCBSND Base Physician Payment Schedule,2960.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77610,Not in chargemaster,77610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77610,BCBSND Base Physician Payment Schedule,1887.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7761026,Not in chargemaster,77610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7761026,BCBSND Base Physician Payment Schedule,144.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77610TC,Not in chargemaster,77610TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77610TC,BCBSND Base Physician Payment Schedule,1742.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7760526,Not in chargemaster,77605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7760526,BCBSND Base Physician Payment Schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77605TC,Not in chargemaster,77605TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77605TC,BCBSND Base Physician Payment Schedule,2118.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77605,Not in chargemaster,77605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77605,BCBSND Base Physician Payment Schedule,2334.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77600,Not in chargemaster,77600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77600,BCBSND Base Physician Payment Schedule,1269.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7760026,Not in chargemaster,77600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7760026,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77600TC,Not in chargemaster,77600TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77600TC,BCBSND Base Physician Payment Schedule,1120.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7747026,Not in chargemaster,77470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7747026,BCBSND Base Physician Payment Schedule,225.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77470TC,Not in chargemaster,77470TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77470TC,BCBSND Base Physician Payment Schedule,72.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77470,Not in chargemaster,77470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77470,BCBSND Base Physician Payment Schedule,297.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77469,Not in chargemaster,77469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77469,BCBSND Base Physician Payment Schedule,751.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77435,Not in chargemaster,77435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77435,BCBSND Base Physician Payment Schedule,1515.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77432,Not in chargemaster,77432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77432,BCBSND Base Physician Payment Schedule,1003.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77431,Not in chargemaster,77431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77431,BCBSND Base Physician Payment Schedule,249.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77427,Not in chargemaster,77427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77427,BCBSND Base Physician Payment Schedule,449.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77417,Not in chargemaster,77417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77417,BCBSND Base Physician Payment Schedule,32.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77423,Not in chargemaster,77423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77423,BCBSND Base Physician Payment Schedule,189.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77372,Not in chargemaster,77372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77372,BCBSND Base Physician Payment Schedule,2981.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77401,Not in chargemaster,77401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77401,BCBSND Base Physician Payment Schedule,69.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77402,Not in chargemaster,77402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77402,BCBSND Base Physician Payment Schedule,274.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77407,Not in chargemaster,77407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77407,BCBSND Base Physician Payment Schedule,658.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77412,Not in chargemaster,77412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77412,BCBSND Base Physician Payment Schedule,490.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77373,Not in chargemaster,77373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77373,BCBSND Base Physician Payment Schedule,3430.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77387,Not in chargemaster,77387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77387,BCBSND Base Physician Payment Schedule,196.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7738726,Not in chargemaster,77387,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7738726,BCBSND Base Physician Payment Schedule,38.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77387TC,Not in chargemaster,77387TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77387TC,BCBSND Base Physician Payment Schedule,157.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77370,Not in chargemaster,77370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77370,BCBSND Base Physician Payment Schedule,353.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77371,Not in chargemaster,77371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77371,BCBSND Base Physician Payment Schedule,3398.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77338,Not in chargemaster,77338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77338,BCBSND Base Physician Payment Schedule,1211.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7733826,Not in chargemaster,77338,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7733826,BCBSND Base Physician Payment Schedule,472.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77338TC,Not in chargemaster,77338TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77338TC,BCBSND Base Physician Payment Schedule,738.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77336,Not in chargemaster,77336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77336,BCBSND Base Physician Payment Schedule,226.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77334,Not in chargemaster,77334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77334,BCBSND Base Physician Payment Schedule,315.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7733426,Not in chargemaster,77334,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7733426,BCBSND Base Physician Payment Schedule,127.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77334TC,Not in chargemaster,77334TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77334TC,BCBSND Base Physician Payment Schedule,188.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7733326,Not in chargemaster,77333,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7733326,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77333TC,Not in chargemaster,77333TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77333TC,BCBSND Base Physician Payment Schedule,229.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77333,Not in chargemaster,77333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77333,BCBSND Base Physician Payment Schedule,312.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77332,Not in chargemaster,77332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77332,BCBSND Base Physician Payment Schedule,116.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7733226,Not in chargemaster,77332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7733226,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77332TC,Not in chargemaster,77332TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77332TC,BCBSND Base Physician Payment Schedule,66.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7733126,Not in chargemaster,77331,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7733126,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77331TC,Not in chargemaster,77331TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77331TC,BCBSND Base Physician Payment Schedule,53.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77331,Not in chargemaster,77331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77331,BCBSND Base Physician Payment Schedule,149.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77321,Not in chargemaster,77321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77321,BCBSND Base Physician Payment Schedule,230.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7732126,Not in chargemaster,77321,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7732126,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77321TC,Not in chargemaster,77321TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77321TC,BCBSND Base Physician Payment Schedule,123.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7731826,Not in chargemaster,77318,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7731826,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77318TC,Not in chargemaster,77318TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77318TC,BCBSND Base Physician Payment Schedule,596.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77318,Not in chargemaster,77318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77318,BCBSND Base Physician Payment Schedule,915.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77317,Not in chargemaster,77317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77317,BCBSND Base Physician Payment Schedule,642.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7731726,Not in chargemaster,77317,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7731726,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77317TC,Not in chargemaster,77317TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77317TC,BCBSND Base Physician Payment Schedule,439.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7731626,Not in chargemaster,77316,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7731626,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77316TC,Not in chargemaster,77316TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77316TC,BCBSND Base Physician Payment Schedule,335.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77316,Not in chargemaster,77316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77316,BCBSND Base Physician Payment Schedule,490.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77307,Not in chargemaster,77307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77307,BCBSND Base Physician Payment Schedule,637.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7730726,Not in chargemaster,77307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7730726,BCBSND Base Physician Payment Schedule,320.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77307TC,Not in chargemaster,77307TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77307TC,BCBSND Base Physician Payment Schedule,316.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7730626,Not in chargemaster,77306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7730626,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77306TC,Not in chargemaster,77306TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77306TC,BCBSND Base Physician Payment Schedule,175.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77306,Not in chargemaster,77306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77306,BCBSND Base Physician Payment Schedule,329.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77301,Not in chargemaster,77301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77301,BCBSND Base Physician Payment Schedule,5107.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7730126,Not in chargemaster,77301,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7730126,BCBSND Base Physician Payment Schedule,880.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77301TC,Not in chargemaster,77301TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77301TC,BCBSND Base Physician Payment Schedule,4227.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7730026,Not in chargemaster,77300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7730026,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77300TC,Not in chargemaster,77300TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77300TC,BCBSND Base Physician Payment Schedule,95.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77300,Not in chargemaster,77300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77300,BCBSND Base Physician Payment Schedule,163.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77295,Not in chargemaster,77295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77295,BCBSND Base Physician Payment Schedule,1213.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7729526,Not in chargemaster,77295,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7729526,BCBSND Base Physician Payment Schedule,472.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77295TC,Not in chargemaster,77295TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77295TC,BCBSND Base Physician Payment Schedule,740.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7729326,Not in chargemaster,77293,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7729326,BCBSND Base Physician Payment Schedule,222.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77293TC,Not in chargemaster,77293TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77293TC,BCBSND Base Physician Payment Schedule,804.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77293,Not in chargemaster,77293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77293,BCBSND Base Physician Payment Schedule,1026.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77290,Not in chargemaster,77290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77290,BCBSND Base Physician Payment Schedule,1352.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7729026,Not in chargemaster,77290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7729026,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77290TC,Not in chargemaster,77290TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77290TC,BCBSND Base Physician Payment Schedule,1179.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7728526,Not in chargemaster,77285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7728526,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77285TC,Not in chargemaster,77285TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77285TC,BCBSND Base Physician Payment Schedule,1157.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77285,Not in chargemaster,77285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77285,BCBSND Base Physician Payment Schedule,1278.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77280,Not in chargemaster,77280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77280,BCBSND Base Physician Payment Schedule,760.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7728026,Not in chargemaster,77280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7728026,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77280TC,Not in chargemaster,77280TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77280TC,BCBSND Base Physician Payment Schedule,682.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77263,Not in chargemaster,77263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77263,BCBSND Base Physician Payment Schedule,398.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77262,Not in chargemaster,77262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77262,BCBSND Base Physician Payment Schedule,255.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77261,Not in chargemaster,77261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77261,BCBSND Base Physician Payment Schedule,168.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77086,Not in chargemaster,77086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77086,BCBSND Base Physician Payment Schedule,77.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7708626,Not in chargemaster,77086,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7708626,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77086TC,Not in chargemaster,77086TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77086TC,BCBSND Base Physician Payment Schedule,60.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7708526,Not in chargemaster,77085,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7708526,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77085TC,Not in chargemaster,77085TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77085TC,BCBSND Base Physician Payment Schedule,89.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77085,Not in chargemaster,77085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77085,BCBSND Base Physician Payment Schedule,119.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77084,Not in chargemaster,77084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77084,BCBSND Base Physician Payment Schedule,990.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7708426,Not in chargemaster,77084,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7708426,BCBSND Base Physician Payment Schedule,167.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77084TC,Not in chargemaster,77084TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77084TC,BCBSND Base Physician Payment Schedule,822.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7708126,Not in chargemaster,77081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7708126,BCBSND Base Physician Payment Schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77081TC,Not in chargemaster,77081TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77081TC,BCBSND Base Physician Payment Schedule,51.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77081,Not in chargemaster,77081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77081,BCBSND Base Physician Payment Schedule,72.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77080,Not in chargemaster,77080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77080,BCBSND Base Physician Payment Schedule,89.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7708026,77080,77080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7708026,BCBSND Base Physician Payment Schedule,20.55,22.5,Fee schedule,,20.55,20.55,20.55,20.55,,,0
unity,Fee schedule,Non-facility 77080TC,Not in chargemaster,77080TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77080TC,BCBSND Base Physician Payment Schedule,68.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7707826,Not in chargemaster,77078,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7707826,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77078TC,Not in chargemaster,77078TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77078TC,BCBSND Base Physician Payment Schedule,288.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77078,Not in chargemaster,77078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77078,BCBSND Base Physician Payment Schedule,314.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77077,Not in chargemaster,77077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77077,BCBSND Base Physician Payment Schedule,102.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7707726,Not in chargemaster,77077,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7707726,BCBSND Base Physician Payment Schedule,35.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77077TC,Not in chargemaster,77077TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77077TC,BCBSND Base Physician Payment Schedule,66.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7707626,Not in chargemaster,77076,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7707626,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77076TC,Not in chargemaster,77076TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77076TC,BCBSND Base Physician Payment Schedule,157.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77076,Not in chargemaster,77076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77076,BCBSND Base Physician Payment Schedule,230.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77075,Not in chargemaster,77075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77075,BCBSND Base Physician Payment Schedule,214.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7707526,Not in chargemaster,77075,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7707526,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77075TC,Not in chargemaster,77075TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77075TC,BCBSND Base Physician Payment Schedule,156.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7707426,Not in chargemaster,77074,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7707426,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77074TC,Not in chargemaster,77074TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77074TC,BCBSND Base Physician Payment Schedule,94.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77074,Not in chargemaster,77074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77074,BCBSND Base Physician Payment Schedule,141.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77073,Not in chargemaster,77073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77073,BCBSND Base Physician Payment Schedule,98.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7707326,Not in chargemaster,77073,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7707326,BCBSND Base Physician Payment Schedule,28.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77073TC,Not in chargemaster,77073TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77073TC,BCBSND Base Physician Payment Schedule,70.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7707226,Not in chargemaster,77072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7707226,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77072TC,Not in chargemaster,77072TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77072TC,BCBSND Base Physician Payment Schedule,36.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77072,Not in chargemaster,77072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77072,BCBSND Base Physician Payment Schedule,56.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77071,Not in chargemaster,77071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77071,BCBSND Base Physician Payment Schedule,123.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7706726,77067,77067,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7706726,BCBSND Base Physician Payment Schedule,80.02,91.21,Fee schedule,,80.02,80.02,80.02,80.02,,,0
unity,Fee schedule,Non-facility 77067TC,Not in chargemaster,77067TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77067TC,BCBSND Base Physician Payment Schedule,228.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77067,Not in chargemaster,77067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77067,BCBSND Base Physician Payment Schedule,308.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77066,Not in chargemaster,77066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77066,BCBSND Base Physician Payment Schedule,379.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7706626,77066,77066,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7706626,BCBSND Base Physician Payment Schedule,104.24,127.6,Fee schedule,,104.24,104.24,104.24,104.24,,,0
unity,Fee schedule,Non-facility 77066TC,Not in chargemaster,77066TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77066TC,BCBSND Base Physician Payment Schedule,275.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7706526,77065,77065,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7706526,BCBSND Base Physician Payment Schedule,85.16,103.4,Fee schedule,,85.16,85.16,85.16,85.16,,,0
unity,Fee schedule,Non-facility 77065TC,Not in chargemaster,77065TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77065TC,BCBSND Base Physician Payment Schedule,216.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77065,Not in chargemaster,77065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77065,BCBSND Base Physician Payment Schedule,301.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77063,Not in chargemaster,77063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77063,BCBSND Base Physician Payment Schedule,120.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7706326,Not in chargemaster,77063,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7706326,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77063TC,Not in chargemaster,77063TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77063TC,BCBSND Base Physician Payment Schedule,57.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7705426,Not in chargemaster,77054,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7705426,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77054TC,Not in chargemaster,77054TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77054TC,BCBSND Base Physician Payment Schedule,118.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77061,Not in chargemaster,77061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77061,BCBSND Base Physician Payment Schedule,96.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7706126,Not in chargemaster,77061,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7706126,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77061TC,Not in chargemaster,77061TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77061TC,BCBSND Base Physician Payment Schedule,46.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77062,Not in chargemaster,77062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77062,BCBSND Base Physician Payment Schedule,120.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7706226,Not in chargemaster,77062,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7706226,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77062TC,Not in chargemaster,77062TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77062TC,BCBSND Base Physician Payment Schedule,57.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77054,Not in chargemaster,77054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77054,BCBSND Base Physician Payment Schedule,165.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77053,Not in chargemaster,77053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77053,BCBSND Base Physician Payment Schedule,127.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7705326,Not in chargemaster,77053,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7705326,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77053TC,Not in chargemaster,77053TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77053TC,BCBSND Base Physician Payment Schedule,89.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7704926,Not in chargemaster,77049,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7704926,BCBSND Base Physician Payment Schedule,239.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77049TC,Not in chargemaster,77049TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77049TC,BCBSND Base Physician Payment Schedule,797.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77049,Not in chargemaster,77049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77049,BCBSND Base Physician Payment Schedule,1037.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77048,Not in chargemaster,77048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77048,BCBSND Base Physician Payment Schedule,1018.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7704826,Not in chargemaster,77048,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7704826,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77048TC,Not in chargemaster,77048TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77048TC,BCBSND Base Physician Payment Schedule,800.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7704726,Not in chargemaster,77047,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7704726,BCBSND Base Physician Payment Schedule,166.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77047TC,Not in chargemaster,77047TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77047TC,BCBSND Base Physician Payment Schedule,483.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77047,Not in chargemaster,77047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77047,BCBSND Base Physician Payment Schedule,650.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77046,Not in chargemaster,77046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77046,BCBSND Base Physician Payment Schedule,638.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7704626,Not in chargemaster,77046,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7704626,BCBSND Base Physician Payment Schedule,151.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77046TC,Not in chargemaster,77046TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77046TC,BCBSND Base Physician Payment Schedule,486.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7702226,Not in chargemaster,77022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7702226,BCBSND Base Physician Payment Schedule,449.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77022TC,Not in chargemaster,77022TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77022TC,BCBSND Base Physician Payment Schedule,1475.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77022,Not in chargemaster,77022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77022,BCBSND Base Physician Payment Schedule,1925.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7702126,Not in chargemaster,77021,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7702126,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77021TC,Not in chargemaster,77021TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77021TC,BCBSND Base Physician Payment Schedule,1109.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77021,Not in chargemaster,77021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77021,BCBSND Base Physician Payment Schedule,1261.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77014,Not in chargemaster,77014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77014,BCBSND Base Physician Payment Schedule,312.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7701426,Not in chargemaster,77014,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7701426,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77014TC,Not in chargemaster,77014TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77014TC,BCBSND Base Physician Payment Schedule,218.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7701326,Not in chargemaster,77013,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7701326,BCBSND Base Physician Payment Schedule,397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77013TC,Not in chargemaster,77013TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77013TC,BCBSND Base Physician Payment Schedule,1122.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77013,Not in chargemaster,77013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77013,BCBSND Base Physician Payment Schedule,1520.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7701226,Not in chargemaster,77012,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7701226,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77012TC,Not in chargemaster,77012TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77012TC,BCBSND Base Physician Payment Schedule,217.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77012,Not in chargemaster,77012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77012,BCBSND Base Physician Payment Schedule,371.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77011,Not in chargemaster,77011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77011,BCBSND Base Physician Payment Schedule,611.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7701126,Not in chargemaster,77011,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7701126,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77011TC,Not in chargemaster,77011TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77011TC,BCBSND Base Physician Payment Schedule,478.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7700326,Not in chargemaster,77003,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7700326,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77003TC,Not in chargemaster,77003TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77003TC,BCBSND Base Physician Payment Schedule,165.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77003,Not in chargemaster,77003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77003,BCBSND Base Physician Payment Schedule,227.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77002,Not in chargemaster,77002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77002,BCBSND Base Physician Payment Schedule,244.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7700226,Not in chargemaster,77002,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7700226,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77002TC,Not in chargemaster,77002TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77002TC,BCBSND Base Physician Payment Schedule,186.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7700126,Not in chargemaster,77001,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7700126,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77001TC,Not in chargemaster,77001TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77001TC,BCBSND Base Physician Payment Schedule,179.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 77001,Not in chargemaster,77001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,77001,BCBSND Base Physician Payment Schedule,218.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7699826,Not in chargemaster,76998,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7699826,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76998TC,Not in chargemaster,76998TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76998TC,BCBSND Base Physician Payment Schedule,261.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76998,Not in chargemaster,76998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76998,BCBSND Base Physician Payment Schedule,393.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76983,Not in chargemaster,76983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76983,BCBSND Base Physician Payment Schedule,131.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7698326,Not in chargemaster,76983,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7698326,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76983TC,Not in chargemaster,76983TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76983TC,BCBSND Base Physician Payment Schedule,79.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7698226,Not in chargemaster,76982,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7698226,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76982TC,Not in chargemaster,76982TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76982TC,BCBSND Base Physician Payment Schedule,154.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76982,Not in chargemaster,76982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76982,BCBSND Base Physician Payment Schedule,216.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76981,Not in chargemaster,76981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76981,BCBSND Base Physician Payment Schedule,243.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7698126,Not in chargemaster,76981,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7698126,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76981TC,Not in chargemaster,76981TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76981TC,BCBSND Base Physician Payment Schedule,181.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7697926,Not in chargemaster,76979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7697926,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76979TC,Not in chargemaster,76979TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76979TC,BCBSND Base Physician Payment Schedule,416.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76979,Not in chargemaster,76979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76979,BCBSND Base Physician Payment Schedule,505.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76978,Not in chargemaster,76978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76978,BCBSND Base Physician Payment Schedule,739.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7697826,Not in chargemaster,76978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7697826,BCBSND Base Physician Payment Schedule,168.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76978TC,Not in chargemaster,76978TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76978TC,BCBSND Base Physician Payment Schedule,571.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7697726,Not in chargemaster,76977,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7697726,BCBSND Base Physician Payment Schedule,5.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76977TC,Not in chargemaster,76977TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76977TC,BCBSND Base Physician Payment Schedule,9.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76977,Not in chargemaster,76977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76977,BCBSND Base Physician Payment Schedule,15.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7697526,Not in chargemaster,76975,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7697526,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76975TC,Not in chargemaster,76975TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76975TC,BCBSND Base Physician Payment Schedule,153.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76975,Not in chargemaster,76975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76975,BCBSND Base Physician Payment Schedule,240.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76970,Not in chargemaster,76970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76970,BCBSND Base Physician Payment Schedule,202.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7697026,Not in chargemaster,76970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7697026,BCBSND Base Physician Payment Schedule,40.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76970TC,Not in chargemaster,76970TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76970TC,BCBSND Base Physician Payment Schedule,161.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7696526,Not in chargemaster,76965,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7696526,BCBSND Base Physician Payment Schedule,141.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76965TC,Not in chargemaster,76965TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76965TC,BCBSND Base Physician Payment Schedule,58.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76965,Not in chargemaster,76965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76965,BCBSND Base Physician Payment Schedule,200.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76948,Not in chargemaster,76948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76948,BCBSND Base Physician Payment Schedule,168.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7694826,Not in chargemaster,76948,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7694826,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76948TC,Not in chargemaster,76948TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76948TC,BCBSND Base Physician Payment Schedule,99.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7694626,Not in chargemaster,76946,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7694626,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76946TC,Not in chargemaster,76946TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76946TC,BCBSND Base Physician Payment Schedule,31.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76946,Not in chargemaster,76946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76946,BCBSND Base Physician Payment Schedule,70.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7694526,Not in chargemaster,76945,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7694526,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76945TC,Not in chargemaster,76945TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76945TC,BCBSND Base Physician Payment Schedule,152.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76945,Not in chargemaster,76945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76945,BCBSND Base Physician Payment Schedule,221.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76942,Not in chargemaster,76942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76942,BCBSND Base Physician Payment Schedule,125.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7694226,76942,76942,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7694226,BCBSND Base Physician Payment Schedule,66.07,74.91,Fee schedule,,66.07,66.07,66.07,66.07,,,0
unity,Fee schedule,Non-facility 76942TC,Not in chargemaster,76942TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76942TC,BCBSND Base Physician Payment Schedule,59.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7694126,Not in chargemaster,76941,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7694126,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76941TC,Not in chargemaster,76941TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76941TC,BCBSND Base Physician Payment Schedule,152.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76941,Not in chargemaster,76941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76941,BCBSND Base Physician Payment Schedule,292.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7694026,Not in chargemaster,76940,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7694026,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76940TC,Not in chargemaster,76940TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76940TC,BCBSND Base Physician Payment Schedule,170.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76940,Not in chargemaster,76940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76940,BCBSND Base Physician Payment Schedule,385.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7693726,76937,76937,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7693726,BCBSND Base Physician Payment Schedule,30.1,33.38,Fee schedule,,30.1,30.1,30.1,30.1,,,0
unity,Fee schedule,Non-facility 76937TC,Not in chargemaster,76937TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76937TC,BCBSND Base Physician Payment Schedule,51.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76937,Not in chargemaster,76937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76937,BCBSND Base Physician Payment Schedule,81.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76936,Not in chargemaster,76936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76936,BCBSND Base Physician Payment Schedule,603.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7693626,Not in chargemaster,76936,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7693626,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76936TC,Not in chargemaster,76936TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76936TC,BCBSND Base Physician Payment Schedule,400.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7693226,Not in chargemaster,76932,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7693226,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76932TC,Not in chargemaster,76932TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76932TC,BCBSND Base Physician Payment Schedule,153.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76932,Not in chargemaster,76932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76932,BCBSND Base Physician Payment Schedule,225.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7688626,Not in chargemaster,76886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7688626,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76886TC,Not in chargemaster,76886TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76886TC,BCBSND Base Physician Payment Schedule,172.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76886,Not in chargemaster,76886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76886,BCBSND Base Physician Payment Schedule,237.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76885,Not in chargemaster,76885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76885,BCBSND Base Physician Payment Schedule,324.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7688526,Not in chargemaster,76885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7688526,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76885TC,Not in chargemaster,76885TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76885TC,BCBSND Base Physician Payment Schedule,247.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7688226,Not in chargemaster,76882,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7688226,BCBSND Base Physician Payment Schedule,50.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76882TC,Not in chargemaster,76882TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76882TC,BCBSND Base Physician Payment Schedule,75.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76882,Not in chargemaster,76882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76882,BCBSND Base Physician Payment Schedule,126.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76881,Not in chargemaster,76881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76881,BCBSND Base Physician Payment Schedule,172.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7688126,Not in chargemaster,76881,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7688126,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76881TC,Not in chargemaster,76881TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76881TC,BCBSND Base Physician Payment Schedule,107.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7687326,Not in chargemaster,76873,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7687326,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76873TC,Not in chargemaster,76873TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76873TC,BCBSND Base Physician Payment Schedule,226.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76873,Not in chargemaster,76873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76873,BCBSND Base Physician Payment Schedule,389.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76872,Not in chargemaster,76872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76872,BCBSND Base Physician Payment Schedule,357.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7687226,Not in chargemaster,76872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7687226,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76872TC,Not in chargemaster,76872TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76872TC,BCBSND Base Physician Payment Schedule,287.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7687026,76870,76870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7687026,BCBSND Base Physician Payment Schedule,66.07,70.58,Fee schedule,,66.07,66.07,66.07,66.07,,,0
unity,Fee schedule,Non-facility 76870TC,Not in chargemaster,76870TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76870TC,BCBSND Base Physician Payment Schedule,170.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76870,Not in chargemaster,76870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76870,BCBSND Base Physician Payment Schedule,236.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76857,Not in chargemaster,76857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76857,BCBSND Base Physician Payment Schedule,106.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7685726,Not in chargemaster,76857,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7685726,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76857TC,Not in chargemaster,76857TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76857TC,BCBSND Base Physician Payment Schedule,55.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7685626,76856,76856,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7685626,BCBSND Base Physician Payment Schedule,71.21,76.01,Fee schedule,,71.21,71.21,71.21,71.21,,,0
unity,Fee schedule,Non-facility 76856TC,Not in chargemaster,76856TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76856TC,BCBSND Base Physician Payment Schedule,175.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76856,Not in chargemaster,76856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76856,BCBSND Base Physician Payment Schedule,246.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76831,Not in chargemaster,76831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76831,BCBSND Base Physician Payment Schedule,268.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7683126,Not in chargemaster,76831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7683126,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76831TC,Not in chargemaster,76831TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76831TC,BCBSND Base Physician Payment Schedule,193.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7683026,76830,76830,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7683026,BCBSND Base Physician Payment Schedule,71.94,76.79,Fee schedule,,71.94,71.94,71.94,71.94,,,0
unity,Fee schedule,Non-facility 76830TC,Not in chargemaster,76830TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76830TC,BCBSND Base Physician Payment Schedule,205.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76830,Not in chargemaster,76830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76830,BCBSND Base Physician Payment Schedule,277.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76828,Not in chargemaster,76828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76828,BCBSND Base Physician Payment Schedule,114.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7682826,Not in chargemaster,76828,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7682826,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76828TC,Not in chargemaster,76828TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76828TC,BCBSND Base Physician Payment Schedule,56.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7682726,Not in chargemaster,76827,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7682726,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76827TC,Not in chargemaster,76827TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76827TC,BCBSND Base Physician Payment Schedule,104.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76827,Not in chargemaster,76827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76827,BCBSND Base Physician Payment Schedule,163.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76826,Not in chargemaster,76826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76826,BCBSND Base Physician Payment Schedule,367.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7682626,Not in chargemaster,76826,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7682626,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76826TC,Not in chargemaster,76826TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76826TC,BCBSND Base Physician Payment Schedule,282.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7682526,Not in chargemaster,76825,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7682526,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76825TC,Not in chargemaster,76825TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76825TC,BCBSND Base Physician Payment Schedule,444.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76825,Not in chargemaster,76825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76825,BCBSND Base Physician Payment Schedule,615.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76821,Not in chargemaster,76821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76821,BCBSND Base Physician Payment Schedule,201.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7682126,Not in chargemaster,76821,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7682126,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76821TC,Not in chargemaster,76821TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76821TC,BCBSND Base Physician Payment Schedule,129.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7682026,Not in chargemaster,76820,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7682026,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76820TC,Not in chargemaster,76820TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76820TC,BCBSND Base Physician Payment Schedule,50.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76820,Not in chargemaster,76820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76820,BCBSND Base Physician Payment Schedule,102.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76819,Not in chargemaster,76819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76819,BCBSND Base Physician Payment Schedule,192.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681926,Not in chargemaster,76819,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681926,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76819TC,Not in chargemaster,76819TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76819TC,BCBSND Base Physician Payment Schedule,112.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681826,Not in chargemaster,76818,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681826,BCBSND Base Physician Payment Schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76818TC,Not in chargemaster,76818TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76818TC,BCBSND Base Physician Payment Schedule,152.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76818,Not in chargemaster,76818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76818,BCBSND Base Physician Payment Schedule,261.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76817,Not in chargemaster,76817,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76817,BCBSND Base Physician Payment Schedule,213.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681726,76817,76817,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681726,BCBSND Base Physician Payment Schedule,77.81,83.77,Fee schedule,,77.81,77.81,77.81,77.81,,,0
unity,Fee schedule,Non-facility 76817TC,Not in chargemaster,76817TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76817TC,BCBSND Base Physician Payment Schedule,135.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681626,Not in chargemaster,76816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681626,BCBSND Base Physician Payment Schedule,88.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76816TC,Not in chargemaster,76816TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76816TC,BCBSND Base Physician Payment Schedule,164.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76816,Not in chargemaster,76816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76816,BCBSND Base Physician Payment Schedule,252.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76815,Not in chargemaster,76815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76815,BCBSND Base Physician Payment Schedule,187.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681526,76815,76815,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681526,BCBSND Base Physician Payment Schedule,67.54,70.58,Fee schedule,,67.54,67.54,67.54,67.54,,,0
unity,Fee schedule,Non-facility 76815TC,Not in chargemaster,76815TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76815TC,BCBSND Base Physician Payment Schedule,119.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681426,Not in chargemaster,76814,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681426,BCBSND Base Physician Payment Schedule,102.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76814TC,Not in chargemaster,76814TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76814TC,BCBSND Base Physician Payment Schedule,67.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76814,Not in chargemaster,76814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76814,BCBSND Base Physician Payment Schedule,170.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76813,Not in chargemaster,76813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76813,BCBSND Base Physician Payment Schedule,267.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681326,Not in chargemaster,76813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681326,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76813TC,Not in chargemaster,76813TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76813TC,BCBSND Base Physician Payment Schedule,144.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681226,Not in chargemaster,76812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681226,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76812TC,Not in chargemaster,76812TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76812TC,BCBSND Base Physician Payment Schedule,255.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76812,Not in chargemaster,76812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76812,BCBSND Base Physician Payment Schedule,440.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76811,Not in chargemaster,76811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76811,BCBSND Base Physician Payment Schedule,389.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681126,Not in chargemaster,76811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681126,BCBSND Base Physician Payment Schedule,196.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76811TC,Not in chargemaster,76811TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76811TC,BCBSND Base Physician Payment Schedule,192.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7681026,76810,76810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7681026,BCBSND Base Physician Payment Schedule,102.77,108.58,Fee schedule,,102.77,102.77,102.77,102.77,,,0
unity,Fee schedule,Non-facility 76810TC,Not in chargemaster,76810TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76810TC,BCBSND Base Physician Payment Schedule,98.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76810,Not in chargemaster,76810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76810,BCBSND Base Physician Payment Schedule,201,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76805,Not in chargemaster,76805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76805,BCBSND Base Physician Payment Schedule,313.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7680526,76805,76805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7680526,BCBSND Base Physician Payment Schedule,103.51,110.14,Fee schedule,,103.51,103.51,103.51,103.51,,,0
unity,Fee schedule,Non-facility 76805TC,Not in chargemaster,76805TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76805TC,BCBSND Base Physician Payment Schedule,209.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7680226,Not in chargemaster,76802,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7680226,BCBSND Base Physician Payment Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76802TC,Not in chargemaster,76802TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76802TC,BCBSND Base Physician Payment Schedule,50.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76802,Not in chargemaster,76802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76802,BCBSND Base Physician Payment Schedule,136.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76801,Not in chargemaster,76801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76801,BCBSND Base Physician Payment Schedule,271.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7680126,76801,76801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7680126,BCBSND Base Physician Payment Schedule,103.51,109.37,Fee schedule,,103.51,103.51,103.51,103.51,,,0
unity,Fee schedule,Non-facility 76801TC,Not in chargemaster,76801TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76801TC,BCBSND Base Physician Payment Schedule,168.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7680026,Not in chargemaster,76800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7680026,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76800TC,Not in chargemaster,76800TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76800TC,BCBSND Base Physician Payment Schedule,196.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76800,Not in chargemaster,76800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76800,BCBSND Base Physician Payment Schedule,318.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76776,Not in chargemaster,76776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76776,BCBSND Base Physician Payment Schedule,354.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7677626,Not in chargemaster,76776,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7677626,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76776TC,Not in chargemaster,76776TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76776TC,BCBSND Base Physician Payment Schedule,274.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7677526,76775,76775,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7677526,BCBSND Base Physician Payment Schedule,60.2,63.61,Fee schedule,,60.2,60.2,60.2,60.2,,,0
unity,Fee schedule,Non-facility 76775TC,Not in chargemaster,76775TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76775TC,BCBSND Base Physician Payment Schedule,69.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76775,Not in chargemaster,76775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76775,BCBSND Base Physician Payment Schedule,129.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76770,Not in chargemaster,76770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76770,BCBSND Base Physician Payment Schedule,253.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7677026,76770,76770,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7677026,BCBSND Base Physician Payment Schedule,76.35,81.44,Fee schedule,,76.35,76.35,76.35,76.35,,,0
unity,Fee schedule,Non-facility 76770TC,Not in chargemaster,76770TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76770TC,BCBSND Base Physician Payment Schedule,177.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7670626,Not in chargemaster,76706,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7670626,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76706TC,Not in chargemaster,76706TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76706TC,BCBSND Base Physician Payment Schedule,200.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76706,Not in chargemaster,76706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76706,BCBSND Base Physician Payment Schedule,257.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76705,Not in chargemaster,76705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76705,BCBSND Base Physician Payment Schedule,204.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7670526,76705,76705,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7670526,BCBSND Base Physician Payment Schedule,60.93,59.23,Fee schedule,,59.23,59.23,59.23,59.23,,,0
unity,Fee schedule,Non-facility 76705TC,Not in chargemaster,76705TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76705TC,BCBSND Base Physician Payment Schedule,143.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7670026,76700,76700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7670026,BCBSND Base Physician Payment Schedule,85.16,89.2,Fee schedule,,85.16,85.16,85.16,85.16,,,0
unity,Fee schedule,Non-facility 76700TC,Not in chargemaster,76700TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76700TC,BCBSND Base Physician Payment Schedule,190.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76700,Not in chargemaster,76700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76700,BCBSND Base Physician Payment Schedule,275.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76642,Not in chargemaster,76642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76642,BCBSND Base Physician Payment Schedule,195.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7664226,Not in chargemaster,76642,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7664226,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76642TC,Not in chargemaster,76642TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76642TC,BCBSND Base Physician Payment Schedule,124.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7664126,Not in chargemaster,76641,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7664126,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76641TC,Not in chargemaster,76641TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76641TC,BCBSND Base Physician Payment Schedule,164.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76641,Not in chargemaster,76641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76641,BCBSND Base Physician Payment Schedule,239.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76604,Not in chargemaster,76604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76604,BCBSND Base Physician Payment Schedule,176.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7660426,Not in chargemaster,76604,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7660426,BCBSND Base Physician Payment Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76604TC,Not in chargemaster,76604TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76604TC,BCBSND Base Physician Payment Schedule,116.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7653626,76536,76536,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7653626,BCBSND Base Physician Payment Schedule,58.73,62.05,Fee schedule,,58.73,58.73,58.73,58.73,,,0
unity,Fee schedule,Non-facility 76536TC,Not in chargemaster,76536TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76536TC,BCBSND Base Physician Payment Schedule,203.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76536,Not in chargemaster,76536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76536,BCBSND Base Physician Payment Schedule,262.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76529,Not in chargemaster,76529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76529,BCBSND Base Physician Payment Schedule,185.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7652926,Not in chargemaster,76529,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7652926,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76529TC,Not in chargemaster,76529TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76529TC,BCBSND Base Physician Payment Schedule,117.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7651926,Not in chargemaster,76519,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7651926,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76519TC,Not in chargemaster,76519TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76519TC,BCBSND Base Physician Payment Schedule,82.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76519,Not in chargemaster,76519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76519,BCBSND Base Physician Payment Schedule,147.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76516,Not in chargemaster,76516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76516,BCBSND Base Physician Payment Schedule,106.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7651626,Not in chargemaster,76516,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7651626,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76516TC,Not in chargemaster,76516TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76516TC,BCBSND Base Physician Payment Schedule,58.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7651426,Not in chargemaster,76514,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7651426,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76514TC,Not in chargemaster,76514TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76514TC,BCBSND Base Physician Payment Schedule,9.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76514,Not in chargemaster,76514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76514,BCBSND Base Physician Payment Schedule,25.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76513,Not in chargemaster,76513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76513,BCBSND Base Physician Payment Schedule,222.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7651326,Not in chargemaster,76513,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7651326,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76513TC,Not in chargemaster,76513TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76513TC,BCBSND Base Physician Payment Schedule,147.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7651226,Not in chargemaster,76512,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7651226,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76512TC,Not in chargemaster,76512TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76512TC,BCBSND Base Physician Payment Schedule,49.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76512,Not in chargemaster,76512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76512,BCBSND Base Physician Payment Schedule,114.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76511,Not in chargemaster,76511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76511,BCBSND Base Physician Payment Schedule,135.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7651126,Not in chargemaster,76511,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7651126,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76511TC,Not in chargemaster,76511TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76511TC,BCBSND Base Physician Payment Schedule,60.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7651026,Not in chargemaster,76510,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7651026,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76510TC,Not in chargemaster,76510TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76510TC,BCBSND Base Physician Payment Schedule,100.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76510,Not in chargemaster,76510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76510,BCBSND Base Physician Payment Schedule,199.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76506,Not in chargemaster,76506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76506,BCBSND Base Physician Payment Schedule,259.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7650626,Not in chargemaster,76506,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7650626,BCBSND Base Physician Payment Schedule,66.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76506TC,Not in chargemaster,76506TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76506TC,BCBSND Base Physician Payment Schedule,193.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7639126,Not in chargemaster,76391,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7639126,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76391TC,Not in chargemaster,76391TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76391TC,BCBSND Base Physician Payment Schedule,499.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76391,Not in chargemaster,76391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76391,BCBSND Base Physician Payment Schedule,615.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76390,Not in chargemaster,76390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76390,BCBSND Base Physician Payment Schedule,1150.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7639026,Not in chargemaster,76390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7639026,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76390TC,Not in chargemaster,76390TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76390TC,BCBSND Base Physician Payment Schedule,1004.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7638026,Not in chargemaster,76380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7638026,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76380TC,Not in chargemaster,76380TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76380TC,BCBSND Base Physician Payment Schedule,271.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76380,Not in chargemaster,76380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76380,BCBSND Base Physician Payment Schedule,372.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76377,Not in chargemaster,76377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76377,BCBSND Base Physician Payment Schedule,157.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7637726,Not in chargemaster,76377,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7637726,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76377TC,Not in chargemaster,76377TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76377TC,BCBSND Base Physician Payment Schedule,74.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7637626,Not in chargemaster,76376,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7637626,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76376TC,Not in chargemaster,76376TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76376TC,BCBSND Base Physician Payment Schedule,30.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76376,Not in chargemaster,76376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76376,BCBSND Base Physician Payment Schedule,51.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76125,Not in chargemaster,76125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76125,BCBSND Base Physician Payment Schedule,106.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7612526,Not in chargemaster,76125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7612526,BCBSND Base Physician Payment Schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76125TC,Not in chargemaster,76125TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76125TC,BCBSND Base Physician Payment Schedule,78.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76140,Not in chargemaster,76140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76140,BCBSND Base Physician Payment Schedule,60.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7612026,Not in chargemaster,76120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7612026,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76120TC,Not in chargemaster,76120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76120TC,BCBSND Base Physician Payment Schedule,208.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76120,Not in chargemaster,76120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76120,BCBSND Base Physician Payment Schedule,247.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76102,Not in chargemaster,76102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76102,BCBSND Base Physician Payment Schedule,401.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7610226,Not in chargemaster,76102,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7610226,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76102TC,Not in chargemaster,76102TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76102TC,BCBSND Base Physician Payment Schedule,335.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7610126,Not in chargemaster,76101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7610126,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76101TC,Not in chargemaster,76101TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76101TC,BCBSND Base Physician Payment Schedule,164.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76101,Not in chargemaster,76101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76101,BCBSND Base Physician Payment Schedule,221.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76100,Not in chargemaster,76100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76100,BCBSND Base Physician Payment Schedule,218.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7610026,Not in chargemaster,76100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7610026,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76100TC,Not in chargemaster,76100TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76100TC,BCBSND Base Physician Payment Schedule,154.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7609826,Not in chargemaster,76098,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7609826,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76098TC,Not in chargemaster,76098TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76098TC,BCBSND Base Physician Payment Schedule,62.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76098,Not in chargemaster,76098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76098,BCBSND Base Physician Payment Schedule,95.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76080,Not in chargemaster,76080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76080,BCBSND Base Physician Payment Schedule,131.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7608026,Not in chargemaster,76080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7608026,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76080TC,Not in chargemaster,76080TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76080TC,BCBSND Base Physician Payment Schedule,76.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7601026,Not in chargemaster,76010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7601026,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76010TC,Not in chargemaster,76010TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76010TC,BCBSND Base Physician Payment Schedule,45.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76010,Not in chargemaster,76010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76010,BCBSND Base Physician Payment Schedule,64.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76000,Not in chargemaster,76000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76000,BCBSND Base Physician Payment Schedule,93.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7600026,Not in chargemaster,76000,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7600026,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 76000TC,Not in chargemaster,76000TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,76000TC,BCBSND Base Physician Payment Schedule,61.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7598926,Not in chargemaster,75989,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7598926,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75989TC,Not in chargemaster,75989TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75989TC,BCBSND Base Physician Payment Schedule,146.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75989,Not in chargemaster,75989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75989,BCBSND Base Physician Payment Schedule,267.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75984,Not in chargemaster,75984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75984,BCBSND Base Physician Payment Schedule,221.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7598426,Not in chargemaster,75984,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7598426,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75984TC,Not in chargemaster,75984TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75984TC,BCBSND Base Physician Payment Schedule,148.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7597026,Not in chargemaster,75970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7597026,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75970TC,Not in chargemaster,75970TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75970TC,BCBSND Base Physician Payment Schedule,1151.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75970,Not in chargemaster,75970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75970,BCBSND Base Physician Payment Schedule,1234.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7595926,Not in chargemaster,75959,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7595926,BCBSND Base Physician Payment Schedule,358.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7595826,Not in chargemaster,75958,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7595826,BCBSND Base Physician Payment Schedule,408.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7595726,Not in chargemaster,75957,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7595726,BCBSND Base Physician Payment Schedule,615.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7595626,Not in chargemaster,75956,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7595626,BCBSND Base Physician Payment Schedule,719.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7590226,Not in chargemaster,75902,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7590226,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75902TC,Not in chargemaster,75902TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75902TC,BCBSND Base Physician Payment Schedule,153.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75902,Not in chargemaster,75902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75902,BCBSND Base Physician Payment Schedule,193.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75901,Not in chargemaster,75901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75901,BCBSND Base Physician Payment Schedule,501.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7590126,Not in chargemaster,75901,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7590126,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75901TC,Not in chargemaster,75901TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75901TC,BCBSND Base Physician Payment Schedule,452.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7589826,Not in chargemaster,75898,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7589826,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75898TC,Not in chargemaster,75898TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75898TC,BCBSND Base Physician Payment Schedule,104.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75898,Not in chargemaster,75898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75898,BCBSND Base Physician Payment Schedule,292.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7589426,Not in chargemaster,75894,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7589426,BCBSND Base Physician Payment Schedule,149.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75894TC,Not in chargemaster,75894TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75894TC,BCBSND Base Physician Payment Schedule,2409.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75894,Not in chargemaster,75894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75894,BCBSND Base Physician Payment Schedule,2559.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7589326,Not in chargemaster,75893,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7589326,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75893TC,Not in chargemaster,75893TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75893TC,BCBSND Base Physician Payment Schedule,204.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75893,Not in chargemaster,75893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75893,BCBSND Base Physician Payment Schedule,261.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75891,Not in chargemaster,75891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75891,BCBSND Base Physician Payment Schedule,305.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7589126,Not in chargemaster,75891,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7589126,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75891TC,Not in chargemaster,75891TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75891TC,BCBSND Base Physician Payment Schedule,190.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7588926,Not in chargemaster,75889,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7588926,BCBSND Base Physician Payment Schedule,112.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75889TC,Not in chargemaster,75889TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75889TC,BCBSND Base Physician Payment Schedule,188.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75889,Not in chargemaster,75889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75889,BCBSND Base Physician Payment Schedule,300.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75887,Not in chargemaster,75887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75887,BCBSND Base Physician Payment Schedule,332.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7588726,Not in chargemaster,75887,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7588726,BCBSND Base Physician Payment Schedule,143.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75887TC,Not in chargemaster,75887TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75887TC,BCBSND Base Physician Payment Schedule,189.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7588526,Not in chargemaster,75885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7588526,BCBSND Base Physician Payment Schedule,141.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75885TC,Not in chargemaster,75885TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75885TC,BCBSND Base Physician Payment Schedule,188.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75885,Not in chargemaster,75885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75885,BCBSND Base Physician Payment Schedule,329.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75880,Not in chargemaster,75880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75880,BCBSND Base Physician Payment Schedule,266.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7588026,Not in chargemaster,75880,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7588026,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75880TC,Not in chargemaster,75880TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75880TC,BCBSND Base Physician Payment Schedule,193.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7587226,Not in chargemaster,75872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7587226,BCBSND Base Physician Payment Schedule,118.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75872TC,Not in chargemaster,75872TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75872TC,BCBSND Base Physician Payment Schedule,193.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75872,Not in chargemaster,75872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75872,BCBSND Base Physician Payment Schedule,312.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75870,Not in chargemaster,75870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75870,BCBSND Base Physician Payment Schedule,410.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7587026,Not in chargemaster,75870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7587026,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75870TC,Not in chargemaster,75870TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75870TC,BCBSND Base Physician Payment Schedule,277.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7586026,Not in chargemaster,75860,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7586026,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75860TC,Not in chargemaster,75860TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75860TC,BCBSND Base Physician Payment Schedule,189.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75860,Not in chargemaster,75860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75860,BCBSND Base Physician Payment Schedule,306.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75842,Not in chargemaster,75842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75842,BCBSND Base Physician Payment Schedule,380.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7584226,Not in chargemaster,75842,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7584226,BCBSND Base Physician Payment Schedule,156.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75842TC,Not in chargemaster,75842TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75842TC,BCBSND Base Physician Payment Schedule,223.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7584026,Not in chargemaster,75840,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7584026,BCBSND Base Physician Payment Schedule,118.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75840TC,Not in chargemaster,75840TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75840TC,BCBSND Base Physician Payment Schedule,193.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75840,Not in chargemaster,75840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75840,BCBSND Base Physician Payment Schedule,312.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75833,Not in chargemaster,75833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75833,BCBSND Base Physician Payment Schedule,348.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7583326,Not in chargemaster,75833,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7583326,BCBSND Base Physician Payment Schedule,151.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75833TC,Not in chargemaster,75833TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75833TC,BCBSND Base Physician Payment Schedule,197.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7583126,Not in chargemaster,75831,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7583126,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75831TC,Not in chargemaster,75831TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75831TC,BCBSND Base Physician Payment Schedule,178.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75831,Not in chargemaster,75831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75831,BCBSND Base Physician Payment Schedule,291.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75827,Not in chargemaster,75827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75827,BCBSND Base Physician Payment Schedule,290.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7582726,Not in chargemaster,75827,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7582726,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75827TC,Not in chargemaster,75827TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75827TC,BCBSND Base Physician Payment Schedule,174.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7582526,Not in chargemaster,75825,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7582526,BCBSND Base Physician Payment Schedule,115.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75825TC,Not in chargemaster,75825TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75825TC,BCBSND Base Physician Payment Schedule,163.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75825,Not in chargemaster,75825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75825,BCBSND Base Physician Payment Schedule,278.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75822,Not in chargemaster,75822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75822,BCBSND Base Physician Payment Schedule,280.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7582226,Not in chargemaster,75822,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7582226,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75822TC,Not in chargemaster,75822TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75822TC,BCBSND Base Physician Payment Schedule,172.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7582026,Not in chargemaster,75820,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7582026,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75820TC,Not in chargemaster,75820TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75820TC,BCBSND Base Physician Payment Schedule,170.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75820,Not in chargemaster,75820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75820,BCBSND Base Physician Payment Schedule,241.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7581026,Not in chargemaster,75810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7581026,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75810TC,Not in chargemaster,75810TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75810TC,BCBSND Base Physician Payment Schedule,1257.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75810,Not in chargemaster,75810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75810,BCBSND Base Physician Payment Schedule,1360.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75809,Not in chargemaster,75809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75809,BCBSND Base Physician Payment Schedule,206.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7580926,Not in chargemaster,75809,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7580926,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75809TC,Not in chargemaster,75809TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75809TC,BCBSND Base Physician Payment Schedule,156.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7580726,Not in chargemaster,75807,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7580726,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75807TC,Not in chargemaster,75807TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75807TC,BCBSND Base Physician Payment Schedule,608.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75807,Not in chargemaster,75807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75807,BCBSND Base Physician Payment Schedule,724.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7580526,Not in chargemaster,75805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7580526,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75805TC,Not in chargemaster,75805TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75805TC,BCBSND Base Physician Payment Schedule,610.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75805,Not in chargemaster,75805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75805,BCBSND Base Physician Payment Schedule,695.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7580326,Not in chargemaster,75803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7580326,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75803TC,Not in chargemaster,75803TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75803TC,BCBSND Base Physician Payment Schedule,541.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75803,Not in chargemaster,75803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75803,BCBSND Base Physician Payment Schedule,663.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7580126,Not in chargemaster,75801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7580126,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75801TC,Not in chargemaster,75801TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75801TC,BCBSND Base Physician Payment Schedule,541.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75801,Not in chargemaster,75801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75801,BCBSND Base Physician Payment Schedule,631.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7577426,Not in chargemaster,75774,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7577426,BCBSND Base Physician Payment Schedule,101.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75774TC,Not in chargemaster,75774TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75774TC,BCBSND Base Physician Payment Schedule,137.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75774,Not in chargemaster,75774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75774,BCBSND Base Physician Payment Schedule,238.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75756,Not in chargemaster,75756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75756,BCBSND Base Physician Payment Schedule,366.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7575626,Not in chargemaster,75756,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7575626,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75756TC,Not in chargemaster,75756TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75756TC,BCBSND Base Physician Payment Schedule,250.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7574626,Not in chargemaster,75746,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7574626,BCBSND Base Physician Payment Schedule,115.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75746TC,Not in chargemaster,75746TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75746TC,BCBSND Base Physician Payment Schedule,206.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75746,Not in chargemaster,75746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75746,BCBSND Base Physician Payment Schedule,321.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75743,Not in chargemaster,75743,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75743,BCBSND Base Physician Payment Schedule,354.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7574326,Not in chargemaster,75743,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7574326,BCBSND Base Physician Payment Schedule,167.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75743TC,Not in chargemaster,75743TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75743TC,BCBSND Base Physician Payment Schedule,187.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7574126,Not in chargemaster,75741,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7574126,BCBSND Base Physician Payment Schedule,131.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75741TC,Not in chargemaster,75741TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75741TC,BCBSND Base Physician Payment Schedule,184.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75741,Not in chargemaster,75741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75741,BCBSND Base Physician Payment Schedule,316.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75736,Not in chargemaster,75736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75736,BCBSND Base Physician Payment Schedule,336.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7573626,Not in chargemaster,75736,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7573626,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75736TC,Not in chargemaster,75736TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75736TC,BCBSND Base Physician Payment Schedule,223.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7573326,Not in chargemaster,75733,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7573326,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75733TC,Not in chargemaster,75733TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75733TC,BCBSND Base Physician Payment Schedule,260.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75733,Not in chargemaster,75733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75733,BCBSND Base Physician Payment Schedule,393.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75731,Not in chargemaster,75731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75731,BCBSND Base Physician Payment Schedule,364.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7573126,Not in chargemaster,75731,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7573126,BCBSND Base Physician Payment Schedule,118.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75731TC,Not in chargemaster,75731TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75731TC,BCBSND Base Physician Payment Schedule,246,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7572626,Not in chargemaster,75726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7572626,BCBSND Base Physician Payment Schedule,204.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75726TC,Not in chargemaster,75726TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75726TC,BCBSND Base Physician Payment Schedule,199.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75726,Not in chargemaster,75726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75726,BCBSND Base Physician Payment Schedule,403.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75716,Not in chargemaster,75716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75716,BCBSND Base Physician Payment Schedule,383.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7571626,Not in chargemaster,75716,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7571626,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75716TC,Not in chargemaster,75716TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75716TC,BCBSND Base Physician Payment Schedule,184.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7571026,Not in chargemaster,75710,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7571026,BCBSND Base Physician Payment Schedule,179.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75710TC,Not in chargemaster,75710TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75710TC,BCBSND Base Physician Payment Schedule,179.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75710,Not in chargemaster,75710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75710,BCBSND Base Physician Payment Schedule,359.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75705,Not in chargemaster,75705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75705,BCBSND Base Physician Payment Schedule,555.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7570526,Not in chargemaster,75705,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7570526,BCBSND Base Physician Payment Schedule,242.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75705TC,Not in chargemaster,75705TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75705TC,BCBSND Base Physician Payment Schedule,312.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7563526,Not in chargemaster,75635,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7563526,BCBSND Base Physician Payment Schedule,245.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75635TC,Not in chargemaster,75635TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75635TC,BCBSND Base Physician Payment Schedule,919.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75635,Not in chargemaster,75635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75635,BCBSND Base Physician Payment Schedule,1165.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75630,Not in chargemaster,75630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75630,BCBSND Base Physician Payment Schedule,371.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7563026,Not in chargemaster,75630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7563026,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75630TC,Not in chargemaster,75630TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75630TC,BCBSND Base Physician Payment Schedule,168.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7562526,Not in chargemaster,75625,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7562526,BCBSND Base Physician Payment Schedule,146.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75625TC,Not in chargemaster,75625TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75625TC,BCBSND Base Physician Payment Schedule,159.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75625,Not in chargemaster,75625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75625,BCBSND Base Physician Payment Schedule,305.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75605,Not in chargemaster,75605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75605,BCBSND Base Physician Payment Schedule,288.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7560526,Not in chargemaster,75605,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7560526,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75605TC,Not in chargemaster,75605TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75605TC,BCBSND Base Physician Payment Schedule,174.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7560026,Not in chargemaster,75600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7560026,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75600TC,Not in chargemaster,75600TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75600TC,BCBSND Base Physician Payment Schedule,407.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75600,Not in chargemaster,75600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75600,BCBSND Base Physician Payment Schedule,459.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75574,Not in chargemaster,75574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75574,BCBSND Base Physician Payment Schedule,928.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7557426,Not in chargemaster,75574,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7557426,BCBSND Base Physician Payment Schedule,245.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75574TC,Not in chargemaster,75574TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75574TC,BCBSND Base Physician Payment Schedule,682.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7557326,Not in chargemaster,75573,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7557326,BCBSND Base Physician Payment Schedule,263.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75573TC,Not in chargemaster,75573TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75573TC,BCBSND Base Physician Payment Schedule,587.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75573,Not in chargemaster,75573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75573,BCBSND Base Physician Payment Schedule,851.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75572,Not in chargemaster,75572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75572,BCBSND Base Physician Payment Schedule,638.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7557226,Not in chargemaster,75572,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7557226,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75572TC,Not in chargemaster,75572TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75572TC,BCBSND Base Physician Payment Schedule,457.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7557126,Not in chargemaster,75571,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7557126,BCBSND Base Physician Payment Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75571TC,Not in chargemaster,75571TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75571TC,BCBSND Base Physician Payment Schedule,214.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75571,Not in chargemaster,75571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75571,BCBSND Base Physician Payment Schedule,274.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75565,Not in chargemaster,75565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75565,BCBSND Base Physician Payment Schedule,139.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7556526,Not in chargemaster,75565,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7556526,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75565TC,Not in chargemaster,75565TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75565TC,BCBSND Base Physician Payment Schedule,113.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7556326,Not in chargemaster,75563,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7556326,BCBSND Base Physician Payment Schedule,306.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75563TC,Not in chargemaster,75563TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75563TC,BCBSND Base Physician Payment Schedule,989,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75563,Not in chargemaster,75563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75563,BCBSND Base Physician Payment Schedule,1295.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75561,Not in chargemaster,75561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75561,BCBSND Base Physician Payment Schedule,1091.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7556126,Not in chargemaster,75561,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7556126,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75561TC,Not in chargemaster,75561TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75561TC,BCBSND Base Physician Payment Schedule,826.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7555926,Not in chargemaster,75559,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7555926,BCBSND Base Physician Payment Schedule,295.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75559TC,Not in chargemaster,75559TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75559TC,BCBSND Base Physician Payment Schedule,853.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75559,Not in chargemaster,75559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75559,BCBSND Base Physician Payment Schedule,1149.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75557,Not in chargemaster,75557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75557,BCBSND Base Physician Payment Schedule,817.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7555726,Not in chargemaster,75557,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7555726,BCBSND Base Physician Payment Schedule,240.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 75557TC,Not in chargemaster,75557TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,75557TC,BCBSND Base Physician Payment Schedule,576.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7477526,Not in chargemaster,74775,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7477526,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74775TC,Not in chargemaster,74775TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74775TC,BCBSND Base Physician Payment Schedule,146.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74775,Not in chargemaster,74775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74775,BCBSND Base Physician Payment Schedule,210.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7474226,Not in chargemaster,74742,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7474226,BCBSND Base Physician Payment Schedule,63.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74742TC,Not in chargemaster,74742TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74742TC,BCBSND Base Physician Payment Schedule,314.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74742,Not in chargemaster,74742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74742,BCBSND Base Physician Payment Schedule,378.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7474026,Not in chargemaster,74740,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7474026,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74740TC,Not in chargemaster,74740TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74740TC,BCBSND Base Physician Payment Schedule,165.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74740,Not in chargemaster,74740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74740,BCBSND Base Physician Payment Schedule,204.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74713,Not in chargemaster,74713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74713,BCBSND Base Physician Payment Schedule,578.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7471326,Not in chargemaster,74713,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7471326,BCBSND Base Physician Payment Schedule,193.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74713TC,Not in chargemaster,74713TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74713TC,BCBSND Base Physician Payment Schedule,385.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7471226,Not in chargemaster,74712,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7471226,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74712TC,Not in chargemaster,74712TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74712TC,BCBSND Base Physician Payment Schedule,913.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74712,Not in chargemaster,74712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74712,BCBSND Base Physician Payment Schedule,1224.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74710,Not in chargemaster,74710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74710,BCBSND Base Physician Payment Schedule,87.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7471026,Not in chargemaster,74710,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7471026,BCBSND Base Physician Payment Schedule,35.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74710TC,Not in chargemaster,74710TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74710TC,BCBSND Base Physician Payment Schedule,52.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7448526,Not in chargemaster,74485,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7448526,BCBSND Base Physician Payment Schedule,83.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74485TC,Not in chargemaster,74485TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74485TC,BCBSND Base Physician Payment Schedule,169.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74485,Not in chargemaster,74485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74485,BCBSND Base Physician Payment Schedule,252.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7447026,Not in chargemaster,74470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7447026,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74470TC,Not in chargemaster,74470TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74470TC,BCBSND Base Physician Payment Schedule,124.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74470,Not in chargemaster,74470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74470,BCBSND Base Physician Payment Schedule,179.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74455,Not in chargemaster,74455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74455,BCBSND Base Physician Payment Schedule,221.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7445526,Not in chargemaster,74455,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7445526,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74455TC,Not in chargemaster,74455TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74455TC,BCBSND Base Physician Payment Schedule,188.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7445026,Not in chargemaster,74450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7445026,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74450TC,Not in chargemaster,74450TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74450TC,BCBSND Base Physician Payment Schedule,146.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74450,Not in chargemaster,74450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74450,BCBSND Base Physician Payment Schedule,179.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7444526,Not in chargemaster,74445,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7444526,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74445TC,Not in chargemaster,74445TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74445TC,BCBSND Base Physician Payment Schedule,112.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74445,Not in chargemaster,74445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74445,BCBSND Base Physician Payment Schedule,226.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7444026,Not in chargemaster,74440,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7444026,BCBSND Base Physician Payment Schedule,38.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74440TC,Not in chargemaster,74440TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74440TC,BCBSND Base Physician Payment Schedule,170.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74440,Not in chargemaster,74440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74440,BCBSND Base Physician Payment Schedule,209.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74430,Not in chargemaster,74430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74430,BCBSND Base Physician Payment Schedule,89.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7443026,Not in chargemaster,74430,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7443026,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74430TC,Not in chargemaster,74430TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74430TC,BCBSND Base Physician Payment Schedule,56.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7442526,Not in chargemaster,74425,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7442526,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74425TC,Not in chargemaster,74425TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74425TC,BCBSND Base Physician Payment Schedule,243.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74425,Not in chargemaster,74425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74425,BCBSND Base Physician Payment Schedule,295.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74420,Not in chargemaster,74420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74420,BCBSND Base Physician Payment Schedule,165.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7442026,Not in chargemaster,74420,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7442026,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74420TC,Not in chargemaster,74420TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74420TC,BCBSND Base Physician Payment Schedule,112.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7441526,Not in chargemaster,74415,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7441526,BCBSND Base Physician Payment Schedule,50.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74415TC,Not in chargemaster,74415TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74415TC,BCBSND Base Physician Payment Schedule,296.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74415,Not in chargemaster,74415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74415,BCBSND Base Physician Payment Schedule,347,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74410,Not in chargemaster,74410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74410,BCBSND Base Physician Payment Schedule,295.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7441026,Not in chargemaster,74410,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7441026,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74410TC,Not in chargemaster,74410TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74410TC,BCBSND Base Physician Payment Schedule,246,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7440026,Not in chargemaster,74400,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7440026,BCBSND Base Physician Payment Schedule,50.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74400TC,Not in chargemaster,74400TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74400TC,BCBSND Base Physician Payment Schedule,240.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74400,Not in chargemaster,74400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74400,BCBSND Base Physician Payment Schedule,290.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7436326,Not in chargemaster,74363,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7436326,BCBSND Base Physician Payment Schedule,91.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74363TC,Not in chargemaster,74363TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74363TC,BCBSND Base Physician Payment Schedule,608.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74363,Not in chargemaster,74363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74363,BCBSND Base Physician Payment Schedule,699.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7436026,Not in chargemaster,74360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7436026,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74360TC,Not in chargemaster,74360TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74360TC,BCBSND Base Physician Payment Schedule,315.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74360,Not in chargemaster,74360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74360,BCBSND Base Physician Payment Schedule,374.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7435526,Not in chargemaster,74355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7435526,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74355TC,Not in chargemaster,74355TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74355TC,BCBSND Base Physician Payment Schedule,261.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74355,Not in chargemaster,74355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74355,BCBSND Base Physician Payment Schedule,341.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7434026,Not in chargemaster,74340,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7434026,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74340TC,Not in chargemaster,74340TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74340TC,BCBSND Base Physician Payment Schedule,261.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74340,Not in chargemaster,74340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74340,BCBSND Base Physician Payment Schedule,318.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7433026,Not in chargemaster,74330,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7433026,BCBSND Base Physician Payment Schedule,95.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74330TC,Not in chargemaster,74330TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74330TC,BCBSND Base Physician Payment Schedule,315.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74330,Not in chargemaster,74330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74330,BCBSND Base Physician Payment Schedule,410.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7432926,Not in chargemaster,74329,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7432926,BCBSND Base Physician Payment Schedule,74.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74329TC,Not in chargemaster,74329TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74329TC,BCBSND Base Physician Payment Schedule,314.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74329,Not in chargemaster,74329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74329,BCBSND Base Physician Payment Schedule,388.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7432826,Not in chargemaster,74328,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7432826,BCBSND Base Physician Payment Schedule,74.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74328TC,Not in chargemaster,74328TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74328TC,BCBSND Base Physician Payment Schedule,315.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74328,Not in chargemaster,74328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74328,BCBSND Base Physician Payment Schedule,389.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7430126,Not in chargemaster,74301,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7430126,BCBSND Base Physician Payment Schedule,22.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7430026,74300,74300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7430026,BCBSND Base Physician Payment Schedule,37.44,46.57,Fee schedule,,37.44,37.44,37.44,37.44,,,0
unity,Fee schedule,Non-facility 74290,Not in chargemaster,74290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74290,BCBSND Base Physician Payment Schedule,186.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7429026,Not in chargemaster,74290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7429026,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74290TC,Not in chargemaster,74290TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74290TC,BCBSND Base Physician Payment Schedule,153.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7428326,Not in chargemaster,74283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7428326,BCBSND Base Physician Payment Schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74283TC,Not in chargemaster,74283TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74283TC,BCBSND Base Physician Payment Schedule,335.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74283,Not in chargemaster,74283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74283,BCBSND Base Physician Payment Schedule,550.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74280,Not in chargemaster,74280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74280,BCBSND Base Physician Payment Schedule,498.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7428026,Not in chargemaster,74280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7428026,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74280TC,Not in chargemaster,74280TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74280TC,BCBSND Base Physician Payment Schedule,368.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7427026,Not in chargemaster,74270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7427026,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74270TC,Not in chargemaster,74270TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74270TC,BCBSND Base Physician Payment Schedule,236.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74270,Not in chargemaster,74270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74270,BCBSND Base Physician Payment Schedule,344.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74263,Not in chargemaster,74263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74263,BCBSND Base Physician Payment Schedule,2039.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7426326,Not in chargemaster,74263,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7426326,BCBSND Base Physician Payment Schedule,238.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74263TC,Not in chargemaster,74263TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74263TC,BCBSND Base Physician Payment Schedule,1800.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7426226,Not in chargemaster,74262,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7426226,BCBSND Base Physician Payment Schedule,259.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74262TC,Not in chargemaster,74262TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74262TC,BCBSND Base Physician Payment Schedule,1164.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74262,Not in chargemaster,74262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74262,BCBSND Base Physician Payment Schedule,1423.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74261,Not in chargemaster,74261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74261,BCBSND Base Physician Payment Schedule,1259.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7426126,Not in chargemaster,74261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7426126,BCBSND Base Physician Payment Schedule,249.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74261TC,Not in chargemaster,74261TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74261TC,BCBSND Base Physician Payment Schedule,1010.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7425126,Not in chargemaster,74251,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7425126,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74251TC,Not in chargemaster,74251TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74251TC,BCBSND Base Physician Payment Schedule,796.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74251,Not in chargemaster,74251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74251,BCBSND Base Physician Payment Schedule,918.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74250,Not in chargemaster,74250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74250,BCBSND Base Physician Payment Schedule,270.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7425026,Not in chargemaster,74250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7425026,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74250TC,Not in chargemaster,74250TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74250TC,BCBSND Base Physician Payment Schedule,185.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7424826,Not in chargemaster,74248,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7424826,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74248TC,Not in chargemaster,74248TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74248TC,BCBSND Base Physician Payment Schedule,109.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74248,Not in chargemaster,74248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74248,BCBSND Base Physician Payment Schedule,182.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74246,Not in chargemaster,74246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74246,BCBSND Base Physician Payment Schedule,310.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7424626,Not in chargemaster,74246,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7424626,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74246TC,Not in chargemaster,74246TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74246TC,BCBSND Base Physician Payment Schedule,216.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7424026,Not in chargemaster,74240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7424026,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74240TC,Not in chargemaster,74240TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74240TC,BCBSND Base Physician Payment Schedule,184.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74240,Not in chargemaster,74240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74240,BCBSND Base Physician Payment Schedule,269.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7423526,Not in chargemaster,74235,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7423526,BCBSND Base Physician Payment Schedule,124.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74235TC,Not in chargemaster,74235TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74235TC,BCBSND Base Physician Payment Schedule,260.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74235,Not in chargemaster,74235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74235,BCBSND Base Physician Payment Schedule,384.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74230,Not in chargemaster,74230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74230,BCBSND Base Physician Payment Schedule,293.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7423026,Not in chargemaster,74230,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7423026,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74230TC,Not in chargemaster,74230TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74230TC,BCBSND Base Physician Payment Schedule,238.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7422126,Not in chargemaster,74221,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7422126,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74221TC,Not in chargemaster,74221TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74221TC,BCBSND Base Physician Payment Schedule,170.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74221,Not in chargemaster,74221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74221,BCBSND Base Physician Payment Schedule,243.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74220,Not in chargemaster,74220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74220,BCBSND Base Physician Payment Schedule,215.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7422026,Not in chargemaster,74220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7422026,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74220TC,Not in chargemaster,74220TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74220TC,BCBSND Base Physician Payment Schedule,153.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7421026,Not in chargemaster,74210,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7421026,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74210TC,Not in chargemaster,74210TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74210TC,BCBSND Base Physician Payment Schedule,150.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74210,Not in chargemaster,74210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74210,BCBSND Base Physician Payment Schedule,211.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7419026,Not in chargemaster,74190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7419026,BCBSND Base Physician Payment Schedule,48.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74190TC,Not in chargemaster,74190TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74190TC,BCBSND Base Physician Payment Schedule,130.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74190,Not in chargemaster,74190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74190,BCBSND Base Physician Payment Schedule,178.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74185,Not in chargemaster,74185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74185,BCBSND Base Physician Payment Schedule,1028.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7418526,74185,74185,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7418526,BCBSND Base Physician Payment Schedule,185.73,227.52,Fee schedule,,185.73,185.73,185.73,185.73,,,0
unity,Fee schedule,Non-facility 74185TC,Not in chargemaster,74185TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74185TC,BCBSND Base Physician Payment Schedule,843.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7418326,74183,74183,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7418326,BCBSND Base Physician Payment Schedule,227.57,248.2,Fee schedule,,227.57,227.57,227.57,227.57,,,0
unity,Fee schedule,Non-facility 74183TC,Not in chargemaster,74183TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74183TC,BCBSND Base Physician Payment Schedule,795.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74183,Not in chargemaster,74183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74183,BCBSND Base Physician Payment Schedule,1023.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74182,Not in chargemaster,74182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74182,BCBSND Base Physician Payment Schedule,929.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7418226,Not in chargemaster,74182,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7418226,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74182TC,Not in chargemaster,74182TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74182TC,BCBSND Base Physician Payment Schedule,748.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7418126,74181,74181,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7418126,BCBSND Base Physician Payment Schedule,152.69,160.56,Fee schedule,,152.69,152.69,152.69,152.69,,,0
unity,Fee schedule,Non-facility 74181TC,Not in chargemaster,74181TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74181TC,BCBSND Base Physician Payment Schedule,428.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74181,Not in chargemaster,74181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74181,BCBSND Base Physician Payment Schedule,581.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74178,Not in chargemaster,74178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74178,BCBSND Base Physician Payment Schedule,964.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7417826,74178,74178,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7417826,BCBSND Base Physician Payment Schedule,208.48,255.26,Fee schedule,,208.48,208.48,208.48,208.48,,,0
unity,Fee schedule,Non-facility 74178TC,Not in chargemaster,74178TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74178TC,BCBSND Base Physician Payment Schedule,755.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7417726,74177,74177,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7417726,BCBSND Base Physician Payment Schedule,190.13,232.86,Fee schedule,,190.13,190.13,190.13,190.13,,,0
unity,Fee schedule,Non-facility 74177TC,Not in chargemaster,74177TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74177TC,BCBSND Base Physician Payment Schedule,666.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74177,Not in chargemaster,74177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74177,BCBSND Base Physician Payment Schedule,856.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74176,Not in chargemaster,74176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74176,BCBSND Base Physician Payment Schedule,499.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7417626,74176,74176,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7417626,BCBSND Base Physician Payment Schedule,181.32,222.11,Fee schedule,,181.32,181.32,181.32,181.32,,,0
unity,Fee schedule,Non-facility 74176TC,Not in chargemaster,74176TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74176TC,BCBSND Base Physician Payment Schedule,317.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7417526,Not in chargemaster,74175,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7417526,BCBSND Base Physician Payment Schedule,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74175TC,Not in chargemaster,74175TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74175TC,BCBSND Base Physician Payment Schedule,656.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74175,Not in chargemaster,74175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74175,BCBSND Base Physician Payment Schedule,845.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74174,Not in chargemaster,74174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74174,BCBSND Base Physician Payment Schedule,1062.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7417426,Not in chargemaster,74174,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7417426,BCBSND Base Physician Payment Schedule,227.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74174TC,Not in chargemaster,74174TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74174TC,BCBSND Base Physician Payment Schedule,835.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7417026,74170,74170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7417026,BCBSND Base Physician Payment Schedule,146.09,179.12,Fee schedule,,146.09,146.09,146.09,146.09,,,0
unity,Fee schedule,Non-facility 74170TC,Not in chargemaster,74170TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74170TC,BCBSND Base Physician Payment Schedule,589.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74170,Not in chargemaster,74170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74170,BCBSND Base Physician Payment Schedule,735.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74160,Not in chargemaster,74160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74160,BCBSND Base Physician Payment Schedule,651.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7416026,74160,74160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7416026,BCBSND Base Physician Payment Schedule,132.87,162.11,Fee schedule,,132.87,132.87,132.87,132.87,,,0
unity,Fee schedule,Non-facility 74160TC,Not in chargemaster,74160TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74160TC,BCBSND Base Physician Payment Schedule,518.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7415026,74150,74150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7415026,BCBSND Base Physician Payment Schedule,124.06,151.95,Fee schedule,,124.06,124.06,124.06,124.06,,,0
unity,Fee schedule,Non-facility 74150TC,Not in chargemaster,74150TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74150TC,BCBSND Base Physician Payment Schedule,252.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74150,Not in chargemaster,74150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74150,BCBSND Base Physician Payment Schedule,376.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74022,Not in chargemaster,74022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74022,BCBSND Base Physician Payment Schedule,108.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7402226,74022,74022,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7402226,BCBSND Base Physician Payment Schedule,33.03,34.9,Fee schedule,,33.03,33.03,33.03,33.03,,,0
unity,Fee schedule,Non-facility 74022TC,Not in chargemaster,74022TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74022TC,BCBSND Base Physician Payment Schedule,75.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7402126,74021,74021,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7402126,BCBSND Base Physician Payment Schedule,27.9,34.89,Fee schedule,,27.9,27.9,27.9,27.9,,,0
unity,Fee schedule,Non-facility 74021TC,Not in chargemaster,74021TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74021TC,BCBSND Base Physician Payment Schedule,65.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74021,Not in chargemaster,74021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74021,BCBSND Base Physician Payment Schedule,93.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74019,Not in chargemaster,74019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74019,BCBSND Base Physician Payment Schedule,80.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7401926,74019,74019,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7401926,BCBSND Base Physician Payment Schedule,24.23,29.48,Fee schedule,,24.23,24.23,24.23,24.23,,,0
unity,Fee schedule,Non-facility 74019TC,Not in chargemaster,74019TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74019TC,BCBSND Base Physician Payment Schedule,56.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7401826,74018,74018,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7401826,BCBSND Base Physician Payment Schedule,19.09,20.17,Fee schedule,,19.09,19.09,19.09,19.09,,,0
unity,Fee schedule,Non-facility 74018TC,Not in chargemaster,74018TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74018TC,BCBSND Base Physician Payment Schedule,46.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 74018,Not in chargemaster,74018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,74018,BCBSND Base Physician Payment Schedule,65.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73725,Not in chargemaster,73725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73725,BCBSND Base Physician Payment Schedule,1025.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7372526,Not in chargemaster,73725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7372526,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73725TC,Not in chargemaster,73725TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73725TC,BCBSND Base Physician Payment Schedule,838.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7372326,Not in chargemaster,73723,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7372326,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73723TC,Not in chargemaster,73723TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73723TC,BCBSND Base Physician Payment Schedule,971.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73723,Not in chargemaster,73723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73723,BCBSND Base Physician Payment Schedule,1195.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73722,Not in chargemaster,73722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73722,BCBSND Base Physician Payment Schedule,974.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7372226,Not in chargemaster,73722,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7372226,BCBSND Base Physician Payment Schedule,170.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73722TC,Not in chargemaster,73722TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73722TC,BCBSND Base Physician Payment Schedule,803.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7372126,73721,73721,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7372126,BCBSND Base Physician Payment Schedule,140.95,152.02,Fee schedule,,140.95,140.95,140.95,140.95,,,0
unity,Fee schedule,Non-facility 73721TC,Not in chargemaster,73721TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73721TC,BCBSND Base Physician Payment Schedule,454.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73721,Not in chargemaster,73721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73721,BCBSND Base Physician Payment Schedule,595.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73720,Not in chargemaster,73720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73720,BCBSND Base Physician Payment Schedule,1022.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7372026,73720,73720,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7372026,BCBSND Base Physician Payment Schedule,222.43,236.57,Fee schedule,,222.43,222.43,222.43,222.43,,,0
unity,Fee schedule,Non-facility 73720TC,Not in chargemaster,73720TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73720TC,BCBSND Base Physician Payment Schedule,799.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7371926,Not in chargemaster,73719,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7371926,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73719TC,Not in chargemaster,73719TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73719TC,BCBSND Base Physician Payment Schedule,630.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73719,Not in chargemaster,73719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73719,BCBSND Base Physician Payment Schedule,800.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73718,Not in chargemaster,73718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73718,BCBSND Base Physician Payment Schedule,677.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7371826,73718,73718,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7371826,BCBSND Base Physician Payment Schedule,140.21,148.93,Fee schedule,,140.21,140.21,140.21,140.21,,,0
unity,Fee schedule,Non-facility 73718TC,Not in chargemaster,73718TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73718TC,BCBSND Base Physician Payment Schedule,537.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7370626,Not in chargemaster,73706,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7370626,BCBSND Base Physician Payment Schedule,195.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73706TC,Not in chargemaster,73706TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73706TC,BCBSND Base Physician Payment Schedule,738.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73706,Not in chargemaster,73706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73706,BCBSND Base Physician Payment Schedule,933.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73702,Not in chargemaster,73702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73702,BCBSND Base Physician Payment Schedule,613.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7370226,Not in chargemaster,73702,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7370226,BCBSND Base Physician Payment Schedule,126.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73702TC,Not in chargemaster,73702TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73702TC,BCBSND Base Physician Payment Schedule,486.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7370126,73701,73701,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7370126,BCBSND Base Physician Payment Schedule,120.39,148.68,Fee schedule,,120.39,120.39,120.39,120.39,,,0
unity,Fee schedule,Non-facility 73701TC,Not in chargemaster,73701TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73701TC,BCBSND Base Physician Payment Schedule,383.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73701,Not in chargemaster,73701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73701,BCBSND Base Physician Payment Schedule,503.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73700,Not in chargemaster,73700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73700,BCBSND Base Physician Payment Schedule,400.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7370026,73700,73700,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7370026,BCBSND Base Physician Payment Schedule,104.24,128.07,Fee schedule,,104.24,104.24,104.24,104.24,,,0
unity,Fee schedule,Non-facility 73700TC,Not in chargemaster,73700TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73700TC,BCBSND Base Physician Payment Schedule,295.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7366026,73660,73660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7366026,BCBSND Base Physician Payment Schedule,13.95,14.74,Fee schedule,,13.95,13.95,13.95,13.95,,,0
unity,Fee schedule,Non-facility 73660TC,Not in chargemaster,73660TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73660TC,BCBSND Base Physician Payment Schedule,49.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73660,Not in chargemaster,73660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73660,BCBSND Base Physician Payment Schedule,63.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73650,Not in chargemaster,73650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73650,BCBSND Base Physician Payment Schedule,63.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7365026,73650,73650,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7365026,BCBSND Base Physician Payment Schedule,16.88,17.83,Fee schedule,,16.88,16.88,16.88,16.88,,,0
unity,Fee schedule,Non-facility 73650TC,Not in chargemaster,73650TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73650TC,BCBSND Base Physician Payment Schedule,46.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7363026,73630,73630,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7363026,BCBSND Base Physician Payment Schedule,17.62,18.62,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73630TC,Not in chargemaster,73630TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73630TC,BCBSND Base Physician Payment Schedule,56.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73630,Not in chargemaster,73630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73630,BCBSND Base Physician Payment Schedule,73.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73620,Not in chargemaster,73620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73620,BCBSND Base Physician Payment Schedule,62.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7362026,73620,73620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7362026,BCBSND Base Physician Payment Schedule,16.15,17.06,Fee schedule,,16.15,16.15,16.15,16.15,,,0
unity,Fee schedule,Non-facility 73620TC,Not in chargemaster,73620TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73620TC,BCBSND Base Physician Payment Schedule,46.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7361526,Not in chargemaster,73615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7361526,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73615TC,Not in chargemaster,73615TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73615TC,BCBSND Base Physician Payment Schedule,229.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73615,Not in chargemaster,73615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73615,BCBSND Base Physician Payment Schedule,290.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73610,Not in chargemaster,73610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73610,BCBSND Base Physician Payment Schedule,78.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7361026,73610,73610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7361026,BCBSND Base Physician Payment Schedule,18.35,19.39,Fee schedule,,18.35,18.35,18.35,18.35,,,0
unity,Fee schedule,Non-facility 73610TC,Not in chargemaster,73610TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73610TC,BCBSND Base Physician Payment Schedule,60.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7360026,73600,73600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7360026,BCBSND Base Physician Payment Schedule,17.62,18.62,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73600TC,Not in chargemaster,73600TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73600TC,BCBSND Base Physician Payment Schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73600,Not in chargemaster,73600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73600,BCBSND Base Physician Payment Schedule,71.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73592,Not in chargemaster,73592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73592,BCBSND Base Physician Payment Schedule,68.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7359226,Not in chargemaster,73592,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7359226,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73592TC,Not in chargemaster,73592TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73592TC,BCBSND Base Physician Payment Schedule,51.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7359026,73590,73590,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7359026,BCBSND Base Physician Payment Schedule,16.88,19.39,Fee schedule,,16.88,16.88,16.88,16.88,,,0
unity,Fee schedule,Non-facility 73590TC,Not in chargemaster,73590TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73590TC,BCBSND Base Physician Payment Schedule,52.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73590,Not in chargemaster,73590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73590,BCBSND Base Physician Payment Schedule,68.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73580,Not in chargemaster,73580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73580,BCBSND Base Physician Payment Schedule,309.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7358026,Not in chargemaster,73580,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7358026,BCBSND Base Physician Payment Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73580TC,Not in chargemaster,73580TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73580TC,BCBSND Base Physician Payment Schedule,249.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7356526,73565,73565,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7356526,BCBSND Base Physician Payment Schedule,18.35,21.71,Fee schedule,,18.35,18.35,18.35,18.35,,,0
unity,Fee schedule,Non-facility 73565TC,Not in chargemaster,73565TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73565TC,BCBSND Base Physician Payment Schedule,69.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73565,Not in chargemaster,73565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73565,BCBSND Base Physician Payment Schedule,87.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73564,Not in chargemaster,73564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73564,BCBSND Base Physician Payment Schedule,98.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7356426,73564,73564,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7356426,BCBSND Base Physician Payment Schedule,23.49,27.15,Fee schedule,,23.49,23.49,23.49,23.49,,,0
unity,Fee schedule,Non-facility 73564TC,Not in chargemaster,73564TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73564TC,BCBSND Base Physician Payment Schedule,75.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7356226,73562,73562,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7356226,BCBSND Base Physician Payment Schedule,19.82,22.5,Fee schedule,,19.82,19.82,19.82,19.82,,,0
unity,Fee schedule,Non-facility 73562TC,Not in chargemaster,73562TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73562TC,BCBSND Base Physician Payment Schedule,68.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73562,Not in chargemaster,73562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73562,BCBSND Base Physician Payment Schedule,88.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73560,Not in chargemaster,73560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73560,BCBSND Base Physician Payment Schedule,75.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7356026,73560,73560,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7356026,BCBSND Base Physician Payment Schedule,17.62,21.71,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73560TC,Not in chargemaster,73560TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73560TC,BCBSND Base Physician Payment Schedule,57.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7355226,Not in chargemaster,73552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7355226,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73552TC,Not in chargemaster,73552TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73552TC,BCBSND Base Physician Payment Schedule,58.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73552,Not in chargemaster,73552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73552,BCBSND Base Physician Payment Schedule,77.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73551,Not in chargemaster,73551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73551,BCBSND Base Physician Payment Schedule,65.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7355126,Not in chargemaster,73551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7355126,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73551TC,Not in chargemaster,73551TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73551TC,BCBSND Base Physician Payment Schedule,47.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7352526,Not in chargemaster,73525,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7352526,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73525TC,Not in chargemaster,73525TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73525TC,BCBSND Base Physician Payment Schedule,217.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73525,Not in chargemaster,73525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73525,BCBSND Base Physician Payment Schedule,278.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73523,Not in chargemaster,73523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73523,BCBSND Base Physician Payment Schedule,132.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7352326,Not in chargemaster,73523,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7352326,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73523TC,Not in chargemaster,73523TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73523TC,BCBSND Base Physician Payment Schedule,99.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7352226,Not in chargemaster,73522,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7352226,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73522TC,Not in chargemaster,73522TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73522TC,BCBSND Base Physician Payment Schedule,85.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73522,Not in chargemaster,73522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73522,BCBSND Base Physician Payment Schedule,116.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73521,Not in chargemaster,73521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73521,BCBSND Base Physician Payment Schedule,89.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7352126,Not in chargemaster,73521,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7352126,BCBSND Base Physician Payment Schedule,23.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73521TC,Not in chargemaster,73521TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73521TC,BCBSND Base Physician Payment Schedule,66.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7350326,Not in chargemaster,73503,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7350326,BCBSND Base Physician Payment Schedule,28.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73503TC,Not in chargemaster,73503TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73503TC,BCBSND Base Physician Payment Schedule,97.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73503,Not in chargemaster,73503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73503,BCBSND Base Physician Payment Schedule,126.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73502,Not in chargemaster,73502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73502,BCBSND Base Physician Payment Schedule,101.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7350226,Not in chargemaster,73502,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7350226,BCBSND Base Physician Payment Schedule,23.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73502TC,Not in chargemaster,73502TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73502TC,BCBSND Base Physician Payment Schedule,78.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7350126,Not in chargemaster,73501,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7350126,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73501TC,Not in chargemaster,73501TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73501TC,BCBSND Base Physician Payment Schedule,51.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73501,Not in chargemaster,73501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73501,BCBSND Base Physician Payment Schedule,71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73225,Not in chargemaster,73225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73225,BCBSND Base Physician Payment Schedule,1052.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7322526,Not in chargemaster,73225,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7322526,BCBSND Base Physician Payment Schedule,181.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73225TC,Not in chargemaster,73225TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73225TC,BCBSND Base Physician Payment Schedule,871.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7322326,Not in chargemaster,73223,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7322326,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73223TC,Not in chargemaster,73223TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73223TC,BCBSND Base Physician Payment Schedule,973.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73223,Not in chargemaster,73223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73223,BCBSND Base Physician Payment Schedule,1197.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73222,Not in chargemaster,73222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73222,BCBSND Base Physician Payment Schedule,972.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7322226,Not in chargemaster,73222,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7322226,BCBSND Base Physician Payment Schedule,170.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73222TC,Not in chargemaster,73222TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73222TC,BCBSND Base Physician Payment Schedule,801.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7322126,73221,73221,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7322126,BCBSND Base Physician Payment Schedule,143.15,152.02,Fee schedule,,143.15,143.15,143.15,143.15,,,0
unity,Fee schedule,Non-facility 73221TC,Not in chargemaster,73221TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73221TC,BCBSND Base Physician Payment Schedule,454.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73221,Not in chargemaster,73221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73221,BCBSND Base Physician Payment Schedule,597.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73220,Not in chargemaster,73220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73220,BCBSND Base Physician Payment Schedule,1273.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7322026,Not in chargemaster,73220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7322026,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73220TC,Not in chargemaster,73220TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73220TC,BCBSND Base Physician Payment Schedule,1050.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7321926,Not in chargemaster,73219,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7321926,BCBSND Base Physician Payment Schedule,170.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73219TC,Not in chargemaster,73219TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73219TC,BCBSND Base Physician Payment Schedule,871.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73219,Not in chargemaster,73219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73219,BCBSND Base Physician Payment Schedule,1041.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73218,Not in chargemaster,73218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73218,BCBSND Base Physician Payment Schedule,946.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7321826,Not in chargemaster,73218,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7321826,BCBSND Base Physician Payment Schedule,140.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73218TC,Not in chargemaster,73218TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73218TC,BCBSND Base Physician Payment Schedule,805.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7320626,Not in chargemaster,73206,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7320626,BCBSND Base Physician Payment Schedule,186.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73206TC,Not in chargemaster,73206TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73206TC,BCBSND Base Physician Payment Schedule,674.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73206,Not in chargemaster,73206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73206,BCBSND Base Physician Payment Schedule,860.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73202,Not in chargemaster,73202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73202,BCBSND Base Physician Payment Schedule,739.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7320226,Not in chargemaster,73202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7320226,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73202TC,Not in chargemaster,73202TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73202TC,BCBSND Base Physician Payment Schedule,612.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7320126,Not in chargemaster,73201,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7320126,BCBSND Base Physician Payment Schedule,120.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73201TC,Not in chargemaster,73201TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73201TC,BCBSND Base Physician Payment Schedule,464.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73201,Not in chargemaster,73201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73201,BCBSND Base Physician Payment Schedule,585.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73200,Not in chargemaster,73200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73200,BCBSND Base Physician Payment Schedule,467.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7320026,73200,73200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7320026,BCBSND Base Physician Payment Schedule,104.24,111.69,Fee schedule,,104.24,104.24,104.24,104.24,,,0
unity,Fee schedule,Non-facility 73200TC,Not in chargemaster,73200TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73200TC,BCBSND Base Physician Payment Schedule,363.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7314026,73140,73140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7314026,BCBSND Base Physician Payment Schedule,14.68,17.91,Fee schedule,,14.68,14.68,14.68,14.68,,,0
unity,Fee schedule,Non-facility 73140TC,Not in chargemaster,73140TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73140TC,BCBSND Base Physician Payment Schedule,66.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73140,Not in chargemaster,73140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73140,BCBSND Base Physician Payment Schedule,80.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73130,Not in chargemaster,73130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73130,BCBSND Base Physician Payment Schedule,78.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7313026,73130,73130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7313026,BCBSND Base Physician Payment Schedule,18.35,19.39,Fee schedule,,18.35,18.35,18.35,18.35,,,0
unity,Fee schedule,Non-facility 73130TC,Not in chargemaster,73130TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73130TC,BCBSND Base Physician Payment Schedule,60.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7312026,73120,73120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7312026,BCBSND Base Physician Payment Schedule,17.62,18.62,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73120TC,Not in chargemaster,73120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73120TC,BCBSND Base Physician Payment Schedule,50.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73120,Not in chargemaster,73120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73120,BCBSND Base Physician Payment Schedule,67.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73115,Not in chargemaster,73115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73115,BCBSND Base Physician Payment Schedule,286.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7311526,Not in chargemaster,73115,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7311526,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73115TC,Not in chargemaster,73115TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73115TC,BCBSND Base Physician Payment Schedule,227.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7311026,73110,73110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7311026,BCBSND Base Physician Payment Schedule,18.35,19.39,Fee schedule,,18.35,18.35,18.35,18.35,,,0
unity,Fee schedule,Non-facility 73110TC,Not in chargemaster,73110TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73110TC,BCBSND Base Physician Payment Schedule,69.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73110,Not in chargemaster,73110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73110,BCBSND Base Physician Payment Schedule,87.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73100,Not in chargemaster,73100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73100,BCBSND Base Physician Payment Schedule,73.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7310026,73100,73100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7310026,BCBSND Base Physician Payment Schedule,17.62,20.94,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73100TC,Not in chargemaster,73100TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73100TC,BCBSND Base Physician Payment Schedule,56.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7309226,73092,73092,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7309226,BCBSND Base Physician Payment Schedule,16.88,18.62,Fee schedule,,16.88,16.88,16.88,16.88,,,0
unity,Fee schedule,Non-facility 73092TC,Not in chargemaster,73092TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73092TC,BCBSND Base Physician Payment Schedule,51.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73092,Not in chargemaster,73092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73092,BCBSND Base Physician Payment Schedule,68.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73090,Not in chargemaster,73090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73090,BCBSND Base Physician Payment Schedule,64.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7309026,73090,73090,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7309026,BCBSND Base Physician Payment Schedule,17.62,18.62,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73090TC,Not in chargemaster,73090TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73090TC,BCBSND Base Physician Payment Schedule,47.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7308526,Not in chargemaster,73085,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7308526,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73085TC,Not in chargemaster,73085TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73085TC,BCBSND Base Physician Payment Schedule,193.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73085,Not in chargemaster,73085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73085,BCBSND Base Physician Payment Schedule,254.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73080,Not in chargemaster,73080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73080,BCBSND Base Physician Payment Schedule,69.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7308026,Not in chargemaster,73080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7308026,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73080TC,Not in chargemaster,73080TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73080TC,BCBSND Base Physician Payment Schedule,51.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7307026,73070,73070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7307026,BCBSND Base Physician Payment Schedule,17.62,17.83,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73070TC,Not in chargemaster,73070TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73070TC,BCBSND Base Physician Payment Schedule,46.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73070,Not in chargemaster,73070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73070,BCBSND Base Physician Payment Schedule,63.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73060,Not in chargemaster,73060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73060,BCBSND Base Physician Payment Schedule,70.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7306026,73060,73060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7306026,BCBSND Base Physician Payment Schedule,17.62,19.39,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73060TC,Not in chargemaster,73060TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73060TC,BCBSND Base Physician Payment Schedule,52.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7305026,Not in chargemaster,73050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7305026,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73050TC,Not in chargemaster,73050TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73050TC,BCBSND Base Physician Payment Schedule,50.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73050,Not in chargemaster,73050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73050,BCBSND Base Physician Payment Schedule,70.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73040,Not in chargemaster,73040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73040,BCBSND Base Physician Payment Schedule,272.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7304026,Not in chargemaster,73040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7304026,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73040TC,Not in chargemaster,73040TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73040TC,BCBSND Base Physician Payment Schedule,215.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7303026,73030,73030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7303026,BCBSND Base Physician Payment Schedule,19.82,22.5,Fee schedule,,19.82,19.82,19.82,19.82,,,0
unity,Fee schedule,Non-facility 73030TC,Not in chargemaster,73030TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73030TC,BCBSND Base Physician Payment Schedule,54.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73030,Not in chargemaster,73030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73030,BCBSND Base Physician Payment Schedule,74.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73020,Not in chargemaster,73020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73020,BCBSND Base Physician Payment Schedule,47.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7302026,73020,73020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7302026,BCBSND Base Physician Payment Schedule,16.15,17.06,Fee schedule,,16.15,16.15,16.15,16.15,,,0
unity,Fee schedule,Non-facility 73020TC,Not in chargemaster,73020TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73020TC,BCBSND Base Physician Payment Schedule,31.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7301026,73010,73010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7301026,BCBSND Base Physician Payment Schedule,19.09,21.71,Fee schedule,,19.09,19.09,19.09,19.09,,,0
unity,Fee schedule,Non-facility 73010TC,Not in chargemaster,73010TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73010TC,BCBSND Base Physician Payment Schedule,42.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73010,Not in chargemaster,73010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73010,BCBSND Base Physician Payment Schedule,62.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 73000,Not in chargemaster,73000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73000,BCBSND Base Physician Payment Schedule,70.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7300026,73000,73000,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7300026,BCBSND Base Physician Payment Schedule,17.62,18.62,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 73000TC,Not in chargemaster,73000TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,73000TC,BCBSND Base Physician Payment Schedule,52.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7229526,Not in chargemaster,72295,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7229526,BCBSND Base Physician Payment Schedule,88.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72295TC,Not in chargemaster,72295TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72295TC,BCBSND Base Physician Payment Schedule,149.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72295,Not in chargemaster,72295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72295,BCBSND Base Physician Payment Schedule,238.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72285,Not in chargemaster,72285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72285,BCBSND Base Physician Payment Schedule,269.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7228526,Not in chargemaster,72285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7228526,BCBSND Base Physician Payment Schedule,123.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72285TC,Not in chargemaster,72285TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72285TC,BCBSND Base Physician Payment Schedule,146.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7227526,Not in chargemaster,72275,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7227526,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72275TC,Not in chargemaster,72275TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72275TC,BCBSND Base Physician Payment Schedule,212.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72275,Not in chargemaster,72275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72275,BCBSND Base Physician Payment Schedule,294.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72270,Not in chargemaster,72270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72270,BCBSND Base Physician Payment Schedule,312.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7227026,Not in chargemaster,72270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7227026,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72270TC,Not in chargemaster,72270TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72270TC,BCBSND Base Physician Payment Schedule,172.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7226526,Not in chargemaster,72265,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7226526,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72265TC,Not in chargemaster,72265TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72265TC,BCBSND Base Physician Payment Schedule,143.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72265,Not in chargemaster,72265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72265,BCBSND Base Physician Payment Schedule,228.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72255,Not in chargemaster,72255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72255,BCBSND Base Physician Payment Schedule,250.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7225526,Not in chargemaster,72255,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7225526,BCBSND Base Physician Payment Schedule,99.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72255TC,Not in chargemaster,72255TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72255TC,BCBSND Base Physician Payment Schedule,151.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7224026,Not in chargemaster,72240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7224026,BCBSND Base Physician Payment Schedule,95.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72240TC,Not in chargemaster,72240TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72240TC,BCBSND Base Physician Payment Schedule,151.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72240,Not in chargemaster,72240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72240,BCBSND Base Physician Payment Schedule,247.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72220,Not in chargemaster,72220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72220,BCBSND Base Physician Payment Schedule,70.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7222026,72220,72220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7222026,BCBSND Base Physician Payment Schedule,18.35,19.39,Fee schedule,,18.35,18.35,18.35,18.35,,,0
unity,Fee schedule,Non-facility 72220TC,Not in chargemaster,72220TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72220TC,BCBSND Base Physician Payment Schedule,52.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7220226,Not in chargemaster,72202,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7220226,BCBSND Base Physician Payment Schedule,24.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72202TC,Not in chargemaster,72202TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72202TC,BCBSND Base Physician Payment Schedule,61.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72202,Not in chargemaster,72202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72202,BCBSND Base Physician Payment Schedule,85.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72200,Not in chargemaster,72200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72200,BCBSND Base Physician Payment Schedule,72.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7220026,72200,72200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7220026,BCBSND Base Physician Payment Schedule,18.35,19.39,Fee schedule,,18.35,18.35,18.35,18.35,,,0
unity,Fee schedule,Non-facility 72200TC,Not in chargemaster,72200TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72200TC,BCBSND Base Physician Payment Schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219826,Not in chargemaster,72198,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219826,BCBSND Base Physician Payment Schedule,184.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72198TC,Not in chargemaster,72198TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72198TC,BCBSND Base Physician Payment Schedule,839.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72198,Not in chargemaster,72198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72198,BCBSND Base Physician Payment Schedule,1024.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72197,Not in chargemaster,72197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72197,BCBSND Base Physician Payment Schedule,1021.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219726,72197,72197,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219726,BCBSND Base Physician Payment Schedule,227.57,248.2,Fee schedule,,227.57,227.57,227.57,227.57,,,0
unity,Fee schedule,Non-facility 72197TC,Not in chargemaster,72197TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72197TC,BCBSND Base Physician Payment Schedule,793.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219626,Not in chargemaster,72196,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219626,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72196TC,Not in chargemaster,72196TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72196TC,BCBSND Base Physician Payment Schedule,631.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72196,Not in chargemaster,72196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72196,BCBSND Base Physician Payment Schedule,812.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72195,Not in chargemaster,72195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72195,BCBSND Base Physician Payment Schedule,696.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219526,Not in chargemaster,72195,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219526,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72195TC,Not in chargemaster,72195TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72195TC,BCBSND Base Physician Payment Schedule,544.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219426,72194,72194,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219426,BCBSND Base Physician Payment Schedule,127,134.19,Fee schedule,,127,127,127,127,,,0
unity,Fee schedule,Non-facility 72194TC,Not in chargemaster,72194TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72194TC,BCBSND Base Physician Payment Schedule,596.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72194,Not in chargemaster,72194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72194,BCBSND Base Physician Payment Schedule,723.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72193,Not in chargemaster,72193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72193,BCBSND Base Physician Payment Schedule,640.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219326,72193,72193,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219326,BCBSND Base Physician Payment Schedule,120.39,148.68,Fee schedule,,120.39,120.39,120.39,120.39,,,0
unity,Fee schedule,Non-facility 72193TC,Not in chargemaster,72193TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72193TC,BCBSND Base Physician Payment Schedule,520.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219226,72192,72192,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219226,BCBSND Base Physician Payment Schedule,113.05,138.82,Fee schedule,,113.05,113.05,113.05,113.05,,,0
unity,Fee schedule,Non-facility 72192TC,Not in chargemaster,72192TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72192TC,BCBSND Base Physician Payment Schedule,256.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72192,Not in chargemaster,72192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72192,BCBSND Base Physician Payment Schedule,369.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72191,Not in chargemaster,72191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72191,BCBSND Base Physician Payment Schedule,844.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219126,Not in chargemaster,72191,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219126,BCBSND Base Physician Payment Schedule,186.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72191TC,Not in chargemaster,72191TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72191TC,BCBSND Base Physician Payment Schedule,657.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7219026,Not in chargemaster,72190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7219026,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72190TC,Not in chargemaster,72190TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72190TC,BCBSND Base Physician Payment Schedule,64.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72190,Not in chargemaster,72190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72190,BCBSND Base Physician Payment Schedule,90.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72170,Not in chargemaster,72170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72170,BCBSND Base Physician Payment Schedule,63.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7217026,72170,72170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7217026,BCBSND Base Physician Payment Schedule,18.35,27.5,Fee schedule,,18.35,18.35,18.35,18.35,,,0
unity,Fee schedule,Non-facility 72170TC,Not in chargemaster,72170TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72170TC,BCBSND Base Physician Payment Schedule,45.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7215926,Not in chargemaster,72159,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7215926,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72159TC,Not in chargemaster,72159TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72159TC,BCBSND Base Physician Payment Schedule,871.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72159,Not in chargemaster,72159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72159,BCBSND Base Physician Payment Schedule,1059.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72158,Not in chargemaster,72158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72158,BCBSND Base Physician Payment Schedule,950.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7215826,72158,72158,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7215826,BCBSND Base Physician Payment Schedule,238.58,262.94,Fee schedule,,238.58,238.58,238.58,238.58,,,0
unity,Fee schedule,Non-facility 72158TC,Not in chargemaster,72158TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72158TC,BCBSND Base Physician Payment Schedule,712.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7215726,72157,72157,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7215726,BCBSND Base Physician Payment Schedule,238.58,291.08,Fee schedule,,238.58,238.58,238.58,238.58,,,0
unity,Fee schedule,Non-facility 72157TC,Not in chargemaster,72157TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72157TC,BCBSND Base Physician Payment Schedule,716.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72157,Not in chargemaster,72157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72157,BCBSND Base Physician Payment Schedule,954.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72156,Not in chargemaster,72156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72156,BCBSND Base Physician Payment Schedule,952.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7215626,72156,72156,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7215626,BCBSND Base Physician Payment Schedule,238.58,284.66,Fee schedule,,238.58,238.58,238.58,238.58,,,0
unity,Fee schedule,Non-facility 72156TC,Not in chargemaster,72156TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72156TC,BCBSND Base Physician Payment Schedule,714.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7214926,Not in chargemaster,72149,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7214926,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72149TC,Not in chargemaster,72149TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72149TC,BCBSND Base Physician Payment Schedule,624.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72149,Not in chargemaster,72149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72149,BCBSND Base Physician Payment Schedule,810.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72148,Not in chargemaster,72148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72148,BCBSND Base Physician Payment Schedule,558.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7214826,72148,72148,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7214826,BCBSND Base Physician Payment Schedule,154.9,203.5,Fee schedule,,154.9,154.9,154.9,154.9,,,0
unity,Fee schedule,Non-facility 72148TC,Not in chargemaster,72148TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72148TC,BCBSND Base Physician Payment Schedule,403.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7214726,Not in chargemaster,72147,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7214726,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72147TC,Not in chargemaster,72147TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72147TC,BCBSND Base Physician Payment Schedule,632.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72147,Not in chargemaster,72147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72147,BCBSND Base Physician Payment Schedule,818.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72146,Not in chargemaster,72146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72146,BCBSND Base Physician Payment Schedule,557.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7214626,72146,72146,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7214626,BCBSND Base Physician Payment Schedule,154.9,177.63,Fee schedule,,154.9,154.9,154.9,154.9,,,0
unity,Fee schedule,Non-facility 72146TC,Not in chargemaster,72146TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72146TC,BCBSND Base Physician Payment Schedule,402.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7214226,Not in chargemaster,72142,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7214226,BCBSND Base Physician Payment Schedule,186.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72142TC,Not in chargemaster,72142TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72142TC,BCBSND Base Physician Payment Schedule,637.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72142,Not in chargemaster,72142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72142,BCBSND Base Physician Payment Schedule,824.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72141,Not in chargemaster,72141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72141,BCBSND Base Physician Payment Schedule,557.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7214126,72141,72141,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7214126,BCBSND Base Physician Payment Schedule,154.9,177.63,Fee schedule,,154.9,154.9,154.9,154.9,,,0
unity,Fee schedule,Non-facility 72141TC,Not in chargemaster,72141TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72141TC,BCBSND Base Physician Payment Schedule,402.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7213326,Not in chargemaster,72133,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7213326,BCBSND Base Physician Payment Schedule,131.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72133TC,Not in chargemaster,72133TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72133TC,BCBSND Base Physician Payment Schedule,468.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72133,Not in chargemaster,72133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72133,BCBSND Base Physician Payment Schedule,600.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72132,Not in chargemaster,72132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72132,BCBSND Base Physician Payment Schedule,507.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7213226,Not in chargemaster,72132,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7213226,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72132TC,Not in chargemaster,72132TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72132TC,BCBSND Base Physician Payment Schedule,380.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7213126,72131,72131,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7213126,BCBSND Base Physician Payment Schedule,104.24,128.07,Fee schedule,,104.24,104.24,104.24,104.24,,,0
unity,Fee schedule,Non-facility 72131TC,Not in chargemaster,72131TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72131TC,BCBSND Base Physician Payment Schedule,295.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72131,Not in chargemaster,72131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72131,BCBSND Base Physician Payment Schedule,400.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72130,Not in chargemaster,72130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72130,BCBSND Base Physician Payment Schedule,604,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7213026,Not in chargemaster,72130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7213026,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72130TC,Not in chargemaster,72130TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72130TC,BCBSND Base Physician Payment Schedule,471.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7212926,Not in chargemaster,72129,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7212926,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72129TC,Not in chargemaster,72129TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72129TC,BCBSND Base Physician Payment Schedule,383.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72129,Not in chargemaster,72129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72129,BCBSND Base Physician Payment Schedule,510.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72128,Not in chargemaster,72128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72128,BCBSND Base Physician Payment Schedule,402.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7212826,72128,72128,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7212826,BCBSND Base Physician Payment Schedule,104.24,128.07,Fee schedule,,104.24,104.24,104.24,104.24,,,0
unity,Fee schedule,Non-facility 72128TC,Not in chargemaster,72128TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72128TC,BCBSND Base Physician Payment Schedule,297.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7212726,Not in chargemaster,72127,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7212726,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72127TC,Not in chargemaster,72127TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72127TC,BCBSND Base Physician Payment Schedule,470.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72127,Not in chargemaster,72127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72127,BCBSND Base Physician Payment Schedule,602.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72126,Not in chargemaster,72126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72126,BCBSND Base Physician Payment Schedule,506.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7212626,Not in chargemaster,72126,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7212626,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72126TC,Not in chargemaster,72126TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72126TC,BCBSND Base Physician Payment Schedule,379.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7212526,72125,72125,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7212526,BCBSND Base Physician Payment Schedule,104.24,136.14,Fee schedule,,104.24,104.24,104.24,104.24,,,0
unity,Fee schedule,Non-facility 72125TC,Not in chargemaster,72125TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72125TC,BCBSND Base Physician Payment Schedule,297.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72125,Not in chargemaster,72125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72125,BCBSND Base Physician Payment Schedule,402.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72120,Not in chargemaster,72120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72120,BCBSND Base Physician Payment Schedule,88.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7212026,Not in chargemaster,72120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7212026,BCBSND Base Physician Payment Schedule,23.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72120TC,Not in chargemaster,72120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72120TC,BCBSND Base Physician Payment Schedule,65.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7211426,Not in chargemaster,72114,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7211426,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72114TC,Not in chargemaster,72114TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72114TC,BCBSND Base Physician Payment Schedule,102.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72114,Not in chargemaster,72114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72114,BCBSND Base Physician Payment Schedule,133.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72110,Not in chargemaster,72110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72110,BCBSND Base Physician Payment Schedule,108.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7211026,72110,72110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7211026,BCBSND Base Physician Payment Schedule,27.16,35.68,Fee schedule,,27.16,27.16,27.16,27.16,,,0
unity,Fee schedule,Non-facility 72110TC,Not in chargemaster,72110TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72110TC,BCBSND Base Physician Payment Schedule,81.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7210026,72100,72100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7210026,BCBSND Base Physician Payment Schedule,23.49,26.38,Fee schedule,,23.49,23.49,23.49,23.49,,,0
unity,Fee schedule,Non-facility 72100TC,Not in chargemaster,72100TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72100TC,BCBSND Base Physician Payment Schedule,61.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72100,Not in chargemaster,72100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72100,BCBSND Base Physician Payment Schedule,85.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72084,Not in chargemaster,72084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72084,BCBSND Base Physician Payment Schedule,210.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7208426,Not in chargemaster,72084,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7208426,BCBSND Base Physician Payment Schedule,43.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72084TC,Not in chargemaster,72084TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72084TC,BCBSND Base Physician Payment Schedule,167.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7208326,Not in chargemaster,72083,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7208326,BCBSND Base Physician Payment Schedule,38.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72083TC,Not in chargemaster,72083TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72083TC,BCBSND Base Physician Payment Schedule,139.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72083,Not in chargemaster,72083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72083,BCBSND Base Physician Payment Schedule,177.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72082,Not in chargemaster,72082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72082,BCBSND Base Physician Payment Schedule,152.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7208226,72082,72082,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7208226,BCBSND Base Physician Payment Schedule,33.77,40.13,Fee schedule,,33.77,33.77,33.77,33.77,,,0
unity,Fee schedule,Non-facility 72082TC,Not in chargemaster,72082TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72082TC,BCBSND Base Physician Payment Schedule,118.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7208126,72081,72081,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7208126,BCBSND Base Physician Payment Schedule,27.9,33,Fee schedule,,27.9,27.9,27.9,27.9,,,0
unity,Fee schedule,Non-facility 72081TC,Not in chargemaster,72081TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72081TC,BCBSND Base Physician Payment Schedule,65.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72081,Not in chargemaster,72081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72081,BCBSND Base Physician Payment Schedule,93.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72080,Not in chargemaster,72080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72080,BCBSND Base Physician Payment Schedule,76.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7208026,Not in chargemaster,72080,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7208026,BCBSND Base Physician Payment Schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72080TC,Not in chargemaster,72080TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72080TC,BCBSND Base Physician Payment Schedule,53.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7207426,Not in chargemaster,72074,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7207426,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72074TC,Not in chargemaster,72074TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72074TC,BCBSND Base Physician Payment Schedule,70.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72074,Not in chargemaster,72074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72074,BCBSND Base Physician Payment Schedule,96.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72072,Not in chargemaster,72072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72072,BCBSND Base Physician Payment Schedule,86.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7207226,72072,72072,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7207226,BCBSND Base Physician Payment Schedule,24.23,24.05,Fee schedule,,24.05,24.05,24.05,24.05,,,0
unity,Fee schedule,Non-facility 72072TC,Not in chargemaster,72072TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72072TC,BCBSND Base Physician Payment Schedule,61.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7207026,72070,72070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7207026,BCBSND Base Physician Payment Schedule,21.29,24.82,Fee schedule,,21.29,21.29,21.29,21.29,,,0
unity,Fee schedule,Non-facility 72070TC,Not in chargemaster,72070TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72070TC,BCBSND Base Physician Payment Schedule,49.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72070,Not in chargemaster,72070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72070,BCBSND Base Physician Payment Schedule,70.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72052,Not in chargemaster,72052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72052,BCBSND Base Physician Payment Schedule,133.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7205226,Not in chargemaster,72052,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7205226,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72052TC,Not in chargemaster,72052TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72052TC,BCBSND Base Physician Payment Schedule,102.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7205026,72050,72050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7205026,BCBSND Base Physician Payment Schedule,28.63,35.68,Fee schedule,,28.63,28.63,28.63,28.63,,,0
unity,Fee schedule,Non-facility 72050TC,Not in chargemaster,72050TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72050TC,BCBSND Base Physician Payment Schedule,85.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72050,Not in chargemaster,72050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72050,BCBSND Base Physician Payment Schedule,113.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72040,Not in chargemaster,72040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72040,BCBSND Base Physician Payment Schedule,85.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7204026,72040,72040,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7204026,BCBSND Base Physician Payment Schedule,23.49,31.41,Fee schedule,,23.49,23.49,23.49,23.49,,,0
unity,Fee schedule,Non-facility 72040TC,Not in chargemaster,72040TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72040TC,BCBSND Base Physician Payment Schedule,61.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7202026,72020,72020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7202026,BCBSND Base Physician Payment Schedule,16.88,17.06,Fee schedule,,16.88,16.88,16.88,16.88,,,0
unity,Fee schedule,Non-facility 72020TC,Not in chargemaster,72020TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72020TC,BCBSND Base Physician Payment Schedule,37.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 72020,Not in chargemaster,72020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,72020,BCBSND Base Physician Payment Schedule,54.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71555,Not in chargemaster,71555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71555,BCBSND Base Physician Payment Schedule,1018.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7155526,Not in chargemaster,71555,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7155526,BCBSND Base Physician Payment Schedule,186.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71555TC,Not in chargemaster,71555TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71555TC,BCBSND Base Physician Payment Schedule,832.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7155226,Not in chargemaster,71552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7155226,BCBSND Base Physician Payment Schedule,233.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71552TC,Not in chargemaster,71552TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71552TC,BCBSND Base Physician Payment Schedule,1247.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71552,Not in chargemaster,71552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71552,BCBSND Base Physician Payment Schedule,1481,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71551,Not in chargemaster,71551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71551,BCBSND Base Physician Payment Schedule,1171.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7155126,Not in chargemaster,71551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7155126,BCBSND Base Physician Payment Schedule,179.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71551TC,Not in chargemaster,71551TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71551TC,BCBSND Base Physician Payment Schedule,992.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7155026,Not in chargemaster,71550,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7155026,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71550TC,Not in chargemaster,71550TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71550TC,BCBSND Base Physician Payment Schedule,913.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71550,Not in chargemaster,71550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71550,BCBSND Base Physician Payment Schedule,1066.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71275,Not in chargemaster,71275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71275,BCBSND Base Physician Payment Schedule,788.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7127526,Not in chargemaster,71275,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7127526,BCBSND Base Physician Payment Schedule,189.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71275TC,Not in chargemaster,71275TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71275TC,BCBSND Base Physician Payment Schedule,598.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7127026,71270,71270,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7127026,BCBSND Base Physician Payment Schedule,143.15,151.25,Fee schedule,,143.15,143.15,143.15,143.15,,,0
unity,Fee schedule,Non-facility 71270TC,Not in chargemaster,71270TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71270TC,BCBSND Base Physician Payment Schedule,460.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71270,Not in chargemaster,71270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71270,BCBSND Base Physician Payment Schedule,603.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71260,Not in chargemaster,71260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71260,BCBSND Base Physician Payment Schedule,507.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7126026,71260,71260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7126026,BCBSND Base Physician Payment Schedule,129.94,137.29,Fee schedule,,129.94,129.94,129.94,129.94,,,0
unity,Fee schedule,Non-facility 71260TC,Not in chargemaster,71260TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71260TC,BCBSND Base Physician Payment Schedule,377.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7125026,71250,71250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7125026,BCBSND Base Physician Payment Schedule,120.39,111.69,Fee schedule,,111.69,111.69,111.69,111.69,,,0
unity,Fee schedule,Non-facility 71250TC,Not in chargemaster,71250TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71250TC,BCBSND Base Physician Payment Schedule,282.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71250,Not in chargemaster,71250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71250,BCBSND Base Physician Payment Schedule,403.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71130,Not in chargemaster,71130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71130,BCBSND Base Physician Payment Schedule,89.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7113026,71130,71130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7113026,BCBSND Base Physician Payment Schedule,23.49,24.82,Fee schedule,,23.49,23.49,23.49,23.49,,,0
unity,Fee schedule,Non-facility 71130TC,Not in chargemaster,71130TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71130TC,BCBSND Base Physician Payment Schedule,66.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7112026,Not in chargemaster,71120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7112026,BCBSND Base Physician Payment Schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71120TC,Not in chargemaster,71120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71120TC,BCBSND Base Physician Payment Schedule,52.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71120,Not in chargemaster,71120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71120,BCBSND Base Physician Payment Schedule,73.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71111,Not in chargemaster,71111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71111,BCBSND Base Physician Payment Schedule,114.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7111126,Not in chargemaster,71111,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7111126,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71111TC,Not in chargemaster,71111TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71111TC,BCBSND Base Physician Payment Schedule,80.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7111026,Not in chargemaster,71110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7111026,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71110TC,Not in chargemaster,71110TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71110TC,BCBSND Base Physician Payment Schedule,65.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71110,Not in chargemaster,71110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71110,BCBSND Base Physician Payment Schedule,96.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71101,Not in chargemaster,71101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71101,BCBSND Base Physician Payment Schedule,91.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7110126,71101,71101,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7110126,BCBSND Base Physician Payment Schedule,27.9,29.48,Fee schedule,,27.9,27.9,27.9,27.9,,,0
unity,Fee schedule,Non-facility 71101TC,Not in chargemaster,71101TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71101TC,BCBSND Base Physician Payment Schedule,63.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7110026,71100,71100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7110026,BCBSND Base Physician Payment Schedule,23.49,24.82,Fee schedule,,23.49,23.49,23.49,23.49,,,0
unity,Fee schedule,Non-facility 71100TC,Not in chargemaster,71100TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71100TC,BCBSND Base Physician Payment Schedule,56.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71100,Not in chargemaster,71100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71100,BCBSND Base Physician Payment Schedule,79.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71048,Not in chargemaster,71048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71048,BCBSND Base Physician Payment Schedule,99.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7104826,71048,71048,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7104826,BCBSND Base Physician Payment Schedule,33.77,18.34,Fee schedule,,18.34,18.34,18.34,18.34,,,0
unity,Fee schedule,Non-facility 71048TC,Not in chargemaster,71048TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71048TC,BCBSND Base Physician Payment Schedule,66.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7104726,71047,71047,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7104726,BCBSND Base Physician Payment Schedule,28.63,30.25,Fee schedule,,28.63,28.63,28.63,28.63,,,0
unity,Fee schedule,Non-facility 71047TC,Not in chargemaster,71047TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71047TC,BCBSND Base Physician Payment Schedule,63.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71047,Not in chargemaster,71047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71047,BCBSND Base Physician Payment Schedule,92.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71046,Not in chargemaster,71046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71046,BCBSND Base Physician Payment Schedule,73.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7104626,71046,71046,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7104626,BCBSND Base Physician Payment Schedule,22.76,24.05,Fee schedule,,22.76,22.76,22.76,22.76,,,0
unity,Fee schedule,Non-facility 71046TC,Not in chargemaster,71046TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71046TC,BCBSND Base Physician Payment Schedule,50.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7104526,71045,71045,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7104526,BCBSND Base Physician Payment Schedule,19.09,20.17,Fee schedule,,19.09,19.09,19.09,19.09,,,0
unity,Fee schedule,Non-facility 71045TC,Not in chargemaster,71045TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71045TC,BCBSND Base Physician Payment Schedule,37.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 71045,Not in chargemaster,71045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,71045,BCBSND Base Physician Payment Schedule,57.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7055926,Not in chargemaster,70559,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7055926,BCBSND Base Physician Payment Schedule,342.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7055826,Not in chargemaster,70558,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7055826,BCBSND Base Physician Payment Schedule,357.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7055726,Not in chargemaster,70557,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7055726,BCBSND Base Physician Payment Schedule,336.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7055526,Not in chargemaster,70555,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7055526,BCBSND Base Physician Payment Schedule,262.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70555TC,Not in chargemaster,70555TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70555TC,BCBSND Base Physician Payment Schedule,922.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70555,Not in chargemaster,70555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70555,BCBSND Base Physician Payment Schedule,1184.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7055426,Not in chargemaster,70554,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7055426,BCBSND Base Physician Payment Schedule,219.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70554TC,Not in chargemaster,70554TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70554TC,BCBSND Base Physician Payment Schedule,922.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70554,Not in chargemaster,70554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70554,BCBSND Base Physician Payment Schedule,1142.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70553,Not in chargemaster,70553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70553,BCBSND Base Physician Payment Schedule,944.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7055326,70553,70553,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7055326,BCBSND Base Physician Payment Schedule,238.58,260.62,Fee schedule,,238.58,238.58,238.58,238.58,,,0
unity,Fee schedule,Non-facility 70553TC,Not in chargemaster,70553TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70553TC,BCBSND Base Physician Payment Schedule,706.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7055226,Not in chargemaster,70552,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7055226,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70552TC,Not in chargemaster,70552TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70552TC,BCBSND Base Physician Payment Schedule,619.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70552,Not in chargemaster,70552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70552,BCBSND Base Physician Payment Schedule,805.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70551,Not in chargemaster,70551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70551,BCBSND Base Physician Payment Schedule,574.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7055126,70551,70551,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7055126,BCBSND Base Physician Payment Schedule,154.9,162.89,Fee schedule,,154.9,154.9,154.9,154.9,,,0
unity,Fee schedule,Non-facility 70551TC,Not in chargemaster,70551TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70551TC,BCBSND Base Physician Payment Schedule,419.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054926,Not in chargemaster,70549,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054926,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70549TC,Not in chargemaster,70549TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70549TC,BCBSND Base Physician Payment Schedule,846.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70549,Not in chargemaster,70549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70549,BCBSND Base Physician Payment Schedule,1034.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70548,Not in chargemaster,70548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70548,BCBSND Base Physician Payment Schedule,720.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054826,Not in chargemaster,70548,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054826,BCBSND Base Physician Payment Schedule,156.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70548TC,Not in chargemaster,70548TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70548TC,BCBSND Base Physician Payment Schedule,564.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054726,Not in chargemaster,70547,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054726,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70547TC,Not in chargemaster,70547TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70547TC,BCBSND Base Physician Payment Schedule,525.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70547,Not in chargemaster,70547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70547,BCBSND Base Physician Payment Schedule,650.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70546,Not in chargemaster,70546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70546,BCBSND Base Physician Payment Schedule,994.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054626,Not in chargemaster,70546,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054626,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70546TC,Not in chargemaster,70546TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70546TC,BCBSND Base Physician Payment Schedule,840.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054526,Not in chargemaster,70545,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054526,BCBSND Base Physician Payment Schedule,124.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70545TC,Not in chargemaster,70545TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70545TC,BCBSND Base Physician Payment Schedule,554.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70545,Not in chargemaster,70545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70545,BCBSND Base Physician Payment Schedule,679.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70544,Not in chargemaster,70544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70544,BCBSND Base Physician Payment Schedule,647.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054426,70544,70544,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054426,BCBSND Base Physician Payment Schedule,124.8,132.64,Fee schedule,,124.8,124.8,124.8,124.8,,,0
unity,Fee schedule,Non-facility 70544TC,Not in chargemaster,70544TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70544TC,BCBSND Base Physician Payment Schedule,523.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054326,70543,70543,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054326,BCBSND Base Physician Payment Schedule,222.43,236.57,Fee schedule,,222.43,222.43,222.43,222.43,,,0
unity,Fee schedule,Non-facility 70543TC,Not in chargemaster,70543TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70543TC,BCBSND Base Physician Payment Schedule,797.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70543,Not in chargemaster,70543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70543,BCBSND Base Physician Payment Schedule,1020.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70542,Not in chargemaster,70542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70542,BCBSND Base Physician Payment Schedule,814.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054226,Not in chargemaster,70542,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054226,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70542TC,Not in chargemaster,70542TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70542TC,BCBSND Base Physician Payment Schedule,644.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7054026,Not in chargemaster,70540,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7054026,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70540TC,Not in chargemaster,70540TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70540TC,BCBSND Base Physician Payment Schedule,547.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70540,Not in chargemaster,70540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70540,BCBSND Base Physician Payment Schedule,686.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70498,Not in chargemaster,70498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70498,BCBSND Base Physician Payment Schedule,771.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7049826,Not in chargemaster,70498,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7049826,BCBSND Base Physician Payment Schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70498TC,Not in chargemaster,70498TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70498TC,BCBSND Base Physician Payment Schedule,589.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7049626,Not in chargemaster,70496,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7049626,BCBSND Base Physician Payment Schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70496TC,Not in chargemaster,70496TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70496TC,BCBSND Base Physician Payment Schedule,590.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70496,Not in chargemaster,70496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70496,BCBSND Base Physician Payment Schedule,772.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70492,Not in chargemaster,70492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70492,BCBSND Base Physician Payment Schedule,630.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7049226,70492,70492,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7049226,BCBSND Base Physician Payment Schedule,169.58,159.78,Fee schedule,,159.78,159.78,159.78,159.78,,,0
unity,Fee schedule,Non-facility 70492TC,Not in chargemaster,70492TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70492TC,BCBSND Base Physician Payment Schedule,460.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7049126,70491,70491,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7049126,BCBSND Base Physician Payment Schedule,143.88,152.02,Fee schedule,,143.88,143.88,143.88,143.88,,,0
unity,Fee schedule,Non-facility 70491TC,Not in chargemaster,70491TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70491TC,BCBSND Base Physician Payment Schedule,376.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70491,Not in chargemaster,70491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70491,BCBSND Base Physician Payment Schedule,520.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70490,Not in chargemaster,70490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70490,BCBSND Base Physician Payment Schedule,416.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7049026,Not in chargemaster,70490,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7049026,BCBSND Base Physician Payment Schedule,133.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70490TC,Not in chargemaster,70490TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70490TC,BCBSND Base Physician Payment Schedule,282.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7048826,Not in chargemaster,70488,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7048826,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70488TC,Not in chargemaster,70488TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70488TC,BCBSND Base Physician Payment Schedule,395.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70488,Not in chargemaster,70488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70488,BCBSND Base Physician Payment Schedule,527.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70487,Not in chargemaster,70487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70487,BCBSND Base Physician Payment Schedule,429.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7048726,Not in chargemaster,70487,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7048726,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70487TC,Not in chargemaster,70487TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70487TC,BCBSND Base Physician Payment Schedule,311.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7048626,70486,70486,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7048626,BCBSND Base Physician Payment Schedule,89.56,125.65,Fee schedule,,89.56,89.56,89.56,89.56,,,0
unity,Fee schedule,Non-facility 70486TC,Not in chargemaster,70486TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70486TC,BCBSND Base Physician Payment Schedule,271.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70486,Not in chargemaster,70486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70486,BCBSND Base Physician Payment Schedule,361.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70482,Not in chargemaster,70482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70482,BCBSND Base Physician Payment Schedule,652.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7048226,70482,70482,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7048226,BCBSND Base Physician Payment Schedule,131.4,159.78,Fee schedule,,131.4,131.4,131.4,131.4,,,0
unity,Fee schedule,Non-facility 70482TC,Not in chargemaster,70482TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70482TC,BCBSND Base Physician Payment Schedule,521.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7048126,Not in chargemaster,70481,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7048126,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70481TC,Not in chargemaster,70481TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70481TC,BCBSND Base Physician Payment Schedule,471.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70481,Not in chargemaster,70481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70481,BCBSND Base Physician Payment Schedule,589.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70480,Not in chargemaster,70480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70480,BCBSND Base Physician Payment Schedule,518.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7048026,70480,70480,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7048026,BCBSND Base Physician Payment Schedule,132.87,141.94,Fee schedule,,132.87,132.87,132.87,132.87,,,0
unity,Fee schedule,Non-facility 70480TC,Not in chargemaster,70480TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70480TC,BCBSND Base Physician Payment Schedule,385.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7047026,70470,70470,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7047026,BCBSND Base Physician Payment Schedule,132.14,140.39,Fee schedule,,132.14,132.14,132.14,132.14,,,0
unity,Fee schedule,Non-facility 70470TC,Not in chargemaster,70470TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70470TC,BCBSND Base Physician Payment Schedule,360.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70470,Not in chargemaster,70470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70470,BCBSND Base Physician Payment Schedule,492.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70460,Not in chargemaster,70460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70460,BCBSND Base Physician Payment Schedule,418.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7046026,70460,70460,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7046026,BCBSND Base Physician Payment Schedule,117.46,124.11,Fee schedule,,117.46,117.46,117.46,117.46,,,0
unity,Fee schedule,Non-facility 70460TC,Not in chargemaster,70460TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70460TC,BCBSND Base Physician Payment Schedule,300.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7045026,70450,70450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7045026,BCBSND Base Physician Payment Schedule,88.83,93.07,Fee schedule,,88.83,88.83,88.83,88.83,,,0
unity,Fee schedule,Non-facility 70450TC,Not in chargemaster,70450TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70450TC,BCBSND Base Physician Payment Schedule,205.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70450,Not in chargemaster,70450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70450,BCBSND Base Physician Payment Schedule,294.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70390,Not in chargemaster,70390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70390,BCBSND Base Physician Payment Schedule,255.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7039026,Not in chargemaster,70390,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7039026,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70390TC,Not in chargemaster,70390TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70390TC,BCBSND Base Physician Payment Schedule,216.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7038026,Not in chargemaster,70380,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7038026,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70380TC,Not in chargemaster,70380TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70380TC,BCBSND Base Physician Payment Schedule,63.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70380,Not in chargemaster,70380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70380,BCBSND Base Physician Payment Schedule,81.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70371,Not in chargemaster,70371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70371,BCBSND Base Physician Payment Schedule,239.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7037126,Not in chargemaster,70371,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7037126,BCBSND Base Physician Payment Schedule,88.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70371TC,Not in chargemaster,70371TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70371TC,BCBSND Base Physician Payment Schedule,150.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7037026,Not in chargemaster,70370,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7037026,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70370TC,Not in chargemaster,70370TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70370TC,BCBSND Base Physician Payment Schedule,170.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70370,Not in chargemaster,70370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70370,BCBSND Base Physician Payment Schedule,201.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70360,Not in chargemaster,70360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70360,BCBSND Base Physician Payment Schedule,68.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7036026,70360,70360,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7036026,BCBSND Base Physician Payment Schedule,19.09,18.62,Fee schedule,,18.62,18.62,18.62,18.62,,,0
unity,Fee schedule,Non-facility 70360TC,Not in chargemaster,70360TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70360TC,BCBSND Base Physician Payment Schedule,49.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7035526,Not in chargemaster,70355,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7035526,BCBSND Base Physician Payment Schedule,22.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70355TC,Not in chargemaster,70355TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70355TC,BCBSND Base Physician Payment Schedule,19.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70355,Not in chargemaster,70355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70355,BCBSND Base Physician Payment Schedule,41.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70350,Not in chargemaster,70350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70350,BCBSND Base Physician Payment Schedule,38.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7035026,Not in chargemaster,70350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7035026,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70350TC,Not in chargemaster,70350TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70350TC,BCBSND Base Physician Payment Schedule,18.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7033626,Not in chargemaster,70336,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7033626,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70336TC,Not in chargemaster,70336TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70336TC,BCBSND Base Physician Payment Schedule,662.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70336,Not in chargemaster,70336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70336,BCBSND Base Physician Payment Schedule,816.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70332,Not in chargemaster,70332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70332,BCBSND Base Physician Payment Schedule,182.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7033226,Not in chargemaster,70332,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7033226,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70332TC,Not in chargemaster,70332TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70332TC,BCBSND Base Physician Payment Schedule,125.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7033026,Not in chargemaster,70330,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7033026,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70330TC,Not in chargemaster,70330TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70330TC,BCBSND Base Physician Payment Schedule,90.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70330,Not in chargemaster,70330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70330,BCBSND Base Physician Payment Schedule,116.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70328,Not in chargemaster,70328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70328,BCBSND Base Physician Payment Schedule,75.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7032826,Not in chargemaster,70328,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7032826,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70328TC,Not in chargemaster,70328TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70328TC,BCBSND Base Physician Payment Schedule,56.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7032026,Not in chargemaster,70320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7032026,BCBSND Base Physician Payment Schedule,24.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70320TC,Not in chargemaster,70320TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70320TC,BCBSND Base Physician Payment Schedule,101.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70320,Not in chargemaster,70320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70320,BCBSND Base Physician Payment Schedule,125.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70310,Not in chargemaster,70310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70310,BCBSND Base Physician Payment Schedule,88.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7031026,Not in chargemaster,70310,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7031026,BCBSND Base Physician Payment Schedule,16.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70310TC,Not in chargemaster,70310TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70310TC,BCBSND Base Physician Payment Schedule,72.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7030026,Not in chargemaster,70300,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7030026,BCBSND Base Physician Payment Schedule,11.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70300TC,Not in chargemaster,70300TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70300TC,BCBSND Base Physician Payment Schedule,18.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70300,Not in chargemaster,70300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70300,BCBSND Base Physician Payment Schedule,30.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70260,Not in chargemaster,70260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70260,BCBSND Base Physician Payment Schedule,98.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7026026,70260,70260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7026026,BCBSND Base Physician Payment Schedule,30.1,38.01,Fee schedule,,30.1,30.1,30.1,30.1,,,0
unity,Fee schedule,Non-facility 70260TC,Not in chargemaster,70260TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70260TC,BCBSND Base Physician Payment Schedule,68.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7025026,70250,70250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7025026,BCBSND Base Physician Payment Schedule,21.29,27.93,Fee schedule,,21.29,21.29,21.29,21.29,,,0
unity,Fee schedule,Non-facility 70250TC,Not in chargemaster,70250TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70250TC,BCBSND Base Physician Payment Schedule,58.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70250,Not in chargemaster,70250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70250,BCBSND Base Physician Payment Schedule,79.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70240,Not in chargemaster,70240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70240,BCBSND Base Physician Payment Schedule,75.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7024026,Not in chargemaster,70240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7024026,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70240TC,Not in chargemaster,70240TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70240TC,BCBSND Base Physician Payment Schedule,54.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7022026,70220,70220,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7022026,BCBSND Base Physician Payment Schedule,23.49,27.93,Fee schedule,,23.49,23.49,23.49,23.49,,,0
unity,Fee schedule,Non-facility 70220TC,Not in chargemaster,70220TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70220TC,BCBSND Base Physician Payment Schedule,58.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70220,Not in chargemaster,70220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70220,BCBSND Base Physician Payment Schedule,82.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70210,Not in chargemaster,70210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70210,BCBSND Base Physician Payment Schedule,69.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7021026,Not in chargemaster,70210,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7021026,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70210TC,Not in chargemaster,70210TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70210TC,BCBSND Base Physician Payment Schedule,51.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7020026,Not in chargemaster,70200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7020026,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70200TC,Not in chargemaster,70200TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70200TC,BCBSND Base Physician Payment Schedule,75.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70200,Not in chargemaster,70200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70200,BCBSND Base Physician Payment Schedule,104.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70190,Not in chargemaster,70190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70190,BCBSND Base Physician Payment Schedule,86.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7019026,Not in chargemaster,70190,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7019026,BCBSND Base Physician Payment Schedule,23.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70190TC,Not in chargemaster,70190TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70190TC,BCBSND Base Physician Payment Schedule,62.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7017026,Not in chargemaster,70170,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7017026,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70170TC,Not in chargemaster,70170TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70170TC,BCBSND Base Physician Payment Schedule,95.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70170,Not in chargemaster,70170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70170,BCBSND Base Physician Payment Schedule,126.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7016026,70160,70160,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7016026,BCBSND Base Physician Payment Schedule,18.35,19.39,Fee schedule,,18.35,18.35,18.35,18.35,,,0
unity,Fee schedule,Non-facility 70160TC,Not in chargemaster,70160TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70160TC,BCBSND Base Physician Payment Schedule,63.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70160,Not in chargemaster,70160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70160,BCBSND Base Physician Payment Schedule,81.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70150,Not in chargemaster,70150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70150,BCBSND Base Physician Payment Schedule,103.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7015026,70150,70150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7015026,BCBSND Base Physician Payment Schedule,27.9,29.48,Fee schedule,,27.9,27.9,27.9,27.9,,,0
unity,Fee schedule,Non-facility 70150TC,Not in chargemaster,70150TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70150TC,BCBSND Base Physician Payment Schedule,75.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7014026,Not in chargemaster,70140,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7014026,BCBSND Base Physician Payment Schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70140TC,Not in chargemaster,70140TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70140TC,BCBSND Base Physician Payment Schedule,48.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70140,Not in chargemaster,70140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70140,BCBSND Base Physician Payment Schedule,69.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70134,Not in chargemaster,70134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70134,BCBSND Base Physician Payment Schedule,126.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7013426,Not in chargemaster,70134,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7013426,BCBSND Base Physician Payment Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70134TC,Not in chargemaster,70134TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70134TC,BCBSND Base Physician Payment Schedule,89.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7013026,Not in chargemaster,70130,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7013026,BCBSND Base Physician Payment Schedule,35.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70130TC,Not in chargemaster,70130TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70130TC,BCBSND Base Physician Payment Schedule,98.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70130,Not in chargemaster,70130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70130,BCBSND Base Physician Payment Schedule,134.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70120,Not in chargemaster,70120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70120,BCBSND Base Physician Payment Schedule,82.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7012026,Not in chargemaster,70120,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7012026,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70120TC,Not in chargemaster,70120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70120TC,BCBSND Base Physician Payment Schedule,63.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7011026,70110,70110,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7011026,BCBSND Base Physician Payment Schedule,26.43,27.93,Fee schedule,,26.43,26.43,26.43,26.43,,,0
unity,Fee schedule,Non-facility 70110TC,Not in chargemaster,70110TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70110TC,BCBSND Base Physician Payment Schedule,68.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70110,Not in chargemaster,70110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70110,BCBSND Base Physician Payment Schedule,94.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70100,Not in chargemaster,70100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70100,BCBSND Base Physician Payment Schedule,82.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7010026,Not in chargemaster,70100,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7010026,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70100TC,Not in chargemaster,70100TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70100TC,BCBSND Base Physician Payment Schedule,63.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7003026,Not in chargemaster,70030,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7003026,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70030TC,Not in chargemaster,70030TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70030TC,BCBSND Base Physician Payment Schedule,52.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70030,Not in chargemaster,70030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70030,BCBSND Base Physician Payment Schedule,69.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70015,Not in chargemaster,70015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70015,BCBSND Base Physician Payment Schedule,364.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 7001526,Not in chargemaster,70015,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,7001526,BCBSND Base Physician Payment Schedule,124.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70015TC,Not in chargemaster,70015TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70015TC,BCBSND Base Physician Payment Schedule,240.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 70010,Not in chargemaster,70010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,70010,BCBSND Base Physician Payment Schedule,141.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69990,Not in chargemaster,69990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69990,BCBSND Base Physician Payment Schedule,462.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69970,Not in chargemaster,69970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69970,BCBSND Base Physician Payment Schedule,4467,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69960,Not in chargemaster,69960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69960,BCBSND Base Physician Payment Schedule,3978.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69955,Not in chargemaster,69955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69955,BCBSND Base Physician Payment Schedule,4124.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69950,Not in chargemaster,69950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69950,BCBSND Base Physician Payment Schedule,3688.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69930,Not in chargemaster,69930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69930,BCBSND Base Physician Payment Schedule,2551,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69915,Not in chargemaster,69915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69915,BCBSND Base Physician Payment Schedule,3174.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69910,Not in chargemaster,69910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69910,BCBSND Base Physician Payment Schedule,2089.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69905,Not in chargemaster,69905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69905,BCBSND Base Physician Payment Schedule,1910.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69806,Not in chargemaster,69806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69806,BCBSND Base Physician Payment Schedule,1942.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69805,Not in chargemaster,69805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69805,BCBSND Base Physician Payment Schedule,2167.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69801,Not in chargemaster,69801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69801,BCBSND Base Physician Payment Schedule,444.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69745,Not in chargemaster,69745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69745,BCBSND Base Physician Payment Schedule,2588.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69740,Not in chargemaster,69740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69740,BCBSND Base Physician Payment Schedule,2429.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69725,Not in chargemaster,69725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69725,BCBSND Base Physician Payment Schedule,3918.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69720,Not in chargemaster,69720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69720,BCBSND Base Physician Payment Schedule,2476.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69718,Not in chargemaster,69718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69718,BCBSND Base Physician Payment Schedule,2765.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69717,Not in chargemaster,69717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69717,BCBSND Base Physician Payment Schedule,2320.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69715,Not in chargemaster,69715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69715,BCBSND Base Physician Payment Schedule,2736.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69714,Not in chargemaster,69714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69714,BCBSND Base Physician Payment Schedule,2211.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69711,Not in chargemaster,69711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69711,BCBSND Base Physician Payment Schedule,1763.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69700,Not in chargemaster,69700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69700,BCBSND Base Physician Payment Schedule,1402.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69676,Not in chargemaster,69676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69676,BCBSND Base Physician Payment Schedule,1729.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69670,Not in chargemaster,69670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69670,BCBSND Base Physician Payment Schedule,1970.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69667,Not in chargemaster,69667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69667,BCBSND Base Physician Payment Schedule,1683.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69666,Not in chargemaster,69666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69666,BCBSND Base Physician Payment Schedule,1684.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69662,Not in chargemaster,69662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69662,BCBSND Base Physician Payment Schedule,2401.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69661,Not in chargemaster,69661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69661,BCBSND Base Physician Payment Schedule,2517.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69660,Not in chargemaster,69660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69660,BCBSND Base Physician Payment Schedule,1928.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69650,Not in chargemaster,69650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69650,BCBSND Base Physician Payment Schedule,1670.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69646,Not in chargemaster,69646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69646,BCBSND Base Physician Payment Schedule,3218.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69645,Not in chargemaster,69645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69645,BCBSND Base Physician Payment Schedule,3036.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69644,Not in chargemaster,69644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69644,BCBSND Base Physician Payment Schedule,3085.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69643,Not in chargemaster,69643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69643,BCBSND Base Physician Payment Schedule,2546.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69642,Not in chargemaster,69642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69642,BCBSND Base Physician Payment Schedule,2787.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69641,Not in chargemaster,69641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69641,BCBSND Base Physician Payment Schedule,2169.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69637,Not in chargemaster,69637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69637,BCBSND Base Physician Payment Schedule,2868.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69636,Not in chargemaster,69636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69636,BCBSND Base Physician Payment Schedule,2881.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69635,Not in chargemaster,69635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69635,BCBSND Base Physician Payment Schedule,2575.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69633,Not in chargemaster,69633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69633,BCBSND Base Physician Payment Schedule,2174.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69632,Not in chargemaster,69632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69632,BCBSND Base Physician Payment Schedule,2244.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69631,Not in chargemaster,69631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69631,BCBSND Base Physician Payment Schedule,1841.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69620,Not in chargemaster,69620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69620,BCBSND Base Physician Payment Schedule,1471.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69610,Not in chargemaster,69610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69610,BCBSND Base Physician Payment Schedule,789.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69605,Not in chargemaster,69605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69605,BCBSND Base Physician Payment Schedule,3256.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69604,Not in chargemaster,69604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69604,BCBSND Base Physician Payment Schedule,2317.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69603,Not in chargemaster,69603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69603,BCBSND Base Physician Payment Schedule,2630.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69602,Not in chargemaster,69602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69602,BCBSND Base Physician Payment Schedule,2267.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69601,Not in chargemaster,69601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69601,BCBSND Base Physician Payment Schedule,2144.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69554,Not in chargemaster,69554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69554,BCBSND Base Physician Payment Schedule,5255.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69552,Not in chargemaster,69552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69552,BCBSND Base Physician Payment Schedule,3277.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69550,Not in chargemaster,69550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69550,BCBSND Base Physician Payment Schedule,2170.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69540,Not in chargemaster,69540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69540,BCBSND Base Physician Payment Schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69535,Not in chargemaster,69535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69535,BCBSND Base Physician Payment Schedule,5538.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69530,Not in chargemaster,69530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69530,BCBSND Base Physician Payment Schedule,3451.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69511,Not in chargemaster,69511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69511,BCBSND Base Physician Payment Schedule,2573.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69505,Not in chargemaster,69505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69505,BCBSND Base Physician Payment Schedule,2512.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69502,Not in chargemaster,69502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69502,BCBSND Base Physician Payment Schedule,1990.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69501,Not in chargemaster,69501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69501,BCBSND Base Physician Payment Schedule,1496.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69450,Not in chargemaster,69450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69450,BCBSND Base Physician Payment Schedule,1132.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69440,Not in chargemaster,69440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69440,BCBSND Base Physician Payment Schedule,1432.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69436,Not in chargemaster,69436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69436,BCBSND Base Physician Payment Schedule,328.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69433,Not in chargemaster,69433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69433,BCBSND Base Physician Payment Schedule,412.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69424,Not in chargemaster,69424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69424,BCBSND Base Physician Payment Schedule,265.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69421,Not in chargemaster,69421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69421,BCBSND Base Physician Payment Schedule,309.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69420,Not in chargemaster,69420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69420,BCBSND Base Physician Payment Schedule,389.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69320,Not in chargemaster,69320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69320,BCBSND Base Physician Payment Schedule,3191.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69310,Not in chargemaster,69310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69310,BCBSND Base Physician Payment Schedule,2274.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69300,Not in chargemaster,69300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69300,BCBSND Base Physician Payment Schedule,1295.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69222,Not in chargemaster,69222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69222,BCBSND Base Physician Payment Schedule,441.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69220,Not in chargemaster,69220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69220,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69210,69210,69210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69210,BCBSND Base Physician Payment Schedule,99.84,110.75,Fee schedule,,99.84,99.84,99.84,99.84,,,0
unity,Fee schedule,Non-facility 69209,69209,69209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69209,BCBSND Base Physician Payment Schedule,29.36,30,Fee schedule,,29.36,29.36,29.36,29.36,,,0
unity,Fee schedule,Non-facility 69205,Not in chargemaster,69205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69205,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69200,69200,69200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69200,BCBSND Base Physician Payment Schedule,169.58,269.76,Fee schedule,,169.58,169.58,169.58,169.58,,,0
unity,Fee schedule,Non-facility 69155,Not in chargemaster,69155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69155,BCBSND Base Physician Payment Schedule,3424.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69150,Not in chargemaster,69150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69150,BCBSND Base Physician Payment Schedule,2147.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69145,Not in chargemaster,69145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69145,BCBSND Base Physician Payment Schedule,832.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69140,Not in chargemaster,69140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69140,BCBSND Base Physician Payment Schedule,1825.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69120,Not in chargemaster,69120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69120,BCBSND Base Physician Payment Schedule,819.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69110,Not in chargemaster,69110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69110,BCBSND Base Physician Payment Schedule,966.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69105,Not in chargemaster,69105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69105,BCBSND Base Physician Payment Schedule,293.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69100,Not in chargemaster,69100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69100,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69020,Not in chargemaster,69020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69020,BCBSND Base Physician Payment Schedule,480.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69090,Not in chargemaster,69090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69090,BCBSND Base Physician Payment Schedule,116.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69005,Not in chargemaster,69005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69005,BCBSND Base Physician Payment Schedule,453.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 69000,Not in chargemaster,69000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69000,BCBSND Base Physician Payment Schedule,392.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68850,Not in chargemaster,68850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68850,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68840,Not in chargemaster,68840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68840,BCBSND Base Physician Payment Schedule,271.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68816,Not in chargemaster,68816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68816,BCBSND Base Physician Payment Schedule,1634.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68815,Not in chargemaster,68815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68815,BCBSND Base Physician Payment Schedule,810.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68811,Not in chargemaster,68811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68811,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68810,Not in chargemaster,68810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68810,BCBSND Base Physician Payment Schedule,331.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68801,Not in chargemaster,68801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68801,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68770,Not in chargemaster,68770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68770,BCBSND Base Physician Payment Schedule,1303.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68761,Not in chargemaster,68761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68761,BCBSND Base Physician Payment Schedule,308.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68760,Not in chargemaster,68760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68760,BCBSND Base Physician Payment Schedule,445.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68750,Not in chargemaster,68750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68750,BCBSND Base Physician Payment Schedule,1700.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68745,Not in chargemaster,68745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68745,BCBSND Base Physician Payment Schedule,1630.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68720,Not in chargemaster,68720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68720,BCBSND Base Physician Payment Schedule,1624.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68705,Not in chargemaster,68705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68705,BCBSND Base Physician Payment Schedule,527.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68700,Not in chargemaster,68700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68700,BCBSND Base Physician Payment Schedule,1253.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68550,Not in chargemaster,68550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68550,BCBSND Base Physician Payment Schedule,2448.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68540,Not in chargemaster,68540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68540,BCBSND Base Physician Payment Schedule,1982.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68530,Not in chargemaster,68530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68530,BCBSND Base Physician Payment Schedule,901.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68525,Not in chargemaster,68525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68525,BCBSND Base Physician Payment Schedule,548.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68520,Not in chargemaster,68520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68520,BCBSND Base Physician Payment Schedule,1474.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68510,Not in chargemaster,68510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68510,BCBSND Base Physician Payment Schedule,947.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68505,Not in chargemaster,68505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68505,BCBSND Base Physician Payment Schedule,2095.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68500,Not in chargemaster,68500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68500,BCBSND Base Physician Payment Schedule,2105.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68440,Not in chargemaster,68440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68440,BCBSND Base Physician Payment Schedule,214.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68420,Not in chargemaster,68420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68420,BCBSND Base Physician Payment Schedule,686.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68400,Not in chargemaster,68400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68400,BCBSND Base Physician Payment Schedule,609.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68371,Not in chargemaster,68371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68371,BCBSND Base Physician Payment Schedule,856.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68362,Not in chargemaster,68362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68362,BCBSND Base Physician Payment Schedule,1359.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68360,Not in chargemaster,68360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68360,BCBSND Base Physician Payment Schedule,1120.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68340,Not in chargemaster,68340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68340,BCBSND Base Physician Payment Schedule,1206.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68335,Not in chargemaster,68335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68335,BCBSND Base Physician Payment Schedule,1341.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68330,Not in chargemaster,68330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68330,BCBSND Base Physician Payment Schedule,1281.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68328,Not in chargemaster,68328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68328,BCBSND Base Physician Payment Schedule,1471.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68326,Not in chargemaster,68326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68326,BCBSND Base Physician Payment Schedule,1337.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68325,Not in chargemaster,68325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68325,BCBSND Base Physician Payment Schedule,1362.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68320,Not in chargemaster,68320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68320,BCBSND Base Physician Payment Schedule,1532.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68200,Not in chargemaster,68200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68200,BCBSND Base Physician Payment Schedule,87.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68135,Not in chargemaster,68135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68135,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68130,Not in chargemaster,68130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68130,BCBSND Base Physician Payment Schedule,1138.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68115,Not in chargemaster,68115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68115,BCBSND Base Physician Payment Schedule,674.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68110,Not in chargemaster,68110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68110,BCBSND Base Physician Payment Schedule,486.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68100,Not in chargemaster,68100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68100,BCBSND Base Physician Payment Schedule,371.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68040,Not in chargemaster,68040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68040,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 68020,Not in chargemaster,68020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68020,BCBSND Base Physician Payment Schedule,250.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67975,Not in chargemaster,67975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67975,BCBSND Base Physician Payment Schedule,1422.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67974,Not in chargemaster,67974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67974,BCBSND Base Physician Payment Schedule,1927.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67973,Not in chargemaster,67973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67973,BCBSND Base Physician Payment Schedule,1931.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67971,Not in chargemaster,67971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67971,BCBSND Base Physician Payment Schedule,1501.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67966,Not in chargemaster,67966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67966,BCBSND Base Physician Payment Schedule,1612.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67961,Not in chargemaster,67961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67961,BCBSND Base Physician Payment Schedule,1210.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67950,Not in chargemaster,67950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67950,BCBSND Base Physician Payment Schedule,1206.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67938,67938,67938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67938,BCBSND Base Physician Payment Schedule,540.3,528.86,Fee schedule,,528.86,528.86,528.86,528.86,,,0
unity,Fee schedule,Non-facility 67935,Not in chargemaster,67935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67935,BCBSND Base Physician Payment Schedule,1242.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67930,Not in chargemaster,67930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67930,BCBSND Base Physician Payment Schedule,767.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67924,Not in chargemaster,67924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67924,BCBSND Base Physician Payment Schedule,1341.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67923,Not in chargemaster,67923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67923,BCBSND Base Physician Payment Schedule,1259.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67922,Not in chargemaster,67922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67922,BCBSND Base Physician Payment Schedule,618.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67921,Not in chargemaster,67921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67921,BCBSND Base Physician Payment Schedule,982.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67917,Not in chargemaster,67917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67917,BCBSND Base Physician Payment Schedule,1284.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67916,Not in chargemaster,67916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67916,BCBSND Base Physician Payment Schedule,1259.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67915,Not in chargemaster,67915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67915,BCBSND Base Physician Payment Schedule,635.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67914,Not in chargemaster,67914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67914,BCBSND Base Physician Payment Schedule,1002.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67912,Not in chargemaster,67912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67912,BCBSND Base Physician Payment Schedule,1885.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67911,Not in chargemaster,67911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67911,BCBSND Base Physician Payment Schedule,1164.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67909,Not in chargemaster,67909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67909,BCBSND Base Physician Payment Schedule,1132.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67908,Not in chargemaster,67908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67908,BCBSND Base Physician Payment Schedule,1073.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67906,Not in chargemaster,67906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67906,BCBSND Base Physician Payment Schedule,1051.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67904,Not in chargemaster,67904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67904,BCBSND Base Physician Payment Schedule,1535.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67903,Not in chargemaster,67903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67903,BCBSND Base Physician Payment Schedule,1247.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67902,Not in chargemaster,67902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67902,BCBSND Base Physician Payment Schedule,1504.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67901,Not in chargemaster,67901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67901,BCBSND Base Physician Payment Schedule,1624.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67900,Not in chargemaster,67900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67900,BCBSND Base Physician Payment Schedule,1343.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67882,Not in chargemaster,67882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67882,BCBSND Base Physician Payment Schedule,1181.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67880,Not in chargemaster,67880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67880,BCBSND Base Physician Payment Schedule,961.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67875,Not in chargemaster,67875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67875,BCBSND Base Physician Payment Schedule,367.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67850,Not in chargemaster,67850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67850,BCBSND Base Physician Payment Schedule,449.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67840,Not in chargemaster,67840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67840,BCBSND Base Physician Payment Schedule,580.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67835,Not in chargemaster,67835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67835,BCBSND Base Physician Payment Schedule,912.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67830,Not in chargemaster,67830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67830,BCBSND Base Physician Payment Schedule,559.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67825,Not in chargemaster,67825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67825,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67820,Not in chargemaster,67820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67820,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67810,Not in chargemaster,67810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67810,BCBSND Base Physician Payment Schedule,376.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67808,Not in chargemaster,67808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67808,BCBSND Base Physician Payment Schedule,764.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67805,Not in chargemaster,67805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67805,BCBSND Base Physician Payment Schedule,419.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67801,Not in chargemaster,67801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67801,BCBSND Base Physician Payment Schedule,338.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67800,Not in chargemaster,67800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67800,BCBSND Base Physician Payment Schedule,267.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67715,Not in chargemaster,67715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67715,BCBSND Base Physician Payment Schedule,527.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67710,Not in chargemaster,67710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67710,BCBSND Base Physician Payment Schedule,490.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67700,Not in chargemaster,67700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67700,BCBSND Base Physician Payment Schedule,581.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67570,Not in chargemaster,67570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67570,BCBSND Base Physician Payment Schedule,2619.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67560,Not in chargemaster,67560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67560,BCBSND Base Physician Payment Schedule,2182.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67550,Not in chargemaster,67550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67550,BCBSND Base Physician Payment Schedule,2130.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67515,Not in chargemaster,67515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67515,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67505,Not in chargemaster,67505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67505,BCBSND Base Physician Payment Schedule,172.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67500,Not in chargemaster,67500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67500,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67450,Not in chargemaster,67450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67450,BCBSND Base Physician Payment Schedule,2754.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67445,Not in chargemaster,67445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67445,BCBSND Base Physician Payment Schedule,3059.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67440,Not in chargemaster,67440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67440,BCBSND Base Physician Payment Schedule,2653.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67430,Not in chargemaster,67430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67430,BCBSND Base Physician Payment Schedule,2739.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67420,Not in chargemaster,67420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67420,BCBSND Base Physician Payment Schedule,3492.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67415,Not in chargemaster,67415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67415,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67414,Not in chargemaster,67414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67414,BCBSND Base Physician Payment Schedule,2905.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67413,Not in chargemaster,67413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67413,BCBSND Base Physician Payment Schedule,1893.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67412,Not in chargemaster,67412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67412,BCBSND Base Physician Payment Schedule,1916.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67405,Not in chargemaster,67405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67405,BCBSND Base Physician Payment Schedule,1758.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67400,Not in chargemaster,67400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67400,BCBSND Base Physician Payment Schedule,2045.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67346,Not in chargemaster,67346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67346,BCBSND Base Physician Payment Schedule,400.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67345,Not in chargemaster,67345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67345,BCBSND Base Physician Payment Schedule,508,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67343,Not in chargemaster,67343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67343,BCBSND Base Physician Payment Schedule,1365.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67340,Not in chargemaster,67340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67340,BCBSND Base Physician Payment Schedule,742.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67335,Not in chargemaster,67335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67335,BCBSND Base Physician Payment Schedule,306.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67334,Not in chargemaster,67334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67334,BCBSND Base Physician Payment Schedule,625.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67332,Not in chargemaster,67332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67332,BCBSND Base Physician Payment Schedule,687.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67331,Not in chargemaster,67331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67331,BCBSND Base Physician Payment Schedule,635,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67320,Not in chargemaster,67320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67320,BCBSND Base Physician Payment Schedule,668.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67318,Not in chargemaster,67318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67318,BCBSND Base Physician Payment Schedule,1469.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67316,Not in chargemaster,67316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67316,BCBSND Base Physician Payment Schedule,1670.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67314,Not in chargemaster,67314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67314,BCBSND Base Physician Payment Schedule,1408,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67312,Not in chargemaster,67312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67312,BCBSND Base Physician Payment Schedule,1490.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67311,Not in chargemaster,67311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67311,BCBSND Base Physician Payment Schedule,1239.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67255,Not in chargemaster,67255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67255,BCBSND Base Physician Payment Schedule,1420.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67250,Not in chargemaster,67250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67250,BCBSND Base Physician Payment Schedule,1749.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67229,Not in chargemaster,67229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67229,BCBSND Base Physician Payment Schedule,2418.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67228,Not in chargemaster,67228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67228,BCBSND Base Physician Payment Schedule,709.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67227,Not in chargemaster,67227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67227,BCBSND Base Physician Payment Schedule,611.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67225,Not in chargemaster,67225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67225,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67221,Not in chargemaster,67221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67221,BCBSND Base Physician Payment Schedule,584.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67220,Not in chargemaster,67220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67220,BCBSND Base Physician Payment Schedule,1107.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67218,Not in chargemaster,67218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67218,BCBSND Base Physician Payment Schedule,2893.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67210,Not in chargemaster,67210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67210,BCBSND Base Physician Payment Schedule,1075.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67208,Not in chargemaster,67208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67208,BCBSND Base Physician Payment Schedule,1247.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67145,Not in chargemaster,67145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67145,BCBSND Base Physician Payment Schedule,1097.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67141,Not in chargemaster,67141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67141,BCBSND Base Physician Payment Schedule,1090.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67121,Not in chargemaster,67121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67121,BCBSND Base Physician Payment Schedule,1881.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67120,Not in chargemaster,67120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67120,BCBSND Base Physician Payment Schedule,1386.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67115,Not in chargemaster,67115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67115,BCBSND Base Physician Payment Schedule,1035.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67113,Not in chargemaster,67113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67113,BCBSND Base Physician Payment Schedule,2778.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67110,Not in chargemaster,67110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67110,BCBSND Base Physician Payment Schedule,1843.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67108,Not in chargemaster,67108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67108,BCBSND Base Physician Payment Schedule,2486.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67107,Not in chargemaster,67107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67107,BCBSND Base Physician Payment Schedule,2346.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67105,Not in chargemaster,67105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67105,BCBSND Base Physician Payment Schedule,616.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67101,Not in chargemaster,67101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67101,BCBSND Base Physician Payment Schedule,689.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67043,Not in chargemaster,67043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67043,BCBSND Base Physician Payment Schedule,2520.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67042,Not in chargemaster,67042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67042,BCBSND Base Physician Payment Schedule,2388.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67041,Not in chargemaster,67041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67041,BCBSND Base Physician Payment Schedule,2388.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67040,Not in chargemaster,67040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67040,BCBSND Base Physician Payment Schedule,2161.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67039,Not in chargemaster,67039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67039,BCBSND Base Physician Payment Schedule,1999.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67036,Not in chargemaster,67036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67036,BCBSND Base Physician Payment Schedule,1867.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67031,Not in chargemaster,67031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67031,BCBSND Base Physician Payment Schedule,811.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67030,Not in chargemaster,67030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67030,BCBSND Base Physician Payment Schedule,1129.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67028,Not in chargemaster,67028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67028,BCBSND Base Physician Payment Schedule,209.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67027,Not in chargemaster,67027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67027,BCBSND Base Physician Payment Schedule,1766.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67025,Not in chargemaster,67025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67025,BCBSND Base Physician Payment Schedule,1534.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67015,Not in chargemaster,67015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67015,BCBSND Base Physician Payment Schedule,1229.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67010,Not in chargemaster,67010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67010,BCBSND Base Physician Payment Schedule,1124.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 67005,Not in chargemaster,67005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67005,BCBSND Base Physician Payment Schedule,980.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66990,Not in chargemaster,66990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66990,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66986,Not in chargemaster,66986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66986,BCBSND Base Physician Payment Schedule,1882.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66987,Not in chargemaster,66987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66987,BCBSND Base Physician Payment Schedule,2600.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66988,Not in chargemaster,66988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66988,BCBSND Base Physician Payment Schedule,2600.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66985,Not in chargemaster,66985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66985,BCBSND Base Physician Payment Schedule,1594.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66984,Not in chargemaster,66984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66984,BCBSND Base Physician Payment Schedule,1134.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66982,Not in chargemaster,66982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66982,BCBSND Base Physician Payment Schedule,1556.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66983,Not in chargemaster,66983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66983,BCBSND Base Physician Payment Schedule,1557.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66940,Not in chargemaster,66940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66940,BCBSND Base Physician Payment Schedule,1626.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66930,Not in chargemaster,66930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66930,BCBSND Base Physician Payment Schedule,1780.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66920,Not in chargemaster,66920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66920,BCBSND Base Physician Payment Schedule,1562.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66852,Not in chargemaster,66852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66852,BCBSND Base Physician Payment Schedule,1750.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66850,Not in chargemaster,66850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66850,BCBSND Base Physician Payment Schedule,1642.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66840,Not in chargemaster,66840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66840,BCBSND Base Physician Payment Schedule,1441.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66830,Not in chargemaster,66830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66830,BCBSND Base Physician Payment Schedule,1474.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66825,Not in chargemaster,66825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66825,BCBSND Base Physician Payment Schedule,1650.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66821,Not in chargemaster,66821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66821,BCBSND Base Physician Payment Schedule,690.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66820,Not in chargemaster,66820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66820,BCBSND Base Physician Payment Schedule,894.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66770,Not in chargemaster,66770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66770,BCBSND Base Physician Payment Schedule,1101.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66762,Not in chargemaster,66762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66762,BCBSND Base Physician Payment Schedule,991.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66761,Not in chargemaster,66761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66761,BCBSND Base Physician Payment Schedule,623.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66740,Not in chargemaster,66740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66740,BCBSND Base Physician Payment Schedule,913.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66720,Not in chargemaster,66720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66720,BCBSND Base Physician Payment Schedule,960.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66711,Not in chargemaster,66711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66711,BCBSND Base Physician Payment Schedule,1044.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66710,Not in chargemaster,66710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66710,BCBSND Base Physician Payment Schedule,922.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66700,Not in chargemaster,66700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66700,BCBSND Base Physician Payment Schedule,940.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66682,Not in chargemaster,66682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66682,BCBSND Base Physician Payment Schedule,1400.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66680,Not in chargemaster,66680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66680,BCBSND Base Physician Payment Schedule,1078.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66635,Not in chargemaster,66635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66635,BCBSND Base Physician Payment Schedule,1189.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66630,Not in chargemaster,66630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66630,BCBSND Base Physician Payment Schedule,1178.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66625,Not in chargemaster,66625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66625,BCBSND Base Physician Payment Schedule,890.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66605,Not in chargemaster,66605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66605,BCBSND Base Physician Payment Schedule,2241.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66600,Not in chargemaster,66600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66600,BCBSND Base Physician Payment Schedule,1806.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66505,Not in chargemaster,66505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66505,BCBSND Base Physician Payment Schedule,846.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66500,Not in chargemaster,66500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66500,BCBSND Base Physician Payment Schedule,775.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66250,Not in chargemaster,66250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66250,BCBSND Base Physician Payment Schedule,1568.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66225,Not in chargemaster,66225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66225,BCBSND Base Physician Payment Schedule,1938.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66185,Not in chargemaster,66185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66185,BCBSND Base Physician Payment Schedule,1758.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66184,Not in chargemaster,66184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66184,BCBSND Base Physician Payment Schedule,1633.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66183,Not in chargemaster,66183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66183,BCBSND Base Physician Payment Schedule,2137.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66180,Not in chargemaster,66180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66180,BCBSND Base Physician Payment Schedule,2366,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66179,Not in chargemaster,66179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66179,BCBSND Base Physician Payment Schedule,2241.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66175,Not in chargemaster,66175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66175,BCBSND Base Physician Payment Schedule,2058.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66174,Not in chargemaster,66174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66174,BCBSND Base Physician Payment Schedule,1965.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66172,Not in chargemaster,66172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66172,BCBSND Base Physician Payment Schedule,2473.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66170,Not in chargemaster,66170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66170,BCBSND Base Physician Payment Schedule,2271.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66160,Not in chargemaster,66160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66160,BCBSND Base Physician Payment Schedule,2050.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66155,Not in chargemaster,66155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66155,BCBSND Base Physician Payment Schedule,1820.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66150,Not in chargemaster,66150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66150,BCBSND Base Physician Payment Schedule,1822.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66130,Not in chargemaster,66130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66130,BCBSND Base Physician Payment Schedule,1463.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66030,Not in chargemaster,66030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66030,BCBSND Base Physician Payment Schedule,360.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 66020,Not in chargemaster,66020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66020,BCBSND Base Physician Payment Schedule,403.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65930,Not in chargemaster,65930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65930,BCBSND Base Physician Payment Schedule,1329.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65920,Not in chargemaster,65920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65920,BCBSND Base Physician Payment Schedule,1642.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65900,Not in chargemaster,65900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65900,BCBSND Base Physician Payment Schedule,2037.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65880,Not in chargemaster,65880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65880,BCBSND Base Physician Payment Schedule,1380.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65875,Not in chargemaster,65875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65875,BCBSND Base Physician Payment Schedule,1311.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65870,Not in chargemaster,65870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65870,BCBSND Base Physician Payment Schedule,1231.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65865,Not in chargemaster,65865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65865,BCBSND Base Physician Payment Schedule,987.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65860,Not in chargemaster,65860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65860,BCBSND Base Physician Payment Schedule,643.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65855,Not in chargemaster,65855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65855,BCBSND Base Physician Payment Schedule,513.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65850,Not in chargemaster,65850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65850,BCBSND Base Physician Payment Schedule,1751.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65820,Not in chargemaster,65820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65820,BCBSND Base Physician Payment Schedule,1630.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65815,Not in chargemaster,65815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65815,BCBSND Base Physician Payment Schedule,1337.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65810,Not in chargemaster,65810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65810,BCBSND Base Physician Payment Schedule,964.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65800,Not in chargemaster,65800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65800,BCBSND Base Physician Payment Schedule,248.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65785,Not in chargemaster,65785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65785,BCBSND Base Physician Payment Schedule,4951.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65782,Not in chargemaster,65782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65782,BCBSND Base Physician Payment Schedule,2387.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65781,Not in chargemaster,65781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65781,BCBSND Base Physician Payment Schedule,2765.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65780,Not in chargemaster,65780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65780,BCBSND Base Physician Payment Schedule,1383.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65779,Not in chargemaster,65779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65779,BCBSND Base Physician Payment Schedule,2527.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65778,Not in chargemaster,65778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65778,BCBSND Base Physician Payment Schedule,2921.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65775,Not in chargemaster,65775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65775,BCBSND Base Physician Payment Schedule,1169.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65772,Not in chargemaster,65772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65772,BCBSND Base Physician Payment Schedule,940.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65770,Not in chargemaster,65770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65770,BCBSND Base Physician Payment Schedule,2904.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65771,Not in chargemaster,65771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65771,BCBSND Base Physician Payment Schedule,1750.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65756,Not in chargemaster,65756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65756,BCBSND Base Physician Payment Schedule,2454.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65760,Not in chargemaster,65760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65760,BCBSND Base Physician Payment Schedule,3659.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65765,Not in chargemaster,65765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65765,BCBSND Base Physician Payment Schedule,3768.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65767,Not in chargemaster,65767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65767,BCBSND Base Physician Payment Schedule,2422.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65755,Not in chargemaster,65755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65755,BCBSND Base Physician Payment Schedule,2588.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65750,Not in chargemaster,65750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65750,BCBSND Base Physician Payment Schedule,2600.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65730,Not in chargemaster,65730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65730,BCBSND Base Physician Payment Schedule,2586.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65710,Not in chargemaster,65710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65710,BCBSND Base Physician Payment Schedule,2338.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65600,Not in chargemaster,65600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65600,BCBSND Base Physician Payment Schedule,859.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65450,Not in chargemaster,65450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65450,BCBSND Base Physician Payment Schedule,678.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65436,Not in chargemaster,65436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65436,BCBSND Base Physician Payment Schedule,804.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65435,Not in chargemaster,65435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65435,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65430,Not in chargemaster,65430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65430,BCBSND Base Physician Payment Schedule,240.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65426,Not in chargemaster,65426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65426,BCBSND Base Physician Payment Schedule,1382.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65420,Not in chargemaster,65420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65420,BCBSND Base Physician Payment Schedule,1101.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65410,Not in chargemaster,65410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65410,BCBSND Base Physician Payment Schedule,299.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65400,Not in chargemaster,65400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65400,BCBSND Base Physician Payment Schedule,1424.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65290,Not in chargemaster,65290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65290,BCBSND Base Physician Payment Schedule,1020.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65286,Not in chargemaster,65286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65286,BCBSND Base Physician Payment Schedule,1463.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65285,Not in chargemaster,65285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65285,BCBSND Base Physician Payment Schedule,2306.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65280,Not in chargemaster,65280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65280,BCBSND Base Physician Payment Schedule,1394.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65275,Not in chargemaster,65275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65275,BCBSND Base Physician Payment Schedule,1215.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65273,Not in chargemaster,65273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65273,BCBSND Base Physician Payment Schedule,792.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65272,Not in chargemaster,65272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65272,BCBSND Base Physician Payment Schedule,1079.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65270,Not in chargemaster,65270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65270,BCBSND Base Physician Payment Schedule,582.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65265,Not in chargemaster,65265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65265,BCBSND Base Physician Payment Schedule,2269.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65260,Not in chargemaster,65260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65260,BCBSND Base Physician Payment Schedule,2020.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65235,Not in chargemaster,65235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65235,BCBSND Base Physician Payment Schedule,1493.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65222,Not in chargemaster,65222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65222,BCBSND Base Physician Payment Schedule,141.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65220,65220,65220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65220,BCBSND Base Physician Payment Schedule,124.8,124.23,Fee schedule,,124.23,124.23,124.23,124.23,,,0
unity,Fee schedule,Non-facility 65210,65210,65210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65210,BCBSND Base Physician Payment Schedule,95.43,149.08,Fee schedule,,95.43,95.43,95.43,95.43,,,0
unity,Fee schedule,Non-facility 65205,65205,65205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65205,BCBSND Base Physician Payment Schedule,77.81,120.68,Fee schedule,,77.81,77.81,77.81,77.81,,,0
unity,Fee schedule,Non-facility 65175,Not in chargemaster,65175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65175,BCBSND Base Physician Payment Schedule,1488.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65155,Not in chargemaster,65155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65155,BCBSND Base Physician Payment Schedule,1879.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65150,Not in chargemaster,65150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65150,BCBSND Base Physician Payment Schedule,1325.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65140,Not in chargemaster,65140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65140,BCBSND Base Physician Payment Schedule,1797.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65135,Not in chargemaster,65135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65135,BCBSND Base Physician Payment Schedule,1663.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65130,Not in chargemaster,65130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65130,BCBSND Base Physician Payment Schedule,1642.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65125,Not in chargemaster,65125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65125,BCBSND Base Physician Payment Schedule,951.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65114,Not in chargemaster,65114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65114,BCBSND Base Physician Payment Schedule,3190.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65112,Not in chargemaster,65112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65112,BCBSND Base Physician Payment Schedule,3049.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65110,Not in chargemaster,65110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65110,BCBSND Base Physician Payment Schedule,2644.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65105,Not in chargemaster,65105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65105,BCBSND Base Physician Payment Schedule,1876.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65103,Not in chargemaster,65103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65103,BCBSND Base Physician Payment Schedule,1711.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65101,Not in chargemaster,65101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65101,BCBSND Base Physician Payment Schedule,1650.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65093,Not in chargemaster,65093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65093,BCBSND Base Physician Payment Schedule,1419.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 65091,Not in chargemaster,65091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65091,BCBSND Base Physician Payment Schedule,1432.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64913,Not in chargemaster,64913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64913,BCBSND Base Physician Payment Schedule,378.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64912,Not in chargemaster,64912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64912,BCBSND Base Physician Payment Schedule,1934.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64911,Not in chargemaster,64911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64911,BCBSND Base Physician Payment Schedule,2171.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64910,Not in chargemaster,64910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64910,BCBSND Base Physician Payment Schedule,1668.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64907,Not in chargemaster,64907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64907,BCBSND Base Physician Payment Schedule,2766.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64905,Not in chargemaster,64905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64905,BCBSND Base Physician Payment Schedule,2166.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64902,Not in chargemaster,64902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64902,BCBSND Base Physician Payment Schedule,1474.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64901,Not in chargemaster,64901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64901,BCBSND Base Physician Payment Schedule,1271.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64898,Not in chargemaster,64898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64898,BCBSND Base Physician Payment Schedule,2915.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64897,Not in chargemaster,64897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64897,BCBSND Base Physician Payment Schedule,2692.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64896,Not in chargemaster,64896,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64896,BCBSND Base Physician Payment Schedule,3039.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64895,Not in chargemaster,64895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64895,BCBSND Base Physician Payment Schedule,2818.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64893,Not in chargemaster,64893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64893,BCBSND Base Physician Payment Schedule,2379.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64892,Not in chargemaster,64892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64892,BCBSND Base Physician Payment Schedule,2229.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64891,Not in chargemaster,64891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64891,BCBSND Base Physician Payment Schedule,2439.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64890,Not in chargemaster,64890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64890,BCBSND Base Physician Payment Schedule,2293.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64886,Not in chargemaster,64886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64886,BCBSND Base Physician Payment Schedule,2697.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64885,Not in chargemaster,64885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64885,BCBSND Base Physician Payment Schedule,2338.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64876,Not in chargemaster,64876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64876,BCBSND Base Physician Payment Schedule,419.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64874,Not in chargemaster,64874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64874,BCBSND Base Physician Payment Schedule,370.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64872,Not in chargemaster,64872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64872,BCBSND Base Physician Payment Schedule,248.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64868,Not in chargemaster,64868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64868,BCBSND Base Physician Payment Schedule,2103.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64866,Not in chargemaster,64866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64866,BCBSND Base Physician Payment Schedule,2696.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64865,Not in chargemaster,64865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64865,BCBSND Base Physician Payment Schedule,2297,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64864,Not in chargemaster,64864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64864,BCBSND Base Physician Payment Schedule,1822.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64862,Not in chargemaster,64862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64862,BCBSND Base Physician Payment Schedule,2921.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64861,Not in chargemaster,64861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64861,BCBSND Base Physician Payment Schedule,3210.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64859,Not in chargemaster,64859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64859,BCBSND Base Physician Payment Schedule,530.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64858,Not in chargemaster,64858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64858,BCBSND Base Physician Payment Schedule,2498.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64857,Not in chargemaster,64857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64857,BCBSND Base Physician Payment Schedule,2234.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64856,Not in chargemaster,64856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64856,BCBSND Base Physician Payment Schedule,2145.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64840,Not in chargemaster,64840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64840,BCBSND Base Physician Payment Schedule,2040.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64837,Not in chargemaster,64837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64837,BCBSND Base Physician Payment Schedule,781.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64836,Not in chargemaster,64836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64836,BCBSND Base Physician Payment Schedule,1731.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64835,Not in chargemaster,64835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64835,BCBSND Base Physician Payment Schedule,1731.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64834,Not in chargemaster,64834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64834,BCBSND Base Physician Payment Schedule,1569.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64832,Not in chargemaster,64832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64832,BCBSND Base Physician Payment Schedule,714.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64831,Not in chargemaster,64831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64831,BCBSND Base Physician Payment Schedule,1457.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64823,Not in chargemaster,64823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64823,BCBSND Base Physician Payment Schedule,1673.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64822,Not in chargemaster,64822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64822,BCBSND Base Physician Payment Schedule,1471.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64821,Not in chargemaster,64821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64821,BCBSND Base Physician Payment Schedule,1471.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64820,Not in chargemaster,64820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64820,BCBSND Base Physician Payment Schedule,1544.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64818,Not in chargemaster,64818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64818,BCBSND Base Physician Payment Schedule,1654.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64809,Not in chargemaster,64809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64809,BCBSND Base Physician Payment Schedule,2299.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64804,Not in chargemaster,64804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64804,BCBSND Base Physician Payment Schedule,2507.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64802,Not in chargemaster,64802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64802,BCBSND Base Physician Payment Schedule,1764.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64795,Not in chargemaster,64795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64795,BCBSND Base Physician Payment Schedule,408.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64792,Not in chargemaster,64792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64792,BCBSND Base Physician Payment Schedule,2242.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64790,Not in chargemaster,64790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64790,BCBSND Base Physician Payment Schedule,1771.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64788,Not in chargemaster,64788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64788,BCBSND Base Physician Payment Schedule,851.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64787,Not in chargemaster,64787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64787,BCBSND Base Physician Payment Schedule,510.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64786,Not in chargemaster,64786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64786,BCBSND Base Physician Payment Schedule,2145.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64784,Not in chargemaster,64784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64784,BCBSND Base Physician Payment Schedule,1546.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64783,Not in chargemaster,64783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64783,BCBSND Base Physician Payment Schedule,463.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64782,Not in chargemaster,64782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64782,BCBSND Base Physician Payment Schedule,963.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64778,Not in chargemaster,64778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64778,BCBSND Base Physician Payment Schedule,388.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64776,Not in chargemaster,64776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64776,BCBSND Base Physician Payment Schedule,824.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64774,Not in chargemaster,64774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64774,BCBSND Base Physician Payment Schedule,866.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64772,Not in chargemaster,64772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64772,BCBSND Base Physician Payment Schedule,1194.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64771,Not in chargemaster,64771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64771,BCBSND Base Physician Payment Schedule,1286.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64766,Not in chargemaster,64766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64766,BCBSND Base Physician Payment Schedule,1347.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64763,Not in chargemaster,64763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64763,BCBSND Base Physician Payment Schedule,1091.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64760,Not in chargemaster,64760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64760,BCBSND Base Physician Payment Schedule,1102.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64755,Not in chargemaster,64755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64755,BCBSND Base Physician Payment Schedule,1968.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64746,Not in chargemaster,64746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64746,BCBSND Base Physician Payment Schedule,913.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64744,Not in chargemaster,64744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64744,BCBSND Base Physician Payment Schedule,1048.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64742,Not in chargemaster,64742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64742,BCBSND Base Physician Payment Schedule,1031.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64740,Not in chargemaster,64740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64740,BCBSND Base Physician Payment Schedule,991.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64738,Not in chargemaster,64738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64738,BCBSND Base Physician Payment Schedule,954.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64736,Not in chargemaster,64736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64736,BCBSND Base Physician Payment Schedule,734.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64734,Not in chargemaster,64734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64734,BCBSND Base Physician Payment Schedule,1057.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64732,Not in chargemaster,64732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64732,BCBSND Base Physician Payment Schedule,936.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64727,Not in chargemaster,64727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64727,BCBSND Base Physician Payment Schedule,386.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64726,Not in chargemaster,64726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64726,BCBSND Base Physician Payment Schedule,567.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64722,Not in chargemaster,64722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64722,BCBSND Base Physician Payment Schedule,759.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64721,Not in chargemaster,64721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64721,BCBSND Base Physician Payment Schedule,920.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64719,Not in chargemaster,64719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64719,BCBSND Base Physician Payment Schedule,850.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64718,Not in chargemaster,64718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64718,BCBSND Base Physician Payment Schedule,1258.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64716,Not in chargemaster,64716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64716,BCBSND Base Physician Payment Schedule,1087.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64714,Not in chargemaster,64714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64714,BCBSND Base Physician Payment Schedule,1551.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64713,Not in chargemaster,64713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64713,BCBSND Base Physician Payment Schedule,1656.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64712,Not in chargemaster,64712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64712,BCBSND Base Physician Payment Schedule,1244.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64708,Not in chargemaster,64708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64708,BCBSND Base Physician Payment Schedule,1065.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64704,Not in chargemaster,64704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64704,BCBSND Base Physician Payment Schedule,679.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64702,Not in chargemaster,64702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64702,BCBSND Base Physician Payment Schedule,1063.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64681,Not in chargemaster,64681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64681,BCBSND Base Physician Payment Schedule,1183.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64680,Not in chargemaster,64680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64680,BCBSND Base Physician Payment Schedule,701.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64653,Not in chargemaster,64653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64653,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64650,Not in chargemaster,64650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64650,BCBSND Base Physician Payment Schedule,168.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64647,Not in chargemaster,64647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64647,BCBSND Base Physician Payment Schedule,373.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64646,Not in chargemaster,64646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64646,BCBSND Base Physician Payment Schedule,323.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64645,Not in chargemaster,64645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64645,BCBSND Base Physician Payment Schedule,245.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64644,Not in chargemaster,64644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64644,BCBSND Base Physician Payment Schedule,358.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64643,Not in chargemaster,64643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64643,BCBSND Base Physician Payment Schedule,194.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64642,Not in chargemaster,64642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64642,BCBSND Base Physician Payment Schedule,307.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64640,Not in chargemaster,64640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64640,BCBSND Base Physician Payment Schedule,517.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64636,Not in chargemaster,64636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64636,BCBSND Base Physician Payment Schedule,357.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64635,Not in chargemaster,64635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64635,BCBSND Base Physician Payment Schedule,866.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64634,Not in chargemaster,64634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64634,BCBSND Base Physician Payment Schedule,392.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64633,Not in chargemaster,64633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64633,BCBSND Base Physician Payment Schedule,876.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64632,Not in chargemaster,64632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64632,BCBSND Base Physician Payment Schedule,183.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64630,Not in chargemaster,64630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64630,BCBSND Base Physician Payment Schedule,509.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64625,Not in chargemaster,64625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64625,BCBSND Base Physician Payment Schedule,1038.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64624,Not in chargemaster,64624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64624,BCBSND Base Physician Payment Schedule,849.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64620,Not in chargemaster,64620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64620,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64617,Not in chargemaster,64617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64617,BCBSND Base Physician Payment Schedule,339.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64616,Not in chargemaster,64616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64616,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64615,Not in chargemaster,64615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64615,BCBSND Base Physician Payment Schedule,317.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64612,Not in chargemaster,64612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64612,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64611,Not in chargemaster,64611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64611,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64610,Not in chargemaster,64610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64610,BCBSND Base Physician Payment Schedule,1637.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64605,Not in chargemaster,64605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64605,BCBSND Base Physician Payment Schedule,1308.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64600,Not in chargemaster,64600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64600,BCBSND Base Physician Payment Schedule,935.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64595,Not in chargemaster,64595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64595,BCBSND Base Physician Payment Schedule,499.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64590,Not in chargemaster,64590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64590,BCBSND Base Physician Payment Schedule,556.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64585,Not in chargemaster,64585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64585,BCBSND Base Physician Payment Schedule,517.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64581,Not in chargemaster,64581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64581,BCBSND Base Physician Payment Schedule,1407.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64580,Not in chargemaster,64580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64580,BCBSND Base Physician Payment Schedule,658.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64575,Not in chargemaster,64575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64575,BCBSND Base Physician Payment Schedule,719.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64570,Not in chargemaster,64570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64570,BCBSND Base Physician Payment Schedule,1547.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64569,Not in chargemaster,64569,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64569,BCBSND Base Physician Payment Schedule,1607.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64568,Not in chargemaster,64568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64568,BCBSND Base Physician Payment Schedule,1325.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64566,Not in chargemaster,64566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64566,BCBSND Base Physician Payment Schedule,263.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64561,Not in chargemaster,64561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64561,BCBSND Base Physician Payment Schedule,1568.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64555,Not in chargemaster,64555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64555,BCBSND Base Physician Payment Schedule,3909.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64553,Not in chargemaster,64553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64553,BCBSND Base Physician Payment Schedule,4221.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64530,Not in chargemaster,64530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64530,BCBSND Base Physician Payment Schedule,449.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64520,Not in chargemaster,64520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64520,BCBSND Base Physician Payment Schedule,447.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64517,Not in chargemaster,64517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64517,BCBSND Base Physician Payment Schedule,401.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64510,Not in chargemaster,64510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64510,BCBSND Base Physician Payment Schedule,289.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64505,Not in chargemaster,64505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64505,BCBSND Base Physician Payment Schedule,265.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64495,Not in chargemaster,64495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64495,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64494,Not in chargemaster,64494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64494,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64493,Not in chargemaster,64493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64493,BCBSND Base Physician Payment Schedule,361.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64492,Not in chargemaster,64492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64492,BCBSND Base Physician Payment Schedule,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64491,Not in chargemaster,64491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64491,BCBSND Base Physician Payment Schedule,199.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64490,Not in chargemaster,64490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64490,BCBSND Base Physician Payment Schedule,397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64489,Not in chargemaster,64489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64489,BCBSND Base Physician Payment Schedule,586.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64488,Not in chargemaster,64488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64488,BCBSND Base Physician Payment Schedule,285.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64487,Not in chargemaster,64487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64487,BCBSND Base Physician Payment Schedule,378.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64486,Not in chargemaster,64486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64486,BCBSND Base Physician Payment Schedule,232.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64484,Not in chargemaster,64484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64484,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64483,Not in chargemaster,64483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64483,BCBSND Base Physician Payment Schedule,494.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64480,Not in chargemaster,64480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64480,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64479,Not in chargemaster,64479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64479,BCBSND Base Physician Payment Schedule,532.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64463,Not in chargemaster,64463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64463,BCBSND Base Physician Payment Schedule,418.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64462,Not in chargemaster,64462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64462,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64461,Not in chargemaster,64461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64461,BCBSND Base Physician Payment Schedule,275.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64455,Not in chargemaster,64455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64455,BCBSND Base Physician Payment Schedule,101.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64454,Not in chargemaster,64454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64454,BCBSND Base Physician Payment Schedule,444.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64451,Not in chargemaster,64451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64451,BCBSND Base Physician Payment Schedule,439.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64450,64450,64450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64450,BCBSND Base Physician Payment Schedule,160.03,110,Fee schedule,,110,110,110,110,,,0
unity,Fee schedule,Non-facility 64449,Not in chargemaster,64449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64449,BCBSND Base Physician Payment Schedule,131.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64448,Not in chargemaster,64448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64448,BCBSND Base Physician Payment Schedule,129.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64447,Not in chargemaster,64447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64447,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64446,Not in chargemaster,64446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64446,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64445,Not in chargemaster,64445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64445,BCBSND Base Physician Payment Schedule,262.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64435,Not in chargemaster,64435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64435,BCBSND Base Physician Payment Schedule,153.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64430,Not in chargemaster,64430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64430,BCBSND Base Physician Payment Schedule,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64425,Not in chargemaster,64425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64425,BCBSND Base Physician Payment Schedule,234.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64421,Not in chargemaster,64421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64421,BCBSND Base Physician Payment Schedule,71.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64420,Not in chargemaster,64420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64420,BCBSND Base Physician Payment Schedule,209.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64418,Not in chargemaster,64418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64418,BCBSND Base Physician Payment Schedule,177.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64417,Not in chargemaster,64417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64417,BCBSND Base Physician Payment Schedule,285.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64416,Not in chargemaster,64416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64416,BCBSND Base Physician Payment Schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64415,Not in chargemaster,64415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64415,BCBSND Base Physician Payment Schedule,236.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64408,Not in chargemaster,64408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64408,BCBSND Base Physician Payment Schedule,144.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64405,Not in chargemaster,64405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64405,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 64400,Not in chargemaster,64400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64400,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63746,Not in chargemaster,63746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63746,BCBSND Base Physician Payment Schedule,1277.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63744,Not in chargemaster,63744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63744,BCBSND Base Physician Payment Schedule,1441.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63741,Not in chargemaster,63741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63741,BCBSND Base Physician Payment Schedule,1430.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63740,Not in chargemaster,63740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63740,BCBSND Base Physician Payment Schedule,2067.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63710,Not in chargemaster,63710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63710,BCBSND Base Physician Payment Schedule,2305.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63709,Not in chargemaster,63709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63709,BCBSND Base Physician Payment Schedule,2352.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63707,Not in chargemaster,63707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63707,BCBSND Base Physician Payment Schedule,1968.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63706,Not in chargemaster,63706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63706,BCBSND Base Physician Payment Schedule,3902.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63704,Not in chargemaster,63704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63704,BCBSND Base Physician Payment Schedule,3506.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63702,Not in chargemaster,63702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63702,BCBSND Base Physician Payment Schedule,3021.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63700,Not in chargemaster,63700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63700,BCBSND Base Physician Payment Schedule,2761.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63688,Not in chargemaster,63688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63688,BCBSND Base Physician Payment Schedule,785.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63685,Not in chargemaster,63685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63685,BCBSND Base Physician Payment Schedule,761.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63664,Not in chargemaster,63664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63664,BCBSND Base Physician Payment Schedule,1856.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63663,Not in chargemaster,63663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63663,BCBSND Base Physician Payment Schedule,1789.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63662,Not in chargemaster,63662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63662,BCBSND Base Physician Payment Schedule,1783.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63661,Not in chargemaster,63661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63661,BCBSND Base Physician Payment Schedule,1344.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63655,Not in chargemaster,63655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63655,BCBSND Base Physician Payment Schedule,1762.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63650,Not in chargemaster,63650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63650,BCBSND Base Physician Payment Schedule,3977.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63621,Not in chargemaster,63621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63621,BCBSND Base Physician Payment Schedule,535.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63620,Not in chargemaster,63620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63620,BCBSND Base Physician Payment Schedule,2370.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63610,Not in chargemaster,63610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63610,BCBSND Base Physician Payment Schedule,1229.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63600,Not in chargemaster,63600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63600,BCBSND Base Physician Payment Schedule,2310.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63308,Not in chargemaster,63308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63308,BCBSND Base Physician Payment Schedule,687.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63307,Not in chargemaster,63307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63307,BCBSND Base Physician Payment Schedule,5107.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63306,Not in chargemaster,63306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63306,BCBSND Base Physician Payment Schedule,5215.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63305,Not in chargemaster,63305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63305,BCBSND Base Physician Payment Schedule,5307.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63304,Not in chargemaster,63304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63304,BCBSND Base Physician Payment Schedule,4983.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63303,Not in chargemaster,63303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63303,BCBSND Base Physician Payment Schedule,4911.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63302,Not in chargemaster,63302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63302,BCBSND Base Physician Payment Schedule,4620.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63301,Not in chargemaster,63301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63301,BCBSND Base Physician Payment Schedule,4676.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63300,Not in chargemaster,63300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63300,BCBSND Base Physician Payment Schedule,3901.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63295,Not in chargemaster,63295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63295,BCBSND Base Physician Payment Schedule,701.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63290,Not in chargemaster,63290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63290,BCBSND Base Physician Payment Schedule,5930.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63287,Not in chargemaster,63287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63287,BCBSND Base Physician Payment Schedule,5829.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63286,Not in chargemaster,63286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63286,BCBSND Base Physician Payment Schedule,5487.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63285,Not in chargemaster,63285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63285,BCBSND Base Physician Payment Schedule,5553.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63283,Not in chargemaster,63283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63283,BCBSND Base Physician Payment Schedule,4028.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63282,Not in chargemaster,63282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63282,BCBSND Base Physician Payment Schedule,4190.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63281,Not in chargemaster,63281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63281,BCBSND Base Physician Payment Schedule,4442.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63280,Not in chargemaster,63280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63280,BCBSND Base Physician Payment Schedule,4494.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63278,Not in chargemaster,63278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63278,BCBSND Base Physician Payment Schedule,3370.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63277,Not in chargemaster,63277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63277,BCBSND Base Physician Payment Schedule,3310.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63276,Not in chargemaster,63276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63276,BCBSND Base Physician Payment Schedule,3797.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63275,Not in chargemaster,63275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63275,BCBSND Base Physician Payment Schedule,3827.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63273,Not in chargemaster,63273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63273,BCBSND Base Physician Payment Schedule,3955.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63272,Not in chargemaster,63272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63272,BCBSND Base Physician Payment Schedule,4007.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63271,Not in chargemaster,63271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63271,BCBSND Base Physician Payment Schedule,4392.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63270,Not in chargemaster,63270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63270,BCBSND Base Physician Payment Schedule,4405.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63268,Not in chargemaster,63268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63268,BCBSND Base Physician Payment Schedule,3004.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63267,Not in chargemaster,63267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63267,BCBSND Base Physician Payment Schedule,2912.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63266,Not in chargemaster,63266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63266,BCBSND Base Physician Payment Schedule,3652.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63265,Not in chargemaster,63265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63265,BCBSND Base Physician Payment Schedule,3544.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63252,Not in chargemaster,63252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63252,BCBSND Base Physician Payment Schedule,6450.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63251,Not in chargemaster,63251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63251,BCBSND Base Physician Payment Schedule,6452,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63250,Not in chargemaster,63250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63250,BCBSND Base Physician Payment Schedule,6312.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63200,Not in chargemaster,63200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63200,BCBSND Base Physician Payment Schedule,3243.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63199,Not in chargemaster,63199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63199,BCBSND Base Physician Payment Schedule,4643.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63198,Not in chargemaster,63198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63198,BCBSND Base Physician Payment Schedule,4431.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63197,Not in chargemaster,63197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63197,BCBSND Base Physician Payment Schedule,3624.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63196,Not in chargemaster,63196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63196,BCBSND Base Physician Payment Schedule,3772.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63195,Not in chargemaster,63195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63195,BCBSND Base Physician Payment Schedule,3249.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63194,Not in chargemaster,63194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63194,BCBSND Base Physician Payment Schedule,3381.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63191,Not in chargemaster,63191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63191,BCBSND Base Physician Payment Schedule,2919.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63190,Not in chargemaster,63190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63190,BCBSND Base Physician Payment Schedule,2644.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63185,Not in chargemaster,63185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63185,BCBSND Base Physician Payment Schedule,2433.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63182,Not in chargemaster,63182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63182,BCBSND Base Physician Payment Schedule,3454.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63180,Not in chargemaster,63180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63180,BCBSND Base Physician Payment Schedule,3146.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63173,Not in chargemaster,63173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63173,BCBSND Base Physician Payment Schedule,3655.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63172,Not in chargemaster,63172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63172,BCBSND Base Physician Payment Schedule,2937.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63170,Not in chargemaster,63170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63170,BCBSND Base Physician Payment Schedule,3373.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63103,Not in chargemaster,63103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63103,BCBSND Base Physician Payment Schedule,626.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63102,Not in chargemaster,63102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63102,BCBSND Base Physician Payment Schedule,4810.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63101,Not in chargemaster,63101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63101,BCBSND Base Physician Payment Schedule,4938.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63091,Not in chargemaster,63091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63091,BCBSND Base Physician Payment Schedule,380.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63090,Not in chargemaster,63090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63090,BCBSND Base Physician Payment Schedule,4175.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63088,Not in chargemaster,63088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63088,BCBSND Base Physician Payment Schedule,545.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63087,Not in chargemaster,63087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63087,BCBSND Base Physician Payment Schedule,5124.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63086,Not in chargemaster,63086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63086,BCBSND Base Physician Payment Schedule,405.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63085,Not in chargemaster,63085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63085,BCBSND Base Physician Payment Schedule,4091.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63082,Not in chargemaster,63082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63082,BCBSND Base Physician Payment Schedule,566.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63081,Not in chargemaster,63081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63081,BCBSND Base Physician Payment Schedule,3740.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63078,Not in chargemaster,63078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63078,BCBSND Base Physician Payment Schedule,441.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63077,Not in chargemaster,63077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63077,BCBSND Base Physician Payment Schedule,3202.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63076,Not in chargemaster,63076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63076,BCBSND Base Physician Payment Schedule,524.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63075,Not in chargemaster,63075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63075,BCBSND Base Physician Payment Schedule,2870.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63066,Not in chargemaster,63066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63066,BCBSND Base Physician Payment Schedule,438.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63064,Not in chargemaster,63064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63064,BCBSND Base Physician Payment Schedule,3782.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63057,Not in chargemaster,63057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63057,BCBSND Base Physician Payment Schedule,681.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63056,Not in chargemaster,63056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63056,BCBSND Base Physician Payment Schedule,3162.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63055,Not in chargemaster,63055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63055,BCBSND Base Physician Payment Schedule,3452.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63051,Not in chargemaster,63051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63051,BCBSND Base Physician Payment Schedule,3624.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63050,Not in chargemaster,63050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63050,BCBSND Base Physician Payment Schedule,3194.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63048,Not in chargemaster,63048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63048,BCBSND Base Physician Payment Schedule,450,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63047,Not in chargemaster,63047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63047,BCBSND Base Physician Payment Schedule,2341.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63046,Not in chargemaster,63046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63046,BCBSND Base Physician Payment Schedule,2605.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63045,Not in chargemaster,63045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63045,BCBSND Base Physician Payment Schedule,2730.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63040,Not in chargemaster,63040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63040,BCBSND Base Physician Payment Schedule,2957.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63042,Not in chargemaster,63042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63042,BCBSND Base Physician Payment Schedule,2755.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63043,Not in chargemaster,63043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63043,BCBSND Base Physician Payment Schedule,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63044,Not in chargemaster,63044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63044,BCBSND Base Physician Payment Schedule,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63035,Not in chargemaster,63035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63035,BCBSND Base Physician Payment Schedule,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63030,Not in chargemaster,63030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63030,BCBSND Base Physician Payment Schedule,2063.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63020,Not in chargemaster,63020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63020,BCBSND Base Physician Payment Schedule,2457.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63017,Not in chargemaster,63017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63017,BCBSND Base Physician Payment Schedule,2671.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63016,Not in chargemaster,63016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63016,BCBSND Base Physician Payment Schedule,3230.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63015,Not in chargemaster,63015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63015,BCBSND Base Physician Payment Schedule,3139.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63012,Not in chargemaster,63012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63012,BCBSND Base Physician Payment Schedule,2535.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63011,Not in chargemaster,63011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63011,BCBSND Base Physician Payment Schedule,2306.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63005,Not in chargemaster,63005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63005,BCBSND Base Physician Payment Schedule,2528.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63003,Not in chargemaster,63003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63003,BCBSND Base Physician Payment Schedule,2624.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 63001,Not in chargemaster,63001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63001,BCBSND Base Physician Payment Schedule,2622.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62370,Not in chargemaster,62370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62370,BCBSND Base Physician Payment Schedule,207.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62369,Not in chargemaster,62369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62369,BCBSND Base Physician Payment Schedule,200.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62368,Not in chargemaster,62368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62368,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62367,Not in chargemaster,62367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62367,BCBSND Base Physician Payment Schedule,67.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62365,Not in chargemaster,62365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62365,BCBSND Base Physician Payment Schedule,622.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62362,Not in chargemaster,62362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62362,BCBSND Base Physician Payment Schedule,809.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62361,Not in chargemaster,62361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62361,BCBSND Base Physician Payment Schedule,904.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62360,Not in chargemaster,62360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62360,BCBSND Base Physician Payment Schedule,663.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62355,Not in chargemaster,62355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62355,BCBSND Base Physician Payment Schedule,571.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62351,Not in chargemaster,62351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62351,BCBSND Base Physician Payment Schedule,1844.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62350,Not in chargemaster,62350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62350,BCBSND Base Physician Payment Schedule,840.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62329,Not in chargemaster,62329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62329,BCBSND Base Physician Payment Schedule,674.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62328,Not in chargemaster,62328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62328,BCBSND Base Physician Payment Schedule,543.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62327,Not in chargemaster,62327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62327,BCBSND Base Physician Payment Schedule,519.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62326,Not in chargemaster,62326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62326,BCBSND Base Physician Payment Schedule,306.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62325,Not in chargemaster,62325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62325,BCBSND Base Physician Payment Schedule,509.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62324,Not in chargemaster,62324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62324,BCBSND Base Physician Payment Schedule,298.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62323,Not in chargemaster,62323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62323,BCBSND Base Physician Payment Schedule,535.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62322,Not in chargemaster,62322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62322,BCBSND Base Physician Payment Schedule,313.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62321,Not in chargemaster,62321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62321,BCBSND Base Physician Payment Schedule,541.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62320,Not in chargemaster,62320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62320,BCBSND Base Physician Payment Schedule,342.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62305,Not in chargemaster,62305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62305,BCBSND Base Physician Payment Schedule,580.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62304,Not in chargemaster,62304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62304,BCBSND Base Physician Payment Schedule,533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62303,Not in chargemaster,62303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62303,BCBSND Base Physician Payment Schedule,551.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62302,Not in chargemaster,62302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62302,BCBSND Base Physician Payment Schedule,541.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62294,Not in chargemaster,62294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62294,BCBSND Base Physician Payment Schedule,2009.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62292,Not in chargemaster,62292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62292,BCBSND Base Physician Payment Schedule,1225.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62291,Not in chargemaster,62291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62291,BCBSND Base Physician Payment Schedule,701.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62290,Not in chargemaster,62290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62290,BCBSND Base Physician Payment Schedule,739.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62287,Not in chargemaster,62287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62287,BCBSND Base Physician Payment Schedule,1230.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62284,Not in chargemaster,62284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62284,BCBSND Base Physician Payment Schedule,415.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62282,Not in chargemaster,62282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62282,BCBSND Base Physician Payment Schedule,643.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62281,Not in chargemaster,62281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62281,BCBSND Base Physician Payment Schedule,501.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62280,Not in chargemaster,62280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62280,BCBSND Base Physician Payment Schedule,742.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62273,Not in chargemaster,62273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62273,BCBSND Base Physician Payment Schedule,359.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62272,Not in chargemaster,62272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62272,BCBSND Base Physician Payment Schedule,383.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62270,Not in chargemaster,62270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62270,BCBSND Base Physician Payment Schedule,291.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62269,Not in chargemaster,62269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62269,BCBSND Base Physician Payment Schedule,561.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62268,Not in chargemaster,62268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62268,BCBSND Base Physician Payment Schedule,546.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62267,Not in chargemaster,62267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62267,BCBSND Base Physician Payment Schedule,557.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62264,Not in chargemaster,62264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62264,BCBSND Base Physician Payment Schedule,919.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62263,Not in chargemaster,62263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62263,BCBSND Base Physician Payment Schedule,1284.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62258,Not in chargemaster,62258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62258,BCBSND Base Physician Payment Schedule,2352.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62256,Not in chargemaster,62256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62256,BCBSND Base Physician Payment Schedule,1275.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62252,Not in chargemaster,62252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62252,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 6225226,Not in chargemaster,62252,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,6225226,BCBSND Base Physician Payment Schedule,97.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62252TC,Not in chargemaster,62252TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62252TC,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62230,Not in chargemaster,62230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62230,BCBSND Base Physician Payment Schedule,1781.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62225,Not in chargemaster,62225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62225,BCBSND Base Physician Payment Schedule,1113.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62223,Not in chargemaster,62223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62223,BCBSND Base Physician Payment Schedule,2203.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62220,Not in chargemaster,62220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62220,BCBSND Base Physician Payment Schedule,2090.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62201,Not in chargemaster,62201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62201,BCBSND Base Physician Payment Schedule,2554.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62200,Not in chargemaster,62200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62200,BCBSND Base Physician Payment Schedule,2915.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62194,Not in chargemaster,62194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62194,BCBSND Base Physician Payment Schedule,1032.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62192,Not in chargemaster,62192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62192,BCBSND Base Physician Payment Schedule,2078.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62190,Not in chargemaster,62190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62190,BCBSND Base Physician Payment Schedule,1958.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62180,Not in chargemaster,62180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62180,BCBSND Base Physician Payment Schedule,3388.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62165,Not in chargemaster,62165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62165,BCBSND Base Physician Payment Schedule,3222.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62164,Not in chargemaster,62164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62164,BCBSND Base Physician Payment Schedule,4432.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62163,Not in chargemaster,62163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62163,BCBSND Base Physician Payment Schedule,2595.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62162,Not in chargemaster,62162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62162,BCBSND Base Physician Payment Schedule,4003.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62161,Not in chargemaster,62161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62161,BCBSND Base Physician Payment Schedule,3204.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62160,Not in chargemaster,62160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62160,BCBSND Base Physician Payment Schedule,401.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62148,Not in chargemaster,62148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62148,BCBSND Base Physician Payment Schedule,269.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62147,Not in chargemaster,62147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62147,BCBSND Base Physician Payment Schedule,3012.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62146,Not in chargemaster,62146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62146,BCBSND Base Physician Payment Schedule,2394.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62145,Not in chargemaster,62145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62145,BCBSND Base Physician Payment Schedule,3015.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62143,Not in chargemaster,62143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62143,BCBSND Base Physician Payment Schedule,2204.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62142,Not in chargemaster,62142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62142,BCBSND Base Physician Payment Schedule,1874.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62141,Not in chargemaster,62141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62141,BCBSND Base Physician Payment Schedule,2417.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62140,Not in chargemaster,62140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62140,BCBSND Base Physician Payment Schedule,2171.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62121,Not in chargemaster,62121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62121,BCBSND Base Physician Payment Schedule,3306.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62120,Not in chargemaster,62120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62120,BCBSND Base Physician Payment Schedule,4450.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62117,Not in chargemaster,62117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62117,BCBSND Base Physician Payment Schedule,4167.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62115,Not in chargemaster,62115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62115,BCBSND Base Physician Payment Schedule,3553.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62100,Not in chargemaster,62100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62100,BCBSND Base Physician Payment Schedule,3349.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62010,Not in chargemaster,62010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62010,BCBSND Base Physician Payment Schedule,3250.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62005,Not in chargemaster,62005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62005,BCBSND Base Physician Payment Schedule,2691.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 62000,Not in chargemaster,62000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62000,BCBSND Base Physician Payment Schedule,2183.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61888,Not in chargemaster,61888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61888,BCBSND Base Physician Payment Schedule,836.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61886,Not in chargemaster,61886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61886,BCBSND Base Physician Payment Schedule,1812.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61885,Not in chargemaster,61885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61885,BCBSND Base Physician Payment Schedule,1096.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61880,Not in chargemaster,61880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61880,BCBSND Base Physician Payment Schedule,1220.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61870,Not in chargemaster,61870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61870,BCBSND Base Physician Payment Schedule,2507.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61868,Not in chargemaster,61868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61868,BCBSND Base Physician Payment Schedule,1060.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61867,Not in chargemaster,61867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61867,BCBSND Base Physician Payment Schedule,4838.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61864,Not in chargemaster,61864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61864,BCBSND Base Physician Payment Schedule,601.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61863,Not in chargemaster,61863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61863,BCBSND Base Physician Payment Schedule,3182.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61860,Not in chargemaster,61860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61860,BCBSND Base Physician Payment Schedule,3314.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61850,Not in chargemaster,61850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61850,BCBSND Base Physician Payment Schedule,2082.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61800,Not in chargemaster,61800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61800,BCBSND Base Physician Payment Schedule,323,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61799,Not in chargemaster,61799,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61799,BCBSND Base Physician Payment Schedule,644.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61798,Not in chargemaster,61798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61798,BCBSND Base Physician Payment Schedule,2921.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61797,Not in chargemaster,61797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61797,BCBSND Base Physician Payment Schedule,466.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61796,Not in chargemaster,61796,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61796,BCBSND Base Physician Payment Schedule,2146.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61791,Not in chargemaster,61791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61791,BCBSND Base Physician Payment Schedule,2382.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61790,Not in chargemaster,61790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61790,BCBSND Base Physician Payment Schedule,1858.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61783,Not in chargemaster,61783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61783,BCBSND Base Physician Payment Schedule,496.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61782,Not in chargemaster,61782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61782,BCBSND Base Physician Payment Schedule,367.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61781,Not in chargemaster,61781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61781,BCBSND Base Physician Payment Schedule,499.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61770,Not in chargemaster,61770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61770,BCBSND Base Physician Payment Schedule,3438.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61760,Not in chargemaster,61760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61760,BCBSND Base Physician Payment Schedule,3348.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61751,Not in chargemaster,61751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61751,BCBSND Base Physician Payment Schedule,2919.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61750,Not in chargemaster,61750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61750,BCBSND Base Physician Payment Schedule,2983.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61735,Not in chargemaster,61735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61735,BCBSND Base Physician Payment Schedule,3373.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61720,Not in chargemaster,61720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61720,BCBSND Base Physician Payment Schedule,2690.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61711,Not in chargemaster,61711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61711,BCBSND Base Physician Payment Schedule,5501.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61710,Not in chargemaster,61710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61710,BCBSND Base Physician Payment Schedule,4558.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61708,Not in chargemaster,61708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61708,BCBSND Base Physician Payment Schedule,5405.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61705,Not in chargemaster,61705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61705,BCBSND Base Physician Payment Schedule,5527.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61703,Not in chargemaster,61703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61703,BCBSND Base Physician Payment Schedule,2876.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61702,Not in chargemaster,61702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61702,BCBSND Base Physician Payment Schedule,8596.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61700,Not in chargemaster,61700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61700,BCBSND Base Physician Payment Schedule,7250.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61698,Not in chargemaster,61698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61698,BCBSND Base Physician Payment Schedule,10133.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61697,Not in chargemaster,61697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61697,BCBSND Base Physician Payment Schedule,9005.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61692,Not in chargemaster,61692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61692,BCBSND Base Physician Payment Schedule,7789.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61690,Not in chargemaster,61690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61690,BCBSND Base Physician Payment Schedule,4627.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61686,Not in chargemaster,61686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61686,BCBSND Base Physician Payment Schedule,9849.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61684,Not in chargemaster,61684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61684,BCBSND Base Physician Payment Schedule,6043.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61682,Not in chargemaster,61682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61682,BCBSND Base Physician Payment Schedule,9083.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61680,Not in chargemaster,61680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61680,BCBSND Base Physician Payment Schedule,4781.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61651,Not in chargemaster,61651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61651,BCBSND Base Physician Payment Schedule,519.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61650,Not in chargemaster,61650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61650,BCBSND Base Physician Payment Schedule,1212,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61645,Not in chargemaster,61645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61645,BCBSND Base Physician Payment Schedule,1775.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61642,Not in chargemaster,61642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61642,BCBSND Base Physician Payment Schedule,722.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61641,Not in chargemaster,61641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61641,BCBSND Base Physician Payment Schedule,361.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61640,Not in chargemaster,61640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61640,BCBSND Base Physician Payment Schedule,1028.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61635,Not in chargemaster,61635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61635,BCBSND Base Physician Payment Schedule,3083.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61630,Not in chargemaster,61630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61630,BCBSND Base Physician Payment Schedule,2901.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61626,Not in chargemaster,61626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61626,BCBSND Base Physician Payment Schedule,1880.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61624,Not in chargemaster,61624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61624,BCBSND Base Physician Payment Schedule,2447.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61623,Not in chargemaster,61623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61623,BCBSND Base Physician Payment Schedule,1215.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61619,Not in chargemaster,61619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61619,BCBSND Base Physician Payment Schedule,2982.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61618,Not in chargemaster,61618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61618,BCBSND Base Physician Payment Schedule,2705.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61616,Not in chargemaster,61616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61616,BCBSND Base Physician Payment Schedule,7051.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61615,Not in chargemaster,61615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61615,BCBSND Base Physician Payment Schedule,5968.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61613,Not in chargemaster,61613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61613,BCBSND Base Physician Payment Schedule,7001.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61611,Not in chargemaster,61611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61611,BCBSND Base Physician Payment Schedule,995.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61608,Not in chargemaster,61608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61608,BCBSND Base Physician Payment Schedule,6915.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61607,Not in chargemaster,61607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61607,BCBSND Base Physician Payment Schedule,5675.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61606,Not in chargemaster,61606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61606,BCBSND Base Physician Payment Schedule,6225.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61605,Not in chargemaster,61605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61605,BCBSND Base Physician Payment Schedule,4569.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61601,Not in chargemaster,61601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61601,BCBSND Base Physician Payment Schedule,5110.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61600,Not in chargemaster,61600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61600,BCBSND Base Physician Payment Schedule,4504.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61598,Not in chargemaster,61598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61598,BCBSND Base Physician Payment Schedule,6051.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61597,Not in chargemaster,61597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61597,BCBSND Base Physician Payment Schedule,6239.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61596,Not in chargemaster,61596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61596,BCBSND Base Physician Payment Schedule,5145.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61595,Not in chargemaster,61595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61595,BCBSND Base Physician Payment Schedule,5010.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61592,Not in chargemaster,61592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61592,BCBSND Base Physician Payment Schedule,6736.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61591,Not in chargemaster,61591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61591,BCBSND Base Physician Payment Schedule,6507.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61590,Not in chargemaster,61590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61590,BCBSND Base Physician Payment Schedule,6436.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61586,Not in chargemaster,61586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61586,BCBSND Base Physician Payment Schedule,5228.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61585,Not in chargemaster,61585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61585,BCBSND Base Physician Payment Schedule,6904.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61584,Not in chargemaster,61584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61584,BCBSND Base Physician Payment Schedule,6084.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61583,Not in chargemaster,61583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61583,BCBSND Base Physician Payment Schedule,6117.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61582,Not in chargemaster,61582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61582,BCBSND Base Physician Payment Schedule,6513.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61581,Not in chargemaster,61581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61581,BCBSND Base Physician Payment Schedule,5623.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61580,Not in chargemaster,61580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61580,BCBSND Base Physician Payment Schedule,5178.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61576,Not in chargemaster,61576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61576,BCBSND Base Physician Payment Schedule,8909.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61575,Not in chargemaster,61575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61575,BCBSND Base Physician Payment Schedule,5318.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61571,Not in chargemaster,61571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61571,BCBSND Base Physician Payment Schedule,4219.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61570,Not in chargemaster,61570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61570,BCBSND Base Physician Payment Schedule,3961.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61567,Not in chargemaster,61567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61567,BCBSND Base Physician Payment Schedule,5427.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61566,Not in chargemaster,61566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61566,BCBSND Base Physician Payment Schedule,4761.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61564,Not in chargemaster,61564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61564,BCBSND Base Physician Payment Schedule,5104.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61563,Not in chargemaster,61563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61563,BCBSND Base Physician Payment Schedule,4202.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61559,Not in chargemaster,61559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61559,BCBSND Base Physician Payment Schedule,5078.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61558,Not in chargemaster,61558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61558,BCBSND Base Physician Payment Schedule,3981.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61557,Not in chargemaster,61557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61557,BCBSND Base Physician Payment Schedule,3564.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61556,Not in chargemaster,61556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61556,BCBSND Base Physician Payment Schedule,3616.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61552,Not in chargemaster,61552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61552,BCBSND Base Physician Payment Schedule,3139.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61550,Not in chargemaster,61550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61550,BCBSND Base Physician Payment Schedule,2514.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61548,Not in chargemaster,61548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61548,BCBSND Base Physician Payment Schedule,3318.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61546,Not in chargemaster,61546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61546,BCBSND Base Physician Payment Schedule,4895.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61545,Not in chargemaster,61545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61545,BCBSND Base Physician Payment Schedule,6776.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61544,Not in chargemaster,61544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61544,BCBSND Base Physician Payment Schedule,4028.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61543,Not in chargemaster,61543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61543,BCBSND Base Physician Payment Schedule,4609.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61541,Not in chargemaster,61541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61541,BCBSND Base Physician Payment Schedule,4558.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61540,Not in chargemaster,61540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61540,BCBSND Base Physician Payment Schedule,4622.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61539,Not in chargemaster,61539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61539,BCBSND Base Physician Payment Schedule,5010.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61538,Not in chargemaster,61538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61538,BCBSND Base Physician Payment Schedule,5662.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61537,Not in chargemaster,61537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61537,BCBSND Base Physician Payment Schedule,5236.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61536,Not in chargemaster,61536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61536,BCBSND Base Physician Payment Schedule,5476.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61535,Not in chargemaster,61535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61535,BCBSND Base Physician Payment Schedule,2116.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61534,Not in chargemaster,61534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61534,BCBSND Base Physician Payment Schedule,3489.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61533,Not in chargemaster,61533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61533,BCBSND Base Physician Payment Schedule,3234.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61531,Not in chargemaster,61531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61531,BCBSND Base Physician Payment Schedule,2585.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61530,Not in chargemaster,61530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61530,BCBSND Base Physician Payment Schedule,6545.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61526,Not in chargemaster,61526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61526,BCBSND Base Physician Payment Schedule,7116.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61524,Not in chargemaster,61524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61524,BCBSND Base Physician Payment Schedule,4417.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61522,Not in chargemaster,61522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61522,BCBSND Base Physician Payment Schedule,4640.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61521,Not in chargemaster,61521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61521,BCBSND Base Physician Payment Schedule,6772.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61520,Not in chargemaster,61520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61520,BCBSND Base Physician Payment Schedule,7963.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61519,Not in chargemaster,61519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61519,BCBSND Base Physician Payment Schedule,6272.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61518,Not in chargemaster,61518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61518,BCBSND Base Physician Payment Schedule,5869.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61517,Not in chargemaster,61517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61517,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61516,Not in chargemaster,61516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61516,BCBSND Base Physician Payment Schedule,3967.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61514,Not in chargemaster,61514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61514,BCBSND Base Physician Payment Schedule,4047.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61512,Not in chargemaster,61512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61512,BCBSND Base Physician Payment Schedule,5419.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61510,Not in chargemaster,61510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61510,BCBSND Base Physician Payment Schedule,4651.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61501,Not in chargemaster,61501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61501,BCBSND Base Physician Payment Schedule,2414.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61500,Not in chargemaster,61500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61500,BCBSND Base Physician Payment Schedule,2781.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61460,Not in chargemaster,61460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61460,BCBSND Base Physician Payment Schedule,4465.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61458,Not in chargemaster,61458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61458,BCBSND Base Physician Payment Schedule,4263.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61450,Not in chargemaster,61450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61450,BCBSND Base Physician Payment Schedule,4072.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61345,Not in chargemaster,61345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61345,BCBSND Base Physician Payment Schedule,4327.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61343,Not in chargemaster,61343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61343,BCBSND Base Physician Payment Schedule,4656.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61340,Not in chargemaster,61340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61340,BCBSND Base Physician Payment Schedule,3053.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61333,Not in chargemaster,61333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61333,BCBSND Base Physician Payment Schedule,4287.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61330,Not in chargemaster,61330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61330,BCBSND Base Physician Payment Schedule,3799.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61323,Not in chargemaster,61323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61323,BCBSND Base Physician Payment Schedule,5083.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61322,Not in chargemaster,61322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61322,BCBSND Base Physician Payment Schedule,5044.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61321,Not in chargemaster,61321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61321,BCBSND Base Physician Payment Schedule,4510.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61320,Not in chargemaster,61320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61320,BCBSND Base Physician Payment Schedule,4026.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61316,Not in chargemaster,61316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61316,BCBSND Base Physician Payment Schedule,186.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61315,Not in chargemaster,61315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61315,BCBSND Base Physician Payment Schedule,4381.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61314,Not in chargemaster,61314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61314,BCBSND Base Physician Payment Schedule,3873.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61313,Not in chargemaster,61313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61313,BCBSND Base Physician Payment Schedule,4202.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61312,Not in chargemaster,61312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61312,BCBSND Base Physician Payment Schedule,4402.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61305,Not in chargemaster,61305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61305,BCBSND Base Physician Payment Schedule,4254.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61304,Not in chargemaster,61304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61304,BCBSND Base Physician Payment Schedule,3481.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61253,Not in chargemaster,61253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61253,BCBSND Base Physician Payment Schedule,2101.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61250,Not in chargemaster,61250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61250,BCBSND Base Physician Payment Schedule,1834.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61215,Not in chargemaster,61215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61215,BCBSND Base Physician Payment Schedule,1070.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61210,Not in chargemaster,61210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61210,BCBSND Base Physician Payment Schedule,781.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61156,Not in chargemaster,61156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61156,BCBSND Base Physician Payment Schedule,2631.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61154,Not in chargemaster,61154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61154,BCBSND Base Physician Payment Schedule,2692.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61151,Not in chargemaster,61151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61151,BCBSND Base Physician Payment Schedule,2101.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61150,Not in chargemaster,61150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61150,BCBSND Base Physician Payment Schedule,2863.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61140,Not in chargemaster,61140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61140,BCBSND Base Physician Payment Schedule,2682.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61120,Not in chargemaster,61120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61120,BCBSND Base Physician Payment Schedule,1579.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61108,Not in chargemaster,61108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61108,BCBSND Base Physician Payment Schedule,1896.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61107,Not in chargemaster,61107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61107,BCBSND Base Physician Payment Schedule,666.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61105,Not in chargemaster,61105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61105,BCBSND Base Physician Payment Schedule,972.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61070,Not in chargemaster,61070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61070,BCBSND Base Physician Payment Schedule,119.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61055,Not in chargemaster,61055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61055,BCBSND Base Physician Payment Schedule,261.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61050,Not in chargemaster,61050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61050,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61026,Not in chargemaster,61026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61026,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61020,Not in chargemaster,61020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61020,BCBSND Base Physician Payment Schedule,222.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61001,Not in chargemaster,61001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61001,BCBSND Base Physician Payment Schedule,226.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 61000,Not in chargemaster,61000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,61000,BCBSND Base Physician Payment Schedule,238.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60650,Not in chargemaster,60650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60650,BCBSND Base Physician Payment Schedule,2541.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60605,Not in chargemaster,60605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60605,BCBSND Base Physician Payment Schedule,3539.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60600,Not in chargemaster,60600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60600,BCBSND Base Physician Payment Schedule,2914.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60545,Not in chargemaster,60545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60545,BCBSND Base Physician Payment Schedule,2625.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60540,Not in chargemaster,60540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60540,BCBSND Base Physician Payment Schedule,2277.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60522,Not in chargemaster,60522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60522,BCBSND Base Physician Payment Schedule,2896.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60521,Not in chargemaster,60521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60521,BCBSND Base Physician Payment Schedule,2380.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60520,Not in chargemaster,60520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60520,BCBSND Base Physician Payment Schedule,2231.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60512,Not in chargemaster,60512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60512,BCBSND Base Physician Payment Schedule,516.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60505,Not in chargemaster,60505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60505,BCBSND Base Physician Payment Schedule,2945.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60502,Not in chargemaster,60502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60502,BCBSND Base Physician Payment Schedule,2752.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60500,Not in chargemaster,60500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60500,BCBSND Base Physician Payment Schedule,2053.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60300,Not in chargemaster,60300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60300,BCBSND Base Physician Payment Schedule,237.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60281,Not in chargemaster,60281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60281,BCBSND Base Physician Payment Schedule,1237.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60280,Not in chargemaster,60280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60280,BCBSND Base Physician Payment Schedule,935.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60271,Not in chargemaster,60271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60271,BCBSND Base Physician Payment Schedule,2237.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60270,Not in chargemaster,60270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60270,BCBSND Base Physician Payment Schedule,2898.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60260,Not in chargemaster,60260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60260,BCBSND Base Physician Payment Schedule,2308.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60254,Not in chargemaster,60254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60254,BCBSND Base Physician Payment Schedule,3538.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60252,Not in chargemaster,60252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60252,BCBSND Base Physician Payment Schedule,2799.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60240,Not in chargemaster,60240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60240,BCBSND Base Physician Payment Schedule,1947.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60225,Not in chargemaster,60225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60225,BCBSND Base Physician Payment Schedule,1972.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60220,Not in chargemaster,60220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60220,BCBSND Base Physician Payment Schedule,1493.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60212,Not in chargemaster,60212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60212,BCBSND Base Physician Payment Schedule,2191.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60210,Not in chargemaster,60210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60210,BCBSND Base Physician Payment Schedule,1497.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60200,Not in chargemaster,60200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60200,BCBSND Base Physician Payment Schedule,1405.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60100,Not in chargemaster,60100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60100,BCBSND Base Physician Payment Schedule,233.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 60000,Not in chargemaster,60000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60000,BCBSND Base Physician Payment Schedule,366.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59871,Not in chargemaster,59871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59871,BCBSND Base Physician Payment Schedule,282.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59870,Not in chargemaster,59870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59870,BCBSND Base Physician Payment Schedule,1079.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59866,Not in chargemaster,59866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59866,BCBSND Base Physician Payment Schedule,509.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59857,Not in chargemaster,59857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59857,BCBSND Base Physician Payment Schedule,1234.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59856,Not in chargemaster,59856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59856,BCBSND Base Physician Payment Schedule,1054.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59855,Not in chargemaster,59855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59855,BCBSND Base Physician Payment Schedule,897.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59852,Not in chargemaster,59852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59852,BCBSND Base Physician Payment Schedule,1217.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59851,Not in chargemaster,59851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59851,BCBSND Base Physician Payment Schedule,883.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59850,Not in chargemaster,59850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59850,BCBSND Base Physician Payment Schedule,824.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59841,Not in chargemaster,59841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59841,BCBSND Base Physician Payment Schedule,864.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59840,Not in chargemaster,59840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59840,BCBSND Base Physician Payment Schedule,502.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59830,Not in chargemaster,59830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59830,BCBSND Base Physician Payment Schedule,963.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59821,Not in chargemaster,59821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59821,BCBSND Base Physician Payment Schedule,867.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59820,Not in chargemaster,59820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59820,BCBSND Base Physician Payment Schedule,870.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59812,Not in chargemaster,59812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59812,BCBSND Base Physician Payment Schedule,726.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59622,Not in chargemaster,59622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59622,BCBSND Base Physician Payment Schedule,2798.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59620,Not in chargemaster,59620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59620,BCBSND Base Physician Payment Schedule,2022.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59618,Not in chargemaster,59618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59618,BCBSND Base Physician Payment Schedule,5074.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59614,Not in chargemaster,59614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59614,BCBSND Base Physician Payment Schedule,2426.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59612,Not in chargemaster,59612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59612,BCBSND Base Physician Payment Schedule,1951.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59610,Not in chargemaster,59610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59610,BCBSND Base Physician Payment Schedule,4752.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59525,Not in chargemaster,59525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59525,BCBSND Base Physician Payment Schedule,1035.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59515,Not in chargemaster,59515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59515,BCBSND Base Physician Payment Schedule,2708.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59514,Not in chargemaster,59514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59514,BCBSND Base Physician Payment Schedule,1951.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59510,Not in chargemaster,59510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59510,BCBSND Base Physician Payment Schedule,5009.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59430,Not in chargemaster,59430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59430,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59426,Not in chargemaster,59426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59426,BCBSND Base Physician Payment Schedule,1766.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59425,Not in chargemaster,59425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59425,BCBSND Base Physician Payment Schedule,992.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59414,Not in chargemaster,59414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59414,BCBSND Base Physician Payment Schedule,195.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59412,Not in chargemaster,59412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59412,BCBSND Base Physician Payment Schedule,220.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59410,Not in chargemaster,59410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59410,BCBSND Base Physician Payment Schedule,2223.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59409,59409,59409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59409,BCBSND Base Physician Payment Schedule,1727.34,1744.14,Fee schedule,,1727.34,1727.34,1727.34,1727.34,,,0
unity,Fee schedule,Non-facility 59400,Not in chargemaster,59400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59400,BCBSND Base Physician Payment Schedule,4516.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59350,Not in chargemaster,59350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59350,BCBSND Base Physician Payment Schedule,599.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59325,Not in chargemaster,59325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59325,BCBSND Base Physician Payment Schedule,516.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59320,Not in chargemaster,59320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59320,BCBSND Base Physician Payment Schedule,321.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59300,Not in chargemaster,59300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59300,BCBSND Base Physician Payment Schedule,451.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59200,Not in chargemaster,59200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59200,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59160,Not in chargemaster,59160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59160,BCBSND Base Physician Payment Schedule,508,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59151,Not in chargemaster,59151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59151,BCBSND Base Physician Payment Schedule,1633.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59150,Not in chargemaster,59150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59150,BCBSND Base Physician Payment Schedule,1673.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59140,Not in chargemaster,59140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59140,BCBSND Base Physician Payment Schedule,875.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59136,Not in chargemaster,59136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59136,BCBSND Base Physician Payment Schedule,1905.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59135,Not in chargemaster,59135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59135,BCBSND Base Physician Payment Schedule,1987.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59130,Not in chargemaster,59130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59130,BCBSND Base Physician Payment Schedule,2009.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59121,Not in chargemaster,59121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59121,BCBSND Base Physician Payment Schedule,1726.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59120,Not in chargemaster,59120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59120,BCBSND Base Physician Payment Schedule,1724.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59100,Not in chargemaster,59100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59100,BCBSND Base Physician Payment Schedule,1810.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59076,Not in chargemaster,59076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59076,BCBSND Base Physician Payment Schedule,1115.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59074,Not in chargemaster,59074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59074,BCBSND Base Physician Payment Schedule,819.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59072,Not in chargemaster,59072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59072,BCBSND Base Physician Payment Schedule,1115.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59070,Not in chargemaster,59070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59070,BCBSND Base Physician Payment Schedule,853.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59051,Not in chargemaster,59051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59051,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59050,Not in chargemaster,59050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59050,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59030,Not in chargemaster,59030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59030,BCBSND Base Physician Payment Schedule,240.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59025,Not in chargemaster,59025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59025,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5902526,Not in chargemaster,59025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5902526,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59025TC,Not in chargemaster,59025TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59025TC,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5902026,Not in chargemaster,59020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5902026,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59020TC,Not in chargemaster,59020TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59020TC,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59020,Not in chargemaster,59020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59020,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59015,Not in chargemaster,59015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59015,BCBSND Base Physician Payment Schedule,331.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59012,Not in chargemaster,59012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59012,BCBSND Base Physician Payment Schedule,430.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59001,Not in chargemaster,59001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59001,BCBSND Base Physician Payment Schedule,380.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 59000,Not in chargemaster,59000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59000,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58976,Not in chargemaster,58976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58976,BCBSND Base Physician Payment Schedule,538.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58970,Not in chargemaster,58970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58970,BCBSND Base Physician Payment Schedule,495.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58974,Not in chargemaster,58974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58974,BCBSND Base Physician Payment Schedule,538.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58960,Not in chargemaster,58960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58960,BCBSND Base Physician Payment Schedule,2054.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58958,Not in chargemaster,58958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58958,BCBSND Base Physician Payment Schedule,3694.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58957,Not in chargemaster,58957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58957,BCBSND Base Physician Payment Schedule,3337.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58956,Not in chargemaster,58956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58956,BCBSND Base Physician Payment Schedule,2874,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58954,Not in chargemaster,58954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58954,BCBSND Base Physician Payment Schedule,4582.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58953,Not in chargemaster,58953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58953,BCBSND Base Physician Payment Schedule,4229.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58952,Not in chargemaster,58952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58952,BCBSND Base Physician Payment Schedule,3448.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58951,Not in chargemaster,58951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58951,BCBSND Base Physician Payment Schedule,3036.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58950,Not in chargemaster,58950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58950,BCBSND Base Physician Payment Schedule,2399.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58943,Not in chargemaster,58943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58943,BCBSND Base Physician Payment Schedule,2472.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58940,Not in chargemaster,58940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58940,BCBSND Base Physician Payment Schedule,1148.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58925,Not in chargemaster,58925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58925,BCBSND Base Physician Payment Schedule,1613.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58920,Not in chargemaster,58920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58920,BCBSND Base Physician Payment Schedule,1512.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58900,Not in chargemaster,58900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58900,BCBSND Base Physician Payment Schedule,908.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58825,Not in chargemaster,58825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58825,BCBSND Base Physician Payment Schedule,1500.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58822,Not in chargemaster,58822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58822,BCBSND Base Physician Payment Schedule,1510.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58820,Not in chargemaster,58820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58820,BCBSND Base Physician Payment Schedule,695.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58805,Not in chargemaster,58805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58805,BCBSND Base Physician Payment Schedule,889,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58800,Not in chargemaster,58800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58800,BCBSND Base Physician Payment Schedule,731.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58770,Not in chargemaster,58770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58770,BCBSND Base Physician Payment Schedule,1833.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58760,Not in chargemaster,58760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58760,BCBSND Base Physician Payment Schedule,1742.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58752,Not in chargemaster,58752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58752,BCBSND Base Physician Payment Schedule,1929.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58750,Not in chargemaster,58750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58750,BCBSND Base Physician Payment Schedule,1935.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58740,Not in chargemaster,58740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58740,BCBSND Base Physician Payment Schedule,1905.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58720,Not in chargemaster,58720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58720,BCBSND Base Physician Payment Schedule,1583.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58700,Not in chargemaster,58700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58700,BCBSND Base Physician Payment Schedule,1681.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58674,Not in chargemaster,58674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58674,BCBSND Base Physician Payment Schedule,1738.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58673,Not in chargemaster,58673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58673,BCBSND Base Physician Payment Schedule,1699.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58672,Not in chargemaster,58672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58672,BCBSND Base Physician Payment Schedule,1564.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58671,Not in chargemaster,58671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58671,BCBSND Base Physician Payment Schedule,783.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58670,Not in chargemaster,58670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58670,BCBSND Base Physician Payment Schedule,784.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58662,Not in chargemaster,58662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58662,BCBSND Base Physician Payment Schedule,1514.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58661,Not in chargemaster,58661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58661,BCBSND Base Physician Payment Schedule,1384.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58660,Not in chargemaster,58660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58660,BCBSND Base Physician Payment Schedule,1442.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58615,Not in chargemaster,58615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58615,BCBSND Base Physician Payment Schedule,531.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58611,Not in chargemaster,58611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58611,BCBSND Base Physician Payment Schedule,164.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58605,Not in chargemaster,58605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58605,BCBSND Base Physician Payment Schedule,708.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58600,Not in chargemaster,58600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58600,BCBSND Base Physician Payment Schedule,782.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58575,Not in chargemaster,58575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58575,BCBSND Base Physician Payment Schedule,4030.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58573,Not in chargemaster,58573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58573,BCBSND Base Physician Payment Schedule,2571.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58572,Not in chargemaster,58572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58572,BCBSND Base Physician Payment Schedule,2192.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58571,Not in chargemaster,58571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58571,BCBSND Base Physician Payment Schedule,1903.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58570,Not in chargemaster,58570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58570,BCBSND Base Physician Payment Schedule,1687.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58565,Not in chargemaster,58565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58565,BCBSND Base Physician Payment Schedule,3791.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58563,Not in chargemaster,58563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58563,BCBSND Base Physician Payment Schedule,4082.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58562,Not in chargemaster,58562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58562,BCBSND Base Physician Payment Schedule,830.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58561,Not in chargemaster,58561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58561,BCBSND Base Physician Payment Schedule,769.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58560,Not in chargemaster,58560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58560,BCBSND Base Physician Payment Schedule,672.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58559,Not in chargemaster,58559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58559,BCBSND Base Physician Payment Schedule,611.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58558,Not in chargemaster,58558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58558,BCBSND Base Physician Payment Schedule,2907.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58555,Not in chargemaster,58555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58555,BCBSND Base Physician Payment Schedule,679.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58554,Not in chargemaster,58554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58554,BCBSND Base Physician Payment Schedule,2799.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58553,Not in chargemaster,58553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58553,BCBSND Base Physician Payment Schedule,2400.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58552,Not in chargemaster,58552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58552,BCBSND Base Physician Payment Schedule,2093.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58550,Not in chargemaster,58550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58550,BCBSND Base Physician Payment Schedule,1878.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58548,Not in chargemaster,58548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58548,BCBSND Base Physician Payment Schedule,3963.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58546,Not in chargemaster,58546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58546,BCBSND Base Physician Payment Schedule,2386.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58545,Not in chargemaster,58545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58545,BCBSND Base Physician Payment Schedule,1913.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58544,Not in chargemaster,58544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58544,BCBSND Base Physician Payment Schedule,1925.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58543,Not in chargemaster,58543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58543,BCBSND Base Physician Payment Schedule,1788.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58542,Not in chargemaster,58542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58542,BCBSND Base Physician Payment Schedule,1759.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58541,Not in chargemaster,58541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58541,BCBSND Base Physician Payment Schedule,1546.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58540,Not in chargemaster,58540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58540,BCBSND Base Physician Payment Schedule,1949.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58520,Not in chargemaster,58520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58520,BCBSND Base Physician Payment Schedule,1695.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58410,Not in chargemaster,58410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58410,BCBSND Base Physician Payment Schedule,1731.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58400,Not in chargemaster,58400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58400,BCBSND Base Physician Payment Schedule,964.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58356,Not in chargemaster,58356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58356,BCBSND Base Physician Payment Schedule,3820.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58353,Not in chargemaster,58353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58353,BCBSND Base Physician Payment Schedule,2092.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58350,Not in chargemaster,58350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58350,BCBSND Base Physician Payment Schedule,265.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58346,Not in chargemaster,58346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58346,BCBSND Base Physician Payment Schedule,1002.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58345,Not in chargemaster,58345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58345,BCBSND Base Physician Payment Schedule,607.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58340,Not in chargemaster,58340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58340,BCBSND Base Physician Payment Schedule,405.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58323,Not in chargemaster,58323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58323,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58322,Not in chargemaster,58322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58322,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58321,Not in chargemaster,58321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58321,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58301,58301,58301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58301,BCBSND Base Physician Payment Schedule,213.62,215,Fee schedule,,213.62,213.62,213.62,213.62,,,0
unity,Fee schedule,Non-facility 58300,Not in chargemaster,58300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58300,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58294,Not in chargemaster,58294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58294,BCBSND Base Physician Payment Schedule,2601.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58293,Not in chargemaster,58293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58293,BCBSND Base Physician Payment Schedule,2914.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58292,Not in chargemaster,58292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58292,BCBSND Base Physician Payment Schedule,2805,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58291,Not in chargemaster,58291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58291,BCBSND Base Physician Payment Schedule,2661.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58290,Not in chargemaster,58290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58290,BCBSND Base Physician Payment Schedule,2456.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58285,Not in chargemaster,58285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58285,BCBSND Base Physician Payment Schedule,2970.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58280,Not in chargemaster,58280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58280,BCBSND Base Physician Payment Schedule,2255.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58275,Not in chargemaster,58275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58275,BCBSND Base Physician Payment Schedule,2103.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58270,Not in chargemaster,58270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58270,BCBSND Base Physician Payment Schedule,1896.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58267,Not in chargemaster,58267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58267,BCBSND Base Physician Payment Schedule,2269.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58263,Not in chargemaster,58263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58263,BCBSND Base Physician Payment Schedule,2119.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58262,Not in chargemaster,58262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58262,BCBSND Base Physician Payment Schedule,1972.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58260,Not in chargemaster,58260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58260,BCBSND Base Physician Payment Schedule,1776.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58240,Not in chargemaster,58240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58240,BCBSND Base Physician Payment Schedule,6152.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58210,Not in chargemaster,58210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58210,BCBSND Base Physician Payment Schedule,3844.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58200,Not in chargemaster,58200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58200,BCBSND Base Physician Payment Schedule,2865.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58180,Not in chargemaster,58180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58180,BCBSND Base Physician Payment Schedule,2043.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58152,Not in chargemaster,58152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58152,BCBSND Base Physician Payment Schedule,2667.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58150,58150,58150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58150,BCBSND Base Physician Payment Schedule,2147.24,2120.37,Fee schedule,,2120.37,2120.37,2120.37,2120.37,,,0
unity,Fee schedule,Non-facility 58146,Not in chargemaster,58146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58146,BCBSND Base Physician Payment Schedule,2465.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58145,Not in chargemaster,58145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58145,BCBSND Base Physician Payment Schedule,1192.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58140,Not in chargemaster,58140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58140,BCBSND Base Physician Payment Schedule,1976.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58120,Not in chargemaster,58120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58120,BCBSND Base Physician Payment Schedule,593.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58110,Not in chargemaster,58110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58110,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 58100,58100,58100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58100,BCBSND Base Physician Payment Schedule,205.55,232.84,Fee schedule,,205.55,205.55,205.55,205.55,,,0
unity,Fee schedule,Non-facility 57800,Not in chargemaster,57800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57800,BCBSND Base Physician Payment Schedule,147.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57720,Not in chargemaster,57720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57720,BCBSND Base Physician Payment Schedule,684.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57700,Not in chargemaster,57700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57700,BCBSND Base Physician Payment Schedule,710.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57558,Not in chargemaster,57558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57558,BCBSND Base Physician Payment Schedule,303.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57556,Not in chargemaster,57556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57556,BCBSND Base Physician Payment Schedule,1234.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57555,Not in chargemaster,57555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57555,BCBSND Base Physician Payment Schedule,1303.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57550,Not in chargemaster,57550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57550,BCBSND Base Physician Payment Schedule,894.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57545,Not in chargemaster,57545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57545,BCBSND Base Physician Payment Schedule,1767.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57540,Not in chargemaster,57540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57540,BCBSND Base Physician Payment Schedule,1676.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57531,Not in chargemaster,57531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57531,BCBSND Base Physician Payment Schedule,3885.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57530,Not in chargemaster,57530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57530,BCBSND Base Physician Payment Schedule,764.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57522,Not in chargemaster,57522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57522,BCBSND Base Physician Payment Schedule,605.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57520,Not in chargemaster,57520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57520,BCBSND Base Physician Payment Schedule,704,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57513,Not in chargemaster,57513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57513,BCBSND Base Physician Payment Schedule,372.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57511,Not in chargemaster,57511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57511,BCBSND Base Physician Payment Schedule,367.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57510,Not in chargemaster,57510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57510,BCBSND Base Physician Payment Schedule,317.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57505,Not in chargemaster,57505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57505,BCBSND Base Physician Payment Schedule,270.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57500,Not in chargemaster,57500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57500,BCBSND Base Physician Payment Schedule,301.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57461,Not in chargemaster,57461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57461,BCBSND Base Physician Payment Schedule,723.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57460,Not in chargemaster,57460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57460,BCBSND Base Physician Payment Schedule,644.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57456,Not in chargemaster,57456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57456,BCBSND Base Physician Payment Schedule,306.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57455,Not in chargemaster,57455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57455,BCBSND Base Physician Payment Schedule,325.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57454,Not in chargemaster,57454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57454,BCBSND Base Physician Payment Schedule,345.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57452,Not in chargemaster,57452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57452,BCBSND Base Physician Payment Schedule,253.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57426,Not in chargemaster,57426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57426,BCBSND Base Physician Payment Schedule,1825.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57425,Not in chargemaster,57425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57425,BCBSND Base Physician Payment Schedule,2078.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57423,Not in chargemaster,57423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57423,BCBSND Base Physician Payment Schedule,1969.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57421,Not in chargemaster,57421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57421,BCBSND Base Physician Payment Schedule,356.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57420,Not in chargemaster,57420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57420,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57415,Not in chargemaster,57415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57415,BCBSND Base Physician Payment Schedule,358.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57410,Not in chargemaster,57410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57410,BCBSND Base Physician Payment Schedule,225.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57400,Not in chargemaster,57400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57400,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57335,Not in chargemaster,57335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57335,BCBSND Base Physician Payment Schedule,2493,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57330,Not in chargemaster,57330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57330,BCBSND Base Physician Payment Schedule,1605.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57320,Not in chargemaster,57320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57320,BCBSND Base Physician Payment Schedule,1163.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57311,Not in chargemaster,57311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57311,BCBSND Base Physician Payment Schedule,1151.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57310,Not in chargemaster,57310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57310,BCBSND Base Physician Payment Schedule,1016.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57308,Not in chargemaster,57308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57308,BCBSND Base Physician Payment Schedule,1394.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57307,Not in chargemaster,57307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57307,BCBSND Base Physician Payment Schedule,2230.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57305,Not in chargemaster,57305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57305,BCBSND Base Physician Payment Schedule,2052.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57300,Not in chargemaster,57300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57300,BCBSND Base Physician Payment Schedule,1251.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57296,Not in chargemaster,57296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57296,BCBSND Base Physician Payment Schedule,2011.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57295,Not in chargemaster,57295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57295,BCBSND Base Physician Payment Schedule,1044.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57292,Not in chargemaster,57292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57292,BCBSND Base Physician Payment Schedule,1756.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57291,Not in chargemaster,57291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57291,BCBSND Base Physician Payment Schedule,1151.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57289,Not in chargemaster,57289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57289,BCBSND Base Physician Payment Schedule,1662.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57288,Not in chargemaster,57288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57288,BCBSND Base Physician Payment Schedule,1555.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57287,Not in chargemaster,57287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57287,BCBSND Base Physician Payment Schedule,1518.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57285,Not in chargemaster,57285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57285,BCBSND Base Physician Payment Schedule,1459.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57284,Not in chargemaster,57284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57284,BCBSND Base Physician Payment Schedule,1753.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57283,Not in chargemaster,57283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57283,BCBSND Base Physician Payment Schedule,1486.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57282,Not in chargemaster,57282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57282,BCBSND Base Physician Payment Schedule,1114.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57280,Not in chargemaster,57280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57280,BCBSND Base Physician Payment Schedule,2045.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57270,Not in chargemaster,57270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57270,BCBSND Base Physician Payment Schedule,1720.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57268,Not in chargemaster,57268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57268,BCBSND Base Physician Payment Schedule,1054.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57267,Not in chargemaster,57267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57267,BCBSND Base Physician Payment Schedule,538.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57265,Not in chargemaster,57265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57265,BCBSND Base Physician Payment Schedule,1848.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57260,Not in chargemaster,57260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57260,BCBSND Base Physician Payment Schedule,1646.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57250,Not in chargemaster,57250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57250,BCBSND Base Physician Payment Schedule,1292.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57240,Not in chargemaster,57240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57240,BCBSND Base Physician Payment Schedule,1283.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57230,Not in chargemaster,57230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57230,BCBSND Base Physician Payment Schedule,869.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57220,Not in chargemaster,57220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57220,BCBSND Base Physician Payment Schedule,709.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57210,Not in chargemaster,57210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57210,BCBSND Base Physician Payment Schedule,812.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57200,Not in chargemaster,57200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57200,BCBSND Base Physician Payment Schedule,673.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57180,Not in chargemaster,57180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57180,BCBSND Base Physician Payment Schedule,364.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57170,Not in chargemaster,57170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57170,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57160,Not in chargemaster,57160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57160,BCBSND Base Physician Payment Schedule,143.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57156,Not in chargemaster,57156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57156,BCBSND Base Physician Payment Schedule,450,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57155,Not in chargemaster,57155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57155,BCBSND Base Physician Payment Schedule,800.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57150,Not in chargemaster,57150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57150,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57135,Not in chargemaster,57135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57135,BCBSND Base Physician Payment Schedule,468.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57130,Not in chargemaster,57130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57130,BCBSND Base Physician Payment Schedule,435.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57120,Not in chargemaster,57120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57120,BCBSND Base Physician Payment Schedule,1109.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57112,Not in chargemaster,57112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57112,BCBSND Base Physician Payment Schedule,3874.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57111,Not in chargemaster,57111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57111,BCBSND Base Physician Payment Schedule,3622.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57110,Not in chargemaster,57110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57110,BCBSND Base Physician Payment Schedule,1918.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57109,Not in chargemaster,57109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57109,BCBSND Base Physician Payment Schedule,3622.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57107,Not in chargemaster,57107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57107,BCBSND Base Physician Payment Schedule,3048.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57106,Not in chargemaster,57106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57106,BCBSND Base Physician Payment Schedule,1093.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57105,Not in chargemaster,57105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57105,BCBSND Base Physician Payment Schedule,334.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57100,Not in chargemaster,57100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57100,BCBSND Base Physician Payment Schedule,202.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57065,Not in chargemaster,57065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57065,BCBSND Base Physician Payment Schedule,467.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57061,Not in chargemaster,57061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57061,BCBSND Base Physician Payment Schedule,297.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57023,Not in chargemaster,57023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57023,BCBSND Base Physician Payment Schedule,672.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57022,Not in chargemaster,57022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57022,BCBSND Base Physician Payment Schedule,374.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57020,Not in chargemaster,57020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57020,BCBSND Base Physician Payment Schedule,232.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57010,Not in chargemaster,57010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57010,BCBSND Base Physician Payment Schedule,950.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 57000,Not in chargemaster,57000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57000,BCBSND Base Physician Payment Schedule,417.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56821,Not in chargemaster,56821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56821,BCBSND Base Physician Payment Schedule,335.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56820,Not in chargemaster,56820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56820,BCBSND Base Physician Payment Schedule,251.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56810,Not in chargemaster,56810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56810,BCBSND Base Physician Payment Schedule,566.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56805,Not in chargemaster,56805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56805,BCBSND Base Physician Payment Schedule,2468.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56800,Not in chargemaster,56800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56800,BCBSND Base Physician Payment Schedule,526.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56740,Not in chargemaster,56740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56740,BCBSND Base Physician Payment Schedule,654.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56700,Not in chargemaster,56700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56700,BCBSND Base Physician Payment Schedule,416.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56640,Not in chargemaster,56640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56640,BCBSND Base Physician Payment Schedule,3183.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56637,Not in chargemaster,56637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56637,BCBSND Base Physician Payment Schedule,3144.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56634,Not in chargemaster,56634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56634,BCBSND Base Physician Payment Schedule,2707.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56633,Not in chargemaster,56633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56633,BCBSND Base Physician Payment Schedule,2566.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56632,Not in chargemaster,56632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56632,BCBSND Base Physician Payment Schedule,2956.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56631,Not in chargemaster,56631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56631,BCBSND Base Physician Payment Schedule,2483.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56630,Not in chargemaster,56630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56630,BCBSND Base Physician Payment Schedule,1987.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56625,Not in chargemaster,56625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56625,BCBSND Base Physician Payment Schedule,1366.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56620,Not in chargemaster,56620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56620,BCBSND Base Physician Payment Schedule,1168.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56606,Not in chargemaster,56606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56606,BCBSND Base Physician Payment Schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56605,Not in chargemaster,56605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56605,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56515,Not in chargemaster,56515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56515,BCBSND Base Physician Payment Schedule,532.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56501,Not in chargemaster,56501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56501,BCBSND Base Physician Payment Schedule,344.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56442,Not in chargemaster,56442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56442,BCBSND Base Physician Payment Schedule,99.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56441,Not in chargemaster,56441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56441,BCBSND Base Physician Payment Schedule,346.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56440,Not in chargemaster,56440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56440,BCBSND Base Physician Payment Schedule,385.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56420,Not in chargemaster,56420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56420,BCBSND Base Physician Payment Schedule,328.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 56405,Not in chargemaster,56405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56405,BCBSND Base Physician Payment Schedule,270.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55920,Not in chargemaster,55920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55920,BCBSND Base Physician Payment Schedule,960.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55876,Not in chargemaster,55876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55876,BCBSND Base Physician Payment Schedule,305.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55875,Not in chargemaster,55875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55875,BCBSND Base Physician Payment Schedule,1629.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55874,Not in chargemaster,55874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55874,BCBSND Base Physician Payment Schedule,6393.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55873,Not in chargemaster,55873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55873,BCBSND Base Physician Payment Schedule,12885.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55870,Not in chargemaster,55870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55870,BCBSND Base Physician Payment Schedule,369.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55866,Not in chargemaster,55866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55866,BCBSND Base Physician Payment Schedule,3060.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55865,Not in chargemaster,55865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55865,BCBSND Base Physician Payment Schedule,2831.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55862,Not in chargemaster,55862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55862,BCBSND Base Physician Payment Schedule,2324.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55860,Not in chargemaster,55860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55860,BCBSND Base Physician Payment Schedule,1855.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55845,Not in chargemaster,55845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55845,BCBSND Base Physician Payment Schedule,2890.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55842,Not in chargemaster,55842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55842,BCBSND Base Physician Payment Schedule,2483.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55840,Not in chargemaster,55840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55840,BCBSND Base Physician Payment Schedule,2481.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55831,Not in chargemaster,55831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55831,BCBSND Base Physician Payment Schedule,2005.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55821,Not in chargemaster,55821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55821,BCBSND Base Physician Payment Schedule,1852.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55815,Not in chargemaster,55815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55815,BCBSND Base Physician Payment Schedule,3738.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55812,Not in chargemaster,55812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55812,BCBSND Base Physician Payment Schedule,3412.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55810,Not in chargemaster,55810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55810,BCBSND Base Physician Payment Schedule,2779.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55801,Not in chargemaster,55801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55801,BCBSND Base Physician Payment Schedule,2321.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55725,Not in chargemaster,55725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55725,BCBSND Base Physician Payment Schedule,1258.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55720,Not in chargemaster,55720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55720,BCBSND Base Physician Payment Schedule,958,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55706,Not in chargemaster,55706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55706,BCBSND Base Physician Payment Schedule,789.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55705,Not in chargemaster,55705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55705,BCBSND Base Physician Payment Schedule,563.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55700,Not in chargemaster,55700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55700,BCBSND Base Physician Payment Schedule,520.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55680,Not in chargemaster,55680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55680,BCBSND Base Physician Payment Schedule,733.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55650,Not in chargemaster,55650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55650,BCBSND Base Physician Payment Schedule,1521.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55605,Not in chargemaster,55605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55605,BCBSND Base Physician Payment Schedule,1106.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55600,Not in chargemaster,55600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55600,BCBSND Base Physician Payment Schedule,891.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55550,Not in chargemaster,55550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55550,BCBSND Base Physician Payment Schedule,908.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55540,Not in chargemaster,55540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55540,BCBSND Base Physician Payment Schedule,1178.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55535,Not in chargemaster,55535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55535,BCBSND Base Physician Payment Schedule,911.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55530,Not in chargemaster,55530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55530,BCBSND Base Physician Payment Schedule,743.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55520,55520,55520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55520,BCBSND Base Physician Payment Schedule,969.01,812.79,Fee schedule,,812.79,812.79,812.79,812.79,,,0
unity,Fee schedule,Non-facility 55500,Not in chargemaster,55500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55500,BCBSND Base Physician Payment Schedule,833.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55400,Not in chargemaster,55400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55400,BCBSND Base Physician Payment Schedule,1058.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55300,Not in chargemaster,55300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55300,BCBSND Base Physician Payment Schedule,395.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55250,Not in chargemaster,55250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55250,BCBSND Base Physician Payment Schedule,757.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55200,Not in chargemaster,55200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55200,BCBSND Base Physician Payment Schedule,865.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55180,Not in chargemaster,55180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55180,BCBSND Base Physician Payment Schedule,1468.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55175,Not in chargemaster,55175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55175,BCBSND Base Physician Payment Schedule,767.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55150,Not in chargemaster,55150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55150,BCBSND Base Physician Payment Schedule,1042.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55120,Not in chargemaster,55120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55120,BCBSND Base Physician Payment Schedule,748.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55110,Not in chargemaster,55110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55110,BCBSND Base Physician Payment Schedule,821.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55100,Not in chargemaster,55100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55100,BCBSND Base Physician Payment Schedule,472.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55060,Not in chargemaster,55060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55060,BCBSND Base Physician Payment Schedule,805.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55041,Not in chargemaster,55041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55041,BCBSND Base Physician Payment Schedule,1082.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55040,Not in chargemaster,55040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55040,BCBSND Base Physician Payment Schedule,713.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 55000,Not in chargemaster,55000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55000,BCBSND Base Physician Payment Schedule,248.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54901,Not in chargemaster,54901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54901,BCBSND Base Physician Payment Schedule,2242.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54900,Not in chargemaster,54900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54900,BCBSND Base Physician Payment Schedule,1697.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54865,Not in chargemaster,54865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54865,BCBSND Base Physician Payment Schedule,758.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54861,Not in chargemaster,54861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54861,BCBSND Base Physician Payment Schedule,1202.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54860,Not in chargemaster,54860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54860,BCBSND Base Physician Payment Schedule,886.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54840,Not in chargemaster,54840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54840,BCBSND Base Physician Payment Schedule,680.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54830,Not in chargemaster,54830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54830,BCBSND Base Physician Payment Schedule,786.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54800,Not in chargemaster,54800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54800,BCBSND Base Physician Payment Schedule,266.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54700,54700,54700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54700,BCBSND Base Physician Payment Schedule,453.67,440,Fee schedule,,440,440,440,440,,,0
unity,Fee schedule,Non-facility 54692,Not in chargemaster,54692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54692,BCBSND Base Physician Payment Schedule,1607.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54690,Not in chargemaster,54690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54690,BCBSND Base Physician Payment Schedule,1390.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54680,Not in chargemaster,54680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54680,BCBSND Base Physician Payment Schedule,1670.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54670,Not in chargemaster,54670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54670,BCBSND Base Physician Payment Schedule,862.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54660,Not in chargemaster,54660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54660,BCBSND Base Physician Payment Schedule,755.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54650,Not in chargemaster,54650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54650,BCBSND Base Physician Payment Schedule,1508.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54640,Not in chargemaster,54640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54640,BCBSND Base Physician Payment Schedule,921.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54620,Not in chargemaster,54620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54620,BCBSND Base Physician Payment Schedule,634.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54600,Not in chargemaster,54600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54600,BCBSND Base Physician Payment Schedule,959.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54560,Not in chargemaster,54560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54560,BCBSND Base Physician Payment Schedule,1456.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54550,Not in chargemaster,54550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54550,BCBSND Base Physician Payment Schedule,1042.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54535,Not in chargemaster,54535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54535,BCBSND Base Physician Payment Schedule,1577.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54530,Not in chargemaster,54530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54530,BCBSND Base Physician Payment Schedule,1073.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54522,Not in chargemaster,54522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54522,BCBSND Base Physician Payment Schedule,1248.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54520,Not in chargemaster,54520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54520,BCBSND Base Physician Payment Schedule,690.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54512,Not in chargemaster,54512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54512,BCBSND Base Physician Payment Schedule,1142.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54505,Not in chargemaster,54505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54505,BCBSND Base Physician Payment Schedule,444.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54500,Not in chargemaster,54500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54500,BCBSND Base Physician Payment Schedule,157.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54450,Not in chargemaster,54450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54450,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54438,Not in chargemaster,54438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54438,BCBSND Base Physician Payment Schedule,2836.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54440,Not in chargemaster,54440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54440,BCBSND Base Physician Payment Schedule,3409.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54437,Not in chargemaster,54437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54437,BCBSND Base Physician Payment Schedule,1429.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54435,Not in chargemaster,54435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54435,BCBSND Base Physician Payment Schedule,879.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54430,Not in chargemaster,54430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54430,BCBSND Base Physician Payment Schedule,1354.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54420,Not in chargemaster,54420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54420,BCBSND Base Physician Payment Schedule,1492.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54417,Not in chargemaster,54417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54417,BCBSND Base Physician Payment Schedule,1905.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54416,Not in chargemaster,54416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54416,BCBSND Base Physician Payment Schedule,1507.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54415,Not in chargemaster,54415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54415,BCBSND Base Physician Payment Schedule,1120.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54411,Not in chargemaster,54411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54411,BCBSND Base Physician Payment Schedule,2181.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54410,Not in chargemaster,54410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54410,BCBSND Base Physician Payment Schedule,1824.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54408,Not in chargemaster,54408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54408,BCBSND Base Physician Payment Schedule,1675.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54406,Not in chargemaster,54406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54406,BCBSND Base Physician Payment Schedule,1549.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54405,Not in chargemaster,54405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54405,BCBSND Base Physician Payment Schedule,1715.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54401,Not in chargemaster,54401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54401,BCBSND Base Physician Payment Schedule,1393.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54400,Not in chargemaster,54400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54400,BCBSND Base Physician Payment Schedule,1126.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54390,Not in chargemaster,54390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54390,BCBSND Base Physician Payment Schedule,2632.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54385,Not in chargemaster,54385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54385,BCBSND Base Physician Payment Schedule,1970.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54380,Not in chargemaster,54380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54380,BCBSND Base Physician Payment Schedule,1695.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54360,Not in chargemaster,54360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54360,BCBSND Base Physician Payment Schedule,1528.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54352,Not in chargemaster,54352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54352,BCBSND Base Physician Payment Schedule,3003.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54348,Not in chargemaster,54348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54348,BCBSND Base Physician Payment Schedule,2145.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54344,Not in chargemaster,54344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54344,BCBSND Base Physician Payment Schedule,2006.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54340,Not in chargemaster,54340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54340,BCBSND Base Physician Payment Schedule,1206.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54336,Not in chargemaster,54336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54336,BCBSND Base Physician Payment Schedule,2521.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54332,Not in chargemaster,54332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54332,BCBSND Base Physician Payment Schedule,2146.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54328,Not in chargemaster,54328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54328,BCBSND Base Physician Payment Schedule,1988.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54326,Not in chargemaster,54326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54326,BCBSND Base Physician Payment Schedule,2001.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54324,Not in chargemaster,54324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54324,BCBSND Base Physician Payment Schedule,2052.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54322,Not in chargemaster,54322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54322,BCBSND Base Physician Payment Schedule,1657.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54318,Not in chargemaster,54318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54318,BCBSND Base Physician Payment Schedule,1507.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54316,Not in chargemaster,54316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54316,BCBSND Base Physician Payment Schedule,2112.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54312,Not in chargemaster,54312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54312,BCBSND Base Physician Payment Schedule,1735.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54308,Not in chargemaster,54308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54308,BCBSND Base Physician Payment Schedule,1516.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54304,Not in chargemaster,54304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54304,BCBSND Base Physician Payment Schedule,1587.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54300,Not in chargemaster,54300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54300,BCBSND Base Physician Payment Schedule,1366.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54250,Not in chargemaster,54250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54250,BCBSND Base Physician Payment Schedule,257.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5425026,Not in chargemaster,54250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5425026,BCBSND Base Physician Payment Schedule,231.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54250TC,Not in chargemaster,54250TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54250TC,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5424026,Not in chargemaster,54240,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5424026,BCBSND Base Physician Payment Schedule,138.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54240TC,Not in chargemaster,54240TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54240TC,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54240,Not in chargemaster,54240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54240,BCBSND Base Physician Payment Schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54235,Not in chargemaster,54235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54235,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54231,Not in chargemaster,54231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54231,BCBSND Base Physician Payment Schedule,298.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54230,Not in chargemaster,54230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54230,BCBSND Base Physician Payment Schedule,210.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54220,Not in chargemaster,54220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54220,BCBSND Base Physician Payment Schedule,445.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54205,Not in chargemaster,54205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54205,BCBSND Base Physician Payment Schedule,1127.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54200,Not in chargemaster,54200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54200,BCBSND Base Physician Payment Schedule,232.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54164,Not in chargemaster,54164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54164,BCBSND Base Physician Payment Schedule,406.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54163,Not in chargemaster,54163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54163,BCBSND Base Physician Payment Schedule,460.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54162,Not in chargemaster,54162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54162,BCBSND Base Physician Payment Schedule,542.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54161,Not in chargemaster,54161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54161,BCBSND Base Physician Payment Schedule,416.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54160,Not in chargemaster,54160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54160,BCBSND Base Physician Payment Schedule,461.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54150,54150,54150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54150,BCBSND Base Physician Payment Schedule,323,325.83,Fee schedule,,323,323,323,323,,,0
unity,Fee schedule,Non-facility 54135,Not in chargemaster,54135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54135,BCBSND Base Physician Payment Schedule,3206.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54130,Not in chargemaster,54130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54130,BCBSND Base Physician Payment Schedule,2529.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54125,Not in chargemaster,54125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54125,BCBSND Base Physician Payment Schedule,1727.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54120,Not in chargemaster,54120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54120,BCBSND Base Physician Payment Schedule,1338.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54115,Not in chargemaster,54115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54115,BCBSND Base Physician Payment Schedule,960.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54112,Not in chargemaster,54112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54112,BCBSND Base Physician Payment Schedule,1987.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54111,Not in chargemaster,54111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54111,BCBSND Base Physician Payment Schedule,1696.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54110,Not in chargemaster,54110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54110,BCBSND Base Physician Payment Schedule,1322.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54105,Not in chargemaster,54105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54105,BCBSND Base Physician Payment Schedule,568.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54100,Not in chargemaster,54100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54100,BCBSND Base Physician Payment Schedule,416.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54065,Not in chargemaster,54065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54065,BCBSND Base Physician Payment Schedule,460.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54060,Not in chargemaster,54060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54060,BCBSND Base Physician Payment Schedule,394.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54057,Not in chargemaster,54057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54057,BCBSND Base Physician Payment Schedule,289.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54056,Not in chargemaster,54056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54056,BCBSND Base Physician Payment Schedule,292.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54055,Not in chargemaster,54055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54055,BCBSND Base Physician Payment Schedule,263.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54050,Not in chargemaster,54050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54050,BCBSND Base Physician Payment Schedule,281.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54015,Not in chargemaster,54015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54015,BCBSND Base Physician Payment Schedule,648.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54001,Not in chargemaster,54001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54001,BCBSND Base Physician Payment Schedule,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 54000,Not in chargemaster,54000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54000,BCBSND Base Physician Payment Schedule,329.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53860,Not in chargemaster,53860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53860,BCBSND Base Physician Payment Schedule,4387.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53855,Not in chargemaster,53855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53855,BCBSND Base Physician Payment Schedule,1548.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53854,Not in chargemaster,53854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53854,BCBSND Base Physician Payment Schedule,3757.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53852,Not in chargemaster,53852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53852,BCBSND Base Physician Payment Schedule,3156.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53850,Not in chargemaster,53850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53850,BCBSND Base Physician Payment Schedule,3255,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53665,Not in chargemaster,53665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53665,BCBSND Base Physician Payment Schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53661,Not in chargemaster,53661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53661,BCBSND Base Physician Payment Schedule,146.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53660,Not in chargemaster,53660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53660,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53621,Not in chargemaster,53621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53621,BCBSND Base Physician Payment Schedule,292.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53620,Not in chargemaster,53620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53620,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53605,Not in chargemaster,53605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53605,BCBSND Base Physician Payment Schedule,137.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53601,Not in chargemaster,53601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53601,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53600,Not in chargemaster,53600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53600,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53520,Not in chargemaster,53520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53520,BCBSND Base Physician Payment Schedule,1180.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53515,Not in chargemaster,53515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53515,BCBSND Base Physician Payment Schedule,1686.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53510,Not in chargemaster,53510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53510,BCBSND Base Physician Payment Schedule,1338.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53505,Not in chargemaster,53505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53505,BCBSND Base Physician Payment Schedule,1027.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53502,Not in chargemaster,53502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53502,BCBSND Base Physician Payment Schedule,1028.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53500,Not in chargemaster,53500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53500,BCBSND Base Physician Payment Schedule,1589.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53460,Not in chargemaster,53460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53460,BCBSND Base Physician Payment Schedule,969.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53450,Not in chargemaster,53450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53450,BCBSND Base Physician Payment Schedule,866.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53449,Not in chargemaster,53449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53449,BCBSND Base Physician Payment Schedule,1297.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53448,Not in chargemaster,53448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53448,BCBSND Base Physician Payment Schedule,2711.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53447,Not in chargemaster,53447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53447,BCBSND Base Physician Payment Schedule,1712.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53446,Not in chargemaster,53446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53446,BCBSND Base Physician Payment Schedule,1360.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53445,Not in chargemaster,53445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53445,BCBSND Base Physician Payment Schedule,1598.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53444,Not in chargemaster,53444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53444,BCBSND Base Physician Payment Schedule,1682.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53442,Not in chargemaster,53442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53442,BCBSND Base Physician Payment Schedule,1660.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53440,Not in chargemaster,53440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53440,BCBSND Base Physician Payment Schedule,1595.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53431,Not in chargemaster,53431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53431,BCBSND Base Physician Payment Schedule,2446.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53430,Not in chargemaster,53430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53430,BCBSND Base Physician Payment Schedule,2060.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53425,Not in chargemaster,53425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53425,BCBSND Base Physician Payment Schedule,1985.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53420,Not in chargemaster,53420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53420,BCBSND Base Physician Payment Schedule,1783.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53415,Not in chargemaster,53415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53415,BCBSND Base Physician Payment Schedule,2396.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53410,Not in chargemaster,53410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53410,BCBSND Base Physician Payment Schedule,2074.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53405,Not in chargemaster,53405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53405,BCBSND Base Physician Payment Schedule,1851.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53400,Not in chargemaster,53400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53400,BCBSND Base Physician Payment Schedule,1700.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53275,Not in chargemaster,53275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53275,BCBSND Base Physician Payment Schedule,556.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53270,Not in chargemaster,53270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53270,BCBSND Base Physician Payment Schedule,438.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53265,Not in chargemaster,53265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53265,BCBSND Base Physician Payment Schedule,473.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53260,Not in chargemaster,53260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53260,BCBSND Base Physician Payment Schedule,430.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53250,Not in chargemaster,53250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53250,BCBSND Base Physician Payment Schedule,838.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53240,Not in chargemaster,53240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53240,BCBSND Base Physician Payment Schedule,897.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53235,Not in chargemaster,53235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53235,BCBSND Base Physician Payment Schedule,1341.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53230,Not in chargemaster,53230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53230,BCBSND Base Physician Payment Schedule,1290.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53220,Not in chargemaster,53220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53220,BCBSND Base Physician Payment Schedule,956.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53215,Not in chargemaster,53215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53215,BCBSND Base Physician Payment Schedule,1968.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53210,Not in chargemaster,53210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53210,BCBSND Base Physician Payment Schedule,1655.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53200,Not in chargemaster,53200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53200,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53085,Not in chargemaster,53085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53085,BCBSND Base Physician Payment Schedule,1374.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53080,Not in chargemaster,53080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53080,BCBSND Base Physician Payment Schedule,889,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53060,Not in chargemaster,53060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53060,BCBSND Base Physician Payment Schedule,394.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53040,Not in chargemaster,53040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53040,BCBSND Base Physician Payment Schedule,831,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53025,Not in chargemaster,53025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53025,BCBSND Base Physician Payment Schedule,143.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53020,Not in chargemaster,53020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53020,BCBSND Base Physician Payment Schedule,205.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53010,Not in chargemaster,53010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53010,BCBSND Base Physician Payment Schedule,623.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 53000,Not in chargemaster,53000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53000,BCBSND Base Physician Payment Schedule,313.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52700,Not in chargemaster,52700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52700,BCBSND Base Physician Payment Schedule,934.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52649,Not in chargemaster,52649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52649,BCBSND Base Physician Payment Schedule,1749.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52648,Not in chargemaster,52648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52648,BCBSND Base Physician Payment Schedule,3510.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52647,Not in chargemaster,52647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52647,BCBSND Base Physician Payment Schedule,3402.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52640,Not in chargemaster,52640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52640,BCBSND Base Physician Payment Schedule,669.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52630,Not in chargemaster,52630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52630,BCBSND Base Physician Payment Schedule,851.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52601,Not in chargemaster,52601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52601,BCBSND Base Physician Payment Schedule,1545.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52500,Not in chargemaster,52500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52500,BCBSND Base Physician Payment Schedule,1035.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52450,Not in chargemaster,52450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52450,BCBSND Base Physician Payment Schedule,997.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52442,Not in chargemaster,52442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52442,BCBSND Base Physician Payment Schedule,2068.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52441,Not in chargemaster,52441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52441,BCBSND Base Physician Payment Schedule,2840.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52402,Not in chargemaster,52402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52402,BCBSND Base Physician Payment Schedule,565.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52400,Not in chargemaster,52400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52400,BCBSND Base Physician Payment Schedule,1011.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52356,Not in chargemaster,52356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52356,BCBSND Base Physician Payment Schedule,879.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52355,Not in chargemaster,52355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52355,BCBSND Base Physician Payment Schedule,989.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52354,Not in chargemaster,52354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52354,BCBSND Base Physician Payment Schedule,883.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52353,Not in chargemaster,52353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52353,BCBSND Base Physician Payment Schedule,830.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52352,Not in chargemaster,52352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52352,BCBSND Base Physician Payment Schedule,750.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52351,Not in chargemaster,52351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52351,BCBSND Base Physician Payment Schedule,639.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52346,Not in chargemaster,52346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52346,BCBSND Base Physician Payment Schedule,944.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52345,Not in chargemaster,52345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52345,BCBSND Base Physician Payment Schedule,834.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52344,Not in chargemaster,52344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52344,BCBSND Base Physician Payment Schedule,780.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52343,Not in chargemaster,52343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52343,BCBSND Base Physician Payment Schedule,728.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52342,Not in chargemaster,52342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52342,BCBSND Base Physician Payment Schedule,652.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52341,Not in chargemaster,52341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52341,BCBSND Base Physician Payment Schedule,601.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52334,Not in chargemaster,52334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52334,BCBSND Base Physician Payment Schedule,386.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52332,Not in chargemaster,52332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52332,BCBSND Base Physician Payment Schedule,950.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52330,Not in chargemaster,52330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52330,BCBSND Base Physician Payment Schedule,1217.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52327,Not in chargemaster,52327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52327,BCBSND Base Physician Payment Schedule,557.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52325,Not in chargemaster,52325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52325,BCBSND Base Physician Payment Schedule,676.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52320,Not in chargemaster,52320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52320,BCBSND Base Physician Payment Schedule,521.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52318,Not in chargemaster,52318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52318,BCBSND Base Physician Payment Schedule,1002.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52317,Not in chargemaster,52317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52317,BCBSND Base Physician Payment Schedule,1833.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52315,Not in chargemaster,52315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52315,BCBSND Base Physician Payment Schedule,974.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52310,Not in chargemaster,52310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52310,BCBSND Base Physician Payment Schedule,606.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52305,Not in chargemaster,52305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52305,BCBSND Base Physician Payment Schedule,590.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52301,Not in chargemaster,52301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52301,BCBSND Base Physician Payment Schedule,612.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52300,Not in chargemaster,52300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52300,BCBSND Base Physician Payment Schedule,591.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52290,Not in chargemaster,52290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52290,BCBSND Base Physician Payment Schedule,516.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52287,Not in chargemaster,52287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52287,BCBSND Base Physician Payment Schedule,753.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52285,Not in chargemaster,52285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52285,BCBSND Base Physician Payment Schedule,680.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52283,Not in chargemaster,52283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52283,BCBSND Base Physician Payment Schedule,683.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52282,Not in chargemaster,52282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52282,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52281,Not in chargemaster,52281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52281,BCBSND Base Physician Payment Schedule,672.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52277,Not in chargemaster,52277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52277,BCBSND Base Physician Payment Schedule,682.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52276,Not in chargemaster,52276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52276,BCBSND Base Physician Payment Schedule,559.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52275,Not in chargemaster,52275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52275,BCBSND Base Physician Payment Schedule,1104.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52270,Not in chargemaster,52270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52270,BCBSND Base Physician Payment Schedule,842.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52265,Not in chargemaster,52265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52265,BCBSND Base Physician Payment Schedule,797.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52260,Not in chargemaster,52260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52260,BCBSND Base Physician Payment Schedule,446.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52250,Not in chargemaster,52250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52250,BCBSND Base Physician Payment Schedule,506.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52240,Not in chargemaster,52240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52240,BCBSND Base Physician Payment Schedule,830.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52235,Not in chargemaster,52235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52235,BCBSND Base Physician Payment Schedule,610.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52234,Not in chargemaster,52234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52234,BCBSND Base Physician Payment Schedule,519.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52224,Not in chargemaster,52224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52224,BCBSND Base Physician Payment Schedule,1595.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52214,Not in chargemaster,52214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52214,BCBSND Base Physician Payment Schedule,1527.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52204,Not in chargemaster,52204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52204,BCBSND Base Physician Payment Schedule,805.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52010,Not in chargemaster,52010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52010,BCBSND Base Physician Payment Schedule,831.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52007,Not in chargemaster,52007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52007,BCBSND Base Physician Payment Schedule,991.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52005,Not in chargemaster,52005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52005,BCBSND Base Physician Payment Schedule,614.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52001,Not in chargemaster,52001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52001,BCBSND Base Physician Payment Schedule,872.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 52000,Not in chargemaster,52000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52000,BCBSND Base Physician Payment Schedule,439.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51992,Not in chargemaster,51992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51992,BCBSND Base Physician Payment Schedule,1783.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51990,Not in chargemaster,51990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51990,BCBSND Base Physician Payment Schedule,1584.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51980,Not in chargemaster,51980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51980,BCBSND Base Physician Payment Schedule,1511.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51960,Not in chargemaster,51960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51960,BCBSND Base Physician Payment Schedule,2936.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51940,Not in chargemaster,51940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51940,BCBSND Base Physician Payment Schedule,3479.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51925,Not in chargemaster,51925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51925,BCBSND Base Physician Payment Schedule,2255.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51920,Not in chargemaster,51920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51920,BCBSND Base Physician Payment Schedule,1617.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51900,Not in chargemaster,51900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51900,BCBSND Base Physician Payment Schedule,1747.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51880,Not in chargemaster,51880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51880,BCBSND Base Physician Payment Schedule,987.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51865,Not in chargemaster,51865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51865,BCBSND Base Physician Payment Schedule,1906.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51860,Not in chargemaster,51860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51860,BCBSND Base Physician Payment Schedule,1581.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51845,Not in chargemaster,51845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51845,BCBSND Base Physician Payment Schedule,1233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51841,Not in chargemaster,51841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51841,BCBSND Base Physician Payment Schedule,1674.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51840,Not in chargemaster,51840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51840,BCBSND Base Physician Payment Schedule,1446.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51820,Not in chargemaster,51820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51820,BCBSND Base Physician Payment Schedule,2297.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51800,Not in chargemaster,51800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51800,BCBSND Base Physician Payment Schedule,2211.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51798,Not in chargemaster,51798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51798,BCBSND Base Physician Payment Schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5179726,Not in chargemaster,51797,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5179726,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51797TC,Not in chargemaster,51797TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51797TC,BCBSND Base Physician Payment Schedule,253.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51797,Not in chargemaster,51797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51797,BCBSND Base Physician Payment Schedule,338.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51792,Not in chargemaster,51792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51792,BCBSND Base Physician Payment Schedule,516.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5179226,Not in chargemaster,51792,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5179226,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51792TC,Not in chargemaster,51792TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51792TC,BCBSND Base Physician Payment Schedule,400.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5178526,Not in chargemaster,51785,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5178526,BCBSND Base Physician Payment Schedule,195.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51785TC,Not in chargemaster,51785TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51785TC,BCBSND Base Physician Payment Schedule,585.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51785,Not in chargemaster,51785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51785,BCBSND Base Physician Payment Schedule,781.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51784,Not in chargemaster,51784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51784,BCBSND Base Physician Payment Schedule,140.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5178426,Not in chargemaster,51784,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5178426,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51784TC,Not in chargemaster,51784TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51784TC,BCBSND Base Physician Payment Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5174126,Not in chargemaster,51741,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5174126,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51741TC,Not in chargemaster,51741TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51741TC,BCBSND Base Physician Payment Schedule,11.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51741,Not in chargemaster,51741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51741,BCBSND Base Physician Payment Schedule,30.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51736,Not in chargemaster,51736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51736,BCBSND Base Physician Payment Schedule,28.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5173626,Not in chargemaster,51736,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5173626,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51736TC,Not in chargemaster,51736TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51736TC,BCBSND Base Physician Payment Schedule,11.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5172926,Not in chargemaster,51729,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5172926,BCBSND Base Physician Payment Schedule,268.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51729TC,Not in chargemaster,51729TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51729TC,BCBSND Base Physician Payment Schedule,514.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51729,Not in chargemaster,51729,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51729,BCBSND Base Physician Payment Schedule,783.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51728,Not in chargemaster,51728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51728,BCBSND Base Physician Payment Schedule,734.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5172826,Not in chargemaster,51728,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5172826,BCBSND Base Physician Payment Schedule,221.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51728TC,Not in chargemaster,51728TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51728TC,BCBSND Base Physician Payment Schedule,512.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5172726,Not in chargemaster,51727,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5172726,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51727TC,Not in chargemaster,51727TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51727TC,BCBSND Base Physician Payment Schedule,499.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51727,Not in chargemaster,51727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51727,BCBSND Base Physician Payment Schedule,725.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51726,Not in chargemaster,51726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51726,BCBSND Base Physician Payment Schedule,604.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5172626,Not in chargemaster,51726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5172626,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51726TC,Not in chargemaster,51726TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51726TC,BCBSND Base Physician Payment Schedule,425.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 5172526,Not in chargemaster,51725,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,5172526,BCBSND Base Physician Payment Schedule,160.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51725TC,Not in chargemaster,51725TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51725TC,BCBSND Base Physician Payment Schedule,283.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51725,Not in chargemaster,51725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51725,BCBSND Base Physician Payment Schedule,443.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51720,Not in chargemaster,51720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51720,BCBSND Base Physician Payment Schedule,174.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51715,Not in chargemaster,51715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51715,BCBSND Base Physician Payment Schedule,717.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51710,Not in chargemaster,51710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51710,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51705,Not in chargemaster,51705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51705,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51703,Not in chargemaster,51703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51703,BCBSND Base Physician Payment Schedule,292.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51702,51702,51702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51702,BCBSND Base Physician Payment Schedule,127.73,149.79,Fee schedule,,127.73,127.73,127.73,127.73,,,0
unity,Fee schedule,Non-facility 51701,Not in chargemaster,51701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51701,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51700,Not in chargemaster,51700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51700,BCBSND Base Physician Payment Schedule,157.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51610,Not in chargemaster,51610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51610,BCBSND Base Physician Payment Schedule,251.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51605,Not in chargemaster,51605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51605,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51600,Not in chargemaster,51600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51600,BCBSND Base Physician Payment Schedule,431.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51597,Not in chargemaster,51597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51597,BCBSND Base Physician Payment Schedule,4865.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51596,Not in chargemaster,51596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51596,BCBSND Base Physician Payment Schedule,4990.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51595,Not in chargemaster,51595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51595,BCBSND Base Physician Payment Schedule,4640.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51590,Not in chargemaster,51590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51590,BCBSND Base Physician Payment Schedule,4102.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51585,Not in chargemaster,51585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51585,BCBSND Base Physician Payment Schedule,4475.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51580,Not in chargemaster,51580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51580,BCBSND Base Physician Payment Schedule,4019.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51575,Not in chargemaster,51575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51575,BCBSND Base Physician Payment Schedule,3865.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51570,Not in chargemaster,51570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51570,BCBSND Base Physician Payment Schedule,3128,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51565,Not in chargemaster,51565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51565,BCBSND Base Physician Payment Schedule,2759.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51555,Not in chargemaster,51555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51555,BCBSND Base Physician Payment Schedule,2685.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51550,Not in chargemaster,51550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51550,BCBSND Base Physician Payment Schedule,2042.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51535,Not in chargemaster,51535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51535,BCBSND Base Physician Payment Schedule,1654.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51530,Not in chargemaster,51530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51530,BCBSND Base Physician Payment Schedule,1632.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51525,Not in chargemaster,51525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51525,BCBSND Base Physician Payment Schedule,1821.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51520,Not in chargemaster,51520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51520,BCBSND Base Physician Payment Schedule,1260.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51500,Not in chargemaster,51500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51500,BCBSND Base Physician Payment Schedule,1348.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51102,Not in chargemaster,51102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51102,BCBSND Base Physician Payment Schedule,497.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51101,Not in chargemaster,51101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51101,BCBSND Base Physician Payment Schedule,298.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51100,Not in chargemaster,51100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51100,BCBSND Base Physician Payment Schedule,143.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51080,Not in chargemaster,51080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51080,BCBSND Base Physician Payment Schedule,865.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51065,Not in chargemaster,51065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51065,BCBSND Base Physician Payment Schedule,1227.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51060,Not in chargemaster,51060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51060,BCBSND Base Physician Payment Schedule,1233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51050,Not in chargemaster,51050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51050,BCBSND Base Physician Payment Schedule,998.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51045,Not in chargemaster,51045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51045,BCBSND Base Physician Payment Schedule,1059.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51040,Not in chargemaster,51040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51040,BCBSND Base Physician Payment Schedule,612.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51030,Not in chargemaster,51030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51030,BCBSND Base Physician Payment Schedule,999.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 51020,Not in chargemaster,51020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51020,BCBSND Base Physician Payment Schedule,991.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50980,Not in chargemaster,50980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50980,BCBSND Base Physician Payment Schedule,755.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50976,Not in chargemaster,50976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50976,BCBSND Base Physician Payment Schedule,988.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50974,Not in chargemaster,50974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50974,BCBSND Base Physician Payment Schedule,1001.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50972,Not in chargemaster,50972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50972,BCBSND Base Physician Payment Schedule,759.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50970,Not in chargemaster,50970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50970,BCBSND Base Physician Payment Schedule,784.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50961,Not in chargemaster,50961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50961,BCBSND Base Physician Payment Schedule,819.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50957,Not in chargemaster,50957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50957,BCBSND Base Physician Payment Schedule,910.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50955,Not in chargemaster,50955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50955,BCBSND Base Physician Payment Schedule,901.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50953,Not in chargemaster,50953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50953,BCBSND Base Physician Payment Schedule,843.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50951,Not in chargemaster,50951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50951,BCBSND Base Physician Payment Schedule,795.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50948,Not in chargemaster,50948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50948,BCBSND Base Physician Payment Schedule,2700.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50947,Not in chargemaster,50947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50947,BCBSND Base Physician Payment Schedule,2940.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50945,Not in chargemaster,50945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50945,BCBSND Base Physician Payment Schedule,2060.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50940,Not in chargemaster,50940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50940,BCBSND Base Physician Payment Schedule,1880.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50930,Not in chargemaster,50930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50930,BCBSND Base Physician Payment Schedule,2336.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50920,Not in chargemaster,50920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50920,BCBSND Base Physician Payment Schedule,1866.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50900,Not in chargemaster,50900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50900,BCBSND Base Physician Payment Schedule,1784.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50860,Not in chargemaster,50860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50860,BCBSND Base Physician Payment Schedule,2004.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50845,Not in chargemaster,50845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50845,BCBSND Base Physician Payment Schedule,2652.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50840,Not in chargemaster,50840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50840,BCBSND Base Physician Payment Schedule,2606.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50830,Not in chargemaster,50830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50830,BCBSND Base Physician Payment Schedule,3820.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50825,Not in chargemaster,50825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50825,BCBSND Base Physician Payment Schedule,3513.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50820,Not in chargemaster,50820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50820,BCBSND Base Physician Payment Schedule,2785.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50815,Not in chargemaster,50815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50815,BCBSND Base Physician Payment Schedule,2594.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50810,Not in chargemaster,50810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50810,BCBSND Base Physician Payment Schedule,2995.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50800,Not in chargemaster,50800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50800,BCBSND Base Physician Payment Schedule,1963.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50785,Not in chargemaster,50785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50785,BCBSND Base Physician Payment Schedule,2573.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50783,Not in chargemaster,50783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50783,BCBSND Base Physician Payment Schedule,2389.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50782,Not in chargemaster,50782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50782,BCBSND Base Physician Payment Schedule,2278.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50780,Not in chargemaster,50780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50780,BCBSND Base Physician Payment Schedule,2349.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50770,Not in chargemaster,50770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50770,BCBSND Base Physician Payment Schedule,2445.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50760,Not in chargemaster,50760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50760,BCBSND Base Physician Payment Schedule,2399.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50750,Not in chargemaster,50750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50750,BCBSND Base Physician Payment Schedule,2445.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50740,Not in chargemaster,50740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50740,BCBSND Base Physician Payment Schedule,2617.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50728,Not in chargemaster,50728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50728,BCBSND Base Physician Payment Schedule,1561.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50727,Not in chargemaster,50727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50727,BCBSND Base Physician Payment Schedule,1078.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50725,Not in chargemaster,50725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50725,BCBSND Base Physician Payment Schedule,2338.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50722,Not in chargemaster,50722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50722,BCBSND Base Physician Payment Schedule,2189.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50715,Not in chargemaster,50715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50715,BCBSND Base Physician Payment Schedule,2551.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50706,Not in chargemaster,50706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50706,BCBSND Base Physician Payment Schedule,1979.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50705,Not in chargemaster,50705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50705,BCBSND Base Physician Payment Schedule,3967.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50700,Not in chargemaster,50700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50700,BCBSND Base Physician Payment Schedule,1961.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50695,Not in chargemaster,50695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50695,BCBSND Base Physician Payment Schedule,2930.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50694,Not in chargemaster,50694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50694,BCBSND Base Physician Payment Schedule,2418.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50693,Not in chargemaster,50693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50693,BCBSND Base Physician Payment Schedule,2178.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50690,Not in chargemaster,50690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50690,BCBSND Base Physician Payment Schedule,226.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50688,Not in chargemaster,50688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50688,BCBSND Base Physician Payment Schedule,164.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50686,Not in chargemaster,50686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50686,BCBSND Base Physician Payment Schedule,295.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50684,Not in chargemaster,50684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50684,BCBSND Base Physician Payment Schedule,245.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50660,Not in chargemaster,50660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50660,BCBSND Base Physician Payment Schedule,2424,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50650,Not in chargemaster,50650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50650,BCBSND Base Physician Payment Schedule,2202.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50630,Not in chargemaster,50630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50630,BCBSND Base Physician Payment Schedule,1891.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50620,Not in chargemaster,50620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50620,BCBSND Base Physician Payment Schedule,1916,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50610,Not in chargemaster,50610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50610,BCBSND Base Physician Payment Schedule,2003.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50606,Not in chargemaster,50606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50606,BCBSND Base Physician Payment Schedule,1306.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50605,Not in chargemaster,50605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50605,BCBSND Base Physician Payment Schedule,2119.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50600,Not in chargemaster,50600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50600,BCBSND Base Physician Payment Schedule,1989.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50593,Not in chargemaster,50593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50593,BCBSND Base Physician Payment Schedule,9052.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50592,Not in chargemaster,50592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50592,BCBSND Base Physician Payment Schedule,6694.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50590,Not in chargemaster,50590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50590,BCBSND Base Physician Payment Schedule,1554.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50580,Not in chargemaster,50580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50580,BCBSND Base Physician Payment Schedule,1286.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50576,Not in chargemaster,50576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50576,BCBSND Base Physician Payment Schedule,1194.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50575,Not in chargemaster,50575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50575,BCBSND Base Physician Payment Schedule,1515.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50574,Not in chargemaster,50574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50574,BCBSND Base Physician Payment Schedule,1197.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50572,Not in chargemaster,50572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50572,BCBSND Base Physician Payment Schedule,1126.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50570,Not in chargemaster,50570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50570,BCBSND Base Physician Payment Schedule,1040.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50562,Not in chargemaster,50562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50562,BCBSND Base Physician Payment Schedule,1228.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50561,Not in chargemaster,50561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50561,BCBSND Base Physician Payment Schedule,1002.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50557,Not in chargemaster,50557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50557,BCBSND Base Physician Payment Schedule,886.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50555,Not in chargemaster,50555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50555,BCBSND Base Physician Payment Schedule,872.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50553,Not in chargemaster,50553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50553,BCBSND Base Physician Payment Schedule,812.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50551,Not in chargemaster,50551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50551,BCBSND Base Physician Payment Schedule,760.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50548,Not in chargemaster,50548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50548,BCBSND Base Physician Payment Schedule,2854.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50547,Not in chargemaster,50547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50547,BCBSND Base Physician Payment Schedule,3423.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50546,Not in chargemaster,50546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50546,BCBSND Base Physician Payment Schedule,2553.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50545,Not in chargemaster,50545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50545,BCBSND Base Physician Payment Schedule,2838.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50544,Not in chargemaster,50544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50544,BCBSND Base Physician Payment Schedule,2639.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50543,Not in chargemaster,50543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50543,BCBSND Base Physician Payment Schedule,3156.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50542,Not in chargemaster,50542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50542,BCBSND Base Physician Payment Schedule,2470.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50541,Not in chargemaster,50541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50541,BCBSND Base Physician Payment Schedule,1945.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50540,Not in chargemaster,50540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50540,BCBSND Base Physician Payment Schedule,2432.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50526,Not in chargemaster,50526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50526,BCBSND Base Physician Payment Schedule,3371.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50525,Not in chargemaster,50525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50525,BCBSND Base Physician Payment Schedule,3144.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50520,Not in chargemaster,50520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50520,BCBSND Base Physician Payment Schedule,2477.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50500,Not in chargemaster,50500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50500,BCBSND Base Physician Payment Schedule,2636.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50437,Not in chargemaster,50437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50437,BCBSND Base Physician Payment Schedule,535.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50436,Not in chargemaster,50436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50436,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50435,Not in chargemaster,50435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50435,BCBSND Base Physician Payment Schedule,1176.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50434,Not in chargemaster,50434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50434,BCBSND Base Physician Payment Schedule,1913.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50433,Not in chargemaster,50433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50433,BCBSND Base Physician Payment Schedule,2402.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50432,Not in chargemaster,50432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50432,BCBSND Base Physician Payment Schedule,1857.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50431,Not in chargemaster,50431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50431,BCBSND Base Physician Payment Schedule,540.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50430,Not in chargemaster,50430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50430,BCBSND Base Physician Payment Schedule,1187.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50405,Not in chargemaster,50405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50405,BCBSND Base Physician Payment Schedule,2959.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50400,Not in chargemaster,50400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50400,BCBSND Base Physician Payment Schedule,2467.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50396,Not in chargemaster,50396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50396,BCBSND Base Physician Payment Schedule,246.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50391,Not in chargemaster,50391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50391,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50390,Not in chargemaster,50390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50390,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50389,Not in chargemaster,50389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50389,BCBSND Base Physician Payment Schedule,784.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50387,Not in chargemaster,50387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50387,BCBSND Base Physician Payment Schedule,1146.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50386,Not in chargemaster,50386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50386,BCBSND Base Physician Payment Schedule,1549.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50385,Not in chargemaster,50385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50385,BCBSND Base Physician Payment Schedule,2261.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50384,Not in chargemaster,50384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50384,BCBSND Base Physician Payment Schedule,1878.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50382,Not in chargemaster,50382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50382,BCBSND Base Physician Payment Schedule,2299.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50380,Not in chargemaster,50380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50380,BCBSND Base Physician Payment Schedule,4292.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50370,Not in chargemaster,50370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50370,BCBSND Base Physician Payment Schedule,2573.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50365,Not in chargemaster,50365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50365,BCBSND Base Physician Payment Schedule,6134.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50360,Not in chargemaster,50360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50360,BCBSND Base Physician Payment Schedule,5163.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50340,Not in chargemaster,50340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50340,BCBSND Base Physician Payment Schedule,2024.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50329,Not in chargemaster,50329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50329,BCBSND Base Physician Payment Schedule,386.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50328,Not in chargemaster,50328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50328,BCBSND Base Physician Payment Schedule,405.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50327,Not in chargemaster,50327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50327,BCBSND Base Physician Payment Schedule,463.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50290,Not in chargemaster,50290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50290,BCBSND Base Physician Payment Schedule,1904.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50300,Not in chargemaster,50300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50300,BCBSND Base Physician Payment Schedule,2078.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50320,Not in chargemaster,50320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50320,BCBSND Base Physician Payment Schedule,3209.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50323,Not in chargemaster,50323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50323,BCBSND Base Physician Payment Schedule,2078.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50325,Not in chargemaster,50325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50325,BCBSND Base Physician Payment Schedule,3209.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50280,Not in chargemaster,50280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50280,BCBSND Base Physician Payment Schedule,2032.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50250,Not in chargemaster,50250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50250,BCBSND Base Physician Payment Schedule,2579.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50240,Not in chargemaster,50240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50240,BCBSND Base Physician Payment Schedule,2810.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50236,Not in chargemaster,50236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50236,BCBSND Base Physician Payment Schedule,3105.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50234,Not in chargemaster,50234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50234,BCBSND Base Physician Payment Schedule,2761.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50230,Not in chargemaster,50230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50230,BCBSND Base Physician Payment Schedule,2719.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50225,Not in chargemaster,50225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50225,BCBSND Base Physician Payment Schedule,2549.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50220,Not in chargemaster,50220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50220,BCBSND Base Physician Payment Schedule,2225.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50205,Not in chargemaster,50205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50205,BCBSND Base Physician Payment Schedule,1610.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50200,Not in chargemaster,50200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50200,BCBSND Base Physician Payment Schedule,1135.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50135,Not in chargemaster,50135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50135,BCBSND Base Physician Payment Schedule,2377.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50130,Not in chargemaster,50130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50130,BCBSND Base Physician Payment Schedule,2189.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50125,Not in chargemaster,50125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50125,BCBSND Base Physician Payment Schedule,2081.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50120,Not in chargemaster,50120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50120,BCBSND Base Physician Payment Schedule,2012.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50100,Not in chargemaster,50100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50100,BCBSND Base Physician Payment Schedule,2310.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50081,Not in chargemaster,50081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50081,BCBSND Base Physician Payment Schedule,2708.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50080,Not in chargemaster,50080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50080,BCBSND Base Physician Payment Schedule,1841.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50075,Not in chargemaster,50075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50075,BCBSND Base Physician Payment Schedule,3090.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50070,Not in chargemaster,50070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50070,BCBSND Base Physician Payment Schedule,2512.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50065,Not in chargemaster,50065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50065,BCBSND Base Physician Payment Schedule,2562.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50060,Not in chargemaster,50060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50060,BCBSND Base Physician Payment Schedule,2416.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50045,Not in chargemaster,50045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50045,BCBSND Base Physician Payment Schedule,1975.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50040,Not in chargemaster,50040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50040,BCBSND Base Physician Payment Schedule,1954.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50020,Not in chargemaster,50020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50020,BCBSND Base Physician Payment Schedule,2146.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 50010,Not in chargemaster,50010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50010,BCBSND Base Physician Payment Schedule,1559.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49905,Not in chargemaster,49905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49905,BCBSND Base Physician Payment Schedule,756.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49904,Not in chargemaster,49904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49904,BCBSND Base Physician Payment Schedule,2978.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49900,Not in chargemaster,49900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49900,BCBSND Base Physician Payment Schedule,1743.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49657,Not in chargemaster,49657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49657,BCBSND Base Physician Payment Schedule,2827.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49656,Not in chargemaster,49656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49656,BCBSND Base Physician Payment Schedule,1961.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49655,Not in chargemaster,49655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49655,BCBSND Base Physician Payment Schedule,2211.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49654,Not in chargemaster,49654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49654,BCBSND Base Physician Payment Schedule,1808.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49653,Not in chargemaster,49653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49653,BCBSND Base Physician Payment Schedule,1987.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49652,Not in chargemaster,49652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49652,BCBSND Base Physician Payment Schedule,1592.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49651,49651,49651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49651,BCBSND Base Physician Payment Schedule,1195.11,1225,Fee schedule,,1195.11,1195.11,1195.11,1195.11,,,0
unity,Fee schedule,Non-facility 49650,49650,49650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49650,BCBSND Base Physician Payment Schedule,917.63,945,Fee schedule,,917.63,917.63,917.63,917.63,,,0
unity,Fee schedule,Non-facility 49611,Not in chargemaster,49611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49611,BCBSND Base Physician Payment Schedule,1300.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49610,Not in chargemaster,49610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49610,BCBSND Base Physician Payment Schedule,1477.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49606,Not in chargemaster,49606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49606,BCBSND Base Physician Payment Schedule,2429.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49605,Not in chargemaster,49605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49605,BCBSND Base Physician Payment Schedule,10615.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49600,Not in chargemaster,49600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49600,BCBSND Base Physician Payment Schedule,1568.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49590,Not in chargemaster,49590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49590,BCBSND Base Physician Payment Schedule,1224.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49587,49587,49587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49587,BCBSND Base Physician Payment Schedule,1017.46,1004.47,Fee schedule,,1004.47,1004.47,1004.47,1004.47,,,0
unity,Fee schedule,Non-facility 49585,49585,49585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49585,BCBSND Base Physician Payment Schedule,951.39,937.74,Fee schedule,,937.74,937.74,937.74,937.74,,,0
unity,Fee schedule,Non-facility 49582,Not in chargemaster,49582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49582,BCBSND Base Physician Payment Schedule,1031.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49580,Not in chargemaster,49580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49580,BCBSND Base Physician Payment Schedule,711.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49572,Not in chargemaster,49572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49572,BCBSND Base Physician Payment Schedule,1105.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49570,Not in chargemaster,49570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49570,BCBSND Base Physician Payment Schedule,889.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49568,49568,49568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49568,BCBSND Base Physician Payment Schedule,572.6,590,Fee schedule,,572.6,572.6,572.6,572.6,,,0
unity,Fee schedule,Non-facility 49566,49566,49566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49566,BCBSND Base Physician Payment Schedule,2007.03,1969.88,Fee schedule,,1969.88,1969.88,1969.88,1969.88,,,0
unity,Fee schedule,Non-facility 49565,49565,49565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49565,BCBSND Base Physician Payment Schedule,1642.92,1612.11,Fee schedule,,1612.11,1612.11,1612.11,1612.11,,,0
unity,Fee schedule,Non-facility 49561,49561,49561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49561,BCBSND Base Physician Payment Schedule,1988.68,1949.29,Fee schedule,,1949.29,1949.29,1949.29,1949.29,,,0
unity,Fee schedule,Non-facility 49560,49560,49560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49560,BCBSND Base Physician Payment Schedule,1578.32,1625,Fee schedule,,1578.32,1578.32,1578.32,1578.32,,,0
unity,Fee schedule,Non-facility 49557,Not in chargemaster,49557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49557,BCBSND Base Physician Payment Schedule,1547.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49555,Not in chargemaster,49555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49555,BCBSND Base Physician Payment Schedule,1287.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49553,Not in chargemaster,49553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49553,BCBSND Base Physician Payment Schedule,1349.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49550,Not in chargemaster,49550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49550,BCBSND Base Physician Payment Schedule,1231.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49540,Not in chargemaster,49540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49540,BCBSND Base Physician Payment Schedule,1441.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49525,Not in chargemaster,49525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49525,BCBSND Base Physician Payment Schedule,1226.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49521,Not in chargemaster,49521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49521,BCBSND Base Physician Payment Schedule,1533.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49520,49520,49520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49520,BCBSND Base Physician Payment Schedule,1350.74,1327.46,Fee schedule,,1327.46,1327.46,1327.46,1327.46,,,0
unity,Fee schedule,Non-facility 49507,49507,49507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49507,BCBSND Base Physician Payment Schedule,1253.11,1232.8,Fee schedule,,1232.8,1232.8,1232.8,1232.8,,,0
unity,Fee schedule,Non-facility 49505,49505,49505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49505,BCBSND Base Physician Payment Schedule,1113.63,1145,Fee schedule,,1113.63,1113.63,1113.63,1113.63,,,0
unity,Fee schedule,Non-facility 49501,Not in chargemaster,49501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49501,BCBSND Base Physician Payment Schedule,1294.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49500,Not in chargemaster,49500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49500,BCBSND Base Physician Payment Schedule,880.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49496,Not in chargemaster,49496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49496,BCBSND Base Physician Payment Schedule,1312.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49495,Not in chargemaster,49495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49495,BCBSND Base Physician Payment Schedule,872.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49492,Not in chargemaster,49492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49492,BCBSND Base Physician Payment Schedule,2050.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49491,Not in chargemaster,49491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49491,BCBSND Base Physician Payment Schedule,1703.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49465,Not in chargemaster,49465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49465,BCBSND Base Physician Payment Schedule,318.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49460,Not in chargemaster,49460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49460,BCBSND Base Physician Payment Schedule,1526.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49452,Not in chargemaster,49452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49452,BCBSND Base Physician Payment Schedule,1827.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49451,Not in chargemaster,49451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49451,BCBSND Base Physician Payment Schedule,1492.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49450,Not in chargemaster,49450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49450,BCBSND Base Physician Payment Schedule,1377.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49446,Not in chargemaster,49446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49446,BCBSND Base Physician Payment Schedule,1880.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49442,Not in chargemaster,49442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49442,BCBSND Base Physician Payment Schedule,1852.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49441,Not in chargemaster,49441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49441,BCBSND Base Physician Payment Schedule,2216.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49440,Not in chargemaster,49440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49440,BCBSND Base Physician Payment Schedule,1956.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49436,Not in chargemaster,49436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49436,BCBSND Base Physician Payment Schedule,397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49435,Not in chargemaster,49435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49435,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49429,Not in chargemaster,49429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49429,BCBSND Base Physician Payment Schedule,980.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49428,Not in chargemaster,49428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49428,BCBSND Base Physician Payment Schedule,923.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49427,Not in chargemaster,49427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49427,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49426,Not in chargemaster,49426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49426,BCBSND Base Physician Payment Schedule,1427.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49425,Not in chargemaster,49425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49425,BCBSND Base Physician Payment Schedule,1522.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49424,Not in chargemaster,49424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49424,BCBSND Base Physician Payment Schedule,351.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49423,Not in chargemaster,49423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49423,BCBSND Base Physician Payment Schedule,1246.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49422,Not in chargemaster,49422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49422,BCBSND Base Physician Payment Schedule,474.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49421,Not in chargemaster,49421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49421,BCBSND Base Physician Payment Schedule,488.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49419,Not in chargemaster,49419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49419,BCBSND Base Physician Payment Schedule,919.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49418,Not in chargemaster,49418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49418,BCBSND Base Physician Payment Schedule,2504.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49412,Not in chargemaster,49412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49412,BCBSND Base Physician Payment Schedule,176.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49411,Not in chargemaster,49411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49411,BCBSND Base Physician Payment Schedule,1021.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49407,Not in chargemaster,49407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49407,BCBSND Base Physician Payment Schedule,1515.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49406,Not in chargemaster,49406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49406,BCBSND Base Physician Payment Schedule,1844.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49405,Not in chargemaster,49405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49405,BCBSND Base Physician Payment Schedule,1845.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49402,Not in chargemaster,49402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49402,BCBSND Base Physician Payment Schedule,1830.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49400,Not in chargemaster,49400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49400,BCBSND Base Physician Payment Schedule,304.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49327,Not in chargemaster,49327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49327,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49326,Not in chargemaster,49326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49326,BCBSND Base Physician Payment Schedule,405.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49325,Not in chargemaster,49325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49325,BCBSND Base Physician Payment Schedule,888.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49324,Not in chargemaster,49324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49324,BCBSND Base Physician Payment Schedule,832.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49323,Not in chargemaster,49323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49323,BCBSND Base Physician Payment Schedule,1368.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49322,Not in chargemaster,49322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49322,BCBSND Base Physician Payment Schedule,796.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49321,Not in chargemaster,49321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49321,BCBSND Base Physician Payment Schedule,735.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49320,Not in chargemaster,49320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49320,BCBSND Base Physician Payment Schedule,700.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49255,Not in chargemaster,49255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49255,BCBSND Base Physician Payment Schedule,1678.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49250,Not in chargemaster,49250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49250,BCBSND Base Physician Payment Schedule,1254.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49220,Not in chargemaster,49220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49220,BCBSND Base Physician Payment Schedule,2081.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49215,Not in chargemaster,49215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49215,BCBSND Base Physician Payment Schedule,4733.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49205,Not in chargemaster,49205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49205,BCBSND Base Physician Payment Schedule,3717.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49204,Not in chargemaster,49204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49204,BCBSND Base Physician Payment Schedule,3245.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49203,Not in chargemaster,49203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49203,BCBSND Base Physician Payment Schedule,2545.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49185,Not in chargemaster,49185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49185,BCBSND Base Physician Payment Schedule,2453.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49180,Not in chargemaster,49180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49180,BCBSND Base Physician Payment Schedule,356.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49084,Not in chargemaster,49084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49084,BCBSND Base Physician Payment Schedule,231.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49083,49083,49083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49083,BCBSND Base Physician Payment Schedule,628.39,280.32,Fee schedule,,280.32,280.32,280.32,280.32,,,0
unity,Fee schedule,Non-facility 49082,49082,49082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49082,BCBSND Base Physician Payment Schedule,427.25,157.31,Fee schedule,,157.31,157.31,157.31,157.31,,,0
unity,Fee schedule,Non-facility 49062,Not in chargemaster,49062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49062,BCBSND Base Physician Payment Schedule,1642.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49060,Not in chargemaster,49060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49060,BCBSND Base Physician Payment Schedule,2350.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49040,Not in chargemaster,49040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49040,BCBSND Base Physician Payment Schedule,2140.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49020,Not in chargemaster,49020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49020,BCBSND Base Physician Payment Schedule,3403.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49014,Not in chargemaster,49014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49014,BCBSND Base Physician Payment Schedule,771.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49013,Not in chargemaster,49013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49013,BCBSND Base Physician Payment Schedule,933.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49010,Not in chargemaster,49010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49010,BCBSND Base Physician Payment Schedule,1973.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49002,Not in chargemaster,49002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49002,BCBSND Base Physician Payment Schedule,2234.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 49000,49000,49000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49000,BCBSND Base Physician Payment Schedule,1642.92,1618.51,Fee schedule,,1618.51,1618.51,1618.51,1618.51,,,0
unity,Fee schedule,Non-facility 48556,Not in chargemaster,48556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48556,BCBSND Base Physician Payment Schedule,2725.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48554,Not in chargemaster,48554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48554,BCBSND Base Physician Payment Schedule,5465.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48552,Not in chargemaster,48552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48552,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48548,Not in chargemaster,48548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48548,BCBSND Base Physician Payment Schedule,3565.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48547,Not in chargemaster,48547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48547,BCBSND Base Physician Payment Schedule,3843.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48545,Not in chargemaster,48545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48545,BCBSND Base Physician Payment Schedule,2883.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48540,Not in chargemaster,48540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48540,BCBSND Base Physician Payment Schedule,2807.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48520,Not in chargemaster,48520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48520,BCBSND Base Physician Payment Schedule,2339.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48510,Not in chargemaster,48510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48510,BCBSND Base Physician Payment Schedule,2349.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48500,Not in chargemaster,48500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48500,BCBSND Base Physician Payment Schedule,2465.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48400,Not in chargemaster,48400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48400,BCBSND Base Physician Payment Schedule,230.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48155,Not in chargemaster,48155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48155,BCBSND Base Physician Payment Schedule,3876.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48160,Not in chargemaster,48160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48160,BCBSND Base Physician Payment Schedule,6267.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48154,Not in chargemaster,48154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48154,BCBSND Base Physician Payment Schedule,6225.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48153,Not in chargemaster,48153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48153,BCBSND Base Physician Payment Schedule,6645.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48152,Not in chargemaster,48152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48152,BCBSND Base Physician Payment Schedule,6199.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48150,Not in chargemaster,48150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48150,BCBSND Base Physician Payment Schedule,6672.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48148,Not in chargemaster,48148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48148,BCBSND Base Physician Payment Schedule,2676.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48146,Not in chargemaster,48146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48146,BCBSND Base Physician Payment Schedule,4035.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48145,Not in chargemaster,48145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48145,BCBSND Base Physician Payment Schedule,3500.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48140,Not in chargemaster,48140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48140,BCBSND Base Physician Payment Schedule,3346.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48120,Not in chargemaster,48120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48120,BCBSND Base Physician Payment Schedule,2364.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48105,Not in chargemaster,48105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48105,BCBSND Base Physician Payment Schedule,6076.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48102,Not in chargemaster,48102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48102,BCBSND Base Physician Payment Schedule,1130.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48100,Not in chargemaster,48100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48100,BCBSND Base Physician Payment Schedule,1891.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48020,Not in chargemaster,48020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48020,BCBSND Base Physician Payment Schedule,2523.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48001,Not in chargemaster,48001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48001,BCBSND Base Physician Payment Schedule,4949.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 48000,Not in chargemaster,48000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48000,BCBSND Base Physician Payment Schedule,4039.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47900,Not in chargemaster,47900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47900,BCBSND Base Physician Payment Schedule,2920.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47802,Not in chargemaster,47802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47802,BCBSND Base Physician Payment Schedule,3271.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47801,Not in chargemaster,47801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47801,BCBSND Base Physician Payment Schedule,2387.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47800,Not in chargemaster,47800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47800,BCBSND Base Physician Payment Schedule,3376.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47785,Not in chargemaster,47785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47785,BCBSND Base Physician Payment Schedule,6962.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47780,Not in chargemaster,47780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47780,BCBSND Base Physician Payment Schedule,5296.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47765,Not in chargemaster,47765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47765,BCBSND Base Physician Payment Schedule,6517.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47760,Not in chargemaster,47760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47760,BCBSND Base Physician Payment Schedule,4822.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47741,Not in chargemaster,47741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47741,BCBSND Base Physician Payment Schedule,3163.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47740,Not in chargemaster,47740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47740,BCBSND Base Physician Payment Schedule,2815.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47721,Not in chargemaster,47721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47721,BCBSND Base Physician Payment Schedule,2903.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47720,Not in chargemaster,47720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47720,BCBSND Base Physician Payment Schedule,2474.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47715,Not in chargemaster,47715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47715,BCBSND Base Physician Payment Schedule,2852.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47712,Not in chargemaster,47712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47712,BCBSND Base Physician Payment Schedule,4283.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47711,Not in chargemaster,47711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47711,BCBSND Base Physician Payment Schedule,3335.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47701,Not in chargemaster,47701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47701,BCBSND Base Physician Payment Schedule,3723.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47700,Not in chargemaster,47700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47700,BCBSND Base Physician Payment Schedule,2261.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47620,Not in chargemaster,47620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47620,BCBSND Base Physician Payment Schedule,2951.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47612,Not in chargemaster,47612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47612,BCBSND Base Physician Payment Schedule,2733.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47610,Not in chargemaster,47610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47610,BCBSND Base Physician Payment Schedule,2688.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47605,Not in chargemaster,47605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47605,BCBSND Base Physician Payment Schedule,2407.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47600,47600,47600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47600,BCBSND Base Physician Payment Schedule,2288.19,2355,Fee schedule,,2288.19,2288.19,2288.19,2288.19,,,0
unity,Fee schedule,Non-facility 47570,Not in chargemaster,47570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47570,BCBSND Base Physician Payment Schedule,1660.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47564,Not in chargemaster,47564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47564,BCBSND Base Physician Payment Schedule,2384.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47563,Not in chargemaster,47563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47563,BCBSND Base Physician Payment Schedule,1533.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47562,47562,47562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47562,BCBSND Base Physician Payment Schedule,1408.74,1487.44,Fee schedule,,1408.74,1408.74,1408.74,1408.74,,,0
unity,Fee schedule,Non-facility 47556,Not in chargemaster,47556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47556,BCBSND Base Physician Payment Schedule,795.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47555,Not in chargemaster,47555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47555,BCBSND Base Physician Payment Schedule,701.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47554,Not in chargemaster,47554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47554,BCBSND Base Physician Payment Schedule,1103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47553,Not in chargemaster,47553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47553,BCBSND Base Physician Payment Schedule,590.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47552,Not in chargemaster,47552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47552,BCBSND Base Physician Payment Schedule,584.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47550,Not in chargemaster,47550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47550,BCBSND Base Physician Payment Schedule,353.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47544,Not in chargemaster,47544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47544,BCBSND Base Physician Payment Schedule,2077.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47543,Not in chargemaster,47543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47543,BCBSND Base Physician Payment Schedule,968.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47542,Not in chargemaster,47542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47542,BCBSND Base Physician Payment Schedule,1085,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47541,Not in chargemaster,47541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47541,BCBSND Base Physician Payment Schedule,2541.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47540,Not in chargemaster,47540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47540,BCBSND Base Physician Payment Schedule,10063.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47539,Not in chargemaster,47539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47539,BCBSND Base Physician Payment Schedule,9864.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47538,Not in chargemaster,47538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47538,BCBSND Base Physician Payment Schedule,8946.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47537,Not in chargemaster,47537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47537,BCBSND Base Physician Payment Schedule,940.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47536,Not in chargemaster,47536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47536,BCBSND Base Physician Payment Schedule,1457.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47535,Not in chargemaster,47535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47535,BCBSND Base Physician Payment Schedule,2069.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47534,Not in chargemaster,47534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47534,BCBSND Base Physician Payment Schedule,2987.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47533,Not in chargemaster,47533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47533,BCBSND Base Physician Payment Schedule,2628.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47532,Not in chargemaster,47532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47532,BCBSND Base Physician Payment Schedule,1772.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47531,Not in chargemaster,47531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47531,BCBSND Base Physician Payment Schedule,806.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47490,Not in chargemaster,47490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47490,BCBSND Base Physician Payment Schedule,704,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47480,Not in chargemaster,47480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47480,BCBSND Base Physician Payment Schedule,1880.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47460,Not in chargemaster,47460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47460,BCBSND Base Physician Payment Schedule,2721.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47425,Not in chargemaster,47425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47425,BCBSND Base Physician Payment Schedule,2929.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47420,Not in chargemaster,47420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47420,BCBSND Base Physician Payment Schedule,2870.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47400,Not in chargemaster,47400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47400,BCBSND Base Physician Payment Schedule,4618.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47383,Not in chargemaster,47383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47383,BCBSND Base Physician Payment Schedule,14322.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47382,Not in chargemaster,47382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47382,BCBSND Base Physician Payment Schedule,9198.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47381,Not in chargemaster,47381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47381,BCBSND Base Physician Payment Schedule,3172.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47380,Not in chargemaster,47380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47380,BCBSND Base Physician Payment Schedule,3091.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47371,Not in chargemaster,47371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47371,BCBSND Base Physician Payment Schedule,2691.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47370,Not in chargemaster,47370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47370,BCBSND Base Physician Payment Schedule,2672.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47362,Not in chargemaster,47362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47362,BCBSND Base Physician Payment Schedule,3107.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47361,Not in chargemaster,47361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47361,BCBSND Base Physician Payment Schedule,6484.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47360,Not in chargemaster,47360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47360,BCBSND Base Physician Payment Schedule,4022.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47350,Not in chargemaster,47350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47350,BCBSND Base Physician Payment Schedule,2927.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47300,Not in chargemaster,47300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47300,BCBSND Base Physician Payment Schedule,2416.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47147,Not in chargemaster,47147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47147,BCBSND Base Physician Payment Schedule,819.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47146,Not in chargemaster,47146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47146,BCBSND Base Physician Payment Schedule,702.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47142,Not in chargemaster,47142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47142,BCBSND Base Physician Payment Schedule,10088,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47141,Not in chargemaster,47141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47141,BCBSND Base Physician Payment Schedule,9143.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47140,Not in chargemaster,47140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47140,BCBSND Base Physician Payment Schedule,7633.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47135,Not in chargemaster,47135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47135,BCBSND Base Physician Payment Schedule,11529.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47130,Not in chargemaster,47130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47130,BCBSND Base Physician Payment Schedule,7080.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47125,Not in chargemaster,47125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47125,BCBSND Base Physician Payment Schedule,6592.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47122,Not in chargemaster,47122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47122,BCBSND Base Physician Payment Schedule,7348.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47120,Not in chargemaster,47120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47120,BCBSND Base Physician Payment Schedule,4992.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47100,Not in chargemaster,47100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47100,BCBSND Base Physician Payment Schedule,1808.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47015,Not in chargemaster,47015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47015,BCBSND Base Physician Payment Schedule,2493.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47010,Not in chargemaster,47010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47010,BCBSND Base Physician Payment Schedule,2586.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47001,Not in chargemaster,47001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47001,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 47000,Not in chargemaster,47000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47000,BCBSND Base Physician Payment Schedule,649.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46948,Not in chargemaster,46948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46948,BCBSND Base Physician Payment Schedule,933.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46947,Not in chargemaster,46947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46947,BCBSND Base Physician Payment Schedule,818.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46946,Not in chargemaster,46946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46946,BCBSND Base Physician Payment Schedule,797.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46945,Not in chargemaster,46945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46945,BCBSND Base Physician Payment Schedule,706.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46942,Not in chargemaster,46942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46942,BCBSND Base Physician Payment Schedule,493.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46940,Not in chargemaster,46940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46940,BCBSND Base Physician Payment Schedule,517.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46930,Not in chargemaster,46930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46930,BCBSND Base Physician Payment Schedule,449.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46924,Not in chargemaster,46924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46924,BCBSND Base Physician Payment Schedule,1129.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46922,Not in chargemaster,46922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46922,BCBSND Base Physician Payment Schedule,615.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46917,Not in chargemaster,46917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46917,BCBSND Base Physician Payment Schedule,879.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46916,Not in chargemaster,46916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46916,BCBSND Base Physician Payment Schedule,513.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46910,Not in chargemaster,46910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46910,BCBSND Base Physician Payment Schedule,542.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46900,Not in chargemaster,46900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46900,BCBSND Base Physician Payment Schedule,496.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46761,Not in chargemaster,46761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46761,BCBSND Base Physician Payment Schedule,1957.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46760,Not in chargemaster,46760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46760,BCBSND Base Physician Payment Schedule,2319.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46754,Not in chargemaster,46754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46754,BCBSND Base Physician Payment Schedule,682.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46753,Not in chargemaster,46753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46753,BCBSND Base Physician Payment Schedule,1316.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46751,Not in chargemaster,46751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46751,BCBSND Base Physician Payment Schedule,1411.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46750,Not in chargemaster,46750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46750,BCBSND Base Physician Payment Schedule,1596.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46748,Not in chargemaster,46748,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46748,BCBSND Base Physician Payment Schedule,9060.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46746,Not in chargemaster,46746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46746,BCBSND Base Physician Payment Schedule,8347.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46744,Not in chargemaster,46744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46744,BCBSND Base Physician Payment Schedule,7565.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46742,Not in chargemaster,46742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46742,BCBSND Base Physician Payment Schedule,5336.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46740,Not in chargemaster,46740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46740,BCBSND Base Physician Payment Schedule,4607.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46735,Not in chargemaster,46735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46735,BCBSND Base Physician Payment Schedule,4865.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46730,Not in chargemaster,46730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46730,BCBSND Base Physician Payment Schedule,4219.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46716,Not in chargemaster,46716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46716,BCBSND Base Physician Payment Schedule,2601.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46715,Not in chargemaster,46715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46715,BCBSND Base Physician Payment Schedule,1173.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46712,Not in chargemaster,46712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46712,BCBSND Base Physician Payment Schedule,4772.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46710,Not in chargemaster,46710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46710,BCBSND Base Physician Payment Schedule,2373.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46707,Not in chargemaster,46707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46707,BCBSND Base Physician Payment Schedule,1057.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46706,Not in chargemaster,46706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46706,BCBSND Base Physician Payment Schedule,377.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46705,Not in chargemaster,46705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46705,BCBSND Base Physician Payment Schedule,1199.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46700,Not in chargemaster,46700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46700,BCBSND Base Physician Payment Schedule,1392.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46615,Not in chargemaster,46615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46615,BCBSND Base Physician Payment Schedule,337.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46614,Not in chargemaster,46614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46614,BCBSND Base Physician Payment Schedule,309.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46612,Not in chargemaster,46612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46612,BCBSND Base Physician Payment Schedule,653.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46611,Not in chargemaster,46611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46611,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46610,Not in chargemaster,46610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46610,BCBSND Base Physician Payment Schedule,535.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46608,Not in chargemaster,46608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46608,BCBSND Base Physician Payment Schedule,563.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6004,Not in chargemaster,G6004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6004,BCBSND Base Physician Payment Schedule,328.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6003,Not in chargemaster,G6003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6003,BCBSND Base Physician Payment Schedule,434.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G600226,Not in chargemaster,G600226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G600226,BCBSND Base Physician Payment Schedule,42.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6002TC,Not in chargemaster,G6002TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6002TC,BCBSND Base Physician Payment Schedule,127.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6002,Not in chargemaster,G6002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6002,BCBSND Base Physician Payment Schedule,169.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6001,Not in chargemaster,G6001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6001,BCBSND Base Physician Payment Schedule,264.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G600126,Not in chargemaster,G600126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G600126,BCBSND Base Physician Payment Schedule,66.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6001TC,Not in chargemaster,G6001TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6001TC,BCBSND Base Physician Payment Schedule,198.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2088,Not in chargemaster,G2088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2088,BCBSND Base Physician Payment Schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2087,Not in chargemaster,G2087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2087,BCBSND Base Physician Payment Schedule,749.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2086,Not in chargemaster,G2086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2086,BCBSND Base Physician Payment Schedule,840.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2083,Not in chargemaster,G2083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2083,BCBSND Base Physician Payment Schedule,2258.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2082,Not in chargemaster,G2082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2082,BCBSND Base Physician Payment Schedule,1545.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2065,Not in chargemaster,G2065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2065,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2064,Not in chargemaster,G2064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2064,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2063,Not in chargemaster,G2063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2063,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2062,Not in chargemaster,G2062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2062,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2061,Not in chargemaster,G2061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2061,BCBSND Base Physician Payment Schedule,24.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2058,Not in chargemaster,G2058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2058,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2012,Not in chargemaster,G2012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2012,BCBSND Base Physician Payment Schedule,30.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2011,Not in chargemaster,G2011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2011,BCBSND Base Physician Payment Schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0518,Not in chargemaster,G0518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0518,BCBSND Base Physician Payment Schedule,1089.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2000,Not in chargemaster,G2000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2000,BCBSND Base Physician Payment Schedule,366.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0517,Not in chargemaster,G0517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0517,BCBSND Base Physician Payment Schedule,509.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G2010,Not in chargemaster,G2010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2010,BCBSND Base Physician Payment Schedule,24.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0516,Not in chargemaster,G0516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0516,BCBSND Base Physician Payment Schedule,548.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0514,Not in chargemaster,G0514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0514,BCBSND Base Physician Payment Schedule,135.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0513,Not in chargemaster,G0513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0513,BCBSND Base Physician Payment Schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0512,Not in chargemaster,G0512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0512,BCBSND Base Physician Payment Schedule,288.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0511,G0511,G0511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0511,BCBSND Base Physician Payment Schedule,135.81,135,Fee schedule,,135,135,135,135,,,0
unity,Fee schedule,Non-facility G0509,Not in chargemaster,G0509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0509,BCBSND Base Physician Payment Schedule,402.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0508,Not in chargemaster,G0508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0508,BCBSND Base Physician Payment Schedule,436.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0506,Not in chargemaster,G0506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0506,BCBSND Base Physician Payment Schedule,129.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0500,Not in chargemaster,G0500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0500,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0473,Not in chargemaster,G0473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0473,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0460,Not in chargemaster,G0460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0460,BCBSND Base Physician Payment Schedule,441.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0459,Not in chargemaster,G0459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0459,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0455,Not in chargemaster,G0455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0455,BCBSND Base Physician Payment Schedule,266.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0458,Not in chargemaster,G0458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0458,BCBSND Base Physician Payment Schedule,2113.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0454,Not in chargemaster,G0454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0454,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0453,Not in chargemaster,G0453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0453,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G045226,Not in chargemaster,G045226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G045226,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0451,Not in chargemaster,G0451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0451,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0447,Not in chargemaster,G0447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0447,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0448,Not in chargemaster,G0448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0448,BCBSND Base Physician Payment Schedule,1954.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0446,Not in chargemaster,G0446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0446,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0445,Not in chargemaster,G0445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0445,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0444,Not in chargemaster,G0444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0444,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0443,Not in chargemaster,G0443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0443,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0442,Not in chargemaster,G0442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0442,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0439,G0439,G0439,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0439,BCBSND Base Physician Payment Schedule,238.58,143,Fee schedule,,143,143,143,143,,,0
unity,Fee schedule,Non-facility G0438,G0438,G0438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0438,BCBSND Base Physician Payment Schedule,351.63,211.64,Fee schedule,,211.64,211.64,211.64,211.64,,,0
unity,Fee schedule,Non-facility G0429,Not in chargemaster,G0429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0429,BCBSND Base Physician Payment Schedule,202.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0427,Not in chargemaster,G0427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0427,BCBSND Base Physician Payment Schedule,416.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0426,Not in chargemaster,G0426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0426,BCBSND Base Physician Payment Schedule,281.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0425,Not in chargemaster,G0425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0425,BCBSND Base Physician Payment Schedule,207.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0424,Not in chargemaster,G0424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0424,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0423,Not in chargemaster,G0423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0423,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0422,Not in chargemaster,G0422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0422,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0421,Not in chargemaster,G0421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0421,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0420,Not in chargemaster,G0420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0420,BCBSND Base Physician Payment Schedule,232.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G041626,Not in chargemaster,G041626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G041626,BCBSND Base Physician Payment Schedule,377.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0416TC,Not in chargemaster,G0416TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0416TC,BCBSND Base Physician Payment Schedule,330.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q003526,Not in chargemaster,Q003526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q003526,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0035TC,Not in chargemaster,Q0035TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0035TC,BCBSND Base Physician Payment Schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0083,Not in chargemaster,Q0083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0083,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0084,Not in chargemaster,Q0084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0084,BCBSND Base Physician Payment Schedule,289.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility P3001,Not in chargemaster,P3001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,P3001,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9986,Not in chargemaster,G9986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9986,BCBSND Base Physician Payment Schedule,231.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9987,Not in chargemaster,G9987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9987,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility H0004,Not in chargemaster,H0004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,H0004,BCBSND Base Physician Payment Schedule,40.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility H0005,Not in chargemaster,H0005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,H0005,BCBSND Base Physician Payment Schedule,64.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility H0020,Not in chargemaster,H0020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,H0020,BCBSND Base Physician Payment Schedule,15.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility H0047,Not in chargemaster,H0047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,H0047,BCBSND Base Physician Payment Schedule,19.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility H2035,Not in chargemaster,H2035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,H2035,BCBSND Base Physician Payment Schedule,42.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9985,Not in chargemaster,G9985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9985,BCBSND Base Physician Payment Schedule,163.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9984,Not in chargemaster,G9984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9984,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9983,Not in chargemaster,G9983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9983,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9982,Not in chargemaster,G9982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9982,BCBSND Base Physician Payment Schedule,350.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9981,Not in chargemaster,G9981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9981,BCBSND Base Physician Payment Schedule,268.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9980,Not in chargemaster,G9980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9980,BCBSND Base Physician Payment Schedule,157.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9979,Not in chargemaster,G9979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9979,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9157,Not in chargemaster,G9157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9157,BCBSND Base Physician Payment Schedule,202.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9978,Not in chargemaster,G9978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9978,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G9685,Not in chargemaster,G9685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G9685,BCBSND Base Physician Payment Schedule,419.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6016,Not in chargemaster,G6016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6016,BCBSND Base Physician Payment Schedule,842.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6017,Not in chargemaster,G6017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6017,BCBSND Base Physician Payment Schedule,200.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6015,Not in chargemaster,G6015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6015,BCBSND Base Physician Payment Schedule,846.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6014,Not in chargemaster,G6014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6014,BCBSND Base Physician Payment Schedule,601.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6013,Not in chargemaster,G6013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6013,BCBSND Base Physician Payment Schedule,601.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6012,Not in chargemaster,G6012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6012,BCBSND Base Physician Payment Schedule,600.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6011,Not in chargemaster,G6011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6011,BCBSND Base Physician Payment Schedule,609.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6010,Not in chargemaster,G6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6010,BCBSND Base Physician Payment Schedule,449.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6009,Not in chargemaster,G6009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6009,BCBSND Base Physician Payment Schedule,449.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6008,Not in chargemaster,G6008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6008,BCBSND Base Physician Payment Schedule,453.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6007,Not in chargemaster,G6007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6007,BCBSND Base Physician Payment Schedule,616.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6006,Not in chargemaster,G6006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6006,BCBSND Base Physician Payment Schedule,328.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G6005,Not in chargemaster,G6005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G6005,BCBSND Base Physician Payment Schedule,328.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0092,Not in chargemaster,Q0092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0092,BCBSND Base Physician Payment Schedule,48.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q3014,Not in chargemaster,Q3014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q3014,BCBSND Base Physician Payment Schedule,42.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility R0070,Not in chargemaster,R0070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,R0070,BCBSND Base Physician Payment Schedule,181.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility R0075,Not in chargemaster,R0075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,R0075,BCBSND Base Physician Payment Schedule,77.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0270,Not in chargemaster,S0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0270,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0271,Not in chargemaster,S0271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0271,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0272,Not in chargemaster,S0272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0272,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0273,Not in chargemaster,S0273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0273,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0274,Not in chargemaster,S0274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0274,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0302,Not in chargemaster,S0302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0302,BCBSND Base Physician Payment Schedule,284.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0353,Not in chargemaster,S0353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0353,BCBSND Base Physician Payment Schedule,168.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0354,Not in chargemaster,S0354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0354,BCBSND Base Physician Payment Schedule,168.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0613,Not in chargemaster,S0613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0613,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0618,Not in chargemaster,S0618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0618,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0620,Not in chargemaster,S0620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0620,BCBSND Base Physician Payment Schedule,215.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0621,Not in chargemaster,S0621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0621,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S0630,Not in chargemaster,S0630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0630,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2066,Not in chargemaster,S2066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2066,BCBSND Base Physician Payment Schedule,5852.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2067,Not in chargemaster,S2067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2067,BCBSND Base Physician Payment Schedule,5852.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2068,Not in chargemaster,S2068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2068,BCBSND Base Physician Payment Schedule,3337.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2079,Not in chargemaster,S2079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2079,BCBSND Base Physician Payment Schedule,2860.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2083,Not in chargemaster,S2083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2083,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2095,Not in chargemaster,S2095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2095,BCBSND Base Physician Payment Schedule,1867.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2117,Not in chargemaster,S2117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2117,BCBSND Base Physician Payment Schedule,1649.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2120,Not in chargemaster,S2120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2120,BCBSND Base Physician Payment Schedule,4069.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2300,Not in chargemaster,S2300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2300,BCBSND Base Physician Payment Schedule,1241.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2325,Not in chargemaster,S2325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2325,BCBSND Base Physician Payment Schedule,2145.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S2342,Not in chargemaster,S2342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2342,BCBSND Base Physician Payment Schedule,264.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S3900,Not in chargemaster,S3900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S3900,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S8080,Not in chargemaster,S8080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8080,BCBSND Base Physician Payment Schedule,883.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S808026,Not in chargemaster,S808026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S808026,BCBSND Base Physician Payment Schedule,88.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S8080TC,Not in chargemaster,S8080TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8080TC,BCBSND Base Physician Payment Schedule,794.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S8085,Not in chargemaster,S8085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8085,BCBSND Base Physician Payment Schedule,2038.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S808526,Not in chargemaster,S808526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S808526,BCBSND Base Physician Payment Schedule,157.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S8085TC,Not in chargemaster,S8085TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8085TC,BCBSND Base Physician Payment Schedule,1880.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S8930,Not in chargemaster,S8930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8930,BCBSND Base Physician Payment Schedule,77.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S8948,Not in chargemaster,S8948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8948,BCBSND Base Physician Payment Schedule,26.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S9088,Not in chargemaster,S9088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9088,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S9145,Not in chargemaster,S9145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9145,BCBSND Base Physician Payment Schedule,231.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S9152,Not in chargemaster,S9152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9152,BCBSND Base Physician Payment Schedule,252.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S9455,Not in chargemaster,S9455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9455,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S9470,Not in chargemaster,S9470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9470,BCBSND Base Physician Payment Schedule,40.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S9472,Not in chargemaster,S9472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9472,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility S9482,Not in chargemaster,S9482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9482,BCBSND Base Physician Payment Schedule,40.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility V2785,Not in chargemaster,V2785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2785,BCBSND Base Physician Payment Schedule,3794.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0091,Not in chargemaster,Q0091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0091,BCBSND Base Physician Payment Schedule,88.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility Q0035,Not in chargemaster,Q0035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0035,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0416,Not in chargemaster,G0416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0416,BCBSND Base Physician Payment Schedule,707.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0415,Not in chargemaster,G0415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0415,BCBSND Base Physician Payment Schedule,2906.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0414,Not in chargemaster,G0414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0414,BCBSND Base Physician Payment Schedule,2129.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0413,Not in chargemaster,G0413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0413,BCBSND Base Physician Payment Schedule,2255.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0412,Not in chargemaster,G0412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0412,BCBSND Base Physician Payment Schedule,1542.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0409,Not in chargemaster,G0409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0409,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0408,Not in chargemaster,G0408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0408,BCBSND Base Physician Payment Schedule,214.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0407,Not in chargemaster,G0407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0407,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0406,Not in chargemaster,G0406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0406,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0405,G0405,G0405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0405,BCBSND Base Physician Payment Schedule,17.62,17.04,Fee schedule,,17.04,17.04,17.04,17.04,,,0
unity,Fee schedule,Non-facility G0404,Not in chargemaster,G0404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0404,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0403,Not in chargemaster,G0403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0403,BCBSND Base Physician Payment Schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0402,Not in chargemaster,G0402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0402,BCBSND Base Physician Payment Schedule,342.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0396,Not in chargemaster,G0396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0396,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0372,Not in chargemaster,G0372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0372,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0343,Not in chargemaster,G0343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0343,BCBSND Base Physician Payment Schedule,2370.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0397,Not in chargemaster,G0397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0397,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0398,Not in chargemaster,G0398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0398,BCBSND Base Physician Payment Schedule,242.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G039826,Not in chargemaster,G039826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G039826,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0398TC,Not in chargemaster,G0398TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0398TC,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0399,Not in chargemaster,G0399,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0399,BCBSND Base Physician Payment Schedule,242.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G039926,Not in chargemaster,G039926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G039926,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0399TC,Not in chargemaster,G0399TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0399TC,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0400,Not in chargemaster,G0400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0400,BCBSND Base Physician Payment Schedule,242.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G040026,Not in chargemaster,G040026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G040026,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0400TC,Not in chargemaster,G0400TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0400TC,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0342,Not in chargemaster,G0342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0342,BCBSND Base Physician Payment Schedule,1435.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0341,Not in chargemaster,G0341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0341,BCBSND Base Physician Payment Schedule,4387.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0337,Not in chargemaster,G0337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0337,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0329,Not in chargemaster,G0329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0329,BCBSND Base Physician Payment Schedule,23.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G029726,Not in chargemaster,G029726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G029726,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0297TC,Not in chargemaster,G0297TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0297TC,BCBSND Base Physician Payment Schedule,385.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0297,Not in chargemaster,G0297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0297,BCBSND Base Physician Payment Schedule,491.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0296,Not in chargemaster,G0296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0296,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0289,Not in chargemaster,G0289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0289,BCBSND Base Physician Payment Schedule,183.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0288,Not in chargemaster,G0288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0288,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0283,Not in chargemaster,G0283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0283,BCBSND Base Physician Payment Schedule,28.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0281,Not in chargemaster,G0281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0281,BCBSND Base Physician Payment Schedule,28.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G027926,Not in chargemaster,G027926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G027926,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0279TC,Not in chargemaster,G0279TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0279TC,BCBSND Base Physician Payment Schedule,57.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0279,Not in chargemaster,G0279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0279,BCBSND Base Physician Payment Schedule,120.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0278,Not in chargemaster,G0278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0278,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0277,Not in chargemaster,G0277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0277,BCBSND Base Physician Payment Schedule,281.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0276,Not in chargemaster,G0276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0276,BCBSND Base Physician Payment Schedule,789.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0271,Not in chargemaster,G0271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0271,BCBSND Base Physician Payment Schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0270,Not in chargemaster,G0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0270,BCBSND Base Physician Payment Schedule,67.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0268,Not in chargemaster,G0268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0268,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0269,Not in chargemaster,G0269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0269,BCBSND Base Physician Payment Schedule,1867.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0252,Not in chargemaster,G0252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0252,BCBSND Base Physician Payment Schedule,2039.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G025226,Not in chargemaster,G025226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G025226,BCBSND Base Physician Payment Schedule,158.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0252TC,Not in chargemaster,G0252TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0252TC,BCBSND Base Physician Payment Schedule,1880.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0255,Not in chargemaster,G0255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0255,BCBSND Base Physician Payment Schedule,179.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G025526,Not in chargemaster,G025526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G025526,BCBSND Base Physician Payment Schedule,179.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0259,Not in chargemaster,G0259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0259,BCBSND Base Physician Payment Schedule,456.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0260,Not in chargemaster,G0260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0260,BCBSND Base Physician Payment Schedule,613.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0250,Not in chargemaster,G0250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0250,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0249,Not in chargemaster,G0249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0249,BCBSND Base Physician Payment Schedule,120.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0248,Not in chargemaster,G0248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0248,BCBSND Base Physician Payment Schedule,120.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0247,Not in chargemaster,G0247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0247,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0246,Not in chargemaster,G0246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0246,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0245,Not in chargemaster,G0245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0245,BCBSND Base Physician Payment Schedule,137.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0239,Not in chargemaster,G0239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0239,BCBSND Base Physician Payment Schedule,24.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0238,Not in chargemaster,G0238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0238,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0237,Not in chargemaster,G0237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0237,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0181,Not in chargemaster,G0181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0181,BCBSND Base Physician Payment Schedule,221.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0182,Not in chargemaster,G0182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0182,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0186,Not in chargemaster,G0186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0186,BCBSND Base Physician Payment Schedule,1107.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0219,Not in chargemaster,G0219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0219,BCBSND Base Physician Payment Schedule,2253.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G021926,Not in chargemaster,G021926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G021926,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0219TC,Not in chargemaster,G0219TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0219TC,BCBSND Base Physician Payment Schedule,2104.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0180,Not in chargemaster,G0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0180,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0179,Not in chargemaster,G0179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0179,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0168,G0168,G0168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0168,BCBSND Base Physician Payment Schedule,222.43,200,Fee schedule,,200,200,200,200,,,0
unity,Fee schedule,Non-facility G0166,Not in chargemaster,G0166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0166,BCBSND Base Physician Payment Schedule,212.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0141,Not in chargemaster,G0141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0141,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0130,Not in chargemaster,G0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0130,BCBSND Base Physician Payment Schedule,78.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G013026,Not in chargemaster,G013026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G013026,BCBSND Base Physician Payment Schedule,23.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0130TC,Not in chargemaster,G0130TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0130TC,BCBSND Base Physician Payment Schedule,55.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0128,Not in chargemaster,G0128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0128,BCBSND Base Physician Payment Schedule,15.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0127,Not in chargemaster,G0127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0127,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0124,Not in chargemaster,G0124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0124,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0122,Not in chargemaster,G0122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0122,BCBSND Base Physician Payment Schedule,643.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G012226,Not in chargemaster,G012226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G012226,BCBSND Base Physician Payment Schedule,104.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0122TC,Not in chargemaster,G0122TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0122TC,BCBSND Base Physician Payment Schedule,539.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0121,G0121,G0121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0121,BCBSND Base Physician Payment Schedule,692.26,469.74,Fee schedule,,469.74,469.74,469.74,469.74,,,0
unity,Fee schedule,Non-facility G0120,Not in chargemaster,G0120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0120,BCBSND Base Physician Payment Schedule,441.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G012026,Not in chargemaster,G012026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G012026,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0120TC,Not in chargemaster,G0120TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0120TC,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0118,Not in chargemaster,G0118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0118,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0117,Not in chargemaster,G0117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0117,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0109,Not in chargemaster,G0109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0109,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0108,Not in chargemaster,G0108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0108,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G010626,Not in chargemaster,G010626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G010626,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0106TC,Not in chargemaster,G0106TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0106TC,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0106,Not in chargemaster,G0106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0106,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0105,G0105,G0105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0105,BCBSND Base Physician Payment Schedule,690.79,469.74,Fee schedule,,469.74,469.74,469.74,469.74,,,0
unity,Fee schedule,Non-facility G0104,G0104,G0104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0104,BCBSND Base Physician Payment Schedule,365.58,137.02,Fee schedule,,137.02,137.02,137.02,137.02,,,0
unity,Fee schedule,Non-facility G0102,Not in chargemaster,G0102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0102,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0101,Not in chargemaster,G0101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0101,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0087,Not in chargemaster,G0087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0087,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0086,Not in chargemaster,G0086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0086,BCBSND Base Physician Payment Schedule,160.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0085,Not in chargemaster,G0085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0085,BCBSND Base Physician Payment Schedule,463.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0084,Not in chargemaster,G0084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0084,BCBSND Base Physician Payment Schedule,375.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0083,Not in chargemaster,G0083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0083,BCBSND Base Physician Payment Schedule,270.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0082,Not in chargemaster,G0082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0082,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0081,Not in chargemaster,G0081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0081,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0080,Not in chargemaster,G0080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0080,BCBSND Base Physician Payment Schedule,463.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0079,Not in chargemaster,G0079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0079,BCBSND Base Physician Payment Schedule,381.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0078,Not in chargemaster,G0078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0078,BCBSND Base Physician Payment Schedule,272.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0077,Not in chargemaster,G0077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0077,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0076,Not in chargemaster,G0076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0076,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99497,Not in chargemaster,99497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99497,BCBSND Base Physician Payment Schedule,176.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99496,Not in chargemaster,99496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99496,BCBSND Base Physician Payment Schedule,504.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99495,Not in chargemaster,99495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99495,BCBSND Base Physician Payment Schedule,381.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99494,Not in chargemaster,99494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99494,BCBSND Base Physician Payment Schedule,129.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99493,Not in chargemaster,99493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99493,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99492,Not in chargemaster,99492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99492,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99490,Not in chargemaster,99490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99490,BCBSND Base Physician Payment Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99489,Not in chargemaster,99489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99489,BCBSND Base Physician Payment Schedule,91.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99487,Not in chargemaster,99487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99487,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99486,Not in chargemaster,99486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99486,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99485,Not in chargemaster,99485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99485,BCBSND Base Physician Payment Schedule,160.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99484,Not in chargemaster,99484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99484,BCBSND Base Physician Payment Schedule,97.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99483,Not in chargemaster,99483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99483,BCBSND Base Physician Payment Schedule,539.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99480,Not in chargemaster,99480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99480,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99479,Not in chargemaster,99479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99479,BCBSND Base Physician Payment Schedule,258.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99478,Not in chargemaster,99478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99478,BCBSND Base Physician Payment Schedule,284.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99477,Not in chargemaster,99477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99477,BCBSND Base Physician Payment Schedule,724.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99476,Not in chargemaster,99476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99476,BCBSND Base Physician Payment Schedule,719.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99475,Not in chargemaster,99475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99475,BCBSND Base Physician Payment Schedule,1162.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99474,Not in chargemaster,99474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99474,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99473,Not in chargemaster,99473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99473,BCBSND Base Physician Payment Schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99472,Not in chargemaster,99472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99472,BCBSND Base Physician Payment Schedule,834.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99471,Not in chargemaster,99471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99471,BCBSND Base Physician Payment Schedule,1650.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99469,Not in chargemaster,99469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99469,BCBSND Base Physician Payment Schedule,825.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99468,Not in chargemaster,99468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99468,BCBSND Base Physician Payment Schedule,1907.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99467,Not in chargemaster,99467,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99467,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99466,Not in chargemaster,99466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99466,BCBSND Base Physician Payment Schedule,494.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99465,Not in chargemaster,99465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99465,BCBSND Base Physician Payment Schedule,303.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99464,Not in chargemaster,99464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99464,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99463,Not in chargemaster,99463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99463,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99462,Not in chargemaster,99462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99462,BCBSND Base Physician Payment Schedule,87.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99461,Not in chargemaster,99461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99461,BCBSND Base Physician Payment Schedule,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99460,Not in chargemaster,99460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99460,BCBSND Base Physician Payment Schedule,198.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99458,Not in chargemaster,99458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99458,BCBSND Base Physician Payment Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99457,Not in chargemaster,99457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99457,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99454,Not in chargemaster,99454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99454,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99449,Not in chargemaster,99449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99449,BCBSND Base Physician Payment Schedule,150.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99453,Not in chargemaster,99453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99453,BCBSND Base Physician Payment Schedule,38.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99448,Not in chargemaster,99448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99448,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99447,Not in chargemaster,99447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99447,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99446,Not in chargemaster,99446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99446,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99443,Not in chargemaster,99443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99443,BCBSND Base Physician Payment Schedule,224.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99442,Not in chargemaster,99442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99442,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99441,Not in chargemaster,99441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99441,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99423,Not in chargemaster,99423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99423,BCBSND Base Physician Payment Schedule,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99422,Not in chargemaster,99422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99422,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99421,Not in chargemaster,99421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99421,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99416,Not in chargemaster,99416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99416,BCBSND Base Physician Payment Schedule,8.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99415,Not in chargemaster,99415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99415,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99412,Not in chargemaster,99412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99412,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99411,Not in chargemaster,99411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99411,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99409,Not in chargemaster,99409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99409,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99408,Not in chargemaster,99408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99408,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99407,9420001,99407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99407,BCBSND Base Physician Payment Schedule,60.2,101.14,Fee schedule,,60.2,60.2,60.2,60.2,,,0
unity,Fee schedule,Non-facility 99406,9420000,99406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99406,BCBSND Base Physician Payment Schedule,31.57,53.55,Fee schedule,,31.57,31.57,31.57,31.57,,,0
unity,Fee schedule,Non-facility 99404,Not in chargemaster,99404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99404,BCBSND Base Physician Payment Schedule,237.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99403,Not in chargemaster,99403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99403,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99402,Not in chargemaster,99402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99402,BCBSND Base Physician Payment Schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99401,Not in chargemaster,99401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99401,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99397,99397,99397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99397,BCBSND Base Physician Payment Schedule,284.1,290,Fee schedule,,284.1,284.1,284.1,284.1,,,0
unity,Fee schedule,Non-facility 99396,99396,99396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99396,BCBSND Base Physician Payment Schedule,264.28,270,Fee schedule,,264.28,264.28,264.28,264.28,,,0
unity,Fee schedule,Non-facility 99395,99395,99395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99395,BCBSND Base Physician Payment Schedule,248.13,250,Fee schedule,,248.13,248.13,248.13,248.13,,,0
unity,Fee schedule,Non-facility 99394,99394,99394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99394,BCBSND Base Physician Payment Schedule,242.25,250,Fee schedule,,242.25,242.25,242.25,242.25,,,0
unity,Fee schedule,Non-facility 99393,99393,99393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99393,BCBSND Base Physician Payment Schedule,220.23,225,Fee schedule,,220.23,220.23,220.23,220.23,,,0
unity,Fee schedule,Non-facility 99392,99392,99392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99392,BCBSND Base Physician Payment Schedule,220.96,225,Fee schedule,,220.96,220.96,220.96,220.96,,,0
unity,Fee schedule,Non-facility 99391,99391,99391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99391,BCBSND Base Physician Payment Schedule,207.75,210,Fee schedule,,207.75,207.75,207.75,207.75,,,0
unity,Fee schedule,Non-facility 99387,99387,99387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99387,BCBSND Base Physician Payment Schedule,346.5,342.17,Fee schedule,,342.17,342.17,342.17,342.17,,,0
unity,Fee schedule,Non-facility 99386,99386,99386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99386,BCBSND Base Physician Payment Schedule,318.6,325,Fee schedule,,318.6,318.6,318.6,318.6,,,0
unity,Fee schedule,Non-facility 99385,99385,99385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99385,BCBSND Base Physician Payment Schedule,275.29,282,Fee schedule,,275.29,275.29,275.29,275.29,,,0
unity,Fee schedule,Non-facility 99384,99384,99384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99384,BCBSND Base Physician Payment Schedule,284.1,290,Fee schedule,,284.1,284.1,284.1,284.1,,,0
unity,Fee schedule,Non-facility 99383,99383,99383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99383,BCBSND Base Physician Payment Schedule,251.06,255,Fee schedule,,251.06,251.06,251.06,251.06,,,0
unity,Fee schedule,Non-facility 99382,99382,99382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99382,BCBSND Base Physician Payment Schedule,240.78,238.51,Fee schedule,,238.51,238.51,238.51,238.51,,,0
unity,Fee schedule,Non-facility 99381,99381,99381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99381,BCBSND Base Physician Payment Schedule,229.77,238,Fee schedule,,229.77,229.77,229.77,229.77,,,0
unity,Fee schedule,Non-facility 99380,Not in chargemaster,99380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99380,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99379,Not in chargemaster,99379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99379,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99378,Not in chargemaster,99378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99378,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99377,Not in chargemaster,99377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99377,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99375,Not in chargemaster,99375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99375,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99374,Not in chargemaster,99374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99374,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99368,Not in chargemaster,99368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99368,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99367,Not in chargemaster,99367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99367,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99366,Not in chargemaster,99366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99366,BCBSND Base Physician Payment Schedule,91.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99360,Not in chargemaster,99360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99360,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99359,Not in chargemaster,99359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99359,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99358,Not in chargemaster,99358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99358,BCBSND Base Physician Payment Schedule,231.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99357,Not in chargemaster,99357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99357,BCBSND Base Physician Payment Schedule,193.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99356,Not in chargemaster,99356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99356,BCBSND Base Physician Payment Schedule,191.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99355,Not in chargemaster,99355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99355,BCBSND Base Physician Payment Schedule,204.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99354,Not in chargemaster,99354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99354,BCBSND Base Physician Payment Schedule,268.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99350,Not in chargemaster,99350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99350,BCBSND Base Physician Payment Schedule,371.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99349,Not in chargemaster,99349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99349,BCBSND Base Physician Payment Schedule,266.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99348,Not in chargemaster,99348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99348,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99347,Not in chargemaster,99347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99347,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99345,Not in chargemaster,99345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99345,BCBSND Base Physician Payment Schedule,460.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99344,Not in chargemaster,99344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99344,BCBSND Base Physician Payment Schedule,378.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99343,Not in chargemaster,99343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99343,BCBSND Base Physician Payment Schedule,266.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99342,Not in chargemaster,99342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99342,BCBSND Base Physician Payment Schedule,162.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99341,Not in chargemaster,99341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99341,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99340,Not in chargemaster,99340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99340,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99339,Not in chargemaster,99339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99339,BCBSND Base Physician Payment Schedule,160.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99337,Not in chargemaster,99337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99337,BCBSND Base Physician Payment Schedule,402.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99336,Not in chargemaster,99336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99336,BCBSND Base Physician Payment Schedule,278.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99335,Not in chargemaster,99335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99335,BCBSND Base Physician Payment Schedule,197.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99334,Not in chargemaster,99334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99334,BCBSND Base Physician Payment Schedule,124.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99328,Not in chargemaster,99328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99328,BCBSND Base Physician Payment Schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99327,Not in chargemaster,99327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99327,BCBSND Base Physician Payment Schedule,384.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99326,Not in chargemaster,99326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99326,BCBSND Base Physician Payment Schedule,286.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99325,Not in chargemaster,99325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99325,BCBSND Base Physician Payment Schedule,164.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99324,Not in chargemaster,99324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99324,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99318,Not in chargemaster,99318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99318,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99316,99316,99316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99316,BCBSND Base Physician Payment Schedule,218.03,213.68,Fee schedule,,213.68,213.68,213.68,213.68,,,0
unity,Fee schedule,Non-facility 99315,99315,99315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99315,BCBSND Base Physician Payment Schedule,151.96,149.08,Fee schedule,,149.08,149.08,149.08,149.08,,,0
unity,Fee schedule,Non-facility 99310,Not in chargemaster,99310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99310,BCBSND Base Physician Payment Schedule,278.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99309,99309,99309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99309,BCBSND Base Physician Payment Schedule,188.66,195,Fee schedule,,188.66,188.66,188.66,188.66,,,0
unity,Fee schedule,Non-facility 99308,99308,99308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99308,BCBSND Base Physician Payment Schedule,143.15,145,Fee schedule,,143.15,143.15,143.15,143.15,,,0
unity,Fee schedule,Non-facility 99307,99307,99307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99307,BCBSND Base Physician Payment Schedule,91.03,95,Fee schedule,,91.03,91.03,91.03,91.03,,,0
unity,Fee schedule,Non-facility 99306,Not in chargemaster,99306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99306,BCBSND Base Physician Payment Schedule,345.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99305,99305,99305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99305,BCBSND Base Physician Payment Schedule,267.95,235.13,Fee schedule,,235.13,235.13,235.13,235.13,,,0
unity,Fee schedule,Non-facility 99304,99304,99304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99304,BCBSND Base Physician Payment Schedule,187.2,195,Fee schedule,,187.2,187.2,187.2,187.2,,,0
unity,Fee schedule,Non-facility 99292,99292,99292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99292,BCBSND Base Physician Payment Schedule,256.2,262,Fee schedule,,256.2,256.2,256.2,256.2,,,0
unity,Fee schedule,Non-facility 99291,99291,99291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99291,BCBSND Base Physician Payment Schedule,579.2,480,Fee schedule,,480,480,480,480,,,0
unity,Fee schedule,Non-facility 99285,99285,99285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99285,BCBSND Base Physician Payment Schedule,360.44,370,Fee schedule,,360.44,360.44,360.44,360.44,,,0
unity,Fee schedule,Non-facility 99284,99284,99284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99284,BCBSND Base Physician Payment Schedule,248.13,250,Fee schedule,,248.13,248.13,248.13,248.13,,,0
unity,Fee schedule,Non-facility 99283,99283,99283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99283,BCBSND Base Physician Payment Schedule,135.07,130,Fee schedule,,130,130,130,130,,,0
unity,Fee schedule,Non-facility 99282,99282,99282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99282,BCBSND Base Physician Payment Schedule,90.29,90,Fee schedule,,90,90,90,90,,,0
unity,Fee schedule,Non-facility 99281,99281,99281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99281,BCBSND Base Physician Payment Schedule,46.98,50,Fee schedule,,46.98,46.98,46.98,46.98,,,0
unity,Fee schedule,Non-facility 99255,Not in chargemaster,99255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99255,BCBSND Base Physician Payment Schedule,422.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99254,Not in chargemaster,99254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99254,BCBSND Base Physician Payment Schedule,351.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99253,Not in chargemaster,99253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99253,BCBSND Base Physician Payment Schedule,241.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99252,Not in chargemaster,99252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99252,BCBSND Base Physician Payment Schedule,156.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99251,Not in chargemaster,99251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99251,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99245,Not in chargemaster,99245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99245,BCBSND Base Physician Payment Schedule,467.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99244,Not in chargemaster,99244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99244,BCBSND Base Physician Payment Schedule,383.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99243,Not in chargemaster,99243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99243,BCBSND Base Physician Payment Schedule,256.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99242,Not in chargemaster,99242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99242,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99241,99241,99241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99241,BCBSND Base Physician Payment Schedule,99.1,97.26,Fee schedule,,97.26,97.26,97.26,97.26,,,0
unity,Fee schedule,Non-facility 99239,99239,99239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99239,BCBSND Base Physician Payment Schedule,221.7,230,Fee schedule,,221.7,221.7,221.7,221.7,,,0
unity,Fee schedule,Non-facility 99238,99238,99238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99238,BCBSND Base Physician Payment Schedule,151.22,155,Fee schedule,,151.22,151.22,151.22,151.22,,,0
unity,Fee schedule,Non-facility 99236,99236,99236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99236,BCBSND Base Physician Payment Schedule,450.74,465,Fee schedule,,450.74,450.74,450.74,450.74,,,0
unity,Fee schedule,Non-facility 99235,99235,99235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99235,BCBSND Base Physician Payment Schedule,350.17,360,Fee schedule,,350.17,350.17,350.17,350.17,,,0
unity,Fee schedule,Non-facility 99234,99234,99234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99234,BCBSND Base Physician Payment Schedule,276.76,285,Fee schedule,,276.76,276.76,276.76,276.76,,,0
unity,Fee schedule,Non-facility 99233,99233,99233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99233,BCBSND Base Physician Payment Schedule,215.83,225,Fee schedule,,215.83,215.83,215.83,215.83,,,0
unity,Fee schedule,Non-facility 99232,99232,99232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99232,BCBSND Base Physician Payment Schedule,149.76,155,Fee schedule,,149.76,149.76,149.76,149.76,,,0
unity,Fee schedule,Non-facility 99231,99231,99231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99231,BCBSND Base Physician Payment Schedule,81.49,85,Fee schedule,,81.49,81.49,81.49,81.49,,,0
unity,Fee schedule,Non-facility 99226,99226,99226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99226,BCBSND Base Physician Payment Schedule,216.56,225,Fee schedule,,216.56,216.56,216.56,216.56,,,0
unity,Fee schedule,Non-facility 99225,99225,99225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99225,BCBSND Base Physician Payment Schedule,150.49,155,Fee schedule,,150.49,150.49,150.49,150.49,,,0
unity,Fee schedule,Non-facility 99224,99224,99224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99224,BCBSND Base Physician Payment Schedule,82.22,85,Fee schedule,,82.22,82.22,82.22,82.22,,,0
unity,Fee schedule,Non-facility 99223,99223,99223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99223,BCBSND Base Physician Payment Schedule,419.17,430,Fee schedule,,419.17,419.17,419.17,419.17,,,0
unity,Fee schedule,Non-facility 99222,99222,99222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99222,BCBSND Base Physician Payment Schedule,285.56,290,Fee schedule,,285.56,285.56,285.56,285.56,,,0
unity,Fee schedule,Non-facility 99221,99221,99221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99221,BCBSND Base Physician Payment Schedule,211.42,215,Fee schedule,,211.42,211.42,211.42,211.42,,,0
unity,Fee schedule,Non-facility 99220,99220,99220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99220,BCBSND Base Physician Payment Schedule,383.2,395,Fee schedule,,383.2,383.2,383.2,383.2,,,0
unity,Fee schedule,Non-facility 99219,99219,99219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99219,BCBSND Base Physician Payment Schedule,281.16,290,Fee schedule,,281.16,281.16,281.16,281.16,,,0
unity,Fee schedule,Non-facility 99218,99218,99218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99218,BCBSND Base Physician Payment Schedule,207.02,214,Fee schedule,,207.02,207.02,207.02,207.02,,,0
unity,Fee schedule,Non-facility 99217,99217,99217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99217,BCBSND Base Physician Payment Schedule,150.49,155,Fee schedule,,150.49,150.49,150.49,150.49,,,0
unity,Fee schedule,Non-facility 99215,99215,99215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99215,BCBSND Base Physician Payment Schedule,301.72,300,Fee schedule,,300,300,300,300,,,0
unity,Fee schedule,Non-facility 99214,99214,99214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99214,BCBSND Base Physician Payment Schedule,224.63,230,Fee schedule,,224.63,224.63,224.63,224.63,,,0
unity,Fee schedule,Non-facility 99213,99213,99213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99213,BCBSND Base Physician Payment Schedule,154.9,158,Fee schedule,,154.9,154.9,154.9,154.9,,,0
unity,Fee schedule,Non-facility 99212,99212,99212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99212,BCBSND Base Physician Payment Schedule,93.96,97,Fee schedule,,93.96,93.96,93.96,93.96,,,0
unity,Fee schedule,Non-facility 99498,Not in chargemaster,99498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99498,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0380,Not in chargemaster,A0380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0380,BCBSND Base Physician Payment Schedule,20.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0390,Not in chargemaster,A0390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0390,BCBSND Base Physician Payment Schedule,20.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0425,Not in chargemaster,A0425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0425,BCBSND Base Physician Payment Schedule,20.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0426,Not in chargemaster,A0426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0426,BCBSND Base Physician Payment Schedule,674.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0427,Not in chargemaster,A0427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0427,BCBSND Base Physician Payment Schedule,1068.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0428,Not in chargemaster,A0428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0428,BCBSND Base Physician Payment Schedule,562.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0429,Not in chargemaster,A0429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0429,BCBSND Base Physician Payment Schedule,899.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0433,Not in chargemaster,A0433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0433,BCBSND Base Physician Payment Schedule,1546.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0434,Not in chargemaster,A0434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0434,BCBSND Base Physician Payment Schedule,1828.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility A0998,Not in chargemaster,A0998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A0998,BCBSND Base Physician Payment Schedule,542.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0120,Not in chargemaster,D0120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0120,BCBSND Base Physician Payment Schedule,44.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0140,Not in chargemaster,D0140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0140,BCBSND Base Physician Payment Schedule,64.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0145,Not in chargemaster,D0145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0145,BCBSND Base Physician Payment Schedule,57.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0150,Not in chargemaster,D0150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0150,BCBSND Base Physician Payment Schedule,66.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0160,Not in chargemaster,D0160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0160,BCBSND Base Physician Payment Schedule,107.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0170,Not in chargemaster,D0170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0170,BCBSND Base Physician Payment Schedule,54.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0171,Not in chargemaster,D0171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0171,BCBSND Base Physician Payment Schedule,17.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0180,Not in chargemaster,D0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0180,BCBSND Base Physician Payment Schedule,70.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0210,Not in chargemaster,D0210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0210,BCBSND Base Physician Payment Schedule,126.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0220,Not in chargemaster,D0220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0220,BCBSND Base Physician Payment Schedule,26.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0230,Not in chargemaster,D0230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0230,BCBSND Base Physician Payment Schedule,13.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0240,Not in chargemaster,D0240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0240,BCBSND Base Physician Payment Schedule,37.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0250,Not in chargemaster,D0250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0250,BCBSND Base Physician Payment Schedule,80.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0251,Not in chargemaster,D0251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0251,BCBSND Base Physician Payment Schedule,80.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0270,Not in chargemaster,D0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0270,BCBSND Base Physician Payment Schedule,26.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0272,Not in chargemaster,D0272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0272,BCBSND Base Physician Payment Schedule,40.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0273,Not in chargemaster,D0273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0273,BCBSND Base Physician Payment Schedule,43.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0274,Not in chargemaster,D0274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0274,BCBSND Base Physician Payment Schedule,53.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0277,Not in chargemaster,D0277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0277,BCBSND Base Physician Payment Schedule,53.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0310,Not in chargemaster,D0310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0310,BCBSND Base Physician Payment Schedule,359.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0330,Not in chargemaster,D0330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0330,BCBSND Base Physician Payment Schedule,104.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0340,Not in chargemaster,D0340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0340,BCBSND Base Physician Payment Schedule,110.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0350,Not in chargemaster,D0350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0350,BCBSND Base Physician Payment Schedule,64.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0364,Not in chargemaster,D0364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0364,BCBSND Base Physician Payment Schedule,559.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0365,Not in chargemaster,D0365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0365,BCBSND Base Physician Payment Schedule,559.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0366,Not in chargemaster,D0366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0366,BCBSND Base Physician Payment Schedule,559.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0367,Not in chargemaster,D0367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0367,BCBSND Base Physician Payment Schedule,559.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0368,Not in chargemaster,D0368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0368,BCBSND Base Physician Payment Schedule,559.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0369,Not in chargemaster,D0369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0369,BCBSND Base Physician Payment Schedule,1378.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0370,Not in chargemaster,D0370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0370,BCBSND Base Physician Payment Schedule,499.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0371,Not in chargemaster,D0371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0371,BCBSND Base Physician Payment Schedule,1291.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0380,Not in chargemaster,D0380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0380,BCBSND Base Physician Payment Schedule,344.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0381,Not in chargemaster,D0381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0381,BCBSND Base Physician Payment Schedule,344.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0382,Not in chargemaster,D0382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0382,BCBSND Base Physician Payment Schedule,344.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0383,Not in chargemaster,D0383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0383,BCBSND Base Physician Payment Schedule,344.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0384,Not in chargemaster,D0384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0384,BCBSND Base Physician Payment Schedule,344.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0385,Not in chargemaster,D0385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0385,BCBSND Base Physician Payment Schedule,947.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0386,Not in chargemaster,D0386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0386,BCBSND Base Physician Payment Schedule,516.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0391,Not in chargemaster,D0391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0391,BCBSND Base Physician Payment Schedule,344.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0393,Not in chargemaster,D0393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0393,BCBSND Base Physician Payment Schedule,465.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0394,Not in chargemaster,D0394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0394,BCBSND Base Physician Payment Schedule,465.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0395,Not in chargemaster,D0395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0395,BCBSND Base Physician Payment Schedule,465.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0411,Not in chargemaster,D0411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0411,BCBSND Base Physician Payment Schedule,13.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0412,Not in chargemaster,D0412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0412,BCBSND Base Physician Payment Schedule,13.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0414,Not in chargemaster,D0414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0414,BCBSND Base Physician Payment Schedule,179.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0422,Not in chargemaster,D0422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0422,BCBSND Base Physician Payment Schedule,49.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0423,Not in chargemaster,D0423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0423,BCBSND Base Physician Payment Schedule,51.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0460,Not in chargemaster,D0460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0460,BCBSND Base Physician Payment Schedule,50.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0470,Not in chargemaster,D0470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0470,BCBSND Base Physician Payment Schedule,111.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D0600,Not in chargemaster,D0600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D0600,BCBSND Base Physician Payment Schedule,9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1110,Not in chargemaster,D1110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1110,BCBSND Base Physician Payment Schedule,87.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1120,Not in chargemaster,D1120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1120,BCBSND Base Physician Payment Schedule,67.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1206,Not in chargemaster,D1206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1206,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1208,Not in chargemaster,D1208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1208,BCBSND Base Physician Payment Schedule,37.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1330,Not in chargemaster,D1330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1330,BCBSND Base Physician Payment Schedule,31.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1351,Not in chargemaster,D1351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1351,BCBSND Base Physician Payment Schedule,52.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1352,Not in chargemaster,D1352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1352,BCBSND Base Physician Payment Schedule,52.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1354,Not in chargemaster,D1354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1354,BCBSND Base Physician Payment Schedule,6.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1510,Not in chargemaster,D1510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1510,BCBSND Base Physician Payment Schedule,314.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1516,Not in chargemaster,D1516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1516,BCBSND Base Physician Payment Schedule,449.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1517,Not in chargemaster,D1517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1517,BCBSND Base Physician Payment Schedule,449.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1520,Not in chargemaster,D1520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1520,BCBSND Base Physician Payment Schedule,314.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1526,Not in chargemaster,D1526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1526,BCBSND Base Physician Payment Schedule,449.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1527,Not in chargemaster,D1527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1527,BCBSND Base Physician Payment Schedule,449.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D1575,Not in chargemaster,D1575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D1575,BCBSND Base Physician Payment Schedule,314.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2140,Not in chargemaster,D2140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2140,BCBSND Base Physician Payment Schedule,128.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2150,Not in chargemaster,D2150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2150,BCBSND Base Physician Payment Schedule,156.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2160,Not in chargemaster,D2160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2160,BCBSND Base Physician Payment Schedule,186.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2161,Not in chargemaster,D2161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2161,BCBSND Base Physician Payment Schedule,218.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2330,Not in chargemaster,D2330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2330,BCBSND Base Physician Payment Schedule,139.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2331,Not in chargemaster,D2331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2331,BCBSND Base Physician Payment Schedule,176.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2332,Not in chargemaster,D2332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2332,BCBSND Base Physician Payment Schedule,209.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2335,Not in chargemaster,D2335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2335,BCBSND Base Physician Payment Schedule,239.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2390,Not in chargemaster,D2390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2390,BCBSND Base Physician Payment Schedule,243.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2391,Not in chargemaster,D2391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2391,BCBSND Base Physician Payment Schedule,149.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2392,Not in chargemaster,D2392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2392,BCBSND Base Physician Payment Schedule,202.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2393,Not in chargemaster,D2393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2393,BCBSND Base Physician Payment Schedule,242.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2394,Not in chargemaster,D2394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2394,BCBSND Base Physician Payment Schedule,263.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2410,Not in chargemaster,D2410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2410,BCBSND Base Physician Payment Schedule,513.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2420,Not in chargemaster,D2420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2420,BCBSND Base Physician Payment Schedule,610.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2430,Not in chargemaster,D2430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2430,BCBSND Base Physician Payment Schedule,758.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2510,Not in chargemaster,D2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2510,BCBSND Base Physician Payment Schedule,732.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2520,Not in chargemaster,D2520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2520,BCBSND Base Physician Payment Schedule,802.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2530,Not in chargemaster,D2530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2530,BCBSND Base Physician Payment Schedule,843.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2542,Not in chargemaster,D2542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2542,BCBSND Base Physician Payment Schedule,939.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2543,Not in chargemaster,D2543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2543,BCBSND Base Physician Payment Schedule,945.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2544,Not in chargemaster,D2544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2544,BCBSND Base Physician Payment Schedule,1092.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2610,Not in chargemaster,D2610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2610,BCBSND Base Physician Payment Schedule,651.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2620,Not in chargemaster,D2620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2620,BCBSND Base Physician Payment Schedule,758.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2630,Not in chargemaster,D2630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2630,BCBSND Base Physician Payment Schedule,798.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2642,Not in chargemaster,D2642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2642,BCBSND Base Physician Payment Schedule,885.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2643,Not in chargemaster,D2643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2643,BCBSND Base Physician Payment Schedule,945.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2644,Not in chargemaster,D2644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2644,BCBSND Base Physician Payment Schedule,1056.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2650,Not in chargemaster,D2650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2650,BCBSND Base Physician Payment Schedule,633.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2651,Not in chargemaster,D2651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2651,BCBSND Base Physician Payment Schedule,752.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2652,Not in chargemaster,D2652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2652,BCBSND Base Physician Payment Schedule,831.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2662,Not in chargemaster,D2662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2662,BCBSND Base Physician Payment Schedule,761.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2663,Not in chargemaster,D2663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2663,BCBSND Base Physician Payment Schedule,904.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2664,Not in chargemaster,D2664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2664,BCBSND Base Physician Payment Schedule,981.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2710,Not in chargemaster,D2710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2710,BCBSND Base Physician Payment Schedule,396.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2712,Not in chargemaster,D2712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2712,BCBSND Base Physician Payment Schedule,422.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2720,Not in chargemaster,D2720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2720,BCBSND Base Physician Payment Schedule,978.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2721,Not in chargemaster,D2721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2721,BCBSND Base Physician Payment Schedule,861.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2722,Not in chargemaster,D2722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2722,BCBSND Base Physician Payment Schedule,913.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2740,Not in chargemaster,D2740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2740,BCBSND Base Physician Payment Schedule,1146.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2750,Not in chargemaster,D2750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2750,BCBSND Base Physician Payment Schedule,1170.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2751,Not in chargemaster,D2751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2751,BCBSND Base Physician Payment Schedule,1108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2752,Not in chargemaster,D2752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2752,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2780,Not in chargemaster,D2780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2780,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2781,Not in chargemaster,D2781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2781,BCBSND Base Physician Payment Schedule,1030.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2782,Not in chargemaster,D2782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2782,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2783,Not in chargemaster,D2783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2783,BCBSND Base Physician Payment Schedule,1046.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2790,Not in chargemaster,D2790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2790,BCBSND Base Physician Payment Schedule,1158.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2791,Not in chargemaster,D2791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2791,BCBSND Base Physician Payment Schedule,1030.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2792,Not in chargemaster,D2792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2792,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2794,Not in chargemaster,D2794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2794,BCBSND Base Physician Payment Schedule,1030.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2799,Not in chargemaster,D2799,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2799,BCBSND Base Physician Payment Schedule,329.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2910,Not in chargemaster,D2910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2910,BCBSND Base Physician Payment Schedule,74.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2915,Not in chargemaster,D2915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2915,BCBSND Base Physician Payment Schedule,97.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2920,Not in chargemaster,D2920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2920,BCBSND Base Physician Payment Schedule,74.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2921,Not in chargemaster,D2921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2921,BCBSND Base Physician Payment Schedule,97.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2929,Not in chargemaster,D2929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2929,BCBSND Base Physician Payment Schedule,368.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2930,Not in chargemaster,D2930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2930,BCBSND Base Physician Payment Schedule,246.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2931,Not in chargemaster,D2931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2931,BCBSND Base Physician Payment Schedule,300.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2932,Not in chargemaster,D2932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2932,BCBSND Base Physician Payment Schedule,278.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2933,Not in chargemaster,D2933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2933,BCBSND Base Physician Payment Schedule,289.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2934,Not in chargemaster,D2934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2934,BCBSND Base Physician Payment Schedule,289.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2940,Not in chargemaster,D2940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2940,BCBSND Base Physician Payment Schedule,97.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2941,Not in chargemaster,D2941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2941,BCBSND Base Physician Payment Schedule,98.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2949,Not in chargemaster,D2949,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2949,BCBSND Base Physician Payment Schedule,34.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2950,Not in chargemaster,D2950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2950,BCBSND Base Physician Payment Schedule,186.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2951,Not in chargemaster,D2951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2951,BCBSND Base Physician Payment Schedule,51.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2952,Not in chargemaster,D2952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2952,BCBSND Base Physician Payment Schedule,384.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2953,Not in chargemaster,D2953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2953,BCBSND Base Physician Payment Schedule,78.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2954,Not in chargemaster,D2954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2954,BCBSND Base Physician Payment Schedule,303.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2955,Not in chargemaster,D2955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2955,BCBSND Base Physician Payment Schedule,183.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2957,Not in chargemaster,D2957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2957,BCBSND Base Physician Payment Schedule,25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2960,Not in chargemaster,D2960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2960,BCBSND Base Physician Payment Schedule,483.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2961,Not in chargemaster,D2961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2961,BCBSND Base Physician Payment Schedule,729.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2962,Not in chargemaster,D2962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2962,BCBSND Base Physician Payment Schedule,997.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2971,Not in chargemaster,D2971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2971,BCBSND Base Physician Payment Schedule,47.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2975,Not in chargemaster,D2975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2975,BCBSND Base Physician Payment Schedule,293.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2980,Not in chargemaster,D2980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2980,BCBSND Base Physician Payment Schedule,191.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2981,Not in chargemaster,D2981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2981,BCBSND Base Physician Payment Schedule,134.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2982,Not in chargemaster,D2982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2982,BCBSND Base Physician Payment Schedule,134.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2983,Not in chargemaster,D2983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2983,BCBSND Base Physician Payment Schedule,134.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D2990,Not in chargemaster,D2990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D2990,BCBSND Base Physician Payment Schedule,52.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3110,Not in chargemaster,D3110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3110,BCBSND Base Physician Payment Schedule,44.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3120,Not in chargemaster,D3120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3120,BCBSND Base Physician Payment Schedule,44.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3220,Not in chargemaster,D3220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3220,BCBSND Base Physician Payment Schedule,167.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3221,Not in chargemaster,D3221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3221,BCBSND Base Physician Payment Schedule,166.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3222,Not in chargemaster,D3222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3222,BCBSND Base Physician Payment Schedule,168.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3230,Not in chargemaster,D3230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3230,BCBSND Base Physician Payment Schedule,258.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3240,Not in chargemaster,D3240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3240,BCBSND Base Physician Payment Schedule,314.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3310,Not in chargemaster,D3310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3310,BCBSND Base Physician Payment Schedule,707.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3320,Not in chargemaster,D3320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3320,BCBSND Base Physician Payment Schedule,824.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3330,Not in chargemaster,D3330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3330,BCBSND Base Physician Payment Schedule,1113.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3331,Not in chargemaster,D3331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3331,BCBSND Base Physician Payment Schedule,208.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3332,Not in chargemaster,D3332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3332,BCBSND Base Physician Payment Schedule,359.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3333,Not in chargemaster,D3333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3333,BCBSND Base Physician Payment Schedule,224.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3346,Not in chargemaster,D3346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3346,BCBSND Base Physician Payment Schedule,764.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3347,Not in chargemaster,D3347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3347,BCBSND Base Physician Payment Schedule,876.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3348,Not in chargemaster,D3348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3348,BCBSND Base Physician Payment Schedule,1252.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3351,Not in chargemaster,D3351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3351,BCBSND Base Physician Payment Schedule,318.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3352,Not in chargemaster,D3352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3352,BCBSND Base Physician Payment Schedule,168.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3353,Not in chargemaster,D3353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3353,BCBSND Base Physician Payment Schedule,513.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3355,Not in chargemaster,D3355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3355,BCBSND Base Physician Payment Schedule,318.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3356,Not in chargemaster,D3356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3356,BCBSND Base Physician Payment Schedule,168.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3357,Not in chargemaster,D3357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3357,BCBSND Base Physician Payment Schedule,168.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3410,Not in chargemaster,D3410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3410,BCBSND Base Physician Payment Schedule,642.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3421,Not in chargemaster,D3421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3421,BCBSND Base Physician Payment Schedule,746.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3425,Not in chargemaster,D3425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3425,BCBSND Base Physician Payment Schedule,854.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3426,Not in chargemaster,D3426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3426,BCBSND Base Physician Payment Schedule,307.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3427,Not in chargemaster,D3427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3427,BCBSND Base Physician Payment Schedule,367.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3430,Not in chargemaster,D3430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3430,BCBSND Base Physician Payment Schedule,192.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3432,Not in chargemaster,D3432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3432,BCBSND Base Physician Payment Schedule,314.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3450,Not in chargemaster,D3450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3450,BCBSND Base Physician Payment Schedule,321.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3470,Not in chargemaster,D3470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3470,BCBSND Base Physician Payment Schedule,642.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3920,Not in chargemaster,D3920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3920,BCBSND Base Physician Payment Schedule,390.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D3950,Not in chargemaster,D3950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3950,BCBSND Base Physician Payment Schedule,192.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4210,Not in chargemaster,D4210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4210,BCBSND Base Physician Payment Schedule,577.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4211,Not in chargemaster,D4211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4211,BCBSND Base Physician Payment Schedule,259.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4212,Not in chargemaster,D4212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4212,BCBSND Base Physician Payment Schedule,359.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4230,Not in chargemaster,D4230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4230,BCBSND Base Physician Payment Schedule,939.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4231,Not in chargemaster,D4231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4231,BCBSND Base Physician Payment Schedule,563,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4240,Not in chargemaster,D4240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4240,BCBSND Base Physician Payment Schedule,612.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4241,Not in chargemaster,D4241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4241,BCBSND Base Physician Payment Schedule,347.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4245,Not in chargemaster,D4245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4245,BCBSND Base Physician Payment Schedule,629.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4249,Not in chargemaster,D4249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4249,BCBSND Base Physician Payment Schedule,783.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4260,Not in chargemaster,D4260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4260,BCBSND Base Physician Payment Schedule,1112.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4261,Not in chargemaster,D4261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4261,BCBSND Base Physician Payment Schedule,487.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4263,Not in chargemaster,D4263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4263,BCBSND Base Physician Payment Schedule,359.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4264,Not in chargemaster,D4264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4264,BCBSND Base Physician Payment Schedule,314.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4266,Not in chargemaster,D4266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4266,BCBSND Base Physician Payment Schedule,359.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4267,Not in chargemaster,D4267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4267,BCBSND Base Physician Payment Schedule,613.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4270,Not in chargemaster,D4270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4270,BCBSND Base Physician Payment Schedule,642.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4273,Not in chargemaster,D4273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4273,BCBSND Base Physician Payment Schedule,640.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4274,Not in chargemaster,D4274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4274,BCBSND Base Physician Payment Schedule,260.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4275,Not in chargemaster,D4275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4275,BCBSND Base Physician Payment Schedule,646.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4276,Not in chargemaster,D4276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4276,BCBSND Base Physician Payment Schedule,1027.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4277,Not in chargemaster,D4277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4277,BCBSND Base Physician Payment Schedule,413.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4278,Not in chargemaster,D4278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4278,BCBSND Base Physician Payment Schedule,137.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4283,Not in chargemaster,D4283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4283,BCBSND Base Physician Payment Schedule,213.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4285,Not in chargemaster,D4285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4285,BCBSND Base Physician Payment Schedule,215.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4320,Not in chargemaster,D4320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4320,BCBSND Base Physician Payment Schedule,436.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4321,Not in chargemaster,D4321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4321,BCBSND Base Physician Payment Schedule,306.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4341,Not in chargemaster,D4341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4341,BCBSND Base Physician Payment Schedule,220.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4342,Not in chargemaster,D4342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4342,BCBSND Base Physician Payment Schedule,97.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4346,Not in chargemaster,D4346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4346,BCBSND Base Physician Payment Schedule,112.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4355,Not in chargemaster,D4355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4355,BCBSND Base Physician Payment Schedule,112.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4910,Not in chargemaster,D4910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4910,BCBSND Base Physician Payment Schedule,128.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D4920,Not in chargemaster,D4920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D4920,BCBSND Base Physician Payment Schedule,63.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5110,Not in chargemaster,D5110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5110,BCBSND Base Physician Payment Schedule,1387.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5120,Not in chargemaster,D5120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5120,BCBSND Base Physician Payment Schedule,1440.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5130,Not in chargemaster,D5130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5130,BCBSND Base Physician Payment Schedule,1506.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5140,Not in chargemaster,D5140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5140,BCBSND Base Physician Payment Schedule,1510.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5211,Not in chargemaster,D5211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5211,BCBSND Base Physician Payment Schedule,1165.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5212,Not in chargemaster,D5212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5212,BCBSND Base Physician Payment Schedule,1165.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5213,Not in chargemaster,D5213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5213,BCBSND Base Physician Payment Schedule,1532.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5214,Not in chargemaster,D5214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5214,BCBSND Base Physician Payment Schedule,1533.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5221,Not in chargemaster,D5221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5221,BCBSND Base Physician Payment Schedule,1235.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5222,Not in chargemaster,D5222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5222,BCBSND Base Physician Payment Schedule,1235.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5223,Not in chargemaster,D5223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5223,BCBSND Base Physician Payment Schedule,1624.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5224,Not in chargemaster,D5224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5224,BCBSND Base Physician Payment Schedule,1624.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5225,Not in chargemaster,D5225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5225,BCBSND Base Physician Payment Schedule,1371.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5226,Not in chargemaster,D5226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5226,BCBSND Base Physician Payment Schedule,1371.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5282,Not in chargemaster,D5282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5282,BCBSND Base Physician Payment Schedule,924.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5283,Not in chargemaster,D5283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5283,BCBSND Base Physician Payment Schedule,924.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5410,Not in chargemaster,D5410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5410,BCBSND Base Physician Payment Schedule,64.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5411,Not in chargemaster,D5411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5411,BCBSND Base Physician Payment Schedule,64.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5421,Not in chargemaster,D5421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5421,BCBSND Base Physician Payment Schedule,64.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5422,Not in chargemaster,D5422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5422,BCBSND Base Physician Payment Schedule,64.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5511,Not in chargemaster,D5511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5511,BCBSND Base Physician Payment Schedule,177.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5512,Not in chargemaster,D5512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5512,BCBSND Base Physician Payment Schedule,177.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5520,Not in chargemaster,D5520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5520,BCBSND Base Physician Payment Schedule,153.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5611,Not in chargemaster,D5611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5611,BCBSND Base Physician Payment Schedule,162.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5612,Not in chargemaster,D5612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5612,BCBSND Base Physician Payment Schedule,162.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5621,Not in chargemaster,D5621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5621,BCBSND Base Physician Payment Schedule,186.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5622,Not in chargemaster,D5622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5622,BCBSND Base Physician Payment Schedule,186.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5630,Not in chargemaster,D5630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5630,BCBSND Base Physician Payment Schedule,164.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5640,Not in chargemaster,D5640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5640,BCBSND Base Physician Payment Schedule,153.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5650,Not in chargemaster,D5650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5650,BCBSND Base Physician Payment Schedule,153.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5660,Not in chargemaster,D5660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5660,BCBSND Base Physician Payment Schedule,208.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5670,Not in chargemaster,D5670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5670,BCBSND Base Physician Payment Schedule,810.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5671,Not in chargemaster,D5671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5671,BCBSND Base Physician Payment Schedule,810.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5710,Not in chargemaster,D5710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5710,BCBSND Base Physician Payment Schedule,475.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5711,Not in chargemaster,D5711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5711,BCBSND Base Physician Payment Schedule,475.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5720,Not in chargemaster,D5720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5720,BCBSND Base Physician Payment Schedule,457.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5721,Not in chargemaster,D5721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5721,BCBSND Base Physician Payment Schedule,457.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5730,Not in chargemaster,D5730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5730,BCBSND Base Physician Payment Schedule,294.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5731,Not in chargemaster,D5731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5731,BCBSND Base Physician Payment Schedule,294.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5740,Not in chargemaster,D5740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5740,BCBSND Base Physician Payment Schedule,258.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5741,Not in chargemaster,D5741,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5741,BCBSND Base Physician Payment Schedule,258.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5750,Not in chargemaster,D5750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5750,BCBSND Base Physician Payment Schedule,416.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5751,Not in chargemaster,D5751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5751,BCBSND Base Physician Payment Schedule,416.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5760,Not in chargemaster,D5760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5760,BCBSND Base Physician Payment Schedule,421.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5761,Not in chargemaster,D5761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5761,BCBSND Base Physician Payment Schedule,421.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5810,Not in chargemaster,D5810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5810,BCBSND Base Physician Payment Schedule,770.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5811,Not in chargemaster,D5811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5811,BCBSND Base Physician Payment Schedule,770.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5820,Not in chargemaster,D5820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5820,BCBSND Base Physician Payment Schedule,642.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5821,Not in chargemaster,D5821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5821,BCBSND Base Physician Payment Schedule,642.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5850,Not in chargemaster,D5850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5850,BCBSND Base Physician Payment Schedule,167.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5851,Not in chargemaster,D5851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5851,BCBSND Base Physician Payment Schedule,167.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5862,Not in chargemaster,D5862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5862,BCBSND Base Physician Payment Schedule,571.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5863,Not in chargemaster,D5863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5863,BCBSND Base Physician Payment Schedule,1553.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5864,Not in chargemaster,D5864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5864,BCBSND Base Physician Payment Schedule,1537.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5865,Not in chargemaster,D5865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5865,BCBSND Base Physician Payment Schedule,1553.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D5867,Not in chargemaster,D5867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D5867,BCBSND Base Physician Payment Schedule,244.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6010,Not in chargemaster,D6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6010,BCBSND Base Physician Payment Schedule,2154.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6011,Not in chargemaster,D6011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6011,BCBSND Base Physician Payment Schedule,179.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6012,Not in chargemaster,D6012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6012,BCBSND Base Physician Payment Schedule,1728.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6013,Not in chargemaster,D6013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6013,BCBSND Base Physician Payment Schedule,899.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6040,Not in chargemaster,D6040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6040,BCBSND Base Physician Payment Schedule,3597.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6050,Not in chargemaster,D6050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6050,BCBSND Base Physician Payment Schedule,4497.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6051,Not in chargemaster,D6051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6051,BCBSND Base Physician Payment Schedule,562.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6055,Not in chargemaster,D6055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6055,BCBSND Base Physician Payment Schedule,1003.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6056,Not in chargemaster,D6056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6056,BCBSND Base Physician Payment Schedule,648.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6057,Not in chargemaster,D6057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6057,BCBSND Base Physician Payment Schedule,810.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6058,Not in chargemaster,D6058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6058,BCBSND Base Physician Payment Schedule,1171.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6059,Not in chargemaster,D6059,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6059,BCBSND Base Physician Payment Schedule,1171.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6060,Not in chargemaster,D6060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6060,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6061,Not in chargemaster,D6061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6061,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6062,Not in chargemaster,D6062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6062,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6063,Not in chargemaster,D6063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6063,BCBSND Base Physician Payment Schedule,1030.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6064,Not in chargemaster,D6064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6064,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6065,Not in chargemaster,D6065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6065,BCBSND Base Physician Payment Schedule,1046.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6066,Not in chargemaster,D6066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6066,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6067,Not in chargemaster,D6067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6067,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6068,Not in chargemaster,D6068,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6068,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6069,Not in chargemaster,D6069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6069,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6070,Not in chargemaster,D6070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6070,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6071,Not in chargemaster,D6071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6071,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6072,Not in chargemaster,D6072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6072,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6073,Not in chargemaster,D6073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6073,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6074,Not in chargemaster,D6074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6074,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6075,Not in chargemaster,D6075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6075,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6076,Not in chargemaster,D6076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6076,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6077,Not in chargemaster,D6077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6077,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6080,Not in chargemaster,D6080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6080,BCBSND Base Physician Payment Schedule,220.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6081,Not in chargemaster,D6081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6081,BCBSND Base Physician Payment Schedule,33.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6085,Not in chargemaster,D6085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6085,BCBSND Base Physician Payment Schedule,329.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6090,Not in chargemaster,D6090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6090,BCBSND Base Physician Payment Schedule,273.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6091,Not in chargemaster,D6091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6091,BCBSND Base Physician Payment Schedule,565.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6092,Not in chargemaster,D6092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6092,BCBSND Base Physician Payment Schedule,74.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6093,Not in chargemaster,D6093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6093,BCBSND Base Physician Payment Schedule,141.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6094,Not in chargemaster,D6094,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6094,BCBSND Base Physician Payment Schedule,1085.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6095,Not in chargemaster,D6095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6095,BCBSND Base Physician Payment Schedule,290.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6096,Not in chargemaster,D6096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6096,BCBSND Base Physician Payment Schedule,183.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6100,Not in chargemaster,D6100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6100,BCBSND Base Physician Payment Schedule,828.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6101,Not in chargemaster,D6101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6101,BCBSND Base Physician Payment Schedule,347.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6102,Not in chargemaster,D6102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6102,BCBSND Base Physician Payment Schedule,487.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6110,Not in chargemaster,D6110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6110,BCBSND Base Physician Payment Schedule,2280.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6111,Not in chargemaster,D6111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6111,BCBSND Base Physician Payment Schedule,2280.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6112,Not in chargemaster,D6112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6112,BCBSND Base Physician Payment Schedule,2280.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6113,Not in chargemaster,D6113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6113,BCBSND Base Physician Payment Schedule,2280.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6114,Not in chargemaster,D6114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6114,BCBSND Base Physician Payment Schedule,7599,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6115,Not in chargemaster,D6115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6115,BCBSND Base Physician Payment Schedule,7599,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6116,Not in chargemaster,D6116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6116,BCBSND Base Physician Payment Schedule,1993.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6117,Not in chargemaster,D6117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6117,BCBSND Base Physician Payment Schedule,1993.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6118,Not in chargemaster,D6118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6118,BCBSND Base Physician Payment Schedule,899.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6119,Not in chargemaster,D6119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6119,BCBSND Base Physician Payment Schedule,899.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6194,Not in chargemaster,D6194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6194,BCBSND Base Physician Payment Schedule,1030.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6205,Not in chargemaster,D6205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6205,BCBSND Base Physician Payment Schedule,849.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6210,Not in chargemaster,D6210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6210,BCBSND Base Physician Payment Schedule,995.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6211,Not in chargemaster,D6211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6211,BCBSND Base Physician Payment Schedule,995.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6212,Not in chargemaster,D6212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6212,BCBSND Base Physician Payment Schedule,995.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6214,Not in chargemaster,D6214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6214,BCBSND Base Physician Payment Schedule,995.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6240,Not in chargemaster,D6240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6240,BCBSND Base Physician Payment Schedule,1007.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6241,Not in chargemaster,D6241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6241,BCBSND Base Physician Payment Schedule,1007.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6242,Not in chargemaster,D6242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6242,BCBSND Base Physician Payment Schedule,1007.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6245,Not in chargemaster,D6245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6245,BCBSND Base Physician Payment Schedule,944.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6250,Not in chargemaster,D6250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6250,BCBSND Base Physician Payment Schedule,921.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6251,Not in chargemaster,D6251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6251,BCBSND Base Physician Payment Schedule,921.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6252,Not in chargemaster,D6252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6252,BCBSND Base Physician Payment Schedule,921.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6253,Not in chargemaster,D6253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6253,BCBSND Base Physician Payment Schedule,261.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6545,Not in chargemaster,D6545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6545,BCBSND Base Physician Payment Schedule,461.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6548,Not in chargemaster,D6548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6548,BCBSND Base Physician Payment Schedule,461.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6549,Not in chargemaster,D6549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6549,BCBSND Base Physician Payment Schedule,416.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6600,Not in chargemaster,D6600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6600,BCBSND Base Physician Payment Schedule,736.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6601,Not in chargemaster,D6601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6601,BCBSND Base Physician Payment Schedule,798.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6602,Not in chargemaster,D6602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6602,BCBSND Base Physician Payment Schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6603,Not in chargemaster,D6603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6603,BCBSND Base Physician Payment Schedule,843.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6604,Not in chargemaster,D6604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6604,BCBSND Base Physician Payment Schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6605,Not in chargemaster,D6605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6605,BCBSND Base Physician Payment Schedule,843.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6606,Not in chargemaster,D6606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6606,BCBSND Base Physician Payment Schedule,781.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6607,Not in chargemaster,D6607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6607,BCBSND Base Physician Payment Schedule,839.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6608,Not in chargemaster,D6608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6608,BCBSND Base Physician Payment Schedule,939.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6609,Not in chargemaster,D6609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6609,BCBSND Base Physician Payment Schedule,945.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6610,Not in chargemaster,D6610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6610,BCBSND Base Physician Payment Schedule,929.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6611,Not in chargemaster,D6611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6611,BCBSND Base Physician Payment Schedule,945.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6612,Not in chargemaster,D6612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6612,BCBSND Base Physician Payment Schedule,906.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6613,Not in chargemaster,D6613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6613,BCBSND Base Physician Payment Schedule,945.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6614,Not in chargemaster,D6614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6614,BCBSND Base Physician Payment Schedule,894.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6615,Not in chargemaster,D6615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6615,BCBSND Base Physician Payment Schedule,945.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6624,Not in chargemaster,D6624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6624,BCBSND Base Physician Payment Schedule,731.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6634,Not in chargemaster,D6634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6634,BCBSND Base Physician Payment Schedule,945.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6710,Not in chargemaster,D6710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6710,BCBSND Base Physician Payment Schedule,851.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6720,Not in chargemaster,D6720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6720,BCBSND Base Physician Payment Schedule,979.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6721,Not in chargemaster,D6721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6721,BCBSND Base Physician Payment Schedule,861.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6722,Not in chargemaster,D6722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6722,BCBSND Base Physician Payment Schedule,916.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6740,Not in chargemaster,D6740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6740,BCBSND Base Physician Payment Schedule,1146.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6750,Not in chargemaster,D6750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6750,BCBSND Base Physician Payment Schedule,1133.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6751,Not in chargemaster,D6751,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6751,BCBSND Base Physician Payment Schedule,1046.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6752,Not in chargemaster,D6752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6752,BCBSND Base Physician Payment Schedule,1141.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6780,Not in chargemaster,D6780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6780,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6781,Not in chargemaster,D6781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6781,BCBSND Base Physician Payment Schedule,979.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6782,Not in chargemaster,D6782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6782,BCBSND Base Physician Payment Schedule,988.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6783,Not in chargemaster,D6783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6783,BCBSND Base Physician Payment Schedule,962.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6790,Not in chargemaster,D6790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6790,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6791,Not in chargemaster,D6791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6791,BCBSND Base Physician Payment Schedule,1030.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6792,Not in chargemaster,D6792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6792,BCBSND Base Physician Payment Schedule,1123.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6793,Not in chargemaster,D6793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6793,BCBSND Base Physician Payment Schedule,182.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6794,Not in chargemaster,D6794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6794,BCBSND Base Physician Payment Schedule,1030.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6930,Not in chargemaster,D6930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6930,BCBSND Base Physician Payment Schedule,132.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6940,Not in chargemaster,D6940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6940,BCBSND Base Physician Payment Schedule,359.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6950,Not in chargemaster,D6950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6950,BCBSND Base Physician Payment Schedule,506.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D6980,Not in chargemaster,D6980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6980,BCBSND Base Physician Payment Schedule,239.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7111,Not in chargemaster,D7111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7111,BCBSND Base Physician Payment Schedule,56.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7140,Not in chargemaster,D7140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7140,BCBSND Base Physician Payment Schedule,132.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7210,Not in chargemaster,D7210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7210,BCBSND Base Physician Payment Schedule,251.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7220,Not in chargemaster,D7220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7220,BCBSND Base Physician Payment Schedule,251.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7230,Not in chargemaster,D7230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7230,BCBSND Base Physician Payment Schedule,469.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7240,Not in chargemaster,D7240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7240,BCBSND Base Physician Payment Schedule,469.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7241,Not in chargemaster,D7241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7241,BCBSND Base Physician Payment Schedule,568.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7250,Not in chargemaster,D7250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7250,BCBSND Base Physician Payment Schedule,254.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7251,Not in chargemaster,D7251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7251,BCBSND Base Physician Payment Schedule,404.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7260,Not in chargemaster,D7260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7260,BCBSND Base Physician Payment Schedule,1124.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7261,Not in chargemaster,D7261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7261,BCBSND Base Physician Payment Schedule,666.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7270,Not in chargemaster,D7270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7270,BCBSND Base Physician Payment Schedule,456.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7272,Not in chargemaster,D7272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7272,BCBSND Base Physician Payment Schedule,746.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7280,Not in chargemaster,D7280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7280,BCBSND Base Physician Payment Schedule,480.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7282,Not in chargemaster,D7282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7282,BCBSND Base Physician Payment Schedule,269.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7283,Not in chargemaster,D7283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7283,BCBSND Base Physician Payment Schedule,131.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7285,Not in chargemaster,D7285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7285,BCBSND Base Physician Payment Schedule,334.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7286,Not in chargemaster,D7286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7286,BCBSND Base Physician Payment Schedule,449.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7290,Not in chargemaster,D7290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7290,BCBSND Base Physician Payment Schedule,417.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7292,Not in chargemaster,D7292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7292,BCBSND Base Physician Payment Schedule,719.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7294,Not in chargemaster,D7294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7294,BCBSND Base Physician Payment Schedule,449.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7296,Not in chargemaster,D7296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7296,BCBSND Base Physician Payment Schedule,258.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7297,Not in chargemaster,D7297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7297,BCBSND Base Physician Payment Schedule,337.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7310,Not in chargemaster,D7310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7310,BCBSND Base Physician Payment Schedule,241.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7311,Not in chargemaster,D7311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7311,BCBSND Base Physician Payment Schedule,151.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7320,Not in chargemaster,D7320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7320,BCBSND Base Physician Payment Schedule,295.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7321,Not in chargemaster,D7321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7321,BCBSND Base Physician Payment Schedule,211.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7340,Not in chargemaster,D7340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7340,BCBSND Base Physician Payment Schedule,764.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7350,Not in chargemaster,D7350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7350,BCBSND Base Physician Payment Schedule,830.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7410,Not in chargemaster,D7410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7410,BCBSND Base Physician Payment Schedule,323.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7411,Not in chargemaster,D7411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7411,BCBSND Base Physician Payment Schedule,629.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7412,Not in chargemaster,D7412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7412,BCBSND Base Physician Payment Schedule,700.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7413,Not in chargemaster,D7413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7413,BCBSND Base Physician Payment Schedule,642.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7414,Not in chargemaster,D7414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7414,BCBSND Base Physician Payment Schedule,905.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7415,Not in chargemaster,D7415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7415,BCBSND Base Physician Payment Schedule,912.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7440,Not in chargemaster,D7440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7440,BCBSND Base Physician Payment Schedule,507.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7441,Not in chargemaster,D7441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7441,BCBSND Base Physician Payment Schedule,1027.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7450,Not in chargemaster,D7450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7450,BCBSND Base Physician Payment Schedule,453.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7451,Not in chargemaster,D7451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7451,BCBSND Base Physician Payment Schedule,590.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7460,Not in chargemaster,D7460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7460,BCBSND Base Physician Payment Schedule,430.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7461,Not in chargemaster,D7461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7461,BCBSND Base Physician Payment Schedule,533.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7465,Not in chargemaster,D7465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7465,BCBSND Base Physician Payment Schedule,494.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7471,Not in chargemaster,D7471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7471,BCBSND Base Physician Payment Schedule,559.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7472,Not in chargemaster,D7472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7472,BCBSND Base Physician Payment Schedule,561.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7473,Not in chargemaster,D7473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7473,BCBSND Base Physician Payment Schedule,462.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7485,Not in chargemaster,D7485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7485,BCBSND Base Physician Payment Schedule,507.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7490,Not in chargemaster,D7490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7490,BCBSND Base Physician Payment Schedule,7966.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7510,Not in chargemaster,D7510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7510,BCBSND Base Physician Payment Schedule,139.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7511,Not in chargemaster,D7511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7511,BCBSND Base Physician Payment Schedule,282.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7520,Not in chargemaster,D7520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7520,BCBSND Base Physician Payment Schedule,494.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7521,Not in chargemaster,D7521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7521,BCBSND Base Physician Payment Schedule,1124.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7530,Not in chargemaster,D7530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7530,BCBSND Base Physician Payment Schedule,476.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7540,Not in chargemaster,D7540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7540,BCBSND Base Physician Payment Schedule,929.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7550,Not in chargemaster,D7550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7550,BCBSND Base Physician Payment Schedule,449.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7560,Not in chargemaster,D7560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7560,BCBSND Base Physician Payment Schedule,3013.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7610,Not in chargemaster,D7610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7610,BCBSND Base Physician Payment Schedule,4946.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7620,Not in chargemaster,D7620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7620,BCBSND Base Physician Payment Schedule,3687.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7630,Not in chargemaster,D7630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7630,BCBSND Base Physician Payment Schedule,6386,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7640,Not in chargemaster,D7640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7640,BCBSND Base Physician Payment Schedule,4047.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7650,Not in chargemaster,D7650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7650,BCBSND Base Physician Payment Schedule,4047.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7660,Not in chargemaster,D7660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7660,BCBSND Base Physician Payment Schedule,2441.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7670,Not in chargemaster,D7670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7670,BCBSND Base Physician Payment Schedule,517.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7671,Not in chargemaster,D7671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7671,BCBSND Base Physician Payment Schedule,518.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7680,Not in chargemaster,D7680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7680,BCBSND Base Physician Payment Schedule,9174.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7710,Not in chargemaster,D7710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7710,BCBSND Base Physician Payment Schedule,5756.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7720,Not in chargemaster,D7720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7720,BCBSND Base Physician Payment Schedule,2826.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7730,Not in chargemaster,D7730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7730,BCBSND Base Physician Payment Schedule,8319.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7740,Not in chargemaster,D7740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7740,BCBSND Base Physician Payment Schedule,4137.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7750,Not in chargemaster,D7750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7750,BCBSND Base Physician Payment Schedule,5216.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7760,Not in chargemaster,D7760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7760,BCBSND Base Physician Payment Schedule,3854.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7770,Not in chargemaster,D7770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7770,BCBSND Base Physician Payment Schedule,1324.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7771,Not in chargemaster,D7771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7771,BCBSND Base Physician Payment Schedule,1088.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7780,Not in chargemaster,D7780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7780,BCBSND Base Physician Payment Schedule,12277.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7881,Not in chargemaster,D7881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7881,BCBSND Base Physician Payment Schedule,67.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7910,Not in chargemaster,D7910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7910,BCBSND Base Physician Payment Schedule,359.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7911,Not in chargemaster,D7911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7911,BCBSND Base Physician Payment Schedule,741.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7912,Not in chargemaster,D7912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7912,BCBSND Base Physician Payment Schedule,899.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7960,Not in chargemaster,D7960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7960,BCBSND Base Physician Payment Schedule,313.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7963,Not in chargemaster,D7963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7963,BCBSND Base Physician Payment Schedule,313.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7970,Not in chargemaster,D7970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7970,BCBSND Base Physician Payment Schedule,598.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7971,Not in chargemaster,D7971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7971,BCBSND Base Physician Payment Schedule,164.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7972,Not in chargemaster,D7972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7972,BCBSND Base Physician Payment Schedule,396.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7979,Not in chargemaster,D7979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7979,BCBSND Base Physician Payment Schedule,168.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7980,Not in chargemaster,D7980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7980,BCBSND Base Physician Payment Schedule,717.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7982,Not in chargemaster,D7982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7982,BCBSND Base Physician Payment Schedule,2023.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7983,Not in chargemaster,D7983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7983,BCBSND Base Physician Payment Schedule,2113.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7990,Not in chargemaster,D7990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7990,BCBSND Base Physician Payment Schedule,1843.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D7997,Not in chargemaster,D7997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7997,BCBSND Base Physician Payment Schedule,337.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8010,Not in chargemaster,D8010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8010,BCBSND Base Physician Payment Schedule,1632,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8020,Not in chargemaster,D8020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8020,BCBSND Base Physician Payment Schedule,1632,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8030,Not in chargemaster,D8030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8030,BCBSND Base Physician Payment Schedule,1632,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8040,Not in chargemaster,D8040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8040,BCBSND Base Physician Payment Schedule,1632,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8050,Not in chargemaster,D8050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8050,BCBSND Base Physician Payment Schedule,2958,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8060,Not in chargemaster,D8060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8060,BCBSND Base Physician Payment Schedule,2958,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8070,Not in chargemaster,D8070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8070,BCBSND Base Physician Payment Schedule,5916,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8080,Not in chargemaster,D8080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8080,BCBSND Base Physician Payment Schedule,5916,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8090,Not in chargemaster,D8090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8090,BCBSND Base Physician Payment Schedule,5916,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8210,Not in chargemaster,D8210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8210,BCBSND Base Physician Payment Schedule,1006.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8220,Not in chargemaster,D8220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8220,BCBSND Base Physician Payment Schedule,1006.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8660,Not in chargemaster,D8660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8660,BCBSND Base Physician Payment Schedule,231.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8670,Not in chargemaster,D8670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8670,BCBSND Base Physician Payment Schedule,214.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8680,Not in chargemaster,D8680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8680,BCBSND Base Physician Payment Schedule,682.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8681,Not in chargemaster,D8681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8681,BCBSND Base Physician Payment Schedule,64.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8690,Not in chargemaster,D8690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8690,BCBSND Base Physician Payment Schedule,648.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D8695,Not in chargemaster,D8695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D8695,BCBSND Base Physician Payment Schedule,359.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9110,Not in chargemaster,D9110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9110,BCBSND Base Physician Payment Schedule,78.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9120,Not in chargemaster,D9120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9120,BCBSND Base Physician Payment Schedule,179.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9130,Not in chargemaster,D9130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9130,BCBSND Base Physician Payment Schedule,77.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9210,Not in chargemaster,D9210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9210,BCBSND Base Physician Payment Schedule,31.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9211,Not in chargemaster,D9211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9211,BCBSND Base Physician Payment Schedule,31.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9212,Not in chargemaster,D9212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9212,BCBSND Base Physician Payment Schedule,50.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9215,Not in chargemaster,D9215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9215,BCBSND Base Physician Payment Schedule,33.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9219,Not in chargemaster,D9219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9219,BCBSND Base Physician Payment Schedule,49.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9222,Not in chargemaster,D9222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9222,BCBSND Base Physician Payment Schedule,269.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9223,Not in chargemaster,D9223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9223,BCBSND Base Physician Payment Schedule,245.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9230,Not in chargemaster,D9230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9230,BCBSND Base Physician Payment Schedule,68.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9239,Not in chargemaster,D9239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9239,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9243,Not in chargemaster,D9243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9243,BCBSND Base Physician Payment Schedule,22.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9310,Not in chargemaster,D9310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9310,BCBSND Base Physician Payment Schedule,78.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9311,Not in chargemaster,D9311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9311,BCBSND Base Physician Payment Schedule,26.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9613,Not in chargemaster,D9613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9613,BCBSND Base Physician Payment Schedule,64.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9930,Not in chargemaster,D9930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9930,BCBSND Base Physician Payment Schedule,109.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9932,Not in chargemaster,D9932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9932,BCBSND Base Physician Payment Schedule,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9933,Not in chargemaster,D9933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9933,BCBSND Base Physician Payment Schedule,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9934,Not in chargemaster,D9934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9934,BCBSND Base Physician Payment Schedule,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9935,Not in chargemaster,D9935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9935,BCBSND Base Physician Payment Schedule,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9942,Not in chargemaster,D9942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9942,BCBSND Base Physician Payment Schedule,120.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9943,Not in chargemaster,D9943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9943,BCBSND Base Physician Payment Schedule,64.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9944,Not in chargemaster,D9944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9944,BCBSND Base Physician Payment Schedule,975.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9945,Not in chargemaster,D9945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9945,BCBSND Base Physician Payment Schedule,975.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9946,Not in chargemaster,D9946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9946,BCBSND Base Physician Payment Schedule,975.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9971,Not in chargemaster,D9971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9971,BCBSND Base Physician Payment Schedule,59.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9973,Not in chargemaster,D9973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9973,BCBSND Base Physician Payment Schedule,80.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility D9974,Not in chargemaster,D9974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D9974,BCBSND Base Physician Payment Schedule,286.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0008,Not in chargemaster,G0008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0008,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0009,Not in chargemaster,G0009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0009,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility G0010,Not in chargemaster,G0010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0010,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99211,99211,99211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99211,BCBSND Base Physician Payment Schedule,47.72,50,Fee schedule,,47.72,47.72,47.72,47.72,,,0
unity,Fee schedule,Non-facility 99205,99205,99205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99205,BCBSND Base Physician Payment Schedule,429.45,440,Fee schedule,,429.45,429.45,429.45,429.45,,,0
unity,Fee schedule,Non-facility 99204,99204,99204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99204,BCBSND Base Physician Payment Schedule,339.89,350,Fee schedule,,339.89,339.89,339.89,339.89,,,0
unity,Fee schedule,Non-facility 99203,99203,99203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99203,BCBSND Base Physician Payment Schedule,222.43,230,Fee schedule,,222.43,222.43,222.43,222.43,,,0
unity,Fee schedule,Non-facility 99202,99202,99202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99202,BCBSND Base Physician Payment Schedule,157.1,163,Fee schedule,,157.1,157.1,157.1,157.1,,,0
unity,Fee schedule,Non-facility 99201,99201,99201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99201,BCBSND Base Physician Payment Schedule,94.7,98,Fee schedule,,94.7,94.7,94.7,94.7,,,0
unity,Fee schedule,Non-facility 99195,Not in chargemaster,99195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99195,BCBSND Base Physician Payment Schedule,209.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99184,Not in chargemaster,99184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99184,BCBSND Base Physician Payment Schedule,464.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99188,Not in chargemaster,99188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99188,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99190,Not in chargemaster,99190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99190,BCBSND Base Physician Payment Schedule,326.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99191,Not in chargemaster,99191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99191,BCBSND Base Physician Payment Schedule,201.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99192,Not in chargemaster,99192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99192,BCBSND Base Physician Payment Schedule,149.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99183,Not in chargemaster,99183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99183,BCBSND Base Physician Payment Schedule,231.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99177,Not in chargemaster,99177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99177,BCBSND Base Physician Payment Schedule,9.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99175,Not in chargemaster,99175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99175,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99174,Not in chargemaster,99174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99174,BCBSND Base Physician Payment Schedule,11.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99173,Not in chargemaster,99173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99173,BCBSND Base Physician Payment Schedule,5.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99170,Not in chargemaster,99170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99170,BCBSND Base Physician Payment Schedule,328.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99157,Not in chargemaster,99157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99157,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99156,Not in chargemaster,99156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99156,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99155,Not in chargemaster,99155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99155,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99153,Not in chargemaster,99153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99153,BCBSND Base Physician Payment Schedule,22.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99152,Not in chargemaster,99152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99152,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99151,Not in chargemaster,99151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99151,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99091,Not in chargemaster,99091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99091,BCBSND Base Physician Payment Schedule,120.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98967,Not in chargemaster,98967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98967,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98968,Not in chargemaster,98968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98968,BCBSND Base Physician Payment Schedule,83.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98970,Not in chargemaster,98970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98970,BCBSND Base Physician Payment Schedule,24.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98971,Not in chargemaster,98971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98971,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98972,Not in chargemaster,98972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98972,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99000,Not in chargemaster,99000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99000,BCBSND Base Physician Payment Schedule,15.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 99001,Not in chargemaster,99001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99001,BCBSND Base Physician Payment Schedule,7.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98966,Not in chargemaster,98966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98966,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98962,Not in chargemaster,98962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98962,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98961,Not in chargemaster,98961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98961,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98960,Not in chargemaster,98960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98960,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98943,Not in chargemaster,98943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98943,BCBSND Base Physician Payment Schedule,52.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98942,Not in chargemaster,98942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98942,BCBSND Base Physician Payment Schedule,99.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98941,Not in chargemaster,98941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98941,BCBSND Base Physician Payment Schedule,76.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98940,Not in chargemaster,98940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98940,BCBSND Base Physician Payment Schedule,53.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98929,Not in chargemaster,98929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98929,BCBSND Base Physician Payment Schedule,162.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98928,Not in chargemaster,98928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98928,BCBSND Base Physician Payment Schedule,136.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98927,Not in chargemaster,98927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98927,BCBSND Base Physician Payment Schedule,111.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98926,Not in chargemaster,98926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98926,BCBSND Base Physician Payment Schedule,85.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 98925,Not in chargemaster,98925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98925,BCBSND Base Physician Payment Schedule,59.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97814,Not in chargemaster,97814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97814,BCBSND Base Physician Payment Schedule,63.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97813,Not in chargemaster,97813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97813,BCBSND Base Physician Payment Schedule,77.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97811,Not in chargemaster,97811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97811,BCBSND Base Physician Payment Schedule,53.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97810,Not in chargemaster,97810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97810,BCBSND Base Physician Payment Schedule,69.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97804,Not in chargemaster,97804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97804,BCBSND Base Physician Payment Schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97803,Not in chargemaster,97803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97803,BCBSND Base Physician Payment Schedule,67.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97802,Not in chargemaster,97802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97802,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97763,Not in chargemaster,97763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97763,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97761,Not in chargemaster,97761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97761,BCBSND Base Physician Payment Schedule,87.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97760,Not in chargemaster,97760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97760,BCBSND Base Physician Payment Schedule,102.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97755,Not in chargemaster,97755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97755,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97750,Not in chargemaster,97750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97750,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97610,Not in chargemaster,97610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97610,BCBSND Base Physician Payment Schedule,670.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97608,Not in chargemaster,97608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97608,BCBSND Base Physician Payment Schedule,699.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97607,Not in chargemaster,97607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97607,BCBSND Base Physician Payment Schedule,697.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97606,Not in chargemaster,97606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97606,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97605,Not in chargemaster,97605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97605,BCBSND Base Physician Payment Schedule,91.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97598,Not in chargemaster,97598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97598,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97602,Not in chargemaster,97602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97602,BCBSND Base Physician Payment Schedule,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97597,97597,97597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97597,BCBSND Base Physician Payment Schedule,201.14,190,Fee schedule,,190,190,190,190,,,0
unity,Fee schedule,Non-facility 97542,Not in chargemaster,97542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97542,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97537,Not in chargemaster,97537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97537,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97535,Not in chargemaster,97535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97535,BCBSND Base Physician Payment Schedule,71.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97533,Not in chargemaster,97533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97533,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97530,Not in chargemaster,97530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97530,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97168,Not in chargemaster,97168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97168,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97167,Not in chargemaster,97167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97167,BCBSND Base Physician Payment Schedule,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97166,Not in chargemaster,97166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97166,BCBSND Base Physician Payment Schedule,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97165,Not in chargemaster,97165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97165,BCBSND Base Physician Payment Schedule,189.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97164,Not in chargemaster,97164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97164,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97163,Not in chargemaster,97163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97163,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97162,Not in chargemaster,97162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97162,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97161,Not in chargemaster,97161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97161,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97140,Not in chargemaster,97140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97140,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97150,Not in chargemaster,97150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97150,BCBSND Base Physician Payment Schedule,38.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97151,Not in chargemaster,97151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97151,BCBSND Base Physician Payment Schedule,50.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97152,Not in chargemaster,97152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97152,BCBSND Base Physician Payment Schedule,38.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97153,Not in chargemaster,97153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97153,BCBSND Base Physician Payment Schedule,16.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97154,Not in chargemaster,97154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97154,BCBSND Base Physician Payment Schedule,3.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97155,Not in chargemaster,97155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97155,BCBSND Base Physician Payment Schedule,36.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97156,Not in chargemaster,97156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97156,BCBSND Base Physician Payment Schedule,39.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97157,Not in chargemaster,97157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97157,BCBSND Base Physician Payment Schedule,39.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97158,Not in chargemaster,97158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97158,BCBSND Base Physician Payment Schedule,7.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97130,Not in chargemaster,97130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97130,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97139,Not in chargemaster,97139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97139,BCBSND Base Physician Payment Schedule,34.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97129,Not in chargemaster,97129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97129,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97124,Not in chargemaster,97124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97124,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97116,Not in chargemaster,97116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97116,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97113,Not in chargemaster,97113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97113,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97112,Not in chargemaster,97112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97112,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97110,Not in chargemaster,97110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97110,BCBSND Base Physician Payment Schedule,63.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97036,Not in chargemaster,97036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97036,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97039,Not in chargemaster,97039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97039,BCBSND Base Physician Payment Schedule,26.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97035,Not in chargemaster,97035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97035,BCBSND Base Physician Payment Schedule,30.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97034,Not in chargemaster,97034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97034,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97033,Not in chargemaster,97033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97033,BCBSND Base Physician Payment Schedule,43.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97032,Not in chargemaster,97032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97032,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97028,Not in chargemaster,97028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97028,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97026,Not in chargemaster,97026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97026,BCBSND Base Physician Payment Schedule,13.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97024,Not in chargemaster,97024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97024,BCBSND Base Physician Payment Schedule,14.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97022,Not in chargemaster,97022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97022,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97018,Not in chargemaster,97018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97018,BCBSND Base Physician Payment Schedule,12.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97016,Not in chargemaster,97016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97016,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97014,Not in chargemaster,97014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97014,BCBSND Base Physician Payment Schedule,30.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97012,Not in chargemaster,97012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97012,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 97010,Not in chargemaster,97010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97010,BCBSND Base Physician Payment Schedule,13.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96936,Not in chargemaster,96936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96936,BCBSND Base Physician Payment Schedule,91.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96935,Not in chargemaster,96935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96935,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96934,Not in chargemaster,96934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96934,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96933,Not in chargemaster,96933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96933,BCBSND Base Physician Payment Schedule,95.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96932,Not in chargemaster,96932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96932,BCBSND Base Physician Payment Schedule,262.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96931,Not in chargemaster,96931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96931,BCBSND Base Physician Payment Schedule,357.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96922,Not in chargemaster,96922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96922,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96921,Not in chargemaster,96921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96921,BCBSND Base Physician Payment Schedule,370.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96920,Not in chargemaster,96920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96920,BCBSND Base Physician Payment Schedule,338.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96913,Not in chargemaster,96913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96913,BCBSND Base Physician Payment Schedule,298.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96912,Not in chargemaster,96912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96912,BCBSND Base Physician Payment Schedule,205.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96910,Not in chargemaster,96910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96910,BCBSND Base Physician Payment Schedule,240.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96904,Not in chargemaster,96904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96904,BCBSND Base Physician Payment Schedule,141.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96902,Not in chargemaster,96902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96902,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96900,Not in chargemaster,96900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96900,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96574,Not in chargemaster,96574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96574,BCBSND Base Physician Payment Schedule,556.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96573,Not in chargemaster,96573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96573,BCBSND Base Physician Payment Schedule,442.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96571,Not in chargemaster,96571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96571,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96570,Not in chargemaster,96570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96570,BCBSND Base Physician Payment Schedule,119.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96567,Not in chargemaster,96567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96567,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96542,Not in chargemaster,96542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96542,BCBSND Base Physician Payment Schedule,273.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96523,Not in chargemaster,96523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96523,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96522,Not in chargemaster,96522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96522,BCBSND Base Physician Payment Schedule,253.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96521,Not in chargemaster,96521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96521,BCBSND Base Physician Payment Schedule,303.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96450,Not in chargemaster,96450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96450,BCBSND Base Physician Payment Schedule,372.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96446,Not in chargemaster,96446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96446,BCBSND Base Physician Payment Schedule,416.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96440,Not in chargemaster,96440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96440,BCBSND Base Physician Payment Schedule,1852.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96425,Not in chargemaster,96425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96425,BCBSND Base Physician Payment Schedule,374.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96423,Not in chargemaster,96423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96423,BCBSND Base Physician Payment Schedule,163.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96422,Not in chargemaster,96422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96422,BCBSND Base Physician Payment Schedule,353.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96420,Not in chargemaster,96420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96420,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96417,Not in chargemaster,96417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96417,BCBSND Base Physician Payment Schedule,140.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96416,Not in chargemaster,96416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96416,BCBSND Base Physician Payment Schedule,289.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96415,Not in chargemaster,96415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96415,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96413,Not in chargemaster,96413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96413,BCBSND Base Physician Payment Schedule,289.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96411,Not in chargemaster,96411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96411,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96409,Not in chargemaster,96409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96409,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96406,Not in chargemaster,96406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96406,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96405,Not in chargemaster,96405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96405,BCBSND Base Physician Payment Schedule,172.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96402,Not in chargemaster,96402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96402,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96401,Not in chargemaster,96401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96401,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96377,Not in chargemaster,96377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96377,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96375,Not in chargemaster,96375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96375,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96374,Not in chargemaster,96374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96374,BCBSND Base Physician Payment Schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96373,Not in chargemaster,96373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96373,BCBSND Base Physician Payment Schedule,38.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96372,96372,96372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96372,BCBSND Base Physician Payment Schedule,29.36,37,Fee schedule,,29.36,29.36,29.36,29.36,,,0
unity,Fee schedule,Non-facility 96371,Not in chargemaster,96371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96371,BCBSND Base Physician Payment Schedule,131.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96370,Not in chargemaster,96370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96370,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96369,Not in chargemaster,96369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96369,BCBSND Base Physician Payment Schedule,329.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96368,Not in chargemaster,96368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96368,BCBSND Base Physician Payment Schedule,43.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96367,Not in chargemaster,96367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96367,BCBSND Base Physician Payment Schedule,63.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96366,Not in chargemaster,96366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96366,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96365,Not in chargemaster,96365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96365,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96361,Not in chargemaster,96361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96361,BCBSND Base Physician Payment Schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96360,Not in chargemaster,96360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96360,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96171,Not in chargemaster,96171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96171,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96170,Not in chargemaster,96170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96170,BCBSND Base Physician Payment Schedule,168.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96168,Not in chargemaster,96168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96168,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96167,Not in chargemaster,96167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96167,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96165,Not in chargemaster,96165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96165,BCBSND Base Physician Payment Schedule,9.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96164,Not in chargemaster,96164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96164,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96161,Not in chargemaster,96161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96161,BCBSND Base Physician Payment Schedule,5.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96160,Not in chargemaster,96160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96160,BCBSND Base Physician Payment Schedule,5.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96159,Not in chargemaster,96159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96159,BCBSND Base Physician Payment Schedule,48.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96158,Not in chargemaster,96158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96158,BCBSND Base Physician Payment Schedule,138.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96156,Not in chargemaster,96156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96156,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96146,Not in chargemaster,96146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96146,BCBSND Base Physician Payment Schedule,4.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96139,Not in chargemaster,96139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96139,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96138,Not in chargemaster,96138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96138,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96137,Not in chargemaster,96137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96137,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96136,Not in chargemaster,96136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96136,BCBSND Base Physician Payment Schedule,97.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96133,Not in chargemaster,96133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96133,BCBSND Base Physician Payment Schedule,208.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96132,Not in chargemaster,96132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96132,BCBSND Base Physician Payment Schedule,277.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96131,Not in chargemaster,96131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96131,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96130,Not in chargemaster,96130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96130,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96127,Not in chargemaster,96127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96127,BCBSND Base Physician Payment Schedule,10.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96125,Not in chargemaster,96125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96125,BCBSND Base Physician Payment Schedule,227.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96121,Not in chargemaster,96121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96121,BCBSND Base Physician Payment Schedule,175.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96116,Not in chargemaster,96116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96116,BCBSND Base Physician Payment Schedule,202.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96113,Not in chargemaster,96113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96113,BCBSND Base Physician Payment Schedule,127.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96112,Not in chargemaster,96112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96112,BCBSND Base Physician Payment Schedule,285.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96110,Not in chargemaster,96110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96110,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96105,Not in chargemaster,96105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96105,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96040,Not in chargemaster,96040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96040,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9602026,Not in chargemaster,96020,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9602026,BCBSND Base Physician Payment Schedule,341.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96004,Not in chargemaster,96004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96004,BCBSND Base Physician Payment Schedule,237.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96003,Not in chargemaster,96003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96003,BCBSND Base Physician Payment Schedule,35.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96002,Not in chargemaster,96002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96002,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96001,Not in chargemaster,96001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96001,BCBSND Base Physician Payment Schedule,231.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 96000,Not in chargemaster,96000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96000,BCBSND Base Physician Payment Schedule,196,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95992,Not in chargemaster,95992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95992,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95991,Not in chargemaster,95991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95991,BCBSND Base Physician Payment Schedule,237.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95990,Not in chargemaster,95990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95990,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95984,Not in chargemaster,95984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95984,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95983,Not in chargemaster,95983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95983,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95982,Not in chargemaster,95982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95982,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95981,Not in chargemaster,95981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95981,BCBSND Base Physician Payment Schedule,74.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95980,Not in chargemaster,95980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95980,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95977,Not in chargemaster,95977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95977,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95976,Not in chargemaster,95976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95976,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95972,Not in chargemaster,95972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95972,BCBSND Base Physician Payment Schedule,118.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95971,Not in chargemaster,95971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95971,BCBSND Base Physician Payment Schedule,105.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95970,Not in chargemaster,95970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95970,BCBSND Base Physician Payment Schedule,40.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9596726,Not in chargemaster,95967,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9596726,BCBSND Base Physician Payment Schedule,390.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9596626,Not in chargemaster,95966,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9596626,BCBSND Base Physician Payment Schedule,447.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9596526,Not in chargemaster,95965,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9596526,BCBSND Base Physician Payment Schedule,881.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95962,Not in chargemaster,95962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95962,BCBSND Base Physician Payment Schedule,546.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9596226,Not in chargemaster,95962,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9596226,BCBSND Base Physician Payment Schedule,361.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95962TC,Not in chargemaster,95962TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95962TC,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9596126,Not in chargemaster,95961,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9596126,BCBSND Base Physician Payment Schedule,339.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95961TC,Not in chargemaster,95961TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95961TC,BCBSND Base Physician Payment Schedule,306.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95961,Not in chargemaster,95961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95961,BCBSND Base Physician Payment Schedule,645.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95958,Not in chargemaster,95958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95958,BCBSND Base Physician Payment Schedule,1210.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9595826,Not in chargemaster,95958,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9595826,BCBSND Base Physician Payment Schedule,476.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95958TC,Not in chargemaster,95958TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95958TC,BCBSND Base Physician Payment Schedule,734.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9595726,Not in chargemaster,95957,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9595726,BCBSND Base Physician Payment Schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95957TC,Not in chargemaster,95957TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95957TC,BCBSND Base Physician Payment Schedule,315.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95957,Not in chargemaster,95957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95957,BCBSND Base Physician Payment Schedule,531.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95955,Not in chargemaster,95955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95955,BCBSND Base Physician Payment Schedule,436.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9595526,Not in chargemaster,95955,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9595526,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95955TC,Not in chargemaster,95955TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95955TC,BCBSND Base Physician Payment Schedule,323,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9595426,Not in chargemaster,95954,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9595426,BCBSND Base Physician Payment Schedule,237.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95954TC,Not in chargemaster,95954TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95954TC,BCBSND Base Physician Payment Schedule,571.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95954,Not in chargemaster,95954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95954,BCBSND Base Physician Payment Schedule,809.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95939,Not in chargemaster,95939,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95939,BCBSND Base Physician Payment Schedule,1089.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95940,Not in chargemaster,95940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95940,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95941,Not in chargemaster,95941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95941,BCBSND Base Physician Payment Schedule,346.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95943,Not in chargemaster,95943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95943,BCBSND Base Physician Payment Schedule,383.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9594326,Not in chargemaster,95943,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9594326,BCBSND Base Physician Payment Schedule,196.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95943TC,Not in chargemaster,95943TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95943TC,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9593926,Not in chargemaster,95939,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9593926,BCBSND Base Physician Payment Schedule,250.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95939TC,Not in chargemaster,95939TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95939TC,BCBSND Base Physician Payment Schedule,839.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9593826,Not in chargemaster,95938,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9593826,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95938TC,Not in chargemaster,95938TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95938TC,BCBSND Base Physician Payment Schedule,628.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95938,Not in chargemaster,95938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95938,BCBSND Base Physician Payment Schedule,725.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95937,Not in chargemaster,95937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95937,BCBSND Base Physician Payment Schedule,195.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9593726,Not in chargemaster,95937,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9593726,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95937TC,Not in chargemaster,95937TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95937TC,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9593326,Not in chargemaster,95933,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9593326,BCBSND Base Physician Payment Schedule,66.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95933TC,Not in chargemaster,95933TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95933TC,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95933,Not in chargemaster,95933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95933,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95930,Not in chargemaster,95930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95930,BCBSND Base Physician Payment Schedule,138.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9593026,Not in chargemaster,95930,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9593026,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95930TC,Not in chargemaster,95930TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95930TC,BCBSND Base Physician Payment Schedule,99.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592926,Not in chargemaster,95929,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592926,BCBSND Base Physician Payment Schedule,167.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95929TC,Not in chargemaster,95929TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95929TC,BCBSND Base Physician Payment Schedule,314.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95929,Not in chargemaster,95929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95929,BCBSND Base Physician Payment Schedule,482.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95928,Not in chargemaster,95928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95928,BCBSND Base Physician Payment Schedule,468.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592826,Not in chargemaster,95928,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592826,BCBSND Base Physician Payment Schedule,167.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95928TC,Not in chargemaster,95928TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95928TC,BCBSND Base Physician Payment Schedule,300.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592726,Not in chargemaster,95927,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592726,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95927TC,Not in chargemaster,95927TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95927TC,BCBSND Base Physician Payment Schedule,218.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95927,Not in chargemaster,95927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95927,BCBSND Base Physician Payment Schedule,275.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95926,Not in chargemaster,95926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95926,BCBSND Base Physician Payment Schedule,276.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592626,Not in chargemaster,95926,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592626,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95926TC,Not in chargemaster,95926TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95926TC,BCBSND Base Physician Payment Schedule,218.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592526,Not in chargemaster,95925,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592526,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95925TC,Not in chargemaster,95925TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95925TC,BCBSND Base Physician Payment Schedule,231.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95925,Not in chargemaster,95925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95925,BCBSND Base Physician Payment Schedule,289.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95924,Not in chargemaster,95924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95924,BCBSND Base Physician Payment Schedule,312.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592426,Not in chargemaster,95924,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592426,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95924TC,Not in chargemaster,95924TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95924TC,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592326,Not in chargemaster,95923,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592326,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95923TC,Not in chargemaster,95923TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95923TC,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95923,Not in chargemaster,95923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95923,BCBSND Base Physician Payment Schedule,267.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95922,Not in chargemaster,95922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95922,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592226,Not in chargemaster,95922,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592226,BCBSND Base Physician Payment Schedule,101.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95922TC,Not in chargemaster,95922TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95922TC,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9592126,Not in chargemaster,95921,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9592126,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95921TC,Not in chargemaster,95921TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95921TC,BCBSND Base Physician Payment Schedule,83.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95921,Not in chargemaster,95921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95921,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95913,Not in chargemaster,95913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95913,BCBSND Base Physician Payment Schedule,631.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9591326,Not in chargemaster,95913,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9591326,BCBSND Base Physician Payment Schedule,395.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95913TC,Not in chargemaster,95913TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95913TC,BCBSND Base Physician Payment Schedule,235.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9591226,Not in chargemaster,95912,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9591226,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95912TC,Not in chargemaster,95912TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95912TC,BCBSND Base Physician Payment Schedule,212.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95912,Not in chargemaster,95912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95912,BCBSND Base Physician Payment Schedule,545.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95911,Not in chargemaster,95911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95911,BCBSND Base Physician Payment Schedule,476.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9591126,Not in chargemaster,95911,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9591126,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95911TC,Not in chargemaster,95911TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95911TC,BCBSND Base Physician Payment Schedule,196.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9591026,Not in chargemaster,95910,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9591026,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95910TC,Not in chargemaster,95910TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95910TC,BCBSND Base Physician Payment Schedule,171.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95910,Not in chargemaster,95910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95910,BCBSND Base Physician Payment Schedule,397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95909,Not in chargemaster,95909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95909,BCBSND Base Physician Payment Schedule,302.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9590926,Not in chargemaster,95909,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9590926,BCBSND Base Physician Payment Schedule,168.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95909TC,Not in chargemaster,95909TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95909TC,BCBSND Base Physician Payment Schedule,133.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9590826,Not in chargemaster,95908,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9590826,BCBSND Base Physician Payment Schedule,140.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95908TC,Not in chargemaster,95908TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95908TC,BCBSND Base Physician Payment Schedule,111.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95908,Not in chargemaster,95908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95908,BCBSND Base Physician Payment Schedule,252.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95907,Not in chargemaster,95907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95907,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9590726,Not in chargemaster,95907,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9590726,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95907TC,Not in chargemaster,95907TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95907TC,BCBSND Base Physician Payment Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9590526,Not in chargemaster,95905,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9590526,BCBSND Base Physician Payment Schedule,5.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95905TC,Not in chargemaster,95905TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95905TC,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95905,Not in chargemaster,95905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95905,BCBSND Base Physician Payment Schedule,112.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95887,Not in chargemaster,95887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95887,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9588726,Not in chargemaster,95887,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9588726,BCBSND Base Physician Payment Schedule,79.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95887TC,Not in chargemaster,95887TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95887TC,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9588626,Not in chargemaster,95886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9588626,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95886TC,Not in chargemaster,95886TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95886TC,BCBSND Base Physician Payment Schedule,105.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95886,Not in chargemaster,95886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95886,BCBSND Base Physician Payment Schedule,201.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95885,Not in chargemaster,95885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95885,BCBSND Base Physician Payment Schedule,129.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9588526,Not in chargemaster,95885,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9588526,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95885TC,Not in chargemaster,95885TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95885TC,BCBSND Base Physician Payment Schedule,91.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9587526,Not in chargemaster,95875,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9587526,BCBSND Base Physician Payment Schedule,123.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95875TC,Not in chargemaster,95875TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95875TC,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95875,Not in chargemaster,95875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95875,BCBSND Base Physician Payment Schedule,277.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95874,Not in chargemaster,95874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95874,BCBSND Base Physician Payment Schedule,163.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9587426,Not in chargemaster,95874,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9587426,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95874TC,Not in chargemaster,95874TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95874TC,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9587326,Not in chargemaster,95873,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9587326,BCBSND Base Physician Payment Schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95873TC,Not in chargemaster,95873TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95873TC,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95873,Not in chargemaster,95873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95873,BCBSND Base Physician Payment Schedule,159.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95872,Not in chargemaster,95872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95872,BCBSND Base Physician Payment Schedule,415.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9587226,Not in chargemaster,95872,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9587226,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95872TC,Not in chargemaster,95872TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95872TC,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9587026,Not in chargemaster,95870,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9587026,BCBSND Base Physician Payment Schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95870TC,Not in chargemaster,95870TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95870TC,BCBSND Base Physician Payment Schedule,146.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95870,Not in chargemaster,95870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95870,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95869,Not in chargemaster,95869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95869,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586926,Not in chargemaster,95869,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586926,BCBSND Base Physician Payment Schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95869TC,Not in chargemaster,95869TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95869TC,BCBSND Base Physician Payment Schedule,157.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586826,Not in chargemaster,95868,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586826,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95868TC,Not in chargemaster,95868TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95868TC,BCBSND Base Physician Payment Schedule,161.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95868,Not in chargemaster,95868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95868,BCBSND Base Physician Payment Schedule,293.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95867,Not in chargemaster,95867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95867,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586726,Not in chargemaster,95867,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586726,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95867TC,Not in chargemaster,95867TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95867TC,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586626,Not in chargemaster,95866,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586626,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95866TC,Not in chargemaster,95866TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95866TC,BCBSND Base Physician Payment Schedule,140.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95866,Not in chargemaster,95866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95866,BCBSND Base Physician Payment Schedule,281.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95865,Not in chargemaster,95865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95865,BCBSND Base Physician Payment Schedule,318.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586526,Not in chargemaster,95865,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586526,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95865TC,Not in chargemaster,95865TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95865TC,BCBSND Base Physician Payment Schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586426,Not in chargemaster,95864,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586426,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95864TC,Not in chargemaster,95864TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95864TC,BCBSND Base Physician Payment Schedule,295.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95864,Not in chargemaster,95864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95864,BCBSND Base Physician Payment Schedule,519.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95863,Not in chargemaster,95863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95863,BCBSND Base Physician Payment Schedule,441.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586326,Not in chargemaster,95863,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586326,BCBSND Base Physician Payment Schedule,209.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95863TC,Not in chargemaster,95863TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95863TC,BCBSND Base Physician Payment Schedule,232.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586126,Not in chargemaster,95861,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586126,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95861TC,Not in chargemaster,95861TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95861TC,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95861,Not in chargemaster,95861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95861,BCBSND Base Physician Payment Schedule,357.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95860,Not in chargemaster,95860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95860,BCBSND Base Physician Payment Schedule,249.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9586026,Not in chargemaster,95860,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9586026,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95860TC,Not in chargemaster,95860TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95860TC,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95857,Not in chargemaster,95857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95857,BCBSND Base Physician Payment Schedule,115.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95852,Not in chargemaster,95852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95852,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95851,Not in chargemaster,95851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95851,BCBSND Base Physician Payment Schedule,45.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95836,Not in chargemaster,95836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95836,BCBSND Base Physician Payment Schedule,234.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95830,Not in chargemaster,95830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95830,BCBSND Base Physician Payment Schedule,1044.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95829,Not in chargemaster,95829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95829,BCBSND Base Physician Payment Schedule,3884.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9582926,Not in chargemaster,95829,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9582926,BCBSND Base Physician Payment Schedule,706.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95829TC,Not in chargemaster,95829TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95829TC,BCBSND Base Physician Payment Schedule,3177.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9582426,Not in chargemaster,95824,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9582426,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95822,Not in chargemaster,95822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95822,BCBSND Base Physician Payment Schedule,814.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9582226,Not in chargemaster,95822,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9582226,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95822TC,Not in chargemaster,95822TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95822TC,BCBSND Base Physician Payment Schedule,692.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9581926,Not in chargemaster,95819,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9581926,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95819TC,Not in chargemaster,95819TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95819TC,BCBSND Base Physician Payment Schedule,776.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95819,Not in chargemaster,95819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95819,BCBSND Base Physician Payment Schedule,897.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95816,Not in chargemaster,95816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95816,BCBSND Base Physician Payment Schedule,756.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9581626,Not in chargemaster,95816,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9581626,BCBSND Base Physician Payment Schedule,120.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95816TC,Not in chargemaster,95816TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95816TC,BCBSND Base Physician Payment Schedule,635.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9581326,Not in chargemaster,95813,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9581326,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95813TC,Not in chargemaster,95813TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95813TC,BCBSND Base Physician Payment Schedule,665.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95813,Not in chargemaster,95813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95813,BCBSND Base Physician Payment Schedule,847.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95812,Not in chargemaster,95812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95812,BCBSND Base Physician Payment Schedule,681.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9581226,Not in chargemaster,95812,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9581226,BCBSND Base Physician Payment Schedule,120.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95812TC,Not in chargemaster,95812TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95812TC,BCBSND Base Physician Payment Schedule,561.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9581126,Not in chargemaster,95811,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9581126,BCBSND Base Physician Payment Schedule,262.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95811TC,Not in chargemaster,95811TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95811TC,BCBSND Base Physician Payment Schedule,1057.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95811,Not in chargemaster,95811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95811,BCBSND Base Physician Payment Schedule,1319.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95810,Not in chargemaster,95810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95810,BCBSND Base Physician Payment Schedule,1263.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9581026,Not in chargemaster,95810,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9581026,BCBSND Base Physician Payment Schedule,253.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95810TC,Not in chargemaster,95810TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95810TC,BCBSND Base Physician Payment Schedule,1010.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9580826,Not in chargemaster,95808,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9580826,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95808TC,Not in chargemaster,95808TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95808TC,BCBSND Base Physician Payment Schedule,1169.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95808,Not in chargemaster,95808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95808,BCBSND Base Physician Payment Schedule,1352.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95807,Not in chargemaster,95807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95807,BCBSND Base Physician Payment Schedule,843.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9580726,Not in chargemaster,95807,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9580726,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95807TC,Not in chargemaster,95807TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95807TC,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9580626,Not in chargemaster,95806,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9580626,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95806TC,Not in chargemaster,95806TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95806TC,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95806,Not in chargemaster,95806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95806,BCBSND Base Physician Payment Schedule,242.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95805,Not in chargemaster,95805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95805,BCBSND Base Physician Payment Schedule,859.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9580526,Not in chargemaster,95805,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9580526,BCBSND Base Physician Payment Schedule,123.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95805TC,Not in chargemaster,95805TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95805TC,BCBSND Base Physician Payment Schedule,736.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9580326,Not in chargemaster,95803,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9580326,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95803TC,Not in chargemaster,95803TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95803TC,BCBSND Base Physician Payment Schedule,216.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95803,Not in chargemaster,95803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95803,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95801,Not in chargemaster,95801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95801,BCBSND Base Physician Payment Schedule,184.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9580126,Not in chargemaster,95801,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9580126,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95801TC,Not in chargemaster,95801TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95801TC,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9580026,Not in chargemaster,95800,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9580026,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95800TC,Not in chargemaster,95800TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95800TC,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95800,Not in chargemaster,95800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95800,BCBSND Base Physician Payment Schedule,343.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95783,Not in chargemaster,95783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95783,BCBSND Base Physician Payment Schedule,1989.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9578326,Not in chargemaster,95783,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9578326,BCBSND Base Physician Payment Schedule,286.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95783TC,Not in chargemaster,95783TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95783TC,BCBSND Base Physician Payment Schedule,1703.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9578226,Not in chargemaster,95782,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9578226,BCBSND Base Physician Payment Schedule,263.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95782TC,Not in chargemaster,95782TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95782TC,BCBSND Base Physician Payment Schedule,1607.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95782,Not in chargemaster,95782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95782,BCBSND Base Physician Payment Schedule,1871.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95726,Not in chargemaster,95726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95726,BCBSND Base Physician Payment Schedule,868.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95725,Not in chargemaster,95725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95725,BCBSND Base Physician Payment Schedule,627.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95724,Not in chargemaster,95724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95724,BCBSND Base Physician Payment Schedule,687.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95723,Not in chargemaster,95723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95723,BCBSND Base Physician Payment Schedule,549.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95722,Not in chargemaster,95722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95722,BCBSND Base Physician Payment Schedule,538.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95721,Not in chargemaster,95721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95721,BCBSND Base Physician Payment Schedule,443.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95720,Not in chargemaster,95720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95720,BCBSND Base Physician Payment Schedule,439.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95719,Not in chargemaster,95719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95719,BCBSND Base Physician Payment Schedule,334.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95718,Not in chargemaster,95718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95718,BCBSND Base Physician Payment Schedule,284.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95717,Not in chargemaster,95717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95717,BCBSND Base Physician Payment Schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95250,Not in chargemaster,95250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95250,BCBSND Base Physician Payment Schedule,310.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95251,Not in chargemaster,95251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95251,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95700,Not in chargemaster,95700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95700,BCBSND Base Physician Payment Schedule,322.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95705,Not in chargemaster,95705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95705,BCBSND Base Physician Payment Schedule,322.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95706,Not in chargemaster,95706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95706,BCBSND Base Physician Payment Schedule,322.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95707,Not in chargemaster,95707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95707,BCBSND Base Physician Payment Schedule,322.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95708,Not in chargemaster,95708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95708,BCBSND Base Physician Payment Schedule,619.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95709,Not in chargemaster,95709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95709,BCBSND Base Physician Payment Schedule,619.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95710,Not in chargemaster,95710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95710,BCBSND Base Physician Payment Schedule,619.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95711,Not in chargemaster,95711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95711,BCBSND Base Physician Payment Schedule,322.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95712,Not in chargemaster,95712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95712,BCBSND Base Physician Payment Schedule,322.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95713,Not in chargemaster,95713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95713,BCBSND Base Physician Payment Schedule,619.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95714,Not in chargemaster,95714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95714,BCBSND Base Physician Payment Schedule,619.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95715,Not in chargemaster,95715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95715,BCBSND Base Physician Payment Schedule,619.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95716,Not in chargemaster,95716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95716,BCBSND Base Physician Payment Schedule,1158.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95249,Not in chargemaster,95249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95249,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95180,Not in chargemaster,95180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95180,BCBSND Base Physician Payment Schedule,284.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95170,Not in chargemaster,95170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95170,BCBSND Base Physician Payment Schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95165,Not in chargemaster,95165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95165,BCBSND Base Physician Payment Schedule,30.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95149,Not in chargemaster,95149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95149,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95148,Not in chargemaster,95148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95148,BCBSND Base Physician Payment Schedule,172.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95147,Not in chargemaster,95147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95147,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95146,Not in chargemaster,95146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95146,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95145,Not in chargemaster,95145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95145,BCBSND Base Physician Payment Schedule,63.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95144,Not in chargemaster,95144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95144,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95117,95117,95117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95117,BCBSND Base Physician Payment Schedule,22.02,22.73,Fee schedule,,22.02,22.02,22.02,22.02,,,0
unity,Fee schedule,Non-facility 95120,Not in chargemaster,95120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95120,BCBSND Base Physician Payment Schedule,49.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95125,Not in chargemaster,95125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95125,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95115,95115,95115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95115,BCBSND Base Physician Payment Schedule,19.09,19.88,Fee schedule,,19.09,19.09,19.09,19.09,,,0
unity,Fee schedule,Non-facility 95079,Not in chargemaster,95079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95079,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95076,Not in chargemaster,95076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95076,BCBSND Base Physician Payment Schedule,247.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95071,Not in chargemaster,95071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95071,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95070,Not in chargemaster,95070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95070,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95065,Not in chargemaster,95065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95065,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95060,Not in chargemaster,95060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95060,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95056,Not in chargemaster,95056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95056,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95052,Not in chargemaster,95052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95052,BCBSND Base Physician Payment Schedule,13.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95044,Not in chargemaster,95044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95044,BCBSND Base Physician Payment Schedule,11.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95028,Not in chargemaster,95028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95028,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95027,Not in chargemaster,95027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95027,BCBSND Base Physician Payment Schedule,10.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95024,Not in chargemaster,95024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95024,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95018,Not in chargemaster,95018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95018,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95017,Not in chargemaster,95017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95017,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95012,Not in chargemaster,95012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95012,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 95004,Not in chargemaster,95004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95004,BCBSND Base Physician Payment Schedule,8.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94781,Not in chargemaster,94781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94781,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94780,Not in chargemaster,94780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94780,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94762,Not in chargemaster,94762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94762,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94770,Not in chargemaster,94770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94770,BCBSND Base Physician Payment Schedule,15.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94772,Not in chargemaster,94772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94772,BCBSND Base Physician Payment Schedule,242.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9477226,Not in chargemaster,94772,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9477226,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94772TC,Not in chargemaster,94772TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94772TC,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94774,Not in chargemaster,94774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94774,BCBSND Base Physician Payment Schedule,414.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94775,Not in chargemaster,94775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94775,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94776,Not in chargemaster,94776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94776,BCBSND Base Physician Payment Schedule,342.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94777,Not in chargemaster,94777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94777,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94761,Not in chargemaster,94761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94761,BCBSND Base Physician Payment Schedule,8.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94760,Not in chargemaster,94760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94760,BCBSND Base Physician Payment Schedule,5.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9475026,Not in chargemaster,94750,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9475026,BCBSND Base Physician Payment Schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94750TC,Not in chargemaster,94750TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94750TC,BCBSND Base Physician Payment Schedule,159.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94750,Not in chargemaster,94750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94750,BCBSND Base Physician Payment Schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94729,Not in chargemaster,94729,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94729,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9472926,Not in chargemaster,94729,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9472926,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94729TC,Not in chargemaster,94729TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94729TC,BCBSND Base Physician Payment Schedule,97.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9472826,Not in chargemaster,94728,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9472826,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94728TC,Not in chargemaster,94728TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94728TC,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94728,Not in chargemaster,94728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94728,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94727,Not in chargemaster,94727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94727,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9472726,Not in chargemaster,94727,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9472726,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94727TC,Not in chargemaster,94727TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94727TC,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9472626,Not in chargemaster,94726,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9472626,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94726TC,Not in chargemaster,94726TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94726TC,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94726,Not in chargemaster,94726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94726,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94690,Not in chargemaster,94690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94690,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9469026,Not in chargemaster,94690,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9469026,BCBSND Base Physician Payment Schedule,8.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94690TC,Not in chargemaster,94690TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94690TC,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9468126,Not in chargemaster,94681,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9468126,BCBSND Base Physician Payment Schedule,21.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94681TC,Not in chargemaster,94681TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94681TC,BCBSND Base Physician Payment Schedule,88.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94681,Not in chargemaster,94681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94681,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94680,Not in chargemaster,94680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94680,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9468026,Not in chargemaster,94680,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9468026,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94680TC,Not in chargemaster,94680TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94680TC,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94669,Not in chargemaster,94669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94669,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94668,Not in chargemaster,94668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94668,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94667,Not in chargemaster,94667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94667,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94664,Not in chargemaster,94664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94664,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94662,Not in chargemaster,94662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94662,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94660,Not in chargemaster,94660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94660,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94645,Not in chargemaster,94645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94645,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94644,Not in chargemaster,94644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94644,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94640,94640,94640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94640,BCBSND Base Physician Payment Schedule,36.71,44,Fee schedule,,36.71,36.71,36.71,36.71,,,0
unity,Fee schedule,Non-facility 94642,Not in chargemaster,94642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94642,BCBSND Base Physician Payment Schedule,244.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94621,Not in chargemaster,94621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94621,BCBSND Base Physician Payment Schedule,330.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9462126,Not in chargemaster,94621,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9462126,BCBSND Base Physician Payment Schedule,146.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94621TC,Not in chargemaster,94621TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94621TC,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9461826,Not in chargemaster,94618,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9461826,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94618TC,Not in chargemaster,94618TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94618TC,BCBSND Base Physician Payment Schedule,22.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94618,Not in chargemaster,94618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94618,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94617,Not in chargemaster,94617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94617,BCBSND Base Physician Payment Schedule,189.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9461726,Not in chargemaster,94617,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9461726,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94617TC,Not in chargemaster,94617TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94617TC,BCBSND Base Physician Payment Schedule,119.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94610,Not in chargemaster,94610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94610,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94453,Not in chargemaster,94453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94453,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9445326,Not in chargemaster,94453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9445326,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94453TC,Not in chargemaster,94453TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94453TC,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9445226,Not in chargemaster,94452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9445226,BCBSND Base Physician Payment Schedule,30.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94452TC,Not in chargemaster,94452TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94452TC,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94452,Not in chargemaster,94452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94452,BCBSND Base Physician Payment Schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94450,Not in chargemaster,94450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94450,BCBSND Base Physician Payment Schedule,138.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9445026,Not in chargemaster,94450,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9445026,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94450TC,Not in chargemaster,94450TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94450TC,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9440026,Not in chargemaster,94400,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9440026,BCBSND Base Physician Payment Schedule,40.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94400TC,Not in chargemaster,94400TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94400TC,BCBSND Base Physician Payment Schedule,76.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94400,Not in chargemaster,94400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94400,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94375,Not in chargemaster,94375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94375,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9437526,Not in chargemaster,94375,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9437526,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94375TC,Not in chargemaster,94375TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94375TC,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9425026,Not in chargemaster,94250,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9425026,BCBSND Base Physician Payment Schedule,11.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94250TC,Not in chargemaster,94250TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94250TC,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94250,Not in chargemaster,94250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94250,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94200,Not in chargemaster,94200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94200,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9420026,Not in chargemaster,94200,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9420026,BCBSND Base Physician Payment Schedule,9.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94200TC,Not in chargemaster,94200TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94200TC,BCBSND Base Physician Payment Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9415026,Not in chargemaster,94150,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9415026,BCBSND Base Physician Payment Schedule,8.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94150TC,Not in chargemaster,94150TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94150TC,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94150,Not in chargemaster,94150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94150,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94070,Not in chargemaster,94070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94070,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9407026,Not in chargemaster,94070,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9407026,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94070TC,Not in chargemaster,94070TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94070TC,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9406026,Not in chargemaster,94060,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9406026,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94060TC,Not in chargemaster,94060TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94060TC,BCBSND Base Physician Payment Schedule,95.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94060,Not in chargemaster,94060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94060,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94016,Not in chargemaster,94016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94016,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94015,Not in chargemaster,94015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94015,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94014,Not in chargemaster,94014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94014,BCBSND Base Physician Payment Schedule,115.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94013,Not in chargemaster,94013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94013,BCBSND Base Physician Payment Schedule,40.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94012,Not in chargemaster,94012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94012,BCBSND Base Physician Payment Schedule,294.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94011,Not in chargemaster,94011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94011,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94010,Not in chargemaster,94010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94010,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9401026,Not in chargemaster,94010,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9401026,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94010TC,Not in chargemaster,94010TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94010TC,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94005,Not in chargemaster,94005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94005,BCBSND Base Physician Payment Schedule,193.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94004,Not in chargemaster,94004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94004,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94003,Not in chargemaster,94003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94003,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 94002,Not in chargemaster,94002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94002,BCBSND Base Physician Payment Schedule,193.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9399026,Not in chargemaster,93990,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9399026,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93990TC,Not in chargemaster,93990TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93990TC,BCBSND Base Physician Payment Schedule,270.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93990,Not in chargemaster,93990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93990,BCBSND Base Physician Payment Schedule,322.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93986,Not in chargemaster,93986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93986,BCBSND Base Physician Payment Schedule,320.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9398626,Not in chargemaster,93986,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9398626,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93986TC,Not in chargemaster,93986TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93986TC,BCBSND Base Physician Payment Schedule,268.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9398526,Not in chargemaster,93985,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9398526,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93985TC,Not in chargemaster,93985TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93985TC,BCBSND Base Physician Payment Schedule,472.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93985,Not in chargemaster,93985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93985,BCBSND Base Physician Payment Schedule,552.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93981,Not in chargemaster,93981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93981,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9398126,Not in chargemaster,93981,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9398126,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93981TC,Not in chargemaster,93981TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93981TC,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9398026,Not in chargemaster,93980,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9398026,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93980TC,Not in chargemaster,93980TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93980TC,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93980,Not in chargemaster,93980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93980,BCBSND Base Physician Payment Schedule,254,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93979,Not in chargemaster,93979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93979,BCBSND Base Physician Payment Schedule,251.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9397926,Not in chargemaster,93979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9397926,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93979TC,Not in chargemaster,93979TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93979TC,BCBSND Base Physician Payment Schedule,199.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9397826,Not in chargemaster,93978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9397826,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93978TC,Not in chargemaster,93978TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93978TC,BCBSND Base Physician Payment Schedule,308.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93978,Not in chargemaster,93978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93978,BCBSND Base Physician Payment Schedule,390.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93976,Not in chargemaster,93976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93976,BCBSND Base Physician Payment Schedule,340.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9397626,Not in chargemaster,93976,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9397626,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93976TC,Not in chargemaster,93976TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93976TC,BCBSND Base Physician Payment Schedule,257.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9397526,Not in chargemaster,93975,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9397526,BCBSND Base Physician Payment Schedule,119.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93975TC,Not in chargemaster,93975TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93975TC,BCBSND Base Physician Payment Schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93975,Not in chargemaster,93975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93975,BCBSND Base Physician Payment Schedule,574.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93971,Not in chargemaster,93971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93971,BCBSND Base Physician Payment Schedule,252.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9397126,93971,93971,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9397126,BCBSND Base Physician Payment Schedule,46.25,47.12,Fee schedule,,46.25,46.25,46.25,46.25,,,0
unity,Fee schedule,Non-facility 93971TC,Not in chargemaster,93971TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93971TC,BCBSND Base Physician Payment Schedule,206.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9397026,93970,93970,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9397026,BCBSND Base Physician Payment Schedule,71.94,71.76,Fee schedule,,71.76,71.76,71.76,71.76,,,0
unity,Fee schedule,Non-facility 93970TC,Not in chargemaster,93970TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93970TC,BCBSND Base Physician Payment Schedule,332.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93970,Not in chargemaster,93970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93970,BCBSND Base Physician Payment Schedule,404.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93931,Not in chargemaster,93931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93931,BCBSND Base Physician Payment Schedule,267.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9393126,Not in chargemaster,93931,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9393126,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93931TC,Not in chargemaster,93931TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93931TC,BCBSND Base Physician Payment Schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9393026,Not in chargemaster,93930,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9393026,BCBSND Base Physician Payment Schedule,83.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93930TC,Not in chargemaster,93930TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93930TC,BCBSND Base Physician Payment Schedule,344.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93930,Not in chargemaster,93930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93930,BCBSND Base Physician Payment Schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93926,Not in chargemaster,93926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93926,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9392626,Not in chargemaster,93926,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9392626,BCBSND Base Physician Payment Schedule,50.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93926TC,Not in chargemaster,93926TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93926TC,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9392526,Not in chargemaster,93925,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9392526,BCBSND Base Physician Payment Schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93925TC,Not in chargemaster,93925TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93925TC,BCBSND Base Physician Payment Schedule,444.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93925,Not in chargemaster,93925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93925,BCBSND Base Physician Payment Schedule,526.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93924,Not in chargemaster,93924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93924,BCBSND Base Physician Payment Schedule,339.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9392426,Not in chargemaster,93924,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9392426,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93924TC,Not in chargemaster,93924TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93924TC,BCBSND Base Physician Payment Schedule,287.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9392326,Not in chargemaster,93923,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9392326,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93923TC,Not in chargemaster,93923TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93923TC,BCBSND Base Physician Payment Schedule,228.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93923,Not in chargemaster,93923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93923,BCBSND Base Physician Payment Schedule,274.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93922,Not in chargemaster,93922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93922,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9392226,Not in chargemaster,93922,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9392226,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93922TC,Not in chargemaster,93922TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93922TC,BCBSND Base Physician Payment Schedule,149.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9389326,Not in chargemaster,93893,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9389326,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93893TC,Not in chargemaster,93893TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93893TC,BCBSND Base Physician Payment Schedule,615.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93893,Not in chargemaster,93893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93893,BCBSND Base Physician Payment Schedule,741.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93892,Not in chargemaster,93892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93892,BCBSND Base Physician Payment Schedule,646.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9389226,Not in chargemaster,93892,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9389226,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93892TC,Not in chargemaster,93892TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93892TC,BCBSND Base Physician Payment Schedule,521.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9389026,Not in chargemaster,93890,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9389026,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93890TC,Not in chargemaster,93890TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93890TC,BCBSND Base Physician Payment Schedule,466.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93890,Not in chargemaster,93890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93890,BCBSND Base Physician Payment Schedule,574.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93888,Not in chargemaster,93888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93888,BCBSND Base Physician Payment Schedule,336.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9388826,Not in chargemaster,93888,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9388826,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93888TC,Not in chargemaster,93888TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93888TC,BCBSND Base Physician Payment Schedule,281.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9388626,Not in chargemaster,93886,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9388626,BCBSND Base Physician Payment Schedule,99.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93886TC,Not in chargemaster,93886TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93886TC,BCBSND Base Physician Payment Schedule,466.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93886,Not in chargemaster,93886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93886,BCBSND Base Physician Payment Schedule,565.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93882,Not in chargemaster,93882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93882,BCBSND Base Physician Payment Schedule,267.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9388226,Not in chargemaster,93882,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9388226,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93882TC,Not in chargemaster,93882TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93882TC,BCBSND Base Physician Payment Schedule,214.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9388026,93880,93880,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9388026,BCBSND Base Physician Payment Schedule,82.95,63.07,Fee schedule,,63.07,63.07,63.07,63.07,,,0
unity,Fee schedule,Non-facility 93880TC,Not in chargemaster,93880TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93880TC,BCBSND Base Physician Payment Schedule,331.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93880,Not in chargemaster,93880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93880,BCBSND Base Physician Payment Schedule,414.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93798,Not in chargemaster,93798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93798,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93797,Not in chargemaster,93797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93797,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93793,Not in chargemaster,93793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93793,BCBSND Base Physician Payment Schedule,24.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93792,Not in chargemaster,93792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93792,BCBSND Base Physician Payment Schedule,135.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93790,Not in chargemaster,93790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93790,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93788,Not in chargemaster,93788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93788,BCBSND Base Physician Payment Schedule,10.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93786,Not in chargemaster,93786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93786,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93784,Not in chargemaster,93784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93784,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93770,Not in chargemaster,93770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93770,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93750,Not in chargemaster,93750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93750,BCBSND Base Physician Payment Schedule,120.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93724,Not in chargemaster,93724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93724,BCBSND Base Physician Payment Schedule,590.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93740,Not in chargemaster,93740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93740,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93745,Not in chargemaster,93745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93745,BCBSND Base Physician Payment Schedule,165.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9374526,Not in chargemaster,93745,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9374526,BCBSND Base Physician Payment Schedule,108.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93745TC,Not in chargemaster,93745TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93745TC,BCBSND Base Physician Payment Schedule,56.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9372426,Not in chargemaster,93724,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9372426,BCBSND Base Physician Payment Schedule,510.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93724TC,Not in chargemaster,93724TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93724TC,BCBSND Base Physician Payment Schedule,79.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93702,Not in chargemaster,93702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93702,BCBSND Base Physician Payment Schedule,286.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93701,Not in chargemaster,93701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93701,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93668,Not in chargemaster,93668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93668,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9366226,Not in chargemaster,93662,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9366226,BCBSND Base Physician Payment Schedule,299.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9366026,Not in chargemaster,93660,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9366026,BCBSND Base Physician Payment Schedule,196,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93660TC,Not in chargemaster,93660TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93660TC,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93660,Not in chargemaster,93660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93660,BCBSND Base Physician Payment Schedule,330.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93657,Not in chargemaster,93657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93657,BCBSND Base Physician Payment Schedule,908.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93656,Not in chargemaster,93656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93656,BCBSND Base Physician Payment Schedule,2394.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93655,Not in chargemaster,93655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93655,BCBSND Base Physician Payment Schedule,909.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93654,Not in chargemaster,93654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93654,BCBSND Base Physician Payment Schedule,2388.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93653,Not in chargemaster,93653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93653,BCBSND Base Physician Payment Schedule,1783.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93650,Not in chargemaster,93650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93650,BCBSND Base Physician Payment Schedule,1260.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93644,Not in chargemaster,93644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93644,BCBSND Base Physician Payment Schedule,413.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9364426,Not in chargemaster,93644,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9364426,BCBSND Base Physician Payment Schedule,306.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93644TC,Not in chargemaster,93644TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93644TC,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9364226,Not in chargemaster,93642,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9364226,BCBSND Base Physician Payment Schedule,543.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93642TC,Not in chargemaster,93642TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93642TC,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93642,Not in chargemaster,93642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93642,BCBSND Base Physician Payment Schedule,712.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9364126,Not in chargemaster,93641,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9364126,BCBSND Base Physician Payment Schedule,664.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93641TC,Not in chargemaster,93641TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93641TC,BCBSND Base Physician Payment Schedule,640.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93641,Not in chargemaster,93641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93641,BCBSND Base Physician Payment Schedule,1305.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9364026,Not in chargemaster,93640,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9364026,BCBSND Base Physician Payment Schedule,379.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93640TC,Not in chargemaster,93640TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93640TC,BCBSND Base Physician Payment Schedule,640.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93640,Not in chargemaster,93640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93640,BCBSND Base Physician Payment Schedule,1020.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9363126,Not in chargemaster,93631,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9363126,BCBSND Base Physician Payment Schedule,839.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93631TC,Not in chargemaster,93631TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93631TC,BCBSND Base Physician Payment Schedule,570.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93631,Not in chargemaster,93631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93631,BCBSND Base Physician Payment Schedule,1410.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9362426,Not in chargemaster,93624,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9362426,BCBSND Base Physician Payment Schedule,510.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93624TC,Not in chargemaster,93624TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93624TC,BCBSND Base Physician Payment Schedule,169.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93624,Not in chargemaster,93624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93624,BCBSND Base Physician Payment Schedule,680.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9362326,Not in chargemaster,93623,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9362326,BCBSND Base Physician Payment Schedule,336.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9362226,Not in chargemaster,93622,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9362226,BCBSND Base Physician Payment Schedule,365.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9362126,Not in chargemaster,93621,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9362126,BCBSND Base Physician Payment Schedule,249.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9362026,Not in chargemaster,93620,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9362026,BCBSND Base Physician Payment Schedule,1333.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9361926,Not in chargemaster,93619,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9361926,BCBSND Base Physician Payment Schedule,831.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93619TC,Not in chargemaster,93619TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93619TC,BCBSND Base Physician Payment Schedule,689.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93619,Not in chargemaster,93619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93619,BCBSND Base Physician Payment Schedule,1521.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9361826,Not in chargemaster,93618,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9361826,BCBSND Base Physician Payment Schedule,469.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93618TC,Not in chargemaster,93618TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93618TC,BCBSND Base Physician Payment Schedule,354.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93618,Not in chargemaster,93618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93618,BCBSND Base Physician Payment Schedule,823.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9361626,Not in chargemaster,93616,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9361626,BCBSND Base Physician Payment Schedule,126.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93616TC,Not in chargemaster,93616TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93616TC,BCBSND Base Physician Payment Schedule,28.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93616,Not in chargemaster,93616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93616,BCBSND Base Physician Payment Schedule,154.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9361526,Not in chargemaster,93615,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9361526,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93615TC,Not in chargemaster,93615TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93615TC,BCBSND Base Physician Payment Schedule,28.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93615,Not in chargemaster,93615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93615,BCBSND Base Physician Payment Schedule,108.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93613,Not in chargemaster,93613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93613,BCBSND Base Physician Payment Schedule,633.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9361226,Not in chargemaster,93612,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9361226,BCBSND Base Physician Payment Schedule,344.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93612TC,Not in chargemaster,93612TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93612TC,BCBSND Base Physician Payment Schedule,144.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93612,Not in chargemaster,93612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93612,BCBSND Base Physician Payment Schedule,489.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9361026,Not in chargemaster,93610,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9361026,BCBSND Base Physician Payment Schedule,347.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93610TC,Not in chargemaster,93610TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93610TC,BCBSND Base Physician Payment Schedule,122.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93610,Not in chargemaster,93610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93610,BCBSND Base Physician Payment Schedule,470.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9360926,Not in chargemaster,93609,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9360926,BCBSND Base Physician Payment Schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93609TC,Not in chargemaster,93609TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93609TC,BCBSND Base Physician Payment Schedule,244.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93609,Not in chargemaster,93609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93609,BCBSND Base Physician Payment Schedule,835.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9360326,Not in chargemaster,93603,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9360326,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93603TC,Not in chargemaster,93603TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93603TC,BCBSND Base Physician Payment Schedule,150.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93603,Not in chargemaster,93603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93603,BCBSND Base Physician Payment Schedule,398.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9360226,Not in chargemaster,93602,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9360226,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93602TC,Not in chargemaster,93602TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93602TC,BCBSND Base Physician Payment Schedule,99.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93602,Not in chargemaster,93602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93602,BCBSND Base Physician Payment Schedule,347.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9360026,Not in chargemaster,93600,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9360026,BCBSND Base Physician Payment Schedule,253.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93600TC,Not in chargemaster,93600TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93600TC,BCBSND Base Physician Payment Schedule,176.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93600,Not in chargemaster,93600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93600,BCBSND Base Physician Payment Schedule,429.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93592,Not in chargemaster,93592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93592,BCBSND Base Physician Payment Schedule,835.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93591,Not in chargemaster,93591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93591,BCBSND Base Physician Payment Schedule,1900.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93590,Not in chargemaster,93590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93590,BCBSND Base Physician Payment Schedule,2292.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93583,Not in chargemaster,93583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93583,BCBSND Base Physician Payment Schedule,1582.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93582,Not in chargemaster,93582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93582,BCBSND Base Physician Payment Schedule,1416.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93581,Not in chargemaster,93581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93581,BCBSND Base Physician Payment Schedule,2828.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93580,Not in chargemaster,93580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93580,BCBSND Base Physician Payment Schedule,2076.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9357226,Not in chargemaster,93572,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9357226,BCBSND Base Physician Payment Schedule,112.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93572TC,Not in chargemaster,93572TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93572TC,BCBSND Base Physician Payment Schedule,203.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93572,Not in chargemaster,93572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93572,BCBSND Base Physician Payment Schedule,316.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9357126,Not in chargemaster,93571,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9357126,BCBSND Base Physician Payment Schedule,155.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93571TC,Not in chargemaster,93571TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93571TC,BCBSND Base Physician Payment Schedule,405.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93571,Not in chargemaster,93571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93571,BCBSND Base Physician Payment Schedule,560.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93568,Not in chargemaster,93568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93568,BCBSND Base Physician Payment Schedule,281.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93567,Not in chargemaster,93567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93567,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93566,Not in chargemaster,93566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93566,BCBSND Base Physician Payment Schedule,306.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93565,Not in chargemaster,93565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93565,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93564,Not in chargemaster,93564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93564,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93563,Not in chargemaster,93563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93563,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9356226,Not in chargemaster,93562,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9356226,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93562TC,Not in chargemaster,93562TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93562TC,BCBSND Base Physician Payment Schedule,30.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93562,Not in chargemaster,93562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93562,BCBSND Base Physician Payment Schedule,108.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9356126,Not in chargemaster,93561,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9356126,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93561TC,Not in chargemaster,93561TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93561TC,BCBSND Base Physician Payment Schedule,48.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93561,Not in chargemaster,93561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93561,BCBSND Base Physician Payment Schedule,145.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9353326,Not in chargemaster,93533,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9353326,BCBSND Base Physician Payment Schedule,751.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93533TC,Not in chargemaster,93533TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93533TC,BCBSND Base Physician Payment Schedule,4205.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93533,Not in chargemaster,93533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93533,BCBSND Base Physician Payment Schedule,4957.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9353226,Not in chargemaster,93532,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9353226,BCBSND Base Physician Payment Schedule,1122.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93532TC,Not in chargemaster,93532TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93532TC,BCBSND Base Physician Payment Schedule,4205.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93532,Not in chargemaster,93532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93532,BCBSND Base Physician Payment Schedule,5327.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9353126,Not in chargemaster,93531,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9353126,BCBSND Base Physician Payment Schedule,899.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93531TC,Not in chargemaster,93531TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93531TC,BCBSND Base Physician Payment Schedule,4334.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93531,Not in chargemaster,93531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93531,BCBSND Base Physician Payment Schedule,5233.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9353026,Not in chargemaster,93530,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9353026,BCBSND Base Physician Payment Schedule,433.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93530TC,Not in chargemaster,93530TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93530TC,BCBSND Base Physician Payment Schedule,1515.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93530,Not in chargemaster,93530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93530,BCBSND Base Physician Payment Schedule,1948.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93505,Not in chargemaster,93505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93505,BCBSND Base Physician Payment Schedule,1479.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9350526,Not in chargemaster,93505,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9350526,BCBSND Base Physician Payment Schedule,474.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93505TC,Not in chargemaster,93505TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93505TC,BCBSND Base Physician Payment Schedule,1005.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93503,Not in chargemaster,93503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93503,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93464,Not in chargemaster,93464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93464,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9346426,Not in chargemaster,93464,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9346426,BCBSND Base Physician Payment Schedule,186.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93464TC,Not in chargemaster,93464TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93464TC,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93463,Not in chargemaster,93463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93463,BCBSND Base Physician Payment Schedule,207.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93462,Not in chargemaster,93462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93462,BCBSND Base Physician Payment Schedule,447.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9346126,Not in chargemaster,93461,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9346126,BCBSND Base Physician Payment Schedule,880.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93461TC,Not in chargemaster,93461TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93461TC,BCBSND Base Physician Payment Schedule,2128.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93461,Not in chargemaster,93461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93461,BCBSND Base Physician Payment Schedule,3009.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93460,Not in chargemaster,93460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93460,BCBSND Base Physician Payment Schedule,2689.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9346026,Not in chargemaster,93460,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9346026,BCBSND Base Physician Payment Schedule,796.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93460TC,Not in chargemaster,93460TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93460TC,BCBSND Base Physician Payment Schedule,1892.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345926,Not in chargemaster,93459,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345926,BCBSND Base Physician Payment Schedule,712.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93459TC,Not in chargemaster,93459TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93459TC,BCBSND Base Physician Payment Schedule,1717.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93459,Not in chargemaster,93459,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93459,BCBSND Base Physician Payment Schedule,2429.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93458,Not in chargemaster,93458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93458,BCBSND Base Physician Payment Schedule,2232.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345826,Not in chargemaster,93458,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345826,BCBSND Base Physician Payment Schedule,628.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93458TC,Not in chargemaster,93458TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93458TC,BCBSND Base Physician Payment Schedule,1604.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345726,Not in chargemaster,93457,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345726,BCBSND Base Physician Payment Schedule,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93457TC,Not in chargemaster,93457TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93457TC,BCBSND Base Physician Payment Schedule,1924.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93457,Not in chargemaster,93457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93457,BCBSND Base Physician Payment Schedule,2672.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93456,Not in chargemaster,93456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93456,BCBSND Base Physician Payment Schedule,2412.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345626,Not in chargemaster,93456,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345626,BCBSND Base Physician Payment Schedule,662.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93456TC,Not in chargemaster,93456TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93456TC,BCBSND Base Physician Payment Schedule,1750.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345526,Not in chargemaster,93455,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345526,BCBSND Base Physician Payment Schedule,592.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93455TC,Not in chargemaster,93455TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93455TC,BCBSND Base Physician Payment Schedule,1573.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93455,Not in chargemaster,93455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93455,BCBSND Base Physician Payment Schedule,2166.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93454,Not in chargemaster,93454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93454,BCBSND Base Physician Payment Schedule,1906.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345426,Not in chargemaster,93454,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345426,BCBSND Base Physician Payment Schedule,508.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93454TC,Not in chargemaster,93454TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93454TC,BCBSND Base Physician Payment Schedule,1397.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345326,Not in chargemaster,93453,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345326,BCBSND Base Physician Payment Schedule,673.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93453TC,Not in chargemaster,93453TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93453TC,BCBSND Base Physician Payment Schedule,1777.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93453,Not in chargemaster,93453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93453,BCBSND Base Physician Payment Schedule,2451.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93452,Not in chargemaster,93452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93452,BCBSND Base Physician Payment Schedule,1902.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345226,Not in chargemaster,93452,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345226,BCBSND Base Physician Payment Schedule,502.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93452TC,Not in chargemaster,93452TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93452TC,BCBSND Base Physician Payment Schedule,1399.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9345126,Not in chargemaster,93451,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9345126,BCBSND Base Physician Payment Schedule,278.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93451TC,Not in chargemaster,93451TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93451TC,BCBSND Base Physician Payment Schedule,1478.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93451,Not in chargemaster,93451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93451,BCBSND Base Physician Payment Schedule,1757.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93356,Not in chargemaster,93356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93356,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93355,Not in chargemaster,93355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93355,BCBSND Base Physician Payment Schedule,483.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93352,Not in chargemaster,93352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93352,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9335126,Not in chargemaster,93351,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9335126,BCBSND Base Physician Payment Schedule,177.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93351TC,Not in chargemaster,93351TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93351TC,BCBSND Base Physician Payment Schedule,309.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93351,Not in chargemaster,93351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93351,BCBSND Base Physician Payment Schedule,486.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93350,Not in chargemaster,93350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93350,BCBSND Base Physician Payment Schedule,393.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9335026,Not in chargemaster,93350,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9335026,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93350TC,Not in chargemaster,93350TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93350TC,BCBSND Base Physician Payment Schedule,245.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9332526,Not in chargemaster,93325,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9332526,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93325TC,Not in chargemaster,93325TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93325TC,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93325,Not in chargemaster,93325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93325,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93321,Not in chargemaster,93321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93321,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9332126,Not in chargemaster,93321,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9332126,BCBSND Base Physician Payment Schedule,15.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93321TC,Not in chargemaster,93321TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93321TC,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9332026,Not in chargemaster,93320,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9332026,BCBSND Base Physician Payment Schedule,38.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93320TC,Not in chargemaster,93320TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93320TC,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93320,Not in chargemaster,93320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93320,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9331826,Not in chargemaster,93318,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9331826,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9331726,Not in chargemaster,93317,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9331726,BCBSND Base Physician Payment Schedule,191.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93316,Not in chargemaster,93316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93316,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9331526,Not in chargemaster,93315,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9331526,BCBSND Base Physician Payment Schedule,269.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93315TC,Not in chargemaster,93315TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93315TC,BCBSND Base Physician Payment Schedule,530.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93315,Not in chargemaster,93315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93315,BCBSND Base Physician Payment Schedule,799.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9331426,Not in chargemaster,93314,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9331426,BCBSND Base Physician Payment Schedule,190.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93314TC,Not in chargemaster,93314TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93314TC,BCBSND Base Physician Payment Schedule,300.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93314,Not in chargemaster,93314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93314,BCBSND Base Physician Payment Schedule,490.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93313,Not in chargemaster,93313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93313,BCBSND Base Physician Payment Schedule,24.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9331226,Not in chargemaster,93312,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9331226,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93312TC,Not in chargemaster,93312TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93312TC,BCBSND Base Physician Payment Schedule,281.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93312,Not in chargemaster,93312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93312,BCBSND Base Physician Payment Schedule,510.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93308,Not in chargemaster,93308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93308,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9330826,Not in chargemaster,93308,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9330826,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93308TC,Not in chargemaster,93308TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93308TC,BCBSND Base Physician Payment Schedule,151.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9330726,Not in chargemaster,93307,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9330726,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93307TC,Not in chargemaster,93307TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93307TC,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93307,Not in chargemaster,93307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93307,BCBSND Base Physician Payment Schedule,292.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93306,Not in chargemaster,93306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93306,BCBSND Base Physician Payment Schedule,430.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9330626,Not in chargemaster,93306,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9330626,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93306TC,Not in chargemaster,93306TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93306TC,BCBSND Base Physician Payment Schedule,277.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9330426,Not in chargemaster,93304,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9330426,BCBSND Base Physician Payment Schedule,76.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93304TC,Not in chargemaster,93304TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93304TC,BCBSND Base Physician Payment Schedule,255.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93304,Not in chargemaster,93304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93304,BCBSND Base Physician Payment Schedule,331.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93303,Not in chargemaster,93303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93303,BCBSND Base Physician Payment Schedule,483.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9330326,Not in chargemaster,93303,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9330326,BCBSND Base Physician Payment Schedule,132.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93303TC,Not in chargemaster,93303TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93303TC,BCBSND Base Physician Payment Schedule,350.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93298,Not in chargemaster,93298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93298,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93297,Not in chargemaster,93297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93297,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93296,Not in chargemaster,93296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93296,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93295,Not in chargemaster,93295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93295,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93294,Not in chargemaster,93294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93294,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93293,Not in chargemaster,93293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93293,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9329326,Not in chargemaster,93293,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9329326,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93293TC,Not in chargemaster,93293TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93293TC,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9329226,Not in chargemaster,93292,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9329226,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93292TC,Not in chargemaster,93292TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93292TC,BCBSND Base Physician Payment Schedule,48.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93292,Not in chargemaster,93292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93292,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93291,Not in chargemaster,93291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93291,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9329126,Not in chargemaster,93291,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9329126,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93291TC,Not in chargemaster,93291TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93291TC,BCBSND Base Physician Payment Schedule,50.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9329026,Not in chargemaster,93290,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9329026,BCBSND Base Physician Payment Schedule,45.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93290TC,Not in chargemaster,93290TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93290TC,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93290,Not in chargemaster,93290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93290,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93289,Not in chargemaster,93289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93289,BCBSND Base Physician Payment Schedule,137.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328926,Not in chargemaster,93289,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328926,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93289TC,Not in chargemaster,93289TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93289TC,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328826,Not in chargemaster,93288,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328826,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93288TC,Not in chargemaster,93288TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93288TC,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93288,Not in chargemaster,93288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93288,BCBSND Base Physician Payment Schedule,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93287,Not in chargemaster,93287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93287,BCBSND Base Physician Payment Schedule,99.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328726,Not in chargemaster,93287,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328726,BCBSND Base Physician Payment Schedule,48.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93287TC,Not in chargemaster,93287TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93287TC,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328626,Not in chargemaster,93286,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328626,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93286TC,Not in chargemaster,93286TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93286TC,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93286,Not in chargemaster,93286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93286,BCBSND Base Physician Payment Schedule,83.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93285,Not in chargemaster,93285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93285,BCBSND Base Physician Payment Schedule,111.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328526,Not in chargemaster,93285,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328526,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93285TC,Not in chargemaster,93285TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93285TC,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328426,Not in chargemaster,93284,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328426,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93284TC,Not in chargemaster,93284TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93284TC,BCBSND Base Physician Payment Schedule,74.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93284,Not in chargemaster,93284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93284,BCBSND Base Physician Payment Schedule,206.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93283,Not in chargemaster,93283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93283,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328326,Not in chargemaster,93283,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328326,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93283TC,Not in chargemaster,93283TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93283TC,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328226,Not in chargemaster,93282,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328226,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93282TC,Not in chargemaster,93282TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93282TC,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93282,Not in chargemaster,93282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93282,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93281,Not in chargemaster,93281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93281,BCBSND Base Physician Payment Schedule,159.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328126,Not in chargemaster,93281,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328126,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93281TC,Not in chargemaster,93281TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93281TC,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9328026,Not in chargemaster,93280,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9328026,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93280TC,Not in chargemaster,93280TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93280TC,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93280,Not in chargemaster,93280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93280,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93279,Not in chargemaster,93279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93279,BCBSND Base Physician Payment Schedule,126.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9327926,Not in chargemaster,93279,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9327926,BCBSND Base Physician Payment Schedule,67.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93279TC,Not in chargemaster,93279TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93279TC,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9327826,Not in chargemaster,93278,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9327826,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93278TC,Not in chargemaster,93278TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93278TC,BCBSND Base Physician Payment Schedule,35.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93278,Not in chargemaster,93278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93278,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93272,Not in chargemaster,93272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93272,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93271,Not in chargemaster,93271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93271,BCBSND Base Physician Payment Schedule,342.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93270,Not in chargemaster,93270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93270,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93268,Not in chargemaster,93268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93268,BCBSND Base Physician Payment Schedule,414.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93264,Not in chargemaster,93264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93264,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9326126,Not in chargemaster,93261,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9326126,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93261TC,Not in chargemaster,93261TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93261TC,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93261,Not in chargemaster,93261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93261,BCBSND Base Physician Payment Schedule,137.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93260,Not in chargemaster,93260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93260,BCBSND Base Physician Payment Schedule,149.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9326026,Not in chargemaster,93260,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9326026,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93260TC,Not in chargemaster,93260TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93260TC,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93229,Not in chargemaster,93229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93229,BCBSND Base Physician Payment Schedule,1455.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93228,Not in chargemaster,93228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93228,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93227,Not in chargemaster,93227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93227,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93226,Not in chargemaster,93226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93226,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93225,Not in chargemaster,93225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93225,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93224,Not in chargemaster,93224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93224,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9305026,Not in chargemaster,93050,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9305026,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93050TC,Not in chargemaster,93050TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93050TC,BCBSND Base Physician Payment Schedule,16.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93050,Not in chargemaster,93050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93050,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93042,Not in chargemaster,93042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93042,BCBSND Base Physician Payment Schedule,14.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93041,Not in chargemaster,93041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93041,BCBSND Base Physician Payment Schedule,11.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93040,Not in chargemaster,93040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93040,BCBSND Base Physician Payment Schedule,26.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9302526,Not in chargemaster,93025,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9302526,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93025TC,Not in chargemaster,93025TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93025TC,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93025,Not in chargemaster,93025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93025,BCBSND Base Physician Payment Schedule,292.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93024,Not in chargemaster,93024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93024,BCBSND Base Physician Payment Schedule,227.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9302426,Not in chargemaster,93024,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9302426,BCBSND Base Physician Payment Schedule,119.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93024TC,Not in chargemaster,93024TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93024TC,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93018,Not in chargemaster,93018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93018,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93017,Not in chargemaster,93017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93017,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93016,Not in chargemaster,93016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93016,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93015,Not in chargemaster,93015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93015,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93010,93010,93010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93010,BCBSND Base Physician Payment Schedule,17.62,20,Fee schedule,,17.62,17.62,17.62,17.62,,,0
unity,Fee schedule,Non-facility 93005,Not in chargemaster,93005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93005,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 93000,Not in chargemaster,93000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93000,BCBSND Base Physician Payment Schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92998,Not in chargemaster,92998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92998,BCBSND Base Physician Payment Schedule,687.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92997,Not in chargemaster,92997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92997,BCBSND Base Physician Payment Schedule,1357.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92987,Not in chargemaster,92987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92987,BCBSND Base Physician Payment Schedule,2890.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92990,Not in chargemaster,92990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92990,BCBSND Base Physician Payment Schedule,2309.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92992,Not in chargemaster,92992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92992,BCBSND Base Physician Payment Schedule,2266.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92993,Not in chargemaster,92993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92993,BCBSND Base Physician Payment Schedule,1791.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92986,Not in chargemaster,92986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92986,BCBSND Base Physician Payment Schedule,2802.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9297926,Not in chargemaster,92979,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9297926,BCBSND Base Physician Payment Schedule,162.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92979TC,Not in chargemaster,92979TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92979TC,BCBSND Base Physician Payment Schedule,211.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92979,Not in chargemaster,92979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92979,BCBSND Base Physician Payment Schedule,373.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9297826,Not in chargemaster,92978,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9297826,BCBSND Base Physician Payment Schedule,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92978TC,Not in chargemaster,92978TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92978TC,BCBSND Base Physician Payment Schedule,405.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92978,Not in chargemaster,92978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92978,BCBSND Base Physician Payment Schedule,606.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92977,Not in chargemaster,92977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92977,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92975,Not in chargemaster,92975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92975,BCBSND Base Physician Payment Schedule,802.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92974,Not in chargemaster,92974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92974,BCBSND Base Physician Payment Schedule,343.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92973,Not in chargemaster,92973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92973,BCBSND Base Physician Payment Schedule,375.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92971,Not in chargemaster,92971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92971,BCBSND Base Physician Payment Schedule,213.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92970,Not in chargemaster,92970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92970,BCBSND Base Physician Payment Schedule,403.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92961,Not in chargemaster,92961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92961,BCBSND Base Physician Payment Schedule,526.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92960,Not in chargemaster,92960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92960,BCBSND Base Physician Payment Schedule,331.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92953,Not in chargemaster,92953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92953,BCBSND Base Physician Payment Schedule,2.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92950,92950,92950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92950,BCBSND Base Physician Payment Schedule,672.44,381.92,Fee schedule,,381.92,381.92,381.92,381.92,,,0
unity,Fee schedule,Non-facility 92943,Not in chargemaster,92943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92943,BCBSND Base Physician Payment Schedule,1414.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92941,Not in chargemaster,92941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92941,BCBSND Base Physician Payment Schedule,1414.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92937,Not in chargemaster,92937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92937,BCBSND Base Physician Payment Schedule,1256.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92933,Not in chargemaster,92933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92933,BCBSND Base Physician Payment Schedule,1412.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92928,Not in chargemaster,92928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92928,BCBSND Base Physician Payment Schedule,1258.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92924,Not in chargemaster,92924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92924,BCBSND Base Physician Payment Schedule,1348.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92920,Not in chargemaster,92920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92920,BCBSND Base Physician Payment Schedule,1131.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92640,Not in chargemaster,92640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92640,BCBSND Base Physician Payment Schedule,237.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92626,Not in chargemaster,92626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92626,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92627,Not in chargemaster,92627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92627,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92630,Not in chargemaster,92630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92630,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92633,Not in chargemaster,92633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92633,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92625,Not in chargemaster,92625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92625,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92621,Not in chargemaster,92621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92621,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92620,Not in chargemaster,92620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92620,BCBSND Base Physician Payment Schedule,196,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92618,Not in chargemaster,92618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92618,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92617,Not in chargemaster,92617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92617,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92616,Not in chargemaster,92616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92616,BCBSND Base Physician Payment Schedule,450.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92615,Not in chargemaster,92615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92615,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92614,Not in chargemaster,92614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92614,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92613,Not in chargemaster,92613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92613,BCBSND Base Physician Payment Schedule,79.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92612,Not in chargemaster,92612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92612,BCBSND Base Physician Payment Schedule,416.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92611,Not in chargemaster,92611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92611,BCBSND Base Physician Payment Schedule,192.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92610,Not in chargemaster,92610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92610,BCBSND Base Physician Payment Schedule,181.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92609,Not in chargemaster,92609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92609,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92608,Not in chargemaster,92608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92608,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92607,Not in chargemaster,92607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92607,BCBSND Base Physician Payment Schedule,268.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92606,Not in chargemaster,92606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92606,BCBSND Base Physician Payment Schedule,175.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92605,Not in chargemaster,92605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92605,BCBSND Base Physician Payment Schedule,198.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92604,Not in chargemaster,92604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92604,BCBSND Base Physician Payment Schedule,193.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92603,Not in chargemaster,92603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92603,BCBSND Base Physician Payment Schedule,323.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92602,Not in chargemaster,92602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92602,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92601,Not in chargemaster,92601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92601,BCBSND Base Physician Payment Schedule,347.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92597,Not in chargemaster,92597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92597,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92596,Not in chargemaster,92596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92596,BCBSND Base Physician Payment Schedule,135.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92588,Not in chargemaster,92588,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92588,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9258826,Not in chargemaster,92588,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9258826,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92588TC,Not in chargemaster,92588TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92588TC,BCBSND Base Physician Payment Schedule,9.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92591,Not in chargemaster,92591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92591,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9258726,Not in chargemaster,92587,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9258726,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92587TC,Not in chargemaster,92587TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92587TC,BCBSND Base Physician Payment Schedule,7.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92587,Not in chargemaster,92587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92587,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92586,Not in chargemaster,92586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92586,BCBSND Base Physician Payment Schedule,196.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9258526,Not in chargemaster,92585,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9258526,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92585TC,Not in chargemaster,92585TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92585TC,BCBSND Base Physician Payment Schedule,224.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92585,Not in chargemaster,92585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92585,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92584,Not in chargemaster,92584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92584,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92583,Not in chargemaster,92583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92583,BCBSND Base Physician Payment Schedule,99.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92582,Not in chargemaster,92582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92582,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92579,Not in chargemaster,92579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92579,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92577,Not in chargemaster,92577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92577,BCBSND Base Physician Payment Schedule,28.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92576,Not in chargemaster,92576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92576,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92575,Not in chargemaster,92575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92575,BCBSND Base Physician Payment Schedule,135.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92572,Not in chargemaster,92572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92572,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92571,Not in chargemaster,92571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92571,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92570,Not in chargemaster,92570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92570,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92568,Not in chargemaster,92568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92568,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92567,92567,92567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92567,BCBSND Base Physician Payment Schedule,33.03,22.01,Fee schedule,,22.01,22.01,22.01,22.01,,,0
unity,Fee schedule,Non-facility 92565,Not in chargemaster,92565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92565,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92564,Not in chargemaster,92564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92564,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92563,Not in chargemaster,92563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92563,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92562,Not in chargemaster,92562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92562,BCBSND Base Physician Payment Schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92561,Not in chargemaster,92561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92561,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92558,Not in chargemaster,92558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92558,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92559,Not in chargemaster,92559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92559,BCBSND Base Physician Payment Schedule,46.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92560,Not in chargemaster,92560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92560,BCBSND Base Physician Payment Schedule,87.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92557,Not in chargemaster,92557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92557,BCBSND Base Physician Payment Schedule,79.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92556,Not in chargemaster,92556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92556,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92555,Not in chargemaster,92555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92555,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92553,Not in chargemaster,92553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92553,BCBSND Base Physician Payment Schedule,79.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92552,Not in chargemaster,92552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92552,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92551,Not in chargemaster,92551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92551,BCBSND Base Physician Payment Schedule,24.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92550,Not in chargemaster,92550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92550,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92549,Not in chargemaster,92549,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92549,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9254926,Not in chargemaster,92549,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9254926,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92549TC,Not in chargemaster,92549TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92549TC,BCBSND Base Physician Payment Schedule,38.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9254826,Not in chargemaster,92548,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9254826,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92548TC,Not in chargemaster,92548TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92548TC,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92548,Not in chargemaster,92548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92548,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92547,Not in chargemaster,92547,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92547,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9254626,Not in chargemaster,92546,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9254626,BCBSND Base Physician Payment Schedule,31.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92546TC,Not in chargemaster,92546TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92546TC,BCBSND Base Physician Payment Schedule,199.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92546,Not in chargemaster,92546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92546,BCBSND Base Physician Payment Schedule,231.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92545,Not in chargemaster,92545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92545,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9254526,Not in chargemaster,92545,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9254526,BCBSND Base Physician Payment Schedule,27.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92545TC,Not in chargemaster,92545TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92545TC,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9254426,Not in chargemaster,92544,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9254426,BCBSND Base Physician Payment Schedule,30.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92544TC,Not in chargemaster,92544TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92544TC,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92544,Not in chargemaster,92544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92544,BCBSND Base Physician Payment Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92542,Not in chargemaster,92542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92542,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9254226,Not in chargemaster,92542,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9254226,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92542TC,Not in chargemaster,92542TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92542TC,BCBSND Base Physician Payment Schedule,8.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9254126,Not in chargemaster,92541,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9254126,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92541TC,Not in chargemaster,92541TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92541TC,BCBSND Base Physician Payment Schedule,8.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92541,Not in chargemaster,92541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92541,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92540,Not in chargemaster,92540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92540,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9254026,Not in chargemaster,92540,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9254026,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92540TC,Not in chargemaster,92540TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92540TC,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9253826,Not in chargemaster,92538,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9253826,BCBSND Base Physician Payment Schedule,33.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92538TC,Not in chargemaster,92538TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92538TC,BCBSND Base Physician Payment Schedule,13.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92538,Not in chargemaster,92538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92538,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92537,Not in chargemaster,92537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92537,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 9253726,Not in chargemaster,92537,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,9253726,BCBSND Base Physician Payment Schedule,66.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92537TC,Not in chargemaster,92537TC,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92537TC,BCBSND Base Physician Payment Schedule,20.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92526,Not in chargemaster,92526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92526,BCBSND Base Physician Payment Schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92531,Not in chargemaster,92531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92531,BCBSND Base Physician Payment Schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92532,Not in chargemaster,92532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92532,BCBSND Base Physician Payment Schedule,86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92533,Not in chargemaster,92533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92533,BCBSND Base Physician Payment Schedule,135.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92534,Not in chargemaster,92534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92534,BCBSND Base Physician Payment Schedule,51.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92524,Not in chargemaster,92524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92524,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92523,Not in chargemaster,92523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92523,BCBSND Base Physician Payment Schedule,403.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92522,Not in chargemaster,92522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92522,BCBSND Base Physician Payment Schedule,192.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92521,Not in chargemaster,92521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92521,BCBSND Base Physician Payment Schedule,235.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92520,Not in chargemaster,92520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92520,BCBSND Base Physician Payment Schedule,167.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92516,Not in chargemaster,92516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92516,BCBSND Base Physician Payment Schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92512,Not in chargemaster,92512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92512,BCBSND Base Physician Payment Schedule,124.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92511,Not in chargemaster,92511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92511,BCBSND Base Physician Payment Schedule,233.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92508,Not in chargemaster,92508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92508,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92507,Not in chargemaster,92507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92507,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92504,Not in chargemaster,92504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92504,BCBSND Base Physician Payment Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92502,Not in chargemaster,92502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92502,BCBSND Base Physician Payment Schedule,197.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92371,Not in chargemaster,92371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92371,BCBSND Base Physician Payment Schedule,23.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92370,Not in chargemaster,92370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92370,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92358,Not in chargemaster,92358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92358,BCBSND Base Physician Payment Schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92355,Not in chargemaster,92355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92355,BCBSND Base Physician Payment Schedule,42.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92354,Not in chargemaster,92354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92354,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 92353,Not in chargemaster,92353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92353,BCBSND Base Physician Payment Schedule,105.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4206,Not in chargemaster,A4206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4206,BCBSND Base HME Schedule,0.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4207,Not in chargemaster,A4207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4207,BCBSND Base HME Schedule,0.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4208,Not in chargemaster,A4208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4208,BCBSND Base HME Schedule,0.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4209,Not in chargemaster,A4209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4209,BCBSND Base HME Schedule,0.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4210,Not in chargemaster,A4210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4210,BCBSND Base HME Schedule,262.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4211,Not in chargemaster,A4211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4211,BCBSND Base HME Schedule,46.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4212,Not in chargemaster,A4212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4212,BCBSND Base HME Schedule,14.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4213,Not in chargemaster,A4213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4213,BCBSND Base HME Schedule,0.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4215,Not in chargemaster,A4215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4215,BCBSND Base HME Schedule,0.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4216,Not in chargemaster,A4216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4216,BCBSND Base HME Schedule,0.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4217,Not in chargemaster,A4217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4217,BCBSND Base HME Schedule,3.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4218,Not in chargemaster,A4218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4218,BCBSND Base HME Schedule,0.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4220,Not in chargemaster,A4220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4220,BCBSND Base HME Schedule,114.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4221,Not in chargemaster,A4221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4221,BCBSND Base HME Schedule,24.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4222,Not in chargemaster,A4222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4222,BCBSND Base HME Schedule,46.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4223,Not in chargemaster,A4223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4223,BCBSND Base HME Schedule,46.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4224,Not in chargemaster,A4224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4224,BCBSND Base HME Schedule,24.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4225,Not in chargemaster,A4225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4225,BCBSND Base HME Schedule,3.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4230,Not in chargemaster,A4230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4230,BCBSND Base HME Schedule,18.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4231,Not in chargemaster,A4231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4231,BCBSND Base HME Schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4232,Not in chargemaster,A4232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4232,BCBSND Base HME Schedule,4.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4233,Not in chargemaster,A4233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4233,BCBSND Base HME Schedule,0.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4234,Not in chargemaster,A4234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4234,BCBSND Base HME Schedule,2.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4235,Not in chargemaster,A4235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4235,BCBSND Base HME Schedule,1.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4236,Not in chargemaster,A4236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4236,BCBSND Base HME Schedule,1.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4244,Not in chargemaster,A4244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4244,BCBSND Base HME Schedule,1.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4245,Not in chargemaster,A4245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4245,BCBSND Base HME Schedule,4.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4246,Not in chargemaster,A4246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4246,BCBSND Base HME Schedule,17.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4247,Not in chargemaster,A4247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4247,BCBSND Base HME Schedule,7.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4248,Not in chargemaster,A4248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4248,BCBSND Base HME Schedule,17.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4250,Not in chargemaster,A4250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4250,BCBSND Base HME Schedule,36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4252,Not in chargemaster,A4252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4252,BCBSND Base HME Schedule,1.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4253,Not in chargemaster,A4253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4253,BCBSND Base HME Schedule,28.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4255,Not in chargemaster,A4255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4255,BCBSND Base HME Schedule,5.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4256,Not in chargemaster,A4256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4256,BCBSND Base HME Schedule,3.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4257,Not in chargemaster,A4257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4257,BCBSND Base HME Schedule,16.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4258,Not in chargemaster,A4258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4258,BCBSND Base HME Schedule,2.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4259,Not in chargemaster,A4259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4259,BCBSND Base HME Schedule,1.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4265,Not in chargemaster,A4265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4265,BCBSND Base HME Schedule,4.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4280,Not in chargemaster,A4280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4280,BCBSND Base HME Schedule,6.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4290,Not in chargemaster,A4290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4290,BCBSND Base HME Schedule,229.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4300,Not in chargemaster,A4300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4300,BCBSND Base HME Schedule,31.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4305,Not in chargemaster,A4305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4305,BCBSND Base HME Schedule,329.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4306,Not in chargemaster,A4306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4306,BCBSND Base HME Schedule,329.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4310,Not in chargemaster,A4310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4310,BCBSND Base HME Schedule,9.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4311,Not in chargemaster,A4311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4311,BCBSND Base HME Schedule,18.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4312,Not in chargemaster,A4312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4312,BCBSND Base HME Schedule,20.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4313,Not in chargemaster,A4313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4313,BCBSND Base HME Schedule,20.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4314,Not in chargemaster,A4314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4314,BCBSND Base HME Schedule,32.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4315,Not in chargemaster,A4315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4315,BCBSND Base HME Schedule,33.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4316,Not in chargemaster,A4316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4316,BCBSND Base HME Schedule,35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4320,Not in chargemaster,A4320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4320,BCBSND Base HME Schedule,6.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4321,Not in chargemaster,A4321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4321,BCBSND Base HME Schedule,9.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4322,Not in chargemaster,A4322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4322,BCBSND Base HME Schedule,3.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4326,Not in chargemaster,A4326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4326,BCBSND Base HME Schedule,12.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4327,Not in chargemaster,A4327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4327,BCBSND Base HME Schedule,57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4328,Not in chargemaster,A4328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4328,BCBSND Base HME Schedule,13.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4330,Not in chargemaster,A4330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4330,BCBSND Base HME Schedule,9.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4331,Not in chargemaster,A4331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4331,BCBSND Base HME Schedule,4.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4332,Not in chargemaster,A4332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4332,BCBSND Base HME Schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4333,Not in chargemaster,A4333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4333,BCBSND Base HME Schedule,2.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4334,Not in chargemaster,A4334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4334,BCBSND Base HME Schedule,6.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4335,Not in chargemaster,A4335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4335,BCBSND Base HME Schedule,2.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4336,Not in chargemaster,A4336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4336,BCBSND Base HME Schedule,1.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4338,Not in chargemaster,A4338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4338,BCBSND Base HME Schedule,15.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4340,Not in chargemaster,A4340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4340,BCBSND Base HME Schedule,40.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4344,Not in chargemaster,A4344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4344,BCBSND Base HME Schedule,20.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4346,Not in chargemaster,A4346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4346,BCBSND Base HME Schedule,25.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4349,Not in chargemaster,A4349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4349,BCBSND Base HME Schedule,2.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4351,Not in chargemaster,A4351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4351,BCBSND Base HME Schedule,1.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4352,Not in chargemaster,A4352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4352,BCBSND Base HME Schedule,6.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4353,Not in chargemaster,A4353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4353,BCBSND Base HME Schedule,8.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4354,Not in chargemaster,A4354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4354,BCBSND Base HME Schedule,12.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4355,Not in chargemaster,A4355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4355,BCBSND Base HME Schedule,9.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4356,Not in chargemaster,A4356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4356,BCBSND Base HME Schedule,58.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4357,Not in chargemaster,A4357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4357,BCBSND Base HME Schedule,12.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4358,Not in chargemaster,A4358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4358,BCBSND Base HME Schedule,8.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4360,Not in chargemaster,A4360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4360,BCBSND Base HME Schedule,0.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4361,Not in chargemaster,A4361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4361,BCBSND Base HME Schedule,23.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4362,Not in chargemaster,A4362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4362,BCBSND Base HME Schedule,4.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4363,Not in chargemaster,A4363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4363,BCBSND Base HME Schedule,2.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4364,Not in chargemaster,A4364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4364,BCBSND Base HME Schedule,3.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4366,Not in chargemaster,A4366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4366,BCBSND Base HME Schedule,1.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4367,Not in chargemaster,A4367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4367,BCBSND Base HME Schedule,9.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4368,Not in chargemaster,A4368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4368,BCBSND Base HME Schedule,0.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4369,Not in chargemaster,A4369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4369,BCBSND Base HME Schedule,2.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4371,Not in chargemaster,A4371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4371,BCBSND Base HME Schedule,4.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4372,Not in chargemaster,A4372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4372,BCBSND Base HME Schedule,5.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4373,Not in chargemaster,A4373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4373,BCBSND Base HME Schedule,8.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4375,Not in chargemaster,A4375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4375,BCBSND Base HME Schedule,21.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4376,Not in chargemaster,A4376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4376,BCBSND Base HME Schedule,60.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4377,Not in chargemaster,A4377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4377,BCBSND Base HME Schedule,5.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4378,Not in chargemaster,A4378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4378,BCBSND Base HME Schedule,39.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4379,Not in chargemaster,A4379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4379,BCBSND Base HME Schedule,19.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4380,Not in chargemaster,A4380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4380,BCBSND Base HME Schedule,47.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4381,Not in chargemaster,A4381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4381,BCBSND Base HME Schedule,5.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4382,Not in chargemaster,A4382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4382,BCBSND Base HME Schedule,31.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4383,Not in chargemaster,A4383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4383,BCBSND Base HME Schedule,36.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4384,Not in chargemaster,A4384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4384,BCBSND Base HME Schedule,12.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4385,Not in chargemaster,A4385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4385,BCBSND Base HME Schedule,6.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4387,Not in chargemaster,A4387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4387,BCBSND Base HME Schedule,2.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4388,Not in chargemaster,A4388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4388,BCBSND Base HME Schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4389,Not in chargemaster,A4389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4389,BCBSND Base HME Schedule,7.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4390,Not in chargemaster,A4390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4390,BCBSND Base HME Schedule,12.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4391,Not in chargemaster,A4391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4391,BCBSND Base HME Schedule,9.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4392,Not in chargemaster,A4392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4392,BCBSND Base HME Schedule,10.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4393,Not in chargemaster,A4393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4393,BCBSND Base HME Schedule,11.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4394,Not in chargemaster,A4394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4394,BCBSND Base HME Schedule,3.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4395,Not in chargemaster,A4395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4395,BCBSND Base HME Schedule,0.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4396,Not in chargemaster,A4396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4396,BCBSND Base HME Schedule,51.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4397,Not in chargemaster,A4397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4397,BCBSND Base HME Schedule,6.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4398,Not in chargemaster,A4398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4398,BCBSND Base HME Schedule,16.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4399,Not in chargemaster,A4399,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4399,BCBSND Base HME Schedule,15.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4400,Not in chargemaster,A4400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4400,BCBSND Base HME Schedule,62.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4402,Not in chargemaster,A4402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4402,BCBSND Base HME Schedule,2.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4404,Not in chargemaster,A4404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4404,BCBSND Base HME Schedule,2.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4405,Not in chargemaster,A4405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4405,BCBSND Base HME Schedule,4.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4406,Not in chargemaster,A4406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4406,BCBSND Base HME Schedule,7.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4407,Not in chargemaster,A4407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4407,BCBSND Base HME Schedule,11.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4408,Not in chargemaster,A4408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4408,BCBSND Base HME Schedule,12.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4409,Not in chargemaster,A4409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4409,BCBSND Base HME Schedule,7.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4410,Not in chargemaster,A4410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4410,BCBSND Base HME Schedule,11.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4411,Not in chargemaster,A4411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4411,BCBSND Base HME Schedule,6.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4412,Not in chargemaster,A4412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4412,BCBSND Base HME Schedule,3.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4413,Not in chargemaster,A4413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4413,BCBSND Base HME Schedule,7.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4414,Not in chargemaster,A4414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4414,BCBSND Base HME Schedule,6.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4415,Not in chargemaster,A4415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4415,BCBSND Base HME Schedule,7.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4416,Not in chargemaster,A4416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4416,BCBSND Base HME Schedule,3.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4417,Not in chargemaster,A4417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4417,BCBSND Base HME Schedule,4.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4418,Not in chargemaster,A4418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4418,BCBSND Base HME Schedule,2.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4419,Not in chargemaster,A4419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4419,BCBSND Base HME Schedule,2.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4421,Not in chargemaster,A4421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4421,BCBSND Base HME Schedule,1.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4422,Not in chargemaster,A4422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4422,BCBSND Base HME Schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4423,Not in chargemaster,A4423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4423,BCBSND Base HME Schedule,2.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4424,Not in chargemaster,A4424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4424,BCBSND Base HME Schedule,6.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4425,Not in chargemaster,A4425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4425,BCBSND Base HME Schedule,4.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4426,Not in chargemaster,A4426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4426,BCBSND Base HME Schedule,3.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4427,Not in chargemaster,A4427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4427,BCBSND Base HME Schedule,3.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4428,Not in chargemaster,A4428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4428,BCBSND Base HME Schedule,8.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4429,Not in chargemaster,A4429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4429,BCBSND Base HME Schedule,10.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4430,Not in chargemaster,A4430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4430,BCBSND Base HME Schedule,10.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4431,Not in chargemaster,A4431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4431,BCBSND Base HME Schedule,7.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4432,Not in chargemaster,A4432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4432,BCBSND Base HME Schedule,4.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4433,Not in chargemaster,A4433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4433,BCBSND Base HME Schedule,4.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4434,Not in chargemaster,A4434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4434,BCBSND Base HME Schedule,4.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4435,Not in chargemaster,A4435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4435,BCBSND Base HME Schedule,7.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4450,Not in chargemaster,A4450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4450,BCBSND Base HME Schedule,0.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4452,Not in chargemaster,A4452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4452,BCBSND Base HME Schedule,0.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4455,Not in chargemaster,A4455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4455,BCBSND Base HME Schedule,1.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4456,Not in chargemaster,A4456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4456,BCBSND Base HME Schedule,0.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4461,Not in chargemaster,A4461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4461,BCBSND Base HME Schedule,4.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4463,Not in chargemaster,A4463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4463,BCBSND Base HME Schedule,17.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4465,Not in chargemaster,A4465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4465,BCBSND Base HME Schedule,26.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4481,Not in chargemaster,A4481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4481,BCBSND Base HME Schedule,0.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4483,Not in chargemaster,A4483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4483,BCBSND Base HME Schedule,9.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4490,Not in chargemaster,A4490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4490,BCBSND Base HME Schedule,37.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4495,Not in chargemaster,A4495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4495,BCBSND Base HME Schedule,25.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4500,Not in chargemaster,A4500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4500,BCBSND Base HME Schedule,19.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4510,Not in chargemaster,A4510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4510,BCBSND Base HME Schedule,47.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4520,Not in chargemaster,A4520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4520,BCBSND Base HME Schedule,2.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4554,Not in chargemaster,A4554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4554,BCBSND Base HME Schedule,0.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4556,Not in chargemaster,A4556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4556,BCBSND Base HME Schedule,15.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4557,Not in chargemaster,A4557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4557,BCBSND Base HME Schedule,14.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4558,Not in chargemaster,A4558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4558,BCBSND Base HME Schedule,5.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4559,Not in chargemaster,A4559,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4559,BCBSND Base HME Schedule,0.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4561,Not in chargemaster,A4561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4561,BCBSND Base HME Schedule,26.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4562,Not in chargemaster,A4562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4562,BCBSND Base HME Schedule,65.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4563,Not in chargemaster,A4563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4563,BCBSND Base HME Schedule,143.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4565,Not in chargemaster,A4565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4565,BCBSND Base HME Schedule,9.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4566,Not in chargemaster,A4566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4566,BCBSND Base HME Schedule,137.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4570,Not in chargemaster,A4570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4570,BCBSND Base HME Schedule,25.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4580,Not in chargemaster,A4580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4580,BCBSND Base HME Schedule,114.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4590,Not in chargemaster,A4590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4590,BCBSND Base HME Schedule,170.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4595,Not in chargemaster,A4595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4595,BCBSND Base HME Schedule,17.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4601,Not in chargemaster,A4601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4601,BCBSND Base HME Schedule,450.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4602,Not in chargemaster,A4602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4602,BCBSND Base HME Schedule,4.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4604,Not in chargemaster,A4604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4604,BCBSND Base HME Schedule,50.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4605,Not in chargemaster,A4605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4605,BCBSND Base HME Schedule,20.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4606,Not in chargemaster,A4606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4606,BCBSND Base HME Schedule,58.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4608,Not in chargemaster,A4608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4608,BCBSND Base HME Schedule,64.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4611,Not in chargemaster,A4611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4611,BCBSND Base HME Schedule,285.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4612,Not in chargemaster,A4612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4612,BCBSND Base HME Schedule,116.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4613,Not in chargemaster,A4613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4613,BCBSND Base HME Schedule,178.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4614,Not in chargemaster,A4614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4614,BCBSND Base HME Schedule,30.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4615,Not in chargemaster,A4615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4615,BCBSND Base HME Schedule,0.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4616,Not in chargemaster,A4616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4616,BCBSND Base HME Schedule,0.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4617,Not in chargemaster,A4617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4617,BCBSND Base HME Schedule,3.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4618,Not in chargemaster,A4618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4618,BCBSND Base HME Schedule,11.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4618-RR,Not in chargemaster,A4618-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4618-RR,BCBSND Base HME Schedule,1.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4619,Not in chargemaster,A4619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4619,BCBSND Base HME Schedule,2.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4620,Not in chargemaster,A4620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4620,BCBSND Base HME Schedule,0.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4623,Not in chargemaster,A4623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4623,BCBSND Base HME Schedule,8.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4624,Not in chargemaster,A4624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4624,BCBSND Base HME Schedule,2.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4625,Not in chargemaster,A4625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4625,BCBSND Base HME Schedule,7.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4626,Not in chargemaster,A4626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4626,BCBSND Base HME Schedule,3.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4627,Not in chargemaster,A4627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4627,BCBSND Base HME Schedule,16.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4628,Not in chargemaster,A4628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4628,BCBSND Base HME Schedule,4.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4629,Not in chargemaster,A4629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4629,BCBSND Base HME Schedule,5.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4630,Not in chargemaster,A4630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4630,BCBSND Base HME Schedule,7.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4633,Not in chargemaster,A4633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4633,BCBSND Base HME Schedule,52.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4635,Not in chargemaster,A4635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4635,BCBSND Base HME Schedule,6.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4635-RR,Not in chargemaster,A4635-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4635-RR,BCBSND Base HME Schedule,0.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4636,Not in chargemaster,A4636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4636,BCBSND Base HME Schedule,3.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4636-RR,Not in chargemaster,A4636-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4636-RR,BCBSND Base HME Schedule,0.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4637,Not in chargemaster,A4637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4637,BCBSND Base HME Schedule,2.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4637-RR,Not in chargemaster,A4637-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4637-RR,BCBSND Base HME Schedule,0.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4639-RR,Not in chargemaster,A4639-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4639-RR,BCBSND Base HME Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4640,Not in chargemaster,A4640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4640,BCBSND Base HME Schedule,64.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4640-RR,Not in chargemaster,A4640-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4640-RR,BCBSND Base HME Schedule,6.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4650,Not in chargemaster,A4650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4650,BCBSND Base HME Schedule,153.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4657,Not in chargemaster,A4657,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4657,BCBSND Base HME Schedule,0.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4660,Not in chargemaster,A4660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4660,BCBSND Base HME Schedule,76.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4663,Not in chargemaster,A4663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4663,BCBSND Base HME Schedule,41.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4670,Not in chargemaster,A4670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4670,BCBSND Base HME Schedule,111.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4770,Not in chargemaster,A4770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4770,BCBSND Base HME Schedule,72.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4772,Not in chargemaster,A4772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4772,BCBSND Base HME Schedule,55.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4773,Not in chargemaster,A4773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4773,BCBSND Base HME Schedule,24.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4860,Not in chargemaster,A4860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4860,BCBSND Base HME Schedule,4.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4911,Not in chargemaster,A4911,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4911,BCBSND Base HME Schedule,84.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4913,Not in chargemaster,A4913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4913,BCBSND Base HME Schedule,7.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A4927,Not in chargemaster,A4927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A4927,BCBSND Base HME Schedule,16.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5051,Not in chargemaster,A5051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5051,BCBSND Base HME Schedule,2.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5052,Not in chargemaster,A5052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5052,BCBSND Base HME Schedule,1.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5053,Not in chargemaster,A5053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5053,BCBSND Base HME Schedule,1.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5054,Not in chargemaster,A5054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5054,BCBSND Base HME Schedule,2.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5055,Not in chargemaster,A5055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5055,BCBSND Base HME Schedule,1.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5056,Not in chargemaster,A5056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5056,BCBSND Base HME Schedule,5.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5057,Not in chargemaster,A5057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5057,BCBSND Base HME Schedule,12.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5061,Not in chargemaster,A5061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5061,BCBSND Base HME Schedule,4.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5062,Not in chargemaster,A5062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5062,BCBSND Base HME Schedule,2.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5063,Not in chargemaster,A5063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5063,BCBSND Base HME Schedule,3.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5071,Not in chargemaster,A5071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5071,BCBSND Base HME Schedule,7.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5072,Not in chargemaster,A5072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5072,BCBSND Base HME Schedule,4.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5073,Not in chargemaster,A5073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5073,BCBSND Base HME Schedule,4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5081,Not in chargemaster,A5081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5081,BCBSND Base HME Schedule,3.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5082,Not in chargemaster,A5082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5082,BCBSND Base HME Schedule,15.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5083,Not in chargemaster,A5083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5083,BCBSND Base HME Schedule,0.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5093,Not in chargemaster,A5093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5093,BCBSND Base HME Schedule,2.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5102,Not in chargemaster,A5102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5102,BCBSND Base HME Schedule,28.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5105,Not in chargemaster,A5105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5105,BCBSND Base HME Schedule,51.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5112,Not in chargemaster,A5112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5112,BCBSND Base HME Schedule,44.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5113,Not in chargemaster,A5113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5113,BCBSND Base HME Schedule,5.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5114,Not in chargemaster,A5114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5114,BCBSND Base HME Schedule,11.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5120,Not in chargemaster,A5120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5120,BCBSND Base HME Schedule,0.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5121,Not in chargemaster,A5121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5121,BCBSND Base HME Schedule,9.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5122,Not in chargemaster,A5122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5122,BCBSND Base HME Schedule,16.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5126,Not in chargemaster,A5126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5126,BCBSND Base HME Schedule,1.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5131,Not in chargemaster,A5131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5131,BCBSND Base HME Schedule,20.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5200,Not in chargemaster,A5200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5200,BCBSND Base HME Schedule,14.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5500,Not in chargemaster,A5500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5500,BCBSND Base HME Schedule,81.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5501,Not in chargemaster,A5501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5501,BCBSND Base HME Schedule,243.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5503,Not in chargemaster,A5503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5503,BCBSND Base HME Schedule,39.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5504,Not in chargemaster,A5504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5504,BCBSND Base HME Schedule,39.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5505,Not in chargemaster,A5505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5505,BCBSND Base HME Schedule,39.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5506,Not in chargemaster,A5506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5506,BCBSND Base HME Schedule,39.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5507,Not in chargemaster,A5507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5507,BCBSND Base HME Schedule,39.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5512,Not in chargemaster,A5512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5512,BCBSND Base HME Schedule,33.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5513,Not in chargemaster,A5513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5513,BCBSND Base HME Schedule,49.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A5514,Not in chargemaster,A5514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A5514,BCBSND Base HME Schedule,49.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6010,Not in chargemaster,A6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6010,BCBSND Base HME Schedule,39.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6011,Not in chargemaster,A6011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6011,BCBSND Base HME Schedule,2.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6021,Not in chargemaster,A6021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6021,BCBSND Base HME Schedule,26.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6022,Not in chargemaster,A6022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6022,BCBSND Base HME Schedule,26.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6023,Not in chargemaster,A6023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6023,BCBSND Base HME Schedule,243.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6024,Not in chargemaster,A6024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6024,BCBSND Base HME Schedule,7.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6025,Not in chargemaster,A6025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6025,BCBSND Base HME Schedule,111.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6154,Not in chargemaster,A6154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6154,BCBSND Base HME Schedule,18.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6196,Not in chargemaster,A6196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6196,BCBSND Base HME Schedule,9.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6197,Not in chargemaster,A6197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6197,BCBSND Base HME Schedule,21.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6198,Not in chargemaster,A6198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6198,BCBSND Base HME Schedule,12.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6199,Not in chargemaster,A6199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6199,BCBSND Base HME Schedule,6.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6203,Not in chargemaster,A6203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6203,BCBSND Base HME Schedule,4.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6204,Not in chargemaster,A6204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6204,BCBSND Base HME Schedule,7.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6207,Not in chargemaster,A6207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6207,BCBSND Base HME Schedule,9.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6209,Not in chargemaster,A6209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6209,BCBSND Base HME Schedule,9.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6210,Not in chargemaster,A6210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6210,BCBSND Base HME Schedule,25.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6211,Not in chargemaster,A6211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6211,BCBSND Base HME Schedule,37.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6212,Not in chargemaster,A6212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6212,BCBSND Base HME Schedule,12.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6213,Not in chargemaster,A6213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6213,BCBSND Base HME Schedule,10.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6214,Not in chargemaster,A6214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6214,BCBSND Base HME Schedule,13.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6216,Not in chargemaster,A6216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6216,BCBSND Base HME Schedule,0.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6217,Not in chargemaster,A6217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6217,BCBSND Base HME Schedule,0.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6219,Not in chargemaster,A6219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6219,BCBSND Base HME Schedule,1.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6220,Not in chargemaster,A6220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6220,BCBSND Base HME Schedule,3.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6222,Not in chargemaster,A6222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6222,BCBSND Base HME Schedule,2.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6223,Not in chargemaster,A6223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6223,BCBSND Base HME Schedule,3.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6224,Not in chargemaster,A6224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6224,BCBSND Base HME Schedule,4.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6229,Not in chargemaster,A6229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6229,BCBSND Base HME Schedule,4.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6231,Not in chargemaster,A6231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6231,BCBSND Base HME Schedule,6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6232,Not in chargemaster,A6232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6232,BCBSND Base HME Schedule,8.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6233,Not in chargemaster,A6233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6233,BCBSND Base HME Schedule,24.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6234,Not in chargemaster,A6234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6234,BCBSND Base HME Schedule,8.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6235,Not in chargemaster,A6235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6235,BCBSND Base HME Schedule,21.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6236,Not in chargemaster,A6236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6236,BCBSND Base HME Schedule,34.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6237,Not in chargemaster,A6237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6237,BCBSND Base HME Schedule,10.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6238,Not in chargemaster,A6238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6238,BCBSND Base HME Schedule,29.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6239,Not in chargemaster,A6239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6239,BCBSND Base HME Schedule,1.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6240,Not in chargemaster,A6240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6240,BCBSND Base HME Schedule,15.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6241,Not in chargemaster,A6241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6241,BCBSND Base HME Schedule,3.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6242,Not in chargemaster,A6242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6242,BCBSND Base HME Schedule,7.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6243,Not in chargemaster,A6243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6243,BCBSND Base HME Schedule,15.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6244,Not in chargemaster,A6244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6244,BCBSND Base HME Schedule,50.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6245,Not in chargemaster,A6245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6245,BCBSND Base HME Schedule,9.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6246,Not in chargemaster,A6246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6246,BCBSND Base HME Schedule,12.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6247,Not in chargemaster,A6247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6247,BCBSND Base HME Schedule,30.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6248,Not in chargemaster,A6248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6248,BCBSND Base HME Schedule,20.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6250,Not in chargemaster,A6250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6250,BCBSND Base HME Schedule,7.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6251,Not in chargemaster,A6251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6251,BCBSND Base HME Schedule,2.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6252,Not in chargemaster,A6252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6252,BCBSND Base HME Schedule,4.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6253,Not in chargemaster,A6253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6253,BCBSND Base HME Schedule,8.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6254,Not in chargemaster,A6254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6254,BCBSND Base HME Schedule,1.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6255,Not in chargemaster,A6255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6255,BCBSND Base HME Schedule,3.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6257,Not in chargemaster,A6257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6257,BCBSND Base HME Schedule,1.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6258,Not in chargemaster,A6258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6258,BCBSND Base HME Schedule,5.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6259,Not in chargemaster,A6259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6259,BCBSND Base HME Schedule,13.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6260,Not in chargemaster,A6260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6260,BCBSND Base HME Schedule,0.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6262,Not in chargemaster,A6262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6262,BCBSND Base HME Schedule,3.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6266,Not in chargemaster,A6266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6266,BCBSND Base HME Schedule,2.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6402,Not in chargemaster,A6402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6402,BCBSND Base HME Schedule,0.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6403,Not in chargemaster,A6403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6403,BCBSND Base HME Schedule,0.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6407,Not in chargemaster,A6407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6407,BCBSND Base HME Schedule,2.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6410,Not in chargemaster,A6410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6410,BCBSND Base HME Schedule,0.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6413,Not in chargemaster,A6413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6413,BCBSND Base HME Schedule,0.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6441,Not in chargemaster,A6441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6441,BCBSND Base HME Schedule,0.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6442,Not in chargemaster,A6442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6442,BCBSND Base HME Schedule,0.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6443,Not in chargemaster,A6443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6443,BCBSND Base HME Schedule,0.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6444,Not in chargemaster,A6444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6444,BCBSND Base HME Schedule,0.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6445,Not in chargemaster,A6445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6445,BCBSND Base HME Schedule,0.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6446,Not in chargemaster,A6446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6446,BCBSND Base HME Schedule,0.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6447,Not in chargemaster,A6447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6447,BCBSND Base HME Schedule,0.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6448,Not in chargemaster,A6448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6448,BCBSND Base HME Schedule,1.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6449,Not in chargemaster,A6449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6449,BCBSND Base HME Schedule,2.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6450,Not in chargemaster,A6450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6450,BCBSND Base HME Schedule,2.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6451,Not in chargemaster,A6451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6451,BCBSND Base HME Schedule,2.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6452,Not in chargemaster,A6452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6452,BCBSND Base HME Schedule,7.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6453,Not in chargemaster,A6453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6453,BCBSND Base HME Schedule,0.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6454,Not in chargemaster,A6454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6454,BCBSND Base HME Schedule,1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6455,Not in chargemaster,A6455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6455,BCBSND Base HME Schedule,1.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6456,Not in chargemaster,A6456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6456,BCBSND Base HME Schedule,1.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6457,Not in chargemaster,A6457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6457,BCBSND Base HME Schedule,1.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6530,Not in chargemaster,A6530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6530,BCBSND Base HME Schedule,39.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6531,Not in chargemaster,A6531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6531,BCBSND Base HME Schedule,55.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6532,Not in chargemaster,A6532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6532,BCBSND Base HME Schedule,77.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6533,Not in chargemaster,A6533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6533,BCBSND Base HME Schedule,61.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6534,Not in chargemaster,A6534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6534,BCBSND Base HME Schedule,51.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6535,Not in chargemaster,A6535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6535,BCBSND Base HME Schedule,118.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6536,Not in chargemaster,A6536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6536,BCBSND Base HME Schedule,99.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6537,Not in chargemaster,A6537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6537,BCBSND Base HME Schedule,143.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6538,Not in chargemaster,A6538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6538,BCBSND Base HME Schedule,314.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6539,Not in chargemaster,A6539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6539,BCBSND Base HME Schedule,48.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6540,Not in chargemaster,A6540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6540,BCBSND Base HME Schedule,83.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6541,Not in chargemaster,A6541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6541,BCBSND Base HME Schedule,286.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6544,Not in chargemaster,A6544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6544,BCBSND Base HME Schedule,19.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6545,Not in chargemaster,A6545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6545,BCBSND Base HME Schedule,108.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A6550,Not in chargemaster,A6550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A6550,BCBSND Base HME Schedule,28.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7000,Not in chargemaster,A7000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7000,BCBSND Base HME Schedule,9.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7001,Not in chargemaster,A7001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7001,BCBSND Base HME Schedule,51.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7002,Not in chargemaster,A7002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7002,BCBSND Base HME Schedule,4.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7003,Not in chargemaster,A7003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7003,BCBSND Base HME Schedule,2.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7004,Not in chargemaster,A7004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7004,BCBSND Base HME Schedule,1.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7005,Not in chargemaster,A7005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7005,BCBSND Base HME Schedule,19.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7006,Not in chargemaster,A7006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7006,BCBSND Base HME Schedule,8.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7007,Not in chargemaster,A7007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7007,BCBSND Base HME Schedule,3.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7008,Not in chargemaster,A7008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7008,BCBSND Base HME Schedule,14.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7009,Not in chargemaster,A7009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7009,BCBSND Base HME Schedule,53.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7010,Not in chargemaster,A7010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7010,BCBSND Base HME Schedule,19.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7012,Not in chargemaster,A7012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7012,BCBSND Base HME Schedule,3.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7013,Not in chargemaster,A7013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7013,BCBSND Base HME Schedule,0.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7014,Not in chargemaster,A7014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7014,BCBSND Base HME Schedule,4.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7015,Not in chargemaster,A7015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7015,BCBSND Base HME Schedule,1.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7016,Not in chargemaster,A7016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7016,BCBSND Base HME Schedule,9.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7017,Not in chargemaster,A7017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7017,BCBSND Base HME Schedule,129.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7017-RR,Not in chargemaster,A7017-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7017-RR,BCBSND Base HME Schedule,13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7018,Not in chargemaster,A7018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7018,BCBSND Base HME Schedule,0.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7020,Not in chargemaster,A7020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7020,BCBSND Base HME Schedule,18.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7025-RR,Not in chargemaster,A7025-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7025-RR,BCBSND Base HME Schedule,55.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7026,Not in chargemaster,A7026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7026,BCBSND Base HME Schedule,36.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7027,Not in chargemaster,A7027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7027,BCBSND Base HME Schedule,196.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7028,Not in chargemaster,A7028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7028,BCBSND Base HME Schedule,54.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7029,Not in chargemaster,A7029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7029,BCBSND Base HME Schedule,19.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7030,Not in chargemaster,A7030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7030,BCBSND Base HME Schedule,153.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7031,Not in chargemaster,A7031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7031,BCBSND Base HME Schedule,47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7032,Not in chargemaster,A7032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7032,BCBSND Base HME Schedule,26.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7033,Not in chargemaster,A7033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7033,BCBSND Base HME Schedule,20.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7034,Not in chargemaster,A7034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7034,BCBSND Base HME Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7035,Not in chargemaster,A7035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7035,BCBSND Base HME Schedule,26.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7036,Not in chargemaster,A7036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7036,BCBSND Base HME Schedule,13.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7037,Not in chargemaster,A7037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7037,BCBSND Base HME Schedule,20.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7038,Not in chargemaster,A7038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7038,BCBSND Base HME Schedule,3.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7039,Not in chargemaster,A7039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7039,BCBSND Base HME Schedule,9.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7040,Not in chargemaster,A7040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7040,BCBSND Base HME Schedule,52.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7041,Not in chargemaster,A7041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7041,BCBSND Base HME Schedule,98.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7044,Not in chargemaster,A7044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7044,BCBSND Base HME Schedule,100.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7045,Not in chargemaster,A7045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7045,BCBSND Base HME Schedule,14.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7045-RR,Not in chargemaster,A7045-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7045-RR,BCBSND Base HME Schedule,1.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7046,Not in chargemaster,A7046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7046,BCBSND Base HME Schedule,16.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7047,Not in chargemaster,A7047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7047,BCBSND Base HME Schedule,154.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7048,Not in chargemaster,A7048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7048,BCBSND Base HME Schedule,90,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7501,Not in chargemaster,A7501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7501,BCBSND Base HME Schedule,134.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7502,Not in chargemaster,A7502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7502,BCBSND Base HME Schedule,63.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7503,Not in chargemaster,A7503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7503,BCBSND Base HME Schedule,14.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7504,Not in chargemaster,A7504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7504,BCBSND Base HME Schedule,0.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7505,Not in chargemaster,A7505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7505,BCBSND Base HME Schedule,6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7506,Not in chargemaster,A7506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7506,BCBSND Base HME Schedule,0.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7507,Not in chargemaster,A7507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7507,BCBSND Base HME Schedule,3.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7508,Not in chargemaster,A7508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7508,BCBSND Base HME Schedule,3.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7509,Not in chargemaster,A7509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7509,BCBSND Base HME Schedule,1.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7520,Not in chargemaster,A7520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7520,BCBSND Base HME Schedule,60.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7521,Not in chargemaster,A7521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7521,BCBSND Base HME Schedule,60.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7522,Not in chargemaster,A7522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7522,BCBSND Base HME Schedule,57.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7524,Not in chargemaster,A7524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7524,BCBSND Base HME Schedule,98.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7525,Not in chargemaster,A7525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7525,BCBSND Base HME Schedule,2.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7526,Not in chargemaster,A7526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7526,BCBSND Base HME Schedule,4.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A7527,Not in chargemaster,A7527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A7527,BCBSND Base HME Schedule,4.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A8000,Not in chargemaster,A8000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A8000,BCBSND Base HME Schedule,195.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A8000-RR,Not in chargemaster,A8000-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A8000-RR,BCBSND Base HME Schedule,19.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A8001,Not in chargemaster,A8001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A8001,BCBSND Base HME Schedule,195.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A8001-RR,Not in chargemaster,A8001-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A8001-RR,BCBSND Base HME Schedule,19.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A8002,Not in chargemaster,A8002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A8002,BCBSND Base HME Schedule,232.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A8003,Not in chargemaster,A8003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A8003,BCBSND Base HME Schedule,232.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A8004,Not in chargemaster,A8004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A8004,BCBSND Base HME Schedule,232.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A9155,Not in chargemaster,A9155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A9155,BCBSND Base HME Schedule,7.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A9273,Not in chargemaster,A9273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A9273,BCBSND Base HME Schedule,13.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A9275,Not in chargemaster,A9275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A9275,BCBSND Base HME Schedule,1013.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A9276,Not in chargemaster,A9276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A9276,BCBSND Base HME Schedule,13.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A9277,Not in chargemaster,A9277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A9277,BCBSND Base HME Schedule,716.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A9278,Not in chargemaster,A9278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A9278,BCBSND Base HME Schedule,607.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A9283,Not in chargemaster,A9283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A9283,BCBSND Base HME Schedule,12.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip A9300,Not in chargemaster,A9300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,A9300,BCBSND Base HME Schedule,1.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4034,Not in chargemaster,B4034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4034,BCBSND Base HME Schedule,4.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4035,Not in chargemaster,B4035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4035,BCBSND Base HME Schedule,7.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4036,Not in chargemaster,B4036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4036,BCBSND Base HME Schedule,5.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4081,Not in chargemaster,B4081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4081,BCBSND Base HME Schedule,18.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4082,Not in chargemaster,B4082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4082,BCBSND Base HME Schedule,13.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4083,Not in chargemaster,B4083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4083,BCBSND Base HME Schedule,2.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4087,Not in chargemaster,B4087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4087,BCBSND Base HME Schedule,31.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4088,Not in chargemaster,B4088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4088,BCBSND Base HME Schedule,154.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4100,Not in chargemaster,B4100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4100,BCBSND Base HME Schedule,0.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4102,Not in chargemaster,B4102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4102,BCBSND Base HME Schedule,2.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4103,Not in chargemaster,B4103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4103,BCBSND Base HME Schedule,2.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4104,Not in chargemaster,B4104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4104,BCBSND Base HME Schedule,0.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4105,Not in chargemaster,B4105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4105,BCBSND Base HME Schedule,105,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4149,Not in chargemaster,B4149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4149,BCBSND Base HME Schedule,1.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4150,Not in chargemaster,B4150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4150,BCBSND Base HME Schedule,0.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4152,Not in chargemaster,B4152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4152,BCBSND Base HME Schedule,0.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4153,Not in chargemaster,B4153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4153,BCBSND Base HME Schedule,1.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4154,Not in chargemaster,B4154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4154,BCBSND Base HME Schedule,0.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4155,Not in chargemaster,B4155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4155,BCBSND Base HME Schedule,0.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4157,Not in chargemaster,B4157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4157,BCBSND Base HME Schedule,6.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4158,Not in chargemaster,B4158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4158,BCBSND Base HME Schedule,1.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4159,Not in chargemaster,B4159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4159,BCBSND Base HME Schedule,1.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4160,Not in chargemaster,B4160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4160,BCBSND Base HME Schedule,0.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4161,Not in chargemaster,B4161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4161,BCBSND Base HME Schedule,2.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4162,Not in chargemaster,B4162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4162,BCBSND Base HME Schedule,3.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4164,Not in chargemaster,B4164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4164,BCBSND Base HME Schedule,22.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4168,Not in chargemaster,B4168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4168,BCBSND Base HME Schedule,32.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4176,Not in chargemaster,B4176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4176,BCBSND Base HME Schedule,63.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4178,Not in chargemaster,B4178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4178,BCBSND Base HME Schedule,76.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4180,Not in chargemaster,B4180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4180,BCBSND Base HME Schedule,32.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4185,Not in chargemaster,B4185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4185,BCBSND Base HME Schedule,14.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4187,Not in chargemaster,B4187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4187,BCBSND Base HME Schedule,90.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4189,Not in chargemaster,B4189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4189,BCBSND Base HME Schedule,235.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4193,Not in chargemaster,B4193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4193,BCBSND Base HME Schedule,304.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4197,Not in chargemaster,B4197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4197,BCBSND Base HME Schedule,371.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4199,Not in chargemaster,B4199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4199,BCBSND Base HME Schedule,424.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4216,Not in chargemaster,B4216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4216,BCBSND Base HME Schedule,10.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4220,Not in chargemaster,B4220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4220,BCBSND Base HME Schedule,10.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4222,Not in chargemaster,B4222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4222,BCBSND Base HME Schedule,13.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B4224,Not in chargemaster,B4224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B4224,BCBSND Base HME Schedule,33.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B5000,Not in chargemaster,B5000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B5000,BCBSND Base HME Schedule,15.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B5100,Not in chargemaster,B5100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B5100,BCBSND Base HME Schedule,6.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B5200,Not in chargemaster,B5200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B5200,BCBSND Base HME Schedule,0.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B9002,Not in chargemaster,B9002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B9002,BCBSND Base HME Schedule,878.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B9002-RR,Not in chargemaster,B9002-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B9002-RR,BCBSND Base HME Schedule,86.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B9004,Not in chargemaster,B9004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B9004,BCBSND Base HME Schedule,3348.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B9004-RR,Not in chargemaster,B9004-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B9004-RR,BCBSND Base HME Schedule,530.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B9006,Not in chargemaster,B9006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B9006,BCBSND Base HME Schedule,3348.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip B9006-RR,Not in chargemaster,B9006-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,B9006-RR,BCBSND Base HME Schedule,530.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip D3460,Not in chargemaster,D3460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D3460,BCBSND Base HME Schedule,975.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip D7880,Not in chargemaster,D7880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D7880,BCBSND Base HME Schedule,607.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0100,Not in chargemaster,E0100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0100,BCBSND Base HME Schedule,22.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0100-RR,Not in chargemaster,E0100-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0100-RR,BCBSND Base HME Schedule,6.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0105,Not in chargemaster,E0105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0105,BCBSND Base HME Schedule,59.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0105-RR,Not in chargemaster,E0105-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0105-RR,BCBSND Base HME Schedule,9.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0110,Not in chargemaster,E0110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0110,BCBSND Base HME Schedule,99.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0110-RR,Not in chargemaster,E0110-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0110-RR,BCBSND Base HME Schedule,17.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0111,Not in chargemaster,E0111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0111,BCBSND Base HME Schedule,63.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0111-RR,Not in chargemaster,E0111-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0111-RR,BCBSND Base HME Schedule,9.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0112,Not in chargemaster,E0112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0112,BCBSND Base HME Schedule,46.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0112-RR,Not in chargemaster,E0112-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0112-RR,BCBSND Base HME Schedule,10.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0113,Not in chargemaster,E0113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0113,BCBSND Base HME Schedule,27.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0113-RR,Not in chargemaster,E0113-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0113-RR,BCBSND Base HME Schedule,5.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0114,Not in chargemaster,E0114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0114,BCBSND Base HME Schedule,60.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0114-RR,Not in chargemaster,E0114-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0114-RR,BCBSND Base HME Schedule,9.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0116,Not in chargemaster,E0116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0116,BCBSND Base HME Schedule,35.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0116-RR,Not in chargemaster,E0116-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0116-RR,BCBSND Base HME Schedule,6.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0117-RR,Not in chargemaster,E0117-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0117-RR,BCBSND Base HME Schedule,24.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0118,Not in chargemaster,E0118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0118,BCBSND Base HME Schedule,107.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0130,Not in chargemaster,E0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0130,BCBSND Base HME Schedule,56.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0130-RR,Not in chargemaster,E0130-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0130-RR,BCBSND Base HME Schedule,8.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0135,Not in chargemaster,E0135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0135,BCBSND Base HME Schedule,60.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0135-RR,Not in chargemaster,E0135-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0135-RR,BCBSND Base HME Schedule,8.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0140-RR,Not in chargemaster,E0140-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0140-RR,BCBSND Base HME Schedule,33.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0141,Not in chargemaster,E0141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0141,BCBSND Base HME Schedule,70.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0141-RR,Not in chargemaster,E0141-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0141-RR,BCBSND Base HME Schedule,9.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0143,Not in chargemaster,E0143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0143,BCBSND Base HME Schedule,72.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0143-RR,Not in chargemaster,E0143-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0143-RR,BCBSND Base HME Schedule,8.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0144-RR,Not in chargemaster,E0144-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0144-RR,BCBSND Base HME Schedule,31.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0147,Not in chargemaster,E0147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0147,BCBSND Base HME Schedule,498.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0147-RR,Not in chargemaster,E0147-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0147-RR,BCBSND Base HME Schedule,49.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0148,Not in chargemaster,E0148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0148,BCBSND Base HME Schedule,104.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0148-RR,Not in chargemaster,E0148-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0148-RR,BCBSND Base HME Schedule,10.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0149-RR,Not in chargemaster,E0149-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0149-RR,BCBSND Base HME Schedule,16.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0153,Not in chargemaster,E0153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0153,BCBSND Base HME Schedule,76.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0153-RR,Not in chargemaster,E0153-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0153-RR,BCBSND Base HME Schedule,8.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0154,Not in chargemaster,E0154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0154,BCBSND Base HME Schedule,61.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0154-RR,Not in chargemaster,E0154-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0154-RR,BCBSND Base HME Schedule,6.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0155,Not in chargemaster,E0155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0155,BCBSND Base HME Schedule,25.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0155-RR,Not in chargemaster,E0155-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0155-RR,BCBSND Base HME Schedule,2.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0156,Not in chargemaster,E0156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0156,BCBSND Base HME Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0156-RR,Not in chargemaster,E0156-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0156-RR,BCBSND Base HME Schedule,2.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0157,Not in chargemaster,E0157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0157,BCBSND Base HME Schedule,69.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0157-RR,Not in chargemaster,E0157-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0157-RR,BCBSND Base HME Schedule,6.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0158,Not in chargemaster,E0158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0158,BCBSND Base HME Schedule,25.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0158-RR,Not in chargemaster,E0158-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0158-RR,BCBSND Base HME Schedule,2.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0159,Not in chargemaster,E0159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0159,BCBSND Base HME Schedule,16.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0159-RR,Not in chargemaster,E0159-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0159-RR,BCBSND Base HME Schedule,1.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0160,Not in chargemaster,E0160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0160,BCBSND Base HME Schedule,34.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0160-RR,Not in chargemaster,E0160-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0160-RR,BCBSND Base HME Schedule,3.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0161,Not in chargemaster,E0161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0161,BCBSND Base HME Schedule,27.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0161-RR,Not in chargemaster,E0161-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0161-RR,BCBSND Base HME Schedule,3.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0162,Not in chargemaster,E0162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0162,BCBSND Base HME Schedule,186.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0162-RR,Not in chargemaster,E0162-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0162-RR,BCBSND Base HME Schedule,19.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0163,Not in chargemaster,E0163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0163,BCBSND Base HME Schedule,76.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0163-RR,Not in chargemaster,E0163-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0163-RR,BCBSND Base HME Schedule,11.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0165-RR,Not in chargemaster,E0165-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0165-RR,BCBSND Base HME Schedule,16.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0167,Not in chargemaster,E0167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0167,BCBSND Base HME Schedule,11.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0167-RR,Not in chargemaster,E0167-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0167-RR,BCBSND Base HME Schedule,1.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0168,Not in chargemaster,E0168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0168,BCBSND Base HME Schedule,139.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0168-RR,Not in chargemaster,E0168-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0168-RR,BCBSND Base HME Schedule,13.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0170-RR,Not in chargemaster,E0170-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0170-RR,BCBSND Base HME Schedule,187.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0171-RR,Not in chargemaster,E0171-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0171-RR,BCBSND Base HME Schedule,34.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0172,Not in chargemaster,E0172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0172,BCBSND Base HME Schedule,69.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0175,Not in chargemaster,E0175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0175,BCBSND Base HME Schedule,84.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0175-RR,Not in chargemaster,E0175-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0175-RR,BCBSND Base HME Schedule,8.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0181-RR,Not in chargemaster,E0181-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0181-RR,BCBSND Base HME Schedule,21.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0182-RR,Not in chargemaster,E0182-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0182-RR,BCBSND Base HME Schedule,26.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0184,Not in chargemaster,E0184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0184,BCBSND Base HME Schedule,187.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0184-RR,Not in chargemaster,E0184-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0184-RR,BCBSND Base HME Schedule,20.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0185,Not in chargemaster,E0185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0185,BCBSND Base HME Schedule,246.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0185-RR,Not in chargemaster,E0185-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0185-RR,BCBSND Base HME Schedule,26.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0186-RR,Not in chargemaster,E0186-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0186-RR,BCBSND Base HME Schedule,21.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0187-RR,Not in chargemaster,E0187-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0187-RR,BCBSND Base HME Schedule,24.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0188,Not in chargemaster,E0188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0188,BCBSND Base HME Schedule,28.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0188-RR,Not in chargemaster,E0188-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0188-RR,BCBSND Base HME Schedule,2.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0189,Not in chargemaster,E0189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0189,BCBSND Base HME Schedule,55.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0189-RR,Not in chargemaster,E0189-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0189-RR,BCBSND Base HME Schedule,5.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0191,Not in chargemaster,E0191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0191,BCBSND Base HME Schedule,12.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0191-RR,Not in chargemaster,E0191-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0191-RR,BCBSND Base HME Schedule,1.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0193-RR,Not in chargemaster,E0193-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0193-RR,BCBSND Base HME Schedule,776.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0194-RR,Not in chargemaster,E0194-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0194-RR,BCBSND Base HME Schedule,4158.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0196-RR,Not in chargemaster,E0196-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0196-RR,BCBSND Base HME Schedule,36.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0197-RR,Not in chargemaster,E0197-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0197-RR,BCBSND Base HME Schedule,25.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0198-RR,Not in chargemaster,E0198-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0198-RR,BCBSND Base HME Schedule,28.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0199,Not in chargemaster,E0199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0199,BCBSND Base HME Schedule,34.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0199-RR,Not in chargemaster,E0199-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0199-RR,BCBSND Base HME Schedule,3.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0200,Not in chargemaster,E0200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0200,BCBSND Base HME Schedule,86.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0200-RR,Not in chargemaster,E0200-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0200-RR,BCBSND Base HME Schedule,11.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0202-RR,Not in chargemaster,E0202-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0202-RR,BCBSND Base HME Schedule,68.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0203-RR,Not in chargemaster,E0203-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0203-RR,BCBSND Base HME Schedule,3.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0205,Not in chargemaster,E0205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0205,BCBSND Base HME Schedule,248,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0205-RR,Not in chargemaster,E0205-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0205-RR,BCBSND Base HME Schedule,27.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0210,Not in chargemaster,E0210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0210,BCBSND Base HME Schedule,35.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0210-RR,Not in chargemaster,E0210-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0210-RR,BCBSND Base HME Schedule,3.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0215,Not in chargemaster,E0215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0215,BCBSND Base HME Schedule,90.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0215-RR,Not in chargemaster,E0215-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0215-RR,BCBSND Base HME Schedule,9.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0217,Not in chargemaster,E0217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0217,BCBSND Base HME Schedule,634.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0217-RR,Not in chargemaster,E0217-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0217-RR,BCBSND Base HME Schedule,70.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0221,Not in chargemaster,E0221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0221,BCBSND Base HME Schedule,3196.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0225,Not in chargemaster,E0225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0225,BCBSND Base HME Schedule,496.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0225-RR,Not in chargemaster,E0225-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0225-RR,BCBSND Base HME Schedule,48.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0231,Not in chargemaster,E0231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0231,BCBSND Base HME Schedule,496.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0232,Not in chargemaster,E0232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0232,BCBSND Base HME Schedule,496.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0235-RR,Not in chargemaster,E0235-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0235-RR,BCBSND Base HME Schedule,18.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0236-RR,Not in chargemaster,E0236-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0236-RR,BCBSND Base HME Schedule,56.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0239,Not in chargemaster,E0239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0239,BCBSND Base HME Schedule,488.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0239-RR,Not in chargemaster,E0239-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0239-RR,BCBSND Base HME Schedule,48.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0244,Not in chargemaster,E0244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0244,BCBSND Base HME Schedule,50.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0249,Not in chargemaster,E0249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0249,BCBSND Base HME Schedule,127.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0249-RR,Not in chargemaster,E0249-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0249-RR,BCBSND Base HME Schedule,13.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0250-RR,Not in chargemaster,E0250-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0250-RR,BCBSND Base HME Schedule,72.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0251-RR,Not in chargemaster,E0251-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0251-RR,BCBSND Base HME Schedule,67.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0255-RR,Not in chargemaster,E0255-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0255-RR,BCBSND Base HME Schedule,82.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0256-RR,Not in chargemaster,E0256-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0256-RR,BCBSND Base HME Schedule,71.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0260-RR,Not in chargemaster,E0260-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0260-RR,BCBSND Base HME Schedule,88.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0261-RR,Not in chargemaster,E0261-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0261-RR,BCBSND Base HME Schedule,87.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0265-RR,Not in chargemaster,E0265-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0265-RR,BCBSND Base HME Schedule,175.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0266-RR,Not in chargemaster,E0266-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0266-RR,BCBSND Base HME Schedule,153.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0271,Not in chargemaster,E0271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0271,BCBSND Base HME Schedule,165.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0271-RR,Not in chargemaster,E0271-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0271-RR,BCBSND Base HME Schedule,16.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0272,Not in chargemaster,E0272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0272,BCBSND Base HME Schedule,169.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0272-RR,Not in chargemaster,E0272-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0272-RR,BCBSND Base HME Schedule,17.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0275,Not in chargemaster,E0275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0275,BCBSND Base HME Schedule,15.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0275-RR,Not in chargemaster,E0275-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0275-RR,BCBSND Base HME Schedule,1.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0276,Not in chargemaster,E0276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0276,BCBSND Base HME Schedule,13.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0276-RR,Not in chargemaster,E0276-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0276-RR,BCBSND Base HME Schedule,1.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0277-RR,Not in chargemaster,E0277-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0277-RR,BCBSND Base HME Schedule,356.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0280,Not in chargemaster,E0280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0280,BCBSND Base HME Schedule,36.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0280-RR,Not in chargemaster,E0280-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0280-RR,BCBSND Base HME Schedule,3.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0290-RR,Not in chargemaster,E0290-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0290-RR,BCBSND Base HME Schedule,67.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0291-RR,Not in chargemaster,E0291-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0291-RR,BCBSND Base HME Schedule,50.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0292-RR,Not in chargemaster,E0292-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0292-RR,BCBSND Base HME Schedule,73.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0293-RR,Not in chargemaster,E0293-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0293-RR,BCBSND Base HME Schedule,65.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0294-RR,Not in chargemaster,E0294-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0294-RR,BCBSND Base HME Schedule,86.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0295-RR,Not in chargemaster,E0295-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0295-RR,BCBSND Base HME Schedule,85.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0296-RR,Not in chargemaster,E0296-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0296-RR,BCBSND Base HME Schedule,139.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0297-RR,Not in chargemaster,E0297-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0297-RR,BCBSND Base HME Schedule,121.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0300-RR,Not in chargemaster,E0300-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0300-RR,BCBSND Base HME Schedule,287.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0301-RR,Not in chargemaster,E0301-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0301-RR,BCBSND Base HME Schedule,200.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0302-RR,Not in chargemaster,E0302-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0302-RR,BCBSND Base HME Schedule,573.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0303-RR,Not in chargemaster,E0303-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0303-RR,BCBSND Base HME Schedule,211.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0304-RR,Not in chargemaster,E0304-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0304-RR,BCBSND Base HME Schedule,601.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0305-RR,Not in chargemaster,E0305-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0305-RR,BCBSND Base HME Schedule,13.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0310,Not in chargemaster,E0310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0310,BCBSND Base HME Schedule,144.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0310-RR,Not in chargemaster,E0310-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0310-RR,BCBSND Base HME Schedule,14.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0316-RR,Not in chargemaster,E0316-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0316-RR,BCBSND Base HME Schedule,212.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0325,Not in chargemaster,E0325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0325,BCBSND Base HME Schedule,10.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0325-RR,Not in chargemaster,E0325-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0325-RR,BCBSND Base HME Schedule,1.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0326,Not in chargemaster,E0326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0326,BCBSND Base HME Schedule,11.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0326-RR,Not in chargemaster,E0326-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0326-RR,BCBSND Base HME Schedule,1.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0328,Not in chargemaster,E0328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0328,BCBSND Base HME Schedule,984.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0370,Not in chargemaster,E0370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0370,BCBSND Base HME Schedule,114.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0371-RR,Not in chargemaster,E0371-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0371-RR,BCBSND Base HME Schedule,277.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0372-RR,Not in chargemaster,E0372-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0372-RR,BCBSND Base HME Schedule,302.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0373-RR,Not in chargemaster,E0373-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0373-RR,BCBSND Base HME Schedule,321.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0424-RR,Not in chargemaster,E0424-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0424-RR,BCBSND Base HME Schedule,141.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0430,Not in chargemaster,E0430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0430,BCBSND Base HME Schedule,790.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0431-RR,Not in chargemaster,E0431-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0431-RR,BCBSND Base HME Schedule,27.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0433-RR,Not in chargemaster,E0433-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0433-RR,BCBSND Base HME Schedule,44.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0434-RR,Not in chargemaster,E0434-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0434-RR,BCBSND Base HME Schedule,54.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0435,Not in chargemaster,E0435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0435,BCBSND Base HME Schedule,737.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0439-RR,Not in chargemaster,E0439-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0439-RR,BCBSND Base HME Schedule,141.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0440,Not in chargemaster,E0440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0440,BCBSND Base HME Schedule,4691.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0441,Not in chargemaster,E0441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0441,BCBSND Base HME Schedule,63.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0442,Not in chargemaster,E0442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0442,BCBSND Base HME Schedule,63.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0443,Not in chargemaster,E0443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0443,BCBSND Base HME Schedule,73.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0444,Not in chargemaster,E0444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0444,BCBSND Base HME Schedule,60.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0445-RR,Not in chargemaster,E0445-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0445-RR,BCBSND Base HME Schedule,360.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0447,Not in chargemaster,E0447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0447,BCBSND Base HME Schedule,90.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0457,Not in chargemaster,E0457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0457,BCBSND Base HME Schedule,894.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0459-RR,Not in chargemaster,E0459-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0459-RR,BCBSND Base HME Schedule,5.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0462-RR,Not in chargemaster,E0462-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0462-RR,BCBSND Base HME Schedule,341.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0465-RR,Not in chargemaster,E0465-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0465-RR,BCBSND Base HME Schedule,1718.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0466-RR,Not in chargemaster,E0466-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0466-RR,BCBSND Base HME Schedule,1497.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0467-RR,Not in chargemaster,E0467-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0467-RR,BCBSND Base HME Schedule,1406.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0470-RR,Not in chargemaster,E0470-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0470-RR,BCBSND Base HME Schedule,196.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0471-RR,Not in chargemaster,E0471-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0471-RR,BCBSND Base HME Schedule,456.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0472-RR,Not in chargemaster,E0472-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0472-RR,BCBSND Base HME Schedule,506.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0480-RR,Not in chargemaster,E0480-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0480-RR,BCBSND Base HME Schedule,56.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0481,Not in chargemaster,E0481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0481,BCBSND Base HME Schedule,674.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0482-RR,Not in chargemaster,E0482-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0482-RR,BCBSND Base HME Schedule,494.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0483-RR,Not in chargemaster,E0483-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0483-RR,BCBSND Base HME Schedule,1358.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0484,Not in chargemaster,E0484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0484,BCBSND Base HME Schedule,57.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0484-RR,Not in chargemaster,E0484-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0484-RR,BCBSND Base HME Schedule,5.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0486,Not in chargemaster,E0486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0486,BCBSND Base HME Schedule,1498.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0486-RR,Not in chargemaster,E0486-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0486-RR,BCBSND Base HME Schedule,124.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0500-RR,Not in chargemaster,E0500-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0500-RR,BCBSND Base HME Schedule,137.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0550-RR,Not in chargemaster,E0550-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0550-RR,BCBSND Base HME Schedule,64.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0555,Not in chargemaster,E0555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0555,BCBSND Base HME Schedule,0.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0560,Not in chargemaster,E0560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0560,BCBSND Base HME Schedule,231.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0560-RR,Not in chargemaster,E0560-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0560-RR,BCBSND Base HME Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0561,Not in chargemaster,E0561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0561,BCBSND Base HME Schedule,106.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0561-RR,Not in chargemaster,E0561-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0561-RR,BCBSND Base HME Schedule,10.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0562,Not in chargemaster,E0562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0562,BCBSND Base HME Schedule,239.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0562-RR,Not in chargemaster,E0562-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0562-RR,BCBSND Base HME Schedule,23.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0565-RR,Not in chargemaster,E0565-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0565-RR,BCBSND Base HME Schedule,65.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0570-RR,Not in chargemaster,E0570-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0570-RR,BCBSND Base HME Schedule,12.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0572-RR,Not in chargemaster,E0572-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0572-RR,BCBSND Base HME Schedule,31.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0574-RR,Not in chargemaster,E0574-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0574-RR,BCBSND Base HME Schedule,46.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0575-RR,Not in chargemaster,E0575-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0575-RR,BCBSND Base HME Schedule,131.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0580,Not in chargemaster,E0580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0580,BCBSND Base HME Schedule,146.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0580-RR,Not in chargemaster,E0580-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0580-RR,BCBSND Base HME Schedule,14.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0585-RR,Not in chargemaster,E0585-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0585-RR,BCBSND Base HME Schedule,30.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0600-RR,Not in chargemaster,E0600-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0600-RR,BCBSND Base HME Schedule,52.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0601-RR,Not in chargemaster,E0601-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0601-RR,BCBSND Base HME Schedule,77.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0602,Not in chargemaster,E0602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0602,BCBSND Base HME Schedule,46.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0602-RR,Not in chargemaster,E0602-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0602-RR,BCBSND Base HME Schedule,4.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0603 ,Not in chargemaster,E0603 ,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0603 ,BCBSND Base HME Schedule,226.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0603-RR,Not in chargemaster,E0603-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0603-RR,BCBSND Base HME Schedule,18.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0604-RR,Not in chargemaster,E0604-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0604-RR,BCBSND Base HME Schedule,48.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0605,Not in chargemaster,E0605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0605,BCBSND Base HME Schedule,28.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0605-RR,Not in chargemaster,E0605-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0605-RR,BCBSND Base HME Schedule,3.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0606-RR,Not in chargemaster,E0606-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0606-RR,BCBSND Base HME Schedule,28.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0607,Not in chargemaster,E0607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0607,BCBSND Base HME Schedule,85.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0607-RR,Not in chargemaster,E0607-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0607-RR,BCBSND Base HME Schedule,8.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0610,Not in chargemaster,E0610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0610,BCBSND Base HME Schedule,303.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0610-RR,Not in chargemaster,E0610-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0610-RR,BCBSND Base HME Schedule,30.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0615,Not in chargemaster,E0615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0615,BCBSND Base HME Schedule,611.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0615-RR,Not in chargemaster,E0615-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0615-RR,BCBSND Base HME Schedule,74.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0616,Not in chargemaster,E0616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0616,BCBSND Base HME Schedule,4993.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0617-RR,Not in chargemaster,E0617-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0617-RR,BCBSND Base HME Schedule,388.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0618-RR,Not in chargemaster,E0618-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0618-RR,BCBSND Base HME Schedule,312.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0619-RR,Not in chargemaster,E0619-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0619-RR,BCBSND Base HME Schedule,26.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0620-RR,Not in chargemaster,E0620-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0620-RR,BCBSND Base HME Schedule,111.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0621,Not in chargemaster,E0621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0621,BCBSND Base HME Schedule,92.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0621-RR,Not in chargemaster,E0621-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0621-RR,BCBSND Base HME Schedule,9.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0627,Not in chargemaster,E0627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0627,BCBSND Base HME Schedule,332.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0627-RR,Not in chargemaster,E0627-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0627-RR,BCBSND Base HME Schedule,33.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0629,Not in chargemaster,E0629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0629,BCBSND Base HME Schedule,325.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0629-RR,Not in chargemaster,E0629-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0629-RR,BCBSND Base HME Schedule,32.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0630-RR,Not in chargemaster,E0630-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0630-RR,BCBSND Base HME Schedule,81.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0635-RR,Not in chargemaster,E0635-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0635-RR,BCBSND Base HME Schedule,134.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0636-RR,Not in chargemaster,E0636-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0636-RR,BCBSND Base HME Schedule,1175.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0637,Not in chargemaster,E0637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0637,BCBSND Base HME Schedule,3183.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0639-RR,Not in chargemaster,E0639-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0639-RR,BCBSND Base HME Schedule,142.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0640-RR,Not in chargemaster,E0640-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0640-RR,BCBSND Base HME Schedule,142.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0641,Not in chargemaster,E0641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0641,BCBSND Base HME Schedule,1293.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0642,Not in chargemaster,E0642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0642,BCBSND Base HME Schedule,1293.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0650,Not in chargemaster,E0650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0650,BCBSND Base HME Schedule,920.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0650-RR,Not in chargemaster,E0650-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0650-RR,BCBSND Base HME Schedule,113.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0651,Not in chargemaster,E0651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0651,BCBSND Base HME Schedule,1173.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0651-RR,Not in chargemaster,E0651-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0651-RR,BCBSND Base HME Schedule,119.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0652,Not in chargemaster,E0652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0652,BCBSND Base HME Schedule,6168.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0652-RR,Not in chargemaster,E0652-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0652-RR,BCBSND Base HME Schedule,616.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0655,Not in chargemaster,E0655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0655,BCBSND Base HME Schedule,137.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0655-RR,Not in chargemaster,E0655-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0655-RR,BCBSND Base HME Schedule,16.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0656-RR,Not in chargemaster,E0656-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0656-RR,BCBSND Base HME Schedule,73.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0657-RR,Not in chargemaster,E0657-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0657-RR,BCBSND Base HME Schedule,69.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0660,Not in chargemaster,E0660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0660,BCBSND Base HME Schedule,204.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0660-RR,Not in chargemaster,E0660-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0660-RR,BCBSND Base HME Schedule,21.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0665,Not in chargemaster,E0665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0665,BCBSND Base HME Schedule,175.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0665-RR,Not in chargemaster,E0665-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0665-RR,BCBSND Base HME Schedule,17.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0666,Not in chargemaster,E0666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0666,BCBSND Base HME Schedule,168.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0666-RR,Not in chargemaster,E0666-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0666-RR,BCBSND Base HME Schedule,16.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0667,Not in chargemaster,E0667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0667,BCBSND Base HME Schedule,351.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0667-RR,Not in chargemaster,E0667-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0667-RR,BCBSND Base HME Schedule,39.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0668,Not in chargemaster,E0668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0668,BCBSND Base HME Schedule,479.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0668-RR,Not in chargemaster,E0668-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0668-RR,BCBSND Base HME Schedule,47.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0669,Not in chargemaster,E0669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0669,BCBSND Base HME Schedule,234.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0669-RR,Not in chargemaster,E0669-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0669-RR,BCBSND Base HME Schedule,23.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0670,Not in chargemaster,E0670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0670,BCBSND Base HME Schedule,1365.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0670-RR,Not in chargemaster,E0670-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0670-RR,BCBSND Base HME Schedule,146.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0671,Not in chargemaster,E0671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0671,BCBSND Base HME Schedule,530.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0671-RR,Not in chargemaster,E0671-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0671-RR,BCBSND Base HME Schedule,53.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0672,Not in chargemaster,E0672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0672,BCBSND Base HME Schedule,412.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0672-RR,Not in chargemaster,E0672-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0672-RR,BCBSND Base HME Schedule,41.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0673,Not in chargemaster,E0673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0673,BCBSND Base HME Schedule,342.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0673-RR,Not in chargemaster,E0673-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0673-RR,BCBSND Base HME Schedule,34.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0675-RR,Not in chargemaster,E0675-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0675-RR,BCBSND Base HME Schedule,491.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0691,Not in chargemaster,E0691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0691,BCBSND Base HME Schedule,1148.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0691-RR,Not in chargemaster,E0691-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0691-RR,BCBSND Base HME Schedule,114.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0692,Not in chargemaster,E0692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0692,BCBSND Base HME Schedule,1441.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0692-RR,Not in chargemaster,E0692-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0692-RR,BCBSND Base HME Schedule,144.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0693,Not in chargemaster,E0693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0693,BCBSND Base HME Schedule,1777.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0693-RR,Not in chargemaster,E0693-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0693-RR,BCBSND Base HME Schedule,177.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0694,Not in chargemaster,E0694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0694,BCBSND Base HME Schedule,5657.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0694-RR,Not in chargemaster,E0694-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0694-RR,BCBSND Base HME Schedule,565.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0700,Not in chargemaster,E0700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0700,BCBSND Base HME Schedule,10.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0705,Not in chargemaster,E0705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0705,BCBSND Base HME Schedule,52.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0705-RR,Not in chargemaster,E0705-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0705-RR,BCBSND Base HME Schedule,5.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0720,Not in chargemaster,E0720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0720,BCBSND Base HME Schedule,164.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0730,Not in chargemaster,E0730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0730,BCBSND Base HME Schedule,164.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0731,Not in chargemaster,E0731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0731,BCBSND Base HME Schedule,174.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0740-RR,Not in chargemaster,E0740-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0740-RR,BCBSND Base HME Schedule,66.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0744-RR,Not in chargemaster,E0744-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0744-RR,BCBSND Base HME Schedule,108.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0745-RR,Not in chargemaster,E0745-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0745-RR,BCBSND Base HME Schedule,97.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0747,Not in chargemaster,E0747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0747,BCBSND Base HME Schedule,5004.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0747-RR,Not in chargemaster,E0747-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0747-RR,BCBSND Base HME Schedule,497.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0748,Not in chargemaster,E0748,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0748,BCBSND Base HME Schedule,4972,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0748-RR,Not in chargemaster,E0748-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0748-RR,BCBSND Base HME Schedule,497.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0749-RR,Not in chargemaster,E0749-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0749-RR,BCBSND Base HME Schedule,338.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0760,Not in chargemaster,E0760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0760,BCBSND Base HME Schedule,4131.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0760-RR,Not in chargemaster,E0760-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0760-RR,BCBSND Base HME Schedule,413.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0762-RR,Not in chargemaster,E0762-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0762-RR,BCBSND Base HME Schedule,140.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0764-RR,Not in chargemaster,E0764-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0764-RR,BCBSND Base HME Schedule,1414.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0765,Not in chargemaster,E0765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0765,BCBSND Base HME Schedule,107.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0765-RR,Not in chargemaster,E0765-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0765-RR,BCBSND Base HME Schedule,10.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0766-RR,Not in chargemaster,E0766-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0766-RR,BCBSND Base HME Schedule,557.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0770,Not in chargemaster,E0770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0770,BCBSND Base HME Schedule,1166.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0776,Not in chargemaster,E0776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0776,BCBSND Base HME Schedule,154.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0776-RR,Not in chargemaster,E0776-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0776-RR,BCBSND Base HME Schedule,12.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0779-RR,Not in chargemaster,E0779-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0779-RR,BCBSND Base HME Schedule,19.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0780,Not in chargemaster,E0780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0780,BCBSND Base HME Schedule,13.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0781-RR,Not in chargemaster,E0781-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0781-RR,BCBSND Base HME Schedule,279.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0782,Not in chargemaster,E0782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0782,BCBSND Base HME Schedule,4663.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0782-RR,Not in chargemaster,E0782-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0782-RR,BCBSND Base HME Schedule,466.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0783,Not in chargemaster,E0783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0783,BCBSND Base HME Schedule,8892.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0783-RR,Not in chargemaster,E0783-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0783-RR,BCBSND Base HME Schedule,889.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0784-RR,Not in chargemaster,E0784-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0784-RR,BCBSND Base HME Schedule,499.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0785,Not in chargemaster,E0785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0785,BCBSND Base HME Schedule,603.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0786,Not in chargemaster,E0786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0786,BCBSND Base HME Schedule,10205.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0786-RR,Not in chargemaster,E0786-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0786-RR,BCBSND Base HME Schedule,1020.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0791-RR,Not in chargemaster,E0791-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0791-RR,BCBSND Base HME Schedule,327.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0840,Not in chargemaster,E0840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0840,BCBSND Base HME Schedule,93.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0840-RR,Not in chargemaster,E0840-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0840-RR,BCBSND Base HME Schedule,17.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0849-RR,Not in chargemaster,E0849-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0849-RR,BCBSND Base HME Schedule,65.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0850,Not in chargemaster,E0850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0850,BCBSND Base HME Schedule,134.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0850-RR,Not in chargemaster,E0850-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0850-RR,BCBSND Base HME Schedule,18.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0855-RR,Not in chargemaster,E0855-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0855-RR,BCBSND Base HME Schedule,63.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0856-RR,Not in chargemaster,E0856-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0856-RR,BCBSND Base HME Schedule,19.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0860,Not in chargemaster,E0860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0860,BCBSND Base HME Schedule,49.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0860-RR,Not in chargemaster,E0860-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0860-RR,BCBSND Base HME Schedule,7.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0870,Not in chargemaster,E0870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0870,BCBSND Base HME Schedule,126.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0870-RR,Not in chargemaster,E0870-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0870-RR,BCBSND Base HME Schedule,14.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0880,Not in chargemaster,E0880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0880,BCBSND Base HME Schedule,160.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0880-RR,Not in chargemaster,E0880-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0880-RR,BCBSND Base HME Schedule,21.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0890,Not in chargemaster,E0890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0890,BCBSND Base HME Schedule,153.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0890-RR,Not in chargemaster,E0890-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0890-RR,BCBSND Base HME Schedule,35.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0900,Not in chargemaster,E0900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0900,BCBSND Base HME Schedule,163.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0900-RR,Not in chargemaster,E0900-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0900-RR,BCBSND Base HME Schedule,30.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0910-RR,Not in chargemaster,E0910-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0910-RR,BCBSND Base HME Schedule,14.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0911-RR,Not in chargemaster,E0911-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0911-RR,BCBSND Base HME Schedule,48.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0912-RR,Not in chargemaster,E0912-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0912-RR,BCBSND Base HME Schedule,99.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0920-RR,Not in chargemaster,E0920-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0920-RR,BCBSND Base HME Schedule,58.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0930-RR,Not in chargemaster,E0930-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0930-RR,BCBSND Base HME Schedule,50.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0935-RR,Not in chargemaster,E0935-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0935-RR,BCBSND Base HME Schedule,29.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0936,Not in chargemaster,E0936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0936,BCBSND Base HME Schedule,348.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0940-RR,Not in chargemaster,E0940-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0940-RR,BCBSND Base HME Schedule,26.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0941-RR,Not in chargemaster,E0941-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0941-RR,BCBSND Base HME Schedule,55.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0942,Not in chargemaster,E0942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0942,BCBSND Base HME Schedule,23.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0942-RR,Not in chargemaster,E0942-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0942-RR,BCBSND Base HME Schedule,2.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0944,Not in chargemaster,E0944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0944,BCBSND Base HME Schedule,58.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0944-RR,Not in chargemaster,E0944-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0944-RR,BCBSND Base HME Schedule,5.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0945,Not in chargemaster,E0945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0945,BCBSND Base HME Schedule,56.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0945-RR,Not in chargemaster,E0945-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0945-RR,BCBSND Base HME Schedule,5.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0946-RR,Not in chargemaster,E0946-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0946-RR,BCBSND Base HME Schedule,75.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0947,Not in chargemaster,E0947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0947,BCBSND Base HME Schedule,775.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0947-RR,Not in chargemaster,E0947-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0947-RR,BCBSND Base HME Schedule,80.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0948,Not in chargemaster,E0948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0948,BCBSND Base HME Schedule,749.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0948-RR,Not in chargemaster,E0948-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0948-RR,BCBSND Base HME Schedule,74.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0950,Not in chargemaster,E0950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0950,BCBSND Base HME Schedule,91.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0950-RR,Not in chargemaster,E0950-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0950-RR,BCBSND Base HME Schedule,9.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0951,Not in chargemaster,E0951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0951,BCBSND Base HME Schedule,16.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0951-RR,Not in chargemaster,E0951-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0951-RR,BCBSND Base HME Schedule,1.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0952,Not in chargemaster,E0952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0952,BCBSND Base HME Schedule,18.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0952-RR,Not in chargemaster,E0952-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0952-RR,BCBSND Base HME Schedule,1.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0953,Not in chargemaster,E0953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0953,BCBSND Base HME Schedule,91.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0953-RR,Not in chargemaster,E0953-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0953-RR,BCBSND Base HME Schedule,9.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0954,Not in chargemaster,E0954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0954,BCBSND Base HME Schedule,60.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0954-RR,Not in chargemaster,E0954-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0954-RR,BCBSND Base HME Schedule,6.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0955-RR,Not in chargemaster,E0955-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0955-RR,BCBSND Base HME Schedule,17.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0956,Not in chargemaster,E0956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0956,BCBSND Base HME Schedule,91.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0956-RR,Not in chargemaster,E0956-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0956-RR,BCBSND Base HME Schedule,9.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0957,Not in chargemaster,E0957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0957,BCBSND Base HME Schedule,134.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0957-RR,Not in chargemaster,E0957-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0957-RR,BCBSND Base HME Schedule,13.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0958-RR,Not in chargemaster,E0958-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0958-RR,BCBSND Base HME Schedule,48.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0959,Not in chargemaster,E0959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0959,BCBSND Base HME Schedule,48.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0959-RR,Not in chargemaster,E0959-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0959-RR,BCBSND Base HME Schedule,4.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0960,Not in chargemaster,E0960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0960,BCBSND Base HME Schedule,84.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0960-RR,Not in chargemaster,E0960-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0960-RR,BCBSND Base HME Schedule,8.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0961,Not in chargemaster,E0961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0961,BCBSND Base HME Schedule,26.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0961-RR,Not in chargemaster,E0961-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0961-RR,BCBSND Base HME Schedule,2.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0966,Not in chargemaster,E0966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0966,BCBSND Base HME Schedule,80.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0966-RR,Not in chargemaster,E0966-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0966-RR,BCBSND Base HME Schedule,8.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0967,Not in chargemaster,E0967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0967,BCBSND Base HME Schedule,79.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0967-RR,Not in chargemaster,E0967-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0967-RR,BCBSND Base HME Schedule,7.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0968-RR,Not in chargemaster,E0968-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0968-RR,BCBSND Base HME Schedule,22.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0969,Not in chargemaster,E0969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0969,BCBSND Base HME Schedule,185.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0969-RR,Not in chargemaster,E0969-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0969-RR,BCBSND Base HME Schedule,18.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0970,Not in chargemaster,E0970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0970,BCBSND Base HME Schedule,84.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0971,Not in chargemaster,E0971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0971,BCBSND Base HME Schedule,38.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0971-RR,Not in chargemaster,E0971-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0971-RR,BCBSND Base HME Schedule,3.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0973,Not in chargemaster,E0973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0973,BCBSND Base HME Schedule,72.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0973-RR,Not in chargemaster,E0973-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0973-RR,BCBSND Base HME Schedule,7.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0974,Not in chargemaster,E0974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0974,BCBSND Base HME Schedule,82.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0974-RR,Not in chargemaster,E0974-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0974-RR,BCBSND Base HME Schedule,8.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0978,Not in chargemaster,E0978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0978,BCBSND Base HME Schedule,31.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0978-RR,Not in chargemaster,E0978-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0978-RR,BCBSND Base HME Schedule,3.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0980,Not in chargemaster,E0980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0980,BCBSND Base HME Schedule,42.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0980-RR,Not in chargemaster,E0980-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0980-RR,BCBSND Base HME Schedule,4.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0981,Not in chargemaster,E0981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0981,BCBSND Base HME Schedule,46.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0981-RR,Not in chargemaster,E0981-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0981-RR,BCBSND Base HME Schedule,4.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0982,Not in chargemaster,E0982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0982,BCBSND Base HME Schedule,50.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0982-RR,Not in chargemaster,E0982-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0982-RR,BCBSND Base HME Schedule,5.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0983-RR,Not in chargemaster,E0983-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0983-RR,BCBSND Base HME Schedule,288.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0984-RR,Not in chargemaster,E0984-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0984-RR,BCBSND Base HME Schedule,244.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0985-RR,Not in chargemaster,E0985-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0985-RR,BCBSND Base HME Schedule,24.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0986-RR,Not in chargemaster,E0986-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0986-RR,BCBSND Base HME Schedule,621.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0988-RR,Not in chargemaster,E0988-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0988-RR,BCBSND Base HME Schedule,382.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0990,Not in chargemaster,E0990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0990,BCBSND Base HME Schedule,90.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0990-RR,Not in chargemaster,E0990-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0990-RR,BCBSND Base HME Schedule,9.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0992,Not in chargemaster,E0992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0992,BCBSND Base HME Schedule,97.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0992-RR,Not in chargemaster,E0992-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0992-RR,BCBSND Base HME Schedule,9.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0994,Not in chargemaster,E0994,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0994,BCBSND Base HME Schedule,19.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0994-RR,Not in chargemaster,E0994-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0994-RR,BCBSND Base HME Schedule,1.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0995,Not in chargemaster,E0995,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0995,BCBSND Base HME Schedule,30.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E0995-RR,Not in chargemaster,E0995-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E0995-RR,BCBSND Base HME Schedule,3.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1002-RR,Not in chargemaster,E1002-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1002-RR,BCBSND Base HME Schedule,414.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1003-RR,Not in chargemaster,E1003-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1003-RR,BCBSND Base HME Schedule,475.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1004-RR,Not in chargemaster,E1004-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1004-RR,BCBSND Base HME Schedule,524.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1005-RR,Not in chargemaster,E1005-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1005-RR,BCBSND Base HME Schedule,572.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1006-RR,Not in chargemaster,E1006-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1006-RR,BCBSND Base HME Schedule,704.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1007-RR,Not in chargemaster,E1007-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1007-RR,BCBSND Base HME Schedule,894.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1008-RR,Not in chargemaster,E1008-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1008-RR,BCBSND Base HME Schedule,910.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1010-RR,Not in chargemaster,E1010-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1010-RR,BCBSND Base HME Schedule,122.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1012-RR,Not in chargemaster,E1012-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1012-RR,BCBSND Base HME Schedule,122.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1014-RR,Not in chargemaster,E1014-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1014-RR,BCBSND Base HME Schedule,46.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1015,Not in chargemaster,E1015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1015,BCBSND Base HME Schedule,136.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1015-RR,Not in chargemaster,E1015-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1015-RR,BCBSND Base HME Schedule,13.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1016,Not in chargemaster,E1016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1016,BCBSND Base HME Schedule,127.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1016-RR,Not in chargemaster,E1016-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1016-RR,BCBSND Base HME Schedule,12.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1020-RR,Not in chargemaster,E1020-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1020-RR,BCBSND Base HME Schedule,21.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1028-RR,Not in chargemaster,E1028-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1028-RR,BCBSND Base HME Schedule,16.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1029-RR,Not in chargemaster,E1029-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1029-RR,BCBSND Base HME Schedule,40.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1030-RR,Not in chargemaster,E1030-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1030-RR,BCBSND Base HME Schedule,127.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1031-RR,Not in chargemaster,E1031-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1031-RR,BCBSND Base HME Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1035-RR,Not in chargemaster,E1035-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1035-RR,BCBSND Base HME Schedule,683.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1036-RR,Not in chargemaster,E1036-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1036-RR,BCBSND Base HME Schedule,973.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1037-RR,Not in chargemaster,E1037-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1037-RR,BCBSND Base HME Schedule,125,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1038-RR,Not in chargemaster,E1038-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1038-RR,BCBSND Base HME Schedule,17.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1039-RR,Not in chargemaster,E1039-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1039-RR,BCBSND Base HME Schedule,39.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1050-RR,Not in chargemaster,E1050-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1050-RR,BCBSND Base HME Schedule,130.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1060-RR,Not in chargemaster,E1060-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1060-RR,BCBSND Base HME Schedule,161.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1070-RR,Not in chargemaster,E1070-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1070-RR,BCBSND Base HME Schedule,139.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1083-RR,Not in chargemaster,E1083-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1083-RR,BCBSND Base HME Schedule,94.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1084-RR,Not in chargemaster,E1084-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1084-RR,BCBSND Base HME Schedule,112.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1085,Not in chargemaster,E1085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1085,BCBSND Base HME Schedule,1550.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1086,Not in chargemaster,E1086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1086,BCBSND Base HME Schedule,1987.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1087-RR,Not in chargemaster,E1087-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1087-RR,BCBSND Base HME Schedule,161.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1088-RR,Not in chargemaster,E1088-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1088-RR,BCBSND Base HME Schedule,192.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1089,Not in chargemaster,E1089,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1089,BCBSND Base HME Schedule,2962.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1090,Not in chargemaster,E1090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1090,BCBSND Base HME Schedule,3355.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1092-RR,Not in chargemaster,E1092-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1092-RR,BCBSND Base HME Schedule,144.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1093-RR,Not in chargemaster,E1093-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1093-RR,BCBSND Base HME Schedule,135.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1100-RR,Not in chargemaster,E1100-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1100-RR,BCBSND Base HME Schedule,132.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1110-RR,Not in chargemaster,E1110-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1110-RR,BCBSND Base HME Schedule,129.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1130,Not in chargemaster,E1130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1130,BCBSND Base HME Schedule,978.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1140,Not in chargemaster,E1140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1140,BCBSND Base HME Schedule,1504.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1150-RR,Not in chargemaster,E1150-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1150-RR,BCBSND Base HME Schedule,104.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1160-RR,Not in chargemaster,E1160-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1160-RR,BCBSND Base HME Schedule,79.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1161-RR,Not in chargemaster,E1161-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1161-RR,BCBSND Base HME Schedule,302.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1170-RR,Not in chargemaster,E1170-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1170-RR,BCBSND Base HME Schedule,114.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1171-RR,Not in chargemaster,E1171-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1171-RR,BCBSND Base HME Schedule,102.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1172-RR,Not in chargemaster,E1172-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1172-RR,BCBSND Base HME Schedule,106.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1180-RR,Not in chargemaster,E1180-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1180-RR,BCBSND Base HME Schedule,110.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1190-RR,Not in chargemaster,E1190-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1190-RR,BCBSND Base HME Schedule,149.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1195-RR,Not in chargemaster,E1195-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1195-RR,BCBSND Base HME Schedule,160.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1200-RR,Not in chargemaster,E1200-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1200-RR,BCBSND Base HME Schedule,111.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1220,Not in chargemaster,E1220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1220,BCBSND Base HME Schedule,2861.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1221-RR,Not in chargemaster,E1221-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1221-RR,BCBSND Base HME Schedule,60.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1222-RR,Not in chargemaster,E1222-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1222-RR,BCBSND Base HME Schedule,86.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1223-RR,Not in chargemaster,E1223-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1223-RR,BCBSND Base HME Schedule,89.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1224-RR,Not in chargemaster,E1224-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1224-RR,BCBSND Base HME Schedule,102.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1225-RR,Not in chargemaster,E1225-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1225-RR,BCBSND Base HME Schedule,44.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1226,Not in chargemaster,E1226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1226,BCBSND Base HME Schedule,463.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1226-RR,Not in chargemaster,E1226-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1226-RR,BCBSND Base HME Schedule,46.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1227,Not in chargemaster,E1227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1227,BCBSND Base HME Schedule,301.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1227-RR,Not in chargemaster,E1227-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1227-RR,BCBSND Base HME Schedule,30.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1228-RR,Not in chargemaster,E1228-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1228-RR,BCBSND Base HME Schedule,35.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1230,Not in chargemaster,E1230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1230,BCBSND Base HME Schedule,2890.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1230-RR,Not in chargemaster,E1230-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1230-RR,BCBSND Base HME Schedule,284.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1232-RR,Not in chargemaster,E1232-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1232-RR,BCBSND Base HME Schedule,273.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1233-RR,Not in chargemaster,E1233-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1233-RR,BCBSND Base HME Schedule,283.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1234-RR,Not in chargemaster,E1234-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1234-RR,BCBSND Base HME Schedule,246.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1235-RR,Not in chargemaster,E1235-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1235-RR,BCBSND Base HME Schedule,237.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1236-RR,Not in chargemaster,E1236-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1236-RR,BCBSND Base HME Schedule,209.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1237-RR,Not in chargemaster,E1237-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1237-RR,BCBSND Base HME Schedule,211.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1238-RR,Not in chargemaster,E1238-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1238-RR,BCBSND Base HME Schedule,209.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1240-RR,Not in chargemaster,E1240-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1240-RR,BCBSND Base HME Schedule,111.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1250,Not in chargemaster,E1250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1250,BCBSND Base HME Schedule,1873.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1260,Not in chargemaster,E1260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1260,BCBSND Base HME Schedule,2066.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1270-RR,Not in chargemaster,E1270-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1270-RR,BCBSND Base HME Schedule,100.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1280-RR,Not in chargemaster,E1280-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1280-RR,BCBSND Base HME Schedule,167.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1285,Not in chargemaster,E1285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1285,BCBSND Base HME Schedule,2972.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1290,Not in chargemaster,E1290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1290,BCBSND Base HME Schedule,3084.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1295-RR,Not in chargemaster,E1295-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1295-RR,BCBSND Base HME Schedule,155.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1296,Not in chargemaster,E1296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1296,BCBSND Base HME Schedule,628.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1296-RR,Not in chargemaster,E1296-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1296-RR,BCBSND Base HME Schedule,63.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1297,Not in chargemaster,E1297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1297,BCBSND Base HME Schedule,133.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1297-RR,Not in chargemaster,E1297-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1297-RR,BCBSND Base HME Schedule,14.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1298,Not in chargemaster,E1298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1298,BCBSND Base HME Schedule,460.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1298-RR,Not in chargemaster,E1298-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1298-RR,BCBSND Base HME Schedule,47.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1300,Not in chargemaster,E1300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1300,BCBSND Base HME Schedule,511.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1310,Not in chargemaster,E1310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1310,BCBSND Base HME Schedule,2744.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1310-RR,Not in chargemaster,E1310-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1310-RR,BCBSND Base HME Schedule,234.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1353,Not in chargemaster,E1353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1353,BCBSND Base HME Schedule,44.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1354,Not in chargemaster,E1354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1354,BCBSND Base HME Schedule,27.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1355,Not in chargemaster,E1355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1355,BCBSND Base HME Schedule,27.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1356,Not in chargemaster,E1356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1356,BCBSND Base HME Schedule,27.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1357,Not in chargemaster,E1357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1357,BCBSND Base HME Schedule,27.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1358,Not in chargemaster,E1358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1358,BCBSND Base HME Schedule,27.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1372,Not in chargemaster,E1372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1372,BCBSND Base HME Schedule,138.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1372-RR,Not in chargemaster,E1372-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1372-RR,BCBSND Base HME Schedule,15.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1390-RR,Not in chargemaster,E1390-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1390-RR,BCBSND Base HME Schedule,141.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1391-RR,Not in chargemaster,E1391-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1391-RR,BCBSND Base HME Schedule,115.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1392-RR,Not in chargemaster,E1392-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1392-RR,BCBSND Base HME Schedule,54.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1405-RR,Not in chargemaster,E1405-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1405-RR,BCBSND Base HME Schedule,145.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1406-RR,Not in chargemaster,E1406-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1406-RR,BCBSND Base HME Schedule,124.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1500,Not in chargemaster,E1500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1500,BCBSND Base HME Schedule,126.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1700-RR,Not in chargemaster,E1700-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1700-RR,BCBSND Base HME Schedule,44.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1701,Not in chargemaster,E1701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1701,BCBSND Base HME Schedule,13.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1702,Not in chargemaster,E1702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1702,BCBSND Base HME Schedule,28.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1800-RR,Not in chargemaster,E1800-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1800-RR,BCBSND Base HME Schedule,156.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1801-RR,Not in chargemaster,E1801-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1801-RR,BCBSND Base HME Schedule,148.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1802-RR,Not in chargemaster,E1802-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1802-RR,BCBSND Base HME Schedule,417.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1805-RR,Not in chargemaster,E1805-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1805-RR,BCBSND Base HME Schedule,156.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1806-RR,Not in chargemaster,E1806-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1806-RR,BCBSND Base HME Schedule,121.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1810-RR,Not in chargemaster,E1810-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1810-RR,BCBSND Base HME Schedule,156.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1811-RR,Not in chargemaster,E1811-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1811-RR,BCBSND Base HME Schedule,154.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1812-RR,Not in chargemaster,E1812-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1812-RR,BCBSND Base HME Schedule,109.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1815-RR,Not in chargemaster,E1815-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1815-RR,BCBSND Base HME Schedule,156.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1816-RR,Not in chargemaster,E1816-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1816-RR,BCBSND Base HME Schedule,156.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1818-RR,Not in chargemaster,E1818-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1818-RR,BCBSND Base HME Schedule,160.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1820,Not in chargemaster,E1820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1820,BCBSND Base HME Schedule,98.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1820-RR,Not in chargemaster,E1820-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1820-RR,BCBSND Base HME Schedule,9.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1821,Not in chargemaster,E1821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1821,BCBSND Base HME Schedule,134.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1821-RR,Not in chargemaster,E1821-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1821-RR,BCBSND Base HME Schedule,13.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1825-RR,Not in chargemaster,E1825-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1825-RR,BCBSND Base HME Schedule,156.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1830-RR,Not in chargemaster,E1830-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1830-RR,BCBSND Base HME Schedule,156.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1831-RR,Not in chargemaster,E1831-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1831-RR,BCBSND Base HME Schedule,84.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1840-RR,Not in chargemaster,E1840-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1840-RR,BCBSND Base HME Schedule,454.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E1841-RR,Not in chargemaster,E1841-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E1841-RR,BCBSND Base HME Schedule,578.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2000-RR,Not in chargemaster,E2000-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2000-RR,BCBSND Base HME Schedule,59.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2100,Not in chargemaster,E2100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2100,BCBSND Base HME Schedule,821.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2100-RR,Not in chargemaster,E2100-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2100-RR,BCBSND Base HME Schedule,82.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2101,Not in chargemaster,E2101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2101,BCBSND Base HME Schedule,240.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2101-RR,Not in chargemaster,E2101-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2101-RR,BCBSND Base HME Schedule,24.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2120-RR,Not in chargemaster,E2120-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2120-RR,BCBSND Base HME Schedule,362.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2201,Not in chargemaster,E2201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2201,BCBSND Base HME Schedule,369.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2201-RR,Not in chargemaster,E2201-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2201-RR,BCBSND Base HME Schedule,36.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2202,Not in chargemaster,E2202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2202,BCBSND Base HME Schedule,525.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2202-RR,Not in chargemaster,E2202-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2202-RR,BCBSND Base HME Schedule,52.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2203,Not in chargemaster,E2203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2203,BCBSND Base HME Schedule,490.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2203-RR,Not in chargemaster,E2203-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2203-RR,BCBSND Base HME Schedule,49.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2204,Not in chargemaster,E2204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2204,BCBSND Base HME Schedule,861.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2204-RR,Not in chargemaster,E2204-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2204-RR,BCBSND Base HME Schedule,86.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2205,Not in chargemaster,E2205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2205,BCBSND Base HME Schedule,38.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2205-RR,Not in chargemaster,E2205-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2205-RR,BCBSND Base HME Schedule,3.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2206,Not in chargemaster,E2206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2206,BCBSND Base HME Schedule,43.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2206-RR,Not in chargemaster,E2206-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2206-RR,BCBSND Base HME Schedule,4.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2207,Not in chargemaster,E2207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2207,BCBSND Base HME Schedule,50.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2207-RR,Not in chargemaster,E2207-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2207-RR,BCBSND Base HME Schedule,5.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2208,Not in chargemaster,E2208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2208,BCBSND Base HME Schedule,95.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2208-RR,Not in chargemaster,E2208-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2208-RR,BCBSND Base HME Schedule,9.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2209,Not in chargemaster,E2209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2209,BCBSND Base HME Schedule,95.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2209-RR,Not in chargemaster,E2209-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2209-RR,BCBSND Base HME Schedule,9.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2210,Not in chargemaster,E2210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2210,BCBSND Base HME Schedule,6.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2210-RR,Not in chargemaster,E2210-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2210-RR,BCBSND Base HME Schedule,0.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2211,Not in chargemaster,E2211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2211,BCBSND Base HME Schedule,39.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2211-RR,Not in chargemaster,E2211-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2211-RR,BCBSND Base HME Schedule,3.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2212,Not in chargemaster,E2212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2212,BCBSND Base HME Schedule,6.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2212-RR,Not in chargemaster,E2212-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2212-RR,BCBSND Base HME Schedule,0.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2213,Not in chargemaster,E2213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2213,BCBSND Base HME Schedule,33.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2213-RR,Not in chargemaster,E2213-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2213-RR,BCBSND Base HME Schedule,3.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2214,Not in chargemaster,E2214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2214,BCBSND Base HME Schedule,38.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2214-RR,Not in chargemaster,E2214-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2214-RR,BCBSND Base HME Schedule,3.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2215,Not in chargemaster,E2215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2215,BCBSND Base HME Schedule,11.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2215-RR,Not in chargemaster,E2215-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2215-RR,BCBSND Base HME Schedule,1.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2216,Not in chargemaster,E2216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2216,BCBSND Base HME Schedule,52.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2216-RR,Not in chargemaster,E2216-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2216-RR,BCBSND Base HME Schedule,5.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2217,Not in chargemaster,E2217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2217,BCBSND Base HME Schedule,46.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2217-RR,Not in chargemaster,E2217-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2217-RR,BCBSND Base HME Schedule,4.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2218,Not in chargemaster,E2218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2218,BCBSND Base HME Schedule,52.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2218-RR,Not in chargemaster,E2218-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2218-RR,BCBSND Base HME Schedule,5.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2219,Not in chargemaster,E2219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2219,BCBSND Base HME Schedule,46.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2219-RR,Not in chargemaster,E2219-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2219-RR,BCBSND Base HME Schedule,4.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2220,Not in chargemaster,E2220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2220,BCBSND Base HME Schedule,31.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2220-RR,Not in chargemaster,E2220-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2220-RR,BCBSND Base HME Schedule,3.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2221,Not in chargemaster,E2221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2221,BCBSND Base HME Schedule,29.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2221-RR,Not in chargemaster,E2221-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2221-RR,BCBSND Base HME Schedule,2.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2222,Not in chargemaster,E2222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2222,BCBSND Base HME Schedule,24.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2222-RR,Not in chargemaster,E2222-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2222-RR,BCBSND Base HME Schedule,2.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2224,Not in chargemaster,E2224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2224,BCBSND Base HME Schedule,108,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2224-RR,Not in chargemaster,E2224-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2224-RR,BCBSND Base HME Schedule,10.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2225,Not in chargemaster,E2225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2225,BCBSND Base HME Schedule,20.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2225-RR,Not in chargemaster,E2225-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2225-RR,BCBSND Base HME Schedule,2.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2226,Not in chargemaster,E2226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2226,BCBSND Base HME Schedule,43.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2226-RR,Not in chargemaster,E2226-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2226-RR,BCBSND Base HME Schedule,4.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2227-RR,Not in chargemaster,E2227-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2227-RR,BCBSND Base HME Schedule,239.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2228-RR,Not in chargemaster,E2228-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2228-RR,BCBSND Base HME Schedule,108.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2231,Not in chargemaster,E2231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2231,BCBSND Base HME Schedule,160.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2231-RR,Not in chargemaster,E2231-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2231-RR,BCBSND Base HME Schedule,16.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2310-RR,Not in chargemaster,E2310-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2310-RR,BCBSND Base HME Schedule,121.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2311-RR,Not in chargemaster,E2311-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2311-RR,BCBSND Base HME Schedule,244.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2312-RR,Not in chargemaster,E2312-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2312-RR,BCBSND Base HME Schedule,257.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2313-RR,Not in chargemaster,E2313-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2313-RR,BCBSND Base HME Schedule,40.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2321-RR,Not in chargemaster,E2321-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2321-RR,BCBSND Base HME Schedule,164.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2322-RR,Not in chargemaster,E2322-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2322-RR,BCBSND Base HME Schedule,152.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2323,Not in chargemaster,E2323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2323,BCBSND Base HME Schedule,74.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2323-RR,Not in chargemaster,E2323-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2323-RR,BCBSND Base HME Schedule,7.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2324,Not in chargemaster,E2324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2324,BCBSND Base HME Schedule,48.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2324-RR,Not in chargemaster,E2324-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2324-RR,BCBSND Base HME Schedule,4.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2325-RR,Not in chargemaster,E2325-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2325-RR,BCBSND Base HME Schedule,146.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2326-RR,Not in chargemaster,E2326-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2326-RR,BCBSND Base HME Schedule,38.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2327-RR,Not in chargemaster,E2327-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2327-RR,BCBSND Base HME Schedule,285.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2328-RR,Not in chargemaster,E2328-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2328-RR,BCBSND Base HME Schedule,538.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2329-RR,Not in chargemaster,E2329-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2329-RR,BCBSND Base HME Schedule,193.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2330-RR,Not in chargemaster,E2330-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2330-RR,BCBSND Base HME Schedule,373.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2340,Not in chargemaster,E2340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2340,BCBSND Base HME Schedule,457.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2340-RR,Not in chargemaster,E2340-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2340-RR,BCBSND Base HME Schedule,45.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2341,Not in chargemaster,E2341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2341,BCBSND Base HME Schedule,686.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2341-RR,Not in chargemaster,E2341-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2341-RR,BCBSND Base HME Schedule,68.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2342,Not in chargemaster,E2342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2342,BCBSND Base HME Schedule,572.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2342-RR,Not in chargemaster,E2342-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2342-RR,BCBSND Base HME Schedule,57.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2343,Not in chargemaster,E2343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2343,BCBSND Base HME Schedule,916,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2343-RR,Not in chargemaster,E2343-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2343-RR,BCBSND Base HME Schedule,91.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2351,Not in chargemaster,E2351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2351,BCBSND Base HME Schedule,769.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2351-RR,Not in chargemaster,E2351-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2351-RR,BCBSND Base HME Schedule,76.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2359,Not in chargemaster,E2359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2359,BCBSND Base HME Schedule,195.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2359-RR,Not in chargemaster,E2359-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2359-RR,BCBSND Base HME Schedule,19.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2360,Not in chargemaster,E2360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2360,BCBSND Base HME Schedule,133.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2360-RR,Not in chargemaster,E2360-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2360-RR,BCBSND Base HME Schedule,13.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2361,Not in chargemaster,E2361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2361,BCBSND Base HME Schedule,130.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2361-RR,Not in chargemaster,E2361-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2361-RR,BCBSND Base HME Schedule,13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2362,Not in chargemaster,E2362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2362,BCBSND Base HME Schedule,115.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2362-RR,Not in chargemaster,E2362-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2362-RR,BCBSND Base HME Schedule,11.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2363,Not in chargemaster,E2363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2363,BCBSND Base HME Schedule,167.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2363-RR,Not in chargemaster,E2363-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2363-RR,BCBSND Base HME Schedule,16.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2364,Not in chargemaster,E2364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2364,BCBSND Base HME Schedule,133.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2364-RR,Not in chargemaster,E2364-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2364-RR,BCBSND Base HME Schedule,13.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2365,Not in chargemaster,E2365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2365,BCBSND Base HME Schedule,91.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2365-RR,Not in chargemaster,E2365-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2365-RR,BCBSND Base HME Schedule,9.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2366,Not in chargemaster,E2366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2366,BCBSND Base HME Schedule,201.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2366-RR,Not in chargemaster,E2366-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2366-RR,BCBSND Base HME Schedule,20.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2367,Not in chargemaster,E2367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2367,BCBSND Base HME Schedule,441.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2367-RR,Not in chargemaster,E2367-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2367-RR,BCBSND Base HME Schedule,44.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2368-RR,Not in chargemaster,E2368-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2368-RR,BCBSND Base HME Schedule,46.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2369-RR,Not in chargemaster,E2369-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2369-RR,BCBSND Base HME Schedule,42.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2370-RR,Not in chargemaster,E2370-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2370-RR,BCBSND Base HME Schedule,63.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2371,Not in chargemaster,E2371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2371,BCBSND Base HME Schedule,153.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2371-RR,Not in chargemaster,E2371-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2371-RR,BCBSND Base HME Schedule,15.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2372,Not in chargemaster,E2372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2372,BCBSND Base HME Schedule,115.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2373-RR,Not in chargemaster,E2373-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2373-RR,BCBSND Base HME Schedule,87.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2374-RR,Not in chargemaster,E2374-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2374-RR,BCBSND Base HME Schedule,55.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2375-RR,Not in chargemaster,E2375-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2375-RR,BCBSND Base HME Schedule,77.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2376-RR,Not in chargemaster,E2376-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2376-RR,BCBSND Base HME Schedule,138.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2377-RR,Not in chargemaster,E2377-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2377-RR,BCBSND Base HME Schedule,51.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2378-RR,Not in chargemaster,E2378-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2378-RR,BCBSND Base HME Schedule,62.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2381,Not in chargemaster,E2381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2381,BCBSND Base HME Schedule,68.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2381-RR,Not in chargemaster,E2381-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2381-RR,BCBSND Base HME Schedule,6.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2382,Not in chargemaster,E2382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2382,BCBSND Base HME Schedule,20.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2382-RR,Not in chargemaster,E2382-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2382-RR,BCBSND Base HME Schedule,2.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2383,Not in chargemaster,E2383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2383,BCBSND Base HME Schedule,140.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2383-RR,Not in chargemaster,E2383-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2383-RR,BCBSND Base HME Schedule,14.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2384,Not in chargemaster,E2384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2384,BCBSND Base HME Schedule,72.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2384-RR,Not in chargemaster,E2384-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2384-RR,BCBSND Base HME Schedule,7.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2385,Not in chargemaster,E2385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2385,BCBSND Base HME Schedule,49.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2385-RR,Not in chargemaster,E2385-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2385-RR,BCBSND Base HME Schedule,4.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2386,Not in chargemaster,E2386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2386,BCBSND Base HME Schedule,124.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2386-RR,Not in chargemaster,E2386-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2386-RR,BCBSND Base HME Schedule,12.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2387,Not in chargemaster,E2387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2387,BCBSND Base HME Schedule,56.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2387-RR,Not in chargemaster,E2387-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2387-RR,BCBSND Base HME Schedule,5.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2388,Not in chargemaster,E2388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2388,BCBSND Base HME Schedule,52.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2388-RR,Not in chargemaster,E2388-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2388-RR,BCBSND Base HME Schedule,5.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2389,Not in chargemaster,E2389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2389,BCBSND Base HME Schedule,29.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2389-RR,Not in chargemaster,E2389-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2389-RR,BCBSND Base HME Schedule,2.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2390,Not in chargemaster,E2390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2390,BCBSND Base HME Schedule,45.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2390-RR,Not in chargemaster,E2390-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2390-RR,BCBSND Base HME Schedule,4.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2391,Not in chargemaster,E2391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2391,BCBSND Base HME Schedule,19.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2391-RR,Not in chargemaster,E2391-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2391-RR,BCBSND Base HME Schedule,1.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2392,Not in chargemaster,E2392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2392,BCBSND Base HME Schedule,48.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2392-RR,Not in chargemaster,E2392-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2392-RR,BCBSND Base HME Schedule,4.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2394,Not in chargemaster,E2394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2394,BCBSND Base HME Schedule,67.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2394-RR,Not in chargemaster,E2394-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2394-RR,BCBSND Base HME Schedule,6.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2395,Not in chargemaster,E2395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2395,BCBSND Base HME Schedule,50.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2395-RR,Not in chargemaster,E2395-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2395-RR,BCBSND Base HME Schedule,5.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2396,Not in chargemaster,E2396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2396,BCBSND Base HME Schedule,56.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2396-RR,Not in chargemaster,E2396-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2396-RR,BCBSND Base HME Schedule,5.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2397,Not in chargemaster,E2397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2397,BCBSND Base HME Schedule,504.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2397-RR,Not in chargemaster,E2397-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2397-RR,BCBSND Base HME Schedule,50.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2402-RR,Not in chargemaster,E2402-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2402-RR,BCBSND Base HME Schedule,107.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2500,Not in chargemaster,E2500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2500,BCBSND Base HME Schedule,499.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2500-RR,Not in chargemaster,E2500-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2500-RR,BCBSND Base HME Schedule,49.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2502,Not in chargemaster,E2502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2502,BCBSND Base HME Schedule,1528.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2502-RR,Not in chargemaster,E2502-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2502-RR,BCBSND Base HME Schedule,152.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2504,Not in chargemaster,E2504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2504,BCBSND Base HME Schedule,2015.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2504-RR,Not in chargemaster,E2504-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2504-RR,BCBSND Base HME Schedule,201.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2506,Not in chargemaster,E2506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2506,BCBSND Base HME Schedule,2955.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2506-RR,Not in chargemaster,E2506-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2506-RR,BCBSND Base HME Schedule,295.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2508,Not in chargemaster,E2508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2508,BCBSND Base HME Schedule,4570.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2508-RR,Not in chargemaster,E2508-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2508-RR,BCBSND Base HME Schedule,457.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2510,Not in chargemaster,E2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2510,BCBSND Base HME Schedule,8649.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2510-RR,Not in chargemaster,E2510-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2510-RR,BCBSND Base HME Schedule,864.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2601,Not in chargemaster,E2601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2601,BCBSND Base HME Schedule,48.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2601-RR,Not in chargemaster,E2601-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2601-RR,BCBSND Base HME Schedule,4.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2602,Not in chargemaster,E2602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2602,BCBSND Base HME Schedule,100.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2602-RR,Not in chargemaster,E2602-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2602-RR,BCBSND Base HME Schedule,10.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2603,Not in chargemaster,E2603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2603,BCBSND Base HME Schedule,127.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2603-RR,Not in chargemaster,E2603-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2603-RR,BCBSND Base HME Schedule,12.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2604,Not in chargemaster,E2604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2604,BCBSND Base HME Schedule,170.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2604-RR,Not in chargemaster,E2604-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2604-RR,BCBSND Base HME Schedule,17.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2605,Not in chargemaster,E2605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2605,BCBSND Base HME Schedule,245.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2605-RR,Not in chargemaster,E2605-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2605-RR,BCBSND Base HME Schedule,24.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2606,Not in chargemaster,E2606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2606,BCBSND Base HME Schedule,378.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2606-RR,Not in chargemaster,E2606-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2606-RR,BCBSND Base HME Schedule,37.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2607,Not in chargemaster,E2607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2607,BCBSND Base HME Schedule,238.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2607-RR,Not in chargemaster,E2607-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2607-RR,BCBSND Base HME Schedule,23.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2608,Not in chargemaster,E2608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2608,BCBSND Base HME Schedule,298.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2608-RR,Not in chargemaster,E2608-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2608-RR,BCBSND Base HME Schedule,29.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2611,Not in chargemaster,E2611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2611,BCBSND Base HME Schedule,206.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2611-RR,Not in chargemaster,E2611-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2611-RR,BCBSND Base HME Schedule,20.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2612,Not in chargemaster,E2612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2612,BCBSND Base HME Schedule,366.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2612-RR,Not in chargemaster,E2612-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2612-RR,BCBSND Base HME Schedule,36.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2613,Not in chargemaster,E2613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2613,BCBSND Base HME Schedule,361.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2613-RR,Not in chargemaster,E2613-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2613-RR,BCBSND Base HME Schedule,36.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2614,Not in chargemaster,E2614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2614,BCBSND Base HME Schedule,504.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2614-RR,Not in chargemaster,E2614-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2614-RR,BCBSND Base HME Schedule,50.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2615,Not in chargemaster,E2615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2615,BCBSND Base HME Schedule,409.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2615-RR,Not in chargemaster,E2615-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2615-RR,BCBSND Base HME Schedule,40.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2616,Not in chargemaster,E2616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2616,BCBSND Base HME Schedule,551.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2616-RR,Not in chargemaster,E2616-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2616-RR,BCBSND Base HME Schedule,55.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2619,Not in chargemaster,E2619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2619,BCBSND Base HME Schedule,54.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2619-RR,Not in chargemaster,E2619-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2619-RR,BCBSND Base HME Schedule,5.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2620,Not in chargemaster,E2620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2620,BCBSND Base HME Schedule,456.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2620-RR,Not in chargemaster,E2620-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2620-RR,BCBSND Base HME Schedule,45.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2621,Not in chargemaster,E2621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2621,BCBSND Base HME Schedule,516.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2621-RR,Not in chargemaster,E2621-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2621-RR,BCBSND Base HME Schedule,51.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2622,Not in chargemaster,E2622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2622,BCBSND Base HME Schedule,345.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2622-RR,Not in chargemaster,E2622-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2622-RR,BCBSND Base HME Schedule,34.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2623,Not in chargemaster,E2623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2623,BCBSND Base HME Schedule,437.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2623-RR,Not in chargemaster,E2623-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2623-RR,BCBSND Base HME Schedule,43.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2624,Not in chargemaster,E2624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2624,BCBSND Base HME Schedule,350.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2624-RR,Not in chargemaster,E2624-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2624-RR,BCBSND Base HME Schedule,35.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2625,Not in chargemaster,E2625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2625,BCBSND Base HME Schedule,436.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2625-RR,Not in chargemaster,E2625-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2625-RR,BCBSND Base HME Schedule,43.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2626,Not in chargemaster,E2626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2626,BCBSND Base HME Schedule,674.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2626-RR,Not in chargemaster,E2626-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2626-RR,BCBSND Base HME Schedule,67.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2627,Not in chargemaster,E2627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2627,BCBSND Base HME Schedule,1039.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2627-RR,Not in chargemaster,E2627-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2627-RR,BCBSND Base HME Schedule,103.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2628,Not in chargemaster,E2628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2628,BCBSND Base HME Schedule,809.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2628-RR,Not in chargemaster,E2628-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2628-RR,BCBSND Base HME Schedule,80.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2629,Not in chargemaster,E2629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2629,BCBSND Base HME Schedule,1017.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2629-RR,Not in chargemaster,E2629-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2629-RR,BCBSND Base HME Schedule,101.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2630,Not in chargemaster,E2630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2630,BCBSND Base HME Schedule,695.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2630-RR,Not in chargemaster,E2630-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2630-RR,BCBSND Base HME Schedule,69.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2631,Not in chargemaster,E2631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2631,BCBSND Base HME Schedule,279.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2631-RR,Not in chargemaster,E2631-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2631-RR,BCBSND Base HME Schedule,27.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2632,Not in chargemaster,E2632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2632,BCBSND Base HME Schedule,178.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2632-RR,Not in chargemaster,E2632-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2632-RR,BCBSND Base HME Schedule,17.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2633,Not in chargemaster,E2633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2633,BCBSND Base HME Schedule,148.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip E2633-RR,Not in chargemaster,E2633-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,E2633-RR,BCBSND Base HME Schedule,14.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0001-RR,Not in chargemaster,K0001-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0001-RR,BCBSND Base HME Schedule,33.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0002-RR,Not in chargemaster,K0002-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0002-RR,BCBSND Base HME Schedule,55.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0003-RR,Not in chargemaster,K0003-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0003-RR,BCBSND Base HME Schedule,55.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0004-RR,Not in chargemaster,K0004-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0004-RR,BCBSND Base HME Schedule,77.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0005,Not in chargemaster,K0005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0005,BCBSND Base HME Schedule,2323.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0005-RR,Not in chargemaster,K0005-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0005-RR,BCBSND Base HME Schedule,232.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0006-RR,Not in chargemaster,K0006-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0006-RR,BCBSND Base HME Schedule,87.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0007-RR,Not in chargemaster,K0007-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0007-RR,BCBSND Base HME Schedule,115.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0009-RR,Not in chargemaster,K0009-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0009-RR,BCBSND Base HME Schedule,91.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0010-RR,Not in chargemaster,K0010-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0010-RR,BCBSND Base HME Schedule,544.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0011-RR,Not in chargemaster,K0011-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0011-RR,BCBSND Base HME Schedule,609.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0012-RR,Not in chargemaster,K0012-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0012-RR,BCBSND Base HME Schedule,373.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0015-RR,Not in chargemaster,K0015-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0015-RR,BCBSND Base HME Schedule,16.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0017,Not in chargemaster,K0017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0017,BCBSND Base HME Schedule,52.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0017-RR,Not in chargemaster,K0017-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0017-RR,BCBSND Base HME Schedule,5.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0018,Not in chargemaster,K0018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0018,BCBSND Base HME Schedule,29.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0018-RR,Not in chargemaster,K0018-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0018-RR,BCBSND Base HME Schedule,2.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0019,Not in chargemaster,K0019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0019,BCBSND Base HME Schedule,15.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0019-RR,Not in chargemaster,K0019-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0019-RR,BCBSND Base HME Schedule,1.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0020,Not in chargemaster,K0020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0020,BCBSND Base HME Schedule,50.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0020-RR,Not in chargemaster,K0020-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0020-RR,BCBSND Base HME Schedule,5.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0037,Not in chargemaster,K0037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0037,BCBSND Base HME Schedule,45.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0037-RR,Not in chargemaster,K0037-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0037-RR,BCBSND Base HME Schedule,4.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0038,Not in chargemaster,K0038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0038,BCBSND Base HME Schedule,25.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0038-RR,Not in chargemaster,K0038-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0038-RR,BCBSND Base HME Schedule,2.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0039,Not in chargemaster,K0039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0039,BCBSND Base HME Schedule,56.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0039-RR,Not in chargemaster,K0039-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0039-RR,BCBSND Base HME Schedule,5.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0040,Not in chargemaster,K0040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0040,BCBSND Base HME Schedule,62.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0040-RR,Not in chargemaster,K0040-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0040-RR,BCBSND Base HME Schedule,6.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0041,Not in chargemaster,K0041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0041,BCBSND Base HME Schedule,53.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0041-RR,Not in chargemaster,K0041-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0041-RR,BCBSND Base HME Schedule,5.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0042,Not in chargemaster,K0042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0042,BCBSND Base HME Schedule,33.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0042-RR,Not in chargemaster,K0042-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0042-RR,BCBSND Base HME Schedule,3.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0043,Not in chargemaster,K0043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0043,BCBSND Base HME Schedule,20.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0043-RR,Not in chargemaster,K0043-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0043-RR,BCBSND Base HME Schedule,2.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0044,Not in chargemaster,K0044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0044,BCBSND Base HME Schedule,18.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0044-RR,Not in chargemaster,K0044-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0044-RR,BCBSND Base HME Schedule,1.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0045,Not in chargemaster,K0045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0045,BCBSND Base HME Schedule,53.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0045-RR,Not in chargemaster,K0045-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0045-RR,BCBSND Base HME Schedule,5.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0046,Not in chargemaster,K0046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0046,BCBSND Base HME Schedule,21.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0046-RR,Not in chargemaster,K0046-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0046-RR,BCBSND Base HME Schedule,2.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0047,Not in chargemaster,K0047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0047,BCBSND Base HME Schedule,76.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0047-RR,Not in chargemaster,K0047-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0047-RR,BCBSND Base HME Schedule,7.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0050,Not in chargemaster,K0050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0050,BCBSND Base HME Schedule,34.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0050-RR,Not in chargemaster,K0050-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0050-RR,BCBSND Base HME Schedule,3.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0051,Not in chargemaster,K0051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0051,BCBSND Base HME Schedule,55.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0051-RR,Not in chargemaster,K0051-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0051-RR,BCBSND Base HME Schedule,5.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0052,Not in chargemaster,K0052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0052,BCBSND Base HME Schedule,83.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0052-RR,Not in chargemaster,K0052-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0052-RR,BCBSND Base HME Schedule,8.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0053,Not in chargemaster,K0053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0053,BCBSND Base HME Schedule,93.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0053-RR,Not in chargemaster,K0053-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0053-RR,BCBSND Base HME Schedule,9.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0056,Not in chargemaster,K0056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0056,BCBSND Base HME Schedule,106.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0056-RR,Not in chargemaster,K0056-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0056-RR,BCBSND Base HME Schedule,10.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0065,Not in chargemaster,K0065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0065,BCBSND Base HME Schedule,52.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0065-RR,Not in chargemaster,K0065-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0065-RR,BCBSND Base HME Schedule,5.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0069,Not in chargemaster,K0069,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0069,BCBSND Base HME Schedule,105.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0069-RR,Not in chargemaster,K0069-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0069-RR,BCBSND Base HME Schedule,10.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0070-RR,Not in chargemaster,K0070-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0070-RR,BCBSND Base HME Schedule,18.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0071,Not in chargemaster,K0071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0071,BCBSND Base HME Schedule,123.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0071-RR,Not in chargemaster,K0071-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0071-RR,BCBSND Base HME Schedule,12.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0072,Not in chargemaster,K0072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0072,BCBSND Base HME Schedule,72.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0072-RR,Not in chargemaster,K0072-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0072-RR,BCBSND Base HME Schedule,7.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0073,Not in chargemaster,K0073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0073,BCBSND Base HME Schedule,39.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0073-RR,Not in chargemaster,K0073-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0073-RR,BCBSND Base HME Schedule,3.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0077,Not in chargemaster,K0077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0077,BCBSND Base HME Schedule,61.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0077-RR,Not in chargemaster,K0077-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0077-RR,BCBSND Base HME Schedule,6.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0098,Not in chargemaster,K0098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0098,BCBSND Base HME Schedule,27.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0098-RR,Not in chargemaster,K0098-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0098-RR,BCBSND Base HME Schedule,2.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0105,Not in chargemaster,K0105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0105,BCBSND Base HME Schedule,111.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0105-RR,Not in chargemaster,K0105-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0105-RR,BCBSND Base HME Schedule,11.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0195-RR,Not in chargemaster,K0195-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0195-RR,BCBSND Base HME Schedule,14.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0455-RR,Not in chargemaster,K0455-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0455-RR,BCBSND Base HME Schedule,304.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0552,Not in chargemaster,K0552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0552,BCBSND Base HME Schedule,3.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0553,Not in chargemaster,K0553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0553,BCBSND Base HME Schedule,245.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0554,Not in chargemaster,K0554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0554,BCBSND Base HME Schedule,270.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0554-RR,Not in chargemaster,K0554-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0554-RR,BCBSND Base HME Schedule,27.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0601,Not in chargemaster,K0601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0601,BCBSND Base HME Schedule,1.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0602,Not in chargemaster,K0602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0602,BCBSND Base HME Schedule,7.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0603,Not in chargemaster,K0603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0603,BCBSND Base HME Schedule,0.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0604,Not in chargemaster,K0604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0604,BCBSND Base HME Schedule,7.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0605,Not in chargemaster,K0605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0605,BCBSND Base HME Schedule,18.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0606-RR,Not in chargemaster,K0606-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0606-RR,BCBSND Base HME Schedule,3218.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0607-RR,Not in chargemaster,K0607-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0607-RR,BCBSND Base HME Schedule,24.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0608,Not in chargemaster,K0608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0608,BCBSND Base HME Schedule,154.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0608-RR,Not in chargemaster,K0608-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0608-RR,BCBSND Base HME Schedule,15.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0609,Not in chargemaster,K0609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0609,BCBSND Base HME Schedule,1030.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0672,Not in chargemaster,K0672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0672,BCBSND Base HME Schedule,94.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0730-RR,Not in chargemaster,K0730-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0730-RR,BCBSND Base HME Schedule,220.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0733,Not in chargemaster,K0733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0733,BCBSND Base HME Schedule,31.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0733-RR,Not in chargemaster,K0733-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0733-RR,BCBSND Base HME Schedule,3.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0738-RR,Not in chargemaster,K0738-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0738-RR,BCBSND Base HME Schedule,44.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0739,Not in chargemaster,K0739,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0739,BCBSND Base HME Schedule,22.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0740,Not in chargemaster,K0740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0740,BCBSND Base HME Schedule,22.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0744,Not in chargemaster,K0744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0744,BCBSND Base HME Schedule,2.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0745,Not in chargemaster,K0745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0745,BCBSND Base HME Schedule,4.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0746,Not in chargemaster,K0746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0746,BCBSND Base HME Schedule,8.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0800,Not in chargemaster,K0800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0800,BCBSND Base HME Schedule,1022.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0800-RR,Not in chargemaster,K0800-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0800-RR,BCBSND Base HME Schedule,102.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0801,Not in chargemaster,K0801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0801,BCBSND Base HME Schedule,1819.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0801-RR,Not in chargemaster,K0801-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0801-RR,BCBSND Base HME Schedule,181.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0802,Not in chargemaster,K0802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0802,BCBSND Base HME Schedule,2291.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0802-RR,Not in chargemaster,K0802-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0802-RR,BCBSND Base HME Schedule,229.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0806,Not in chargemaster,K0806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0806,BCBSND Base HME Schedule,1575.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0806-RR,Not in chargemaster,K0806-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0806-RR,BCBSND Base HME Schedule,157.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0807,Not in chargemaster,K0807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0807,BCBSND Base HME Schedule,2427.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0807-RR,Not in chargemaster,K0807-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0807-RR,BCBSND Base HME Schedule,242.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0808,Not in chargemaster,K0808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0808,BCBSND Base HME Schedule,3753.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0808-RR,Not in chargemaster,K0808-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0808-RR,BCBSND Base HME Schedule,375.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0812,Not in chargemaster,K0812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0812,BCBSND Base HME Schedule,2890.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0813-RR,Not in chargemaster,K0813-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0813-RR,BCBSND Base HME Schedule,318.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0814-RR,Not in chargemaster,K0814-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0814-RR,BCBSND Base HME Schedule,358.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0815-RR,Not in chargemaster,K0815-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0815-RR,BCBSND Base HME Schedule,407.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0816-RR,Not in chargemaster,K0816-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0816-RR,BCBSND Base HME Schedule,370.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0820-RR,Not in chargemaster,K0820-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0820-RR,BCBSND Base HME Schedule,338.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0821-RR,Not in chargemaster,K0821-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0821-RR,BCBSND Base HME Schedule,368.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0822-RR,Not in chargemaster,K0822-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0822-RR,BCBSND Base HME Schedule,418.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0823-RR,Not in chargemaster,K0823-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0823-RR,BCBSND Base HME Schedule,397.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0824-RR,Not in chargemaster,K0824-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0824-RR,BCBSND Base HME Schedule,568.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0825-RR,Not in chargemaster,K0825-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0825-RR,BCBSND Base HME Schedule,516.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0826-RR,Not in chargemaster,K0826-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0826-RR,BCBSND Base HME Schedule,883.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0827-RR,Not in chargemaster,K0827-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0827-RR,BCBSND Base HME Schedule,767.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0828-RR,Not in chargemaster,K0828-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0828-RR,BCBSND Base HME Schedule,1039.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0829-RR,Not in chargemaster,K0829-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0829-RR,BCBSND Base HME Schedule,994.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0830-RR,Not in chargemaster,K0830-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0830-RR,BCBSND Base HME Schedule,60.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0831-RR,Not in chargemaster,K0831-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0831-RR,BCBSND Base HME Schedule,57.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0835-RR,Not in chargemaster,K0835-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0835-RR,BCBSND Base HME Schedule,461.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0836-RR,Not in chargemaster,K0836-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0836-RR,BCBSND Base HME Schedule,478.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0837-RR,Not in chargemaster,K0837-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0837-RR,BCBSND Base HME Schedule,577.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0838-RR,Not in chargemaster,K0838-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0838-RR,BCBSND Base HME Schedule,513.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0839-RR,Not in chargemaster,K0839-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0839-RR,BCBSND Base HME Schedule,760.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0840-RR,Not in chargemaster,K0840-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0840-RR,BCBSND Base HME Schedule,1161.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0841-RR,Not in chargemaster,K0841-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0841-RR,BCBSND Base HME Schedule,509.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0842-RR,Not in chargemaster,K0842-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0842-RR,BCBSND Base HME Schedule,509.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0843-RR,Not in chargemaster,K0843-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0843-RR,BCBSND Base HME Schedule,607.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0848-RR,Not in chargemaster,K0848-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0848-RR,BCBSND Base HME Schedule,873.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0849-RR,Not in chargemaster,K0849-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0849-RR,BCBSND Base HME Schedule,839.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0850-RR,Not in chargemaster,K0850-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0850-RR,BCBSND Base HME Schedule,1012.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0851-RR,Not in chargemaster,K0851-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0851-RR,BCBSND Base HME Schedule,973.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0852-RR,Not in chargemaster,K0852-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0852-RR,BCBSND Base HME Schedule,1170.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0853-RR,Not in chargemaster,K0853-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0853-RR,BCBSND Base HME Schedule,1202.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0854-RR,Not in chargemaster,K0854-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0854-RR,BCBSND Base HME Schedule,1592.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0855-RR,Not in chargemaster,K0855-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0855-RR,BCBSND Base HME Schedule,1504.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0856-RR,Not in chargemaster,K0856-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0856-RR,BCBSND Base HME Schedule,937.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0857-RR,Not in chargemaster,K0857-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0857-RR,BCBSND Base HME Schedule,955.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0858-RR,Not in chargemaster,K0858-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0858-RR,BCBSND Base HME Schedule,1162.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0859-RR,Not in chargemaster,K0859-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0859-RR,BCBSND Base HME Schedule,1108.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0860-RR,Not in chargemaster,K0860-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0860-RR,BCBSND Base HME Schedule,1661.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0861-RR,Not in chargemaster,K0861-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0861-RR,BCBSND Base HME Schedule,938.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0862-RR,Not in chargemaster,K0862-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0862-RR,BCBSND Base HME Schedule,1162.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0863-RR,Not in chargemaster,K0863-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0863-RR,BCBSND Base HME Schedule,1661.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0864-RR,Not in chargemaster,K0864-RR,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0864-RR,BCBSND Base HME Schedule,1976.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0868,Not in chargemaster,K0868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0868,BCBSND Base HME Schedule,691.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0869,Not in chargemaster,K0869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0869,BCBSND Base HME Schedule,691.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0870,Not in chargemaster,K0870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0870,BCBSND Base HME Schedule,7313.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0871,Not in chargemaster,K0871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0871,BCBSND Base HME Schedule,7313.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0877,Not in chargemaster,K0877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0877,BCBSND Base HME Schedule,607.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0878,Not in chargemaster,K0878,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0878,BCBSND Base HME Schedule,7313.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0879,Not in chargemaster,K0879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0879,BCBSND Base HME Schedule,820.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0880,Not in chargemaster,K0880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0880,BCBSND Base HME Schedule,1283.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0884,Not in chargemaster,K0884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0884,BCBSND Base HME Schedule,927.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0885,Not in chargemaster,K0885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0885,BCBSND Base HME Schedule,916.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0886,Not in chargemaster,K0886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0886,BCBSND Base HME Schedule,846.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0890,Not in chargemaster,K0890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0890,BCBSND Base HME Schedule,1395.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0891,Not in chargemaster,K0891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0891,BCBSND Base HME Schedule,1848.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0898,Not in chargemaster,K0898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0898,BCBSND Base HME Schedule,7313.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip K0899,Not in chargemaster,K0899,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,K0899,BCBSND Base HME Schedule,7313.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0112,Not in chargemaster,L0112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0112,BCBSND Base HME Schedule,1615.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0113,Not in chargemaster,L0113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0113,BCBSND Base HME Schedule,329.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0120,Not in chargemaster,L0120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0120,BCBSND Base HME Schedule,28.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0130,Not in chargemaster,L0130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0130,BCBSND Base HME Schedule,174.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0140,Not in chargemaster,L0140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0140,BCBSND Base HME Schedule,77.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0150,Not in chargemaster,L0150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0150,BCBSND Base HME Schedule,115.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0160,Not in chargemaster,L0160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0160,BCBSND Base HME Schedule,167.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0170,Not in chargemaster,L0170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0170,BCBSND Base HME Schedule,688.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0172,Not in chargemaster,L0172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0172,BCBSND Base HME Schedule,140.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0174,Not in chargemaster,L0174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0174,BCBSND Base HME Schedule,343.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0180,Not in chargemaster,L0180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0180,BCBSND Base HME Schedule,395.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0190,Not in chargemaster,L0190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0190,BCBSND Base HME Schedule,549.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0200,Not in chargemaster,L0200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0200,BCBSND Base HME Schedule,596.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0220,Not in chargemaster,L0220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0220,BCBSND Base HME Schedule,130.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0450,Not in chargemaster,L0450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0450,BCBSND Base HME Schedule,185.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0454,Not in chargemaster,L0454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0454,BCBSND Base HME Schedule,400.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0455,Not in chargemaster,L0455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0455,BCBSND Base HME Schedule,400.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0456,Not in chargemaster,L0456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0456,BCBSND Base HME Schedule,1148.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0457,Not in chargemaster,L0457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0457,BCBSND Base HME Schedule,1148.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0458,Not in chargemaster,L0458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0458,BCBSND Base HME Schedule,1029.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0460,Not in chargemaster,L0460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0460,BCBSND Base HME Schedule,1159.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0462,Not in chargemaster,L0462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0462,BCBSND Base HME Schedule,1441.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0464,Not in chargemaster,L0464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0464,BCBSND Base HME Schedule,1716.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0466,Not in chargemaster,L0466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0466,BCBSND Base HME Schedule,416.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0467,Not in chargemaster,L0467,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0467,BCBSND Base HME Schedule,416.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0468,Not in chargemaster,L0468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0468,BCBSND Base HME Schedule,489.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0469,Not in chargemaster,L0469,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0469,BCBSND Base HME Schedule,489.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0470,Not in chargemaster,L0470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0470,BCBSND Base HME Schedule,680.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0472,Not in chargemaster,L0472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0472,BCBSND Base HME Schedule,431.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0480,Not in chargemaster,L0480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0480,BCBSND Base HME Schedule,1889.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0482,Not in chargemaster,L0482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0482,BCBSND Base HME Schedule,2112.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0484,Not in chargemaster,L0484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0484,BCBSND Base HME Schedule,2280.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0486,Not in chargemaster,L0486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0486,BCBSND Base HME Schedule,2310.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0488,Not in chargemaster,L0488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0488,BCBSND Base HME Schedule,1159.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0490,Not in chargemaster,L0490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0490,BCBSND Base HME Schedule,326.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0491,Not in chargemaster,L0491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0491,BCBSND Base HME Schedule,886.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0492,Not in chargemaster,L0492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0492,BCBSND Base HME Schedule,558.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0621,Not in chargemaster,L0621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0621,BCBSND Base HME Schedule,121.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0622,Not in chargemaster,L0622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0622,BCBSND Base HME Schedule,275.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0623,Not in chargemaster,L0623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0623,BCBSND Base HME Schedule,204.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0625,Not in chargemaster,L0625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0625,BCBSND Base HME Schedule,63.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0626,Not in chargemaster,L0626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0626,BCBSND Base HME Schedule,90.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0627,Not in chargemaster,L0627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0627,BCBSND Base HME Schedule,475.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0628,Not in chargemaster,L0628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0628,BCBSND Base HME Schedule,97.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0630,Not in chargemaster,L0630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0630,BCBSND Base HME Schedule,187.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0631,Not in chargemaster,L0631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0631,BCBSND Base HME Schedule,1187.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0633,Not in chargemaster,L0633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0633,BCBSND Base HME Schedule,331.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0635,Not in chargemaster,L0635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0635,BCBSND Base HME Schedule,1022.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0636,Not in chargemaster,L0636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0636,BCBSND Base HME Schedule,1778.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0637,Not in chargemaster,L0637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0637,BCBSND Base HME Schedule,1197.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0638,Not in chargemaster,L0638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0638,BCBSND Base HME Schedule,1522.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0639,Not in chargemaster,L0639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0639,BCBSND Base HME Schedule,1197.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0640,Not in chargemaster,L0640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0640,BCBSND Base HME Schedule,1208.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0641,Not in chargemaster,L0641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0641,BCBSND Base HME Schedule,90.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0642,Not in chargemaster,L0642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0642,BCBSND Base HME Schedule,475.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0643,Not in chargemaster,L0643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0643,BCBSND Base HME Schedule,187.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0648,Not in chargemaster,L0648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0648,BCBSND Base HME Schedule,1187.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0649,Not in chargemaster,L0649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0649,BCBSND Base HME Schedule,331.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0650,Not in chargemaster,L0650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0650,BCBSND Base HME Schedule,1197.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0651,Not in chargemaster,L0651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0651,BCBSND Base HME Schedule,1197.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0700,Not in chargemaster,L0700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0700,BCBSND Base HME Schedule,2184.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0710,Not in chargemaster,L0710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0710,BCBSND Base HME Schedule,2548.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0810,Not in chargemaster,L0810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0810,BCBSND Base HME Schedule,2877.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0820,Not in chargemaster,L0820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0820,BCBSND Base HME Schedule,2489.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0830,Not in chargemaster,L0830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0830,BCBSND Base HME Schedule,3348.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0859,Not in chargemaster,L0859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0859,BCBSND Base HME Schedule,1734.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0861,Not in chargemaster,L0861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0861,BCBSND Base HME Schedule,248.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0970,Not in chargemaster,L0970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0970,BCBSND Base HME Schedule,162.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0972,Not in chargemaster,L0972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0972,BCBSND Base HME Schedule,118.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0974,Not in chargemaster,L0974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0974,BCBSND Base HME Schedule,191.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0976,Not in chargemaster,L0976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0976,BCBSND Base HME Schedule,216.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0978,Not in chargemaster,L0978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0978,BCBSND Base HME Schedule,205.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0980,Not in chargemaster,L0980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0980,BCBSND Base HME Schedule,18.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0982,Not in chargemaster,L0982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0982,BCBSND Base HME Schedule,17.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L0984,Not in chargemaster,L0984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L0984,BCBSND Base HME Schedule,71.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1000,Not in chargemaster,L1000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1000,BCBSND Base HME Schedule,2526.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1001,Not in chargemaster,L1001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1001,BCBSND Base HME Schedule,2184.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1005,Not in chargemaster,L1005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1005,BCBSND Base HME Schedule,3695.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1010,Not in chargemaster,L1010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1010,BCBSND Base HME Schedule,71.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1020,Not in chargemaster,L1020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1020,BCBSND Base HME Schedule,92.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1025,Not in chargemaster,L1025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1025,BCBSND Base HME Schedule,133.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1030,Not in chargemaster,L1030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1030,BCBSND Base HME Schedule,67.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1040,Not in chargemaster,L1040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1040,BCBSND Base HME Schedule,83.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1050,Not in chargemaster,L1050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1050,BCBSND Base HME Schedule,88.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1060,Not in chargemaster,L1060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1060,BCBSND Base HME Schedule,102.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1070,Not in chargemaster,L1070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1070,BCBSND Base HME Schedule,96.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1080,Not in chargemaster,L1080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1080,BCBSND Base HME Schedule,75.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1085,Not in chargemaster,L1085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1085,BCBSND Base HME Schedule,164.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1090,Not in chargemaster,L1090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1090,BCBSND Base HME Schedule,105.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1100,Not in chargemaster,L1100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1100,BCBSND Base HME Schedule,169.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1110,Not in chargemaster,L1110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1110,BCBSND Base HME Schedule,272.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1120,Not in chargemaster,L1120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1120,BCBSND Base HME Schedule,45.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1200,Not in chargemaster,L1200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1200,BCBSND Base HME Schedule,2006.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1210,Not in chargemaster,L1210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1210,BCBSND Base HME Schedule,372.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1220,Not in chargemaster,L1220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1220,BCBSND Base HME Schedule,246.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1230,Not in chargemaster,L1230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1230,BCBSND Base HME Schedule,806.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1240,Not in chargemaster,L1240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1240,BCBSND Base HME Schedule,82.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1250,Not in chargemaster,L1250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1250,BCBSND Base HME Schedule,77.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1260,Not in chargemaster,L1260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1260,BCBSND Base HME Schedule,80.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1270,Not in chargemaster,L1270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1270,BCBSND Base HME Schedule,82.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1280,Not in chargemaster,L1280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1280,BCBSND Base HME Schedule,92.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1290,Not in chargemaster,L1290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1290,BCBSND Base HME Schedule,83.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1300,Not in chargemaster,L1300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1300,BCBSND Base HME Schedule,2216.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1310,Not in chargemaster,L1310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1310,BCBSND Base HME Schedule,2347.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1600,Not in chargemaster,L1600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1600,BCBSND Base HME Schedule,140.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1610,Not in chargemaster,L1610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1610,BCBSND Base HME Schedule,46.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1620,Not in chargemaster,L1620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1620,BCBSND Base HME Schedule,143.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1630,Not in chargemaster,L1630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1630,BCBSND Base HME Schedule,180.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1640,Not in chargemaster,L1640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1640,BCBSND Base HME Schedule,604.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1650,Not in chargemaster,L1650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1650,BCBSND Base HME Schedule,278.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1652,Not in chargemaster,L1652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1652,BCBSND Base HME Schedule,411.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1660,Not in chargemaster,L1660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1660,BCBSND Base HME Schedule,182.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1680,Not in chargemaster,L1680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1680,BCBSND Base HME Schedule,1301.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1685,Not in chargemaster,L1685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1685,BCBSND Base HME Schedule,1270.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1686,Not in chargemaster,L1686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1686,BCBSND Base HME Schedule,1097.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1690,Not in chargemaster,L1690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1690,BCBSND Base HME Schedule,2232.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1700,Not in chargemaster,L1700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1700,BCBSND Base HME Schedule,1630.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1710,Not in chargemaster,L1710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1710,BCBSND Base HME Schedule,1909,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1720,Not in chargemaster,L1720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1720,BCBSND Base HME Schedule,1407.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1730,Not in chargemaster,L1730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1730,BCBSND Base HME Schedule,1210.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1755,Not in chargemaster,L1755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1755,BCBSND Base HME Schedule,1690.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1810,Not in chargemaster,L1810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1810,BCBSND Base HME Schedule,107.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1812,Not in chargemaster,L1812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1812,BCBSND Base HME Schedule,107.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1820,Not in chargemaster,L1820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1820,BCBSND Base HME Schedule,151.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1830,Not in chargemaster,L1830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1830,BCBSND Base HME Schedule,98.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1831,Not in chargemaster,L1831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1831,BCBSND Base HME Schedule,339.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1832,Not in chargemaster,L1832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1832,BCBSND Base HME Schedule,649.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1833,Not in chargemaster,L1833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1833,BCBSND Base HME Schedule,649.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1834,Not in chargemaster,L1834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1834,BCBSND Base HME Schedule,875.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1836,Not in chargemaster,L1836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1836,BCBSND Base HME Schedule,154.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1840,Not in chargemaster,L1840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1840,BCBSND Base HME Schedule,981.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1843,Not in chargemaster,L1843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1843,BCBSND Base HME Schedule,1036,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1844,Not in chargemaster,L1844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1844,BCBSND Base HME Schedule,1916.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1845,Not in chargemaster,L1845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1845,BCBSND Base HME Schedule,901.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1846,Not in chargemaster,L1846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1846,BCBSND Base HME Schedule,1198.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1847,Not in chargemaster,L1847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1847,BCBSND Base HME Schedule,664.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1848,Not in chargemaster,L1848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1848,BCBSND Base HME Schedule,664.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1850,Not in chargemaster,L1850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1850,BCBSND Base HME Schedule,350.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1851,Not in chargemaster,L1851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1851,BCBSND Base HME Schedule,1036,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1852,Not in chargemaster,L1852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1852,BCBSND Base HME Schedule,901.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1860,Not in chargemaster,L1860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1860,BCBSND Base HME Schedule,1145.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1900,Not in chargemaster,L1900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1900,BCBSND Base HME Schedule,314.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1902,Not in chargemaster,L1902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1902,BCBSND Base HME Schedule,85.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1904,Not in chargemaster,L1904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1904,BCBSND Base HME Schedule,502.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1906,Not in chargemaster,L1906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1906,BCBSND Base HME Schedule,171.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1907,Not in chargemaster,L1907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1907,BCBSND Base HME Schedule,649.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1910,Not in chargemaster,L1910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1910,BCBSND Base HME Schedule,288.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1920,Not in chargemaster,L1920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1920,BCBSND Base HME Schedule,469.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1930,Not in chargemaster,L1930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1930,BCBSND Base HME Schedule,275.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1932,Not in chargemaster,L1932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1932,BCBSND Base HME Schedule,1030.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1940,Not in chargemaster,L1940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1940,BCBSND Base HME Schedule,528.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1945,Not in chargemaster,L1945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1945,BCBSND Base HME Schedule,1017.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1950,Not in chargemaster,L1950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1950,BCBSND Base HME Schedule,860.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1951,Not in chargemaster,L1951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1951,BCBSND Base HME Schedule,969.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1960,Not in chargemaster,L1960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1960,BCBSND Base HME Schedule,591.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1970,Not in chargemaster,L1970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1970,BCBSND Base HME Schedule,798.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1971,Not in chargemaster,L1971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1971,BCBSND Base HME Schedule,541.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1980,Not in chargemaster,L1980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1980,BCBSND Base HME Schedule,422.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L1990,Not in chargemaster,L1990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L1990,BCBSND Base HME Schedule,476.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2000,Not in chargemaster,L2000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2000,BCBSND Base HME Schedule,1122.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2005,Not in chargemaster,L2005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2005,BCBSND Base HME Schedule,4740.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2010,Not in chargemaster,L2010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2010,BCBSND Base HME Schedule,1155.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2020,Not in chargemaster,L2020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2020,BCBSND Base HME Schedule,1246.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2030,Not in chargemaster,L2030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2030,BCBSND Base HME Schedule,1081.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2034,Not in chargemaster,L2034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2034,BCBSND Base HME Schedule,2403.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2035,Not in chargemaster,L2035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2035,BCBSND Base HME Schedule,200.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2036,Not in chargemaster,L2036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2036,BCBSND Base HME Schedule,2174.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2037,Not in chargemaster,L2037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2037,BCBSND Base HME Schedule,1778.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2038,Not in chargemaster,L2038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2038,BCBSND Base HME Schedule,1526.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2040,Not in chargemaster,L2040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2040,BCBSND Base HME Schedule,246.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2050,Not in chargemaster,L2050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2050,BCBSND Base HME Schedule,562.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2060,Not in chargemaster,L2060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2060,BCBSND Base HME Schedule,632.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2070,Not in chargemaster,L2070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2070,BCBSND Base HME Schedule,143.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2080,Not in chargemaster,L2080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2080,BCBSND Base HME Schedule,384.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2090,Not in chargemaster,L2090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2090,BCBSND Base HME Schedule,520.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2106,Not in chargemaster,L2106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2106,BCBSND Base HME Schedule,726.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2108,Not in chargemaster,L2108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2108,BCBSND Base HME Schedule,1299.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2112,Not in chargemaster,L2112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2112,BCBSND Base HME Schedule,498.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2114,Not in chargemaster,L2114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2114,BCBSND Base HME Schedule,624.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2116,Not in chargemaster,L2116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2116,BCBSND Base HME Schedule,760.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2126,Not in chargemaster,L2126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2126,BCBSND Base HME Schedule,1436,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2128,Not in chargemaster,L2128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2128,BCBSND Base HME Schedule,1831.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2132,Not in chargemaster,L2132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2132,BCBSND Base HME Schedule,1113.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2134,Not in chargemaster,L2134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2134,BCBSND Base HME Schedule,1032.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2136,Not in chargemaster,L2136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2136,BCBSND Base HME Schedule,1419.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2180,Not in chargemaster,L2180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2180,BCBSND Base HME Schedule,162.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2182,Not in chargemaster,L2182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2182,BCBSND Base HME Schedule,104.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2184,Not in chargemaster,L2184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2184,BCBSND Base HME Schedule,144.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2186,Not in chargemaster,L2186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2186,BCBSND Base HME Schedule,192.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2188,Not in chargemaster,L2188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2188,BCBSND Base HME Schedule,319.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2190,Not in chargemaster,L2190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2190,BCBSND Base HME Schedule,96.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2192,Not in chargemaster,L2192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2192,BCBSND Base HME Schedule,380.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2200,Not in chargemaster,L2200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2200,BCBSND Base HME Schedule,67.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2210,Not in chargemaster,L2210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2210,BCBSND Base HME Schedule,95.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2220,Not in chargemaster,L2220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2220,BCBSND Base HME Schedule,113.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2230,Not in chargemaster,L2230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2230,BCBSND Base HME Schedule,89.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2232,Not in chargemaster,L2232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2232,BCBSND Base HME Schedule,110.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2240,Not in chargemaster,L2240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2240,BCBSND Base HME Schedule,89.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2250,Not in chargemaster,L2250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2250,BCBSND Base HME Schedule,449.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2260,Not in chargemaster,L2260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2260,BCBSND Base HME Schedule,244.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2265,Not in chargemaster,L2265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2265,BCBSND Base HME Schedule,125.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2270,Not in chargemaster,L2270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2270,BCBSND Base HME Schedule,62.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2275,Not in chargemaster,L2275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2275,BCBSND Base HME Schedule,159.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2280,Not in chargemaster,L2280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2280,BCBSND Base HME Schedule,483.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2300,Not in chargemaster,L2300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2300,BCBSND Base HME Schedule,287.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2310,Not in chargemaster,L2310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2310,BCBSND Base HME Schedule,142.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2320,Not in chargemaster,L2320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2320,BCBSND Base HME Schedule,280.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2330,Not in chargemaster,L2330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2330,BCBSND Base HME Schedule,462.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2335,Not in chargemaster,L2335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2335,BCBSND Base HME Schedule,254.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2340,Not in chargemaster,L2340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2340,BCBSND Base HME Schedule,477.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2350,Not in chargemaster,L2350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2350,BCBSND Base HME Schedule,1111.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2360,Not in chargemaster,L2360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2360,BCBSND Base HME Schedule,61.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2370,Not in chargemaster,L2370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2370,BCBSND Base HME Schedule,274.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2375,Not in chargemaster,L2375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2375,BCBSND Base HME Schedule,120.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2380,Not in chargemaster,L2380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2380,BCBSND Base HME Schedule,175.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2385,Not in chargemaster,L2385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2385,BCBSND Base HME Schedule,190.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2387,Not in chargemaster,L2387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2387,BCBSND Base HME Schedule,176.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2390,Not in chargemaster,L2390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2390,BCBSND Base HME Schedule,155.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2395,Not in chargemaster,L2395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2395,BCBSND Base HME Schedule,198.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2397,Not in chargemaster,L2397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2397,BCBSND Base HME Schedule,137.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2405,Not in chargemaster,L2405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2405,BCBSND Base HME Schedule,100.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2415,Not in chargemaster,L2415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2415,BCBSND Base HME Schedule,140.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2425,Not in chargemaster,L2425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2425,BCBSND Base HME Schedule,165.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2430,Not in chargemaster,L2430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2430,BCBSND Base HME Schedule,165.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2492,Not in chargemaster,L2492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2492,BCBSND Base HME Schedule,136.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2500,Not in chargemaster,L2500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2500,BCBSND Base HME Schedule,336.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2510,Not in chargemaster,L2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2510,BCBSND Base HME Schedule,775.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2520,Not in chargemaster,L2520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2520,BCBSND Base HME Schedule,526.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2525,Not in chargemaster,L2525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2525,BCBSND Base HME Schedule,1463.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2526,Not in chargemaster,L2526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2526,BCBSND Base HME Schedule,947.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2530,Not in chargemaster,L2530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2530,BCBSND Base HME Schedule,334.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2540,Not in chargemaster,L2540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2540,BCBSND Base HME Schedule,512.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2550,Not in chargemaster,L2550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2550,BCBSND Base HME Schedule,408.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2570,Not in chargemaster,L2570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2570,BCBSND Base HME Schedule,508.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2580,Not in chargemaster,L2580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2580,BCBSND Base HME Schedule,648.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2600,Not in chargemaster,L2600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2600,BCBSND Base HME Schedule,238.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2610,Not in chargemaster,L2610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2610,BCBSND Base HME Schedule,271.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2620,Not in chargemaster,L2620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2620,BCBSND Base HME Schedule,285.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2622,Not in chargemaster,L2622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2622,BCBSND Base HME Schedule,327.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2624,Not in chargemaster,L2624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2624,BCBSND Base HME Schedule,353.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2627,Not in chargemaster,L2627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2627,BCBSND Base HME Schedule,2440.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2628,Not in chargemaster,L2628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2628,BCBSND Base HME Schedule,2385.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2630,Not in chargemaster,L2630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2630,BCBSND Base HME Schedule,352.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2640,Not in chargemaster,L2640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2640,BCBSND Base HME Schedule,358.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2650,Not in chargemaster,L2650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2650,BCBSND Base HME Schedule,128.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2660,Not in chargemaster,L2660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2660,BCBSND Base HME Schedule,265.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2670,Not in chargemaster,L2670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2670,BCBSND Base HME Schedule,242.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2680,Not in chargemaster,L2680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2680,BCBSND Base HME Schedule,222.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2750,Not in chargemaster,L2750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2750,BCBSND Base HME Schedule,89.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2755,Not in chargemaster,L2755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2755,BCBSND Base HME Schedule,150.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2760,Not in chargemaster,L2760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2760,BCBSND Base HME Schedule,86.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2768,Not in chargemaster,L2768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2768,BCBSND Base HME Schedule,150.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2780,Not in chargemaster,L2780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2780,BCBSND Base HME Schedule,72.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2785,Not in chargemaster,L2785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2785,BCBSND Base HME Schedule,33.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2795,Not in chargemaster,L2795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2795,BCBSND Base HME Schedule,90.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2800,Not in chargemaster,L2800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2800,BCBSND Base HME Schedule,124.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2810,Not in chargemaster,L2810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2810,BCBSND Base HME Schedule,83.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2820,Not in chargemaster,L2820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2820,BCBSND Base HME Schedule,123.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2830,Not in chargemaster,L2830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2830,BCBSND Base HME Schedule,133.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2840,Not in chargemaster,L2840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2840,BCBSND Base HME Schedule,46.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L2850,Not in chargemaster,L2850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L2850,BCBSND Base HME Schedule,84.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3000,Not in chargemaster,L3000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3000,BCBSND Base HME Schedule,362.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3001,Not in chargemaster,L3001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3001,BCBSND Base HME Schedule,152.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3002,Not in chargemaster,L3002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3002,BCBSND Base HME Schedule,186.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3003,Not in chargemaster,L3003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3003,BCBSND Base HME Schedule,201.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3010,Not in chargemaster,L3010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3010,BCBSND Base HME Schedule,201.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3020,Not in chargemaster,L3020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3020,BCBSND Base HME Schedule,229.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3030,Not in chargemaster,L3030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3030,BCBSND Base HME Schedule,88.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3031,Not in chargemaster,L3031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3031,BCBSND Base HME Schedule,141.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3040,Not in chargemaster,L3040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3040,BCBSND Base HME Schedule,54.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3050,Not in chargemaster,L3050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3050,BCBSND Base HME Schedule,54.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3060,Not in chargemaster,L3060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3060,BCBSND Base HME Schedule,85.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3070,Not in chargemaster,L3070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3070,BCBSND Base HME Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3080,Not in chargemaster,L3080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3080,BCBSND Base HME Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3090,Not in chargemaster,L3090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3090,BCBSND Base HME Schedule,46.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3100,Not in chargemaster,L3100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3100,BCBSND Base HME Schedule,49.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3140,Not in chargemaster,L3140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3140,BCBSND Base HME Schedule,102.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3150,Not in chargemaster,L3150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3150,BCBSND Base HME Schedule,93.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3170,Not in chargemaster,L3170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3170,BCBSND Base HME Schedule,58.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3201,Not in chargemaster,L3201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3201,BCBSND Base HME Schedule,77.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3202,Not in chargemaster,L3202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3202,BCBSND Base HME Schedule,77.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3204,Not in chargemaster,L3204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3204,BCBSND Base HME Schedule,77.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3206,Not in chargemaster,L3206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3206,BCBSND Base HME Schedule,77.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3208,Not in chargemaster,L3208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3208,BCBSND Base HME Schedule,66.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3209,Not in chargemaster,L3209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3209,BCBSND Base HME Schedule,74.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3211,Not in chargemaster,L3211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3211,BCBSND Base HME Schedule,85.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3212,Not in chargemaster,L3212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3212,BCBSND Base HME Schedule,101.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3213,Not in chargemaster,L3213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3213,BCBSND Base HME Schedule,114.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3214,Not in chargemaster,L3214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3214,BCBSND Base HME Schedule,131.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3215,Not in chargemaster,L3215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3215,BCBSND Base HME Schedule,124.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3216,Not in chargemaster,L3216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3216,BCBSND Base HME Schedule,159.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3221,Not in chargemaster,L3221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3221,BCBSND Base HME Schedule,149,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3224,Not in chargemaster,L3224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3224,BCBSND Base HME Schedule,65.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3225,Not in chargemaster,L3225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3225,BCBSND Base HME Schedule,87.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3260,Not in chargemaster,L3260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3260,BCBSND Base HME Schedule,31.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3265,Not in chargemaster,L3265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3265,BCBSND Base HME Schedule,17.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3300,Not in chargemaster,L3300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3300,BCBSND Base HME Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3310,Not in chargemaster,L3310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3310,BCBSND Base HME Schedule,93.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3330,Not in chargemaster,L3330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3330,BCBSND Base HME Schedule,653.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3332,Not in chargemaster,L3332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3332,BCBSND Base HME Schedule,85.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3334,Not in chargemaster,L3334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3334,BCBSND Base HME Schedule,44.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3340,Not in chargemaster,L3340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3340,BCBSND Base HME Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3350,Not in chargemaster,L3350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3350,BCBSND Base HME Schedule,26.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3360,Not in chargemaster,L3360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3360,BCBSND Base HME Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3370,Not in chargemaster,L3370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3370,BCBSND Base HME Schedule,57.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3380,Not in chargemaster,L3380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3380,BCBSND Base HME Schedule,57.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3390,Not in chargemaster,L3390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3390,BCBSND Base HME Schedule,57.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3400,Not in chargemaster,L3400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3400,BCBSND Base HME Schedule,46.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3410,Not in chargemaster,L3410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3410,BCBSND Base HME Schedule,107.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3420,Not in chargemaster,L3420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3420,BCBSND Base HME Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3430,Not in chargemaster,L3430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3430,BCBSND Base HME Schedule,185.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3440,Not in chargemaster,L3440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3440,BCBSND Base HME Schedule,88.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3450,Not in chargemaster,L3450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3450,BCBSND Base HME Schedule,121.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3455,Not in chargemaster,L3455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3455,BCBSND Base HME Schedule,46.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3460,Not in chargemaster,L3460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3460,BCBSND Base HME Schedule,39.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3465,Not in chargemaster,L3465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3465,BCBSND Base HME Schedule,67.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3470,Not in chargemaster,L3470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3470,BCBSND Base HME Schedule,71.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3480,Not in chargemaster,L3480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3480,BCBSND Base HME Schedule,71.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3485,Not in chargemaster,L3485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3485,BCBSND Base HME Schedule,18.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3500,Not in chargemaster,L3500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3500,BCBSND Base HME Schedule,33.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3510,Not in chargemaster,L3510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3510,BCBSND Base HME Schedule,33.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3520,Not in chargemaster,L3520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3520,BCBSND Base HME Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3530,Not in chargemaster,L3530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3530,BCBSND Base HME Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3540,Not in chargemaster,L3540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3540,BCBSND Base HME Schedule,58.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3550,Not in chargemaster,L3550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3550,BCBSND Base HME Schedule,10.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3560,Not in chargemaster,L3560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3560,BCBSND Base HME Schedule,26.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3570,Not in chargemaster,L3570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3570,BCBSND Base HME Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3580,Not in chargemaster,L3580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3580,BCBSND Base HME Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3590,Not in chargemaster,L3590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3590,BCBSND Base HME Schedule,61.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3595,Not in chargemaster,L3595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3595,BCBSND Base HME Schedule,48.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3600,Not in chargemaster,L3600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3600,BCBSND Base HME Schedule,88.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3610,Not in chargemaster,L3610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3610,BCBSND Base HME Schedule,116.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3620,Not in chargemaster,L3620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3620,BCBSND Base HME Schedule,88.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3630,Not in chargemaster,L3630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3630,BCBSND Base HME Schedule,116.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3640,Not in chargemaster,L3640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3640,BCBSND Base HME Schedule,49.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3650,Not in chargemaster,L3650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3650,BCBSND Base HME Schedule,61.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3660,Not in chargemaster,L3660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3660,BCBSND Base HME Schedule,140.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3670,Not in chargemaster,L3670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3670,BCBSND Base HME Schedule,118.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3671,Not in chargemaster,L3671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3671,BCBSND Base HME Schedule,946.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3674,Not in chargemaster,L3674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3674,BCBSND Base HME Schedule,1242.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3675,Not in chargemaster,L3675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3675,BCBSND Base HME Schedule,184.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3677,Not in chargemaster,L3677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3677,BCBSND Base HME Schedule,61.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3702,Not in chargemaster,L3702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3702,BCBSND Base HME Schedule,303.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3710,Not in chargemaster,L3710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3710,BCBSND Base HME Schedule,129.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3720,Not in chargemaster,L3720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3720,BCBSND Base HME Schedule,683.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3730,Not in chargemaster,L3730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3730,BCBSND Base HME Schedule,941.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3740,Not in chargemaster,L3740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3740,BCBSND Base HME Schedule,1116.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3760,Not in chargemaster,L3760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3760,BCBSND Base HME Schedule,525.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3761,Not in chargemaster,L3761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3761,BCBSND Base HME Schedule,525.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3762,Not in chargemaster,L3762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3762,BCBSND Base HME Schedule,112.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3763,Not in chargemaster,L3763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3763,BCBSND Base HME Schedule,705.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3764,Not in chargemaster,L3764,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3764,BCBSND Base HME Schedule,806.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3765,Not in chargemaster,L3765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3765,BCBSND Base HME Schedule,1347.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3766,Not in chargemaster,L3766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3766,BCBSND Base HME Schedule,1426.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3806,Not in chargemaster,L3806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3806,BCBSND Base HME Schedule,477.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3807,Not in chargemaster,L3807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3807,BCBSND Base HME Schedule,262.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3808,Not in chargemaster,L3808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3808,BCBSND Base HME Schedule,381.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3809,Not in chargemaster,L3809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3809,BCBSND Base HME Schedule,262.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3900,Not in chargemaster,L3900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3900,BCBSND Base HME Schedule,1352.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3901,Not in chargemaster,L3901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3901,BCBSND Base HME Schedule,2151.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3904,Not in chargemaster,L3904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3904,BCBSND Base HME Schedule,4080.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3905,Not in chargemaster,L3905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3905,BCBSND Base HME Schedule,1042.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3906,Not in chargemaster,L3906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3906,BCBSND Base HME Schedule,427.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3908,Not in chargemaster,L3908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3908,BCBSND Base HME Schedule,62.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3912,Not in chargemaster,L3912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3912,BCBSND Base HME Schedule,99.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3913,Not in chargemaster,L3913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3913,BCBSND Base HME Schedule,284.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3915,Not in chargemaster,L3915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3915,BCBSND Base HME Schedule,558.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3916,Not in chargemaster,L3916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3916,BCBSND Base HME Schedule,558.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3917,Not in chargemaster,L3917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3917,BCBSND Base HME Schedule,110.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3918,Not in chargemaster,L3918,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3918,BCBSND Base HME Schedule,110.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3919,Not in chargemaster,L3919,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3919,BCBSND Base HME Schedule,284.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3921,Not in chargemaster,L3921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3921,BCBSND Base HME Schedule,337.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3923,Not in chargemaster,L3923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3923,BCBSND Base HME Schedule,90.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3924,Not in chargemaster,L3924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3924,BCBSND Base HME Schedule,90.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3925,Not in chargemaster,L3925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3925,BCBSND Base HME Schedule,51.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3927,Not in chargemaster,L3927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3927,BCBSND Base HME Schedule,36.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3929,Not in chargemaster,L3929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3929,BCBSND Base HME Schedule,81.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3930,Not in chargemaster,L3930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3930,BCBSND Base HME Schedule,81.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3931,Not in chargemaster,L3931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3931,BCBSND Base HME Schedule,201.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3933,Not in chargemaster,L3933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3933,BCBSND Base HME Schedule,224.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3935,Not in chargemaster,L3935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3935,BCBSND Base HME Schedule,232.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3960,Not in chargemaster,L3960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3960,BCBSND Base HME Schedule,767.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3961,Not in chargemaster,L3961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3961,BCBSND Base HME Schedule,1765.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3962,Not in chargemaster,L3962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3962,BCBSND Base HME Schedule,749.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3967,Not in chargemaster,L3967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3967,BCBSND Base HME Schedule,2084.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3971,Not in chargemaster,L3971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3971,BCBSND Base HME Schedule,1978.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3973,Not in chargemaster,L3973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3973,BCBSND Base HME Schedule,2084.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3975,Not in chargemaster,L3975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3975,BCBSND Base HME Schedule,1765.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3976,Not in chargemaster,L3976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3976,BCBSND Base HME Schedule,1765.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3977,Not in chargemaster,L3977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3977,BCBSND Base HME Schedule,1978.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3978,Not in chargemaster,L3978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3978,BCBSND Base HME Schedule,2084.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3980,Not in chargemaster,L3980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3980,BCBSND Base HME Schedule,323.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3981,Not in chargemaster,L3981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3981,BCBSND Base HME Schedule,1059.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3982,Not in chargemaster,L3982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3982,BCBSND Base HME Schedule,399.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3984,Not in chargemaster,L3984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3984,BCBSND Base HME Schedule,413.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L3995,Not in chargemaster,L3995,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L3995,BCBSND Base HME Schedule,34.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4000,Not in chargemaster,L4000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4000,BCBSND Base HME Schedule,1544.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4002,Not in chargemaster,L4002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4002,BCBSND Base HME Schedule,21.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4010,Not in chargemaster,L4010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4010,BCBSND Base HME Schedule,776.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4020,Not in chargemaster,L4020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4020,BCBSND Base HME Schedule,919.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4030,Not in chargemaster,L4030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4030,BCBSND Base HME Schedule,539.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4040,Not in chargemaster,L4040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4040,BCBSND Base HME Schedule,455.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4045,Not in chargemaster,L4045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4045,BCBSND Base HME Schedule,421.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4050,Not in chargemaster,L4050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4050,BCBSND Base HME Schedule,440.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4055,Not in chargemaster,L4055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4055,BCBSND Base HME Schedule,285.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4060,Not in chargemaster,L4060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4060,BCBSND Base HME Schedule,452.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4070,Not in chargemaster,L4070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4070,BCBSND Base HME Schedule,300.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4080,Not in chargemaster,L4080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4080,BCBSND Base HME Schedule,108.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4090,Not in chargemaster,L4090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4090,BCBSND Base HME Schedule,96.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4100,Not in chargemaster,L4100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4100,BCBSND Base HME Schedule,111.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4110,Not in chargemaster,L4110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4110,BCBSND Base HME Schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4130,Not in chargemaster,L4130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4130,BCBSND Base HME Schedule,608.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4205,Not in chargemaster,L4205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4205,BCBSND Base HME Schedule,26.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4210,Not in chargemaster,L4210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4210,BCBSND Base HME Schedule,34.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4350,Not in chargemaster,L4350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4350,BCBSND Base HME Schedule,95.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4360,Not in chargemaster,L4360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4360,BCBSND Base HME Schedule,319.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4361,Not in chargemaster,L4361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4361,BCBSND Base HME Schedule,319.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4370,Not in chargemaster,L4370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4370,BCBSND Base HME Schedule,221.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4386,Not in chargemaster,L4386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4386,BCBSND Base HME Schedule,183.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4387,Not in chargemaster,L4387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4387,BCBSND Base HME Schedule,183.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4392,Not in chargemaster,L4392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4392,BCBSND Base HME Schedule,26.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4394,Not in chargemaster,L4394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4394,BCBSND Base HME Schedule,19.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4396,Not in chargemaster,L4396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4396,BCBSND Base HME Schedule,190.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4397,Not in chargemaster,L4397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4397,BCBSND Base HME Schedule,190.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4398,Not in chargemaster,L4398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4398,BCBSND Base HME Schedule,87.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L4631,Not in chargemaster,L4631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L4631,BCBSND Base HME Schedule,1589.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5000,Not in chargemaster,L5000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5000,BCBSND Base HME Schedule,574.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5010,Not in chargemaster,L5010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5010,BCBSND Base HME Schedule,1519.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5020,Not in chargemaster,L5020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5020,BCBSND Base HME Schedule,2666.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5050,Not in chargemaster,L5050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5050,BCBSND Base HME Schedule,2832.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5060,Not in chargemaster,L5060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5060,BCBSND Base HME Schedule,3839.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5100,Not in chargemaster,L5100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5100,BCBSND Base HME Schedule,2644.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5105,Not in chargemaster,L5105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5105,BCBSND Base HME Schedule,4335.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5150,Not in chargemaster,L5150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5150,BCBSND Base HME Schedule,4425.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5160,Not in chargemaster,L5160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5160,BCBSND Base HME Schedule,4873.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5200,Not in chargemaster,L5200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5200,BCBSND Base HME Schedule,3758.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5210,Not in chargemaster,L5210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5210,BCBSND Base HME Schedule,2975.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5220,Not in chargemaster,L5220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5220,BCBSND Base HME Schedule,3428.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5230,Not in chargemaster,L5230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5230,BCBSND Base HME Schedule,5770.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5250,Not in chargemaster,L5250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5250,BCBSND Base HME Schedule,7414.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5270,Not in chargemaster,L5270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5270,BCBSND Base HME Schedule,6763.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5280,Not in chargemaster,L5280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5280,BCBSND Base HME Schedule,7682.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5301,Not in chargemaster,L5301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5301,BCBSND Base HME Schedule,2633.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5312,Not in chargemaster,L5312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5312,BCBSND Base HME Schedule,4149.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5321,Not in chargemaster,L5321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5321,BCBSND Base HME Schedule,3739.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5331,Not in chargemaster,L5331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5331,BCBSND Base HME Schedule,6373.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5341,Not in chargemaster,L5341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5341,BCBSND Base HME Schedule,6901.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5400,Not in chargemaster,L5400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5400,BCBSND Base HME Schedule,1396.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5410,Not in chargemaster,L5410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5410,BCBSND Base HME Schedule,475.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5420,Not in chargemaster,L5420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5420,BCBSND Base HME Schedule,1944.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5430,Not in chargemaster,L5430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5430,BCBSND Base HME Schedule,572.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5450,Not in chargemaster,L5450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5450,BCBSND Base HME Schedule,557.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5460,Not in chargemaster,L5460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5460,BCBSND Base HME Schedule,652.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5500,Not in chargemaster,L5500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5500,BCBSND Base HME Schedule,1924.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5505,Not in chargemaster,L5505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5505,BCBSND Base HME Schedule,2240.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5510,Not in chargemaster,L5510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5510,BCBSND Base HME Schedule,1917.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5520,Not in chargemaster,L5520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5520,BCBSND Base HME Schedule,1636.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5530,Not in chargemaster,L5530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5530,BCBSND Base HME Schedule,2153.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5535,Not in chargemaster,L5535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5535,BCBSND Base HME Schedule,1929.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5540,Not in chargemaster,L5540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5540,BCBSND Base HME Schedule,2311.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5560,Not in chargemaster,L5560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5560,BCBSND Base HME Schedule,2701.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5570,Not in chargemaster,L5570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5570,BCBSND Base HME Schedule,2923.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5580,Not in chargemaster,L5580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5580,BCBSND Base HME Schedule,3284.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5585,Not in chargemaster,L5585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5585,BCBSND Base HME Schedule,3292.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5590,Not in chargemaster,L5590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5590,BCBSND Base HME Schedule,3492.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5595,Not in chargemaster,L5595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5595,BCBSND Base HME Schedule,4580.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5600,Not in chargemaster,L5600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5600,BCBSND Base HME Schedule,5058.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5610,Not in chargemaster,L5610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5610,BCBSND Base HME Schedule,3050.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5611,Not in chargemaster,L5611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5611,BCBSND Base HME Schedule,2444.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5613,Not in chargemaster,L5613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5613,BCBSND Base HME Schedule,3495.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5614,Not in chargemaster,L5614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5614,BCBSND Base HME Schedule,1952.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5616,Not in chargemaster,L5616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5616,BCBSND Base HME Schedule,2028.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5617,Not in chargemaster,L5617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5617,BCBSND Base HME Schedule,645.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5618,Not in chargemaster,L5618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5618,BCBSND Base HME Schedule,319.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5620,Not in chargemaster,L5620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5620,BCBSND Base HME Schedule,316.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5622,Not in chargemaster,L5622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5622,BCBSND Base HME Schedule,412.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5624,Not in chargemaster,L5624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5624,BCBSND Base HME Schedule,414.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5626,Not in chargemaster,L5626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5626,BCBSND Base HME Schedule,542.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5628,Not in chargemaster,L5628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5628,BCBSND Base HME Schedule,549.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5629,Not in chargemaster,L5629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5629,BCBSND Base HME Schedule,361.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5630,Not in chargemaster,L5630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5630,BCBSND Base HME Schedule,557.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5631,Not in chargemaster,L5631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5631,BCBSND Base HME Schedule,499.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5632,Not in chargemaster,L5632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5632,BCBSND Base HME Schedule,310.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5634,Not in chargemaster,L5634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5634,BCBSND Base HME Schedule,461.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5636,Not in chargemaster,L5636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5636,BCBSND Base HME Schedule,386.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5637,Not in chargemaster,L5637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5637,BCBSND Base HME Schedule,328.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5638,Not in chargemaster,L5638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5638,BCBSND Base HME Schedule,738.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5639,Not in chargemaster,L5639,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5639,BCBSND Base HME Schedule,1700.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5640,Not in chargemaster,L5640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5640,BCBSND Base HME Schedule,969.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5642,Not in chargemaster,L5642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5642,BCBSND Base HME Schedule,939.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5643,Not in chargemaster,L5643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5643,BCBSND Base HME Schedule,2361.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5644,Not in chargemaster,L5644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5644,BCBSND Base HME Schedule,895.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5645,Not in chargemaster,L5645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5645,BCBSND Base HME Schedule,1210.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5646,Not in chargemaster,L5646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5646,BCBSND Base HME Schedule,807.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5647,Not in chargemaster,L5647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5647,BCBSND Base HME Schedule,1104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5648,Not in chargemaster,L5648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5648,BCBSND Base HME Schedule,998.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5649,Not in chargemaster,L5649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5649,BCBSND Base HME Schedule,2411.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5650,Not in chargemaster,L5650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5650,BCBSND Base HME Schedule,740.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5651,Not in chargemaster,L5651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5651,BCBSND Base HME Schedule,1821.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5652,Not in chargemaster,L5652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5652,BCBSND Base HME Schedule,661.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5653,Not in chargemaster,L5653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5653,BCBSND Base HME Schedule,882.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5654,Not in chargemaster,L5654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5654,BCBSND Base HME Schedule,379.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5655,Not in chargemaster,L5655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5655,BCBSND Base HME Schedule,301.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5656,Not in chargemaster,L5656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5656,BCBSND Base HME Schedule,435.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5658,Not in chargemaster,L5658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5658,BCBSND Base HME Schedule,474.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5661,Not in chargemaster,L5661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5661,BCBSND Base HME Schedule,692.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5665,Not in chargemaster,L5665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5665,BCBSND Base HME Schedule,582.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5666,Not in chargemaster,L5666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5666,BCBSND Base HME Schedule,79.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5668,Not in chargemaster,L5668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5668,BCBSND Base HME Schedule,114.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5670,Not in chargemaster,L5670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5670,BCBSND Base HME Schedule,411.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5671,Not in chargemaster,L5671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5671,BCBSND Base HME Schedule,754.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5672,Not in chargemaster,L5672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5672,BCBSND Base HME Schedule,452.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5673,Not in chargemaster,L5673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5673,BCBSND Base HME Schedule,862.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5676,Not in chargemaster,L5676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5676,BCBSND Base HME Schedule,509.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5677,Not in chargemaster,L5677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5677,BCBSND Base HME Schedule,560.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5678,Not in chargemaster,L5678,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5678,BCBSND Base HME Schedule,58.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5679,Not in chargemaster,L5679,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5679,BCBSND Base HME Schedule,718.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5680,Not in chargemaster,L5680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5680,BCBSND Base HME Schedule,422.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5681,Not in chargemaster,L5681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5681,BCBSND Base HME Schedule,1524.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5682,Not in chargemaster,L5682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5682,BCBSND Base HME Schedule,711.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5683,Not in chargemaster,L5683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5683,BCBSND Base HME Schedule,1524.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5684,Not in chargemaster,L5684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5684,BCBSND Base HME Schedule,55.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5685,Not in chargemaster,L5685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5685,BCBSND Base HME Schedule,148.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5686,Not in chargemaster,L5686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5686,BCBSND Base HME Schedule,68.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5688,Not in chargemaster,L5688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5688,BCBSND Base HME Schedule,69.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5690,Not in chargemaster,L5690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5690,BCBSND Base HME Schedule,111.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5692,Not in chargemaster,L5692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5692,BCBSND Base HME Schedule,156.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5694,Not in chargemaster,L5694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5694,BCBSND Base HME Schedule,230.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5695,Not in chargemaster,L5695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5695,BCBSND Base HME Schedule,225.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5696,Not in chargemaster,L5696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5696,BCBSND Base HME Schedule,210.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5697,Not in chargemaster,L5697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5697,BCBSND Base HME Schedule,99.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5698,Not in chargemaster,L5698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5698,BCBSND Base HME Schedule,118.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5699,Not in chargemaster,L5699,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5699,BCBSND Base HME Schedule,212.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5700,Not in chargemaster,L5700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5700,BCBSND Base HME Schedule,3228.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5701,Not in chargemaster,L5701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5701,BCBSND Base HME Schedule,4308.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5702,Not in chargemaster,L5702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5702,BCBSND Base HME Schedule,5938.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5703,Not in chargemaster,L5703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5703,BCBSND Base HME Schedule,2574.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5704,Not in chargemaster,L5704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5704,BCBSND Base HME Schedule,673.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5705,Not in chargemaster,L5705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5705,BCBSND Base HME Schedule,1143.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5706,Not in chargemaster,L5706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5706,BCBSND Base HME Schedule,1128.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5707,Not in chargemaster,L5707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5707,BCBSND Base HME Schedule,1557.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5710,Not in chargemaster,L5710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5710,BCBSND Base HME Schedule,482.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5711,Not in chargemaster,L5711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5711,BCBSND Base HME Schedule,594.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5712,Not in chargemaster,L5712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5712,BCBSND Base HME Schedule,490.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5714,Not in chargemaster,L5714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5714,BCBSND Base HME Schedule,577.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5716,Not in chargemaster,L5716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5716,BCBSND Base HME Schedule,1105.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5718,Not in chargemaster,L5718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5718,BCBSND Base HME Schedule,1381.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5722,Not in chargemaster,L5722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5722,BCBSND Base HME Schedule,1142.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5724,Not in chargemaster,L5724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5724,BCBSND Base HME Schedule,1794.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5726,Not in chargemaster,L5726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5726,BCBSND Base HME Schedule,1979.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5728,Not in chargemaster,L5728,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5728,BCBSND Base HME Schedule,3258.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5780,Not in chargemaster,L5780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5780,BCBSND Base HME Schedule,1307.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5781,Not in chargemaster,L5781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5781,BCBSND Base HME Schedule,4628.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5782,Not in chargemaster,L5782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5782,BCBSND Base HME Schedule,4879.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5785,Not in chargemaster,L5785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5785,BCBSND Base HME Schedule,591.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5790,Not in chargemaster,L5790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5790,BCBSND Base HME Schedule,818.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5795,Not in chargemaster,L5795,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5795,BCBSND Base HME Schedule,1221.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5810,Not in chargemaster,L5810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5810,BCBSND Base HME Schedule,614.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5811,Not in chargemaster,L5811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5811,BCBSND Base HME Schedule,1074.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5812,Not in chargemaster,L5812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5812,BCBSND Base HME Schedule,791.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5814,Not in chargemaster,L5814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5814,BCBSND Base HME Schedule,4296.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5816,Not in chargemaster,L5816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5816,BCBSND Base HME Schedule,1290.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5818,Not in chargemaster,L5818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5818,BCBSND Base HME Schedule,1456.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5822,Not in chargemaster,L5822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5822,BCBSND Base HME Schedule,2142.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5824,Not in chargemaster,L5824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5824,BCBSND Base HME Schedule,2326.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5826,Not in chargemaster,L5826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5826,BCBSND Base HME Schedule,3612.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5828,Not in chargemaster,L5828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5828,BCBSND Base HME Schedule,3612.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5830,Not in chargemaster,L5830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5830,BCBSND Base HME Schedule,2158.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5840,Not in chargemaster,L5840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5840,BCBSND Base HME Schedule,4439.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5845,Not in chargemaster,L5845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5845,BCBSND Base HME Schedule,2073.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5848,Not in chargemaster,L5848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5848,BCBSND Base HME Schedule,1243.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5850,Not in chargemaster,L5850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5850,BCBSND Base HME Schedule,194.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5855,Not in chargemaster,L5855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5855,BCBSND Base HME Schedule,465.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5856,Not in chargemaster,L5856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5856,BCBSND Base HME Schedule,27751.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5857,Not in chargemaster,L5857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5857,BCBSND Base HME Schedule,9834.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5858,Not in chargemaster,L5858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5858,BCBSND Base HME Schedule,21500.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5859,Not in chargemaster,L5859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5859,BCBSND Base HME Schedule,16785.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5910,Not in chargemaster,L5910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5910,BCBSND Base HME Schedule,549.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5920,Not in chargemaster,L5920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5920,BCBSND Base HME Schedule,799.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5925,Not in chargemaster,L5925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5925,BCBSND Base HME Schedule,509.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5930,Not in chargemaster,L5930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5930,BCBSND Base HME Schedule,3881.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5940,Not in chargemaster,L5940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5940,BCBSND Base HME Schedule,760.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5950,Not in chargemaster,L5950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5950,BCBSND Base HME Schedule,919.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5960,Not in chargemaster,L5960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5960,BCBSND Base HME Schedule,1096.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5961,Not in chargemaster,L5961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5961,BCBSND Base HME Schedule,5833.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5962,Not in chargemaster,L5962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5962,BCBSND Base HME Schedule,851.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5964,Not in chargemaster,L5964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5964,BCBSND Base HME Schedule,1203.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5966,Not in chargemaster,L5966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5966,BCBSND Base HME Schedule,1530.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5968,Not in chargemaster,L5968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5968,BCBSND Base HME Schedule,4203.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5969,Not in chargemaster,L5969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5969,BCBSND Base HME Schedule,18145.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5970,Not in chargemaster,L5970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5970,BCBSND Base HME Schedule,258.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5971,Not in chargemaster,L5971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5971,BCBSND Base HME Schedule,258.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5972,Not in chargemaster,L5972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5972,BCBSND Base HME Schedule,500.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5973,Not in chargemaster,L5973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5973,BCBSND Base HME Schedule,20176.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5974,Not in chargemaster,L5974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5974,BCBSND Base HME Schedule,268.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5975,Not in chargemaster,L5975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5975,BCBSND Base HME Schedule,536.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5976,Not in chargemaster,L5976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5976,BCBSND Base HME Schedule,687.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5978,Not in chargemaster,L5978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5978,BCBSND Base HME Schedule,332.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5979,Not in chargemaster,L5979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5979,BCBSND Base HME Schedule,3142.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5980,Not in chargemaster,L5980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5980,BCBSND Base HME Schedule,5624.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5981,Not in chargemaster,L5981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5981,BCBSND Base HME Schedule,3675.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5982,Not in chargemaster,L5982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5982,BCBSND Base HME Schedule,876.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5984,Not in chargemaster,L5984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5984,BCBSND Base HME Schedule,686.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5985,Not in chargemaster,L5985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5985,BCBSND Base HME Schedule,325.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5986,Not in chargemaster,L5986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5986,BCBSND Base HME Schedule,961.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5987,Not in chargemaster,L5987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5987,BCBSND Base HME Schedule,8322.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5988,Not in chargemaster,L5988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5988,BCBSND Base HME Schedule,2310.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L5990,Not in chargemaster,L5990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L5990,BCBSND Base HME Schedule,2098.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6000,Not in chargemaster,L6000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6000,BCBSND Base HME Schedule,1511.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6010,Not in chargemaster,L6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6010,BCBSND Base HME Schedule,1790.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6020,Not in chargemaster,L6020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6020,BCBSND Base HME Schedule,1594.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6026,Not in chargemaster,L6026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6026,BCBSND Base HME Schedule,5418.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6050,Not in chargemaster,L6050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6050,BCBSND Base HME Schedule,2325.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6055,Not in chargemaster,L6055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6055,BCBSND Base HME Schedule,3219.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6100,Not in chargemaster,L6100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6100,BCBSND Base HME Schedule,2302.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6110,Not in chargemaster,L6110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6110,BCBSND Base HME Schedule,2375.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6120,Not in chargemaster,L6120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6120,BCBSND Base HME Schedule,2982.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6130,Not in chargemaster,L6130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6130,BCBSND Base HME Schedule,3218.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6200,Not in chargemaster,L6200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6200,BCBSND Base HME Schedule,3469.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6205,Not in chargemaster,L6205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6205,BCBSND Base HME Schedule,4248.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6250,Not in chargemaster,L6250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6250,BCBSND Base HME Schedule,3088.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6300,Not in chargemaster,L6300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6300,BCBSND Base HME Schedule,4529.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6310,Not in chargemaster,L6310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6310,BCBSND Base HME Schedule,3452.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6320,Not in chargemaster,L6320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6320,BCBSND Base HME Schedule,2072.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6350,Not in chargemaster,L6350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6350,BCBSND Base HME Schedule,5203.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6360,Not in chargemaster,L6360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6360,BCBSND Base HME Schedule,3623.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6370,Not in chargemaster,L6370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6370,BCBSND Base HME Schedule,2310.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6380,Not in chargemaster,L6380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6380,BCBSND Base HME Schedule,1324.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6382,Not in chargemaster,L6382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6382,BCBSND Base HME Schedule,1800.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6384,Not in chargemaster,L6384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6384,BCBSND Base HME Schedule,2496.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6386,Not in chargemaster,L6386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6386,BCBSND Base HME Schedule,456.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6388,Not in chargemaster,L6388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6388,BCBSND Base HME Schedule,575.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6400,Not in chargemaster,L6400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6400,BCBSND Base HME Schedule,3519.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6450,Not in chargemaster,L6450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6450,BCBSND Base HME Schedule,4676.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6500,Not in chargemaster,L6500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6500,BCBSND Base HME Schedule,4599.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6550,Not in chargemaster,L6550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6550,BCBSND Base HME Schedule,5752.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6570,Not in chargemaster,L6570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6570,BCBSND Base HME Schedule,5985.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6580,Not in chargemaster,L6580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6580,BCBSND Base HME Schedule,2140.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6582,Not in chargemaster,L6582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6582,BCBSND Base HME Schedule,2087.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6584,Not in chargemaster,L6584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6584,BCBSND Base HME Schedule,2328.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6586,Not in chargemaster,L6586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6586,BCBSND Base HME Schedule,2422.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6588,Not in chargemaster,L6588,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6588,BCBSND Base HME Schedule,3215.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6590,Not in chargemaster,L6590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6590,BCBSND Base HME Schedule,3225.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6600,Not in chargemaster,L6600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6600,BCBSND Base HME Schedule,213.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6605,Not in chargemaster,L6605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6605,BCBSND Base HME Schedule,210.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6610,Not in chargemaster,L6610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6610,BCBSND Base HME Schedule,192.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6611,Not in chargemaster,L6611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6611,BCBSND Base HME Schedule,476.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6615,Not in chargemaster,L6615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6615,BCBSND Base HME Schedule,222.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6616,Not in chargemaster,L6616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6616,BCBSND Base HME Schedule,73.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6620,Not in chargemaster,L6620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6620,BCBSND Base HME Schedule,387.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6621,Not in chargemaster,L6621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6621,BCBSND Base HME Schedule,2646.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6623,Not in chargemaster,L6623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6623,BCBSND Base HME Schedule,729.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6624,Not in chargemaster,L6624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6624,BCBSND Base HME Schedule,4356.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6625,Not in chargemaster,L6625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6625,BCBSND Base HME Schedule,605.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6628,Not in chargemaster,L6628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6628,BCBSND Base HME Schedule,726.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6629,Not in chargemaster,L6629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6629,BCBSND Base HME Schedule,208.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6630,Not in chargemaster,L6630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6630,BCBSND Base HME Schedule,245.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6632,Not in chargemaster,L6632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6632,BCBSND Base HME Schedule,98.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6635,Not in chargemaster,L6635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6635,BCBSND Base HME Schedule,235.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6637,Not in chargemaster,L6637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6637,BCBSND Base HME Schedule,417.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6638,Not in chargemaster,L6638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6638,BCBSND Base HME Schedule,2892.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6640,Not in chargemaster,L6640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6640,BCBSND Base HME Schedule,333.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6641,Not in chargemaster,L6641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6641,BCBSND Base HME Schedule,183.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6642,Not in chargemaster,L6642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6642,BCBSND Base HME Schedule,247.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6645,Not in chargemaster,L6645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6645,BCBSND Base HME Schedule,363.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6646,Not in chargemaster,L6646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6646,BCBSND Base HME Schedule,3648.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6647,Not in chargemaster,L6647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6647,BCBSND Base HME Schedule,600.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6648,Not in chargemaster,L6648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6648,BCBSND Base HME Schedule,3763.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6650,Not in chargemaster,L6650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6650,BCBSND Base HME Schedule,385.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6655,Not in chargemaster,L6655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6655,BCBSND Base HME Schedule,85.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6660,Not in chargemaster,L6660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6660,BCBSND Base HME Schedule,106.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6665,Not in chargemaster,L6665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6665,BCBSND Base HME Schedule,52.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6670,Not in chargemaster,L6670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6670,BCBSND Base HME Schedule,54.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6672,Not in chargemaster,L6672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6672,BCBSND Base HME Schedule,230.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6675,Not in chargemaster,L6675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6675,BCBSND Base HME Schedule,136.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6676,Not in chargemaster,L6676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6676,BCBSND Base HME Schedule,161.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6677,Not in chargemaster,L6677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6677,BCBSND Base HME Schedule,343.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6680,Not in chargemaster,L6680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6680,BCBSND Base HME Schedule,279.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6682,Not in chargemaster,L6682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6682,BCBSND Base HME Schedule,304.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6684,Not in chargemaster,L6684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6684,BCBSND Base HME Schedule,433.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6686,Not in chargemaster,L6686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6686,BCBSND Base HME Schedule,671.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6687,Not in chargemaster,L6687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6687,BCBSND Base HME Schedule,874.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6688,Not in chargemaster,L6688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6688,BCBSND Base HME Schedule,602.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6689,Not in chargemaster,L6689,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6689,BCBSND Base HME Schedule,1022.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6690,Not in chargemaster,L6690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6690,BCBSND Base HME Schedule,782.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6691,Not in chargemaster,L6691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6691,BCBSND Base HME Schedule,392.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6692,Not in chargemaster,L6692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6692,BCBSND Base HME Schedule,796.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6693,Not in chargemaster,L6693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6693,BCBSND Base HME Schedule,3284.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6694,Not in chargemaster,L6694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6694,BCBSND Base HME Schedule,862.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6695,Not in chargemaster,L6695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6695,BCBSND Base HME Schedule,718.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6696,Not in chargemaster,L6696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6696,BCBSND Base HME Schedule,1524.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6697,Not in chargemaster,L6697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6697,BCBSND Base HME Schedule,1524.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6698,Not in chargemaster,L6698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6698,BCBSND Base HME Schedule,754.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6703,Not in chargemaster,L6703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6703,BCBSND Base HME Schedule,420.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6704,Not in chargemaster,L6704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6704,BCBSND Base HME Schedule,819.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6706,Not in chargemaster,L6706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6706,BCBSND Base HME Schedule,526.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6707,Not in chargemaster,L6707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6707,BCBSND Base HME Schedule,1625.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6708,Not in chargemaster,L6708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6708,BCBSND Base HME Schedule,1133.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6709,Not in chargemaster,L6709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6709,BCBSND Base HME Schedule,1756.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6711,Not in chargemaster,L6711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6711,BCBSND Base HME Schedule,777.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6712,Not in chargemaster,L6712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6712,BCBSND Base HME Schedule,1432.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6713,Not in chargemaster,L6713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6713,BCBSND Base HME Schedule,1807.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6714,Not in chargemaster,L6714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6714,BCBSND Base HME Schedule,1530.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6715,Not in chargemaster,L6715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6715,BCBSND Base HME Schedule,3659.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6721,Not in chargemaster,L6721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6721,BCBSND Base HME Schedule,2720.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6722,Not in chargemaster,L6722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6722,BCBSND Base HME Schedule,2345.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6805,Not in chargemaster,L6805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6805,BCBSND Base HME Schedule,405.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6810,Not in chargemaster,L6810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6810,BCBSND Base HME Schedule,250.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6880,Not in chargemaster,L6880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6880,BCBSND Base HME Schedule,27695.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6881,Not in chargemaster,L6881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6881,BCBSND Base HME Schedule,4729.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6882,Not in chargemaster,L6882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6882,BCBSND Base HME Schedule,3587.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6883,Not in chargemaster,L6883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6883,BCBSND Base HME Schedule,1949.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6884,Not in chargemaster,L6884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6884,BCBSND Base HME Schedule,2539.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6885,Not in chargemaster,L6885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6885,BCBSND Base HME Schedule,3623.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6890,Not in chargemaster,L6890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6890,BCBSND Base HME Schedule,206.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6895,Not in chargemaster,L6895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6895,BCBSND Base HME Schedule,649.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6900,Not in chargemaster,L6900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6900,BCBSND Base HME Schedule,1718.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6905,Not in chargemaster,L6905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6905,BCBSND Base HME Schedule,1670.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6910,Not in chargemaster,L6910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6910,BCBSND Base HME Schedule,1627.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6915,Not in chargemaster,L6915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6915,BCBSND Base HME Schedule,712.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6920,Not in chargemaster,L6920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6920,BCBSND Base HME Schedule,9229.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6925,Not in chargemaster,L6925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6925,BCBSND Base HME Schedule,9954.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6930,Not in chargemaster,L6930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6930,BCBSND Base HME Schedule,9697.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6935,Not in chargemaster,L6935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6935,BCBSND Base HME Schedule,10411.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6940,Not in chargemaster,L6940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6940,BCBSND Base HME Schedule,13309.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6945,Not in chargemaster,L6945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6945,BCBSND Base HME Schedule,15483.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6950,Not in chargemaster,L6950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6950,BCBSND Base HME Schedule,15127.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6955,Not in chargemaster,L6955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6955,BCBSND Base HME Schedule,18117.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6960,Not in chargemaster,L6960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6960,BCBSND Base HME Schedule,18272.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6965,Not in chargemaster,L6965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6965,BCBSND Base HME Schedule,19797.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6970,Not in chargemaster,L6970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6970,BCBSND Base HME Schedule,20042.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L6975,Not in chargemaster,L6975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L6975,BCBSND Base HME Schedule,21473.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7007,Not in chargemaster,L7007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7007,BCBSND Base HME Schedule,3914.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7008,Not in chargemaster,L7008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7008,BCBSND Base HME Schedule,6588.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7009,Not in chargemaster,L7009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7009,BCBSND Base HME Schedule,4099.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7040,Not in chargemaster,L7040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7040,BCBSND Base HME Schedule,3207.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7045,Not in chargemaster,L7045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7045,BCBSND Base HME Schedule,1838.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7170,Not in chargemaster,L7170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7170,BCBSND Base HME Schedule,6999.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7180,Not in chargemaster,L7180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7180,BCBSND Base HME Schedule,40620.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7181,Not in chargemaster,L7181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7181,BCBSND Base HME Schedule,46352.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7185,Not in chargemaster,L7185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7185,BCBSND Base HME Schedule,7261.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7186,Not in chargemaster,L7186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7186,BCBSND Base HME Schedule,13161.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7190,Not in chargemaster,L7190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7190,BCBSND Base HME Schedule,9187.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7191,Not in chargemaster,L7191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7191,BCBSND Base HME Schedule,13484.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7259,Not in chargemaster,L7259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7259,BCBSND Base HME Schedule,4387.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7360,Not in chargemaster,L7360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7360,BCBSND Base HME Schedule,258.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7362,Not in chargemaster,L7362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7362,BCBSND Base HME Schedule,380.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7364,Not in chargemaster,L7364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7364,BCBSND Base HME Schedule,453.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7366,Not in chargemaster,L7366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7366,BCBSND Base HME Schedule,610.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7367,Not in chargemaster,L7367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7367,BCBSND Base HME Schedule,450.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7368,Not in chargemaster,L7368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7368,BCBSND Base HME Schedule,583.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7400,Not in chargemaster,L7400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7400,BCBSND Base HME Schedule,354.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7401,Not in chargemaster,L7401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7401,BCBSND Base HME Schedule,396.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7402,Not in chargemaster,L7402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7402,BCBSND Base HME Schedule,428.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7403,Not in chargemaster,L7403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7403,BCBSND Base HME Schedule,426.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7404,Not in chargemaster,L7404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7404,BCBSND Base HME Schedule,643.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7405,Not in chargemaster,L7405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7405,BCBSND Base HME Schedule,840.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7520,Not in chargemaster,L7520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7520,BCBSND Base HME Schedule,39.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7600,Not in chargemaster,L7600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7600,BCBSND Base HME Schedule,433.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7700,Not in chargemaster,L7700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7700,BCBSND Base HME Schedule,136.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7900,Not in chargemaster,L7900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7900,BCBSND Base HME Schedule,611.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L7902,Not in chargemaster,L7902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L7902,BCBSND Base HME Schedule,21.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8000,Not in chargemaster,L8000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8000,BCBSND Base HME Schedule,42.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8001,Not in chargemaster,L8001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8001,BCBSND Base HME Schedule,145.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8002,Not in chargemaster,L8002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8002,BCBSND Base HME Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8010,Not in chargemaster,L8010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8010,BCBSND Base HME Schedule,93.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8015,Not in chargemaster,L8015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8015,BCBSND Base HME Schedule,69.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8020,Not in chargemaster,L8020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8020,BCBSND Base HME Schedule,228.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8030,Not in chargemaster,L8030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8030,BCBSND Base HME Schedule,405.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8031,Not in chargemaster,L8031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8031,BCBSND Base HME Schedule,405.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8032,Not in chargemaster,L8032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8032,BCBSND Base HME Schedule,45.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8035,Not in chargemaster,L8035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8035,BCBSND Base HME Schedule,4238.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8040,Not in chargemaster,L8040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8040,BCBSND Base HME Schedule,2672.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8041,Not in chargemaster,L8041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8041,BCBSND Base HME Schedule,3220.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8042,Not in chargemaster,L8042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8042,BCBSND Base HME Schedule,3619.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8043,Not in chargemaster,L8043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8043,BCBSND Base HME Schedule,4053.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8044,Not in chargemaster,L8044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8044,BCBSND Base HME Schedule,4487.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8045,Not in chargemaster,L8045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8045,BCBSND Base HME Schedule,2809.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8046,Not in chargemaster,L8046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8046,BCBSND Base HME Schedule,2895.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8047,Not in chargemaster,L8047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8047,BCBSND Base HME Schedule,1483.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8049,Not in chargemaster,L8049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8049,BCBSND Base HME Schedule,43.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8300,Not in chargemaster,L8300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8300,BCBSND Base HME Schedule,109.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8310,Not in chargemaster,L8310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8310,BCBSND Base HME Schedule,176.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8320,Not in chargemaster,L8320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8320,BCBSND Base HME Schedule,60.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8330,Not in chargemaster,L8330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8330,BCBSND Base HME Schedule,56.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8400,Not in chargemaster,L8400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8400,BCBSND Base HME Schedule,17.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8410,Not in chargemaster,L8410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8410,BCBSND Base HME Schedule,24.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8415,Not in chargemaster,L8415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8415,BCBSND Base HME Schedule,26.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8417,Not in chargemaster,L8417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8417,BCBSND Base HME Schedule,86.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8420,Not in chargemaster,L8420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8420,BCBSND Base HME Schedule,22.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8430,Not in chargemaster,L8430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8430,BCBSND Base HME Schedule,27.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8435,Not in chargemaster,L8435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8435,BCBSND Base HME Schedule,23.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8440,Not in chargemaster,L8440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8440,BCBSND Base HME Schedule,47.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8460,Not in chargemaster,L8460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8460,BCBSND Base HME Schedule,75.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8465,Not in chargemaster,L8465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8465,BCBSND Base HME Schedule,55.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8470,Not in chargemaster,L8470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8470,BCBSND Base HME Schedule,10.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8480,Not in chargemaster,L8480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8480,BCBSND Base HME Schedule,13.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8485,Not in chargemaster,L8485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8485,BCBSND Base HME Schedule,15.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8500,Not in chargemaster,L8500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8500,BCBSND Base HME Schedule,750.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8501,Not in chargemaster,L8501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8501,BCBSND Base HME Schedule,137.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8505,Not in chargemaster,L8505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8505,BCBSND Base HME Schedule,11.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8507,Not in chargemaster,L8507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8507,BCBSND Base HME Schedule,48.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8509,Not in chargemaster,L8509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8509,BCBSND Base HME Schedule,126.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8510,Not in chargemaster,L8510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8510,BCBSND Base HME Schedule,292.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8511,Not in chargemaster,L8511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8511,BCBSND Base HME Schedule,84.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8512,Not in chargemaster,L8512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8512,BCBSND Base HME Schedule,2.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8513,Not in chargemaster,L8513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8513,BCBSND Base HME Schedule,6.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8514,Not in chargemaster,L8514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8514,BCBSND Base HME Schedule,109.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8515,Not in chargemaster,L8515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8515,BCBSND Base HME Schedule,73.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8600,Not in chargemaster,L8600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8600,BCBSND Base HME Schedule,947.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8603,Not in chargemaster,L8603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8603,BCBSND Base HME Schedule,498.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8605,Not in chargemaster,L8605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8605,BCBSND Base HME Schedule,830.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8606,Not in chargemaster,L8606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8606,BCBSND Base HME Schedule,251.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8607,Not in chargemaster,L8607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8607,BCBSND Base HME Schedule,49.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8609,Not in chargemaster,L8609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8609,BCBSND Base HME Schedule,7552.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8610,Not in chargemaster,L8610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8610,BCBSND Base HME Schedule,887.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8612,Not in chargemaster,L8612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8612,BCBSND Base HME Schedule,765.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8613,Not in chargemaster,L8613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8613,BCBSND Base HME Schedule,292.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8614,Not in chargemaster,L8614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8614,BCBSND Base HME Schedule,22088.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8615,Not in chargemaster,L8615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8615,BCBSND Base HME Schedule,522.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8616,Not in chargemaster,L8616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8616,BCBSND Base HME Schedule,121.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8617,Not in chargemaster,L8617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8617,BCBSND Base HME Schedule,106.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8618,Not in chargemaster,L8618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8618,BCBSND Base HME Schedule,30.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8619,Not in chargemaster,L8619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8619,BCBSND Base HME Schedule,9482.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8621,Not in chargemaster,L8621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8621,BCBSND Base HME Schedule,0.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8622,Not in chargemaster,L8622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8622,BCBSND Base HME Schedule,0.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8623,Not in chargemaster,L8623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8623,BCBSND Base HME Schedule,75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8624,Not in chargemaster,L8624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8624,BCBSND Base HME Schedule,186.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8625,Not in chargemaster,L8625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8625,BCBSND Base HME Schedule,218.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8627,Not in chargemaster,L8627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8627,BCBSND Base HME Schedule,8032.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8628,Not in chargemaster,L8628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8628,BCBSND Base HME Schedule,1449.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8629,Not in chargemaster,L8629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8629,BCBSND Base HME Schedule,207.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8630,Not in chargemaster,L8630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8630,BCBSND Base HME Schedule,503.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8631,Not in chargemaster,L8631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8631,BCBSND Base HME Schedule,2511.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8641,Not in chargemaster,L8641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8641,BCBSND Base HME Schedule,531,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8642,Not in chargemaster,L8642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8642,BCBSND Base HME Schedule,347.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8658,Not in chargemaster,L8658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8658,BCBSND Base HME Schedule,462.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8659,Not in chargemaster,L8659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8659,BCBSND Base HME Schedule,2236.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8670,Not in chargemaster,L8670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8670,BCBSND Base HME Schedule,633.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8679,Not in chargemaster,L8679,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8679,BCBSND Base HME Schedule,9777.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8680,Not in chargemaster,L8680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8680,BCBSND Base HME Schedule,582.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8681,Not in chargemaster,L8681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8681,BCBSND Base HME Schedule,1227.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8682,Not in chargemaster,L8682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8682,BCBSND Base HME Schedule,6985.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8683,Not in chargemaster,L8683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8683,BCBSND Base HME Schedule,6148.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8684,Not in chargemaster,L8684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8684,BCBSND Base HME Schedule,909.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8685,Not in chargemaster,L8685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8685,BCBSND Base HME Schedule,16590.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8686,Not in chargemaster,L8686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8686,BCBSND Base HME Schedule,10586.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8687,Not in chargemaster,L8687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8687,BCBSND Base HME Schedule,21591.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8688,Not in chargemaster,L8688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8688,BCBSND Base HME Schedule,13776.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8689,Not in chargemaster,L8689,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8689,BCBSND Base HME Schedule,1999.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8690,Not in chargemaster,L8690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8690,BCBSND Base HME Schedule,5514.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8691,Not in chargemaster,L8691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8691,BCBSND Base HME Schedule,1996.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8692,Not in chargemaster,L8692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8692,BCBSND Base HME Schedule,6634.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8693,Not in chargemaster,L8693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8693,BCBSND Base HME Schedule,1757.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8694,Not in chargemaster,L8694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8694,BCBSND Base HME Schedule,1094.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8695,Not in chargemaster,L8695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8695,BCBSND Base HME Schedule,19.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip L8696,Not in chargemaster,L8696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,L8696,BCBSND Base HME Schedule,251.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0477,Not in chargemaster,Q0477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0477,BCBSND Base HME Schedule,867.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0478,Not in chargemaster,Q0478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0478,BCBSND Base HME Schedule,205.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0479,Not in chargemaster,Q0479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0479,BCBSND Base HME Schedule,13399.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0480,Not in chargemaster,Q0480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0480,BCBSND Base HME Schedule,100736.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0481,Not in chargemaster,Q0481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0481,BCBSND Base HME Schedule,16252.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0482,Not in chargemaster,Q0482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0482,BCBSND Base HME Schedule,5090.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0483,Not in chargemaster,Q0483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0483,BCBSND Base HME Schedule,20971.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0484,Not in chargemaster,Q0484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0484,BCBSND Base HME Schedule,4072.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0485,Not in chargemaster,Q0485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0485,BCBSND Base HME Schedule,393.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0486,Not in chargemaster,Q0486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0486,BCBSND Base HME Schedule,327.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0487,Not in chargemaster,Q0487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0487,BCBSND Base HME Schedule,381.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0489,Not in chargemaster,Q0489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0489,BCBSND Base HME Schedule,18180.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0490,Not in chargemaster,Q0490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0490,BCBSND Base HME Schedule,786.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0491,Not in chargemaster,Q0491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0491,BCBSND Base HME Schedule,1236.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0492,Not in chargemaster,Q0492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0492,BCBSND Base HME Schedule,99.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0493,Not in chargemaster,Q0493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0493,BCBSND Base HME Schedule,283.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0494,Not in chargemaster,Q0494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0494,BCBSND Base HME Schedule,240,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0495,Not in chargemaster,Q0495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0495,BCBSND Base HME Schedule,4672.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0496,Not in chargemaster,Q0496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0496,BCBSND Base HME Schedule,1676.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0497,Not in chargemaster,Q0497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0497,BCBSND Base HME Schedule,523.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0498,Not in chargemaster,Q0498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0498,BCBSND Base HME Schedule,574.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0499,Not in chargemaster,Q0499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0499,BCBSND Base HME Schedule,186.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0500,Not in chargemaster,Q0500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0500,BCBSND Base HME Schedule,34.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0501,Not in chargemaster,Q0501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0501,BCBSND Base HME Schedule,571.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0502,Not in chargemaster,Q0502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0502,BCBSND Base HME Schedule,727.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0503,Not in chargemaster,Q0503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0503,BCBSND Base HME Schedule,1454.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0504,Not in chargemaster,Q0504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0504,BCBSND Base HME Schedule,767.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q0506,Not in chargemaster,Q0506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0506,BCBSND Base HME Schedule,955.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4001,Not in chargemaster,Q4001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4001,BCBSND Base HME Schedule,55.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4002,Not in chargemaster,Q4002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4002,BCBSND Base HME Schedule,211.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4003,Not in chargemaster,Q4003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4003,BCBSND Base HME Schedule,40.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4004,Not in chargemaster,Q4004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4004,BCBSND Base HME Schedule,139.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4005,Not in chargemaster,Q4005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4005,BCBSND Base HME Schedule,14.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4006,Not in chargemaster,Q4006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4006,BCBSND Base HME Schedule,33.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4007,Not in chargemaster,Q4007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4007,BCBSND Base HME Schedule,7.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4008,Not in chargemaster,Q4008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4008,BCBSND Base HME Schedule,16.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4009,Not in chargemaster,Q4009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4009,BCBSND Base HME Schedule,9.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4010,Not in chargemaster,Q4010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4010,BCBSND Base HME Schedule,22.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4011,Not in chargemaster,Q4011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4011,BCBSND Base HME Schedule,4.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4012,Not in chargemaster,Q4012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4012,BCBSND Base HME Schedule,11.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4013,Not in chargemaster,Q4013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4013,BCBSND Base HME Schedule,18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4014,Not in chargemaster,Q4014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4014,BCBSND Base HME Schedule,30.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4015,Not in chargemaster,Q4015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4015,BCBSND Base HME Schedule,9.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4016,Not in chargemaster,Q4016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4016,BCBSND Base HME Schedule,15.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4017,Not in chargemaster,Q4017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4017,BCBSND Base HME Schedule,10.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4018,Not in chargemaster,Q4018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4018,BCBSND Base HME Schedule,16.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4019,Not in chargemaster,Q4019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4019,BCBSND Base HME Schedule,5.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4020,Not in chargemaster,Q4020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4020,BCBSND Base HME Schedule,8.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4021,Not in chargemaster,Q4021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4021,BCBSND Base HME Schedule,7.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4022,Not in chargemaster,Q4022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4022,BCBSND Base HME Schedule,13.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4023,Not in chargemaster,Q4023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4023,BCBSND Base HME Schedule,3.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4024,Not in chargemaster,Q4024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4024,BCBSND Base HME Schedule,6.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4025,Not in chargemaster,Q4025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4025,BCBSND Base HME Schedule,43.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4026,Not in chargemaster,Q4026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4026,BCBSND Base HME Schedule,134.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4027,Not in chargemaster,Q4027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4027,BCBSND Base HME Schedule,21.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4028,Not in chargemaster,Q4028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4028,BCBSND Base HME Schedule,67.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4029,Not in chargemaster,Q4029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4029,BCBSND Base HME Schedule,33.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4030,Not in chargemaster,Q4030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4030,BCBSND Base HME Schedule,86.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4031,Not in chargemaster,Q4031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4031,BCBSND Base HME Schedule,16.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4032,Not in chargemaster,Q4032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4032,BCBSND Base HME Schedule,43.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4033,Not in chargemaster,Q4033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4033,BCBSND Base HME Schedule,30.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4034,Not in chargemaster,Q4034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4034,BCBSND Base HME Schedule,76.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4035,Not in chargemaster,Q4035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4035,BCBSND Base HME Schedule,15.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4036,Not in chargemaster,Q4036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4036,BCBSND Base HME Schedule,38.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4037,Not in chargemaster,Q4037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4037,BCBSND Base HME Schedule,18.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4038,Not in chargemaster,Q4038,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4038,BCBSND Base HME Schedule,47.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4039,Not in chargemaster,Q4039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4039,BCBSND Base HME Schedule,9.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4040,Not in chargemaster,Q4040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4040,BCBSND Base HME Schedule,23.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4041,Not in chargemaster,Q4041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4041,BCBSND Base HME Schedule,22.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4042,Not in chargemaster,Q4042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4042,BCBSND Base HME Schedule,39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4043,Not in chargemaster,Q4043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4043,BCBSND Base HME Schedule,11.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4044,Not in chargemaster,Q4044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4044,BCBSND Base HME Schedule,19.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4045,Not in chargemaster,Q4045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4045,BCBSND Base HME Schedule,13.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4046,Not in chargemaster,Q4046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4046,BCBSND Base HME Schedule,21.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4047,Not in chargemaster,Q4047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4047,BCBSND Base HME Schedule,6.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4048,Not in chargemaster,Q4048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4048,BCBSND Base HME Schedule,10.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4049,Not in chargemaster,Q4049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4049,BCBSND Base HME Schedule,2.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4051,Not in chargemaster,Q4051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4051,BCBSND Base HME Schedule,19.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4101,Not in chargemaster,Q4101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4101,BCBSND Base HME Schedule,33.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4102,Not in chargemaster,Q4102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4102,BCBSND Base HME Schedule,11.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4103,Not in chargemaster,Q4103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4103,BCBSND Base HME Schedule,1.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4104,Not in chargemaster,Q4104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4104,BCBSND Base HME Schedule,53.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4105,Not in chargemaster,Q4105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4105,BCBSND Base HME Schedule,59.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4106,Not in chargemaster,Q4106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4106,BCBSND Base HME Schedule,34.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4107,Not in chargemaster,Q4107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4107,BCBSND Base HME Schedule,85.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4108,Not in chargemaster,Q4108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4108,BCBSND Base HME Schedule,52.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4110,Not in chargemaster,Q4110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4110,BCBSND Base HME Schedule,47.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4111,Not in chargemaster,Q4111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4111,BCBSND Base HME Schedule,7.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4112,Not in chargemaster,Q4112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4112,BCBSND Base HME Schedule,762.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4113,Not in chargemaster,Q4113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4113,BCBSND Base HME Schedule,762.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4114,Not in chargemaster,Q4114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4114,BCBSND Base HME Schedule,1762.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4115,Not in chargemaster,Q4115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4115,BCBSND Base HME Schedule,21.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4117,Not in chargemaster,Q4117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4117,BCBSND Base HME Schedule,20.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4118,Not in chargemaster,Q4118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4118,BCBSND Base HME Schedule,3.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4121,Not in chargemaster,Q4121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4121,BCBSND Base HME Schedule,46.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4122,Not in chargemaster,Q4122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4122,BCBSND Base HME Schedule,110.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4123,Not in chargemaster,Q4123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4123,BCBSND Base HME Schedule,91.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4124,Not in chargemaster,Q4124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4124,BCBSND Base HME Schedule,13.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4125,Not in chargemaster,Q4125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4125,BCBSND Base HME Schedule,160.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4126,Not in chargemaster,Q4126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4126,BCBSND Base HME Schedule,82.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4127,Not in chargemaster,Q4127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4127,BCBSND Base HME Schedule,32.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4128,Not in chargemaster,Q4128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4128,BCBSND Base HME Schedule,51.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4132,Not in chargemaster,Q4132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4132,BCBSND Base HME Schedule,128.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4133,Not in chargemaster,Q4133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4133,BCBSND Base HME Schedule,151.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4137,Not in chargemaster,Q4137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4137,BCBSND Base HME Schedule,166.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4138,Not in chargemaster,Q4138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4138,BCBSND Base HME Schedule,215.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4140,Not in chargemaster,Q4140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4140,BCBSND Base HME Schedule,164.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4141,Not in chargemaster,Q4141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4141,BCBSND Base HME Schedule,98.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4145,Not in chargemaster,Q4145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4145,BCBSND Base HME Schedule,21.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4147,Not in chargemaster,Q4147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4147,BCBSND Base HME Schedule,48.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4148,Not in chargemaster,Q4148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4148,BCBSND Base HME Schedule,244.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4149,Not in chargemaster,Q4149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4149,BCBSND Base HME Schedule,152.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4151,Not in chargemaster,Q4151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4151,BCBSND Base HME Schedule,139.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4152,Not in chargemaster,Q4152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4152,BCBSND Base HME Schedule,100.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4154,Not in chargemaster,Q4154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4154,BCBSND Base HME Schedule,307.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4156,Not in chargemaster,Q4156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4156,BCBSND Base HME Schedule,174.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4157,Not in chargemaster,Q4157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4157,BCBSND Base HME Schedule,178.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4158,Not in chargemaster,Q4158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4158,BCBSND Base HME Schedule,156.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4159,Not in chargemaster,Q4159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4159,BCBSND Base HME Schedule,1108.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4160,Not in chargemaster,Q4160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4160,BCBSND Base HME Schedule,224.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4162,Not in chargemaster,Q4162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4162,BCBSND Base HME Schedule,1994.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4163,Not in chargemaster,Q4163,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4163,BCBSND Base HME Schedule,380.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4165,Not in chargemaster,Q4165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4165,BCBSND Base HME Schedule,11.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4166,Not in chargemaster,Q4166,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4166,BCBSND Base HME Schedule,18.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4167,Not in chargemaster,Q4167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4167,BCBSND Base HME Schedule,105.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4169,Not in chargemaster,Q4169,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4169,BCBSND Base HME Schedule,266,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4173,Not in chargemaster,Q4173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4173,BCBSND Base HME Schedule,262.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4174,Not in chargemaster,Q4174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4174,BCBSND Base HME Schedule,1401.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4175,Not in chargemaster,Q4175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4175,BCBSND Base HME Schedule,65.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4176,Not in chargemaster,Q4176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4176,BCBSND Base HME Schedule,67.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4177,Not in chargemaster,Q4177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4177,BCBSND Base HME Schedule,153,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4178,Not in chargemaster,Q4178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4178,BCBSND Base HME Schedule,191.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4180,Not in chargemaster,Q4180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4180,BCBSND Base HME Schedule,152.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4182,Not in chargemaster,Q4182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4182,BCBSND Base HME Schedule,41.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4183,Not in chargemaster,Q4183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4183,BCBSND Base HME Schedule,85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4184,Not in chargemaster,Q4184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4184,BCBSND Base HME Schedule,247.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4186,Not in chargemaster,Q4186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4186,BCBSND Base HME Schedule,175.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4187,Not in chargemaster,Q4187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4187,BCBSND Base HME Schedule,258.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4189,Not in chargemaster,Q4189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4189,BCBSND Base HME Schedule,21.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4194,Not in chargemaster,Q4194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4194,BCBSND Base HME Schedule,252,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4195,Not in chargemaster,Q4195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4195,BCBSND Base HME Schedule,123.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4196,Not in chargemaster,Q4196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4196,BCBSND Base HME Schedule,118.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4208,Not in chargemaster,Q4208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4208,BCBSND Base HME Schedule,191.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4213,Not in chargemaster,Q4213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4213,BCBSND Base HME Schedule,45.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4218,Not in chargemaster,Q4218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4218,BCBSND Base HME Schedule,127.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip Q4219,Not in chargemaster,Q4219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q4219,BCBSND Base HME Schedule,100.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S1030,Not in chargemaster,S1030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S1030,BCBSND Base HME Schedule,85.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S1031,Not in chargemaster,S1031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S1031,BCBSND Base HME Schedule,85.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S1034,Not in chargemaster,S1034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S1034,BCBSND Base HME Schedule,5997.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S1035,Not in chargemaster,S1035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S1035,BCBSND Base HME Schedule,13.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S1036,Not in chargemaster,S1036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S1036,BCBSND Base HME Schedule,716.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S1040,Not in chargemaster,S1040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S1040,BCBSND Base HME Schedule,2269.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S5160,Not in chargemaster,S5160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S5160,BCBSND Base HME Schedule,22.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S5161,Not in chargemaster,S5161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S5161,BCBSND Base HME Schedule,22.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S5165,Not in chargemaster,S5165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S5165,BCBSND Base HME Schedule,22.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8100,Not in chargemaster,S8100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8100,BCBSND Base HME Schedule,16.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8101,Not in chargemaster,S8101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8101,BCBSND Base HME Schedule,16.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8120,Not in chargemaster,S8120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8120,BCBSND Base HME Schedule,34.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8121,Not in chargemaster,S8121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8121,BCBSND Base HME Schedule,34.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8185,Not in chargemaster,S8185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8185,BCBSND Base HME Schedule,75.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8189,Not in chargemaster,S8189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8189,BCBSND Base HME Schedule,112.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8427,Not in chargemaster,S8427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8427,BCBSND Base HME Schedule,41.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8428,Not in chargemaster,S8428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8428,BCBSND Base HME Schedule,46.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8429,Not in chargemaster,S8429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8429,BCBSND Base HME Schedule,41.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8430,Not in chargemaster,S8430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8430,BCBSND Base HME Schedule,1.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8431,Not in chargemaster,S8431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8431,BCBSND Base HME Schedule,2.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8450,Not in chargemaster,S8450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8450,BCBSND Base HME Schedule,39.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8451,Not in chargemaster,S8451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8451,BCBSND Base HME Schedule,53.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8452,Not in chargemaster,S8452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8452,BCBSND Base HME Schedule,25.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip S8490,Not in chargemaster,S8490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8490,BCBSND Base HME Schedule,21.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2020,Not in chargemaster,V2020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2020,BCBSND Base HME Schedule,200,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2025,Not in chargemaster,V2025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2025,BCBSND Base HME Schedule,300,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2100,Not in chargemaster,V2100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2100,BCBSND Base HME Schedule,57.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2101,Not in chargemaster,V2101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2101,BCBSND Base HME Schedule,60.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2102,Not in chargemaster,V2102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2102,BCBSND Base HME Schedule,84.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2103,Not in chargemaster,V2103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2103,BCBSND Base HME Schedule,46.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2104,Not in chargemaster,V2104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2104,BCBSND Base HME Schedule,52.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2105,Not in chargemaster,V2105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2105,BCBSND Base HME Schedule,45.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2106,Not in chargemaster,V2106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2106,BCBSND Base HME Schedule,49.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2107,Not in chargemaster,V2107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2107,BCBSND Base HME Schedule,51.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2108,Not in chargemaster,V2108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2108,BCBSND Base HME Schedule,62.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2109,Not in chargemaster,V2109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2109,BCBSND Base HME Schedule,54.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2110,Not in chargemaster,V2110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2110,BCBSND Base HME Schedule,53.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2111,Not in chargemaster,V2111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2111,BCBSND Base HME Schedule,55.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2112,Not in chargemaster,V2112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2112,BCBSND Base HME Schedule,61.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2113,Not in chargemaster,V2113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2113,BCBSND Base HME Schedule,69.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2114,Not in chargemaster,V2114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2114,BCBSND Base HME Schedule,91.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2115,Not in chargemaster,V2115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2115,BCBSND Base HME Schedule,96.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2118,Not in chargemaster,V2118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2118,BCBSND Base HME Schedule,80.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2121,Not in chargemaster,V2121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2121,BCBSND Base HME Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2199,Not in chargemaster,V2199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2199,BCBSND Base HME Schedule,136.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2200,Not in chargemaster,V2200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2200,BCBSND Base HME Schedule,60.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2201,Not in chargemaster,V2201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2201,BCBSND Base HME Schedule,70.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2202,Not in chargemaster,V2202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2202,BCBSND Base HME Schedule,93.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2203,Not in chargemaster,V2203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2203,BCBSND Base HME Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2204,Not in chargemaster,V2204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2204,BCBSND Base HME Schedule,62.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2205,Not in chargemaster,V2205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2205,BCBSND Base HME Schedule,72.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2206,Not in chargemaster,V2206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2206,BCBSND Base HME Schedule,68.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2207,Not in chargemaster,V2207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2207,BCBSND Base HME Schedule,70.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2208,Not in chargemaster,V2208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2208,BCBSND Base HME Schedule,75.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2209,Not in chargemaster,V2209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2209,BCBSND Base HME Schedule,76.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2210,Not in chargemaster,V2210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2210,BCBSND Base HME Schedule,81.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2211,Not in chargemaster,V2211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2211,BCBSND Base HME Schedule,108.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2212,Not in chargemaster,V2212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2212,BCBSND Base HME Schedule,111.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2213,Not in chargemaster,V2213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2213,BCBSND Base HME Schedule,112.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2214,Not in chargemaster,V2214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2214,BCBSND Base HME Schedule,107.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2215,Not in chargemaster,V2215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2215,BCBSND Base HME Schedule,95.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2218,Not in chargemaster,V2218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2218,BCBSND Base HME Schedule,111.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2219,Not in chargemaster,V2219,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2219,BCBSND Base HME Schedule,65.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2220,Not in chargemaster,V2220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2220,BCBSND Base HME Schedule,41.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2221,Not in chargemaster,V2221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2221,BCBSND Base HME Schedule,100.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2300,Not in chargemaster,V2300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2300,BCBSND Base HME Schedule,79.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2301,Not in chargemaster,V2301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2301,BCBSND Base HME Schedule,84.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2302,Not in chargemaster,V2302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2302,BCBSND Base HME Schedule,90.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2303,Not in chargemaster,V2303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2303,BCBSND Base HME Schedule,75.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2304,Not in chargemaster,V2304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2304,BCBSND Base HME Schedule,80.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2305,Not in chargemaster,V2305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2305,BCBSND Base HME Schedule,90.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2306,Not in chargemaster,V2306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2306,BCBSND Base HME Schedule,101.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2307,Not in chargemaster,V2307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2307,BCBSND Base HME Schedule,86.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2308,Not in chargemaster,V2308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2308,BCBSND Base HME Schedule,89.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2309,Not in chargemaster,V2309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2309,BCBSND Base HME Schedule,95.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2310,Not in chargemaster,V2310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2310,BCBSND Base HME Schedule,94.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2311,Not in chargemaster,V2311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2311,BCBSND Base HME Schedule,97.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2312,Not in chargemaster,V2312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2312,BCBSND Base HME Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2313,Not in chargemaster,V2313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2313,BCBSND Base HME Schedule,109.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2314,Not in chargemaster,V2314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2314,BCBSND Base HME Schedule,117.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2315,Not in chargemaster,V2315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2315,BCBSND Base HME Schedule,130.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2318,Not in chargemaster,V2318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2318,BCBSND Base HME Schedule,161.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2319,Not in chargemaster,V2319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2319,BCBSND Base HME Schedule,54.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2320,Not in chargemaster,V2320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2320,BCBSND Base HME Schedule,57.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2321,Not in chargemaster,V2321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2321,BCBSND Base HME Schedule,129.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2410,Not in chargemaster,V2410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2410,BCBSND Base HME Schedule,131.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2430,Not in chargemaster,V2430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2430,BCBSND Base HME Schedule,134.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2500,Not in chargemaster,V2500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2500,BCBSND Base HME Schedule,94.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2501,Not in chargemaster,V2501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2501,BCBSND Base HME Schedule,166.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2502,Not in chargemaster,V2502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2502,BCBSND Base HME Schedule,187.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2503,Not in chargemaster,V2503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2503,BCBSND Base HME Schedule,154.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2510,Not in chargemaster,V2510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2510,BCBSND Base HME Schedule,135.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2511,Not in chargemaster,V2511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2511,BCBSND Base HME Schedule,175.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2512,Not in chargemaster,V2512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2512,BCBSND Base HME Schedule,206.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2513,Not in chargemaster,V2513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2513,BCBSND Base HME Schedule,173.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2520,Not in chargemaster,V2520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2520,BCBSND Base HME Schedule,114.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2521,Not in chargemaster,V2521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2521,BCBSND Base HME Schedule,221.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2522,Not in chargemaster,V2522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2522,BCBSND Base HME Schedule,193.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2523,Not in chargemaster,V2523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2523,BCBSND Base HME Schedule,165.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2530,Not in chargemaster,V2530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2530,BCBSND Base HME Schedule,266.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2531,Not in chargemaster,V2531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2531,BCBSND Base HME Schedule,602.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2623,Not in chargemaster,V2623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2623,BCBSND Base HME Schedule,1042.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2624,Not in chargemaster,V2624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2624,BCBSND Base HME Schedule,84.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2625,Not in chargemaster,V2625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2625,BCBSND Base HME Schedule,535.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2626,Not in chargemaster,V2626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2626,BCBSND Base HME Schedule,219.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2627,Not in chargemaster,V2627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2627,BCBSND Base HME Schedule,1838.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2628,Not in chargemaster,V2628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2628,BCBSND Base HME Schedule,445.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2630,Not in chargemaster,V2630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2630,BCBSND Base HME Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2631,Not in chargemaster,V2631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2631,BCBSND Base HME Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2632,Not in chargemaster,V2632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2632,BCBSND Base HME Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2700,Not in chargemaster,V2700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2700,BCBSND Base HME Schedule,56.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2710,Not in chargemaster,V2710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2710,BCBSND Base HME Schedule,84.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2715,Not in chargemaster,V2715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2715,BCBSND Base HME Schedule,12.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2718,Not in chargemaster,V2718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2718,BCBSND Base HME Schedule,31.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2730,Not in chargemaster,V2730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2730,BCBSND Base HME Schedule,23.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2744,Not in chargemaster,V2744,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2744,BCBSND Base HME Schedule,18.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2745,Not in chargemaster,V2745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2745,BCBSND Base HME Schedule,11.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2750,Not in chargemaster,V2750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2750,BCBSND Base HME Schedule,67.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2755,Not in chargemaster,V2755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2755,BCBSND Base HME Schedule,19.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2760,Not in chargemaster,V2760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2760,BCBSND Base HME Schedule,23.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2762,Not in chargemaster,V2762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2762,BCBSND Base HME Schedule,66.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2770,Not in chargemaster,V2770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2770,BCBSND Base HME Schedule,21.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2780,Not in chargemaster,V2780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2780,BCBSND Base HME Schedule,13.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2781,Not in chargemaster,V2781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2781,BCBSND Base HME Schedule,121.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2782,Not in chargemaster,V2782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2782,BCBSND Base HME Schedule,71.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2783,Not in chargemaster,V2783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2783,BCBSND Base HME Schedule,81.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V2784,Not in chargemaster,V2784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V2784,BCBSND Base HME Schedule,52.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V5095,Not in chargemaster,V5095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V5095,BCBSND Base HME Schedule,24645.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Home Med Equip V5140,Not in chargemaster,V5140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,V5140,BCBSND Base HME Schedule,3909.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0042T,Not in chargemaster,0042T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0042T,BCBSND Base Physician Payment Schedule,777.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0054T,Not in chargemaster,0054T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0054T,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0055T,Not in chargemaster,0055T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0055T,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0071T,Not in chargemaster,0071T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0071T,BCBSND Base Physician Payment Schedule,4082.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0072T,Not in chargemaster,0072T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0072T,BCBSND Base Physician Payment Schedule,4082.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0174T,Not in chargemaster,0174T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0174T,BCBSND Base Physician Payment Schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0175T,Not in chargemaster,0175T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0175T,BCBSND Base Physician Payment Schedule,19.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0191T,Not in chargemaster,0191T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0191T,BCBSND Base Physician Payment Schedule,2784.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0200T,Not in chargemaster,0200T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0200T,BCBSND Base Physician Payment Schedule,4876.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0201T,Not in chargemaster,0201T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0201T,BCBSND Base Physician Payment Schedule,4876.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0219T,Not in chargemaster,0219T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0219T,BCBSND Base Physician Payment Schedule,2737.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0220T,Not in chargemaster,0220T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0220T,BCBSND Base Physician Payment Schedule,2691.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0221T,Not in chargemaster,0221T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0221T,BCBSND Base Physician Payment Schedule,3376.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0222T,Not in chargemaster,0222T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0222T,BCBSND Base Physician Payment Schedule,835.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0228T,Not in chargemaster,0228T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0228T,BCBSND Base Physician Payment Schedule,532.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0229T,Not in chargemaster,0229T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0229T,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0230T,Not in chargemaster,0230T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0230T,BCBSND Base Physician Payment Schedule,494.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0231T,Not in chargemaster,0231T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0231T,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0232T,Not in chargemaster,0232T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0232T,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0234T,Not in chargemaster,0234T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0234T,BCBSND Base Physician Payment Schedule,1410.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0235T,Not in chargemaster,0235T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0235T,BCBSND Base Physician Payment Schedule,1410.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0236T,Not in chargemaster,0236T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0236T,BCBSND Base Physician Payment Schedule,954.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0237T,Not in chargemaster,0237T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0237T,BCBSND Base Physician Payment Schedule,1325.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0238T,Not in chargemaster,0238T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0238T,BCBSND Base Physician Payment Schedule,857.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0253T,Not in chargemaster,0253T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0253T,BCBSND Base Physician Payment Schedule,464.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0274T,Not in chargemaster,0274T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0274T,BCBSND Base Physician Payment Schedule,1230.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0275T,Not in chargemaster,0275T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0275T,BCBSND Base Physician Payment Schedule,1230.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0278T,Not in chargemaster,0278T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0278T,BCBSND Base Physician Payment Schedule,37.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0290T,Not in chargemaster,0290T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0290T,BCBSND Base Physician Payment Schedule,2338.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0295T,Not in chargemaster,0295T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0295T,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0296T,Not in chargemaster,0296T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0296T,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0297T,Not in chargemaster,0297T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0297T,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0298T,Not in chargemaster,0298T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0298T,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0308T,Not in chargemaster,0308T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0308T,BCBSND Base Physician Payment Schedule,1882.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0312T,Not in chargemaster,0312T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0312T,BCBSND Base Physician Payment Schedule,1325.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0313T,Not in chargemaster,0313T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0313T,BCBSND Base Physician Payment Schedule,1607.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0314T,Not in chargemaster,0314T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0314T,BCBSND Base Physician Payment Schedule,1547.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0315T,Not in chargemaster,0315T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0315T,BCBSND Base Physician Payment Schedule,836.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0316T,Not in chargemaster,0316T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0316T,BCBSND Base Physician Payment Schedule,836.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0362T,Not in chargemaster,0362T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0362T,BCBSND Base Physician Payment Schedule,7.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0373T,Not in chargemaster,0373T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0373T,BCBSND Base Physician Payment Schedule,16.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0402T,Not in chargemaster,0402T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0402T,BCBSND Base Physician Payment Schedule,659.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0474T,Not in chargemaster,0474T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0474T,BCBSND Base Physician Payment Schedule,2784.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95970,Not in chargemaster,95970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95970,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95170,Not in chargemaster,95170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95170,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95165,Not in chargemaster,95165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95165,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95149,Not in chargemaster,95149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95149,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95148,Not in chargemaster,95148,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95148,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95147,Not in chargemaster,95147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95147,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95146,Not in chargemaster,95146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95146,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95145,Not in chargemaster,95145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95145,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95079,Not in chargemaster,95079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95079,BCBSND Base Physician Payment Schedule,143.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95144,Not in chargemaster,95144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95144,BCBSND Base Physician Payment Schedule,6.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95024,Not in chargemaster,95024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95024,BCBSND Base Physician Payment Schedule,2.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95018,Not in chargemaster,95018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95018,BCBSND Base Physician Payment Schedule,14.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95076,Not in chargemaster,95076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95076,BCBSND Base Physician Payment Schedule,156.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95017,Not in chargemaster,95017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95017,BCBSND Base Physician Payment Schedule,8.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94781,Not in chargemaster,94781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94781,BCBSND Base Physician Payment Schedule,17.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93798,Not in chargemaster,93798,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93798,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93797,Not in chargemaster,93797,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93797,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93568,Not in chargemaster,93568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93568,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93567,Not in chargemaster,93567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93567,BCBSND Base Physician Payment Schedule,112.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92960,Not in chargemaster,92960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92960,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92640,Not in chargemaster,92640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92640,BCBSND Base Physician Payment Schedule,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92950,92950,92950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92950,BCBSND Base Physician Payment Schedule,393.48,381.92,Fee schedule,,381.92,381.92,381.92,381.92,,,0
unity,Fee schedule,Facility 94780,Not in chargemaster,94780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94780,BCBSND Base Physician Payment Schedule,49.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93566,Not in chargemaster,93566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93566,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 94660,Not in chargemaster,94660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,94660,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93750,Not in chargemaster,93750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93750,BCBSND Base Physician Payment Schedule,101.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93356,Not in chargemaster,93356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93356,BCBSND Base Physician Payment Schedule,24.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 93264,Not in chargemaster,93264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,93264,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92627,Not in chargemaster,92627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92627,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92626,Not in chargemaster,92626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92626,BCBSND Base Physician Payment Schedule,159.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92625,Not in chargemaster,92625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92625,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92621,Not in chargemaster,92621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92621,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92620,Not in chargemaster,92620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92620,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92618,Not in chargemaster,92618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92618,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92616,Not in chargemaster,92616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92616,BCBSND Base Physician Payment Schedule,209.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92614,Not in chargemaster,92614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92614,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92612,Not in chargemaster,92612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92612,BCBSND Base Physician Payment Schedule,143.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92606,Not in chargemaster,92606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92606,BCBSND Base Physician Payment Schedule,150.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92610,Not in chargemaster,92610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92610,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92605,Not in chargemaster,92605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92605,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92604,Not in chargemaster,92604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92604,BCBSND Base Physician Payment Schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92603,Not in chargemaster,92603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92603,BCBSND Base Physician Payment Schedule,255.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92602,Not in chargemaster,92602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92602,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92601,Not in chargemaster,92601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92601,BCBSND Base Physician Payment Schedule,263.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92579,Not in chargemaster,92579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92579,BCBSND Base Physician Payment Schedule,80.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92570,Not in chargemaster,92570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92570,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92568,Not in chargemaster,92568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92568,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92567,92567,92567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92567,BCBSND Base Physician Payment Schedule,22.76,22.01,Fee schedule,,22.01,22.01,22.01,22.01,,,0
unity,Fee schedule,Facility 92557,Not in chargemaster,92557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92557,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92520,Not in chargemaster,92520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92520,BCBSND Base Physician Payment Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92516,Not in chargemaster,92516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92516,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92512,Not in chargemaster,92512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92512,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92353,Not in chargemaster,92353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92353,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92511,Not in chargemaster,92511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92511,BCBSND Base Physician Payment Schedule,79.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92504,Not in chargemaster,92504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92504,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92370,Not in chargemaster,92370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92370,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92352,Not in chargemaster,92352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92352,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92342,Not in chargemaster,92342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92342,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92341,Not in chargemaster,92341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92341,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92317,Not in chargemaster,92317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92317,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92340,Not in chargemaster,92340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92340,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92316,Not in chargemaster,92316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92316,BCBSND Base Physician Payment Schedule,67.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92315,Not in chargemaster,92315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92315,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92314,Not in chargemaster,92314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92314,BCBSND Base Physician Payment Schedule,74.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92313,Not in chargemaster,92313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92313,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92312,Not in chargemaster,92312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92312,BCBSND Base Physician Payment Schedule,129.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92311,Not in chargemaster,92311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92311,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92230,Not in chargemaster,92230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92230,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92310,Not in chargemaster,92310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92310,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92260,Not in chargemaster,92260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92260,BCBSND Base Physician Payment Schedule,22.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92202,Not in chargemaster,92202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92202,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92072,Not in chargemaster,92072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92072,BCBSND Base Physician Payment Schedule,202.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92020,Not in chargemaster,92020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92020,BCBSND Base Physician Payment Schedule,43.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92201,Not in chargemaster,92201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92201,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92100,Not in chargemaster,92100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92100,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92071,Not in chargemaster,92071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92071,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92015,Not in chargemaster,92015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92015,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92014,Not in chargemaster,92014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92014,BCBSND Base Physician Payment Schedule,163.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92012,Not in chargemaster,92012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92012,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92004,Not in chargemaster,92004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92004,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90913,Not in chargemaster,90913,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90913,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90912,Not in chargemaster,90912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90912,BCBSND Base Physician Payment Schedule,92.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90901,Not in chargemaster,90901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90901,BCBSND Base Physician Payment Schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90887,Not in chargemaster,90887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90887,BCBSND Base Physician Payment Schedule,158.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 92002,Not in chargemaster,92002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,92002,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90880,Not in chargemaster,90880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90880,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90876,Not in chargemaster,90876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90876,BCBSND Base Physician Payment Schedule,204.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90870,Not in chargemaster,90870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90870,BCBSND Base Physician Payment Schedule,228.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90865,Not in chargemaster,90865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90865,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90853,Not in chargemaster,90853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90853,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90849,Not in chargemaster,90849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90849,BCBSND Base Physician Payment Schedule,60.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90847,Not in chargemaster,90847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90847,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90846,Not in chargemaster,90846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90846,BCBSND Base Physician Payment Schedule,209.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90845,Not in chargemaster,90845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90845,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90840,Not in chargemaster,90840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90840,BCBSND Base Physician Payment Schedule,129.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90839,Not in chargemaster,90839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90839,BCBSND Base Physician Payment Schedule,270.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88329,Not in chargemaster,88329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88329,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90792,Not in chargemaster,90792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90792,BCBSND Base Physician Payment Schedule,290.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90832,Not in chargemaster,90832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90832,BCBSND Base Physician Payment Schedule,129.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90833,Not in chargemaster,90833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90833,BCBSND Base Physician Payment Schedule,135.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90834,Not in chargemaster,90834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90834,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90836,Not in chargemaster,90836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90836,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90837,Not in chargemaster,90837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90837,BCBSND Base Physician Payment Schedule,259.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90838,Not in chargemaster,90838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90838,BCBSND Base Physician Payment Schedule,224.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 90791,Not in chargemaster,90791,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,90791,BCBSND Base Physician Payment Schedule,259.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88325,Not in chargemaster,88325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88325,BCBSND Base Physician Payment Schedule,306.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86079,Not in chargemaster,86079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86079,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86078,Not in chargemaster,86078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86078,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 86077,Not in chargemaster,86077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,86077,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 80502,Not in chargemaster,80502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,80502,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69620,Not in chargemaster,69620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69620,BCBSND Base Physician Payment Schedule,1020.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 85097,Not in chargemaster,85097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,85097,BCBSND Base Physician Payment Schedule,104.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 89049,Not in chargemaster,89049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,89049,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88363,Not in chargemaster,88363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88363,BCBSND Base Physician Payment Schedule,41.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 88321,Not in chargemaster,88321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,88321,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 80500,Not in chargemaster,80500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,80500,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69801,Not in chargemaster,69801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69801,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69610,Not in chargemaster,69610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69610,BCBSND Base Physician Payment Schedule,604.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69540,Not in chargemaster,69540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69540,BCBSND Base Physician Payment Schedule,262.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69433,Not in chargemaster,69433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69433,BCBSND Base Physician Payment Schedule,273.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69424,Not in chargemaster,69424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69424,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69420,Not in chargemaster,69420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69420,BCBSND Base Physician Payment Schedule,248.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69300,Not in chargemaster,69300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69300,BCBSND Base Physician Payment Schedule,963.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69222,Not in chargemaster,69222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69222,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69220,Not in chargemaster,69220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69220,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69110,Not in chargemaster,69110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69110,BCBSND Base Physician Payment Schedule,681.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69210,69210,69210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69210,BCBSND Base Physician Payment Schedule,70.47,110.75,Fee schedule,,70.47,70.47,70.47,70.47,,,0
unity,Fee schedule,Facility 69200,69200,69200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69200,BCBSND Base Physician Payment Schedule,99.1,269.76,Fee schedule,,99.1,99.1,99.1,99.1,,,0
unity,Fee schedule,Facility 69145,Not in chargemaster,69145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69145,BCBSND Base Physician Payment Schedule,524.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69105,Not in chargemaster,69105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69105,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69100,Not in chargemaster,69100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69100,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69020,Not in chargemaster,69020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69020,BCBSND Base Physician Payment Schedule,294.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69005,Not in chargemaster,69005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69005,BCBSND Base Physician Payment Schedule,330.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 69000,Not in chargemaster,69000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,69000,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68850,Not in chargemaster,68850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68850,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68840,Not in chargemaster,68840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68840,BCBSND Base Physician Payment Schedule,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68816,Not in chargemaster,68816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68816,BCBSND Base Physician Payment Schedule,326.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68815,Not in chargemaster,68815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68815,BCBSND Base Physician Payment Schedule,460.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68810,Not in chargemaster,68810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68810,BCBSND Base Physician Payment Schedule,264.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68801,Not in chargemaster,68801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68801,BCBSND Base Physician Payment Schedule,160.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68761,Not in chargemaster,68761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68761,BCBSND Base Physician Payment Schedule,243.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68760,Not in chargemaster,68760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68760,BCBSND Base Physician Payment Schedule,301.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68705,Not in chargemaster,68705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68705,BCBSND Base Physician Payment Schedule,343.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68530,Not in chargemaster,68530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68530,BCBSND Base Physician Payment Schedule,530.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68510,Not in chargemaster,68510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68510,BCBSND Base Physician Payment Schedule,606.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68440,Not in chargemaster,68440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68440,BCBSND Base Physician Payment Schedule,205.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68420,Not in chargemaster,68420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68420,BCBSND Base Physician Payment Schedule,348.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68400,Not in chargemaster,68400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68400,BCBSND Base Physician Payment Schedule,272.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68360,Not in chargemaster,68360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68360,BCBSND Base Physician Payment Schedule,850.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68340,Not in chargemaster,68340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68340,BCBSND Base Physician Payment Schedule,825.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68330,Not in chargemaster,68330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68330,BCBSND Base Physician Payment Schedule,955.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68320,Not in chargemaster,68320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68320,BCBSND Base Physician Payment Schedule,1118.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68200,Not in chargemaster,68200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68200,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68135,Not in chargemaster,68135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68135,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68130,Not in chargemaster,68130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68130,BCBSND Base Physician Payment Schedule,854.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68115,Not in chargemaster,68115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68115,BCBSND Base Physician Payment Schedule,380.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68110,Not in chargemaster,68110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68110,BCBSND Base Physician Payment Schedule,306.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68100,Not in chargemaster,68100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68100,BCBSND Base Physician Payment Schedule,199.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68040,Not in chargemaster,68040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68040,BCBSND Base Physician Payment Schedule,102.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 68020,Not in chargemaster,68020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,68020,BCBSND Base Physician Payment Schedule,228.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67966,Not in chargemaster,67966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67966,BCBSND Base Physician Payment Schedule,1363.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67961,Not in chargemaster,67961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67961,BCBSND Base Physician Payment Schedule,944.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67950,Not in chargemaster,67950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67950,BCBSND Base Physician Payment Schedule,961.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67938,67938,67938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67938,BCBSND Base Physician Payment Schedule,240.78,528.86,Fee schedule,,240.78,240.78,240.78,240.78,,,0
unity,Fee schedule,Facility 67935,Not in chargemaster,67935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67935,BCBSND Base Physician Payment Schedule,919.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67930,Not in chargemaster,67930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67930,BCBSND Base Physician Payment Schedule,497.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67924,Not in chargemaster,67924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67924,BCBSND Base Physician Payment Schedule,949.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67923,Not in chargemaster,67923,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67923,BCBSND Base Physician Payment Schedule,893.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67922,Not in chargemaster,67922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67922,BCBSND Base Physician Payment Schedule,405.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67921,Not in chargemaster,67921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67921,BCBSND Base Physician Payment Schedule,643.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67917,Not in chargemaster,67917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67917,BCBSND Base Physician Payment Schedule,949.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67916,Not in chargemaster,67916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67916,BCBSND Base Physician Payment Schedule,891.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67915,Not in chargemaster,67915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67915,BCBSND Base Physician Payment Schedule,408.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67914,Not in chargemaster,67914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67914,BCBSND Base Physician Payment Schedule,678.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67912,Not in chargemaster,67912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67912,BCBSND Base Physician Payment Schedule,1011.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67909,Not in chargemaster,67909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67909,BCBSND Base Physician Payment Schedule,911.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67908,Not in chargemaster,67908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67908,BCBSND Base Physician Payment Schedule,889,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67904,Not in chargemaster,67904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67904,BCBSND Base Physician Payment Schedule,1239.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67903,Not in chargemaster,67903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67903,BCBSND Base Physician Payment Schedule,1002.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67901,Not in chargemaster,67901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67901,BCBSND Base Physician Payment Schedule,1214.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67900,Not in chargemaster,67900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67900,BCBSND Base Physician Payment Schedule,1055.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67882,Not in chargemaster,67882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67882,BCBSND Base Physician Payment Schedule,979.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67880,Not in chargemaster,67880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67880,BCBSND Base Physician Payment Schedule,762.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67875,Not in chargemaster,67875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67875,BCBSND Base Physician Payment Schedule,199.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67850,Not in chargemaster,67850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67850,BCBSND Base Physician Payment Schedule,275.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67840,Not in chargemaster,67840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67840,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67830,Not in chargemaster,67830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67830,BCBSND Base Physician Payment Schedule,284.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67825,Not in chargemaster,67825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67825,BCBSND Base Physician Payment Schedule,251.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67810,Not in chargemaster,67810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67810,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67805,Not in chargemaster,67805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67805,BCBSND Base Physician Payment Schedule,339.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67801,Not in chargemaster,67801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67801,BCBSND Base Physician Payment Schedule,274.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67800,Not in chargemaster,67800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67800,BCBSND Base Physician Payment Schedule,213.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67715,Not in chargemaster,67715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67715,BCBSND Base Physician Payment Schedule,222.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67710,Not in chargemaster,67710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67710,BCBSND Base Physician Payment Schedule,201.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67700,Not in chargemaster,67700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67700,BCBSND Base Physician Payment Schedule,240.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67515,Not in chargemaster,67515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67515,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67505,Not in chargemaster,67505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67505,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67228,Not in chargemaster,67228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67228,BCBSND Base Physician Payment Schedule,634.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67227,Not in chargemaster,67227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67227,BCBSND Base Physician Payment Schedule,531.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67500,Not in chargemaster,67500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67500,BCBSND Base Physician Payment Schedule,127.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67345,Not in chargemaster,67345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67345,BCBSND Base Physician Payment Schedule,453.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67225,Not in chargemaster,67225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67225,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67221,Not in chargemaster,67221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67221,BCBSND Base Physician Payment Schedule,441.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67220,Not in chargemaster,67220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67220,BCBSND Base Physician Payment Schedule,1036.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67210,Not in chargemaster,67210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67210,BCBSND Base Physician Payment Schedule,1036.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67208,Not in chargemaster,67208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67208,BCBSND Base Physician Payment Schedule,1197.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67145,Not in chargemaster,67145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67145,BCBSND Base Physician Payment Schedule,1031.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67141,Not in chargemaster,67141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67141,BCBSND Base Physician Payment Schedule,1009.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67105,Not in chargemaster,67105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67105,BCBSND Base Physician Payment Schedule,570.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67120,Not in chargemaster,67120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67120,BCBSND Base Physician Payment Schedule,1153.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67110,Not in chargemaster,67110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67110,BCBSND Base Physician Payment Schedule,1687.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67101,Not in chargemaster,67101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67101,BCBSND Base Physician Payment Schedule,590.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67031,Not in chargemaster,67031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67031,BCBSND Base Physician Payment Schedule,738.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67028,Not in chargemaster,67028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67028,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66821,Not in chargemaster,66821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66821,BCBSND Base Physician Payment Schedule,646.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66770,Not in chargemaster,66770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66770,BCBSND Base Physician Payment Schedule,1000.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66762,Not in chargemaster,66762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66762,BCBSND Base Physician Payment Schedule,881.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66761,Not in chargemaster,66761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66761,BCBSND Base Physician Payment Schedule,490.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66740,Not in chargemaster,66740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66740,BCBSND Base Physician Payment Schedule,814.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66720,Not in chargemaster,66720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66720,BCBSND Base Physician Payment Schedule,846.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 67025,Not in chargemaster,67025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,67025,BCBSND Base Physician Payment Schedule,1311.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66710,Not in chargemaster,66710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66710,BCBSND Base Physician Payment Schedule,814.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66130,Not in chargemaster,66130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66130,BCBSND Base Physician Payment Schedule,1176.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66030,Not in chargemaster,66030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66030,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65860,Not in chargemaster,65860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65860,BCBSND Base Physician Payment Schedule,521.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66700,Not in chargemaster,66700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66700,BCBSND Base Physician Payment Schedule,814.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66250,Not in chargemaster,66250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66250,BCBSND Base Physician Payment Schedule,1155.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 66020,Not in chargemaster,66020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,66020,BCBSND Base Physician Payment Schedule,271.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65855,Not in chargemaster,65855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65855,BCBSND Base Physician Payment Schedule,430.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65815,Not in chargemaster,65815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65815,BCBSND Base Physician Payment Schedule,989.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65800,Not in chargemaster,65800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65800,BCBSND Base Physician Payment Schedule,189.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65785,Not in chargemaster,65785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65785,BCBSND Base Physician Payment Schedule,918.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65779,Not in chargemaster,65779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65779,BCBSND Base Physician Payment Schedule,313.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65778,Not in chargemaster,65778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65778,BCBSND Base Physician Payment Schedule,113.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65772,Not in chargemaster,65772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65772,BCBSND Base Physician Payment Schedule,840.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65600,Not in chargemaster,65600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65600,BCBSND Base Physician Payment Schedule,705.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65450,Not in chargemaster,65450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65450,BCBSND Base Physician Payment Schedule,665.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65436,Not in chargemaster,65436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65436,BCBSND Base Physician Payment Schedule,767.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65435,Not in chargemaster,65435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65435,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65430,Not in chargemaster,65430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65430,BCBSND Base Physician Payment Schedule,212.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65426,Not in chargemaster,65426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65426,BCBSND Base Physician Payment Schedule,993.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65420,Not in chargemaster,65420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65420,BCBSND Base Physician Payment Schedule,782.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65410,Not in chargemaster,65410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65410,BCBSND Base Physician Payment Schedule,214.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65400,Not in chargemaster,65400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65400,BCBSND Base Physician Payment Schedule,1250.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65275,Not in chargemaster,65275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65275,BCBSND Base Physician Payment Schedule,962.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65286,Not in chargemaster,65286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65286,BCBSND Base Physician Payment Schedule,1031.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65272,Not in chargemaster,65272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65272,BCBSND Base Physician Payment Schedule,734.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65222,Not in chargemaster,65222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65222,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65270,Not in chargemaster,65270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65270,BCBSND Base Physician Payment Schedule,292.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65220,65220,65220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65220,BCBSND Base Physician Payment Schedule,87.36,124.23,Fee schedule,,87.36,87.36,87.36,87.36,,,0
unity,Fee schedule,Facility 65210,65210,65210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65210,BCBSND Base Physician Payment Schedule,76.35,149.08,Fee schedule,,76.35,76.35,76.35,76.35,,,0
unity,Fee schedule,Facility 64681,Not in chargemaster,64681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64681,BCBSND Base Physician Payment Schedule,550.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64680,Not in chargemaster,64680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64680,BCBSND Base Physician Payment Schedule,342.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65205,65205,65205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65205,BCBSND Base Physician Payment Schedule,60.93,120.68,Fee schedule,,60.93,60.93,60.93,60.93,,,0
unity,Fee schedule,Facility 64721,Not in chargemaster,64721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64721,BCBSND Base Physician Payment Schedule,908.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64653,Not in chargemaster,64653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64653,BCBSND Base Physician Payment Schedule,112.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64650,Not in chargemaster,64650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64650,BCBSND Base Physician Payment Schedule,87.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64647,Not in chargemaster,64647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64647,BCBSND Base Physician Payment Schedule,285.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64646,Not in chargemaster,64646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64646,BCBSND Base Physician Payment Schedule,243.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64645,Not in chargemaster,64645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64645,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64644,Not in chargemaster,64644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64644,BCBSND Base Physician Payment Schedule,247.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64643,Not in chargemaster,64643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64643,BCBSND Base Physician Payment Schedule,151.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64642,Not in chargemaster,64642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64642,BCBSND Base Physician Payment Schedule,226.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 65125,Not in chargemaster,65125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,65125,BCBSND Base Physician Payment Schedule,606.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64640,Not in chargemaster,64640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64640,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64636,Not in chargemaster,64636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64636,BCBSND Base Physician Payment Schedule,126.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64635,Not in chargemaster,64635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64635,BCBSND Base Physician Payment Schedule,467.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64634,Not in chargemaster,64634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64634,BCBSND Base Physician Payment Schedule,143.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64633,Not in chargemaster,64633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64633,BCBSND Base Physician Payment Schedule,474.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64632,Not in chargemaster,64632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64632,BCBSND Base Physician Payment Schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64630,Not in chargemaster,64630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64630,BCBSND Base Physician Payment Schedule,399.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64625,Not in chargemaster,64625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64625,BCBSND Base Physician Payment Schedule,410.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64624,Not in chargemaster,64624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64624,BCBSND Base Physician Payment Schedule,310.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64620,Not in chargemaster,64620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64620,BCBSND Base Physician Payment Schedule,369.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64617,Not in chargemaster,64617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64617,BCBSND Base Physician Payment Schedule,229.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64616,Not in chargemaster,64616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64616,BCBSND Base Physician Payment Schedule,230.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64615,Not in chargemaster,64615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64615,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64612,Not in chargemaster,64612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64612,BCBSND Base Physician Payment Schedule,245.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64611,Not in chargemaster,64611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64611,BCBSND Base Physician Payment Schedule,221.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64610,Not in chargemaster,64610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64610,BCBSND Base Physician Payment Schedule,1027.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64605,Not in chargemaster,64605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64605,BCBSND Base Physician Payment Schedule,748.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64600,Not in chargemaster,64600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64600,BCBSND Base Physician Payment Schedule,483.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64595,Not in chargemaster,64595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64595,BCBSND Base Physician Payment Schedule,267.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64590,Not in chargemaster,64590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64590,BCBSND Base Physician Payment Schedule,339.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64585,Not in chargemaster,64585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64585,BCBSND Base Physician Payment Schedule,303.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64566,Not in chargemaster,64566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64566,BCBSND Base Physician Payment Schedule,66.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64561,Not in chargemaster,64561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64561,BCBSND Base Physician Payment Schedule,643.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64555,Not in chargemaster,64555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64555,BCBSND Base Physician Payment Schedule,724.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64553,Not in chargemaster,64553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64553,BCBSND Base Physician Payment Schedule,755.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64530,Not in chargemaster,64530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64530,BCBSND Base Physician Payment Schedule,195.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64520,Not in chargemaster,64520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64520,BCBSND Base Physician Payment Schedule,174.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64517,Not in chargemaster,64517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64517,BCBSND Base Physician Payment Schedule,264.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64510,Not in chargemaster,64510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64510,BCBSND Base Physician Payment Schedule,158.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64505,Not in chargemaster,64505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64505,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64495,Not in chargemaster,64495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64495,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64494,Not in chargemaster,64494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64494,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64493,Not in chargemaster,64493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64493,BCBSND Base Physician Payment Schedule,189.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64492,Not in chargemaster,64492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64492,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64491,Not in chargemaster,64491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64491,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64490,Not in chargemaster,64490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64490,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64489,Not in chargemaster,64489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64489,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64488,Not in chargemaster,64488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64488,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64487,Not in chargemaster,64487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64487,BCBSND Base Physician Payment Schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64486,Not in chargemaster,64486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64486,BCBSND Base Physician Payment Schedule,118.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64484,Not in chargemaster,64484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64484,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64483,Not in chargemaster,64483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64483,BCBSND Base Physician Payment Schedule,235.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64480,Not in chargemaster,64480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64480,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64479,Not in chargemaster,64479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64479,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64463,Not in chargemaster,64463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64463,BCBSND Base Physician Payment Schedule,175.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64462,Not in chargemaster,64462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64462,BCBSND Base Physician Payment Schedule,104.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64461,Not in chargemaster,64461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64461,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64455,Not in chargemaster,64455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64455,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64454,Not in chargemaster,64454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64454,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64451,Not in chargemaster,64451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64451,BCBSND Base Physician Payment Schedule,168.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64447,Not in chargemaster,64447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64447,BCBSND Base Physician Payment Schedule,112.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64450,64450,64450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64450,BCBSND Base Physician Payment Schedule,90.29,110,Fee schedule,,90.29,90.29,90.29,90.29,,,0
unity,Fee schedule,Facility 64445,Not in chargemaster,64445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64445,BCBSND Base Physician Payment Schedule,113.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64435,Not in chargemaster,64435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64435,BCBSND Base Physician Payment Schedule,92.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64430,Not in chargemaster,64430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64430,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64425,Not in chargemaster,64425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64425,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64421,Not in chargemaster,64421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64421,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64420,Not in chargemaster,64420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64420,BCBSND Base Physician Payment Schedule,126.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64418,Not in chargemaster,64418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64418,BCBSND Base Physician Payment Schedule,120.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64417,Not in chargemaster,64417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64417,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64415,Not in chargemaster,64415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64415,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64408,Not in chargemaster,64408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64408,BCBSND Base Physician Payment Schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64405,Not in chargemaster,64405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64405,BCBSND Base Physician Payment Schedule,113.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63663,Not in chargemaster,63663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63663,BCBSND Base Physician Payment Schedule,954.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63661,Not in chargemaster,63661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63661,BCBSND Base Physician Payment Schedule,684.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62370,Not in chargemaster,62370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62370,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62369,Not in chargemaster,62369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62369,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62368,Not in chargemaster,62368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62368,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 64400,Not in chargemaster,64400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,64400,BCBSND Base Physician Payment Schedule,105.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62367,Not in chargemaster,62367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62367,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62329,Not in chargemaster,62329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62329,BCBSND Base Physician Payment Schedule,239.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62328,Not in chargemaster,62328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62328,BCBSND Base Physician Payment Schedule,190.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62327,Not in chargemaster,62327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62327,BCBSND Base Physician Payment Schedule,212.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62326,Not in chargemaster,62326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62326,BCBSND Base Physician Payment Schedule,184.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62325,Not in chargemaster,62325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62325,BCBSND Base Physician Payment Schedule,229.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62324,Not in chargemaster,62324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62324,BCBSND Base Physician Payment Schedule,189.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62323,Not in chargemaster,62323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62323,BCBSND Base Physician Payment Schedule,209.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62322,Not in chargemaster,62322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62322,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62321,Not in chargemaster,62321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62321,BCBSND Base Physician Payment Schedule,226.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62320,Not in chargemaster,62320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62320,BCBSND Base Physician Payment Schedule,209.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62305,Not in chargemaster,62305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62305,BCBSND Base Physician Payment Schedule,263.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62304,Not in chargemaster,62304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62304,BCBSND Base Physician Payment Schedule,253.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 63650,Not in chargemaster,63650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,63650,BCBSND Base Physician Payment Schedule,875.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62303,Not in chargemaster,62303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62303,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62291,Not in chargemaster,62291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62291,BCBSND Base Physician Payment Schedule,335.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62302,Not in chargemaster,62302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62302,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62290,Not in chargemaster,62290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62290,BCBSND Base Physician Payment Schedule,351.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62284,Not in chargemaster,62284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62284,BCBSND Base Physician Payment Schedule,183.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62282,Not in chargemaster,62282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62282,BCBSND Base Physician Payment Schedule,303.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62281,Not in chargemaster,62281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62281,BCBSND Base Physician Payment Schedule,336.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62280,Not in chargemaster,62280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62280,BCBSND Base Physician Payment Schedule,359.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62273,Not in chargemaster,62273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62273,BCBSND Base Physician Payment Schedule,239.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62272,Not in chargemaster,62272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62272,BCBSND Base Physician Payment Schedule,186.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62267,Not in chargemaster,62267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62267,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62270,Not in chargemaster,62270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62270,BCBSND Base Physician Payment Schedule,131.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62264,Not in chargemaster,62264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62264,BCBSND Base Physician Payment Schedule,514.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60100,Not in chargemaster,60100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60100,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60300,Not in chargemaster,60300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60300,BCBSND Base Physician Payment Schedule,104.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 60000,Not in chargemaster,60000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,60000,BCBSND Base Physician Payment Schedule,320.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59841,Not in chargemaster,59841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59841,BCBSND Base Physician Payment Schedule,784.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59840,Not in chargemaster,59840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59840,BCBSND Base Physician Payment Schedule,460.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59821,Not in chargemaster,59821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59821,BCBSND Base Physician Payment Schedule,782.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59820,Not in chargemaster,59820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59820,BCBSND Base Physician Payment Schedule,789.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59812,Not in chargemaster,59812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59812,BCBSND Base Physician Payment Schedule,645.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59430,Not in chargemaster,59430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59430,BCBSND Base Physician Payment Schedule,297.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59426,Not in chargemaster,59426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59426,BCBSND Base Physician Payment Schedule,1336.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59300,Not in chargemaster,59300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59300,BCBSND Base Physician Payment Schedule,312.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59200,Not in chargemaster,59200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59200,BCBSND Base Physician Payment Schedule,95.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59425,Not in chargemaster,59425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59425,BCBSND Base Physician Payment Schedule,758.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59160,Not in chargemaster,59160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59160,BCBSND Base Physician Payment Schedule,388.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59074,Not in chargemaster,59074,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59074,BCBSND Base Physician Payment Schedule,659.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59000,Not in chargemaster,59000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59000,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59015,Not in chargemaster,59015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59015,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 59070,Not in chargemaster,59070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,59070,BCBSND Base Physician Payment Schedule,659.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58976,Not in chargemaster,58976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58976,BCBSND Base Physician Payment Schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58565,Not in chargemaster,58565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58565,BCBSND Base Physician Payment Schedule,952.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58563,Not in chargemaster,58563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58563,BCBSND Base Physician Payment Schedule,527.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58558,Not in chargemaster,58558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58558,BCBSND Base Physician Payment Schedule,494.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58970,Not in chargemaster,58970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58970,BCBSND Base Physician Payment Schedule,421.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58974,Not in chargemaster,58974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58974,BCBSND Base Physician Payment Schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 62263,Not in chargemaster,62263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,62263,BCBSND Base Physician Payment Schedule,653.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58800,Not in chargemaster,58800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58800,BCBSND Base Physician Payment Schedule,654.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58562,Not in chargemaster,58562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58562,BCBSND Base Physician Payment Schedule,474.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58356,Not in chargemaster,58356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58356,BCBSND Base Physician Payment Schedule,752.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58353,Not in chargemaster,58353,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58353,BCBSND Base Physician Payment Schedule,480.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58350,Not in chargemaster,58350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58350,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58340,Not in chargemaster,58340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58340,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58323,Not in chargemaster,58323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58323,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58555,Not in chargemaster,58555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58555,BCBSND Base Physician Payment Schedule,324.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58322,Not in chargemaster,58322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58322,BCBSND Base Physician Payment Schedule,124.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58321,Not in chargemaster,58321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58321,BCBSND Base Physician Payment Schedule,102.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58301,58301,58301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58301,BCBSND Base Physician Payment Schedule,143.15,215,Fee schedule,,143.15,143.15,143.15,143.15,,,0
unity,Fee schedule,Facility 58120,Not in chargemaster,58120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58120,BCBSND Base Physician Payment Schedule,481.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58110,Not in chargemaster,58110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58110,BCBSND Base Physician Payment Schedule,87.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58100,58100,58100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58100,BCBSND Base Physician Payment Schedule,136.54,232.84,Fee schedule,,136.54,136.54,136.54,136.54,,,0
unity,Fee schedule,Facility 57800,Not in chargemaster,57800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57800,BCBSND Base Physician Payment Schedule,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 58300,Not in chargemaster,58300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,58300,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57558,Not in chargemaster,57558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57558,BCBSND Base Physician Payment Schedule,259.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57522,Not in chargemaster,57522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57522,BCBSND Base Physician Payment Schedule,529.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57520,Not in chargemaster,57520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57520,BCBSND Base Physician Payment Schedule,604.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57513,Not in chargemaster,57513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57513,BCBSND Base Physician Payment Schedule,297.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57511,Not in chargemaster,57511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57511,BCBSND Base Physician Payment Schedule,298.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57510,Not in chargemaster,57510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57510,BCBSND Base Physician Payment Schedule,241.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57505,Not in chargemaster,57505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57505,BCBSND Base Physician Payment Schedule,212.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57500,Not in chargemaster,57500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57500,BCBSND Base Physician Payment Schedule,159.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57461,Not in chargemaster,57461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57461,BCBSND Base Physician Payment Schedule,395.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57460,Not in chargemaster,57460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57460,BCBSND Base Physician Payment Schedule,342.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57456,Not in chargemaster,57456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57456,BCBSND Base Physician Payment Schedule,216.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57455,Not in chargemaster,57455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57455,BCBSND Base Physician Payment Schedule,234.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57454,Not in chargemaster,57454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57454,BCBSND Base Physician Payment Schedule,285.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57452,Not in chargemaster,57452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57452,BCBSND Base Physician Payment Schedule,193.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57421,Not in chargemaster,57421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57421,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57180,Not in chargemaster,57180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57180,BCBSND Base Physician Payment Schedule,243.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57170,Not in chargemaster,57170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57170,BCBSND Base Physician Payment Schedule,101.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57160,Not in chargemaster,57160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57160,BCBSND Base Physician Payment Schedule,99.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57156,Not in chargemaster,57156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57156,BCBSND Base Physician Payment Schedule,315.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57155,Not in chargemaster,57155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57155,BCBSND Base Physician Payment Schedule,596.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57420,Not in chargemaster,57420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57420,BCBSND Base Physician Payment Schedule,192.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57150,Not in chargemaster,57150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57150,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57135,Not in chargemaster,57135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57135,BCBSND Base Physician Payment Schedule,384.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57105,Not in chargemaster,57105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57105,BCBSND Base Physician Payment Schedule,288.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57100,Not in chargemaster,57100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57100,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57130,Not in chargemaster,57130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57130,BCBSND Base Physician Payment Schedule,354.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57065,Not in chargemaster,57065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57065,BCBSND Base Physician Payment Schedule,381.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56821,Not in chargemaster,56821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56821,BCBSND Base Physician Payment Schedule,242.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57061,Not in chargemaster,57061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57061,BCBSND Base Physician Payment Schedule,226.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 57020,Not in chargemaster,57020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,57020,BCBSND Base Physician Payment Schedule,172.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56606,Not in chargemaster,56606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56606,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56605,Not in chargemaster,56605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56605,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56820,Not in chargemaster,56820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56820,BCBSND Base Physician Payment Schedule,181.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56515,Not in chargemaster,56515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56515,BCBSND Base Physician Payment Schedule,438.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56501,Not in chargemaster,56501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56501,BCBSND Base Physician Payment Schedule,264.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56441,Not in chargemaster,56441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56441,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56420,Not in chargemaster,56420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56420,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 56405,Not in chargemaster,56405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,56405,BCBSND Base Physician Payment Schedule,251.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55876,Not in chargemaster,55876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55876,BCBSND Base Physician Payment Schedule,213.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55874,Not in chargemaster,55874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55874,BCBSND Base Physician Payment Schedule,350.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55873,Not in chargemaster,55873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55873,BCBSND Base Physician Payment Schedule,1619.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55870,Not in chargemaster,55870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55870,BCBSND Base Physician Payment Schedule,300.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55700,Not in chargemaster,55700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55700,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55250,Not in chargemaster,55250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55250,BCBSND Base Physician Payment Schedule,480.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54235,Not in chargemaster,54235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54235,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55200,Not in chargemaster,55200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55200,BCBSND Base Physician Payment Schedule,587.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55100,Not in chargemaster,55100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55100,BCBSND Base Physician Payment Schedule,352.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54231,Not in chargemaster,54231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54231,BCBSND Base Physician Payment Schedule,245.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54230,Not in chargemaster,54230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54230,BCBSND Base Physician Payment Schedule,167.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54220,Not in chargemaster,54220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54220,BCBSND Base Physician Payment Schedule,283.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54162,Not in chargemaster,54162,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54162,BCBSND Base Physician Payment Schedule,422.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54200,Not in chargemaster,54200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54200,BCBSND Base Physician Payment Schedule,176.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 55000,Not in chargemaster,55000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,55000,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54450,Not in chargemaster,54450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54450,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54160,Not in chargemaster,54160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54160,BCBSND Base Physician Payment Schedule,306.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54105,Not in chargemaster,54105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54105,BCBSND Base Physician Payment Schedule,450,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54150,54150,54150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54150,BCBSND Base Physician Payment Schedule,208.48,325.83,Fee schedule,,208.48,208.48,208.48,208.48,,,0
unity,Fee schedule,Facility 54115,Not in chargemaster,54115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54115,BCBSND Base Physician Payment Schedule,898.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54100,Not in chargemaster,54100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54100,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54065,Not in chargemaster,54065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54065,BCBSND Base Physician Payment Schedule,359.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54060,Not in chargemaster,54060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54060,BCBSND Base Physician Payment Schedule,274.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54057,Not in chargemaster,54057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54057,BCBSND Base Physician Payment Schedule,199.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54056,Not in chargemaster,54056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54056,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54055,Not in chargemaster,54055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54055,BCBSND Base Physician Payment Schedule,196,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54050,Not in chargemaster,54050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54050,BCBSND Base Physician Payment Schedule,219.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54001,Not in chargemaster,54001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54001,BCBSND Base Physician Payment Schedule,295.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 54000,Not in chargemaster,54000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,54000,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53860,Not in chargemaster,53860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53860,BCBSND Base Physician Payment Schedule,473.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53855,Not in chargemaster,53855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53855,BCBSND Base Physician Payment Schedule,175.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53854,Not in chargemaster,53854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53854,BCBSND Base Physician Payment Schedule,793.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53852,Not in chargemaster,53852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53852,BCBSND Base Physician Payment Schedule,794.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53850,Not in chargemaster,53850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53850,BCBSND Base Physician Payment Schedule,741.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53661,Not in chargemaster,53661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53661,BCBSND Base Physician Payment Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53660,Not in chargemaster,53660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53660,BCBSND Base Physician Payment Schedule,88.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53621,Not in chargemaster,53621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53621,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53620,Not in chargemaster,53620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53620,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53601,Not in chargemaster,53601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53601,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53270,Not in chargemaster,53270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53270,BCBSND Base Physician Payment Schedule,389.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53265,Not in chargemaster,53265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53265,BCBSND Base Physician Payment Schedule,397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52648,Not in chargemaster,52648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52648,BCBSND Base Physician Payment Schedule,1463.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53260,Not in chargemaster,53260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53260,BCBSND Base Physician Payment Schedule,383.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53600,Not in chargemaster,53600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53600,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53200,Not in chargemaster,53200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53200,BCBSND Base Physician Payment Schedule,300.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52647,Not in chargemaster,52647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52647,BCBSND Base Physician Payment Schedule,1372.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 53060,Not in chargemaster,53060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,53060,BCBSND Base Physician Payment Schedule,352.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52442,Not in chargemaster,52442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52442,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52332,Not in chargemaster,52332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52332,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52330,Not in chargemaster,52330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52330,BCBSND Base Physician Payment Schedule,557.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52317,Not in chargemaster,52317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52317,BCBSND Base Physician Payment Schedule,737.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52315,Not in chargemaster,52315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52315,BCBSND Base Physician Payment Schedule,580.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52310,Not in chargemaster,52310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52310,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52441,Not in chargemaster,52441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52441,BCBSND Base Physician Payment Schedule,445.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52287,Not in chargemaster,52287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52287,BCBSND Base Physician Payment Schedule,358.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52285,Not in chargemaster,52285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52285,BCBSND Base Physician Payment Schedule,414.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52283,Not in chargemaster,52283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52283,BCBSND Base Physician Payment Schedule,426.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52275,Not in chargemaster,52275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52275,BCBSND Base Physician Payment Schedule,525.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52281,Not in chargemaster,52281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52281,BCBSND Base Physician Payment Schedule,320.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52270,Not in chargemaster,52270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52270,BCBSND Base Physician Payment Schedule,383.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52224,Not in chargemaster,52224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52224,BCBSND Base Physician Payment Schedule,432.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52265,Not in chargemaster,52265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52265,BCBSND Base Physician Payment Schedule,345.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52214,Not in chargemaster,52214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52214,BCBSND Base Physician Payment Schedule,373.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52204,Not in chargemaster,52204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52204,BCBSND Base Physician Payment Schedule,298.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52010,Not in chargemaster,52010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52010,BCBSND Base Physician Payment Schedule,349.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52007,Not in chargemaster,52007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52007,BCBSND Base Physician Payment Schedule,349.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52005,Not in chargemaster,52005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52005,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52001,Not in chargemaster,52001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52001,BCBSND Base Physician Payment Schedule,607.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 52000,Not in chargemaster,52000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,52000,BCBSND Base Physician Payment Schedule,171.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51720,Not in chargemaster,51720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51720,BCBSND Base Physician Payment Schedule,92.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51715,Not in chargemaster,51715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51715,BCBSND Base Physician Payment Schedule,425.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51710,Not in chargemaster,51710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51710,BCBSND Base Physician Payment Schedule,167.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51705,Not in chargemaster,51705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51705,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51703,Not in chargemaster,51703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51703,BCBSND Base Physician Payment Schedule,163.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51702,51702,51702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51702,BCBSND Base Physician Payment Schedule,54.32,149.79,Fee schedule,,54.32,54.32,54.32,54.32,,,0
unity,Fee schedule,Facility 51701,Not in chargemaster,51701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51701,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51700,Not in chargemaster,51700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51700,BCBSND Base Physician Payment Schedule,66.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51610,Not in chargemaster,51610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51610,BCBSND Base Physician Payment Schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51102,Not in chargemaster,51102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51102,BCBSND Base Physician Payment Schedule,308.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51101,Not in chargemaster,51101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51101,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50961,Not in chargemaster,50961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50961,BCBSND Base Physician Payment Schedule,670.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51100,Not in chargemaster,51100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51100,BCBSND Base Physician Payment Schedule,82.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 51600,Not in chargemaster,51600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,51600,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50957,Not in chargemaster,50957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50957,BCBSND Base Physician Payment Schedule,751.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50955,Not in chargemaster,50955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50955,BCBSND Base Physician Payment Schedule,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50953,Not in chargemaster,50953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50953,BCBSND Base Physician Payment Schedule,690.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50706,Not in chargemaster,50706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50706,BCBSND Base Physician Payment Schedule,389.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50705,Not in chargemaster,50705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50705,BCBSND Base Physician Payment Schedule,375.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50695,Not in chargemaster,50695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50695,BCBSND Base Physician Payment Schedule,731.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50694,Not in chargemaster,50694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50694,BCBSND Base Physician Payment Schedule,571.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50693,Not in chargemaster,50693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50693,BCBSND Base Physician Payment Schedule,434.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50951,Not in chargemaster,50951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50951,BCBSND Base Physician Payment Schedule,648.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50690,Not in chargemaster,50690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50690,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50686,Not in chargemaster,50686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50686,BCBSND Base Physician Payment Schedule,186.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50684,Not in chargemaster,50684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50684,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50606,Not in chargemaster,50606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50606,BCBSND Base Physician Payment Schedule,323.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50593,Not in chargemaster,50593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50593,BCBSND Base Physician Payment Schedule,977.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50592,Not in chargemaster,50592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50592,BCBSND Base Physician Payment Schedule,728.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50590,Not in chargemaster,50590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50590,BCBSND Base Physician Payment Schedule,1205.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50561,Not in chargemaster,50561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50561,BCBSND Base Physician Payment Schedule,833.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50557,Not in chargemaster,50557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50557,BCBSND Base Physician Payment Schedule,733.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50555,Not in chargemaster,50555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50555,BCBSND Base Physician Payment Schedule,723.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50553,Not in chargemaster,50553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50553,BCBSND Base Physician Payment Schedule,663.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50551,Not in chargemaster,50551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50551,BCBSND Base Physician Payment Schedule,622.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50435,Not in chargemaster,50435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50435,BCBSND Base Physician Payment Schedule,211.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50434,Not in chargemaster,50434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50434,BCBSND Base Physician Payment Schedule,408.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50433,Not in chargemaster,50433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50433,BCBSND Base Physician Payment Schedule,543.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50432,Not in chargemaster,50432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50432,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50431,Not in chargemaster,50431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50431,BCBSND Base Physician Payment Schedule,138.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50391,Not in chargemaster,50391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50391,BCBSND Base Physician Payment Schedule,209.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50430,Not in chargemaster,50430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50430,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50389,Not in chargemaster,50389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50389,BCBSND Base Physician Payment Schedule,113.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50387,Not in chargemaster,50387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50387,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50386,Not in chargemaster,50386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50386,BCBSND Base Physician Payment Schedule,343.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50385,Not in chargemaster,50385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50385,BCBSND Base Physician Payment Schedule,463.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50384,Not in chargemaster,50384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50384,BCBSND Base Physician Payment Schedule,488.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49465,Not in chargemaster,49465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49465,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49460,Not in chargemaster,49460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49460,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49452,Not in chargemaster,49452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49452,BCBSND Base Physician Payment Schedule,295.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50382,Not in chargemaster,50382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50382,BCBSND Base Physician Payment Schedule,545.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49451,Not in chargemaster,49451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49451,BCBSND Base Physician Payment Schedule,191.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49450,Not in chargemaster,49450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49450,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49446,Not in chargemaster,49446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49446,BCBSND Base Physician Payment Schedule,315.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49442,Not in chargemaster,49442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49442,BCBSND Base Physician Payment Schedule,440.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49441,Not in chargemaster,49441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49441,BCBSND Base Physician Payment Schedule,513.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49424,Not in chargemaster,49424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49424,BCBSND Base Physician Payment Schedule,81.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49423,Not in chargemaster,49423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49423,BCBSND Base Physician Payment Schedule,150.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 50200,Not in chargemaster,50200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,50200,BCBSND Base Physician Payment Schedule,271.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49440,Not in chargemaster,49440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49440,BCBSND Base Physician Payment Schedule,435.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49418,Not in chargemaster,49418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49418,BCBSND Base Physician Payment Schedule,431.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49411,Not in chargemaster,49411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49411,BCBSND Base Physician Payment Schedule,391.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49407,Not in chargemaster,49407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49407,BCBSND Base Physician Payment Schedule,444.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49406,Not in chargemaster,49406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49406,BCBSND Base Physician Payment Schedule,418.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49405,Not in chargemaster,49405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49405,BCBSND Base Physician Payment Schedule,419.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49185,Not in chargemaster,49185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49185,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49180,Not in chargemaster,49180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49180,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49083,49083,49083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49083,BCBSND Base Physician Payment Schedule,228.31,280.32,Fee schedule,,228.31,228.31,228.31,228.31,,,0
unity,Fee schedule,Facility 47544,Not in chargemaster,47544,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47544,BCBSND Base Physician Payment Schedule,334.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47543,Not in chargemaster,47543,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47543,BCBSND Base Physician Payment Schedule,309.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47542,Not in chargemaster,47542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47542,BCBSND Base Physician Payment Schedule,290.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47541,Not in chargemaster,47541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47541,BCBSND Base Physician Payment Schedule,707.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49400,Not in chargemaster,49400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49400,BCBSND Base Physician Payment Schedule,196.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47540,Not in chargemaster,47540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47540,BCBSND Base Physician Payment Schedule,939.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47539,Not in chargemaster,47539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47539,BCBSND Base Physician Payment Schedule,904.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47538,Not in chargemaster,47538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47538,BCBSND Base Physician Payment Schedule,504.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47537,Not in chargemaster,47537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47537,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47536,Not in chargemaster,47536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47536,BCBSND Base Physician Payment Schedule,281.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47535,Not in chargemaster,47535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47535,BCBSND Base Physician Payment Schedule,416.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47534,Not in chargemaster,47534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47534,BCBSND Base Physician Payment Schedule,790.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47533,Not in chargemaster,47533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47533,BCBSND Base Physician Payment Schedule,566.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 49082,49082,49082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,49082,BCBSND Base Physician Payment Schedule,157.1,157.31,Fee schedule,,157.1,157.1,157.1,157.1,,,0
unity,Fee schedule,Facility 48102,Not in chargemaster,48102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,48102,BCBSND Base Physician Payment Schedule,508,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47532,Not in chargemaster,47532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47532,BCBSND Base Physician Payment Schedule,452.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47383,Not in chargemaster,47383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47383,BCBSND Base Physician Payment Schedule,967.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47000,Not in chargemaster,47000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47000,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47531,Not in chargemaster,47531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47531,BCBSND Base Physician Payment Schedule,149.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 47382,Not in chargemaster,47382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,47382,BCBSND Base Physician Payment Schedule,1576.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46942,Not in chargemaster,46942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46942,BCBSND Base Physician Payment Schedule,274.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46940,Not in chargemaster,46940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46940,BCBSND Base Physician Payment Schedule,305.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46930,Not in chargemaster,46930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46930,BCBSND Base Physician Payment Schedule,317.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46924,Not in chargemaster,46924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46924,BCBSND Base Physician Payment Schedule,381.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46922,Not in chargemaster,46922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46922,BCBSND Base Physician Payment Schedule,288.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46917,Not in chargemaster,46917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46917,BCBSND Base Physician Payment Schedule,270.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46916,Not in chargemaster,46916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46916,BCBSND Base Physician Payment Schedule,298.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46910,Not in chargemaster,46910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46910,BCBSND Base Physician Payment Schedule,281.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46900,Not in chargemaster,46900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46900,BCBSND Base Physician Payment Schedule,287.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46615,Not in chargemaster,46615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46615,BCBSND Base Physician Payment Schedule,193.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46614,Not in chargemaster,46614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46614,BCBSND Base Physician Payment Schedule,135.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46612,Not in chargemaster,46612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46612,BCBSND Base Physician Payment Schedule,202.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46611,Not in chargemaster,46611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46611,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46610,Not in chargemaster,46610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46610,BCBSND Base Physician Payment Schedule,171.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46608,Not in chargemaster,46608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46608,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46754,Not in chargemaster,46754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46754,BCBSND Base Physician Payment Schedule,496.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46607,Not in chargemaster,46607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46607,BCBSND Base Physician Payment Schedule,267.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46606,Not in chargemaster,46606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46606,BCBSND Base Physician Payment Schedule,159.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46604,Not in chargemaster,46604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46604,BCBSND Base Physician Payment Schedule,138.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46601,Not in chargemaster,46601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46601,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46600,46600,46600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46600,BCBSND Base Physician Payment Schedule,85.89,87.32,Fee schedule,,85.89,85.89,85.89,85.89,,,0
unity,Fee schedule,Facility 46505,Not in chargemaster,46505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46505,BCBSND Base Physician Payment Schedule,513.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46500,Not in chargemaster,46500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46500,BCBSND Base Physician Payment Schedule,381.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46320,Not in chargemaster,46320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46320,BCBSND Base Physician Payment Schedule,236.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46285,Not in chargemaster,46285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46285,BCBSND Base Physician Payment Schedule,882.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46275,Not in chargemaster,46275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46275,BCBSND Base Physician Payment Schedule,883.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46270,46270,46270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46270,BCBSND Base Physician Payment Schedule,839.08,865,Fee schedule,,839.08,839.08,839.08,839.08,,,0
unity,Fee schedule,Facility 46255,46255,46255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46255,BCBSND Base Physician Payment Schedule,756.12,751.04,Fee schedule,,751.04,751.04,751.04,751.04,,,0
unity,Fee schedule,Facility 46250,46250,46250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46250,BCBSND Base Physician Payment Schedule,674.64,669.42,Fee schedule,,669.42,669.42,669.42,669.42,,,0
unity,Fee schedule,Facility 46230,Not in chargemaster,46230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46230,BCBSND Base Physician Payment Schedule,367.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46221,Not in chargemaster,46221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46221,BCBSND Base Physician Payment Schedule,405.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46220,Not in chargemaster,46220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46220,BCBSND Base Physician Payment Schedule,251.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46200,Not in chargemaster,46200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46200,BCBSND Base Physician Payment Schedule,700.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46083,46083,46083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46083,BCBSND Base Physician Payment Schedule,229.77,227.16,Fee schedule,,227.16,227.16,227.16,227.16,,,0
unity,Fee schedule,Facility 46050,46050,46050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46050,BCBSND Base Physician Payment Schedule,209.22,210.84,Fee schedule,,209.22,209.22,209.22,209.22,,,0
unity,Fee schedule,Facility 46080,Not in chargemaster,46080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46080,BCBSND Base Physician Payment Schedule,337.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46040,46040,46040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46040,BCBSND Base Physician Payment Schedule,892.67,882.38,Fee schedule,,882.38,882.38,882.38,882.38,,,0
unity,Fee schedule,Facility 46030,Not in chargemaster,46030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46030,BCBSND Base Physician Payment Schedule,190.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 46020,Not in chargemaster,46020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46020,BCBSND Base Physician Payment Schedule,500.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45388,Not in chargemaster,45388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45388,BCBSND Base Physician Payment Schedule,574.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45520,Not in chargemaster,45520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45520,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45915,Not in chargemaster,45915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45915,BCBSND Base Physician Payment Schedule,488.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45398,Not in chargemaster,45398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45398,BCBSND Base Physician Payment Schedule,501.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45386,Not in chargemaster,45386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45386,BCBSND Base Physician Payment Schedule,448.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45385,45385,45385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45385,BCBSND Base Physician Payment Schedule,539.56,666.19,Fee schedule,,539.56,539.56,539.56,539.56,,,0
unity,Fee schedule,Facility 45384,45384,45384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45384,BCBSND Base Physician Payment Schedule,484.51,585.72,Fee schedule,,484.51,484.51,484.51,484.51,,,0
unity,Fee schedule,Facility 45382,Not in chargemaster,45382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45382,BCBSND Base Physician Payment Schedule,549.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45381,Not in chargemaster,45381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45381,BCBSND Base Physician Payment Schedule,425.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45380,45380,45380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45380,BCBSND Base Physician Payment Schedule,425.04,561.81,Fee schedule,,425.04,425.04,425.04,425.04,,,0
unity,Fee schedule,Facility 45379,Not in chargemaster,45379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45379,BCBSND Base Physician Payment Schedule,507.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45378,45378,45378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45378,BCBSND Base Physician Payment Schedule,392.74,460,Fee schedule,,392.74,392.74,392.74,392.74,,,0
unity,Fee schedule,Facility 45350,Not in chargemaster,45350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45350,BCBSND Base Physician Payment Schedule,214.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45346,Not in chargemaster,45346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45346,BCBSND Base Physician Payment Schedule,339.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45340,Not in chargemaster,45340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45340,BCBSND Base Physician Payment Schedule,164.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45338,Not in chargemaster,45338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45338,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45335,Not in chargemaster,45335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45335,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45334,Not in chargemaster,45334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45334,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45333,Not in chargemaster,45333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45333,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45332,Not in chargemaster,45332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45332,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45331,45331,45331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45331,BCBSND Base Physician Payment Schedule,151.22,181.5,Fee schedule,,151.22,151.22,151.22,151.22,,,0
unity,Fee schedule,Facility 45320,Not in chargemaster,45320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45320,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45330,45330,45330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45330,BCBSND Base Physician Payment Schedule,118.19,141.81,Fee schedule,,118.19,118.19,118.19,118.19,,,0
unity,Fee schedule,Facility 45317,Not in chargemaster,45317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45317,BCBSND Base Physician Payment Schedule,235.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45315,Not in chargemaster,45315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45315,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45309,Not in chargemaster,45309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45309,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45308,Not in chargemaster,45308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45308,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45307,Not in chargemaster,45307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45307,BCBSND Base Physician Payment Schedule,206.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45305,Not in chargemaster,45305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45305,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45303,Not in chargemaster,45303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45303,BCBSND Base Physician Payment Schedule,179.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44405,Not in chargemaster,44405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44405,BCBSND Base Physician Payment Schedule,387.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44404,Not in chargemaster,44404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44404,BCBSND Base Physician Payment Schedule,364.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45005,Not in chargemaster,45005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45005,BCBSND Base Physician Payment Schedule,344.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 45300,Not in chargemaster,45300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45300,BCBSND Base Physician Payment Schedule,101.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44705,Not in chargemaster,44705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44705,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44401,Not in chargemaster,44401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44401,BCBSND Base Physician Payment Schedule,513.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44394,Not in chargemaster,44394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44394,BCBSND Base Physician Payment Schedule,478.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44392,Not in chargemaster,44392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44392,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44391,Not in chargemaster,44391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44391,BCBSND Base Physician Payment Schedule,488.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44390,Not in chargemaster,44390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44390,BCBSND Base Physician Payment Schedule,445.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44389,Not in chargemaster,44389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44389,BCBSND Base Physician Payment Schedule,364.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44388,44388,44388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44388,BCBSND Base Physician Payment Schedule,331.81,668.17,Fee schedule,,331.81,331.81,331.81,331.81,,,0
unity,Fee schedule,Facility 44386,Not in chargemaster,44386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44386,BCBSND Base Physician Payment Schedule,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44385,Not in chargemaster,44385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44385,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44382,Not in chargemaster,44382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44382,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44381,Not in chargemaster,44381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44381,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43763,Not in chargemaster,43763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43763,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43762,Not in chargemaster,43762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43762,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43761,Not in chargemaster,43761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43761,BCBSND Base Physician Payment Schedule,220.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43757,Not in chargemaster,43757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43757,BCBSND Base Physician Payment Schedule,161.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43756,Not in chargemaster,43756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43756,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 44380,Not in chargemaster,44380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44380,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43755,Not in chargemaster,43755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43755,BCBSND Base Physician Payment Schedule,124.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43453,Not in chargemaster,43453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43453,BCBSND Base Physician Payment Schedule,181.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43255,Not in chargemaster,43255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43255,BCBSND Base Physician Payment Schedule,425.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43270,Not in chargemaster,43270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43270,BCBSND Base Physician Payment Schedule,475.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43754,Not in chargemaster,43754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43754,BCBSND Base Physician Payment Schedule,75.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43450,Not in chargemaster,43450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43450,BCBSND Base Physician Payment Schedule,166.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43252,Not in chargemaster,43252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43252,BCBSND Base Physician Payment Schedule,358.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43251,43251,43251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43251,BCBSND Base Physician Payment Schedule,415.5,440,Fee schedule,,415.5,415.5,415.5,415.5,,,0
unity,Fee schedule,Facility 43250,Not in chargemaster,43250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43250,BCBSND Base Physician Payment Schedule,362.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43249,43249,43249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43249,BCBSND Base Physician Payment Schedule,324.47,387.2,Fee schedule,,324.47,324.47,324.47,324.47,,,0
unity,Fee schedule,Facility 43248,Not in chargemaster,43248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43248,BCBSND Base Physician Payment Schedule,350.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43247,43247,43247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43247,BCBSND Base Physician Payment Schedule,375.13,412.5,Fee schedule,,375.13,375.13,375.13,375.13,,,0
unity,Fee schedule,Facility 43245,Not in chargemaster,43245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43245,BCBSND Base Physician Payment Schedule,372.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43239,43239,43239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43239,BCBSND Base Physician Payment Schedule,292.91,371.88,Fee schedule,,292.91,292.91,292.91,292.91,,,0
unity,Fee schedule,Facility 43236,Not in chargemaster,43236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43236,BCBSND Base Physician Payment Schedule,292.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43229,Not in chargemaster,43229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43229,BCBSND Base Physician Payment Schedule,418.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43235,43235,43235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43235,BCBSND Base Physician Payment Schedule,259.87,315.35,Fee schedule,,259.87,259.87,259.87,259.87,,,0
unity,Fee schedule,Facility 43227,Not in chargemaster,43227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43227,BCBSND Base Physician Payment Schedule,348.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43226,Not in chargemaster,43226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43226,BCBSND Base Physician Payment Schedule,275.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43220,43220,43220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43220,BCBSND Base Physician Payment Schedule,249.59,282.81,Fee schedule,,249.59,249.59,249.59,249.59,,,0
unity,Fee schedule,Facility 43217,Not in chargemaster,43217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43217,BCBSND Base Physician Payment Schedule,339.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43216,Not in chargemaster,43216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43216,BCBSND Base Physician Payment Schedule,283.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43215,Not in chargemaster,43215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43215,BCBSND Base Physician Payment Schedule,299.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43213,Not in chargemaster,43213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43213,BCBSND Base Physician Payment Schedule,549.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43206,Not in chargemaster,43206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43206,BCBSND Base Physician Payment Schedule,281.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43202,Not in chargemaster,43202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43202,BCBSND Base Physician Payment Schedule,218.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43201,Not in chargemaster,43201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43201,BCBSND Base Physician Payment Schedule,218.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43200,Not in chargemaster,43200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43200,BCBSND Base Physician Payment Schedule,184.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43198,Not in chargemaster,43198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43198,BCBSND Base Physician Payment Schedule,209.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42810,Not in chargemaster,42810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42810,BCBSND Base Physician Payment Schedule,594.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42809,Not in chargemaster,42809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42809,BCBSND Base Physician Payment Schedule,261.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42808,Not in chargemaster,42808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42808,BCBSND Base Physician Payment Schedule,342.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42806,Not in chargemaster,42806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42806,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 43197,Not in chargemaster,43197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43197,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42804,Not in chargemaster,42804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42804,BCBSND Base Physician Payment Schedule,240.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42800,Not in chargemaster,42800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42800,BCBSND Base Physician Payment Schedule,236.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42720,Not in chargemaster,42720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42720,BCBSND Base Physician Payment Schedule,818.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42700,Not in chargemaster,42700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42700,BCBSND Base Physician Payment Schedule,283.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42665,Not in chargemaster,42665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42665,BCBSND Base Physician Payment Schedule,438.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42660,Not in chargemaster,42660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42660,BCBSND Base Physician Payment Schedule,184.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42650,Not in chargemaster,42650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42650,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42600,Not in chargemaster,42600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42600,BCBSND Base Physician Payment Schedule,733.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42550,Not in chargemaster,42550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42550,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42505,Not in chargemaster,42505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42505,BCBSND Base Physician Payment Schedule,948.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42500,Not in chargemaster,42500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42500,BCBSND Base Physician Payment Schedule,712.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42450,Not in chargemaster,42450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42450,BCBSND Base Physician Payment Schedule,756.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42409,Not in chargemaster,42409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42409,BCBSND Base Physician Payment Schedule,471.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42408,Not in chargemaster,42408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42408,BCBSND Base Physician Payment Schedule,735.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42405,Not in chargemaster,42405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42405,BCBSND Base Physician Payment Schedule,475.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42400,Not in chargemaster,42400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42400,BCBSND Base Physician Payment Schedule,113.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42340,Not in chargemaster,42340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42340,BCBSND Base Physician Payment Schedule,708.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42335,Not in chargemaster,42335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42335,BCBSND Base Physician Payment Schedule,541.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42330,Not in chargemaster,42330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42330,BCBSND Base Physician Payment Schedule,344.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42320,Not in chargemaster,42320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42320,BCBSND Base Physician Payment Schedule,369.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42310,Not in chargemaster,42310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42310,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42300,Not in chargemaster,42300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42300,BCBSND Base Physician Payment Schedule,322.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42281,Not in chargemaster,42281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42281,BCBSND Base Physician Payment Schedule,340.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42280,Not in chargemaster,42280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42280,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42260,Not in chargemaster,42260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42260,BCBSND Base Physician Payment Schedule,1393.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42182,Not in chargemaster,42182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42182,BCBSND Base Physician Payment Schedule,538.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42180,Not in chargemaster,42180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42180,BCBSND Base Physician Payment Schedule,387.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42160,Not in chargemaster,42160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42160,BCBSND Base Physician Payment Schedule,304.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42140,Not in chargemaster,42140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42140,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42107,Not in chargemaster,42107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42107,BCBSND Base Physician Payment Schedule,714.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42106,Not in chargemaster,42106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42106,BCBSND Base Physician Payment Schedule,356.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42104,Not in chargemaster,42104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42104,BCBSND Base Physician Payment Schedule,286.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42100,Not in chargemaster,42100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42100,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 42000,Not in chargemaster,42000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42000,BCBSND Base Physician Payment Schedule,218.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41874,Not in chargemaster,41874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41874,BCBSND Base Physician Payment Schedule,529.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41872,Not in chargemaster,41872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41872,BCBSND Base Physician Payment Schedule,626.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41830,Not in chargemaster,41830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41830,BCBSND Base Physician Payment Schedule,654.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41828,Not in chargemaster,41828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41828,BCBSND Base Physician Payment Schedule,472.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41827,Not in chargemaster,41827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41827,BCBSND Base Physician Payment Schedule,630.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41826,Not in chargemaster,41826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41826,BCBSND Base Physician Payment Schedule,431.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41825,Not in chargemaster,41825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41825,BCBSND Base Physician Payment Schedule,251.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41823,Not in chargemaster,41823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41823,BCBSND Base Physician Payment Schedule,753.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41822,Not in chargemaster,41822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41822,BCBSND Base Physician Payment Schedule,419.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41806,Not in chargemaster,41806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41806,BCBSND Base Physician Payment Schedule,577,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41805,Not in chargemaster,41805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41805,BCBSND Base Physician Payment Schedule,397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41800,Not in chargemaster,41800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41800,BCBSND Base Physician Payment Schedule,320.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41530,Not in chargemaster,41530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41530,BCBSND Base Physician Payment Schedule,783.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41520,Not in chargemaster,41520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41520,BCBSND Base Physician Payment Schedule,519.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41252,Not in chargemaster,41252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41252,BCBSND Base Physician Payment Schedule,441.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41251,Not in chargemaster,41251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41251,BCBSND Base Physician Payment Schedule,386.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41116,Not in chargemaster,41116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41116,BCBSND Base Physician Payment Schedule,453.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41115,Not in chargemaster,41115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41115,BCBSND Base Physician Payment Schedule,305.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41250,Not in chargemaster,41250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41250,BCBSND Base Physician Payment Schedule,325.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41113,Not in chargemaster,41113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41113,BCBSND Base Physician Payment Schedule,569.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41112,Not in chargemaster,41112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41112,BCBSND Base Physician Payment Schedule,516.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41110,Not in chargemaster,41110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41110,BCBSND Base Physician Payment Schedule,273.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41108,Not in chargemaster,41108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41108,BCBSND Base Physician Payment Schedule,184.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41105,Not in chargemaster,41105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41105,BCBSND Base Physician Payment Schedule,228.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41100,Not in chargemaster,41100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41100,BCBSND Base Physician Payment Schedule,221.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41018,Not in chargemaster,41018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41018,BCBSND Base Physician Payment Schedule,841.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41017,Not in chargemaster,41017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41017,BCBSND Base Physician Payment Schedule,723.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41016,Not in chargemaster,41016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41016,BCBSND Base Physician Payment Schedule,728.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41015,Not in chargemaster,41015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41015,BCBSND Base Physician Payment Schedule,654.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41010,Not in chargemaster,41010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41010,BCBSND Base Physician Payment Schedule,226.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41009,Not in chargemaster,41009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41009,BCBSND Base Physician Payment Schedule,601.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41008,Not in chargemaster,41008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41008,BCBSND Base Physician Payment Schedule,546.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41007,Not in chargemaster,41007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41007,BCBSND Base Physician Payment Schedule,487.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41006,Not in chargemaster,41006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41006,BCBSND Base Physician Payment Schedule,502.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41005,Not in chargemaster,41005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41005,BCBSND Base Physician Payment Schedule,242.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 41000,Not in chargemaster,41000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41000,BCBSND Base Physician Payment Schedule,229.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40845,Not in chargemaster,40845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40845,BCBSND Base Physician Payment Schedule,2557.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40844,Not in chargemaster,40844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40844,BCBSND Base Physician Payment Schedule,2510.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40843,Not in chargemaster,40843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40843,BCBSND Base Physician Payment Schedule,1864.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40842,Not in chargemaster,40842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40842,BCBSND Base Physician Payment Schedule,1437.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40840,Not in chargemaster,40840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40840,BCBSND Base Physician Payment Schedule,1322.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40831,Not in chargemaster,40831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40831,BCBSND Base Physician Payment Schedule,487.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40830,Not in chargemaster,40830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40830,BCBSND Base Physician Payment Schedule,355.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40820,Not in chargemaster,40820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40820,BCBSND Base Physician Payment Schedule,350.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40819,Not in chargemaster,40819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40819,BCBSND Base Physician Payment Schedule,445.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40818,Not in chargemaster,40818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40818,BCBSND Base Physician Payment Schedule,571.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40816,Not in chargemaster,40816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40816,BCBSND Base Physician Payment Schedule,646.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40814,Not in chargemaster,40814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40814,BCBSND Base Physician Payment Schedule,617.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40812,Not in chargemaster,40812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40812,BCBSND Base Physician Payment Schedule,400.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40810,Not in chargemaster,40810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40810,BCBSND Base Physician Payment Schedule,259.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40808,Not in chargemaster,40808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40808,BCBSND Base Physician Payment Schedule,181.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40806,Not in chargemaster,40806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40806,BCBSND Base Physician Payment Schedule,63.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40805,Not in chargemaster,40805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40805,BCBSND Base Physician Payment Schedule,440.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40804,Not in chargemaster,40804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40804,BCBSND Base Physician Payment Schedule,248.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40801,Not in chargemaster,40801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40801,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40800,Not in chargemaster,40800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40800,BCBSND Base Physician Payment Schedule,261.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40654,Not in chargemaster,40654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40654,BCBSND Base Physician Payment Schedule,892.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40652,Not in chargemaster,40652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40652,BCBSND Base Physician Payment Schedule,750.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40650,Not in chargemaster,40650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40650,BCBSND Base Physician Payment Schedule,645.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40520,Not in chargemaster,40520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40520,BCBSND Base Physician Payment Schedule,748.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40530,Not in chargemaster,40530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40530,BCBSND Base Physician Payment Schedule,843.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40510,40510,40510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40510,BCBSND Base Physician Payment Schedule,737.77,742.5,Fee schedule,,737.77,737.77,737.77,737.77,,,0
unity,Fee schedule,Facility 40500,Not in chargemaster,40500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40500,BCBSND Base Physician Payment Schedule,763.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38510,38510,38510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38510,BCBSND Base Physician Payment Schedule,887.53,880,Fee schedule,,880,880,880,880,,,0
unity,Fee schedule,Facility 38505,Not in chargemaster,38505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38505,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 40490,Not in chargemaster,40490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40490,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38792,Not in chargemaster,38792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38792,BCBSND Base Physician Payment Schedule,71.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38500,38500,38500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38500,BCBSND Base Physician Payment Schedule,541.77,506,Fee schedule,,506,506,506,506,,,0
unity,Fee schedule,Facility 38222,Not in chargemaster,38222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38222,BCBSND Base Physician Payment Schedule,164.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38221,Not in chargemaster,38221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38221,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38300,Not in chargemaster,38300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38300,BCBSND Base Physician Payment Schedule,433.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 38220,Not in chargemaster,38220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38220,BCBSND Base Physician Payment Schedule,147.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37785,Not in chargemaster,37785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37785,BCBSND Base Physician Payment Schedule,547.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37766,Not in chargemaster,37766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37766,BCBSND Base Physician Payment Schedule,708.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37253,Not in chargemaster,37253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37253,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37252,Not in chargemaster,37252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37252,BCBSND Base Physician Payment Schedule,193.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37765,Not in chargemaster,37765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37765,BCBSND Base Physician Payment Schedule,578.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37609,Not in chargemaster,37609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37609,BCBSND Base Physician Payment Schedule,436.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37249,Not in chargemaster,37249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37249,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37248,Not in chargemaster,37248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37248,BCBSND Base Physician Payment Schedule,634.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37247,Not in chargemaster,37247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37247,BCBSND Base Physician Payment Schedule,364.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37246,Not in chargemaster,37246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37246,BCBSND Base Physician Payment Schedule,742.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37244,Not in chargemaster,37244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37244,BCBSND Base Physician Payment Schedule,1416.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37243,Not in chargemaster,37243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37243,BCBSND Base Physician Payment Schedule,1196.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37242,Not in chargemaster,37242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37242,BCBSND Base Physician Payment Schedule,1016.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37241,Not in chargemaster,37241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37241,BCBSND Base Physician Payment Schedule,932.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37239,Not in chargemaster,37239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37239,BCBSND Base Physician Payment Schedule,325.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37238,Not in chargemaster,37238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37238,BCBSND Base Physician Payment Schedule,651.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37237,Not in chargemaster,37237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37237,BCBSND Base Physician Payment Schedule,453.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37236,Not in chargemaster,37236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37236,BCBSND Base Physician Payment Schedule,949.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37235,Not in chargemaster,37235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37235,BCBSND Base Physician Payment Schedule,858.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37234,Not in chargemaster,37234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37234,BCBSND Base Physician Payment Schedule,609.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37233,Not in chargemaster,37233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37233,BCBSND Base Physician Payment Schedule,695.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37232,Not in chargemaster,37232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37232,BCBSND Base Physician Payment Schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37231,Not in chargemaster,37231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37231,BCBSND Base Physician Payment Schedule,1617.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37230,Not in chargemaster,37230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37230,BCBSND Base Physician Payment Schedule,1492.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37229,Not in chargemaster,37229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37229,BCBSND Base Physician Payment Schedule,1501.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37228,Not in chargemaster,37228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37228,BCBSND Base Physician Payment Schedule,1159.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37227,Not in chargemaster,37227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37227,BCBSND Base Physician Payment Schedule,1548.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37226,Not in chargemaster,37226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37226,BCBSND Base Physician Payment Schedule,1111.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37225,Not in chargemaster,37225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37225,BCBSND Base Physician Payment Schedule,1287.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37224,Not in chargemaster,37224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37224,BCBSND Base Physician Payment Schedule,950.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37223,Not in chargemaster,37223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37223,BCBSND Base Physician Payment Schedule,454.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37222,Not in chargemaster,37222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37222,BCBSND Base Physician Payment Schedule,397.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37221,Not in chargemaster,37221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37221,BCBSND Base Physician Payment Schedule,1056.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37197,Not in chargemaster,37197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37197,BCBSND Base Physician Payment Schedule,641.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37220,Not in chargemaster,37220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37220,BCBSND Base Physician Payment Schedule,855.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37193,Not in chargemaster,37193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37193,BCBSND Base Physician Payment Schedule,743.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37192,Not in chargemaster,37192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37192,BCBSND Base Physician Payment Schedule,735.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37191,Not in chargemaster,37191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37191,BCBSND Base Physician Payment Schedule,475.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37188,Not in chargemaster,37188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37188,BCBSND Base Physician Payment Schedule,594.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37187,Not in chargemaster,37187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37187,BCBSND Base Physician Payment Schedule,837.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37186,Not in chargemaster,37186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37186,BCBSND Base Physician Payment Schedule,520.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37185,Not in chargemaster,37185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37185,BCBSND Base Physician Payment Schedule,350.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37184,Not in chargemaster,37184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37184,BCBSND Base Physician Payment Schedule,927.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 37183,Not in chargemaster,37183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37183,BCBSND Base Physician Payment Schedule,793.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36909,Not in chargemaster,36909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36909,BCBSND Base Physician Payment Schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36908,Not in chargemaster,36908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36908,BCBSND Base Physician Payment Schedule,441.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36907,Not in chargemaster,36907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36907,BCBSND Base Physician Payment Schedule,311.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36906,Not in chargemaster,36906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36906,BCBSND Base Physician Payment Schedule,1091.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36905,Not in chargemaster,36905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36905,BCBSND Base Physician Payment Schedule,945.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36904,Not in chargemaster,36904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36904,BCBSND Base Physician Payment Schedule,788.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36903,Not in chargemaster,36903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36903,BCBSND Base Physician Payment Schedule,675.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36902,Not in chargemaster,36902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36902,BCBSND Base Physician Payment Schedule,509.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36901,Not in chargemaster,36901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36901,BCBSND Base Physician Payment Schedule,359.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36600,Not in chargemaster,36600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36600,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36598,Not in chargemaster,36598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36598,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36597,Not in chargemaster,36597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36597,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36596,Not in chargemaster,36596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36596,BCBSND Base Physician Payment Schedule,92.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36590,Not in chargemaster,36590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36590,BCBSND Base Physician Payment Schedule,404.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36595,Not in chargemaster,36595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36595,BCBSND Base Physician Payment Schedule,386.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36860,Not in chargemaster,36860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36860,BCBSND Base Physician Payment Schedule,237.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36589,Not in chargemaster,36589,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36589,BCBSND Base Physician Payment Schedule,291.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36585,Not in chargemaster,36585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36585,BCBSND Base Physician Payment Schedule,577,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36584,Not in chargemaster,36584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36584,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36583,Not in chargemaster,36583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36583,BCBSND Base Physician Payment Schedule,698.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36582,Not in chargemaster,36582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36582,BCBSND Base Physician Payment Schedule,616.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36581,Not in chargemaster,36581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36581,BCBSND Base Physician Payment Schedule,389.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36580,Not in chargemaster,36580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36580,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36578,Not in chargemaster,36578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36578,BCBSND Base Physician Payment Schedule,432.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36576,Not in chargemaster,36576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36576,BCBSND Base Physician Payment Schedule,392.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36575,Not in chargemaster,36575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36575,BCBSND Base Physician Payment Schedule,74.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36573,Not in chargemaster,36573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36573,BCBSND Base Physician Payment Schedule,179.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36572,Not in chargemaster,36572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36572,BCBSND Base Physician Payment Schedule,192.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36571,Not in chargemaster,36571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36571,BCBSND Base Physician Payment Schedule,662.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36566,Not in chargemaster,36566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36566,BCBSND Base Physician Payment Schedule,767.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36570,Not in chargemaster,36570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36570,BCBSND Base Physician Payment Schedule,705.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36565,Not in chargemaster,36565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36565,BCBSND Base Physician Payment Schedule,712.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36563,Not in chargemaster,36563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36563,BCBSND Base Physician Payment Schedule,778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36561,Not in chargemaster,36561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36561,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36560,Not in chargemaster,36560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36560,BCBSND Base Physician Payment Schedule,813.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36558,Not in chargemaster,36558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36558,BCBSND Base Physician Payment Schedule,554.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36557,Not in chargemaster,36557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36557,BCBSND Base Physician Payment Schedule,679.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36556,Not in chargemaster,36556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36556,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36555,Not in chargemaster,36555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36555,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36522,Not in chargemaster,36522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36522,BCBSND Base Physician Payment Schedule,207.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36516,Not in chargemaster,36516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36516,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36514,Not in chargemaster,36514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36514,BCBSND Base Physician Payment Schedule,201.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36510,Not in chargemaster,36510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36510,BCBSND Base Physician Payment Schedule,113.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36483,Not in chargemaster,36483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36483,BCBSND Base Physician Payment Schedule,191.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36482,Not in chargemaster,36482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36482,BCBSND Base Physician Payment Schedule,381.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36481,Not in chargemaster,36481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36481,BCBSND Base Physician Payment Schedule,701.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36479,Not in chargemaster,36479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36479,BCBSND Base Physician Payment Schedule,290.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36478,Not in chargemaster,36478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36478,BCBSND Base Physician Payment Schedule,591.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36476,Not in chargemaster,36476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36476,BCBSND Base Physician Payment Schedule,287.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36475,Not in chargemaster,36475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36475,BCBSND Base Physician Payment Schedule,593.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36474,Not in chargemaster,36474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36474,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36473,Not in chargemaster,36473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36473,BCBSND Base Physician Payment Schedule,380.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36471,Not in chargemaster,36471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36471,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36470,Not in chargemaster,36470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36470,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36466,Not in chargemaster,36466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36466,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36410,Not in chargemaster,36410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36410,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36406,Not in chargemaster,36406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36406,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36405,Not in chargemaster,36405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36405,BCBSND Base Physician Payment Schedule,32.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36465,Not in chargemaster,36465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36465,BCBSND Base Physician Payment Schedule,255.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36400,Not in chargemaster,36400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36400,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36254,Not in chargemaster,36254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36254,BCBSND Base Physician Payment Schedule,882.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36253,Not in chargemaster,36253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36253,BCBSND Base Physician Payment Schedule,759.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36252,Not in chargemaster,36252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36252,BCBSND Base Physician Payment Schedule,765.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36251,Not in chargemaster,36251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36251,BCBSND Base Physician Payment Schedule,551.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36248,Not in chargemaster,36248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36248,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36247,Not in chargemaster,36247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36247,BCBSND Base Physician Payment Schedule,642.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36246,Not in chargemaster,36246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36246,BCBSND Base Physician Payment Schedule,539.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36245,Not in chargemaster,36245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36245,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36228,Not in chargemaster,36228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36228,BCBSND Base Physician Payment Schedule,512.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36227,Not in chargemaster,36227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36227,BCBSND Base Physician Payment Schedule,250.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36226,Not in chargemaster,36226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36226,BCBSND Base Physician Payment Schedule,754.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36225,Not in chargemaster,36225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36225,BCBSND Base Physician Payment Schedule,671.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36224,Not in chargemaster,36224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36224,BCBSND Base Physician Payment Schedule,765.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36223,Not in chargemaster,36223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36223,BCBSND Base Physician Payment Schedule,673.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36222,Not in chargemaster,36222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36222,BCBSND Base Physician Payment Schedule,601.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36221,Not in chargemaster,36221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36221,BCBSND Base Physician Payment Schedule,427.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36218,Not in chargemaster,36218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36218,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36217,Not in chargemaster,36217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36217,BCBSND Base Physician Payment Schedule,698.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36216,Not in chargemaster,36216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36216,BCBSND Base Physician Payment Schedule,579.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36215,Not in chargemaster,36215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36215,BCBSND Base Physician Payment Schedule,450,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36200,Not in chargemaster,36200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36200,BCBSND Base Physician Payment Schedule,298.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36160,Not in chargemaster,36160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36160,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36140,Not in chargemaster,36140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36140,BCBSND Base Physician Payment Schedule,190.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36100,Not in chargemaster,36100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36100,BCBSND Base Physician Payment Schedule,325.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36015,Not in chargemaster,36015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36015,BCBSND Base Physician Payment Schedule,367.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36014,Not in chargemaster,36014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36014,BCBSND Base Physician Payment Schedule,323.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36013,Not in chargemaster,36013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36013,BCBSND Base Physician Payment Schedule,259.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36012,Not in chargemaster,36012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36012,BCBSND Base Physician Payment Schedule,369.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36011,Not in chargemaster,36011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36011,BCBSND Base Physician Payment Schedule,335.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36010,Not in chargemaster,36010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36010,BCBSND Base Physician Payment Schedule,234.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36005,Not in chargemaster,36005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36005,BCBSND Base Physician Payment Schedule,101.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36002,Not in chargemaster,36002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36002,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33286,Not in chargemaster,33286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33286,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32998,Not in chargemaster,32998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32998,BCBSND Base Physician Payment Schedule,937.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32994,Not in chargemaster,32994,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32994,BCBSND Base Physician Payment Schedule,939.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32562,Not in chargemaster,32562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32562,BCBSND Base Physician Payment Schedule,128.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32561,Not in chargemaster,32561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32561,BCBSND Base Physician Payment Schedule,143.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32560,Not in chargemaster,32560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32560,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32557,Not in chargemaster,32557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32557,BCBSND Base Physician Payment Schedule,323,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32556,Not in chargemaster,32556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32556,BCBSND Base Physician Payment Schedule,261.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32555,Not in chargemaster,32555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32555,BCBSND Base Physician Payment Schedule,236.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32554,32554,32554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32554,BCBSND Base Physician Payment Schedule,190.13,220,Fee schedule,,190.13,190.13,190.13,190.13,,,0
unity,Fee schedule,Facility 32553,Not in chargemaster,32553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32553,BCBSND Base Physician Payment Schedule,379.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32552,Not in chargemaster,32552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32552,BCBSND Base Physician Payment Schedule,334.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32405,Not in chargemaster,32405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32405,BCBSND Base Physician Payment Schedule,190.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31830,Not in chargemaster,31830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31830,BCBSND Base Physician Payment Schedule,740.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32960,Not in chargemaster,32960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32960,BCBSND Base Physician Payment Schedule,192.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46607,Not in chargemaster,46607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46607,BCBSND Base Physician Payment Schedule,422.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46606,Not in chargemaster,46606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46606,BCBSND Base Physician Payment Schedule,536.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46604,Not in chargemaster,46604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46604,BCBSND Base Physician Payment Schedule,1394.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46601,Not in chargemaster,46601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46601,BCBSND Base Physician Payment Schedule,300.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46600,46600,46600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46600,BCBSND Base Physician Payment Schedule,215.83,87.32,Fee schedule,,87.32,87.32,87.32,87.32,,,0
unity,Fee schedule,Non-facility 46505,Not in chargemaster,46505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46505,BCBSND Base Physician Payment Schedule,627.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46500,Not in chargemaster,46500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46500,BCBSND Base Physician Payment Schedule,626.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46320,Not in chargemaster,46320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46320,BCBSND Base Physician Payment Schedule,414.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46288,Not in chargemaster,46288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46288,BCBSND Base Physician Payment Schedule,1170.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46285,Not in chargemaster,46285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46285,BCBSND Base Physician Payment Schedule,1158.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46280,Not in chargemaster,46280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46280,BCBSND Base Physician Payment Schedule,1006.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46275,Not in chargemaster,46275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46275,BCBSND Base Physician Payment Schedule,1165.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46270,46270,46270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46270,BCBSND Base Physician Payment Schedule,1105.55,865,Fee schedule,,865,865,865,865,,,0
unity,Fee schedule,Non-facility 46262,Not in chargemaster,46262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46262,BCBSND Base Physician Payment Schedule,1180.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46261,Not in chargemaster,46261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46261,BCBSND Base Physician Payment Schedule,1112.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46260,Not in chargemaster,46260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46260,BCBSND Base Physician Payment Schedule,1018.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46258,Not in chargemaster,46258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46258,BCBSND Base Physician Payment Schedule,1007.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46257,Not in chargemaster,46257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46257,BCBSND Base Physician Payment Schedule,906.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46255,46255,46255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46255,BCBSND Base Physician Payment Schedule,1092.34,751.04,Fee schedule,,751.04,751.04,751.04,751.04,,,0
unity,Fee schedule,Non-facility 46250,46250,46250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46250,BCBSND Base Physician Payment Schedule,999.84,669.42,Fee schedule,,669.42,669.42,669.42,669.42,,,0
unity,Fee schedule,Non-facility 46230,Not in chargemaster,46230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46230,BCBSND Base Physician Payment Schedule,618.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46221,Not in chargemaster,46221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46221,BCBSND Base Physician Payment Schedule,575.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46220,Not in chargemaster,46220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46220,BCBSND Base Physician Payment Schedule,480.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46200,Not in chargemaster,46200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46200,BCBSND Base Physician Payment Schedule,972.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46083,46083,46083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46083,BCBSND Base Physician Payment Schedule,405.22,227.16,Fee schedule,,227.16,227.16,227.16,227.16,,,0
unity,Fee schedule,Non-facility 46080,Not in chargemaster,46080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46080,BCBSND Base Physician Payment Schedule,568.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46070,Not in chargemaster,46070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46070,BCBSND Base Physician Payment Schedule,561.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46060,Not in chargemaster,46060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46060,BCBSND Base Physician Payment Schedule,1021.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46050,46050,46050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46050,BCBSND Base Physician Payment Schedule,460.28,210.84,Fee schedule,,210.84,210.84,210.84,210.84,,,0
unity,Fee schedule,Non-facility 46045,Not in chargemaster,46045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46045,BCBSND Base Physician Payment Schedule,929.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46040,46040,46040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46040,BCBSND Base Physician Payment Schedule,1154.74,882.38,Fee schedule,,882.38,882.38,882.38,882.38,,,0
unity,Fee schedule,Non-facility 46030,Not in chargemaster,46030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46030,BCBSND Base Physician Payment Schedule,303.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 46020,Not in chargemaster,46020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,46020,BCBSND Base Physician Payment Schedule,594.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45990,Not in chargemaster,45990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45990,BCBSND Base Physician Payment Schedule,225.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45915,Not in chargemaster,45915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45915,BCBSND Base Physician Payment Schedule,726.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45910,Not in chargemaster,45910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45910,BCBSND Base Physician Payment Schedule,406.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45905,Not in chargemaster,45905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45905,BCBSND Base Physician Payment Schedule,356.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45900,Not in chargemaster,45900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45900,BCBSND Base Physician Payment Schedule,450.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45825,Not in chargemaster,45825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45825,BCBSND Base Physician Payment Schedule,3284.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45820,Not in chargemaster,45820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45820,BCBSND Base Physician Payment Schedule,2719.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45805,Not in chargemaster,45805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45805,BCBSND Base Physician Payment Schedule,3142.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45800,Not in chargemaster,45800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45800,BCBSND Base Physician Payment Schedule,2712.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45563,Not in chargemaster,45563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45563,BCBSND Base Physician Payment Schedule,3545.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45562,Not in chargemaster,45562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45562,BCBSND Base Physician Payment Schedule,2401.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45560,Not in chargemaster,45560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45560,BCBSND Base Physician Payment Schedule,1469.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45550,Not in chargemaster,45550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45550,BCBSND Base Physician Payment Schedule,3111.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45541,Not in chargemaster,45541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45541,BCBSND Base Physician Payment Schedule,2007.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45540,Not in chargemaster,45540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45540,BCBSND Base Physician Payment Schedule,2250.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45520,Not in chargemaster,45520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45520,BCBSND Base Physician Payment Schedule,326.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45505,Not in chargemaster,45505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45505,BCBSND Base Physician Payment Schedule,1265.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45500,Not in chargemaster,45500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45500,BCBSND Base Physician Payment Schedule,1201.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45402,Not in chargemaster,45402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45402,BCBSND Base Physician Payment Schedule,3221.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45400,Not in chargemaster,45400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45400,BCBSND Base Physician Payment Schedule,2412.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45398,Not in chargemaster,45398,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45398,BCBSND Base Physician Payment Schedule,1642.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45397,Not in chargemaster,45397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45397,BCBSND Base Physician Payment Schedule,4541.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45395,Not in chargemaster,45395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45395,BCBSND Base Physician Payment Schedule,4175.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45393,Not in chargemaster,45393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45393,BCBSND Base Physician Payment Schedule,536.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45392,Not in chargemaster,45392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45392,BCBSND Base Physician Payment Schedule,644.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45391,Not in chargemaster,45391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45391,BCBSND Base Physician Payment Schedule,545.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45390,Not in chargemaster,45390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45390,BCBSND Base Physician Payment Schedule,704,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45389,Not in chargemaster,45389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45389,BCBSND Base Physician Payment Schedule,614.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45388,Not in chargemaster,45388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45388,BCBSND Base Physician Payment Schedule,6085.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45386,Not in chargemaster,45386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45386,BCBSND Base Physician Payment Schedule,1278.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45385,45385,45385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45385,BCBSND Base Physician Payment Schedule,930.1,666.19,Fee schedule,,666.19,666.19,666.19,666.19,,,0
unity,Fee schedule,Non-facility 45384,45384,45384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45384,BCBSND Base Physician Payment Schedule,993.24,585.72,Fee schedule,,585.72,585.72,585.72,585.72,,,0
unity,Fee schedule,Non-facility 45382,Not in chargemaster,45382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45382,BCBSND Base Physician Payment Schedule,1469.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45381,Not in chargemaster,45381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45381,BCBSND Base Physician Payment Schedule,883.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45380,45380,45380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45380,BCBSND Base Physician Payment Schedule,890.46,561.81,Fee schedule,,561.81,561.81,561.81,561.81,,,0
unity,Fee schedule,Non-facility 45379,Not in chargemaster,45379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45379,BCBSND Base Physician Payment Schedule,891.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45378,45378,45378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45378,BCBSND Base Physician Payment Schedule,691.52,460,Fee schedule,,460,460,460,460,,,0
unity,Fee schedule,Non-facility 45350,Not in chargemaster,45350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45350,BCBSND Base Physician Payment Schedule,1307.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45349,Not in chargemaster,45349,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45349,BCBSND Base Physician Payment Schedule,420.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45347,Not in chargemaster,45347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45347,BCBSND Base Physician Payment Schedule,325.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45346,Not in chargemaster,45346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45346,BCBSND Base Physician Payment Schedule,5745.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45342,Not in chargemaster,45342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45342,BCBSND Base Physician Payment Schedule,358.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45341,Not in chargemaster,45341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45341,BCBSND Base Physician Payment Schedule,262.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45340,Not in chargemaster,45340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45340,BCBSND Base Physician Payment Schedule,948.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45338,Not in chargemaster,45338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45338,BCBSND Base Physician Payment Schedule,592.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45337,Not in chargemaster,45337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45337,BCBSND Base Physician Payment Schedule,245.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45335,Not in chargemaster,45335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45335,BCBSND Base Physician Payment Schedule,556.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45334,Not in chargemaster,45334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45334,BCBSND Base Physician Payment Schedule,1103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45333,Not in chargemaster,45333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45333,BCBSND Base Physician Payment Schedule,654.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45332,Not in chargemaster,45332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45332,BCBSND Base Physician Payment Schedule,553.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45331,45331,45331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45331,BCBSND Base Physician Payment Schedule,574.8,181.5,Fee schedule,,181.5,181.5,181.5,181.5,,,0
unity,Fee schedule,Non-facility 45330,45330,45330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45330,BCBSND Base Physician Payment Schedule,365.58,141.81,Fee schedule,,141.81,141.81,141.81,141.81,,,0
unity,Fee schedule,Non-facility 45327,Not in chargemaster,45327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45327,BCBSND Base Physician Payment Schedule,250.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45321,Not in chargemaster,45321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45321,BCBSND Base Physician Payment Schedule,220.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45320,Not in chargemaster,45320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45320,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45317,Not in chargemaster,45317,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45317,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45315,Not in chargemaster,45315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45315,BCBSND Base Physician Payment Schedule,435.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45309,Not in chargemaster,45309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45309,BCBSND Base Physician Payment Schedule,398.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45308,Not in chargemaster,45308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45308,BCBSND Base Physician Payment Schedule,385.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45307,Not in chargemaster,45307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45307,BCBSND Base Physician Payment Schedule,391.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45305,Not in chargemaster,45305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45305,BCBSND Base Physician Payment Schedule,339.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45303,Not in chargemaster,45303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45303,BCBSND Base Physician Payment Schedule,2000.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45300,Not in chargemaster,45300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45300,BCBSND Base Physician Payment Schedule,258.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45190,Not in chargemaster,45190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45190,BCBSND Base Physician Payment Schedule,1484.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45172,Not in chargemaster,45172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45172,BCBSND Base Physician Payment Schedule,1725.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45171,45171,45171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45171,BCBSND Base Physician Payment Schedule,1284.68,1283.44,Fee schedule,,1283.44,1283.44,1283.44,1283.44,,,0
unity,Fee schedule,Non-facility 45160,Not in chargemaster,45160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45160,BCBSND Base Physician Payment Schedule,2190.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45150,Not in chargemaster,45150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45150,BCBSND Base Physician Payment Schedule,891.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45136,Not in chargemaster,45136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45136,BCBSND Base Physician Payment Schedule,3804.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45135,Not in chargemaster,45135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45135,BCBSND Base Physician Payment Schedule,2744.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45130,Not in chargemaster,45130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45130,BCBSND Base Physician Payment Schedule,2303.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45126,Not in chargemaster,45126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45126,BCBSND Base Physician Payment Schedule,5884.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45123,Not in chargemaster,45123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45123,BCBSND Base Physician Payment Schedule,2366.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45121,Not in chargemaster,45121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45121,BCBSND Base Physician Payment Schedule,3733.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45120,Not in chargemaster,45120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45120,BCBSND Base Physician Payment Schedule,3417.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45119,Not in chargemaster,45119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45119,BCBSND Base Physician Payment Schedule,4092.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45116,Not in chargemaster,45116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45116,BCBSND Base Physician Payment Schedule,3280.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45114,Not in chargemaster,45114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45114,BCBSND Base Physician Payment Schedule,3892.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45113,Not in chargemaster,45113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45113,BCBSND Base Physician Payment Schedule,3979.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45112,Not in chargemaster,45112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45112,BCBSND Base Physician Payment Schedule,3960.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45111,Not in chargemaster,45111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45111,BCBSND Base Physician Payment Schedule,2312.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45110,Not in chargemaster,45110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45110,BCBSND Base Physician Payment Schedule,3900.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45108,Not in chargemaster,45108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45108,BCBSND Base Physician Payment Schedule,790.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45100,Not in chargemaster,45100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45100,BCBSND Base Physician Payment Schedule,635,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45020,Not in chargemaster,45020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45020,BCBSND Base Physician Payment Schedule,1217.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45005,Not in chargemaster,45005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45005,BCBSND Base Physician Payment Schedule,615.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 45000,Not in chargemaster,45000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,45000,BCBSND Base Physician Payment Schedule,906.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44970,44970,44970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44970,BCBSND Base Physician Payment Schedule,1283.94,1375,Fee schedule,,1283.94,1283.94,1283.94,1283.94,,,0
unity,Fee schedule,Non-facility 44960,Not in chargemaster,44960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44960,BCBSND Base Physician Payment Schedule,1876.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44955,Not in chargemaster,44955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44955,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44950,44950,44950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44950,BCBSND Base Physician Payment Schedule,1374.97,1346.62,Fee schedule,,1346.62,1346.62,1346.62,1346.62,,,0
unity,Fee schedule,Non-facility 44900,Not in chargemaster,44900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44900,BCBSND Base Physician Payment Schedule,1675.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44850,Not in chargemaster,44850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44850,BCBSND Base Physician Payment Schedule,1591.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44820,Not in chargemaster,44820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44820,BCBSND Base Physician Payment Schedule,1783.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44800,Not in chargemaster,44800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44800,BCBSND Base Physician Payment Schedule,1642.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44721,Not in chargemaster,44721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44721,BCBSND Base Physician Payment Schedule,822.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44720,Not in chargemaster,44720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44720,BCBSND Base Physician Payment Schedule,588.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44705,Not in chargemaster,44705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44705,BCBSND Base Physician Payment Schedule,231.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44701,Not in chargemaster,44701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44701,BCBSND Base Physician Payment Schedule,364.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44700,Not in chargemaster,44700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44700,BCBSND Base Physician Payment Schedule,2133.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44680,Not in chargemaster,44680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44680,BCBSND Base Physician Payment Schedule,2266.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44661,Not in chargemaster,44661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44661,BCBSND Base Physician Payment Schedule,3308.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44660,Not in chargemaster,44660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44660,BCBSND Base Physician Payment Schedule,2842.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44650,Not in chargemaster,44650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44650,BCBSND Base Physician Payment Schedule,3087.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44640,Not in chargemaster,44640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44640,BCBSND Base Physician Payment Schedule,2987.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44626,Not in chargemaster,44626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44626,BCBSND Base Physician Payment Schedule,3415.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44625,Not in chargemaster,44625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44625,BCBSND Base Physician Payment Schedule,2156.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44620,Not in chargemaster,44620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44620,BCBSND Base Physician Payment Schedule,1847,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44615,Not in chargemaster,44615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44615,BCBSND Base Physician Payment Schedule,2302.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44605,Not in chargemaster,44605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44605,BCBSND Base Physician Payment Schedule,2784.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44604,Not in chargemaster,44604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44604,BCBSND Base Physician Payment Schedule,2259.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44603,Not in chargemaster,44603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44603,BCBSND Base Physician Payment Schedule,3461.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44602,Not in chargemaster,44602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44602,BCBSND Base Physician Payment Schedule,3016.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44500,Not in chargemaster,44500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44500,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44408,Not in chargemaster,44408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44408,BCBSND Base Physician Payment Schedule,490.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44407,Not in chargemaster,44407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44407,BCBSND Base Physician Payment Schedule,583.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44406,Not in chargemaster,44406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44406,BCBSND Base Physician Payment Schedule,485.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44405,Not in chargemaster,44405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44405,BCBSND Base Physician Payment Schedule,1167.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44404,Not in chargemaster,44404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44404,BCBSND Base Physician Payment Schedule,835.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44403,Not in chargemaster,44403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44403,BCBSND Base Physician Payment Schedule,643.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44402,Not in chargemaster,44402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44402,BCBSND Base Physician Payment Schedule,554.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44401,Not in chargemaster,44401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44401,BCBSND Base Physician Payment Schedule,5889.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44394,Not in chargemaster,44394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44394,BCBSND Base Physician Payment Schedule,889,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44392,Not in chargemaster,44392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44392,BCBSND Base Physician Payment Schedule,776.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44391,Not in chargemaster,44391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44391,BCBSND Base Physician Payment Schedule,1414.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44390,Not in chargemaster,44390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44390,BCBSND Base Physician Payment Schedule,823.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44389,Not in chargemaster,44389,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44389,BCBSND Base Physician Payment Schedule,839.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44388,44388,44388,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44388,BCBSND Base Physician Payment Schedule,637.93,668.17,Fee schedule,,637.93,637.93,637.93,637.93,,,0
unity,Fee schedule,Non-facility 44386,Not in chargemaster,44386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44386,BCBSND Base Physician Payment Schedule,626.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44385,Not in chargemaster,44385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44385,BCBSND Base Physician Payment Schedule,419.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44384,Not in chargemaster,44384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44384,BCBSND Base Physician Payment Schedule,325.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44382,Not in chargemaster,44382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44382,BCBSND Base Physician Payment Schedule,597.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44381,Not in chargemaster,44381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44381,BCBSND Base Physician Payment Schedule,2046.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44380,Not in chargemaster,44380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44380,BCBSND Base Physician Payment Schedule,381.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44379,Not in chargemaster,44379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44379,BCBSND Base Physician Payment Schedule,866.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44378,Not in chargemaster,44378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44378,BCBSND Base Physician Payment Schedule,814.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44377,Not in chargemaster,44377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44377,BCBSND Base Physician Payment Schedule,633.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44376,Not in chargemaster,44376,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44376,BCBSND Base Physician Payment Schedule,601.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44373,Not in chargemaster,44373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44373,BCBSND Base Physician Payment Schedule,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44372,Not in chargemaster,44372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44372,BCBSND Base Physician Payment Schedule,508.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44370,Not in chargemaster,44370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44370,BCBSND Base Physician Payment Schedule,564.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44369,Not in chargemaster,44369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44369,BCBSND Base Physician Payment Schedule,521.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44366,Not in chargemaster,44366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44366,BCBSND Base Physician Payment Schedule,508.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44365,Not in chargemaster,44365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44365,BCBSND Base Physician Payment Schedule,384.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44364,Not in chargemaster,44364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44364,BCBSND Base Physician Payment Schedule,433.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44363,Not in chargemaster,44363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44363,BCBSND Base Physician Payment Schedule,406.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44361,Not in chargemaster,44361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44361,BCBSND Base Physician Payment Schedule,335.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44360,Not in chargemaster,44360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44360,BCBSND Base Physician Payment Schedule,303.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44346,Not in chargemaster,44346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44346,BCBSND Base Physician Payment Schedule,2522.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44345,Not in chargemaster,44345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44345,BCBSND Base Physician Payment Schedule,2237.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44340,Not in chargemaster,44340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44340,BCBSND Base Physician Payment Schedule,1325.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44322,Not in chargemaster,44322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44322,BCBSND Base Physician Payment Schedule,2146.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44320,Not in chargemaster,44320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44320,BCBSND Base Physician Payment Schedule,2562.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44316,Not in chargemaster,44316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44316,BCBSND Base Physician Payment Schedule,3028.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44314,Not in chargemaster,44314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44314,BCBSND Base Physician Payment Schedule,2142.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44312,Not in chargemaster,44312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44312,BCBSND Base Physician Payment Schedule,1264.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44310,Not in chargemaster,44310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44310,BCBSND Base Physician Payment Schedule,2221.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44300,44300,44300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44300,BCBSND Base Physician Payment Schedule,1801.48,1772.54,Fee schedule,,1772.54,1772.54,1772.54,1772.54,,,0
unity,Fee schedule,Non-facility 44227,Not in chargemaster,44227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44227,BCBSND Base Physician Payment Schedule,3553.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44213,Not in chargemaster,44213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44213,BCBSND Base Physician Payment Schedule,398.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44212,Not in chargemaster,44212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44212,BCBSND Base Physician Payment Schedule,4332.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44211,Not in chargemaster,44211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44211,BCBSND Base Physician Payment Schedule,4494.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44210,Not in chargemaster,44210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44210,BCBSND Base Physician Payment Schedule,3768.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44208,Not in chargemaster,44208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44208,BCBSND Base Physician Payment Schedule,4212.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44207,Not in chargemaster,44207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44207,BCBSND Base Physician Payment Schedule,3867.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44206,Not in chargemaster,44206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44206,BCBSND Base Physician Payment Schedule,3728.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44205,Not in chargemaster,44205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44205,BCBSND Base Physician Payment Schedule,2849.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44204,Not in chargemaster,44204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44204,BCBSND Base Physician Payment Schedule,3281.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44203,Not in chargemaster,44203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44203,BCBSND Base Physician Payment Schedule,513.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44202,Not in chargemaster,44202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44202,BCBSND Base Physician Payment Schedule,2961.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44188,Not in chargemaster,44188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44188,BCBSND Base Physician Payment Schedule,2601.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44187,Not in chargemaster,44187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44187,BCBSND Base Physician Payment Schedule,2335.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44186,Not in chargemaster,44186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44186,BCBSND Base Physician Payment Schedule,1393.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44180,Not in chargemaster,44180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44180,BCBSND Base Physician Payment Schedule,1966.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44160,Not in chargemaster,44160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44160,BCBSND Base Physician Payment Schedule,2653.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44158,Not in chargemaster,44158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44158,BCBSND Base Physician Payment Schedule,4809.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44157,Not in chargemaster,44157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44157,BCBSND Base Physician Payment Schedule,4692.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44156,Not in chargemaster,44156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44156,BCBSND Base Physician Payment Schedule,4947.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44155,Not in chargemaster,44155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44155,BCBSND Base Physician Payment Schedule,4409.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44151,Not in chargemaster,44151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44151,BCBSND Base Physician Payment Schedule,4621.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44150,Not in chargemaster,44150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44150,BCBSND Base Physician Payment Schedule,3975.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44147,Not in chargemaster,44147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44147,BCBSND Base Physician Payment Schedule,4140.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44146,Not in chargemaster,44146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44146,BCBSND Base Physician Payment Schedule,4497.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44145,Not in chargemaster,44145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44145,BCBSND Base Physician Payment Schedule,3528.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44144,Not in chargemaster,44144,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44144,BCBSND Base Physician Payment Schedule,3775.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44143,Not in chargemaster,44143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44143,BCBSND Base Physician Payment Schedule,3553.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44141,Not in chargemaster,44141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44141,BCBSND Base Physician Payment Schedule,3893.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44140,44140,44140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44140,BCBSND Base Physician Payment Schedule,2868.13,2813.2,Fee schedule,,2813.2,2813.2,2813.2,2813.2,,,0
unity,Fee schedule,Non-facility 44139,Not in chargemaster,44139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44139,BCBSND Base Physician Payment Schedule,258.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44130,Not in chargemaster,44130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44130,BCBSND Base Physician Payment Schedule,2810.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44137,Not in chargemaster,44137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44137,BCBSND Base Physician Payment Schedule,2868.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44128,Not in chargemaster,44128,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44128,BCBSND Base Physician Payment Schedule,521.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44127,Not in chargemaster,44127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44127,BCBSND Base Physician Payment Schedule,6118.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44126,Not in chargemaster,44126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44126,BCBSND Base Physician Payment Schedule,5291.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44125,Not in chargemaster,44125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44125,BCBSND Base Physician Payment Schedule,2520.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44121,Not in chargemaster,44121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44121,BCBSND Base Physician Payment Schedule,516.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44120,Not in chargemaster,44120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44120,BCBSND Base Physician Payment Schedule,2615.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44111,Not in chargemaster,44111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44111,BCBSND Base Physician Payment Schedule,2088.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44110,Not in chargemaster,44110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44110,BCBSND Base Physician Payment Schedule,1801.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44100,Not in chargemaster,44100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44100,BCBSND Base Physician Payment Schedule,228.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44055,Not in chargemaster,44055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44055,BCBSND Base Physician Payment Schedule,3188.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44050,44050,44050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44050,BCBSND Base Physician Payment Schedule,2000.42,1962.77,Fee schedule,,1962.77,1962.77,1962.77,1962.77,,,0
unity,Fee schedule,Non-facility 44025,44025,44025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44025,BCBSND Base Physician Payment Schedule,2100.26,2077.77,Fee schedule,,2077.77,2077.77,2077.77,2077.77,,,0
unity,Fee schedule,Non-facility 44021,Not in chargemaster,44021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44021,BCBSND Base Physician Payment Schedule,2083.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44020,Not in chargemaster,44020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44020,BCBSND Base Physician Payment Schedule,2083.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44015,Not in chargemaster,44015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44015,BCBSND Base Physician Payment Schedule,304.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44010,Not in chargemaster,44010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44010,BCBSND Base Physician Payment Schedule,1827.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 44005,44005,44005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,44005,BCBSND Base Physician Payment Schedule,2338.11,2282.5,Fee schedule,,2282.5,2282.5,2282.5,2282.5,,,0
unity,Fee schedule,Non-facility 43888,Not in chargemaster,43888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43888,BCBSND Base Physician Payment Schedule,988.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43887,Not in chargemaster,43887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43887,BCBSND Base Physician Payment Schedule,698.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43886,Not in chargemaster,43886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43886,BCBSND Base Physician Payment Schedule,776.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43880,Not in chargemaster,43880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43880,BCBSND Base Physician Payment Schedule,3406.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43870,Not in chargemaster,43870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43870,BCBSND Base Physician Payment Schedule,1518.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43865,Not in chargemaster,43865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43865,BCBSND Base Physician Payment Schedule,3664.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43860,Not in chargemaster,43860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43860,BCBSND Base Physician Payment Schedule,3503.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43855,Not in chargemaster,43855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43855,BCBSND Base Physician Payment Schedule,3622.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43850,Not in chargemaster,43850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43850,BCBSND Base Physician Payment Schedule,3491.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43848,Not in chargemaster,43848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43848,BCBSND Base Physician Payment Schedule,4146.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43847,Not in chargemaster,43847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43847,BCBSND Base Physician Payment Schedule,3868.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43846,Not in chargemaster,43846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43846,BCBSND Base Physician Payment Schedule,3478.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43845,Not in chargemaster,43845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43845,BCBSND Base Physician Payment Schedule,4169.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43843,Not in chargemaster,43843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43843,BCBSND Base Physician Payment Schedule,2747,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43842,Not in chargemaster,43842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43842,BCBSND Base Physician Payment Schedule,2452.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43840,Not in chargemaster,43840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43840,BCBSND Base Physician Payment Schedule,2912.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43832,Not in chargemaster,43832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43832,BCBSND Base Physician Payment Schedule,2226.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43831,Not in chargemaster,43831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43831,BCBSND Base Physician Payment Schedule,1286.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43830,Not in chargemaster,43830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43830,BCBSND Base Physician Payment Schedule,1500.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43825,Not in chargemaster,43825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43825,BCBSND Base Physician Payment Schedule,2806.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43820,Not in chargemaster,43820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43820,BCBSND Base Physician Payment Schedule,2876.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43810,Not in chargemaster,43810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43810,BCBSND Base Physician Payment Schedule,2180.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43800,Not in chargemaster,43800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43800,BCBSND Base Physician Payment Schedule,1996.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43775,Not in chargemaster,43775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43775,BCBSND Base Physician Payment Schedule,2390.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43774,Not in chargemaster,43774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43774,BCBSND Base Physician Payment Schedule,2056.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43773,Not in chargemaster,43773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43773,BCBSND Base Physician Payment Schedule,2736.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43772,Not in chargemaster,43772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43772,BCBSND Base Physician Payment Schedule,2037.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43771,Not in chargemaster,43771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43771,BCBSND Base Physician Payment Schedule,2736.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43770,Not in chargemaster,43770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43770,BCBSND Base Physician Payment Schedule,2408.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43763,Not in chargemaster,43763,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43763,BCBSND Base Physician Payment Schedule,707.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43762,Not in chargemaster,43762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43762,BCBSND Base Physician Payment Schedule,473.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43761,Not in chargemaster,43761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43761,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43757,Not in chargemaster,43757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43757,BCBSND Base Physician Payment Schedule,716.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43756,Not in chargemaster,43756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43756,BCBSND Base Physician Payment Schedule,521.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43755,Not in chargemaster,43755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43755,BCBSND Base Physician Payment Schedule,358.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43754,Not in chargemaster,43754,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43754,BCBSND Base Physician Payment Schedule,380.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43753,Not in chargemaster,43753,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43753,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43752,Not in chargemaster,43752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43752,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43653,Not in chargemaster,43653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43653,BCBSND Base Physician Payment Schedule,1227.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43652,Not in chargemaster,43652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43652,BCBSND Base Physician Payment Schedule,1636.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43651,Not in chargemaster,43651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43651,BCBSND Base Physician Payment Schedule,1400.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43645,Not in chargemaster,43645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43645,BCBSND Base Physician Payment Schedule,3960.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43644,Not in chargemaster,43644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43644,BCBSND Base Physician Payment Schedule,3719.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43641,Not in chargemaster,43641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43641,BCBSND Base Physician Payment Schedule,2577.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43640,Not in chargemaster,43640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43640,BCBSND Base Physician Payment Schedule,2521.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43635,Not in chargemaster,43635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43635,BCBSND Base Physician Payment Schedule,241.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43634,Not in chargemaster,43634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43634,BCBSND Base Physician Payment Schedule,4558.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43633,Not in chargemaster,43633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43633,BCBSND Base Physician Payment Schedule,4120.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43632,Not in chargemaster,43632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43632,BCBSND Base Physician Payment Schedule,4356.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43631,Not in chargemaster,43631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43631,BCBSND Base Physician Payment Schedule,3105.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43622,Not in chargemaster,43622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43622,BCBSND Base Physician Payment Schedule,4957.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43621,Not in chargemaster,43621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43621,BCBSND Base Physician Payment Schedule,4861.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43620,Not in chargemaster,43620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43620,BCBSND Base Physician Payment Schedule,4249.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43611,Not in chargemaster,43611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43611,BCBSND Base Physician Payment Schedule,2615.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43610,Not in chargemaster,43610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43610,BCBSND Base Physician Payment Schedule,2098.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43605,Not in chargemaster,43605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43605,BCBSND Base Physician Payment Schedule,1794.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43520,Not in chargemaster,43520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43520,BCBSND Base Physician Payment Schedule,1463.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43510,Not in chargemaster,43510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43510,BCBSND Base Physician Payment Schedule,2029.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43502,Not in chargemaster,43502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43502,BCBSND Base Physician Payment Schedule,3267.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43501,Not in chargemaster,43501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43501,BCBSND Base Physician Payment Schedule,2883.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43500,Not in chargemaster,43500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43500,BCBSND Base Physician Payment Schedule,1675.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43460,Not in chargemaster,43460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43460,BCBSND Base Physician Payment Schedule,450,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43453,Not in chargemaster,43453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43453,BCBSND Base Physician Payment Schedule,1840.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43450,Not in chargemaster,43450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43450,BCBSND Base Physician Payment Schedule,357.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43425,Not in chargemaster,43425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43425,BCBSND Base Physician Payment Schedule,3064.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43420,Not in chargemaster,43420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43420,BCBSND Base Physician Payment Schedule,2136.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43415,Not in chargemaster,43415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43415,BCBSND Base Physician Payment Schedule,5471.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43410,Not in chargemaster,43410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43410,BCBSND Base Physician Payment Schedule,2156.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43405,Not in chargemaster,43405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43405,BCBSND Base Physician Payment Schedule,3091.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43400,Not in chargemaster,43400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43400,BCBSND Base Physician Payment Schedule,3260.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43361,Not in chargemaster,43361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43361,BCBSND Base Physician Payment Schedule,5771.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43360,Not in chargemaster,43360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43360,BCBSND Base Physician Payment Schedule,4787.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43352,Not in chargemaster,43352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43352,BCBSND Base Physician Payment Schedule,2262.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43351,Not in chargemaster,43351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43351,BCBSND Base Physician Payment Schedule,2794.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43341,Not in chargemaster,43341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43341,BCBSND Base Physician Payment Schedule,2975.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43340,Not in chargemaster,43340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43340,BCBSND Base Physician Payment Schedule,2953.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43338,Not in chargemaster,43338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43338,BCBSND Base Physician Payment Schedule,247.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43337,Not in chargemaster,43337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43337,BCBSND Base Physician Payment Schedule,3292.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43336,Not in chargemaster,43336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43336,BCBSND Base Physician Payment Schedule,3085.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43335,Not in chargemaster,43335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43335,BCBSND Base Physician Payment Schedule,2844.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43334,Not in chargemaster,43334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43334,BCBSND Base Physician Payment Schedule,2658.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43333,Not in chargemaster,43333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43333,BCBSND Base Physician Payment Schedule,2702.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43332,Not in chargemaster,43332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43332,BCBSND Base Physician Payment Schedule,2474.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43331,Not in chargemaster,43331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43331,BCBSND Base Physician Payment Schedule,2845.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43330,Not in chargemaster,43330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43330,BCBSND Base Physician Payment Schedule,2860.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43328,Not in chargemaster,43328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43328,BCBSND Base Physician Payment Schedule,2393.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43327,Not in chargemaster,43327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43327,BCBSND Base Physician Payment Schedule,1754.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43325,Not in chargemaster,43325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43325,BCBSND Base Physician Payment Schedule,2908.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43320,Not in chargemaster,43320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43320,BCBSND Base Physician Payment Schedule,2991.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43314,Not in chargemaster,43314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43314,BCBSND Base Physician Payment Schedule,6261.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43313,Not in chargemaster,43313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43313,BCBSND Base Physician Payment Schedule,5809.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43312,Not in chargemaster,43312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43312,BCBSND Base Physician Payment Schedule,3389.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43310,Not in chargemaster,43310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43310,BCBSND Base Physician Payment Schedule,3150.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43305,Not in chargemaster,43305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43305,BCBSND Base Physician Payment Schedule,2296.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43300,Not in chargemaster,43300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43300,BCBSND Base Physician Payment Schedule,1298.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43288,Not in chargemaster,43288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43288,BCBSND Base Physician Payment Schedule,8061.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43287,Not in chargemaster,43287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43287,BCBSND Base Physician Payment Schedule,7668.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43286,Not in chargemaster,43286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43286,BCBSND Base Physician Payment Schedule,6775.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43285,Not in chargemaster,43285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43285,BCBSND Base Physician Payment Schedule,1432.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43284,Not in chargemaster,43284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43284,BCBSND Base Physician Payment Schedule,1390.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43283,Not in chargemaster,43283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43283,BCBSND Base Physician Payment Schedule,337.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43282,Not in chargemaster,43282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43282,BCBSND Base Physician Payment Schedule,3716.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43281,Not in chargemaster,43281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43281,BCBSND Base Physician Payment Schedule,3304.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43280,43280,43280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43280,BCBSND Base Physician Payment Schedule,2310.95,2381,Fee schedule,,2310.95,2310.95,2310.95,2310.95,,,0
unity,Fee schedule,Non-facility 43279,Not in chargemaster,43279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43279,BCBSND Base Physician Payment Schedule,2756.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43278,Not in chargemaster,43278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43278,BCBSND Base Physician Payment Schedule,918.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43277,Not in chargemaster,43277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43277,BCBSND Base Physician Payment Schedule,801.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43276,Not in chargemaster,43276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43276,BCBSND Base Physician Payment Schedule,1020.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43275,Not in chargemaster,43275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43275,BCBSND Base Physician Payment Schedule,797.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43274,Not in chargemaster,43274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43274,BCBSND Base Physician Payment Schedule,980.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43273,Not in chargemaster,43273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43273,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43270,Not in chargemaster,43270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43270,BCBSND Base Physician Payment Schedule,1493.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43266,Not in chargemaster,43266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43266,BCBSND Base Physician Payment Schedule,461.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43265,Not in chargemaster,43265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43265,BCBSND Base Physician Payment Schedule,918.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43264,Not in chargemaster,43264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43264,BCBSND Base Physician Payment Schedule,770.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43263,Not in chargemaster,43263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43263,BCBSND Base Physician Payment Schedule,756.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43262,Not in chargemaster,43262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43262,BCBSND Base Physician Payment Schedule,756.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43261,Not in chargemaster,43261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43261,BCBSND Base Physician Payment Schedule,716.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43260,Not in chargemaster,43260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43260,BCBSND Base Physician Payment Schedule,683.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43259,Not in chargemaster,43259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43259,BCBSND Base Physician Payment Schedule,479.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43257,Not in chargemaster,43257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43257,BCBSND Base Physician Payment Schedule,494.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43255,Not in chargemaster,43255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43255,BCBSND Base Physician Payment Schedule,1372.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43254,Not in chargemaster,43254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43254,BCBSND Base Physician Payment Schedule,572.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43253,Not in chargemaster,43253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43253,BCBSND Base Physician Payment Schedule,557.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43252,Not in chargemaster,43252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43252,BCBSND Base Physician Payment Schedule,679.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43251,43251,43251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43251,BCBSND Base Physician Payment Schedule,996.91,440,Fee schedule,,440,440,440,440,,,0
unity,Fee schedule,Non-facility 43250,Not in chargemaster,43250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43250,BCBSND Base Physician Payment Schedule,906.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43249,43249,43249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43249,BCBSND Base Physician Payment Schedule,2279.38,387.2,Fee schedule,,387.2,387.2,387.2,387.2,,,0
unity,Fee schedule,Non-facility 43248,Not in chargemaster,43248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43248,BCBSND Base Physician Payment Schedule,812.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43247,43247,43247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43247,BCBSND Base Physician Payment Schedule,775.94,412.5,Fee schedule,,412.5,412.5,412.5,412.5,,,0
unity,Fee schedule,Non-facility 43246,Not in chargemaster,43246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43246,BCBSND Base Physician Payment Schedule,425.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43245,Not in chargemaster,43245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43245,BCBSND Base Physician Payment Schedule,1232.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43244,Not in chargemaster,43244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43244,BCBSND Base Physician Payment Schedule,519.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43243,Not in chargemaster,43243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43243,BCBSND Base Physician Payment Schedule,502.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43242,Not in chargemaster,43242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43242,BCBSND Base Physician Payment Schedule,556.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43241,Not in chargemaster,43241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43241,BCBSND Base Physician Payment Schedule,300.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43240,Not in chargemaster,43240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43240,BCBSND Base Physician Payment Schedule,831.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43239,43239,43239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43239,BCBSND Base Physician Payment Schedule,780.35,371.88,Fee schedule,,371.88,371.88,371.88,371.88,,,0
unity,Fee schedule,Non-facility 43238,Not in chargemaster,43238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43238,BCBSND Base Physician Payment Schedule,491.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43237,Not in chargemaster,43237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43237,BCBSND Base Physician Payment Schedule,414.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43236,Not in chargemaster,43236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43236,BCBSND Base Physician Payment Schedule,781.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43235,43235,43235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43235,BCBSND Base Physician Payment Schedule,585.81,315.35,Fee schedule,,315.35,315.35,315.35,315.35,,,0
unity,Fee schedule,Non-facility 43233,Not in chargemaster,43233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43233,BCBSND Base Physician Payment Schedule,485.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43232,Not in chargemaster,43232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43232,BCBSND Base Physician Payment Schedule,422.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43231,Not in chargemaster,43231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43231,BCBSND Base Physician Payment Schedule,336.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43229,Not in chargemaster,43229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43229,BCBSND Base Physician Payment Schedule,1454.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43227,Not in chargemaster,43227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43227,BCBSND Base Physician Payment Schedule,1298.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43226,Not in chargemaster,43226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43226,BCBSND Base Physician Payment Schedule,748.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43220,43220,43220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43220,BCBSND Base Physician Payment Schedule,2113.47,282.81,Fee schedule,,282.81,282.81,282.81,282.81,,,0
unity,Fee schedule,Non-facility 43217,Not in chargemaster,43217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43217,BCBSND Base Physician Payment Schedule,839.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43216,Not in chargemaster,43216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43216,BCBSND Base Physician Payment Schedule,821.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43215,Not in chargemaster,43215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43215,BCBSND Base Physician Payment Schedule,803.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43214,Not in chargemaster,43214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43214,BCBSND Base Physician Payment Schedule,408.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43213,Not in chargemaster,43213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43213,BCBSND Base Physician Payment Schedule,2568.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43212,Not in chargemaster,43212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43212,BCBSND Base Physician Payment Schedule,402.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43211,Not in chargemaster,43211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43211,BCBSND Base Physician Payment Schedule,496.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43210,Not in chargemaster,43210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43210,BCBSND Base Physician Payment Schedule,918.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43206,Not in chargemaster,43206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43206,BCBSND Base Physician Payment Schedule,597.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43205,Not in chargemaster,43205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43205,BCBSND Base Physician Payment Schedule,298.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43204,Not in chargemaster,43204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43204,BCBSND Base Physician Payment Schedule,286.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43202,Not in chargemaster,43202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43202,BCBSND Base Physician Payment Schedule,707.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43201,Not in chargemaster,43201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43201,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43200,Not in chargemaster,43200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43200,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43198,Not in chargemaster,43198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43198,BCBSND Base Physician Payment Schedule,446.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43197,Not in chargemaster,43197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43197,BCBSND Base Physician Payment Schedule,405.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43196,Not in chargemaster,43196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43196,BCBSND Base Physician Payment Schedule,413.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43195,Not in chargemaster,43195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43195,BCBSND Base Physician Payment Schedule,387.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43194,Not in chargemaster,43194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43194,BCBSND Base Physician Payment Schedule,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43193,Not in chargemaster,43193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43193,BCBSND Base Physician Payment Schedule,356.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43192,Not in chargemaster,43192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43192,BCBSND Base Physician Payment Schedule,356.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43191,Not in chargemaster,43191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43191,BCBSND Base Physician Payment Schedule,325.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43180,Not in chargemaster,43180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43180,BCBSND Base Physician Payment Schedule,1151.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43135,Not in chargemaster,43135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43135,BCBSND Base Physician Payment Schedule,3128,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43130,Not in chargemaster,43130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43130,BCBSND Base Physician Payment Schedule,1663.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43124,Not in chargemaster,43124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43124,BCBSND Base Physician Payment Schedule,8114.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43123,Not in chargemaster,43123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43123,BCBSND Base Physician Payment Schedule,9629.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43122,Not in chargemaster,43122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43122,BCBSND Base Physician Payment Schedule,5459.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43121,Not in chargemaster,43121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43121,BCBSND Base Physician Payment Schedule,6079.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43118,Not in chargemaster,43118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43118,BCBSND Base Physician Payment Schedule,7738.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43117,Not in chargemaster,43117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43117,BCBSND Base Physician Payment Schedule,6926.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43116,Not in chargemaster,43116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43116,BCBSND Base Physician Payment Schedule,10648.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43113,Not in chargemaster,43113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43113,BCBSND Base Physician Payment Schedule,9284.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43112,Not in chargemaster,43112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43112,BCBSND Base Physician Payment Schedule,7434.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43108,Not in chargemaster,43108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43108,BCBSND Base Physician Payment Schedule,9511.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43107,Not in chargemaster,43107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43107,BCBSND Base Physician Payment Schedule,6355.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43101,Not in chargemaster,43101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43101,BCBSND Base Physician Payment Schedule,2136.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43100,Not in chargemaster,43100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43100,BCBSND Base Physician Payment Schedule,1322.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43045,Not in chargemaster,43045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43045,BCBSND Base Physician Payment Schedule,2763.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43030,Not in chargemaster,43030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43030,BCBSND Base Physician Payment Schedule,1093.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 43020,Not in chargemaster,43020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,43020,BCBSND Base Physician Payment Schedule,1194.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42972,Not in chargemaster,42972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42972,BCBSND Base Physician Payment Schedule,1065.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42971,Not in chargemaster,42971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42971,BCBSND Base Physician Payment Schedule,950.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42970,Not in chargemaster,42970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42970,BCBSND Base Physician Payment Schedule,861.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42962,Not in chargemaster,42962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42962,BCBSND Base Physician Payment Schedule,1079.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42961,Not in chargemaster,42961,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42961,BCBSND Base Physician Payment Schedule,875.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42960,Not in chargemaster,42960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42960,BCBSND Base Physician Payment Schedule,347.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42955,Not in chargemaster,42955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42955,BCBSND Base Physician Payment Schedule,1593,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42953,Not in chargemaster,42953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42953,BCBSND Base Physician Payment Schedule,2008.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42950,Not in chargemaster,42950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42950,BCBSND Base Physician Payment Schedule,1678.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42900,Not in chargemaster,42900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42900,BCBSND Base Physician Payment Schedule,701.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42894,Not in chargemaster,42894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42894,BCBSND Base Physician Payment Schedule,4972.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42892,Not in chargemaster,42892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42892,BCBSND Base Physician Payment Schedule,3934.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42890,Not in chargemaster,42890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42890,BCBSND Base Physician Payment Schedule,2993.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42870,Not in chargemaster,42870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42870,BCBSND Base Physician Payment Schedule,1231.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42860,Not in chargemaster,42860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42860,BCBSND Base Physician Payment Schedule,396.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42845,Not in chargemaster,42845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42845,BCBSND Base Physician Payment Schedule,4690.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42844,Not in chargemaster,42844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42844,BCBSND Base Physician Payment Schedule,2912.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42842,Not in chargemaster,42842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42842,BCBSND Base Physician Payment Schedule,2112.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42836,Not in chargemaster,42836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42836,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42835,Not in chargemaster,42835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42835,BCBSND Base Physician Payment Schedule,404.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42831,Not in chargemaster,42831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42831,BCBSND Base Physician Payment Schedule,472.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42830,Not in chargemaster,42830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42830,BCBSND Base Physician Payment Schedule,436.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42826,Not in chargemaster,42826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42826,BCBSND Base Physician Payment Schedule,528.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42825,Not in chargemaster,42825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42825,BCBSND Base Physician Payment Schedule,552.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42821,Not in chargemaster,42821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42821,BCBSND Base Physician Payment Schedule,632.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42820,Not in chargemaster,42820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42820,BCBSND Base Physician Payment Schedule,606.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42815,Not in chargemaster,42815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42815,BCBSND Base Physician Payment Schedule,1146.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42810,Not in chargemaster,42810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42810,BCBSND Base Physician Payment Schedule,807.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42809,Not in chargemaster,42809,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42809,BCBSND Base Physician Payment Schedule,422.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42808,Not in chargemaster,42808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42808,BCBSND Base Physician Payment Schedule,479.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42806,Not in chargemaster,42806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42806,BCBSND Base Physician Payment Schedule,464.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42804,Not in chargemaster,42804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42804,BCBSND Base Physician Payment Schedule,414.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42800,Not in chargemaster,42800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42800,BCBSND Base Physician Payment Schedule,329.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42725,Not in chargemaster,42725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42725,BCBSND Base Physician Payment Schedule,1692.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42720,Not in chargemaster,42720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42720,BCBSND Base Physician Payment Schedule,950.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42700,Not in chargemaster,42700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42700,BCBSND Base Physician Payment Schedule,400.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42665,Not in chargemaster,42665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42665,BCBSND Base Physician Payment Schedule,720.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42660,Not in chargemaster,42660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42660,BCBSND Base Physician Payment Schedule,258.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42650,Not in chargemaster,42650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42650,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42600,Not in chargemaster,42600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42600,BCBSND Base Physician Payment Schedule,1069.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42550,Not in chargemaster,42550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42550,BCBSND Base Physician Payment Schedule,322.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42510,Not in chargemaster,42510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42510,BCBSND Base Physician Payment Schedule,1288.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42509,Not in chargemaster,42509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42509,BCBSND Base Physician Payment Schedule,1738.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42507,Not in chargemaster,42507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42507,BCBSND Base Physician Payment Schedule,1046.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42505,Not in chargemaster,42505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42505,BCBSND Base Physician Payment Schedule,1175.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42500,Not in chargemaster,42500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42500,BCBSND Base Physician Payment Schedule,916.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42450,Not in chargemaster,42450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42450,BCBSND Base Physician Payment Schedule,968.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42440,Not in chargemaster,42440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42440,BCBSND Base Physician Payment Schedule,866.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42426,Not in chargemaster,42426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42426,BCBSND Base Physician Payment Schedule,2846.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42425,Not in chargemaster,42425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42425,BCBSND Base Physician Payment Schedule,1759.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42420,Not in chargemaster,42420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42420,BCBSND Base Physician Payment Schedule,2495.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42415,Not in chargemaster,42415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42415,BCBSND Base Physician Payment Schedule,2220.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42410,Not in chargemaster,42410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42410,BCBSND Base Physician Payment Schedule,1314.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42409,Not in chargemaster,42409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42409,BCBSND Base Physician Payment Schedule,763.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42408,Not in chargemaster,42408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42408,BCBSND Base Physician Payment Schedule,1103.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42405,Not in chargemaster,42405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42405,BCBSND Base Physician Payment Schedule,632.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42400,Not in chargemaster,42400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42400,BCBSND Base Physician Payment Schedule,216.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42340,Not in chargemaster,42340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42340,BCBSND Base Physician Payment Schedule,1041.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42335,Not in chargemaster,42335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42335,BCBSND Base Physician Payment Schedule,847.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42330,Not in chargemaster,42330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42330,BCBSND Base Physician Payment Schedule,486.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42320,Not in chargemaster,42320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42320,BCBSND Base Physician Payment Schedule,536.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42310,Not in chargemaster,42310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42310,BCBSND Base Physician Payment Schedule,366.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42305,Not in chargemaster,42305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42305,BCBSND Base Physician Payment Schedule,899.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42300,Not in chargemaster,42300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42300,BCBSND Base Physician Payment Schedule,447.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42281,Not in chargemaster,42281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42281,BCBSND Base Physician Payment Schedule,477.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42280,Not in chargemaster,42280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42280,BCBSND Base Physician Payment Schedule,372.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42260,Not in chargemaster,42260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42260,BCBSND Base Physician Payment Schedule,1747.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42235,Not in chargemaster,42235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42235,BCBSND Base Physician Payment Schedule,1519.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42227,Not in chargemaster,42227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42227,BCBSND Base Physician Payment Schedule,1736.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42226,Not in chargemaster,42226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42226,BCBSND Base Physician Payment Schedule,1856.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42225,Not in chargemaster,42225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42225,BCBSND Base Physician Payment Schedule,2073.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42220,Not in chargemaster,42220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42220,BCBSND Base Physician Payment Schedule,1247.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42215,Not in chargemaster,42215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42215,BCBSND Base Physician Payment Schedule,1516.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42210,Not in chargemaster,42210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42210,BCBSND Base Physician Payment Schedule,2327.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42205,Not in chargemaster,42205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42205,BCBSND Base Physician Payment Schedule,2086.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42200,Not in chargemaster,42200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42200,BCBSND Base Physician Payment Schedule,2001.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42182,Not in chargemaster,42182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42182,BCBSND Base Physician Payment Schedule,685.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42180,Not in chargemaster,42180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42180,BCBSND Base Physician Payment Schedule,526.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42160,Not in chargemaster,42160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42160,BCBSND Base Physician Payment Schedule,492.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42145,Not in chargemaster,42145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42145,BCBSND Base Physician Payment Schedule,1453.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42140,Not in chargemaster,42140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42140,BCBSND Base Physician Payment Schedule,590.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42120,Not in chargemaster,42120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42120,BCBSND Base Physician Payment Schedule,2109.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42107,Not in chargemaster,42107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42107,BCBSND Base Physician Payment Schedule,974.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42106,Not in chargemaster,42106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42106,BCBSND Base Physician Payment Schedule,559.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42104,Not in chargemaster,42104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42104,BCBSND Base Physician Payment Schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42100,Not in chargemaster,42100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42100,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 42000,Not in chargemaster,42000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,42000,BCBSND Base Physician Payment Schedule,329.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41874,Not in chargemaster,41874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41874,BCBSND Base Physician Payment Schedule,822.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41872,Not in chargemaster,41872,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41872,BCBSND Base Physician Payment Schedule,941.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41830,Not in chargemaster,41830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41830,BCBSND Base Physician Payment Schedule,959.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41828,Not in chargemaster,41828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41828,BCBSND Base Physician Payment Schedule,730.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41827,Not in chargemaster,41827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41827,BCBSND Base Physician Payment Schedule,936.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41826,Not in chargemaster,41826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41826,BCBSND Base Physician Payment Schedule,657.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41825,Not in chargemaster,41825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41825,BCBSND Base Physician Payment Schedule,454.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41823,Not in chargemaster,41823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41823,BCBSND Base Physician Payment Schedule,1067.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41822,Not in chargemaster,41822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41822,BCBSND Base Physician Payment Schedule,725.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41806,Not in chargemaster,41806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41806,BCBSND Base Physician Payment Schedule,840.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41821,Not in chargemaster,41821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41821,BCBSND Base Physician Payment Schedule,241.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41805,Not in chargemaster,41805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41805,BCBSND Base Physician Payment Schedule,620.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41800,Not in chargemaster,41800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41800,BCBSND Base Physician Payment Schedule,615.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41530,Not in chargemaster,41530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41530,BCBSND Base Physician Payment Schedule,1990.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41520,Not in chargemaster,41520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41520,BCBSND Base Physician Payment Schedule,745.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41512,Not in chargemaster,41512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41512,BCBSND Base Physician Payment Schedule,1381.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41510,Not in chargemaster,41510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41510,BCBSND Base Physician Payment Schedule,937.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41252,Not in chargemaster,41252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41252,BCBSND Base Physician Payment Schedule,673.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41251,Not in chargemaster,41251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41251,BCBSND Base Physician Payment Schedule,648.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41250,Not in chargemaster,41250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41250,BCBSND Base Physician Payment Schedule,585.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41155,Not in chargemaster,41155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41155,BCBSND Base Physician Payment Schedule,6326.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41153,Not in chargemaster,41153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41153,BCBSND Base Physician Payment Schedule,5022.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41150,Not in chargemaster,41150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41150,BCBSND Base Physician Payment Schedule,4611.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41145,Not in chargemaster,41145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41145,BCBSND Base Physician Payment Schedule,5794.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41140,Not in chargemaster,41140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41140,BCBSND Base Physician Payment Schedule,4579.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41135,Not in chargemaster,41135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41135,BCBSND Base Physician Payment Schedule,4556.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41130,Not in chargemaster,41130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41130,BCBSND Base Physician Payment Schedule,2758.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41120,Not in chargemaster,41120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41120,BCBSND Base Physician Payment Schedule,2230.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41116,Not in chargemaster,41116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41116,BCBSND Base Physician Payment Schedule,697.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41115,Not in chargemaster,41115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41115,BCBSND Base Physician Payment Schedule,532.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41114,Not in chargemaster,41114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41114,BCBSND Base Physician Payment Schedule,1302.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41113,Not in chargemaster,41113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41113,BCBSND Base Physician Payment Schedule,763.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41112,Not in chargemaster,41112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41112,BCBSND Base Physician Payment Schedule,702.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41110,Not in chargemaster,41110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41110,BCBSND Base Physician Payment Schedule,461.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41108,Not in chargemaster,41108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41108,BCBSND Base Physician Payment Schedule,325.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41105,Not in chargemaster,41105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41105,BCBSND Base Physician Payment Schedule,370.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41100,Not in chargemaster,41100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41100,BCBSND Base Physician Payment Schedule,367.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41019,Not in chargemaster,41019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41019,BCBSND Base Physician Payment Schedule,1020.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41018,Not in chargemaster,41018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41018,BCBSND Base Physician Payment Schedule,1070.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41017,Not in chargemaster,41017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41017,BCBSND Base Physician Payment Schedule,951.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41016,Not in chargemaster,41016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41016,BCBSND Base Physician Payment Schedule,955.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41015,Not in chargemaster,41015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41015,BCBSND Base Physician Payment Schedule,851.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41010,Not in chargemaster,41010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41010,BCBSND Base Physician Payment Schedule,438.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41009,Not in chargemaster,41009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41009,BCBSND Base Physician Payment Schedule,866.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41008,Not in chargemaster,41008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41008,BCBSND Base Physician Payment Schedule,806.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41007,Not in chargemaster,41007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41007,BCBSND Base Physician Payment Schedule,706.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41006,Not in chargemaster,41006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41006,BCBSND Base Physician Payment Schedule,720.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41005,Not in chargemaster,41005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41005,BCBSND Base Physician Payment Schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 41000,Not in chargemaster,41000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,41000,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40845,Not in chargemaster,40845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40845,BCBSND Base Physician Payment Schedule,3090.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40844,Not in chargemaster,40844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40844,BCBSND Base Physician Payment Schedule,3152.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40843,Not in chargemaster,40843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40843,BCBSND Base Physician Payment Schedule,2508.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40842,Not in chargemaster,40842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40842,BCBSND Base Physician Payment Schedule,1923.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40840,Not in chargemaster,40840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40840,BCBSND Base Physician Payment Schedule,1756.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40831,Not in chargemaster,40831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40831,BCBSND Base Physician Payment Schedule,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40830,Not in chargemaster,40830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40830,BCBSND Base Physician Payment Schedule,585.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40820,Not in chargemaster,40820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40820,BCBSND Base Physician Payment Schedule,544.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40819,Not in chargemaster,40819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40819,BCBSND Base Physician Payment Schedule,591.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40818,Not in chargemaster,40818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40818,BCBSND Base Physician Payment Schedule,769.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40816,Not in chargemaster,40816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40816,BCBSND Base Physician Payment Schedule,840.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40814,Not in chargemaster,40814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40814,BCBSND Base Physician Payment Schedule,798.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40812,Not in chargemaster,40812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40812,BCBSND Base Physician Payment Schedule,601.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40810,Not in chargemaster,40810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40810,BCBSND Base Physician Payment Schedule,441.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40808,Not in chargemaster,40808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40808,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40806,Not in chargemaster,40806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40806,BCBSND Base Physician Payment Schedule,208.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40805,Not in chargemaster,40805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40805,BCBSND Base Physician Payment Schedule,623.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40804,Not in chargemaster,40804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40804,BCBSND Base Physician Payment Schedule,413.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40801,Not in chargemaster,40801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40801,BCBSND Base Physician Payment Schedule,630.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40800,Not in chargemaster,40800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40800,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40761,Not in chargemaster,40761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40761,BCBSND Base Physician Payment Schedule,2309.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40720,Not in chargemaster,40720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40720,BCBSND Base Physician Payment Schedule,2189.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40702,Not in chargemaster,40702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40702,BCBSND Base Physician Payment Schedule,2132.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40701,Not in chargemaster,40701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40701,BCBSND Base Physician Payment Schedule,2541.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40700,Not in chargemaster,40700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40700,BCBSND Base Physician Payment Schedule,2145.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40654,Not in chargemaster,40654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40654,BCBSND Base Physician Payment Schedule,1213.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40652,Not in chargemaster,40652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40652,BCBSND Base Physician Payment Schedule,1067.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40650,Not in chargemaster,40650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40650,BCBSND Base Physician Payment Schedule,974.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40530,Not in chargemaster,40530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40530,BCBSND Base Physician Payment Schedule,1145.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40527,Not in chargemaster,40527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40527,BCBSND Base Physician Payment Schedule,1301.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40525,Not in chargemaster,40525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40525,BCBSND Base Physician Payment Schedule,1165.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40520,Not in chargemaster,40520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40520,BCBSND Base Physician Payment Schedule,1043.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40510,40510,40510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40510,BCBSND Base Physician Payment Schedule,1025.54,742.5,Fee schedule,,742.5,742.5,742.5,742.5,,,0
unity,Fee schedule,Non-facility 40500,Not in chargemaster,40500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40500,BCBSND Base Physician Payment Schedule,1079.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 40490,Not in chargemaster,40490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,40490,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39561,Not in chargemaster,39561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39561,BCBSND Base Physician Payment Schedule,2633.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39560,Not in chargemaster,39560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39560,BCBSND Base Physician Payment Schedule,1699.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39545,Not in chargemaster,39545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39545,BCBSND Base Physician Payment Schedule,1897.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39541,Not in chargemaster,39541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39541,BCBSND Base Physician Payment Schedule,2006.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39540,Not in chargemaster,39540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39540,BCBSND Base Physician Payment Schedule,1858.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39503,Not in chargemaster,39503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39503,BCBSND Base Physician Payment Schedule,12714.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39501,Not in chargemaster,39501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39501,BCBSND Base Physician Payment Schedule,1819.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39402,Not in chargemaster,39402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39402,BCBSND Base Physician Payment Schedule,857.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39401,Not in chargemaster,39401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39401,BCBSND Base Physician Payment Schedule,655.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39220,Not in chargemaster,39220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39220,BCBSND Base Physician Payment Schedule,2407.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39200,Not in chargemaster,39200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39200,BCBSND Base Physician Payment Schedule,1850.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39010,Not in chargemaster,39010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39010,BCBSND Base Physician Payment Schedule,1670.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 39000,Not in chargemaster,39000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,39000,BCBSND Base Physician Payment Schedule,1052.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38900,Not in chargemaster,38900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38900,BCBSND Base Physician Payment Schedule,295.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38794,Not in chargemaster,38794,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38794,BCBSND Base Physician Payment Schedule,625.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38792,Not in chargemaster,38792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38792,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38790,Not in chargemaster,38790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38790,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38780,Not in chargemaster,38780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38780,BCBSND Base Physician Payment Schedule,2196.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38770,Not in chargemaster,38770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38770,BCBSND Base Physician Payment Schedule,1704.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38765,Not in chargemaster,38765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38765,BCBSND Base Physician Payment Schedule,2769.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38760,Not in chargemaster,38760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38760,BCBSND Base Physician Payment Schedule,1783.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38747,Not in chargemaster,38747,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38747,BCBSND Base Physician Payment Schedule,571.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38746,Not in chargemaster,38746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38746,BCBSND Base Physician Payment Schedule,456.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38745,Not in chargemaster,38745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38745,BCBSND Base Physician Payment Schedule,1875.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38740,Not in chargemaster,38740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38740,BCBSND Base Physician Payment Schedule,1489.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38724,Not in chargemaster,38724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38724,BCBSND Base Physician Payment Schedule,3050.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38720,Not in chargemaster,38720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38720,BCBSND Base Physician Payment Schedule,2828.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38700,Not in chargemaster,38700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38700,BCBSND Base Physician Payment Schedule,1694.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38573,Not in chargemaster,38573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38573,BCBSND Base Physician Payment Schedule,2460.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38572,Not in chargemaster,38572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38572,BCBSND Base Physician Payment Schedule,1932.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38571,Not in chargemaster,38571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38571,BCBSND Base Physician Payment Schedule,1407.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38570,Not in chargemaster,38570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38570,BCBSND Base Physician Payment Schedule,1085.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38564,Not in chargemaster,38564,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38564,BCBSND Base Physician Payment Schedule,1499.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38562,Not in chargemaster,38562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38562,BCBSND Base Physician Payment Schedule,1498.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38555,Not in chargemaster,38555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38555,BCBSND Base Physician Payment Schedule,2169.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38550,Not in chargemaster,38550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38550,BCBSND Base Physician Payment Schedule,1094.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38542,Not in chargemaster,38542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38542,BCBSND Base Physician Payment Schedule,1091.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38531,Not in chargemaster,38531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38531,BCBSND Base Physician Payment Schedule,919.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38530,Not in chargemaster,38530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38530,BCBSND Base Physician Payment Schedule,1199.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38525,38525,38525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38525,BCBSND Base Physician Payment Schedule,932.31,921.4,Fee schedule,,921.4,921.4,921.4,921.4,,,0
unity,Fee schedule,Non-facility 38520,Not in chargemaster,38520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38520,BCBSND Base Physician Payment Schedule,986.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38510,38510,38510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38510,BCBSND Base Physician Payment Schedule,1108.49,880,Fee schedule,,880,880,880,880,,,0
unity,Fee schedule,Non-facility 38505,Not in chargemaster,38505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38505,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38500,38500,38500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38500,BCBSND Base Physician Payment Schedule,710.61,506,Fee schedule,,506,506,506,506,,,0
unity,Fee schedule,Non-facility 38382,Not in chargemaster,38382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38382,BCBSND Base Physician Payment Schedule,1441.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38381,Not in chargemaster,38381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38381,BCBSND Base Physician Payment Schedule,1705.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38380,Not in chargemaster,38380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38380,BCBSND Base Physician Payment Schedule,1200.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38308,Not in chargemaster,38308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38308,BCBSND Base Physician Payment Schedule,966.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38305,Not in chargemaster,38305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38305,BCBSND Base Physician Payment Schedule,1037.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38300,Not in chargemaster,38300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38300,BCBSND Base Physician Payment Schedule,690.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38243,Not in chargemaster,38243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38243,BCBSND Base Physician Payment Schedule,256.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38242,Not in chargemaster,38242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38242,BCBSND Base Physician Payment Schedule,266.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38241,Not in chargemaster,38241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38241,BCBSND Base Physician Payment Schedule,368.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38240,Not in chargemaster,38240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38240,BCBSND Base Physician Payment Schedule,497.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38232,Not in chargemaster,38232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38232,BCBSND Base Physician Payment Schedule,422.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38230,Not in chargemaster,38230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38230,BCBSND Base Physician Payment Schedule,434.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38222,Not in chargemaster,38222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38222,BCBSND Base Physician Payment Schedule,362.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38221,Not in chargemaster,38221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38221,BCBSND Base Physician Payment Schedule,328.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38220,Not in chargemaster,38220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38220,BCBSND Base Physician Payment Schedule,350.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38215,Not in chargemaster,38215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38215,BCBSND Base Physician Payment Schedule,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38214,Not in chargemaster,38214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38214,BCBSND Base Physician Payment Schedule,88.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38213,Not in chargemaster,38213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38213,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38212,Not in chargemaster,38212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38212,BCBSND Base Physician Payment Schedule,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38211,Not in chargemaster,38211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38211,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38210,Not in chargemaster,38210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38210,BCBSND Base Physician Payment Schedule,168.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38209,Not in chargemaster,38209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38209,BCBSND Base Physician Payment Schedule,25.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38208,Not in chargemaster,38208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38208,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38207,Not in chargemaster,38207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38207,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38206,Not in chargemaster,38206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38206,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38205,Not in chargemaster,38205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38205,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38204,Not in chargemaster,38204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38204,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38200,Not in chargemaster,38200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38200,BCBSND Base Physician Payment Schedule,282.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38120,Not in chargemaster,38120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38120,BCBSND Base Physician Payment Schedule,2251.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38115,Not in chargemaster,38115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38115,BCBSND Base Physician Payment Schedule,2729.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38102,Not in chargemaster,38102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38102,BCBSND Base Physician Payment Schedule,560.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38101,Not in chargemaster,38101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38101,BCBSND Base Physician Payment Schedule,2493,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 38100,Not in chargemaster,38100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,38100,BCBSND Base Physician Payment Schedule,2465.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37790,Not in chargemaster,37790,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37790,BCBSND Base Physician Payment Schedule,1029.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37788,Not in chargemaster,37788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37788,BCBSND Base Physician Payment Schedule,2680.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37785,Not in chargemaster,37785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37785,BCBSND Base Physician Payment Schedule,748.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37780,Not in chargemaster,37780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37780,BCBSND Base Physician Payment Schedule,496.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37766,Not in chargemaster,37766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37766,BCBSND Base Physician Payment Schedule,1087.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37765,Not in chargemaster,37765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37765,BCBSND Base Physician Payment Schedule,930.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37761,Not in chargemaster,37761,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37761,BCBSND Base Physician Payment Schedule,1153.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37760,Not in chargemaster,37760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37760,BCBSND Base Physician Payment Schedule,1328.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37735,Not in chargemaster,37735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37735,BCBSND Base Physician Payment Schedule,1236.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37722,Not in chargemaster,37722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37722,BCBSND Base Physician Payment Schedule,1004.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37718,Not in chargemaster,37718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37718,BCBSND Base Physician Payment Schedule,895.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37700,Not in chargemaster,37700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37700,BCBSND Base Physician Payment Schedule,519.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37660,Not in chargemaster,37660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37660,BCBSND Base Physician Payment Schedule,2813.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37650,Not in chargemaster,37650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37650,BCBSND Base Physician Payment Schedule,975.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37619,Not in chargemaster,37619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37619,BCBSND Base Physician Payment Schedule,3698.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37618,Not in chargemaster,37618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37618,BCBSND Base Physician Payment Schedule,824.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37617,Not in chargemaster,37617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37617,BCBSND Base Physician Payment Schedule,2835.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37616,Not in chargemaster,37616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37616,BCBSND Base Physician Payment Schedule,2350.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37615,Not in chargemaster,37615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37615,BCBSND Base Physician Payment Schedule,1124.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37609,Not in chargemaster,37609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37609,BCBSND Base Physician Payment Schedule,656.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37607,Not in chargemaster,37607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37607,BCBSND Base Physician Payment Schedule,797.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37606,Not in chargemaster,37606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37606,BCBSND Base Physician Payment Schedule,1519.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37605,Not in chargemaster,37605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37605,BCBSND Base Physician Payment Schedule,1573.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37600,Not in chargemaster,37600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37600,BCBSND Base Physician Payment Schedule,1557.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37565,Not in chargemaster,37565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37565,BCBSND Base Physician Payment Schedule,1536.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37500,Not in chargemaster,37500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37500,BCBSND Base Physician Payment Schedule,1348.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37501,Not in chargemaster,37501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37501,BCBSND Base Physician Payment Schedule,546.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37253,Not in chargemaster,37253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37253,BCBSND Base Physician Payment Schedule,394.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37252,Not in chargemaster,37252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37252,BCBSND Base Physician Payment Schedule,2443.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37249,Not in chargemaster,37249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37249,BCBSND Base Physician Payment Schedule,1150.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37248,Not in chargemaster,37248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37248,BCBSND Base Physician Payment Schedule,3151.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37247,Not in chargemaster,37247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37247,BCBSND Base Physician Payment Schedule,1507.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37246,Not in chargemaster,37246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37246,BCBSND Base Physician Payment Schedule,4283.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37244,Not in chargemaster,37244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37244,BCBSND Base Physician Payment Schedule,14738.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37243,Not in chargemaster,37243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37243,BCBSND Base Physician Payment Schedule,20083.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37242,Not in chargemaster,37242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37242,BCBSND Base Physician Payment Schedule,15913.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37241,Not in chargemaster,37241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37241,BCBSND Base Physician Payment Schedule,10291.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37239,Not in chargemaster,37239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37239,BCBSND Base Physician Payment Schedule,3072.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37238,Not in chargemaster,37238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37238,BCBSND Base Physician Payment Schedule,6631.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37237,Not in chargemaster,37237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37237,BCBSND Base Physician Payment Schedule,3905.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37236,Not in chargemaster,37236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37236,BCBSND Base Physician Payment Schedule,7038.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37235,Not in chargemaster,37235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37235,BCBSND Base Physician Payment Schedule,8541.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37234,Not in chargemaster,37234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37234,BCBSND Base Physician Payment Schedule,8106.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37233,Not in chargemaster,37233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37233,BCBSND Base Physician Payment Schedule,2620.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37232,Not in chargemaster,37232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37232,BCBSND Base Physician Payment Schedule,2134.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37231,Not in chargemaster,37231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37231,BCBSND Base Physician Payment Schedule,29445.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37230,Not in chargemaster,37230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37230,BCBSND Base Physician Payment Schedule,21270.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37229,Not in chargemaster,37229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37229,BCBSND Base Physician Payment Schedule,23649.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37228,Not in chargemaster,37228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37228,BCBSND Base Physician Payment Schedule,10317.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37227,Not in chargemaster,37227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37227,BCBSND Base Physician Payment Schedule,30290.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37226,Not in chargemaster,37226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37226,BCBSND Base Physician Payment Schedule,20921.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37225,Not in chargemaster,37225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37225,BCBSND Base Physician Payment Schedule,23558.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37224,Not in chargemaster,37224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37224,BCBSND Base Physician Payment Schedule,7168.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37223,Not in chargemaster,37223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37223,BCBSND Base Physician Payment Schedule,3997.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37222,Not in chargemaster,37222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37222,BCBSND Base Physician Payment Schedule,1559.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37221,Not in chargemaster,37221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37221,BCBSND Base Physician Payment Schedule,8160.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37220,Not in chargemaster,37220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37220,BCBSND Base Physician Payment Schedule,6026.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37218,Not in chargemaster,37218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37218,BCBSND Base Physician Payment Schedule,1744.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37217,Not in chargemaster,37217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37217,BCBSND Base Physician Payment Schedule,2302.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37216,Not in chargemaster,37216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37216,BCBSND Base Physician Payment Schedule,2075.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37215,Not in chargemaster,37215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37215,BCBSND Base Physician Payment Schedule,2131.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37214,Not in chargemaster,37214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37214,BCBSND Base Physician Payment Schedule,262.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37213,Not in chargemaster,37213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37213,BCBSND Base Physician Payment Schedule,496.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37212,Not in chargemaster,37212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37212,BCBSND Base Physician Payment Schedule,720.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37211,Not in chargemaster,37211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37211,BCBSND Base Physician Payment Schedule,823.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37200,Not in chargemaster,37200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37200,BCBSND Base Physician Payment Schedule,462.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37197,Not in chargemaster,37197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37197,BCBSND Base Physician Payment Schedule,3351.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37193,Not in chargemaster,37193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37193,BCBSND Base Physician Payment Schedule,3310.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37195,Not in chargemaster,37195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37195,BCBSND Base Physician Payment Schedule,729.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37192,Not in chargemaster,37192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37192,BCBSND Base Physician Payment Schedule,2810.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37191,Not in chargemaster,37191,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37191,BCBSND Base Physician Payment Schedule,4995.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37188,Not in chargemaster,37188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37188,BCBSND Base Physician Payment Schedule,3400.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37187,Not in chargemaster,37187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37187,BCBSND Base Physician Payment Schedule,4041.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37186,Not in chargemaster,37186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37186,BCBSND Base Physician Payment Schedule,2760.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37185,Not in chargemaster,37185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37185,BCBSND Base Physician Payment Schedule,1242.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37184,Not in chargemaster,37184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37184,BCBSND Base Physician Payment Schedule,4111.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37183,Not in chargemaster,37183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37183,BCBSND Base Physician Payment Schedule,12926.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37182,Not in chargemaster,37182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37182,BCBSND Base Physician Payment Schedule,1742.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37181,Not in chargemaster,37181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37181,BCBSND Base Physician Payment Schedule,4969.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37180,Not in chargemaster,37180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37180,BCBSND Base Physician Payment Schedule,4550.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37160,Not in chargemaster,37160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37160,BCBSND Base Physician Payment Schedule,4733.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37145,Not in chargemaster,37145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37145,BCBSND Base Physician Payment Schedule,4607.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 37140,Not in chargemaster,37140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,37140,BCBSND Base Physician Payment Schedule,4969.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36909,Not in chargemaster,36909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36909,BCBSND Base Physician Payment Schedule,4171.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36908,Not in chargemaster,36908,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36908,BCBSND Base Physician Payment Schedule,4377.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36907,Not in chargemaster,36907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36907,BCBSND Base Physician Payment Schedule,1443.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36906,Not in chargemaster,36906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36906,BCBSND Base Physician Payment Schedule,13335.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36905,Not in chargemaster,36905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36905,BCBSND Base Physician Payment Schedule,5046.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36904,Not in chargemaster,36904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36904,BCBSND Base Physician Payment Schedule,4019.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36903,Not in chargemaster,36903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36903,BCBSND Base Physician Payment Schedule,10742.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36902,Not in chargemaster,36902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36902,BCBSND Base Physician Payment Schedule,2714.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36901,Not in chargemaster,36901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36901,BCBSND Base Physician Payment Schedule,1448.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36861,Not in chargemaster,36861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36861,BCBSND Base Physician Payment Schedule,297.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36860,Not in chargemaster,36860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36860,BCBSND Base Physician Payment Schedule,517.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36838,Not in chargemaster,36838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36838,BCBSND Base Physician Payment Schedule,2444.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36835,Not in chargemaster,36835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36835,BCBSND Base Physician Payment Schedule,1017.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36833,Not in chargemaster,36833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36833,BCBSND Base Physician Payment Schedule,1729.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36832,Not in chargemaster,36832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36832,BCBSND Base Physician Payment Schedule,1612.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36831,Not in chargemaster,36831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36831,BCBSND Base Physician Payment Schedule,1314.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36830,Not in chargemaster,36830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36830,BCBSND Base Physician Payment Schedule,1424.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36825,Not in chargemaster,36825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36825,BCBSND Base Physician Payment Schedule,1696.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36823,Not in chargemaster,36823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36823,BCBSND Base Physician Payment Schedule,2988.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36821,Not in chargemaster,36821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36821,BCBSND Base Physician Payment Schedule,1417.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36820,Not in chargemaster,36820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36820,BCBSND Base Physician Payment Schedule,1556.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36819,Not in chargemaster,36819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36819,BCBSND Base Physician Payment Schedule,1561.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36818,Not in chargemaster,36818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36818,BCBSND Base Physician Payment Schedule,1476.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36815,Not in chargemaster,36815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36815,BCBSND Base Physician Payment Schedule,287.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36810,Not in chargemaster,36810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36810,BCBSND Base Physician Payment Schedule,448.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36800,Not in chargemaster,36800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36800,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36680,Not in chargemaster,36680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36680,BCBSND Base Physician Payment Schedule,127.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36660,Not in chargemaster,36660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36660,BCBSND Base Physician Payment Schedule,144.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36640,Not in chargemaster,36640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36640,BCBSND Base Physician Payment Schedule,242.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36625,Not in chargemaster,36625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36625,BCBSND Base Physician Payment Schedule,224.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36620,Not in chargemaster,36620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36620,BCBSND Base Physician Payment Schedule,93.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36600,Not in chargemaster,36600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36600,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36598,Not in chargemaster,36598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36598,BCBSND Base Physician Payment Schedule,252.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36597,Not in chargemaster,36597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36597,BCBSND Base Physician Payment Schedule,278.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36596,Not in chargemaster,36596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36596,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36595,Not in chargemaster,36595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36595,BCBSND Base Physician Payment Schedule,1313.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36593,Not in chargemaster,36593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36593,BCBSND Base Physician Payment Schedule,65.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36592,Not in chargemaster,36592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36592,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36591,Not in chargemaster,36591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36591,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36590,Not in chargemaster,36590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36590,BCBSND Base Physician Payment Schedule,469.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36589,Not in chargemaster,36589,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36589,BCBSND Base Physician Payment Schedule,349.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36585,Not in chargemaster,36585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36585,BCBSND Base Physician Payment Schedule,2306.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36584,Not in chargemaster,36584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36584,BCBSND Base Physician Payment Schedule,728.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36583,Not in chargemaster,36583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36583,BCBSND Base Physician Payment Schedule,2647.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36582,Not in chargemaster,36582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36582,BCBSND Base Physician Payment Schedule,2073.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36581,Not in chargemaster,36581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36581,BCBSND Base Physician Payment Schedule,1681.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36580,Not in chargemaster,36580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36580,BCBSND Base Physician Payment Schedule,456.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36578,Not in chargemaster,36578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36578,BCBSND Base Physician Payment Schedule,985.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36576,Not in chargemaster,36576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36576,BCBSND Base Physician Payment Schedule,713.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36575,Not in chargemaster,36575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36575,BCBSND Base Physician Payment Schedule,335.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36573,Not in chargemaster,36573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36573,BCBSND Base Physician Payment Schedule,835.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36572,Not in chargemaster,36572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36572,BCBSND Base Physician Payment Schedule,905.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36571,Not in chargemaster,36571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36571,BCBSND Base Physician Payment Schedule,2719.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36570,Not in chargemaster,36570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36570,BCBSND Base Physician Payment Schedule,3106.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36569,Not in chargemaster,36569,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36569,BCBSND Base Physician Payment Schedule,200.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36568,Not in chargemaster,36568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36568,BCBSND Base Physician Payment Schedule,196.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36566,Not in chargemaster,36566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36566,BCBSND Base Physician Payment Schedule,9707,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36565,Not in chargemaster,36565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36565,BCBSND Base Physician Payment Schedule,1836.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36563,Not in chargemaster,36563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36563,BCBSND Base Physician Payment Schedule,2490.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36561,Not in chargemaster,36561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36561,BCBSND Base Physician Payment Schedule,2247.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36560,Not in chargemaster,36560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36560,BCBSND Base Physician Payment Schedule,2747.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36558,Not in chargemaster,36558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36558,BCBSND Base Physician Payment Schedule,1700.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36557,Not in chargemaster,36557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36557,BCBSND Base Physician Payment Schedule,2302.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36556,Not in chargemaster,36556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36556,BCBSND Base Physician Payment Schedule,446.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36555,Not in chargemaster,36555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36555,BCBSND Base Physician Payment Schedule,392.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36522,Not in chargemaster,36522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36522,BCBSND Base Physician Payment Schedule,4008.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36516,Not in chargemaster,36516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36516,BCBSND Base Physician Payment Schedule,4069.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36514,Not in chargemaster,36514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36514,BCBSND Base Physician Payment Schedule,1407.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36513,Not in chargemaster,36513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36513,BCBSND Base Physician Payment Schedule,231.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36512,Not in chargemaster,36512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36512,BCBSND Base Physician Payment Schedule,229.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36511,Not in chargemaster,36511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36511,BCBSND Base Physician Payment Schedule,231.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36510,Not in chargemaster,36510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36510,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36500,Not in chargemaster,36500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36500,BCBSND Base Physician Payment Schedule,388.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36483,Not in chargemaster,36483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36483,BCBSND Base Physician Payment Schedule,326.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36482,Not in chargemaster,36482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36482,BCBSND Base Physician Payment Schedule,3966.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36481,Not in chargemaster,36481,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36481,BCBSND Base Physician Payment Schedule,4011.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36479,Not in chargemaster,36479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36479,BCBSND Base Physician Payment Schedule,681.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36478,Not in chargemaster,36478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36478,BCBSND Base Physician Payment Schedule,2221.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36476,Not in chargemaster,36476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36476,BCBSND Base Physician Payment Schedule,646.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36475,Not in chargemaster,36475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36475,BCBSND Base Physician Payment Schedule,2857.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36474,Not in chargemaster,36474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36474,BCBSND Base Physician Payment Schedule,604.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36473,Not in chargemaster,36473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36473,BCBSND Base Physician Payment Schedule,2966.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36471,Not in chargemaster,36471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36471,BCBSND Base Physician Payment Schedule,410.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36470,Not in chargemaster,36470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36470,BCBSND Base Physician Payment Schedule,227.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36466,Not in chargemaster,36466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36466,BCBSND Base Physician Payment Schedule,3497.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36468,Not in chargemaster,36468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36468,BCBSND Base Physician Payment Schedule,239.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36465,Not in chargemaster,36465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36465,BCBSND Base Physician Payment Schedule,3152.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36460,Not in chargemaster,36460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36460,BCBSND Base Physician Payment Schedule,741.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36456,Not in chargemaster,36456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36456,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36455,Not in chargemaster,36455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36455,BCBSND Base Physician Payment Schedule,270.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36450,Not in chargemaster,36450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36450,BCBSND Base Physician Payment Schedule,361.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36440,Not in chargemaster,36440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36440,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36430,Not in chargemaster,36430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36430,BCBSND Base Physician Payment Schedule,72.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36425,Not in chargemaster,36425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36425,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36420,Not in chargemaster,36420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36420,BCBSND Base Physician Payment Schedule,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36410,Not in chargemaster,36410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36410,BCBSND Base Physician Payment Schedule,35.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36406,Not in chargemaster,36406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36406,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36405,Not in chargemaster,36405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36405,BCBSND Base Physician Payment Schedule,48.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36400,Not in chargemaster,36400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36400,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36262,Not in chargemaster,36262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36262,BCBSND Base Physician Payment Schedule,657.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36261,Not in chargemaster,36261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36261,BCBSND Base Physician Payment Schedule,862.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36260,Not in chargemaster,36260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36260,BCBSND Base Physician Payment Schedule,1389.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36254,Not in chargemaster,36254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36254,BCBSND Base Physician Payment Schedule,4524.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36253,Not in chargemaster,36253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36253,BCBSND Base Physician Payment Schedule,4621.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36252,Not in chargemaster,36252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36252,BCBSND Base Physician Payment Schedule,3142.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36251,Not in chargemaster,36251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36251,BCBSND Base Physician Payment Schedule,2918.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36248,Not in chargemaster,36248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36248,BCBSND Base Physician Payment Schedule,287.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36247,Not in chargemaster,36247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36247,BCBSND Base Physician Payment Schedule,3173.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36246,Not in chargemaster,36246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36246,BCBSND Base Physician Payment Schedule,1802.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36245,Not in chargemaster,36245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36245,BCBSND Base Physician Payment Schedule,2803.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36228,Not in chargemaster,36228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36228,BCBSND Base Physician Payment Schedule,2765.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36227,Not in chargemaster,36227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36227,BCBSND Base Physician Payment Schedule,521.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36226,Not in chargemaster,36226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36226,BCBSND Base Physician Payment Schedule,4089.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36225,Not in chargemaster,36225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36225,BCBSND Base Physician Payment Schedule,3211.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36224,Not in chargemaster,36224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36224,BCBSND Base Physician Payment Schedule,4326.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36223,Not in chargemaster,36223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36223,BCBSND Base Physician Payment Schedule,3349.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36222,Not in chargemaster,36222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36222,BCBSND Base Physician Payment Schedule,2609.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36221,Not in chargemaster,36221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36221,BCBSND Base Physician Payment Schedule,2205.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36218,Not in chargemaster,36218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36218,BCBSND Base Physician Payment Schedule,480.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36217,Not in chargemaster,36217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36217,BCBSND Base Physician Payment Schedule,3959.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36216,Not in chargemaster,36216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36216,BCBSND Base Physician Payment Schedule,2390.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36215,Not in chargemaster,36215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36215,BCBSND Base Physician Payment Schedule,2255.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36200,Not in chargemaster,36200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36200,BCBSND Base Physician Payment Schedule,1236.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36160,Not in chargemaster,36160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36160,BCBSND Base Physician Payment Schedule,1143.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36140,Not in chargemaster,36140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36140,BCBSND Base Physician Payment Schedule,1002.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36100,Not in chargemaster,36100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36100,BCBSND Base Physician Payment Schedule,1090.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36015,Not in chargemaster,36015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36015,BCBSND Base Physician Payment Schedule,1888.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36014,Not in chargemaster,36014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36014,BCBSND Base Physician Payment Schedule,1742.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36013,Not in chargemaster,36013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36013,BCBSND Base Physician Payment Schedule,1672.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36012,Not in chargemaster,36012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36012,BCBSND Base Physician Payment Schedule,1839.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36011,Not in chargemaster,36011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36011,BCBSND Base Physician Payment Schedule,1811.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36010,Not in chargemaster,36010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36010,BCBSND Base Physician Payment Schedule,1104.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36005,Not in chargemaster,36005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36005,BCBSND Base Physician Payment Schedule,619.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36002,Not in chargemaster,36002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36002,BCBSND Base Physician Payment Schedule,325.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 36000,Not in chargemaster,36000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36000,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35907,Not in chargemaster,35907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35907,BCBSND Base Physician Payment Schedule,4062.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35905,Not in chargemaster,35905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35905,BCBSND Base Physician Payment Schedule,3777.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35903,Not in chargemaster,35903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35903,BCBSND Base Physician Payment Schedule,1204.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35901,Not in chargemaster,35901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35901,BCBSND Base Physician Payment Schedule,1002.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35884,Not in chargemaster,35884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35884,BCBSND Base Physician Payment Schedule,2644.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35883,Not in chargemaster,35883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35883,BCBSND Base Physician Payment Schedule,2564.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35881,Not in chargemaster,35881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35881,BCBSND Base Physician Payment Schedule,2178.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35879,Not in chargemaster,35879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35879,BCBSND Base Physician Payment Schedule,1974.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35876,Not in chargemaster,35876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35876,BCBSND Base Physician Payment Schedule,2020.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35875,Not in chargemaster,35875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35875,BCBSND Base Physician Payment Schedule,1269.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35870,Not in chargemaster,35870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35870,BCBSND Base Physician Payment Schedule,2655.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35860,Not in chargemaster,35860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35860,BCBSND Base Physician Payment Schedule,1784.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35840,Not in chargemaster,35840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35840,BCBSND Base Physician Payment Schedule,2559.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35820,Not in chargemaster,35820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35820,BCBSND Base Physician Payment Schedule,4278.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35800,Not in chargemaster,35800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35800,BCBSND Base Physician Payment Schedule,1528.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35703,Not in chargemaster,35703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35703,BCBSND Base Physician Payment Schedule,886.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35702,Not in chargemaster,35702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35702,BCBSND Base Physician Payment Schedule,873.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35701,Not in chargemaster,35701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35701,BCBSND Base Physician Payment Schedule,929.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35700,Not in chargemaster,35700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35700,BCBSND Base Physician Payment Schedule,325.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35697,Not in chargemaster,35697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35697,BCBSND Base Physician Payment Schedule,314.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35695,Not in chargemaster,35695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35695,BCBSND Base Physician Payment Schedule,2185.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35694,Not in chargemaster,35694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35694,BCBSND Base Physician Payment Schedule,2105.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35693,Not in chargemaster,35693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35693,BCBSND Base Physician Payment Schedule,1775.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35691,Not in chargemaster,35691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35691,BCBSND Base Physician Payment Schedule,2015.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35686,Not in chargemaster,35686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35686,BCBSND Base Physician Payment Schedule,343.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35685,Not in chargemaster,35685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35685,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35683,Not in chargemaster,35683,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35683,BCBSND Base Physician Payment Schedule,872.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35682,Not in chargemaster,35682,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35682,BCBSND Base Physician Payment Schedule,755.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35681,Not in chargemaster,35681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35681,BCBSND Base Physician Payment Schedule,173.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35671,Not in chargemaster,35671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35671,BCBSND Base Physician Payment Schedule,2396.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35666,Not in chargemaster,35666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35666,BCBSND Base Physician Payment Schedule,2717.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35665,Not in chargemaster,35665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35665,BCBSND Base Physician Payment Schedule,2505.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35663,Not in chargemaster,35663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35663,BCBSND Base Physician Payment Schedule,2594.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35661,Not in chargemaster,35661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35661,BCBSND Base Physician Payment Schedule,2313.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35656,Not in chargemaster,35656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35656,BCBSND Base Physician Payment Schedule,2305.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35654,Not in chargemaster,35654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35654,BCBSND Base Physician Payment Schedule,2923.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35650,Not in chargemaster,35650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35650,BCBSND Base Physician Payment Schedule,2178.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35647,Not in chargemaster,35647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35647,BCBSND Base Physician Payment Schedule,3302.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35646,Not in chargemaster,35646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35646,BCBSND Base Physician Payment Schedule,3663.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35645,Not in chargemaster,35645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35645,BCBSND Base Physician Payment Schedule,2017.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35642,Not in chargemaster,35642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35642,BCBSND Base Physician Payment Schedule,2100.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35638,Not in chargemaster,35638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35638,BCBSND Base Physician Payment Schedule,3721.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35637,Not in chargemaster,35637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35637,BCBSND Base Physician Payment Schedule,3539.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35636,Not in chargemaster,35636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35636,BCBSND Base Physician Payment Schedule,3401.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35634,Not in chargemaster,35634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35634,BCBSND Base Physician Payment Schedule,3773.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35633,Not in chargemaster,35633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35633,BCBSND Base Physician Payment Schedule,4232.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35632,Not in chargemaster,35632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35632,BCBSND Base Physician Payment Schedule,3855.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35631,Not in chargemaster,35631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35631,BCBSND Base Physician Payment Schedule,3952.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35626,Not in chargemaster,35626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35626,BCBSND Base Physician Payment Schedule,3385.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35623,Not in chargemaster,35623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35623,BCBSND Base Physician Payment Schedule,2799.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35621,Not in chargemaster,35621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35621,BCBSND Base Physician Payment Schedule,2341.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35616,Not in chargemaster,35616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35616,BCBSND Base Physician Payment Schedule,2350.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35612,Not in chargemaster,35612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35612,BCBSND Base Physician Payment Schedule,2224.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35606,Not in chargemaster,35606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35606,BCBSND Base Physician Payment Schedule,2502.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35601,Not in chargemaster,35601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35601,BCBSND Base Physician Payment Schedule,2984.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35600,Not in chargemaster,35600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35600,BCBSND Base Physician Payment Schedule,546.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35587,Not in chargemaster,35587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35587,BCBSND Base Physician Payment Schedule,2910.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35585,Not in chargemaster,35585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35585,BCBSND Base Physician Payment Schedule,3574.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35583,Not in chargemaster,35583,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35583,BCBSND Base Physician Payment Schedule,3083.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35572,Not in chargemaster,35572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35572,BCBSND Base Physician Payment Schedule,737.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35571,Not in chargemaster,35571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35571,BCBSND Base Physician Payment Schedule,2829.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35570,Not in chargemaster,35570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35570,BCBSND Base Physician Payment Schedule,3141.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35566,Not in chargemaster,35566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35566,BCBSND Base Physician Payment Schedule,3567.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35565,Not in chargemaster,35565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35565,BCBSND Base Physician Payment Schedule,2793.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35563,Not in chargemaster,35563,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35563,BCBSND Base Physician Payment Schedule,2820.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35560,Not in chargemaster,35560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35560,BCBSND Base Physician Payment Schedule,3636,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35558,Not in chargemaster,35558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35558,BCBSND Base Physician Payment Schedule,2624.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35556,Not in chargemaster,35556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35556,BCBSND Base Physician Payment Schedule,2989.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35540,Not in chargemaster,35540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35540,BCBSND Base Physician Payment Schedule,5218.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35539,Not in chargemaster,35539,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35539,BCBSND Base Physician Payment Schedule,4680.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35538,Not in chargemaster,35538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35538,BCBSND Base Physician Payment Schedule,4987.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35537,Not in chargemaster,35537,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35537,BCBSND Base Physician Payment Schedule,4450.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35536,Not in chargemaster,35536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35536,BCBSND Base Physician Payment Schedule,3605.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35535,Not in chargemaster,35535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35535,BCBSND Base Physician Payment Schedule,4061.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35533,Not in chargemaster,35533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35533,BCBSND Base Physician Payment Schedule,3213.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35531,Not in chargemaster,35531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35531,BCBSND Base Physician Payment Schedule,4157.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35526,Not in chargemaster,35526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35526,BCBSND Base Physician Payment Schedule,3681.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35525,Not in chargemaster,35525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35525,BCBSND Base Physician Payment Schedule,2423.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35523,Not in chargemaster,35523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35523,BCBSND Base Physician Payment Schedule,2734.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35522,Not in chargemaster,35522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35522,BCBSND Base Physician Payment Schedule,2597.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35521,Not in chargemaster,35521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35521,BCBSND Base Physician Payment Schedule,2614.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35518,Not in chargemaster,35518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35518,BCBSND Base Physician Payment Schedule,2435.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35516,Not in chargemaster,35516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35516,BCBSND Base Physician Payment Schedule,2600.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35515,Not in chargemaster,35515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35515,BCBSND Base Physician Payment Schedule,2828.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35512,Not in chargemaster,35512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35512,BCBSND Base Physician Payment Schedule,2570.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35511,Not in chargemaster,35511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35511,BCBSND Base Physician Payment Schedule,2389.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35510,Not in chargemaster,35510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35510,BCBSND Base Physician Payment Schedule,2620.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35509,Not in chargemaster,35509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35509,BCBSND Base Physician Payment Schedule,3014.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35508,Not in chargemaster,35508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35508,BCBSND Base Physician Payment Schedule,2828.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35506,Not in chargemaster,35506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35506,BCBSND Base Physician Payment Schedule,2716.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35501,Not in chargemaster,35501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35501,BCBSND Base Physician Payment Schedule,3114.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35500,Not in chargemaster,35500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35500,BCBSND Base Physician Payment Schedule,681.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35400,Not in chargemaster,35400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35400,BCBSND Base Physician Payment Schedule,317.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35390,Not in chargemaster,35390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35390,BCBSND Base Physician Payment Schedule,341.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35372,Not in chargemaster,35372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35372,BCBSND Base Physician Payment Schedule,2088.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35371,Not in chargemaster,35371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35371,BCBSND Base Physician Payment Schedule,1743.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35363,Not in chargemaster,35363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35363,BCBSND Base Physician Payment Schedule,3464.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35361,Not in chargemaster,35361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35361,BCBSND Base Physician Payment Schedule,3246.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35355,Not in chargemaster,35355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35355,BCBSND Base Physician Payment Schedule,2201.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35351,Not in chargemaster,35351,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35351,BCBSND Base Physician Payment Schedule,2738.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35341,Not in chargemaster,35341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35341,BCBSND Base Physician Payment Schedule,2934.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35331,Not in chargemaster,35331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35331,BCBSND Base Physician Payment Schedule,3100.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35321,Not in chargemaster,35321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35321,BCBSND Base Physician Payment Schedule,1904.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35311,Not in chargemaster,35311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35311,BCBSND Base Physician Payment Schedule,3312.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35306,Not in chargemaster,35306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35306,BCBSND Base Physician Payment Schedule,951.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35305,Not in chargemaster,35305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35305,BCBSND Base Physician Payment Schedule,2614.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35304,Not in chargemaster,35304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35304,BCBSND Base Physician Payment Schedule,2721.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35303,Not in chargemaster,35303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35303,BCBSND Base Physician Payment Schedule,2642.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35302,Not in chargemaster,35302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35302,BCBSND Base Physician Payment Schedule,2393.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35301,Not in chargemaster,35301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35301,BCBSND Base Physician Payment Schedule,2415.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35286,Not in chargemaster,35286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35286,BCBSND Base Physician Payment Schedule,1993.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35281,Not in chargemaster,35281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35281,BCBSND Base Physician Payment Schedule,3473.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35276,Not in chargemaster,35276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35276,BCBSND Base Physician Payment Schedule,3094.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35271,Not in chargemaster,35271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35271,BCBSND Base Physician Payment Schedule,2933.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35266,Not in chargemaster,35266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35266,BCBSND Base Physician Payment Schedule,1844.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35261,Not in chargemaster,35261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35261,BCBSND Base Physician Payment Schedule,2087.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35256,Not in chargemaster,35256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35256,BCBSND Base Physician Payment Schedule,2186.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35251,Not in chargemaster,35251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35251,BCBSND Base Physician Payment Schedule,3722.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35246,Not in chargemaster,35246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35246,BCBSND Base Physician Payment Schedule,3324.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35241,Not in chargemaster,35241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35241,BCBSND Base Physician Payment Schedule,3047.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35236,Not in chargemaster,35236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35236,BCBSND Base Physician Payment Schedule,2142.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35231,Not in chargemaster,35231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35231,BCBSND Base Physician Payment Schedule,2671.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35226,Not in chargemaster,35226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35226,BCBSND Base Physician Payment Schedule,1774.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35221,Not in chargemaster,35221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35221,BCBSND Base Physician Payment Schedule,3130.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35216,Not in chargemaster,35216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35216,BCBSND Base Physician Payment Schedule,4411.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35211,Not in chargemaster,35211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35211,BCBSND Base Physician Payment Schedule,2954.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35207,Not in chargemaster,35207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35207,BCBSND Base Physician Payment Schedule,1597.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35206,Not in chargemaster,35206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35206,BCBSND Base Physician Payment Schedule,1664.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35201,Not in chargemaster,35201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35201,BCBSND Base Physician Payment Schedule,2007.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35190,Not in chargemaster,35190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35190,BCBSND Base Physician Payment Schedule,1625.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35189,Not in chargemaster,35189,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35189,BCBSND Base Physician Payment Schedule,3219.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35188,Not in chargemaster,35188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35188,BCBSND Base Physician Payment Schedule,2714.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35184,Not in chargemaster,35184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35184,BCBSND Base Physician Payment Schedule,2054.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35182,Not in chargemaster,35182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35182,BCBSND Base Physician Payment Schedule,3801.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35180,Not in chargemaster,35180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35180,BCBSND Base Physician Payment Schedule,1866.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35152,Not in chargemaster,35152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35152,BCBSND Base Physician Payment Schedule,2979.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35151,Not in chargemaster,35151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35151,BCBSND Base Physician Payment Schedule,2640.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35142,Not in chargemaster,35142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35142,BCBSND Base Physician Payment Schedule,2837.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35141,Not in chargemaster,35141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35141,BCBSND Base Physician Payment Schedule,2352.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35132,Not in chargemaster,35132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35132,BCBSND Base Physician Payment Schedule,3486.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35131,Not in chargemaster,35131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35131,BCBSND Base Physician Payment Schedule,2938.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35122,Not in chargemaster,35122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35122,BCBSND Base Physician Payment Schedule,4033.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35121,Not in chargemaster,35121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35121,BCBSND Base Physician Payment Schedule,3372.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35112,Not in chargemaster,35112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35112,BCBSND Base Physician Payment Schedule,3486.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35111,Not in chargemaster,35111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35111,BCBSND Base Physician Payment Schedule,2832.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35103,Not in chargemaster,35103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35103,BCBSND Base Physician Payment Schedule,4774.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35102,Not in chargemaster,35102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35102,BCBSND Base Physician Payment Schedule,4011.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35092,Not in chargemaster,35092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35092,BCBSND Base Physician Payment Schedule,5561.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35091,Not in chargemaster,35091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35091,BCBSND Base Physician Payment Schedule,3818.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35082,Not in chargemaster,35082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35082,BCBSND Base Physician Payment Schedule,4660.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35081,Not in chargemaster,35081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35081,BCBSND Base Physician Payment Schedule,3694.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35045,Not in chargemaster,35045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35045,BCBSND Base Physician Payment Schedule,2087.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35022,Not in chargemaster,35022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35022,BCBSND Base Physician Payment Schedule,3061.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35021,Not in chargemaster,35021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35021,BCBSND Base Physician Payment Schedule,2675.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35013,Not in chargemaster,35013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35013,BCBSND Base Physician Payment Schedule,2691.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35011,Not in chargemaster,35011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35011,BCBSND Base Physician Payment Schedule,2139.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35005,Not in chargemaster,35005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35005,BCBSND Base Physician Payment Schedule,2120.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35002,Not in chargemaster,35002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35002,BCBSND Base Physician Payment Schedule,2422.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 35001,Not in chargemaster,35001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,35001,BCBSND Base Physician Payment Schedule,2393.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34833,Not in chargemaster,34833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34833,BCBSND Base Physician Payment Schedule,861.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34834,Not in chargemaster,34834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34834,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34841,Not in chargemaster,34841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34841,BCBSND Base Physician Payment Schedule,3234.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34842,Not in chargemaster,34842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34842,BCBSND Base Physician Payment Schedule,3234.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34843,Not in chargemaster,34843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34843,BCBSND Base Physician Payment Schedule,3672.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34844,Not in chargemaster,34844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34844,BCBSND Base Physician Payment Schedule,3672.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34845,Not in chargemaster,34845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34845,BCBSND Base Physician Payment Schedule,3234.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34846,Not in chargemaster,34846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34846,BCBSND Base Physician Payment Schedule,3234.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34847,Not in chargemaster,34847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34847,BCBSND Base Physician Payment Schedule,3672.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34848,Not in chargemaster,34848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34848,BCBSND Base Physician Payment Schedule,3672.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34832,Not in chargemaster,34832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34832,BCBSND Base Physician Payment Schedule,4043.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34831,Not in chargemaster,34831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34831,BCBSND Base Physician Payment Schedule,4113.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34830,Not in chargemaster,34830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34830,BCBSND Base Physician Payment Schedule,3759.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34820,Not in chargemaster,34820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34820,BCBSND Base Physician Payment Schedule,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34813,Not in chargemaster,34813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34813,BCBSND Base Physician Payment Schedule,506.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34812,Not in chargemaster,34812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34812,BCBSND Base Physician Payment Schedule,441.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34808,Not in chargemaster,34808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34808,BCBSND Base Physician Payment Schedule,426.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34718,Not in chargemaster,34718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34718,BCBSND Base Physician Payment Schedule,2648.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34717,Not in chargemaster,34717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34717,BCBSND Base Physician Payment Schedule,949.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34716,Not in chargemaster,34716,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34716,BCBSND Base Physician Payment Schedule,792.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34715,Not in chargemaster,34715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34715,BCBSND Base Physician Payment Schedule,640.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34714,Not in chargemaster,34714,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34714,BCBSND Base Physician Payment Schedule,577.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34713,Not in chargemaster,34713,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34713,BCBSND Base Physician Payment Schedule,266.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34712,Not in chargemaster,34712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34712,BCBSND Base Physician Payment Schedule,1409.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34711,Not in chargemaster,34711,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34711,BCBSND Base Physician Payment Schedule,637.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34710,Not in chargemaster,34710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34710,BCBSND Base Physician Payment Schedule,1711.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34709,Not in chargemaster,34709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34709,BCBSND Base Physician Payment Schedule,691.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34708,Not in chargemaster,34708,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34708,BCBSND Base Physician Payment Schedule,3954.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34707,Not in chargemaster,34707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34707,BCBSND Base Physician Payment Schedule,2477.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34706,Not in chargemaster,34706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34706,BCBSND Base Physician Payment Schedule,4928.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34705,Not in chargemaster,34705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34705,BCBSND Base Physician Payment Schedule,3268.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34704,Not in chargemaster,34704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34704,BCBSND Base Physician Payment Schedule,4877.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34703,Not in chargemaster,34703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34703,BCBSND Base Physician Payment Schedule,2927.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34702,Not in chargemaster,34702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34702,BCBSND Base Physician Payment Schedule,3961.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34701,Not in chargemaster,34701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34701,BCBSND Base Physician Payment Schedule,2654.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34530,Not in chargemaster,34530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34530,BCBSND Base Physician Payment Schedule,2000.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34520,Not in chargemaster,34520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34520,BCBSND Base Physician Payment Schedule,2107.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34510,Not in chargemaster,34510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34510,BCBSND Base Physician Payment Schedule,2175.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34502,Not in chargemaster,34502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34502,BCBSND Base Physician Payment Schedule,3285.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34501,Not in chargemaster,34501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34501,BCBSND Base Physician Payment Schedule,1898.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34490,Not in chargemaster,34490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34490,BCBSND Base Physician Payment Schedule,1358.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34471,Not in chargemaster,34471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34471,BCBSND Base Physician Payment Schedule,2298.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34451,Not in chargemaster,34451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34451,BCBSND Base Physician Payment Schedule,3061.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34421,Not in chargemaster,34421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34421,BCBSND Base Physician Payment Schedule,1582.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34401,Not in chargemaster,34401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34401,BCBSND Base Physician Payment Schedule,3097.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34203,Not in chargemaster,34203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34203,BCBSND Base Physician Payment Schedule,2027.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34201,Not in chargemaster,34201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34201,BCBSND Base Physician Payment Schedule,2189.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34151,Not in chargemaster,34151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34151,BCBSND Base Physician Payment Schedule,2967.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34111,Not in chargemaster,34111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34111,BCBSND Base Physician Payment Schedule,1282.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34101,Not in chargemaster,34101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34101,BCBSND Base Physician Payment Schedule,1275.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34051,Not in chargemaster,34051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34051,BCBSND Base Physician Payment Schedule,2103.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 34001,Not in chargemaster,34001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,34001,BCBSND Base Physician Payment Schedule,1949.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33993,Not in chargemaster,33993,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33993,BCBSND Base Physician Payment Schedule,369.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33992,Not in chargemaster,33992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33992,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33991,Not in chargemaster,33991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33991,BCBSND Base Physician Payment Schedule,1327.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33990,Not in chargemaster,33990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33990,BCBSND Base Physician Payment Schedule,904.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33989,Not in chargemaster,33989,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33989,BCBSND Base Physician Payment Schedule,1051.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33988,Not in chargemaster,33988,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33988,BCBSND Base Physician Payment Schedule,1656.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33987,Not in chargemaster,33987,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33987,BCBSND Base Physician Payment Schedule,443.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33986,Not in chargemaster,33986,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33986,BCBSND Base Physician Payment Schedule,1115.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33985,Not in chargemaster,33985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33985,BCBSND Base Physician Payment Schedule,1093.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33984,Not in chargemaster,33984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33984,BCBSND Base Physician Payment Schedule,605.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33983,Not in chargemaster,33983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33983,BCBSND Base Physician Payment Schedule,4922.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33982,Not in chargemaster,33982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33982,BCBSND Base Physician Payment Schedule,4163.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33981,Not in chargemaster,33981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33981,BCBSND Base Physician Payment Schedule,1772.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33980,Not in chargemaster,33980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33980,BCBSND Base Physician Payment Schedule,3785.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33979,Not in chargemaster,33979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33979,BCBSND Base Physician Payment Schedule,4147.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33978,Not in chargemaster,33978,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33978,BCBSND Base Physician Payment Schedule,2830.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33977,Not in chargemaster,33977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33977,BCBSND Base Physician Payment Schedule,2394.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33976,Not in chargemaster,33976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33976,BCBSND Base Physician Payment Schedule,3381.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33975,Not in chargemaster,33975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33975,BCBSND Base Physician Payment Schedule,2780.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33974,Not in chargemaster,33974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33974,BCBSND Base Physician Payment Schedule,1886.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33973,Not in chargemaster,33973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33973,BCBSND Base Physician Payment Schedule,1091.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33971,Not in chargemaster,33971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33971,BCBSND Base Physician Payment Schedule,1495.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33970,Not in chargemaster,33970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33970,BCBSND Base Physician Payment Schedule,753.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33969,Not in chargemaster,33969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33969,BCBSND Base Physician Payment Schedule,580.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33968,Not in chargemaster,33968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33968,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33967,Not in chargemaster,33967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33967,BCBSND Base Physician Payment Schedule,551.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33966,Not in chargemaster,33966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33966,BCBSND Base Physician Payment Schedule,504.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33965,Not in chargemaster,33965,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33965,BCBSND Base Physician Payment Schedule,393.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33964,Not in chargemaster,33964,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33964,BCBSND Base Physician Payment Schedule,1051.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33963,Not in chargemaster,33963,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33963,BCBSND Base Physician Payment Schedule,996.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33962,Not in chargemaster,33962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33962,BCBSND Base Physician Payment Schedule,498.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33959,Not in chargemaster,33959,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33959,BCBSND Base Physician Payment Schedule,498.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33958,Not in chargemaster,33958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33958,BCBSND Base Physician Payment Schedule,393.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33957,Not in chargemaster,33957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33957,BCBSND Base Physician Payment Schedule,393.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33956,Not in chargemaster,33956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33956,BCBSND Base Physician Payment Schedule,1778.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33955,Not in chargemaster,33955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33955,BCBSND Base Physician Payment Schedule,1766.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33954,Not in chargemaster,33954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33954,BCBSND Base Physician Payment Schedule,1014.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33953,Not in chargemaster,33953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33953,BCBSND Base Physician Payment Schedule,1007.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33952,Not in chargemaster,33952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33952,BCBSND Base Physician Payment Schedule,911.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33951,Not in chargemaster,33951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33951,BCBSND Base Physician Payment Schedule,903.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33949,Not in chargemaster,33949,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33949,BCBSND Base Physician Payment Schedule,494.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33948,Not in chargemaster,33948,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33948,BCBSND Base Physician Payment Schedule,508.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33947,Not in chargemaster,33947,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33947,BCBSND Base Physician Payment Schedule,730.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33946,Not in chargemaster,33946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33946,BCBSND Base Physician Payment Schedule,657.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33945,Not in chargemaster,33945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33945,BCBSND Base Physician Payment Schedule,10359.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33935,Not in chargemaster,33935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33935,BCBSND Base Physician Payment Schedule,10546.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33927,Not in chargemaster,33927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33927,BCBSND Base Physician Payment Schedule,5436.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33926,Not in chargemaster,33926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33926,BCBSND Base Physician Payment Schedule,5141.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33925,Not in chargemaster,33925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33925,BCBSND Base Physician Payment Schedule,3651.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33924,Not in chargemaster,33924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33924,BCBSND Base Physician Payment Schedule,608.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33922,Not in chargemaster,33922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33922,BCBSND Base Physician Payment Schedule,2950.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33920,Not in chargemaster,33920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33920,BCBSND Base Physician Payment Schedule,3850.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33917,Not in chargemaster,33917,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33917,BCBSND Base Physician Payment Schedule,3092.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33916,Not in chargemaster,33916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33916,BCBSND Base Physician Payment Schedule,8988.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33915,Not in chargemaster,33915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33915,BCBSND Base Physician Payment Schedule,2927.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33910,Not in chargemaster,33910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33910,BCBSND Base Physician Payment Schedule,5665.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33891,Not in chargemaster,33891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33891,BCBSND Base Physician Payment Schedule,2060.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33889,Not in chargemaster,33889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33889,BCBSND Base Physician Payment Schedule,1684.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33886,Not in chargemaster,33886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33886,BCBSND Base Physician Payment Schedule,2037.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33884,Not in chargemaster,33884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33884,BCBSND Base Physician Payment Schedule,844.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33883,Not in chargemaster,33883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33883,BCBSND Base Physician Payment Schedule,2374.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33881,Not in chargemaster,33881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33881,BCBSND Base Physician Payment Schedule,3280.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33880,Not in chargemaster,33880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33880,BCBSND Base Physician Payment Schedule,3821.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33877,Not in chargemaster,33877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33877,BCBSND Base Physician Payment Schedule,7719.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33875,Not in chargemaster,33875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33875,BCBSND Base Physician Payment Schedule,5836.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33871,Not in chargemaster,33871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33871,BCBSND Base Physician Payment Schedule,6954.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33866,Not in chargemaster,33866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33866,BCBSND Base Physician Payment Schedule,1966.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33864,Not in chargemaster,33864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33864,BCBSND Base Physician Payment Schedule,6855.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33863,Not in chargemaster,33863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33863,BCBSND Base Physician Payment Schedule,6710.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33859,Not in chargemaster,33859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33859,BCBSND Base Physician Payment Schedule,5193.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33858,Not in chargemaster,33858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33858,BCBSND Base Physician Payment Schedule,7233.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33853,Not in chargemaster,33853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33853,BCBSND Base Physician Payment Schedule,3893.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33852,Not in chargemaster,33852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33852,BCBSND Base Physician Payment Schedule,2970.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33851,Not in chargemaster,33851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33851,BCBSND Base Physician Payment Schedule,2701.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33845,Not in chargemaster,33845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33845,BCBSND Base Physician Payment Schedule,2830.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33840,Not in chargemaster,33840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33840,BCBSND Base Physician Payment Schedule,2629.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33824,Not in chargemaster,33824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33824,BCBSND Base Physician Payment Schedule,2506.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33822,Not in chargemaster,33822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33822,BCBSND Base Physician Payment Schedule,2166.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33820,Not in chargemaster,33820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33820,BCBSND Base Physician Payment Schedule,2054.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33814,Not in chargemaster,33814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33814,BCBSND Base Physician Payment Schedule,3234.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33813,Not in chargemaster,33813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33813,BCBSND Base Physician Payment Schedule,2632.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33803,Not in chargemaster,33803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33803,BCBSND Base Physician Payment Schedule,2446.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33802,Not in chargemaster,33802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33802,BCBSND Base Physician Payment Schedule,2300.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33800,Not in chargemaster,33800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33800,BCBSND Base Physician Payment Schedule,2095.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33788,Not in chargemaster,33788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33788,BCBSND Base Physician Payment Schedule,3258.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33786,Not in chargemaster,33786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33786,BCBSND Base Physician Payment Schedule,4845.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33783,Not in chargemaster,33783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33783,BCBSND Base Physician Payment Schedule,7434.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33782,Not in chargemaster,33782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33782,BCBSND Base Physician Payment Schedule,6875.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33781,Not in chargemaster,33781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33781,BCBSND Base Physician Payment Schedule,4922.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33780,Not in chargemaster,33780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33780,BCBSND Base Physician Payment Schedule,5038.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33779,Not in chargemaster,33779,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33779,BCBSND Base Physician Payment Schedule,4948.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33778,Not in chargemaster,33778,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33778,BCBSND Base Physician Payment Schedule,4996.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33777,Not in chargemaster,33777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33777,BCBSND Base Physician Payment Schedule,4022.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33776,Not in chargemaster,33776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33776,BCBSND Base Physician Payment Schedule,4163.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33775,Not in chargemaster,33775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33775,BCBSND Base Physician Payment Schedule,3937.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33774,Not in chargemaster,33774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33774,BCBSND Base Physician Payment Schedule,3821.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33771,Not in chargemaster,33771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33771,BCBSND Base Physician Payment Schedule,4636.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33770,Not in chargemaster,33770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33770,BCBSND Base Physician Payment Schedule,4504.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33768,Not in chargemaster,33768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33768,BCBSND Base Physician Payment Schedule,886.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33767,Not in chargemaster,33767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33767,BCBSND Base Physician Payment Schedule,3022.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33766,Not in chargemaster,33766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33766,BCBSND Base Physician Payment Schedule,2834.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33764,Not in chargemaster,33764,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33764,BCBSND Base Physician Payment Schedule,2794.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33762,Not in chargemaster,33762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33762,BCBSND Base Physician Payment Schedule,2724.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33755,Not in chargemaster,33755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33755,BCBSND Base Physician Payment Schedule,2794.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33750,Not in chargemaster,33750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33750,BCBSND Base Physician Payment Schedule,2683.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33737,Not in chargemaster,33737,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33737,BCBSND Base Physician Payment Schedule,2755.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33736,Not in chargemaster,33736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33736,BCBSND Base Physician Payment Schedule,2985.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33735,Not in chargemaster,33735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33735,BCBSND Base Physician Payment Schedule,2749.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33732,Not in chargemaster,33732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33732,BCBSND Base Physician Payment Schedule,3500.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33730,Not in chargemaster,33730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33730,BCBSND Base Physician Payment Schedule,4262.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33726,Not in chargemaster,33726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33726,BCBSND Base Physician Payment Schedule,4320.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33724,Not in chargemaster,33724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33724,BCBSND Base Physician Payment Schedule,3269.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33722,Not in chargemaster,33722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33722,BCBSND Base Physician Payment Schedule,3458.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33720,Not in chargemaster,33720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33720,BCBSND Base Physician Payment Schedule,3286.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33710,Not in chargemaster,33710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33710,BCBSND Base Physician Payment Schedule,4360.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33702,Not in chargemaster,33702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33702,BCBSND Base Physician Payment Schedule,3284.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33697,Not in chargemaster,33697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33697,BCBSND Base Physician Payment Schedule,4370.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33694,Not in chargemaster,33694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33694,BCBSND Base Physician Payment Schedule,4148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33692,Not in chargemaster,33692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33692,BCBSND Base Physician Payment Schedule,4161.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33690,Not in chargemaster,33690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33690,BCBSND Base Physician Payment Schedule,2546.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33688,Not in chargemaster,33688,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33688,BCBSND Base Physician Payment Schedule,4008.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33684,Not in chargemaster,33684,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33684,BCBSND Base Physician Payment Schedule,4015.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33681,Not in chargemaster,33681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33681,BCBSND Base Physician Payment Schedule,3910.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33677,Not in chargemaster,33677,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33677,BCBSND Base Physician Payment Schedule,4470.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33676,Not in chargemaster,33676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33676,BCBSND Base Physician Payment Schedule,4301.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33675,Not in chargemaster,33675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33675,BCBSND Base Physician Payment Schedule,4191.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33670,Not in chargemaster,33670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33670,BCBSND Base Physician Payment Schedule,4197.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33665,Not in chargemaster,33665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33665,BCBSND Base Physician Payment Schedule,4068.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33660,Not in chargemaster,33660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33660,BCBSND Base Physician Payment Schedule,3734.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33647,Not in chargemaster,33647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33647,BCBSND Base Physician Payment Schedule,3862.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33645,Not in chargemaster,33645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33645,BCBSND Base Physician Payment Schedule,3680.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33641,Not in chargemaster,33641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33641,BCBSND Base Physician Payment Schedule,3484.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33622,Not in chargemaster,33622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33622,BCBSND Base Physician Payment Schedule,7313.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33621,Not in chargemaster,33621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33621,BCBSND Base Physician Payment Schedule,1975.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33620,Not in chargemaster,33620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33620,BCBSND Base Physician Payment Schedule,3506.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33619,Not in chargemaster,33619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33619,BCBSND Base Physician Payment Schedule,5819.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33617,Not in chargemaster,33617,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33617,BCBSND Base Physician Payment Schedule,4599.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33615,Not in chargemaster,33615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33615,BCBSND Base Physician Payment Schedule,4243.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33612,Not in chargemaster,33612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33612,BCBSND Base Physician Payment Schedule,4258.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33611,Not in chargemaster,33611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33611,BCBSND Base Physician Payment Schedule,4148.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33610,Not in chargemaster,33610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33610,BCBSND Base Physician Payment Schedule,3770.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33608,Not in chargemaster,33608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33608,BCBSND Base Physician Payment Schedule,3824.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33606,Not in chargemaster,33606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33606,BCBSND Base Physician Payment Schedule,3776.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33602,Not in chargemaster,33602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33602,BCBSND Base Physician Payment Schedule,3542.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33600,Not in chargemaster,33600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33600,BCBSND Base Physician Payment Schedule,3648.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33572,Not in chargemaster,33572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33572,BCBSND Base Physician Payment Schedule,490.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33548,Not in chargemaster,33548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33548,BCBSND Base Physician Payment Schedule,6298.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33545,Not in chargemaster,33545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33545,BCBSND Base Physician Payment Schedule,6540.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33542,Not in chargemaster,33542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33542,BCBSND Base Physician Payment Schedule,5590.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33536,Not in chargemaster,33536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33536,BCBSND Base Physician Payment Schedule,5618.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33535,Not in chargemaster,33535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33535,BCBSND Base Physician Payment Schedule,5213.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33534,Not in chargemaster,33534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33534,BCBSND Base Physician Payment Schedule,4674.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33533,Not in chargemaster,33533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33533,BCBSND Base Physician Payment Schedule,3978.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33530,Not in chargemaster,33530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33530,BCBSND Base Physician Payment Schedule,1120.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33523,Not in chargemaster,33523,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33523,BCBSND Base Physician Payment Schedule,1773.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33522,Not in chargemaster,33522,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33522,BCBSND Base Physician Payment Schedule,1560.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33521,Not in chargemaster,33521,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33521,BCBSND Base Physician Payment Schedule,1392.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33519,Not in chargemaster,33519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33519,BCBSND Base Physician Payment Schedule,1159.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33518,Not in chargemaster,33518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33518,BCBSND Base Physician Payment Schedule,877.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33517,Not in chargemaster,33517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33517,BCBSND Base Physician Payment Schedule,399.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33516,Not in chargemaster,33516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33516,BCBSND Base Physician Payment Schedule,5756.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33514,Not in chargemaster,33514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33514,BCBSND Base Physician Payment Schedule,5554.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33513,Not in chargemaster,33513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33513,BCBSND Base Physician Payment Schedule,5278.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33512,Not in chargemaster,33512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33512,BCBSND Base Physician Payment Schedule,5143.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33511,Not in chargemaster,33511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33511,BCBSND Base Physician Payment Schedule,4515.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33510,Not in chargemaster,33510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33510,BCBSND Base Physician Payment Schedule,4113.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33508,Not in chargemaster,33508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33508,BCBSND Base Physician Payment Schedule,35.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33507,Not in chargemaster,33507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33507,BCBSND Base Physician Payment Schedule,3662.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33506,Not in chargemaster,33506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33506,BCBSND Base Physician Payment Schedule,4368.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33505,Not in chargemaster,33505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33505,BCBSND Base Physician Payment Schedule,4389.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33504,Not in chargemaster,33504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33504,BCBSND Base Physician Payment Schedule,3111.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33503,Not in chargemaster,33503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33503,BCBSND Base Physician Payment Schedule,2813.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33502,Not in chargemaster,33502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33502,BCBSND Base Physician Payment Schedule,2708.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33501,Not in chargemaster,33501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33501,BCBSND Base Physician Payment Schedule,2369.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33500,Not in chargemaster,33500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33500,BCBSND Base Physician Payment Schedule,3318.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33496,Not in chargemaster,33496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33496,BCBSND Base Physician Payment Schedule,3537.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33478,Not in chargemaster,33478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33478,BCBSND Base Physician Payment Schedule,3339.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33477,Not in chargemaster,33477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33477,BCBSND Base Physician Payment Schedule,2893.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33476,Not in chargemaster,33476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33476,BCBSND Base Physician Payment Schedule,3231.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33475,Not in chargemaster,33475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33475,BCBSND Base Physician Payment Schedule,4959.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33474,Not in chargemaster,33474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33474,BCBSND Base Physician Payment Schedule,4629.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33471,Not in chargemaster,33471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33471,BCBSND Base Physician Payment Schedule,2810.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33470,Not in chargemaster,33470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33470,BCBSND Base Physician Payment Schedule,2628.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33468,Not in chargemaster,33468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33468,BCBSND Base Physician Payment Schedule,5215.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33465,Not in chargemaster,33465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33465,BCBSND Base Physician Payment Schedule,5864.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33464,Not in chargemaster,33464,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33464,BCBSND Base Physician Payment Schedule,5191.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33463,Not in chargemaster,33463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33463,BCBSND Base Physician Payment Schedule,6567.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33460,Not in chargemaster,33460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33460,BCBSND Base Physician Payment Schedule,5115.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33440,Not in chargemaster,33440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33440,BCBSND Base Physician Payment Schedule,7299.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33430,Not in chargemaster,33430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33430,BCBSND Base Physician Payment Schedule,5957.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33427,Not in chargemaster,33427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33427,BCBSND Base Physician Payment Schedule,5195.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33426,Not in chargemaster,33426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33426,BCBSND Base Physician Payment Schedule,5065.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33425,Not in chargemaster,33425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33425,BCBSND Base Physician Payment Schedule,5811.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33422,Not in chargemaster,33422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33422,BCBSND Base Physician Payment Schedule,3536.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33420,Not in chargemaster,33420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33420,BCBSND Base Physician Payment Schedule,3081.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33419,Not in chargemaster,33419,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33419,BCBSND Base Physician Payment Schedule,904.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33418,Not in chargemaster,33418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33418,BCBSND Base Physician Payment Schedule,3829.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33417,Not in chargemaster,33417,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33417,BCBSND Base Physician Payment Schedule,3540.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33416,Not in chargemaster,33416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33416,BCBSND Base Physician Payment Schedule,4297.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33415,Not in chargemaster,33415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33415,BCBSND Base Physician Payment Schedule,4318.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33414,Not in chargemaster,33414,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33414,BCBSND Base Physician Payment Schedule,4569.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33413,Not in chargemaster,33413,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33413,BCBSND Base Physician Payment Schedule,6872.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33412,Not in chargemaster,33412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33412,BCBSND Base Physician Payment Schedule,6714.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33411,Not in chargemaster,33411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33411,BCBSND Base Physician Payment Schedule,7150.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33410,Not in chargemaster,33410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33410,BCBSND Base Physician Payment Schedule,5409.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33406,Not in chargemaster,33406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33406,BCBSND Base Physician Payment Schedule,6126.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33405,Not in chargemaster,33405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33405,BCBSND Base Physician Payment Schedule,4827.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33404,Not in chargemaster,33404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33404,BCBSND Base Physician Payment Schedule,3716.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33391,Not in chargemaster,33391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33391,BCBSND Base Physician Payment Schedule,4877.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33390,Not in chargemaster,33390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33390,BCBSND Base Physician Payment Schedule,4104.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33369,Not in chargemaster,33369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33369,BCBSND Base Physician Payment Schedule,2089.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33368,Not in chargemaster,33368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33368,BCBSND Base Physician Payment Schedule,1583.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33367,Not in chargemaster,33367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33367,BCBSND Base Physician Payment Schedule,1342.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33366,Not in chargemaster,33366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33366,BCBSND Base Physician Payment Schedule,3356.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33365,Not in chargemaster,33365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33365,BCBSND Base Physician Payment Schedule,3081.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33364,Not in chargemaster,33364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33364,BCBSND Base Physician Payment Schedule,2916.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33363,Not in chargemaster,33363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33363,BCBSND Base Physician Payment Schedule,2915.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33362,Not in chargemaster,33362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33362,BCBSND Base Physician Payment Schedule,2812.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33361,Not in chargemaster,33361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33361,BCBSND Base Physician Payment Schedule,2581.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33340,Not in chargemaster,33340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33340,BCBSND Base Physician Payment Schedule,1683.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33335,Not in chargemaster,33335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33335,BCBSND Base Physician Payment Schedule,3974.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33330,Not in chargemaster,33330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33330,BCBSND Base Physician Payment Schedule,3025.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33322,Not in chargemaster,33322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33322,BCBSND Base Physician Payment Schedule,2951.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33321,Not in chargemaster,33321,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33321,BCBSND Base Physician Payment Schedule,2520.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33320,Not in chargemaster,33320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33320,BCBSND Base Physician Payment Schedule,2235.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33315,Not in chargemaster,33315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33315,BCBSND Base Physician Payment Schedule,4067.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33310,Not in chargemaster,33310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33310,BCBSND Base Physician Payment Schedule,2480.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33305,Not in chargemaster,33305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33305,BCBSND Base Physician Payment Schedule,8732.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33300,Not in chargemaster,33300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33300,BCBSND Base Physician Payment Schedule,5216.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33289,Not in chargemaster,33289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33289,BCBSND Base Physician Payment Schedule,701.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33286,Not in chargemaster,33286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33286,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33285,Not in chargemaster,33285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33285,BCBSND Base Physician Payment Schedule,10494.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33275,Not in chargemaster,33275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33275,BCBSND Base Physician Payment Schedule,1134.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33274,Not in chargemaster,33274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33274,BCBSND Base Physician Payment Schedule,1036.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33273,Not in chargemaster,33273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33273,BCBSND Base Physician Payment Schedule,850.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33272,Not in chargemaster,33272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33272,BCBSND Base Physician Payment Schedule,739.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33271,Not in chargemaster,33271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33271,BCBSND Base Physician Payment Schedule,966.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33270,Not in chargemaster,33270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33270,BCBSND Base Physician Payment Schedule,1206.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33266,Not in chargemaster,33266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33266,BCBSND Base Physician Payment Schedule,3922.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33265,Not in chargemaster,33265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33265,BCBSND Base Physician Payment Schedule,2885.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33264,Not in chargemaster,33264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33264,BCBSND Base Physician Payment Schedule,864.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33263,Not in chargemaster,33263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33263,BCBSND Base Physician Payment Schedule,826.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33262,Not in chargemaster,33262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33262,BCBSND Base Physician Payment Schedule,795.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33261,Not in chargemaster,33261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33261,BCBSND Base Physician Payment Schedule,3424.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33259,Not in chargemaster,33259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33259,BCBSND Base Physician Payment Schedule,1789.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33258,Not in chargemaster,33258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33258,BCBSND Base Physician Payment Schedule,1378.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33257,Not in chargemaster,33257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33257,BCBSND Base Physician Payment Schedule,1233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33256,Not in chargemaster,33256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33256,BCBSND Base Physician Payment Schedule,4116.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33255,Not in chargemaster,33255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33255,BCBSND Base Physician Payment Schedule,3456.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33254,Not in chargemaster,33254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33254,BCBSND Base Physician Payment Schedule,2869.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33251,Not in chargemaster,33251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33251,BCBSND Base Physician Payment Schedule,3455.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33250,Not in chargemaster,33250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33250,BCBSND Base Physician Payment Schedule,3092.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33249,Not in chargemaster,33249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33249,BCBSND Base Physician Payment Schedule,1954.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33244,Not in chargemaster,33244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33244,BCBSND Base Physician Payment Schedule,1843.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33243,Not in chargemaster,33243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33243,BCBSND Base Physician Payment Schedule,2909.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33241,Not in chargemaster,33241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33241,BCBSND Base Physician Payment Schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33240,Not in chargemaster,33240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33240,BCBSND Base Physician Payment Schedule,777.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33238,Not in chargemaster,33238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33238,BCBSND Base Physician Payment Schedule,1993.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33237,Not in chargemaster,33237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33237,BCBSND Base Physician Payment Schedule,1775.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33236,Not in chargemaster,33236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33236,BCBSND Base Physician Payment Schedule,1655.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33235,Not in chargemaster,33235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33235,BCBSND Base Physician Payment Schedule,1358.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33234,Not in chargemaster,33234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33234,BCBSND Base Physician Payment Schedule,1034.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33233,Not in chargemaster,33233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33233,BCBSND Base Physician Payment Schedule,490.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33231,Not in chargemaster,33231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33231,BCBSND Base Physician Payment Schedule,855.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33230,Not in chargemaster,33230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33230,BCBSND Base Physician Payment Schedule,814.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33229,Not in chargemaster,33229,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33229,BCBSND Base Physician Payment Schedule,797.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33228,Not in chargemaster,33228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33228,BCBSND Base Physician Payment Schedule,754.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33227,Not in chargemaster,33227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33227,BCBSND Base Physician Payment Schedule,720.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33226,Not in chargemaster,33226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33226,BCBSND Base Physician Payment Schedule,1057.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33225,Not in chargemaster,33225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33225,BCBSND Base Physician Payment Schedule,1002.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33224,Not in chargemaster,33224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33224,BCBSND Base Physician Payment Schedule,1099.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33223,Not in chargemaster,33223,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33223,BCBSND Base Physician Payment Schedule,872.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33222,Not in chargemaster,33222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33222,BCBSND Base Physician Payment Schedule,722.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33221,Not in chargemaster,33221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33221,BCBSND Base Physician Payment Schedule,770.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33220,Not in chargemaster,33220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33220,BCBSND Base Physician Payment Schedule,800.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33218,Not in chargemaster,33218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33218,BCBSND Base Physician Payment Schedule,822.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33217,Not in chargemaster,33217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33217,BCBSND Base Physician Payment Schedule,780.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33216,Not in chargemaster,33216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33216,BCBSND Base Physician Payment Schedule,792.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33215,Not in chargemaster,33215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33215,BCBSND Base Physician Payment Schedule,661.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33214,Not in chargemaster,33214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33214,BCBSND Base Physician Payment Schedule,1019.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33213,Not in chargemaster,33213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33213,BCBSND Base Physician Payment Schedule,714.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33212,Not in chargemaster,33212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33212,BCBSND Base Physician Payment Schedule,684.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33211,Not in chargemaster,33211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33211,BCBSND Base Physician Payment Schedule,359.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33210,Not in chargemaster,33210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33210,BCBSND Base Physician Payment Schedule,347.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33208,Not in chargemaster,33208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33208,BCBSND Base Physician Payment Schedule,1110.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33207,Not in chargemaster,33207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33207,BCBSND Base Physician Payment Schedule,1021.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33206,Not in chargemaster,33206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33206,BCBSND Base Physician Payment Schedule,967.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33203,Not in chargemaster,33203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33203,BCBSND Base Physician Payment Schedule,1711.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33202,Not in chargemaster,33202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33202,BCBSND Base Physician Payment Schedule,1635.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33141,Not in chargemaster,33141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33141,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33140,Not in chargemaster,33140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33140,BCBSND Base Physician Payment Schedule,3313.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33130,Not in chargemaster,33130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33130,BCBSND Base Physician Payment Schedule,2902.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33120,Not in chargemaster,33120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33120,BCBSND Base Physician Payment Schedule,4454.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33050,Not in chargemaster,33050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33050,BCBSND Base Physician Payment Schedule,2129.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33031,Not in chargemaster,33031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33031,BCBSND Base Physician Payment Schedule,5263.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33030,Not in chargemaster,33030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33030,BCBSND Base Physician Payment Schedule,4248.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33025,Not in chargemaster,33025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33025,BCBSND Base Physician Payment Schedule,1634.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33020,Not in chargemaster,33020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33020,BCBSND Base Physician Payment Schedule,1753.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33019,Not in chargemaster,33019,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33019,BCBSND Base Physician Payment Schedule,482.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33018,Not in chargemaster,33018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33018,BCBSND Base Physician Payment Schedule,593.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33017,Not in chargemaster,33017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33017,BCBSND Base Physician Payment Schedule,521.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 33016,Not in chargemaster,33016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33016,BCBSND Base Physician Payment Schedule,502.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32998,Not in chargemaster,32998,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32998,BCBSND Base Physician Payment Schedule,7309.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32997,Not in chargemaster,32997,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32997,BCBSND Base Physician Payment Schedule,722.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32994,Not in chargemaster,32994,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32994,BCBSND Base Physician Payment Schedule,11435.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32960,Not in chargemaster,32960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32960,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32940,Not in chargemaster,32940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32940,BCBSND Base Physician Payment Schedule,2614.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32906,Not in chargemaster,32906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32906,BCBSND Base Physician Payment Schedule,3498.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32905,Not in chargemaster,32905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32905,BCBSND Base Physician Payment Schedule,2830.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32900,Not in chargemaster,32900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32900,BCBSND Base Physician Payment Schedule,3012.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32854,Not in chargemaster,32854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32854,BCBSND Base Physician Payment Schedule,10365.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32853,Not in chargemaster,32853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32853,BCBSND Base Physician Payment Schedule,9759.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32852,Not in chargemaster,32852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32852,BCBSND Base Physician Payment Schedule,7564.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32851,Not in chargemaster,32851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32851,BCBSND Base Physician Payment Schedule,6962.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32820,Not in chargemaster,32820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32820,BCBSND Base Physician Payment Schedule,2818.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32815,Not in chargemaster,32815,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32815,BCBSND Base Physician Payment Schedule,5939.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32810,Not in chargemaster,32810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32810,BCBSND Base Physician Payment Schedule,1907.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32800,Not in chargemaster,32800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32800,BCBSND Base Physician Payment Schedule,2002.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32701,Not in chargemaster,32701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32701,BCBSND Base Physician Payment Schedule,454.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32674,Not in chargemaster,32674,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32674,BCBSND Base Physician Payment Schedule,457.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32673,Not in chargemaster,32673,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32673,BCBSND Base Physician Payment Schedule,2581.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32672,Not in chargemaster,32672,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32672,BCBSND Base Physician Payment Schedule,3231.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32671,Not in chargemaster,32671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32671,BCBSND Base Physician Payment Schedule,3768.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32670,Not in chargemaster,32670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32670,BCBSND Base Physician Payment Schedule,3404.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32669,Not in chargemaster,32669,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32669,BCBSND Base Physician Payment Schedule,2850.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32668,Not in chargemaster,32668,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32668,BCBSND Base Physician Payment Schedule,332.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32667,Not in chargemaster,32667,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32667,BCBSND Base Physician Payment Schedule,332.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32666,Not in chargemaster,32666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32666,BCBSND Base Physician Payment Schedule,1841.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32665,Not in chargemaster,32665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32665,BCBSND Base Physician Payment Schedule,2612.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32664,Not in chargemaster,32664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32664,BCBSND Base Physician Payment Schedule,1795.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32663,Not in chargemaster,32663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32663,BCBSND Base Physician Payment Schedule,2967.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32662,Not in chargemaster,32662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32662,BCBSND Base Physician Payment Schedule,1890.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32661,Not in chargemaster,32661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32661,BCBSND Base Physician Payment Schedule,1690.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32659,Not in chargemaster,32659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32659,BCBSND Base Physician Payment Schedule,1549.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32658,Not in chargemaster,32658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32658,BCBSND Base Physician Payment Schedule,1512.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32656,Not in chargemaster,32656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32656,BCBSND Base Physician Payment Schedule,1699.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32655,Not in chargemaster,32655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32655,BCBSND Base Physician Payment Schedule,2025.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32654,Not in chargemaster,32654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32654,BCBSND Base Physician Payment Schedule,2463.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32653,Not in chargemaster,32653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32653,BCBSND Base Physician Payment Schedule,2251.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32652,Not in chargemaster,32652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32652,BCBSND Base Physician Payment Schedule,3523.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32651,Not in chargemaster,32651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32651,BCBSND Base Physician Payment Schedule,2321.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32650,Not in chargemaster,32650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32650,BCBSND Base Physician Payment Schedule,1410.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32609,Not in chargemaster,32609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32609,BCBSND Base Physician Payment Schedule,545.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32608,Not in chargemaster,32608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32608,BCBSND Base Physician Payment Schedule,804.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32607,Not in chargemaster,32607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32607,BCBSND Base Physician Payment Schedule,654.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32606,Not in chargemaster,32606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32606,BCBSND Base Physician Payment Schedule,982.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32604,Not in chargemaster,32604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32604,BCBSND Base Physician Payment Schedule,1018.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32601,Not in chargemaster,32601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32601,BCBSND Base Physician Payment Schedule,655.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32562,Not in chargemaster,32562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32562,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32561,Not in chargemaster,32561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32561,BCBSND Base Physician Payment Schedule,195.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32560,Not in chargemaster,32560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32560,BCBSND Base Physician Payment Schedule,541.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32557,Not in chargemaster,32557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32557,BCBSND Base Physician Payment Schedule,1288.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32556,Not in chargemaster,32556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32556,BCBSND Base Physician Payment Schedule,1398.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32555,Not in chargemaster,32555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32555,BCBSND Base Physician Payment Schedule,649.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32554,32554,32554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32554,BCBSND Base Physician Payment Schedule,464.69,220,Fee schedule,,220,220,220,220,,,0
unity,Fee schedule,Non-facility 32553,Not in chargemaster,32553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32553,BCBSND Base Physician Payment Schedule,1108.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32552,Not in chargemaster,32552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32552,BCBSND Base Physician Payment Schedule,387.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32551,32551,32551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32551,BCBSND Base Physician Payment Schedule,334.75,407,Fee schedule,,334.75,334.75,334.75,334.75,,,0
unity,Fee schedule,Non-facility 32550,Not in chargemaster,32550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32550,BCBSND Base Physician Payment Schedule,1648.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32540,Not in chargemaster,32540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32540,BCBSND Base Physician Payment Schedule,3677.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32507,Not in chargemaster,32507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32507,BCBSND Base Physician Payment Schedule,331.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32506,Not in chargemaster,32506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32506,BCBSND Base Physician Payment Schedule,331.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32505,Not in chargemaster,32505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32505,BCBSND Base Physician Payment Schedule,1974.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32504,Not in chargemaster,32504,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32504,BCBSND Base Physician Payment Schedule,4342.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32503,Not in chargemaster,32503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32503,BCBSND Base Physician Payment Schedule,3810.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32501,Not in chargemaster,32501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32501,BCBSND Base Physician Payment Schedule,516.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32491,Not in chargemaster,32491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32491,BCBSND Base Physician Payment Schedule,3118.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32488,Not in chargemaster,32488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32488,BCBSND Base Physician Payment Schedule,5079.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32486,Not in chargemaster,32486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32486,BCBSND Base Physician Payment Schedule,4998.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32484,Not in chargemaster,32484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32484,BCBSND Base Physician Payment Schedule,3041.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32482,Not in chargemaster,32482,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32482,BCBSND Base Physician Payment Schedule,3362.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32480,Not in chargemaster,32480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32480,BCBSND Base Physician Payment Schedule,3137.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32445,Not in chargemaster,32445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32445,BCBSND Base Physician Payment Schedule,7508.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32442,Not in chargemaster,32442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32442,BCBSND Base Physician Payment Schedule,6505.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32440,Not in chargemaster,32440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32440,BCBSND Base Physician Payment Schedule,3321.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32405,Not in chargemaster,32405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32405,BCBSND Base Physician Payment Schedule,831,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32400,Not in chargemaster,32400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32400,BCBSND Base Physician Payment Schedule,334.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32320,Not in chargemaster,32320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32320,BCBSND Base Physician Payment Schedule,3387.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32310,Not in chargemaster,32310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32310,BCBSND Base Physician Payment Schedule,1933.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32225,Not in chargemaster,32225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32225,BCBSND Base Physician Payment Schedule,2108.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32220,Not in chargemaster,32220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32220,BCBSND Base Physician Payment Schedule,3369.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32215,Not in chargemaster,32215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32215,BCBSND Base Physician Payment Schedule,1689.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32200,Not in chargemaster,32200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32200,BCBSND Base Physician Payment Schedule,2407.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32160,Not in chargemaster,32160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32160,BCBSND Base Physician Payment Schedule,1686.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32151,Not in chargemaster,32151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32151,BCBSND Base Physician Payment Schedule,2129.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32150,Not in chargemaster,32150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32150,BCBSND Base Physician Payment Schedule,2127.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32141,Not in chargemaster,32141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32141,BCBSND Base Physician Payment Schedule,3232.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32140,Not in chargemaster,32140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32140,BCBSND Base Physician Payment Schedule,2098.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32124,Not in chargemaster,32124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32124,BCBSND Base Physician Payment Schedule,1963.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32120,Not in chargemaster,32120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32120,BCBSND Base Physician Payment Schedule,1849.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32110,Not in chargemaster,32110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32110,BCBSND Base Physician Payment Schedule,3112.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32100,Not in chargemaster,32100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32100,BCBSND Base Physician Payment Schedule,1717.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32098,Not in chargemaster,32098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32098,BCBSND Base Physician Payment Schedule,1612.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32097,Not in chargemaster,32097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32097,BCBSND Base Physician Payment Schedule,1700.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32096,Not in chargemaster,32096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32096,BCBSND Base Physician Payment Schedule,1699.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32036,Not in chargemaster,32036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32036,BCBSND Base Physician Payment Schedule,1651.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 32035,Not in chargemaster,32035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32035,BCBSND Base Physician Payment Schedule,1541.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31830,Not in chargemaster,31830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31830,BCBSND Base Physician Payment Schedule,973.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31825,Not in chargemaster,31825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31825,BCBSND Base Physician Payment Schedule,1258.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31820,Not in chargemaster,31820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31820,BCBSND Base Physician Payment Schedule,911.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31805,Not in chargemaster,31805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31805,BCBSND Base Physician Payment Schedule,1729.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31800,Not in chargemaster,31800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31800,BCBSND Base Physician Payment Schedule,1494.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31786,Not in chargemaster,31786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31786,BCBSND Base Physician Payment Schedule,3057.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31785,Not in chargemaster,31785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31785,BCBSND Base Physician Payment Schedule,2263.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31781,Not in chargemaster,31781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31781,BCBSND Base Physician Payment Schedule,2940.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31780,Not in chargemaster,31780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31780,BCBSND Base Physician Payment Schedule,2512.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31775,Not in chargemaster,31775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31775,BCBSND Base Physician Payment Schedule,2964.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31770,Not in chargemaster,31770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31770,BCBSND Base Physician Payment Schedule,2821.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31766,Not in chargemaster,31766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31766,BCBSND Base Physician Payment Schedule,3771.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31760,Not in chargemaster,31760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31760,BCBSND Base Physician Payment Schedule,2909.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31755,Not in chargemaster,31755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31755,BCBSND Base Physician Payment Schedule,3611.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31750,Not in chargemaster,31750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31750,BCBSND Base Physician Payment Schedule,2872.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31730,Not in chargemaster,31730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31730,BCBSND Base Physician Payment Schedule,2484.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31725,Not in chargemaster,31725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31725,BCBSND Base Physician Payment Schedule,166.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31720,Not in chargemaster,31720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31720,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31717,Not in chargemaster,31717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31717,BCBSND Base Physician Payment Schedule,569.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31661,Not in chargemaster,31661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31661,BCBSND Base Physician Payment Schedule,436.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31660,Not in chargemaster,31660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31660,BCBSND Base Physician Payment Schedule,411.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31654,Not in chargemaster,31654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31654,BCBSND Base Physician Payment Schedule,255.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31653,Not in chargemaster,31653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31653,BCBSND Base Physician Payment Schedule,2393.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31652,Not in chargemaster,31652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31652,BCBSND Base Physician Payment Schedule,2294.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31651,Not in chargemaster,31651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31651,BCBSND Base Physician Payment Schedule,156.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31649,Not in chargemaster,31649,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31649,BCBSND Base Physician Payment Schedule,143.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31648,Not in chargemaster,31648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31648,BCBSND Base Physician Payment Schedule,423.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31647,Not in chargemaster,31647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31647,BCBSND Base Physician Payment Schedule,445.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31646,Not in chargemaster,31646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31646,BCBSND Base Physician Payment Schedule,299.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31645,Not in chargemaster,31645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31645,BCBSND Base Physician Payment Schedule,552.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31643,Not in chargemaster,31643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31643,BCBSND Base Physician Payment Schedule,369.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31641,Not in chargemaster,31641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31641,BCBSND Base Physician Payment Schedule,541.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31640,Not in chargemaster,31640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31640,BCBSND Base Physician Payment Schedule,529.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31638,Not in chargemaster,31638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31638,BCBSND Base Physician Payment Schedule,526.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31637,Not in chargemaster,31637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31637,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31636,Not in chargemaster,31636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31636,BCBSND Base Physician Payment Schedule,464.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31635,Not in chargemaster,31635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31635,BCBSND Base Physician Payment Schedule,593.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31634,Not in chargemaster,31634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31634,BCBSND Base Physician Payment Schedule,3593.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31633,Not in chargemaster,31633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31633,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31632,Not in chargemaster,31632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31632,BCBSND Base Physician Payment Schedule,133.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31631,Not in chargemaster,31631,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31631,BCBSND Base Physician Payment Schedule,481.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31630,Not in chargemaster,31630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31630,BCBSND Base Physician Payment Schedule,419.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31629,Not in chargemaster,31629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31629,BCBSND Base Physician Payment Schedule,944.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31628,Not in chargemaster,31628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31628,BCBSND Base Physician Payment Schedule,763.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31627,Not in chargemaster,31627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31627,BCBSND Base Physician Payment Schedule,2665.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31626,Not in chargemaster,31626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31626,BCBSND Base Physician Payment Schedule,1748.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31625,Not in chargemaster,31625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31625,BCBSND Base Physician Payment Schedule,719.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31624,Not in chargemaster,31624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31624,BCBSND Base Physician Payment Schedule,525.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31623,Not in chargemaster,31623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31623,BCBSND Base Physician Payment Schedule,562.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31622,Not in chargemaster,31622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31622,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31615,Not in chargemaster,31615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31615,BCBSND Base Physician Payment Schedule,358.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31614,Not in chargemaster,31614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31614,BCBSND Base Physician Payment Schedule,1522.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31613,Not in chargemaster,31613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31613,BCBSND Base Physician Payment Schedule,913.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31612,Not in chargemaster,31612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31612,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31611,Not in chargemaster,31611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31611,BCBSND Base Physician Payment Schedule,1109.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31610,Not in chargemaster,31610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31610,BCBSND Base Physician Payment Schedule,2002.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31605,Not in chargemaster,31605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31605,BCBSND Base Physician Payment Schedule,712.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31603,Not in chargemaster,31603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31603,BCBSND Base Physician Payment Schedule,682.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31601,Not in chargemaster,31601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31601,BCBSND Base Physician Payment Schedule,948.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31600,Not in chargemaster,31600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31600,BCBSND Base Physician Payment Schedule,652.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31592,Not in chargemaster,31592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31592,BCBSND Base Physician Payment Schedule,3602.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31591,Not in chargemaster,31591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31591,BCBSND Base Physician Payment Schedule,2258.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31590,Not in chargemaster,31590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31590,BCBSND Base Physician Payment Schedule,1831.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31587,Not in chargemaster,31587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31587,BCBSND Base Physician Payment Schedule,2484.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31584,Not in chargemaster,31584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31584,BCBSND Base Physician Payment Schedule,2948.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31580,Not in chargemaster,31580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31580,BCBSND Base Physician Payment Schedule,2662.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31579,Not in chargemaster,31579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31579,BCBSND Base Physician Payment Schedule,400.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31578,Not in chargemaster,31578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31578,BCBSND Base Physician Payment Schedule,631.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31577,Not in chargemaster,31577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31577,BCBSND Base Physician Payment Schedule,582.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31576,Not in chargemaster,31576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31576,BCBSND Base Physician Payment Schedule,560.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31575,Not in chargemaster,31575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31575,BCBSND Base Physician Payment Schedule,256.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31574,Not in chargemaster,31574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31574,BCBSND Base Physician Payment Schedule,2094.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31573,Not in chargemaster,31573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31573,BCBSND Base Physician Payment Schedule,574.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31572,Not in chargemaster,31572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31572,BCBSND Base Physician Payment Schedule,1083.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31571,Not in chargemaster,31571,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31571,BCBSND Base Physician Payment Schedule,521.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31570,Not in chargemaster,31570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31570,BCBSND Base Physician Payment Schedule,710.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31561,Not in chargemaster,31561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31561,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31560,Not in chargemaster,31560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31560,BCBSND Base Physician Payment Schedule,655.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31554,Not in chargemaster,31554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31554,BCBSND Base Physician Payment Schedule,3514.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31553,Not in chargemaster,31553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31553,BCBSND Base Physician Payment Schedule,3513.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31552,Not in chargemaster,31552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31552,BCBSND Base Physician Payment Schedule,3086.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31551,Not in chargemaster,31551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31551,BCBSND Base Physician Payment Schedule,3199.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31546,Not in chargemaster,31546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31546,BCBSND Base Physician Payment Schedule,1152.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31545,Not in chargemaster,31545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31545,BCBSND Base Physician Payment Schedule,758.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31541,Not in chargemaster,31541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31541,BCBSND Base Physician Payment Schedule,552.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31540,Not in chargemaster,31540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31540,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31536,Not in chargemaster,31536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31536,BCBSND Base Physician Payment Schedule,440.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31535,Not in chargemaster,31535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31535,BCBSND Base Physician Payment Schedule,395.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31531,Not in chargemaster,31531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31531,BCBSND Base Physician Payment Schedule,443.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31530,Not in chargemaster,31530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31530,BCBSND Base Physician Payment Schedule,418.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31529,Not in chargemaster,31529,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31529,BCBSND Base Physician Payment Schedule,336.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31528,Not in chargemaster,31528,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31528,BCBSND Base Physician Payment Schedule,300.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31527,Not in chargemaster,31527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31527,BCBSND Base Physician Payment Schedule,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31526,Not in chargemaster,31526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31526,BCBSND Base Physician Payment Schedule,327.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31525,Not in chargemaster,31525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31525,BCBSND Base Physician Payment Schedule,524.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31520,Not in chargemaster,31520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31520,BCBSND Base Physician Payment Schedule,325.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31515,Not in chargemaster,31515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31515,BCBSND Base Physician Payment Schedule,433.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31513,Not in chargemaster,31513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31513,BCBSND Base Physician Payment Schedule,273.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31512,Not in chargemaster,31512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31512,BCBSND Base Physician Payment Schedule,439.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31511,Not in chargemaster,31511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31511,BCBSND Base Physician Payment Schedule,443.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31510,Not in chargemaster,31510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31510,BCBSND Base Physician Payment Schedule,444.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31505,Not in chargemaster,31505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31505,BCBSND Base Physician Payment Schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31502,Not in chargemaster,31502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31502,BCBSND Base Physician Payment Schedule,74.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31500,31500,31500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31500,BCBSND Base Physician Payment Schedule,303.92,228.58,Fee schedule,,228.58,228.58,228.58,228.58,,,0
unity,Fee schedule,Non-facility 31420,Not in chargemaster,31420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31420,BCBSND Base Physician Payment Schedule,1724.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31400,Not in chargemaster,31400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31400,BCBSND Base Physician Payment Schedule,2056.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31395,Not in chargemaster,31395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31395,BCBSND Base Physician Payment Schedule,6272.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31390,Not in chargemaster,31390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31390,BCBSND Base Physician Payment Schedule,5952.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31382,Not in chargemaster,31382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31382,BCBSND Base Physician Payment Schedule,4433.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31380,Not in chargemaster,31380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31380,BCBSND Base Physician Payment Schedule,4041.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31375,Not in chargemaster,31375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31375,BCBSND Base Physician Payment Schedule,4099.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31370,Not in chargemaster,31370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31370,BCBSND Base Physician Payment Schedule,4318.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31368,Not in chargemaster,31368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31368,BCBSND Base Physician Payment Schedule,5099.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31367,Not in chargemaster,31367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31367,BCBSND Base Physician Payment Schedule,4596.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31365,Not in chargemaster,31365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31365,BCBSND Base Physician Payment Schedule,5380.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31360,Not in chargemaster,31360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31360,BCBSND Base Physician Payment Schedule,4348.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31300,Not in chargemaster,31300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31300,BCBSND Base Physician Payment Schedule,2652.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31298,Not in chargemaster,31298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31298,BCBSND Base Physician Payment Schedule,7495.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31297,Not in chargemaster,31297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31297,BCBSND Base Physician Payment Schedule,3899.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31296,Not in chargemaster,31296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31296,BCBSND Base Physician Payment Schedule,3983.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31295,Not in chargemaster,31295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31295,BCBSND Base Physician Payment Schedule,3930.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31294,Not in chargemaster,31294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31294,BCBSND Base Physician Payment Schedule,2581.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31293,Not in chargemaster,31293,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31293,BCBSND Base Physician Payment Schedule,2254.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31292,Not in chargemaster,31292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31292,BCBSND Base Physician Payment Schedule,2086.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31291,Not in chargemaster,31291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31291,BCBSND Base Physician Payment Schedule,2565.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31290,Not in chargemaster,31290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31290,BCBSND Base Physician Payment Schedule,2401.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31288,Not in chargemaster,31288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31288,BCBSND Base Physician Payment Schedule,492.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31287,Not in chargemaster,31287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31287,BCBSND Base Physician Payment Schedule,424.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31276,Not in chargemaster,31276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31276,BCBSND Base Physician Payment Schedule,797.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31267,Not in chargemaster,31267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31267,BCBSND Base Physician Payment Schedule,558.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31259,Not in chargemaster,31259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31259,BCBSND Base Physician Payment Schedule,996.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31257,Not in chargemaster,31257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31257,BCBSND Base Physician Payment Schedule,941.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31256,Not in chargemaster,31256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31256,BCBSND Base Physician Payment Schedule,379.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31255,Not in chargemaster,31255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31255,BCBSND Base Physician Payment Schedule,683.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31254,Not in chargemaster,31254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31254,BCBSND Base Physician Payment Schedule,880.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31253,Not in chargemaster,31253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31253,BCBSND Base Physician Payment Schedule,1057.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31241,Not in chargemaster,31241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31241,BCBSND Base Physician Payment Schedule,937.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31240,Not in chargemaster,31240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31240,BCBSND Base Physician Payment Schedule,331.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31239,Not in chargemaster,31239,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31239,BCBSND Base Physician Payment Schedule,1278.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31238,Not in chargemaster,31238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31238,BCBSND Base Physician Payment Schedule,521.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31237,Not in chargemaster,31237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31237,BCBSND Base Physician Payment Schedule,529.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31235,Not in chargemaster,31235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31235,BCBSND Base Physician Payment Schedule,623.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31233,Not in chargemaster,31233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31233,BCBSND Base Physician Payment Schedule,546.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31231,Not in chargemaster,31231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31231,BCBSND Base Physician Payment Schedule,402.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31230,Not in chargemaster,31230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31230,BCBSND Base Physician Payment Schedule,4249.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31225,Not in chargemaster,31225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31225,BCBSND Base Physician Payment Schedule,3829.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31205,Not in chargemaster,31205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31205,BCBSND Base Physician Payment Schedule,1933.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31201,Not in chargemaster,31201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31201,BCBSND Base Physician Payment Schedule,1614.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31200,Not in chargemaster,31200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31200,BCBSND Base Physician Payment Schedule,1251.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31090,Not in chargemaster,31090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31090,BCBSND Base Physician Payment Schedule,2227.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31087,Not in chargemaster,31087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31087,BCBSND Base Physician Payment Schedule,2294.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31086,Not in chargemaster,31086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31086,BCBSND Base Physician Payment Schedule,2396.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31085,Not in chargemaster,31085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31085,BCBSND Base Physician Payment Schedule,2542.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31084,Not in chargemaster,31084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31084,BCBSND Base Physician Payment Schedule,2461.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31081,Not in chargemaster,31081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31081,BCBSND Base Physician Payment Schedule,2376.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31080,Not in chargemaster,31080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31080,BCBSND Base Physician Payment Schedule,2208.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31075,Not in chargemaster,31075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31075,BCBSND Base Physician Payment Schedule,1676.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31070,Not in chargemaster,31070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31070,BCBSND Base Physician Payment Schedule,948.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31051,Not in chargemaster,31051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31051,BCBSND Base Physician Payment Schedule,1394.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31050,Not in chargemaster,31050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31050,BCBSND Base Physician Payment Schedule,1040.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31040,Not in chargemaster,31040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31040,BCBSND Base Physician Payment Schedule,1648.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31032,Not in chargemaster,31032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31032,BCBSND Base Physician Payment Schedule,1213.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31030,Not in chargemaster,31030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31030,BCBSND Base Physician Payment Schedule,1355.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31020,Not in chargemaster,31020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31020,BCBSND Base Physician Payment Schedule,992.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31002,Not in chargemaster,31002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31002,BCBSND Base Physician Payment Schedule,395.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 31000,Not in chargemaster,31000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31000,BCBSND Base Physician Payment Schedule,379.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30930,Not in chargemaster,30930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30930,BCBSND Base Physician Payment Schedule,247.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30920,Not in chargemaster,30920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30920,BCBSND Base Physician Payment Schedule,1785.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30915,Not in chargemaster,30915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30915,BCBSND Base Physician Payment Schedule,1231.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30906,Not in chargemaster,30906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30906,BCBSND Base Physician Payment Schedule,737.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30905,30905,30905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30905,BCBSND Base Physician Payment Schedule,707.67,560.79,Fee schedule,,560.79,560.79,560.79,560.79,,,0
unity,Fee schedule,Non-facility 30903,Not in chargemaster,30903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30903,BCBSND Base Physician Payment Schedule,476.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30901,30901,30901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30901,BCBSND Base Physician Payment Schedule,300.25,280,Fee schedule,,280,280,280,280,,,0
unity,Fee schedule,Non-facility 30802,Not in chargemaster,30802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30802,BCBSND Base Physician Payment Schedule,577,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30801,Not in chargemaster,30801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30801,BCBSND Base Physician Payment Schedule,453.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30630,Not in chargemaster,30630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30630,BCBSND Base Physician Payment Schedule,1354.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30620,Not in chargemaster,30620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30620,BCBSND Base Physician Payment Schedule,1339.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30600,Not in chargemaster,30600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30600,BCBSND Base Physician Payment Schedule,1238.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30580,Not in chargemaster,30580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30580,BCBSND Base Physician Payment Schedule,1307.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30560,Not in chargemaster,30560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30560,BCBSND Base Physician Payment Schedule,612.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30545,Not in chargemaster,30545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30545,BCBSND Base Physician Payment Schedule,2029.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30540,Not in chargemaster,30540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30540,BCBSND Base Physician Payment Schedule,1485.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30520,Not in chargemaster,30520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30520,BCBSND Base Physician Payment Schedule,1353.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30465,Not in chargemaster,30465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30465,BCBSND Base Physician Payment Schedule,2095.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30462,Not in chargemaster,30462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30462,BCBSND Base Physician Payment Schedule,3371.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30460,Not in chargemaster,30460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30460,BCBSND Base Physician Payment Schedule,1753.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30450,Not in chargemaster,30450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30450,BCBSND Base Physician Payment Schedule,3656.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30435,Not in chargemaster,30435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30435,BCBSND Base Physician Payment Schedule,2762.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30430,Not in chargemaster,30430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30430,BCBSND Base Physician Payment Schedule,2182.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30420,Not in chargemaster,30420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30420,BCBSND Base Physician Payment Schedule,2960.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30410,Not in chargemaster,30410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30410,BCBSND Base Physician Payment Schedule,2926.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30400,Not in chargemaster,30400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30400,BCBSND Base Physician Payment Schedule,2520.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30320,Not in chargemaster,30320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30320,BCBSND Base Physician Payment Schedule,974.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30310,Not in chargemaster,30310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30310,BCBSND Base Physician Payment Schedule,425.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30300,30300,30300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30300,BCBSND Base Physician Payment Schedule,396.41,276.13,Fee schedule,,276.13,276.13,276.13,276.13,,,0
unity,Fee schedule,Non-facility 30220,Not in chargemaster,30220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30220,BCBSND Base Physician Payment Schedule,638.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30210,Not in chargemaster,30210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30210,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30200,Not in chargemaster,30200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30200,BCBSND Base Physician Payment Schedule,233.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30160,Not in chargemaster,30160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30160,BCBSND Base Physician Payment Schedule,1659.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30150,Not in chargemaster,30150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30150,BCBSND Base Physician Payment Schedule,1649.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30140,Not in chargemaster,30140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30140,BCBSND Base Physician Payment Schedule,593.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30130,Not in chargemaster,30130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30130,BCBSND Base Physician Payment Schedule,828.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30125,Not in chargemaster,30125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30125,BCBSND Base Physician Payment Schedule,1318.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30124,Not in chargemaster,30124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30124,BCBSND Base Physician Payment Schedule,611.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30120,Not in chargemaster,30120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30120,BCBSND Base Physician Payment Schedule,1072.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30118,Not in chargemaster,30118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30118,BCBSND Base Physician Payment Schedule,1621.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30117,Not in chargemaster,30117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30117,BCBSND Base Physician Payment Schedule,1943.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30115,Not in chargemaster,30115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30115,BCBSND Base Physician Payment Schedule,932.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30110,Not in chargemaster,30110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30110,BCBSND Base Physician Payment Schedule,500.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30100,Not in chargemaster,30100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30100,BCBSND Base Physician Payment Schedule,295.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30020,Not in chargemaster,30020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30020,BCBSND Base Physician Payment Schedule,532.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 30000,Not in chargemaster,30000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30000,BCBSND Base Physician Payment Schedule,527.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29916,Not in chargemaster,29916,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29916,BCBSND Base Physician Payment Schedule,2171.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29915,Not in chargemaster,29915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29915,BCBSND Base Physician Payment Schedule,2170.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29914,Not in chargemaster,29914,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29914,BCBSND Base Physician Payment Schedule,2108.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29907,Not in chargemaster,29907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29907,BCBSND Base Physician Payment Schedule,1857.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29906,Not in chargemaster,29906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29906,BCBSND Base Physician Payment Schedule,1405.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29905,Not in chargemaster,29905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29905,BCBSND Base Physician Payment Schedule,1095.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29904,Not in chargemaster,29904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29904,BCBSND Base Physician Payment Schedule,1349.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29902,Not in chargemaster,29902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29902,BCBSND Base Physician Payment Schedule,1204.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29901,Not in chargemaster,29901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29901,BCBSND Base Physician Payment Schedule,1134.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29900,Not in chargemaster,29900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29900,BCBSND Base Physician Payment Schedule,1053.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29899,Not in chargemaster,29899,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29899,BCBSND Base Physician Payment Schedule,2185.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29898,Not in chargemaster,29898,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29898,BCBSND Base Physician Payment Schedule,1192.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29897,Not in chargemaster,29897,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29897,BCBSND Base Physician Payment Schedule,1057.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29895,Not in chargemaster,29895,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29895,BCBSND Base Physician Payment Schedule,983.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29894,Not in chargemaster,29894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29894,BCBSND Base Physician Payment Schedule,1056.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29893,Not in chargemaster,29893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29893,BCBSND Base Physician Payment Schedule,1344.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29892,Not in chargemaster,29892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29892,BCBSND Base Physician Payment Schedule,1378.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29891,Not in chargemaster,29891,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29891,BCBSND Base Physician Payment Schedule,1418.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29889,Not in chargemaster,29889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29889,BCBSND Base Physician Payment Schedule,2592.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29888,Not in chargemaster,29888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29888,BCBSND Base Physician Payment Schedule,2078.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29887,Not in chargemaster,29887,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29887,BCBSND Base Physician Payment Schedule,1590.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29886,Not in chargemaster,29886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29886,BCBSND Base Physician Payment Schedule,1347.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29885,Not in chargemaster,29885,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29885,BCBSND Base Physician Payment Schedule,1598.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29884,Not in chargemaster,29884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29884,BCBSND Base Physician Payment Schedule,1310.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29883,Not in chargemaster,29883,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29883,BCBSND Base Physician Payment Schedule,1782.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29882,Not in chargemaster,29882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29882,BCBSND Base Physician Payment Schedule,1466.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29881,Not in chargemaster,29881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29881,BCBSND Base Physician Payment Schedule,1145.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29880,Not in chargemaster,29880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29880,BCBSND Base Physician Payment Schedule,1188.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29879,Not in chargemaster,29879,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29879,BCBSND Base Physician Payment Schedule,1401.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29877,Not in chargemaster,29877,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29877,BCBSND Base Physician Payment Schedule,1314.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29876,Not in chargemaster,29876,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29876,BCBSND Base Physician Payment Schedule,1383.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29875,Not in chargemaster,29875,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29875,BCBSND Base Physician Payment Schedule,1050.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29874,Not in chargemaster,29874,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29874,BCBSND Base Physician Payment Schedule,1138.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29873,Not in chargemaster,29873,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29873,BCBSND Base Physician Payment Schedule,1118.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29871,Not in chargemaster,29871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29871,BCBSND Base Physician Payment Schedule,1087.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29870,Not in chargemaster,29870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29870,BCBSND Base Physician Payment Schedule,1205.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29868,Not in chargemaster,29868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29868,BCBSND Base Physician Payment Schedule,3548.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29867,Not in chargemaster,29867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29867,BCBSND Base Physician Payment Schedule,2710.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29866,Not in chargemaster,29866,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29866,BCBSND Base Physician Payment Schedule,2226.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29863,Not in chargemaster,29863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29863,BCBSND Base Physician Payment Schedule,1726.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29862,Not in chargemaster,29862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29862,BCBSND Base Physician Payment Schedule,1721.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29861,Not in chargemaster,29861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29861,BCBSND Base Physician Payment Schedule,1528.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29860,Not in chargemaster,29860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29860,BCBSND Base Physician Payment Schedule,1412.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29856,Not in chargemaster,29856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29856,BCBSND Base Physician Payment Schedule,2099.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29855,Not in chargemaster,29855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29855,BCBSND Base Physician Payment Schedule,1656.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29851,Not in chargemaster,29851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29851,BCBSND Base Physician Payment Schedule,1972.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29850,Not in chargemaster,29850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29850,BCBSND Base Physician Payment Schedule,1319.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29848,Not in chargemaster,29848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29848,BCBSND Base Physician Payment Schedule,1078.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29847,Not in chargemaster,29847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29847,BCBSND Base Physician Payment Schedule,1151.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29846,Not in chargemaster,29846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29846,BCBSND Base Physician Payment Schedule,1105.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29845,Not in chargemaster,29845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29845,BCBSND Base Physician Payment Schedule,1234.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29844,Not in chargemaster,29844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29844,BCBSND Base Physician Payment Schedule,1057.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29843,Not in chargemaster,29843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29843,BCBSND Base Physician Payment Schedule,1027.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29840,Not in chargemaster,29840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29840,BCBSND Base Physician Payment Schedule,953.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29838,Not in chargemaster,29838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29838,BCBSND Base Physician Payment Schedule,1253.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29837,Not in chargemaster,29837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29837,BCBSND Base Physician Payment Schedule,1115.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29836,Not in chargemaster,29836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29836,BCBSND Base Physician Payment Schedule,1236.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29835,Not in chargemaster,29835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29835,BCBSND Base Physician Payment Schedule,1076.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29834,Not in chargemaster,29834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29834,BCBSND Base Physician Payment Schedule,1041.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29830,Not in chargemaster,29830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29830,BCBSND Base Physician Payment Schedule,966.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29828,Not in chargemaster,29828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29828,BCBSND Base Physician Payment Schedule,1946.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29827,Not in chargemaster,29827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29827,BCBSND Base Physician Payment Schedule,2269.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29826,Not in chargemaster,29826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29826,BCBSND Base Physician Payment Schedule,370.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29825,Not in chargemaster,29825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29825,BCBSND Base Physician Payment Schedule,1241.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29824,Not in chargemaster,29824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29824,BCBSND Base Physician Payment Schedule,1428.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29823,Not in chargemaster,29823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29823,BCBSND Base Physician Payment Schedule,1328.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29822,Not in chargemaster,29822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29822,BCBSND Base Physician Payment Schedule,1220.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29821,Not in chargemaster,29821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29821,BCBSND Base Physician Payment Schedule,1255.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29820,Not in chargemaster,29820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29820,BCBSND Base Physician Payment Schedule,1136.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29819,Not in chargemaster,29819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29819,BCBSND Base Physician Payment Schedule,1241.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29807,Not in chargemaster,29807,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29807,BCBSND Base Physician Payment Schedule,2192.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29806,Not in chargemaster,29806,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29806,BCBSND Base Physician Payment Schedule,2241.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29805,Not in chargemaster,29805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29805,BCBSND Base Physician Payment Schedule,994.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29804,Not in chargemaster,29804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29804,BCBSND Base Physician Payment Schedule,1303.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29800,Not in chargemaster,29800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29800,BCBSND Base Physician Payment Schedule,1118.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29750,Not in chargemaster,29750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29750,BCBSND Base Physician Payment Schedule,224.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29740,Not in chargemaster,29740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29740,BCBSND Base Physician Payment Schedule,207.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29730,Not in chargemaster,29730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29730,BCBSND Base Physician Payment Schedule,129.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29720,Not in chargemaster,29720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29720,BCBSND Base Physician Payment Schedule,174.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29710,Not in chargemaster,29710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29710,BCBSND Base Physician Payment Schedule,255.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29705,Not in chargemaster,29705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29705,BCBSND Base Physician Payment Schedule,133.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29700,Not in chargemaster,29700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29700,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29584,Not in chargemaster,29584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29584,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29581,29581,29581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29581,BCBSND Base Physician Payment Schedule,186.46,185,Fee schedule,,185,185,185,185,,,0
unity,Fee schedule,Non-facility 29580,Not in chargemaster,29580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29580,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29550,Not in chargemaster,29550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29550,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29540,Not in chargemaster,29540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29540,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29530,Not in chargemaster,29530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29530,BCBSND Base Physician Payment Schedule,63.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29520,Not in chargemaster,29520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29520,BCBSND Base Physician Payment Schedule,73.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29515,29515,29515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29515,BCBSND Base Physician Payment Schedule,147.55,154.76,Fee schedule,,147.55,147.55,147.55,147.55,,,0
unity,Fee schedule,Non-facility 29505,29505,29505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29505,BCBSND Base Physician Payment Schedule,176.92,180.31,Fee schedule,,176.92,176.92,176.92,176.92,,,0
unity,Fee schedule,Non-facility 29450,Not in chargemaster,29450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29450,BCBSND Base Physician Payment Schedule,301.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29445,Not in chargemaster,29445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29445,BCBSND Base Physician Payment Schedule,273.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29440,Not in chargemaster,29440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29440,BCBSND Base Physician Payment Schedule,90.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29435,Not in chargemaster,29435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29435,BCBSND Base Physician Payment Schedule,238.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29425,Not in chargemaster,29425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29425,BCBSND Base Physician Payment Schedule,159.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29405,29405,29405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29405,BCBSND Base Physician Payment Schedule,165.91,175.34,Fee schedule,,165.91,165.91,165.91,165.91,,,0
unity,Fee schedule,Non-facility 29365,Not in chargemaster,29365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29365,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29358,Not in chargemaster,29358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29358,BCBSND Base Physician Payment Schedule,331.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29355,Not in chargemaster,29355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29355,BCBSND Base Physician Payment Schedule,295.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29345,Not in chargemaster,29345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29345,BCBSND Base Physician Payment Schedule,282.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29325,Not in chargemaster,29325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29325,BCBSND Base Physician Payment Schedule,563.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29305,Not in chargemaster,29305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29305,BCBSND Base Physician Payment Schedule,508.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29280,Not in chargemaster,29280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29280,BCBSND Base Physician Payment Schedule,64.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29260,Not in chargemaster,29260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29260,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29240,29240,29240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29240,BCBSND Base Physician Payment Schedule,64.6,122.1,Fee schedule,,64.6,64.6,64.6,64.6,,,0
unity,Fee schedule,Non-facility 29200,Not in chargemaster,29200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29200,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29131,Not in chargemaster,29131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29131,BCBSND Base Physician Payment Schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29130,29130,29130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29130,BCBSND Base Physician Payment Schedule,86.62,87.32,Fee schedule,,86.62,86.62,86.62,86.62,,,0
unity,Fee schedule,Non-facility 29126,Not in chargemaster,29126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29126,BCBSND Base Physician Payment Schedule,160.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29125,29125,29125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29125,BCBSND Base Physician Payment Schedule,133.61,140.56,Fee schedule,,133.61,133.61,133.61,133.61,,,0
unity,Fee schedule,Non-facility 29105,29105,29105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29105,BCBSND Base Physician Payment Schedule,169.58,188.84,Fee schedule,,169.58,169.58,169.58,169.58,,,0
unity,Fee schedule,Non-facility 29086,Not in chargemaster,29086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29086,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29085,Not in chargemaster,29085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29085,BCBSND Base Physician Payment Schedule,196.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29075,29075,29075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29075,BCBSND Base Physician Payment Schedule,178.39,186.7,Fee schedule,,178.39,178.39,178.39,178.39,,,0
unity,Fee schedule,Non-facility 29065,29065,29065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29065,BCBSND Base Physician Payment Schedule,198.21,207.28,Fee schedule,,198.21,198.21,198.21,198.21,,,0
unity,Fee schedule,Non-facility 29058,Not in chargemaster,29058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29058,BCBSND Base Physician Payment Schedule,257.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29055,Not in chargemaster,29055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29055,BCBSND Base Physician Payment Schedule,456.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29049,Not in chargemaster,29049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29049,BCBSND Base Physician Payment Schedule,204.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29046,Not in chargemaster,29046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29046,BCBSND Base Physician Payment Schedule,644.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29044,Not in chargemaster,29044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29044,BCBSND Base Physician Payment Schedule,588.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29040,Not in chargemaster,29040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29040,BCBSND Base Physician Payment Schedule,599.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29035,Not in chargemaster,29035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29035,BCBSND Base Physician Payment Schedule,523.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29015,Not in chargemaster,29015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29015,BCBSND Base Physician Payment Schedule,603.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29010,Not in chargemaster,29010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29010,BCBSND Base Physician Payment Schedule,560.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 29000,Not in chargemaster,29000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29000,BCBSND Base Physician Payment Schedule,711.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28890,Not in chargemaster,28890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28890,BCBSND Base Physician Payment Schedule,673.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28825,Not in chargemaster,28825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28825,BCBSND Base Physician Payment Schedule,1130.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28820,Not in chargemaster,28820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28820,BCBSND Base Physician Payment Schedule,1182.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28810,Not in chargemaster,28810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28810,BCBSND Base Physician Payment Schedule,908.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28805,Not in chargemaster,28805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28805,BCBSND Base Physician Payment Schedule,1531.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28800,Not in chargemaster,28800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28800,BCBSND Base Physician Payment Schedule,1131.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28760,Not in chargemaster,28760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28760,BCBSND Base Physician Payment Schedule,1655.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28755,Not in chargemaster,28755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28755,BCBSND Base Physician Payment Schedule,1079.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28750,Not in chargemaster,28750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28750,BCBSND Base Physician Payment Schedule,1687.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28740,Not in chargemaster,28740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28740,BCBSND Base Physician Payment Schedule,1776.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28737,Not in chargemaster,28737,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28737,BCBSND Base Physician Payment Schedule,1460.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28735,Not in chargemaster,28735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28735,BCBSND Base Physician Payment Schedule,1642.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28730,Not in chargemaster,28730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28730,BCBSND Base Physician Payment Schedule,1557.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28725,Not in chargemaster,28725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28725,BCBSND Base Physician Payment Schedule,1649.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28715,Not in chargemaster,28715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28715,BCBSND Base Physician Payment Schedule,1990.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28705,Not in chargemaster,28705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28705,BCBSND Base Physician Payment Schedule,2603.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28675,Not in chargemaster,28675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28675,BCBSND Base Physician Payment Schedule,1205.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28666,Not in chargemaster,28666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28666,BCBSND Base Physician Payment Schedule,351.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28665,Not in chargemaster,28665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28665,BCBSND Base Physician Payment Schedule,323.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28660,Not in chargemaster,28660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28660,BCBSND Base Physician Payment Schedule,251.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28645,Not in chargemaster,28645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28645,BCBSND Base Physician Payment Schedule,1389.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28636,Not in chargemaster,28636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28636,BCBSND Base Physician Payment Schedule,659.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28635,Not in chargemaster,28635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28635,BCBSND Base Physician Payment Schedule,369.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28630,Not in chargemaster,28630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28630,BCBSND Base Physician Payment Schedule,329.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28615,Not in chargemaster,28615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28615,BCBSND Base Physician Payment Schedule,1720,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28606,Not in chargemaster,28606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28606,BCBSND Base Physician Payment Schedule,821.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28605,Not in chargemaster,28605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28605,BCBSND Base Physician Payment Schedule,703.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28600,Not in chargemaster,28600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28600,BCBSND Base Physician Payment Schedule,454.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28585,Not in chargemaster,28585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28585,BCBSND Base Physician Payment Schedule,1830.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28576,Not in chargemaster,28576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28576,BCBSND Base Physician Payment Schedule,817.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28575,Not in chargemaster,28575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28575,BCBSND Base Physician Payment Schedule,781.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28570,Not in chargemaster,28570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28570,BCBSND Base Physician Payment Schedule,482.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28555,Not in chargemaster,28555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28555,BCBSND Base Physician Payment Schedule,1805.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28546,Not in chargemaster,28546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28546,BCBSND Base Physician Payment Schedule,1228.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28545,Not in chargemaster,28545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28545,BCBSND Base Physician Payment Schedule,636.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28540,Not in chargemaster,28540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28540,BCBSND Base Physician Payment Schedule,408.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28531,Not in chargemaster,28531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28531,BCBSND Base Physician Payment Schedule,714.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28530,Not in chargemaster,28530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28530,BCBSND Base Physician Payment Schedule,242.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28525,Not in chargemaster,28525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28525,BCBSND Base Physician Payment Schedule,1211.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28515,28515,28515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28515,BCBSND Base Physician Payment Schedule,342.82,355,Fee schedule,,342.82,342.82,342.82,342.82,,,0
unity,Fee schedule,Non-facility 28510,28510,28510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28510,BCBSND Base Physician Payment Schedule,254.73,266.2,Fee schedule,,254.73,254.73,254.73,254.73,,,0
unity,Fee schedule,Non-facility 28505,Not in chargemaster,28505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28505,BCBSND Base Physician Payment Schedule,1403.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28496,Not in chargemaster,28496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28496,BCBSND Base Physician Payment Schedule,952.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28495,Not in chargemaster,28495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28495,BCBSND Base Physician Payment Schedule,374.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28490,28490,28490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28490,BCBSND Base Physician Payment Schedule,298.78,316.6,Fee schedule,,298.78,298.78,298.78,298.78,,,0
unity,Fee schedule,Non-facility 28485,Not in chargemaster,28485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28485,BCBSND Base Physician Payment Schedule,1166.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28476,Not in chargemaster,28476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28476,BCBSND Base Physician Payment Schedule,775.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28475,Not in chargemaster,28475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28475,BCBSND Base Physician Payment Schedule,541.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28470,28470,28470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28470,BCBSND Base Physician Payment Schedule,459.55,476.32,Fee schedule,,459.55,459.55,459.55,459.55,,,0
unity,Fee schedule,Non-facility 28465,Not in chargemaster,28465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28465,BCBSND Base Physician Payment Schedule,1334.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28456,Not in chargemaster,28456,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28456,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28455,Not in chargemaster,28455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28455,BCBSND Base Physician Payment Schedule,607.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28450,Not in chargemaster,28450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28450,BCBSND Base Physician Payment Schedule,445.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28446,Not in chargemaster,28446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28446,BCBSND Base Physician Payment Schedule,2594.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28445,Not in chargemaster,28445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28445,BCBSND Base Physician Payment Schedule,2195.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28436,Not in chargemaster,28436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28436,BCBSND Base Physician Payment Schedule,987.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28435,Not in chargemaster,28435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28435,BCBSND Base Physician Payment Schedule,767.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28430,Not in chargemaster,28430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28430,BCBSND Base Physician Payment Schedule,502.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28420,Not in chargemaster,28420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28420,BCBSND Base Physician Payment Schedule,2723.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28415,Not in chargemaster,28415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28415,BCBSND Base Physician Payment Schedule,2369.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28406,Not in chargemaster,28406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28406,BCBSND Base Physician Payment Schedule,1143.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28405,Not in chargemaster,28405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28405,BCBSND Base Physician Payment Schedule,816.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28400,Not in chargemaster,28400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28400,BCBSND Base Physician Payment Schedule,520.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28360,Not in chargemaster,28360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28360,BCBSND Base Physician Payment Schedule,2314.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28345,Not in chargemaster,28345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28345,BCBSND Base Physician Payment Schedule,1100.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28344,Not in chargemaster,28344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28344,BCBSND Base Physician Payment Schedule,900.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28341,Not in chargemaster,28341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28341,BCBSND Base Physician Payment Schedule,1409.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28340,Not in chargemaster,28340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28340,BCBSND Base Physician Payment Schedule,1216.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28322,Not in chargemaster,28322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28322,BCBSND Base Physician Payment Schedule,1656.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28320,Not in chargemaster,28320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28320,BCBSND Base Physician Payment Schedule,1296.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28315,Not in chargemaster,28315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28315,BCBSND Base Physician Payment Schedule,1020.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28313,Not in chargemaster,28313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28313,BCBSND Base Physician Payment Schedule,1110.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28312,Not in chargemaster,28312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28312,BCBSND Base Physician Payment Schedule,1063.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28310,Not in chargemaster,28310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28310,BCBSND Base Physician Payment Schedule,1158.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28309,Not in chargemaster,28309,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28309,BCBSND Base Physician Payment Schedule,1870.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28308,Not in chargemaster,28308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28308,BCBSND Base Physician Payment Schedule,1206.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28307,Not in chargemaster,28307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28307,BCBSND Base Physician Payment Schedule,1314.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28306,Not in chargemaster,28306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28306,BCBSND Base Physician Payment Schedule,1283.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28305,Not in chargemaster,28305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28305,BCBSND Base Physician Payment Schedule,1416.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28304,Not in chargemaster,28304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28304,BCBSND Base Physician Payment Schedule,1733.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28302,Not in chargemaster,28302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28302,BCBSND Base Physician Payment Schedule,1516.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28300,Not in chargemaster,28300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28300,BCBSND Base Physician Payment Schedule,1378.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28299,Not in chargemaster,28299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28299,BCBSND Base Physician Payment Schedule,2136.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28298,Not in chargemaster,28298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28298,BCBSND Base Physician Payment Schedule,1784.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28297,Not in chargemaster,28297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28297,BCBSND Base Physician Payment Schedule,2222.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28296,Not in chargemaster,28296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28296,BCBSND Base Physician Payment Schedule,1921.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28295,Not in chargemaster,28295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28295,BCBSND Base Physician Payment Schedule,2094.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28292,Not in chargemaster,28292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28292,BCBSND Base Physician Payment Schedule,1533.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28291,Not in chargemaster,28291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28291,BCBSND Base Physician Payment Schedule,1546.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28289,Not in chargemaster,28289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28289,BCBSND Base Physician Payment Schedule,1511.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28288,Not in chargemaster,28288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28288,BCBSND Base Physician Payment Schedule,1289.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28286,Not in chargemaster,28286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28286,BCBSND Base Physician Payment Schedule,946.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28285,Not in chargemaster,28285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28285,BCBSND Base Physician Payment Schedule,1136.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28280,Not in chargemaster,28280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28280,BCBSND Base Physician Payment Schedule,1088.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28272,Not in chargemaster,28272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28272,BCBSND Base Physician Payment Schedule,825.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28270,Not in chargemaster,28270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28270,BCBSND Base Physician Payment Schedule,1043.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28264,Not in chargemaster,28264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28264,BCBSND Base Physician Payment Schedule,2141.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28262,Not in chargemaster,28262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28262,BCBSND Base Physician Payment Schedule,2966.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28261,Not in chargemaster,28261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28261,BCBSND Base Physician Payment Schedule,2542.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28260,Not in chargemaster,28260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28260,BCBSND Base Physician Payment Schedule,1482.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28250,Not in chargemaster,28250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28250,BCBSND Base Physician Payment Schedule,1229.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28240,Not in chargemaster,28240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28240,BCBSND Base Physician Payment Schedule,949.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28238,Not in chargemaster,28238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28238,BCBSND Base Physician Payment Schedule,1409.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28234,Not in chargemaster,28234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28234,BCBSND Base Physician Payment Schedule,866.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28232,Not in chargemaster,28232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28232,BCBSND Base Physician Payment Schedule,814.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28230,Not in chargemaster,28230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28230,BCBSND Base Physician Payment Schedule,922.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28226,Not in chargemaster,28226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28226,BCBSND Base Physician Payment Schedule,1298.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28225,Not in chargemaster,28225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28225,BCBSND Base Physician Payment Schedule,884.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28222,Not in chargemaster,28222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28222,BCBSND Base Physician Payment Schedule,1098.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28220,Not in chargemaster,28220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28220,BCBSND Base Physician Payment Schedule,955.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28210,Not in chargemaster,28210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28210,BCBSND Base Physician Payment Schedule,1247.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28208,Not in chargemaster,28208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28208,BCBSND Base Physician Payment Schedule,1020.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28202,Not in chargemaster,28202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28202,BCBSND Base Physician Payment Schedule,1280.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28200,Not in chargemaster,28200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28200,BCBSND Base Physician Payment Schedule,1045.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28193,Not in chargemaster,28193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28193,BCBSND Base Physician Payment Schedule,1121.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28192,Not in chargemaster,28192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28192,BCBSND Base Physician Payment Schedule,991.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28190,Not in chargemaster,28190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28190,BCBSND Base Physician Payment Schedule,533.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28175,Not in chargemaster,28175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28175,BCBSND Base Physician Payment Schedule,1001.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28173,Not in chargemaster,28173,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28173,BCBSND Base Physician Payment Schedule,1559.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28171,Not in chargemaster,28171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28171,BCBSND Base Physician Payment Schedule,2357.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28160,Not in chargemaster,28160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28160,BCBSND Base Physician Payment Schedule,879.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28153,Not in chargemaster,28153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28153,BCBSND Base Physician Payment Schedule,875.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28150,Not in chargemaster,28150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28150,BCBSND Base Physician Payment Schedule,891.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28140,Not in chargemaster,28140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28140,BCBSND Base Physician Payment Schedule,1246.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28130,Not in chargemaster,28130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28130,BCBSND Base Physician Payment Schedule,1336.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28126,Not in chargemaster,28126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28126,BCBSND Base Physician Payment Schedule,831,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28124,Not in chargemaster,28124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28124,BCBSND Base Physician Payment Schedule,1013.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28122,Not in chargemaster,28122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28122,BCBSND Base Physician Payment Schedule,1260.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28120,Not in chargemaster,28120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28120,BCBSND Base Physician Payment Schedule,1433.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28119,Not in chargemaster,28119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28119,BCBSND Base Physician Payment Schedule,1109.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28118,Not in chargemaster,28118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28118,BCBSND Base Physician Payment Schedule,1271.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28116,Not in chargemaster,28116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28116,BCBSND Base Physician Payment Schedule,1615.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28114,Not in chargemaster,28114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28114,BCBSND Base Physician Payment Schedule,2238.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28113,Not in chargemaster,28113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28113,BCBSND Base Physician Payment Schedule,1243.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28112,Not in chargemaster,28112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28112,BCBSND Base Physician Payment Schedule,1032.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28111,Not in chargemaster,28111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28111,BCBSND Base Physician Payment Schedule,1034.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28110,Not in chargemaster,28110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28110,BCBSND Base Physician Payment Schedule,980.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28108,Not in chargemaster,28108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28108,BCBSND Base Physician Payment Schedule,929.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28107,Not in chargemaster,28107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28107,BCBSND Base Physician Payment Schedule,1083.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28106,Not in chargemaster,28106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28106,BCBSND Base Physician Payment Schedule,905.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28104,Not in chargemaster,28104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28104,BCBSND Base Physician Payment Schedule,1120.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28103,Not in chargemaster,28103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28103,BCBSND Base Physician Payment Schedule,825.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28102,Not in chargemaster,28102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28102,BCBSND Base Physician Payment Schedule,1287.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28100,Not in chargemaster,28100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28100,BCBSND Base Physician Payment Schedule,1293.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28092,Not in chargemaster,28092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28092,BCBSND Base Physician Payment Schedule,896.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28090,Not in chargemaster,28090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28090,BCBSND Base Physician Payment Schedule,989.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28088,Not in chargemaster,28088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28088,BCBSND Base Physician Payment Schedule,917.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28086,Not in chargemaster,28086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28086,BCBSND Base Physician Payment Schedule,1136.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28080,Not in chargemaster,28080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28080,BCBSND Base Physician Payment Schedule,1114.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28072,Not in chargemaster,28072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28072,BCBSND Base Physician Payment Schedule,1032.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28070,Not in chargemaster,28070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28070,BCBSND Base Physician Payment Schedule,1120.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28062,Not in chargemaster,28062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28062,BCBSND Base Physician Payment Schedule,1232.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28060,Not in chargemaster,28060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28060,BCBSND Base Physician Payment Schedule,1106.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28055,Not in chargemaster,28055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28055,BCBSND Base Physician Payment Schedule,817.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28054,Not in chargemaster,28054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28054,BCBSND Base Physician Payment Schedule,789.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28052,Not in chargemaster,28052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28052,BCBSND Base Physician Payment Schedule,943.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28050,Not in chargemaster,28050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28050,BCBSND Base Physician Payment Schedule,894.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28047,Not in chargemaster,28047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28047,BCBSND Base Physician Payment Schedule,2207.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28046,Not in chargemaster,28046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28046,BCBSND Base Physician Payment Schedule,1517.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28045,Not in chargemaster,28045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28045,BCBSND Base Physician Payment Schedule,1031.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28043,Not in chargemaster,28043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28043,BCBSND Base Physician Payment Schedule,831.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28041,Not in chargemaster,28041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28041,BCBSND Base Physician Payment Schedule,959.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28039,Not in chargemaster,28039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28039,BCBSND Base Physician Payment Schedule,1049.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28035,Not in chargemaster,28035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28035,BCBSND Base Physician Payment Schedule,1114.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28024,Not in chargemaster,28024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28024,BCBSND Base Physician Payment Schedule,967.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28022,Not in chargemaster,28022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28022,BCBSND Base Physician Payment Schedule,1032.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28020,Not in chargemaster,28020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28020,BCBSND Base Physician Payment Schedule,1137.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28011,Not in chargemaster,28011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28011,BCBSND Base Physician Payment Schedule,667.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28010,Not in chargemaster,28010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28010,BCBSND Base Physician Payment Schedule,491.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28008,Not in chargemaster,28008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28008,BCBSND Base Physician Payment Schedule,917.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28005,Not in chargemaster,28005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28005,BCBSND Base Physician Payment Schedule,1221.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28003,Not in chargemaster,28003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28003,BCBSND Base Physician Payment Schedule,1481.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28002,Not in chargemaster,28002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28002,BCBSND Base Physician Payment Schedule,936.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 28001,Not in chargemaster,28001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28001,BCBSND Base Physician Payment Schedule,591.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27894,Not in chargemaster,27894,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27894,BCBSND Base Physician Payment Schedule,1785.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27893,Not in chargemaster,27893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27893,BCBSND Base Physician Payment Schedule,1293.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27892,Not in chargemaster,27892,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27892,BCBSND Base Physician Payment Schedule,1166.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27889,Not in chargemaster,27889,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27889,BCBSND Base Physician Payment Schedule,1366.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27888,Not in chargemaster,27888,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27888,BCBSND Base Physician Payment Schedule,1391.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27886,Not in chargemaster,27886,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27886,BCBSND Base Physician Payment Schedule,1391.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27884,Not in chargemaster,27884,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27884,BCBSND Base Physician Payment Schedule,1216.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27882,Not in chargemaster,27882,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27882,BCBSND Base Physician Payment Schedule,1270.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27881,Not in chargemaster,27881,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27881,BCBSND Base Physician Payment Schedule,1823.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27880,Not in chargemaster,27880,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27880,BCBSND Base Physician Payment Schedule,1934.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27871,Not in chargemaster,27871,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27871,BCBSND Base Physician Payment Schedule,1459.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27870,Not in chargemaster,27870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27870,BCBSND Base Physician Payment Schedule,2166.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27860,Not in chargemaster,27860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27860,BCBSND Base Physician Payment Schedule,360.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27848,Not in chargemaster,27848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27848,BCBSND Base Physician Payment Schedule,1693.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27846,Not in chargemaster,27846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27846,BCBSND Base Physician Payment Schedule,1512.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27842,Not in chargemaster,27842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27842,BCBSND Base Physician Payment Schedule,1042.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27840,27840,27840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27840,BCBSND Base Physician Payment Schedule,795.76,796.47,Fee schedule,,795.76,795.76,795.76,795.76,,,0
unity,Fee schedule,Non-facility 27832,Not in chargemaster,27832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27832,BCBSND Base Physician Payment Schedule,1601.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27831,Not in chargemaster,27831,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27831,BCBSND Base Physician Payment Schedule,853.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27830,Not in chargemaster,27830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27830,BCBSND Base Physician Payment Schedule,815.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27829,Not in chargemaster,27829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27829,BCBSND Base Physician Payment Schedule,1482.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27828,Not in chargemaster,27828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27828,BCBSND Base Physician Payment Schedule,2796.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27827,Not in chargemaster,27827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27827,BCBSND Base Physician Payment Schedule,2352.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27826,Not in chargemaster,27826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27826,BCBSND Base Physician Payment Schedule,1802.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27825,Not in chargemaster,27825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27825,BCBSND Base Physician Payment Schedule,1154.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27824,Not in chargemaster,27824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27824,BCBSND Base Physician Payment Schedule,668.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27823,Not in chargemaster,27823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27823,BCBSND Base Physician Payment Schedule,2074.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27822,Not in chargemaster,27822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27822,BCBSND Base Physician Payment Schedule,1833.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27818,Not in chargemaster,27818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27818,BCBSND Base Physician Payment Schedule,1027.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27816,Not in chargemaster,27816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27816,BCBSND Base Physician Payment Schedule,687.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27814,Not in chargemaster,27814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27814,BCBSND Base Physician Payment Schedule,1624.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27810,Not in chargemaster,27810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27810,BCBSND Base Physician Payment Schedule,989.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27808,Not in chargemaster,27808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27808,BCBSND Base Physician Payment Schedule,702.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27792,Not in chargemaster,27792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27792,BCBSND Base Physician Payment Schedule,1369.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27788,Not in chargemaster,27788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27788,BCBSND Base Physician Payment Schedule,896.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27786,27786,27786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27786,BCBSND Base Physician Payment Schedule,661.42,680,Fee schedule,,661.42,661.42,661.42,661.42,,,0
unity,Fee schedule,Non-facility 27784,Not in chargemaster,27784,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27784,BCBSND Base Physician Payment Schedule,1505.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27781,Not in chargemaster,27781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27781,BCBSND Base Physician Payment Schedule,912.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27780,27780,27780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27780,BCBSND Base Physician Payment Schedule,646.01,658.76,Fee schedule,,646.01,646.01,646.01,646.01,,,0
unity,Fee schedule,Non-facility 27769,Not in chargemaster,27769,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27769,BCBSND Base Physician Payment Schedule,1545.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27768,Not in chargemaster,27768,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27768,BCBSND Base Physician Payment Schedule,936.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27767,Not in chargemaster,27767,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27767,BCBSND Base Physician Payment Schedule,604.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27766,Not in chargemaster,27766,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27766,BCBSND Base Physician Payment Schedule,1278.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27762,Not in chargemaster,27762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27762,BCBSND Base Physician Payment Schedule,1010.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27760,Not in chargemaster,27760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27760,BCBSND Base Physician Payment Schedule,701.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27759,Not in chargemaster,27759,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27759,BCBSND Base Physician Payment Schedule,2117.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27758,Not in chargemaster,27758,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27758,BCBSND Base Physician Payment Schedule,1896.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27756,Not in chargemaster,27756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27756,BCBSND Base Physician Payment Schedule,1216.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27752,Not in chargemaster,27752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27752,BCBSND Base Physician Payment Schedule,1131.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27750,Not in chargemaster,27750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27750,BCBSND Base Physician Payment Schedule,727.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27745,Not in chargemaster,27745,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27745,BCBSND Base Physician Payment Schedule,1612.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27742,Not in chargemaster,27742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27742,BCBSND Base Physician Payment Schedule,1647.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27740,Not in chargemaster,27740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27740,BCBSND Base Physician Payment Schedule,1499.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27734,Not in chargemaster,27734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27734,BCBSND Base Physician Payment Schedule,1391.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27732,Not in chargemaster,27732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27732,BCBSND Base Physician Payment Schedule,952.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27730,Not in chargemaster,27730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27730,BCBSND Base Physician Payment Schedule,1242.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27727,Not in chargemaster,27727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27727,BCBSND Base Physician Payment Schedule,2200.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27726,Not in chargemaster,27726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27726,BCBSND Base Physician Payment Schedule,2030.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27725,Not in chargemaster,27725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27725,BCBSND Base Physician Payment Schedule,2578.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27724,Not in chargemaster,27724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27724,BCBSND Base Physician Payment Schedule,2674.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27722,Not in chargemaster,27722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27722,BCBSND Base Physician Payment Schedule,1892.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27720,Not in chargemaster,27720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27720,BCBSND Base Physician Payment Schedule,1855.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27715,Not in chargemaster,27715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27715,BCBSND Base Physician Payment Schedule,2273.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27712,Not in chargemaster,27712,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27712,BCBSND Base Physician Payment Schedule,2336.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27709,Not in chargemaster,27709,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27709,BCBSND Base Physician Payment Schedule,2474.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27707,Not in chargemaster,27707,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27707,BCBSND Base Physician Payment Schedule,843.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27705,Not in chargemaster,27705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27705,BCBSND Base Physician Payment Schedule,1605.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27704,Not in chargemaster,27704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27704,BCBSND Base Physician Payment Schedule,1213.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27703,Not in chargemaster,27703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27703,BCBSND Base Physician Payment Schedule,2366.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27702,Not in chargemaster,27702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27702,BCBSND Base Physician Payment Schedule,2044.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27700,Not in chargemaster,27700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27700,BCBSND Base Physician Payment Schedule,1298.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27698,Not in chargemaster,27698,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27698,BCBSND Base Physician Payment Schedule,1350.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27696,Not in chargemaster,27696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27696,BCBSND Base Physician Payment Schedule,1181.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27695,Not in chargemaster,27695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27695,BCBSND Base Physician Payment Schedule,1002.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27692,Not in chargemaster,27692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27692,BCBSND Base Physician Payment Schedule,220.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27691,Not in chargemaster,27691,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27691,BCBSND Base Physician Payment Schedule,1575.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27690,Not in chargemaster,27690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27690,BCBSND Base Physician Payment Schedule,1351.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27687,Not in chargemaster,27687,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27687,BCBSND Base Physician Payment Schedule,960.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27686,Not in chargemaster,27686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27686,BCBSND Base Physician Payment Schedule,1145.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27685,Not in chargemaster,27685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27685,BCBSND Base Physician Payment Schedule,1396.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27681,Not in chargemaster,27681,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27681,BCBSND Base Physician Payment Schedule,1094.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27680,Not in chargemaster,27680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27680,BCBSND Base Physician Payment Schedule,897.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27676,Not in chargemaster,27676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27676,BCBSND Base Physician Payment Schedule,1266.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27675,Not in chargemaster,27675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27675,BCBSND Base Physician Payment Schedule,1038.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27665,Not in chargemaster,27665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27665,BCBSND Base Physician Payment Schedule,876.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27664,Not in chargemaster,27664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27664,BCBSND Base Physician Payment Schedule,762,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27659,Not in chargemaster,27659,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27659,BCBSND Base Physician Payment Schedule,993.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27658,Not in chargemaster,27658,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27658,BCBSND Base Physician Payment Schedule,780.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27656,Not in chargemaster,27656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27656,BCBSND Base Physician Payment Schedule,1339.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27654,Not in chargemaster,27654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27654,BCBSND Base Physician Payment Schedule,1507.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27652,Not in chargemaster,27652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27652,BCBSND Base Physician Payment Schedule,1406.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27650,Not in chargemaster,27650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27650,BCBSND Base Physician Payment Schedule,1391.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27648,Not in chargemaster,27648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27648,BCBSND Base Physician Payment Schedule,420.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27647,Not in chargemaster,27647,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27647,BCBSND Base Physician Payment Schedule,2153.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27646,Not in chargemaster,27646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27646,BCBSND Base Physician Payment Schedule,3267.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27645,Not in chargemaster,27645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27645,BCBSND Base Physician Payment Schedule,3765.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27641,Not in chargemaster,27641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27641,BCBSND Base Physician Payment Schedule,1401.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27640,Not in chargemaster,27640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27640,BCBSND Base Physician Payment Schedule,1761.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27638,Not in chargemaster,27638,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27638,BCBSND Base Physician Payment Schedule,1622.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27637,Not in chargemaster,27637,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27637,BCBSND Base Physician Payment Schedule,1584.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27635,Not in chargemaster,27635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27635,BCBSND Base Physician Payment Schedule,1231.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27634,Not in chargemaster,27634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27634,BCBSND Base Physician Payment Schedule,1448.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27632,Not in chargemaster,27632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27632,BCBSND Base Physician Payment Schedule,876.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27630,Not in chargemaster,27630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27630,BCBSND Base Physician Payment Schedule,1160.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27626,Not in chargemaster,27626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27626,BCBSND Base Physician Payment Schedule,1280.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27625,Not in chargemaster,27625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27625,BCBSND Base Physician Payment Schedule,1221.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27620,Not in chargemaster,27620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27620,BCBSND Base Physician Payment Schedule,946.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27619,Not in chargemaster,27619,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27619,BCBSND Base Physician Payment Schedule,977.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27618,Not in chargemaster,27618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27618,BCBSND Base Physician Payment Schedule,994.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27616,Not in chargemaster,27616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27616,BCBSND Base Physician Payment Schedule,2703.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27615,Not in chargemaster,27615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27615,BCBSND Base Physician Payment Schedule,2176.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27614,Not in chargemaster,27614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27614,BCBSND Base Physician Payment Schedule,1221.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27613,Not in chargemaster,27613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27613,BCBSND Base Physician Payment Schedule,530.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27612,Not in chargemaster,27612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27612,BCBSND Base Physician Payment Schedule,1180.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27610,Not in chargemaster,27610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27610,BCBSND Base Physician Payment Schedule,1373.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27607,Not in chargemaster,27607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27607,BCBSND Base Physician Payment Schedule,1281.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27606,Not in chargemaster,27606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27606,BCBSND Base Physician Payment Schedule,586.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27605,Not in chargemaster,27605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27605,BCBSND Base Physician Payment Schedule,721.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27604,Not in chargemaster,27604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27604,BCBSND Base Physician Payment Schedule,1002.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27603,Not in chargemaster,27603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27603,BCBSND Base Physician Payment Schedule,1125.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27602,Not in chargemaster,27602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27602,BCBSND Base Physician Payment Schedule,1029.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27601,Not in chargemaster,27601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27601,BCBSND Base Physician Payment Schedule,945.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27600,Not in chargemaster,27600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27600,BCBSND Base Physician Payment Schedule,859.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27598,Not in chargemaster,27598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27598,BCBSND Base Physician Payment Schedule,1512.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27596,Not in chargemaster,27596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27596,BCBSND Base Physician Payment Schedule,1518.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27594,Not in chargemaster,27594,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27594,BCBSND Base Physician Payment Schedule,1085.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27592,Not in chargemaster,27592,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27592,BCBSND Base Physician Payment Schedule,1437.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27591,Not in chargemaster,27591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27591,BCBSND Base Physician Payment Schedule,2048.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27590,Not in chargemaster,27590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27590,BCBSND Base Physician Payment Schedule,1689.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27580,Not in chargemaster,27580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27580,BCBSND Base Physician Payment Schedule,3096.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27570,Not in chargemaster,27570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27570,BCBSND Base Physician Payment Schedule,318.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27566,Not in chargemaster,27566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27566,BCBSND Base Physician Payment Schedule,1895.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27562,Not in chargemaster,27562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27562,BCBSND Base Physician Payment Schedule,1028.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27560,Not in chargemaster,27560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27560,BCBSND Base Physician Payment Schedule,788.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27558,Not in chargemaster,27558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27558,BCBSND Base Physician Payment Schedule,2534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27557,Not in chargemaster,27557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27557,BCBSND Base Physician Payment Schedule,2223.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27556,Not in chargemaster,27556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27556,BCBSND Base Physician Payment Schedule,1863.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27552,Not in chargemaster,27552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27552,BCBSND Base Physician Payment Schedule,1331.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27550,Not in chargemaster,27550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27550,BCBSND Base Physician Payment Schedule,1104.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27540,Not in chargemaster,27540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27540,BCBSND Base Physician Payment Schedule,1717.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27538,Not in chargemaster,27538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27538,BCBSND Base Physician Payment Schedule,1007.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27536,Not in chargemaster,27536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27536,BCBSND Base Physician Payment Schedule,2520.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27535,Not in chargemaster,27535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27535,BCBSND Base Physician Payment Schedule,1905.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27532,Not in chargemaster,27532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27532,BCBSND Base Physician Payment Schedule,1303.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27530,27530,27530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27530,BCBSND Base Physician Payment Schedule,638.67,648.11,Fee schedule,,638.67,638.67,638.67,638.67,,,0
unity,Fee schedule,Non-facility 27524,Not in chargemaster,27524,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27524,BCBSND Base Physician Payment Schedule,1595.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27520,Not in chargemaster,27520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27520,BCBSND Base Physician Payment Schedule,679.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27519,Not in chargemaster,27519,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27519,BCBSND Base Physician Payment Schedule,1893.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27517,Not in chargemaster,27517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27517,BCBSND Base Physician Payment Schedule,1454.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27516,Not in chargemaster,27516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27516,BCBSND Base Physician Payment Schedule,1082.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27514,Not in chargemaster,27514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27514,BCBSND Base Physician Payment Schedule,2054.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27513,Not in chargemaster,27513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27513,BCBSND Base Physician Payment Schedule,2636.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27511,Not in chargemaster,27511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27511,BCBSND Base Physician Payment Schedule,2120.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27510,Not in chargemaster,27510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27510,BCBSND Base Physician Payment Schedule,1441.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27509,Not in chargemaster,27509,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27509,BCBSND Base Physician Payment Schedule,1399.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27508,Not in chargemaster,27508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27508,BCBSND Base Physician Payment Schedule,1107.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27507,Not in chargemaster,27507,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27507,BCBSND Base Physician Payment Schedule,2060.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27506,Not in chargemaster,27506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27506,BCBSND Base Physician Payment Schedule,2836.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27503,Not in chargemaster,27503,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27503,BCBSND Base Physician Payment Schedule,1697.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27502,Not in chargemaster,27502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27502,BCBSND Base Physician Payment Schedule,1610.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27501,Not in chargemaster,27501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27501,BCBSND Base Physician Payment Schedule,1069.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27500,Not in chargemaster,27500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27500,BCBSND Base Physician Payment Schedule,1101.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27499,Not in chargemaster,27499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27499,BCBSND Base Physician Payment Schedule,1485.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27498,Not in chargemaster,27498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27498,BCBSND Base Physician Payment Schedule,1386.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27497,Not in chargemaster,27497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27497,BCBSND Base Physician Payment Schedule,1231.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27496,Not in chargemaster,27496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27496,BCBSND Base Physician Payment Schedule,1153.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27495,Not in chargemaster,27495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27495,BCBSND Base Physician Payment Schedule,2393.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27488,Not in chargemaster,27488,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27488,BCBSND Base Physician Payment Schedule,2547.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27487,Not in chargemaster,27487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27487,BCBSND Base Physician Payment Schedule,3735.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27486,Not in chargemaster,27486,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27486,BCBSND Base Physician Payment Schedule,2986.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27485,Not in chargemaster,27485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27485,BCBSND Base Physician Payment Schedule,1421.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27479,Not in chargemaster,27479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27479,BCBSND Base Physician Payment Schedule,1949.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27477,Not in chargemaster,27477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27477,BCBSND Base Physician Payment Schedule,1553.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27475,Not in chargemaster,27475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27475,BCBSND Base Physician Payment Schedule,1403.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27472,Not in chargemaster,27472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27472,BCBSND Base Physician Payment Schedule,2680.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27470,Not in chargemaster,27470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27470,BCBSND Base Physician Payment Schedule,2498.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27468,Not in chargemaster,27468,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27468,BCBSND Base Physician Payment Schedule,2848.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27466,Not in chargemaster,27466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27466,BCBSND Base Physician Payment Schedule,2512.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27465,Not in chargemaster,27465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27465,BCBSND Base Physician Payment Schedule,2655.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27457,Not in chargemaster,27457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27457,BCBSND Base Physician Payment Schedule,2040.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27455,Not in chargemaster,27455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27455,BCBSND Base Physician Payment Schedule,2018.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27454,Not in chargemaster,27454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27454,BCBSND Base Physician Payment Schedule,2749.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27450,Not in chargemaster,27450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27450,BCBSND Base Physician Payment Schedule,2153.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27448,Not in chargemaster,27448,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27448,BCBSND Base Physician Payment Schedule,1741.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27447,Not in chargemaster,27447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27447,BCBSND Base Physician Payment Schedule,2874.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27446,Not in chargemaster,27446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27446,BCBSND Base Physician Payment Schedule,2458.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27445,Not in chargemaster,27445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27445,BCBSND Base Physician Payment Schedule,2664.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27443,Not in chargemaster,27443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27443,BCBSND Base Physician Payment Schedule,1722.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27442,Not in chargemaster,27442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27442,BCBSND Base Physician Payment Schedule,1849.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27441,Not in chargemaster,27441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27441,BCBSND Base Physician Payment Schedule,1747.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27440,Not in chargemaster,27440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27440,BCBSND Base Physician Payment Schedule,1691.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27438,Not in chargemaster,27438,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27438,BCBSND Base Physician Payment Schedule,1784.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27437,Not in chargemaster,27437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27437,BCBSND Base Physician Payment Schedule,1396.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27435,Not in chargemaster,27435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27435,BCBSND Base Physician Payment Schedule,1714.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27430,Not in chargemaster,27430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27430,BCBSND Base Physician Payment Schedule,1571.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27429,Not in chargemaster,27429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27429,BCBSND Base Physician Payment Schedule,2658.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27428,Not in chargemaster,27428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27428,BCBSND Base Physician Payment Schedule,2363.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27427,Not in chargemaster,27427,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27427,BCBSND Base Physician Payment Schedule,1507.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27425,Not in chargemaster,27425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27425,BCBSND Base Physician Payment Schedule,951.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27424,Not in chargemaster,27424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27424,BCBSND Base Physician Payment Schedule,1584.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27422,Not in chargemaster,27422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27422,BCBSND Base Physician Payment Schedule,1576.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27420,Not in chargemaster,27420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27420,BCBSND Base Physician Payment Schedule,1576.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27418,Not in chargemaster,27418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27418,BCBSND Base Physician Payment Schedule,1755.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27416,Not in chargemaster,27416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27416,BCBSND Base Physician Payment Schedule,2079.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27415,Not in chargemaster,27415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27415,BCBSND Base Physician Payment Schedule,2912.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27412,Not in chargemaster,27412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27412,BCBSND Base Physician Payment Schedule,3501.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27409,Not in chargemaster,27409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27409,BCBSND Base Physician Payment Schedule,2050.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27407,Not in chargemaster,27407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27407,BCBSND Base Physician Payment Schedule,1684.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27405,Not in chargemaster,27405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27405,BCBSND Base Physician Payment Schedule,1431.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27403,Not in chargemaster,27403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27403,BCBSND Base Physician Payment Schedule,1362.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27400,Not in chargemaster,27400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27400,BCBSND Base Physician Payment Schedule,1471.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27397,Not in chargemaster,27397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27397,BCBSND Base Physician Payment Schedule,1938.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27396,Not in chargemaster,27396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27396,BCBSND Base Physician Payment Schedule,1305.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27395,Not in chargemaster,27395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27395,BCBSND Base Physician Payment Schedule,1865.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27394,Not in chargemaster,27394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27394,BCBSND Base Physician Payment Schedule,1385.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27393,Not in chargemaster,27393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27393,BCBSND Base Physician Payment Schedule,1078.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27392,Not in chargemaster,27392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27392,BCBSND Base Physician Payment Schedule,1509.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27391,Not in chargemaster,27391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27391,BCBSND Base Physician Payment Schedule,1195.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27390,Not in chargemaster,27390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27390,BCBSND Base Physician Payment Schedule,948.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27386,Not in chargemaster,27386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27386,BCBSND Base Physician Payment Schedule,1790.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27385,Not in chargemaster,27385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27385,BCBSND Base Physician Payment Schedule,1246.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27381,Not in chargemaster,27381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27381,BCBSND Base Physician Payment Schedule,1714.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27380,Not in chargemaster,27380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27380,BCBSND Base Physician Payment Schedule,1286.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27372,Not in chargemaster,27372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27372,BCBSND Base Physician Payment Schedule,1266.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27369,Not in chargemaster,27369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27369,BCBSND Base Physician Payment Schedule,328.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27365,Not in chargemaster,27365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27365,BCBSND Base Physician Payment Schedule,4379.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27364,Not in chargemaster,27364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27364,BCBSND Base Physician Payment Schedule,3319.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27360,Not in chargemaster,27360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27360,BCBSND Base Physician Payment Schedule,1859.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27358,Not in chargemaster,27358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27358,BCBSND Base Physician Payment Schedule,589.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27357,Not in chargemaster,27357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27357,BCBSND Base Physician Payment Schedule,1728.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27356,Not in chargemaster,27356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27356,BCBSND Base Physician Payment Schedule,1565.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27355,Not in chargemaster,27355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27355,BCBSND Base Physician Payment Schedule,1281,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27350,Not in chargemaster,27350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27350,BCBSND Base Physician Payment Schedule,1382.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27347,Not in chargemaster,27347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27347,BCBSND Base Physician Payment Schedule,1115.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27345,Not in chargemaster,27345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27345,BCBSND Base Physician Payment Schedule,1023.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27340,Not in chargemaster,27340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27340,BCBSND Base Physician Payment Schedule,785.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27339,Not in chargemaster,27339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27339,BCBSND Base Physician Payment Schedule,1603.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27337,Not in chargemaster,27337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27337,BCBSND Base Physician Payment Schedule,889,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27335,Not in chargemaster,27335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27335,BCBSND Base Physician Payment Schedule,1621.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27334,Not in chargemaster,27334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27334,BCBSND Base Physician Payment Schedule,1450.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27333,Not in chargemaster,27333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27333,BCBSND Base Physician Payment Schedule,1242.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27332,Not in chargemaster,27332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27332,BCBSND Base Physician Payment Schedule,1363.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27331,Not in chargemaster,27331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27331,BCBSND Base Physician Payment Schedule,1004.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27330,Not in chargemaster,27330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27330,BCBSND Base Physician Payment Schedule,870.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27329,Not in chargemaster,27329,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27329,BCBSND Base Physician Payment Schedule,2211.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27328,Not in chargemaster,27328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27328,BCBSND Base Physician Payment Schedule,1322.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27327,27327,27327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27327,BCBSND Base Physician Payment Schedule,1023.34,605,Fee schedule,,605,605,605,605,,,0
unity,Fee schedule,Non-facility 27326,Not in chargemaster,27326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27326,BCBSND Base Physician Payment Schedule,1096.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27325,Not in chargemaster,27325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27325,BCBSND Base Physician Payment Schedule,1187.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27324,Not in chargemaster,27324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27324,BCBSND Base Physician Payment Schedule,855.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27323,Not in chargemaster,27323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27323,BCBSND Base Physician Payment Schedule,580.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27310,Not in chargemaster,27310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27310,BCBSND Base Physician Payment Schedule,1549.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27307,Not in chargemaster,27307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27307,BCBSND Base Physician Payment Schedule,1015.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27306,Not in chargemaster,27306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27306,BCBSND Base Physician Payment Schedule,724.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27305,Not in chargemaster,27305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27305,BCBSND Base Physician Payment Schedule,1018.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27303,Not in chargemaster,27303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27303,BCBSND Base Physician Payment Schedule,1358.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27301,27301,27301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27301,BCBSND Base Physician Payment Schedule,1426.36,1239.27,Fee schedule,,1239.27,1239.27,1239.27,1239.27,,,0
unity,Fee schedule,Non-facility 27295,Not in chargemaster,27295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27295,BCBSND Base Physician Payment Schedule,2674.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27290,Not in chargemaster,27290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27290,BCBSND Base Physician Payment Schedule,3449.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27286,Not in chargemaster,27286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27286,BCBSND Base Physician Payment Schedule,3499.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27284,Not in chargemaster,27284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27284,BCBSND Base Physician Payment Schedule,3422.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27282,Not in chargemaster,27282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27282,BCBSND Base Physician Payment Schedule,1816.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27280,Not in chargemaster,27280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27280,BCBSND Base Physician Payment Schedule,2879.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27279,Not in chargemaster,27279,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27279,BCBSND Base Physician Payment Schedule,1860.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27275,Not in chargemaster,27275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27275,BCBSND Base Physician Payment Schedule,386.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27269,Not in chargemaster,27269,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27269,BCBSND Base Physician Payment Schedule,2642.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27268,Not in chargemaster,27268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27268,BCBSND Base Physician Payment Schedule,1146.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27267,Not in chargemaster,27267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27267,BCBSND Base Physician Payment Schedule,924.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27266,Not in chargemaster,27266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27266,BCBSND Base Physician Payment Schedule,1233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27265,Not in chargemaster,27265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27265,BCBSND Base Physician Payment Schedule,855.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27259,Not in chargemaster,27259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27259,BCBSND Base Physician Payment Schedule,3284.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27258,Not in chargemaster,27258,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27258,BCBSND Base Physician Payment Schedule,2356.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27257,Not in chargemaster,27257,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27257,BCBSND Base Physician Payment Schedule,766.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27256,Not in chargemaster,27256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27256,BCBSND Base Physician Payment Schedule,643.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27254,Not in chargemaster,27254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27254,BCBSND Base Physician Payment Schedule,2702.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27253,Not in chargemaster,27253,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27253,BCBSND Base Physician Payment Schedule,1998.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27252,Not in chargemaster,27252,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27252,BCBSND Base Physician Payment Schedule,1601.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27250,Not in chargemaster,27250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27250,BCBSND Base Physician Payment Schedule,391.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27248,Not in chargemaster,27248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27248,BCBSND Base Physician Payment Schedule,1583.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27246,Not in chargemaster,27246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27246,BCBSND Base Physician Payment Schedule,821.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27245,Not in chargemaster,27245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27245,BCBSND Base Physician Payment Schedule,2606.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27244,Not in chargemaster,27244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27244,BCBSND Base Physician Payment Schedule,2608.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27240,Not in chargemaster,27240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27240,BCBSND Base Physician Payment Schedule,2021.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27238,Not in chargemaster,27238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27238,BCBSND Base Physician Payment Schedule,982.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27236,Not in chargemaster,27236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27236,BCBSND Base Physician Payment Schedule,2534.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27235,Not in chargemaster,27235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27235,BCBSND Base Physician Payment Schedule,1925.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27232,Not in chargemaster,27232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27232,BCBSND Base Physician Payment Schedule,1587.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27230,Not in chargemaster,27230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27230,BCBSND Base Physician Payment Schedule,1019.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27228,Not in chargemaster,27228,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27228,BCBSND Base Physician Payment Schedule,3990.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27227,Not in chargemaster,27227,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27227,BCBSND Base Physician Payment Schedule,3512.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27226,Not in chargemaster,27226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27226,BCBSND Base Physician Payment Schedule,2241.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27222,Not in chargemaster,27222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27222,BCBSND Base Physician Payment Schedule,2065.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27220,Not in chargemaster,27220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27220,BCBSND Base Physician Payment Schedule,910.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27218,Not in chargemaster,27218,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27218,BCBSND Base Physician Payment Schedule,2457.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27217,Not in chargemaster,27217,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27217,BCBSND Base Physician Payment Schedule,1781.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27216,Not in chargemaster,27216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27216,BCBSND Base Physician Payment Schedule,1898.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27215,Not in chargemaster,27215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27215,BCBSND Base Physician Payment Schedule,1280.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27202,Not in chargemaster,27202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27202,BCBSND Base Physician Payment Schedule,1122.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27200,Not in chargemaster,27200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27200,BCBSND Base Physician Payment Schedule,390.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27198,Not in chargemaster,27198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27198,BCBSND Base Physician Payment Schedule,648.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27197,Not in chargemaster,27197,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27197,BCBSND Base Physician Payment Schedule,270.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27187,Not in chargemaster,27187,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27187,BCBSND Base Physician Payment Schedule,2111.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27185,Not in chargemaster,27185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27185,BCBSND Base Physician Payment Schedule,1521.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27181,Not in chargemaster,27181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27181,BCBSND Base Physician Payment Schedule,2376.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27179,Not in chargemaster,27179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27179,BCBSND Base Physician Payment Schedule,2073.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27178,Not in chargemaster,27178,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27178,BCBSND Base Physician Payment Schedule,1950.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27177,Not in chargemaster,27177,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27177,BCBSND Base Physician Payment Schedule,2363.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27176,Not in chargemaster,27176,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27176,BCBSND Base Physician Payment Schedule,1950.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27175,Not in chargemaster,27175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27175,BCBSND Base Physician Payment Schedule,1412.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27170,Not in chargemaster,27170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27170,BCBSND Base Physician Payment Schedule,2493.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27165,Not in chargemaster,27165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27165,BCBSND Base Physician Payment Schedule,2912.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27161,Not in chargemaster,27161,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27161,BCBSND Base Physician Payment Schedule,2588.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27158,Not in chargemaster,27158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27158,BCBSND Base Physician Payment Schedule,2973.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27156,Not in chargemaster,27156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27156,BCBSND Base Physician Payment Schedule,3631.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27151,Not in chargemaster,27151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27151,BCBSND Base Physician Payment Schedule,3368.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27147,Not in chargemaster,27147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27147,BCBSND Base Physician Payment Schedule,3112.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27146,Not in chargemaster,27146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27146,BCBSND Base Physician Payment Schedule,2711.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27140,Not in chargemaster,27140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27140,BCBSND Base Physician Payment Schedule,1897.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27138,Not in chargemaster,27138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27138,BCBSND Base Physician Payment Schedule,3248.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27137,Not in chargemaster,27137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27137,BCBSND Base Physician Payment Schedule,3125.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27134,Not in chargemaster,27134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27134,BCBSND Base Physician Payment Schedule,4066.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27132,Not in chargemaster,27132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27132,BCBSND Base Physician Payment Schedule,3556.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27130,Not in chargemaster,27130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27130,BCBSND Base Physician Payment Schedule,2878.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27125,Not in chargemaster,27125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27125,BCBSND Base Physician Payment Schedule,2401.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27122,Not in chargemaster,27122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27122,BCBSND Base Physician Payment Schedule,2335.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27120,Not in chargemaster,27120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27120,BCBSND Base Physician Payment Schedule,2757.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27111,Not in chargemaster,27111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27111,BCBSND Base Physician Payment Schedule,1910.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27110,Not in chargemaster,27110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27110,BCBSND Base Physician Payment Schedule,2057.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27105,Not in chargemaster,27105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27105,BCBSND Base Physician Payment Schedule,1839.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27100,Not in chargemaster,27100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27100,BCBSND Base Physician Payment Schedule,1754.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27098,Not in chargemaster,27098,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27098,BCBSND Base Physician Payment Schedule,1471.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27097,Not in chargemaster,27097,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27097,BCBSND Base Physician Payment Schedule,1446.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27096,Not in chargemaster,27096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27096,BCBSND Base Physician Payment Schedule,338.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27095,Not in chargemaster,27095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27095,BCBSND Base Physician Payment Schedule,613.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27093,Not in chargemaster,27093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27093,BCBSND Base Physician Payment Schedule,456.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27091,Not in chargemaster,27091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27091,BCBSND Base Physician Payment Schedule,3389.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27090,Not in chargemaster,27090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27090,BCBSND Base Physician Payment Schedule,1762.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27087,Not in chargemaster,27087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27087,BCBSND Base Physician Payment Schedule,1305.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27086,Not in chargemaster,27086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27086,BCBSND Base Physician Payment Schedule,644.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27080,Not in chargemaster,27080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27080,BCBSND Base Physician Payment Schedule,1085.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27078,Not in chargemaster,27078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27078,BCBSND Base Physician Payment Schedule,4381.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27077,Not in chargemaster,27077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27077,BCBSND Base Physician Payment Schedule,6004.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27076,Not in chargemaster,27076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27076,BCBSND Base Physician Payment Schedule,5380.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27075,Not in chargemaster,27075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27075,BCBSND Base Physician Payment Schedule,4444.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27071,Not in chargemaster,27071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27071,BCBSND Base Physician Payment Schedule,2002.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27070,Not in chargemaster,27070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27070,BCBSND Base Physician Payment Schedule,1858.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27067,Not in chargemaster,27067,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27067,BCBSND Base Physician Payment Schedule,2194.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27066,Not in chargemaster,27066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27066,BCBSND Base Physician Payment Schedule,1717.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27065,Not in chargemaster,27065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27065,BCBSND Base Physician Payment Schedule,1101.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27062,Not in chargemaster,27062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27062,BCBSND Base Physician Payment Schedule,960.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27060,Not in chargemaster,27060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27060,BCBSND Base Physician Payment Schedule,983.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27059,Not in chargemaster,27059,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27059,BCBSND Base Physician Payment Schedule,3850.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27057,Not in chargemaster,27057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27057,BCBSND Base Physician Payment Schedule,2149.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27054,Not in chargemaster,27054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27054,BCBSND Base Physician Payment Schedule,1454.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27052,Not in chargemaster,27052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27052,BCBSND Base Physician Payment Schedule,1222.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27050,Not in chargemaster,27050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27050,BCBSND Base Physician Payment Schedule,850.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27049,Not in chargemaster,27049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27049,BCBSND Base Physician Payment Schedule,2839.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27048,Not in chargemaster,27048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27048,BCBSND Base Physician Payment Schedule,1293.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27047,Not in chargemaster,27047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27047,BCBSND Base Physician Payment Schedule,1020.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27045,Not in chargemaster,27045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27045,BCBSND Base Physician Payment Schedule,1568.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27043,Not in chargemaster,27043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27043,BCBSND Base Physician Payment Schedule,996.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27041,Not in chargemaster,27041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27041,BCBSND Base Physician Payment Schedule,1479.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27040,Not in chargemaster,27040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27040,BCBSND Base Physician Payment Schedule,726.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27036,Not in chargemaster,27036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27036,BCBSND Base Physician Payment Schedule,2145.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27035,Not in chargemaster,27035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27035,BCBSND Base Physician Payment Schedule,2424,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27033,Not in chargemaster,27033,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27033,BCBSND Base Physician Payment Schedule,2064.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27030,Not in chargemaster,27030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27030,BCBSND Base Physician Payment Schedule,1990.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27027,Not in chargemaster,27027,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27027,BCBSND Base Physician Payment Schedule,1895.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27025,Not in chargemaster,27025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27025,BCBSND Base Physician Payment Schedule,1946.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27006,Not in chargemaster,27006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27006,BCBSND Base Physician Payment Schedule,1519.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27005,Not in chargemaster,27005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27005,BCBSND Base Physician Payment Schedule,1532.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27003,Not in chargemaster,27003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27003,BCBSND Base Physician Payment Schedule,1264.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27001,Not in chargemaster,27001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27001,BCBSND Base Physician Payment Schedule,1146.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 27000,Not in chargemaster,27000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27000,BCBSND Base Physician Payment Schedule,855.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26992,Not in chargemaster,26992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26992,BCBSND Base Physician Payment Schedule,2095.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26991,Not in chargemaster,26991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26991,BCBSND Base Physician Payment Schedule,1501.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26990,Not in chargemaster,26990,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26990,BCBSND Base Physician Payment Schedule,1385.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26952,Not in chargemaster,26952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26952,BCBSND Base Physician Payment Schedule,1388.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26951,Not in chargemaster,26951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26951,BCBSND Base Physician Payment Schedule,1405.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26910,Not in chargemaster,26910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26910,BCBSND Base Physician Payment Schedule,1551.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26863,Not in chargemaster,26863,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26863,BCBSND Base Physician Payment Schedule,485.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26862,Not in chargemaster,26862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26862,BCBSND Base Physician Payment Schedule,1555.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26861,Not in chargemaster,26861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26861,BCBSND Base Physician Payment Schedule,218.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26860,Not in chargemaster,26860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26860,BCBSND Base Physician Payment Schedule,1221.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26852,Not in chargemaster,26852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26852,BCBSND Base Physician Payment Schedule,1703.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26850,Not in chargemaster,26850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26850,BCBSND Base Physician Payment Schedule,1488.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26844,Not in chargemaster,26844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26844,BCBSND Base Physician Payment Schedule,1758.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26843,Not in chargemaster,26843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26843,BCBSND Base Physician Payment Schedule,1589.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26842,Not in chargemaster,26842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26842,BCBSND Base Physician Payment Schedule,1678.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26841,Not in chargemaster,26841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26841,BCBSND Base Physician Payment Schedule,1560.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26820,Not in chargemaster,26820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26820,BCBSND Base Physician Payment Schedule,1692.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26785,Not in chargemaster,26785,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26785,BCBSND Base Physician Payment Schedule,1153.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26776,Not in chargemaster,26776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26776,BCBSND Base Physician Payment Schedule,942.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26775,Not in chargemaster,26775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26775,BCBSND Base Physician Payment Schedule,810.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26770,26770,26770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26770,BCBSND Base Physician Payment Schedule,593.15,591.33,Fee schedule,,591.33,591.33,591.33,591.33,,,0
unity,Fee schedule,Non-facility 26765,Not in chargemaster,26765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26765,BCBSND Base Physician Payment Schedule,1058.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26756,Not in chargemaster,26756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26756,BCBSND Base Physician Payment Schedule,889.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26755,26755,26755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26755,BCBSND Base Physician Payment Schedule,669.5,671.53,Fee schedule,,669.5,669.5,669.5,669.5,,,0
unity,Fee schedule,Non-facility 26750,26750,26750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26750,BCBSND Base Physician Payment Schedule,390.54,394.68,Fee schedule,,390.54,390.54,390.54,390.54,,,0
unity,Fee schedule,Non-facility 26746,Not in chargemaster,26746,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26746,BCBSND Base Physician Payment Schedule,1569.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26742,Not in chargemaster,26742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26742,BCBSND Base Physician Payment Schedule,784.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26740,Not in chargemaster,26740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26740,BCBSND Base Physician Payment Schedule,484.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26735,Not in chargemaster,26735,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26735,BCBSND Base Physician Payment Schedule,1256.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26727,Not in chargemaster,26727,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26727,BCBSND Base Physician Payment Schedule,995.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26725,26725,26725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26725,BCBSND Base Physician Payment Schedule,715.75,719.09,Fee schedule,,715.75,715.75,715.75,715.75,,,0
unity,Fee schedule,Non-facility 26720,26720,26720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26720,BCBSND Base Physician Payment Schedule,415.5,425.99,Fee schedule,,415.5,415.5,415.5,415.5,,,0
unity,Fee schedule,Non-facility 26715,Not in chargemaster,26715,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26715,BCBSND Base Physician Payment Schedule,1209.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26706,Not in chargemaster,26706,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26706,BCBSND Base Physician Payment Schedule,933.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26705,Not in chargemaster,26705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26705,BCBSND Base Physician Payment Schedule,888.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26700,26700,26700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26700,BCBSND Base Physician Payment Schedule,701.07,690.71,Fee schedule,,690.71,690.71,690.71,690.71,,,0
unity,Fee schedule,Non-facility 26686,Not in chargemaster,26686,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26686,BCBSND Base Physician Payment Schedule,1321.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26685,Not in chargemaster,26685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26685,BCBSND Base Physician Payment Schedule,1214.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26676,Not in chargemaster,26676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26676,BCBSND Base Physician Payment Schedule,1067.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26675,Not in chargemaster,26675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26675,BCBSND Base Physician Payment Schedule,968.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26670,Not in chargemaster,26670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26670,BCBSND Base Physician Payment Schedule,723.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26665,Not in chargemaster,26665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26665,BCBSND Base Physician Payment Schedule,1322.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26650,Not in chargemaster,26650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26650,BCBSND Base Physician Payment Schedule,1010.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26645,Not in chargemaster,26645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26645,BCBSND Base Physician Payment Schedule,908.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26641,Not in chargemaster,26641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26641,BCBSND Base Physician Payment Schedule,807.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26615,Not in chargemaster,26615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26615,BCBSND Base Physician Payment Schedule,1214.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26608,Not in chargemaster,26608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26608,BCBSND Base Physician Payment Schedule,1013.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26607,Not in chargemaster,26607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26607,BCBSND Base Physician Payment Schedule,1025.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26605,26605,26605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26605,BCBSND Base Physician Payment Schedule,684.92,700,Fee schedule,,684.92,684.92,684.92,684.92,,,0
unity,Fee schedule,Non-facility 26600,26600,26600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26600,BCBSND Base Physician Payment Schedule,623.99,640,Fee schedule,,623.99,623.99,623.99,623.99,,,0
unity,Fee schedule,Non-facility 26596,Not in chargemaster,26596,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26596,BCBSND Base Physician Payment Schedule,1651.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26593,Not in chargemaster,26593,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26593,BCBSND Base Physician Payment Schedule,1295.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26591,Not in chargemaster,26591,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26591,BCBSND Base Physician Payment Schedule,957.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26590,Not in chargemaster,26590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26590,BCBSND Base Physician Payment Schedule,2993.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26587,Not in chargemaster,26587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26587,BCBSND Base Physician Payment Schedule,2205.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26580,Not in chargemaster,26580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26580,BCBSND Base Physician Payment Schedule,3213.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26568,Not in chargemaster,26568,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26568,BCBSND Base Physician Payment Schedule,1921.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26567,Not in chargemaster,26567,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26567,BCBSND Base Physician Payment Schedule,1466,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26565,Not in chargemaster,26565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26565,BCBSND Base Physician Payment Schedule,1457.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26562,Not in chargemaster,26562,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26562,BCBSND Base Physician Payment Schedule,2853.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26561,Not in chargemaster,26561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26561,BCBSND Base Physician Payment Schedule,2022.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26560,Not in chargemaster,26560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26560,BCBSND Base Physician Payment Schedule,1278.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26556,Not in chargemaster,26556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26556,BCBSND Base Physician Payment Schedule,7211.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26555,Not in chargemaster,26555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26555,BCBSND Base Physician Payment Schedule,2907.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26554,Not in chargemaster,26554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26554,BCBSND Base Physician Payment Schedule,8095.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26553,Not in chargemaster,26553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26553,BCBSND Base Physician Payment Schedule,6941.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26551,Not in chargemaster,26551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26551,BCBSND Base Physician Payment Schedule,6987.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26550,Not in chargemaster,26550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26550,BCBSND Base Physician Payment Schedule,3481.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26548,Not in chargemaster,26548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26548,BCBSND Base Physician Payment Schedule,1631.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26546,Not in chargemaster,26546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26546,BCBSND Base Physician Payment Schedule,2124.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26545,Not in chargemaster,26545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26545,BCBSND Base Physician Payment Schedule,1525.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26542,Not in chargemaster,26542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26542,BCBSND Base Physician Payment Schedule,1463.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26541,Not in chargemaster,26541,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26541,BCBSND Base Physician Payment Schedule,1714.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26540,Not in chargemaster,26540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26540,BCBSND Base Physician Payment Schedule,1418.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26536,Not in chargemaster,26536,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26536,BCBSND Base Physician Payment Schedule,1529.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26535,Not in chargemaster,26535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26535,BCBSND Base Physician Payment Schedule,916.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26531,Not in chargemaster,26531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26531,BCBSND Base Physician Payment Schedule,1326.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26530,Not in chargemaster,26530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26530,BCBSND Base Physician Payment Schedule,1139.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26525,Not in chargemaster,26525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26525,BCBSND Base Physician Payment Schedule,1394.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26520,Not in chargemaster,26520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26520,BCBSND Base Physician Payment Schedule,1390.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26518,Not in chargemaster,26518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26518,BCBSND Base Physician Payment Schedule,1794.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26517,Not in chargemaster,26517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26517,BCBSND Base Physician Payment Schedule,1771.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26516,Not in chargemaster,26516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26516,BCBSND Base Physician Payment Schedule,1511.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26510,Not in chargemaster,26510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26510,BCBSND Base Physician Payment Schedule,1295.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26508,Not in chargemaster,26508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26508,BCBSND Base Physician Payment Schedule,1366.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26502,Not in chargemaster,26502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26502,BCBSND Base Physician Payment Schedule,1531.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26500,Not in chargemaster,26500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26500,BCBSND Base Physician Payment Schedule,1340.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26499,Not in chargemaster,26499,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26499,BCBSND Base Physician Payment Schedule,1781.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26498,Not in chargemaster,26498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26498,BCBSND Base Physician Payment Schedule,2442.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26497,Not in chargemaster,26497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26497,BCBSND Base Physician Payment Schedule,1855.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26496,Not in chargemaster,26496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26496,BCBSND Base Physician Payment Schedule,1830.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26494,Not in chargemaster,26494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26494,BCBSND Base Physician Payment Schedule,1717.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26492,Not in chargemaster,26492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26492,BCBSND Base Physician Payment Schedule,1896.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26490,Not in chargemaster,26490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26490,BCBSND Base Physician Payment Schedule,1709.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26489,Not in chargemaster,26489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26489,BCBSND Base Physician Payment Schedule,1994.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26485,Not in chargemaster,26485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26485,BCBSND Base Physician Payment Schedule,1720.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26483,Not in chargemaster,26483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26483,BCBSND Base Physician Payment Schedule,1794.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26480,Not in chargemaster,26480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26480,BCBSND Base Physician Payment Schedule,1608.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26479,Not in chargemaster,26479,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26479,BCBSND Base Physician Payment Schedule,1357.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26478,Not in chargemaster,26478,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26478,BCBSND Base Physician Payment Schedule,1339.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26477,Not in chargemaster,26477,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26477,BCBSND Base Physician Payment Schedule,1253.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26476,Not in chargemaster,26476,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26476,BCBSND Base Physician Payment Schedule,1286.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26474,Not in chargemaster,26474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26474,BCBSND Base Physician Payment Schedule,1304.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26471,Not in chargemaster,26471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26471,BCBSND Base Physician Payment Schedule,1327.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26460,Not in chargemaster,26460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26460,BCBSND Base Physician Payment Schedule,869.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26455,Not in chargemaster,26455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26455,BCBSND Base Physician Payment Schedule,890.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26450,Not in chargemaster,26450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26450,BCBSND Base Physician Payment Schedule,897.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26449,Not in chargemaster,26449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26449,BCBSND Base Physician Payment Schedule,1466,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26445,Not in chargemaster,26445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26445,BCBSND Base Physician Payment Schedule,1234.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26442,Not in chargemaster,26442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26442,BCBSND Base Physician Payment Schedule,2038.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26440,Not in chargemaster,26440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26440,BCBSND Base Physician Payment Schedule,1324.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26437,Not in chargemaster,26437,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26437,BCBSND Base Physician Payment Schedule,1343.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26434,Not in chargemaster,26434,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26434,BCBSND Base Physician Payment Schedule,1402.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26433,Not in chargemaster,26433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26433,BCBSND Base Physician Payment Schedule,1146.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26432,Not in chargemaster,26432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26432,BCBSND Base Physician Payment Schedule,1079.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26428,Not in chargemaster,26428,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26428,BCBSND Base Physician Payment Schedule,1624.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26426,Not in chargemaster,26426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26426,BCBSND Base Physician Payment Schedule,1061.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26420,Not in chargemaster,26420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26420,BCBSND Base Physician Payment Schedule,1517.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26418,Not in chargemaster,26418,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26418,BCBSND Base Physician Payment Schedule,1250.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26416,Not in chargemaster,26416,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26416,BCBSND Base Physician Payment Schedule,1893.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26415,Not in chargemaster,26415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26415,BCBSND Base Physician Payment Schedule,1745.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26412,Not in chargemaster,26412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26412,BCBSND Base Physician Payment Schedule,1449.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26410,Not in chargemaster,26410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26410,BCBSND Base Physician Payment Schedule,1215.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26392,Not in chargemaster,26392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26392,BCBSND Base Physician Payment Schedule,2073.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26390,Not in chargemaster,26390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26390,BCBSND Base Physician Payment Schedule,1797.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26373,Not in chargemaster,26373,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26373,BCBSND Base Physician Payment Schedule,1813.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26372,Not in chargemaster,26372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26372,BCBSND Base Physician Payment Schedule,1889.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26370,Not in chargemaster,26370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26370,BCBSND Base Physician Payment Schedule,1613.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26358,Not in chargemaster,26358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26358,BCBSND Base Physician Payment Schedule,2081.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26357,Not in chargemaster,26357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26357,BCBSND Base Physician Payment Schedule,1880.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26356,Not in chargemaster,26356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26356,BCBSND Base Physician Payment Schedule,1678.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26352,Not in chargemaster,26352,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26352,BCBSND Base Physician Payment Schedule,1711.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26350,Not in chargemaster,26350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26350,BCBSND Base Physician Payment Schedule,1527.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26341,Not in chargemaster,26341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26341,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26340,Not in chargemaster,26340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26340,BCBSND Base Physician Payment Schedule,718.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26320,Not in chargemaster,26320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26320,BCBSND Base Physician Payment Schedule,734.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26262,Not in chargemaster,26262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26262,BCBSND Base Physician Payment Schedule,1335.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26260,Not in chargemaster,26260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26260,BCBSND Base Physician Payment Schedule,1693.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26250,Not in chargemaster,26250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26250,BCBSND Base Physician Payment Schedule,2261.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26236,Not in chargemaster,26236,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26236,BCBSND Base Physician Payment Schedule,932.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26235,Not in chargemaster,26235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26235,BCBSND Base Physician Payment Schedule,1042.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26230,Not in chargemaster,26230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26230,BCBSND Base Physician Payment Schedule,1057.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26215,Not in chargemaster,26215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26215,BCBSND Base Physician Payment Schedule,1195.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26210,Not in chargemaster,26210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26210,BCBSND Base Physician Payment Schedule,938.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26205,Not in chargemaster,26205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26205,BCBSND Base Physician Payment Schedule,1279.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26200,Not in chargemaster,26200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26200,BCBSND Base Physician Payment Schedule,955.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26185,Not in chargemaster,26185,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26185,BCBSND Base Physician Payment Schedule,1165.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26180,Not in chargemaster,26180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26180,BCBSND Base Physician Payment Schedule,943.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26170,Not in chargemaster,26170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26170,BCBSND Base Physician Payment Schedule,859.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26160,Not in chargemaster,26160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26160,BCBSND Base Physician Payment Schedule,1199.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26145,Not in chargemaster,26145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26145,BCBSND Base Physician Payment Schedule,1087.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26140,Not in chargemaster,26140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26140,BCBSND Base Physician Payment Schedule,1069.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26135,Not in chargemaster,26135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26135,BCBSND Base Physician Payment Schedule,1168.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26130,Not in chargemaster,26130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26130,BCBSND Base Physician Payment Schedule,984.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26125,Not in chargemaster,26125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26125,BCBSND Base Physician Payment Schedule,577.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26123,Not in chargemaster,26123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26123,BCBSND Base Physician Payment Schedule,1764.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26121,Not in chargemaster,26121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26121,BCBSND Base Physician Payment Schedule,1264.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26118,Not in chargemaster,26118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26118,BCBSND Base Physician Payment Schedule,2230.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26117,Not in chargemaster,26117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26117,BCBSND Base Physician Payment Schedule,1574.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26116,Not in chargemaster,26116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26116,BCBSND Base Physician Payment Schedule,1110.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26115,Not in chargemaster,26115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26115,BCBSND Base Physician Payment Schedule,1118.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26113,Not in chargemaster,26113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26113,BCBSND Base Physician Payment Schedule,1156.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26111,Not in chargemaster,26111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26111,BCBSND Base Physician Payment Schedule,880.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26110,Not in chargemaster,26110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26110,BCBSND Base Physician Payment Schedule,681.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26105,Not in chargemaster,26105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26105,BCBSND Base Physician Payment Schedule,717.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26100,Not in chargemaster,26100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26100,BCBSND Base Physician Payment Schedule,712.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26080,Not in chargemaster,26080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26080,BCBSND Base Physician Payment Schedule,830.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26075,Not in chargemaster,26075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26075,BCBSND Base Physician Payment Schedule,707.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26070,Not in chargemaster,26070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26070,BCBSND Base Physician Payment Schedule,677.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26060,Not in chargemaster,26060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26060,BCBSND Base Physician Payment Schedule,543.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26055,Not in chargemaster,26055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26055,BCBSND Base Physician Payment Schedule,1146.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26045,Not in chargemaster,26045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26045,BCBSND Base Physician Payment Schedule,992.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26040,Not in chargemaster,26040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26040,BCBSND Base Physician Payment Schedule,660.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26037,Not in chargemaster,26037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26037,BCBSND Base Physician Payment Schedule,1198.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26035,Not in chargemaster,26035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26035,BCBSND Base Physician Payment Schedule,1816.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26034,Not in chargemaster,26034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26034,BCBSND Base Physician Payment Schedule,1154.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26030,Not in chargemaster,26030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26030,BCBSND Base Physician Payment Schedule,1038.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26025,Not in chargemaster,26025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26025,BCBSND Base Physician Payment Schedule,889.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26020,Not in chargemaster,26020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26020,BCBSND Base Physician Payment Schedule,1171.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26011,Not in chargemaster,26011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26011,BCBSND Base Physician Payment Schedule,915.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 26010,26010,26010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26010,BCBSND Base Physician Payment Schedule,632.79,569.61,Fee schedule,,569.61,569.61,569.61,569.61,,,0
unity,Fee schedule,Non-facility 25931,Not in chargemaster,25931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25931,BCBSND Base Physician Payment Schedule,1623.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25929,Not in chargemaster,25929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25929,BCBSND Base Physician Payment Schedule,1264.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25927,Not in chargemaster,25927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25927,BCBSND Base Physician Payment Schedule,1761.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25924,Not in chargemaster,25924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25924,BCBSND Base Physician Payment Schedule,1474.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25922,Not in chargemaster,25922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25922,BCBSND Base Physician Payment Schedule,1330.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25920,Not in chargemaster,25920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25920,BCBSND Base Physician Payment Schedule,1511.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25915,Not in chargemaster,25915,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25915,BCBSND Base Physician Payment Schedule,2480.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25909,Not in chargemaster,25909,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25909,BCBSND Base Physician Payment Schedule,1452.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25907,Not in chargemaster,25907,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25907,BCBSND Base Physician Payment Schedule,1300.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25905,Not in chargemaster,25905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25905,BCBSND Base Physician Payment Schedule,1486.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25900,Not in chargemaster,25900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25900,BCBSND Base Physician Payment Schedule,1506.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25830,Not in chargemaster,25830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25830,BCBSND Base Physician Payment Schedule,2065.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25825,Not in chargemaster,25825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25825,BCBSND Base Physician Payment Schedule,1638.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25820,Not in chargemaster,25820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25820,BCBSND Base Physician Payment Schedule,1335.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25810,Not in chargemaster,25810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25810,BCBSND Base Physician Payment Schedule,1834.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25805,Not in chargemaster,25805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25805,BCBSND Base Physician Payment Schedule,1794.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25800,Not in chargemaster,25800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25800,BCBSND Base Physician Payment Schedule,1548.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25695,Not in chargemaster,25695,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25695,BCBSND Base Physician Payment Schedule,1343.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25690,Not in chargemaster,25690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25690,BCBSND Base Physician Payment Schedule,1027.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25685,Not in chargemaster,25685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25685,BCBSND Base Physician Payment Schedule,1557.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25680,Not in chargemaster,25680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25680,BCBSND Base Physician Payment Schedule,1109.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25676,Not in chargemaster,25676,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25676,BCBSND Base Physician Payment Schedule,1336.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25675,Not in chargemaster,25675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25675,BCBSND Base Physician Payment Schedule,934.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25671,Not in chargemaster,25671,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25671,BCBSND Base Physician Payment Schedule,1123.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25670,Not in chargemaster,25670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25670,BCBSND Base Physician Payment Schedule,1286.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25660,Not in chargemaster,25660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25660,BCBSND Base Physician Payment Schedule,876.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25652,Not in chargemaster,25652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25652,BCBSND Base Physician Payment Schedule,1316.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25651,Not in chargemaster,25651,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25651,BCBSND Base Physician Payment Schedule,1031.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25650,Not in chargemaster,25650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25650,BCBSND Base Physician Payment Schedule,686.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25645,Not in chargemaster,25645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25645,BCBSND Base Physician Payment Schedule,1206.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25635,Not in chargemaster,25635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25635,BCBSND Base Physician Payment Schedule,970.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25630,Not in chargemaster,25630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25630,BCBSND Base Physician Payment Schedule,643.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25628,Not in chargemaster,25628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25628,BCBSND Base Physician Payment Schedule,1521.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25624,Not in chargemaster,25624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25624,BCBSND Base Physician Payment Schedule,1019.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25622,25622,25622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25622,BCBSND Base Physician Payment Schedule,643.07,653.08,Fee schedule,,643.07,643.07,643.07,643.07,,,0
unity,Fee schedule,Non-facility 25609,Not in chargemaster,25609,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25609,BCBSND Base Physician Payment Schedule,2221.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25608,Not in chargemaster,25608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25608,BCBSND Base Physician Payment Schedule,1745.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25607,Not in chargemaster,25607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25607,BCBSND Base Physician Payment Schedule,1556.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25606,Not in chargemaster,25606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25606,BCBSND Base Physician Payment Schedule,1402.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25605,25605,25605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25605,BCBSND Base Physician Payment Schedule,1143.73,1167.02,Fee schedule,,1143.73,1143.73,1143.73,1143.73,,,0
unity,Fee schedule,Non-facility 25600,25600,25600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25600,BCBSND Base Physician Payment Schedule,698.13,715,Fee schedule,,698.13,698.13,698.13,698.13,,,0
unity,Fee schedule,Non-facility 25575,Not in chargemaster,25575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25575,BCBSND Base Physician Payment Schedule,1908.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25574,Not in chargemaster,25574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25574,BCBSND Base Physician Payment Schedule,1425.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25565,Not in chargemaster,25565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25565,BCBSND Base Physician Payment Schedule,1090.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25560,25560,25560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25560,BCBSND Base Physician Payment Schedule,598.29,610,Fee schedule,,598.29,598.29,598.29,598.29,,,0
unity,Fee schedule,Non-facility 25545,Not in chargemaster,25545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25545,BCBSND Base Physician Payment Schedule,1316.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25535,Not in chargemaster,25535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25535,BCBSND Base Physician Payment Schedule,1034.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25530,25530,25530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25530,BCBSND Base Physician Payment Schedule,552.04,506.86,Fee schedule,,506.86,506.86,506.86,506.86,,,0
unity,Fee schedule,Non-facility 25526,Not in chargemaster,25526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25526,BCBSND Base Physician Payment Schedule,2023.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25525,Not in chargemaster,25525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25525,BCBSND Base Physician Payment Schedule,1669.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25520,Not in chargemaster,25520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25520,BCBSND Base Physician Payment Schedule,1209.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25515,Not in chargemaster,25515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25515,BCBSND Base Physician Payment Schedule,1416.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25505,Not in chargemaster,25505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25505,BCBSND Base Physician Payment Schedule,1063.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25500,Not in chargemaster,25500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25500,BCBSND Base Physician Payment Schedule,585.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25492,Not in chargemaster,25492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25492,BCBSND Base Physician Payment Schedule,1919.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25491,Not in chargemaster,25491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25491,BCBSND Base Physician Payment Schedule,1565.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25490,Not in chargemaster,25490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25490,BCBSND Base Physician Payment Schedule,1522.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25455,Not in chargemaster,25455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25455,BCBSND Base Physician Payment Schedule,1541.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25450,Not in chargemaster,25450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25450,BCBSND Base Physician Payment Schedule,1305.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25449,Not in chargemaster,25449,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25449,BCBSND Base Physician Payment Schedule,2192.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25447,Not in chargemaster,25447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25447,BCBSND Base Physician Payment Schedule,1753.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25446,Not in chargemaster,25446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25446,BCBSND Base Physician Payment Schedule,2485.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25445,Not in chargemaster,25445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25445,BCBSND Base Physician Payment Schedule,1528.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25444,Not in chargemaster,25444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25444,BCBSND Base Physician Payment Schedule,1754.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25443,Not in chargemaster,25443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25443,BCBSND Base Physician Payment Schedule,1659.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25442,Not in chargemaster,25442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25442,BCBSND Base Physician Payment Schedule,1708.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25441,Not in chargemaster,25441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25441,BCBSND Base Physician Payment Schedule,1987.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25440,Not in chargemaster,25440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25440,BCBSND Base Physician Payment Schedule,1624.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25431,Not in chargemaster,25431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25431,BCBSND Base Physician Payment Schedule,1671.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25430,Not in chargemaster,25430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25430,BCBSND Base Physician Payment Schedule,1546.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25426,Not in chargemaster,25426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25426,BCBSND Base Physician Payment Schedule,2383.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25425,Not in chargemaster,25425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25425,BCBSND Base Physician Payment Schedule,2043.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25420,Not in chargemaster,25420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25420,BCBSND Base Physician Payment Schedule,2474.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25415,Not in chargemaster,25415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25415,BCBSND Base Physician Payment Schedule,2053.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25405,Not in chargemaster,25405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25405,BCBSND Base Physician Payment Schedule,2198.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25400,Not in chargemaster,25400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25400,BCBSND Base Physician Payment Schedule,1700.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25394,Not in chargemaster,25394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25394,BCBSND Base Physician Payment Schedule,1662.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25393,Not in chargemaster,25393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25393,BCBSND Base Physician Payment Schedule,2396.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25392,Not in chargemaster,25392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25392,BCBSND Base Physician Payment Schedule,2151.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25391,Not in chargemaster,25391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25391,BCBSND Base Physician Payment Schedule,2113.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25390,Not in chargemaster,25390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25390,BCBSND Base Physician Payment Schedule,1628.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25375,Not in chargemaster,25375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25375,BCBSND Base Physician Payment Schedule,2023.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25370,Not in chargemaster,25370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25370,BCBSND Base Physician Payment Schedule,2139.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25365,Not in chargemaster,25365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25365,BCBSND Base Physician Payment Schedule,1941.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25360,Not in chargemaster,25360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25360,BCBSND Base Physician Payment Schedule,1384.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25355,Not in chargemaster,25355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25355,BCBSND Base Physician Payment Schedule,1620.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25350,Not in chargemaster,25350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25350,BCBSND Base Physician Payment Schedule,1429.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25337,Not in chargemaster,25337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25337,BCBSND Base Physician Payment Schedule,1873.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25335,Not in chargemaster,25335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25335,BCBSND Base Physician Payment Schedule,2001.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25332,Not in chargemaster,25332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25332,BCBSND Base Physician Payment Schedule,1784.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25320,Not in chargemaster,25320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25320,BCBSND Base Physician Payment Schedule,2080.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25316,Not in chargemaster,25316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25316,BCBSND Base Physician Payment Schedule,1940.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25315,Not in chargemaster,25315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25315,BCBSND Base Physician Payment Schedule,1632.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25312,Not in chargemaster,25312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25312,BCBSND Base Physician Payment Schedule,1520.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25310,Not in chargemaster,25310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25310,BCBSND Base Physician Payment Schedule,1310.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25301,Not in chargemaster,25301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25301,BCBSND Base Physician Payment Schedule,1361.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25300,Not in chargemaster,25300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25300,BCBSND Base Physician Payment Schedule,1446.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25295,Not in chargemaster,25295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25295,BCBSND Base Physician Payment Schedule,1112.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25290,Not in chargemaster,25290,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25290,BCBSND Base Physician Payment Schedule,920.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25280,Not in chargemaster,25280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25280,BCBSND Base Physician Payment Schedule,1196.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25275,Not in chargemaster,25275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25275,BCBSND Base Physician Payment Schedule,1421.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25274,Not in chargemaster,25274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25274,BCBSND Base Physician Payment Schedule,1408.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25272,Not in chargemaster,25272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25272,BCBSND Base Physician Payment Schedule,1181.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25270,Not in chargemaster,25270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25270,BCBSND Base Physician Payment Schedule,1041.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25265,Not in chargemaster,25265,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25265,BCBSND Base Physician Payment Schedule,1584.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25263,Not in chargemaster,25263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25263,BCBSND Base Physician Payment Schedule,1335.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25260,Not in chargemaster,25260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25260,BCBSND Base Physician Payment Schedule,1334.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25259,Not in chargemaster,25259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25259,BCBSND Base Physician Payment Schedule,892.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25251,Not in chargemaster,25251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25251,BCBSND Base Physician Payment Schedule,1524.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25250,Not in chargemaster,25250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25250,BCBSND Base Physician Payment Schedule,1125.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25248,Not in chargemaster,25248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25248,BCBSND Base Physician Payment Schedule,878.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25246,Not in chargemaster,25246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25246,BCBSND Base Physician Payment Schedule,385.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25240,Not in chargemaster,25240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25240,BCBSND Base Physician Payment Schedule,906.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25230,Not in chargemaster,25230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25230,BCBSND Base Physician Payment Schedule,913.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25215,Not in chargemaster,25215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25215,BCBSND Base Physician Payment Schedule,1307.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25210,Not in chargemaster,25210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25210,BCBSND Base Physician Payment Schedule,1036.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25170,Not in chargemaster,25170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25170,BCBSND Base Physician Payment Schedule,3126.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25151,Not in chargemaster,25151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25151,BCBSND Base Physician Payment Schedule,1234.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25150,Not in chargemaster,25150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25150,BCBSND Base Physician Payment Schedule,1195.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25145,Not in chargemaster,25145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25145,BCBSND Base Physician Payment Schedule,1098.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25136,Not in chargemaster,25136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25136,BCBSND Base Physician Payment Schedule,1049.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25135,Not in chargemaster,25135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25135,BCBSND Base Physician Payment Schedule,1183.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25130,Not in chargemaster,25130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25130,BCBSND Base Physician Payment Schedule,947.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25126,Not in chargemaster,25126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25126,BCBSND Base Physician Payment Schedule,1265.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25125,Not in chargemaster,25125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25125,BCBSND Base Physician Payment Schedule,1256.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25120,Not in chargemaster,25120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25120,BCBSND Base Physician Payment Schedule,1058.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25119,Not in chargemaster,25119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25119,BCBSND Base Physician Payment Schedule,1049.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25118,Not in chargemaster,25118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25118,BCBSND Base Physician Payment Schedule,804.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25116,Not in chargemaster,25116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25116,BCBSND Base Physician Payment Schedule,1269.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25115,Not in chargemaster,25115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25115,BCBSND Base Physician Payment Schedule,1601.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25112,Not in chargemaster,25112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25112,BCBSND Base Physician Payment Schedule,818.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25111,25111,25111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25111,BCBSND Base Physician Payment Schedule,678.31,678.63,Fee schedule,,678.31,678.31,678.31,678.31,,,0
unity,Fee schedule,Non-facility 25110,Not in chargemaster,25110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25110,BCBSND Base Physician Payment Schedule,722.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25109,Not in chargemaster,25109,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25109,BCBSND Base Physician Payment Schedule,1136.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25107,Not in chargemaster,25107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25107,BCBSND Base Physician Payment Schedule,1300.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25105,Not in chargemaster,25105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25105,BCBSND Base Physician Payment Schedule,1025.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25101,Not in chargemaster,25101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25101,BCBSND Base Physician Payment Schedule,853.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25100,Not in chargemaster,25100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25100,BCBSND Base Physician Payment Schedule,734.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25085,Not in chargemaster,25085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25085,BCBSND Base Physician Payment Schedule,949.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25078,Not in chargemaster,25078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25078,BCBSND Base Physician Payment Schedule,2469.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25077,Not in chargemaster,25077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25077,BCBSND Base Physician Payment Schedule,1882.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25076,Not in chargemaster,25076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25076,BCBSND Base Physician Payment Schedule,1094.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25075,Not in chargemaster,25075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25075,BCBSND Base Physician Payment Schedule,1065.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25073,Not in chargemaster,25073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25073,BCBSND Base Physician Payment Schedule,1132.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25071,Not in chargemaster,25071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25071,BCBSND Base Physician Payment Schedule,899.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25066,Not in chargemaster,25066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25066,BCBSND Base Physician Payment Schedule,756.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25065,Not in chargemaster,25065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25065,BCBSND Base Physician Payment Schedule,541.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25040,Not in chargemaster,25040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25040,BCBSND Base Physician Payment Schedule,1187.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25035,Not in chargemaster,25035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25035,BCBSND Base Physician Payment Schedule,1234.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25031,Not in chargemaster,25031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25031,BCBSND Base Physician Payment Schedule,740.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25028,Not in chargemaster,25028,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25028,BCBSND Base Physician Payment Schedule,1253.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25025,Not in chargemaster,25025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25025,BCBSND Base Physician Payment Schedule,2552.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25024,Not in chargemaster,25024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25024,BCBSND Base Physician Payment Schedule,1656.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25023,Not in chargemaster,25023,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25023,BCBSND Base Physician Payment Schedule,2531.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25020,Not in chargemaster,25020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25020,BCBSND Base Physician Payment Schedule,1347.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25001,Not in chargemaster,25001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25001,BCBSND Base Physician Payment Schedule,725.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 25000,Not in chargemaster,25000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25000,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24935,Not in chargemaster,24935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24935,BCBSND Base Physician Payment Schedule,2517.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24931,Not in chargemaster,24931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24931,BCBSND Base Physician Payment Schedule,1976.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24930,Not in chargemaster,24930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24930,BCBSND Base Physician Payment Schedule,1641.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24925,Not in chargemaster,24925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24925,BCBSND Base Physician Payment Schedule,1200.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24920,Not in chargemaster,24920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24920,BCBSND Base Physician Payment Schedule,1552.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24900,Not in chargemaster,24900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24900,BCBSND Base Physician Payment Schedule,1563.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24802,Not in chargemaster,24802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24802,BCBSND Base Physician Payment Schedule,2125.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24800,Not in chargemaster,24800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24800,BCBSND Base Physician Payment Schedule,1761.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24685,Not in chargemaster,24685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24685,BCBSND Base Physician Payment Schedule,1383.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24675,Not in chargemaster,24675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24675,BCBSND Base Physician Payment Schedule,968.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24670,Not in chargemaster,24670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24670,BCBSND Base Physician Payment Schedule,613.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24666,Not in chargemaster,24666,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24666,BCBSND Base Physician Payment Schedule,1552.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24665,Not in chargemaster,24665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24665,BCBSND Base Physician Payment Schedule,1385.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24655,Not in chargemaster,24655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24655,BCBSND Base Physician Payment Schedule,930.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24650,24650,24650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24650,BCBSND Base Physician Payment Schedule,551.31,560.79,Fee schedule,,551.31,551.31,551.31,551.31,,,0
unity,Fee schedule,Non-facility 24640,24640,24640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24640,BCBSND Base Physician Payment Schedule,212.15,305.95,Fee schedule,,212.15,212.15,212.15,212.15,,,0
unity,Fee schedule,Non-facility 24635,Not in chargemaster,24635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24635,BCBSND Base Physician Payment Schedule,1426.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24620,Not in chargemaster,24620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24620,BCBSND Base Physician Payment Schedule,1173.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24615,Not in chargemaster,24615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24615,BCBSND Base Physician Payment Schedule,1512.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24605,Not in chargemaster,24605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24605,BCBSND Base Physician Payment Schedule,1001.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24600,Not in chargemaster,24600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24600,BCBSND Base Physician Payment Schedule,782.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24587,Not in chargemaster,24587,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24587,BCBSND Base Physician Payment Schedule,2307.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24586,Not in chargemaster,24586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24586,BCBSND Base Physician Payment Schedule,2305.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24582,Not in chargemaster,24582,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24582,BCBSND Base Physician Payment Schedule,1714.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24579,Not in chargemaster,24579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24579,BCBSND Base Physician Payment Schedule,1761.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24577,Not in chargemaster,24577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24577,BCBSND Base Physician Payment Schedule,1166.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24576,Not in chargemaster,24576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24576,BCBSND Base Physician Payment Schedule,728.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24575,Not in chargemaster,24575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24575,BCBSND Base Physician Payment Schedule,1551.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24566,Not in chargemaster,24566,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24566,BCBSND Base Physician Payment Schedule,1520.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24565,Not in chargemaster,24565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24565,BCBSND Base Physician Payment Schedule,1134.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24560,Not in chargemaster,24560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24560,BCBSND Base Physician Payment Schedule,692.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24546,Not in chargemaster,24546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24546,BCBSND Base Physician Payment Schedule,2200.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24545,Not in chargemaster,24545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24545,BCBSND Base Physician Payment Schedule,1970.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24538,Not in chargemaster,24538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24538,BCBSND Base Physician Payment Schedule,1615.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24535,Not in chargemaster,24535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24535,BCBSND Base Physician Payment Schedule,1302.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24530,Not in chargemaster,24530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24530,BCBSND Base Physician Payment Schedule,800.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24516,Not in chargemaster,24516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24516,BCBSND Base Physician Payment Schedule,1820.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24515,Not in chargemaster,24515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24515,BCBSND Base Physician Payment Schedule,1862.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24505,Not in chargemaster,24505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24505,BCBSND Base Physician Payment Schedule,1052.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24500,24500,24500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24500,BCBSND Base Physician Payment Schedule,754.65,764.53,Fee schedule,,754.65,754.65,754.65,754.65,,,0
unity,Fee schedule,Non-facility 24498,Not in chargemaster,24498,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24498,BCBSND Base Physician Payment Schedule,1836.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24495,Not in chargemaster,24495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24495,BCBSND Base Physician Payment Schedule,1719.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24470,Not in chargemaster,24470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24470,BCBSND Base Physician Payment Schedule,1421.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24435,Not in chargemaster,24435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24435,BCBSND Base Physician Payment Schedule,2278.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24430,Not in chargemaster,24430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24430,BCBSND Base Physician Payment Schedule,2239.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24420,Not in chargemaster,24420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24420,BCBSND Base Physician Payment Schedule,2172.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24410,Not in chargemaster,24410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24410,BCBSND Base Physician Payment Schedule,2241.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24400,Not in chargemaster,24400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24400,BCBSND Base Physician Payment Schedule,1744.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24371,Not in chargemaster,24371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24371,BCBSND Base Physician Payment Schedule,3780.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24370,Not in chargemaster,24370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24370,BCBSND Base Physician Payment Schedule,3277.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24366,Not in chargemaster,24366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24366,BCBSND Base Physician Payment Schedule,1446.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24365,Not in chargemaster,24365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24365,BCBSND Base Physician Payment Schedule,1355.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24363,Not in chargemaster,24363,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24363,BCBSND Base Physician Payment Schedule,3082.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24362,Not in chargemaster,24362,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24362,BCBSND Base Physician Payment Schedule,2249.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24361,Not in chargemaster,24361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24361,BCBSND Base Physician Payment Schedule,2136.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24360,Not in chargemaster,24360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24360,BCBSND Base Physician Payment Schedule,1910.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24359,Not in chargemaster,24359,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24359,BCBSND Base Physician Payment Schedule,1401.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24358,Not in chargemaster,24358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24358,BCBSND Base Physician Payment Schedule,1113.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24357,Not in chargemaster,24357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24357,BCBSND Base Physician Payment Schedule,879.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24346,Not in chargemaster,24346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24346,BCBSND Base Physician Payment Schedule,2332.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24345,Not in chargemaster,24345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24345,BCBSND Base Physician Payment Schedule,1485.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24344,Not in chargemaster,24344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24344,BCBSND Base Physician Payment Schedule,2317.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24343,Not in chargemaster,24343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24343,BCBSND Base Physician Payment Schedule,1499.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24342,Not in chargemaster,24342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24342,BCBSND Base Physician Payment Schedule,1643.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24341,Not in chargemaster,24341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24341,BCBSND Base Physician Payment Schedule,1576.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24340,Not in chargemaster,24340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24340,BCBSND Base Physician Payment Schedule,1300.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24332,Not in chargemaster,24332,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24332,BCBSND Base Physician Payment Schedule,1298.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24331,Not in chargemaster,24331,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24331,BCBSND Base Physician Payment Schedule,1666.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24330,Not in chargemaster,24330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24330,BCBSND Base Physician Payment Schedule,1521.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24320,Not in chargemaster,24320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24320,BCBSND Base Physician Payment Schedule,1655.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24310,Not in chargemaster,24310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24310,BCBSND Base Physician Payment Schedule,997.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24305,Not in chargemaster,24305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24305,BCBSND Base Physician Payment Schedule,1225.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24301,Not in chargemaster,24301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24301,BCBSND Base Physician Payment Schedule,1587.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24300,Not in chargemaster,24300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24300,BCBSND Base Physician Payment Schedule,899.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24220,Not in chargemaster,24220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24220,BCBSND Base Physician Payment Schedule,375.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24201,Not in chargemaster,24201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24201,BCBSND Base Physician Payment Schedule,1156.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24200,Not in chargemaster,24200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24200,BCBSND Base Physician Payment Schedule,455.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24164,Not in chargemaster,24164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24164,BCBSND Base Physician Payment Schedule,1528.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24160,Not in chargemaster,24160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24160,BCBSND Base Physician Payment Schedule,2667.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24155,Not in chargemaster,24155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24155,BCBSND Base Physician Payment Schedule,1806.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24152,Not in chargemaster,24152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24152,BCBSND Base Physician Payment Schedule,2857.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24150,Not in chargemaster,24150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24150,BCBSND Base Physician Payment Schedule,3289.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24149,Not in chargemaster,24149,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24149,BCBSND Base Physician Payment Schedule,2487.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24147,Not in chargemaster,24147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24147,BCBSND Base Physician Payment Schedule,1320.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24145,Not in chargemaster,24145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24145,BCBSND Base Physician Payment Schedule,1256.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24140,Not in chargemaster,24140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24140,BCBSND Base Physician Payment Schedule,1488.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24138,Not in chargemaster,24138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24138,BCBSND Base Physician Payment Schedule,1440.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24136,Not in chargemaster,24136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24136,BCBSND Base Physician Payment Schedule,1338.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24134,Not in chargemaster,24134,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24134,BCBSND Base Physician Payment Schedule,1583.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24130,Not in chargemaster,24130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24130,BCBSND Base Physician Payment Schedule,1078.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24126,Not in chargemaster,24126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24126,BCBSND Base Physician Payment Schedule,1374.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24125,Not in chargemaster,24125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24125,BCBSND Base Physician Payment Schedule,1315.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24120,Not in chargemaster,24120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24120,BCBSND Base Physician Payment Schedule,1126.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24116,Not in chargemaster,24116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24116,BCBSND Base Physician Payment Schedule,1825.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24115,Not in chargemaster,24115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24115,BCBSND Base Physician Payment Schedule,1562.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24110,Not in chargemaster,24110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24110,BCBSND Base Physician Payment Schedule,1242.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24105,Not in chargemaster,24105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24105,BCBSND Base Physician Payment Schedule,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24102,Not in chargemaster,24102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24102,BCBSND Base Physician Payment Schedule,1305.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24101,Not in chargemaster,24101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24101,BCBSND Base Physician Payment Schedule,1060.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24100,Not in chargemaster,24100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24100,BCBSND Base Physician Payment Schedule,884.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24079,Not in chargemaster,24079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24079,BCBSND Base Physician Payment Schedule,2816.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24077,Not in chargemaster,24077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24077,BCBSND Base Physician Payment Schedule,2209.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24076,Not in chargemaster,24076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24076,BCBSND Base Physician Payment Schedule,1151.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24075,Not in chargemaster,24075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24075,BCBSND Base Physician Payment Schedule,1092.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24073,24073,24073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24073,BCBSND Base Physician Payment Schedule,1477.01,1450.26,Fee schedule,,1450.26,1450.26,1450.26,1450.26,,,0
unity,Fee schedule,Non-facility 24071,Not in chargemaster,24071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24071,BCBSND Base Physician Payment Schedule,861.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24066,Not in chargemaster,24066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24066,BCBSND Base Physician Payment Schedule,1311.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24065,Not in chargemaster,24065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24065,BCBSND Base Physician Payment Schedule,543.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24006,Not in chargemaster,24006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24006,BCBSND Base Physician Payment Schedule,1507.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 24000,Not in chargemaster,24000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24000,BCBSND Base Physician Payment Schedule,1011.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23935,Not in chargemaster,23935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23935,BCBSND Base Physician Payment Schedule,1082.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23931,Not in chargemaster,23931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23931,BCBSND Base Physician Payment Schedule,608.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23930,Not in chargemaster,23930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23930,BCBSND Base Physician Payment Schedule,750.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23921,Not in chargemaster,23921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23921,BCBSND Base Physician Payment Schedule,991.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23920,Not in chargemaster,23920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23920,BCBSND Base Physician Payment Schedule,2383.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23900,Not in chargemaster,23900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23900,BCBSND Base Physician Payment Schedule,2943.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23802,Not in chargemaster,23802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23802,BCBSND Base Physician Payment Schedule,2718.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23800,Not in chargemaster,23800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23800,BCBSND Base Physician Payment Schedule,2177.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23700,Not in chargemaster,23700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23700,BCBSND Base Physician Payment Schedule,413.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23680,Not in chargemaster,23680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23680,BCBSND Base Physician Payment Schedule,1971.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23675,Not in chargemaster,23675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23675,BCBSND Base Physician Payment Schedule,1167.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23670,Not in chargemaster,23670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23670,BCBSND Base Physician Payment Schedule,1851.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23665,Not in chargemaster,23665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23665,BCBSND Base Physician Payment Schedule,905.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23660,Not in chargemaster,23660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23660,BCBSND Base Physician Payment Schedule,1236.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23655,23655,23655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23655,BCBSND Base Physician Payment Schedule,854.49,839.77,Fee schedule,,839.77,839.77,839.77,839.77,,,0
unity,Fee schedule,Non-facility 23650,23650,23650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23650,BCBSND Base Physician Payment Schedule,673.9,672.96,Fee schedule,,672.96,672.96,672.96,672.96,,,0
unity,Fee schedule,Non-facility 23630,Not in chargemaster,23630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23630,BCBSND Base Physician Payment Schedule,1650.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23625,Not in chargemaster,23625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23625,BCBSND Base Physician Payment Schedule,803.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23620,Not in chargemaster,23620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23620,BCBSND Base Physician Payment Schedule,565.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23616,Not in chargemaster,23616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23616,BCBSND Base Physician Payment Schedule,2625.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23615,Not in chargemaster,23615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23615,BCBSND Base Physician Payment Schedule,1871.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23605,Not in chargemaster,23605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23605,BCBSND Base Physician Payment Schedule,987.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23600,Not in chargemaster,23600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23600,BCBSND Base Physician Payment Schedule,693.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23585,Not in chargemaster,23585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23585,BCBSND Base Physician Payment Schedule,2076.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23575,Not in chargemaster,23575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23575,BCBSND Base Physician Payment Schedule,855.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23570,Not in chargemaster,23570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23570,BCBSND Base Physician Payment Schedule,491.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23552,Not in chargemaster,23552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23552,BCBSND Base Physician Payment Schedule,1383.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23550,Not in chargemaster,23550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23550,BCBSND Base Physician Payment Schedule,1212.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23545,Not in chargemaster,23545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23545,BCBSND Base Physician Payment Schedule,723.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23540,Not in chargemaster,23540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23540,BCBSND Base Physician Payment Schedule,489.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23532,Not in chargemaster,23532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23532,BCBSND Base Physician Payment Schedule,1323.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23530,Not in chargemaster,23530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23530,BCBSND Base Physician Payment Schedule,1214.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23525,Not in chargemaster,23525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23525,BCBSND Base Physician Payment Schedule,822.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23520,Not in chargemaster,23520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23520,BCBSND Base Physician Payment Schedule,499.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23515,Not in chargemaster,23515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23515,BCBSND Base Physician Payment Schedule,1524.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23505,Not in chargemaster,23505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23505,BCBSND Base Physician Payment Schedule,753.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23500,23500,23500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23500,BCBSND Base Physician Payment Schedule,463.95,467.8,Fee schedule,,463.95,463.95,463.95,463.95,,,0
unity,Fee schedule,Non-facility 23491,Not in chargemaster,23491,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23491,BCBSND Base Physician Payment Schedule,2153.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23490,Not in chargemaster,23490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23490,BCBSND Base Physician Payment Schedule,1826.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23485,Not in chargemaster,23485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23485,BCBSND Base Physician Payment Schedule,2029.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23480,Not in chargemaster,23480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23480,BCBSND Base Physician Payment Schedule,1739.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23474,Not in chargemaster,23474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23474,BCBSND Base Physician Payment Schedule,3714.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23473,Not in chargemaster,23473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23473,BCBSND Base Physician Payment Schedule,3437.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23472,Not in chargemaster,23472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23472,BCBSND Base Physician Payment Schedule,3081.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23470,Not in chargemaster,23470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23470,BCBSND Base Physician Payment Schedule,2548.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23466,Not in chargemaster,23466,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23466,BCBSND Base Physician Payment Schedule,2352.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23465,Not in chargemaster,23465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23465,BCBSND Base Physician Payment Schedule,2373.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23462,Not in chargemaster,23462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23462,BCBSND Base Physician Payment Schedule,2268.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23460,Not in chargemaster,23460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23460,BCBSND Base Physician Payment Schedule,2310.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23455,Not in chargemaster,23455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23455,BCBSND Base Physician Payment Schedule,2108.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23450,Not in chargemaster,23450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23450,BCBSND Base Physician Payment Schedule,2010.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23440,Not in chargemaster,23440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23440,BCBSND Base Physician Payment Schedule,1602.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23430,Not in chargemaster,23430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23430,BCBSND Base Physician Payment Schedule,1577.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23420,Not in chargemaster,23420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23420,BCBSND Base Physician Payment Schedule,2060.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23415,Not in chargemaster,23415,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23415,BCBSND Base Physician Payment Schedule,1476.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23412,Not in chargemaster,23412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23412,BCBSND Base Physician Payment Schedule,1807.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23410,Not in chargemaster,23410,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23410,BCBSND Base Physician Payment Schedule,1738.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23406,Not in chargemaster,23406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23406,BCBSND Base Physician Payment Schedule,1629.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23405,Not in chargemaster,23405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23405,BCBSND Base Physician Payment Schedule,1312.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23400,Not in chargemaster,23400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23400,BCBSND Base Physician Payment Schedule,2061.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23397,Not in chargemaster,23397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23397,BCBSND Base Physician Payment Schedule,2421.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23395,Not in chargemaster,23395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23395,BCBSND Base Physician Payment Schedule,2722.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23350,Not in chargemaster,23350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23350,BCBSND Base Physician Payment Schedule,319.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23335,Not in chargemaster,23335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23335,BCBSND Base Physician Payment Schedule,2697.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23334,Not in chargemaster,23334,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23334,BCBSND Base Physician Payment Schedule,2262.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23333,Not in chargemaster,23333,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23333,BCBSND Base Physician Payment Schedule,981.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23330,Not in chargemaster,23330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23330,BCBSND Base Physician Payment Schedule,608.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23220,Not in chargemaster,23220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23220,BCBSND Base Physician Payment Schedule,4139.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23210,Not in chargemaster,23210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23210,BCBSND Base Physician Payment Schedule,3765.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23200,Not in chargemaster,23200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23200,BCBSND Base Physician Payment Schedule,3204.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23195,Not in chargemaster,23195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23195,BCBSND Base Physician Payment Schedule,1584.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23190,Not in chargemaster,23190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23190,BCBSND Base Physician Payment Schedule,1214.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23184,Not in chargemaster,23184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23184,BCBSND Base Physician Payment Schedule,1562.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23182,Not in chargemaster,23182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23182,BCBSND Base Physician Payment Schedule,1395.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23180,Not in chargemaster,23180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23180,BCBSND Base Physician Payment Schedule,1408.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23174,Not in chargemaster,23174,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23174,BCBSND Base Physician Payment Schedule,1609.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23172,Not in chargemaster,23172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23172,BCBSND Base Physician Payment Schedule,1201.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23170,Not in chargemaster,23170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23170,BCBSND Base Physician Payment Schedule,1189.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23156,Not in chargemaster,23156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23156,BCBSND Base Physician Payment Schedule,1436.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23155,Not in chargemaster,23155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23155,BCBSND Base Physician Payment Schedule,1686.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23150,Not in chargemaster,23150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23150,BCBSND Base Physician Payment Schedule,1412.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23146,Not in chargemaster,23146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23146,BCBSND Base Physician Payment Schedule,1316.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23145,Not in chargemaster,23145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23145,BCBSND Base Physician Payment Schedule,1473.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23140,Not in chargemaster,23140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23140,BCBSND Base Physician Payment Schedule,1171.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23130,Not in chargemaster,23130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23130,BCBSND Base Physician Payment Schedule,1297.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23125,Not in chargemaster,23125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23125,BCBSND Base Physician Payment Schedule,1503.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23120,Not in chargemaster,23120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23120,BCBSND Base Physician Payment Schedule,1237.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23107,Not in chargemaster,23107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23107,BCBSND Base Physician Payment Schedule,1396.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23106,Not in chargemaster,23106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23106,BCBSND Base Physician Payment Schedule,1055.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23105,Not in chargemaster,23105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23105,BCBSND Base Physician Payment Schedule,1347.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23101,Not in chargemaster,23101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23101,BCBSND Base Physician Payment Schedule,966.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23100,Not in chargemaster,23100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23100,BCBSND Base Physician Payment Schedule,1064.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23078,Not in chargemaster,23078,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23078,BCBSND Base Physician Payment Schedule,3054.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23077,Not in chargemaster,23077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23077,BCBSND Base Physician Payment Schedule,2404.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23076,Not in chargemaster,23076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23076,BCBSND Base Physician Payment Schedule,1147.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23075,Not in chargemaster,23075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23075,BCBSND Base Physician Payment Schedule,1056.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23073,Not in chargemaster,23073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23073,BCBSND Base Physician Payment Schedule,1477.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23071,Not in chargemaster,23071,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23071,BCBSND Base Physician Payment Schedule,891.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23066,Not in chargemaster,23066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23066,BCBSND Base Physician Payment Schedule,1192.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23065,Not in chargemaster,23065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23065,BCBSND Base Physician Payment Schedule,468.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23044,Not in chargemaster,23044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23044,BCBSND Base Physician Payment Schedule,1198.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23040,Not in chargemaster,23040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23040,BCBSND Base Physician Payment Schedule,1520.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23035,Not in chargemaster,23035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23035,BCBSND Base Physician Payment Schedule,1441.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23031,Not in chargemaster,23031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23031,BCBSND Base Physician Payment Schedule,847.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23030,Not in chargemaster,23030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23030,BCBSND Base Physician Payment Schedule,913.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23020,Not in chargemaster,23020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23020,BCBSND Base Physician Payment Schedule,1462.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 23000,Not in chargemaster,23000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23000,BCBSND Base Physician Payment Schedule,1210.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22905,Not in chargemaster,22905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22905,BCBSND Base Physician Payment Schedule,2832.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22904,Not in chargemaster,22904,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22904,BCBSND Base Physician Payment Schedule,2241.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22903,Not in chargemaster,22903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22903,BCBSND Base Physician Payment Schedule,933.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22902,Not in chargemaster,22902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22902,BCBSND Base Physician Payment Schedule,967.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22901,Not in chargemaster,22901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22901,BCBSND Base Physician Payment Schedule,1420.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22900,Not in chargemaster,22900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22900,BCBSND Base Physician Payment Schedule,1196.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22870,Not in chargemaster,22870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22870,BCBSND Base Physician Payment Schedule,263.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22869,Not in chargemaster,22869,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22869,BCBSND Base Physician Payment Schedule,943.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22868,Not in chargemaster,22868,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22868,BCBSND Base Physician Payment Schedule,519.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22867,Not in chargemaster,22867,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22867,BCBSND Base Physician Payment Schedule,2076.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22865,Not in chargemaster,22865,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22865,BCBSND Base Physician Payment Schedule,4784.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22864,Not in chargemaster,22864,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22864,BCBSND Base Physician Payment Schedule,4385.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22862,Not in chargemaster,22862,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22862,BCBSND Base Physician Payment Schedule,4903.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22861,Not in chargemaster,22861,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22861,BCBSND Base Physician Payment Schedule,4917.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22859,Not in chargemaster,22859,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22859,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22858,Not in chargemaster,22858,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22858,BCBSND Base Physician Payment Schedule,1090.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22857,Not in chargemaster,22857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22857,BCBSND Base Physician Payment Schedule,3765.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22856,Not in chargemaster,22856,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22856,BCBSND Base Physician Payment Schedule,3478.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22855,Not in chargemaster,22855,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22855,BCBSND Base Physician Payment Schedule,2357.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22854,Not in chargemaster,22854,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22854,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22853,Not in chargemaster,22853,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22853,BCBSND Base Physician Payment Schedule,552.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22852,Not in chargemaster,22852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22852,BCBSND Base Physician Payment Schedule,1486.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22850,Not in chargemaster,22850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22850,BCBSND Base Physician Payment Schedule,1548.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22849,Not in chargemaster,22849,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22849,BCBSND Base Physician Payment Schedule,2771.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22848,Not in chargemaster,22848,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22848,BCBSND Base Physician Payment Schedule,768.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22847,Not in chargemaster,22847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22847,BCBSND Base Physician Payment Schedule,1720,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22846,Not in chargemaster,22846,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22846,BCBSND Base Physician Payment Schedule,1615.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22845,Not in chargemaster,22845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22845,BCBSND Base Physician Payment Schedule,1554.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22844,Not in chargemaster,22844,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22844,BCBSND Base Physician Payment Schedule,2102.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22843,Not in chargemaster,22843,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22843,BCBSND Base Physician Payment Schedule,1739.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22842,Not in chargemaster,22842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22842,BCBSND Base Physician Payment Schedule,1628.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22840,Not in chargemaster,22840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22840,BCBSND Base Physician Payment Schedule,1620.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22830,Not in chargemaster,22830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22830,BCBSND Base Physician Payment Schedule,1736.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22819,Not in chargemaster,22819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22819,BCBSND Base Physician Payment Schedule,5291.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22818,Not in chargemaster,22818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22818,BCBSND Base Physician Payment Schedule,4599.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22812,Not in chargemaster,22812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22812,BCBSND Base Physician Payment Schedule,4691.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22810,Not in chargemaster,22810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22810,BCBSND Base Physician Payment Schedule,4367.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22808,Not in chargemaster,22808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22808,BCBSND Base Physician Payment Schedule,3901.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22804,Not in chargemaster,22804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22804,BCBSND Base Physician Payment Schedule,5162.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22802,Not in chargemaster,22802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22802,BCBSND Base Physician Payment Schedule,4481.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22800,Not in chargemaster,22800,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22800,BCBSND Base Physician Payment Schedule,2890.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22634,Not in chargemaster,22634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22634,BCBSND Base Physician Payment Schedule,1057.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22633,Not in chargemaster,22633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22633,BCBSND Base Physician Payment Schedule,3939.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22632,Not in chargemaster,22632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22632,BCBSND Base Physician Payment Schedule,687.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22630,Not in chargemaster,22630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22630,BCBSND Base Physician Payment Schedule,3346.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22614,Not in chargemaster,22614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22614,BCBSND Base Physician Payment Schedule,835.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22612,Not in chargemaster,22612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22612,BCBSND Base Physician Payment Schedule,3376.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22610,Not in chargemaster,22610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22610,BCBSND Base Physician Payment Schedule,2691.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22600,Not in chargemaster,22600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22600,BCBSND Base Physician Payment Schedule,2737.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22595,Not in chargemaster,22595,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22595,BCBSND Base Physician Payment Schedule,3193.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22590,Not in chargemaster,22590,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22590,BCBSND Base Physician Payment Schedule,3349.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22586,Not in chargemaster,22586,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22586,BCBSND Base Physician Payment Schedule,4293.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22585,Not in chargemaster,22585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22585,BCBSND Base Physician Payment Schedule,698.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22558,Not in chargemaster,22558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22558,BCBSND Base Physician Payment Schedule,3258.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22556,Not in chargemaster,22556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22556,BCBSND Base Physician Payment Schedule,3536.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22554,Not in chargemaster,22554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22554,BCBSND Base Physician Payment Schedule,2666.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22552,Not in chargemaster,22552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22552,BCBSND Base Physician Payment Schedule,847.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22551,Not in chargemaster,22551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22551,BCBSND Base Physician Payment Schedule,3624.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22548,Not in chargemaster,22548,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22548,BCBSND Base Physician Payment Schedule,4146.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22534,Not in chargemaster,22534,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22534,BCBSND Base Physician Payment Schedule,769.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22533,Not in chargemaster,22533,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22533,BCBSND Base Physician Payment Schedule,3526.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22532,Not in chargemaster,22532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22532,BCBSND Base Physician Payment Schedule,3825.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22527,Not in chargemaster,22527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22527,BCBSND Base Physician Payment Schedule,3901.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22526,Not in chargemaster,22526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22526,BCBSND Base Physician Payment Schedule,4657.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22515,Not in chargemaster,22515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22515,BCBSND Base Physician Payment Schedule,7749.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22514,Not in chargemaster,22514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22514,BCBSND Base Physician Payment Schedule,13826.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22513,Not in chargemaster,22513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22513,BCBSND Base Physician Payment Schedule,13885.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22512,Not in chargemaster,22512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22512,BCBSND Base Physician Payment Schedule,1794.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22511,Not in chargemaster,22511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22511,BCBSND Base Physician Payment Schedule,3773.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22510,Not in chargemaster,22510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22510,BCBSND Base Physician Payment Schedule,3809.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22505,Not in chargemaster,22505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22505,BCBSND Base Physician Payment Schedule,276.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22328,Not in chargemaster,22328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22328,BCBSND Base Physician Payment Schedule,599.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22327,Not in chargemaster,22327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22327,BCBSND Base Physician Payment Schedule,3210.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22326,Not in chargemaster,22326,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22326,BCBSND Base Physician Payment Schedule,3178.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22325,Not in chargemaster,22325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22325,BCBSND Base Physician Payment Schedule,3082.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22319,Not in chargemaster,22319,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22319,BCBSND Base Physician Payment Schedule,3865.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22318,Not in chargemaster,22318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22318,BCBSND Base Physician Payment Schedule,3474.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22315,Not in chargemaster,22315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22315,BCBSND Base Physician Payment Schedule,1858.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22310,Not in chargemaster,22310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22310,BCBSND Base Physician Payment Schedule,638.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22226,Not in chargemaster,22226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22226,BCBSND Base Physician Payment Schedule,775.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22224,Not in chargemaster,22224,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22224,BCBSND Base Physician Payment Schedule,3384.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22222,Not in chargemaster,22222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22222,BCBSND Base Physician Payment Schedule,3689.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22220,Not in chargemaster,22220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22220,BCBSND Base Physician Payment Schedule,3475.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22216,Not in chargemaster,22216,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22216,BCBSND Base Physician Payment Schedule,775.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22214,Not in chargemaster,22214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22214,BCBSND Base Physician Payment Schedule,3187.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22212,Not in chargemaster,22212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22212,BCBSND Base Physician Payment Schedule,3174.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22210,Not in chargemaster,22210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22210,BCBSND Base Physician Payment Schedule,3798.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22208,Not in chargemaster,22208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22208,BCBSND Base Physician Payment Schedule,1257.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22207,Not in chargemaster,22207,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22207,BCBSND Base Physician Payment Schedule,5099.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22206,Not in chargemaster,22206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22206,BCBSND Base Physician Payment Schedule,5212.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22116,Not in chargemaster,22116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22116,BCBSND Base Physician Payment Schedule,299.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22114,Not in chargemaster,22114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22114,BCBSND Base Physician Payment Schedule,2371.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22112,Not in chargemaster,22112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22112,BCBSND Base Physician Payment Schedule,2371.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22110,Not in chargemaster,22110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22110,BCBSND Base Physician Payment Schedule,2209.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22103,Not in chargemaster,22103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22103,BCBSND Base Physician Payment Schedule,300.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22102,Not in chargemaster,22102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22102,BCBSND Base Physician Payment Schedule,1736.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22101,Not in chargemaster,22101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22101,BCBSND Base Physician Payment Schedule,1845.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22100,Not in chargemaster,22100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22100,BCBSND Base Physician Payment Schedule,1811.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22015,Not in chargemaster,22015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22015,BCBSND Base Physician Payment Schedule,2002.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 22010,Not in chargemaster,22010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22010,BCBSND Base Physician Payment Schedule,2034.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21936,Not in chargemaster,21936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21936,BCBSND Base Physician Payment Schedule,3009.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21935,Not in chargemaster,21935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21935,BCBSND Base Physician Payment Schedule,2182.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21933,Not in chargemaster,21933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21933,BCBSND Base Physician Payment Schedule,1569.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21932,Not in chargemaster,21932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21932,BCBSND Base Physician Payment Schedule,1408,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21931,Not in chargemaster,21931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21931,BCBSND Base Physician Payment Schedule,999.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21930,Not in chargemaster,21930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21930,BCBSND Base Physician Payment Schedule,1035.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21925,Not in chargemaster,21925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21925,BCBSND Base Physician Payment Schedule,985.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21920,Not in chargemaster,21920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21920,BCBSND Base Physician Payment Schedule,537.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21825,Not in chargemaster,21825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21825,BCBSND Base Physician Payment Schedule,1148.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21820,Not in chargemaster,21820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21820,BCBSND Base Physician Payment Schedule,306.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21813,Not in chargemaster,21813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21813,BCBSND Base Physician Payment Schedule,2110.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21812,Not in chargemaster,21812,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21812,BCBSND Base Physician Payment Schedule,1543.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21811,Not in chargemaster,21811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21811,BCBSND Base Physician Payment Schedule,1265.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21750,Not in chargemaster,21750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21750,BCBSND Base Physician Payment Schedule,1443.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21740,Not in chargemaster,21740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21740,BCBSND Base Physician Payment Schedule,2185.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21725,Not in chargemaster,21725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21725,BCBSND Base Physician Payment Schedule,1145.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21720,Not in chargemaster,21720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21720,BCBSND Base Physician Payment Schedule,1101.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21705,Not in chargemaster,21705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21705,BCBSND Base Physician Payment Schedule,1140.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21700,Not in chargemaster,21700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21700,BCBSND Base Physician Payment Schedule,760.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21685,Not in chargemaster,21685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21685,BCBSND Base Physician Payment Schedule,2067.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21632,Not in chargemaster,21632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21632,BCBSND Base Physician Payment Schedule,2565.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21630,Not in chargemaster,21630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21630,BCBSND Base Physician Payment Schedule,2578.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21627,Not in chargemaster,21627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21627,BCBSND Base Physician Payment Schedule,1142.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21620,Not in chargemaster,21620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21620,BCBSND Base Physician Payment Schedule,1072.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21616,Not in chargemaster,21616,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21616,BCBSND Base Physician Payment Schedule,1520.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21615,Not in chargemaster,21615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21615,BCBSND Base Physician Payment Schedule,1311.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21610,Not in chargemaster,21610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21610,BCBSND Base Physician Payment Schedule,2532.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21603,Not in chargemaster,21603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21603,BCBSND Base Physician Payment Schedule,3723.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21602,Not in chargemaster,21602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21602,BCBSND Base Physician Payment Schedule,3364.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21601,Not in chargemaster,21601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21601,BCBSND Base Physician Payment Schedule,2508.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21600,Not in chargemaster,21600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21600,BCBSND Base Physician Payment Schedule,1170.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21558,Not in chargemaster,21558,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21558,BCBSND Base Physician Payment Schedule,2852.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21557,Not in chargemaster,21557,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21557,BCBSND Base Physician Payment Schedule,2023.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21556,Not in chargemaster,21556,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21556,BCBSND Base Physician Payment Schedule,1117.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21555,Not in chargemaster,21555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21555,BCBSND Base Physician Payment Schedule,900.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21554,Not in chargemaster,21554,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21554,BCBSND Base Physician Payment Schedule,1551.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21552,21552,21552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21552,BCBSND Base Physician Payment Schedule,946.25,941.29,Fee schedule,,941.29,941.29,941.29,941.29,,,0
unity,Fee schedule,Non-facility 21550,21550,21550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21550,BCBSND Base Physician Payment Schedule,550.58,565.05,Fee schedule,,550.58,550.58,550.58,550.58,,,0
unity,Fee schedule,Non-facility 21510,Not in chargemaster,21510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21510,BCBSND Base Physician Payment Schedule,948.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21502,Not in chargemaster,21502,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21502,BCBSND Base Physician Payment Schedule,1072.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21501,Not in chargemaster,21501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21501,BCBSND Base Physician Payment Schedule,985.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21497,Not in chargemaster,21497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21497,BCBSND Base Physician Payment Schedule,1438.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21490,Not in chargemaster,21490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21490,BCBSND Base Physician Payment Schedule,1744.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21485,Not in chargemaster,21485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21485,BCBSND Base Physician Payment Schedule,1850.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21480,Not in chargemaster,21480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21480,BCBSND Base Physician Payment Schedule,245.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21470,Not in chargemaster,21470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21470,BCBSND Base Physician Payment Schedule,2484.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21465,Not in chargemaster,21465,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21465,BCBSND Base Physician Payment Schedule,1769.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21462,Not in chargemaster,21462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21462,BCBSND Base Physician Payment Schedule,4511.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21461,Not in chargemaster,21461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21461,BCBSND Base Physician Payment Schedule,4218.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21454,Not in chargemaster,21454,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21454,BCBSND Base Physician Payment Schedule,1075.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21453,Not in chargemaster,21453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21453,BCBSND Base Physician Payment Schedule,2107.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21452,Not in chargemaster,21452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21452,BCBSND Base Physician Payment Schedule,1477.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21451,Not in chargemaster,21451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21451,BCBSND Base Physician Payment Schedule,1581.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21450,Not in chargemaster,21450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21450,BCBSND Base Physician Payment Schedule,1206.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21445,Not in chargemaster,21445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21445,BCBSND Base Physician Payment Schedule,1629.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21440,Not in chargemaster,21440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21440,BCBSND Base Physician Payment Schedule,1316.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21436,Not in chargemaster,21436,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21436,BCBSND Base Physician Payment Schedule,4347.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21435,Not in chargemaster,21435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21435,BCBSND Base Physician Payment Schedule,2992.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21433,Not in chargemaster,21433,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21433,BCBSND Base Physician Payment Schedule,3707.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21432,Not in chargemaster,21432,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21432,BCBSND Base Physician Payment Schedule,1523.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21431,Not in chargemaster,21431,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21431,BCBSND Base Physician Payment Schedule,1462.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21423,Not in chargemaster,21423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21423,BCBSND Base Physician Payment Schedule,1617.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21422,Not in chargemaster,21422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21422,BCBSND Base Physician Payment Schedule,1354.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21421,Not in chargemaster,21421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21421,BCBSND Base Physician Payment Schedule,1407.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21408,Not in chargemaster,21408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21408,BCBSND Base Physician Payment Schedule,1921.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21407,Not in chargemaster,21407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21407,BCBSND Base Physician Payment Schedule,1356.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21406,Not in chargemaster,21406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21406,BCBSND Base Physician Payment Schedule,1228.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21401,Not in chargemaster,21401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21401,BCBSND Base Physician Payment Schedule,1085,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21400,Not in chargemaster,21400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21400,BCBSND Base Physician Payment Schedule,423.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21395,Not in chargemaster,21395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21395,BCBSND Base Physician Payment Schedule,2153.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21390,Not in chargemaster,21390,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21390,BCBSND Base Physician Payment Schedule,1686.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21387,Not in chargemaster,21387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21387,BCBSND Base Physician Payment Schedule,1653.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21386,Not in chargemaster,21386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21386,BCBSND Base Physician Payment Schedule,1374.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21385,Not in chargemaster,21385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21385,BCBSND Base Physician Payment Schedule,1584.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21366,Not in chargemaster,21366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21366,BCBSND Base Physician Payment Schedule,2718.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21365,Not in chargemaster,21365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21365,BCBSND Base Physician Payment Schedule,2322.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21360,Not in chargemaster,21360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21360,BCBSND Base Physician Payment Schedule,1074.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21356,Not in chargemaster,21356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21356,BCBSND Base Physician Payment Schedule,1045.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21355,Not in chargemaster,21355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21355,BCBSND Base Physician Payment Schedule,900.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21348,Not in chargemaster,21348,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21348,BCBSND Base Physician Payment Schedule,2280.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21347,Not in chargemaster,21347,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21347,BCBSND Base Physician Payment Schedule,2134.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21346,Not in chargemaster,21346,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21346,BCBSND Base Physician Payment Schedule,2011.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21345,Not in chargemaster,21345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21345,BCBSND Base Physician Payment Schedule,1642.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21344,Not in chargemaster,21344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21344,BCBSND Base Physician Payment Schedule,2912.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21343,Not in chargemaster,21343,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21343,BCBSND Base Physician Payment Schedule,2253.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21340,Not in chargemaster,21340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21340,BCBSND Base Physician Payment Schedule,1565.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21339,Not in chargemaster,21339,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21339,BCBSND Base Physician Payment Schedule,1563.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21338,Not in chargemaster,21338,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21338,BCBSND Base Physician Payment Schedule,1375.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21337,Not in chargemaster,21337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21337,BCBSND Base Physician Payment Schedule,858.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21336,Not in chargemaster,21336,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21336,BCBSND Base Physician Payment Schedule,1336.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21335,Not in chargemaster,21335,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21335,BCBSND Base Physician Payment Schedule,1493.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21330,Not in chargemaster,21330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21330,BCBSND Base Physician Payment Schedule,1175.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21325,Not in chargemaster,21325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21325,BCBSND Base Physician Payment Schedule,913.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21320,Not in chargemaster,21320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21320,BCBSND Base Physician Payment Schedule,530.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21315,Not in chargemaster,21315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21315,BCBSND Base Physician Payment Schedule,572.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21310,Not in chargemaster,21310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21310,BCBSND Base Physician Payment Schedule,263.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21296,Not in chargemaster,21296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21296,BCBSND Base Physician Payment Schedule,852.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21295,Not in chargemaster,21295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21295,BCBSND Base Physician Payment Schedule,395.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21282,Not in chargemaster,21282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21282,BCBSND Base Physician Payment Schedule,814.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21280,Not in chargemaster,21280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21280,BCBSND Base Physician Payment Schedule,1206.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21275,Not in chargemaster,21275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21275,BCBSND Base Physician Payment Schedule,1791.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21270,Not in chargemaster,21270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21270,BCBSND Base Physician Payment Schedule,2141.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21268,Not in chargemaster,21268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21268,BCBSND Base Physician Payment Schedule,4318.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21267,Not in chargemaster,21267,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21267,BCBSND Base Physician Payment Schedule,3442.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21263,Not in chargemaster,21263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21263,BCBSND Base Physician Payment Schedule,4828.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21261,Not in chargemaster,21261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21261,BCBSND Base Physician Payment Schedule,5220.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21260,Not in chargemaster,21260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21260,BCBSND Base Physician Payment Schedule,2943.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21256,Not in chargemaster,21256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21256,BCBSND Base Physician Payment Schedule,2641.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21255,Not in chargemaster,21255,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21255,BCBSND Base Physician Payment Schedule,2884.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21249,Not in chargemaster,21249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21249,BCBSND Base Physician Payment Schedule,2948.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21248,Not in chargemaster,21248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21248,BCBSND Base Physician Payment Schedule,2154.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21247,Not in chargemaster,21247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21247,BCBSND Base Physician Payment Schedule,3371.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21246,Not in chargemaster,21246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21246,BCBSND Base Physician Payment Schedule,1811.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21245,Not in chargemaster,21245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21245,BCBSND Base Physician Payment Schedule,2538.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21244,Not in chargemaster,21244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21244,BCBSND Base Physician Payment Schedule,2152.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21243,Not in chargemaster,21243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21243,BCBSND Base Physician Payment Schedule,3454.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21242,Not in chargemaster,21242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21242,BCBSND Base Physician Payment Schedule,2143.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21240,Not in chargemaster,21240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21240,BCBSND Base Physician Payment Schedule,2264.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21235,Not in chargemaster,21235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21235,BCBSND Base Physician Payment Schedule,1519.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21230,Not in chargemaster,21230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21230,BCBSND Base Physician Payment Schedule,1569.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21215,Not in chargemaster,21215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21215,BCBSND Base Physician Payment Schedule,8610.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21210,Not in chargemaster,21210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21210,BCBSND Base Physician Payment Schedule,4149.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21209,Not in chargemaster,21209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21209,BCBSND Base Physician Payment Schedule,1686.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21208,Not in chargemaster,21208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21208,BCBSND Base Physician Payment Schedule,3576.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21206,Not in chargemaster,21206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21206,BCBSND Base Physician Payment Schedule,2416.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21199,Not in chargemaster,21199,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21199,BCBSND Base Physician Payment Schedule,2193.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21198,Not in chargemaster,21198,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21198,BCBSND Base Physician Payment Schedule,2338.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21196,Not in chargemaster,21196,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21196,BCBSND Base Physician Payment Schedule,3005.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21195,Not in chargemaster,21195,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21195,BCBSND Base Physician Payment Schedule,2902.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21194,Not in chargemaster,21194,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21194,BCBSND Base Physician Payment Schedule,3027.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21193,Not in chargemaster,21193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21193,BCBSND Base Physician Payment Schedule,2626.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21188,Not in chargemaster,21188,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21188,BCBSND Base Physician Payment Schedule,3418.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21184,Not in chargemaster,21184,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21184,BCBSND Base Physician Payment Schedule,5309.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21183,Not in chargemaster,21183,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21183,BCBSND Base Physician Payment Schedule,4932.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21182,Not in chargemaster,21182,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21182,BCBSND Base Physician Payment Schedule,4528.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21181,Not in chargemaster,21181,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21181,BCBSND Base Physician Payment Schedule,1574.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21180,Not in chargemaster,21180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21180,BCBSND Base Physician Payment Schedule,3629.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21179,Not in chargemaster,21179,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21179,BCBSND Base Physician Payment Schedule,3244.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21175,Not in chargemaster,21175,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21175,BCBSND Base Physician Payment Schedule,4726.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21172,Not in chargemaster,21172,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21172,BCBSND Base Physician Payment Schedule,4423.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21160,Not in chargemaster,21160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21160,BCBSND Base Physician Payment Schedule,5940.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21159,Not in chargemaster,21159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21159,BCBSND Base Physician Payment Schedule,5475.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21155,Not in chargemaster,21155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21155,BCBSND Base Physician Payment Schedule,4566.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21154,Not in chargemaster,21154,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21154,BCBSND Base Physician Payment Schedule,4113.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21151,Not in chargemaster,21151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21151,BCBSND Base Physician Payment Schedule,3823.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21150,Not in chargemaster,21150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21150,BCBSND Base Physician Payment Schedule,3472.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21147,Not in chargemaster,21147,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21147,BCBSND Base Physician Payment Schedule,3627.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21146,Not in chargemaster,21146,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21146,BCBSND Base Physician Payment Schedule,3442.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21145,Not in chargemaster,21145,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21145,BCBSND Base Physician Payment Schedule,3298.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21143,Not in chargemaster,21143,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21143,BCBSND Base Physician Payment Schedule,3014.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21142,Not in chargemaster,21142,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21142,BCBSND Base Physician Payment Schedule,2901.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21141,Not in chargemaster,21141,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21141,BCBSND Base Physician Payment Schedule,2823.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21139,Not in chargemaster,21139,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21139,BCBSND Base Physician Payment Schedule,2354.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21138,Not in chargemaster,21138,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21138,BCBSND Base Physician Payment Schedule,1950.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21137,Not in chargemaster,21137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21137,BCBSND Base Physician Payment Schedule,1596.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21127,Not in chargemaster,21127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21127,BCBSND Base Physician Payment Schedule,8453.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21125,Not in chargemaster,21125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21125,BCBSND Base Physician Payment Schedule,5938.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21123,Not in chargemaster,21123,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21123,BCBSND Base Physician Payment Schedule,1847,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21122,Not in chargemaster,21122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21122,BCBSND Base Physician Payment Schedule,1625.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21121,Not in chargemaster,21121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21121,BCBSND Base Physician Payment Schedule,1427.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21120,Not in chargemaster,21120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21120,BCBSND Base Physician Payment Schedule,1410.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21116,Not in chargemaster,21116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21116,BCBSND Base Physician Payment Schedule,412.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21110,Not in chargemaster,21110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21110,BCBSND Base Physician Payment Schedule,1731.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21100,Not in chargemaster,21100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21100,BCBSND Base Physician Payment Schedule,1390.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21087,Not in chargemaster,21087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21087,BCBSND Base Physician Payment Schedule,3497.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21086,Not in chargemaster,21086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21086,BCBSND Base Physician Payment Schedule,3497.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21085,Not in chargemaster,21085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21085,BCBSND Base Physician Payment Schedule,1473.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21084,Not in chargemaster,21084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21084,BCBSND Base Physician Payment Schedule,3396.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21083,Not in chargemaster,21083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21083,BCBSND Base Physician Payment Schedule,2967.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21082,Not in chargemaster,21082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21082,BCBSND Base Physician Payment Schedule,3113.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21081,Not in chargemaster,21081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21081,BCBSND Base Physician Payment Schedule,3361.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21080,Not in chargemaster,21080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21080,BCBSND Base Physician Payment Schedule,3658.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21079,Not in chargemaster,21079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21079,BCBSND Base Physician Payment Schedule,3199.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21077,Not in chargemaster,21077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21077,BCBSND Base Physician Payment Schedule,4700.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21076,Not in chargemaster,21076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21076,BCBSND Base Physician Payment Schedule,1900.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21073,Not in chargemaster,21073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21073,BCBSND Base Physician Payment Schedule,801.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21070,Not in chargemaster,21070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21070,BCBSND Base Physician Payment Schedule,1322.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21060,Not in chargemaster,21060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21060,BCBSND Base Physician Payment Schedule,1682.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21050,Not in chargemaster,21050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21050,BCBSND Base Physician Payment Schedule,1850.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21049,Not in chargemaster,21049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21049,BCBSND Base Physician Payment Schedule,2546.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21048,Not in chargemaster,21048,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21048,BCBSND Base Physician Payment Schedule,2239.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21047,Not in chargemaster,21047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21047,BCBSND Base Physician Payment Schedule,2697.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21046,Not in chargemaster,21046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21046,BCBSND Base Physician Payment Schedule,2207.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21045,Not in chargemaster,21045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21045,BCBSND Base Physician Payment Schedule,2546.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21044,Not in chargemaster,21044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21044,BCBSND Base Physician Payment Schedule,1819.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21040,Not in chargemaster,21040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21040,BCBSND Base Physician Payment Schedule,1040.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21034,Not in chargemaster,21034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21034,BCBSND Base Physician Payment Schedule,2733.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21032,Not in chargemaster,21032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21032,BCBSND Base Physician Payment Schedule,817.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21031,Not in chargemaster,21031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21031,BCBSND Base Physician Payment Schedule,816.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21030,Not in chargemaster,21030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21030,BCBSND Base Physician Payment Schedule,1032.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21029,Not in chargemaster,21029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21029,BCBSND Base Physician Payment Schedule,1604.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21026,Not in chargemaster,21026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21026,BCBSND Base Physician Payment Schedule,1180.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21025,Not in chargemaster,21025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21025,BCBSND Base Physician Payment Schedule,1736.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21016,Not in chargemaster,21016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21016,BCBSND Base Physician Payment Schedule,2135.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21015,Not in chargemaster,21015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21015,BCBSND Base Physician Payment Schedule,1488.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21014,Not in chargemaster,21014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21014,BCBSND Base Physician Payment Schedule,1101.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21013,Not in chargemaster,21013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21013,BCBSND Base Physician Payment Schedule,1114.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21012,Not in chargemaster,21012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21012,BCBSND Base Physician Payment Schedule,713.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21011,Not in chargemaster,21011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21011,BCBSND Base Physician Payment Schedule,759.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 21010,Not in chargemaster,21010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21010,BCBSND Base Physician Payment Schedule,1577.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20985,Not in chargemaster,20985,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20985,BCBSND Base Physician Payment Schedule,311.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20983,Not in chargemaster,20983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20983,BCBSND Base Physician Payment Schedule,11936.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20982,Not in chargemaster,20982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20982,BCBSND Base Physician Payment Schedule,8010.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20979,Not in chargemaster,20979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20979,BCBSND Base Physician Payment Schedule,112.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20975,Not in chargemaster,20975,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20975,BCBSND Base Physician Payment Schedule,375.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20974,Not in chargemaster,20974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20974,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20973,Not in chargemaster,20973,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20973,BCBSND Base Physician Payment Schedule,6393.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20972,Not in chargemaster,20972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20972,BCBSND Base Physician Payment Schedule,6052.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20970,Not in chargemaster,20970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20970,BCBSND Base Physician Payment Schedule,6068.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20969,Not in chargemaster,20969,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20969,BCBSND Base Physician Payment Schedule,5770.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20962,Not in chargemaster,20962,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20962,BCBSND Base Physician Payment Schedule,5645.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20957,Not in chargemaster,20957,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20957,BCBSND Base Physician Payment Schedule,5844.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20956,Not in chargemaster,20956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20956,BCBSND Base Physician Payment Schedule,5617.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20955,Not in chargemaster,20955,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20955,BCBSND Base Physician Payment Schedule,5211.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20950,Not in chargemaster,20950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20950,BCBSND Base Physician Payment Schedule,545.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20939,Not in chargemaster,20939,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20939,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20938,Not in chargemaster,20938,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20938,BCBSND Base Physician Payment Schedule,392.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20937,Not in chargemaster,20937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20937,BCBSND Base Physician Payment Schedule,356.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20934,Not in chargemaster,20934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20934,BCBSND Base Physician Payment Schedule,1513.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20933,Not in chargemaster,20933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20933,BCBSND Base Physician Payment Schedule,1391.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20932,Not in chargemaster,20932,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20932,BCBSND Base Physician Payment Schedule,1514.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20931,Not in chargemaster,20931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20931,BCBSND Base Physician Payment Schedule,236.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20924,Not in chargemaster,20924,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20924,BCBSND Base Physician Payment Schedule,1071.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20930,Not in chargemaster,20930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20930,BCBSND Base Physician Payment Schedule,236.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20922,Not in chargemaster,20922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20922,BCBSND Base Physician Payment Schedule,1252.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20920,Not in chargemaster,20920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20920,BCBSND Base Physician Payment Schedule,823.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20912,Not in chargemaster,20912,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20912,BCBSND Base Physician Payment Schedule,1000.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20910,Not in chargemaster,20910,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20910,BCBSND Base Physician Payment Schedule,991.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20902,Not in chargemaster,20902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20902,BCBSND Base Physician Payment Schedule,599.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20900,Not in chargemaster,20900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20900,BCBSND Base Physician Payment Schedule,854.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20838,Not in chargemaster,20838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20838,BCBSND Base Physician Payment Schedule,5919.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20827,Not in chargemaster,20827,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20827,BCBSND Base Physician Payment Schedule,3864.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20824,Not in chargemaster,20824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20824,BCBSND Base Physician Payment Schedule,4381.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20822,Not in chargemaster,20822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20822,BCBSND Base Physician Payment Schedule,3761.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20816,Not in chargemaster,20816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20816,BCBSND Base Physician Payment Schedule,4373.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20808,Not in chargemaster,20808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20808,BCBSND Base Physician Payment Schedule,8406.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20805,Not in chargemaster,20805,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20805,BCBSND Base Physician Payment Schedule,6952.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20802,Not in chargemaster,20802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20802,BCBSND Base Physician Payment Schedule,5839.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20705,Not in chargemaster,20705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20705,BCBSND Base Physician Payment Schedule,255.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20704,Not in chargemaster,20704,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20704,BCBSND Base Physician Payment Schedule,310.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20703,Not in chargemaster,20703,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20703,BCBSND Base Physician Payment Schedule,213.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20702,Not in chargemaster,20702,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20702,BCBSND Base Physician Payment Schedule,298.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20701,Not in chargemaster,20701,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20701,BCBSND Base Physician Payment Schedule,133.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20700,Not in chargemaster,20700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20700,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20697,Not in chargemaster,20697,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20697,BCBSND Base Physician Payment Schedule,4243.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20696,Not in chargemaster,20696,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20696,BCBSND Base Physician Payment Schedule,2520.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20694,Not in chargemaster,20694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20694,BCBSND Base Physician Payment Schedule,899.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20693,Not in chargemaster,20693,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20693,BCBSND Base Physician Payment Schedule,936.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20692,Not in chargemaster,20692,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20692,BCBSND Base Physician Payment Schedule,2369.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20690,Not in chargemaster,20690,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20690,BCBSND Base Physician Payment Schedule,1264.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20680,Not in chargemaster,20680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20680,BCBSND Base Physician Payment Schedule,1291.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20670,Not in chargemaster,20670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20670,BCBSND Base Physician Payment Schedule,773.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20665,Not in chargemaster,20665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20665,BCBSND Base Physician Payment Schedule,234.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20664,Not in chargemaster,20664,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20664,BCBSND Base Physician Payment Schedule,1837.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20663,Not in chargemaster,20663,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20663,BCBSND Base Physician Payment Schedule,999.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20662,Not in chargemaster,20662,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20662,BCBSND Base Physician Payment Schedule,1086.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20661,Not in chargemaster,20661,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20661,BCBSND Base Physician Payment Schedule,1059.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20660,Not in chargemaster,20660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20660,BCBSND Base Physician Payment Schedule,513.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20650,Not in chargemaster,20650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20650,BCBSND Base Physician Payment Schedule,446.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20615,Not in chargemaster,20615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20615,BCBSND Base Physician Payment Schedule,521.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20612,Not in chargemaster,20612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20612,BCBSND Base Physician Payment Schedule,129.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20611,Not in chargemaster,20611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20611,BCBSND Base Physician Payment Schedule,196.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20610,20610,20610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20610,BCBSND Base Physician Payment Schedule,129.94,129.23,Fee schedule,,129.23,129.23,129.23,129.23,,,0
unity,Fee schedule,Non-facility 20606,Not in chargemaster,20606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20606,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20605,20605,20605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20605,BCBSND Base Physician Payment Schedule,109.38,137.02,Fee schedule,,109.38,109.38,109.38,109.38,,,0
unity,Fee schedule,Non-facility 20604,20604,20604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20604,BCBSND Base Physician Payment Schedule,159.3,159,Fee schedule,,159,159,159,159,,,0
unity,Fee schedule,Non-facility 20600,20600,20600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20600,BCBSND Base Physician Payment Schedule,105.71,105,Fee schedule,,105,105,105,105,,,0
unity,Fee schedule,Non-facility 20561,Not in chargemaster,20561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20561,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20560,Not in chargemaster,20560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20560,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20555,Not in chargemaster,20555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20555,BCBSND Base Physician Payment Schedule,695.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20553,20553,20553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20553,BCBSND Base Physician Payment Schedule,133.61,154,Fee schedule,,133.61,133.61,133.61,133.61,,,0
unity,Fee schedule,Non-facility 20552,20552,20552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20552,BCBSND Base Physician Payment Schedule,116.72,120,Fee schedule,,116.72,116.72,116.72,116.72,,,0
unity,Fee schedule,Non-facility 20551,20551,20551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20551,BCBSND Base Physician Payment Schedule,117.46,126.36,Fee schedule,,117.46,117.46,117.46,117.46,,,0
unity,Fee schedule,Non-facility 20550,20550,20550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20550,BCBSND Base Physician Payment Schedule,114.52,122.1,Fee schedule,,114.52,114.52,114.52,114.52,,,0
unity,Fee schedule,Non-facility 20527,Not in chargemaster,20527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20527,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20526,Not in chargemaster,20526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20526,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20525,Not in chargemaster,20525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20525,BCBSND Base Physician Payment Schedule,998.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20520,Not in chargemaster,20520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20520,BCBSND Base Physician Payment Schedule,442.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20501,Not in chargemaster,20501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20501,BCBSND Base Physician Payment Schedule,287.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20500,Not in chargemaster,20500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20500,BCBSND Base Physician Payment Schedule,238.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20251,Not in chargemaster,20251,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20251,BCBSND Base Physician Payment Schedule,907.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20250,Not in chargemaster,20250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20250,BCBSND Base Physician Payment Schedule,835.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20245,Not in chargemaster,20245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20245,BCBSND Base Physician Payment Schedule,739.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20240,Not in chargemaster,20240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20240,BCBSND Base Physician Payment Schedule,309.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20225,Not in chargemaster,20225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20225,BCBSND Base Physician Payment Schedule,875.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20220,Not in chargemaster,20220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20220,BCBSND Base Physician Payment Schedule,516.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20206,Not in chargemaster,20206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20206,BCBSND Base Physician Payment Schedule,496.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20205,20205,20205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20205,BCBSND Base Physician Payment Schedule,621.78,357.5,Fee schedule,,357.5,357.5,357.5,357.5,,,0
unity,Fee schedule,Non-facility 20200,Not in chargemaster,20200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20200,BCBSND Base Physician Payment Schedule,445.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20150,Not in chargemaster,20150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20150,BCBSND Base Physician Payment Schedule,2133.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20103,Not in chargemaster,20103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20103,BCBSND Base Physician Payment Schedule,1216.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20102,Not in chargemaster,20102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20102,BCBSND Base Physician Payment Schedule,1082.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20101,Not in chargemaster,20101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20101,BCBSND Base Physician Payment Schedule,1006.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 20100,Not in chargemaster,20100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20100,BCBSND Base Physician Payment Schedule,1282.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19396,Not in chargemaster,19396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19396,BCBSND Base Physician Payment Schedule,601.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19380,Not in chargemaster,19380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19380,BCBSND Base Physician Payment Schedule,1649.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19371,Not in chargemaster,19371,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19371,BCBSND Base Physician Payment Schedule,1670.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19370,Not in chargemaster,19370,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19370,BCBSND Base Physician Payment Schedule,1461.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19369,Not in chargemaster,19369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19369,BCBSND Base Physician Payment Schedule,4331.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19368,Not in chargemaster,19368,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19368,BCBSND Base Physician Payment Schedule,4664.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19367,Not in chargemaster,19367,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19367,BCBSND Base Physician Payment Schedule,3780.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19366,Not in chargemaster,19366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19366,BCBSND Base Physician Payment Schedule,2964.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19364,Not in chargemaster,19364,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19364,BCBSND Base Physician Payment Schedule,5852.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19361,Not in chargemaster,19361,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19361,BCBSND Base Physician Payment Schedule,3337.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19357,Not in chargemaster,19357,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19357,BCBSND Base Physician Payment Schedule,3183.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19355,Not in chargemaster,19355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19355,BCBSND Base Physician Payment Schedule,1597.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19350,Not in chargemaster,19350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19350,BCBSND Base Physician Payment Schedule,1748.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19342,Not in chargemaster,19342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19342,BCBSND Base Physician Payment Schedule,1965.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19340,Not in chargemaster,19340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19340,BCBSND Base Physician Payment Schedule,2098.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19330,Not in chargemaster,19330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19330,BCBSND Base Physician Payment Schedule,1344.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19328,Not in chargemaster,19328,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19328,BCBSND Base Physician Payment Schedule,1059.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19325,Not in chargemaster,19325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19325,BCBSND Base Physician Payment Schedule,1372.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19324,Not in chargemaster,19324,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19324,BCBSND Base Physician Payment Schedule,1131.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19318,Not in chargemaster,19318,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19318,BCBSND Base Physician Payment Schedule,2328.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19316,Not in chargemaster,19316,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19316,BCBSND Base Physician Payment Schedule,1642.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19307,Not in chargemaster,19307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19307,BCBSND Base Physician Payment Schedule,2567.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19306,Not in chargemaster,19306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19306,BCBSND Base Physician Payment Schedule,2575.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19305,Not in chargemaster,19305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19305,BCBSND Base Physician Payment Schedule,2426.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19303,Not in chargemaster,19303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19303,BCBSND Base Physician Payment Schedule,2043.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19302,Not in chargemaster,19302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19302,BCBSND Base Physician Payment Schedule,1923.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19301,Not in chargemaster,19301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19301,BCBSND Base Physician Payment Schedule,1399.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19300,Not in chargemaster,19300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19300,BCBSND Base Physician Payment Schedule,1162.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19298,Not in chargemaster,19298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19298,BCBSND Base Physician Payment Schedule,2089.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19297,Not in chargemaster,19297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19297,BCBSND Base Physician Payment Schedule,203.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19296,Not in chargemaster,19296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19296,BCBSND Base Physician Payment Schedule,8385.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19294,Not in chargemaster,19294,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19294,BCBSND Base Physician Payment Schedule,353.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19288,Not in chargemaster,19288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19288,BCBSND Base Physician Payment Schedule,1290.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19287,Not in chargemaster,19287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19287,BCBSND Base Physician Payment Schedule,1622.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19286,Not in chargemaster,19286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19286,BCBSND Base Physician Payment Schedule,813.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19285,Not in chargemaster,19285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19285,BCBSND Base Physician Payment Schedule,952.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19284,Not in chargemaster,19284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19284,BCBSND Base Physician Payment Schedule,433.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19283,Not in chargemaster,19283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19283,BCBSND Base Physician Payment Schedule,568.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19282,Not in chargemaster,19282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19282,BCBSND Base Physician Payment Schedule,361.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19281,Not in chargemaster,19281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19281,BCBSND Base Physician Payment Schedule,511.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19126,Not in chargemaster,19126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19126,BCBSND Base Physician Payment Schedule,343.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19125,Not in chargemaster,19125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19125,BCBSND Base Physician Payment Schedule,1178.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19120,Not in chargemaster,19120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19120,BCBSND Base Physician Payment Schedule,1065.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19112,Not in chargemaster,19112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19112,BCBSND Base Physician Payment Schedule,969.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19110,Not in chargemaster,19110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19110,BCBSND Base Physician Payment Schedule,1028.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19105,Not in chargemaster,19105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19105,BCBSND Base Physician Payment Schedule,5699.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19101,Not in chargemaster,19101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19101,BCBSND Base Physician Payment Schedule,706.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19100,Not in chargemaster,19100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19100,BCBSND Base Physician Payment Schedule,323,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19086,Not in chargemaster,19086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19086,BCBSND Base Physician Payment Schedule,1527.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19085,Not in chargemaster,19085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19085,BCBSND Base Physician Payment Schedule,1921.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19084,Not in chargemaster,19084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19084,BCBSND Base Physician Payment Schedule,998.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19083,Not in chargemaster,19083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19083,BCBSND Base Physician Payment Schedule,1259.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19082,Not in chargemaster,19082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19082,BCBSND Base Physician Payment Schedule,1026.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19081,Not in chargemaster,19081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19081,BCBSND Base Physician Payment Schedule,1272.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19030,Not in chargemaster,19030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19030,BCBSND Base Physician Payment Schedule,351.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19020,Not in chargemaster,19020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19020,BCBSND Base Physician Payment Schedule,993.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19001,Not in chargemaster,19001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19001,BCBSND Base Physician Payment Schedule,57.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 19000,19000,19000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19000,BCBSND Base Physician Payment Schedule,228.31,238.51,Fee schedule,,228.31,228.31,228.31,228.31,,,0
unity,Fee schedule,Non-facility 17360,Not in chargemaster,17360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17360,BCBSND Base Physician Payment Schedule,258.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17380,Not in chargemaster,17380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17380,BCBSND Base Physician Payment Schedule,146.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17340,Not in chargemaster,17340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17340,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17315,Not in chargemaster,17315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17315,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17314,Not in chargemaster,17314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17314,BCBSND Base Physician Payment Schedule,792.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17313,Not in chargemaster,17313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17313,BCBSND Base Physician Payment Schedule,1296.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17312,Not in chargemaster,17312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17312,BCBSND Base Physician Payment Schedule,829.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17311,Not in chargemaster,17311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17311,BCBSND Base Physician Payment Schedule,1383.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17286,Not in chargemaster,17286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17286,BCBSND Base Physician Payment Schedule,747.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17284,Not in chargemaster,17284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17284,BCBSND Base Physician Payment Schedule,579.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17283,Not in chargemaster,17283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17283,BCBSND Base Physician Payment Schedule,509.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17282,Not in chargemaster,17282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17282,BCBSND Base Physician Payment Schedule,427.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17281,Not in chargemaster,17281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17281,BCBSND Base Physician Payment Schedule,371.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17280,Not in chargemaster,17280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17280,BCBSND Base Physician Payment Schedule,289.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17276,Not in chargemaster,17276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17276,BCBSND Base Physician Payment Schedule,592.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17274,Not in chargemaster,17274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17274,BCBSND Base Physician Payment Schedule,511.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17273,Not in chargemaster,17273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17273,BCBSND Base Physician Payment Schedule,434.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17272,Not in chargemaster,17272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17272,BCBSND Base Physician Payment Schedule,390.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17271,Not in chargemaster,17271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17271,BCBSND Base Physician Payment Schedule,341.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17270,Not in chargemaster,17270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17270,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17266,Not in chargemaster,17266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17266,BCBSND Base Physician Payment Schedule,488.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17264,Not in chargemaster,17264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17264,BCBSND Base Physician Payment Schedule,428.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17263,Not in chargemaster,17263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17263,BCBSND Base Physician Payment Schedule,400.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17262,Not in chargemaster,17262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17262,BCBSND Base Physician Payment Schedule,367.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17261,Not in chargemaster,17261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17261,BCBSND Base Physician Payment Schedule,303.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17260,Not in chargemaster,17260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17260,BCBSND Base Physician Payment Schedule,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17250,Not in chargemaster,17250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17250,BCBSND Base Physician Payment Schedule,177.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17111,17111,17111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17111,BCBSND Base Physician Payment Schedule,273.09,281.83,Fee schedule,,273.09,273.09,273.09,273.09,,,0
unity,Fee schedule,Non-facility 17110,17110,17110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17110,BCBSND Base Physician Payment Schedule,232.71,230,Fee schedule,,230,230,230,230,,,0
unity,Fee schedule,Non-facility 17108,Not in chargemaster,17108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17108,BCBSND Base Physician Payment Schedule,1331.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17107,Not in chargemaster,17107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17107,BCBSND Base Physician Payment Schedule,934.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17106,Not in chargemaster,17106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17106,BCBSND Base Physician Payment Schedule,713.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 17004,17004,17004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17004,BCBSND Base Physician Payment Schedule,328.88,330,Fee schedule,,328.88,328.88,328.88,328.88,,,0
unity,Fee schedule,Non-facility 17003,17003,17003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17003,BCBSND Base Physician Payment Schedule,12.48,14.2,Fee schedule,,12.48,12.48,12.48,12.48,,,0
unity,Fee schedule,Non-facility 17000,17000,17000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17000,BCBSND Base Physician Payment Schedule,135.81,173.92,Fee schedule,,135.81,135.81,135.81,135.81,,,0
unity,Fee schedule,Non-facility 16036,Not in chargemaster,16036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16036,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 16035,Not in chargemaster,16035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16035,BCBSND Base Physician Payment Schedule,419.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 16030,Not in chargemaster,16030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16030,BCBSND Base Physician Payment Schedule,406.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 16025,16025,16025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16025,BCBSND Base Physician Payment Schedule,322.27,313.06,Fee schedule,,313.06,313.06,313.06,313.06,,,0
unity,Fee schedule,Non-facility 16020,16020,16020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16020,BCBSND Base Physician Payment Schedule,172.51,173.92,Fee schedule,,172.51,172.51,172.51,172.51,,,0
unity,Fee schedule,Non-facility 16000,16000,16000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16000,BCBSND Base Physician Payment Schedule,153.43,155,Fee schedule,,153.43,153.43,153.43,153.43,,,0
unity,Fee schedule,Non-facility 15958,Not in chargemaster,15958,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15958,BCBSND Base Physician Payment Schedule,2501.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15956,Not in chargemaster,15956,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15956,BCBSND Base Physician Payment Schedule,2477.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15953,Not in chargemaster,15953,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15953,BCBSND Base Physician Payment Schedule,2125.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15952,Not in chargemaster,15952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15952,BCBSND Base Physician Payment Schedule,1931.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15951,Not in chargemaster,15951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15951,BCBSND Base Physician Payment Schedule,1886.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15950,Not in chargemaster,15950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15950,BCBSND Base Physician Payment Schedule,1292.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15946,Not in chargemaster,15946,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15946,BCBSND Base Physician Payment Schedule,3456.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15945,Not in chargemaster,15945,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15945,BCBSND Base Physician Payment Schedule,2150.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15944,Not in chargemaster,15944,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15944,BCBSND Base Physician Payment Schedule,1928.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15941,Not in chargemaster,15941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15941,BCBSND Base Physician Payment Schedule,1940.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15940,Not in chargemaster,15940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15940,BCBSND Base Physician Payment Schedule,1489.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15937,Not in chargemaster,15937,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15937,BCBSND Base Physician Payment Schedule,2211.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15936,Not in chargemaster,15936,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15936,BCBSND Base Physician Payment Schedule,1910.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15935,Not in chargemaster,15935,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15935,BCBSND Base Physician Payment Schedule,2438.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15934,Not in chargemaster,15934,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15934,BCBSND Base Physician Payment Schedule,2004.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15933,Not in chargemaster,15933,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15933,BCBSND Base Physician Payment Schedule,1832.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15931,Not in chargemaster,15931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15931,BCBSND Base Physician Payment Schedule,1481.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15922,Not in chargemaster,15922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15922,BCBSND Base Physician Payment Schedule,1673.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15920,Not in chargemaster,15920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15920,BCBSND Base Physician Payment Schedule,1325.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15860,Not in chargemaster,15860,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15860,BCBSND Base Physician Payment Schedule,229.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15852,Not in chargemaster,15852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15852,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15851,Not in chargemaster,15851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15851,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15850,Not in chargemaster,15850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15850,BCBSND Base Physician Payment Schedule,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15845,Not in chargemaster,15845,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15845,BCBSND Base Physician Payment Schedule,2126.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15847,Not in chargemaster,15847,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15847,BCBSND Base Physician Payment Schedule,748.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15842,Not in chargemaster,15842,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15842,BCBSND Base Physician Payment Schedule,5766.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15841,Not in chargemaster,15841,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15841,BCBSND Base Physician Payment Schedule,3785.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15840,Not in chargemaster,15840,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15840,BCBSND Base Physician Payment Schedule,2123.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15839,Not in chargemaster,15839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15839,BCBSND Base Physician Payment Schedule,1867.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15838,Not in chargemaster,15838,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15838,BCBSND Base Physician Payment Schedule,1360.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15837,Not in chargemaster,15837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15837,BCBSND Base Physician Payment Schedule,1827.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15836,Not in chargemaster,15836,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15836,BCBSND Base Physician Payment Schedule,1590.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15835,Not in chargemaster,15835,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15835,BCBSND Base Physician Payment Schedule,1980.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15834,Not in chargemaster,15834,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15834,BCBSND Base Physician Payment Schedule,1888.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15833,Not in chargemaster,15833,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15833,BCBSND Base Physician Payment Schedule,1852.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15832,Not in chargemaster,15832,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15832,BCBSND Base Physician Payment Schedule,1950.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15830,Not in chargemaster,15830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15830,BCBSND Base Physician Payment Schedule,2494.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15822,Not in chargemaster,15822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15822,BCBSND Base Physician Payment Schedule,947.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15823,Not in chargemaster,15823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15823,BCBSND Base Physician Payment Schedule,1280.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15824,Not in chargemaster,15824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15824,BCBSND Base Physician Payment Schedule,1834.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15825,Not in chargemaster,15825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15825,BCBSND Base Physician Payment Schedule,2674.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15826,Not in chargemaster,15826,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15826,BCBSND Base Physician Payment Schedule,1727.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15828,Not in chargemaster,15828,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15828,BCBSND Base Physician Payment Schedule,3243.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15829,Not in chargemaster,15829,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15829,BCBSND Base Physician Payment Schedule,4082.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15821,Not in chargemaster,15821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15821,BCBSND Base Physician Payment Schedule,1278.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15820,Not in chargemaster,15820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15820,BCBSND Base Physician Payment Schedule,1191.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15819,Not in chargemaster,15819,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15819,BCBSND Base Physician Payment Schedule,1685.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15793,Not in chargemaster,15793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15793,BCBSND Base Physician Payment Schedule,1001.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15792,Not in chargemaster,15792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15792,BCBSND Base Physician Payment Schedule,806.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15789,Not in chargemaster,15789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15789,BCBSND Base Physician Payment Schedule,1129.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15788,Not in chargemaster,15788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15788,BCBSND Base Physician Payment Schedule,900.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15787,Not in chargemaster,15787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15787,BCBSND Base Physician Payment Schedule,84.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15786,Not in chargemaster,15786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15786,BCBSND Base Physician Payment Schedule,504.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15783,Not in chargemaster,15783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15783,BCBSND Base Physician Payment Schedule,969.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15782,Not in chargemaster,15782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15782,BCBSND Base Physician Payment Schedule,1126.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15781,Not in chargemaster,15781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15781,BCBSND Base Physician Payment Schedule,1150.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15780,Not in chargemaster,15780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15780,BCBSND Base Physician Payment Schedule,1849.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15777,Not in chargemaster,15777,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15777,BCBSND Base Physician Payment Schedule,458.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15776,Not in chargemaster,15776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15776,BCBSND Base Physician Payment Schedule,1067.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15775,Not in chargemaster,15775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15775,BCBSND Base Physician Payment Schedule,778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15774,Not in chargemaster,15774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15774,BCBSND Base Physician Payment Schedule,371.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15773,Not in chargemaster,15773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15773,BCBSND Base Physician Payment Schedule,1225.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15772,Not in chargemaster,15772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15772,BCBSND Base Physician Payment Schedule,383.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15771,Not in chargemaster,15771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15771,BCBSND Base Physician Payment Schedule,1214.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15770,Not in chargemaster,15770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15770,BCBSND Base Physician Payment Schedule,1398.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15769,Not in chargemaster,15769,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15769,BCBSND Base Physician Payment Schedule,1017.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15760,Not in chargemaster,15760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15760,BCBSND Base Physician Payment Schedule,1772.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15758,Not in chargemaster,15758,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15758,BCBSND Base Physician Payment Schedule,4848,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15757,Not in chargemaster,15757,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15757,BCBSND Base Physician Payment Schedule,4817.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15756,Not in chargemaster,15756,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15756,BCBSND Base Physician Payment Schedule,4846.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15750,Not in chargemaster,15750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15750,BCBSND Base Physician Payment Schedule,1938.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15740,Not in chargemaster,15740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15740,BCBSND Base Physician Payment Schedule,2100.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15738,Not in chargemaster,15738,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15738,BCBSND Base Physician Payment Schedule,2747.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15736,Not in chargemaster,15736,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15736,BCBSND Base Physician Payment Schedule,2591.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15734,Not in chargemaster,15734,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15734,BCBSND Base Physician Payment Schedule,3201.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15733,Not in chargemaster,15733,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15733,BCBSND Base Physician Payment Schedule,2197.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15731,Not in chargemaster,15731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15731,BCBSND Base Physician Payment Schedule,2355.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15730,Not in chargemaster,15730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15730,BCBSND Base Physician Payment Schedule,3152.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15650,Not in chargemaster,15650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15650,BCBSND Base Physician Payment Schedule,1065.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15630,Not in chargemaster,15630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15630,BCBSND Base Physician Payment Schedule,958.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15620,Not in chargemaster,15620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15620,BCBSND Base Physician Payment Schedule,924.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15610,Not in chargemaster,15610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15610,BCBSND Base Physician Payment Schedule,755.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15600,Not in chargemaster,15600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15600,BCBSND Base Physician Payment Schedule,695.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15576,Not in chargemaster,15576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15576,BCBSND Base Physician Payment Schedule,1670.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15574,Not in chargemaster,15574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15574,BCBSND Base Physician Payment Schedule,1890.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15572,Not in chargemaster,15572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15572,BCBSND Base Physician Payment Schedule,1857.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15570,Not in chargemaster,15570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15570,BCBSND Base Physician Payment Schedule,1924.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15278,Not in chargemaster,15278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15278,BCBSND Base Physician Payment Schedule,196,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15277,Not in chargemaster,15277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15277,BCBSND Base Physician Payment Schedule,718.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15276,Not in chargemaster,15276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15276,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15275,Not in chargemaster,15275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15275,BCBSND Base Physician Payment Schedule,328.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15274,Not in chargemaster,15274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15274,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15273,Not in chargemaster,15273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15273,BCBSND Base Physician Payment Schedule,655.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15272,Not in chargemaster,15272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15272,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15271,Not in chargemaster,15271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15271,BCBSND Base Physician Payment Schedule,314.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15261,Not in chargemaster,15261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15261,BCBSND Base Physician Payment Schedule,439.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15260,Not in chargemaster,15260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15260,BCBSND Base Physician Payment Schedule,2092.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15241,Not in chargemaster,15241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15241,BCBSND Base Physician Payment Schedule,380.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15240,Not in chargemaster,15240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15240,BCBSND Base Physician Payment Schedule,1947.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15221,Not in chargemaster,15221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15221,BCBSND Base Physician Payment Schedule,283.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15220,Not in chargemaster,15220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15220,BCBSND Base Physician Payment Schedule,1613.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15201,Not in chargemaster,15201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15201,BCBSND Base Physician Payment Schedule,308.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15200,Not in chargemaster,15200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15200,BCBSND Base Physician Payment Schedule,1756.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15157,Not in chargemaster,15157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15157,BCBSND Base Physician Payment Schedule,381,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15156,Not in chargemaster,15156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15156,BCBSND Base Physician Payment Schedule,340.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15155,Not in chargemaster,15155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15155,BCBSND Base Physician Payment Schedule,1692.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15152,Not in chargemaster,15152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15152,BCBSND Base Physician Payment Schedule,328.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15151,Not in chargemaster,15151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15151,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15150,Not in chargemaster,15150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15150,BCBSND Base Physician Payment Schedule,1490.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15136,Not in chargemaster,15136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15136,BCBSND Base Physician Payment Schedule,207.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15135,Not in chargemaster,15135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15135,BCBSND Base Physician Payment Schedule,1835.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15131,Not in chargemaster,15131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15131,BCBSND Base Physician Payment Schedule,209.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15130,Not in chargemaster,15130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15130,BCBSND Base Physician Payment Schedule,1514.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15121,Not in chargemaster,15121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15121,BCBSND Base Physician Payment Schedule,444.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15120,Not in chargemaster,15120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15120,BCBSND Base Physician Payment Schedule,1788.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15116,Not in chargemaster,15116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15116,BCBSND Base Physician Payment Schedule,353.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15115,Not in chargemaster,15115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15115,BCBSND Base Physician Payment Schedule,1676.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15111,Not in chargemaster,15111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15111,BCBSND Base Physician Payment Schedule,244.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15110,Not in chargemaster,15110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15110,BCBSND Base Physician Payment Schedule,1697.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15101,Not in chargemaster,15101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15101,BCBSND Base Physician Payment Schedule,396.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15100,Not in chargemaster,15100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15100,BCBSND Base Physician Payment Schedule,1823.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15050,Not in chargemaster,15050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15050,BCBSND Base Physician Payment Schedule,1231.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15040,Not in chargemaster,15040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15040,BCBSND Base Physician Payment Schedule,548.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15005,Not in chargemaster,15005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15005,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15004,Not in chargemaster,15004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15004,BCBSND Base Physician Payment Schedule,839.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15003,Not in chargemaster,15003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15003,BCBSND Base Physician Payment Schedule,152.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 15002,Not in chargemaster,15002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15002,BCBSND Base Physician Payment Schedule,737.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14350,Not in chargemaster,14350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14350,BCBSND Base Physician Payment Schedule,1448.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14302,Not in chargemaster,14302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14302,BCBSND Base Physician Payment Schedule,463.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14301,Not in chargemaster,14301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14301,BCBSND Base Physician Payment Schedule,2265.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14061,Not in chargemaster,14061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14061,BCBSND Base Physician Payment Schedule,2081.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14060,Not in chargemaster,14060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14060,BCBSND Base Physician Payment Schedule,1607.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14041,Not in chargemaster,14041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14041,BCBSND Base Physician Payment Schedule,1935.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14040,Not in chargemaster,14040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14040,BCBSND Base Physician Payment Schedule,1582.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14021,Not in chargemaster,14021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14021,BCBSND Base Physician Payment Schedule,1808.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14020,Not in chargemaster,14020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14020,BCBSND Base Physician Payment Schedule,1453.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14001,Not in chargemaster,14001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14001,BCBSND Base Physician Payment Schedule,1677.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 14000,Not in chargemaster,14000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14000,BCBSND Base Physician Payment Schedule,1313.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13160,13160,13160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13160,BCBSND Base Physician Payment Schedule,1687.7,1707.23,Fee schedule,,1687.7,1687.7,1687.7,1687.7,,,0
unity,Fee schedule,Non-facility 13153,Not in chargemaster,13153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13153,BCBSND Base Physician Payment Schedule,400.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13152,Not in chargemaster,13152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13152,BCBSND Base Physician Payment Schedule,1054.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13151,Not in chargemaster,13151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13151,BCBSND Base Physician Payment Schedule,890.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13133,Not in chargemaster,13133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13133,BCBSND Base Physician Payment Schedule,365.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13132,13132,13132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13132,BCBSND Base Physician Payment Schedule,997.64,1040,Fee schedule,,997.64,997.64,997.64,997.64,,,0
unity,Fee schedule,Non-facility 13131,13131,13131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13131,BCBSND Base Physician Payment Schedule,815.59,819.9,Fee schedule,,815.59,815.59,815.59,815.59,,,0
unity,Fee schedule,Non-facility 13122,13122,13122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13122,BCBSND Base Physician Payment Schedule,274.55,284.66,Fee schedule,,274.55,274.55,274.55,274.55,,,0
unity,Fee schedule,Non-facility 13121,Not in chargemaster,13121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13121,BCBSND Base Physician Payment Schedule,898.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13120,Not in chargemaster,13120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13120,BCBSND Base Physician Payment Schedule,744.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13102,Not in chargemaster,13102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13102,BCBSND Base Physician Payment Schedule,251.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13101,Not in chargemaster,13101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13101,BCBSND Base Physician Payment Schedule,837.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 13100,Not in chargemaster,13100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13100,BCBSND Base Physician Payment Schedule,713.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12057,Not in chargemaster,12057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12057,BCBSND Base Physician Payment Schedule,1275.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12056,Not in chargemaster,12056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12056,BCBSND Base Physician Payment Schedule,1199.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12055,Not in chargemaster,12055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12055,BCBSND Base Physician Payment Schedule,1021.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12054,12054,12054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12054,BCBSND Base Physician Payment Schedule,786.96,789.38,Fee schedule,,786.96,786.96,786.96,786.96,,,0
unity,Fee schedule,Non-facility 12053,12053,12053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12053,BCBSND Base Physician Payment Schedule,745.85,740.4,Fee schedule,,740.4,740.4,740.4,740.4,,,0
unity,Fee schedule,Non-facility 12052,12052,12052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12052,BCBSND Base Physician Payment Schedule,636.46,626.81,Fee schedule,,626.81,626.81,626.81,626.81,,,0
unity,Fee schedule,Non-facility 12051,12051,12051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12051,BCBSND Base Physician Payment Schedule,567.46,570,Fee schedule,,567.46,567.46,567.46,567.46,,,0
unity,Fee schedule,Non-facility 12047,Not in chargemaster,12047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12047,BCBSND Base Physician Payment Schedule,1132.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12046,Not in chargemaster,12046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12046,BCBSND Base Physician Payment Schedule,1031.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12045,Not in chargemaster,12045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12045,BCBSND Base Physician Payment Schedule,853.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12044,12044,12044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12044,BCBSND Base Physician Payment Schedule,778.15,790,Fee schedule,,778.15,778.15,778.15,778.15,,,0
unity,Fee schedule,Non-facility 12042,12042,12042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12042,BCBSND Base Physician Payment Schedule,626.92,640,Fee schedule,,626.92,626.92,626.92,626.92,,,0
unity,Fee schedule,Non-facility 12041,12041,12041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12041,BCBSND Base Physician Payment Schedule,527.82,530,Fee schedule,,527.82,527.82,527.82,527.82,,,0
unity,Fee schedule,Non-facility 12037,Not in chargemaster,12037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12037,BCBSND Base Physician Payment Schedule,1028.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12036,Not in chargemaster,12036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12036,BCBSND Base Physician Payment Schedule,905.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12035,12035,12035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12035,BCBSND Base Physician Payment Schedule,809.71,829.83,Fee schedule,,809.71,809.71,809.71,809.71,,,0
unity,Fee schedule,Non-facility 12034,12034,12034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12034,BCBSND Base Physician Payment Schedule,678.31,690,Fee schedule,,678.31,678.31,678.31,678.31,,,0
unity,Fee schedule,Non-facility 12032,12032,12032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12032,BCBSND Base Physician Payment Schedule,630.59,650.24,Fee schedule,,630.59,630.59,630.59,630.59,,,0
unity,Fee schedule,Non-facility 12031,12031,12031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12031,BCBSND Base Physician Payment Schedule,526.35,508.98,Fee schedule,,508.98,508.98,508.98,508.98,,,0
unity,Fee schedule,Non-facility 12021,Not in chargemaster,12021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12021,BCBSND Base Physician Payment Schedule,359.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12020,12020,12020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12020,BCBSND Base Physician Payment Schedule,617.38,601.26,Fee schedule,,601.26,601.26,601.26,601.26,,,0
unity,Fee schedule,Non-facility 12018,Not in chargemaster,12018,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12018,BCBSND Base Physician Payment Schedule,372.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12017,Not in chargemaster,12017,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12017,BCBSND Base Physician Payment Schedule,328.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12016,Not in chargemaster,12016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12016,BCBSND Base Physician Payment Schedule,452.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12015,12015,12015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12015,BCBSND Base Physician Payment Schedule,355.3,367,Fee schedule,,355.3,355.3,355.3,355.3,,,0
unity,Fee schedule,Non-facility 12014,12014,12014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12014,BCBSND Base Physician Payment Schedule,293.64,300.99,Fee schedule,,293.64,293.64,293.64,293.64,,,0
unity,Fee schedule,Non-facility 12013,12013,12013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12013,BCBSND Base Physician Payment Schedule,241.52,257.69,Fee schedule,,241.52,241.52,241.52,241.52,,,0
unity,Fee schedule,Non-facility 12011,12011,12011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12011,BCBSND Base Physician Payment Schedule,231.24,235.69,Fee schedule,,231.24,231.24,231.24,231.24,,,0
unity,Fee schedule,Non-facility 12007,Not in chargemaster,12007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12007,BCBSND Base Physician Payment Schedule,483.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12006,Not in chargemaster,12006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12006,BCBSND Base Physician Payment Schedule,422.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 12005,12005,12005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12005,BCBSND Base Physician Payment Schedule,358.24,354.23,Fee schedule,,354.23,354.23,354.23,354.23,,,0
unity,Fee schedule,Non-facility 12004,12004,12004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12004,BCBSND Base Physician Payment Schedule,270.88,274.01,Fee schedule,,270.88,270.88,270.88,270.88,,,0
unity,Fee schedule,Non-facility 12002,12002,12002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12002,BCBSND Base Physician Payment Schedule,231.98,233.55,Fee schedule,,231.98,231.98,231.98,231.98,,,0
unity,Fee schedule,Non-facility 12001,12001,12001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12001,BCBSND Base Physician Payment Schedule,189.4,193.09,Fee schedule,,189.4,189.4,189.4,189.4,,,0
unity,Fee schedule,Non-facility 11983,11983,11983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11983,BCBSND Base Physician Payment Schedule,304.65,522.5,Fee schedule,,304.65,304.65,304.65,304.65,,,0
unity,Fee schedule,Non-facility 11982,Not in chargemaster,11982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11982,BCBSND Base Physician Payment Schedule,246.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11981,11981,11981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11981,BCBSND Base Physician Payment Schedule,217.29,308,Fee schedule,,217.29,217.29,217.29,217.29,,,0
unity,Fee schedule,Non-facility 11980,Not in chargemaster,11980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11980,BCBSND Base Physician Payment Schedule,197.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11976,11976,11976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11976,BCBSND Base Physician Payment Schedule,304.65,306.67,Fee schedule,,304.65,304.65,304.65,304.65,,,0
unity,Fee schedule,Non-facility 11971,Not in chargemaster,11971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11971,BCBSND Base Physician Payment Schedule,1010.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11970,Not in chargemaster,11970,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11970,BCBSND Base Physician Payment Schedule,1293.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11960,Not in chargemaster,11960,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11960,BCBSND Base Physician Payment Schedule,2063.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11954,Not in chargemaster,11954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11954,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11952,Not in chargemaster,11952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11952,BCBSND Base Physician Payment Schedule,303.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11951,Not in chargemaster,11951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11951,BCBSND Base Physician Payment Schedule,225.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11950,Not in chargemaster,11950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11950,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11922,Not in chargemaster,11922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11922,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11921,Not in chargemaster,11921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11921,BCBSND Base Physician Payment Schedule,446.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11920,Not in chargemaster,11920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11920,BCBSND Base Physician Payment Schedule,391.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11901,Not in chargemaster,11901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11901,BCBSND Base Physician Payment Schedule,144.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11900,11900,11900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11900,BCBSND Base Physician Payment Schedule,114.52,117.83,Fee schedule,,114.52,114.52,114.52,114.52,,,0
unity,Fee schedule,Non-facility 11772,Not in chargemaster,11772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11772,BCBSND Base Physician Payment Schedule,1537.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11771,11771,11771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11771,BCBSND Base Physician Payment Schedule,1269.26,1216,Fee schedule,,1216,1216,1216,1216,,,0
unity,Fee schedule,Non-facility 11770,11770,11770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11770,BCBSND Base Physician Payment Schedule,654.82,615,Fee schedule,,615,615,615,615,,,0
unity,Fee schedule,Non-facility 11765,11765,11765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11765,BCBSND Base Physician Payment Schedule,352.37,380,Fee schedule,,352.37,352.37,352.37,352.37,,,0
unity,Fee schedule,Non-facility 11762,Not in chargemaster,11762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11762,BCBSND Base Physician Payment Schedule,619.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11760,11760,11760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11760,BCBSND Base Physician Payment Schedule,407.43,501.88,Fee schedule,,407.43,407.43,407.43,407.43,,,0
unity,Fee schedule,Non-facility 11755,Not in chargemaster,11755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11755,BCBSND Base Physician Payment Schedule,254.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11750,11750,11750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11750,BCBSND Base Physician Payment Schedule,326.67,472.07,Fee schedule,,326.67,326.67,326.67,326.67,,,0
unity,Fee schedule,Non-facility 11740,11740,11740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11740,BCBSND Base Physician Payment Schedule,111.58,115,Fee schedule,,111.58,111.58,111.58,111.58,,,0
unity,Fee schedule,Non-facility 11732,Not in chargemaster,11732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11732,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11730,11730,11730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11730,BCBSND Base Physician Payment Schedule,230.51,235,Fee schedule,,230.51,230.51,230.51,230.51,,,0
unity,Fee schedule,Non-facility 11721,Not in chargemaster,11721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11721,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11720,Not in chargemaster,11720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11720,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11719,Not in chargemaster,11719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11719,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11646,11646,11646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11646,BCBSND Base Physician Payment Schedule,1069.58,1088.23,Fee schedule,,1069.58,1069.58,1069.58,1069.58,,,0
unity,Fee schedule,Non-facility 11644,11644,11644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11644,BCBSND Base Physician Payment Schedule,820.72,837.64,Fee schedule,,820.72,820.72,820.72,820.72,,,0
unity,Fee schedule,Non-facility 11643,11643,11643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11643,BCBSND Base Physician Payment Schedule,665.09,680.05,Fee schedule,,665.09,665.09,665.09,665.09,,,0
unity,Fee schedule,Non-facility 11642,11642,11642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11642,BCBSND Base Physician Payment Schedule,564.52,577.84,Fee schedule,,564.52,564.52,564.52,564.52,,,0
unity,Fee schedule,Non-facility 11641,11641,11641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11641,BCBSND Base Physician Payment Schedule,497.72,508.28,Fee schedule,,497.72,497.72,497.72,497.72,,,0
unity,Fee schedule,Non-facility 11640,11640,11640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11640,BCBSND Base Physician Payment Schedule,423.58,430.18,Fee schedule,,423.58,423.58,423.58,423.58,,,0
unity,Fee schedule,Non-facility 11626,11626,11626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11626,BCBSND Base Physician Payment Schedule,855.96,866.04,Fee schedule,,855.96,855.96,855.96,855.96,,,0
unity,Fee schedule,Non-facility 11624,11624,11624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11624,BCBSND Base Physician Payment Schedule,708.41,719.09,Fee schedule,,708.41,708.41,708.41,708.41,,,0
unity,Fee schedule,Non-facility 11623,11623,11623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11623,BCBSND Base Physician Payment Schedule,625.45,639.6,Fee schedule,,625.45,625.45,625.45,625.45,,,0
unity,Fee schedule,Non-facility 11622,11622,11622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11622,BCBSND Base Physician Payment Schedule,532.22,547.31,Fee schedule,,532.22,532.22,532.22,532.22,,,0
unity,Fee schedule,Non-facility 11621,11621,11621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11621,BCBSND Base Physician Payment Schedule,480.84,490.52,Fee schedule,,480.84,480.84,480.84,480.84,,,0
unity,Fee schedule,Non-facility 11620,Not in chargemaster,11620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11620,BCBSND Base Physician Payment Schedule,414.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11606,11606,11606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11606,BCBSND Base Physician Payment Schedule,940.38,975,Fee schedule,,940.38,940.38,940.38,940.38,,,0
unity,Fee schedule,Non-facility 11604,11604,11604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11604,BCBSND Base Physician Payment Schedule,655.55,670.12,Fee schedule,,655.55,655.55,655.55,655.55,,,0
unity,Fee schedule,Non-facility 11603,11603,11603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11603,BCBSND Base Physician Payment Schedule,587.28,601.26,Fee schedule,,587.28,587.28,587.28,587.28,,,0
unity,Fee schedule,Non-facility 11602,11602,11602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11602,BCBSND Base Physician Payment Schedule,515.34,535,Fee schedule,,515.34,515.34,515.34,515.34,,,0
unity,Fee schedule,Non-facility 11601,11601,11601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11601,BCBSND Base Physician Payment Schedule,478.63,495,Fee schedule,,478.63,478.63,478.63,478.63,,,0
unity,Fee schedule,Non-facility 11600,11600,11600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11600,BCBSND Base Physician Payment Schedule,411.83,420,Fee schedule,,411.83,411.83,411.83,411.83,,,0
unity,Fee schedule,Non-facility 11471,Not in chargemaster,11471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11471,BCBSND Base Physician Payment Schedule,1107.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11470,Not in chargemaster,11470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11470,BCBSND Base Physician Payment Schedule,908.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11463,Not in chargemaster,11463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11463,BCBSND Base Physician Payment Schedule,1085.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11462,Not in chargemaster,11462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11462,BCBSND Base Physician Payment Schedule,833.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11451,Not in chargemaster,11451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11451,BCBSND Base Physician Payment Schedule,1067.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11450,Not in chargemaster,11450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11450,BCBSND Base Physician Payment Schedule,856.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11446,Not in chargemaster,11446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11446,BCBSND Base Physician Payment Schedule,817.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11444,11444,11444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11444,BCBSND Base Physician Payment Schedule,593.89,594.87,Fee schedule,,593.89,593.89,593.89,593.89,,,0
unity,Fee schedule,Non-facility 11443,11443,11443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11443,BCBSND Base Physician Payment Schedule,473.49,476.32,Fee schedule,,473.49,473.49,473.49,473.49,,,0
unity,Fee schedule,Non-facility 11442,11442,11442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11442,BCBSND Base Physician Payment Schedule,398.62,410,Fee schedule,,398.62,398.62,398.62,398.62,,,0
unity,Fee schedule,Non-facility 11441,11441,11441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11441,BCBSND Base Physician Payment Schedule,358.24,367,Fee schedule,,358.24,358.24,358.24,358.24,,,0
unity,Fee schedule,Non-facility 11440,11440,11440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11440,BCBSND Base Physician Payment Schedule,291.44,297,Fee schedule,,291.44,291.44,291.44,291.44,,,0
unity,Fee schedule,Non-facility 11426,11426,11426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11426,BCBSND Base Physician Payment Schedule,706.94,725,Fee schedule,,706.94,706.94,706.94,706.94,,,0
unity,Fee schedule,Non-facility 11424,11424,11424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11424,BCBSND Base Physician Payment Schedule,492.58,494.78,Fee schedule,,492.58,492.58,492.58,492.58,,,0
unity,Fee schedule,Non-facility 11423,11423,11423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11423,BCBSND Base Physician Payment Schedule,426.51,430.89,Fee schedule,,426.51,426.51,426.51,426.51,,,0
unity,Fee schedule,Non-facility 11422,11422,11422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11422,BCBSND Base Physician Payment Schedule,375.13,380,Fee schedule,,375.13,375.13,375.13,375.13,,,0
unity,Fee schedule,Non-facility 11421,11421,11421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11421,BCBSND Base Physician Payment Schedule,333.28,336.48,Fee schedule,,333.28,333.28,333.28,333.28,,,0
unity,Fee schedule,Non-facility 11420,11420,11420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11420,BCBSND Base Physician Payment Schedule,264.28,265,Fee schedule,,264.28,264.28,264.28,264.28,,,0
unity,Fee schedule,Non-facility 11406,11406,11406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11406,BCBSND Base Physician Payment Schedule,665.83,685,Fee schedule,,665.83,665.83,665.83,665.83,,,0
unity,Fee schedule,Non-facility 11404,11404,11404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11404,BCBSND Base Physician Payment Schedule,465.42,462.84,Fee schedule,,462.84,462.84,462.84,462.84,,,0
unity,Fee schedule,Non-facility 11403,11403,11403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11403,BCBSND Base Physician Payment Schedule,409.63,420,Fee schedule,,409.63,409.63,409.63,409.63,,,0
unity,Fee schedule,Non-facility 11402,11402,11402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11402,BCBSND Base Physician Payment Schedule,354.57,365,Fee schedule,,354.57,354.57,354.57,354.57,,,0
unity,Fee schedule,Non-facility 11401,11401,11401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11401,BCBSND Base Physician Payment Schedule,319.33,318.74,Fee schedule,,318.74,318.74,318.74,318.74,,,0
unity,Fee schedule,Non-facility 11400,11400,11400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11400,BCBSND Base Physician Payment Schedule,262.07,264.09,Fee schedule,,262.07,262.07,262.07,262.07,,,0
unity,Fee schedule,Non-facility 11313,11313,11313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11313,BCBSND Base Physician Payment Schedule,386.87,400,Fee schedule,,386.87,386.87,386.87,386.87,,,0
unity,Fee schedule,Non-facility 11312,11312,11312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11312,BCBSND Base Physician Payment Schedule,331.08,345,Fee schedule,,331.08,331.08,331.08,331.08,,,0
unity,Fee schedule,Non-facility 11311,11311,11311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11311,BCBSND Base Physician Payment Schedule,286.3,290,Fee schedule,,286.3,286.3,286.3,286.3,,,0
unity,Fee schedule,Non-facility 11310,11310,11310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11310,BCBSND Base Physician Payment Schedule,241.52,243.5,Fee schedule,,241.52,241.52,241.52,241.52,,,0
unity,Fee schedule,Non-facility 11308,Not in chargemaster,11308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11308,BCBSND Base Physician Payment Schedule,320.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11307,11307,11307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11307,BCBSND Base Physician Payment Schedule,300.25,307.38,Fee schedule,,300.25,300.25,300.25,300.25,,,0
unity,Fee schedule,Non-facility 11306,11306,11306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11306,BCBSND Base Physician Payment Schedule,256.94,259.11,Fee schedule,,256.94,256.94,256.94,256.94,,,0
unity,Fee schedule,Non-facility 11305,11305,11305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11305,BCBSND Base Physician Payment Schedule,219.5,220,Fee schedule,,219.5,219.5,219.5,219.5,,,0
unity,Fee schedule,Non-facility 11303,11303,11303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11303,BCBSND Base Physician Payment Schedule,322.27,333.64,Fee schedule,,322.27,322.27,322.27,322.27,,,0
unity,Fee schedule,Non-facility 11302,11302,11302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11302,BCBSND Base Physician Payment Schedule,292.91,302.41,Fee schedule,,292.91,292.91,292.91,292.91,,,0
unity,Fee schedule,Non-facility 11301,11301,11301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11301,BCBSND Base Physician Payment Schedule,253.26,256.97,Fee schedule,,253.26,253.26,253.26,253.26,,,0
unity,Fee schedule,Non-facility 11300,11300,11300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11300,BCBSND Base Physician Payment Schedule,208.48,209.42,Fee schedule,,208.48,208.48,208.48,208.48,,,0
unity,Fee schedule,Non-facility 11201,11201,11201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11201,BCBSND Base Physician Payment Schedule,38.91,45,Fee schedule,,38.91,38.91,38.91,38.91,,,0
unity,Fee schedule,Non-facility 11200,11200,11200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11200,BCBSND Base Physician Payment Schedule,184.99,186.7,Fee schedule,,184.99,184.99,184.99,184.99,,,0
unity,Fee schedule,Non-facility 11107,Not in chargemaster,11107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11107,BCBSND Base Physician Payment Schedule,149.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11106,Not in chargemaster,11106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11106,BCBSND Base Physician Payment Schedule,317.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11105,11105,11105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11105,BCBSND Base Physician Payment Schedule,126.27,137.5,Fee schedule,,126.27,126.27,126.27,126.27,,,0
unity,Fee schedule,Non-facility 11104,11104,11104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11104,BCBSND Base Physician Payment Schedule,262.07,275,Fee schedule,,262.07,262.07,262.07,262.07,,,0
unity,Fee schedule,Non-facility 11103,Not in chargemaster,11103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11103,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11102,11102,11102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11102,BCBSND Base Physician Payment Schedule,208.48,210,Fee schedule,,208.48,208.48,208.48,208.48,,,0
unity,Fee schedule,Non-facility 11057,Not in chargemaster,11057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11057,BCBSND Base Physician Payment Schedule,169.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11056,Not in chargemaster,11056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11056,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11055,11055,11055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11055,BCBSND Base Physician Payment Schedule,130.67,120,Fee schedule,,120,120,120,120,,,0
unity,Fee schedule,Non-facility 11047,Not in chargemaster,11047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11047,BCBSND Base Physician Payment Schedule,259.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11046,Not in chargemaster,11046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11046,BCBSND Base Physician Payment Schedule,155.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11045,Not in chargemaster,11045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11045,BCBSND Base Physician Payment Schedule,87.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11044,Not in chargemaster,11044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11044,BCBSND Base Physician Payment Schedule,657.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11043,Not in chargemaster,11043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11043,BCBSND Base Physician Payment Schedule,487.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11042,11042,11042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11042,BCBSND Base Physician Payment Schedule,262.07,265,Fee schedule,,262.07,262.07,262.07,262.07,,,0
unity,Fee schedule,Non-facility 11012,Not in chargemaster,11012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11012,BCBSND Base Physician Payment Schedule,1419.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11011,Not in chargemaster,11011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11011,BCBSND Base Physician Payment Schedule,1108.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11010,Not in chargemaster,11010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11010,BCBSND Base Physician Payment Schedule,995.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11008,Not in chargemaster,11008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11008,BCBSND Base Physician Payment Schedule,586.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11006,Not in chargemaster,11006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11006,BCBSND Base Physician Payment Schedule,1504.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11005,Not in chargemaster,11005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11005,BCBSND Base Physician Payment Schedule,1667.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11004,Not in chargemaster,11004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11004,BCBSND Base Physician Payment Schedule,1224.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11001,Not in chargemaster,11001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11001,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 11000,11000,11000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11000,BCBSND Base Physician Payment Schedule,118.19,115.01,Fee schedule,,115.01,115.01,115.01,115.01,,,0
unity,Fee schedule,Non-facility 10180,10180,10180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10180,BCBSND Base Physician Payment Schedule,535.89,405.82,Fee schedule,,405.82,405.82,405.82,405.82,,,0
unity,Fee schedule,Non-facility 10160,10160,10160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10160,BCBSND Base Physician Payment Schedule,272.35,277.56,Fee schedule,,272.35,272.35,272.35,272.35,,,0
unity,Fee schedule,Non-facility 10140,10140,10140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10140,BCBSND Base Physician Payment Schedule,356.04,347.12,Fee schedule,,347.12,347.12,347.12,347.12,,,0
unity,Fee schedule,Non-facility 10121,10121,10121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10121,BCBSND Base Physician Payment Schedule,569.66,588.48,Fee schedule,,569.66,569.66,569.66,569.66,,,0
unity,Fee schedule,Non-facility 10120,10120,10120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10120,BCBSND Base Physician Payment Schedule,316.4,325.83,Fee schedule,,316.4,316.4,316.4,316.4,,,0
unity,Fee schedule,Non-facility 10081,Not in chargemaster,10081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10081,BCBSND Base Physician Payment Schedule,636.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10080,Not in chargemaster,10080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10080,BCBSND Base Physician Payment Schedule,439.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10061,10061,10061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10061,BCBSND Base Physician Payment Schedule,438.26,445,Fee schedule,,438.26,438.26,438.26,438.26,,,0
unity,Fee schedule,Non-facility 10060,10060,10060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10060,BCBSND Base Physician Payment Schedule,252.53,255,Fee schedule,,252.53,252.53,252.53,252.53,,,0
unity,Fee schedule,Non-facility 10040,Not in chargemaster,10040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10040,BCBSND Base Physician Payment Schedule,228.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10036,Not in chargemaster,10036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10036,BCBSND Base Physician Payment Schedule,801.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10035,Not in chargemaster,10035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10035,BCBSND Base Physician Payment Schedule,942.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10030,Not in chargemaster,10030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10030,BCBSND Base Physician Payment Schedule,1286.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10021,Not in chargemaster,10021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10021,BCBSND Base Physician Payment Schedule,205.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10010,Not in chargemaster,10010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10010,BCBSND Base Physician Payment Schedule,588.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10009,Not in chargemaster,10009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10009,BCBSND Base Physician Payment Schedule,977.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10008,Not in chargemaster,10008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10008,BCBSND Base Physician Payment Schedule,351.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10007,Not in chargemaster,10007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10007,BCBSND Base Physician Payment Schedule,618.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10006,Not in chargemaster,10006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10006,BCBSND Base Physician Payment Schedule,124.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10005,Not in chargemaster,10005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10005,BCBSND Base Physician Payment Schedule,269.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 10004,Not in chargemaster,10004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10004,BCBSND Base Physician Payment Schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0509T,Not in chargemaster,0509T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0509T,BCBSND Base Physician Payment Schedule,159.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0509T26,Not in chargemaster,0509T,26,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0509T26,BCBSND Base Physician Payment Schedule,44.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0509TTC,Not in chargemaster,0509T,TC,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0509TTC,BCBSND Base Physician Payment Schedule,114.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0523T,Not in chargemaster,0523T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0523T,BCBSND Base Physician Payment Schedule,560.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0540T,Not in chargemaster,0540T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0540T,BCBSND Base Physician Payment Schedule,309.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0572T,Not in chargemaster,0572T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0572T,BCBSND Base Physician Payment Schedule,966.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0573T,Not in chargemaster,0573T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0573T,BCBSND Base Physician Payment Schedule,739.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0574T,Not in chargemaster,0574T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0574T,BCBSND Base Physician Payment Schedule,850.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0575T,Not in chargemaster,0575T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0575T,BCBSND Base Physician Payment Schedule,149.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0576T,Not in chargemaster,0576T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0576T,BCBSND Base Physician Payment Schedule,111.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Non-facility 0577T,Not in chargemaster,0577T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0577T,BCBSND Base Physician Payment Schedule,111.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S0270,Not in chargemaster,S0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0270,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S0271,Not in chargemaster,S0271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0271,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S0272,Not in chargemaster,S0272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0272,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S0302,Not in chargemaster,S0302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0302,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S0613,Not in chargemaster,S0613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0613,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S0620,Not in chargemaster,S0620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0620,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S0621,Not in chargemaster,S0621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0621,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S0630,Not in chargemaster,S0630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S0630,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S2083,Not in chargemaster,S2083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2083,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S2120,Not in chargemaster,S2120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2120,BCBSND Base Physician Payment Schedule,179.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S2342,Not in chargemaster,S2342,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S2342,BCBSND Base Physician Payment Schedule,166.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S8930,Not in chargemaster,S8930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S8930,BCBSND Base Physician Payment Schedule,63.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S9088,Not in chargemaster,S9088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9088,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility S9472,Not in chargemaster,S9472,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,S9472,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2088,Not in chargemaster,G2088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2088,BCBSND Base Physician Payment Schedule,71.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2087,Not in chargemaster,G2087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2087,BCBSND Base Physician Payment Schedule,597.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2086,Not in chargemaster,G2086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2086,BCBSND Base Physician Payment Schedule,612.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2083,Not in chargemaster,G2083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2083,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2082,Not in chargemaster,G2082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2082,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2064,Not in chargemaster,G2064,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2064,BCBSND Base Physician Payment Schedule,160.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2063,Not in chargemaster,G2063,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2063,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2058,Not in chargemaster,G2058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2058,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2012,Not in chargemaster,G2012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2012,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0518,Not in chargemaster,G0518,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0518,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2000,Not in chargemaster,G2000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2000,BCBSND Base Physician Payment Schedule,228.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility Q0091,Not in chargemaster,Q0091,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Q0091,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G2010,Not in chargemaster,G2010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G2010,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0517,Not in chargemaster,G0517,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0517,BCBSND Base Physician Payment Schedule,241.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0516,Not in chargemaster,G0516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0516,BCBSND Base Physician Payment Schedule,236.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0514,Not in chargemaster,G0514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0514,BCBSND Base Physician Payment Schedule,127.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0506,Not in chargemaster,G0506,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0506,BCBSND Base Physician Payment Schedule,94.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0513,Not in chargemaster,G0513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0513,BCBSND Base Physician Payment Schedule,127.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0473,Not in chargemaster,G0473,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0473,BCBSND Base Physician Payment Schedule,24.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0460,Not in chargemaster,G0460,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0460,BCBSND Base Physician Payment Schedule,265.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0455,Not in chargemaster,G0455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0455,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0447,Not in chargemaster,G0447,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0447,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0446,Not in chargemaster,G0446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0446,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0445,Not in chargemaster,G0445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0445,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0444,Not in chargemaster,G0444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0444,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0443,Not in chargemaster,G0443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0443,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0402,Not in chargemaster,G0402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0402,BCBSND Base Physician Payment Schedule,262.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0442,Not in chargemaster,G0442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0442,BCBSND Base Physician Payment Schedule,19.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0429,Not in chargemaster,G0429,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0429,BCBSND Base Physician Payment Schedule,145.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0424,Not in chargemaster,G0424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0424,BCBSND Base Physician Payment Schedule,29.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0397,Not in chargemaster,G0397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0397,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0271,Not in chargemaster,G0271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0271,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0396,Not in chargemaster,G0396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0396,BCBSND Base Physician Payment Schedule,69.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0341,Not in chargemaster,G0341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0341,BCBSND Base Physician Payment Schedule,762,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0270,Not in chargemaster,G0270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0270,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0268,Not in chargemaster,G0268,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0268,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0296,Not in chargemaster,G0296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0296,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0259,Not in chargemaster,G0259,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0259,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0260,Not in chargemaster,G0260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0260,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0247,Not in chargemaster,G0247,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0247,BCBSND Base Physician Payment Schedule,46.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0246,Not in chargemaster,G0246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0246,BCBSND Base Physician Payment Schedule,43.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0245,Not in chargemaster,G0245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0245,BCBSND Base Physician Payment Schedule,88.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0186,Not in chargemaster,G0186,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0186,BCBSND Base Physician Payment Schedule,1036.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0168,G0168,G0168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0168,BCBSND Base Physician Payment Schedule,39.64,200,Fee schedule,,39.64,39.64,39.64,39.64,,,0
unity,Fee schedule,Facility G0127,Not in chargemaster,G0127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0127,BCBSND Base Physician Payment Schedule,16.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0105,G0105,G0105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0105,BCBSND Base Physician Payment Schedule,392.01,469.74,Fee schedule,,392.01,392.01,392.01,392.01,,,0
unity,Fee schedule,Facility G0104,G0104,G0104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0104,BCBSND Base Physician Payment Schedule,118.19,137.02,Fee schedule,,118.19,118.19,118.19,118.19,,,0
unity,Fee schedule,Facility G0121,G0121,G0121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0121,BCBSND Base Physician Payment Schedule,393.48,469.74,Fee schedule,,393.48,393.48,393.48,393.48,,,0
unity,Fee schedule,Facility G0102,Not in chargemaster,G0102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0102,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility D6010,Not in chargemaster,D6010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,D6010,BCBSND Base Physician Payment Schedule,1736.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99497,Not in chargemaster,99497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99497,BCBSND Base Physician Payment Schedule,163.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99496,Not in chargemaster,99496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99496,BCBSND Base Physician Payment Schedule,336.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility G0101,Not in chargemaster,G0101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,G0101,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99495,Not in chargemaster,99495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99495,BCBSND Base Physician Payment Schedule,255.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99494,Not in chargemaster,99494,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99494,BCBSND Base Physician Payment Schedule,88.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99493,Not in chargemaster,99493,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99493,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99492,Not in chargemaster,99492,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99492,BCBSND Base Physician Payment Schedule,183.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99490,Not in chargemaster,99490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99490,BCBSND Base Physician Payment Schedule,66.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99489,Not in chargemaster,99489,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99489,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99487,Not in chargemaster,99487,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99487,BCBSND Base Physician Payment Schedule,108.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99484,Not in chargemaster,99484,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99484,BCBSND Base Physician Payment Schedule,66.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99461,Not in chargemaster,99461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99461,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99458,Not in chargemaster,99458,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99458,BCBSND Base Physician Payment Schedule,66.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99443,Not in chargemaster,99443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99443,BCBSND Base Physician Payment Schedule,163.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99483,Not in chargemaster,99483,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99483,BCBSND Base Physician Payment Schedule,375.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99474,Not in chargemaster,99474,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99474,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99457,Not in chargemaster,99457,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99457,BCBSND Base Physician Payment Schedule,66.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99442,Not in chargemaster,99442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99442,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99441,Not in chargemaster,99441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99441,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99423,Not in chargemaster,99423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99423,BCBSND Base Physician Payment Schedule,88.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99422,Not in chargemaster,99422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99422,BCBSND Base Physician Payment Schedule,55.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99421,Not in chargemaster,99421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99421,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99412,Not in chargemaster,99412,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99412,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99411,Not in chargemaster,99411,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99411,BCBSND Base Physician Payment Schedule,16.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99409,Not in chargemaster,99409,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99409,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99408,Not in chargemaster,99408,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99408,BCBSND Base Physician Payment Schedule,69.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99407,9420001,99407,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99407,BCBSND Base Physician Payment Schedule,54.32,101.14,Fee schedule,,54.32,54.32,54.32,54.32,,,0
unity,Fee schedule,Facility 99406,9420000,99406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99406,BCBSND Base Physician Payment Schedule,25.69,53.55,Fee schedule,,25.69,25.69,25.69,25.69,,,0
unity,Fee schedule,Facility 99404,Not in chargemaster,99404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99404,BCBSND Base Physician Payment Schedule,209.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99403,Not in chargemaster,99403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99403,BCBSND Base Physician Payment Schedule,156.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99402,Not in chargemaster,99402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99402,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99401,Not in chargemaster,99401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99401,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99397,99397,99397,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99397,BCBSND Base Physician Payment Schedule,215.09,290,Fee schedule,,215.09,215.09,215.09,215.09,,,0
unity,Fee schedule,Facility 99396,99396,99396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99396,BCBSND Base Physician Payment Schedule,204.08,270,Fee schedule,,204.08,204.08,204.08,204.08,,,0
unity,Fee schedule,Facility 99395,99395,99395,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99395,BCBSND Base Physician Payment Schedule,187.2,250,Fee schedule,,187.2,187.2,187.2,187.2,,,0
unity,Fee schedule,Facility 99394,99394,99394,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99394,BCBSND Base Physician Payment Schedule,182.06,250,Fee schedule,,182.06,182.06,182.06,182.06,,,0
unity,Fee schedule,Facility 99393,99393,99393,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99393,BCBSND Base Physician Payment Schedule,160.77,225,Fee schedule,,160.77,160.77,160.77,160.77,,,0
unity,Fee schedule,Facility 99392,99392,99392,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99392,BCBSND Base Physician Payment Schedule,160.77,225,Fee schedule,,160.77,160.77,160.77,160.77,,,0
unity,Fee schedule,Facility 99391,99391,99391,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99391,BCBSND Base Physician Payment Schedule,147.55,210,Fee schedule,,147.55,147.55,147.55,147.55,,,0
unity,Fee schedule,Facility 99387,99387,99387,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99387,BCBSND Base Physician Payment Schedule,269.41,342.17,Fee schedule,,269.41,269.41,269.41,269.41,,,0
unity,Fee schedule,Facility 99386,99386,99386,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99386,BCBSND Base Physician Payment Schedule,250.33,325,Fee schedule,,250.33,250.33,250.33,250.33,,,0
unity,Fee schedule,Facility 99385,99385,99385,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99385,BCBSND Base Physician Payment Schedule,206.28,282,Fee schedule,,206.28,206.28,206.28,206.28,,,0
unity,Fee schedule,Facility 99384,99384,99384,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99384,BCBSND Base Physician Payment Schedule,215.09,290,Fee schedule,,215.09,215.09,215.09,215.09,,,0
unity,Fee schedule,Facility 99383,99383,99383,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99383,BCBSND Base Physician Payment Schedule,182.06,255,Fee schedule,,182.06,182.06,182.06,182.06,,,0
unity,Fee schedule,Facility 99382,99382,99382,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99382,BCBSND Base Physician Payment Schedule,171.78,238.51,Fee schedule,,171.78,171.78,171.78,171.78,,,0
unity,Fee schedule,Facility 99381,99381,99381,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99381,BCBSND Base Physician Payment Schedule,160.77,238,Fee schedule,,160.77,160.77,160.77,160.77,,,0
unity,Fee schedule,Facility 99380,Not in chargemaster,99380,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99380,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99379,Not in chargemaster,99379,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99379,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99378,Not in chargemaster,99378,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99378,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99377,Not in chargemaster,99377,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99377,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99375,Not in chargemaster,99375,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99375,BCBSND Base Physician Payment Schedule,185.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99355,Not in chargemaster,99355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99355,BCBSND Base Physician Payment Schedule,190.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99374,Not in chargemaster,99374,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99374,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99366,Not in chargemaster,99366,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99366,BCBSND Base Physician Payment Schedule,89.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99292,99292,99292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99292,BCBSND Base Physician Payment Schedule,231.98,262,Fee schedule,,231.98,231.98,231.98,231.98,,,0
unity,Fee schedule,Facility 99245,Not in chargemaster,99245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99245,BCBSND Base Physician Payment Schedule,400.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99244,Not in chargemaster,99244,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99244,BCBSND Base Physician Payment Schedule,323.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99243,Not in chargemaster,99243,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99243,BCBSND Base Physician Payment Schedule,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99291,99291,99291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99291,BCBSND Base Physician Payment Schedule,461.01,480,Fee schedule,,461.01,461.01,461.01,461.01,,,0
unity,Fee schedule,Facility 99354,Not in chargemaster,99354,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99354,BCBSND Base Physician Payment Schedule,252.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99242,Not in chargemaster,99242,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99242,BCBSND Base Physician Payment Schedule,143.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99215,99215,99215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99215,BCBSND Base Physician Payment Schedule,231.24,300,Fee schedule,,231.24,231.24,231.24,231.24,,,0
unity,Fee schedule,Facility 99214,99214,99214,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99214,BCBSND Base Physician Payment Schedule,163.7,230,Fee schedule,,163.7,163.7,163.7,163.7,,,0
unity,Fee schedule,Facility 99213,99213,99213,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99213,BCBSND Base Physician Payment Schedule,106.44,158,Fee schedule,,106.44,106.44,106.44,106.44,,,0
unity,Fee schedule,Facility 99212,99212,99212,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99212,BCBSND Base Physician Payment Schedule,53.59,97,Fee schedule,,53.59,53.59,53.59,53.59,,,0
unity,Fee schedule,Facility 99211,99211,99211,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99211,BCBSND Base Physician Payment Schedule,19.09,50,Fee schedule,,19.09,19.09,19.09,19.09,,,0
unity,Fee schedule,Facility 99205,99205,99205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99205,BCBSND Base Physician Payment Schedule,350.9,440,Fee schedule,,350.9,350.9,350.9,350.9,,,0
unity,Fee schedule,Facility 99204,99204,99204,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99204,BCBSND Base Physician Payment Schedule,268.68,350,Fee schedule,,268.68,268.68,268.68,268.68,,,0
unity,Fee schedule,Facility 99241,99241,99241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99241,BCBSND Base Physician Payment Schedule,68.27,97.26,Fee schedule,,68.27,68.27,68.27,68.27,,,0
unity,Fee schedule,Facility 99203,99203,99203,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99203,BCBSND Base Physician Payment Schedule,157.1,230,Fee schedule,,157.1,157.1,157.1,157.1,,,0
unity,Fee schedule,Facility 99202,99202,99202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99202,BCBSND Base Physician Payment Schedule,104.98,163,Fee schedule,,104.98,104.98,104.98,104.98,,,0
unity,Fee schedule,Facility 98968,Not in chargemaster,98968,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98968,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98967,Not in chargemaster,98967,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98967,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 99201,99201,99201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99201,BCBSND Base Physician Payment Schedule,55.06,98,Fee schedule,,55.06,55.06,55.06,55.06,,,0
unity,Fee schedule,Facility 99170,Not in chargemaster,99170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,99170,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98966,Not in chargemaster,98966,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98966,BCBSND Base Physician Payment Schedule,27.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98943,Not in chargemaster,98943,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98943,BCBSND Base Physician Payment Schedule,45.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98942,Not in chargemaster,98942,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98942,BCBSND Base Physician Payment Schedule,88.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98941,Not in chargemaster,98941,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98941,BCBSND Base Physician Payment Schedule,65.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98940,Not in chargemaster,98940,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98940,BCBSND Base Physician Payment Schedule,42.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98929,Not in chargemaster,98929,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98929,BCBSND Base Physician Payment Schedule,137.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98928,Not in chargemaster,98928,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98928,BCBSND Base Physician Payment Schedule,112.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98927,Not in chargemaster,98927,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98927,BCBSND Base Physician Payment Schedule,89.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98926,Not in chargemaster,98926,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98926,BCBSND Base Physician Payment Schedule,68.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 98925,Not in chargemaster,98925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,98925,BCBSND Base Physician Payment Schedule,45.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97814,Not in chargemaster,97814,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97814,BCBSND Base Physician Payment Schedule,53.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97813,Not in chargemaster,97813,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97813,BCBSND Base Physician Payment Schedule,63.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97811,Not in chargemaster,97811,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97811,BCBSND Base Physician Payment Schedule,49.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97810,Not in chargemaster,97810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97810,BCBSND Base Physician Payment Schedule,58.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97804,Not in chargemaster,97804,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97804,BCBSND Base Physician Payment Schedule,33.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97803,Not in chargemaster,97803,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97803,BCBSND Base Physician Payment Schedule,59.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97610,Not in chargemaster,97610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97610,BCBSND Base Physician Payment Schedule,38.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97802,Not in chargemaster,97802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97802,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97608,Not in chargemaster,97608,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97608,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97607,Not in chargemaster,97607,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97607,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97606,Not in chargemaster,97606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97606,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97605,Not in chargemaster,97605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97605,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97598,Not in chargemaster,97598,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97598,BCBSND Base Physician Payment Schedule,54.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97602,Not in chargemaster,97602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97602,BCBSND Base Physician Payment Schedule,77.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96922,Not in chargemaster,96922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96922,BCBSND Base Physician Payment Schedule,250.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96921,Not in chargemaster,96921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96921,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96450,Not in chargemaster,96450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96450,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 97597,97597,97597,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97597,BCBSND Base Physician Payment Schedule,77.08,190,Fee schedule,,77.08,77.08,77.08,77.08,,,0
unity,Fee schedule,Facility 97129,Not in chargemaster,97129,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,97129,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96920,Not in chargemaster,96920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96920,BCBSND Base Physician Payment Schedule,138.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96542,Not in chargemaster,96542,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96542,BCBSND Base Physician Payment Schedule,88.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96902,Not in chargemaster,96902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96902,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96446,Not in chargemaster,96446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96446,BCBSND Base Physician Payment Schedule,53.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96406,Not in chargemaster,96406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96406,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96171,Not in chargemaster,96171,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96171,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96170,Not in chargemaster,96170,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96170,BCBSND Base Physician Payment Schedule,160.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96440,Not in chargemaster,96440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96440,BCBSND Base Physician Payment Schedule,262.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96405,Not in chargemaster,96405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96405,BCBSND Base Physician Payment Schedule,61.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96168,Not in chargemaster,96168,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96168,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96167,Not in chargemaster,96167,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96167,BCBSND Base Physician Payment Schedule,134.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96165,Not in chargemaster,96165,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96165,BCBSND Base Physician Payment Schedule,8.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96159,Not in chargemaster,96159,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96159,BCBSND Base Physician Payment Schedule,43.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96164,Not in chargemaster,96164,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96164,BCBSND Base Physician Payment Schedule,18.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96158,Not in chargemaster,96158,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96158,BCBSND Base Physician Payment Schedule,125.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96137,Not in chargemaster,96137,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96137,BCBSND Base Physician Payment Schedule,40.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96156,Not in chargemaster,96156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96156,BCBSND Base Physician Payment Schedule,184.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96136,Not in chargemaster,96136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96136,BCBSND Base Physician Payment Schedule,51.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96133,Not in chargemaster,96133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96133,BCBSND Base Physician Payment Schedule,171.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96132,Not in chargemaster,96132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96132,BCBSND Base Physician Payment Schedule,223.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96131,Not in chargemaster,96131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96131,BCBSND Base Physician Payment Schedule,173.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96130,Not in chargemaster,96130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96130,BCBSND Base Physician Payment Schedule,226.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96121,Not in chargemaster,96121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96121,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96116,Not in chargemaster,96116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96116,BCBSND Base Physician Payment Schedule,176.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96113,Not in chargemaster,96113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96113,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95992,Not in chargemaster,95992,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95992,BCBSND Base Physician Payment Schedule,79.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 96112,Not in chargemaster,96112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,96112,BCBSND Base Physician Payment Schedule,267.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95991,Not in chargemaster,95991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95991,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95984,Not in chargemaster,95984,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95984,BCBSND Base Physician Payment Schedule,93.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95983,Not in chargemaster,95983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95983,BCBSND Base Physician Payment Schedule,105.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95982,Not in chargemaster,95982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95982,BCBSND Base Physician Payment Schedule,77.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95981,Not in chargemaster,95981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95981,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95977,Not in chargemaster,95977,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95977,BCBSND Base Physician Payment Schedule,111.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95976,Not in chargemaster,95976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95976,BCBSND Base Physician Payment Schedule,85.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95972,Not in chargemaster,95972,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95972,BCBSND Base Physician Payment Schedule,87.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95971,Not in chargemaster,95971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95971,BCBSND Base Physician Payment Schedule,85.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95857,Not in chargemaster,95857,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95857,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95852,Not in chargemaster,95852,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95852,BCBSND Base Physician Payment Schedule,12.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95851,Not in chargemaster,95851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95851,BCBSND Base Physician Payment Schedule,16.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95726,Not in chargemaster,95726,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95726,BCBSND Base Physician Payment Schedule,851.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95725,Not in chargemaster,95725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95725,BCBSND Base Physician Payment Schedule,612.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95724,Not in chargemaster,95724,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95724,BCBSND Base Physician Payment Schedule,673.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95723,Not in chargemaster,95723,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95723,BCBSND Base Physician Payment Schedule,538.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95722,Not in chargemaster,95722,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95722,BCBSND Base Physician Payment Schedule,528.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95721,Not in chargemaster,95721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95721,BCBSND Base Physician Payment Schedule,434.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95720,Not in chargemaster,95720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95720,BCBSND Base Physician Payment Schedule,433.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95719,Not in chargemaster,95719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95719,BCBSND Base Physician Payment Schedule,330.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95718,Not in chargemaster,95718,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95718,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95180,Not in chargemaster,95180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95180,BCBSND Base Physician Payment Schedule,216.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95717,Not in chargemaster,95717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95717,BCBSND Base Physician Payment Schedule,212.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 95830,Not in chargemaster,95830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,95830,BCBSND Base Physician Payment Schedule,194.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0071T,Not in chargemaster,0071T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0071T,BCBSND Base Physician Payment Schedule,527.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0072T,Not in chargemaster,0072T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0072T,BCBSND Base Physician Payment Schedule,527.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0228T,Not in chargemaster,0228T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0228T,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0229T,Not in chargemaster,0229T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0229T,BCBSND Base Physician Payment Schedule,132.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0230T,Not in chargemaster,0230T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0230T,BCBSND Base Physician Payment Schedule,235.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0231T,Not in chargemaster,0231T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0231T,BCBSND Base Physician Payment Schedule,110.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0232T,Not in chargemaster,0232T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0232T,BCBSND Base Physician Payment Schedule,82.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 0278T,Not in chargemaster,0278T,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,0278T,BCBSND Base Physician Payment Schedule,19.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10004,Not in chargemaster,10004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10004,BCBSND Base Physician Payment Schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10008,Not in chargemaster,10008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10008,BCBSND Base Physician Payment Schedule,129.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10007,Not in chargemaster,10007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10007,BCBSND Base Physician Payment Schedule,197.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10006,Not in chargemaster,10006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10006,BCBSND Base Physician Payment Schedule,104.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10005,Not in chargemaster,10005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10005,BCBSND Base Physician Payment Schedule,151.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11440,11440,11440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11440,BCBSND Base Physician Payment Schedule,215.83,297,Fee schedule,,215.83,215.83,215.83,215.83,,,0
unity,Fee schedule,Facility 11426,11426,11426,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11426,BCBSND Base Physician Payment Schedule,579.2,725,Fee schedule,,579.2,579.2,579.2,579.2,,,0
unity,Fee schedule,Facility 11424,11424,11424,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11424,BCBSND Base Physician Payment Schedule,375.13,494.78,Fee schedule,,375.13,375.13,375.13,375.13,,,0
unity,Fee schedule,Facility 11423,11423,11423,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11423,BCBSND Base Physician Payment Schedule,326.67,430.89,Fee schedule,,326.67,326.67,326.67,326.67,,,0
unity,Fee schedule,Facility 11422,11422,11422,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11422,BCBSND Base Physician Payment Schedule,284.83,380,Fee schedule,,284.83,284.83,284.83,284.83,,,0
unity,Fee schedule,Facility 11421,11421,11421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11421,BCBSND Base Physician Payment Schedule,229.77,336.48,Fee schedule,,229.77,229.77,229.77,229.77,,,0
unity,Fee schedule,Facility 11420,11420,11420,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11420,BCBSND Base Physician Payment Schedule,171.78,265,Fee schedule,,171.78,171.78,171.78,171.78,,,0
unity,Fee schedule,Facility 11406,11406,11406,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11406,BCBSND Base Physician Payment Schedule,520.48,685,Fee schedule,,520.48,520.48,520.48,520.48,,,0
unity,Fee schedule,Facility 11404,11404,11404,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11404,BCBSND Base Physician Payment Schedule,342.09,462.84,Fee schedule,,342.09,342.09,342.09,342.09,,,0
unity,Fee schedule,Facility 11403,11403,11403,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11403,BCBSND Base Physician Payment Schedule,310.52,420,Fee schedule,,310.52,310.52,310.52,310.52,,,0
unity,Fee schedule,Facility 11402,11402,11402,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11402,BCBSND Base Physician Payment Schedule,240.05,365,Fee schedule,,240.05,240.05,240.05,240.05,,,0
unity,Fee schedule,Facility 11401,11401,11401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11401,BCBSND Base Physician Payment Schedule,217.29,318.74,Fee schedule,,217.29,217.29,217.29,217.29,,,0
unity,Fee schedule,Facility 11400,11400,11400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11400,BCBSND Base Physician Payment Schedule,171.05,264.09,Fee schedule,,171.05,171.05,171.05,171.05,,,0
unity,Fee schedule,Facility 11313,11313,11313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11313,BCBSND Base Physician Payment Schedule,207.02,400,Fee schedule,,207.02,207.02,207.02,207.02,,,0
unity,Fee schedule,Facility 11312,11312,11312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11312,BCBSND Base Physician Payment Schedule,159.3,345,Fee schedule,,159.3,159.3,159.3,159.3,,,0
unity,Fee schedule,Facility 11311,11311,11311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11311,BCBSND Base Physician Payment Schedule,134.34,290,Fee schedule,,134.34,134.34,134.34,134.34,,,0
unity,Fee schedule,Facility 11310,11310,11310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11310,BCBSND Base Physician Payment Schedule,98.37,243.5,Fee schedule,,98.37,98.37,98.37,98.37,,,0
unity,Fee schedule,Facility 11308,Not in chargemaster,11308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11308,BCBSND Base Physician Payment Schedule,154.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11307,11307,11307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11307,BCBSND Base Physician Payment Schedule,137.28,307.38,Fee schedule,,137.28,137.28,137.28,137.28,,,0
unity,Fee schedule,Facility 11306,11306,11306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11306,BCBSND Base Physician Payment Schedule,106.44,259.11,Fee schedule,,106.44,106.44,106.44,106.44,,,0
unity,Fee schedule,Facility 11305,11305,11305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11305,BCBSND Base Physician Payment Schedule,82.95,220,Fee schedule,,82.95,82.95,82.95,82.95,,,0
unity,Fee schedule,Facility 11303,11303,11303,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11303,BCBSND Base Physician Payment Schedule,151.96,333.64,Fee schedule,,151.96,151.96,151.96,151.96,,,0
unity,Fee schedule,Facility 11302,11302,11302,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11302,BCBSND Base Physician Payment Schedule,129.2,302.41,Fee schedule,,129.2,129.2,129.2,129.2,,,0
unity,Fee schedule,Facility 11301,11301,11301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11301,BCBSND Base Physician Payment Schedule,110.12,256.97,Fee schedule,,110.12,110.12,110.12,110.12,,,0
unity,Fee schedule,Facility 11300,11300,11300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11300,BCBSND Base Physician Payment Schedule,72.68,209.42,Fee schedule,,72.68,72.68,72.68,72.68,,,0
unity,Fee schedule,Facility 11201,11201,11201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11201,BCBSND Base Physician Payment Schedule,34.5,45,Fee schedule,,34.5,34.5,34.5,34.5,,,0
unity,Fee schedule,Facility 11200,11200,11200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11200,BCBSND Base Physician Payment Schedule,154.16,186.7,Fee schedule,,154.16,154.16,154.16,154.16,,,0
unity,Fee schedule,Facility 11107,Not in chargemaster,11107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11107,BCBSND Base Physician Payment Schedule,66.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11106,Not in chargemaster,11106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11106,BCBSND Base Physician Payment Schedule,124.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11105,11105,11105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11105,BCBSND Base Physician Payment Schedule,55.79,137.5,Fee schedule,,55.79,55.79,55.79,55.79,,,0
unity,Fee schedule,Facility 11104,11104,11104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11104,BCBSND Base Physician Payment Schedule,102.77,275,Fee schedule,,102.77,102.77,102.77,102.77,,,0
unity,Fee schedule,Facility 11103,Not in chargemaster,11103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11103,BCBSND Base Physician Payment Schedule,47.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11102,11102,11102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11102,BCBSND Base Physician Payment Schedule,82.22,210,Fee schedule,,82.22,82.22,82.22,82.22,,,0
unity,Fee schedule,Facility 11057,Not in chargemaster,11057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11057,BCBSND Base Physician Payment Schedule,62.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11056,Not in chargemaster,11056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11056,BCBSND Base Physician Payment Schedule,49.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11055,11055,11055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11055,BCBSND Base Physician Payment Schedule,33.77,120,Fee schedule,,33.77,33.77,33.77,33.77,,,0
unity,Fee schedule,Facility 11047,Not in chargemaster,11047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11047,BCBSND Base Physician Payment Schedule,209.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11046,Not in chargemaster,11046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11046,BCBSND Base Physician Payment Schedule,118.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11045,Not in chargemaster,11045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11045,BCBSND Base Physician Payment Schedule,56.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11044,Not in chargemaster,11044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11044,BCBSND Base Physician Payment Schedule,481.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11043,Not in chargemaster,11043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11043,BCBSND Base Physician Payment Schedule,328.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11042,11042,11042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11042,BCBSND Base Physician Payment Schedule,128.47,265,Fee schedule,,128.47,128.47,128.47,128.47,,,0
unity,Fee schedule,Facility 11012,Not in chargemaster,11012,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11012,BCBSND Base Physician Payment Schedule,887.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11011,Not in chargemaster,11011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11011,BCBSND Base Physician Payment Schedule,637.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11010,Not in chargemaster,11010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11010,BCBSND Base Physician Payment Schedule,584.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11001,Not in chargemaster,11001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11001,BCBSND Base Physician Payment Schedule,30.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11000,11000,11000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11000,BCBSND Base Physician Payment Schedule,60.2,115.01,Fee schedule,,60.2,60.2,60.2,60.2,,,0
unity,Fee schedule,Facility 10180,10180,10180,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10180,BCBSND Base Physician Payment Schedule,375.13,405.82,Fee schedule,,375.13,375.13,375.13,375.13,,,0
unity,Fee schedule,Facility 10160,10160,10160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10160,BCBSND Base Physician Payment Schedule,198.94,277.56,Fee schedule,,198.94,198.94,198.94,198.94,,,0
unity,Fee schedule,Facility 10140,10140,10140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10140,BCBSND Base Physician Payment Schedule,250.33,347.12,Fee schedule,,250.33,250.33,250.33,250.33,,,0
unity,Fee schedule,Facility 10121,10121,10121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10121,BCBSND Base Physician Payment Schedule,391.28,588.48,Fee schedule,,391.28,391.28,391.28,391.28,,,0
unity,Fee schedule,Facility 10120,10120,10120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10120,BCBSND Base Physician Payment Schedule,215.83,325.83,Fee schedule,,215.83,215.83,215.83,215.83,,,0
unity,Fee schedule,Facility 10081,Not in chargemaster,10081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10081,BCBSND Base Physician Payment Schedule,361.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10080,Not in chargemaster,10080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10080,BCBSND Base Physician Payment Schedule,216.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10061,10061,10061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10061,BCBSND Base Physician Payment Schedule,382.47,445,Fee schedule,,382.47,382.47,382.47,382.47,,,0
unity,Fee schedule,Facility 10060,10060,10060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10060,BCBSND Base Physician Payment Schedule,210.69,255,Fee schedule,,210.69,210.69,210.69,210.69,,,0
unity,Fee schedule,Facility 10040,Not in chargemaster,10040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10040,BCBSND Base Physician Payment Schedule,112.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10036,Not in chargemaster,10036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10036,BCBSND Base Physician Payment Schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10035,Not in chargemaster,10035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10035,BCBSND Base Physician Payment Schedule,180.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10030,Not in chargemaster,10030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10030,BCBSND Base Physician Payment Schedule,292.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10021,Not in chargemaster,10021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10021,BCBSND Base Physician Payment Schedule,117.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10010,Not in chargemaster,10010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10010,BCBSND Base Physician Payment Schedule,174.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 10009,Not in chargemaster,10009,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,10009,BCBSND Base Physician Payment Schedule,240.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15121,Not in chargemaster,15121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15121,BCBSND Base Physician Payment Schedule,286.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15120,Not in chargemaster,15120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15120,BCBSND Base Physician Payment Schedule,1464.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15116,Not in chargemaster,15116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15116,BCBSND Base Physician Payment Schedule,322.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15115,Not in chargemaster,15115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15115,BCBSND Base Physician Payment Schedule,1445.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15111,Not in chargemaster,15111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15111,BCBSND Base Physician Payment Schedule,221.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15110,Not in chargemaster,15110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15110,BCBSND Base Physician Payment Schedule,1464.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15101,Not in chargemaster,15101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15101,BCBSND Base Physician Payment Schedule,237.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15100,Not in chargemaster,15100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15100,BCBSND Base Physician Payment Schedule,1511.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15050,Not in chargemaster,15050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15050,BCBSND Base Physician Payment Schedule,960.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15040,Not in chargemaster,15040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15040,BCBSND Base Physician Payment Schedule,264.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15005,Not in chargemaster,15005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15005,BCBSND Base Physician Payment Schedule,195.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15004,Not in chargemaster,15004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15004,BCBSND Base Physician Payment Schedule,561.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15003,Not in chargemaster,15003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15003,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14301,Not in chargemaster,14301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14301,BCBSND Base Physician Payment Schedule,1835.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15002,Not in chargemaster,15002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15002,BCBSND Base Physician Payment Schedule,473.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14061,Not in chargemaster,14061,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14061,BCBSND Base Physician Payment Schedule,1718.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14060,Not in chargemaster,14060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14060,BCBSND Base Physician Payment Schedule,1394.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14041,Not in chargemaster,14041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14041,BCBSND Base Physician Payment Schedule,1604.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14040,Not in chargemaster,14040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14040,BCBSND Base Physician Payment Schedule,1308.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14021,Not in chargemaster,14021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14021,BCBSND Base Physician Payment Schedule,1489.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14020,Not in chargemaster,14020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14020,BCBSND Base Physician Payment Schedule,1178.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14001,Not in chargemaster,14001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14001,BCBSND Base Physician Payment Schedule,1364.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 14000,Not in chargemaster,14000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,14000,BCBSND Base Physician Payment Schedule,1049.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13153,Not in chargemaster,13153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13153,BCBSND Base Physician Payment Schedule,295.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13152,Not in chargemaster,13152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13152,BCBSND Base Physician Payment Schedule,715.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13151,Not in chargemaster,13151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13151,BCBSND Base Physician Payment Schedule,593.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13133,Not in chargemaster,13133,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13133,BCBSND Base Physician Payment Schedule,270.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13132,13132,13132,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13132,BCBSND Base Physician Payment Schedule,646.74,1040,Fee schedule,,646.74,646.74,646.74,646.74,,,0
unity,Fee schedule,Facility 13131,13131,13131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13131,BCBSND Base Physician Payment Schedule,516.81,819.9,Fee schedule,,516.81,516.81,516.81,516.81,,,0
unity,Fee schedule,Facility 13122,13122,13122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13122,BCBSND Base Physician Payment Schedule,177.65,284.66,Fee schedule,,177.65,177.65,177.65,177.65,,,0
unity,Fee schedule,Facility 13121,Not in chargemaster,13121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13121,BCBSND Base Physician Payment Schedule,550.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13120,Not in chargemaster,13120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13120,BCBSND Base Physician Payment Schedule,490.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13102,Not in chargemaster,13102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13102,BCBSND Base Physician Payment Schedule,154.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13101,Not in chargemaster,13101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13101,BCBSND Base Physician Payment Schedule,524.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 13100,Not in chargemaster,13100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,13100,BCBSND Base Physician Payment Schedule,426.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12057,Not in chargemaster,12057,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12057,BCBSND Base Physician Payment Schedule,901.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12056,Not in chargemaster,12056,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12056,BCBSND Base Physician Payment Schedule,814.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12055,Not in chargemaster,12055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12055,BCBSND Base Physician Payment Schedule,635.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12054,12054,12054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12054,BCBSND Base Physician Payment Schedule,466.15,789.38,Fee schedule,,466.15,466.15,466.15,466.15,,,0
unity,Fee schedule,Facility 12053,12053,12053,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12053,BCBSND Base Physician Payment Schedule,455.14,740.4,Fee schedule,,455.14,455.14,455.14,455.14,,,0
unity,Fee schedule,Facility 12052,12052,12052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12052,BCBSND Base Physician Payment Schedule,421.37,626.81,Fee schedule,,421.37,421.37,421.37,421.37,,,0
unity,Fee schedule,Facility 12051,12051,12051,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12051,BCBSND Base Physician Payment Schedule,356.04,570,Fee schedule,,356.04,356.04,356.04,356.04,,,0
unity,Fee schedule,Facility 12047,Not in chargemaster,12047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12047,BCBSND Base Physician Payment Schedule,743.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12046,Not in chargemaster,12046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12046,BCBSND Base Physician Payment Schedule,666.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12045,Not in chargemaster,12045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12045,BCBSND Base Physician Payment Schedule,569.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12044,12044,12044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12044,BCBSND Base Physician Payment Schedule,452.21,790,Fee schedule,,452.21,452.21,452.21,452.21,,,0
unity,Fee schedule,Facility 12042,12042,12042,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12042,BCBSND Base Physician Payment Schedule,414.03,640,Fee schedule,,414.03,414.03,414.03,414.03,,,0
unity,Fee schedule,Facility 12041,12041,12041,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12041,BCBSND Base Physician Payment Schedule,309.79,530,Fee schedule,,309.79,309.79,309.79,309.79,,,0
unity,Fee schedule,Facility 12037,Not in chargemaster,12037,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12037,BCBSND Base Physician Payment Schedule,699.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12036,Not in chargemaster,12036,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12036,BCBSND Base Physician Payment Schedule,598.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12035,12035,12035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12035,BCBSND Base Physician Payment Schedule,509.47,829.83,Fee schedule,,509.47,509.47,509.47,509.47,,,0
unity,Fee schedule,Facility 12034,12034,12034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12034,BCBSND Base Physician Payment Schedule,433.85,690,Fee schedule,,433.85,433.85,433.85,433.85,,,0
unity,Fee schedule,Facility 12032,12032,12032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12032,BCBSND Base Physician Payment Schedule,400.82,650.24,Fee schedule,,400.82,400.82,400.82,400.82,,,0
unity,Fee schedule,Facility 12031,12031,12031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12031,BCBSND Base Physician Payment Schedule,320.07,508.98,Fee schedule,,320.07,320.07,320.07,320.07,,,0
unity,Fee schedule,Facility 12021,Not in chargemaster,12021,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12021,BCBSND Base Physician Payment Schedule,294.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12020,12020,12020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12020,BCBSND Base Physician Payment Schedule,398.62,601.26,Fee schedule,,398.62,398.62,398.62,398.62,,,0
unity,Fee schedule,Facility 12016,Not in chargemaster,12016,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12016,BCBSND Base Physician Payment Schedule,276.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12015,12015,12015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12015,BCBSND Base Physician Payment Schedule,204.08,367,Fee schedule,,204.08,204.08,204.08,204.08,,,0
unity,Fee schedule,Facility 12014,12014,12014,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12014,BCBSND Base Physician Payment Schedule,161.5,300.99,Fee schedule,,161.5,161.5,161.5,161.5,,,0
unity,Fee schedule,Facility 12013,12013,12013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12013,BCBSND Base Physician Payment Schedule,126.27,257.69,Fee schedule,,126.27,126.27,126.27,126.27,,,0
unity,Fee schedule,Facility 12011,12011,12011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12011,BCBSND Base Physician Payment Schedule,119.66,235.69,Fee schedule,,119.66,119.66,119.66,119.66,,,0
unity,Fee schedule,Facility 12007,Not in chargemaster,12007,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12007,BCBSND Base Physician Payment Schedule,310.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12006,Not in chargemaster,12006,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12006,BCBSND Base Physician Payment Schedule,251.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 12005,12005,12005,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12005,BCBSND Base Physician Payment Schedule,205.55,354.23,Fee schedule,,205.55,205.55,205.55,205.55,,,0
unity,Fee schedule,Facility 12004,12004,12004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12004,BCBSND Base Physician Payment Schedule,157.83,274.01,Fee schedule,,157.83,157.83,157.83,157.83,,,0
unity,Fee schedule,Facility 12002,12002,12002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12002,BCBSND Base Physician Payment Schedule,127,233.55,Fee schedule,,127,127,127,127,,,0
unity,Fee schedule,Facility 12001,12001,12001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,12001,BCBSND Base Physician Payment Schedule,95.43,193.09,Fee schedule,,95.43,95.43,95.43,95.43,,,0
unity,Fee schedule,Facility 11983,11983,11983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11983,BCBSND Base Physician Payment Schedule,220.96,522.5,Fee schedule,,220.96,220.96,220.96,220.96,,,0
unity,Fee schedule,Facility 11982,Not in chargemaster,11982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11982,BCBSND Base Physician Payment Schedule,160.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11981,11981,11981,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11981,BCBSND Base Physician Payment Schedule,136.54,308,Fee schedule,,136.54,136.54,136.54,136.54,,,0
unity,Fee schedule,Facility 11980,Not in chargemaster,11980,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11980,BCBSND Base Physician Payment Schedule,118.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11976,11976,11976,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11976,BCBSND Base Physician Payment Schedule,200.41,306.67,Fee schedule,,200.41,200.41,200.41,200.41,,,0
unity,Fee schedule,Facility 11971,Not in chargemaster,11971,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11971,BCBSND Base Physician Payment Schedule,683.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11954,Not in chargemaster,11954,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11954,BCBSND Base Physician Payment Schedule,241.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11952,Not in chargemaster,11952,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11952,BCBSND Base Physician Payment Schedule,222.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11951,Not in chargemaster,11951,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11951,BCBSND Base Physician Payment Schedule,157.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11950,Not in chargemaster,11950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11950,BCBSND Base Physician Payment Schedule,110.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11922,Not in chargemaster,11922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11922,BCBSND Base Physician Payment Schedule,63.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11921,Not in chargemaster,11921,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11921,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11920,Not in chargemaster,11920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11920,BCBSND Base Physician Payment Schedule,237.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11901,Not in chargemaster,11901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11901,BCBSND Base Physician Payment Schedule,99.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11900,11900,11900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11900,BCBSND Base Physician Payment Schedule,63.87,117.83,Fee schedule,,63.87,63.87,63.87,63.87,,,0
unity,Fee schedule,Facility 11772,Not in chargemaster,11772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11772,BCBSND Base Physician Payment Schedule,1224.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11771,11771,11771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11771,BCBSND Base Physician Payment Schedule,935.24,1216,Fee schedule,,935.24,935.24,935.24,935.24,,,0
unity,Fee schedule,Facility 11770,11770,11770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11770,BCBSND Base Physician Payment Schedule,392.01,615,Fee schedule,,392.01,392.01,392.01,392.01,,,0
unity,Fee schedule,Facility 11765,11765,11765,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11765,BCBSND Base Physician Payment Schedule,193.8,380,Fee schedule,,193.8,193.8,193.8,193.8,,,0
unity,Fee schedule,Facility 11762,Not in chargemaster,11762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11762,BCBSND Base Physician Payment Schedule,402.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11760,11760,11760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11760,BCBSND Base Physician Payment Schedule,241.52,501.88,Fee schedule,,241.52,241.52,241.52,241.52,,,0
unity,Fee schedule,Facility 11755,Not in chargemaster,11755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11755,BCBSND Base Physician Payment Schedule,130.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11750,11750,11750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11750,BCBSND Base Physician Payment Schedule,213.62,472.07,Fee schedule,,213.62,213.62,213.62,213.62,,,0
unity,Fee schedule,Facility 11740,11740,11740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11740,BCBSND Base Physician Payment Schedule,66.07,115,Fee schedule,,66.07,66.07,66.07,66.07,,,0
unity,Fee schedule,Facility 11732,Not in chargemaster,11732,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11732,BCBSND Base Physician Payment Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11730,11730,11730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11730,BCBSND Base Physician Payment Schedule,115.25,235,Fee schedule,,115.25,115.25,115.25,115.25,,,0
unity,Fee schedule,Facility 11721,Not in chargemaster,11721,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11721,BCBSND Base Physician Payment Schedule,52.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11720,Not in chargemaster,11720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11720,BCBSND Base Physician Payment Schedule,30.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11719,Not in chargemaster,11719,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11719,BCBSND Base Physician Payment Schedule,16.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11646,11646,11646,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11646,BCBSND Base Physician Payment Schedule,828.06,1088.23,Fee schedule,,828.06,828.06,828.06,828.06,,,0
unity,Fee schedule,Facility 11644,11644,11644,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11644,BCBSND Base Physician Payment Schedule,597.56,837.64,Fee schedule,,597.56,597.56,597.56,597.56,,,0
unity,Fee schedule,Facility 11643,11643,11643,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11643,BCBSND Base Physician Payment Schedule,480.84,680.05,Fee schedule,,480.84,480.84,480.84,480.84,,,0
unity,Fee schedule,Facility 11642,11642,11642,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11642,BCBSND Base Physician Payment Schedule,383.2,577.84,Fee schedule,,383.2,383.2,383.2,383.2,,,0
unity,Fee schedule,Facility 11641,11641,11641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11641,BCBSND Base Physician Payment Schedule,326.67,508.28,Fee schedule,,326.67,326.67,326.67,326.67,,,0
unity,Fee schedule,Facility 11640,11640,11640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11640,BCBSND Base Physician Payment Schedule,263.54,430.18,Fee schedule,,263.54,263.54,263.54,263.54,,,0
unity,Fee schedule,Facility 11626,11626,11626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11626,BCBSND Base Physician Payment Schedule,619.58,866.04,Fee schedule,,619.58,619.58,619.58,619.58,,,0
unity,Fee schedule,Facility 11624,11624,11624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11624,BCBSND Base Physician Payment Schedule,502.86,719.09,Fee schedule,,502.86,502.86,502.86,502.86,,,0
unity,Fee schedule,Facility 11623,11623,11623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11623,BCBSND Base Physician Payment Schedule,442.66,639.6,Fee schedule,,442.66,442.66,442.66,442.66,,,0
unity,Fee schedule,Facility 11622,11622,11622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11622,BCBSND Base Physician Payment Schedule,356.04,547.31,Fee schedule,,356.04,356.04,356.04,356.04,,,0
unity,Fee schedule,Facility 11621,11621,11621,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11621,BCBSND Base Physician Payment Schedule,313.46,490.52,Fee schedule,,313.46,313.46,313.46,313.46,,,0
unity,Fee schedule,Facility 11620,Not in chargemaster,11620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11620,BCBSND Base Physician Payment Schedule,256.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11606,11606,11606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11606,BCBSND Base Physician Payment Schedule,671.7,975,Fee schedule,,671.7,671.7,671.7,671.7,,,0
unity,Fee schedule,Facility 11604,11604,11604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11604,BCBSND Base Physician Payment Schedule,449.27,670.12,Fee schedule,,449.27,449.27,449.27,449.27,,,0
unity,Fee schedule,Facility 11603,11603,11603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11603,BCBSND Base Physician Payment Schedule,406.69,601.26,Fee schedule,,406.69,406.69,406.69,406.69,,,0
unity,Fee schedule,Facility 11602,11602,11602,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11602,BCBSND Base Physician Payment Schedule,339.89,535,Fee schedule,,339.89,339.89,339.89,339.89,,,0
unity,Fee schedule,Facility 11601,11601,11601,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11601,BCBSND Base Physician Payment Schedule,311.26,495,Fee schedule,,311.26,311.26,311.26,311.26,,,0
unity,Fee schedule,Facility 11600,11600,11600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11600,BCBSND Base Physician Payment Schedule,254,420,Fee schedule,,254,254,254,254,,,0
unity,Fee schedule,Facility 11471,Not in chargemaster,11471,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11471,BCBSND Base Physician Payment Schedule,735.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11470,Not in chargemaster,11470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11470,BCBSND Base Physician Payment Schedule,595.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11463,Not in chargemaster,11463,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11463,BCBSND Base Physician Payment Schedule,696.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11462,Not in chargemaster,11462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11462,BCBSND Base Physician Payment Schedule,514.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11451,Not in chargemaster,11451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11451,BCBSND Base Physician Payment Schedule,690.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11450,Not in chargemaster,11450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11450,BCBSND Base Physician Payment Schedule,540.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11446,Not in chargemaster,11446,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11446,BCBSND Base Physician Payment Schedule,679.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 11444,11444,11444,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11444,BCBSND Base Physician Payment Schedule,476.43,594.87,Fee schedule,,476.43,476.43,476.43,476.43,,,0
unity,Fee schedule,Facility 11443,11443,11443,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11443,BCBSND Base Physician Payment Schedule,372.92,476.32,Fee schedule,,372.92,372.92,372.92,372.92,,,0
unity,Fee schedule,Facility 11442,11442,11442,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11442,BCBSND Base Physician Payment Schedule,303.92,410,Fee schedule,,303.92,303.92,303.92,303.92,,,0
unity,Fee schedule,Facility 11441,11441,11441,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,11441,BCBSND Base Physician Payment Schedule,273.82,367,Fee schedule,,273.82,273.82,273.82,273.82,,,0
unity,Fee schedule,Facility 21208,Not in chargemaster,21208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21208,BCBSND Base Physician Payment Schedule,1595.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21086,Not in chargemaster,21086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21086,BCBSND Base Physician Payment Schedule,2893.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21085,Not in chargemaster,21085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21085,BCBSND Base Physician Payment Schedule,1080.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21084,Not in chargemaster,21084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21084,BCBSND Base Physician Payment Schedule,2684.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21083,Not in chargemaster,21083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21083,BCBSND Base Physician Payment Schedule,2319.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21082,Not in chargemaster,21082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21082,BCBSND Base Physician Payment Schedule,2498.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21081,Not in chargemaster,21081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21081,BCBSND Base Physician Payment Schedule,2716.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21080,Not in chargemaster,21080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21080,BCBSND Base Physician Payment Schedule,2971.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21079,Not in chargemaster,21079,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21079,BCBSND Base Physician Payment Schedule,2634.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21077,Not in chargemaster,21077,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21077,BCBSND Base Physician Payment Schedule,3923.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21076,Not in chargemaster,21076,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21076,BCBSND Base Physician Payment Schedule,1581.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21040,Not in chargemaster,21040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21040,BCBSND Base Physician Payment Schedule,818.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21034,Not in chargemaster,21034,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21034,BCBSND Base Physician Payment Schedule,2394.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21073,Not in chargemaster,21073,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21073,BCBSND Base Physician Payment Schedule,527.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21032,Not in chargemaster,21032,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21032,BCBSND Base Physician Payment Schedule,578.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21031,Not in chargemaster,21031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21031,BCBSND Base Physician Payment Schedule,589.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21030,Not in chargemaster,21030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21030,BCBSND Base Physician Payment Schedule,816.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21029,Not in chargemaster,21029,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21029,BCBSND Base Physician Payment Schedule,1314.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21026,Not in chargemaster,21026,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21026,BCBSND Base Physician Payment Schedule,952.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21013,Not in chargemaster,21013,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21013,BCBSND Base Physician Payment Schedule,847.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21025,Not in chargemaster,21025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21025,BCBSND Base Physician Payment Schedule,1462.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21011,Not in chargemaster,21011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21011,BCBSND Base Physician Payment Schedule,541.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20983,Not in chargemaster,20983,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20983,BCBSND Base Physician Payment Schedule,734.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20982,Not in chargemaster,20982,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20982,BCBSND Base Physician Payment Schedule,775.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20979,Not in chargemaster,20979,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20979,BCBSND Base Physician Payment Schedule,68.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20680,Not in chargemaster,20680,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20680,BCBSND Base Physician Payment Schedule,890.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20922,Not in chargemaster,20922,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20922,BCBSND Base Physician Payment Schedule,1026.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20974,Not in chargemaster,20974,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20974,BCBSND Base Physician Payment Schedule,106.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20950,Not in chargemaster,20950,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20950,BCBSND Base Physician Payment Schedule,187.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20900,Not in chargemaster,20900,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20900,BCBSND Base Physician Payment Schedule,391.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20694,Not in chargemaster,20694,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20694,BCBSND Base Physician Payment Schedule,713.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20670,Not in chargemaster,20670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20670,BCBSND Base Physician Payment Schedule,306.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20650,Not in chargemaster,20650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20650,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20665,Not in chargemaster,20665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20665,BCBSND Base Physician Payment Schedule,196.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20615,Not in chargemaster,20615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20615,BCBSND Base Physician Payment Schedule,337.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20612,Not in chargemaster,20612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20612,BCBSND Base Physician Payment Schedule,87.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20611,Not in chargemaster,20611,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20611,BCBSND Base Physician Payment Schedule,127,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20610,20610,20610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20610,BCBSND Base Physician Payment Schedule,96.9,129.23,Fee schedule,,96.9,96.9,96.9,96.9,,,0
unity,Fee schedule,Facility 20606,Not in chargemaster,20606,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20606,BCBSND Base Physician Payment Schedule,111.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20605,20605,20605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20605,BCBSND Base Physician Payment Schedule,79.28,137.02,Fee schedule,,79.28,79.28,79.28,79.28,,,0
unity,Fee schedule,Facility 20604,20604,20604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20604,BCBSND Base Physician Payment Schedule,96.9,159,Fee schedule,,96.9,96.9,96.9,96.9,,,0
unity,Fee schedule,Facility 20600,20600,20600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20600,BCBSND Base Physician Payment Schedule,76.35,105,Fee schedule,,76.35,76.35,76.35,76.35,,,0
unity,Fee schedule,Facility 20561,Not in chargemaster,20561,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20561,BCBSND Base Physician Payment Schedule,52.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20560,Not in chargemaster,20560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20560,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20553,20553,20553,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20553,BCBSND Base Physician Payment Schedule,91.76,154,Fee schedule,,91.76,91.76,91.76,91.76,,,0
unity,Fee schedule,Facility 20552,20552,20552,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20552,BCBSND Base Physician Payment Schedule,81.49,120,Fee schedule,,81.49,81.49,81.49,81.49,,,0
unity,Fee schedule,Facility 20551,20551,20551,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20551,BCBSND Base Physician Payment Schedule,84.42,126.36,Fee schedule,,84.42,84.42,84.42,84.42,,,0
unity,Fee schedule,Facility 20550,20550,20550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20550,BCBSND Base Physician Payment Schedule,82.95,122.1,Fee schedule,,82.95,82.95,82.95,82.95,,,0
unity,Fee schedule,Facility 20527,Not in chargemaster,20527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20527,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20526,Not in chargemaster,20526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20526,BCBSND Base Physician Payment Schedule,121.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20525,Not in chargemaster,20525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20525,BCBSND Base Physician Payment Schedule,521.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20520,Not in chargemaster,20520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20520,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20501,Not in chargemaster,20501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20501,BCBSND Base Physician Payment Schedule,80.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20225,Not in chargemaster,20225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20225,BCBSND Base Physician Payment Schedule,278.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20500,Not in chargemaster,20500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20500,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20220,Not in chargemaster,20220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20220,BCBSND Base Physician Payment Schedule,187.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20206,Not in chargemaster,20206,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20206,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20205,20205,20205,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20205,BCBSND Base Physician Payment Schedule,325.94,357.5,Fee schedule,,325.94,325.94,325.94,325.94,,,0
unity,Fee schedule,Facility 20200,Not in chargemaster,20200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20200,BCBSND Base Physician Payment Schedule,200.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20103,Not in chargemaster,20103,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20103,BCBSND Base Physician Payment Schedule,734.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20102,Not in chargemaster,20102,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20102,BCBSND Base Physician Payment Schedule,545.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 20101,Not in chargemaster,20101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,20101,BCBSND Base Physician Payment Schedule,447.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19355,Not in chargemaster,19355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19355,BCBSND Base Physician Payment Schedule,1313.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19396,Not in chargemaster,19396,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19396,BCBSND Base Physician Payment Schedule,306.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19350,Not in chargemaster,19350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19350,BCBSND Base Physician Payment Schedule,1426.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19300,Not in chargemaster,19300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19300,BCBSND Base Physician Payment Schedule,891.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19298,Not in chargemaster,19298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19298,BCBSND Base Physician Payment Schedule,676.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19296,Not in chargemaster,19296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19296,BCBSND Base Physician Payment Schedule,448.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19288,Not in chargemaster,19288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19288,BCBSND Base Physician Payment Schedule,137.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19287,Not in chargemaster,19287,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19287,BCBSND Base Physician Payment Schedule,273.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19286,Not in chargemaster,19286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19286,BCBSND Base Physician Payment Schedule,92.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19285,Not in chargemaster,19285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19285,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19284,Not in chargemaster,19284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19284,BCBSND Base Physician Payment Schedule,109.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19283,Not in chargemaster,19283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19283,BCBSND Base Physician Payment Schedule,215.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19282,Not in chargemaster,19282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19282,BCBSND Base Physician Payment Schedule,107.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19281,Not in chargemaster,19281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19281,BCBSND Base Physician Payment Schedule,212.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19125,Not in chargemaster,19125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19125,BCBSND Base Physician Payment Schedule,978.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19120,Not in chargemaster,19120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19120,BCBSND Base Physician Payment Schedule,880.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19112,Not in chargemaster,19112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19112,BCBSND Base Physician Payment Schedule,669.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19110,Not in chargemaster,19110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19110,BCBSND Base Physician Payment Schedule,734.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19105,Not in chargemaster,19105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19105,BCBSND Base Physician Payment Schedule,450.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19101,Not in chargemaster,19101,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19101,BCBSND Base Physician Payment Schedule,473.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19100,Not in chargemaster,19100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19100,BCBSND Base Physician Payment Schedule,149.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19086,Not in chargemaster,19086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19086,BCBSND Base Physician Payment Schedule,193.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19085,Not in chargemaster,19085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19085,BCBSND Base Physician Payment Schedule,387.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19084,Not in chargemaster,19084,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19084,BCBSND Base Physician Payment Schedule,165.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19083,Not in chargemaster,19083,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19083,BCBSND Base Physician Payment Schedule,334.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19082,Not in chargemaster,19082,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19082,BCBSND Base Physician Payment Schedule,177.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19081,Not in chargemaster,19081,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19081,BCBSND Base Physician Payment Schedule,353.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19030,Not in chargemaster,19030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19030,BCBSND Base Physician Payment Schedule,162.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19020,Not in chargemaster,19020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19020,BCBSND Base Physician Payment Schedule,655.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19001,Not in chargemaster,19001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19001,BCBSND Base Physician Payment Schedule,46.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 19000,19000,19000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,19000,BCBSND Base Physician Payment Schedule,92.5,238.51,Fee schedule,,92.5,92.5,92.5,92.5,,,0
unity,Fee schedule,Facility 17360,Not in chargemaster,17360,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17360,BCBSND Base Physician Payment Schedule,196,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17340,Not in chargemaster,17340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17340,BCBSND Base Physician Payment Schedule,103.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17315,Not in chargemaster,17315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17315,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17314,Not in chargemaster,17314,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17314,BCBSND Base Physician Payment Schedule,377.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17313,Not in chargemaster,17313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17313,BCBSND Base Physician Payment Schedule,685.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17312,Not in chargemaster,17312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17312,BCBSND Base Physician Payment Schedule,407.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17311,Not in chargemaster,17311,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17311,BCBSND Base Physician Payment Schedule,764.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17286,Not in chargemaster,17286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17286,BCBSND Base Physician Payment Schedule,577,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17284,Not in chargemaster,17284,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17284,BCBSND Base Physician Payment Schedule,425.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17283,Not in chargemaster,17283,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17283,BCBSND Base Physician Payment Schedule,364.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17282,Not in chargemaster,17282,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17282,BCBSND Base Physician Payment Schedule,291.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17281,Not in chargemaster,17281,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17281,BCBSND Base Physician Payment Schedule,250.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17280,Not in chargemaster,17280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17280,BCBSND Base Physician Payment Schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17276,Not in chargemaster,17276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17276,BCBSND Base Physician Payment Schedule,430.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17274,Not in chargemaster,17274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17274,BCBSND Base Physician Payment Schedule,358.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17273,Not in chargemaster,17273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17273,BCBSND Base Physician Payment Schedule,292.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17272,Not in chargemaster,17272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17272,BCBSND Base Physician Payment Schedule,258.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17271,Not in chargemaster,17271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17271,BCBSND Base Physician Payment Schedule,221.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17270,Not in chargemaster,17270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17270,BCBSND Base Physician Payment Schedule,201.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17266,Not in chargemaster,17266,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17266,BCBSND Base Physician Payment Schedule,328.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17264,Not in chargemaster,17264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17264,BCBSND Base Physician Payment Schedule,278.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17263,Not in chargemaster,17263,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17263,BCBSND Base Physician Payment Schedule,260.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17262,Not in chargemaster,17262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17262,BCBSND Base Physician Payment Schedule,234.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17261,Not in chargemaster,17261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17261,BCBSND Base Physician Payment Schedule,182.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17260,Not in chargemaster,17260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17260,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17250,Not in chargemaster,17250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17250,BCBSND Base Physician Payment Schedule,78.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17111,17111,17111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17111,BCBSND Base Physician Payment Schedule,171.78,281.83,Fee schedule,,171.78,171.78,171.78,171.78,,,0
unity,Fee schedule,Facility 17110,17110,17110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17110,BCBSND Base Physician Payment Schedule,140.21,230,Fee schedule,,140.21,140.21,140.21,140.21,,,0
unity,Fee schedule,Facility 17108,Not in chargemaster,17108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17108,BCBSND Base Physician Payment Schedule,1101.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17107,Not in chargemaster,17107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17107,BCBSND Base Physician Payment Schedule,746.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17106,Not in chargemaster,17106,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17106,BCBSND Base Physician Payment Schedule,575.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17004,17004,17004,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17004,BCBSND Base Physician Payment Schedule,204.81,330,Fee schedule,,204.81,204.81,204.81,204.81,,,0
unity,Fee schedule,Facility 17003,17003,17003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17003,BCBSND Base Physician Payment Schedule,4.4,14.2,Fee schedule,,4.4,4.4,4.4,4.4,,,0
unity,Fee schedule,Facility 16030,Not in chargemaster,16030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16030,BCBSND Base Physician Payment Schedule,281.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 17000,17000,17000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,17000,BCBSND Base Physician Payment Schedule,112.32,173.92,Fee schedule,,112.32,112.32,112.32,112.32,,,0
unity,Fee schedule,Facility 16025,16025,16025,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16025,BCBSND Base Physician Payment Schedule,233.44,313.06,Fee schedule,,233.44,233.44,233.44,233.44,,,0
unity,Fee schedule,Facility 16020,16020,16020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16020,BCBSND Base Physician Payment Schedule,114.52,173.92,Fee schedule,,114.52,114.52,114.52,114.52,,,0
unity,Fee schedule,Facility 15851,Not in chargemaster,15851,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15851,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15839,Not in chargemaster,15839,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15839,BCBSND Base Physician Payment Schedule,1559.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15850,Not in chargemaster,15850,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15850,BCBSND Base Physician Payment Schedule,83.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15823,Not in chargemaster,15823,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15823,BCBSND Base Physician Payment Schedule,1140.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15822,Not in chargemaster,15822,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15822,BCBSND Base Physician Payment Schedule,823.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 16000,16000,16000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,16000,BCBSND Base Physician Payment Schedule,97.64,155,Fee schedule,,97.64,97.64,97.64,97.64,,,0
unity,Fee schedule,Facility 15837,Not in chargemaster,15837,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15837,BCBSND Base Physician Payment Schedule,1521.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15821,Not in chargemaster,15821,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15821,BCBSND Base Physician Payment Schedule,1140.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15820,Not in chargemaster,15820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15820,BCBSND Base Physician Payment Schedule,1065.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15793,Not in chargemaster,15793,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15793,BCBSND Base Physician Payment Schedule,738.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15792,Not in chargemaster,15792,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15792,BCBSND Base Physician Payment Schedule,485.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15789,Not in chargemaster,15789,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15789,BCBSND Base Physician Payment Schedule,855.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15788,Not in chargemaster,15788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15788,BCBSND Base Physician Payment Schedule,480.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15787,Not in chargemaster,15787,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15787,BCBSND Base Physician Payment Schedule,36.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15786,Not in chargemaster,15786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15786,BCBSND Base Physician Payment Schedule,282.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15783,Not in chargemaster,15783,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15783,BCBSND Base Physician Payment Schedule,753.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15782,Not in chargemaster,15782,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15782,BCBSND Base Physician Payment Schedule,825.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15781,Not in chargemaster,15781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15781,BCBSND Base Physician Payment Schedule,903.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15780,Not in chargemaster,15780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15780,BCBSND Base Physician Payment Schedule,1419.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15776,Not in chargemaster,15776,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15776,BCBSND Base Physician Payment Schedule,750.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15775,Not in chargemaster,15775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15775,BCBSND Base Physician Payment Schedule,546.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15774,Not in chargemaster,15774,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15774,BCBSND Base Physician Payment Schedule,287.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15773,Not in chargemaster,15773,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15773,BCBSND Base Physician Payment Schedule,1021.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15772,Not in chargemaster,15772,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15772,BCBSND Base Physician Payment Schedule,298.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15731,Not in chargemaster,15731,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15731,BCBSND Base Physician Payment Schedule,2104.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15771,Not in chargemaster,15771,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15771,BCBSND Base Physician Payment Schedule,1010.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15760,Not in chargemaster,15760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15760,BCBSND Base Physician Payment Schedule,1474.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15740,Not in chargemaster,15740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15740,BCBSND Base Physician Payment Schedule,1760.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15730,Not in chargemaster,15730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15730,BCBSND Base Physician Payment Schedule,1936.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15650,Not in chargemaster,15650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15650,BCBSND Base Physician Payment Schedule,801.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15630,Not in chargemaster,15630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15630,BCBSND Base Physician Payment Schedule,717.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15620,Not in chargemaster,15620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15620,BCBSND Base Physician Payment Schedule,679.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15610,Not in chargemaster,15610,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15610,BCBSND Base Physician Payment Schedule,505.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15600,Not in chargemaster,15600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15600,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15576,Not in chargemaster,15576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15576,BCBSND Base Physician Payment Schedule,1389.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15574,Not in chargemaster,15574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15574,BCBSND Base Physician Payment Schedule,1587.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15572,Not in chargemaster,15572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15572,BCBSND Base Physician Payment Schedule,1561.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15570,Not in chargemaster,15570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15570,BCBSND Base Physician Payment Schedule,1554.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15278,Not in chargemaster,15278,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15278,BCBSND Base Physician Payment Schedule,122.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15277,Not in chargemaster,15277,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15277,BCBSND Base Physician Payment Schedule,484.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15276,Not in chargemaster,15276,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15276,BCBSND Base Physician Payment Schedule,55.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15275,Not in chargemaster,15275,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15275,BCBSND Base Physician Payment Schedule,201.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15274,Not in chargemaster,15274,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15274,BCBSND Base Physician Payment Schedule,96.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15273,Not in chargemaster,15273,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15273,BCBSND Base Physician Payment Schedule,427.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15272,Not in chargemaster,15272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15272,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15271,Not in chargemaster,15271,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15271,BCBSND Base Physician Payment Schedule,179.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15261,Not in chargemaster,15261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15261,BCBSND Base Physician Payment Schedule,290.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15260,Not in chargemaster,15260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15260,BCBSND Base Physician Payment Schedule,1775.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15241,Not in chargemaster,15241,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15241,BCBSND Base Physician Payment Schedule,231.24,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15240,Not in chargemaster,15240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15240,BCBSND Base Physician Payment Schedule,1669.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15221,Not in chargemaster,15221,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15221,BCBSND Base Physician Payment Schedule,149.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15220,Not in chargemaster,15220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15220,BCBSND Base Physician Payment Schedule,1283.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15201,Not in chargemaster,15201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15201,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15200,Not in chargemaster,15200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15200,BCBSND Base Physician Payment Schedule,1416.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15157,Not in chargemaster,15157,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15157,BCBSND Base Physician Payment Schedule,353.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15156,Not in chargemaster,15156,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15156,BCBSND Base Physician Payment Schedule,322.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15155,Not in chargemaster,15155,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15155,BCBSND Base Physician Payment Schedule,1554.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15152,Not in chargemaster,15152,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15152,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15151,Not in chargemaster,15151,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15151,BCBSND Base Physician Payment Schedule,235.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15150,Not in chargemaster,15150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15150,BCBSND Base Physician Payment Schedule,1353.68,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15136,Not in chargemaster,15136,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15136,BCBSND Base Physician Payment Schedule,194.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15135,Not in chargemaster,15135,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15135,BCBSND Base Physician Payment Schedule,1595.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15131,Not in chargemaster,15131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15131,BCBSND Base Physician Payment Schedule,194.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 15130,Not in chargemaster,15130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,15130,BCBSND Base Physician Payment Schedule,1258.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 36000,Not in chargemaster,36000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,36000,BCBSND Base Physician Payment Schedule,19.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 33285,Not in chargemaster,33285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,33285,BCBSND Base Physician Payment Schedule,188.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32550,Not in chargemaster,32550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32550,BCBSND Base Physician Payment Schedule,438.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 32400,Not in chargemaster,32400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,32400,BCBSND Base Physician Payment Schedule,182.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31825,Not in chargemaster,31825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31825,BCBSND Base Physician Payment Schedule,1004.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31654,Not in chargemaster,31654,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31654,BCBSND Base Physician Payment Schedule,142.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31730,Not in chargemaster,31730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31730,BCBSND Base Physician Payment Schedule,317.87,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31820,Not in chargemaster,31820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31820,BCBSND Base Physician Payment Schedule,685.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31717,Not in chargemaster,31717,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31717,BCBSND Base Physician Payment Schedule,223.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31653,Not in chargemaster,31653,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31653,BCBSND Base Physician Payment Schedule,519.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31635,Not in chargemaster,31635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31635,BCBSND Base Physician Payment Schedule,371.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31652,Not in chargemaster,31652,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31652,BCBSND Base Physician Payment Schedule,468.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31634,Not in chargemaster,31634,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31634,BCBSND Base Physician Payment Schedule,405.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31633,Not in chargemaster,31633,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31633,BCBSND Base Physician Payment Schedule,133.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31645,Not in chargemaster,31645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31645,BCBSND Base Physician Payment Schedule,310.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31632,Not in chargemaster,31632,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31632,BCBSND Base Physician Payment Schedule,104.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31629,Not in chargemaster,31629,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31629,BCBSND Base Physician Payment Schedule,394.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31628,Not in chargemaster,31628,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31628,BCBSND Base Physician Payment Schedule,371.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31627,Not in chargemaster,31627,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31627,BCBSND Base Physician Payment Schedule,204.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31626,Not in chargemaster,31626,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31626,BCBSND Base Physician Payment Schedule,418.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31625,Not in chargemaster,31625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31625,BCBSND Base Physician Payment Schedule,330.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31624,Not in chargemaster,31624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31624,BCBSND Base Physician Payment Schedule,284.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31623,Not in chargemaster,31623,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31623,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31622,Not in chargemaster,31622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31622,BCBSND Base Physician Payment Schedule,278.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31615,Not in chargemaster,31615,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31615,BCBSND Base Physician Payment Schedule,240.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31612,Not in chargemaster,31612,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31612,BCBSND Base Physician Payment Schedule,100.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31579,Not in chargemaster,31579,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31579,BCBSND Base Physician Payment Schedule,250.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31578,Not in chargemaster,31578,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31578,BCBSND Base Physician Payment Schedule,309.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31577,Not in chargemaster,31577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31577,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31576,Not in chargemaster,31576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31576,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31575,Not in chargemaster,31575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31575,BCBSND Base Physician Payment Schedule,139.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31574,Not in chargemaster,31574,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31574,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31573,Not in chargemaster,31573,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31573,BCBSND Base Physician Payment Schedule,309.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31572,Not in chargemaster,31572,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31572,BCBSND Base Physician Payment Schedule,378.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31525,Not in chargemaster,31525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31525,BCBSND Base Physician Payment Schedule,334.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31515,Not in chargemaster,31515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31515,BCBSND Base Physician Payment Schedule,230.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31512,Not in chargemaster,31512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31512,BCBSND Base Physician Payment Schedule,269.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31511,Not in chargemaster,31511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31511,BCBSND Base Physician Payment Schedule,278.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31570,Not in chargemaster,31570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31570,BCBSND Base Physician Payment Schedule,479.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31510,Not in chargemaster,31510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31510,BCBSND Base Physician Payment Schedule,253.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31298,Not in chargemaster,31298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31298,BCBSND Base Physician Payment Schedule,538.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31297,Not in chargemaster,31297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31297,BCBSND Base Physician Payment Schedule,302.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31296,Not in chargemaster,31296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31296,BCBSND Base Physician Payment Schedule,378.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31295,Not in chargemaster,31295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31295,BCBSND Base Physician Payment Schedule,331.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31505,Not in chargemaster,31505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31505,BCBSND Base Physician Payment Schedule,102.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31254,Not in chargemaster,31254,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31254,BCBSND Base Physician Payment Schedule,512.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31238,Not in chargemaster,31238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31238,BCBSND Base Physician Payment Schedule,350.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31237,Not in chargemaster,31237,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31237,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31235,Not in chargemaster,31235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31235,BCBSND Base Physician Payment Schedule,333.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31233,Not in chargemaster,31233,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31233,BCBSND Base Physician Payment Schedule,281.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31030,Not in chargemaster,31030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31030,BCBSND Base Physician Payment Schedule,1079.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31020,Not in chargemaster,31020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31020,BCBSND Base Physician Payment Schedule,778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31231,Not in chargemaster,31231,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31231,BCBSND Base Physician Payment Schedule,133.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 31000,Not in chargemaster,31000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,31000,BCBSND Base Physician Payment Schedule,221.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30906,Not in chargemaster,30906,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30906,BCBSND Base Physician Payment Schedule,287.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30905,30905,30905,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30905,BCBSND Base Physician Payment Schedule,225.37,560.79,Fee schedule,,225.37,225.37,225.37,225.37,,,0
unity,Fee schedule,Facility 30903,Not in chargemaster,30903,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30903,BCBSND Base Physician Payment Schedule,167.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30901,30901,30901,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30901,BCBSND Base Physician Payment Schedule,120.39,280,Fee schedule,,120.39,120.39,120.39,120.39,,,0
unity,Fee schedule,Facility 30802,Not in chargemaster,30802,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30802,BCBSND Base Physician Payment Schedule,409.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30600,Not in chargemaster,30600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30600,BCBSND Base Physician Payment Schedule,905.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30801,Not in chargemaster,30801,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30801,BCBSND Base Physician Payment Schedule,300.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30580,Not in chargemaster,30580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30580,BCBSND Base Physician Payment Schedule,1000.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30300,30300,30300,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30300,BCBSND Base Physician Payment Schedule,237.11,276.13,Fee schedule,,237.11,237.11,237.11,237.11,,,0
unity,Fee schedule,Facility 30220,Not in chargemaster,30220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30220,BCBSND Base Physician Payment Schedule,262.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30210,Not in chargemaster,30210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30210,BCBSND Base Physician Payment Schedule,207.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30200,Not in chargemaster,30200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30200,BCBSND Base Physician Payment Schedule,121.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30560,Not in chargemaster,30560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30560,BCBSND Base Physician Payment Schedule,295.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30140,Not in chargemaster,30140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30140,BCBSND Base Physician Payment Schedule,375.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30120,Not in chargemaster,30120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30120,BCBSND Base Physician Payment Schedule,895.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30117,Not in chargemaster,30117,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30117,BCBSND Base Physician Payment Schedule,695.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30110,Not in chargemaster,30110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30110,BCBSND Base Physician Payment Schedule,271.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30100,Not in chargemaster,30100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30100,BCBSND Base Physician Payment Schedule,140.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30020,Not in chargemaster,30020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30020,BCBSND Base Physician Payment Schedule,249.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29750,Not in chargemaster,29750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29750,BCBSND Base Physician Payment Schedule,165.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 30000,Not in chargemaster,30000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,30000,BCBSND Base Physician Payment Schedule,248.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29893,Not in chargemaster,29893,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29893,BCBSND Base Physician Payment Schedule,908.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29740,Not in chargemaster,29740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29740,BCBSND Base Physician Payment Schedule,148.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29730,Not in chargemaster,29730,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29730,BCBSND Base Physician Payment Schedule,91.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29720,Not in chargemaster,29720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29720,BCBSND Base Physician Payment Schedule,92.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29710,Not in chargemaster,29710,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29710,BCBSND Base Physician Payment Schedule,176.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29705,Not in chargemaster,29705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29705,BCBSND Base Physician Payment Schedule,96.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29700,Not in chargemaster,29700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29700,BCBSND Base Physician Payment Schedule,70.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29584,Not in chargemaster,29584,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29584,BCBSND Base Physician Payment Schedule,34.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29581,29581,29581,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29581,BCBSND Base Physician Payment Schedule,58.73,185,Fee schedule,,58.73,58.73,58.73,58.73,,,0
unity,Fee schedule,Facility 29870,Not in chargemaster,29870,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29870,BCBSND Base Physician Payment Schedule,866.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29580,Not in chargemaster,29580,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29580,BCBSND Base Physician Payment Schedule,57.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29550,Not in chargemaster,29550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29550,BCBSND Base Physician Payment Schedule,24.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29540,Not in chargemaster,29540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29540,BCBSND Base Physician Payment Schedule,37.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29530,Not in chargemaster,29530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29530,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29520,Not in chargemaster,29520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29520,BCBSND Base Physician Payment Schedule,40.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29515,29515,29515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29515,BCBSND Base Physician Payment Schedule,104.24,154.76,Fee schedule,,104.24,104.24,104.24,104.24,,,0
unity,Fee schedule,Facility 29505,29505,29505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29505,BCBSND Base Physician Payment Schedule,106.44,180.31,Fee schedule,,106.44,106.44,106.44,106.44,,,0
unity,Fee schedule,Facility 29450,Not in chargemaster,29450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29450,BCBSND Base Physician Payment Schedule,239.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29445,Not in chargemaster,29445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29445,BCBSND Base Physician Payment Schedule,215.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29440,Not in chargemaster,29440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29440,BCBSND Base Physician Payment Schedule,60.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29435,Not in chargemaster,29435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29435,BCBSND Base Physician Payment Schedule,172.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29425,Not in chargemaster,29425,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29425,BCBSND Base Physician Payment Schedule,116.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29405,29405,29405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29405,BCBSND Base Physician Payment Schedule,124.06,175.34,Fee schedule,,124.06,124.06,124.06,124.06,,,0
unity,Fee schedule,Facility 29365,Not in chargemaster,29365,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29365,BCBSND Base Physician Payment Schedule,183.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29358,Not in chargemaster,29358,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29358,BCBSND Base Physician Payment Schedule,217.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29355,Not in chargemaster,29355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29355,BCBSND Base Physician Payment Schedule,225.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29345,Not in chargemaster,29345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29345,BCBSND Base Physician Payment Schedule,210.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29325,Not in chargemaster,29325,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29325,BCBSND Base Physician Payment Schedule,373.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29305,Not in chargemaster,29305,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29305,BCBSND Base Physician Payment Schedule,332.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29280,Not in chargemaster,29280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29280,BCBSND Base Physician Payment Schedule,44.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29260,Not in chargemaster,29260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29260,BCBSND Base Physician Payment Schedule,41.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29240,29240,29240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29240,BCBSND Base Physician Payment Schedule,39.64,122.1,Fee schedule,,39.64,39.64,39.64,39.64,,,0
unity,Fee schedule,Facility 29200,Not in chargemaster,29200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29200,BCBSND Base Physician Payment Schedule,39.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29131,Not in chargemaster,29131,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29131,BCBSND Base Physician Payment Schedule,71.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29130,29130,29130,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29130,BCBSND Base Physician Payment Schedule,62.4,87.32,Fee schedule,,62.4,62.4,62.4,62.4,,,0
unity,Fee schedule,Facility 29126,Not in chargemaster,29126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29126,BCBSND Base Physician Payment Schedule,102.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29125,29125,29125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29125,BCBSND Base Physician Payment Schedule,82.95,140.56,Fee schedule,,82.95,82.95,82.95,82.95,,,0
unity,Fee schedule,Facility 29105,29105,29105,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29105,BCBSND Base Physician Payment Schedule,88.83,188.84,Fee schedule,,88.83,88.83,88.83,88.83,,,0
unity,Fee schedule,Facility 29086,Not in chargemaster,29086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29086,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29085,Not in chargemaster,29085,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29085,BCBSND Base Physician Payment Schedule,140.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29075,29075,29075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29075,BCBSND Base Physician Payment Schedule,129.2,186.7,Fee schedule,,129.2,129.2,129.2,129.2,,,0
unity,Fee schedule,Facility 29065,29065,29065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29065,BCBSND Base Physician Payment Schedule,143.15,207.28,Fee schedule,,143.15,143.15,143.15,143.15,,,0
unity,Fee schedule,Facility 29058,Not in chargemaster,29058,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29058,BCBSND Base Physician Payment Schedule,198.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29055,Not in chargemaster,29055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29055,BCBSND Base Physician Payment Schedule,288.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29049,Not in chargemaster,29049,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29049,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29046,Not in chargemaster,29046,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29046,BCBSND Base Physician Payment Schedule,394.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29044,Not in chargemaster,29044,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29044,BCBSND Base Physician Payment Schedule,350.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29040,Not in chargemaster,29040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29040,BCBSND Base Physician Payment Schedule,363.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29035,Not in chargemaster,29035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29035,BCBSND Base Physician Payment Schedule,299.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29015,Not in chargemaster,29015,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29015,BCBSND Base Physician Payment Schedule,380.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29010,Not in chargemaster,29010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29010,BCBSND Base Physician Payment Schedule,336.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 29000,Not in chargemaster,29000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,29000,BCBSND Base Physician Payment Schedule,408.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28890,Not in chargemaster,28890,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28890,BCBSND Base Physician Payment Schedule,468.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28825,Not in chargemaster,28825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28825,BCBSND Base Physician Payment Schedule,778.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28820,Not in chargemaster,28820,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28820,BCBSND Base Physician Payment Schedule,830.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28760,Not in chargemaster,28760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28760,BCBSND Base Physician Payment Schedule,1218.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28755,Not in chargemaster,28755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28755,BCBSND Base Physician Payment Schedule,703.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28750,Not in chargemaster,28750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28750,BCBSND Base Physician Payment Schedule,1234.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28675,Not in chargemaster,28675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28675,BCBSND Base Physician Payment Schedule,853.02,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28665,Not in chargemaster,28665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28665,BCBSND Base Physician Payment Schedule,273.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28660,Not in chargemaster,28660,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28660,BCBSND Base Physician Payment Schedule,192.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28740,Not in chargemaster,28740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28740,BCBSND Base Physician Payment Schedule,1314.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28645,Not in chargemaster,28645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28645,BCBSND Base Physician Payment Schedule,1027.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28636,Not in chargemaster,28636,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28636,BCBSND Base Physician Payment Schedule,421.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28635,Not in chargemaster,28635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28635,BCBSND Base Physician Payment Schedule,279.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28605,Not in chargemaster,28605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28605,BCBSND Base Physician Payment Schedule,629.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28630,Not in chargemaster,28630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28630,BCBSND Base Physician Payment Schedule,234.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28600,Not in chargemaster,28600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28600,BCBSND Base Physician Payment Schedule,389.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28585,Not in chargemaster,28585,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28585,BCBSND Base Physician Payment Schedule,1440.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28575,Not in chargemaster,28575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28575,BCBSND Base Physician Payment Schedule,702.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28570,Not in chargemaster,28570,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28570,BCBSND Base Physician Payment Schedule,405.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28555,Not in chargemaster,28555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28555,BCBSND Base Physician Payment Schedule,1376.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28546,Not in chargemaster,28546,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28546,BCBSND Base Physician Payment Schedule,723.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28545,Not in chargemaster,28545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28545,BCBSND Base Physician Payment Schedule,559.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28540,Not in chargemaster,28540,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28540,BCBSND Base Physician Payment Schedule,367.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28531,Not in chargemaster,28531,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28531,BCBSND Base Physician Payment Schedule,383.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28530,Not in chargemaster,28530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28530,BCBSND Base Physician Payment Schedule,211.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28525,Not in chargemaster,28525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28525,BCBSND Base Physician Payment Schedule,852.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28515,28515,28515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28515,BCBSND Base Physician Payment Schedule,299.51,355,Fee schedule,,299.51,299.51,299.51,299.51,,,0
unity,Fee schedule,Facility 28510,28510,28510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28510,BCBSND Base Physician Payment Schedule,250.33,266.2,Fee schedule,,250.33,250.33,250.33,250.33,,,0
unity,Fee schedule,Facility 28505,Not in chargemaster,28505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28505,BCBSND Base Physician Payment Schedule,1051.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28496,Not in chargemaster,28496,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28496,BCBSND Base Physician Payment Schedule,508.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28495,Not in chargemaster,28495,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28495,BCBSND Base Physician Payment Schedule,311.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28490,28490,28490,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28490,BCBSND Base Physician Payment Schedule,260.61,316.6,Fee schedule,,260.61,260.61,260.61,260.61,,,0
unity,Fee schedule,Facility 28475,Not in chargemaster,28475,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28475,BCBSND Base Physician Payment Schedule,478.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28455,Not in chargemaster,28455,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28455,BCBSND Base Physician Payment Schedule,543.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28470,28470,28470,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28470,BCBSND Base Physician Payment Schedule,429.45,476.32,Fee schedule,,429.45,429.45,429.45,429.45,,,0
unity,Fee schedule,Facility 28450,Not in chargemaster,28450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28450,BCBSND Base Physician Payment Schedule,401.55,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28435,Not in chargemaster,28435,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28435,BCBSND Base Physician Payment Schedule,683.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28405,Not in chargemaster,28405,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28405,BCBSND Base Physician Payment Schedule,739.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28430,Not in chargemaster,28430,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28430,BCBSND Base Physician Payment Schedule,442.66,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28400,Not in chargemaster,28400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28400,BCBSND Base Physician Payment Schedule,480.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28345,Not in chargemaster,28345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28345,BCBSND Base Physician Payment Schedule,770.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28344,Not in chargemaster,28344,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28344,BCBSND Base Physician Payment Schedule,590.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28341,Not in chargemaster,28341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28341,BCBSND Base Physician Payment Schedule,1037.28,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28340,Not in chargemaster,28340,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28340,BCBSND Base Physician Payment Schedule,870.64,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28322,Not in chargemaster,28322,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28322,BCBSND Base Physician Payment Schedule,1215.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28315,Not in chargemaster,28315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28315,BCBSND Base Physician Payment Schedule,688.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28313,Not in chargemaster,28313,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28313,BCBSND Base Physician Payment Schedule,750.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28312,Not in chargemaster,28312,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28312,BCBSND Base Physician Payment Schedule,669.5,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28310,Not in chargemaster,28310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28310,BCBSND Base Physician Payment Schedule,759.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28308,Not in chargemaster,28308,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28308,BCBSND Base Physician Payment Schedule,805.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28307,Not in chargemaster,28307,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28307,BCBSND Base Physician Payment Schedule,878.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28306,Not in chargemaster,28306,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28306,BCBSND Base Physician Payment Schedule,847.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28299,Not in chargemaster,28299,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28299,BCBSND Base Physician Payment Schedule,1233.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28304,Not in chargemaster,28304,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28304,BCBSND Base Physician Payment Schedule,1277.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28298,Not in chargemaster,28298,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28298,BCBSND Base Physician Payment Schedule,1052.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28297,Not in chargemaster,28297,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28297,BCBSND Base Physician Payment Schedule,1277.33,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28296,Not in chargemaster,28296,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28296,BCBSND Base Physician Payment Schedule,1087.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28295,Not in chargemaster,28295,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28295,BCBSND Base Physician Payment Schedule,1186.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28292,Not in chargemaster,28292,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28292,BCBSND Base Physician Payment Schedule,1022.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28291,Not in chargemaster,28291,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28291,BCBSND Base Physician Payment Schedule,1035.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28289,Not in chargemaster,28289,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28289,BCBSND Base Physician Payment Schedule,970.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28288,Not in chargemaster,28288,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28288,BCBSND Base Physician Payment Schedule,914.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28286,Not in chargemaster,28286,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28286,BCBSND Base Physician Payment Schedule,628.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28285,Not in chargemaster,28285,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28285,BCBSND Base Physician Payment Schedule,803.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28280,Not in chargemaster,28280,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28280,BCBSND Base Physician Payment Schedule,736.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28272,Not in chargemaster,28272,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28272,BCBSND Base Physician Payment Schedule,532.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28270,Not in chargemaster,28270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28270,BCBSND Base Physician Payment Schedule,707.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28264,Not in chargemaster,28264,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28264,BCBSND Base Physician Payment Schedule,1631.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28262,Not in chargemaster,28262,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28262,BCBSND Base Physician Payment Schedule,2396.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28261,Not in chargemaster,28261,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28261,BCBSND Base Physician Payment Schedule,1987.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28260,Not in chargemaster,28260,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28260,BCBSND Base Physician Payment Schedule,1098.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28250,Not in chargemaster,28250,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28250,BCBSND Base Physician Payment Schedule,855.96,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28240,Not in chargemaster,28240,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28240,BCBSND Base Physician Payment Schedule,621.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28238,Not in chargemaster,28238,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28238,BCBSND Base Physician Payment Schedule,1025.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28234,Not in chargemaster,28234,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28234,BCBSND Base Physician Payment Schedule,559.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28232,Not in chargemaster,28232,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28232,BCBSND Base Physician Payment Schedule,510.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28230,Not in chargemaster,28230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28230,BCBSND Base Physician Payment Schedule,599.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28226,Not in chargemaster,28226,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28226,BCBSND Base Physician Payment Schedule,833.2,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28225,Not in chargemaster,28225,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28225,BCBSND Base Physician Payment Schedule,557.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28222,Not in chargemaster,28222,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28222,BCBSND Base Physician Payment Schedule,755.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28220,Not in chargemaster,28220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28220,BCBSND Base Physician Payment Schedule,640.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28210,Not in chargemaster,28210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28210,BCBSND Base Physician Payment Schedule,886.06,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28208,Not in chargemaster,28208,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28208,BCBSND Base Physician Payment Schedule,668.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28202,Not in chargemaster,28202,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28202,BCBSND Base Physician Payment Schedule,913.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28200,Not in chargemaster,28200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28200,BCBSND Base Physician Payment Schedule,684.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28193,Not in chargemaster,28193,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28193,BCBSND Base Physician Payment Schedule,780.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28192,Not in chargemaster,28192,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28192,BCBSND Base Physician Payment Schedule,661.42,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28160,Not in chargemaster,28160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28160,BCBSND Base Physician Payment Schedule,564.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28190,Not in chargemaster,28190,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28190,BCBSND Base Physician Payment Schedule,282.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28153,Not in chargemaster,28153,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28153,BCBSND Base Physician Payment Schedule,560.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28150,Not in chargemaster,28150,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28150,BCBSND Base Physician Payment Schedule,588.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28140,Not in chargemaster,28140,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28140,BCBSND Base Physician Payment Schedule,922.03,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28126,Not in chargemaster,28126,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28126,BCBSND Base Physician Payment Schedule,521.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28124,Not in chargemaster,28124,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28124,BCBSND Base Physician Payment Schedule,701.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28122,Not in chargemaster,28122,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28122,BCBSND Base Physician Payment Schedule,926.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28120,Not in chargemaster,28120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28120,BCBSND Base Physician Payment Schedule,1051.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28119,Not in chargemaster,28119,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28119,BCBSND Base Physician Payment Schedule,762.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28118,Not in chargemaster,28118,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28118,BCBSND Base Physician Payment Schedule,883.86,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28116,Not in chargemaster,28116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28116,BCBSND Base Physician Payment Schedule,1220.07,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28114,Not in chargemaster,28114,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28114,BCBSND Base Physician Payment Schedule,1749.36,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28113,Not in chargemaster,28113,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28113,BCBSND Base Physician Payment Schedule,894.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28112,Not in chargemaster,28112,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28112,BCBSND Base Physician Payment Schedule,660.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28111,Not in chargemaster,28111,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28111,BCBSND Base Physician Payment Schedule,684.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28110,Not in chargemaster,28110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28110,BCBSND Base Physician Payment Schedule,612.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28108,Not in chargemaster,28108,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28108,BCBSND Base Physician Payment Schedule,608.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28107,Not in chargemaster,28107,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28107,BCBSND Base Physician Payment Schedule,734.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28100,Not in chargemaster,28100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28100,BCBSND Base Physician Payment Schedule,879.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28104,Not in chargemaster,28104,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28104,BCBSND Base Physician Payment Schedule,748.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28092,Not in chargemaster,28092,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28092,BCBSND Base Physician Payment Schedule,568.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28090,Not in chargemaster,28090,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28090,BCBSND Base Physician Payment Schedule,648.21,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28088,Not in chargemaster,28088,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28088,BCBSND Base Physician Payment Schedule,581.41,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28086,Not in chargemaster,28086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28086,BCBSND Base Physician Payment Schedule,749.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28080,Not in chargemaster,28080,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28080,BCBSND Base Physician Payment Schedule,779.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28072,Not in chargemaster,28072,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28072,BCBSND Base Physician Payment Schedule,677.57,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28070,Not in chargemaster,28070,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28070,BCBSND Base Physician Payment Schedule,748.05,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28062,Not in chargemaster,28062,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28062,BCBSND Base Physician Payment Schedule,858.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28060,Not in chargemaster,28060,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28060,BCBSND Base Physician Payment Schedule,760.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28054,Not in chargemaster,28054,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28054,BCBSND Base Physician Payment Schedule,495.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28052,Not in chargemaster,28052,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28052,BCBSND Base Physician Payment Schedule,600.49,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28045,Not in chargemaster,28045,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28045,BCBSND Base Physician Payment Schedule,731.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28050,Not in chargemaster,28050,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28050,BCBSND Base Physician Payment Schedule,589.48,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28043,Not in chargemaster,28043,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28043,BCBSND Base Physician Payment Schedule,552.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28039,Not in chargemaster,28039,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28039,BCBSND Base Physician Payment Schedule,729.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28035,Not in chargemaster,28035,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28035,BCBSND Base Physician Payment Schedule,749.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28024,Not in chargemaster,28024,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28024,BCBSND Base Physician Payment Schedule,639.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28022,Not in chargemaster,28022,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28022,BCBSND Base Physician Payment Schedule,687.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28020,Not in chargemaster,28020,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28020,BCBSND Base Physician Payment Schedule,760.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28011,Not in chargemaster,28011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28011,BCBSND Base Physician Payment Schedule,594.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28010,Not in chargemaster,28010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28010,BCBSND Base Physician Payment Schedule,439.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28008,Not in chargemaster,28008,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28008,BCBSND Base Physician Payment Schedule,623.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28003,Not in chargemaster,28003,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28003,BCBSND Base Physician Payment Schedule,1184.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28002,Not in chargemaster,28002,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28002,BCBSND Base Physician Payment Schedule,676.11,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27825,Not in chargemaster,27825,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27825,BCBSND Base Physician Payment Schedule,1046.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27830,Not in chargemaster,27830,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27830,BCBSND Base Physician Payment Schedule,754.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27824,Not in chargemaster,27824,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27824,BCBSND Base Physician Payment Schedule,642.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 28001,Not in chargemaster,28001,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,28001,BCBSND Base Physician Payment Schedule,362.65,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27818,Not in chargemaster,27818,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27818,BCBSND Base Physician Payment Schedule,920.56,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27816,Not in chargemaster,27816,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27816,BCBSND Base Physician Payment Schedule,613.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27810,Not in chargemaster,27810,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27810,BCBSND Base Physician Payment Schedule,895.6,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27808,Not in chargemaster,27808,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27808,BCBSND Base Physician Payment Schedule,638.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27788,Not in chargemaster,27788,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27788,BCBSND Base Physician Payment Schedule,814.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27786,27786,27786,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27786,BCBSND Base Physician Payment Schedule,605.63,680,Fee schedule,,605.63,605.63,605.63,605.63,,,0
unity,Fee schedule,Facility 27781,Not in chargemaster,27781,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27781,BCBSND Base Physician Payment Schedule,842.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27762,Not in chargemaster,27762,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27762,BCBSND Base Physician Payment Schedule,916.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27780,27780,27780,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27780,BCBSND Base Physician Payment Schedule,593.15,658.76,Fee schedule,,593.15,593.15,593.15,593.15,,,0
unity,Fee schedule,Facility 27760,Not in chargemaster,27760,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27760,BCBSND Base Physician Payment Schedule,646.74,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27752,Not in chargemaster,27752,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27752,BCBSND Base Physician Payment Schedule,1041.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27614,Not in chargemaster,27614,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27614,BCBSND Base Physician Payment Schedule,858.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27656,Not in chargemaster,27656,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27656,BCBSND Base Physician Payment Schedule,838.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27750,Not in chargemaster,27750,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27750,BCBSND Base Physician Payment Schedule,673.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27685,Not in chargemaster,27685,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27685,BCBSND Base Physician Payment Schedule,980.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27648,Not in chargemaster,27648,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27648,BCBSND Base Physician Payment Schedule,111.58,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27630,Not in chargemaster,27630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27630,BCBSND Base Physician Payment Schedule,760.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27618,Not in chargemaster,27618,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27618,BCBSND Base Physician Payment Schedule,644.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27613,Not in chargemaster,27613,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27613,BCBSND Base Physician Payment Schedule,337.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27605,Not in chargemaster,27605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27605,BCBSND Base Physician Payment Schedule,392.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27604,Not in chargemaster,27604,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27604,BCBSND Base Physician Payment Schedule,705.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27603,Not in chargemaster,27603,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27603,BCBSND Base Physician Payment Schedule,824.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27560,Not in chargemaster,27560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27560,BCBSND Base Physician Payment Schedule,725.29,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27550,Not in chargemaster,27550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27550,BCBSND Base Physician Payment Schedule,1024.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27532,Not in chargemaster,27532,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27532,BCBSND Base Physician Payment Schedule,1220.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27538,Not in chargemaster,27538,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27538,BCBSND Base Physician Payment Schedule,938.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27530,27530,27530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27530,BCBSND Base Physician Payment Schedule,598.29,648.11,Fee schedule,,598.29,598.29,598.29,598.29,,,0
unity,Fee schedule,Facility 27501,Not in chargemaster,27501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27501,BCBSND Base Physician Payment Schedule,1052.7,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27520,Not in chargemaster,27520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27520,BCBSND Base Physician Payment Schedule,626.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27516,Not in chargemaster,27516,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27516,BCBSND Base Physician Payment Schedule,1015.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27508,Not in chargemaster,27508,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27508,BCBSND Base Physician Payment Schedule,1049.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27372,Not in chargemaster,27372,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27372,BCBSND Base Physician Payment Schedule,850.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27096,Not in chargemaster,27096,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27096,BCBSND Base Physician Payment Schedule,175.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27327,27327,27327,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27327,BCBSND Base Physician Payment Schedule,661.42,605,Fee schedule,,605,605,605,605,,,0
unity,Fee schedule,Facility 27323,Not in chargemaster,27323,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27323,BCBSND Base Physician Payment Schedule,372.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27369,Not in chargemaster,27369,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27369,BCBSND Base Physician Payment Schedule,86.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27500,Not in chargemaster,27500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27500,BCBSND Base Physician Payment Schedule,1016.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27301,27301,27301,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27301,BCBSND Base Physician Payment Schedule,1068.12,1239.27,Fee schedule,,1068.12,1068.12,1068.12,1068.12,,,0
unity,Fee schedule,Facility 27256,Not in chargemaster,27256,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27256,BCBSND Base Physician Payment Schedule,506.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27230,Not in chargemaster,27230,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27230,BCBSND Base Physician Payment Schedule,1004.25,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27095,Not in chargemaster,27095,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27095,BCBSND Base Physician Payment Schedule,178.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26775,Not in chargemaster,26775,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26775,BCBSND Base Physician Payment Schedule,731.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27220,Not in chargemaster,27220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27220,BCBSND Base Physician Payment Schedule,897.8,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27093,Not in chargemaster,27093,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27093,BCBSND Base Physician Payment Schedule,146.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27047,Not in chargemaster,27047,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27047,BCBSND Base Physician Payment Schedule,763.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27040,Not in chargemaster,27040,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27040,BCBSND Base Physician Payment Schedule,419.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 27086,Not in chargemaster,27086,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,27086,BCBSND Base Physician Payment Schedule,353.84,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26991,Not in chargemaster,26991,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26991,BCBSND Base Physician Payment Schedule,1112.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26770,26770,26770,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26770,BCBSND Base Physician Payment Schedule,543.97,591.33,Fee schedule,,543.97,543.97,543.97,543.97,,,0
unity,Fee schedule,Facility 26755,26755,26755,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26755,BCBSND Base Physician Payment Schedule,577.74,671.53,Fee schedule,,577.74,577.74,577.74,577.74,,,0
unity,Fee schedule,Facility 26742,Not in chargemaster,26742,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26742,BCBSND Base Physician Payment Schedule,707.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26725,26725,26725,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26725,BCBSND Base Physician Payment Schedule,640.87,719.09,Fee schedule,,640.87,640.87,640.87,640.87,,,0
unity,Fee schedule,Facility 26740,Not in chargemaster,26740,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26740,BCBSND Base Physician Payment Schedule,458.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26720,26720,26720,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26720,BCBSND Base Physician Payment Schedule,390.54,425.99,Fee schedule,,390.54,390.54,390.54,390.54,,,0
unity,Fee schedule,Facility 26705,Not in chargemaster,26705,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26705,BCBSND Base Physician Payment Schedule,808.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26675,Not in chargemaster,26675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26675,BCBSND Base Physician Payment Schedule,886.79,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26700,26700,26700,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26700,BCBSND Base Physician Payment Schedule,650.41,690.71,Fee schedule,,650.41,650.41,650.41,650.41,,,0
unity,Fee schedule,Facility 26670,Not in chargemaster,26670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26670,BCBSND Base Physician Payment Schedule,651.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26645,Not in chargemaster,26645,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26645,BCBSND Base Physician Payment Schedule,831,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26605,26605,26605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26605,BCBSND Base Physician Payment Schedule,620.31,700,Fee schedule,,620.31,620.31,620.31,620.31,,,0
unity,Fee schedule,Facility 26641,Not in chargemaster,26641,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26641,BCBSND Base Physician Payment Schedule,731.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26160,Not in chargemaster,26160,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26160,BCBSND Base Physician Payment Schedule,663.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26600,26600,26600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26600,BCBSND Base Physician Payment Schedule,591.68,640,Fee schedule,,591.68,591.68,591.68,591.68,,,0
unity,Fee schedule,Facility 26341,Not in chargemaster,26341,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26341,BCBSND Base Physician Payment Schedule,160.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26115,Not in chargemaster,26115,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26115,BCBSND Base Physician Payment Schedule,698.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26055,Not in chargemaster,26055,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26055,BCBSND Base Physician Payment Schedule,610.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 26011,Not in chargemaster,26011,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26011,BCBSND Base Physician Payment Schedule,390.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25650,Not in chargemaster,25650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25650,BCBSND Base Physician Payment Schedule,638.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25675,Not in chargemaster,25675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25675,BCBSND Base Physician Payment Schedule,847.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25635,Not in chargemaster,25635,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25635,BCBSND Base Physician Payment Schedule,883.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25630,Not in chargemaster,25630,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25630,BCBSND Base Physician Payment Schedule,596.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25624,Not in chargemaster,25624,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25624,BCBSND Base Physician Payment Schedule,927.17,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25605,25605,25605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25605,BCBSND Base Physician Payment Schedule,1081.33,1167.02,Fee schedule,,1081.33,1081.33,1081.33,1081.33,,,0
unity,Fee schedule,Facility 26010,26010,26010,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,26010,BCBSND Base Physician Payment Schedule,291.44,569.61,Fee schedule,,291.44,291.44,291.44,291.44,,,0
unity,Fee schedule,Facility 25622,25622,25622,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25622,BCBSND Base Physician Payment Schedule,592.42,653.08,Fee schedule,,592.42,592.42,592.42,592.42,,,0
unity,Fee schedule,Facility 25600,25600,25600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25600,BCBSND Base Physician Payment Schedule,665.09,715,Fee schedule,,665.09,665.09,665.09,665.09,,,0
unity,Fee schedule,Facility 25565,Not in chargemaster,25565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25565,BCBSND Base Physician Payment Schedule,982.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25560,25560,25560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25560,BCBSND Base Physician Payment Schedule,536.63,610,Fee schedule,,536.63,536.63,536.63,536.63,,,0
unity,Fee schedule,Facility 25535,Not in chargemaster,25535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25535,BCBSND Base Physician Payment Schedule,957.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25520,Not in chargemaster,25520,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25520,BCBSND Base Physician Payment Schedule,1142.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25530,25530,25530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25530,BCBSND Base Physician Payment Schedule,505.06,506.86,Fee schedule,,505.06,505.06,505.06,505.06,,,0
unity,Fee schedule,Facility 25505,Not in chargemaster,25505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25505,BCBSND Base Physician Payment Schedule,969.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24675,Not in chargemaster,24675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24675,BCBSND Base Physician Payment Schedule,880.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25075,Not in chargemaster,25075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25075,BCBSND Base Physician Payment Schedule,667.3,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24670,Not in chargemaster,24670,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24670,BCBSND Base Physician Payment Schedule,559.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25500,Not in chargemaster,25500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25500,BCBSND Base Physician Payment Schedule,532.22,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25246,Not in chargemaster,25246,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25246,BCBSND Base Physician Payment Schedule,157.1,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 25065,Not in chargemaster,25065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,25065,BCBSND Base Physician Payment Schedule,336.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24655,Not in chargemaster,24655,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24655,BCBSND Base Physician Payment Schedule,842.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24650,24650,24650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24650,BCBSND Base Physician Payment Schedule,510.93,560.79,Fee schedule,,510.93,510.93,510.93,510.93,,,0
unity,Fee schedule,Facility 24640,24640,24640,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24640,BCBSND Base Physician Payment Schedule,165.91,305.95,Fee schedule,,165.91,165.91,165.91,165.91,,,0
unity,Fee schedule,Facility 24600,Not in chargemaster,24600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24600,BCBSND Base Physician Payment Schedule,712.81,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24577,Not in chargemaster,24577,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24577,BCBSND Base Physician Payment Schedule,1067.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24565,Not in chargemaster,24565,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24565,BCBSND Base Physician Payment Schedule,1038.75,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24576,Not in chargemaster,24576,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24576,BCBSND Base Physician Payment Schedule,651.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24560,Not in chargemaster,24560,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24560,BCBSND Base Physician Payment Schedule,617.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24535,Not in chargemaster,24535,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24535,BCBSND Base Physician Payment Schedule,1199.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24505,Not in chargemaster,24505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24505,BCBSND Base Physician Payment Schedule,949.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24530,Not in chargemaster,24530,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24530,BCBSND Base Physician Payment Schedule,731.16,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24220,Not in chargemaster,24220,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24220,BCBSND Base Physician Payment Schedule,143.15,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24201,Not in chargemaster,24201,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24201,BCBSND Base Physician Payment Schedule,767.13,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24075,Not in chargemaster,24075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24075,BCBSND Base Physician Payment Schedule,695.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24066,Not in chargemaster,24066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24066,BCBSND Base Physician Payment Schedule,878.72,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23931,Not in chargemaster,23931,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23931,BCBSND Base Physician Payment Schedule,328.14,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24065,Not in chargemaster,24065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24065,BCBSND Base Physician Payment Schedule,345.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 24500,24500,24500,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24500,BCBSND Base Physician Payment Schedule,694.46,764.53,Fee schedule,,694.46,694.46,694.46,694.46,,,0
unity,Fee schedule,Facility 24200,Not in chargemaster,24200,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,24200,BCBSND Base Physician Payment Schedule,297.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23930,Not in chargemaster,23930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23930,BCBSND Base Physician Payment Schedule,449.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23675,Not in chargemaster,23675,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23675,BCBSND Base Physician Payment Schedule,1061.51,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23650,23650,23650,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23650,BCBSND Base Physician Payment Schedule,613.71,672.96,Fee schedule,,613.71,613.71,613.71,613.71,,,0
unity,Fee schedule,Facility 23665,Not in chargemaster,23665,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23665,BCBSND Base Physician Payment Schedule,837.61,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23625,Not in chargemaster,23625,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23625,BCBSND Base Physician Payment Schedule,742.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23605,Not in chargemaster,23605,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23605,BCBSND Base Physician Payment Schedule,900.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23620,Not in chargemaster,23620,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23620,BCBSND Base Physician Payment Schedule,543.23,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23600,Not in chargemaster,23600,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23600,BCBSND Base Physician Payment Schedule,654.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23066,Not in chargemaster,23066,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23066,BCBSND Base Physician Payment Schedule,763.46,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23575,Not in chargemaster,23575,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23575,BCBSND Base Physician Payment Schedule,795.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23545,Not in chargemaster,23545,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23545,BCBSND Base Physician Payment Schedule,654.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23525,Not in chargemaster,23525,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23525,BCBSND Base Physician Payment Schedule,757.59,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23350,Not in chargemaster,23350,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23350,BCBSND Base Physician Payment Schedule,107.91,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23075,Not in chargemaster,23075,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23075,BCBSND Base Physician Payment Schedule,692.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23505,Not in chargemaster,23505,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23505,BCBSND Base Physician Payment Schedule,705.47,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23330,Not in chargemaster,23330,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23330,BCBSND Base Physician Payment Schedule,350.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23065,Not in chargemaster,23065,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23065,BCBSND Base Physician Payment Schedule,345.76,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23031,Not in chargemaster,23031,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23031,BCBSND Base Physician Payment Schedule,441.19,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23030,Not in chargemaster,23030,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23030,BCBSND Base Physician Payment Schedule,527.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 23000,Not in chargemaster,23000,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,23000,BCBSND Base Physician Payment Schedule,773.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22527,Not in chargemaster,22527,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22527,BCBSND Base Physician Payment Schedule,325.94,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22526,Not in chargemaster,22526,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22526,BCBSND Base Physician Payment Schedule,692.99,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22515,Not in chargemaster,22515,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22515,BCBSND Base Physician Payment Schedule,469.09,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22514,Not in chargemaster,22514,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22514,BCBSND Base Physician Payment Schedule,1015.26,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22513,Not in chargemaster,22513,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22513,BCBSND Base Physician Payment Schedule,1088.67,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22512,Not in chargemaster,22512,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22512,BCBSND Base Physician Payment Schedule,437.52,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22511,Not in chargemaster,22511,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22511,BCBSND Base Physician Payment Schedule,860.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22315,Not in chargemaster,22315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22315,BCBSND Base Physician Payment Schedule,1630.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21930,Not in chargemaster,21930,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21930,BCBSND Base Physician Payment Schedule,769.34,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21925,Not in chargemaster,21925,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21925,BCBSND Base Physician Payment Schedule,764.93,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22902,Not in chargemaster,22902,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22902,BCBSND Base Physician Payment Schedule,702.53,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 22510,Not in chargemaster,22510,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22510,BCBSND Base Physician Payment Schedule,917.63,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21555,Not in chargemaster,21555,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21555,BCBSND Base Physician Payment Schedule,645.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21550,21550,21550,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21550,BCBSND Base Physician Payment Schedule,328.14,565.05,Fee schedule,,328.14,328.14,328.14,328.14,,,0
unity,Fee schedule,Facility 22310,Not in chargemaster,22310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,22310,BCBSND Base Physician Payment Schedule,615.18,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21920,Not in chargemaster,21920,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21920,BCBSND Base Physician Payment Schedule,330.35,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21501,Not in chargemaster,21501,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21501,BCBSND Base Physician Payment Schedule,687.85,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21497,Not in chargemaster,21497,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21497,BCBSND Base Physician Payment Schedule,1203.92,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21485,Not in chargemaster,21485,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21485,BCBSND Base Physician Payment Schedule,1512.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21462,Not in chargemaster,21462,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21462,BCBSND Base Physician Payment Schedule,2341.78,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21480,Not in chargemaster,21480,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21480,BCBSND Base Physician Payment Schedule,67.54,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21461,Not in chargemaster,21461,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21461,BCBSND Base Physician Payment Schedule,2117.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21453,Not in chargemaster,21453,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21453,BCBSND Base Physician Payment Schedule,1800.01,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21452,Not in chargemaster,21452,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21452,BCBSND Base Physician Payment Schedule,885.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21451,Not in chargemaster,21451,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21451,BCBSND Base Physician Payment Schedule,1324.32,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21450,Not in chargemaster,21450,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21450,BCBSND Base Physician Payment Schedule,983.69,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21445,Not in chargemaster,21445,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21445,BCBSND Base Physician Payment Schedule,1316.98,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21440,Not in chargemaster,21440,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21440,BCBSND Base Physician Payment Schedule,1060.77,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21421,Not in chargemaster,21421,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21421,BCBSND Base Physician Payment Schedule,1187.04,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21401,Not in chargemaster,21401,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21401,BCBSND Base Physician Payment Schedule,682.71,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21356,Not in chargemaster,21356,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21356,BCBSND Base Physician Payment Schedule,789.89,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21400,Not in chargemaster,21400,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21400,BCBSND Base Physician Payment Schedule,336.95,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21355,Not in chargemaster,21355,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21355,BCBSND Base Physician Payment Schedule,673.9,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21345,Not in chargemaster,21345,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21345,BCBSND Base Physician Payment Schedule,1318.44,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21337,Not in chargemaster,21337,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21337,BCBSND Base Physician Payment Schedule,617.38,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21320,Not in chargemaster,21320,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21320,BCBSND Base Physician Payment Schedule,280.43,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21315,Not in chargemaster,21315,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21315,BCBSND Base Physician Payment Schedule,316.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21310,Not in chargemaster,21310,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21310,BCBSND Base Physician Payment Schedule,58.73,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21249,Not in chargemaster,21249,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21249,BCBSND Base Physician Payment Schedule,2454.83,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21235,Not in chargemaster,21235,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21235,BCBSND Base Physician Payment Schedule,1183.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21270,Not in chargemaster,21270,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21270,BCBSND Base Physician Payment Schedule,1597.4,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21248,Not in chargemaster,21248,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21248,BCBSND Base Physician Payment Schedule,1736.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21245,Not in chargemaster,21245,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21245,BCBSND Base Physician Payment Schedule,1968.12,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21215,Not in chargemaster,21215,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21215,BCBSND Base Physician Payment Schedule,1705.31,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21210,Not in chargemaster,21210,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21210,BCBSND Base Physician Payment Schedule,1641.45,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21209,Not in chargemaster,21209,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21209,BCBSND Base Physician Payment Schedule,1280.27,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21127,Not in chargemaster,21127,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21127,BCBSND Base Physician Payment Schedule,1679.62,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21125,Not in chargemaster,21125,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21125,BCBSND Base Physician Payment Schedule,1459.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21121,Not in chargemaster,21121,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21121,BCBSND Base Physician Payment Schedule,1205.39,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21120,Not in chargemaster,21120,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21120,BCBSND Base Physician Payment Schedule,1101.88,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21116,Not in chargemaster,21116,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21116,BCBSND Base Physician Payment Schedule,98.37,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21110,Not in chargemaster,21110,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21110,BCBSND Base Physician Payment Schedule,1443.97,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21100,Not in chargemaster,21100,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21100,BCBSND Base Physician Payment Schedule,781.08,,Fee schedule,,,,,,,,0
unity,Fee schedule,Facility 21087,Not in chargemaster,21087,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,21087,BCBSND Base Physician Payment Schedule,2893.82,,Fee schedule,,,,,,,,0
unity,Fee schedule,All other,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Medicare,,Medicare physician fee schedule,,,Fee schedule,,,,,,,,0
unity,Fee schedule,,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Sanford Health Plan,,160% of the Universal Medicare rate based on 2008 RBRVS,,,Fee schedule,,,,,,,,0
unity,Per 15 min,Anesthesia Mod AA,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Mod AA,BCBSND Base Fee $72.38 per unit (base + time),,,Per 15 min,,,,,,,,0
unity,Per 15 min,Anesthesia Mod QX,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Mod QX,BCBSND Base Fee $30.77 per unit (base + time),,,Per 15 min,,,,,,,,0
unity,Per 15 min,Anesthesia Mod QY or QK,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Mod QY or QK,BCBSND Base Fee $36.20 per unit (base + time),,,Per 15 min,,,,,,,,0
unity,Per 15 min,Anesthesia Mod QZ,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Blue Cross Blue Shield North Dakota,Mod QZ,BCBSND Base Fee $61.51 per unit (base + time),,,Per 15 min,,,,,,,,0
unity,Per diem,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota Medicare Advantage,,100% of Blue Cross Medicare rates,,,Per diem,,,,,,,,0
unity,Per diem,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota Medicare Platinum,,100% of Blue Cross Medicare rates,,,Per diem,,,,,,,,0
unity,Per diem,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield Minnesota Medicare Secure,,100% of Blue Cross Medicare rates,,,Per diem,,,,,,,,0
unity,per diem,Swing bed,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Blue Cross Blue Shield North Dakota,,BCBSND base per diem $818.51,,,per diem,,,,,,,,0
unity,Per diem,,N/A,N/A,N/A,N/A,N/A,N/A,Inpatient,N/A,Medicare,,interim rate of $2586 per diem,,,Per diem,,,,,,,,0
unity,Per encounter,RHC,N/A,N/A,N/A,N/A,N/A,N/A,Professional,N/A,Medicare,,interim rate of $239 per RHC encounter,,,Per encounter,,,,,,,,0
unity,Footnotes,Rx pricing is subject to change - approximate prices based on latest drug cost,1,N/A,N/A,N/A,N/A,N/A,N/A,,N/A,N/A,N/A,N/A,,N/A,,,,,,,,0
unity,Footnotes,Other professional services not provided by hospital may be billed separately,2,N/A,N/A,N/A,N/A,N/A,N/A,Hospital,N/A,N/A,N/A,N/A,,N/A,,,,,,,,0
unity,Footnotes,Average payor payment rates may include payor policy adjustments,3,N/A,N/A,N/A,N/A,N/A,N/A,,N/A,N/A,N/A,N/A,,N/A,,,,,,,,0
unity,Footnotes,Payors not found in the CDM or NDC section pay on a fee schedule or bundle basis. Refer to those sections,4,N/A,N/A,N/A,N/A,N/A,N/A,,N/A,N/A,N/A,N/A,,N/A,,,,,,,,0
unity,Footnotes,"hospital chargemaster as of 12/15/2020, pharmacy chargemaster as of 1/11/2021",100,N/A,N/A,N/A,N/A,N/A,N/A,,N/A,N/A,N/A,N/A,,N/A,,,,,,,,0